Aetna stonewalls then says I’m bound to our agreement; I say I’m not and why

April 2, 2014

Dear Mr. Bertolini and Ms. Smith,

January 30, 2014, I submitted my letter of termination to Aetna. You acknowledged receipt of this letter by email on January 30 and by certified mail on February, 7.

March 25, 2014, I finally received your response, dated March 10, 2014, that I am bound to the agreement until 2015.

I now refer you to our Physician Agreement signed September 1, 2012. “Section 6.2 Termination without cause: This Agreement may be terminated by either Party with at least ninety (90) days prior written notice to the other Party. In addition to the foregoing, Group may terminate this Agreement in accordance with the provisions of Section 5.1.” This letter serves to remind you that ninety days from January 30, 2014, my agreement with you is terminated according to Section 6.2.

While I need no cause to terminate, I will voice what has brought me to this point. I will not have my services sold by Aetna on the Federal Obamacare Exchange without my consent. If Aetna can sell my services here, where can they not sell them?

I will not allow Aetna to sell the promise of my services on the Federal exchange against my will, because I refuse to enable the blatant discrimination against certain individuals and groups of Americans created by Aetna’s decision to collude with big government rather than collaborate with patients and physicians. If Aetna can force me to discriminate against certain groups of patients, what can they not force me to do?

The terms of my 2012 agreement with Aetna unilaterally changed, the moment the Patient Protection and Affordable care Act was changed by President Obama and his operatives, in the fashion of a nationalist dictatorship seeking state control of the economy. Since 2013 and now 38 times to date, these politically expedient changes have resulted in selective enforcement of and unequal protection under the law for the American patient. One group of your customers remains subject to the mandates and collectivist policies of Obamacare under threat of monetary penalty while another group of your customers is rewarded with delay or exemption from the iniquities of Obamcare, free to choose health insurance policies of a more Hippocratic, individualized, and patient-centered nature.

Instead of standing for the American patient by standing against such lawless executive over reach, Aetna chose to do the bidding of big government, pursuing profit and politicians over principle and patients. Your decisions violate your Mission Statement and defy your stated core values, particularly, “Integrity- Do the right thing for the right reason”.

Choices such as yours have resulted in millions of customers (patients) losing insurance policies with which they were happy. You cancelled these policies.

Your choices have resulted in one group of your customers (my patients) being offered only policies with benefits and terms they do not want or need and with new usurious premiums and deductibles, while another group of your customers (my patients) remains free to purchase policies with more desirable benefits and terms with lower premiums and deductibles. You created these policies.

Your choices have resulted in one group of your customers (my patients) being subjected to new restricted networks of physicians, hospitals, drugs, and services while another group of your customers (my patients) has access to broader networks of physicians, hospitals, drugs, and services.

Your choices will inevitably result in one group of your customers (my patients) suffering the consequences of such rationing of services while another group of your customers (my patients) will benefit from comparatively easier access to physicians, hospitals, medical care, and services.

Your choices will result in such flagrant discrimination that one group of your customers (my patients) will be subject to financial hardship, potential bankruptcy, and increased morbidity and mortality, while another group of your customers (my patients) will pay less for better benefits and broader access to lifesaving medical care.

According to your own mission statement, you have failed: “Building on our 160-year heritage, Aetna will be a leader cooperating with doctors and hospitals, employers, patients, public officials and others to build a stronger, more effective health care system.” You have chosen to collude with hospitals, public officials, employers and others with no semblance of cooperation with doctors or patients.

According to your mission statement, “Aetna is dedicated to helping people achieve health and financial security by providing easy access to safe, cost-effective, high-quality health care and protecting their finances against health-related risks.” You have made choices which discriminate against one group of customers while favoring another. Perhaps you need two separate mission statements.

I will not be the enabler for such unethical, inhumane discrimination. Without physicians, you sell nothing. Your disrespect, disregard, and disdain for physicians and patients are palpable. You would be better served to pursue patient-centered solutions hand in hand with physicians.

My colleagues and I offer viable solutions for real healthcare reform. I have reached out to you to no avail. Please contact me if you become interested in working with physicians to develop a workable healthcare insurance option to function in a new paradigm-shifting parallel universe, in the void left by the devastating implosion of our current system. We will be here, hunkered in the trenches, actually providing care, saving lives, and fighting to secure our blessings of liberty. You will be exposed, stark naked in the public eye, for selling a false bill of goods, canceling policies that your customers chose, writing policies that discriminate, and promising services that you can’t deliver. You will have to live with the consequences of your bad choices- choices that will result in loss of livelihood and lives of the American people and secure the fundamental transformation of the United States of America.

Sincerely,

Kristin S. Held, MD

 

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6 thoughts on “Aetna stonewalls then says I’m bound to our agreement; I say I’m not and why

  1. Blue Cross Blue Shield is guilty of the same. They have added Health Exchange policies to the already established Blue Choice PPO Network. If you are a physician that takes ANY BCBS PPO plans, you WILL be required to see patients with policies obtained through the exchange. I have confirmed this with our provider rep. They knew they couldn’t add the doctors to the separate Health Exchange networks, so they just threw the Health Exchange policies into the existing networks.

    • Tara,
      You are right on! I discovered this too. I must now address this with Blue Cross Blue Shield. A few other insurance companies have sent letters that I will be listed on the exchange unless I send a letter to say no. Arrogant Obamacare architect Ezekial Emanueal revealed Aetna and Blue Cross’s strategy/perspective in an interview with O’Reilly last month saying “It’s not doctors who participate on the exchange, it’s the insurance companies”. He goes on to say that doctors will have no choice but to play the game because the govt-ins co colluders control all the patients. Then he says-you don’t need a doctor for every part of healthcare. So, this is where we are-patients and doctors really don’t matter anymore. God help us.

  2. Thank you Dr. Held. What a brave, intelligent, and understandable letter. I have been seeing the same doctors, and I have a lot of them, for over 15 years. They provide me with great care, great advice, and sometimes that even get on my case (behind the barn so to speak) only because they know “me.” I want them for another 15 years and not just any doctor the government says I have to use.

  3. Thank you for this letter. We are in desperate times.
    This administration knows no bounds. Ezekiel Emanuel is the same doctor who in the Lancet promoted rationing to leaving out sick babies and seniors, as neither group are producers in an economy but rather drains on healthcare. And this is who designed Obamacare. May G-d help us all. We’re going to need it.

  4. Thank you Dr. Kristin S. Held if more Doctors and Hospitals would do exactly what you have done maybe things could be like they were. I appreciate your true dedication to the Oath you took when becoming a Doctor ~~ do no harm ~~Again Thank-you.

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