Thursday, March 03, 2011
Ask Sen. Green tonight why he is cutting off his own family’s right to appeal health care denials
by Larry Geller
Yup, the Senate is advancing two bills that will take away the right of appeal of health insurance denials to the Insurance Commission from public workers including legislators and their families, QUEST and QExA members, and all those with non-employer health care plans. Just QUEST/QExA alone is more than 260,000 people.
Why would they do that? Senator Green will be on Town Square tonight, 5-6 p.m. on 89.3 FM KIPO on Oahu (also on Maui but I don’t know the frequencies). It would be great if people asked him why he would do such a dumb thing. And I really mean that.
It’s true that many of our legislators, including Sen. Green, have received substantial campaign contributions from insurers, but doesn’t the health of one’s own family trump influence?
It’s hard to explain in a quick article, and I do need to run… but basically, right now, all the people above have the right to appeal to the Insurance Commission if an insurer turns down a medication or treatment, for example. And that has happened, with potentially deadly results. The patient can then appeal to the Insurance Commission.
Not only have lives been saved, but others have found relief from a life of pain by winning the external appeal. It really is a big deal.
Also, right now, the standard for medical necessity, that is, for what the insurance companies have to do, is set in statute.
The bills moving through the Senate (a House bill was killed) will allow insurers to determine medical necessity themselves.
In other words, the fox determines what the hens will get.
Obama’s healthcare law requires that states have certain appeals processes in place. Hawaii does not have to give up its right of external appeal.
One thing that’s almost for certain if Hawaii passes these bills into law—insurers will increase the number of denials since there will be no effective recourse.
The details are a bit more complicated than I’ve explained—that is, how one goes about an appeal now and what will happen in the future.
Tune in to Town Square tonight, particularly if you or your family will be affected. You may want to call in and ask Sen. Green why he is cutting his own throat.
CEO's of health insurance companies have one job and that is to protect their income. They don't make anything, they don't have R&D to be concerned about, there is no innovation in the health insurance business to speak of they just collect money and pass out money. To insure a large paycheck you just make rules or in this case you buy off legislators to make rules to limit the amount of money you pass out. It's time to get rid of the middle man and develop some sort of single payer system for the State of Hawaii. Whose going to pay for it you ask? We are of course, but a government run single payer system will be without the middle men who put millions of dollars of our healthcare premiums in their pockets.
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