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KCWolfman
09-30-2009, 02:04 AM
http://www.foxnews.com/politics/2009/09/29/obamas-health-care-horror-story-inaccurate/

WASHINGTON -- One of President Barack Obama's health care "horror stories" is about a woman who, he says, lost her health insurance on the verge of breast cancer surgery because she didn't disclose a case of acne to the insurer. That's not what happened.

Robin Lynn Beaton, 59, of Waxahachie, Texas, indeed had her insurance suspended and then terminated when she needed it the most. Hers is a cautionary tale about how an insurance company can act in a seemingly arbitrary manner to revoke coverage for lifesaving treatment.

But not for the reasons Obama cites.

She "was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne," he said in one telling.

Beaton did not lose her insurance because she failed to own up to a skin problem in her past. She lost it because, when enrolling in the plan, she had not reported a previous heart condition and did not list her weight accurately.

Obama tells stories of real-life hardships repeatedly, in his speech to a joint session of Congress, in interviews and at his citizen meetings across the country in support of his campaign to rework medical insurance. Beaton's case is just one cited by Obama that mixes fact with fiction.

In reflexively blaming insurance companies, Obama is playing into fears that have become a frightening reality for many Americans. Health insurance under the current system is not always the rock-solid guarantee you think you're paying for.

Especially, it turns out, when you don't fill everything out just right.

In Beaton's case, the insurance company opened an investigation after her visit to a dermatologist and just before her scheduled breast cancer surgery, forcing postponement of her operation almost on the eve of it. The earlier problems on her enrollment form were discovered and her coverage was canceled.

To some lawmakers, that's outrageous enough -- never mind the acne story.

Rep. Joe Barton, Beaton's Republican congressman in Texas, fought the insurer until it restored her coverage, enabling her to get the surgery 10 weeks after it was postponed. She told The Associated Press she owes Barton and his aides her life.

But somewhere along the way, Beaton's case became a White House tale of an insurer canceling coverage because she forgot to report acne.

It's become a political imperative to find real-life examples of people helped or hurt by the issue of the day. People relate more easily to a story than to abstract policy.

But such stories often suffer in the retelling. Corners are cut, complicated situations made sound-bite simple.

It has long been so. Ronald Reagan's "welfare queen" was a politically expedient exaggeration of a real case of welfare fraud. In last year's presidential campaign, scrutiny revealed that Joe the Plumber was likely to benefit from Obama's tax plans, not be hurt by them as Republicans alleged.

Even in his painstakingly prepared speech to Congress, Obama got some material facts wrong.

He said an Illinois man died because his insurance company found an undisclosed case of gallstones in his past, canceled his insurance and delayed a stem-cell transplant for his cancer. The man did lose his insurance, but got it back retroactively and had treatment that his family says extended his life for nearly four years.

Beaton opened an antique shop after retiring as a nurse, and in December 2007 signed up for individual insurance from Blue Cross and Blue Shield of Texas.

She says she thought nothing of a fast-heartbeat episode that had prompted an earlier doctor's visit, and the resulting heart medication she stopped taking two years ago, and did not report that on the enrollment form.

The form asks applicants to list heart conditions and a wide variety of other conditions experienced in the past 10 years, any physician consultations in the last five years, any medication taken in the last year, and more.

Also, Beaton said in an interview, "I wrote down like five pounds less than I weighed," joking that's the sort of mild rounding down that many women do. She is not obese.

In the spring of 2008, Beaton visited a dermatologist. "My face began to break out," she said. "All it was, truly, honestly, was pimples."

The doctor diagnosed mild rosacea, sometimes called adult acne, and seborrheic keratosis, a benign and common skin growth.

Beaton says the visit nevertheless raised a red flag because a notation in her records was misconstrued as meaning precancerous.

Beaton says she's convinced "the acne is what started everything," meaning the insurance company scrutiny. Because she'd had her insurance for months, the acne was not a pre-existing condition that could have imperiled her policy.

Whatever the case, her breast cancer diagnosis that quickly followed surely would have prompted a similar review of her files.

On the Friday before her cancer surgery, she was told her insurance company was opening the investigation and would not pay for her operation before that was concluded, she said. That suspended the surgery.

"They searched high and low for a reason to cancel me," she said.

