AAC Blog
"I think an overwhelming portion of the intensely demonstrated animosity toward President Barack Obama is based on the fact that he is a black man, that he's African American," Carter said. "I live in the South, and I've seen the South come a long way, and I've seen the rest of the country that shared the South's attitude toward minority groups at that time, particularly African Americans"
Continued Carter, who is famously from Georgia: "And that racism inclination still exists. And I think it's bubbled up to the surface because of the belief among many white people, not just in the South but around the country, that African-Americans are not qualified to lead this great country. It's an abominable circumstance, and it grieves me and concerns me very deeply."
Carter made the remarks in Atlanta. He was interviewed in connection with his 85th birthday; the network plans to air more from the interview later.
The 39th president also predicted that Obama will be able to "triumph over the racist attitude that is the basis for the negative environment that we see so vividly demonstrated in public affairs in recent days."
The remarks seem sure to renew the controversy over South Carolina Rep. Joe Wilson's outburst that might otherwise have faded following passage of a House resolution Tuesday rebuking him for his affront to decorum by shouting "You lie!" at President Obama during an address to Congress last week.
Carter spoke directly to the Wilson matter and the 9/12 anti-government protests during a forum at the Carter Center in Atlanta, also on Tuesday.
"I think it's based on racism," Carter said of the tone of the opposition, in response to an audience question. "There is an inherent feeling among many in this country that an African-American should not be president."
Signs carried by protesters at the 9/12 anti-government march on Washington such as "we should bury Obama[care] with Kennedy, for instance, and Obama is a Nazi and Obama's pictures with Hitler's mustache on it -- those kind of things are not just casual outcomes of a sincere debate over whether we should have a national program in health care or not," the former president said. "It's deeper than that."
Wilson's son disputed Carter's characterization. "There is not a racist bone in my dad's body," Alan Wilson, who is running for attorney general in South Carolina, told the Associated Press. "He doesn't even laugh at distasteful jokes. I won't comment on former President Carter, because I don't know President Carter. But I know my dad, and it's just not in him."
White House strategists have been loathe to suggest that Americans don't have legitimate policy concerns as the nation emerges from the worst economic crisis since the Great Depression. White House spokesman Robert Gibbs on Sunday brushed aside suggestions that Saturday's protests against Obama were in any way racially motivated.
"I don't think the president believes that people are upset because of the color of his skin," Gibbs said on CNN's "State of the Union." "I think people are upset because on Monday we celebrate the anniversary of the Lehman Brothers collapse that caused a financial catastrophe unlike anything we've ever seen."
Communications director Anita Dunn echoed his remarks, telling The Washington Post this week that race "is less a part of it than some other people might think."
Carter's comments seem sure to revive the question as a point of controversy. Republican National Committee chairman Michael Steele on Wednesday called for a direct response from the president to Carter's remarks, accusing Democrats of "playing the race card ... from the bottom of the deck."
"As the leader of the Democratic Party President Obama should flatly reject efforts by those in his Party...to inject race into our civil discourse in ways that divide, not unite, Americans," he said.
CHARLOTTE, N.C. Rep. Tricia Cotham of Mecklenburg County has helped bring the “Help is Here Express” bus tour to Charlotte next week as part of an effort to assist uninsured and financially-struggling North Carolinians.
The bus tour will be in Charlotte on Wednesday September 16, 2009 along with American TV icon and former “Leave It To Beaver” star Jerry Mathers, stopping at Eastland Mall from 2–5 pm. The “Help is Here Express” is equipped with computer terminals and mobile phones so people can find out if they may be eligible for help paying for their medicines. There will be assistants aboard to make the application process quick and easy.
“The benefit of this program is undeniable,” Rep. Cotham said. “The “Help is Here Express” has already helped millions of North Carolinians across the state and I am proud to play even just a small role in their valiant efforts”.
