California Nurses Association
For Immediate Release
September 2, 2009
For Immediate Release
September 2, 2009
California's Real Death Panels: Insurers Deny 21% of Claims
PacifiCare's Denials 40%, Cigna's 33% in First Half of 2009
More than one of every five requests for medical claims for insured
patients, even when recommended by a patient's physician, are rejected by
California's largest private insurers, amounting to very real death panels
in practice daily in the nation's biggest state, according to data released
Wednesday by the California Nurses Association/National Nurses Organizing
Committee.
CNA/NNOC researchers analyzed data reported by the insurers to the
California Department of Managed Care. From 2002 through June 30, 2009, six
of the largest insurers operating in California rejected 47.7 million claims
for care -- 22 percent of all claims.
The data will be presented by Don DeMoro, director of CNA/NNOC's research
arm, the Institute for Health and Socio-Economic Policy, at CNA/NNOC's
biennial convention next Tuesday, Sept. 8 in San Francisco. The convention
will also feature a panel presentation from nurse leaders in Canada, Great
Britain, and Australia exploding the myths about their national healthcare
systems.
"With all the dishonest claims made by some politicians about alleged 'death
panels' in proposed national legislation, the reality for patients today is
a daily, cold-hearted rejection of desperately needed medical care by the
nation's biggest and wealthiest insurance companies simply because they
don't want to pay for it," said Deborah Burger, RN, CNA/NNOC co-president.
For the first half of 2009, as the national debate over healthcare reform
was escalating, the rejection rates are even more striking.
Claims denial rates by leading California insurers, first six months of
2009:
a.. PacifiCare -- 39.6 percent
b.. Cigna -- 32.7 percent
c.. HealthNet -- 30 percent
d.. Kaiser Permanente -- 28.3 percent
e.. Blue Cross -- 27.9 percent
f.. Aetna -- 6.4 percent
PacifiCare's Denials 40%, Cigna's 33% in First Half of 2009
More than one of every five requests for medical claims for insured
patients, even when recommended by a patient's physician, are rejected by
California's largest private insurers, amounting to very real death panels
in practice daily in the nation's biggest state, according to data released
Wednesday by the California Nurses Association/National Nurses Organizing
Committee.
CNA/NNOC researchers analyzed data reported by the insurers to the
California Department of Managed Care. From 2002 through June 30, 2009, six
of the largest insurers operating in California rejected 47.7 million claims
for care -- 22 percent of all claims.
The data will be presented by Don DeMoro, director of CNA/NNOC's research
arm, the Institute for Health and Socio-Economic Policy, at CNA/NNOC's
biennial convention next Tuesday, Sept. 8 in San Francisco. The convention
will also feature a panel presentation from nurse leaders in Canada, Great
Britain, and Australia exploding the myths about their national healthcare
systems.
"With all the dishonest claims made by some politicians about alleged 'death
panels' in proposed national legislation, the reality for patients today is
a daily, cold-hearted rejection of desperately needed medical care by the
nation's biggest and wealthiest insurance companies simply because they
don't want to pay for it," said Deborah Burger, RN, CNA/NNOC co-president.
For the first half of 2009, as the national debate over healthcare reform
was escalating, the rejection rates are even more striking.
Claims denial rates by leading California insurers, first six months of
2009:
a.. PacifiCare -- 39.6 percent
b.. Cigna -- 32.7 percent
c.. HealthNet -- 30 percent
d.. Kaiser Permanente -- 28.3 percent
e.. Blue Cross -- 27.9 percent
f.. Aetna -- 6.4 percent
"Every claim that is denied represents a real patient enduring pain and
suffering. Every denial has real, sometimes fatal consequences," said
Burger.
PacifiCare, for example, denied a special procedure for treatment of bone
cancer for Nick Colombo, a 17-year-old teen from Placentia, Calif. Again,
after protests organized by Nick's family and friends, CNA/NNOC, and
netroots activists, PacifiCare reversed its decision. But like Nataline
Sarkisyan, the delay resulted in critical time lost, and Nick ultimately
died. "This was his last effort and the procedure had worked before with
people in Nick's situation," said his older brother Ricky.
Cigna gained notoriety two years ago for denying a liver transplant to
17-year-old Nataline Sarkisyan of Northridge, Calif. and then reversing
itself, tragically too late to save her life.
In 2008, six days before RN Kim Kutcher of Dana Point, Calif., was scheduled
to have special back surgery, Blue Cross denied authorization for the
procedure as "investigational" even though the lumbar artificial disc she
was to receive had FDA approval. At the time of denial, which she calls
"insurance hell," Kutcher had "already gone through pre-op testing, donated
a unit of blood, had appointments with four physicians." Kutcher paid
$60,000 out of pocket for the operation and is still fighting Blue Cross.
Rejection of care is a very lucrative business for the insurance giants. The
top 18 insurance giants racked up $15.9 billion in profits last year.
"The routine denial of care by private insurers is like the elephant in the
room no one in the present national healthcare debate seems to want to talk
about," Burger said. "Nothing in any of the major bills advancing in the
Senate or House or proposed by the administration would challenge this
practice."
