http://www.cnn.com/2008/US/03/25/walmart.insurance.battle/index.html

Guys check this story.



A 52 year old Wal Mart employee named Debbie Shank was involved in a terrible car accident that left her severely brain damaged. After receiving a settlement of $470,000, the idea was that she was going to be taken care of. But that was too happy of an ending for Walmart. What Debbie didn't relise is that WalMart's health plan has a fine print that stated that if there is ever money won in a case for a settlement, Wal Mart has the right to take it. And you bet your sweet ass Wal mart took it.


Wal Mart made 90 billion dollars last quarter and the greedy bastards pursued and took this poor womans money. Not to mention that her son was Killed two weeks after arriving in Iraq at age 18, and her husband is still recovering from prostate cancer.

When a rep from WalMart, John Smiley, was asked about the situation, he replied:
"Though Mrs Shanks case is unbeleivelably sad, Wal-Mart's health plan is bound by very specific rules. ... We wish it could be more flexible in Mrs. Shank's case since her circumstances are clearly extraordinary, but this is done out of fairness to all associates who contribute to, and benefit from, the plan."
Her husband has had to divorce her just so she can get on a goverment health plan, and even that wont help her for long.

Its safe to say that Wal Mart has destroyed a family.

I'd love to get a recording of a Wal-Mart exec saying something about decreasing the surplus population.

That being said, didn't Wal-Mart cave at some point? *searchsearchsearch* Yeah, here it is.

What I find most amusing is that this happens all the time with insurance companies, but because it was Wal-Mart ... Well, clearly Satan is in charge of the corp.

Hi there, and welcome to several months ago!

PRO TIP: Read your insurance paperwork very carefully. Including, if not especially, the small print.

I find it hard to believe that a man named Mr. Smiley would tell me anything but the happiest truth and is most anxious to help everyone.

It would appear names can be deceiving!

I bet he said it with a disarming smile at some point in the spiel. Probably when he was talking about how it helps the other employees.

A more recent article talked to the details that Walmart ended up dropping the case and letting her family keep the settlement funds.

Actually its like this...

She sued the trucking company and won $1 million, after legal fees she only ended up getting $417,000

Wal-Mart had spent out $470,000 in medical expenses for her, and according to their policy if you took legal action and received cash from it, then you had to give back what they paid out in medical expenses.


So what happened here, was she spent more on a lawyers and legal fees then she did on hospital bills. Her lawyer pretty much screwed her over, not Wal-Mart. Wal-Mart's not going to cover your medical expenses, if you're suing someone else to pay for you medical expenses, thats supposedly the idea of a lawsuit. The fact that she paid her lawyer more than the medical costs were, and in the process of winning she was no longer eligible for what had already been paid to her. So in the end her accident after suing cost her $53,000, when before the lawsuit was processed Wal-Mart WAS paying for her medical expenses. I'm sorry for this womans accident, but the spotlight shouldn't be on Wal-Mart and what they're doing, but more on her legal team. Its a company policy that is the same for everyone, the fact that they waived it for this woman who had a terrible lawyer is quite nice of them, and likely to cause them terrible problems in the future as other people then try to get more and now they have a precedent that Wal-Mart has done it before.

This is old news. This was something NBC brought up in late March. Keith Olbermann, their main news anchor was making a big deal about it each night and promised to keep doing so until Walmart backed off. I think CBS and Fox also joined the band wagon. Walmart looking at the news corps about to hand them a PR nightmare of biblical proportions, backed off and let the poor woman keep the money set up in trust to take care of her.

The sad part for her is that the accident destroyed her short term memory. She has already forgotten the law suit. But she also has no memory that her son is dead. each time she asks for him, she has to be told he died. Each time, she relives a mother's worst horror.

