Tag Archives: Ian Pearl

Medicaid to Ian: Drop Dead!

I adore ekg.  For years she has been my liberal foil, challenging my assumptions and sharpening my arguments.  But lately, she has just seemed …off.  Like virtually every liberal worth his or her bureaucracy, she is wildly in favor of a “public option” in the current health care bill.  The more “publicky,” the better. Medicare for all is the dream, and VA care for all is the fantasy.  Yeah, I don’t get that one either.  But unfortunately, it’s a point that seems so evident to the liberal mind that any opposition seems either evil or crazy.

 

Or racist of course.  We can’t forget that one!

 

So her arguments in support of “health reform” have been of the self evident variety.  Hardly worth the title of “reasoned discussion” at all.  In discussing the case of Ian Pearl, she pulls out the familiar trope of the evil insurance company denying coverage for the wronged, ill, Christ figure.  Her blog on Ian’s plight is one part righteous anger and two parts accusatory anger.

 

But I do take her seriously and try to address her disagreements with my position:

 

Ekg, I don’t want to make you sad, so let me address your points one at a time.

 

Now, you are saying I don’t know what I am talking about because:

 

“1st.. Ian wouldn’t die from the ‘public option’… he would die from having to live in an assisted living home…”

 

So in order to live, Ian needs 24 hour home health care that is currently provided by his health insurance.  Now Ian is about to get the boot, the boot to Medicaid, which does not provide the sort of home health care that Ian needs, according to his parents to stay alive.  So once Ian is on Medicaid, his life will be nasty, brutish, and short.  Now assisted living is how Medicaid handles Muscular Dystrophy patients in Ian’s advanced condition.  So if Ian had never been covered under a private insurance plan, he would have been dead a while ago, correct?

 

But you say Medicaid is not a public option.  But the public option is government healthcare.  Do you think he would have a better deal under another government plan?

 

Which leads us to your second point…

 

”2nd medicaid isn’t the ‘public option’ .. that is what the poorest of the poor get. which no matter how bad(and it’s not), is still better than what millions have now..
The public option is low cost private insurance and it’s only low cost to the payer because the gov’t can purchase larger ‘blocks’ and get a better deal than a single person.”

 

If you’re correct, I’ve been following this issue for several months and have never heard that the public option is really private insurance.  In fact, I’m pretty sure you’re wrong on that, so I will call bullshit until you can show me.  What I think you are getting it confused with are the private plans that will be sold through the exchange.  Those will have standardized basic benefits, prices, and will be subsidized for lower income people.  That is not the” public option.”  The public option is a government plan, not really insurance, with benefits and prices designed by the government.  Now the public option might be administered by a private company, in the same way that Tricare is administered by private insurance companies in different Tricare regions of the country, but it’s not a private insurance plan.  If there is a public option and it is administered by private health insurance companies, which seems likely, the insurance companies still win!

 

So one if us is really, really wrong on our understanding of what the public option is.  As long as we have been going over this issue, that’s pretty damn funny.  I don’t care who ya are…

 

Now I couldn’t help but notice this: 

 

“…healthcare companies pass the buck and raise the price while you cheer them on.. whether it’s because they are exempted under anti-trust laws or any other law doesn’t matter..”

 

I have not been exactly “cheering on” the health insurance companies while they raise prices.  Seeing as I’ve been in the middle of open enrollment at work, I find any cheers quite muted.  I’m trying to recall the last time I cheered price increases by health insurance companies in general and my health insurance in particular… let’s see, there was that time… no…how about… oh no… 

 

I guess no.  No cheers from me.

 

As far as anti trust laws go in general, I find them foolish, since monopolies generally require either control of a particular resource or some sort of government grant that gives a legal monopoly to a company.  Baseball has an anti trust exemption since we don’t want multiple baseball leagues bouncing around the country.  We would rather the current owners suck up all the profits.  For health insurance companies, If Senator Leahy or the President wants to pull that trigger, I say, let ‘em.  Just about everything else in the bill is designed to increase health care costs, so what’s one more? 

