POLICY/HEALTH PLANS: Clowns to the left of us, jokers to the right…..

Yet another study showing that even if you’re insured, because of the structure of our insurance system even the insured have trouble paying bills.  Now I know I should leave this well alone. It’s ground that I’ve trampled to death before, such as this story about the insured parents of the sick kid who’ve declared bankruptcy. But when the magic four letter acronym of certain industry trade group pops up (even without a certain lobbyist’s name mentioned) I just can’t help myself.

Along with deductibles and co-payments, The Access Project found other factors associated with medical debt were annual or lifetime "caps" on benefits; extra charges for "out of network" care, even when admitted to in-network hospitals; and complex billing systems by insurers and hospitals that left patients confused about what they owed.

Mohit Ghose, spokesman for the industry trade group, America’s Health Insurance Plans, says the study unfairly blames insurers for rising costs. He says there are many reasons spending on health is going up, including new treatments and drugs, rising demand as the population ages and "defensive medicine" by providers worried that they will be sued if they don’t run every test or offer every alternative to patients. "For too long, people have found it convenient to put any and all problems with the health sector at the doorstep of health insurance plans," says Ghose.

Not actually a direct lie this time, you’ll note. But excuse me again, but if it’s not to sort out that stuff—the over use, the defensive medicine, assess the correct use of technology—then what do AHIPs members do for their customers other than slap on 20% and send them the bill? Not much is the answer.

But I guess AHIP is doing its job. They’ve been getting idiot libertarians from no-name universities to write ridiculous op-eds about the value private insurers bring to the system and than has succeeded in getting them placed in that bastion of Marxism The New York freaking Times!! I’ll spare you the whole thing (although this post at Economist’s View  explains largely what a pile of crock Cowen writes. But this choice piece of outright idiocy has to make an appearance at THCB:

It is precisely because competing insurance companies spend money evaluating the appropriateness of claims that they are willing to pay for so many heart bypasses, extra tests, private hospital rooms and CT scans.

Given what Ghose says in the line above about how insurers aren’t able to do that stuff because it’s just too hard for them, someone at AHIP has clearly not been communicating well with their pet blogger, or at least Cowen has no idea what a health insurer does. Perhaps he should try to get a job at HBS? He’d fit in well there

And given that Cowen is an out-there libertarian nut with no basic chops in health care, and for whom this is his second recent appearance in the Times, it’s worth asking how many op-eds has the Times featured from Alain Enthoven, Vic Fuchs, or anyone else with half a brain on the topic this year? You know my guess as to the answer.

Categories: Uncategorized

Tagged as: ,