To date, the PPA has helped nearly 6 million people across America, including more than 231,000 patients in North Carolina. Since its launch in April 2005, the PPA bus tour has visited all 50 states and more than 2,000 cities to raise awareness about patient assistance programs. The “Help is Here Express” is staffed by trained specialists able to quickly help uninsured patients access information on more than 475 patient assistance programs, including nearly 200 programs offered by pharmaceutical companies. When the “Help is Here Express” moves on, patients can visit PPA’s easy-to-use Web site (www.pparx.org) or call the toll-free phone number (1-888-4PPA-NOW) where trained operators field calls in 150 languages.
Rep. Cotham is an on-leave school administrator and teacher in her second term representing District 100 in Mecklenburg County. She is chair of the Education Subcommittee on Pre-School, Elementary and Secondary Education and vice chair of the Education and Juvenile Justice committees.
By LAURIE KELLMAN - Associated Press Writer
WASHINGTON -- In an extraordinary breach of congressional decorum, a Republican lawmaker shouted "You lie" at President Barack Obama during his speech to Congress Wednesday.
Rep. Joe Wilson, R-S.C., tried to call Obama to apologize in person, but ended up speaking to White House chief of staff Rahm Emanuel.
The contrite congressman, "expressed his apologies" to Emanuel, not the president at whom he had shouted a few hours earlier, Wilson's office said.
By that time, Wilson's House Web site had crashed and he had taken a brutal beating on his Twitter page for breaching protocol and good manners during a presidential speech to a joint session of Congress.
"This evening I let my emotions get the best of me," Wilson said in a statement. "While I disagree with the president's statement, my comments were inappropriate and regrettable. I extend sincere apologies to the president for this lack of civility."
Wilson's outburst came after Obama said that extending health care to all Americans who seek it would not mean insuring illegal immigrants.
"You lie!" Wilson shouted from his seat on the Republican side of the chamber.
Republicans froze, with several looking in Wilson's direction.
House Speaker Nancy Pelosi directed a fierce frown at him; first lady Michelle Obama pursed her lips and shook her head from side to side. Vice President Joe Biden looked down and shook his head, too.
Obama, meanwhile, looked toward the outburst and replied, "That's not true," and went on with his speech.
Right away, Wilson seemed to sense that he had fouled up. Wilson appeared to consult his Blackberry for much of the rest of Obama's speech. He shook his head defiantly after several of the president's statements. When Obama finished, Wilson bolted from the chamber.
Wilson's wasn't the only interruption during Obama's speech, but it was the most notable.
Obama's Republican rival from last year's presidential race for the White House defended the president.
Wilson's behavior was "totally disrespectful," Sen. John McCain, R-Ariz., said on CNN. "There is no place for it in that setting, or any other, and he should apologize for it immediately."
House Majority Leader Steny Hoyer, D-Md., said "I have never in my 29 years heard an outburst of that nature with reference to a president of the United States speaking as a guest of the House and Senate."
"It was a shameful act," he told WTOP radio.
Hoyer said he'll work with GOP lawmakers to decide whether to punish Wilson.
___
Associated Press writer Ben Evans contributed to this report.
Important Briefing From Insurance Commissioner Wayne Goodwin
September 9, 2009
RALEIGH -- More than 240 days have elapsed since I took the oath of office as North Carolina’s first new Insurance Commissioner since 1985. But now that the 2009 Legislative session has come to an end, I wanted to take a few minutes to update you on several issues.
I am very proud to say that I have kept North Carolina’s auto insurance rates the lowest in the South. In July, I settled several years of auto insurance rate cases and rolled back auto insurance rates to pre-2006 levels, froze them through 2011, and ordered $50 million in refunds to more than 1 million policyholders. Overall, North Carolina consumers will now enjoy estimated savings of $545 million on their auto insurance rates.
Dominating my time has been the dogged and determined pursuit of an equitable, lasting legislative solution to the coastal insurance crisis. North Carolina needed action and insurance certainty to avoid the homeowners’ insurance availability crisis that has stricken other states. As this package was developed, I successfully fought for the inclusion of pro-consumer measures that reduce deductibles, offer premium credits for mitigation statewide, allow voluntary installment payment plans, and require the insurance industry to give up the Beach Plan surplus of more than $800 million this year (and potentially more in future years) so that it’s used for policyholders, reinsurance and the like. That mandate on the insurance industry will help keep premiums down. Successful passage of this legislation has prevented a true homeowners’ insurance availability crisis across North Carolina, and accomplished one of the early goals of my administration.
