Aetna demostrates insurance industry callousness about the medical needs of their “members”

This commentary is a personal rant from the author and may not necessarily reflect the opinion of other authors at Box Turtle Bulletin. Additionally, it is not directly within the realm of what this site normally covers. I wrote it anyway. I make no claim that this is representative of anyone else's story, but it's mine.

Timothy Kincaid

February 2nd, 2010

AetnaIn 2004 Aetna Insurance Company adopted the slogan, “We want you to know.” However, I really, really, truly, very much wish I knew nothing about Aetna.

As I wrote last Friday, Aetna, my HMO insurer, decided as of January 1, 2010 to move a medication that I require off of their preferred list. They do allow one other alternate medication, but I have an allergic reaction to that medication which results in redness and eye irritation and my ophthalmologist will not prescribe it.

In my update last Friday, I told you that it looked like a tier override might be possible. It is now clear that this was a misunderstanding. As I do not reside in New Jersey, such an option is not available.

During this process I discovered something interesting. Aetna has in place procedures to ensure that those who decide the pricing are shielded from all contact with those who suffer the consequences of their decisions. Even the intermediaries who speak with doctors are not allowed to talk to these decision makers, instead having all interaction be by means of forms and email.

Aetna wishes to make certain that those who deny coverage are not swayed by emotional appeal or the circumstances of any individual members. Were they to be made aware of the difficulties that they cause, they might be inclined to prioritize ethical practice ahead of gasp-worthy profits ($1.4 billion in 2008) and exorbitant executive salaries (which increased 625% between 2005 and 2008).

So Aetna wins. By taking my drug off the preference list, they will shift $25 per month from their bottom line to mine. And I have no recourse at all other than, of course, informing you, my Congressman, my Senators, my state legislators and the CA Insurance Commissioner of the practices of this corporation.

Ray

February 2nd, 2010

I certainly hope you HAVE informed the Insurance Commissioner. I think the IC is the place to start since advocacy is their freaking job!

Steve

February 2nd, 2010

I share your anger with these behemoth insurance companies. I deal with them every day as a physician. So much for competition.
Please remember that one proposal in the new health plan was to subject these companies to anti-trust regulations just like other industries. That has fallen by the wayside. In my state, two major insurance companies control over 90% of the market. Good luck in trying to make a complaint to the insurance commissioner. I agree that their profits are obscene as are the salaries of these executives who are always trying to improve their “loss ratio”.

Also remember to thank smug Joe Lieberman who derailed any hope for reform when it comes to mega insurance companies. I hope he is sleeping well and enjoying the campaign contributions from major insurers in his state. He is a sanctimonious mealy mouthed politician who symbolizes arrogance, corruption, and the inability to get out of the grip of these special interests that are corrupting health care.

Finally, the drug companies are also to blame. The high prices of so many drugs are also obscene when you look at what others pay outside the U.S.. The endless TV ads for this drug or that and the creation of a perceived need to treat something with their drug is ridiculous. I am not suggesting that this applies to your eye. In general, this direct consumer advertising has driven up drug prices.

You might want to see if you could get the eye drops from Canada over the Internet if that is feasible. Some drops need to be refrigerated, so that might not work. Just a thought.

Timothy Kincaid

February 2nd, 2010

Thanks, Steve.

But yes, Travatan Z is refrigerated.

wister

February 3rd, 2010

While I share your indignation at least you’re not paying for your insurance yourself. Mine has gone from $2,000 a year in 01 to over $8,000 today. And then I have co-pays and drug costs on top of that. And no real long-term care provision.

Priya Lynn

February 3rd, 2010

My sympathies go out to Americans who are forced to live on the edge of disaster because of privatized health care. It makes me so angry that Republicans stand in the way of health care for everyone for no rational reason – its just insane.

Andrew

February 3rd, 2010

I share your indignation as well, and I know you know this, but keep in mind not only the millions of uninsured (which I’m sure you know), but the even larger numbers of the UNDERinsured. My employer just moved to a 3,000 deductible ($6k for family). Single parents working at this company are basically getting the price break associated with being a member of the covered group (up to 90% for some services — have you checked out the drop in price between what the lab wanted to charge you and what the insurance company allowed them to charge you????), but they aren’t really getting any financial coverage at all. And we’re lucky. Small businesses, with their smaller covered group, are routinely are subjected to >25% annual premium increases — we also lost a pension plan in order to accommodate the insurance plan we elected to keep.

But hey, I still have a job (and the benefits that come with it), so I’m still better off than a lot of people.

I guess my comment boils down to…

ARE YOU KIDDING ME? You’re on the Titanic and you’re complaining that the bartender spilled your drink.

