Medical Giant Draws Line Against Insurance Giant

We've heard all the horror stories of private insurers condemning sick people to bankruptcy, suffering and death by denying them coverage or dropping them as policy-holders.

But private insurers have many ways to fuck over sick people, doctors, hospitals and communities, and one of those ways is playing out in Louisville right now.

The rift between health insurance provider Anthem and Norton Healthcare, Louisville’s largest health provider, has widened.

Norton officials on Friday announced the company would end financial accommodations extended to Anthem users and start billing at its regular rate for those out of its network, effective Jan. 1.

SNIP

The feud has been waged publicly for months. Norton said it chose to terminate its contract with Anthem because Anthem has failed to process insurance claims properly and does not offer a rate comparable to other providers. Anthem, meanwhile, maintains Norton wanted too much money — to the tune of a 20 percent increase or more — which Norton has denied.

Read the whole thing.

Anthem's doing a pretty good PR job of making Norton sound like a greedy corporation willing to sacrifice patients for profit, but the truth is that Anthem and other private insurers have been slashing reimbursement rates to doctors and hospitals for years, until the pittance they pay barely covers the cost of procedures. Norton is taking huge risks by courageously standing up and saying No More.

Proving this is also a story about the false equivalence fetish of the mainstream media, Gannett's pathetic local rag published an editorial that erroneously blames both sides equally.

"Irresponsible Feud"

Each party blames the other for the split. Boiled down, Anthem says Norton wants a more than 20 percent rate of increase in reimbursements. Norton says that's not true, but it wants Anthem to pay what other insurers are paying and, besides, it says Anthem is slow in making its claims payments. Anthem says that's not true and — well, you get the picture.

More important, at least 200,000 people have been stuck in the middle of this fiduciary food fight.

News stories have chronicled the worry, confusion and inconvenience added to the burden of patients facing everything from childbirth to cancer treatments. Which hospital should they go to? Which doctor should they see? How much more would it cost to keep using their old (now out-of-network) doctors and facilities?
Meanwhile, spokesmen for the companies have had their say in serial news articles following the mess, and the heads of both companies have written op-eds to present their sides of the story. While pointing fingers at each other, said company heads also patted themselves on the back and polished their community bona fides as solid corporate citizens who care deeply about the health and well-being of people and city.

Hooey.

If they cared so much, they would be locked in a room trying to hammer this out, and they are not doing that.

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If both Anthem and Norton are as committed to the health care needs of the community they serve, as they insist they are, they will get back to the hard work of trying to come together again.

Hooey, to coin a phrase. If the Courier gave a flying fuck about the community it claims to serve, it would come out four-square in favor of the single-payer health insurance system that is the only way to stop abuses like this.

Cross-posted at They Gave Us A Republic ....