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Health Insurers Make It Easy for Scammers to Steal Millions

124 points by danso 7y ago

danso 7y ago
FWIW, the Centers for Medicare & Medicaid Services makes the entire National Provider Identifier database searchable [0] and downloadable (6M rows, 7.25GB)[1], in which you can find all of the story subject's many fraudulent entries. Interestingly, even though CMS tracks and disseminates a file of deactivated NPIs, several/many of this guy's entries are still "Active" [2] [0] https://npiregistry.cms.hhs.gov/ https://npiregistry.cms.hhs.gov/ [1] http://download.cms.gov/nppes/NPI_Files.html http://download.cms.gov/nppes/NPI_Files.html [2] https://npiregistry.cms.hhs.gov/registry/search-results-table?organization_name=KINESIOLOGY+SPECIALISTS&addressType=ANY https://npiregistry.cms.hhs.gov/registry/search-results-tabl...
word-reader 7y ago
The scammer ended up with $4M in his pocket, for providing personal training services to 1000 people. Now, it sounds like he would also fraudulently bill the insurance companies for exercise sessions that didn't happen. But let's say only 800 people got personal training: that's $5000 per person. That's not an absurd amount for personal training over a long period of time. And their health was surely improved by the exercise. Then someone with a personal vendetta against him got his business records because of bad OPSEC. I'm sure a lot of other people involved (clients, business associates) also knew it was a questionable operation, but they were probably pretty happy to have health insurance actually pay for things that improved their health for once. I don't feel like this type of fraud would increase healthcare costs in the way many other actors in the system (who are not about to go to prison) increase them. If this guy had been ordained as a doctor and was just a little more careful with the billing, he'd be hailed for getting insurance companies to pay for exercise treatment. "You say you have pain? I prescribe 'physical therapy' where you work out with one of my assistants for an hour and I talk to you at the end." Easy as that.
- danso 7y ago
  It's kind of a stretch to say that this guy Williams was a hardworking health provider who just wasn't lucky enough to have an approved degree and good opsec. According to the story, his first felony conviction came from using his son's autism to submit fake invoices to get gov't reimbursement (nevermind the felony child abuse that landed him in prison). And then there's the allegations that he highly exaggerated his services (describing "typical fitness exercises" as treatment for "lumbago and sciatica"). And then there's the several examples of clients who did notice and call out the egregious mis-billing: > Another client texted Williams with concerns that her United insurance plan had been billed for 18 workouts in December 2015. That couldn’t be accurate, the woman wrote. “I had to take December off due to my work schedule and family in town,” she wrote. “I understand that people need to be paid but this seems excessive.”
  - word-reader 7y ago
    The guy is a grifter, no doubt. But the general tone of the article implies that I should be concerned about some random sleazeball for raising my healthcare costs, rather than the insurance companies themselves (who in this case basically administered the defrauding of their client, Southwest Airlines, by not having proper vetting procedures), the MDs who undoubtedly commit the vast majority of insurance fraud, or policymakers. edit: First-line treatment for sciatica includes typical fitness stretches and "lumbago" just means "back pain" which is treatable with typical fitness exercises: https://www.verywellhealth.com/back-pain-stretches-exercises-2549756 https://www.verywellhealth.com/back-pain-stretches-exercises...
    - ip26 7y ago
      implies that I should be concerned about some random sleazeball for raising my healthcare costs, rather than the insurance companies themselves We must have read the title differently.
      - word-reader 7y ago
        Ah, true. But they had lots of family sources and court records for Williams, and I suppose no spokesperson from the insurance companies wanted to talk, so most of the article is just about him. I wish journalists would develop some more sources inside insurance companies, PBMs, etc. How they operate internally is just like a void that nobody wants to look in to, apparently. Like how do they decide what they'll pay for? Or how do they decide who gets to be part of their network? How long will they let a doctor send in fraudulent claims? There are probably 1000 analysts or programmers inside UHC alone who would happily help answer these.
joecool1029 7y ago
A bit unrelated, but states make it easy to scam unemployment insurance too! I've had a rando collecting unemployment benefits from my company's account for a year now because my company's name is similar to a grimy company that hires contractors and operates in a different industry. I've never had a relationship with the claimant and don't even know who they are. My theory is: The scammers search for businesses with similar names to whom they contracted for and submit unemployment claims to whomever looks similar on the state business registration website. The state doesn't check to see if there was actually a record of employment and just puts the burden of proof on the business. If the response by the business isn't timely or things get lost in the mail, the state pays out whatever they claim. At this time the risk appears small to the scammer as our fraud reports went nowhere, the cost to my business is large as it screws our UI experience rates up and has now lead to having to change/rebrand the business's name.
