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Public interest law firm?

Original post made by truthjusticetaw, Another Palo Alto neighborhood, on May 13, 2008

I am looking for a lead on a public interest organization or law firm that would be interested in this issue and be willing to pursue it legally.

The federal health care contract appears to be illegal, and leaves patients open to being defrauded simply for trying to comply with the terms of the contract. The federal government has the largest contracts with private insurers in the country, so this is a big deal.

Also, the Democratic candidates for President have been holding up federal coverage as some kind of model for health care reform, when federal workers have in recent years been subject to even greater abuses by private insurers than the rest of the insured public. But again, because of the health care reform issue, makes it relevant to everyone.

Basically, the federal contract contains a provision that makes the financial responsibility of the employee/patient depend on what's in the contract between the provider and the insurance company. But that contract is kept secret from the employee/patient. What's more, the federal government and the insurer know in advance that the contract (which controls financial responsibility) will be kept secret from the patient, even though the federal contract makes it seem as if information is readily available (it's not).

What's more, the federal contract is written in such a way that employees are likely to be tricked into making themselves subject to this provision simply by signing the assignment of benefits for insurance documents they are required to sign in order to get care and have insurance billed by a preferred provider.

So basically what happens is that you can carefully choose a preferred provider, carefully study your plan to be sure your care isn't excluded, get the care, comply with all of your responsibilities, and - surprise! - after you get the care, you are stuck with the huge cost. Insurers can't drop people from federal plans, but this tricky clause allows them to essentially do the same thing as post-claims underwriting, but without all those unpleasant state insurance laws to contend with. Federal employees have no advocate or independent protection in this case. The only recourse is with the federal Office of Personnel Management, which negotiates the contract in the first place, so there is a huge conflict there. The OPM doesn't even have any established avenues to solicit or address complaints or problems like this.

Please post serious leads here, or email to temporary address:
(stands for "truth, justice, and the American way"...)

Comments (2)

Like this comment
Posted by Logical
a resident of Another Palo Alto neighborhood
on May 13, 2008 at 5:59 pm


You might get a better response to this if you changed the name of the post.

For most people "Public Interest" and "Law Firm" are contradictory terms.

Like this comment
Posted by Fireman
a resident of another community
on May 14, 2008 at 8:46 am

ACLU, 39 Drum Street, San Francisco, Ca, 94111.

This is what I got when I contacted them about the CITY OF PALO ALTO,

Your letter to the American Civil Liberties Union of Northern California has been received. Unfortunately, we are unable to offer you legal advice or assistance. The ACLU is a private, non profit organization and are limited resources do not allow us to function as a general provider of legal services. Nor can our small staff do research or investigate many of the problem that come to our attention, no matter how legitimate they may be. In general, we must confine our involvement to a limited number of cases which raise new constitutional issues or which affect large numbers of people, and these are usually at the appellate level. Because of these criteria, we will not be able to provide you legal assistance. If you have sent us any documents, we are returning them.

You might consider contacting the following organizations, as they may be able to assist you.
Employment Law Center
600 harrison Street Suite 120
San Francisco, Ca, 94107
Main: 415 864 8848
clinic: 415 864 8208
Provide legal aid focusing on Employment discrimination cases for low-income individuals.

again we regret that we cannot be of assistance to you.

Signed a nice Person..... Legal assistant...

This Employment Law service could be a starting point for some other City Employee's. Also.

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