I'm with Nightwalker450 on this one...
While Wal-Mart is an evil corporation whose MO is squeezing every last bit of life out of human beings and then discarding the remains, this is not an example of that behaviour...
The problem if the half a mil in legal costs...

the question is, once they took the money back, did they intend on continuing payment of her medical bills, or did they intend to cut her off once they were "reimbursed" for $417,000 ?

if they were going to continue paying her medical fees, she'd likely have used up much more than the 417k she won, but now that she's had the money given back to her, I wonder if her company-sponsored medical insurance is void. She may end up screwed when she runs out of $ and they say "We're sorry, your medical insurance contract was broken when we broke the rules and gave you all that money back! Get well soon."

They shouldn't have sought legal action in the first place. Why do people in the US have to sue for everything? I mean Jesus. She was in a car accident; insurance pays for these things. You don't need to try to get "retribution" in the form of money. If she hadn't won that 417k, Wal-Mart would likely have kept paying her bills for a very long time.

Given that she's severely brain damaged, I have to question whether she was the one deciding to sue.

That's actually pretty standard policy too. My parents' medical insurance does that, I believe my auto insurance does that. I'd guess my medical insurance does as well, but I'm not really sure (never cared enough to check).

I knew I could believe Mr. Smiley.

The lawsuit may have been for the destruction of her short term memory. The woman is now for all intents and purposes dead. She will never learn, or remember anything from after the accident again. It effectively ended her life. What is that worth to someone? How much would I have to pay someone before they'd let me do it to them? I'm guessing its more then a million dollars. So don't be too surprised when someone or their family sues over an injury of that magntude. Now if it was a broken leg, or even a broken back, I might not be so sympathetic. Just imagine getting to wake up every day and here your son was blown up in a war for the first time kind, and waking up in the morning and seeing this ancient fossil stare back at you from the other side of the mirror, and you get the horror of asking yourself what happened while you slept last night. You get these and other fun trauma's every day, and you family has to help you cope with it until you finally die. Tell me, what would it be worth to put up with that? I'd wager easily more then a million dollars.

It is a basic rule in law and in equity that you can't be compensated for the same damage twice. Liability is like a pizza. Everyone involved gets their slice. Some slices are bigger than others, some have more toppings, and some people don't have a slice at all. But, there is only one to be split among everyone. The liability of one entity naturally reduces the liability of all others, because the point is to fully compensate for the injury, no more and no less. When the trucking company accepted liability for that damage, it meant that Wal-Mart's insurance was not liable for it and thus entitled to get the money that it had paid back.




You also get to leave elaborate clues for yourself that will lead you to your bloody murderous vengeance and then forget all about killing your enemy so that you'll have to find someone else to kill like in Memento, which is damn cool in some ways. If you don't transform your life into an endless violent film-noir quest for vengeance after such an accident then you just aren't doing it right.

Nah, I'm pretty sure that it was Loffwyr.

QFT

I was mostly arguing against the value of the damage awarded. My mind is the most precious thing i own, and if someone took it from me, they'd best pay handsomely for it.




Haven't seen the movie, but I think I know have to.

The problem here is that the american system of laissez faire capitalism is completely broken. Here if the other driver is assessed as being at fault by the police their mandatory insurance on all registered cars has to pay a scheduled rate of fees based on clinically assessed damage to the victim.

Works okay. Has problems - like what happens when someone is at fault and driving an unregistered vehicle and other personal fee arrangements

The NZ system is even better. One company has the 'insure all registered vehicles' contract for the entire nation, and they tender for that every couple of years to ensure prices are fair (It's a really big contract so naturally competition is sharp). That company also then automatically fully liable for anyone the driver of an unregistered vehicle injures in a car accident, and the assessment is non contestably carried out by government doctors.

That is a brilliant system. I'm not even sure why this crap should end up in court.

The french system is also better. The government would just pick up the entire tab for her medical care either way. And the kid would still get education for free or no interest loans and a government stipend for a student. sure he'll be eating ramen, but thats okay.

First of all this isn't Laissez Faire capitalism. If it was then Wal-Mart would either a) not give health care and pay the same wages, or b) pay her extra money so she could buy her own insurance. Problem is that when you do this people tend to take the money they are given and spend it on stupid shit instead of health insurance. Wal-Mart is actually being a responsible corporate citizen in this case.

