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Chumas
June 26, 2009 6:17 PM
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Sky blue, water wet.

HMO's and Insurers are in the business of making money, the fact that you've been cured or healed by one of these companies is an unintended consequence.

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BrazDane
June 26, 2009 8:00 PM
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@Chumas: Brilliantly stated - and oh so true!

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CompyPaq
June 26, 2009 6:26 PM
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But we have the best healthcare system in the world!

/sarcasm

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JeffIowa
June 26, 2009 7:15 PM
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@computerwiz3491:
We have the most effective and most responsive healthcare in the world. If you NEED care, you can get it. You just can't afford it.

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floraposte
June 26, 2009 9:11 PM
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@JeffIowa: We're roughly fortieth both in longevity and in preventing infant mortality. So not really in the running for most effective.

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Trai_Dep
June 26, 2009 11:04 PM
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@floraposte: Effective at enriching mercenary doctors and insurance companies. USA! USA! USA!

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Saboth
June 26, 2009 7:49 PM
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@JeffIowa:

It's only responsive and effective if you can pay for it. If you aren't covered (which a LOT of people aren't), you go to the \"free\" system.

And it gets worse every year, even if you do have insurance, there are no guarantees they will cover anything, anymore.

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CompyPaq
June 26, 2009 7:41 PM
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@JeffIowa: If you NEED care but can't afford it, you can't get it.

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Tzepish
June 26, 2009 11:32 PM
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@computerwiz3491: I'd amend this.

If you NEED preventative care, but can't afford it, you can't get it.

If you NEED immediate care, but can't afford it, you get it, but then you go bankrupt.

If you NEED care and can afford it, congrats! You don't have to pay for it.

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lannister80
June 26, 2009 6:30 PM
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Wow, what a surprise! A public system would at least have a *modicum* of integrity.

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Jacob Morgan
June 26, 2009 7:56 PM
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@lannister80:
Like Soviet Russia! Oh, wait....

(Not actually opposed to public health care, socialism, et al.)

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Daniel Parmelee
June 26, 2009 6:33 PM
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This is so full of LOL I almost cried. One of the largest insurers runs a database that just happens to be full of errors that benefit their bottom line. Hmmm.

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legwork
June 26, 2009 6:56 PM
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Would you like the one, two, or three year extended warranty with that healthcare?

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PsiCop
June 26, 2009 7:01 PM
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This is old news. The problems with the Ingenix database were revealed when Cuomo sued, back in 2008. A settlement was announced months ago, in January (see e.g. [www.modernhealthcare.com]). Why is this being presented as new information? It's not.

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bearymore
June 26, 2009 7:13 PM
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@PsiCop: Because it was not widely covered at the time except in the business and specialty (e.g. Modern Health Care) press. Given the public debate about health care taking place now, it is important to get this kind of information to the general public so that they can adequately evaluate the coming tsunami of special interest propaganda.

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PsiCop
June 26, 2009 8:59 PM
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@bearymore: Don't get me wrong, I don't object to people knowing about the Ingenix scam. It's just that it's not new ... especially to the movers & shakers now trying to decide the future of healthcare. They knew about it long ago.

And it was covered in the usual press outlets that I read, e.g. my home state's paper of record, the Hartford Courant. But the article that had been there, is no longer available. The NY Times also reported on it, i recall, but I didn't search their archives, I just used Google News. Just for the record, here's a January story from the NY Times: ([www.nytimes.com]).

I guess I'm asking why suddenly this is being presented as some kind of \"shocking new revelation.\" It really is not. Those who've worked in health care have known about this for a while now.

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Kd McEntire
June 27, 2009 12:26 AM
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@PsiCop: As bearymore stated, for those of us who *don't* work in health care, this is news. They never claimed it was *breaking news*, simply that it was news. And I, for one, am glad to read about it. It just confirms another \"insurance companies suck\" point for me.

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jmujeff
June 26, 2009 7:09 PM
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Holy conflict of interest.

Hearing stuff like this, while not surprising, makes me furious seeing as I shell out $3-4 grand+ a year to UHC for my wife's cancer care.

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HIV 2 Elway
June 26, 2009 7:22 PM
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@jmujeff: What do you think cancer care should cost? Nothing? Is she not getting a service in exchange for your money? $3-4k to treat a life threatening disease seems like a bargain.


Remove the incentive to profit off of medical breakthroughs and you remove new breakthroughs.

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MMD
June 26, 2009 10:01 PM
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@HIV 2 Elway: The actual issue at question here is this: Is she being overcharged for that service based on a corrupt and error-ridden system?

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HIV 2 Elway
June 26, 2009 11:21 PM
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@MMD: I was responding to the comment that $34k a year to treat cancer is a high cost. Seems like a steal to me.


@youbastid: There are more MRI scanners in my city, Kansas City, than there are in many countries with public health care. End of discussion.

