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Insurers Are Dictating Care and We’re Sick, Sick, Sick of It!

Posted on December 21, 2024


N. Adam Brown is a practicing emergency physician, entrepreneur, and healthcare executive. He is the founder of ABIG Health, a healthcare growth strategy firm, and a professor at the University of North Carolina’s Kenan-Flagler Business School. 

MedPage Today –The killing of UnitedHealthcare executive Brian Thompson sent shockwaves through the medical community, Wall Street, and social media.

The motive behind the killing appears to be obvious: the bullets were reportedly inscribedopens in a new tab or window with the words “deny,” “defend,” and “depose,” phrases that refer to insurers’ common practices of denying care, defending their positions in court, and deposing those who challenge them.

Some social media commentatorsopens in a new tab or window embraced the murderer’s rallying cry. I was sickened by those comments suggesting Thompson deserved his fate. Let me be clear: this killing was abominable. No one deserves to lose their life because of a business decision.

That said, many of the decisions insurers like UnitedHealthcare have made are, themselves, abominable. They do deserve our outrage. We can simultaneously be outraged at both Thompson’s killing and the immoral actions of insurance companies.

…article continued below

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Take, for example, Anthem Blue Cross and Blue Shield’s recent decision to limit payment for anesthesia servicesopens in a new tab or window.

This policy would have limited payments based on CMS’ “physician work time values,” determination of how long a surgical case should take to performopens in a new tab or window.

Such a policy is ludicrous. Surgeries, whether routine or complex, can often take longer than expected due to a variety of factors. Imagine a surgeon having to watch the insurance anesthesia clock while performing an organ transplant or removing a brain tumor.

Thankfully, Anthem thought twice (following significant pushback) and reversed course …

READ MORE. 



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