Meanwhile, my work as a law enforcement officer fighting fraud and insurance crimes has resonated around North Carolina. With the worst national and state economy in 70 years, incidences of insurance and financial crimes are on the rise. My Department’s team of criminal investigators and sworn officers has collared criminals and resolved countless cases, sending criminals to jail and helping to reclaim upwards of $5.8 million for consumers victimized by insurance fraud in the most recent year alone. This is in addition to $10 million that my Consumer Services Division has recently reclaimed for individual citizens..
As Insurance Commissioner I’ve also helped lead the way in providing health insurance relief to North Carolinians laid off from small business employment. This new law will ensure that laid off workers, their families and their kids continue to have access to group health insurance in the same way as available to former employees of large businesses.
As insurance Commissioner and State Fire Marshal I have vigorously protected the needs and programs available for our fire, rescue and EMS personnel. Thus far I’ve protected grant funds for firefighters and other first responders statewide. Our valiant “hometown heroes” must be shielded from the effects of massive State and local budget cuts or they will be less able to protect our loved ones, our homes, our businesses, and themselves during times of crisis and catastrophe. My work on behalf of North Carolina’s first responders – more than 1,500 departments and approximately 50,000 volunteers and paid personnel – also translates into lower homeowner insurance premiums in your community. Furthermore, I successfully championed a measure that helps replenish their rosters of firefighters with junior volunteers.
And, my strong support of both the Seniors’ Health Insurance Information Program (SHIIP) and SafeKids of North Carolina continues.
I’ve also developed new and innovative ways of communicating with you and drawing public input. Among the changes I have implemented or improved upon as Insurance Commissioner are: requiring public comment periods during public hearings on insurance rate filings; posting the transcripts and, eventually, the audio from insurance rate filings on the Department’s website; offering an RSS feed, which allows anyone to receive instant notice of filings, important updates, and valuable information for consumers and companies; creating a more user-friendly, information-loaded DOI website; hosting regional, town-hall, public meetings all across the State; and, establishing a DOI Facebook page and a YouTube channel, thus allowing additional means of interaction with and notification of the public on insurance matters.
Finally, please note that my primary campaign mailing address has now changed to P.O. Box 27841, Raleigh, NC 27611-7841.
My campaign will have its First Annual Fall Fundraiser on September 30 at Raleigh's Center City Marriott, followed two days later by another event October 2 at the historic Grove Park Inn in Asheville. If you'd like more information about attending either of these gatherings, email me at info@waynegoodwin.org and we will get you the information. If you can’t attend one of these events but would like to help to help defray some of the political expenses that I incur in our outreach efforts, please feel free to mail a personal check to "The Goodwin Committee" at the address above or contribute online at www.WayneGoodwin.org. Don't forget to provide the contributor information such as address, employer, and profession. Your help is needed and much appreciated.
Thanks again for all of your support. I’m truly humbled to serve as our Insurance Commissioner.
Working together, our best days are yet to come.
http://www.thestate.com/local/story/934836.html
By JOHN O'CONNOR - joconnor@thestate.com
At least 60 of 73 S.C. House Republicans have signed a letter asking Gov. Mark Sanford to resign.
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PDF: Letter from S.C. House GOP to Gov. Mark Sanford
The letter follows Tuesday's call by House Speaker Bobby Harrell, R-Charleston, for the Republican governor to resign. In June, a majority of Senate Republicans signed a similar letter. Sanford has said he will not resign.
At a meeting last month in Myrtle Beach, no House GOP member spoke in Sanford's defense. Republicans control the House.
"The direction of the caucus leaving that meeting was unmistakable," Deputy Majority Leader Bruce Bannister, R-Greenville, said in a written statement. "Governor you have lost the support of legislators who have supported you through thick and thin."
The letter says Sanford's woes are a distraction that prevent other work from getting done.
Sanford has been under fire since a secret five-day trip to Argentina in June. Sanford later admitted an extramarital affair.