Second, and this is going to sound INCREDIBLY harsh, but I have extreme difficulty imagining this woman ever earning enough money in her natural, undamaged life to EVER be worth $470,000. Assuming that from the point at which she was hit by the truck she had 35 years of work left in her, if you discount at a rate of 10%, she would have to earn a little over $48,700 per year. Using BC, Canada minimum wage rates (which is probably close to what they make at Wal-Mart here) she was only making $15,360. I don't know how their wages scale based on seniority at Wal-Mart but that is TRIPLE a minimum wage salary.

This of course begs the question that people NEVER ask: why is medical care so expensive? Doctors are a dime a dozen but they all collude to charge higher prices. If she needs $470K to cover medical expenses then that is ridiculous. But then, doctors save people and lawyers and businessmen don't so let's just shit all over the lawyers and businessmen as evil.

Some of us happen to like this broken laissez faire capitalist system, and would prefer that the government stay the Hell out of our lives.

It is - it is significantly to a corporations advantage to offer health insurance so you can keep employees healthy (same reason my company gives free flu shots), remember she selected to participate in the plan in the example, so wal-mart is offering to pay more and you can participate in a company healthcare scheme. Exactly like you suggest.

Your analysis of the payout is screwed. It compensates for lost income AND care costs. Care costs for what she has (it sounds like dementia) brain damage are very high as you need constant supervision.

Medical care is expensive because the US drives the costs up by loading down students with debt, so your highly trained health professionals need to recover enough money from you. Also, care for people with brain damage is very service intensive requiring full time care, and full time carers are bloody expensive. But don;t worry, the american system of HMO's is here to screw it up again. 25-30% of the USA's healthcare costs are administrative & billing overhead, a number that is much lower in australia, ranging from 3-4% for private schemes to less than 1% for the government scheme.

Agreed, although it's possible to have a representative government (there's a lot of crap I don't want to have to deal with) and still have them stay the hell out of our lives. A proportional system, for example.

In principal I agree with you about the health insurance thing. Strictly speaking however, stocking shelves doesn't require any skill and 0 training. In proper laissez faire economics you wouldn't give a shit about employee morale or health. You'd work them until they can't work anymore and then hire someone new. The only thing you'd have to do is watch them to make sure they aren't stealing or breaking things. Think Victorian England/Charles Dickens. Laissez Faire economics has zero bearing in the modern world.

My math isn't wonky unless my TI BA 2 Plus Financial calculator has some sort of weird glitch in it. I just used simple Time Value of Money calculations. 35 yearly payments of $48.7K are equal to $470K right now at 10% interest. 1 million is actually pretty ridiculous too. That comes out at $103,700 per year. Essentially what the courts did was take the burden off of WalMart and transfer it to the Trucking Company. The biggest tragedy is that the lawyers are now getting paid more for her pain and suffering than she is.

The family needed a much friendlier lawyer. This guy sounds like a shifty SOB. He obviously knew about the WalMart policy. That's why he charged them so much money to prosecute the law suit. He figured that they could get the money from the Trucking Company and still get the money from WalMart EVEN THOUGH HE HAD READ THE INSURANCE POLICY. Then he got surprised that WalMart and the Courts decided to play by the rules so he had to let slip the dogs of war (ie. the media) to get her money back. He basically made WalMart look bad so that he wouldn't.

You are wrong about the Student Loans thing. While it does play some part it isn't the main reason for high costs of health care. It has more to do with the fact that you need 10 years of training to be a doctor. Not just anyone can do it. And they make you pay for it.

Ah, martindv, always the fortress of logic, supporting examples, and well articulated philosophical reasoning. I knew I could count on you.

I personally feel like the US would be better off with socialized healthcare, because the current system is already as complex as a socialized system complete with paperwork, and yet at the same time quality health care is not available to everyone. Is it really more "efficient" to have the current mess of insurance companies, health care providers, and lawsuits and liability dictating through the current legalistic calculus who gets care and to what extent?

