Insurance Companies Robbing Patients Robbing patients to pay CEOs

 leads to unprecedented medical insurance corporation greed.


Over the years, we have frequently commented on the negative role the legal profession and government regulations have had on the healthcare delivery system and rising costs for the patient.

Today we comment on greedy and uncaring medical insurance companies and CEO and executive greed that rivals that seen in other American industries the last few decades.

This particular story is well documented in a recent Jan. 1, 2008 release from The Association of American Physicians and Surgeons.

A year ago, William McGuire, M.D., was ousted from his position as one of the highest paid executives in the U.S. because of a backdating scandal.

More than 80 corporate officials lost their jobs in the scandal.

Dr. McGuire, former chief executive of UnitedHealth Group, agreed to one of the largest executive-pay givebacks in history, forfeiting $620 million in stock option gains and retirement pay, to settle civil and federal claims against stock-option backdating. The final outcome, however, remains uncertain as of Dec. 28, 2007.

McGuire still retains about 24 million stock options that currently could be cashed in for a gain of about $800 million on top of the $500 million in pay he received from UnitedHealth between 1991 and 2006. A freeze on these assets was continued by U.S. District Judge James Rosenbaum in a Dec 26 ruling, pending a decision by the Minnesota Supreme Court on whether he has the power to examine the settlement beyond just rubber-stamping it. State courts give varying degrees of deference to special litigation committees.

The committee, appointed by UnitedHealth¹s board, had concluded that some of the accusations against McGuire might have merit, but the cost and risk of suing him might not be worth it. McGuire neither admitted nor denied wrongdoing.

The two former Minnesota Supreme Court justices on the committee wrote that their ability to evaluate McGuire¹s potential defenses were, "hampered by his unavailability for an interview." They interviewed 50 other people over the course of a year (Joshua Reed, Chicago Sun-Times Dec. 7, 2007).

Judge Rosenbaum also expressed some thoughts about the amount of money that McGuire had claimed when he was forced out of UnitedHealth. "Words such as 'huge,' 'fantastic,' 'astounding,' 'staggering,' or 'astronomical,' do not describe $1 billion," he wrote. "Such a sum can only be thought of as 'transcendent,' or in terms of the gross national product of smaller members of the United Nations" (Vanessa Fuhrmans and Peter Lattman, Wall Street Journal, Dec. 28, 2007).

McGuire is barred from serving as an officer or director of a public company for 10 years. He also still faces a criminal inquiry.

UnitedHealth's current CEO, Stephen Hemsley, plans to voluntarily have his remaining options repriced, effectively forfeiting $50 million, on top of the $190 million in gains he agreed to give back last year on options with questionable grant dates (Wall Street Journal Dec. 7, 2007).

While growing into a colossus, UnitedHealth has repeatedly failed to perform its basic job of paying medical bills. UnitedHealth, which covers 70 million Americans, has been sanctioned in nine states for paying claims slowly; shortchanging doctors, hospitals, or patients; or poorly handling complaints and appeals.

One Nebraska woman complained to state regulators thatUnitedHealth's computers had incorrectly rejected claims related to her son's surgery six times.

At one point, UnitedHealth owed Dr. George Schroedinger, an orthopedic surgeon, $600,000. He and his clinic sued UnitedHealth of the Midwest in 2004.

Deciding for the clinic, U.S. District Judge Stephen Limbaugh of Missouri declared that the company's claims processing systems were "flawed in many ways, denying, reducing, and improperly processing claims on a regular basis. And despite innumerable requests, United was unwilling to remedy the underlying errors in its systems" (Star-Tribune Dec. 12, 2007).

Payment troubles continued after the verdict, and Dr. Schroedinger filed a second lawsuit. "These people can never get it right, which says to me that they just plain lie," he said in an interview.

Failure to pay isn't the only complaint. The insurer also gives incorrect information on which physicians are in its network, creating enormous problems for physicians' staff.

The AMA said that no other insurer has prompted as many complaints as UnitedHealth about abusive and unfair payment practices. AMA officials have met with UnitedHealth executives 16 times since 2000, with little to show for it.

"They have always got a new plan to fix it," said Dr. William G. Plested III, past president of the AMA. But "nothing ever happens."

It seems to us that this case is just the tip of the insurance iceberg. More and more stories are appearing daily in the news media about how insurance company are instructing employees their jobs are to deny claims and/or delay payments.

With such a high percentage of medical premiums and other costs going to the legal profession, to maintain compliance with endless government rules/regulations and being hoarded by the insurance companies and executives — is it any wonder medical costs are increasing so dramatically?

It's time to take a closer look at the medical insurance companies.

UnitedHealth Group is not the first medical insurance company to rob patients, hospitals and clinics to pay obscene salaries to their executives.

It's a modern day robbing patients to pay pimps.

Michael Arnold Glueck, M.D., comments on medical-legal issues and is a visiting fellow in economics and citizenship at the International Trade Education Foundation of the Washington International Trade Council.

Robert J. Cihak, M.D., is a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons.

FDA reviewing safety of Botox

WASHINGTON (Reuters) - Regulators said on Friday they were reviewing the safety of Allergan Inc's (AGN.N: Quote, Profile, Research) Botox and a competing product after reports of deaths and serious reactions in some patients. The Food and Drug Administration said the most serious cases included hospitalizations and deaths and occurred mostly in children treated for cerebral palsy-associated limb spasticity, a use not approved in the United States.

Women's Health and Diabetes

Bigger Breasted Women More Vulnerable to Diabetes, Says Canadian Study
Patrick Totty
4 February 2008

A Canadian study asserts that girls and young women with big breasts run a 68-percent greater chance of acquiring diabetes by middle age than their smaller-breasted peers.

