I Was a Health Insurance Executive. What I Saw Made Me Quit.

26 comments

1. Good choice for your life expectancy.

2. Is there really an appreciable difference between shooting someone on the street and killing someone with bureaucracy and unaccountable power? I’d argue that the second way is maybe worse because it’s tolerated and accepted. Our health care delivery system is hostage to crooks and piecemeal solutions are not gonna solve that.

3. My SO has a buddy who fled the insurance company he was working at after attending a meeting where the focus was quite literally how to get patients to not use their insurance.

4. Thank you for the gift article!

   Things need to change, and they need to change now. For too long insurers have taken our money out of each paycheck, only to deny us the healthcare we need when the time comes.

   The more claims they deny, the richer they get. This is not what the free market is supposed to be like, this is the epitome of human greed and heartlessness.and a very good illustration of why regulations are urgently needed.

   I’m glad the former exec had a change of heart. The harm to real life humans that he once participated in must haunt him, and rightly so. But kudos to him for speaking out.

   Free Luigi.

5. I also drank the kool aid and those golden handcuffs are real. When they start throwing money at you for reducing overall costs, improving patient outcomes is expensive and people live longer, which costs even more.

6. Worked in insurance, not health, but property/casualty. Adjusting claims was basically me taking off some key things that the contractors needed to do the job right. They train you to see these as “unnecessary expenses” and turn the Adjuster into a good solider for the company. After denying a claim for a woman who paid her premiums for 20 years and never filed a claim, even when should have, due to “pre-existing damage” I was done. Never going back.

7. I remember this guy. He wrote an article back during the run up to Obamacare. His description of going to a “health fair” was very effective. He was expecting to see the kind of setup you see at the mall, with tables where you can get screened for blood glucose, lung capacity, blood pressure, etc. and plenty of swag.

   Instead, he saw entire clinics set up in stalls that normally get used to pen animals for he state fair, and people who camped out to get a chance to see a doctor about a disturbing lump or a festering sore that wouldn’t heal. For some, it was the first time they could see a doctor in years.

   And the ACA *Passed*. And still his testimony is as relevant and necessary as ever. Not because the ACA was a bad attempt; it was the *absolute best that could be brought through Congress*.

8. > One of my last acts before resigning was helping to plan a meeting for investors and Wall Street financial analysts — similar to the one that UnitedHealthcare canceled after Mr. Thompson’s horrific killing.

   I was under the impression that they didn’t even cancel the investor meeting. Have I been misinformed?

9. If I started an insurance company; and collected monthly payments while rejecting all claims, I would be charged with fraud.

   So when does it become fraud for everyone

10. The biggest problem is corporate America is going to make an example of him. It would take a massive, loud and long effort by the rest of us, for this event to be more than a one man, failed crusade.
    Sadly, I doubt we have the stamina to do what it takes to enact real change. The wealthy bullies always win in America. Because even if most of us can’t enjoy the trappings of the wealthy, we still worship them like a bunch of love sick monkeys.

11. For profit companies, especially ones with shareholders, focus on maximizing profit at the expense of the insured. Absolutely shocking! Who, other than everyone, would have realized this?

12. Cigna.

    In 2000 they denied my claim for coverage of my son’s birth.

    Simple birthing with no complications.

    They told me that the hospital we went to was “out of network” despite being on the “in network” list.

    It turns out they had enrolled us in the wrong plan (in another state) and we should have gone to the nearest in-network hospital (2 hours away).

    When I pointed out that I had a “confirmation of benefits” showing we were supposed to be in the correct plan, I was told, “that’s only confirmation of the plan you selected, not the plan you got”.

    I told the customer support person that they couldn’t do that, she said, “honey, we’re an insurance company, we can do anything we want”.

13. He benefited from the system for 20 years before growing a conscience? Pass.

14. The problem with health insurance is that the same people who need to fix the system are making a shit ton of money by keeping the system broken. They don’t see people not getting health care. They see another 0 in their bank account.

15. Killing a CEO is terrorism in America, but school shooting are things we need to learn to live with according to those in power.