theonemind 7y ago
I've never really liked the "the business screws up and you pay for it" narrative so common in articles like this. I don't remember my microeconomics class too well, but the inefficiency affects the supply/demand curve, and I believe that the business and the consumer both typically take a loss. Not really so simple a story as "they just raise the price by the amount they lost and take it from you easy-peasy" like the line makes it sound, like consumers have just simply absorbed all cost/risk on the company's behalf. At any rate, fraud like that should increase the inefficiency of the business, and in a competitive market, companies handling fraud better should get an edge, then we end up with a bunch of companies doing the optimal amount of fraud policing. Of course, we have the real problem of not having real competition in the US health care market.
- ip26 7y ago
  It seems pretty obvious the cornerstone of that narrative is a poorly functioning market, lacking competition, price transparency, freedom of choice, etc.
clavalle 7y ago
Tip of the iceberg. I know a fellow that got a bill a drug testing company didn't mean to send him. He was meant to check for a single restricted medication because of some treatment regimen he was on. Instead, it checked for pretty much everything and automatically rechecked both positive and negative results. Long story short, a $50 test turned into a $2500 test, invisible to all but the testing company and the insurance company. The testing company told him to ignore the bill and, indeed, he wasn't charged that amount. It piqued his curiosity and offended his sense of fairness and it led him down a disturbing rabbit hole of uncovering some very bad behavior and desperately trying to get folks to do notice what was happening and do something about it. Basically, this company seems to be in the business of bribing doctors through ridiculously priced leases in their medical office that they pay for to house their 'testing advisors'. We're talking on the order of $15K a month for a broom closet. In return, doctors use the testing company's pre-filled documents for requesting testing -- standing orders for the whole suite of tests with re-checks rather than just what is needed. By the time the insurance companies caught on they'd amassed a huge war chest and were more than happy to tie up the courts fighting claims that they're doing something wrong. One reason I support universal healthcare even though, generally, I'm a free-market proponent, is because it would make this kind of fraud a lot easier to spot and the federal government has a lot more tools to bring to bear to stop it.
- seibelj 7y ago
  I agree that if we are to maintain this opaque system where customers (patients) pay a flat rate for ludicrously overpriced insurance, and then have no insight into prices nor ability to reduce them because they don’t pay for the actual services, then universal healthcare is better. However, universal healthcare is not a panacea as evidenced by many angry patients waiting for procedures in Canada and the UK - although they are leaps and bounds better off than many in the current USA system. An alternative would be to have transparent pricing and open the market much more to for-profit businesses. Notice how vasectomies and laser eye surgery, 2 procedures not typically covered by insurance, have become safer, cheaper, and more effective over the past 20 years as they have been forced to advertise directly to consumers and compete with other vendors. This is the opposite trajectory of almost everything else in the healthcare system. I’m not saying all procedures can become like this - obviously a heart attack is a heart attack - but there are many other specialist procedures that are indeed scheduled in advance that could benefit from a heavy dose of transparency and competition. As another example, I’ve been on the same medication for the past 8 years. I get the same dose, and it’s never changing. Yet my provider makes me visit every 3 months for a refill. They put me in a room and “check up” to make sure the meds are "going well". Often this 30 minute scheduled meeting is less than 5 minutes because my doctor just hits a button on the computer to refill it. Yet insurance pays 4 times a year for this unnecessary visit to a specialist doctor. It doesn't cost me anything (other than deductible) so I'm most annoyed about the time wasting, but I also know that the system is being bilked for thousands of dollars. Multiply that anecdote by a million other situations. I should just be able to buy my meds without being forced to go through a doctor.
reaperducer 7y ago
Before I worked in healthcare, it all seemed so easy. The doctors were the good guys, and the insurance and drug companies were the bad guys. Now I see it differently. Healthcare companies are massive bureaucracies because there are people at every end trying to scam them. All that redundant paperwork is for a reason. You wouldn't believe some of the things that people try to get away with. Plastic surgeons billing tummy tucks as emergency C-sections. People pretending they were the hospital so they can get the insurance company to reimburse them for the IV "hangover cures" they got every morning while partying in Vegas. People walking into office buildings and play-collapsing in the lobby so they can get an ambulance ride to the hospital across town, then once they arrive they run out of the hospital and down the street because all they were really looking for is a free ride. People who have six or seven dependent children from multiple partners on their insurance, then yell at us because the partner they're living with didn't know about all those other children from all those other spouses until they opened some piece of mail from us. I'm not saying that insurance companies are all good. IME, most are not. But if people were just honest and decent, a large part of the healthcare system dysfunction wouldn't exist.