However, concerned that the finding might inspire some women to seek out breast reductions, researchers emphasize that their conclusion is broad and preliminary. They say there are several other factors besides breast size that they must study before definitively linking size to increased vulnerability to diabetes.

Scientists tracked 92,102 mostly white nurses from 14 U.S. states over a 10-year period to determine if their breast size would increase their chances for developing diabetes by age 35. While preliminarily concluding that large breasts were a common factor in the higher incidence of diabetes, they say weight, family history, smoking, diet and ethnicity probably also play large roles.

The reason for breast size as a factor is that breast tissue tends to be insulin-resistant. Bigger breasts create more insulin resistance in women's bodies, thereby increasing their chances of acquiring diabetes.

The researchers also note that while big breasts can be a genetic endowment, many women acquire them if they become obese - and obesity is often cited as a major factor in developing diabetes.

Source: Canadian Medical Association Journal

Yet Another Lurking Link Between Foods and Cancer


New research shows that a high dietary intake of acrylamide can increase the risk of breast cancer. The study was the first epidemiological study using biological markers for measuring acrylamide exposure, and also the first to report an acrylamide/breast cancer link.

The study examined 374 postmenopausal women who had developed breast cancer, and an additional 374 healthy women who were used as controls. An increased acrylamide hemoglobin level doubled the risk of breast cancer.

Acrylamide is a carcinogen created when starchy foods are baked, roasted, fried or toasted. It was found to cause cancer in laboratory rats in 2002.

Lipitor Ads Spark Congressional Probe

Lipitor has been running a series of ads in which a kindly "doctor," Robert Jarvik, inventor of the artificial heart, tells viewers about the benefits of the cholesterol-lowering medication Lipitor. These ads, and their use of celebrity endorsers such as Jarvik, are now being investigated by Congress for potentially misleading viewers.

In the ads, Dr. Jarvik appears to be giving medical advice, but he has never obtained a license to practice or prescribe medicine.

Critics of the drug industry claim that such ads emotionally manipulate viewers and underemphasize the potential side effects of drugs.

The congressional probe focuses on the Lipitor ads, but will likely examine others, such as actress Sally Field's endorsement of the osteoporosis drug Boniva.


This isn’t the first time Pfizer is in trouble over their fraudulent claims of what Lipitor can do for you. In 2005 they were sued by healthcare advocates for lying to women and seniors when they claimed Lipitor would reduce their risk of having a heart attack.

The group argued that the drug not only did not work, but that women who took Lipitor ran a 10 percent higher risk of heart attacks than those taking a placebo.

I don’t know the conclusion of that case, but it surely didn’t stop Pfizer from plowing forward with even more absurd claims, which the FDA bought hook line and sinker.

In 2005 Pfizer sold almost $11 billion worth of Lipitor, but after the FDA approved it for reducing stroke and heart attacks risks among diabetics their sales rose to $13 billion in 2006.

This is an unbelievable “oversight” by the FDA, in light of the fact that Lipitor can double the risk of a deadly stroke for diabetics!

Why Statins are Your WORST Option

Statins such as Lipitor are a particularly bad choice for diabetics, but they are a poor treatment even if your only worry is your heart health.

Now, statins do lower LDL (bad) cholesterol very well. The problem is they lower it too well, because cholesterol is still a necessary and natural chemical that your body needs. Cholesterol:

Waterproofs your cell walls
Helps repair cells
Is vital for digesting fats, regulating hormone levels, and neurological function
Despite cholesterol's infamous reputation, having too little of it in your body is as dangerous, if not more so, than too much. Therefore, the result of taking statin drugs can be numerous dangerous side effects, including:

Muscle pain and weakness (most likely due to the depletion of Co-Q10)
Dizziness and cognitive impairment,
Depression
Pancreatitis
Increased cancer risk
Heart failure
The last one is rather counter to the whole supposed point of cholesterol-lowering drugs, don't you think?

And there is this additional evidence that it more than doubles your risk of stroke if you are diabetic, in return for no benefits whatsoever -- unless you enjoy anything on this list; these are the possible consequences of taking statins in strong doses or for a lengthy period of time:

Depression of mental acuity
Anemia
Acidosis
Frequent fevers
Cataracts
What is Your Underlying Problem, and How Can You Treat THAT?

Make no mistake, Lipitor completely fails to treat the underlying problems causing your high levels of cholesterol. Statins are non-specific inhibitors of a number of very important liver enzymes, including the enzyme that causes your liver to make cholesterol when it is stimulated by high insulin levels.

A far more sensible treatment therefore, is to simply shut down the enzyme that makes cholesterol by reducing your insulin and leptin levels, which is the underlying cause of your high cholesterol. 

By eliminating sugar and most grains, you won’t cause this important enzyme to be blocked, and you also will not block other vital coenzymes such as CoQ10.

This is also exactly what you should be doing if you are diabetic.

To normalize your cholesterol level naturally, and keep your diabetes under control at the same time, these three primary strategies work well 99 percent of the time if properly implemented:

Exercise daily
Eat a low grain, low sugar diet
Take a high quality omega-3 supplement
The omega-3 fats in krill oil or fish oil will influence your HDL cholesterol levels far more safely and effectively than taking a pill -- and for a small fraction of the cost.

I must say I really got a kick out of Robert Jarvik’s public statement where he says in closing: 

“I am a medical scientist specializing in advanced technology to treat heart failure who understands that no one in his or her right mind would want  an artificial heart if it could be avoided with preventive medicine.”

I didn’t say it was a good kick.

To infer that statin drugs are somehow related to preventive medicine is again a grossly misleading statement. There is nothing preventive about these drugs; they do not fix any underlying health issues that might cause problems in the future. Instead they raise your risks of other serious health complications that might cost you your life far sooner than your high cholesterol might have.