Tuesday, March 2, 2010

Wellpoint CEO....

Well, those of you who follow this blog, know that I don't have a lot of empathy for insurance companies, and some of their practices.

THAT being said, I agree with the CEO of Wellpoint Angela Braly's recent stance. She's right, while some of the insurance industries practices are a bit distasteful, such as recission, and denial of claims. The insurance industry is not the main reason costs are increasing. Hospitals, physicians, and other providers are raising rates. Add in a tumbling economy, and you get a risk selection bias as healthier individuals forego insurance, and an increase in COBRA enrollment, which is almost universally full of sick individuals. This creates a problem for the insurance company. While I am not going to say I feel sorry for Wellpoint, I believe that most people are missing the point of Ms Braly's comments.

She's right, we need more than simple health insurance reform. We need DELIVERY system reform, and right now, we're not getting it.

How about this idea. If we are going to mandate that all patients have insurance, and we are going to mandate that all insurance companies cannot deny pre-existing conditions, or cancel policies, and must have higher MLR ratios, then how about MANDATING that all providers accept Medicare patients. Tie it to their DEA number. If they refuse to see new Medicare patients, they lose their DEA number.

Providers need to have some skin in the game too.



Anonymous said...

I'm ok with no medicare/medicais than no dea. sounds like a good idea.

Michael Halasy, MS, PA-C said...

Well, that's the part that everyone is ignoring. Insurance is having to sacrifice, patients are having to sacrifice.

Providers need to participate too. Although this will likely be a very unpopular idea.