Recently, my dad went to an ear, nose, and throat specialist to take a look at his broken cheekbone. The specialist barely looked at his cheekbone, grabbed a little scope, looked in my dad's nose, said "that's terrible, do you have trouble breathing, I'm scheduling a scan", and ended the session. He then charged $2,000 dollars! My dad has never had any problems or discomfort with his nose, which wasn't even the purpose of his visit, so we cancelled the scan and subsequent visits for fear of what the doctor might try to charge for something more complex than looking up my dad's nose.

I'm so disgusted with how many health care providers are basically set up to try and milk insurance companies. What if my dad didn't have insurance? What the hell would we do with a 2000 dollar bill like that? And even if we didn't get ripped off, the insurance company sure did. That was a waste of money that somebody had to foot; a grotesque finanical inefficiency created by one private doctor. I feel very frustrated when some people don't even want to discuss socialized health care because of the term "socialized" when we have abuses like this coming from our current system.

I feel like in these difficult financial times, and with the current problems we face in health care costs for the nation, folks like this doctor are really contributing to how greedy elites are selling the United States down the river. I feel as though over the course of my life I've always done my best to embody a strong spirit of public service, and what I see so many for-profit entities doing runs strongly antithetical to my values. I'm very disappointed that lots of people in the US seem to have taken up what amounts to an ideological position that private enterprise "will always" do everything better than the government; whenever someone states in that extreme form the statement is always by necessity ideological rather than evidence-based. I believe that as a person I would be able to work in the interests of public service either for the federal government or a nonprofit and provide in many examples more good for society and the world than someone might in a for-profit enterprise; to deny that that's even possible in at least certain cases is just dogmatic and ridiculous.

On a tangent, what's the income tax rate like over in the US? For say 100K a year?

Well first, the government might no pick up the entire tab. Some medical care are fully refunded, other are less so (or even not at all). It's supposed to be based on the importance of the medical care, but there are still some problems (mostly with glasses... the Social Security will refund something like 4€ for glasses, except if you accept glasses that are so hideous that poor people prefer to go without glasses than with these things).

Then it's not exactly free of charge: it's paid for by the taxes. In theory at least. The big trouble we have is that in the last 20 years or so it has mostly been paid with money the government didn't have... And borrowing money for daily expenses isn't exactly a good thing. Furthermore even if medical care is mostly free, public hospitals are understaffed and some of them are getting closed down.

I don't say the system is bad. I think it's great (I even got money from the government to go study in Hong-Kong!) but it's not without problems.

Here's a newsflash for all of you pining for socialized health care:

DOCTORS STILL CHARGE $2000 TO LOOKUP YOUR NOSE.

Except now the burden is born by insurance companies AND THE GOVERNMENT. What you end up having is a system in which the Healthy subsidize the unhealthy through taxes.

Complete and total bullshit.
When I go to the doctor, he charges me 25 Euros of which I get 21 Euros back through my government health care.
I pay my doctor, our socialized health care repays me.
Next time you make a statement, at least try to know what you're talking about.

What's your tax rate?

The way it works here in Canada, is he charges me 25 bucks, my private health plan gives me 21 back, and he charges the government 100 dollars.

I know how my system works. Next time take your foot out of your mouth before you open it ArkonC.

My tax rate is 15% because I am at the bottom tax bracket. I would have to pay $54 a month (for one person) for my "free" government health care if my company did not make my payments (and my last job didn't). And that only covers basic emergencies and I think 50% of the cost of care.

Maybe you should have specified it's about the canadian health care, which I know nothing about...
Making a blanket statement about socialized health care like that, well, it just doesn't work...
Also very funny how suddenly 2000 becomes 100, quite a difference...

What makes american health care so expensive compared to other countries is twofold (well, there are a lot more reasons, but these are the 2 big ones):
First, there's the fact that most people, because they have no or very little health care, wait too long to get treatment, and it is much cheaper to cure illness or injury sooner rather than later.
Second, there's the fact that doctors and hospitals have huge malpractice insurance fees which they just pass on to their patients.