Lawmakers are weighing removing Sanford from office for abandoning his post. The State Ethics Commission also is looking into whether Sanford broke state law in his use of business-class airfare on state trade trips, use of the state airplane and other issues.
Rep. Nikki Haley, a Lexington Republican who is running for governor, did not sign the letter. Haley, a Sanford ally, said the letter is a waste of time considering Sanford has never indicated he would consider resigning.
“If and when the governor, the speaker, and the majority leader put together a letter that clearly lays out a positive agenda for the next year and a half, I'll be the first to sign it,” Haley said in a statement. “But that's the only list I intend to attach my name to - a list that is for and about the people of South Carolina and not just another example of the long tradition of political gamesmanship that has held our state and its citizens down for far too long”—
http://www.huffingtonpost.com/robert-reich/the-snowe-job-and-why-a-t_b_280533.html
September 9, 2009 | Huffington Post
Robert Reich
Former Secretary of Labor, Professor at Berkeley
I was just on the phone talking with a reporter for a national media outlet who referred to Senator Olympia Snowe's idea for a public option "trigger" as the "centrist position." Whoa. When the mainstream media start naming something as "centrist" the game is almost over because just about everyone with any authority in our nation's capital wants to be at the "center."
Let me back up a step. The public insurance option has become a lightening rod for Republicans, hate radio jocks, Fox News, the Wall Street Journal's editorial page, and lobbyists for the health-industrial complex who accuse the White House and Democrats of planning a "government takeover" of health care. Anything that has the word "public" in it is always an automatic target for their rants. But most Democrats understand that a public insurance option is essential to control healthcare costs and expand coverage -- both because private for-profit insurers now face so little competition in most markets that only the prod of a public option will force them to lower costs and extend coverage, and also because a nationwide public option would have the scale and authority to negotiate lower rates with drug companies and healthcare providers, thereby pushing private insurers to do the same.
The White House is looking for a way to be in favor of a public option but also get enough Blue Dog Democrats -- many of whom hail from swing districts and states, and therefore need some cover -- to vote for it. One such cover is a Republican Senator from Maine, named Olympia Snowe. If she votes for the bill, Blue Dogs can calm their constituents -- who have been worked up into a lather by the right -- by saying "you see? Even a prominent Republican senator is voting for this."
So will Snowe play ball? It depends. Her idea (evidently encouraged by Rahm Emanuel, the President's chief of staff) is to hold off on any public option. Give the private insurance companies a period of time -- say, five years -- within which to make changes that extend coverage to more people and also drive down long-term costs. If those goals for coverage and cost aren't met by end of the five-year grace period, kaboom: the public option is triggered -- which will force such changes on the insurance companies.
The beauty of Snowe's proposal is that it seems to offer Blue Dogs a way out and liberal Democrats a way in. Nobody has to vote for or against a public option. The public option just happens automatically if its purposes -- wider coverage and lower costs -- aren't achieved. And the trigger idea seems so, well, centrist.
The problem is twofold. First, it's impossible to design airtight goals for coverage and cost reductions that won't be picked over by five thousand lobbyists and as many lawyers and litigators even if, at the end of the grace period, it's apparent to everyone else that the goals aren't met. Washington is a vast cesspool of well-paid specialists who know how to stop anything resembling a "trigger." Believe me, they will.
Second, any controversial proposal with some powerful support behind it that gets delayed -- for five years or three years or whenever -- is politically dead. Supporters lose interest. Public attention wanders. The media are on to other issues. Right now the public option is very much alive because so many Democrats care deeply about it, with good reason. But put it off for years, and assign it to the lawyers and lobbyists I just mentioned, and you can kiss it goodbye for ever.
If the idea is to have a public option waiting in the wings in case private insurers blow it, why wait for it at all? If it gets lower costs and wider coverage, it should be included right from the start.
What worries me isn't just that the mainstream media are calling Snowe's trigger "centrist," but that the White House might see it as an easy out. "I continue to believe that a public option within that basket of insurance choices would help improve quality and bring down costs," the President said Monday. Fine. But he hasn't yet said the public option is essential. He hasn't threatened to veto a bill lacking it. There's even reason to believe the White House has quietly encouraged Olympia Snowe to pursue her "trigger."