The insurer retrieved records from a cardiologist pointing to her unreported heart condition. Then, in an Aug. 22, 2008, letter, the company listed four questions it said she answered inaccurately on her form and a fifth that was insufficiently addressed.

As a result, wrote the insurer, "your coverage is rescinded as of 12/04/07, the original effective date of your policy."

Barton's aides in Texas and Washington had been trying to get Beaton's insurance restored since its suspension in July, without success. But five days after it was finally canceled, Barton called the company president directly, said the lawmaker's spokesman, Sean Brown.

Among the points raised: The possibility of a news conference drawing attention to the case. Barton also said he might name a bill after Robin Beaton.

Four hours later, Barton said, he got a call saying her insurance would be reinstated.

The lawmaker acknowledges Beaton misreported her weight and did not disclose a prior heart problem. But it was wrong, he said, for her coverage to be canceled when she desperately needed treatment for a disease unrelated to those matters.

"To be denied coverage right before potentially lifesaving surgery quite frankly is something that no human being should have to undergo," he said.

Barton is a conservative who is no fan of Obama's health care plans. Still, he's pushing legislation to preserve insurance for people like Beaton when they need treatment for a serious illness that's not related to undisclosed conditions on their sign-up form.

Beaton had her surgery in October 2008, by which time, she said, her tumor had tripled in size.

Clinging to her restored insurance, she is undergoing regular chemotherapy and says she needs back surgery, hip replacement and another round of breast reconstruction.

Did his fact checkers fail to do their work, or did he deliberately misrepresent? Either way, I am disturbed at a bunch of people screaming at insurance companies to stop spreading false statements creating their own misrepresentations.

If they can't get it right now, God knows they won't be able to get it right when the bill is passed.

KCWolfman
09-30-2009, 02:07 AM
This dumb woman lied to insurance companies about her weight and a previous heart condition to get lower rates.

Instead of someone saying, "You know, that is a stupid thing to lie about when it comes to your health" we have a POTUS using her as a poster child against the evil insurance companies.

Saggysack
09-30-2009, 02:29 AM
Woman stands by her account of lost coverage
http://www.star-telegram.com/health/story/1645319.html

By ANNA M. TINSLEY
Despite questions being raised about her battle over health insurance, Robin Lynn Beaton is sticking by her assertion that she lost her health insurance because of acne because that is the condition that initially flagged her medical chart for review by her insurance provider.

True, that review later showed she had a heart condition that she hasnít reported (because she said she no longer had the condition) and indicated she wrote down the wrong weight, about five pounds lighter than she truly was.

But she said that review was triggered because during a 2008 trip to a dermatologist, for acne, that medical personnel wrote a word on her medical chart that could indicate she was precancerous.

"I lost my insurance because of the acne," said Beaton, whose case has been chronicled repeatedly in the Star-Telegram. "If it hadnít been for the acne, they wouldnít have red-flagged the case. And I would have had the surgery as planned.

"The acne is what started the ball rolling," she said. "That is exactly what happened."

Beaton has testified before members of Congress and given many interviews to publications nationwide about her situation.

She said she feels terrible that some news reports are suggesting that President Barack Obama, who publicly spoke about her case, has misstated why she lost her health insurance before her scheduled mastectomy.

"They are trying to discredit the president of the United States," she said. "Thatís really rotten . . . He hasnít tried to do anything but help people like me."

KCWolfman
09-30-2009, 02:56 AM
Woman stands by her account of lost coverage
http://www.star-telegram.com/health/story/1645319.html

By ANNA M. TINSLEY
Despite questions being raised about her battle over health insurance, Robin Lynn Beaton is sticking by her assertion that she lost her health insurance because of acne because that is the condition that initially flagged her medical chart for review by her insurance provider.

True, that review later showed she had a heart condition that she hasn’t reported (because she said she no longer had the condition) and indicated she wrote down the wrong weight, about five pounds lighter than she truly was.

But she said that review was triggered because during a 2008 trip to a dermatologist, for acne, that medical personnel wrote a word on her medical chart that could indicate she was precancerous.

"I lost my insurance because of the acne," said Beaton, whose case has been chronicled repeatedly in the Star-Telegram. "If it hadn’t been for the acne, they wouldn’t have red-flagged the case. And I would have had the surgery as planned.