- gruez 7y ago
  >Healthcare companies are massive bureaucracies because there are people at every end trying to scam them. All that redundant paperwork is for a reason. And what about other countries with way lower healthcare expenditures (by % of GDP)? Are people scamming the healthcare system an American problem?
  - TeMPOraL 7y ago
    > Are people scamming the healthcare system an American problem? Definitely not. In Poland we have public healthcare, and the stories I hear from my doctor acquaintance still reveal ridiculous levels of fraud, mostly the usual scams against large bureaucracies. Public healthcare may be more efficient, but is still full of bureaucratic scars.
    - Retric 7y ago
alexashka 7y ago
A lot of this would be solved by knowing how much people make, what they spend it on and where the money came from. If you want democracy, let people vote on who is a scumbag, investigate those people's financial history and if it's confirmed, ex-communicate them from society. That'd border on real democracy however, so I don't see it taking place anytime soon :)
- vageli 7y ago
  > A lot of this would be solved by knowing how much people make, what they spend it on and where the money came from. > If you want democracy, let people vote on who is a scumbag, investigate those people's financial history and if it's confirmed, ex-communicate them from society. I may be reading your point too narrowly but it sounds like you are advocating for a judicial system.
  - alexashka 7y ago
    A judicial system is concerned with laws. We'll always have scumbags who twist the law in ways to profit themselves. This system is so broken we even have names for sub-categories of scumbags who literally abuse the law - one of them is called patent trolls! That's why we need democracy - to vote on ex-communicating scumbags that try and do that. Law alone is not enough - I don't know why that's not immediately obvious. There's also the question of incentives - if you can't spend money you steal without getting caught, you're far less likely to be a scumbag and steal in the first place. These seem like incredibly obvious things.
drtillberg 7y ago
Maybe 40 years ago only MD doctors were qualified to perform medical procedures and thus to have NPI's, but things change. Now states are all over the place on what professional is qualified to provide what service. Most states probably require some kind of registration, but I also wouldn't be shocked to learn some ancillary physical therapy or acupuncture or chiropractic service can be billed somewhere by someone who only has a PhD. Not in Texas apparently, but somewhere. The article was about a brazen 'slam dunk' fraud, but for the 99% of other schemes that inflate a bill 5%, 10%, 15%, the blame is laid more correctly at the feet of the AMA and it's CPT Codebook (the 99215 in the article) which at once makes billing for things an awful chore and makes prosecuting less brazen schemes a total headache. Look up 99215, for example. First of all, the description is copyrighted IP not freely available for use. Second, if you find it, it's a timed procedure that doesn't have a specific time attached to it. Just proving 'you billed for a long examination and didn't actually spend much time with the patient' generally will not suffice to prove fraud. Instead you need to delve into medical notes, interviews and compare the lengths of other examinations, just to demonstrate falsity for one occasion, one exam. This, and all the secrecy attached to medical records, is a big reason why medical billing anomalies are so unlikely to generate legal department responses.
NoblePublius 7y ago
This guy doesn’t seem like a fraudster so much as an honest practitioner trying to make his skills available to people. Did he injure anyone?
galaxyLogic 7y ago
The thing to take away from this: Doctors, Insurance companies and big and small Pharma (small meaning pharmacies) are in cahoots with each other. Doctors charge for unnecessary operations and insurance companies don't care because they can pass on the costs to people who must have insurance. But then why doesn't competition keep insurance companies more alert? Is it because it is really oligopoly, a bit like either you use Spectrum or Verizon there's really other choice?
- tehlike 7y ago
  Mergers and Acqusitions. Once insurance providers get large, they tend to get acquired. Im sure there is more to "why", but this is one reason.
AFascistWorld 7y ago
Hospitals in California now requires Chinese patients to pay upfront, and from what I gather, you don't even need to ask the doctors and hospitals for them to unknowingly sign you up various healthcare benefits. Some birth tourists in fear of immigration policy changes need to specifically stress and request to not being signed up.
mahgnous 7y ago
I don't see what he did as being wrong. I think insurance providers should cover that. Prevents people from getting sick and actually heals.