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LafinJack
June 27, 2009 7:03 AM
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@HIV 2 Elway: Congratulations on your city wasting a bunch of money on superfluous MRI scanners that could have gone towards, you know, actual medical care.

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Scuba Steve
June 26, 2009 7:41 PM
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@HIV 2 Elway: I'm sure it's not the only reason to have medical breakthroughs.. To normal people.

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HIV 2 Elway
June 26, 2009 7:55 PM
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@Scuba Steve: Not all doctors and medical researchers go into medicine because they have huge hearts and want to save people. Many go into medicine because there is good money in medicine.


My neighbors growing up were some of the nastiest people on the block but were brilliant medical researchers. They certainly didn't choose that field because they were humanitarians. No, they enjoyed the country club lifestyle their profession provided. Remove the incentive to have a high paying career and you'll lose those minds to other technical fields.


I'm not saying our current system is optimized, but there are serious unintended consequences, especially on the technical side, with removing profits from medicine.

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youbastid
June 26, 2009 10:42 PM
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@HIV 2 Elway: Singapore. Public healthcare system. One of the best in the world. One of the world leaders in stem cell research. End of discussion.

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Adhominem
June 26, 2009 9:01 PM
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@HIV 2 Elway:

You would be correct except money Insurance companies make don't go to hospitals and laboratories, they go to pay bonuses and dividends.

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Eyebrows McGee (now with more baby!)
June 26, 2009 7:20 PM
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Our insurer is currently insisting our son wasn't added within the 31 day window. My husband's employer submitted the paperwork 14 days after he was born. (And has proof, luckily.) The insurer's all, \"Oh, we fixed it, he's on there now.\" We go to fill a prescription and, surprise surprise, they still haven't put him on. And they're all, \"Oh, but you didn't add him within the 31-day window.\" It's like a mobius strip of excuses and fake resolutions!

How convenient that they \"lost the paperwork\" in a way that brings them maximum financial benefit.

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Trai_Dep
June 26, 2009 11:12 PM
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@Eyebrows McGee (now with more baby!): Holy cow.
Shakespeare had it wrong about lawyers being first - if he were around today, it'd be infant-threatening insurance employees.
Hope you get all lawyerly on them and bury them under paper, once your son's rightly covered. Make it a hobby. Call your attorney friends and, like a knitting circle, take turns plastering them with suits.
Glad your employer has the paperwork to back you up, btw. Can't imagine how a civilian would have the wherewithal to combat this.

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Eyebrows McGee (now with more baby!)
June 27, 2009 12:05 AM
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@Trai_Dep: Now that we know the employer has proof, I'm not actually that fussed about it and will wait for my husband's employer to handle it, because ...

They're a litigation firm. That does lots and lots and lots of insurance litigation.

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Kd McEntire
June 27, 2009 12:32 AM
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@Eyebrows McGee (now with more baby!): Remember a few posts back, where I said that my insurance company wasn't going to pay for my baby's birth? Yeah, still fighting that and the kid hasn't even been BORN yet. I started talking to them the moment I knew I was pregnant, I'm in my second trimester, and we *still* haven't gotten sorted out what they're going to cover and what they won't. (I think my insistence on getting what they're going to cover in writing ahead of time is freaking them out.)

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CompyPaq
June 26, 2009 7:43 PM
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@Eyebrows McGee (now with more baby!): A while back, when I around 9 years old, my parents dental insurance kept insisting that my brothers and I weren't really dependents. My parents would argue, they would \"fix\" it, but still didn't pay.

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Eyebrows McGee (now with more baby!)
June 26, 2009 9:55 PM
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@computerwiz3491: When my sister was diagnosed with a rare form of arthritis at 16, my parents' insurance company tried to claim it was a pre-existing condition and they didn't have to pay. My dad had to put on his lawyer pants and point out to them that she'd never pre-existed the policy as she'd been on the same one since she was born, and my parents both on the policy for a good ten years before that, so EVEN AS A BLASTOCYST SHE WAS ALREADY ON THE POLICY.

God insurance companies suck.

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ShruggingGalt
June 26, 2009 7:40 PM
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@Eyebrows McGee (now with more baby!): I feel your pain. If anything, the insurance companies need to have some kind of financial penalty for making the same mistakes over and over again, or reimburse the insured for costs to fix the company's mistakes.

I had one insurance company (named in the post above) drop me twice on COBRA claiming non-payment when they had cashed my checks. On time. And both times it took escalation via the appeals process to fix.

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Entomologista
June 26, 2009 7:33 PM
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Bear shits in woods, more at 10.

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Trai_Dep
June 26, 2009 7:40 PM
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Considering that we're entering the beginnings of how to fix our wildly expensive, under-producing health care system, this article is much appreciated.
I'd also add that if someone tried to steal 1/10,000th of the amount pilfered by our beneficent health insurance providers at a 7-11 using a pretend gun, the miscreant would be jailed for a decade. Yet these guys get phat bonus checks.
Nothing to see, move along, we've got the BEST health care system in the world!