EDIT: Also, I was hospitalized several months ago for kidney stones, was in the hospital for 5 days, in a single room, and I saw my bill, it was 2100 Euros, of which I had to pay nothing, it was all taken care of by government health care...
When I was living in the states, I went to the emergency room for a work related accident (stapeled my hand, long story), I had to wait for 5 hours before I saw a doctor, then he called a nurse to pull out the staple, give me some pain killers and slapped me with a 2700 dollar bill. Talking to the nurse, it turns out that over 2000 dollars was for various malpractice insurances, for the doctor, the hospital, the nurse, the pain killer manufacturers...

It became 100 because you used the example of 25 and 2000 would have been ridiculous in that case. Let's use the 2000 then. My government subsidizes 80% (assuming I've paid my 54/mo), that leaves 400 to cover. The plan I have happens to cover 90% so they cover 360. Leaving me to pay 40. The Doctor still gets 2000.

France covers 70%. Britain it is 100%. Can't tell with Germany or the Netherlands. Swedes pay a small fee. Not sure what part of the old world you are from but it sounds like it works about the same. Fact of the matter is that the doctors still get their pound of flesh. But instead of the patient bearing all the burden SOCIETY bears the burden.

Which gets back to my point that public health care is a tax on the healthy to subsidize the unhealthy.

We have mandatory health insurance, the government pays your insurance if you cannot afford it, and my tax rate (state and federal added together) is below 10% - and I am not paying the minimal rate. VAT is at 7,6%.

It's not a perfect system over here in Switzerland, but it shows that "socialist health care" can work very well without leading to high taxes.

For a regular doctors visit, my doctor gets a grand total of 25 Euros, what I payed him, and I get 21 Euros back, there are doctors here that work at the payback rate, 21 Euros, so I would end up paying nothing...
For hospitalization and such, I'm not sure how it works, all I know is I pay 9 Euros a month for additional hospitalization insurance and I pay nothing when I need to go to the hospital...

I actually believe that it makes sense to have the strong help out the weak, the healthy pay health tax that helps out the sick, so their burden is much less and they don't have to declare bankrupcy when they break an arm (which happened to a guy I knew that lived in West Virginia, just like I feel it makes sense that working people pay taxes to help out the unemployed, so they can get back on their feet. Yes, the system has it's flaws, big ones, in fact, if you've got a moment, they are twelve-story flaws with a magnificent entrance hall, carpetting throughout, 24-hour portrage, and an enormous sign on the roof, saying `These are Large Flaws'. But it beats leaving the weak amongst us to fend for themselves...

Additional, my apologies for my overreaction to your initial statement, I guess 2 years in NYC made me a bit sensitive to people talking about the evils of government health care.

Malpractice insurance is ultimately a good thing, because shit happens. Sometimes, a nurse confuses units with CCs and gives you 1000 times the maximum safe dose of a blood thinner. Sometimes you need a limb amputated because of antibiotic resistance flesh-eating bacteria but the guy who draws the lines of you forgets the difference between your right and his right, resulting in the amputation of the wrong limb. Nobody's perfect. And inperfection in medicine usually has bad results.

Malpractice Insurance is a 'necessary evil', Hyzmarca, but the system we have now is making things worse. Frivolous malpractice suits and the tendency of the insurers to pay every suit, regardless, and pass on the costs to the doctors ensures that medical costs continue to rise. Doctors can (and hopefully rarely) do fall back on their Insurance as an excuse not to concern themselves overly much with what they do.

Personally, I think a serious overhaul of the entire malpractice system would do more to fix the 'health care crisis' than having the government pay everything... but then I think a vast overhaul of the entire legal system is in order.

It'd be better if 90% of the money paid into the malpractice insurance funds actually came out as payments to those who've suffered from the malpractice, as opposed to 90% of it going into the pockets of the shareholders of the insurance companies and the bonuses of the executives of the insurance companies and the fees of the lawyers "required" to fight the cases. Maybe then there wouldn't be a 2 grand premium on basic ER treatment.