"The acne is what started the ball rolling," she said. "That is exactly what happened."

Beaton has testified before members of Congress and given many interviews to publications nationwide about her situation.

She said she feels terrible that some news reports are suggesting that President Barack Obama, who publicly spoke about her case, has misstated why she lost her health insurance before her scheduled mastectomy.

"They are trying to discredit the president of the United States," she said. "That’s really rotten . . . He hasn’t tried to do anything but help people like me."

She didn't lose it because of the acne. She lost it because she failed to report her health accurately. What she is saying is that if she didn't have acne, they wouldn't have caught in her lies.

Paint it anyway you want, the insurance company released her due to falsification of records. Had she been honest, her premiums may have been higher, but she would have been covered.

KCWolfman
09-30-2009, 03:05 AM
More importantly, had the fact finders for the POTUS actually checked both sides of the story, they would have had all the info. Trusting one side of an embittered battle is just foolish.

Saggysack
09-30-2009, 03:43 AM
She didn't lose it because of the acne. She lost it because she failed to report her health accurately. What she is saying is that if she didn't have acne, they wouldn't have caught in her lies.

Paint it anyway you want, the insurance company released her due to falsification of records. Had she been honest, her premiums may have been higher, but she would have been covered.

You know what they say about stories and what lies between them?

We can draw our own conclusions and we still wouldn't know half of it. But go ahead and claim you're the expert here from reading a FauxNews puff piece.

Being off from your weight by 5lbs isn't a lie. It's what lies between toilet visits.

Her testimony...
In May 2008, I went to the dermatologist for acne. A word was written on my chart and interpreted incorrectly as meaning pre-cancerous. Shortly thereafter, I was diagnosed with Invasive HER-2 Genetic Breast Cancer, a very aggressive form of breast cancer. I was told I
needed a double mastectomy. When the surgeons scheduled my surgery I was pre-certified for my two days hospitalization. The Friday before the Monday I was scheduled to have my double mastectomy, Blue Cross red flagged my chart due to the dermatologist report. The dermatologist
called Blue Cross directly to report that I only had acne and please not hold up my coming surgery. Blue cross called me to inform me that they were launching a 5 year medical investigation into my medical History and that this would take approximately 3 months.

I was frantic. I did not know what to do or where to turn. I knew I could not pay for the surgery myself. Shortly thereafter I turned to my Congressman Joe Barton for help. Mr. Barton and Christy Townsend worked tirelessly to help me.

Next, I found out that my insurance was completely cancelled; this was devastating. I had to completely refocus on what to do where to turn because my insurance cancelled me. Cancer is expensive and no one wanted to pay for it. This is America and we deserve good Health Care.

Earlier in my life off and on I had a fast beating ofmy heart which was not a current problem, just something that happened when I was upset. I truly did not even think about this when I applied for insurance; I even offered to go take a physical they said no.

The sad thing is Blue Cross gladly took my high premiums and the first time I filed a claim and was suspected of having cancer they searched high and low for a reason to cancel me. There is a nurse who attends my church who works fulltime for Blue Cross and all she does is read medical records looking for reasons to cancel people. After she heard what happened to me,
she told me how very sorry she was.

Blue Cross will do anything to get out of paying for cancer. Another sad fact is anyone who has a catastrophic illness who is not part of a group stands a great chance of being left out in the cold without insurance.

KCWolfman
09-30-2009, 04:47 AM
She has done her own fair share of drawing conclusions.

Blue Cross will do anything to get out of cancer cases.

I promise Utility Review nurses sole job are not to find ways out of contracts. I have worked with many URN's over the course of 20 years and none have stated thus.

If it was "just five pounds" why lie about it? You are taking the word of a woman who "Forgot" she needed medication to control a "forgotten" heart condition. I honestly would have to see written records proving the weight was off by just 5 pounds. If she had the policy for more than 2 months, the variance of poundage from reported to current status is actually a great deal larger than 5 pounds.

The woman is bitter and was busted.

KCWolfman
09-30-2009, 04:52 AM
And as far as attack the source, the same story was reported on yahoo.news, the charlotte observer, and the fort mill times.

Just because Fox News printed the article does not mean they are the author. The byline is actually the AP.

I would have looked in the NY Times for validity for you libbies, but they are just now reporting the ACORN scandal on page 45 hoping for it to die down first.