 

But the issue isn’t anti trust, it’s ERISA.  The federal law governing health plans gives a specific exemption from common contract law.  Under normal (and by this I mean both common and various state laws, although they may differ in specifics) contract law, a contract entered in good faith, even if there are flaws in the actual contract, such as doting the i or crossing the t , is still a valid contract.  Not so for health plans under ERISA.  The insurance company can retroactively cancel the contract of any member for any sort of contractual error.  They certainly have an incentive to dump high cost (i.e. really sick) patients if they can legally get away with it, and thanks to federal law, they can!

 

I guess lobbying really does pay.

 

Inevitably, when these hard luck rescission cases become big news, like Ian Pearl’s case or others that have become a cause celebre  for big government types such as the cases of Robin Beaton and Otto Raddatz’s, the reason they lost their health care was because of rescission; because the law allows them to.  Big government liberals easily forget the real villains in those cases:  ERISA.

 

Health Insurance II:  This time it’s personal.

 

“the quote you used was the PC/CYA reply to being asked why the VP would call someone like Ian or Chuck a fucking “dog”… which is something else you know, but chose to ignore because it doesn’t further your cause..

seriously.. how can you continue to protect an industry that would treat your wife the same way if she was diagnosed with MS tomorrow is simply beyond me..she would just be their new ‘dog’ to rid themselves of..”

 

 

Although I find myself offended at the term “dog” being used for either my wife or Chuck ( Ian I don’t know.  Sorry Ian, I’m sure you’re a nice guy and all…), the context seems to refer to the accounts, rather than the individuals.  But lets assume the worse.  The health insurance execs are meanies, they hate Ian, Chuck, and my wife and think they are dogs, and of course, hope they all die before too much money is spent on the sickly, when it could be much better spent on fabulous executive bonuses.   THIS is one of the key differences between people who trust the free market (as opposed to individual companies or executives) and people who trust the good naturedness of big government (stand by, teachable moment here): 

 

I don’t care that companies may hate me, are greedy, or that they are looking out for their own self interest.  Of course they are!  They are in business to make a goddamn buck!  Not to wipe the tears from our eyes and give us a shoulder to cry on. 

 

But it’s an observation that predates Adam Smith’s invisible hand:  Businesses and individuals in business are conducting commerce for their own ends.  However the result of that is that everyone’s interests are satisfied.  You want a widget, and a greedy company wants to make money by selling widgets.  Money and Widgets are exchanged, and voila!  Everyone gets what they want!  Contracts?  Same thing.  There is a centuries old body of law governing, “lets make a deal” between people.  As a general rule, it works pretty well.  It would probably work pretty well with health insurance too if our government allowed it. 

 

But if your thinking on private enterprise and business is totally dependent on companies being filled with nice guys and gals who think providing profits to their shareholders is less important than holding your hand and skipping through the meadow on a spring day, then you are pretty much going to hate capitalism and the free market.

 

And of course, let’s really get personal:

 

“.. you are as much of an accomplice in this as the ones who do it knowingly.. you have a president who will work with you.. but instead the GOP shat in his hand and walk over to tongue-kiss the insurance companies because they have the money to rile up the rank and inbred and to fund their re-election bid…”

 

 

 

Wow!  Me!  Personally responsible for Ian Pearl’s unfortunate condition, or responsible for the Republicans in Congress sitting on their hands and not embracing the President’s wack-a-nut health plan?  Either way, it’s a lot of responsibility to rest on my shoulders.  In any case, it was the President who spent the summer playing “wash the molars” with the health insurance companies, not the Republicans.  All the poor health insurance companies wanted was forced, mandatory requirement that everyone in the country get health insurance, a windfall worth billions to them.  That’s why they kept their mouths shut all summer and generically praised “health reform.”  Particularly after it looked like the Public Option was off the table. 

 

But a funny thing happened on the way to negotiations; the individual mandate and the fines to enforce it got weakened.  Weakened enough that suddenly the other higher costs enclosed in the health plan suddenly seem to outweigh the lesser amount of new customers the health insurance companies were expected to have the federal government  herd their way.  It is about self interest after all.  That’s what makes the world go round.  As fun as it would be to blame the Republicans for all this, or any of this for that matter, it’s strictly an inter-party squabble.  It’s Democrats versus the President.  Republicans?  They’re just out in the bleachers, yelling, “You lie” occasionally.

