The Affordable Care Act II - Because Mr. Obama Loves You All

[DC Tom]

 

When the corporations have a fiduciary responsibility to their shareholders (as is the case for insurance companies), it is the same thing.

 

[Capco]

Oh of course. Don't take it from some random poster on the internet. Take it straight from the horse's mouth of a former medical director for 3 separate firms:

http://www.pnhp.org/news/2009/september/testimony_of_wendell.php

The situation really can't be spelled out any clearer.

Edited June 29, 2017 by Capco

[grinreaper]

 

Oh of course. Don't take it from some random poster on the internet. Take it straight from the horse's mouth of a former medical director for 3 separate firms:

http://www.pnhp.org/news/2009/september/testimony_of_wendell.php

The situation really can't be spelled out any clearer.

 

6/2/96? You must have had to convert that from a VCR tape. If the testimony of one person 21 years ago who reviewed eligibility and is now on some ethics review board is all you got, then you aren't going to be doing very well here.

[Capco]

6/2/96? You must have had to convert that from a VCR tape. If the testimony of one person 21 years ago who reviewed eligibility and is now on some ethics review board is all you got, then you aren't going to be doing very well here.

 

Apart from the passing of the ACA, what has changed in the past 21 years that makes this testimony irrelevant?

[grinreaper]

 

Apart from the passing of the ACA, what has changed in the past 21 years that makes this testimony irrelevant?

It's testimony from one person who at the time had switched jobs and was on an ethics committee. Her testimony may have been relevant or not at the time. Yes, insurance companies have people that review claims and approve or disapprove payment for medical procedures in advance. If the need for the procedure is at all questionable they are going to deny it and the doctors will have to prove that it is necessary to an appeal board. This is not a bad thing. It helps keep insurance rates down. BTW, each state has an insurance commission that approves rates based on insurance companies bottom line.

[DC Tom]

It's testimony from one person who at the time had switched jobs and was on an ethics committee. Her testimony may have been relevant or not at the time. Yes, insurance companies have people that review claims and approve or disapprove payment for medical procedures in advance. If the need for the procedure is at all questionable they are going to deny it and the doctors will have to prove that it is necessary to an appeal board.

 

Medicare and Medicaid do that, too.

[Capco]

Yes, insurance companies have people that review claims and approve or disapprove payment for medical procedures in advance. If the need for the procedure is at all questionable they are going to deny it and the doctors will have to prove that it is necessary to an appeal board. This is not a bad thing. It helps keep insurance rates down. BTW, each state has an insurance commission that approves rates based on insurance companies bottom line.

 

I agree that unnecessary procedures should be avoided for the reasons you stated.

 

However, when bonuses, positive performance reviews, and raises are in direct proportion to how many claims you successfully deny for whatever arbitrary reason, the people needing that healthcare literally die. She said that was essentially her career for about 30 years. I believe that to be pretty pertinent information. I wouldn't want someone to deny me care just because it means they get a fat Xmas bonus.

 

 

 

Medicare and Medicaid do that, too.

 

Correct, but there is no personal financial motive for the person doing the decision making in Medicare/Medicaid (at least as far as I am aware).

[DC Tom]

 

Correct, but there is no personal financial motive for the person doing the decision making in Medicare/Medicaid (at least as far as I am aware).

 

"Personal?" So shareholders are making medical decisions for insurance companies.

 

You're retarded. Go away.

[Capco]

 

"Personal?" So shareholders are making medical decisions for insurance companies.

 

You're retarded. Go away.

 

During the testimony, she clearly stated that she received financial compensation for denying care to people who later died (i.e. a necessary procedure). When shareholders expect profits from a company that makes medical decisions, her actions as medical director will invariably be repeated by any medical director for any for-profit insurance company in lieu of proper regulation. Obviously the shareholders don't talk directly to the medical directors, but that's a cute thought.

 

Again, if and when the choice is between acquiring more profit or giving more care, the insurance companies will go the route of profit every time. I'm not sure what's so hard for you to comprehend considering your erudition.

[grinreaper]

 

I agree that unnecessary procedures should be avoided for the reasons you stated.

 

However, when bonuses, positive performance reviews, and raises are in direct proportion to how many claims you successfully deny for whatever arbitrary reason, the people needing that healthcare literally die. She said that was essentially her career for about 30 years. I believe that to be pretty pertinent information. I wouldn't want someone to deny me care just because it means they get a fat Xmas bonus.

 

 

 

Correct, but there is no personal financial motive for the person doing the decision making in Medicare/Medicaid (at least as far as I am aware).

I'm not usually this patient with someone who is this obtuse. Did you not get the part about an appeal board? It's sometimes a fine line between denial and acceptance and that is where the appeal board comes in to play.

[DC Tom]

 

During the testimony, she clearly stated that she received financial compensation for denying care to people who later died (i.e. a necessary procedure). When shareholders expect profits from a company that makes medical decisions, her actions as medical director will invariably be repeated by any medical director for any for-profit insurance company in lieu of proper regulation. Obviously the shareholders don't talk directly to the medical directors, but that's a cute thought.

