For reasons too tedious to detail here, I will use this platform to compose the beginning of a draft to New York State’s activist attorney general urging him to take action.   This AG is the guy who successfully sued President Winner over his fraudulent university.   In NYS the AG also proposes and advocates for legislation, as it turns out.   I have a plan.  Relatively short, streamlined cover letter with several attachments laying out the infernal particulars.   Blah blah (see #1)  blah blah blah (#2) etc.

Dear Mr. Attorney General,

I am writing to give you an on-the-ground view of the stressful health care situation for hundreds of thousands of us in New York State.  As described more fully below, citizens of our state have no government agency that intervenes in cases where patients are mistreated by the corporations we buy health insurance from.   This is true even in cases of apparent fraud.  

I urge you to propose legislation to correct this grave oversight. The need for state regulation of health insurance is even more acute in light of the current federal administration’s determination to gut all regulation.

I’ve followed your career and admire the principled and proactive steps your office has taken against the powerful perpetrators of various frauds.  Leaving politics aside, as one must in a letter like this, it is gratifying to see someone in office holding powerful entities responsible for their bad acts.  Your office is well-suited to fix what I believe is a health care emergency affecting the lives of countless New Yorkers, particularly older citizens and those living just above the “poverty line.”

It has been difficult to put the many healthcare-related issues I’ve been forced to navigate into a streamlined letter.  I am certain that my experience as a consumer who buys health insurance on the New York State of Health Marketplace is representative of the experiences of countless others.  I have confirmed this many times over the last few years.  

As frustrating as my ordeals have been, I have the benefits of fluency in English, computer literacy, legal skills.  I cannot imagine the life-shortening stress that is inflicted on the elderly and other vulnerable New Yorkers unable to get so much as a hearing for often unappealable denials of their health care.  I’ve attempted to keep this letter short and to include the devilish details in a series of attachments.

I am therefore attaching a detailed description of the “consumer help” cul du sac that desperate NYS residents can spend a few hours in, looking in vain for help with health insurance-related troubles.  Anyone in your office can retrace the useless steps.  Creating a healthcare ombudsman position would be a good first step here.  (see # 1).  

Corporate “persons” are without conscience and motivated only by a zeal for profit.  When left unregulated, it is no surprise these “persons” act as they see fit.  In the case of health insurance companies, they are free, for example, to repeatedly refer patients to “in network” doctors who are not in network. They are also relatively unrestrained when refusing to provide services, in spite of what the Patient Protection and Affordable Care Act (“PPACA”) may have to say about it.   There is no penalty for these common business practices and they are well aware of it.  Regulations to address these things, with an enforcement arm, would be a good start.  (see #2)

Those mandated by the PPACA to purchase health insurance from the New York State of Health Marketplace may find themselves with a host of new problems during the short holiday season window for purchasing insurance.  A consumer advocate or ombudsperson would greatly aid in resolving problems and errors that presently can only be addressed by a lengthy appeals process.  See  #3

Billing irregularities, including improper bills, which are to be expected in a law as complicated as the PPACA, are probably the most common form of immediate stress most of us are regularly placed under.   The rep at your office’s consumer help desk offered help with billing problems, which I suspect are legion.   I offer a short overview of the larger problem and one recent snapshot as #4.

Thank you for your time.  I am available to amplify anything written here and to testify anywhere you may require.

Yours sincerely,