Widespread violations of patients’ rights by private insurers in Medicare drug benefit program

Medicare Audits Show Problems in Private Plans
By ROBERT PEAR
Published: October 7, 2007
http://www.nytimes.com/2007/10/07/us/07medicare.html?th&emc=th

WASHINGTON, Oct. 6 — Tens of thousands of Medicare recipients have been victims of deceptive sales tactics and had claims improperly denied by private insurers that run the system’s huge new drug benefit program and offer other private insurance options encouraged by the Bush administration, a review of scores of federal audits has found.

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The companies include three of the largest participants in the Medicare market, UnitedHealth, Humana and WellPoint.

The audits document and consumer protection standards. Some violations could directly affect the health of patients — for example, by delaying access to urgently needed medications. In July, Medicare terminated its contract with a private plan in Florida after finding that it posed an “imminent and serious threat” to its 11,000 members.

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For years, Democrats have complained about efforts to “privatize Medicare,” and they are likely to cite the findings as evidence that private insurers cannot be trusted to care for the sickest, most vulnerable Medicare recipients.

But federal officials point with pride to their efforts to police the Medicare market, and they say that competition among private plans has been a boon to beneficiaries, offering more choices at lower cost than anyone expected.

the push for ''smaller'' government and to privatize everything is going get us all exactly this.

and it always will.

there's a place for the private sector and a place for government -- and we getting clear indications where the lines are drawn.

I'm one of the lucky ones, have a plan that works for me with the 'donut' hole covered by state Medicaid (MediCal) and CA state supported ADAP, but I know many not so fortunate.

The article goes on to note the Medicare Advantage policies, another sidetrack to the insurance industry for Medicare recipients.

In lieu of building on a good basic program - Medicare Part A & B - Republicans have chosen to follow the usual smoke 'n mirrors approach to talk their talk while gutting the basic function of the Medicare programs.

I'd love to see VA recipients (a separate, flawed, yet efficient program) and Medicare recipients coalesce around a call for universality, equal access, efficiency and consistent oversight.