 

Again, if and when the choice is between acquiring more profit or giving more care, the insurance companies will go the route of profit every time. I'm not sure what's so hard for you to comprehend considering your erudition.

 

What part of "You're retarded. Go away." did you not understand?

[Capco]

I'm not usually this patient with someone who is this obtuse. Did you not get the part about an appeal board? It's sometimes a fine line between denial and acceptance and that is where the appeal board comes in to play.

 

Thanks for your patience, although I'm trying to be civil. I did read that.

 

Those appeals take time. In the meantime, someone could die (and people have died) simply because a doctor who never met them is working on his/her next pay raise and decided to deny their claim for a necessary procedure.

 

Again, it's not as bad now since the ACA was passed. But that's why protections like the ones the ACA put in place need to be carried over into our next healthcare law.

[Benjamin Franklin]

 

Why don't you ask a lawyer that you may know in how the Newmark decision codifies the common law that corporations are required by law to make as much money as possible.

I wasn't arguing the merits of the case but your statement about following common law.

[Capco]

 

What part of "You're retarded. Go away." did you not understand?

 

So grumpy.

 

Have you eaten today?

[Benjamin Franklin]

 

In 1999, Justice Stephen Breyer protested the Courts refusal to hear the appeal of a prisoner who argued that spending more than two decades on death row amounted to cruel and unusual punishment, and thus violated the Eighth Amendment. Quoting legal opinions from Jamaica, India, Zimbabwe, and the European Court of Human Rights, Breyer observed in a dissenting opinion in Knight v. Florida that a growing number of courts outside the United States . . . have held that lengthy delay in administering a lawful death penalty renders ultimate execution inhuman, degrading or unusually cruel.

 

More recently, in an opinion concurring with the Courts decision to uphold the affirmative-action program at the University of Michigan Law School, Justice Ruth Bader Ginsburg relied on the United Nations International Convention on the Elimination of All Forms of Racial Discrimination.

Justices and judges sometimes consider other laws, philosophy, religious texts to inform their backgrounds on subjects. It doesn't make them binding precedent. Imagine the nightmare of following the Bible or the Republic literally. But that doesn't undermine them as sources. Edited June 29, 2017 by Benjamin Franklin

[grinreaper]

Justices and judges sometimes consider other laws, philosophy, religious texts to inform their backgrounds on subjects. It doesn't make them binding precedent. Imagine the nightmare of following the Bible or the Republic literally. But that doesn't undermine them as sources.

Well, if you are a wise Latina you just follow your instincts.

[GG]

I wasn't arguing the merits of the case but your statement about following common law.

Fine then. Where in common law does it say that corporations have to make as much money as possible?

[Capco]

Fine then. Where in common law does it say that corporations have to make as much money as possible?

 

Afaik, there is no specific statute that says this, but that doesn't make it any less true in practice.

 

"Most large businesses buy their corporate charters from the state of Delaware. And the law of Delaware is clear about corporate purpose. The chief justice of the Delaware Supreme Court, Leo Strine, put it simply in a recent law review article: “Directors must make stockholder welfare their sole end.” In cases where directors have acknowledged sacrificing shareholder interests for other groups, Delaware courts have found those directors violated their fiduciary duties. But is this standard for corporate governance — shareholders over all — good for society?"

 

https://www.nytimes.com/roomfordebate/2015/04/16/what-are-corporations-obligations-to-shareholders/its-law-but-it-shouldnt-be

 

"Directors must make stockholder welfare their sole end." I dunno about you, but I buy stock to make money.

[grinreaper]

 

Afaik, there is no specific statute that says this, but that doesn't make it any less true in practice.

 

"Most large businesses buy their corporate charters from the state of Delaware. And the law of Delaware is clear about corporate purpose. The chief justice of the Delaware Supreme Court, Leo Strine, put it simply in a recent law review article: “Directors must make stockholder welfare their sole end.” In cases where directors have acknowledged sacrificing shareholder interests for other groups, Delaware courts have found those directors violated their fiduciary duties. But is this standard for corporate governance — shareholders over all — good for society?"

 

https://www.nytimes.com/roomfordebate/2015/04/16/what-are-corporations-obligations-to-shareholders/its-law-but-it-shouldnt-be

 

"Directors must make stockholder welfare their sole end." I dunno about you, but I buy stock to make money.

You don't seem to see the forest because the trees get in the way. Stockholder welfare doesn't have to mean just money. It might have to do with the health of the corporation or its reputation. Maybe it has to do with research & development or diversification. There are a myriad of things that might fall under fiduciary duties. You've narrowed your interpretation of fiduciary duties to fit your narrative.

[DC Tom]

You don't seem to see the forest because the trees get in the way. Stockholder welfare doesn't have to mean just money. It might have to do with the health of the corporation or its reputation. Maybe it has to do with research & development or diversification. There are a myriad of things that might fall under fiduciary duties. You've narrowed your interpretation of fiduciary duties to fit your narrative.

 

Or you could just insult his sorry ass. It's much easier.