unixronin: Galen the technomage, from Babylon 5: Crusade (Default)

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unixronin: Galen the technomage, from Babylon 5: Crusade (Default)
Thursday, April 22nd, 2010 03:40 pm

An investigative piece from Reuters discusses how health insurer Wellpoint, the largest umbrella health insurer in the United States, specifically targeted breast cancer victims and used any pretext, however flimsy, to cancel their insurance — and when it couldn't find a plausible excuse, it just made something up.  Despite lawsuits charging illegal rescission of as many as 10,000 Anthem Blue Cross policyholders in California alone (two of which it has so far lost, paying $11 million in fines and $14 million in restitution), Wellpoint maintains it did nothing wrong.  Wellpoint operates Blue Cross/Blue Shield programs nationwide, as well as other subsidiaries.

As reported in another article last month, Assurant Health, another carrier, similarly targeted HIV-positive policyholders for rescission.  Assurant, like Wellpoint, used computer algorithms that automatically initiated a fraud investigation against any subscriber diagnised with HIV.

The investigation last year by the House Energy and Commerce Committee determined that WellPoint and two of the nation's other largest insurance companies -- UnitedHealth Group Inc and Assurant Health, part of Assurant Inc -- made at least $300 million by improperly rescinding more than 19,000 policyholders over one five-year period.

WellPoint itself profited by more than $128 million from the practice, and the committee suggested that the figure might be largely understated because the company refused to provide information about cancellations by several subsidiaries.

And from the second article,

The committee estimated that Assurant alone profited by more than $150 million between 2003 and 2007 from rescission.

When investigated by Congress, Wellpoint hid behind HIPAA as an excuse for refusal to provide information about patients.  Assurant took various measures to cover its tracks, including destroying records and hiding the identities of persons who sat on rescission star-chambers.

One of the [few, IMHO] things the health care bill gets right is to ban the practice of rescission.  What seems still in doubt is whether, once the actual regulations implementing the bill are written, they will have enough teeth to actually stop it.

unixronin: The caduceus (Medical/Health)
Monday, October 5th, 2009 11:05 am

The ground beef you buy may not be what you think you're buying.  The NYT reports on the problem.

Ground beef is usually not simply a chunk of meat run through a grinder.  Instead, records and interviews show, a single portion of hamburger meat is often an amalgam of various grades of meat from different parts of cows and even from different slaughterhouses.  These cuts of meat are particularly vulnerable to E. coli contamination, food experts and officials say.  Despite this, there is no federal requirement for grinders to test their ingredients for the pathogen.

The frozen hamburgers that the Smiths ate, which were made by the food giant Cargill, were labeled “American Chef’s Selection Angus Beef Patties.”  Yet confidential grinding logs and other Cargill records show that the hamburgers were made from a mix of slaughterhouse trimmings and a mash-like product derived from scraps that were ground together at a plant in Wisconsin.  The ingredients came from slaughterhouses in Nebraska, Texas and Uruguay, and from a South Dakota company that processes fatty trimmings and treats them with ammonia to kill bacteria.

And it's pretty hard to pretend that nobody knows there's a potential problem:

Unwritten agreements between some companies appear to stand in the way of ingredient testing.  Many big slaughterhouses will sell only to grinders who agree not to test their shipments for E. coli, according to officials at two large grinding companies.  Slaughterhouses fear that one grinder’s discovery of E. coli will set off a recall of ingredients they sold to others.

Not that they're going to admit anything, of course:

Cargill, whose $116.6 billion in revenues last year made it the country’s largest private company, declined requests to interview company officials or visit its facilities.  “Cargill is not in a position to answer your specific questions, other than to state that we are committed to continuous improvement in the area of food safety,” the company said, citing continuing litigation.

So they say.  But actions speak louder than words:

In the weeks before Ms. Smith’s patty was made, federal inspectors had repeatedly found that Cargill was violating its own safety procedures in handling ground beef, but they imposed no fines or sanctions, records show.  After the outbreak, the department threatened to withhold the seal of approval that declares “U.S. Inspected and Passed by the Department of Agriculture.”

