Monday, October 19, 2009

Every Which Way

It is still, after all, only about the insurance companies and protecting their profits. That is made abundantly clear in this article in today's Los Angeles Times:

By requiring insurers to cover everyone, regardless of pre-existing conditions, healthcare reform will make it more difficult for insurers to control their costs, or "bend the cost curve," by avoiding sick people.

That leaves insurers with the other big cost-containment tool: turning down requests to cover treatments.

"There are going to be a lot of denials," said insurance industry analyst Robert Laszewski, a former health insurance executive. "I am not setting insurance companies up to be villains. But we are telling them to bend the cost curve. How else are they going to bend the cost curve?"

Experts said the legislation under consideration does not significantly enhance patient protections against insurers refusing to cover requests for treatment. Most people currently have no right to challenge health insurers' treatment decisions by suing them for damages.

Apparently reining in administrative costs, which are measurably larger than Medicare's administrative costs, is not something the insurance companies want to consider. They have to keep their executives happy, so paying them reasonable salaries is absolutely out of the question. So is stopping bonus payments to staffers who find a way to screw policy holders out of coverage or to deny them perfectly reasonable treatment.

The one recourse you'd think Congress would grant patients is the right to sue insurers for unfair treatment decisions. Right now, because of a provision in the ERISA law, such suits are not allowable when the coverage is paid for by employers (which is where most of us get our health insurance). Unfortunately, a change in that provision doesn't appear to be in the works. After all, Congress doesn't dare challenge the insurance companies who have been wining and dining them and who have been coughing up big campaign contributions.

Like I said, health care reform is all about insurance company profits and how to maintain or even increase them.

Me, I have 555 days until Medicare. I guess I'm one of the lucky ones.

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Anonymous Anonymous said...

Someone should also check into hospital policy of not submitting claims to medicare in order to bill patients at private pay rates--even going so far as to falsify records in order to do so. Happened to my mother this summer, over the objections of her doctors.

11:45 AM  

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