"The United States remains the only country in the industrialized world
where human lives are sacrificed for private profit, a national disgrace
that seems on the verge of perpetuation," she said.
CNA/NNOC supports an alternative approach, expanding Medicare to cover all
Americans, which would give the U.S. a national system similar to what
exists in other nations. Data released in late August by the Organization
for Economic Co-operation and Development, which tracks developed nations,
found that among 30 industrial nations, the U.S. ranks last in life
expectancy at birth for men, and 24th for women.
suffering. Every denial has real, sometimes fatal consequences," said
Burger.
PacifiCare, for example, denied a special procedure for treatment of bone
cancer for Nick Colombo, a 17-year-old teen from Placentia, Calif. Again,
after protests organized by Nick's family and friends, CNA/NNOC, and
netroots activists, PacifiCare reversed its decision. But like Nataline
Sarkisyan, the delay resulted in critical time lost, and Nick ultimately
died. "This was his last effort and the procedure had worked before with
people in Nick's situation," said his older brother Ricky.
Cigna gained notoriety two years ago for denying a liver transplant to
17-year-old Nataline Sarkisyan of Northridge, Calif. and then reversing
itself, tragically too late to save her life.
In 2008, six days before RN Kim Kutcher of Dana Point, Calif., was scheduled
to have special back surgery, Blue Cross denied authorization for the
procedure as "investigational" even though the lumbar artificial disc she
was to receive had FDA approval. At the time of denial, which she calls
"insurance hell," Kutcher had "already gone through pre-op testing, donated
a unit of blood, had appointments with four physicians." Kutcher paid
$60,000 out of pocket for the operation and is still fighting Blue Cross.
Rejection of care is a very lucrative business for the insurance giants. The
top 18 insurance giants racked up $15.9 billion in profits last year.
"The routine denial of care by private insurers is like the elephant in the
room no one in the present national healthcare debate seems to want to talk
about," Burger said. "Nothing in any of the major bills advancing in the
Senate or House or proposed by the administration would challenge this
practice."
"The United States remains the only country in the industrialized world
where human lives are sacrificed for private profit, a national disgrace
that seems on the verge of perpetuation," she said.
CNA/NNOC supports an alternative approach, expanding Medicare to cover all
Americans, which would give the U.S. a national system similar to what
exists in other nations. Data released in late August by the Organization
for Economic Co-operation and Development, which tracks developed nations,
found that among 30 industrial nations, the U.S. ranks last in life
expectancy at birth for men, and 24th for women.
***
----- Original Message -----
From: jackie goldberg
Sent: Thursday, September 03, 2009 12:36 PM
Subject: FW: URGENT: Obama and the public option
Date: Thu, 3 Sep 2009 12:19:09 -0400
From: info@boldprogressives.org
To: goldbeja@msn.com
Subject: URGENT: Obama and the public option
| Petition to President Obama: "We worked so hard for real change. President Obama, please demand a strong public health insurance option in your speech to Congress. Letting the insurance companies win would not be change we can believe in." Will you sign this petition?  |
We didn't plan to email you again today. But yesterday, news broke that President Obama will make a big speech to Congress next Wednesday on health care -- an issue we know you care about.
And according to news reports, "although House leaders have said their members will demand the inclusion of a public insurance option, Obama has no plans to insist on it himself." *
In response, we got a truly depressing email from Christian S. in Texas:
"Your recent health care ads are great, they hit home. But Obama has decided to drop the public option and for breaking his campaign promise I am dropping out of political activism for the time being."
This fight is absolutely not over, but Christian's feelings are real. If Obama doesn't stand firm on the public option, millions of people will lose hope.
So today, we're launching a petition to President Obama signed by those who volunteered, staffed, voted for, or donated to Obama's campaign in 2008, asking him to please stand firm on the public option.
If that's you, can you sign this petition today? Click here.
Then, please think hard about others you know who worked for change last year -- and forward them this email.
The petition says: "We worked so hard for real change. President Obama, please demand a strong public health insurance option in your speech to Congress. Letting the insurance companies win would not be change we can believe in."
We'll make sure the White House gets our message. In addition to delivering the signatures and personal notes from the petition page, we're planning an ad featuring the voices of those who sign.
Obama's speech "is still being debated in the West Wing." * That means there's still time -- we have one week to persuade Obama to do the right thing.
Can you sign this petition to President Obama today? Click here.
Then, please forward this to others. Again, we have until Wednesday, September 9. Thanks for being a bold progressive.
-- Adam Green, Stephanie Taylor, Michael Snook, Evan Miller, Andrew Perez, and the PCCC team
* Source: "Under fire, President Obama shifts strategy." Politico, Sept. 1, 2009.
Paid for by the Progressive Change Campaign Committee PAC (www.boldprogressives.org) and not authorized by any candidate or candidate's committee. Contributions to the PCCC are not deductible as charitable contributions for federal income tax purposes.
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