Tag Archives: Fraud

Predatory Health Care

Lynne Murray says:

I am very proud of Marilyn Wann, Linda Bacon and many other fat activists whose refusal to shut up and be stigmatized has made it possible for the New York Times to seriously consider Health at Every Size in light of the way fat people have been demonized in debates on health care.

James Morone, a professor of political science and urban studies at Brown University makes a very good point (in the article linked above) that, “The best philosophical way to stop national health insurance is to say we’re not a community, it’s ‘us vs. them.’ ”

This past week I had a long conversation with a friend, who has given me permission to share an encounter she and her father, who is in his 90s, had with a predatory health marketing organization. He lives in a retirement community and she handles most of his financial affairs. She often receives anxious phone calls when her father is targeted by telephone or mail marketers disguised as official representatives. Sometimes she will visit to find that a telemarketer has duped him into signing up for some service that he did not understand. But this was different.

Her father worked for many years for a company that offered generous health care for retirees. He trusted the company and suddenly they seemed to be telling him that he would lose his insurance coverage. She’s been working to get all the documentation sent to her but her father got a scary notice that suggested his coverage might end if he didn’t sign up for a new option. The 800 number on the letter was the same as the one on his health care documentation but she couldn’t get a clear answer from their customer service.

I should mention that my friend has legal training.  She and I read the letter over and over many times before we realized that nowhere in it did it say, “Sign up for this OR you’ll lose your coverage.” Essentially it said, “You must sign up for this within two weeks.  You can always go back to regular Medicare if you don’t like it.”

As a student of words, I have to say that letter was state of the art coercive sales tactics. My friend and I decided that the lawyers had examined it carefully too, because it skated very close to threatening but never crossed the line.

There was a small-print sentence, “Sent by XYZ.” We did a little research and found that the company my friend’s father worked for had outsourced their benefits program to XYZ, and XYZ’s website once we found it, offered ways to cut cost on benefits. My friend is still researching it, but the option they were pushing on her father appears to be the controversial Plan D drug coverage option, which has been a fertile field for many scams, and evidently November is “Scam Season.”

This case doesn’t appear to be an outright fraudulent scam, but so far our best guess is that if her father had been intimidated into signed up for it, it that would mean more money for the insurer, and (in her father’s case) little or no savings compared to his current cost of prescription drugs.

What angered my friend, and me too, is how this sophisticated marketing effort is targeting seniors who are most vulnerable.