Another triumph for the American health-care system

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Another triumph for the American health-care system

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http://www.cnn.com/2008/US/03/25/walmar ... index.html
Brain-damaged woman at center of Wal-Mart suit

By Randi Kaye
CNN

JACKSON, Missouri (CNN) -- Debbie Shank breaks down in tears every time she's told that her 18-year-old son, Jeremy, was killed in Iraq.

Even though the 52-year-old mother of three attended her son's funeral -- she continues to ask how he's doing. When her family reminds her that he's dead -- she weeps as if hearing the news for the first time.

Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.

It was the beginning of a series of battles -- both personal and legal -- that loomed for Shank and her family. One of their biggest was with Wal-Mart's health plan.

Eight years ago, Shank was stocking shelves for the retail giant and signed up for Wal-Mart's health and benefits plan.

Two years after the accident, Shank and her husband, Jim, were awarded about $1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $417,000 was placed in a trust to pay for Debbie Shank's long-term care.

Wal-Mart had paid out about $470,000 for Shank's medical expenses and later sued for the same amount. However, the court ruled it can only recoup what is left in the family's trust.

The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit.

The family's attorney, Maurice Graham, said he informed Wal-Mart about the settlement and believed the Shanks would be allowed to keep the money. Video Watch this couple's story »

"We assumed after three years, they [Wal-Mart] had made a decision to let Debbie Shank use this money for what it was intended to," Graham said.

The Shanks lost their suit to Wal-Mart. Last summer, the couple appealed the ruling -- but also lost it. One week later, their son was killed in Iraq.

"They are quite within their rights. But I just wonder if they need it that bad," Jim Shank said.

In 2007, the retail giant reported net sales in the third quarter of $90 billion.

Legal or not, CNN asked Wal-Mart why the company pursued the money.

Wal-Mart spokesman John Simley, who called Debbie Shank's case "unbelievably sad," replied in a statement: "Wal-Mart's 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."

Jim Shank said he believes Wal-Mart should make an exception.

"My idea of a win-win is -- you keep the paperwork that says you won and let us keep the money so I can take care of my wife," he said.

The family's situation is so dire that last year Jim Shank divorced Debbie, so she could receive more money from Medicaid.

Jim Shank, 54, is recovering from prostate cancer, works two jobs and struggles to pay the bills. He's afraid he won't be able to send their youngest son to college and pay for his and Debbie's care.

"Who needs the money more? A disabled lady in a wheelchair with no future, whatsoever, or does Wal-Mart need $90 billion, plus $200,000?" he asked.

The family's attorney agrees.

"The recovery that Debbie Shank made was recovery for future lost earnings, for her pain and suffering," Graham said.

"She'll never be able to work again. Never have a relationship with her husband or children again. The damage she recovered was for much more than just medical expenses."

Graham said he believes Wal-Mart should be entitled to only about $100,000. Right now, about $277,000 remains in the trust -- far short of the $470,000 Wal-Mart wants back.

Refusing to give up the fight, the Shanks appealed to the U.S. Supreme Court. But just last week, the high court said it would not hear the case.

Graham said the Shanks have exhausted all their resources and there's nothing more they can do but go on with their lives.
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Jim Shank said he's disappointed with the Supreme Court's decision not to hear the case -- not for the sake of his family -- but for those who might face similar circumstances.

For now, he said the family will figure out a way to get by and "do the best we can for Debbie."

"Luckily, she's oblivious to everything," he said. "We don't tell her
what's going on because it will just upset her."
So if you're working for Wal-Mart and you're crippled for life by somebody, Wal-Mart gets first dibs on any money you recover from the negligent party. Even if that means completely draining your finances.

Yup, George W. Bush was right. You have the "greatest health-care system in the world".
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Post by Darth Raptor »

"What about our shareholders, Bob? Who's taking care of them!?"

The Wal-Mart spokescum have literally reached cartoonish levels of villainy.
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Post by brianeyci »

If that was Canada with such a huge injustice, she could call up a powerful and influential MP. During question period, especially if the MP was a maverick type (real definition of maverick not John McCain) the opposition would ram the injustice up the ruling party's ass, who would then have to weigh the benefits of negative media exposure compared to the trouble of making legislation to correct the injustice. It's been done before for everything as mundane to potholes to student loans. For example, I could call up Bob Rae.

But it's the United States, so without a lobbyist you are fucked up the ass, because Congress is too incompetent and corrupt to do anything without them. Can't get a lobbyist without a powerful union, and Wal-Mart closes stores that tries to unionize. A nice little stranglehold the bourgeoise have on the proletariat there.
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Post by Superman »

Goddamn, Wal Mart is evil incarnate.
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Post by Darth Wong »

brianeyci wrote:If that was Canada with such a huge injustice, she could call up a powerful and influential MP. During question period, especially if the MP was a maverick type (real definition of maverick not John McCain) the opposition would ram the injustice up the ruling party's ass, who would then have to weigh the benefits of negative media exposure compared to the trouble of making legislation to correct the injustice. It's been done before for everything as mundane to potholes to student loans. For example, I could call up Bob Rae.

