Mike the Mad Biologist

By way of Echidne, I came across this article about WellPoint’s cancellation of insurance policies belonging to women with breast cancer (italics mine):

Shortly after they were diagnosed with breast cancer, each of the women learned that her health insurance had been canceled. There was Yenny Hsu, who lived and worked in Los Angeles. And there was Patricia Reilling, a successful art gallery owner and interior designer from Louisville, Kentucky….

The women paid their premiums on time. Before they fell ill, neither had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information….

But WellPoint also has specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies, federal investigators told Reuters. The revelation is especially striking for a company whose CEO and president, Angela Braly, has earned plaudits for how her company improved the medical care and treatment of other policyholders with breast cancer.

This wasn’t a computer glitch. People held meetings, made Power Point presentations, wrote memos and emails, organized teams (this can’t have been a one person job), and decided after all of this considerable thought and consideration that denying legitimate, paying customers with cancer was an acceptable thing to do. Then they went home and lived a ‘normal’ life: played with their kids, went out on the town, maybe even went to a school board meeting.

While I’m sure some of these people are stone cold sociopaths or narcissists, most are just masters at suppressing cognitive dissonance. If we assume that most of the people making these decisions are college graduates, and some are business school graduates, this is can only be described as a stunning failure of these institutions to equip their graduates with the philosophical and ethical training to comprehend that what they do is wrong.

Worse, the vaunted ‘free’ market system rewarded these animals for making this decision. Because rewarding sociopathic behavior* is a good organizing principle for a society. When dealing with people like this, who either willfully suppress their humanity or who suffer from a psychological disorder, you don’t try to appeal to the better angels of their nature: they don’t exist. If you must deal with these people, you regulate and circumscribe their activities, and have very strict and direct reward and punishment schemes. Most importantly, they can’t be trusted over the long haul.

Regulator emptor.

*Whether this is clincial antisocial personality disorder or simply massive cognitive dissonance doesn’t really matter: the effect is the same.

Comments

#1 MikeMa
April 23, 2010

The need to please the boss or climb the corporate ladder must be strong with these evil bastards. Their ability to compartmentalize their inhuman activity at work and live presumably normal lives away from work is astonishing. It might be interesting to see how they live their ‘away from work’ lives. Do they beat their spouses and kids? Kick the dog? Shout insults at little leagers who miss a play?

Ethics and compassion have been pushed out of corporate life to maximize profit at all costs. The corporate entity rules.
#2 katydid13
April 23, 2010

I think the problem was long before business school. If you simplfied the language a three year old could tell you that you aren’t allowed to treat people like that.

The thing is, I think lots of three-year-olds aren’t learning that. We have an amazingly self-focused culture. The idea that sometimes you don’t always get exactly what you want because it’s not what is best for everyone is learned.

I think we’ve also taken cognitive dissonance to a new level and you can choose to immerse yourself with people who support that. All the Medicare card holders who complained that they didn’t want the government involved in their health care could effectively surround themselves with information that re-enforced that.

While I’m not a fan of Robert Putnam’s “Bowling Alone” work, I do think there is some truth to the idea that there has been some loss of a sense of community in this country. It’s far easier to screw over people you don’t know than people you do.
#3 Kierra
April 23, 2010

From a more in-depth story at MSNBC (http://www.msnbc.msn.com/id/36711197/ns/health-health_care/)

Brian Sassi, the president and CEO of WellPoint’s consumer division, asserted: “I want to emphasize that rescission is about stopping fraud and material misrepresentation that contributes to spiraling health care costs. Rescission is a tool employed by WellPoint and other health insurers to protect the vast majority of policyholders who provide accurate and complete information from subsidizing the cost of those who do not.”

They are basically demonizing these patients. They convince themselves that they are canceling a fraudulent policy rather than denying life-saving treatment to a cancer patient.
#4 dominich
April 23, 2010

I’m sure you meant ‘caveat regulator’ which might sort of mean ‘beware the regulator’.
#5 Kate from Iowa
April 23, 2010

Is this the same company that did…well, basically the same thing to a 17 year old boy who’d been diagnosed with HIV a few years ago? Or is this endemic to the industry?

I thank whatever floats around in your fluffly little heaven that most of what I deal with in the agency here is home and car insurance. HEalth insurance sucks.
#6 eNeMeE
April 23, 2010

If we assume that most of the people making these decisions are college graduates, and some are business school graduates, this is can only be described as a stunning failure of these institutions to equip their graduates with the philosophical and ethical training to comprehend that what they do is wrong.

…There’s really no ethics taught unless you have to take it and even then the amount learned is, hrm, painful. Engineering students have to take an ethics course and virtually all treat it as a chore, not a learning experience. YMMV, etc, etc.

More anecdote: My brother has an MBA, and his (class’s) idea of a brilliant medical device is not one that does things well and cheaply, but one that does things well enough to gain market share and has high recurring costs that can be protected by patents. This sort of thinking was reinforced in their classes, presentations, and competitions.

…and their required ethics course was a joke – I believe a significant portion of his class did it while ‘on exchange’ (read:vacation) to a university in Asia, and were actually in another country at the time, partying.
#7 Min
April 24, 2010

Mike: “If we assume that most of the people making these decisions are college graduates, and some are business school graduates, this is can only be described as a stunning failure of these institutions to equip their graduates with the philosophical and ethical training to comprehend that what they do is wrong.”

