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68 Comments
- yourmartdotnet, on 01/13/2009, -0/+35at the same they're also underpaying healthcare providers(md/clinics/hospitals) so you're getting screwed twice.
- charm803, on 01/13/2009, -0/+33"Although UnitedHealth Group and Oxford Insurance were the only entities investigated, other major insurers use Ingenix, including Aetna, CIGNA and WellPoint/Empire BlueCross BlueShield."
I am interested to see what kind of information the other major insurers would turn out if they were also investigated.
Price fixing sounds about right in this situation. - haikuFU, on 01/14/2009, -0/+30Good, those ***** screwed me out of $3k for something that should have been fully covered. They said they wouldn't reimburse more than $1k because that was the going rate and the $4k total was more than what it cost elsewhere. Well, I called around, even to different states, and it's right in line.
I'm currently suing them in conciliation court, this is some good evidence to bring with me. :) - Myztry, on 01/14/2009, -0/+22So they underpay to the tune of approximately $100 million dollars.
$50 million gets taken for reimbursement and administration.
Overall result: Scammer up $50 million dollars. PROFIT!
Who says crime doesn't pay?
Of course the CEO administrator will also get a tidy salary (as 'costs') out of the reimbursement money... - uknowwhoibe, on 01/13/2009, -2/+21There comes a point in time and business wherein you are more kin to a utility, than a luxury, that your capitalistic business model must be governed lest you become evil.
- Canadian0207, on 01/14/2009, -0/+18As someone who works in a pharmacy, I'm glad these companies are finally being exposed.
- lazeedigger, on 01/14/2009, -0/+18Judging by how much I've been ripped off by CIGNA and Aetna in the past, it leads me to suspect that $50 Million is barely scratching the tip of the iceberg in terms of how much money these companies are really scamming us.
Here's my experience.
I called my insurance company to made sure I can go see a doctor, of which I was told that I'd be covered 100%. I went for set of xrays, received no treatment, but left me with a bill of $2000+. Since I was covered at 100%, it didn't bother me too much.
A few years later a collection agency called and start hassassing me for thousands of dollars. As it turned out, the claims were rejected because the doctor's rate was too high based on their standards. Without giving me any notice or attempt to collect the money from me, they sent my bills to collection agency, and I ended up fighting over this for well over a month of my time. Mind you, this is the doctor that the insurance company referred me to go see.
In the end, I settled with the collection agency for about $1k because I was only a student at the time, and to this day I consider myself to be very lucky. Assuming half of the US population experience what I've gone through, that's 150,000,000 * $1,000 = $150 Billion. And how much is UnitedHealthCare being ordered to pay? Only $50million? Is this some kind of a bad joke?
I've heard stories like mine from all of my friends and relatives, and I'm sure you have as well. $50 Million fine is a piss in a bucket to these medical insurance scammers, a slap on the wrist. If the government wanted make it right, the government should have fined these guys $50 billion instead.
I'd like to hear my fellow digger's opinions on this. Share with us your medical insurance mishaps, and how much money it took you to get out of it. - algaeturd, on 01/14/2009, -1/+18Is this a ***** joke? EVERY health care insurer charges way too much. Are you going to sue them all? Mine gets hiked every ***** other month. What can I do? Either leave or go without health insurance. It's ***** legalized highway robbery.
- stonebear, on 01/14/2009, -0/+14A $50,000,000.00 fine for hundreds of millions, maybe even billions in illicit profits. Using the judicial system to launder money is when all those Harvard MBAs really start to pay off.
- fuckingusername, on 01/14/2009, -1/+13drug companies are no different at least here in the USA
- humanerror, on 01/14/2009, -1/+12Can we please stop letting these bastards write our laws?
Institute national health care, like every other industrialized nation, and starve these vultures out of existence overnight. - rsHoratio, on 01/14/2009, -0/+11Good luck bro
- itisme1760, on 01/14/2009, -6/+16Another reason why I want to move to France.
- Canadian0207, on 01/14/2009, -1/+10"The $50 million UnitedHealth Group will pay as the settlement will be used to create a nonprofit organization that will determine reimbursement rates for patients."
LOL there goes half of the $50 million - inactive, on 01/14/2009, -0/+8I expect 2009 to be the big year when insurance companies get the heat for all the fraudulent activity of the past decade. Everyone knows they charge too much and dont pay enough. And how many times are do these companies decline or reduce coverage when you should have been fully covered?
