Using the McCarran-Ferguson Act of 1945 which makes them immune to anti-trust laws to their advantage the Medical Insurance companies have grown into HUGE corporations. Nevertheless, they are doomed to spiral down leaving America, eventually, with a government-sponsored single payer system. In the end, they will be victims of their own greed and poor treatment of policy holders and health care providers. America can no longer afford them. This will happen despite the efforts of Physicians to abolish the Affordable Care Act commonly called “Obamacare” which was basically “Romneycare”. Hidden in reports such as THIS ONE are the reasons why they are doomed to failure and evidence of their greed and customer (both provider and patient) mistreatment. Read page 25 which gives a short version of the story that I am about to tell.
A few years back I worked for a non-profit hospital. The state capital hospitals and medical care providers merged into a large health care provider to specialize and to provide education to capital city medical schools, nursing schools, etc. They reached out to hospitals throughout the state to merge with their system to become feeders, although the initial presentation was for merger.
Arrangements between the capital hospital consortium and the outlying hospitals throughout the state were to provide a ‘system’ of medical trauma centers as described by the College of Surgeons whereby critical cases were to be stabilized and transferred via helicopter to the capital hospital consortium.
Enter the huge Medical insurance company that wrote 2/3 of the medical insurance policies throughout the state. Through unknown reasoning the hospitals who were to be the feeder hospitals for this trauma system backed out for financial reasons. When these feeder hospitals attempted to grow, during the beginning of the building phase after the municipal bonds were let, the huge medical insurance company simply made them out of network, thus bankrupting them and causing them to liquidate of find other financing. They did this to two other hospitals in the state before they got to my employer.
When the announcement that the Medical insurance was making our hospital out of network thus reducing reimbursements, employees were asked to write the Medical insurance company asking them not to do it. I never made the telephone call. I filed a complaint with the FTC to keep the insurance company from shutting down my hospital’s multi-million dollar expansion by making them out of network and forcing them to default on their bonding. When the attorney’s case from the FCC was rejected by the Department of justice for prosecution because of McCarran-Ferguson Act, I followed up with my Republican Senator’s office. Because of the Rural Healthcare facility my hospital supported by training was named after the senator, he intervened and the settlement was soon announced in the local media with a gag order to both parties.
I left the names out. I know the name of the FCC attorney, too. I found out that this was going on all over America with various Medical insurance companies. Visit this website
This same Medical Insurance company was sued by the Indiana State Medical Association for not paying legitimate claims to medical doctors. A year after the court agreed settlement the medical insurance company violated the court agreement.
If you need an attorney to deal with a Medical Insurance company go here…
www.healthlawyers.org/...
There are about 18 physicians in the House of Representatives. There are 2 medical doctors running for president. Republicans state they want to abolish “Obamacare” but most want to keep parts of it for political reasons. That IS political.
I am worn out. This is about the 3rd blog tonight. Bernie Sanders is my choice for the Democratic Primary. Preventing “Medicare for All” is postponing the inevitable. Bottom line, medical care in america is too expensive. It must be fixed. Bernie knows what he wants to do. Hillary does not. Then there is Wall Street and Student Loan problems, not to mention all of the other problems with jobs and wealth lopsidedness.
If you want to read my PhD dissertation google” John Garner Postmodernism “. It is on line at I.S.U.
If you want to read my geology hobby stuff Google ”Wikiversity Atlantis Azores”
You need to get away from this politics stuff too. It makes one crazy...
Good Night.