KCWolfman
09-30-2009, 04:57 AM
Even more atrocious is the story of the Illinois man reported dead because his insurance was canceled in the same byline. His insurance reviewed his case, reinstated his insurance and his family said he lived another 4 years solely because of the insurance company's actions with his provider.

Beaton is a former nurse, retired. She knew she could get lower rates if she fudged on her application. When she says "earlier in my life" regarding the time she took meds for her heart condition she meant a scant two years ago. She forgot over the course of two years that she needed meds to live properly due to a heart condition. I am sure it just slipped her mind.

J Diddy
09-30-2009, 05:42 AM
More importantly, had the fact finders for the POTUS actually checked both sides of the story, they would have had all the info. Trusting one side of an embittered battle is just foolish.

I'm not 100% convinced that's not what you're doing.

***SPRAYER
09-30-2009, 05:51 AM
I'm not 100% convinced that's not what you're doing.

Riiiiiiiiight because B.O.'s integrity has been so impeccable.

:drool:

KCWolfman
09-30-2009, 06:06 AM
I'm not 100% convinced that's not what you're doing.

Honestly, there are reasons to be embittered about this particular case. The fact that BC/BS could have denied her for facts unrelated to her pre-existing conditions. I would be all for an amended ruling against such actions. Had she been honest and paid a little higher premium due to her past condition she would have been covered.

However, she doesn't have a leg to stand on as she falsified documents in order to get coverage.

She is a retired RN, she should know the rules and laws regarding insurance coverage. There is no excuse for not reporting heart meds she was taking a scant two years ago. I honestly find it hard to believe a registered nurse forgot she was taking medication to keep her heart regular only two years ago. I would be shocked if an RN doesn't have copies of her own medical history anyway.


However:


If you want to keep assumption out of the equation, I can go with that. And I still support the insurance company for their findings. Ms. Beaton falsified documentation and received coverage. The insurance company found out about the falsified records and dropped her coverage. Those are the only facts in her story thus far.

Seems like the AP did a little more work than the POTUS to get that far.

Saggysack
09-30-2009, 06:09 AM
Paint it anyway you want, the insurance company released her due to falsification of records. Had she been honest, her premiums may have been higher, but she would have been covered.

Yet she was reinstated with the same coverage and premiums after...

Barton later called the company president directly and raised the possibility of a news conference and said he might name a bill after Robin Beaton. Four hours later, Barton said, he got a call saying her insurance would be reinstated.

Aww, how kind of those nice insurance companies. Pretty sad when you have an insurance company more concerned about some bad publicity than someones life. And how am I supposed to give a damn about insurance companies and their interests.

KCWolfman
09-30-2009, 06:13 AM
Yet she was reinstated with the same coverage and premiums after...



Aww, how kind of those nice insurance companies. Pretty sad when you have an insurance company more concerned about some bad publicity than someones life. And how am I supposed to give a damn about insurance companies and their interests.

Where did you get that she was reinstated with the same premiums and coverage? Is that in another article?

And yup, when a congressman makes noise, I imagine the company kowtowed. Do I feel sorry for an insurance company, not hardly. But I do believe in playing by the rules and not crying about it when you are busted for not doing so after the fact.

The woman risked her own life by falsifying documents. And how am I supposed to give a damn about individuals taking advantage of the system and their own interests when I could be asked to pay for their lies?

mlyonsd
09-30-2009, 08:27 AM
More importantly, had the fact finders for the POTUS actually checked both sides of the story, they would have had all the info. Trusting one side of an embittered battle is just foolish.

It would only have been a lie if it were a republican using it as an example in a speech.

I thought you were a little more savvy when it came to politics. Must have been your big layoff.

stevieray
09-30-2009, 08:35 AM
my fav is when he claimed a doctor who checked on a sore throat woudl take out tonsils just to make money..when said doctor isn't the one who would perform the surgery.

***SPRAYER
09-30-2009, 08:49 AM
my fav is when he claimed a doctor who checked on a sore throat woudl take out tonsils just to make money..when said doctor isn't the one who would perform the surgery.

It's amazing the amount of BS that spews from the guy's mouth yet his O-bot followers continue to rationalize it away. The man walks on water as far as they are concerned.