It is not a bug, it’s a feature. At elite business schools students are taught that it is their duty to maximize the profits of the corporation that employs them. Furthermore, if the expected legal penalties to the corporation are small enough, then they are duty bound to commit illegal or tortious acts on behalf of the corporation in order to maximize profit.

Mike: “Worse, the vaunted ‘free’ market system rewarded these animals for making this decision.”

You have always had the caution, caveat emptor. However, with sufficient competition, businesses should vie with each other to serve their customers. This kind of predatory behavior on the part of the insurance companies indicates market failure because of insufficient competition.

Mike: “Because rewarding sociopathic behavior* is a good organizing principle for a society. When dealing with people like this, who either willfully suppress their humanity or who suffer from a psychological disorder, you don’t try to appeal to the better angels of their nature: they don’t exist. If you must deal with these people, you regulate and circumscribe their activities, and have very strict and direct reward and punishment schemes. Most importantly, they can’t be trusted over the long haul.”

Unfortunately, the new health bill increases competition by allowing companies to compete across state lines. However, it does not create enough competition, and it weakens regulation because the companies are governed by the laws and regulations of the states where they are licensed, not of the states where their customers reside.
#8 Dr. Shrinker
April 24, 2010

I don’t know, I think dmabus makes an excellent point.
#9 Joshua
April 24, 2010

I’m sure you meant ‘caveat regulator’ which might sort of mean ‘beware the regulator’.

Actually, emptor/regulator are both nominative, so your suggestion mean something more like “regulator beware”. Which is an accurate description of the current state of affairs where whistleblowers are punished while the sociopaths at the top float away unharmed on golden parachutes.

According to the Online Etymology Dictionary, “regulate” derives from a noun, “regula”, which refers to, I think, a measuring stick. There doesn’t seem to be a verb form of it attested in Latin, or if there were the meaning would refer to measuring, not to regulation in the modern sense of exercising oversight. Regulation in the modern sense would be best covered by either “moderor” or “rectifico”. Possibly rectifico is the best, yielding:

“Rectificat emptor” for “buyer regulate”. One might also alter the subject of the phrase to “citizen”, giving us “rectificat civis” or even “rectificat civitas”, if we want to expand the subject to a more collective sense of “the citizenry”/community rather than the individual.
#10 sailor
April 26, 2010

Simple,

You take a customer, you take the premium, you get the first year to figure out if there is any fraud going on. You fail to find it you pay after that. This collecting premiums and then denying coverage should be illegal.
#11 Wold News
December 23, 2010

The thing is, I think lots of three-year-olds aren’t learning that. We have an amazingly self-focused culture. The idea that sometimes you don’t always get exactly what you want because it’s not what is best for everyone is learned.

I think we’ve also taken cognitive dissonance to a new level and you can choose to immerse yourself with people who support that. All the Medicare card holders who complained that they didn’t want the government involved in their health care could effectively surround themselves with information that re-enforced that.

While I’m not a fan of Robert Putnam’s “Bowling Alone” work, I do think there is some truth to the idea that there has been some loss of a sense of community in this country. It’s far easier to screw over people you don’t know
thanks.
#12 Oyun hilesi
December 23, 2010

According to the Online Etymology Dictionary, “regulate” derives from a noun, “regula”, which refers to, I think, a measuring stick. There doesn’t seem to be a verb form of it attested in Latin, or if there were the meaning would refer to measuring, not to regulation in the modern sense of exercising oversight. Regulation in the modern sense would be best covered by either “moderor” or “rectifico”. Possibly rectifico is the best, yielding: thank you
#13 tek link
December 23, 2010

It is not a bug, it’s a feature. At elite business schools students are taught that it is their duty to maximize the profits of the corporation that employs them. Furthermore, if the expected legal penalties to the corporation are small enough, then they are duty bound to commit illegal or tortious acts on behalf of the corporation in order to maximize profit.

Mike: “Worse, the vaunted ‘free’ market system rewarded these animals for making this decision.”

You have always had the caution, caveat emptor. However, with sufficient competition, businesses should vie with each other to serve their customers. This kind of predatory behavior on the part of the insurance companies indicates market failure because of insufficient competition.

Mike: “Because rewarding sociopathic behavior* is a good organizing principle for a society. When dealing with people like this, who either willfully suppress their humanity or who suffer from a psychological disorder, you don’t try to appeal to the better angels of their nature: they don’t exist. If you must deal with these people, you regulate and circumscribe their activities, and have very strict and direct reward and punishment schemes. Most importantly, they can’t be trusted over the long haul.”

Unfortunately, the new health bill increases competition by allowing companies to compete across state lines. However, it does not create enough competition, and it weakens regulation because the companies are governed by the laws and regulations of the states where they are licensed, not of the states where their customers reside.
#14 yeni hile
December 23, 2010

Worse, the vaunted ‘free’ market system rewarded these animals for making this decision. Because rewarding sociopathic behavior* is a good organizing principle for a society. When dealing with people like this, who either willfully suppress their humanity or who suffer from a psychological disorder, you don’t try to appeal to the better angels of their nature: they don’t exist. If you must deal with these people, you regulate and circumscribe their activities, and have very strict and direct reward and punishment schemes. Most importantly, they can’t be trusted over the long haul.