"Love means never having to say you're sorry" is an oft quoted line from the novel and movie Love Story. But backed by new state laws, modern medicine has given it new meaning. Doctors and hospitals are now being encouraged to say "we're sorry" when they make a serious mistake and there's the potential threat of a medical malpractice suit. So don't be surprised when something goes wrong in a doctor's office, clinic or hospital and you get a registered letter of apology. It's all part of a plan to avoid long-running feuds, which not only run up legal fees and costs to insurers, but also take up court time and ultimately add to everyone's medical costs. Medicine has come a long way since the 1993 movie Malice in which actor Alec Baldwin ranted that, as a famous surgeon, "I am God." Experience, legal suits and state laws have now convinced both doctors and hospitals to be a bit more humble -- particularly in Massachusetts, which has felt the sting of higher medical costs since 2006 when it passed the predecessor to 2010's Affordable Care Act, aka Obamacare. Like its successor, the Massachusetts law didn't initially put any constraints on… (continue reading......)
Each year, I watch the classic 1946 Christmas movie It's a Wonderful Life on TV. The battle between good and evil pits the righteous George Bailey, who runs the credit union owned by the townspeople of Bedford Falls, against the sinister Henry Potter, the bank mogul who keeps them downtrodden and in poverty. This movie resonates today because so many of us have been ripped off, not only by the big banks that thrust us into this recession, but also by the big health insurance companies who raise our rates, co-pays and deductibles beyond reason. I recently glanced at Aetna's 2013 New Jersey small business health insurance plans and was amazed that its most comprehensive plan had gone up 407 percent! Unfortunately we have little or no defense against these Henry Potters of the health insurance industry except to try and find another health insurer that won't gouge us quite as much. Revolution No. 2014 But don't despair. In 2014 help is on the way. Section 1322 of the Affordable Care Act, aka Obamacare, is every big health insurer's worst nightmare: government-sponsored consumer-run health insurance cooperatives. Following in the footsteps of George Bailey and the folks of Bedford Falls, you… (continue reading......)
It looked like a frivolous issue. Self-proclaimed transgender person Ida Hammer, who was legally a man but wanted to be a woman, asked his health insurance company to pay for sex change surgery. His insurer, MVP Health Care, like most other health insurers, said "no." Labeling it "a cosmetic procedure," MVP Health twice denied his appeal. But Ida wouldn't take no for an answer. The 34-year-old New York City resident lined up influential supporters and threatened to sue. When Ida's insurer learned who was backing him, it caved. 'Dog Day Afternoon' This now national story has taken on a life of its own, drawing comments from people around the country, some of them straight, others gay, lesbian and transgender, but most of them negative. And the public outcry is understandable. Health insurance costs nearly $16,000 per family. And with rates rising, why should this elective procedure, costing between $18,000 and $50,000, be paid for by health insurance plans? "In the old days when someone wanted a sex change, they just robbed a bank," said a writer for The Gothamist, referring to the 1975 Al Pacino movie Dog Day Afternoon, in which Pacino's character attempts to rob a bank to pay… (continue reading......)
It wasn't the shot heard 'round the world, but in 2008 when stripper LeAndra Lewis was hit by a stray bullet fired during a fight in the Boom Boom Room in Columbia, S.C., the pain was felt across the country. The bullet, which passed through her intestines, liver and pancreas, prevented LeAndra from working for quite some time. Lewis felt she was entitled to a workers compensation claim. Employers pay for workers comp to pay for injuries that employees suffer while on the job. If they cannot work, it covers their medical care and lost wages. But a South Carolina Court of Appeals ruled that Lewis couldn't collect. As a stripper at the bar, LeAndra worked as an "independent contractor" and was therefore ineligible to collect workers comp. And as an independent contractor myself, I sympathize. 'Alternative arrangement' More and more Americans work in what the Labor Department calls an "alternative arrangement." Somewhere along the line a bean-counting company may have outsourced their jobs and then brought them back as independent contractors. Insurer Allstate did this to hundreds of its agents, who are now appealing to the Internal Revenue Service to review their work status. Independent contractors like Lewis now… (continue reading......)
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