Who would have thought that after the President worked to institutionalize insurance companies into the national driver's seat of our health care bus that they would not be satisfied and do more for the public good? Predicted here on these very pages was that instead they would continue to raise costs and screw insureds.
NYTimes
Insurers Alter Cost Formula, and Patients Pay More
Despite a landmark settlement that was expected to increase coverage for out-of-network care, the nation’s largest health insurers have been switching to a new payment method that in most cases significantly increases the cost to the patient.
Andrew Sullivan for The New York Times
The settlement, reached in 2009, followed New York State’s accusation that the companies manipulated data they used to price such care, shortchanging the nation’s patients by hundreds of millions of dollars.
The agreement required the companies to finance an objective database of doctors’ fees that patients and insurers nationally could rely on. Gov. Andrew M. Cuomo, then the attorney general, said it would increase reimbursements by as much as 28 percent.
It has not turned out that way. Though the settlement required the companies to underwrite the new database with $95 million, it did not obligate them to use it. So by the time the database was finally up and running last year, the same companies, across the country, were rapidly shifting to another calculation method, based on Medicare rates, that usually reduces reimbursement substantially.
Wow. Who could have predicted something like this would happen? Who?
Single Payer Debate
Liked what the reporter wrote here
But few dispute that as the nation debates an overhaul aimed at insuring everybody,the new realpolitik of reimbursement is leaving millions of insured families more vulnerable to catastrophic medical bills, even though they are paying higher premiums, co-payments and deductibles.
Though the new law provides coverage for many who did not have any, far too many still don't have coverage. According to the physicians group PNHP they number 23 million. Gah. And of those who do have coverage, many are apparently finding that its not what they thought it was....
Our experience with out of network/retiree health care
My wife recently had radical abdominal surgery followed by weeks of infusions and the costs are astronomical. Right now we have to pay 20% for in network. We have had one practitioner who was not in network bill us for $1800 more than the insurance company would pay.
The Catholic Hospital where she had her surgery and was kept in for 8 days afterward required us to pay our 20% upfront before they would allow the surgery. She is doing quite well, thankfully, but shiver to think what our situation would be now if we did not have any insurance.
The 2012 Campaigns and Health Care Reform
Lots of talk back during HIR debates about how we could continue to improve it. This article provides more evidence that we should.
Wouldn't it be great to hear the President and other Democrats (besides just Alan Grayson) speak more about that during the campaign instead of letting Republicans and Third way Dems frame the debate in terms of cutting existing coverage?
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All for one, Healthcare for all!