The best way to give Blue Dogs cover is for the President to explain clearly and boldly why the public option is essential to health care reform, and why he's ready to veto any bill that doesn't include it. That's also the only way to give the nation a good chance of getting true health care reform. Hopefully, that's what he'll do Wednesday evening.
Otherwise, we get a trigger to nowhere.—
http://www.latimes.com/business/la-fi-insure4-2009sep04,0,4654309,full.story
September 4, 2009 | Los Angeles Times
By Lisa Girion
California Atty. Gen. Jerry Brown is joining state regulators in scrutinizing the payment practices of seven major health plans in response to complaints from physicians and hospitals.
California Atty. Gen. Jerry Brown is joining state regulators in scrutinizing how HMOs review and pay insurance claims submitted by doctors, hospitals and other medical providers.
His announcement came Thursday as regulators said they had stepped up scrutiny of the payment practices of the state's seven largest health plans in response to complaints from physicians and hospitals.
The increased attention also comes on the heels of a first-of-its-kind report issued this week that said the California health insurers reject 1 in 5 medical claims.
Six of the state's largest insurers rejected 45.7 million claims for medical care, or 22% of all claims, from 2002 to June 30, 2009, according to the California Nurses Assn.'s analysis of data submitted to regulators by the companies.
The rejection rates ranged from a high of 39.6% for PacifiCare to 6.5% for Aetna for the first half of 2009. Cigna denied 33%, and Health Net 30%.
Anthem Blue Cross, the state's largest for-profit health plan, and Kaiser, the state's largest nonprofit plan, each rejected 28% of claims.
Blue Shield, a nonprofit with 3.4 million California members, is the only large health plan that does not report claims-denial figures in its annual report to the state Department of Managed Health Care.
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SIDEBAR: HMOs claims-rejection rate: a breakdown
http://www.latimes.com/business/la-fi-insurebox4-2009sep04,0,7110120.story
September 4, 2009 | LAT
Rejecting medical claims
California's top health plans reject an average of 1 in 5 claims for treatment -- 45.7 million claims over the last seven years. Here's how their rejection rates compared during the first six months of 2009:
PacifiCare: 39.6%
Cigna: 33%
Health Net: 30%
Anthem Blue Cross: 28%
Kaiser Permanente: 28%
Aetna: 6.5%
Blue Shield: Data not available
Source: California Nurses Assn.
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State health plans say claims often are denied because they are duplicates, because patients are no longer members, and because a particular treatment is not a covered benefit.
An industry representative also cautioned that claim rejections do not always equate to actual denials of treatment to patients, and claims may be denied for a number of legitimate reasons.
As for Brown's investigation, "We believe that the attorney general's office will learn that the California Nurses Assn.'s mischaracterization of health plan claims data does not accurately reflect denials of care for consumers or widespread denials of insurance coverage," said Nicole Kasabian Evans, spokeswoman for the California Assn. of Health Plans. "It appears that a good deal of the so-called denials are merely paperwork issues," she said.
Brown's office said that his deputies would soon review records and complaints.
"These high denial rates suggest a system that is dysfunctional, and the public is entitled to know whether wrongful business practices are involved," Brown said.
Doctors complain that too often insurers delay, shortchange or deny legitimate claims.
"Getting health insurers to pay their fair share of medical claims can be as much of a headache for physicians as it is for patients," said Rebecca Patchin, an anesthesiologist at Loma Linda University and board chairwoman of the American Medical Assn. She said each insurer has a different set of "obscure, bureaucratic rules for processing and paying medical claims" that result in as much as $210 billion of "unnecessary cost" annually, studies have shown.
Don DeMoro of the nurses association said he was told a couple of years ago that denial data weren't collected. Recently, however, researchers stumbled across them in a section of the annual reports that insurers file with the Department of Managed Health Care.
Harvey Rosenfield, founder of Consumer Watchdog, a Santa Monica-based advocacy group, criticized the department for failing to publicize the information.
