Dumping Doctors and Limiting Access:
Insurers misinterpret healthcare reform!

Dumping Doctors and Limiting Access - Insurers misinterpret healthcare reform!

The health insurance industry has been faltering for years. The cost of healthcare, including out of pocket expenses, has been steadily and agonizingly on the rise, regardless of who has been in charge at the White House. We have all been upset with the insurance industry as a whole as we seek more affordable and comprehensive options.

In an almost futile effort, the federal government continues to shovel subsidized healthcare dollars back and forth, while National Health Expenditure (NHE) will continue to rise to almost 5 trillion by 2022. The G.W. Bush administration heavily subsidized the Medicare part C advantage senior program at its inception. Obamcare is now shifting healthcare dollars away from the advantage senior program to fund the affordable care act, with one goal to insure more lives. These federal programs clearly influence the commercial insurance industry, but it is ultimately up to the industry decision makers who determine how to spend their money and to support consumers, or not!

Dumping doctors, hospitals and restricting access for patients in the UnitedHealthCare AARP Medicare Advantage senior program is not going to help anyone in the end, including the bottom line! Tell Jack Larsen, CEO of UnitedHealthCare Medicare & Retirement not to be so greedy. His company just earned $2 billion profit in the third quarter of 2013 alone. Stop your temper tantrum and take a time out!

This is an unfortunate trend being seen across the entire industry. Our current model of healthcare spending and delivery, often referred to as “Sick Care”, is not working. Successful healthcare reform will only work if we can prevent people from developing chronic disease in the 1st place. Let’s work together and find solutions before the health insurance bubble bursts.

This post was updated on 11/21/2013.

Read more:

Blame Game as Insurance Dumps Doctors

UnitedHealth drops thousands of doctors from insurance plans

AARP Medicare plan cuts signal major changes, says UnitedHealthcare CEO

52 Million Americans Could Lose Current Coverage Under Obamacare

The fourth Obamacare Shockwave is about to reach us

The two Obamacare charts that no one’s talking about

UnitedHealth cuts thousands of physicians from network

Obamacare’s big winners: Insurers. Oops!

UnitedHealthcare Cancels Physician Contracts in Medicare Advantage Networks

Insurance companies dumping doctors

  • http://denversdietdoctor.com Jeffry Gerber, MD

    Janknitz: The insurance sites will not use wording such as “restricted networks”. They pick much softer language like choosing in-network providers and hospitals with possible options to go out of network. Doesn’t sound as bad using their language, huh?

    Reduced spending and limiting services are nothing new. Both public and private insurers have been doing this for years. The ACA has accelerated this process and also brought the issues to everyone’s attention. Most patients and doctors do not see these as good long-term solutions for healthcare reform.

    The ACA is addressing prevention programs as best they can, but still based on a faltering traditional medical model what is often referred to as sick care. Successful healthcare reform will only work if we can prevent people from developing chronic disease in the 1st place. This will
    be most cost effective, saving money on expensive treatments including medications, surgeries and hospitalizations. The government and insurance industry are so far behind on this one!

    Doctors, consumers and patients all share in your frustration. I do not have all the answers and there is a steep learning curve for all of us. Just trying to share my perspective, inform and hopefully find ways to help us all navigate through change.

  • Janknitz

    Could you explain what United Healthcare is doing exactly to “restrict access for patients”? What does that mean???

    And are changes in Advantage funding part if the ACA or were these long-planned cuts to advantage plans independent of the ACA?

    Advantage plans have thrived for two reasons–they cut costs to the bone, and for all the years since their inception they have enjoyed higher per capita payments than traditional Medicare providers. My understanding is that these cuts have been in the works for some time, independent of the ACA. Please correct me if I’m wrong.

    Doctors never made a peep when prior Medicare cost cutting measures harmed their patients, eg DRG’s which sent patients out of the hospital too fast and too sick and RUGs which limit Medicare coverage for skilled nursing care while documentation cost have soared. If doctors don’t like these new cuts, then maybe they should get off their cans and advocate for their patients instead of asking patients to try to save their jobs!!!!

  • http://denversdietdoctor.com Jeffry Gerber, MD

    Sverlyn: Most of us have issues with the ACA/Obamacare, but reform is upon us. I am well aware of the new federal cuts to the Medicare Advantage programs. These Advantage programs, since their inception back during the G.W. Bush administration, have historically been profitable to industry. The point raised here has to do with how the commercial insurance industry has reacted to these new reforms. Based on your comments, it sounds like you are in total agreement with their actions and that they have no other recourse to help consumers?

  • sverlyn

    I think the unfortunate trend is people commenting on things w/o thought or knowledge. The margins for health insurance are actually pretty modest. The 2 billion in profits you quote don’t mention the amount of services they paid for during that period. Wonder why? Maybe it’s the profit motive that is your real target here.
    Any idea why they’re cutting back on the Advantage program? Hint, it’s not because they’re greedy and want to punish consumers. It’s because Obamacare cuts back drastically on the payouts for the Advantage program. In your world, insurance companies should go ahead and provide the same services despite the fact that they won’t be paid for them? You show a complete ignorance of how economics work

    • SP1966

      Private Profit vs. Government Bureaucracy, I’m betting the bureaucracy costs would far exceed the $2B in profits!

      • http://denversdietdoctor.com Jeffry Gerber, MD

        Maybe!