Private health insurance is all about profit. NOT HEALTH
Some idiot decided 10 years ago that they could pay 10$ less per claim, and make 100 million profit over the next 10 years and the board approved it.
Let them burn, let them all burn. - MelvinSchlubman, on 01/14/2009, -3/+11Not necessarily, but it demonstrates that it the wolves are not regulated we'll get many more stories like and will end up with single-payer.
Let me guess: you're another true-blue believer in the unregulated invisible hand of the marketplace who still fails to understand that this crap is the unintended consequence of that. The insurance cos have a conflict of interest: maximize profit vs act like actual human beings. - sylv3r, on 01/14/2009, -0/+8And the main stream catches this just now? o_0 What have they been doing?
- Dre_the_Geek, on 01/14/2009, -0/+7I knew that health (ha) insurance was a scam in this country (look at the medical records for any other country with nationalized health care and tell me I'm wrong, but I be damned if my company decided to go with these exact jack-holes for 2009! And I wondered why my costs went up so much...
- egodbois, on 01/14/2009, -0/+7My wife used to work for these douchebags as an auditor. So no surprises on that front. They also literally treat their employees like slaves. Management is as corrupt as it gets. The ***** made Office Space look laid back.
- inactive, on 01/14/2009, -0/+7Private health insurance where PROFIT > >> >>>>>>HEALTH
- Rioracer916, on 01/14/2009, -0/+7I hear complaints about underpayment frequently by medical professionals.
It seems like the insurance companies are the new Wall street. They make money by playing shell games with the wealth generated by people who actually do work, ie doctors, nurses, and hospital staff.
I don't see why we as a country can't create ONE group policy that people can buy into at lower rates. The pool will be large enough to cover everyone for basic care. Then structure a tiered system of private insurance and private payment for non-basic care and elective care.
Best of both worlds, and if you're not happy, vote with your wallet. Under our current system, the market mechanism has been broken by collusion. - dxworld, on 01/14/2009, -1/+7You been brainwashed pal. I moved to Spain two years ago with my wife and daughter and universal health care works about a thousand times better than our system. It is far from perfect and has plenty of defects but still no comparison. My father in law had open heart surgery, valve replacement and double bypass and has yet to spend a penny because he is retired. France's system and several other Countries in Europe rank better than Spain when it comes to their medical systems so I cannot even imagine how nice those most be.
All I can say is read up, because in head to head comparison, our system ranks far below most of the universal healthcare systems of the world in industrialized nations. As a matter of fact, we are the only industrialized nation that does not have it. That should tell you something right there.
The problem is, the insurance companies and the healthcare industry would like you to keep thinking exactly like you do so they can continue to make a mint. - OneRottenTomato, on 01/14/2009, -0/+4@roddackroddack
Just like how these awful bureaucrats that created our ruthless postal service and power hungry fire departments. This health system ***** benefits no one besides lining the pockets of these insures. Yea, what we have now is doing so much better. - Klainmeister, on 01/14/2009, -7/+11That's funny, because I have a whole list of reasons why I don't want to move to France...
- SanTe, on 01/14/2009, -0/+4roddack is right about the government creating these monsters though. You can thank the Nixon administration for giving birth to HMOs. Nixon loved the idea of his health industry lobbyists making more money by denying care. He's even on tape saying it.
- enoerew, on 01/14/2009, -0/+4Overcharge millions and you only have to give back at most a few dollars for each person? It'd be hard to believe that each person was only overcharged a few dollars.
So where did the rest of the money go? - pbarney, on 01/14/2009, -0/+4The question nobody's asking is who exactly is getting that $50 mil? I'll bet it's not the people that were overcharged. It'll go into a government coffer somewhere.
- fallentree, on 01/14/2009, -0/+4They'd rather pay Lawyers than doctors.
- TheAirLoom, on 01/14/2009, -0/+3Uhm, isn't overcharging how insurances usually work? lol...
- stonebear, on 01/14/2009, -0/+3There's hope for that; check your spam folder.
- darthjure, on 01/14/2009, -0/+3This was the biggest news story of the day. I wonder why it didn't get more coverage??
- inactive, on 01/14/2009, -0/+3Another company taking on Rockafella's mantra. Pinching pennies from million and no one will notice.
- azhura, on 01/14/2009, -0/+3In May 2005, I started having horrible back pain around my kidneys. I had Aetna HMO through my work, which I would never recommend given that experience which I will describe below.
Before I arrived at ER I called the insurance company on the way to make sure that the visit would be covered. I don't trust HMO's and wanted to make sure. The person who answered (and who never gave me their name) said yes it would be.
