A License to Steal

007 has a license to kill.  Insurance companies have a license to steal.  Here’s a typical example.

My mother suffers from back pain mostly due to her advanced age.  Her doctor prescribed lidocaine patches for the pain.  The patches are expensive, almost five hundred dollars per box.  My mother’s Blue Cross Blue Shield supplemental insurance declined to cover the patches.  Why?  According to BCBS, the FDA says the proper diagnosis for prescribing this patch is diabetes.  What?  Did BCBS make that up?  Sounds like it.

What’s the real reason for squirming out the responsibility to cover the patch?  Answer: it’s too damn expensive.  So let’s find a reason not to cover it.

According to AARP, 200 million insurance claims are rejected every year.  Insurance companies try to spread their risk and keep as much money in their organization for as long as possible as they “adjudicate a claim.”  They use auditing software to sift through millions of submitted claims.  These programs are often referred to as “denial engines” because their intent is to lower the amount of claims paid out.

Can we chalk this thievery up to rising medical costs?  No.  Insurance companies pay only a fraction of what doctors and hospitals charge.  I can hear the insurance company executives laughing in their Dayton, Ohio offices (which are located a long way from my little Starbucks table in Aventura, Florida.)

We need insurance reform badly.  I’m not talking about Obamacare. To facilitate their criminal activities, insurance companies hire supermen lobbyists with some of the money they should be paying out in claims.  They buy yachts, homes, Bentleys, commercial real estate, investment securities and commodities with the rest of their profits. They win. We lose.

It’s time for the public to start suing insurance companies en masse. My daughter is preparing to become a prosecutor. When she reaches the Federal level, watch out Aetna, Blue Cross, and all you other bums!