No, this isn’t about some kinky physician engaging in kinky behavior. This is about America’s Health Insurance Plans.
For the last few years, UnitedHealth underpaid patients for out-of-network services. In effect, UnitedHealthcare skimmed 28% off the top of reimbursement back to patients. As a former UnitedHealthcare victim (UnitedHealthcare calls them “customers”), skimming was only one way the wealthy insurer defrauded patients. Another common scheme from UnitedHealthcare was to flat out refuse to cover certain diagnostic tests as “unnecessary” unless the physician gets a prior authorization. UnitedHealthcare is the only insurance carrier I’ve ever heard of that requires a prior authorization for a cholesterol test in a patient with a history of hyperlipidemia and heart disease.
While the recent high profile announcement of UnitedHealthcare defrauding consumers has made major news, it’s really epidemic of an industry problem. The folks that that brought us HMOs and care rationing came up with these skimming schemes. They are represented by America’s Health Insurance Plans (AHIP) – the trade association at the leading edge of the rationing of care for patients. Why pay for cancer treatment for a patient when you can pay a multi-million dollar bonus to the CEO of the health plan?
As Congress and the new Obama Administration look at health reform and ways to expand coverage, they should take a serious look at America’s Health Insurance Plans. It’s time to Be Part of Health Care Reform, and America’s Health Insurance Plans are not part of the solution.
Reference: New York Times
