Fidelity Investments, Being Chronically Ill with Multiple Sclerosis and Did CIGNA Help? A Call for Regulation in Health Insurance

I put this logo up because I am amazed at how Fidelity seems to be fighting the good fight against Multiple Sclerosis.  Seems.

You know, we have been through a lot starting back in February, 2008.  And, even though we'd been through some really frightening episodes with how Paul's MS took a turn for the worse, and the surreal dealings with CIGNA (worthy of a Dada-esque play) and Paul having to go through chemotherapy, we were just starting to see the light at the end of the tunnel.  Chemo slowed down the progression of his disease.  The 4 new lesions his doctors found (after chemo) were considerably smaller than last year's. Paul's working at Fidelity.  He's feeling and lookng way better than last year.  Then, Wham!  May rolls around.  Yep, this May. Two zero zero nine.

Paul's supervisor at Fidelity, Rick, came to him and told him to start looking for another job.  Just like that.

Let's talk about this because I don't know how you do that to a guy who had just finished chemotherapy.  Chemotherapy.  Hooked up to an IV for five to six hours, full of Cytoxan and then steroids. 

He still showed up for work all during it except on chemo days or days he was sick from it (or he wouldn't get paid).  He was leading his group in activity BUT he was told to "start looking."

My reaction was, "Do they know you were working through chemotherapy?  Do they know this is a new position and you were just starting to build your sales "pipeline?"  Do they know the company they contracted to protect you denied your disability claim?  Do they know they're comparing you to your able-bodied peers who've been in the same job longer and they're not even giving you the chance to hit the high sales cycle of the year?" 

And yes, they knew.

But here was the catch he was presented with by Fidelity: Go on probation in which you would have to consistently bring in $10 million worth of assets per month selling our 401-K plans or sign this mutual agreement giving you two months' severance with a promise you won't sue us.  Nice, huh?  Bringing in $10 million a month, consistently, is technically do-able but as a point of comparison Paul's annual goal his first year was only $30 million.  $10 million dollars per month is $120 million annually.

He sold $7 million worth of assets in July and August but it wasn't enough, oh and he never got the commissions for those sales either.  Another nice, huh?

Had he agreed to probation, then he never would have been able to get another job within Fidelity, which is what he hoped to do. Another catch.

Paul started looking for jobs within the company.  Jobs where his previous 20 years of experience and expertise would be really useful to Fidelity.

Biggest problem with this ultimatum? Some of his symptoms began to appear again.  By mid-June, his physical health was enough to cause us  concern again.  We talked.

We couldn't allow this stress they were putting him under to cause another exacerbation--which was starting to happen.  The stress of probation would do that.  The stress of trying to sell $10 million in assets every month would do that.  His doctor said stress was already causing problems with his health.  His hand was forced.

According to everything I've read about working through chronic conditions we did what we were supposed to do, Paul spoke with Fidelity about his condition, clocked his days as requested, looked for alternatives within Fidelity and we covered ourselves with extra insurance--but it didn't help.

Now Fidelity worked within the current laws (as far as I know while writing this however, I am looking into violations of the Americans With Disabilities Act) but the law does not take into account that:
1. You can be let go despite measurable efforts by the employer while working through your chronic illness and (this does not preclude that they may have violated the ADA by forcing him to do something against his fair accomodations)
2. Disability insurance that you may rely on won't protect you and your family. It is nothing more than a scam.  Yep, a scam.

Hundreds of millions in disability premiums are collected by the Insurance Industry yet according to one attorney we spoke with, 95% of the claims are never paid.  What a racket.  Look at the denial letters CIGNA sent to us.  How about denying a claim 45 days before it's to begin and without all the medical information?

We need more consumer protections against this. We need a single regulating body.

I'll give you a couple of examples of why regulation is needed.  Yesterday's NYTimes, front page article "E. Coli Path Shows Flaws in Ground Beef Inspection."  The industry is allowed to self-regulate.  This article proves self-regulation doesn't work.  Meat goes untested due to poor self-regulation or no regulation at all.  People get food poisoning and in some instances they die or in the instance of the article above, are left paralyzed. This is our food, America.  It shouldn't be sent to consumers full of E. coli.  Ask John Mackey of Whole Foods if this is a "right" or not. 

The Insurance Industry needs very stringent regulation as their behavior causes more misery and more deaths than the meat producers.  The only way for this to begin is to repeal the McCarran Ferguson Act of 1945 which allows the "business of insurance" to be EXEMPT from Federal Anti-Trust Laws.  From the CRS Report: Medical Malpractice Liability Insurance and the McCarran-Ferguson Act, March, 2003:

Insurance consumer advocacy groups have argued that insurers have taken advantage of the McCarran-Ferguson Act to raise prices and restrict coverage, as well as engage in other anti-competitive activities (except boycotts) that would be considered unlawful in any other industry.  When profitability is good, insurers actively compete by lowering rates and expanding coverage in order to increase premium and investment income or retain market share.  But, when times are bad, the antitrust exemption allows insurers to collectively raise premiums without fear of prosecution.  Legal challenges involving alleged price-fixing by insurers are typically dismissed by the courts because of the industry’s special exemption from the antitrust laws.  

