Great Northern States Health Care Initiative: February 2008

Friday, February 29, 2008

Blue Cross letter brings outrage - San Jose Mercury News

"It came in response to a letter Blue Cross wrote last week asking doctors to rat out their patients with undisclosed prior medical conditions so the insurer can dump them from its rolls.

The move comes just months after Blue Cross was fined $1 million by the state for unfairly revoking coverage to scores of its policy holders."

Sunday, February 17, 2008

NEJM -- Market-Based Failure -- A Second Opinion on U.S. Health Care Costs

NEJM -- Market-Based Failure -- A Second Opinion on U.S. Health Care Costs: "Changing demographics and medical technology pose a cost challenge for every nation's system, but ours is the outlier. The extreme failure of the United States to contain medical costs results primarily from our unique, pervasive commercialization. The dominance of for-profit insurance and pharmaceutical companies, a new wave of investor-owned specialty hospitals, and profit-maximizing behavior even by nonprofit players raise costs and distort resource allocation. Profits, billing, marketing, and the gratuitous costs of private bureaucracies siphon off $400 billion to $500 billion of the $2.1 trillion spent, but the more serious and less appreciated syndrome is the set of perverse incentives produced by commercial dominance of the system."

Thursday, February 14, 2008

UnitedHealth accused of shortchanging patients

UnitedHealth accused of shortchanging patients
"AMA weighs in

There is a profit motive for keeping reimbursements low, said Dr. Nancy Nielson, president-elect of the American Medical Association. She also complained that there is no oversight of the data provided by Ingenix.

"It's shocking and unacceptable for an insurance company to hide behind a shroud of secrecy," Nielson said. "Its another example of United Health playing by its own rules.""

I know United Health hides it's for profit business in MN where HMOs must be non-profit. However, it is involved in selling service to those same HMOs. I wonder if it is behind the scenes in WI as well. Does anyone know?