But it's the United States, so without a lobbyist you are fucked up the ass, because Congress is too incompetent and corrupt to do anything without them. Can't get a lobbyist without a powerful union, and Wal-Mart closes stores that tries to unionize. A nice little stranglehold the bourgeoise have on the proletariat there.
That's because in Canada, something like this (although I can't see how it could happen) would be considered a failure of the health-care system. But in America, this is the system working normally. The only reason it's an issue at all is because Wal-Mart has shitloads of money, so people want them to lay off even though they have every right to do this under the system.
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Post by FSTargetDrone »

I'm always amused at how Wal*Mart refers to its employees as "Associates." Yes, we're associates! Doesn't that sounds just so wonderful?

Anyway, talk about a living hell. Bad enough for the woman to have to be told again and again that the son is dead (not to mention the overall strain on the family because of the injury), but even worse for those of the family who have to be the ones to tell her, again and and again. I'm not sure who has it worse.
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Post by Darth Wong »

FSTargetDrone wrote:I'm always amused at how Wal*Mart refers to its employees as "Associates." Yes, we're associates! Doesn't that sounds just so wonderful?

Anyway, talk about a living hell. Bad enough for the woman to have to be told again and again that the son is dead (not to mention the overall strain on the family because of the injury), but even worse for those of the family who have to be the ones to tell her, again and and again. I'm not sure who has it worse.
Clearly, the shareholders of Wal-Mart are the real victims. That's why they're suing her family to get every last penny she has.
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Post by Alan Bolte »

I should probably move to another country. When I read the article, it didn't strike me as wrong, or even abnormal.
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Post by Surlethe »

Alan Bolte wrote:I should probably move to another country. When I read the article, it didn't strike me as wrong, or even abnormal.
Abnormal? No. Wrong? Of course.

Of course, if I bring this up with a more conservative person, he'll shrug and say, "They deserve it; they should have read the fine print," and then decry the decline of personal responsibility.
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Post by Gaidin »

That's got to be one of the most screwed up cases of bad timing I've ever seen. I mean, it doesn't strike me as off, or even wrong, that Wal-Mart is able to recoup its costs for the trucking company's fuckup should the company be forced to pay out. I can't find a good reason to have two company's pay for the one's fuckup in the end. A nice demonstration case of why private healthcare sucks.

Aside: Even if the Shanks missed the fine print in the policy, how did their lawyer miss it? Surely he read the policy?
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Post by Darth Wong »

Wow. And I thought that any normal person would instantly see this as hideously wrong. I guess I underestimated the moral perversion of Reaganism on Americans.
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Post by Aaron »

Darth Wong wrote: That's because in Canada, something like this (although I can't see how it could happen) would be considered a failure of the health-care system. But in America, this is the system working normally. The only reason it's an issue at all is because Wal-Mart has shitloads of money, so people want them to lay off even though they have every right to do this under the system.
Similar things are possible, for example if your a Veteran and your taking advantage of the retraining and income loss program from the military's insurance company (SISIP) and you get a settlement from VA or CPP then they take a large portion of it under similar reasoning. There's a class action in progress right now to stop that.
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Post by The Spartan »

Gaidin wrote:Aside: Even if the Shanks missed the fine print in the policy, how did their lawyer miss it? Surely he read the policy?
You think they were able to afford a lawyer to go over their policy? Or that they would have a different, affordable option if they had noticed that? They worked at Wal-Mart stocking shelves!
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Post by Gaidin »

The Spartan wrote: You think they were able to afford a lawyer to go over their policy? Or that they would have a different, affordable option if they had noticed that? They worked at Wal-Mart stocking shelves!
Not when they first got it no, I wouldn't expect them to have a lawyer to go over the policy. Granted I'm likely armchair generaling here, but it seems sensible that going over the current policy for possible snafus before you sue the trucking company seems sensible.
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Post by Zed Snardbody »

Gaidin wrote:
The Spartan wrote: You think they were able to afford a lawyer to go over their policy? Or that they would have a different, affordable option if they had noticed that? They worked at Wal-Mart stocking shelves!
Not when they first got it no, I wouldn't expect them to have a lawyer to go over the policy. Granted I'm likely armchair generaling here, but it seems sensible that going over the current policy for possible snafus before you sue the trucking company seems sensible.
You're suing the trucking company that crippled your wife. Why are you going to go, well I should check my health insurance while we're at it just for shits and giggles.

