Tag: Deny

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Health

UnitedHealthcare Might Deny Emergency Go to Protection

UnitedHealthcare May Deny Emergency Visit Coverage

“Unnecessary use of the emergency room costs nearly $32 billion annually, driving up health care costs for everyone,” the company said in a statement on Monday. “We are taking steps to make care more affordable, encouraging people who do not have a health care emergency to seek treatment in a more appropriate setting, such as an urgent care center. If one of our members does receive care in an emergency room for a t issue, like pink eye, we will reimburse the emergency facility according to the member’s benefit plan.”

During the pandemic and for months of lockdown, non-Covid care, ranging from knee surgeries to mammograms to emergency room visits, fell. While some experts worried that the lack of care would cause patients’ conditions to worsen, others argued the drop off might provide evidence that some care, like screenings, was unnecessary.

United’s initial decision was viewed by some critics as a message directed at hospitals.

“They see this as a way to get the upper hand in their perpetual battle with providers,” said Jonathan Kolstad, a health economist at the University of California, Berkeley.

It was the latest example of the insurer clashing with doctors and hospitals, said Michael R. Turpin, a former United executive who is now an executive vice president at USI, an insurance brokerage that helps businesses find coverage. Most recently, United’s sparring with anesthesiologists resulted in lawsuits from a sizable physician-owned practice backed by private-equity investors, and the hospitals complain that United has adopted other policies that make it difficult for patients to get their care covered.

A few consumers are already battling insurers and some providers over billing for Covid vaccines, prompting the federal government to remind the participants that it is illegal to bill patients for those costs.

There is also increasing evidence that some of the people who didn’t go to emergency rooms during the pandemic would have been better off seeking care. Experts pointed to the increase in death rates from heart disease, diabetes and other illnesses that could indicate people were putting off necessary care. A recent study in Health Affairs by researchers from the M.I.T. Sloan School of Management, working with Boston Emergency Medical Services, found evidence of an increase in heart attacks that had occurred out of the hospital, particularly in low-income neighborhoods.

Mr. Pollack noted that even post-pandemic, such a policy would be problematic: “There is no justification for these restrictions now or after the public health emergency,” he said.

Categories
Politics

Trump’s Legal professionals Deny He Incited Capitol Mob, Saying It’s Democrats Who Spur Violence

Trump’s Lawyers Deny He Incited Capitol Mob, Saying It’s Democrats Who Spur Violence

Former President Donald J. Trump’s legal team mounted a combative defense on Friday focused more on assailing Democrats for “hypocrisy” and “hatred” than justifying Mr. Trump’s own monthslong effort to overturn a democratic election that culminated in last month’s deadly assault on the Capitol.

After days of powerful video footage showing a mob of Trump supporters beating police officers, chasing lawmakers and threatening to kill the vice president and House speaker, Mr. Trump’s lawyers denied that he had incited what they called a “small group” that turned violent. Instead, they tried to turn the tables by calling out Democrats for their own language, which they deemed just as incendiary as Mr. Trump’s.

In so doing, the former president’s lawyers went after not just the House Democrats serving as managers, or prosecutors, in the Senate impeachment trial, but half of the jurors sitting in front of them in the chamber. A rat-a-tat-tat montage of video clips played by the Trump team showed nearly every Democratic senator as well as President Biden and Vice President Kamala Harris using the word “fight” or the phrase “fight like hell” just as Mr. Trump did at a rally of supporters on Jan. 6 just before the siege of the Capitol.

“Suddenly, the word ‘fight’ is off limits?” said Michael T. van der Veen, one of the lawyers hurriedly hired in recent days to defend Mr. Trump. “Spare us the hypocrisy and false indignation. It’s a term that’s used over and over and over again by politicians on both sides of the aisle. And, of course, the Democrat House managers know that the word ‘fight’ has been used figuratively in political speech forever.”

To emphasize the point, the Trump team played some of the same clips four or five times in less than three hours as some of the Democratic senators shook their heads and at least one of their Republican colleagues laughed appreciatively. The lawyers argued that the trial was “shameful” and “a deliberate attempt by the Democrat Party to smear, censor and cancel” an opponent and then rested their case without using even a quarter of the 16 hours allotted to the former president’s defense.