Of course malpractice insurance is a good thing, but the combination of a lot of lawsuits for malpractice and malpractrice insurance drives the prices through the roof, and that is what makes health care more expensive in the states than in other places, comparatively, that was my point, not that malpractice insurance is a tool of the devil...

Incidentally, our legal system does not permit lawyers to work for a part of the sum they obtain for their client. Win or lose, a lawyer has to bill his client for services rendered. Also, the party that loses a suit is liable for all court fees, and owes the other party compensation for their legal fees and other costs caused by the suit (if someone sues for 10000 and gets 7500 he has to pay 25% of the court costs, and receives half his legal fees and costs from the defending party. If he gets 2500, he pays 75% of the court costs, and owes the defending party 50% of their legal fees and costs, if he gets 5000 the court costs are halved, and the legal fees are paid by each side.)

That does cut down the numbers of frivoulos suits some.

Exactly. Nothing's ever free. It's just that someone else is paying for it. Someone somewhere has to pay the doctor.
Yes it means that healthy people pay for unhealthy people. I've got nothing against that, even if I'm rather healthy (can't remember the last time I went to the doctor because of sickness or injury).

Please. That's like saying my tax money that's earmarked for defense spending is subsidizing Lockheed Martin. It's the responsibility of any government to tend to the safety and health of its citizens which means it's supposed to help those who legitimately don't have the means to help themselves.

I'm really quite tired of hearing conservative Americans and politicians make ridiculous statements like, "If you think socialized health care is so great, go ask a Canadian!" From the Canadians (and British) I've talked to they're quite happy with their health care systems even if they do have a few flaws. I have good insurance but I'd gladly take socialized medicine over American profit driven institutions.

Countdown for thread-locking in three... two... one...

Health care here in Austria is incredible. All the basics are covered, most other things are heavily subsidized, the doctors make decent money but no one is making a killing and yet this place has one of the most cutting edge medical systems on the planet...and the taxes are not out of sight at all. Add to this that there are virtually no homeless and crime is almost non-existent in a major capital city like Vienna, with two million people and a HUGE number of immigrants.

Kind of makes you wonder where we went wrong in the States, neh?

I recovered financially years ago, but I went from owning my house, two cars and a bass boat and having a hundred grand or so in the bank to dead flat broke and living in a single room the size of a crackerbox in three years almost entirely because of my then wifes medical expenses. And I had a tremendous Insurance program. Hey, anyone who tells you that the system in the US isn't horribly broken is selling either you, or more likely, themselves, a good line of BS.


Isshia

God, that's horrible and I'm so sorry to hear that happened. That's the stuff that keeps me up at night when I go through my insurance statements and have to pay for this, that and the other because it's "not covered on my policy" when, damn it, I shouldn't HAVE TO!

I have a few minor problems with Canadian health care, but they could all be solved by having our government NOT intentionally try to sabotage the system to implement a 2 tiered health care system. Seriously in the province I live in the government has made several decisions which have served to undermine the public system, and they were all done as 'cost cutting measures' but actually wound up costing more money then they the systems they were to replace. When things are done for a public company you don't have to gouge for proffit for the share holders, which means more money left over for actually doing the job right. Now we just need to hire private consultants who have seen how private hospitals are run to get rid of the unnessesary administration in our public hospitals, and use the left over money to do things like get more MRI's and the like, and we'll be golden.

It beats being SINless...
Though I wonder what healthcare is like for the average SINner...

Those "not covered" clauses and cap clauses will get ya if you aren't lucky. Careful has little to do with it.

But hey, it was one of the reasons that after I began to recover financially I moved here, and I've never been half so happy anywhere else in my life, so it all worked out for the best in the end. And, I do realize that I was a one in a ...case. The problem is that the "..." number is growing smaller year by year and not larger, making it ever more likely that someone else you know will have it happen to them too.

I hope to god it never happens to any of you here. I hope to god it never happens to anyone...but my wishes keep sliding through the nets somehow.


Isshia

Street doc anyone? Just costs you an arm, and a leg. Or maybe just your left kidney if you're lucky.