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Healthy Profits

November 17, 2010

Do health insurance companies put profits ahead of their customers’ well-being? Wendell Potter seems to think so. Mr. Potter is “a former health insurance insider, now whistleblower.” Yesterday, Amy Goodman from Democracy Now! spoke with him about “squeaky wheels,” Wise, Virginia, “rescissions,” finding ways to deny health care among other topics. Mr. Potter also answered listener questions submitted via Facebook.

“There was a young woman in California, a 17-year-old—I say young woman; she was still a teenager—who was needing a liver transplant. And she was—her family was insured by CIGNA. Her doctors said that it was necessary for her to survive. She was a leukemia patient. CIGNA refused to pay for the transplant. And it became a very well publicized case. And the publicity was so great that CIGNA eventually decided to pay for it. But regrettably, so much time had passed, she had gotten so much sicker, that she died the same day. I had, over the course of my career, handled a lot of what we call high-profile cases. But that was just kind of the straw that broke the camel’s back. I just didn’t have the heart or the stomach to continue being a spokesperson for an industry that, in my view—not just my view, but I knew from the work that I had done—has contributed to a lot of the almost intractable problems of our health care system.” – Wendell Potter

Let’s listen in on the interview by going here.

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One Comment leave one →
  1. Anne R. Key permalink
    November 18, 2010 6:38 am

    Let me tell you my story, Aetna paid out quite a bit for the premature birth of my child. The once he finally came home for a little while the pediatrician recommended a daily prescription, and a round of special shots for the cold and flu season(RSV). The prescription and shots were only covered through the Aetna pharmacy, we figured ok. After Aetna had not shipped the prescription one time we became alarmed and decided to pay out of pocket at a local pharmacy. The price Aetna was charging us for the script was 100$, they paid 80$ we paid 20$. When we had to get the script out of pocket at the last minute, we were shocked when the local pharmacist handed us a total bill for 6$. Onto the shots, which from the Aetna pharmacy topped almost 1,500$ each, of which they paid 1,200$ and we paid 300$. When they where almost too late one time we inquired in the doctors’ office, and were told that their price they would charge us would be a little under 500$. So what’s the moral of the story here. After paying out more than they received, they engaged in trying to trap their customer into their own web of overpriced service to recapture their lost money. This was very apparent, and we had heard this story many many times. After someone’s medical difficulty, if they decide to insure them they directly or indirectly set limits on who their options are and force them into their in-house low-cost negotiated solutions to maximize their future profit stream on a past red ink entry.

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