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Reprehensible Behavior a Cornerstone of its Business Model
Time for a rant.
Although I (and many others) have long been critics of Wall Street's incredibly sleazy, recklessly psychopathic, and relentlessly self-destructive underbelly, there is another corner of the financial services industry that seems to have made reprehensible behavior a cornerstone of its business model.
As the New York Times reports in, "Insurers Alter Cost Formula, and Patients Pay More," the insurance industry seems intent on making Congress look like a bastion of honesty and ethical behavior.
Although I (and many others) have long been critics of Wall Street's incredibly sleazy, recklessly psychopathic, and relentlessly self-destructive underbelly, there is another corner of the financial services industry that seems to have made reprehensible behavior a cornerstone of its business model.
As the New York Times reports in, "Insurers Alter Cost Formula, and Patients Pay More," the insurance industry seems intent on making Congress look like a bastion of honesty and ethical behavior.
Despite a landmark settlement that was
expected to increase coverage for out-of-network care, the nation’s
largest health insurers have been switching to a new payment method that
in most cases significantly increases the cost to the patient.
The settlement, reached in 2009, followed
New York State’s accusation that the companies manipulated data they
used to price such care, shortchanging the nation’s patients by hundreds
of millions of dollars.
The agreement required the companies to
finance an objective database of doctors’ fees that patients and
insurers nationally could rely on. Gov. Andrew M. Cuomo, then the
attorney general, said it would increase reimbursements by as much as 28
percent.
It has not turned out that way. Though
the settlement required the companies to underwrite the new database
with $95 million, it did not obligate them to use it. So by the time the
database was finally up and running last year, the same companies,
across the country, were rapidly shifting to another calculation method,
based on Medicare rates, that usually reduces reimbursement
substantially.
“It’s deplorable,” said Chad Glaser, a
sales manager for a seafood company near Buffalo, who learned that he
was facing hundreds of dollars more in out-of-pocket costs for his son’s
checkups with a specialist who had performed a lifesaving liver
transplant. “I could get balance-billed hundreds of thousands of
dollars, and I have no protection.”
That's not the end of it, of course. In fact, all it takes is about
10 minutes of Googling to come up with plenty of other stories about an
industry that apparently feels really good about doing bad:
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