124 points by danso 7y ago

FWIW, the Centers for Medicare & Medicaid Services makes the entire National Provider Identifier database searchable [0] and downloadable (6M rows, 7.25GB)[1], in which you can find all of the story subject's many fraudulent entries. Interestingly, even though CMS tracks and disseminates a file of deactivated NPIs, several/many of this guy's entries are still "Active" [2] [0] https://npiregistry.cms.hhs.gov/ https://npiregistry.cms.hhs.gov/ [1] http://download.cms.gov/nppes/NPI_Files.html http://download.cms.gov/nppes/NPI_Files.html [2] https://npiregistry.cms.hhs.gov/registry/search-results-table?organization_name=KINESIOLOGY+SPECIALISTS&addressType=ANY https://npiregistry.cms.hhs.gov/registry/search-results-tabl...

word-reader 7y ago

The scammer ended up with $4M in his pocket, for providing personal training services to 1000 people. Now, it sounds like he would also fraudulently bill the insurance companies for exercise sessions that didn't happen. But let's say only 800 people got personal training: that's $5000 per person. That's not an absurd amount for personal training over a long period of time. And their health was surely improved by the exercise. Then someone with a personal vendetta against him got his business records because of bad OPSEC. I'm sure a lot of other people involved (clients, business associates) also knew it was a questionable operation, but they were probably pretty happy to have health insurance actually pay for things that improved their health for once. I don't feel like this type of fraud would increase healthcare costs in the way many other actors in the system (who are not about to go to prison) increase them. If this guy had been ordained as a doctor and was just a little more careful with the billing, he'd be hailed for getting insurance companies to pay for exercise treatment. "You say you have pain? I prescribe 'physical therapy' where you work out with one of my assistants for an hour and I talk to you at the end." Easy as that.

danso 7y ago
It's kind of a stretch to say that this guy Williams was a hardworking health provider who just wasn't lucky enough to have an approved degree and good opsec. According to the story, his first felony conviction came from using his son's autism to submit fake invoices to get gov't reimbursement (nevermind the felony child abuse that landed him in prison). And then there's the allegations that he highly exaggerated his services (describing "typical fitness exercises" as treatment for "lumbago and sciatica"). And then there's the several examples of clients who did notice and call out the egregious mis-billing: > Another client texted Williams with concerns that her United insurance plan had been billed for 18 workouts in December 2015. That couldn’t be accurate, the woman wrote. “I had to take December off due to my work schedule and family in town,” she wrote. “I understand that people need to be paid but this seems excessive.”
- word-reader 7y ago
  The guy is a grifter, no doubt. But the general tone of the article implies that I should be concerned about some random sleazeball for raising my healthcare costs, rather than the insurance companies themselves (who in this case basically administered the defrauding of their client, Southwest Airlines, by not having proper vetting procedures), the MDs who undoubtedly commit the vast majority of insurance fraud, or policymakers. edit: First-line treatment for sciatica includes typical fitness stretches and "lumbago" just means "back pain" which is treatable with typical fitness exercises: https://www.verywellhealth.com/back-pain-stretches-exercises-2549756 https://www.verywellhealth.com/back-pain-stretches-exercises...
  - ip26 7y ago
    implies that I should be concerned about some random sleazeball for raising my healthcare costs, rather than the insurance companies themselves We must have read the title differently.
    - word-reader 7y ago
      Ah, true. But they had lots of family sources and court records for Williams, and I suppose no spokesperson from the insurance companies wanted to talk, so most of the article is just about him. I wish journalists would develop some more sources inside insurance companies, PBMs, etc. How they operate internally is just like a void that nobody wants to look in to, apparently. Like how do they decide what they'll pay for? Or how do they decide who gets to be part of their network? How long will they let a doctor send in fraudulent claims? There are probably 1000 analysts or programmers inside UHC alone who would happily help answer these.

joecool1029 7y ago

A bit unrelated, but states make it easy to scam unemployment insurance too! I've had a rando collecting unemployment benefits from my company's account for a year now because my company's name is similar to a grimy company that hires contractors and operates in a different industry. I've never had a relationship with the claimant and don't even know who they are. My theory is: The scammers search for businesses with similar names to whom they contracted for and submit unemployment claims to whomever looks similar on the state business registration website. The state doesn't check to see if there was actually a record of employment and just puts the burden of proof on the business. If the response by the business isn't timely or things get lost in the mail, the state pays out whatever they claim. At this time the risk appears small to the scammer as our fraud reports went nowhere, the cost to my business is large as it screws our UI experience rates up and has now lead to having to change/rebrand the business's name.