In the process, they tried to effectively narrow the prosecution’s “incitement of insurrection” case as if it centered only on their client’s use of that one phrase in that one speech instead of the relentless campaign that Mr. Trump waged since last summer to discredit an election he would eventually lose and galvanize his supporters to help him cling to power.

“They really didn’t address the facts of the case at all,” said Representative Jamie Raskin, Democrat of Maryland and the lead impeachment manager. “There were a couple propaganda reels about Democratic politicians that would be excluded in any court in the land. They talk about the rules of evidence — all of that was totally irrelevant to the case before us.”

After the Trump team’s abbreviated and at times factually challenged defense, the senators posed their own questions, generally using their queries to score political points. The questions, a total of 28 submitted in writing and read by a clerk, suggested that most Republicans remained likely to vote to acquit Mr. Trump when the Senate reconvenes for final arguments at 10 a.m. Saturday, blocking the two-thirds supermajority required by the Constitution for conviction.

Some of the few Republicans thought to be open to conviction, including Senators Mitt Romney of Utah, Susan Collins of Maine and Lisa Murkowski of Alaska, grilled the lawyers about what Mr. Trump knew and when he knew it during the attack. The managers have argued that it was not just the president’s words and actions in advance of the attack that betrayed his oath, but his failure to act more assertively to stop his supporters after it started.

The Trump Impeachment ›

What You Need to Know

    • A trial is being held to decide whether former President Donald J. Trump is guilty of inciting a deadly mob of his supporters when they stormed the Capitol on Jan. 6, violently breaching security measures and sending lawmakers into hiding as they met to certify President Biden’s victory.
    • The House voted 232 to 197 to approve a single article of impeachment, accusing Mr. Trump of “inciting violence against the government of the United States” in his quest to overturn the election results. Ten Republicans joined the Democrats in voting to impeach him.
    • To convict Mr. Trump, the Senate would need a two-thirds majority to be in agreement. This means at least 17 Republican senators would have to vote with Senate Democrats to convict.
    • A conviction seems unlikely. Last month, only five Republicans in the Senate sided with Democrats in beating back a Republican attempt to dismiss the charges because Mr. Trump is no longer in office. Only 27 senators say they are undecided about whether to convict Mr. Trump.
    • If the Senate convicts Mr. Trump, finding him guilty of “inciting violence against the government of the United States,” senators could then vote on whether to bar him from holding future office. That vote would only require a simple majority, and if it came down to party lines, Democrats would prevail with Vice President Kamala Harris casting the tiebreaking vote.
    • If the Senate does not convict Mr. Trump, the former president could be eligible to run for public office once again. Public opinion surveys show that he remains by far the most popular national figure in the Republican Party.

Responding to the senators, the defense lawyers pointed to mildly worded messages and a video that Mr. Trump posted on Twitter after the building was stormed calling on his supporters not to use violence while still endorsing their cause and telling them that he loved them. The managers repeated that Mr. Trump never made a strong, explicit call on the rioters to halt the attack, nor did he send help.

Mr. Romney and Senator Bill Cassidy, Republican of Louisiana, zeroed in on Mr. Trump’s failure to exhibit concern for his own vice president, Mike Pence, who was targeted for death by the former president’s supporters because he refused to try to block finalization of the election. Even after Mr. Pence was evacuated from the Senate chamber that day, Mr. Trump attacked him on Twitter, saying that “Mike Pence didn’t have the courage to do what should have been done.”

Mr. van der Veen told the senators that “at no point was the president informed that the vice president was in any danger.” But in fact, Senator Tommy Tuberville, Republican of Alabama, told reporters this week that he spoke by telephone with Mr. Trump during the attack and told him that Mr. Pence had been rushed out of the chamber. Officials have said that Mr. Trump never called Mr. Pence to check on his safety and did not speak with him for days.

