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Does UnitedHealthcare Do What It Says?

Stanley Feld M.D.,FACP,MACE

In response to my last blog,” Can You Believe This? UnitedHealthcare Is Committed To Improving the Healthcare System”. I receive this comment: “Believe it or not UnitedHealthcare is trying to repair the healthcare system and becoming user friendly?”

Just after I received that comment four articles appeared in press this week demonstrating that UnitedHealthcare is becoming less user friendly and continues to march forward to try to shut out the competitive environment necessary for constructive reform of the healthcare system.

This sort of information is immediately available through the broad reach of the internet and blogosphere. Ordinary citizens can now monitor events and actions occuriing throughout the country. We can instantly see the inconsistencies.

The major stakeholders in the healthcare system are the patients and the physicians. All actions taken by facilitator stakeholders should be for the improvement of the delivery of care by the physician to the patient. Judgments about patient care should not be directed by the facilitator stakeholder. It should be directed by the patient. Patient choice should not be limited by the facilitator stakeholder. The key to repair of the healthcare system is a competitive environment for the delivery of care and care driven by the patient.

Apparently this is not UnitedHealthcare’s goal.

The St. Petersburg Times published the difficulty physicians and patients are having with UnitedHealthcare about laboratory work. The most convenient place to have laboratory work done is in the physician’s office. One stop service is a great convenience to the patient in an over stressed medical encounter. This is not permitted by UnitedHealthcare even if the physician office is less expensive that one of their designated laboratories.

“The Doctors who deal with United Healthcare soon may be taking a financial hit if they send patients to an out-of-network lab. Out-of-network lab? Pay $50”

United Healthcare plans to make doctors pay a fee if they refer patients elsewhere. The penalty takes effect March 1.

In January, United, which has 2.1-million members in Florida and about 800,000 in the Tampa Bay area, ended its contract with Quest Diagnostics Inc.,

“I’m just flabbergasted,” said Dr. Michael Wasylik, a Tampa orthopedic surgeon who heads the managed care committee for the Florida Medical Association. “I can’t recollect hearing of anything like this in 10 years of handling managed care issues across the state. It’s outrageous.”

“The Connecticut State Medical Society has written to the state attorney general about United’s exclusive contract with LabCorp, saying the company has a limited number of facilities in its area.”
“If I give a patient a script for LabCorp, but they go to the Quest Lab in my building because it’s convenient, do I get fined?” Wasylik asked. “The insurer allows a patient to have out-of-network benefits. But if they use them, they punish the docs. That doesn’t make sense.”

It certainly does not make sense. Worse, it is a direct contradiction to developing a more user friendly healthcare system UnitedHealthcare professes in its advertisement in the Wall Street Journal March 19,2007. It simply forces the patients and physician to be more captive to its controlling tactics.

The AMA provided another contradiction to UnitedHealthcare’s advertisement.
“In a press release, the AMA said it sent a letter in strong opposition to the merger to U.S. Attorney General Alberto Gonzales. The AMA said that it has “deep reservations about United’s goal of dominating the Nevada health insurance market, and in particular the Las Vegas market, by purchasing the state’s largest insurer.”
AMA Board Member James Rohack, M.D. said in the letter, “Federal authorities must not allow United’s blatant grab for dominant market power. The proposed merger would have negative long-term consequences for patients, physicians, hospitals and employers.”

“If the proposed merger is allowed, the AMA estimates that United would control 78 percent of the HMO market in Nevada, and 95 percent of the HMO market in the Las Vegas-Paradise metropolitan area.
It looks like UnitedHealthcare’s plan is to limit the competitive environment.

Then another inconsistency appeared in San Francisco. “United Healthcare under fire over pay” was the headline of a San Francisco Biz Journal article
California Medical Association wants state investigation
The CMA, which represents 35,000 doctors statewide, wants the state Department of Managed Health Care and the Department of Insurance to see if reports of widespread delays, underpayments and other errors on doctors’ contracts by the giant Minnesota-based health plan are the result, as the doctors’ group says it suspects, “of a significant lack of administrative capacity.”

A lame excuse when UnitedHealthcare’s profits and executive salaries are so high.

These are just a few of the examples I picked up on the internet this week. They are a total contradiction of UnitedHealthcare’s advertisement of March 19,2007 in the Wall Street Journal.

Before we can believe UnitedHealthcare really means what it says, it must show us it is ready to repair the healthcare system rather than continue to destroy it.

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