Most policies have no clause for recuperation, they have shit that will stop them from paying after you reach a threshold but its an Americans god given right to sue and keep the money they win whether the law suit is valid or not......An I can't tell where my sarcasm starts and stops in the last part.
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Post by Rye »

Darth Wong wrote:Wow. And I thought that any normal person would instantly see this as hideously wrong. I guess I underestimated the moral perversion of Reaganism on Americans.
I think he meant wrong as in "incorrect", as that fits with the surrounding context better, rather than morally evil, which it surely is. Anyway, that's absolutely repugnant and another reason why I refuse to buy anything from Asda (owned by Walmart over here, though I'd hope they wouldn't have such a clause).
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Post by cosmicalstorm »

It's a horrible story, but from what I gather, if they let her of the hook there would be a thousand lawyers lining up outside their HQ asking the same be done to their clients tomorrow.
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Post by Edi »

cosmicalstorm wrote:It's a horrible story, but from what I gather, if they let her of the hook there would be a thousand lawyers lining up outside their HQ asking the same be done to their clients tomorrow.
That's because they deliberately made a policy that ensures they never have to pay out anything if they can help it.
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Post by Broomstick »

Zed Snardbody wrote:
Gaidin wrote:
The Spartan wrote: You think they were able to afford a lawyer to go over their policy? Or that they would have a different, affordable option if they had noticed that? They worked at Wal-Mart stocking shelves!
Not when they first got it no, I wouldn't expect them to have a lawyer to go over the policy. Granted I'm likely armchair generaling here, but it seems sensible that going over the current policy for possible snafus before you sue the trucking company seems sensible.
You're suing the trucking company that crippled your wife. Why are you going to go, well I should check my health insurance while we're at it just for shits and giggles.

Most policies have no clause for recuperation, they have shit that will stop them from paying after you reach a threshold but its an Americans god given right to sue and keep the money they win whether the law suit is valid or not......An I can't tell where my sarcasm starts and stops in the last part.
Two points:

First: even if the woman HAD read the fine print on her insurance.. so what? What other alternative did she have for health coverage? Keep in mind, too, that in many states if your employer offers ANY type of health insurance coverage, no matter how shit, you are DISQUALIFIED from any sort of state-sponsered health insurance or assistance.

Which is yet another reason why it's ludicrous to say we have a free-makret health system or to promote "consumer responsibility" - the average person effectively has NO CHOICE and NO ALTERNATIVES

Second: that clause about recouping expenses after a lawsuit is FAR more common than people realize. It's not just Wal-Mart. And Wal-Mart certainly did not invent it. I was saddled with just such a health policy back in the early 1990's while working for a clinic - but I had no choice. I had no other alternatives.
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Post by Illuminatus Primus »

Surlethe wrote:
Alan Bolte wrote:I should probably move to another country. When I read the article, it didn't strike me as wrong, or even abnormal.
Abnormal? No. Wrong? Of course.

Of course, if I bring this up with a more conservative person, he'll shrug and say, "They deserve it; they should have read the fine print," and then decry the decline of personal responsibility.
Right. Always from this pompous paragons of personal responsibility too; then the first thing goes wrong because they didn't pay attention and the gov't is out to get them.
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Post by Lettuce »

Alan Bolte wrote:I should probably move to another country. When I read the article, it didn't strike me as wrong, or even abnormal.
I had a similar reaction. It's just business as usual. ....Though, now being uninsured, I find it infuriating that this is the norm.
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Post by Darth Wong »

Did you read the comments on the original article at CNN? It's just sickening how many people immediately rise up to make excuses for this state of affairs.

I particularly liked the one asshole who said that the article was left-wing propaganda, designed to trick the good people of America into accepting a socialist health-care system.
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Post by Lettuce »

I love the call for a boycott. ....Because Wal-Mart will really notice the 5 or 6 people who aren't going to shop there for a few weeks.
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Post by Darth Wong »

Lettuce wrote:I love the call for a boycott. ....Because Wal-Mart will really notice the 5 or 6 people who aren't going to shop there for a few weeks.
In libertarian fantasy-land, powerful corporations fear the public because the public will boycott them the instant they are offended in any way by their conduct.

In reality, they know the public will continue to shop at a place they hate, as long as the prices are low. How many people hate Wal-Mart but still buy their socks there? How many fundies agreed with the call to boycott Disney for owning Miramax, but couldn't say no to their kids who wanted to go to DisneyLand?
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Post by K. A. Pital »

Darth Wong wrote:In libertarian fantasy-land, powerful corporations fear the public because the public will boycott them the instant they are offended in any way by their conduct.
Yeah. Can a company have worse PR than Wal Mart? Only if it's Union Carbide I guess. Did that really bad PR ban either Walmart or even - atrocious, I know - the Bhopal guys from prospering? :roll: No.
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