"There is no more important information to the consumer than whether they can rely on their health insurance company or HMO to give them the treatment they need," Rosenfield said.
The department pointed out that the annual reports are posted on the Web. It also said that most denied claims don't involve patients.
"It's important to point out that a denied claim means that the patient received the medically necessary services, but the doctor or hospital was not paid for that care," said Lynne Randolph, spokeswoman for the Department of Managed Health Care. "The department has been very active in ensuring that providers of care should be paid fairly and on time."
Randolph said the department's provider complaint unit has obtained almost $20 million in disputed claims payments for physicians since 2005.
PacifiCare, the Cypress-based subsidiary of UnitedHealthcare Group, ranked highest in the state for claims denied in the first half of 2009. It has been the subject of considerable scrutiny for its claims-handling practices.
The HMO paid $3.5 million in fines last year for claims payment problems, and the department is conducting a follow-up examination.
"We still do get frequent complaints about PacifiCare, and obviously the numbers in the California Nurses Assn. report backed that up," Randolph said. "We do expect we will be taking some further action."
PacifiCare also faces a hearing this year over state Department of Insurance allegations of 133,000 violations of claims-handling laws that could result in as much as $1.33 billion in fines.
PacifiCare said it has been cooperating with both inquiries and had already corrected most of the identified problems, which it described as technical. The insurer said its claims-denial rate was higher than average because of its unique business model.
"It doesn't truly reflect an impact on the consumer," said PacifiCare spokesman Tyler Mason.
PacifiCare said it delegates the financial responsibility for many of its members' care to physician groups. As a result, many of the denials involve confusion over whether the HMO or the physician groups are responsible for paying certain types of claims. But, the HMO said, consumer bills usually get paid.
Similarly, Woodland Hills-based Health Net said many of its denials were ultimately covered by physician groups that care for patients in exchange for set monthly fees from the insurer.
Cigna spokesman Chris Curran said that, nationwide, the Philadelphia-based insurer approves "more than 99% of eligible claims for care that the doctor recommends."
A spokesman for Oakland-based Kaiser Permanente said the reported denials were not a reflection of the vast majority of care provided within the HMO's network.
Blue Shield defended its failure to break out claims denials in its annual report.
"We've reported the data this way for years, and the [Department of Managed Health Care] has never asked for any additional information," said spokesman Aron Ezra. "We're more than happy to break out the information differently if the [department] requests it from us."
A spokeswoman said the department has requested the information, which it expects the Chicago insurer to provide.
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FOR THE RECORD:
HMO probe: An article in Friday's Business section about California Atty. Gen. Jerry Brown's joining state regulators in inspecting the claims practices of seven major health maintenance organizations called Blue Shield a Chicago insurer. The Blue Shield plan mentioned in the article is Blue Shield of California, which is based in San Francisco. —
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lisa.girion@latimes.com
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http://www.sfgate.com/cgi-bin/blogs/ybenjamin/detail?entry_id=46985
September 05 2009 | SFGate's 'City Brights' blog
Death panels are very real in California & looking for denial stories
Yobie Benjamin
About a month ago Sarah Palin claimed that the insurance reform bill making its way through Congress had provisions for death panels to deny health benefits for grandma. Well, there is NO SUCH provision in any bill that is making its way through any committee in the house or senate.
But it turns out there are real death panels in my state of California. Health insurance companies companies operating in California are required by state law to truthfully submit data on denied claims to the California Department of Managed Care.
Data reported by the insurers to the California Department of Managed Care from 2002 through June 30, 2009 revealed that six of the largest insurers operating in California rejected 47.7 million claims for care or 22 percent of all claims.
More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers.
The denials by insurance companies are REAL DEATH PANELS and it's not only for grandma. These insurance industry death panels make decisions to deny care for men, women, children, babies, old people and young people.
There are hundreds of cases wherein care was denied and people died.
The data will be formally presented by Don DeMoro, director of California Nurses Association's research arm, the Institute for Health and Socio-Economic Policy, at CNA's biennial convention next Tuesday, Sept. 8 in San Francisco. The convention will also feature a panel presentation from nurse leaders in Canada, Great Britain, and Australia discussing the myths about their national health care systems.