Another new account emerged as the trial broke for the day, potentially adding to senators’ understanding of Mr. Trump’s state of mind. Representative Jaime Herrera Beutler, Republican of Washington State, who voted to impeach last month, confirmed a report by CNN that when Representative Kevin McCarthy, the House Republican leader, called Mr. Trump during the attack pleading with him to call off the riot, the president told him, “Well, Kevin, I guess these people are more upset about the election than you are.” A spokesman for Mr. McCarthy did not respond to a request for comment, but Ms. Herrera Beutler said he had relayed details of the conversation to her directly.

The defense team struggled to avoid directly addressing what managers called Mr. Trump’s “big lie” that the election was stolen, which led his supporters to invade the Capitol to try to stop Congress from counting the Electoral College votes ratifying the result. Senator Bernie Sanders of Vermont, an independent who caucuses with the Democrats, challenged Mr. Trump’s lawyers to say whether they believe he actually won the election.

“My judgment?” Mr. van der Veen replied derisively and then demanded: “Who asked that?”

“I did,” Mr. Sanders called out from his seat.

“My judgment’s irrelevant in this proceeding,” Mr. van der Veen said, prompting an eruption from Democratic senators. He repeated that “it’s irrelevant” to the question of whether Mr. Trump incited the riot.

Senate Democrats dismissed the defense’s efforts to equate Mr. Trump’s actions with Democratic speeches. “They’re trying to draw a dangerous and distorted equivalence,” Senator Richard Blumenthal, Democrat of Connecticut, told reporters during a break in the trial. “I think it is plainly a distraction from Donald Trump inviting the mob to Washington.”

But for Republicans looking for reasons to acquit Mr. Trump, the defense was more than enough. “The president’s lawyers blew the House managers’ case out of the water,” said Senator Ron Johnson, Republican of Wisconsin.

Even Ms. Murkowski, who called on Mr. Trump to resign after the Capitol siege, said the defense team was “more on their game” than during the trial’s opening day this week, although by day’s end, she indicated to a reporter she was agonizing over the decision.

“It’s been five weeks — less than five weeks — since an event that shook the very core the very foundation of our democracy,” she said. “And we’ve had a lot to process since then.”

During the question period, senators closely watched for clues about where their colleagues stood. Although most lawmakers still guessed that only a handful of Republicans would vote to convict, an additional group of Republicans, including Senator Mitch McConnell of Kentucky, the minority leader, have said almost nothing to colleagues about the unfolding trial in private or during daily luncheons before it convenes, prompting speculation that they could be preparing to break from the party.

The managers need 17 Republicans to join all 50 Democrats to reach the two-thirds required for conviction. While Mr. Trump can no longer be removed from office because his term has ended, he could be barred from ever seeking public office again.

The former president had trouble recruiting a legal team to defend him. The lawyers who represented him last year during his first impeachment trial did not come back for this one, and the set of lawyers he initially hired for this proceeding backed out in disagreement over strategy.

Bruce L. Castor Jr., the leader of this third set, was widely criticized for his preliminary presentation on Tuesday, including reportedly by Mr. Trump, and his colleague David I. Schoen briefly quit on Thursday night in a dispute over how to use videotape in their presentation.

Mr. Castor and Mr. Schoen were largely supplanted on Friday by Mr. van der Veen, who has no long history with the president and in fact was reported to have once called Mr. Trump a “crook” with an expletive, a statement he has denied. Just last year, Mr. van der Veen represented a client suing Mr. Trump over moves that might limit mail-in voting and accused the president of making claims with “no evidence.”

But Mr. van der Veen on Friday offered the sort of aggressive performance that Mr. Trump prefers from his representatives as he accused the other side of “doctoring the evidence” with “manipulated video,” all to promote “a preposterous and monstrous lie” that the former president encouraged violence.

A personal injury lawyer whose Philadelphia law firm solicits slip-and-fall clients on the radio and whose website boasts of winning judgments stemming from auto accidents and one case “involving a dog bite,” Mr. van der Veen proceeded to lecture Mr. Raskin, who taught constitutional law at American University for more than 25 years, about the Constitution. The managers’ arguments, Mr. van der Veen said, were “less than I would expect from a first-year law student.”

He and his colleagues argued that Mr. Trump was exercising his free-speech rights in his fiery address to a rally before supporters broke into the Capitol. The lawyers leaned heavily on Mr. Trump’s single use of the word “peacefully” as he urged backers to march to the Capitol while minimizing the 20 times he used the word “fight.”