Times have been bad, haven't they?  How much have you seen your premiums rise?  And price-fixing, dismissed because of exemption from the antitrust laws.  What a racket.

And from the Washington Post, further evidence that general reform may not cure Insurance Industry abuse, "Discrimination by Insurers Likely Even With Reform, Experts Say Economic Pressure Could Give Rise to New Biases Against Prior Conditions."

Read the following quote from the article by David Hilzenrath very carefully, especially if you have a chronic condition like my husband.  And if you don't have a chronic condition, still read it because it's tragic how, all of us as consumers, are treated by our insurance providers.

If insurers are prohibited from openly rejecting people with preexisting conditions, they could try to cherry-pick through more subtle means. For example, offering free health club memberships tends to attract people who can use the equipment, says Paul Precht, director of policy at the Medicare Rights Center.
Being uncooperative on insurance claims can chase away the chronically ill. For people who have few medical bills, it is less of a factor, said Karen Pollitz, research professor at the Georgetown University Health Policy Institute.
And to avoid patients with costly, complicated medical conditions, health plans could include in their networks relatively few doctors who specialize in treating those conditions, said Mark V. Pauly, professor of health-care management at the University of Pennsylvania's Wharton School.
By itself, a ban on discrimination would not eliminate the economic pressure to discriminate.
"It would probably increase the incentive for cherry-picking," Pauly said. "I'm strongly motivated to try to avoid you if I'm not allowed to charge you extra."

Being uncooperative on insurance claims.  Sums up the entire industry, doesn't it. Reform, such as it is now, won't cut it.  What's needed is regulation--like the Swiss, who strongly regulate their insurance industry.

What the past year has taught me is it has made a jaded woman out of me, yet somehow it's made me more resilient.  I've learned some obvious and not-so-obvious lessons as well.

• You never know when life is going to come up and pull the carpet out from under you.  Never thought my heretofore robust and never even-sick-with-a-cold husband would be diagnosed with MS.  Unthinkable. Lesson 1.
  
• Accept what life throws you and you move on. You have a life and you have your children to think of. You prepare, just in case.  Lesson 2.
  
• Preparing yourself with say, extra disability insurance, should be enough.  But there are forces out there beyond your immediate control that can take you for a ride--like unscrupulous insurance companies.  Preparation, then, means nothing.  Move on, again.  Learn.  Take action. Lesson 3.
  
• There's no such thing as corporate ethics.  The closest thing I have ever seen so far was from the Times article I referenced above.  Costco willingly tests their ground beef!  Costco has an even more loyal customer in me than ever before. Go Costco! Lesson 4.  No, I don't work for Costco.
  
• Our elected officials need to stop taking money from special interest groups.  Period. Lesson 5.
  
• We need to take our country back from large corporate entities that are opposed to the betterment of the general well-being of the People. Lesson 6.

And it's taught me (Lesson 7 and counting) I'm a lot stronger than I thought, exhausted but stronger, and I will fight in any way possible for what, in this great country of ours, should not be allowed to happen to anyone.

I think my great-grandfather Capt. Richmond M. Welman, (his mom had been born in Virginia hence his first name) a Union surgeon who fought in the Civil War, would be appalled at what we have become.  I've read the diary he kept while at Vicksburg and I know he fought because he believed the nation was being torn apart by slavery.

While not as overt as slavery, I believe the injustices served up on the People by the Health Insurance Industry are as equally destructive to our national well-being.  The ill-conceived arguments and lies that are being used to refute reform, thanks to a handful of racists, ignoramuses and industry lobbying groups, are ripping at the fabric of our society.  Our nation has the potential to be torn apart by a very insidious problem: Access to health care--rather, the denial to access to care.

If you have insurance and you never use it, you're fine.  Try getting sick and using the health insurance you pay dearly for and see what happens then.  You become a pariah.  A second class citizen.  What are we as a nation if we don't all don't have the ability to care for our health? 

The Health Insurance Industry needs to be regulated to prevent our society from ripping itself apart with denial of care and cost of coverage.  If kept unchecked by regulation, they will get to the point where they will ask and receive Government subsidy to pay for your coverage. Or they will sue an entire state for lack of profits.

My blog and my story are a way to regain what our founding fathers had in mind, and it wasn't the good of the corporation, it was the good of the People.

Image above found here.