theonemind 7y ago

I've never really liked the "the business screws up and you pay for it" narrative so common in articles like this. I don't remember my microeconomics class too well, but the inefficiency affects the supply/demand curve, and I believe that the business and the consumer both typically take a loss. Not really so simple a story as "they just raise the price by the amount they lost and take it from you easy-peasy" like the line makes it sound, like consumers have just simply absorbed all cost/risk on the company's behalf. At any rate, fraud like that should increase the inefficiency of the business, and in a competitive market, companies handling fraud better should get an edge, then we end up with a bunch of companies doing the optimal amount of fraud policing. Of course, we have the real problem of not having real competition in the US health care market.

ip26 7y ago
It seems pretty obvious the cornerstone of that narrative is a poorly functioning market, lacking competition, price transparency, freedom of choice, etc.

clavalle 7y ago

Tip of the iceberg. I know a fellow that got a bill a drug testing company didn't mean to send him. He was meant to check for a single restricted medication because of some treatment regimen he was on. Instead, it checked for pretty much everything and automatically rechecked both positive and negative results. Long story short, a $50 test turned into a $2500 test, invisible to all but the testing company and the insurance company. The testing company told him to ignore the bill and, indeed, he wasn't charged that amount. It piqued his curiosity and offended his sense of fairness and it led him down a disturbing rabbit hole of uncovering some very bad behavior and desperately trying to get folks to do notice what was happening and do something about it. Basically, this company seems to be in the business of bribing doctors through ridiculously priced leases in their medical office that they pay for to house their 'testing advisors'. We're talking on the order of $15K a month for a broom closet. In return, doctors use the testing company's pre-filled documents for requesting testing -- standing orders for the whole suite of tests with re-checks rather than just what is needed. By the time the insurance companies caught on they'd amassed a huge war chest and were more than happy to tie up the courts fighting claims that they're doing something wrong. One reason I support universal healthcare even though, generally, I'm a free-market proponent, is because it would make this kind of fraud a lot easier to spot and the federal government has a lot more tools to bring to bear to stop it.

seibelj 7y ago
I agree that if we are to maintain this opaque system where customers (patients) pay a flat rate for ludicrously overpriced insurance, and then have no insight into prices nor ability to reduce them because they don’t pay for the actual services, then universal healthcare is better. However, universal healthcare is not a panacea as evidenced by many angry patients waiting for procedures in Canada and the UK - although they are leaps and bounds better off than many in the current USA system. An alternative would be to have transparent pricing and open the market much more to for-profit businesses. Notice how vasectomies and laser eye surgery, 2 procedures not typically covered by insurance, have become safer, cheaper, and more effective over the past 20 years as they have been forced to advertise directly to consumers and compete with other vendors. This is the opposite trajectory of almost everything else in the healthcare system. I’m not saying all procedures can become like this - obviously a heart attack is a heart attack - but there are many other specialist procedures that are indeed scheduled in advance that could benefit from a heavy dose of transparency and competition. As another example, I’ve been on the same medication for the past 8 years. I get the same dose, and it’s never changing. Yet my provider makes me visit every 3 months for a refill. They put me in a room and “check up” to make sure the meds are "going well". Often this 30 minute scheduled meeting is less than 5 minutes because my doctor just hits a button on the computer to refill it. Yet insurance pays 4 times a year for this unnecessary visit to a specialist doctor. It doesn't cost me anything (other than deductible) so I'm most annoyed about the time wasting, but I also know that the system is being bilked for thousands of dollars. Multiply that anecdote by a million other situations. I should just be able to buy my meds without being forced to go through a doctor.

reaperducer 7y ago

Before I worked in healthcare, it all seemed so easy. The doctors were the good guys, and the insurance and drug companies were the bad guys. Now I see it differently. Healthcare companies are massive bureaucracies because there are people at every end trying to scam them. All that redundant paperwork is for a reason. You wouldn't believe some of the things that people try to get away with. Plastic surgeons billing tummy tucks as emergency C-sections. People pretending they were the hospital so they can get the insurance company to reimburse them for the IV "hangover cures" they got every morning while partying in Vegas. People walking into office buildings and play-collapsing in the lobby so they can get an ambulance ride to the hospital across town, then once they arrive they run out of the hospital and down the street because all they were really looking for is a free ride. People who have six or seven dependent children from multiple partners on their insurance, then yell at us because the partner they're living with didn't know about all those other children from all those other spouses until they opened some piece of mail from us. I'm not saying that insurance companies are all good. IME, most are not. But if people were just honest and decent, a large part of the healthcare system dysfunction wouldn't exist.

