UnitedHealth Takes Next Step in the War Against Its Patients

With the remarkable -and remarkably profitable - success of UnitedHealth Ins Corp's piratical policies, and clearly completely unafraid of any political or legal blowback thanks to its equally successful program of buying Senators with campaign contributions, one of the nation's worst and most predatory health insurance corpo's has just upped the ante by threatening hospitals with ruin if they don't cave in to a patently ridiculous demand.

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, which includes Oxford health plans and has 25 million members across the country, one million of them in New York.

While Congress has been haggling over covering as many as 15 million uninsured Americans, 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.

This isn't, of course, about punishing hospitals for "a clerical error". It's about giving UH yet another excuse to deny patient treatment. It's a damned-if-you-do, damned-if-you-don't scam.

1. The purpose of lightning notification, what the corpo's call cost-cutting "by allowing insurance case managers to jump in right away", is actually meant to inject the insurers into the medical process far earlier, giving them a chance to deny treatment before it's made.
2. If no notification, they "cut costs" by refusing to pay the hospital for treatment.

There's no way the insurance company can lose. They want the hospitals to accept the condition so they can make much earlier treatment rejections, thus saving the costs of the fights afterward and effecting the takeover of medicine by actuarial accountants and number crunchers, Bottom Line always being uppermost in any decision.

IOW, they want to stop second-guessing doctors and simply control the process from the moment of admittance to the moment of treatment rejection. Apparently they've decided that we'll put up with anything in the name of cost-cutting. Another bad decision, but why would they worry about it? Who's going to make them stop when they own the Blue Dog Senate?

I'd suggest a boycott of UH but others will be picking up on this soon and in a very short time they'll all be doing it and you won't be able to get an insurance policy that doesn't. Maybe a premium boycott might work, but it would have to be done by the not-likely-to-be-sick-in-the-next-decade demographic because that's the only demographic UH cares about. They'd just as soon dump the rest. Too expensive.

With this bonehead move in increasing predatory behavior rather than laying off a little, it is actually getting to the point where you really might as well not have private health insurance since it won't cover much more than not having it. Not cost-effective for consumers. At all.

But then I'm sure the new Obama won't let this slide by, now will he?

No, of course not. He'll make a speech condemning it and then sign a Blue Dog law making it mandatory.

And, as Vonnegut used to say, so it goes.

Comments

[arnel]

wow great blog..

[PurpleGirl]

This is BS. You need a pre-authorization from Oxford to enter the hospital or have a procedure/treatment done, so they know when people are going to the hospital already.