Non Fluffy Wicca

Remember when our Shrubbery said that America has the best healthcare in the world, and we would be maintaining the "status quo?" Gee...I guess that only applies to those who don't ever get sick.

Lawsuit claims Health Net gave bonuses for policy rescissions:


Health Net Inc., one of the state's largest health insurers, tied rewards and savings to its employees' ability to cancel policies based on misrepresentations in members' applications, according to documents in a lawsuit against the company.
The documents showed Health Net saved $35.5 million in "unnecessary" health care expenses for rescinding more than 1,000 policies between 2000 and 2006. At the same time, a Health Net analyst received about $21,000 in bonuses for her work, which included exceeding company goals for policy rescissions.
The information was revealed during an arbitration hearing this week in San Bernardino County in a lawsuit filed by Patsy Bates, a 51-year-old hairdresser from Gardena (Los Angeles County) who is suing Health Net for $6 million plus punitive damages for revoking her policy after her breast cancer was diagnosed.
Health insurers in California and nationwide have come under fire for reviewing applications of members after they file medical claims and rescinding their policies based on any discrepancies found in the original health questionnaire. The issue affects members with individual, rather than group, plans because those policies undergo medical underwriting before an applicant is accepted.
Insurers say the practice is legal and necessary because it protects them against fraud, and keeps premiums lower for those members who truthfully reveal their health history. But state regulators and plaintiffs' lawyers have argued that the applications often are vague and confusing, and that it's not fair for insurers to review applications only after members file an expensive claim.
In Bates' case, her lawyers contend that Health Net tied an employee's bonus to her ability to review cases and rescind coverage. State law prohibits insurance companies from offering financial incentives to reduce or deny care.
According to the documents, Health Net analyst Barbara Fowler, who conducted Bates' investigation, exceeded the company's 2002 goal of 15 rescissions a month by averaging 22.9. Fowler's rescission successes were repeatedly lauded in her performance evaluations, which noted she saved the company $5.5 million in 2002 for rescinding 275 contracts. Her bonuses ranged from $1,654 in 2001 to a high of $6,310 in 2005.
"It's certainly reprehensible to set goals for so many health insurance contracts to be rescinded and to give somebody bonuses to achieve that goal," said William Shernoff, Bates' attorney, in a telephone call during a break in the hearing. The proceeding, which is being held in Rancho Cucamonga, is expected to continue through next week.
Health Net officials called Shernoff's interpretation misleading and said the unfolding case will support the insurer's position.
"The evidence will show that nothing in our employees' goals causes them to (stray from) following a fact-based process of identifying misrepresentations on applications," Health Net spokesman Brad Kieffer said.
Health Net contends that Bates' rescission was justified because Bates failed to disclose a heart condition and lied about her weight when she applied for the policy in July 2003, omissions that would have caused the insurer to reject her application.
Bates underwent surgery for breast cancer in September 2003 and her coverage was canceled while she was undergoing chemotherapy in January 2004, leaving her with $190,000 in bills. Kieffer said Bates' cancer diagnosis brought about the review of her application.
Shernoff said Bates, who had insurance when she switched to Health Net to save money, had no incentive to lie. He said an agent filled out the application for her while she was cutting hair.
State regulators said they plan to investigate the case.
State Insurance Commissioner Steve Poizner considers the actions taken by Health Net to be "indefensible, immoral and possibly illegal," said department spokesman Byron Tucker, adding that the agency needs to evaluate the case before taking any steps.
Cindy Ehnes, director of the Department of Managed Health Care, said the case underscores why the department is in the process of investigating insurers and clarifying regulations governing rescissions.
"That process must be fair to the enrollee who has relied on the plan giving them coverage and has sought care relying on that promise," she said.

Posted by mikki at 02:07 PM | Permalink | Comments (0)

Think the Pope agrees? I heard something about mobilizing a panzer division and....

Bishop backs brothel regulation - Yahoo! News:


LONDON (Reuters) - A Roman Catholic bishop in the southern English port city of Portsmouth is backing a campaign to legalize brothels without in any way condoning them.

The Right Reverend Crispian Hollis supported the local branch of the Women's Institute which wants to license brothels.

"If you are going to take a pragmatic view and say prostitution happens, I think there is a need to make sure it's as well regulated as possible for the health of people involved and for the safety of the ladies themselves," Hollis said.

"That's not to say I approve of prostitution in any way. I would be very much happier if there was no prostitution in Portsmouth," he told The Portsmouth News.

"But it's going to be there whatever we do and it has been from time immemorial. So I think that is something we have to be realistic about."