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lpranal
June 26, 2009 9:09 PM
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@Trai_Dep: to build on that statement, if the number of people who died because of lack of health care coverage were instead killed in a war, and we knew that war would cost a trillion dollars to fight, you bet your ass we would still go in there and rescue those people. But, sadly, that war is not on the nightly news, and people still think that saving our own people is somehow socialism.

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Saboth
June 26, 2009 7:47 PM
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Just goes to show we need to scrap this whole medical insurance nonsense and get down to brass tacks. Having a middleman who's sole purpose is to make money off of people's medical problems and has a HIGH incentive not to pay claims is simply self-defeating.

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ThinkerTDM
June 26, 2009 8:10 PM
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@Saboth: I agree, except who will then protect us from being overcharged by the providers? Believe me, many doctors are as greedy as the next guy. I don't think I should get care for free-but I think it should be a reasonable cost. Doctors have many costs- malpractice insurance, student loans, practice costs- but a large part is their enormous cost of self entitlement.

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JeffMc
June 26, 2009 8:55 PM
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@ThinkerTDM: But the insurers aren't protecting us now. How would being gouged by doctors be different than being gouged (or having claims denied) by insurance companies?

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Kd McEntire
June 27, 2009 12:35 AM
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@JeffMc: True. And at least with doctors you're practically guaranteed care! About five years ago insurance company refused to pay somewhere around $3,000 in medical expenses that they'd previously promised to pay for - Xrays, exams, ect. After a year of going round and round with them I finally just called up my doctor's office and started a payment plan. I had them paid off in two years and they were never nasty about it if I had to miss a payment so long as I called and gave them a head's up.

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Kd McEntire
June 27, 2009 12:36 AM
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@Kd McEntire: Just for the record, that was Blue Cross, Blue Shield, Kansas City. I *refuse* to even consider going with BCBS now.

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chakrabs
June 28, 2009 3:28 PM
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@Kd McEntire:
Greedy Docs? I certainly am not in this field for the money, but I'd be lying if it wasnt an incentive. Why should every other field be allowed to set their own prices for their services and let the market bear it out but medicine? Its ridiculous! These companies are going to get a slap on the wrist for bilking people out of billions, but doctors are going to have to give up a substantial portion of their income? I say if we have to take pay cuts, so should every damn person around here from the lawyers to the CEOs. Let the govt. fund my house, then I'll sign on to Obamacare.

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ARP
June 26, 2009 8:21 PM
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@ThinkerTDM: Doctor's \"need\" to make a lot of money because they paid hundreds of thousands of dollars for medical school and have huge loans (we're talking $200k+ at times). Not an excuse, but an explanation as to why doctors, even the ones who got in the medicine for the right reasons, need think too much about bottom line.

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Shoelace
June 26, 2009 8:16 PM
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Is this grounds for the class action suit of all time, or am I missing something?

Can't even begin to estimate the time and effort I've had to put in dealing with this kind of insurance company BS, plus the stress, and the rage with no place to go.

And who's going to verify that they fix their database and keep it fixed - themselves?

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PsiCop
June 26, 2009 9:05 PM
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@Shoelace: It is fodder for a class action, to be sure ... but there is a blizzard of lawsuits underway already. Some have targeted United Healthcare (which owns Ingenix) directly (that would be AG Cuomo, as well as some other government agencies), others have been indirect, e.g. Aetna and Cigna were sued because it used the data, even though it did not generate it (see e.g. [www.nytimes.com]).

I suspect any class action that gets filed, would somehow end up being rolled into one of the suits that's already underway, or else, it will get delayed until those are resolved first.

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Shoelace
June 26, 2009 9:32 PM
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@PsiCop: Thanks for the info! I'll be keeping my eyes open - I want my piece of this one.

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FoxCMK
June 29, 2009 3:25 PM
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And this will only go on to serve the purposes of a nationalized healthcare system which will do absolutely squat to fix the underlying problem, which is:


The cost of medical care in this country is unsustainable and out of control.


There are so many root causes to the cost of care in this country but instead of tightening the screws, our benevolent overlords are looking to use gold-plated nails and a sledgehammer.


Or in lots of other cases (GOP leadership, I'm looking at you) the solution is that there is no solution. We're just fine and dandy!

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usarocks
April 7, 2010 7:13 PM
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This is not about who has a better health care system, it is what we can afford as a health care system. Each system public and private have their benefits and drawbacks. However, the main area that is increasing costs of medical costs besides insurance companies stealing from us, are the following: medical mal practice, hospitals for profit, doctors salaries and getting pharmaceuticals to be more socially oriented. Sounds like socialism, like some crazy interference and creating a less efficient medical system. However, we need to curb costs, most Americans and a growing number of companies no longer have the money to pay these skyrocketing health care costs, the real question is what do we do and what are we willing to accept.

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