As far as I'm concerned, he floats in water, like a turd.

patteeu
09-30-2009, 09:04 AM
I'm not 100% convinced that's not what you're doing.

The woman's own story makes it clear that Obama was telling a whopper.

Saying that her insurance was canceled because she had acne is like someone saying they have cancer because of the chest xray that led to the diagnosis.

Insurance companies don't do extensive, costly audits on people's paperwork when they sign up. They operate like the IRS and do the audits either on a sampling of applications or when something triggers the audit. This is a cost savings measure. If they did audits on everyone as soon as they signed up, it would drive insurance costs up even higher.

patteeu
09-30-2009, 09:05 AM
Yet she was reinstated with the same coverage and premiums after...

All that proves is that the insurance company is PR conscious.

RINGLEADER
09-30-2009, 09:19 AM
This dumb woman lied to insurance companies about her weight and a previous heart condition to get lower rates.

Instead of someone saying, "You know, that is a stupid thing to lie about when it comes to your health" we have a POTUS using her as a poster child against the evil insurance companies.


I was shocked when the insurance company wouldn't replace my new Ferrari when it got hit.

So what if I told them I was actually driving an '01 Toyota Corolla so my insurance payments would be half. I want a new Ferrari.

RINGLEADER
09-30-2009, 09:20 AM
my fav is when he claimed a doctor who checked on a sore throat woudl take out tonsils just to make money..when said doctor isn't the one who would perform the surgery.

Yeah, but it's the Republicans trying to scare people...

:rolleyes:

Velvet_Jones
09-30-2009, 10:32 AM
Problems with this example:
In Texas, a Major Medical policy cannot be "rescinded". Only alternative policies like a temporary health or limited benefit plan can be "rescinded" or "canceled". In Texas, a Major Medical plan must be "reformed". "Reformation" is basically re-underwriting the policy using the current information known to be true and recalculating the rates based on this data. The "Reformation" must still fall within the rating indexing structure mandated by the state or province. Rate indexing basically is a mandated requirement that your highest rate and your lowest rate for like policy offerings be within a certain percentage of each other - usually, and I think this is true in Texas, the highest rate can be no more than the lowest rate + percentage mandated by the state. So if the states rate indexing is 125% then if a low rate is $100, the highest rate can be no more than $225. This raises rates for low risk insureds and caps rates for high risk insureds.

For a non-alternative major medical policies, Texas, and almost all states have guarantee issue laws requiring insurance companies insure high risk people and people with pre-existing illness if they apply for coverage. Most states allow the insurance company to take this into account when rating an insured as long as the rate is within the rate indexing structure. The states may allow the insurance companies to limit the benefits for a pre-existing illness for a specified length of time, usually 3-12 months but sometimes up to 36 months depending on the illness. An insured cannot be denied traditional major medical coverage because of a pre-existing illness. But there is a caveat here, most states do not allow limiting treatment for a pre-existing condition if the insured had “similar or like” coverage within a specific period of time, normally 6 months before the effective date of the current policy. Additionally, an insured being added to a group at the time they are eligible to be added, pre-existing limitations must be waived. Nobody ever mentions this fact.

If pre-existing illness rules were not in place, why get insurance until you are sick? Answer that libtards.

To summarize:
- Robin Lynn Beaton bought an alternative (limited) or temporary insurance plan.
- Robin Lynn Beaton didn’t fill out the application fully and completely.
- A diagnosis of acne or mild rosacea would never have triggered a costly pre-existing condition illness investigation. The more likely scenario is her doctor indicated that she had a prior history of heart disease on his bill for the acne treatment.
- This is an example of “You get what you pay for”.
- I am sorry that this woman allowed herself to get into this situation by not properly insuring herself.
- For this, we are going to fuck up 2 entire industries and nationalize another one.
- Liberals are about controlling other people’s lives and not about fairness. They are also stupid pawns.

Calcountry
09-30-2009, 10:41 AM
It's amazing the amount of BS that spews from the guy's mouth yet his O-bot followers continue to rationalize it away. The man walks on water as far as they are concerned.

As far as I'm concerned, he floats in water, like a turd.I wish he would eat more meat and less fiber.

ROYC75
09-30-2009, 01:46 PM
So who lied, the woman or the POTUS ?

Answer : Both !