Well, after I got out of the hospital, I was hit with the bill of four grand for the visit/CATscan on my kidneys. I filed a complaint with the insurance company. They said that they would look into it. I called them back three times. Finally, I got someone who said that it would probably be fixed and the bill would be paid.
Well, it wasn't. It turns out that information book that they sent me had a little printed clause in it that said that Aetna was only liable for $50 of the ER visit and for none of the CATscan or doctor bill itself itself. I found this out when I filed a complaint with the Illinois Attorney General.
Now tell me, what kind of ***** INSURANCE COMPANY charges me seventy five bucks a paycheck for the supposed insurance and doesn't even cover MY ***** ER VISIT???????? What exactly WAS I getting aside from being royally ***** over? Sorry for all of the swearing but this still makes me want to punch puppies when I think about it.
I still haven't paid the bill yet since I don't have four grand to give to the hospital. I feel bad that the hospital is taking the consequences of Aetna's shady dealings. I also am really mad that the collection is out on my credit record driving down my rating to oh, 520. Loans are a pipe dream at this point.
And, what if this had been a more severe emergency? Frankly, I'm lucky that it's only four grand and not more.
So my word of advise? Stay away from HMO's, tell Aetna to go ***** themselves if they want to be your insurance provider, and ALWAYS read that damn book that you get from your insurance provider. Read the WHOLE book. - OneRottenTomato, on 01/14/2009, -1/+4Thank you for validating why I hate this system in the US. Exactly why I want universal health care.
What's the use of owning a home that's protected by a privatized fire department and live in constant fear that they may drop me for the tiniest hint of a fire hazard while at the same time the neighborhood is burning down all around me? - michaelamyers, on 01/15/2009, -0/+2Anyone else noticed that the health card industry is NOT in financial turmoil??
I'd wager that their profits are still 20% above every other industry & yet they have no problem raising my premiums every year, whether I file a claim or not.
When industry "controls" the industry, you can charge anything you want...until the people you're screwing finally run out of money.... whatcha gonna do when there's no money left for you? brother! - rsHoratio, on 01/14/2009, -1/+3"The $50 million UnitedHealth Group will pay as the settlement will be used to create a nonprofit organization that will determine reimbursement rates for patients."
Lets just hope the nonprofit doesn't end up becoming corrupt to...like thats never happened. - FKnight, on 01/14/2009, -1/+3"What do you do if the governors are also evil?"
At least in those cases, you can vote them out. Not much "voting with your wallet" you can do when everyone in the insurance industry is colluding with one another. - sarahlee, on 01/15/2009, -0/+2As a cancer survivor who has cancer again, I have too many such stories to list here. But I hope you will be joining thousands of us making calls asking congress for a real solution tomorrow:
http://www.healthcare-now.org/campaigns/call/ - OldKenGoat, on 01/14/2009, -0/+2Aren't these the same bastards "endorsed" by AARP? If so, then a POX on both their houses!!
- charlie6969, on 01/14/2009, -0/+2Even though we own the company that sets the prices; there is no conflict of interest. HUH?
- zeitgueist, on 01/14/2009, -1/+3I'd love to hear that list.
- DirtyVicar, on 01/16/2009, -0/+2Wow, gee. Annual earnings of UnitedHealth: $4 billion. So this is analogous to a $40K/yr individual getting slapped with a $500 fine. This isn't going to do ***** to stop this kind of unethical business behavior.
- stonebear, on 01/14/2009, -1/+3Them not wanting you topping the list, no doubt.
- gnimsh, on 01/14/2009, -0/+2Noooo. They would never!
- sarahlee, on 01/15/2009, -0/+2Something you can do:
http://www.healthcare-now.org/campaigns/call/ - sarahlee, on 01/15/2009, -0/+2Relevant chart:
http://digg.com/health/Why_we_need_healthcare_refo ... - zacharytelschow, on 01/14/2009, -1/+2Good luck with a similar suit when the government is raping you for health care and you have to take a number to get your broken leg looked at.
- kindpastor, on 01/20/2009, -0/+1In a completely freed market this company would not exist. See the creation of HMOs by Richard Nixon. When your organization (or group of organizations) receives government funding and protection (as do HMOs) and people are required BY LAW to buy from them (as are many employers) then you will often get corruption.
You're not mistaken in referring to these companies as "wolves" but you are mistaken in calling the government a "woodsman". - sarahlee, on 01/15/2009, -1/+2See:
http://digg.com/health/Why_we_need_healthcare_refo ... -
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