C R

March 12th, 2010

Tim:
Re: refrigeration requirement for your medicine:
Check with a pharmacist re refrigeration requirements for Travatan Z. It may not need refrigeration. True, it’s cousin medicine, Xalatan, does require refrigeration, but only UNTIL opening the bottle, not after.

Leave A Comment

All comments reflect the opinions of commenters only. They are not necessarily those of anyone associated with Box Turtle Bulletin. Comments are subject to our Comments Policy.

(Required)
(Required, never shared)

PLEASE NOTE: All comments are subject to our Comments Policy.

 

Latest Posts

Today's Agenda Is Brought To You By...

Today In History, 1964: "Homosexuality In America"

Today In History, 1965: Gay Rights Advocates Picket the Civil Service Commission

Today In History, 2003: U.S. Supreme Court Overturns Nation's Sodomy Laws

Today In History, 2013: U.S. Supreme Court Declares Defense of Marriage Act Unconstitutional

Today In History, 2013: U.S. Supreme Court Rejects Appeal of California's Prop 8

Today In History, 2015: U.S. Supreme Court Legalizes Marriage Equality Nationwide

Born On This Day, 1951: Lance Loud

Featured Reports

What Are Little Boys Made Of?

In this original BTB Investigation, we unveil the tragic story of Kirk Murphy, a four-year-old boy who was treated for “cross-gender disturbance” in 1970 by a young grad student by the name of George Rekers. This story is a stark reminder that there are severe and damaging consequences when therapists try to ensure that boys will be boys.

Slouching Towards Kampala: Uganda’s Deadly Embrace of Hate

When we first reported on three American anti-gay activists traveling to Kampala for a three-day conference, we had no idea that it would be the first report of a long string of events leading to a proposal to institute the death penalty for LGBT people. But that is exactly what happened. In this report, we review our collection of more than 500 posts to tell the story of one nation’s embrace of hatred toward gay people. This report will be updated continuously as events continue to unfold. Check here for the latest updates.

Paul Cameron’s World

In 2005, the Southern Poverty Law Center wrote that “[Paul] Cameron’s ‘science’ echoes Nazi Germany.” What the SPLC didn”t know was Cameron doesn’t just “echo” Nazi Germany. He quoted extensively from one of the Final Solution’s architects. This puts his fascination with quarantines, mandatory tattoos, and extermination being a “plausible idea” in a whole new and deeply disturbing light.

From the Inside: Focus on the Family’s “Love Won Out”

On February 10, I attended an all-day “Love Won Out” ex-gay conference in Phoenix, put on by Focus on the Family and Exodus International. In this series of reports, I talk about what I learned there: the people who go to these conferences, the things that they hear, and what this all means for them, their families and for the rest of us.

Prologue: Why I Went To “Love Won Out”
Part 1: What’s Love Got To Do With It?
Part 2: Parents Struggle With “No Exceptions”
Part 3: A Whole New Dialect
Part 4: It Depends On How The Meaning of the Word "Change" Changes
Part 5: A Candid Explanation For "Change"

The Heterosexual Agenda: Exposing The Myths

At last, the truth can now be told.

Using the same research methods employed by most anti-gay political pressure groups, we examine the statistics and the case studies that dispel many of the myths about heterosexuality. Download your copy today!

And don‘t miss our companion report, How To Write An Anti-Gay Tract In Fifteen Easy Steps.

Testing The Premise: Are Gays A Threat To Our Children?

Anti-gay activists often charge that gay men and women pose a threat to children. In this report, we explore the supposed connection between homosexuality and child sexual abuse, the conclusions reached by the most knowledgeable professionals in the field, and how anti-gay activists continue to ignore their findings. This has tremendous consequences, not just for gay men and women, but more importantly for the safety of all our children.

Straight From The Source: What the “Dutch Study” Really Says About Gay Couples

Anti-gay activists often cite the “Dutch Study” to claim that gay unions last only about 1½ years and that the these men have an average of eight additional partners per year outside of their steady relationship. In this report, we will take you step by step into the study to see whether the claims are true.

The FRC’s Briefs Are Showing

Tony Perkins’ Family Research Council submitted an Amicus Brief to the Maryland Court of Appeals as that court prepared to consider the issue of gay marriage. We examine just one small section of that brief to reveal the junk science and fraudulent claims of the Family “Research” Council.

Daniel Fetty Doesn’t Count

Daniel FettyThe FBI’s annual Hate Crime Statistics aren’t as complete as they ought to be, and their report for 2004 was no exception. In fact, their most recent report has quite a few glaring holes. Holes big enough for Daniel Fetty to fall through.