Thursday, October 8, 2009

Health Insurance Blues

From the Huffington Post:

A CIGNA employee gave the finger -- literally -- to a woman whose daughter died after the insurance giant refused to cover her liver transplant.

Hilda and Krikor Sarkisyan went to CIGNA's Philadelphia headquarters, along with supporters from the California Nurses Association, to confront the CEO Edward Hanway over the death of her 17-year-old child.

In 2007, Nataline Sarkisyan was denied a liver transplant by the company, on the grounds that the operation was "too experimental" to be covered. Nine days later it changed its mind, in response to protests outside its office. It was too late: Nataline died hours later.

"CIGNA killed my daughter," Nataline's mother Hilda told security. "I want an apology." Sarkisyan was not able to speak to Hanway; a communications specialist talked to her instead. After their conversation, employees heckled the group from a balcony; one man gave them the finger. CIGNA called the police and had the family and their friends escorted from the building.

A CIGNA executive apologized for the incident in a letter about a month later.

"I was very disappointed to learn of the behavior of one of our employees when you were at our company's headquarters," wrote John M. Murabito, executive vice president for human resources.

"I sincerely regret this individual's offensive and inappropriate action," he continued. "Please know that he did not represent the views of our company or the views of other employees who work here. We deeply empathize with you and wish you peace and comfort in your loss."

"What unbelievable nerve," said Americans United For Change spokesman Jeremy Funk in a statement. "A case that should have prompted CIGNA to seriously reevaluate its policies instead led its employees to taunt and insult a grieving mother who lost her daughter. Absolutely sick. Does Congress need any more reasons to pass meaningful health insurance reform now?"

The Sarkisyan family's wrongful-death suit was thrown out of court because of a 1987 Supreme Court ruling that shields employer-paid health care plans from damages over their coverage decisions.

The Sarkisyans say the law needs to be changed to allow people to sue health insurers for these kinds of decisions.

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Vespa Key Largo

Well now it looks like I won't have to trailer my ET4 for seven hours to Sarasota this year for a tune up. I saw this ad in the Citizen this morning telling us that Riva South has taken on Vespa products. I like Riva South, they act like a full time professional dealership and have been in business for a while. I considered a Burgman 650 and a Bandit 1250 before I bought the Bonneville, and I would have gone to Riva South to buy a Suzuki.That they are located only an hour and a half north of my house is a bonus. I'll give them a chance to show me what they can do for my wife's ET4 in the spring and if they treat it as well as Vespa Sarasota did last year I might even go back. Vespa Sarasota is a great shop and if Riva lets me down I'll be ready to trailer the Vespa back there.


I have a feeling that recent ruling by the Federal Government is going to have a huge impact in the Florida Keys, and the fact there hasn't been much public comment after the ruling was handed down, is a measure of how hard people must be thinking about it. For some it's government piracy for others it's common sense and for people caught in the middle it could be financially disastrous. A cutthroat issue indeed. The rule is all about downstairs enclosures.Most of the Florida Keys lie in a flood plain which means that any time Mother nature gets upset there is a really good chance water, and most likely highly corrosive salt water will come washing over an island or two. We had dramatic proof of that in 2005 when Hurricane Wilma pushed flood waters across the Keys causing huge amounts of damage. I found this picture of Marathon under water on the NOAA government website: The solution adopted in the Keys is to require homes to be built on stilts above the flood plain. I visited New Orleans after Katrina ravaged that city and oddly enough the debate in that community turned firmly against the use of stilts as being unsightly. I remember one commentator called homes on stilts "cocktail onions on toothpicks." Very funny I'm sure but come the next flood I'd rather be up here than down there frankly, and the next flood is only a matter of time. So, around here this is generally the first construction step after building a foundation, if one chooses to undertake the extremely long and tedious process that it is building a new house in the Keys:
For someone like me the open space under my house is a bonanza of space to put things, to park my vehicles out of the sun, to use as an open air workshop. The fact is that the salt air of the Keys is horribly corrosive and an un-air conditioned shed is not much protection against rust and corrosion. If I want to preserve something delicate I find space to store it upstairs in my well ventilated house. I am very happy I have no enclosure of any kind under my modest little seven hundred square foot home. Lots of people like to make more use of their downstairs spaces:
Some people like enclosed storage areas, other want garages,
...while some people like to mix it up and use part of the space as a shed and part as open storage or parking:One of the advantages of buying a suburban home outside Key West's old town is the house on stilts concept, elevated to protect against floods while also offering parking storage and shade on a decent sized lot. A wonderful opportunity for creative home ownership you might think. This is where the fly rears it's head out of the ointment. That would be the National Flood Insurance Program, which is a federal program to provide affordable flood insurance and it comes with rules. One of those rules enclosures! The Feds argue that the point of stilt homes is to keep living spaces out of danger and any construction under the flood plain can only be for storage and not used as living space. No fixed kitchens, no bathrooms allowed and so on.The thing is, many people have bought homes in the Keys planning to offset the high cost of buying, by renting out their (illegal) downstairs units. Supposedly they were informed at the time of the purchase that the units were illegal but I'd bet they were also advised that no one cares, "everyone does it." Now it seems the rules are changing and not for the better for people who have illegal units. Best of all is to have no enclosures in my opinion, and to breathe easy like the owner of this manufactured home in the air:The next step in this process was an agreement the county signed in 2002 which set up inspections of people's private property. It was agreed between the Feds and local county government that anyone applying for a permit for any work would be subject automatically to an enclosure inspection. Some people protested but the majority viewed it as "no big deal," not least because not many people got their downstairs enclosures red tagged. That seems likely to change if the Feds follow through on their promise to require compliance if the county wants to participate in the federal flood insurance program. Anyone with a mortgage has to have such insurance to cover their loan, and there are plenty of mortgages that need flood insurance in low lying Monroe County.

This is what helps to make an enclosure legal: flow through. In other words if the land floods, the flood waters won't be pent up bashing the structures lower walls, instead the pressure inside and out will be equalized until the flood waters recede:From where I stand it makes sense to have rules for flood insurance. It also makes sense to enforce them. So then what? Do you grandfather existing units and give them flood insurance despite their potential for damage? Do you tell people to tear the units down and deprive themselves of rent? What do you do? County Commissioner Mario DiGennaro is promising to tilt his lance at the feds and tell them where to get off. I doubt they will be impressed but one can only hope.I foresee a lot of time spent in the courts, a lot of gnashing of teeth and a lot of stress for a great many homeowners across the Keys. I hope eventually there will have to be some sort of compromise but from where I'm sitting it seems to be irresistible force versus immovable object.
It's times like these one takes the wife's scooter out into the back country and one goes for a walk to enjoy the solitude of untrammeled nature.