The picture isn't all bleak.  Not entirely, anyway.  The article calls out Costco as "one of the few big producers that tests trimmings for E. coli before grinding" — though they still use trimmings.

Craig Wilson, Costco’s food safety director, said the company decided it could not rely on its suppliers alone.  “It’s incumbent upon us,” he said.  “If you say, ‘Craig, this is what we’ve done,’ I should be able to go, ‘Cool, I believe you.’  But I’m going to check.”

Costco said it had found E. coli in foreign and domestic beef trimmings and pressured suppliers to fix the problem.  But even Costco, with its huge buying power, said it had met resistance from some big slaughterhouses.  “Tyson will not supply us,” Mr. Wilson said.  “They don’t want us to test.”

On the other hand, some producers just roll over without complaint:

The food safety officer at American Foodservice, which grinds 365 million pounds of hamburger a year, said it stopped testing trimmings a decade ago because of resistance from slaughterhouses.  “They would not sell to us,” said Timothy P. Biela, the officer.  “If I test and it’s positive, I put them in a regulatory situation.  One, I have to tell the government, and two, the government will trace it back to them.  So we don’t do that.”

The USDA is, frankly, little help here.  It refuses to order meat-grinding companies to test their product for contamination.

In August 2008, the U.S.D.A. issued a draft guideline again urging, but not ordering, processors to test ingredients before grinding.  “Optimally, every production lot should be sampled and tested before leaving the supplier and again before use at the receiver,” the draft guideline said.

But the department received critical comments on the guideline, which has not been made official.  Industry officials said that the cost of testing could unfairly burden small processors and that slaughterhouses already test.  In an October 2008 letter to the department, the American Association of Meat Processors said the proposed guideline departed from U.S.D.A.’s strategy of allowing companies to devise their own safety programs, “thus returning to more of the agency’s ‘command and control’ mind-set.”

The emphasis there is mine.  "Allowing companies to devise their own safety programs."  Unless, of course, they want to actually REALLY be safe, like the several small beef producers who wanted to test 100% of their beef for BSE, instead of just spot-sampling in accordance with USDA minimum requirements recommendations, and market it specifically as 100% tested beef — only the USDA wouldn't allow them to do so, due to pressure from large industrial beef producers who didn't want to have to do 100% testing to compete.

Public pressure, in this case, eventually forced Cargill to do the right thing; they recalled almost 425 TONS of contaminated and suspect beef patties.  But they didn't act until a Minnesota Health Department warning was aired on state-wide TV news broadcasts.

The mix of ingredients in the burgers made it almost impossible for either federal officials or Cargill to trace the contamination to a specific slaughterhouse.  Yet after the outbreak, Cargill had new incentives to find out which supplier had sent the tainted meat.

But, "new incentives" or not, apparently Cargill still didn't actually do so.  It took four months of negotiation with the USDA before Cargill "agreed to increase its scrutiny of suppliers and their testing, including audits and periodic checks to determine the accuracy of their laboratories" and "increase testing of finished ground beef" — but still refused to test incoming ingredients, because it might result in embarrassing their suppliers or costing their suppliers money.  That includes suppliers such as Beef Products Inc, a company that processes 3,500 tons of meat trimmings a week into "lean ground beef" using heat, centrifuges and ammonia.  Meat from Beef Products Inc has been banned for use in school lunches, but is widely used by fast-food restaurants and in prepackaged ground meat sold at supermarkets.

Lessons to learn

I see five things to take away from this:

  • Don't assume that a large food producing company is going to do anything to ensure that the food you buy is safe, unless they are forced to do so — and don't assume that the USDA is going to force them to do so.

  • Don't buy industrially prepackaged ground-beef products, including frozen prepared hamburger patties.

  • Don't go to fast food restaurants; you don't know what you're getting.

  • "Angus Beef" is now a meaningless marketing buzzword.  It does not imply quality, or that anything in the package ever came into contact with an Angus steer.

  • When you buy ground beef, buy fresh meat that's ground right there in the store from whole cuts of beef.