At a committee hearing yesterday, three health-care specialists testified that insurers go to great lengths to avoid responsibility for sick people, use deliberately incomprehensible documents to mislead consumers about their benefits, and sell "junk" policies that do not cover needed care.
The report released yesterday alleges that insurers have systematically underpaid for out-of-network care. The issue had been brought to light previously in litigation, committee hearings and other investigations, including a probe by New York Attorney General Andrew M. Cuomo. But as politicians and interests groups clash over the current effort to overhaul the nation's health-care system, it took on new relevance.
Cuomo described it last year as "a scheme by health insurers to defraud consumers by manipulating reimbursement rates."
Many Americans pay higher premiums for the freedom to go outside an insurer's network of doctors and hospitals. When they do, insurers typically pay a percentage of what they call the "usual and customary" rates for the services. How insurers determine the usual rates had long been opaque to consumers and difficult if not impossible for them to challenge.
As it turns out, insurers typically used numbers from Ingenix, a wholly owned subsidiary of the big insurer UnitedHealth Group. Ingenix had an incentive to produce benchmarks that low-balled usual and customary rates and shifted costs from insurers to their customers, the report said.
Ingenix got its data from the same insurers that bought its benchmark information, the report said. Insurers that contributed information to Ingenix often "scrubbed" their data to remove high charges, and Ingenix further manipulated the numbers, removing valid high charges from its calculations, the report said.
Dirty, rotten bastards. I’m not one to throw around insults at individuals directly, but you’re a fucking idiot if you think insurance companies care about you. If you’re one that defends these guys, then your a fucking asshole. On this subject, I have no patience. I want a choice. Yeah, there’s a shit ton of providers in this world, but my employer offers three choices from one provider. Outside my employer and the coverage is either substandard or too expensive. Drop my coverage and I die on the sidewalk because the hospital won’t let me in.
This is insane! This is not how a civilized industrial power cares for their people! Demand better! Call your representatives! Tell them what you want! If you don’t get it, vote them the fuck out!
It’s time Government work for us!