Former Aetna medical director admits to never reviewing medical records before denying care. -Forbes

This is something that has been suspected by care providers for some time. Now the proof has come out in court.

One of the dirty medical secrets that you likely aren’t aware of, is that your Physician, Physician Assistant, or Nurse Practitioner may spend far longer than they spend with you, fighting for your right to get your care that they prescribe from your insurance company. Sometimes it means they lose money on the time they spent with you as it could mean hours on the phone and time spent sending records over to them for supposed review. Sometimes it may mean that one is turned down for coverage for a life threatening illness. Sometimes people die because of it. Sometimes they have to shift to care that may not be optimal, from the perspective of your provider.

Now, in court, a former Aetna medical director admits that he never even looked at the medical records of people who he denied coverage to, relying on nurses employed by the company to determine the validity of the requested coverage. Why this is possible is outrageus, and it flips the old claim we heard from Republicans in the 90s against then First Lady Hilary Clinton, that her proposals for healthcare reform were going to lead to “death panels”. So Clinton’s ideas failed, and we carried on with for profit insurance companies who apparently don’t even need a panel, but entrust life or death decisions to unskilled bureaucratic workers.

The Democrats, today, rolled out their plan for Medicare for All. There is much to debate in this plan, but the goal is to end at some point in the future, the out of control pricing and unregulated nature of the decision making at these corporate companies, many of whom have made their CEOs enormously rich by denying care to those that need it most. Let me remind anyone that is not aware of it, but the U.S. citizen pays far more and gets much worse outcomes than any other industrialized country in the world. While moving to a new system it may *raise our taxes* it may also *reduce your healthcare costs that you pay monthly*. If you could do away with your $500 a month or more you and your family pay for insurance coverage, and get coverage for $25 more in taxes, why would you say no? (The number $25 is just a straw dog). There is also a proposal that the taxes needed for this plan will come from taxing the wealthiest 1%.

I for one am willing to explore this and see exactly how much more I will have to pay for government run healthcare, if anything at all. Under the plan, you will still get to see your favorite doctor, and we will need to train hundreds of thousands of more new providers, but this current system is out of control, prices are vastly too high, and now, we see that they are not even concerned about whether we live or die, just that we pay them their monthly fees.

Want to do something about it? First off, make sure you are not investing in these companies. Cut off their investments by requesting an end to financial support for them in the stock market. Secondly, call your State and Federal congresspeople, demanding that our Insurance Commissioner investigate these companies. At the federal level they need to launch an investigation into this practice as well.

https://www.forbes.com/sites/robertglatter/2018/02/11/former-aetna-medical-director-admits-to-never-reviewing-medical-records-before-denying-care/#e74f11635e53

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