“No thinking person could seriously believe that the president’s Jan. 6 speech on the Ellipse was in any way an incitement to violence or insurrection,” Mr. van der Veen said. “The suggestion is patently absurd on its face. Nothing in the text could ever be construed as encouraging, condoning or inciting unlawful activity of any kind.”

Sensitive to the charge that Mr. Trump endangered police officers, who were beaten and in one case killed during the assault, the lawyers played video clips in which he called himself a “law and order president” along with images of antiracism protests that turned violent last summer.

They likewise showed video clips of Democrats objecting to Electoral College votes in past years when Republicans won, including Mr. Raskin in 2017 when Mr. Trump’s victory was sealed, comparing them with Mr. Trump’s criticism of the 2020 election. At the same time, those videos also showed Mr. Biden, then vice president, gaveling those protests out of order.

Stacey Plaskett, a Democratic delegate from the Virgin Islands and one of the managers, objected that many of the faces shown in the videos of Democratic politicians and street protesters were Black. “It was not lost on me so many of them were people of color and women, Black women,” she said. “Black women like myself who are sick and tired of being sick and tired for our children.”

The defense lawyers contended that Democrats were pursuing Mr. Trump out of personal and partisan animosity, using the word “hatred” 15 times during their formal presentation, and they cast the trial as an effort to suppress a political opponent and his supporters.

“It is about canceling 75 million Trump voters and criminalizing political viewpoints,” Mr. Castor said. “That’s what this trial is really about. It is the only existential issue before us. It asks for constitutional cancel culture to take over in the United States Senate. Are we going to allow canceling and banning and silencing to be sanctioned in this body?”

Emily Cochrane and Maggie Haberman contributed reporting.

Categories
Health

Sacklers Deny Private Accountability for Opioid Epidemic in Home Listening to

Sacklers Deny Personal Responsibility for Opioid Epidemic in House Hearing

Members of Congress on Thursday threw withering comments and angry questions at two members of the Sackler billionaire family who own Purdue Pharma, the maker of OxyContin, in a rare public appearance to take personal responsibility for the deadly opioid epidemic for details over $ 10 billion showing the family withdrew from the company.

The hearing before the House Oversight Committee provided the public with an extremely unusual opportunity to hear directly from some family members whose company is accused in thousands of federal and state lawsuits for misleading marketing of OxyContin, the pain reliever seen as initiating a wave of opioid addiction, which resulted in the deaths of more than 450,000 Americans. Eight family members were individually named in many state cases.

The uniqueness of the Sacklers’ appearance on Thursday was underscored by the likelihood that they will never testify in court, as the ongoing bankruptcy proceedings and statewide litigation can be settled in settlements rather than legal proceedings. Despite the millions of dollars in legal costs incurred by plaintiffs and Purdue alike – and the subsequent Chapter 11 filing for bankruptcy protection in September 2019 – one obstacle to resolution remains: the Sacklers refusal to face personal or criminal accountability and appeal over substantial parts of their property.

During the tense, nearly four-hour hearing, 40-year-old David Sackler and his cousin Dr. Kathe Sackler (72), who both worked for years on the company’s board of directors, testified from a distance and largely avoided the possible booby-traps and diverted the blame for “management” and independent, non-family board members.

Or, as Mr Sackler said, “That is a question for the lawyers.”

Repeatedly, committee members pitted harsh statistics on the destruction from the epidemic against pictures of the family’s simultaneous gains, including a $ 22.5 million mansion in the Bel Air neighborhood of Los Angeles paid in cash in 2018 – which David did Sackler called an investment in which he had not spent a single night.

Throughout the session, both Sacklers expressed regret over OxyContin’s role in the epidemic, but not about their own actions over the years when the company aggressively promoted the pain reliever, with the oversight and encouragement of the board of directors.

In fact, Dr. Sackler embarrassed about patient welfare. “I thought Purdue was acting responsibly to reduce the incidence of abuse and overdose while continuing to serve those in need of pain relief,” she said.