For the first half of 2009, the rejection rates are deeply disturbing. Claims denial rates for the first six months of 2009:
* PacifiCare -- 39.6 percent
* Cigna -- 32.7 percent
* HealthNet -- 30 percent
* Kaiser Permanente -- 28.3 percent
* Blue Cross -- 27.9 percent
* Aetna -- 6.4 percent
If you don't think that every claim denied represents a real human who is sick, you'd have to be crazy. "Every denial has real and sometimes fatal consequences," said Deborah Burger, RN, CNA co-president.
The California Nurses Association cited some cases from its research:
PacifiCare, for example, denied a special procedure for treatment of bone cancer for Nick Colombo, a 17-year-old teen from Placentia, Calif. Again, after protests organized by Nick's family and friends, CNA/NNOC, and netroots activists, PacifiCare reversed its decision. But like Nataline Sarkisyan, the delay resulted in critical time lost, and Nick ultimately died. "This was his last effort and the procedure had worked before with people in Nick's situation," said his older brother Ricky.
Cigna gained notoriety two years ago for denying a liver transplant to 17-year-old Nataline Sarkisyan of Northridge, Calif. and then reversing itself, tragically too late to save her life.
In 2008, six days before RN Kim Kutcher of Dana Point, Calif., was scheduled to have special back surgery, Blue Cross denied authorization for the procedure as "investigational" even though the lumbar artificial disc she was to receive had FDA approval. At the time of denial, which she calls "insurance hell," Kutcher had "already gone through pre-op testing, donated a unit of blood, had appointments with four physicians." Kutcher paid $60,000 out of pocket for the operation and is still fighting Blue Cross.
Rejection of care is a very lucrative business for the insurance giants. The top 18 insurance giants racked up $15.9 billion in profits last year.
By David Brown
Washington Post Staff Writer
Wednesday, September 9, 2009
With pandemic influenza cases on the rise across the country, federal public health authorities on Tuesday urged physicians to prescribe antiviral medicines to high-risk patients promptly but reminded the public that most people won't need, and shouldn't expect to get, the drugs if they come down with the flu.
The guidance is aimed at getting optimal benefit from Tamiflu and Relenza while preventing overuse, hoarding and shortages of the drugs, as was seen briefly during the spring outbreak of swine flu.
Specifically, authorities said, practitioners shouldn't wait for lab tests to confirm the presence of the novel strain of the H1N1 virus before starting antivirals in high-risk patients who show symptoms of flu. The drugs work best when started within 48 hours of illness.
"We think that [time] window is very important," said Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.
She added, however, that "the majority of adolescents and adults and most children won't need antiviral treatment and can be cared for with Mom's chicken soup at home."
About 70 percent of people hospitalized with the new flu strain have had conditions such as pregnancy, diabetes or emphysema that put them at risk for serious complications. For such people, treatment with an antiviral drug if they show signs of flu is "generally recommended," Schuchat said during a telephone news conference.
Doctors should also consider giving preventive treatment to high-risk patients who have been exposed to someone with the flu. However, in a change from the guidance this spring, the CDC now says it is also acceptable for practitioners to watch such patients carefully and prescribe an antiviral only if a fever develops.
By Ann Scott Tyson
Washington Post Staff Writer
Wednesday, September 9, 2009
Defense Secretary Robert M. Gates said in an interview broadcast this week that the United States would not repeat the mistake of abandoning Afghanistan, vowing that "both Afghanistan and Pakistan can count on us for the long term."
In his first interview with the al-Jazeera television network, Gates said the United States made a "serious strategic mistake" by turning its focus away from Afghanistan after Soviet occupation forces were defeated there two decades ago.
"As soon as the Soviets left Afghanistan, we turned our backs on Afghanistan and we did not cultivate our relationship with the Pakistanis properly," he said, noting that U.S. decisions at the time sparked doubts about Americans' commitment to the region. "I believe we've learned our lesson."
Gates's remarks come as he and other American officials weigh whether to deploy more U.S. troops to Afghanistan. The defense secretary said he remained undecided on the issue.
