Doctors Fight Back Against United Healthcare
United Healthcare has shown that it can be thuggish with its providers in the past by threatening to fine them $50 if patients decide to get testing done at facilities other than Laboratory Corp. of America or other United Healthcare selected labs.
Readers have commented that the “AMA could of course advise physicians not to contract with any insurance company. Many physicians are doing just that. They are then be free to treat (and refer) however they wish, and bill their patients whatever they like. Their patients have to pay directly – mastercard comes to mind – and are then responsible for obtaining reimbursement from their own insurance. In fact, wasn’t this very arrangement called “insurance”, back in the day?”
I pointed out that the issue really isn’t about physician profits, but rather a conflict of interest. But even if it were, antitrust laws are supposed to keep a single corporation from getting powerful enough to bully everybody it does business with.
Now the AMA is nervous that United Healthcare may be making “a blatant grab for dominant market power“.
The AMA said UnitedHealth would have 43 percent of Nevada’s commercial health insurance market after acquiring Sierra, compared to its current 14 percent market share. In the Las Vegas market, the combined company’s share would be 56 percent, compared with 18 percent now.
With a grasp over that much of the market, it’s highly likely that we would see United Healthcare try to intimidate its providers in Nevada like we saw with HCA in Colorado last summer. Doctors should be nervous about this because United would have enormous power over contract negotiations with them. And I don’t think we can trust United to be ethical in those negotiations if they have no other incentive.
You say that you “pointed out that the issue really isn’t about physician profits” which is fine, I guess. But please note that I was speaking only of physician incomes, not “physician profits”. I don’t have a problem with physicians profiting from what they do.
Anyway, thanks for pointing back to our respective posts – others who wish to read them can decide for themselves which makes more sense.
I am currently working on a file involving United Health Life insurance and difficulties in getting them to pay a life claim. For reasons of lible and slander….I will not say anything unfavorable about United health Life…..but the facts tend to speak for themselves. I am 73…and working as an insurance consultant after having working for two pretty good insurance companies for 40 years. I am working now as a consumer advocate…..ONLY.
Apr 5th, 2007 at 1:33 am
[...] Joe Paduda regales us on Managed Care Matters with the frustration of getting transparent cost information to make a “consumer-directed” decision. Matthew Holt calls for greater transparency from Kaiser Permanente on The Health Care Blog. United Healthcare is the target of Colorado Health Insurance Insider Jay Norris. And Julie Ferguson of Workers Comp Insider calls for better application of existing OSHA worker safety rules and oversight in the wake of the recent Texas BP disaster that killed 15 people and injured at least 180 others. [...]
Apr 5th, 2007 at 10:05 am
[...] Joe Paduda’s contribution about United Healthcare not helping consumers become better buyers in the consumer-directed health care system accompanies our article about the AMA fighting back against United. [...]