Sunday, July 27, 2008

The Slimy Hand Of The Free Market

Now here's a job for a real go-getter: selling health insurance policies which provide less coverage than Medicare to Medicare beneficiaries who are poor and disabled. Yes, you read that right. And they did it using tactics usually ascribed to used-car salesmen. From the July 26, 2008 edition of The Boston Globe:

One of the nation's largest health insurers has stopped marketing an insurance plan to Massachusetts senior citizens with disabilities after state officials received dozens of complaints that the company was using abusive and misleading sales tactics.

UnitedHealth Group Inc. suspended marketing of a private Medicare plan, called the Evercare Special Needs Plan for People with Limited Income, earlier this week after meeting with officials from the state Medicaid and elder affairs offices. About 3,000 state residents receive coverage through the plan.

Senior citizen advocates said some sales representatives refused to leave people's homes without getting a signature on a policy. Others misrepresented the plan, they said, claiming it would pay for care that is actually not covered. In addition, the advocates said, some agents repeatedly called seniors, despite requests from younger family members that they stop.

"This is just out of control," said Al Norman, executive director of Massachusetts Home Care, an umbrella group for 30 nonprofit agencies that assist seniors. "It shouldn't be happening. These brokers are using high-pressure tactics, bait-and-switch, and intimidation. They were inappropriately pushing people into a product they didn't want and didn't understand."

And didn't need. The results were usually disastrous. Here's one example:

Carmen Pola, 69, of Roxbury, said an insurance agent selling the Evercare plan came to her house and persuaded her to sign up for the coverage even though she was satisfied with her Harvard Pilgrim Health Care insurance. As a result, Pola said, her copayments for doctor visits increased from $15 to $25, and instead of $5 copayments for prescription medications, she is now required to pay full price.

And that's a problem for Ms. Pola and her husband. He's a diabetic, and they couldn't afford to pay to have an insulin prescription filled. She found herself begging for the insulin.

Non-profits and, presumably, the state have been getting complaints about the UnitedHealth Group tactics for at least a year, but it wasn't until just recently that the state called the insurance company in. Apparently that meeting had the desired effect because the company called off the dogs. What is especially dispiriting about this story, however, is that it happened in Massachusetts, the one state that has shown remarkable attention to making certain its residents have health insurance.

Of course, one can't lay the blame solely on the state government. The Federal Government opened the door wide-open for such abuse in its attempt to privatise Medicare one step at a time, something which the article notes:

The Evercare plan is intended for seniors who have significant disabilities, such as long-term illnesses. It has been sold in Massachusetts since 2006. Most enrollees are so-called dual-eligibles - they qualify for benefits under both the federal Medicare plan for people over 65 and the joint federal-state Medicaid program for low-income and disabled people. It is one of a variety of private healthcare plans that have proliferated nationwide in recent years as the federal government has promoted private alternatives to traditional Medicare. Health insurers have responded by devising ever-more specialized plans targeting specific groups. [Emphasis added]

And that's what happens when you let the Republicans take control of the government.

177 days.

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