16. Just to illustrate how bad it is and how much power the insurance companies have . An Illinois based insurance company that’s not a good neighbor lost a lawsuit over their auto repair practices. It wound its way through the court system and was going to the Illinois Supreme Court. A Judge found a huge sum of money to get elected that came through PAC’s and such to the tune of about 10 million. Shortly after the election a judgment against the insurance company worth 1 .5 billion was overturned. Then after another lawsuit same insurance company settled a case alleging the election wrong doing for $250 million. Insurer denied any wrongdoing considered lawsuit meritless and settled just “to bring an end of the litigation”

17. This country desperately needs political leaders who will prioritize healthcare reform. It’s been a race to the bottom for too many ordinary Americans and it seems like the perfect time to earn good will from the public by challenging the status quo. Of course, insurance companies will flex their full lobbying might at any legislative efforts, but not trying is no longer tenable.

18. Yall think it’s a joke but I’m literally at a legal holiday party for a health insurance company **right now. **

    Working remote today but I did an on-site party last night. General sentiment is happy for our paychecks/bonuses but sad for our members. 

    I am not the one pulling strings I’m just the tech guy and they like me. Health insurance execs like Karaoke and vodka more than I realized.

    If PBMs like CVS/Caremark get axed then the insurance companies just have to build their own parallel business vertical. 

    And then UnitedHealthcare/Aetna owns your pharmacy and the pharmacist too. $$$$

19. My insurance just denied my daughter’s wheelchair because it’s only for use in the community. Apparently it’s not medically necessary for her to go to school or the grocery store.

20. > One story that we couldn’t keep out of the press, and that contributed most to my decision to walk away from my career in 2008, involved Nataline Sarkisyan, a 17-year-old leukemia patient in California whose scheduled liver transplant was postponed at the last minute when Cigna told her surgeons it wouldn’t pay. Cigna’s medical director, located 2,500 miles away from Nataline, said she was too sick for the procedure. Nataline’s family stirred up so much media attention that Cigna relented, but it was too late. Nataline died a few hours after Cigna’s change of heart.

    They murdered her. Was anyone held accountable?

    Of course not
    > Sarkisyan’s family retained attorney Mark Geragos to sue Cigna, and requested that Los Angeles County District Attorney Steve Cooley file murder charges against the insurer.[16][17][18][19] The case was thrown out due to a Pilot Life Ins. Co. v. Dedeaux, 1987 U.S. Supreme Court ruling shielding employer-paid healthcare plans from damages over their coverage decisions.[20]

    https://en.m.wikipedia.org/wiki/Death_of_Nataline_Sarkisyan

21. I worked for a non profit health insurance company for about a year. I started in the mailroom. I worked full time. Non profit. What a load of bullshit.

    They labeled me a per diem worker to avoid paying me benefits. The rest of the company talked down to us. Regularly heard higher level workers ask their friends, while in the fuckin mailroom no less, “hey Tom, they demote you or something and got you working down here in the mailroom? I haven’t seen you for a while!”

    I got a sort of promotion to claims adjustment, they made it a temporary position… to keep from having to pay me benefits… while they waited to see if the person I was there to cover would come back from maternity leave. They assured me a position was opening up.

    I spent months seeing just how that position works, and boy… Would it. Piss. You. Off.

    The job didn’t end up opening up. They suggested that I take a position in customer service next. They said I’d finally get benefits. I walked and told my boss in my exit interview that I should have had benefits the entire time. She agreed while also admitting she did nothing to try and get them for me, as it would have made her boss angry at her, to which I asked her why be a boss at all if you didn’t understand half your job was taking care of the needs of your workers, and how badly shed failed at that for me. Didn’t matter to her though. Just another day in health insurance.

    Let me give you a solid piece of advice if you’re reading this and still working in insurance:

    Do fucking better. Get out. Save your soul. You… Are all… Complicit.

22. I had a temp job after college at a local hospital and all I did all day was call insurance companies and bug them to pay the hospital. Most of the calls I’d be on hold for half an hour or more so I’d probably get through for 10 a day. There were probably 40 people in the cubicles around me on an entire floor doing the exact same thing.

    Think about that: at least part of your hospital bill is wasted paying for a room of people to spend all day bugging and begging for a check to be written.

23. Health costs going up 7% annually. What’s the gov doing to control costs? It’s 18% of the country’s budget. At this rate, it’s going to bankrupt the nation. Salary caps for doctors and procedures? Price controls for meds?

24. Good. Now do something about our shitty healthcare system.

25. They are leeches. Parasites.

26. Reasonable Healthcare and Gun policies will never occur in The US. The politicians are bought and paid for. Case Closed.

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