 

 

As for Ian, I don’t have a solution for him.  In that way, I’m no different than ekg.  I would have supported eliminating the part of ERISA that allows these situations to happen in the first place.  He would have either not lost his insurance, or if he had, his parents would have been able to sue the company in court.  That’s not an option available to him under current law.  But even if the Congress were to magically take an interest in that, I doubt it would be done in time to help Ian. 

 

Other than that, I only have Ian’s parent’s word that care under Medicaid is a “death sentence.”  I don’t know if that is their take on their son’s situation or a doctor’s opinion, but in any case, I hope they are wrong.  He’s getting the liberal dream:  government healthcare.  No greedy health insurance companies involved.   It’s government healthcare for Ian soon, and government healthcare for all of us eventually if the President has his way.  But If both Medicaid and Medicare, would have Ian die, why should this be shoved down my throat?  It’s funny that the biggest supporters of government healthcare suddenly are frightened by the thought of someone actually getting it.

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Let's just eliminate that dog.

This is who you protect when you wish for Obama to “fail”. This is the side you have chosen to stand with, protect and help defend.

Insurer ends health program

rather than pay out big

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Ian Pearl has fought for his life every day of his 37 years. Confined to a wheelchair and hooked to a breathing tube, the muscular dystrophy victim refuses to give up.

But his insurance company already has.

Legally barred from discriminating against individuals who submit large claims, the New York-based insurer simply canceled lines of coverage altogether in entire states to avoid paying high-cost claims like Mr. Pearl’s.

In an e-mail, one Guardian Life Insurance Co. executive called high-cost patients such as Mr. Pearl “dogs” that the company could “get rid of.”

That’s right, Mr. Pearl, is a “Dog” that the company needs to “Get rid of”

Let’s put this is perspective for just a second. I told you about a friend of mine recently to try and put a face many of us know on this healthcare debate.  I wanted Chuck’s story to be on everyone’s mind as they were regurgitating the latest poison from Glenn Beck’s mouth. I wanted people to have a visual of the person they were condemning in their almost orgasmic need to have a United States President fail. A failure that  some of these people  dream of, masturbate to…pray for every chance they get. “At all costs” is the motto, “At any cost” is the pledge.

I failed of course, not even the plight of a great man and amazing friend to many of us made a scratch in the shell that surrounds these ideologues.

So I will try again.

Instead of Mr. Pearl, who has the same condition as Chuck, I want to you again put Chuck’s name, his face, his interaction with you, his “self”.. put him in this story. Does that do anything for you ideologues? Can you sit there and hear that Chuck is just a “Dog” who needs to be gotten “rid of” because he dared to buy an insurance policy, he dared to pay it, he dared to get a debilitating degenerative disease and most of all  he dared to not die quickly enough?  The company that waspaid to cover health costs  can’t cancel one ‘dog’  because it would be against the law, so they just cancel an entire state of ‘dogs’. Is there any face I can put on this problem that will make a dent?

You may say “Oh but Kelly, I’m sure the courts will stop the insurance company from canceling everyone with this kind if policy. I’m sure a judge will see that this man, Mr. Pearl will die if this insurance company is allowed to cancel his policy.” But you would be wrong.

A federal court quickly ruled that the company’s actions were legal, so on Dec. 1, barring an order by the federal Department of Health and Human Services, Mr. Pearl will lose his benefits.

So much for that ‘check and balance’.

For those that abhor government intervention, will you cry with Glenn Beck if the  Health “Czar” Kathleen Sebelius orders the company to live up to it’s contract.

Sadly, we all know the answer to that… Yes, yes  you will.

Will those of you who even thought about trying to explain just how President Obama was creating “Death Panels” care to pick up your pitchfork against this actual ‘death panel’?  Mr. Pearl needs 24 hr nursing care, he is on a ventilator and needs hourly breathing treatments and continuous intravenous medication. Without this he will die, here is your Death Panel Sara Palin, will you ‘tweet’ about how evil this is? Will you take hundreds of thousand of dollars for a speech on this kind of injustice, will the people who aped your stupidity write Mr. Pearl or even Chuck’s name on a sign and demand they not be forgotten?

