Angela Braly, CEO for Wellpoint, has been heralded by Forbes Magazine as the highest paid insurance CEO in the US and listed as one of 100 most powerful women in business. In truth, Braly is merely another corporate suit placing profit over people. Her name could be "Jack the Ripper,' and the effect would be the same.

Melanie Shouse crusaded for her two political passions; medical care for all as implemented by a vibrant public option such as the Conyers-Kucinich bill, HR676 (aka Expanded Medicare for All), and electing a little known Illinois Senator, Barack Obama, president. Nationally known as a grassroots healthcare activist; she has been the modern-day equivalent of a female Moses, working to bring medical care for all--home.

Melanie died January 30th, 2010 from breast cancer. More specifically, she died most probably from delayed treatment and policy rescission, caused by her insurer--Wellpoint.

Melanie had insurance, not the "cadillac' type enjoyed by congress, but the individual policy for catastrophic illness, replete with a mandatory five thousand dollar deductible. No benefits kick in, until the five thousand is paid. As an individual, this was the only type of insurance open to her. Who among us can afford five thousand dollars before any benefits become active? It is wage slavery.

Melanie plainly stated this fact at a healthcare rally this past November. She probably knew this would be her epitaph.

""we need to take on the big insurance monopoly and liberate American families from the SLAVERY of skyrocketing insurance premiums and cancelled coverage, which leave millions of us in a state of perpetual fear and insecurity"" --Melanie Shouse, activist.

Melanie did all the right things. She came from a loving family, earned a biology degree with honors, became an activist for those less fortunate, ran a small business with her partner and paid her taxes. She was so well known and respected by President Obama, that he heralded her efforts for healthcare justice in a speech at the Democratic National Committee Annual Meeting. In addition, the president sent a personal letter of condolence to her life partner, Steve Hart. Steve is having the letter framed and hung in a place of honor, as well as the envelope where the return address is simply THE WHITE HOUSE. Her only "crime' was not being wealthy.

Melanie's care was delayed by deductibles and co-pays expensive enough to bankrupt most of us. In addition, her policy was "rescinded' after beginning her third round of chemo. Though her treatments were approved by the Siteman Cancer center, a premier research institution considered one of the top centers in the world; her provider Anthem (under the umbrella Wellpoint), rescinded or cancelled her coverage. Fortunately, for Melanie, she had coverage by the PUBLIC PLANS OF MEDICARE AND MEDICAID (after a 2 year waiting period), by that time. Without the public plans of Medicare and Medicaid; Melanie would have died much earlier. Wellpoint had sent her the equivalent of a death sentence.

I wanted to better understand how insurers can defraud so openly and found five major practices working in an orchestrated manner to steal our money and deny medical care. They are as follows: the use of pre-existing conditions, gender rating, post-claims underwriting, retroactive policy rescission and the rewarding of employees for successful post-claims discovery.

Pre-existing conditions are used to block coverage either by making premiums and deductibles beyond reach financially, or as justification to deny coverage at any price. No one ever asks why any pre-existing condition should serve as the roadblock to medical care. Unless you never become ill--all of us will eventually have a "pre-existing condition.'

Gender rating is institutionalized discrimination against women by pricing premiums approximately 47% higher than those for men.

Post-claims underwriting and rescission go hand in hand. Post-claims underwriting occurs when an insurer investigates ancient medical records looking for any minor hint of a pre-existing condition, for the express purpose of cancelling the policy when medical care is most needed. The cancellation is also known as policy rescission. The fraud lies in the fact that this investigation occurs AFTER a policy has been written and accepted. Once someone has been "rescinded', they are unable to obtain health coverage anywhere else. Wellpoint has a list of some 1400 different conditions that will trigger such post-claim investigation. (http://www.huffingtonpost.com/richard-kirsch/biggest-health-insurer-ad-)

Anecdotal accounts, including those recorded in official testimony before congressional committee chaired by Rep. Bart Stupak documented accounts of patients losing coverage a few weeks before major medical procedures such as double mastectomy, due to some odd note in an old record which was misinterpreted by the clerk. http://www.votesmart.org/speech_detail.php?sc_id=474236&keyword=&phr

Project VoteSmart--Representative Bart Stupak--Hearing Of The Oversight And Investigations Subcommittee Of The House Energy And Commerce Committee--Terminations Of Individual Health Policies By Insurance Companies.

Insurance executives like Braly regard post-claims underwriting and policy rescission necessary fraud prevention practices.

