Thursday, September 19, 2013

Highmark dumps people with pre-existing conditions (as well as cancer patients)

Why is it great to be a "supposedly non-profit" corporate giant in the land of government-subsidized corporate welfare ...

... or why Federal anti-trust laws apparently do not apply to entities like Highmark no matter how horrible the corporation's conduct is ...

Here's two new examples:

1.  Obamacare allows many procedures to be paid at a much higher rate if they are done in a hospital.  Get a stress test in a cardiologist's office?  Using exactly the same machine, the ACA says the cardiologist receives only about one-third the pay that a hospital would.  This is why most cardiology groups in Delaware have sold out to hospitals.  So what does the hospital do?  The hospital leaves the cardiology office open (the machine's already there, right?) and calls the building "a hospital clinic" so that it can continue to charge higher rates to insurance companies and Medicare than the original doctors could.  Got it?

So the same thing happens with infusion clinics that cancer patients depend on to deliver their meds and chemo.  Frankly, it is a really cheesy benefit for hospital chains that they lobbied into the ACA.

But here's the even cheesier wrinkle that Highmark is using in its continual quest to own medical insurance AND medical treatment in Pennsylvania ("und tomorrow the world!"):

Highmark does this billing trick with the Alleghany hospital chain that it bought, essentially paying itself the higher rates.

But if you're not a Highmark hospital?  Guess what?  Highmark refuses to recognize other hospital chains' clinics, and has held up millions, possibly tens of millions, in benefits payments for cancer patients.  Not just once.  But again.

So how do you run your competition out of town?  Figure out a (supposedly) legal way to pay their hospitals less than your hospitals for the same services, and as for those cancer patients who will be eventually cut off from treatment ... ?

I guess they can either go to Highmark or go to the Devil.  Which amounts to the same thing.

2.  Highmark dumps 37,000 insurance customers in PA with pre-existing conditions.  Go find your insurance on the new exchanges, Highmark says.  Or pay the penalties.  Just quit bothering us.  And, again, according to the nice bennies for insurance companies written into Obamacare, guess what?  It is completely legal for them to do so.

Just not ethical.  Or humane. Or ... well, you get the idea.

See, here's the thing:  Highmark is the kind of soulless interlocking corporate giant that cannot exist in a free market, only in a heavily regulated (Delacrat would correctly say, "rigged") market wherein the people who write the policies that give Highmark immunity and special protection are the same people who take Highmark's campaign contributions.

And in Delaware, as we shall discover in our next installment, not only is Highmark still pursuing its state-supported monopolistic strategy, but it already has the Insurance Commissioner in the bag.


Anonymous said...

This or RCCSD BOE voting for RTTT-D, tough call on which is more insane.

kavips said...

Anything new with Highmark?