Question
Since you are such a big fan (lol) of managed health care, I thought you would like to feast your eyes on this article: http://www.msnbc.com/news/339166.asp The same group of lawyers who took on the Tobacco Industry have now focused their attention on managed health care for "unscrupulous business practices." Targeted are Pacificare Health Systems, Foundation Health Systems, Cigna Healthcare, Prudential Health Care and Humana. They already filed suit with Aetna back in October and United Health Care has agreed to sit down and talk rather than be dragged through the courts. But I love this quote:
Cigna spokesman Wendell B. Potter said the lawsuit was an orchestrated effort on the part of a small group of well-funded attorneys to use the court system to create enormous fees for themselves while doing serious potential damage to the worlds best health care system.
HELLO!!! Look who is calling the kettle black! It looks like all hell has broken loose in hell. I thought I would never live to see this day happen. Time to party.
Answer
What a HOOT!!!!!
I love this one! My two favorite groups squaring off, Attorneys and Insurance companies!
Health Insurance in this country is BIG business and I can tell you that no one wins except the insurance companies. It is true that Insurance companies offer bonus' and other forms of kick back to physicians who restrict their rate of referrals to big ticket services. And even when it is ordered by the physician, the tests are performed, the insured person will invariably receive some form of DENIAL letter indicating that the test was not needed, covered, proper procedure not followed, or a host of any other BS reasons why they aren't going to pay for it. So now the patient (who is already paying really high insurance premiums) has to pay for the procedure. And chances are the denial was handed down by somebody in an office somewhere who has NO medical background whatsoever. Just a set of rules to follow on how to wiggle out of payments.
The insurance companies also try to force physicians to become part of their "Preferred Provider Org." They promise the physician lots of patients IF he joins and IF he/she gives discounts on the bill to the insurance company! Do those discounts go to the patient? NOPE! Does the physician see an increase in business? Not enough to make a difference. Been there, tried that! It took about 3 months for me to figure out what the scam was and about 3 minutes to get us removed from their lists.
Aw Jeez, ya had to get me started didn't ya?
See ya in the party room!
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Keeping you safe, healthy, and on the road.
Nurse Red
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