2 ms·

Roger that. I’m against vigilante killings because I don’t want to live in that kind of a society. But a couple days later, Anthem decided to end their insane

Roger that. I’m against vigilante killings because I don’t want to live in that kind of a society. But a couple days later, Anthem decided to end their insane time limits on anesthesia. I’m hoping the public’s reaction to all these events has put a bug in the ear of politicians who ran partly on the idea of “repeal the ACA”: maybe this isn’t a great time to start slashing coverage. People seem pretty upset about it right now.

DennisP 2y ago
I agree with your general points, but if we can trust Vox, the Anthem situation wasn't quite what people thought. The policy was to prevent overpayment to anesthesiologists, because they get paid partly by the hour and there's evidence that they tend to inflate their times. The policy would not have increased costs to patients, because of this: > “Say there is a contract between an insurance company like Anthem and an anesthesiologist,” Garmon told Vox. “What is always in that contract is a clause that says, ‘You, the provider, agree to accept the reimbursement rules in this contract as payment in full.’ That means the provider cannot then turn around and ask [the patient] for money.” There was also a process for anesthesiologists to apply for extra payment if surgery went extra long. https://www.vox.com/policy/390031/anthem-blue-cross-blue-shield-anesthesia-limits-insurance https://www.vox.com/policy/390031/anthem-blue-cross-blue-shi... They make a larger point that the main reason Americans pay so much more for healthcare is that we pay our providers a lot more. Nations with more reasonable costs and high-quality results have controls in place to keep costs down at the provider level.
- SauciestGNU 2y ago
  Vox might be right but under no circumstances would a company admit "hey we're changing this unpopular decision because we're personally afraid of being killed". Tying good patient outcomes to dead CEOs would be literally suicidal for Anthem execs.

DennisP 2y ago

I agree with your general points, but if we can trust Vox, the Anthem situation wasn't quite what people thought. The policy was to prevent overpayment to anesthesiologists, because they get paid partly by the hour and there's evidence that they tend to inflate their times. The policy would not have increased costs to patients, because of this: > “Say there is a contract between an insurance company like Anthem and an anesthesiologist,” Garmon told Vox. “What is always in that contract is a clause that says, ‘You, the provider, agree to accept the reimbursement rules in this contract as payment in full.’ That means the provider cannot then turn around and ask [the patient] for money.” There was also a process for anesthesiologists to apply for extra payment if surgery went extra long. https://www.vox.com/policy/390031/anthem-blue-cross-blue-shield-anesthesia-limits-insurance https://www.vox.com/policy/390031/anthem-blue-cross-blue-shi... They make a larger point that the main reason Americans pay so much more for healthcare is that we pay our providers a lot more. Nations with more reasonable costs and high-quality results have controls in place to keep costs down at the provider level.

SauciestGNU 2y ago
Vox might be right but under no circumstances would a company admit "hey we're changing this unpopular decision because we're personally afraid of being killed". Tying good patient outcomes to dead CEOs would be literally suicidal for Anthem execs.