His comments won praise from Rachel Frost, from the International Union for Sex Workers.

"The bishop should be commended for having the guts to come out and say that," she said.

Posted by mikki at 02:00 PM | Permalink | Comments (0)

Yeah, right. We can trust businesses and the government with our privacy. I mean, after all, they only screw up millions of times every year releasing confidential data and personal identifiers to the world. What are the odds?

Intel official: Expect less privacy - Yahoo! News:


WASHINGTON - As Congress debates new rules for government eavesdropping, a top intelligence official says it is time that people in the United States changed their definition of privacy.

Privacy no longer can mean anonymity, says Donald Kerr, the principal deputy director of national intelligence. Instead, it should mean that government and businesses properly safeguard people's private communications and financial information.

Kerr's comments come as Congress is taking a second look at the Foreign Intelligence Surveillance Act.

Lawmakers hastily changed the 1978 law last summer to allow the government to eavesdrop inside the United States without court permission, so long as one end of the conversation was reasonably believed to be located outside the U.S.

The original law required a court order for any surveillance conducted on U.S. soil, to protect Americans' privacy. The White House argued that the law was obstructing intelligence gathering because, as technology has changed, a growing amount of foreign communications passes through U.S.-based channels.

The most contentious issue in the new legislation is whether to shield telecommunications companies from civil lawsuits for allegedly giving the government access to people's private e-mails and phone calls without a FISA court order between 2001 and 2007.

Some lawmakers, including members of the Senate Judiciary Committee, appear reluctant to grant immunity. Suits might be the only way to determine how far the government has burrowed into people's privacy without court permission.

The committee is expected to decide this week whether its version of the bill will protect telecommunications companies. About 40 wiretapping suits are pending.

The central witness in a California lawsuit against AT&T says the government is vacuuming up billions of e-mails and phone calls as they pass through an AT&T switching station in San Francisco.

Mark Klein, a retired AT&T technician, helped connect a device in 2003 that he says diverted and copied onto a government supercomputer every call, e-mail, and Internet site access on AT&T lines.

The Electronic Frontier Foundation, which filed the class-action suit, claims there are as many as 20 such sites in the U.S.

The White House has promised to veto any bill that does not grant immunity from suits such as this one.

Congressional leaders hope to finish the bill by Thanksgiving. It would replace the FISA update enacted in August that privacy groups and civil libertarians say allows the government to read Americans' e-mails and listen to their phone calls without court oversight.

Kerr said at an October intelligence conference in San Antonio that he finds concerns that the government may be listening in odd when people are "perfectly willing for a green-card holder at an (Internet service provider) who may or may have not have been an illegal entrant to the United States to handle their data."

He noted that government employees face up to five years in prison and $100,000 in fines if convicted of misusing private information.

Millions of people in this country — particularly young people — already have surrendered anonymity to social networking sites such as MySpace and Facebook, and to Internet commerce. These sites reveal to the public, government and corporations what was once closely guarded information, like personal statistics and credit card numbers.

"Those two generations younger than we are have a very different idea of what is essential privacy, what they would wish to protect about their lives and affairs. And so, it's not for us to inflict one size fits all," said Kerr, 68. "Protecting anonymity isn't a fight that can be won. Anyone that's typed in their name on Google understands that."

"Our job now is to engage in a productive debate, which focuses on privacy as a component of appropriate levels of security and public safety," Kerr said. "I think all of us have to really take stock of what we already are willing to give up, in terms of anonymity, but (also) what safeguards we want in place to be sure that giving that doesn't empty our bank account or do something equally bad elsewhere."

Kurt Opsahl, a senior staff lawyer with the Electronic Frontier Foundation, an advocacy group that defends online free speech, privacy and intellectual property rights, said Kerr's argument ignores both privacy laws and American history.

"Anonymity has been important since the Federalist Papers were written under pseudonyms," Opsahl said. "The government has tremendous power: the police power, the ability to arrest, to detain, to take away rights. Tying together that someone has spoken out on an issue with their identity is a far more dangerous thing if it is the government that is trying to tie it together."

Opsahl also said Kerr ignores the distinction between sacrificing protection from an intrusive government and voluntarily disclosing information in exchange for a service.

"There is something fundamentally different from the government having information about you than private parties," he said. "We shouldn't have to give people the choice between taking advantage of modern communication tools and sacrificing their privacy."

"It's just another 'trust us, we're the government,'" he said.

Posted by mikki at 01:59 PM | Permalink | Comments (0)