Frankly, it is hard to imagine a sane person wanting to suffer from any life threatening illness so they can defraud insurance companies. Such thinking begs the question; why should anyone ever be denied medical care for legitimate medical need? Regardless of pre-existing conditions; medical care is a human right.

These abusive practices have become so widespread that even recalcitrant members of the aristocratic US Senate, like Senator Feinstein are now pushing for meaningful reform. In sworn testimony before the Senate"committee, Feinstein argued that the following specific reforms are critical:

1.) repeal of the McCarran-Ferguson Act (otherwise known as the anti-trust exemption);

2.) mandate DOJ (Department of Justice), the task of monitoring and pursuing criminal charges where appropriate against health insurers when they engage in price fixing, bid rigging, or market allocation;

3.) mandate the creation of a robust, non-profit public option which will accept anyone at affordable costs;

Feinstein further summarized that the most egregious abuses of the health insurance for-profit industry were directly traceable to the anti-trust exemption (McCarran-Ferguson Act), and ""as a result, practices such as price fixing, bid rigging, and market allocation, prohibited by Federal law in every other industry, were left up to the states and their enforcement mechanisms." (http://www.govtrack.us/congress/record.xpd?id=111-s20091102-12) History of the Medical Insurance Industry. The United States Senate.

The president and congressional leaders claim they must have 60 votes in the Senate, in order to pass these reforms. Nothing could be further from the truth. The 60 vote criterion is mentioned in order to override a filibuster. These reforms could easily be passed with a simple majority, if the US Senate would actually conduct its business along constitutional precepts. Since we are stuck with the procedural filibuster that can table any substantive discussion; an alternative solution to the engineered deadlock is necessitated. The solution lies with the congressional procedure of "reconciliation.' The CHIPPS or children's health insurance program was pushed through using this device. Senator Harry Reid does not need 60 votes to pass Feinstein's proposed reforms. Senator Harry Reid does not need the Republicans in some false gesture of "bipartisanship.' He just needs some spine, a moral compass and 51 senate votes.

Building a system on gambling which is the essence of insurance is flawed both intellectually and morally. Melanie, and far too many others, paid the ultimate price. In Melanie's case, the delay engineered by her insurer cost her valuable time. We know, that illnesses like cancer have a short shelf life. When treatment is delayed for even a brief window of time--it frequently costs the patient their life. Insurers like Wellpoint know this, and their delaying tactics could be considered the "intent' to commit felony murder. If our government truly represented the people; Wellpoint , Angela Braly, Wellpoint CEO, and corporate counsel, would be facing FELONY MURDER CHARGES, THE SAME AS IF THEY HAD TAKEN A GUN TO MELANIE'S HEAD.

While it is admirable that these Senators are finally "seeing the light,' regarding reforms such as a robust public option, and ending the anti-trust exemption; such reforms will not suffice unless criminal penalties are enforced against executives and their attorneys when they knowingly conspire to delay and deny treatment for life threatening illness.

Until these CEO's and the attorneys who labor to create the legal contrivances used to deny life saving medical care are held criminally liable for their actions; loopholes will be easily found.

The honorary awards in Melanie Shouse's name are definitely touching, but irrelevant. Melanie would have said so herself. If Melanie were here now; she would vehemently object to any memorial--rather she would be challenging everyone to action. If you want to honor this courageous woman, then make her words a battle cry to action. Make this year the last year anyone dies from medical neglect, caused by the cold blooded denial of care for life threatening illnesses. MAKE THIS ISSUE SO RADIOACTIVE THAT NO POLITICIAN OR BUSINESSPERSON DARES TO DENY MEDICAL CARE TO ANYONE EVER AGAIN.

Mohandas Gandhi once said that" "a small body of determined spirits fired by an unquenchable faith in their mission can alter the course of history."

Melanie Shouse was such a small body of determined spirit. In her honor, we must win this war, for our people, for our collective humanity. Melanie would accept nothing less.

Author's Bio: Working as an urban educator for over 25 years--I 'moonlight' as a writer. I write part-time for The Huffington Post and enjoy the task of curmudgeon,(at least where career politicians are concerned). I consider myself a political independent who is absolutely convinced that the '2-party' system has got to go. As my hero, I.F. Stone once said; "all governments lie." I merely wish to point out the lies, especially the incredibly stupid ones.

Feb. 24, 2010

www.opednews.com/articles/The-civil-rights-battle-of-by-Jeanine-Molloff-100223-406.html