"There are issues on both sides of [the argument] and, frankly, I haven't made up my own mind at this point in terms of whether more forces are needed," Gates said, according to a transcript of his 45-minute interview.
Gates was scheduled to meet with President Obama on Tuesday to briefly discuss the assessment given to him last week by the top U.S. commander in Afghanistan, Gen. Stanley McChrystal, Pentagon officials said. The officials added that Gates has received comments on the assessment from senior military leaders including Adm. Michael Mullen, the chairman of the Joint Chiefs of Staff, and Gen. David H. Petraeus, head of U.S. Central Command, and plans to present his own detailed views to Obama later this week.
Gates acknowledged in the interview with al-Jazeera that the heavier fighting and growing number of casualties in Afghanistan have weakened public support for the war. "There is a sort of war awareness on the part of the American people," Gates said.
He added, though, that the possibility of withdrawal is out of the question.
The U.S. military recognized as early as 2005 and 2006 that violence was escalating in Afghanistan, Gates said, but was unable to bolster forces there because of U.S. troop commitments in Iraq. "We have to speak frankly: Because of the troop commitments in Iraq, we didn't have the resources to move in reinforcements . . . as the situation in Afghanistan began to deteriorate," he said.
Gates explained that he did what he could after taking office in January 2007, extending one Army brigade in Afghanistan and adding a second brigade that spring. "That was really about all the resources that we had at that time," he said. "As we have drawn down in Iraq, more capability has become available."
By Robert Barnes
Washington Post Staff Writer
Wednesday, September 9, 2009
Justice Sonia Sotomayor officially took her seat as the Supreme Court's 111th member Tuesday in a tradition-filled ceremony witnessed by President Obama, Vice President Biden, and scores of lawmakers, judges, family members and friends.
Sotomayor took her judicial oath and joined the court on Aug. 8, soon after her Senate confirmation. But Tuesday's investiture ceremony was the first time she joined her eight colleagues in the court's historic chambers, with its marble columns and burgundy draperies.
She sat in the early-19th-century black leather chair once used by Chief Justice John Marshall, the court leader who established the court's authority as the final say on constitutional matters. Chief Justice John G. Roberts Jr. administered the judicial oath, and she swore to "do equal right to the poor and to the rich" with her hand on a Bible signed by every justice who has served in the past 100 years.
Clerk of the Court William K. Suter read the antique language of the president's commission: "Know ye that reposing special trust and confidence in the Wisdom, Uprightness and Learning of Sonia Sotomayor of New York, I have nominated and by and with the advice and consent of the Senate do appoint her an Associate Justice of the Supreme Court of the United States."
Sotomayor, 55, wore a new black robe given by her former law clerks and a bright white jabot that was a gift from the court's other female member, Ruth Bader Ginsburg.
"We wish for you a long and happy career in our common calling," Roberts said at the conclusion of the four-minute ceremony.
"Thank you," Sotomayor replied. She then took the traditional seat for the court's junior justice, all the way to the chief justice's left.
Among those in the courtroom: White House staff members who had worked for her confirmation; judges from the U. S. Court of Appeals for the 2nd Circuit in New York and around the country; several rows of senators who had voted to confirm her; the man she replaced, recently retired Justice David H. Souter; and entertainer Ricky Martin.
The mood was more festive outside the court, where a small crowd cheered when she and Roberts, having shed their robes, took the traditional walk down the court's white marble steps. Roberts left her for a moment in the spotlight by herself as photographers clicked away. She resisted appeals from reporters -- delivered in both English and Spanish -- that she make remarks.
"Tell me when you've had enough," she told reporters with a smile. After posing with her mother, stepfather, brother and sister-in-law, she waved and accompanied them inside, where a private reception waited.
"Bye, guys," she said.
The court's first Latina and third woman will participate in her first hearing Wednesday, when justices hear arguments about the constitutionality of federal and state laws that restrict the role of corporations in election campaigns.
After she spent much of her confirmation hearings pledging respect for the court's precedents, her first decision will be whether two of the court's decisions on the subject should be overruled.