“I was trying to find out, was there anything I could have done differently? Know what I knew then – not what I know now? “Said Dr. Sackler, who served on the board from 1990 to 2018. “There is nothing that I could find otherwise, depending on what I believed and understood at the time.”

She said what she later learned from management and reported to the board was “extremely distressing.”

Mr. Sackler, who served on the board from 2012 to 2018, was similarly sensitive: “I believe I behaved legally and ethically, and I believe the full record will show that I still feel absolutely awful that a product created to help so many people “is linked to death and addiction, he said.

Deeply skeptical committee members asked the Sacklers whether they actually subscribed to newspapers or had access to cable television.

Speaking to the Sacklers, Representative Jim Cooper, Democrat of Tennessee, said, “When I see you testify, my blood boils. I don’t know of any family in America worse than yours. “

West Virginia Republican Carol Miller asked Mr. Sackler if he had ever visited Appalachia to see firsthand the effects of the crisis.

“Yes,” he replied, but not for the express purpose of establishing the facts.

“I was on vacation with my wife,” he said.

In the absence of a direct sense of responsibility by the Sacklers – or by Dr. Craig Landau, Purdue’s chief executive officer since 2017, who also testified – the committee members used their questions to explain the most egregious actions of the company and Dr. Sackler’s father, Dr. Richard Sackler, a practical manager during the height of the epidemic.

In particular, they examined the measures resulting from a nearly $ 635 million fine in 2007 paid by the company and three senior executives after pleading guilty of “misbranding”. The settlement did not include any assumption of liability by one of the Sacklers.

The committee chairman, Representative Carolyn B. Maloney, Democrat of New York, asked Mr. Sackler if the family was concerned about a government investigation following the company’s federal settlement in 2008. Mr. Sackler denied knowing that the investigation had increased.

But then Ms. Maloney read from an email exchange between Mr. Sackler and other relatives in 2007, just a week after that settlement. Regarding courtroom activities, he wrote, “We are rich? For how long? Until what suits reach the family? “

Then she asked Mr. Sackler, “Have you tried to cash out winnings so opioid victims can’t claim them for future losses?”

He replied: “No, I don’t think that’s what I meant then.”

The committee was able to require the Sacklers to submit a list of the companies Ms. Maloney referred to as “offshore shell companies”. According to court records, the family withdrew approximately $ 10 billion from Purdue Pharma between 2008 and 2017.

Mr Sackler said Thursday that the family paid about half of those taxes.

Dr. Landau said that during his tenure the company stopped promoting opioids and focused on developing drugs that reverse overdoses.

Three generations of family members have overseen Purdue since the 1950s when three brothers – including Raymond (David’s grandfather) and Mortimer (Kather’s father) – started it. (A third brother, Dr. Arthur Sackler, sold his stock long before OxyContin was launched.) During the opioid epidemic, family members served on Purdue’s board of directors, often pushing the sales department to rave about – prescribing doctors and downplaying its addictive properties of the drug according to extensive court documents.

Last month, Purdue pleaded guilty to three crimes of setbacks and fraud related to advertising its opioid and failing to report abnormal sales. The Justice Department has agreed with the company $ 8.3 billion in criminal and civil penalties and family members with $ 225 million in civil penalties. The Sacklers did not admit any wrongdoing. The amount they paid is roughly 2 percent of the family’s net worth.

Maura Healey, the attorney general of Massachusetts, the first state to name individual Sacklers in litigation, said the Sacklers want “special treatment.” In a letter to the House Committee, she wrote, “If we let powerful people cover up the facts, avoid accountability, or start a government sponsored OxyContin business – it is no justice. This time we have to get it right. “

In 2019, Congressman Elijah E Cummings, the late committee chairman, opened an investigation into the company and the family to see if their actions should lead to possible policy or legislation changes. In October, the committee released a plethora of documents that underscored how individual Sacklers asked the company to increase sales. The committee tried to get numerous Sacklers to testify, which they opposed through their lawyers, saying that the appearances would hamper the ongoing bankruptcy process.

The committee’s lawyers threatened to summon them. After considerable disputes, the Sacklers agreed to introduce two of the four family members originally requested.