Follow up. I found this posted at another site. Jacob says they were mismanaged. Jacob, the mismanagement might have been intentional.
PacifiCare was founded as a nonprofit corporation by Samuel J. Tibbitts of the Lutheran Hospital Society of Southern California in 1975 and became a federally qualified health maintenance organization (HMO) three years later. In 2009 Claims denial rates by leading California insurers, first six months of 2009: · PacifiCare -- 39.6 percent · Cigna -- 32.7 percent · HealthNet -- 30 percent · Kaiser Permanente -- 28.3 percent · Blue Cross -- 27.9 percent · Aetna -- 6.4 percen "Every claim that is denied represents a real patient enduring pain and suffering. Every denial has real, sometimes fatal consequences," said Burger. PacifiCare, for example, denied a special procedure for treatment of bone cancer for Nick Colombo, a 17-year-old teen from Placentia, Calif. Again, after protests organized by Nick's family and friends, CNA/NNOC, and netroots activists, PacifiCare reversed its decision. But like Nataline Sarkisyan, the delay resulted in critical time lost, and Nick ultimately died. "This was his last effort and the procedure had worked before with people in Nick's situation," said his older brother Ricky. Cigna gained notoriety two years ago for denying a liver transplant to 17-year-old Nataline Sarkisyan of Northridge, Calif. and then reversing itself, tragically too late to save her life. In 2008, six days before RN Kim Kutcher of Dana Point, Calif., was scheduled to have special back surgery, Blue Cross denied authorization for the procedure as "investigational" even though the lumbar artificial disc she was to receive had FDA approval. At the time of denial, which she calls "insurance hell," Kutcher had "already gone through pre-op testing, donated a unit of blood, had appointments with four physicians." Kutcher paid $60,000 out of pocket for the operation and is still fighting Blue Cross. Rejection of care is a very lucrative business for the insurance giants. The top 18 insurance giants racked up $15.9 billion in profits last year. "The routine denial of care by private insurers is like the elephant in the room no one in the present national healthcare debate seems to want to talk about," Burger said. "Nothing in any of the major bills advancing in the Senate or House or proposed by the administration would challenge this practice." The United States remains the only country in the industrialized world where human lives are sacrificed for private profit, a national disgrace that seems on the verge of perpetuation," she said. "At the heart of this case is the $9.2-billion deal that put PacifiCare under the wing of UnitedHealth Group, an insurance behemoth based near Minneapolis that now has 25 million policyholders in 50 states and had $81 billion in revenue last year." J - No man's life, liberty, or property is safe while the legislature is in session. - Mark Twain The artificial aristocracy is a mischievous ingredient in government, and provisions should be made to prevent its ascendancy. - Thomas Jeff ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| Order the Adobe Coldfusion Anthology now! http://www.amazon.com/Adobe-Coldfusion-Anthology-Michael-Dinowitz/dp/1430272155/?tag=houseoffusion Archive: http://www.houseoffusion.com/groups/cf-community/message.cfm/messageid:327104 Subscription: http://www.houseoffusion.com/groups/cf-community/subscribe.cfm Unsubscribe: http://www.houseoffusion.com/groups/cf-community/unsubscribe.cfm