Sadly, we know the answer to that is.. no, no you won’t.

Guardian, a 150-year-old mutual company, reported profits of $437 million last year, a 50 percent increase over $292 million in 2007. It paid dividends of $723 million to policyholders and had $4.3 billion in capital reserves, according to its annual report. The company’s investment income totaled $1.5 billion that year, a small increase from the year earlier.

This is who you protect with your hatred of a President. This is who you protect with  your ‘at any cost’  ideologue.

“In an e-mail to four other Guardian executives entered into evidence in the Pearls’ suit, company Vice President Tim Birely discussed how the company could “eliminate this entire block to get rid of the few dogs.”

.. and don’t think you can get away with the argument of “Well, you Democrats are in power now and we can’t do anything stop you.” It’s condescending, it’s insincere and it’s bullshit. Most insulting of all.. you know it, snicker and use it anyway.

20 years ago a friend of mine took a ride with a person he had just recently started hanging around. He didn’t know him too well but he seemed cool and they got along. That night the new guy told my friend he was going to rob a local mom & pop grocer for some extra cash. My friend wasn’t a violent person, he wasn’t a criminal, he wasn’t a bad person in any way… but he because he was 17 and stupid he didn’t speak up.

The new guy went into the store while my friend waited in the car, he could have left at that point but for whatever reason he didn’t. After a few minutes the new guy came running back out, jumped in the car and away they went. They never spoke of what went on inside the store and it wasn’t until the next morning when the police showed up at his parents house to arrest him that my friend found out that the store owner had been shot and killed by the new guy. My friend was tried and convicted as an accessory to the crime and is on death row awaiting his date with the executioner. Does he deserve to die for a crime he had no part in? Some would say yes he does, but then again.. they would also be the ones to tell Mr. Pearl to go out and get a job if he wants health care.

The real “Dog” here isn’t Mr. Pearl and it isn’t Chuck or any of the other poor souls who have paid their premiums each month only to have them canceled because they did not die quick enough. The real “dogs” are the insurance company who cares more about an enormous bottom line over the lives they are supposed to be protecting. You all fighting reform at all costs.. at any cost, this is the dog you have allowed into your bed by not saying anything even when you know what they are doing is not only wrong, dangerous and against humanity, but could possibly be murderous. Just like the saying “Lie down with dogs, get up with fleas”  this is on you whether you like it or not.

Lindsey Graham is currently finding that sad fact out. Arlen Specter and Colin Powell could have told him, but a conservative republican of Grahams stature, with his conservative record would have ignored their warnings just as the rest of the ideologues will ignore this liberal’s warning. When you go against the beast you create, the beast you’ve allowed to take over to fight your battle for you, when you go against it… you pay their price. It’s apropos that Graham is now the one to fight off charges that can not be defended because they have no basis in reality. “Fake Republican,” “RINO” (Republican in name only), a “traitor,” “disgrace,” “asshat,” “democrat in drag,” and a “wussypants, girly-man, half-a-sissy”.

The beast you fed,nurtured, appeased every step of the way while pretending “that’s  not what my belief..it’s theirs”.. and “Hey, you guys are in power not us”.. that beast is self-aware and is devouring your party.  That is who your next leaders will have no choice but to cater to. The metaphorically date with the executioner that you await for being an accessory to the crime, would be justice in and of itself if so many truly innocent people weren’t being punished along with you. Don’t believe there are ‘truly innocent’ people being punished? Well, I give you one final story

17-Pound, 4-Month-Old Baby

Denied Health Insurance

for Being Too Fat

Underwriters, the people who are in charge of assessing risk for insurance companies, have decided that baby Alex’s pre-existing condition — obesity — makes him a high-risk patient and have denied him coverage.

His parents were shocked.

“I could understand if we could control what he’s eating. But he’s 4 months old. He’s breast-feeding. We can’t put him on the Atkins diet or on a treadmill,” joked his frustrated father, Bernie Lange, a part-time news anchor at KKCO-TV in Grand Junction. “There is just something absurd about denying an infant.”


The beast you continue to actively support or just ignore because the end is justified by the means for you… denied a 4 month old, breastfed baby for the pre-existing condition of  obesity.

I hope you are happy with your creation.

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