Health plans - Health Plan Rip-off?

I don’t always appreciate the New York Times reporting on doctors. Too often, it seems to me, the Times portrays us as opportunistic entrepreneurs, using innovative new technologists to pad our bottom lines, even when these innovations improve care and save lives.


Lately, however, the Times has switched from writing about health plan rip-offs rather than doctor rip-offs.


The Times is focusing on UnitedHealth Group’s ownership of Ingenix, Inc. Ingenix processes data from over one billion health plan transactions from over 100 health plans across the U.S. and translates the data into “usual and customary” fees for individual regions. The problem is that doctor and hospital fees in these regions are well above Ingenix calculations, and patients must pick up the difference. The differences are often considerable, as much as 50% to 70% of the total bill, and may create financial havoc among unsuspecting health consumers who fail to read or don’t understand the fine print in their health plan contracts concerning out-of-network care.


If you would like to read what the Times has to say, here are three recent articles you might want to read.


• Reed Abelson, “Health Plans Place Onus on Insured,” February 19, 2008

• Editorial, “A Rip-Off by Health Insurers,” February 18, 2008

• Reed Abelson, Inquiry Set on Health Billing, Feburary 14, 2008

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This is an important story to follow. UnitedHeatlh Group, Inc, founded in Minnesota in 1977, serves 65 million Americans, including many AARP members, and involves 500.000 physicians. I compliment the Times on bringing this story to our attention