Big Insurance's Latest Bid to Screw Over Hospitals

[PHIMG]

(source New York Times - http://www.nytimes.com/2010/01/25/health/policy/25insure.html?ref=health&pagewanted=all)


A front in the national health care battle has opened in New York City, where a major hospital chain and one of the nation’s largest insurance companies are locked in a struggle over control of treatment and costs that could have broad ramifications for millions of people with private health insurance.

The fight is between Continuum Health Partners, a consortium of five New York hospitals, including Beth Israel Medical Center and St. Luke’s-Roosevelt Hospital Center, both major teaching hospitals, and UnitedHealthcare.

The prestigious hospitals and the major health insurer have been in bitter contract negotiations, not just over rates but also over UnitedHealthcare’s demand that the hospitals notify the insurance company within 24 hours after a patient’s admission. If a hospital failed to do so, UnitedHealthcare would cut its reimbursements for the patient by half.

UnitedHealthcare says the proposed rule is meant to improve the quality of care and cut costs by allowing insurance case managers to jump in right away. The hospitals say that having their reimbursement cut in half is too much to pay for a clerical error, and that the revenue drain would ultimately hurt their patients.

The dispute signals a “ratcheting up” of a long tradition of insurers trying to cut costs, said Jeffrey Rubin, an economics professor at Rutgers University.

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OP's commentary:

Hospitals provide value - they employ doctors that heal people.

Insurers do not provide value - they are needless middlemen who add only unnecessary costs, complexity, heartache and trauma.

Private Health Insurance Must Go!

Medicare can do what Big Insurers do for 3% of spending instead of 30%. If we eliminate the Private Insurers from the provision of medically necessary care (by moving to Medicare For All)... we can save hundreds of billions of dollars every year, enough to give everyone insurance without spending more than we do today.

PRIVATE HEALTH INSURERS SELL AN OVERPRICED DEFECTIVE PRODUCT. Providers hate private insurers and anyone who has had to use thier insurers hates private insurers too.

WALL STREET says we have to put up with it. It's the American way. But we have an alternative in place today. MEDICARE - If it's good enough for grandma, it's good enough for EVERYONE.

DECLARE that you are a MEDICARE FOR ALL DEMOCRAT. No more DLC-style "reform". Demand REAL REFORM TODAY.

[w4rma]

1. Parasites. (nt)

[flyarm]

2. It happened here in Fla with my insurance co and hospitals where i live

last December..

I got a letter from my local Hospital which is part of a group of all Hospitals where i live..the letter said that i could not use this hospital because they could not get any co-operation with Aetna..they told me to contact my insurance group and raise a complaint..

Good thing i didn't have to be on Chemo or heart care or anything like that..because if i did need them ..they are a chain of hospitals here..owned by the same conglomerate..and i would have had no where to go!

Oh and i pay $2,500.00 a month to Aetna!

[unc70]

3. UHC will readily use that technicality to deny paying benefits

Just as they use all sorts of methods to cancel costly policies, even entire small group plans, to avoid continuing coverage for expensive conditions.

Widely documented. This is their version of sticking it to the hospital and to the patient/client(?!).