gruez 7y ago
>Healthcare companies are massive bureaucracies because there are people at every end trying to scam them. All that redundant paperwork is for a reason. And what about other countries with way lower healthcare expenditures (by % of GDP)? Are people scamming the healthcare system an American problem?
- TeMPOraL 7y ago
  > Are people scamming the healthcare system an American problem? Definitely not. In Poland we have public healthcare, and the stories I hear from my doctor acquaintance still reveal ridiculous levels of fraud, mostly the usual scams against large bureaucracies. Public healthcare may be more efficient, but is still full of bureaucratic scars.
  - Retric 7y ago

alexashka 7y ago

A lot of this would be solved by knowing how much people make, what they spend it on and where the money came from. If you want democracy, let people vote on who is a scumbag, investigate those people's financial history and if it's confirmed, ex-communicate them from society. That'd border on real democracy however, so I don't see it taking place anytime soon :)

vageli 7y ago
> A lot of this would be solved by knowing how much people make, what they spend it on and where the money came from. > If you want democracy, let people vote on who is a scumbag, investigate those people's financial history and if it's confirmed, ex-communicate them from society. I may be reading your point too narrowly but it sounds like you are advocating for a judicial system.
- alexashka 7y ago
  A judicial system is concerned with laws. We'll always have scumbags who twist the law in ways to profit themselves. This system is so broken we even have names for sub-categories of scumbags who literally abuse the law - one of them is called patent trolls! That's why we need democracy - to vote on ex-communicating scumbags that try and do that. Law alone is not enough - I don't know why that's not immediately obvious. There's also the question of incentives - if you can't spend money you steal without getting caught, you're far less likely to be a scumbag and steal in the first place. These seem like incredibly obvious things.

drtillberg 7y ago

Maybe 40 years ago only MD doctors were qualified to perform medical procedures and thus to have NPI's, but things change. Now states are all over the place on what professional is qualified to provide what service. Most states probably require some kind of registration, but I also wouldn't be shocked to learn some ancillary physical therapy or acupuncture or chiropractic service can be billed somewhere by someone who only has a PhD. Not in Texas apparently, but somewhere. The article was about a brazen 'slam dunk' fraud, but for the 99% of other schemes that inflate a bill 5%, 10%, 15%, the blame is laid more correctly at the feet of the AMA and it's CPT Codebook (the 99215 in the article) which at once makes billing for things an awful chore and makes prosecuting less brazen schemes a total headache. Look up 99215, for example. First of all, the description is copyrighted IP not freely available for use. Second, if you find it, it's a timed procedure that doesn't have a specific time attached to it. Just proving 'you billed for a long examination and didn't actually spend much time with the patient' generally will not suffice to prove fraud. Instead you need to delve into medical notes, interviews and compare the lengths of other examinations, just to demonstrate falsity for one occasion, one exam. This, and all the secrecy attached to medical records, is a big reason why medical billing anomalies are so unlikely to generate legal department responses.

NoblePublius 7y ago

This guy doesn’t seem like a fraudster so much as an honest practitioner trying to make his skills available to people. Did he injure anyone?

galaxyLogic 7y ago

The thing to take away from this: Doctors, Insurance companies and big and small Pharma (small meaning pharmacies) are in cahoots with each other. Doctors charge for unnecessary operations and insurance companies don't care because they can pass on the costs to people who must have insurance. But then why doesn't competition keep insurance companies more alert? Is it because it is really oligopoly, a bit like either you use Spectrum or Verizon there's really other choice?

tehlike 7y ago
Mergers and Acqusitions. Once insurance providers get large, they tend to get acquired. Im sure there is more to "why", but this is one reason.

AFascistWorld 7y ago

Hospitals in California now requires Chinese patients to pay upfront, and from what I gather, you don't even need to ask the doctors and hospitals for them to unknowingly sign you up various healthcare benefits. Some birth tourists in fear of immigration policy changes need to specifically stress and request to not being signed up.

mahgnous 7y ago

I don't see what he did as being wrong. I think insurance providers should cover that. Prevents people from getting sick and actually heals.