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It was announced today that UnitedHealth has cancelled its contract with Quest Diagnostics, the number one provider of medical diagnostic testing in the United States.

Quest Diagnostics Inc., the top U.S. provider of diagnostic testing services, said Tuesday it has lost its contract with UnitedHealthcare, which accounts for about 7 percent of Quest revenues.

Why did Quest Diagnostics lose this valuable contract from its largest customer?

The mind reels.

Of course, the financial press is playing this as a straight business news story. Shares of Quest are taking a beating. The UnitedHealth business represents 7% of Quest's profits.

At this moment, I have on my desk a bill from Quest. Quest is a pretty familiar name within the Medical-Industrial establishment. I'm wondering why did UnitedHealth pull the plug?

It appears that Quest refused to cave to outrageous demands from UnitedHealth, that might have meant compromising the quality and safety of laboratory testing.

You decide.

This story isn't only about the plunging price of Quest shares. It's about your health and mine and our dangerously depraved, for-profit healthcare system

Does this article from The Street help you figure out what's going on here? Did Quest take the high road, and refuse to participate in business practices which would compromise further our ragged healthcare system?

In the United States, healthcare is only about delivering earnings to Wall Street. It's about cutting costs, and cutting corners, and increasing profits--it not about delivering affordable healthcare as a basic right to all the citizens of this country.

For Quest, which was favored by experts to land the huge deal, the news brought immediate pain. The company's shares plummeted 11% to $54.02. In comparison, LabCorp looked like a big winner with its stock up 3.5% to $67.50.

Meanwhile, UnitedHealth itself was up fractionally as the company went about doing its business of driving hard bargains and impressing Wall Street.

"UnitedHealth promised in their last investor day that they were going to get $300 million worth of medical cost savings over time," notes Sheryl Skolnick, senior vice president of CRT Capital group. "That comes from hospitals, physicians, labs -- you name it. This is just one step in that direction."

I don't know yet what UnitedHealth was demanding of Quest. But in the days ahead, I'm sure we'll find out.

In the meantime, add William McGuire the CEO of UnitedHealth to the other crooks and liars of our era. Cheats and criminals like Mark Foley, Dennis Hastert, George Bush and Dick Cheney.  Mr. McGuire, CEO of UnitedHealth Group Inc. has accumulated stock options worth an estimated $1.6 billion.

Earlier this year, McGuire cashed out options worth $124 million, and in 2004 he was the highest-paid executive in Minnesota, with total compensation of almost $125 million.

Company officials have defended those paydays by pointing to McGuire's success in transforming United from a financially ailing insurer into the second-largest in the country. The company also is a Wall Street darling; its stock price has climbed more than 200 percent in the past five years.

My advice, be careful, no one is protecting you. During these bleak times, remain vigilant and ask questions. Healthcare in America is about winners, losers, and profits.

Also bear in mind, all that counts in the insurance industry is the medical loss ratio which has been plunging for the last ten years. The medical-cost ratio - also called the medical-loss ratio or medical-care ratio - is the key number for health plans in terms of their level of profitability. That ratio, simply, is the percentage of dollars the companies spend on health care. High is good for us, low is good for them--and it's been plunging.

Medical-loss ratios for 2005 (Source: Company 10-K, year-end filings with the Securities and Exchange Commission):

76.9% - Aetna
82.3% - Cigna
83.9% - Health Net
83.2% - Humana
78.6% - UnitedHealth Group
80.6% - WellPoint

The reaction from Wall Street is not the real news. The frightening news is the response from the president of Quest.

The news slammed Quest shares, which plunged more than 12 percent.

. . .Quest, which reported $5.5 billion in revenues last year, said it could not yet estimate the financial impact of losing the national provider contract with United, its largest customer and one of the country's largest health insurers.

What did UnitedHealth require of Quest? The demands were apparently so onerous that Quest gave up its contract with its number one source of business.

``In our response to UnitedHealthcare's request for proposals, we offered to substantially reduce its laboratory costs, while at the same time increasing access and convenience for its members and physicians,'' said Quest Chief Executive Officer Surya N. Mohapatra, in the statement. ``The terms and conditions that were offered by UnitedHealthcare would have been irresponsible for us to accept.''

And this.

Surya N. Moahpatra, Quest's chairman and chief executive officer, told analysts during a conference call that "it would have been fiscally irresponsible" to sign a new contract with United, given its "unreasonable demands" and "unilateral provisions."

"If we had signed that contract, it would have been irresponsible not only for us as a company but for the whole industry," Mohapatra said.

And this.

"We believe patients, physicians and employers will continue to insist they have access to quality and convenient laboratory services from Quest Diagnostics, because of our enhanced patient experience, medical quality and the broadest distribution network," continued Dr. Mohapatra. "We want them to know they have a choice when it comes to selecting a laboratory. Choosing a diagnostic lab with a focus on patients and quality makes a difference for your health."

There's something truly rotten going on here.

Originally posted to nyceve on Tue Oct 03, 2006 at 06:29 PM PDT.

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Comment Preferences

  •  Stories like this are the end result . . . (117+ / 0-)

    of unchecked and unrestrained Republican corruption.

    If the end result of the Mark Foley revulsion is to get rid of these monstrous creatures, that's a good thing.

    But I ask myself, what sort of a country do we live in that it takes a scandal like this to rouse the people?

    •  No. It's private health-care (37+ / 0-)

      They make their money in two ways -- cutting wages to the bone, and slicing off anyone with a risk of actually needing insurance.  The Republicans are aiders and abettors, but the problem is structural.

      •  They arent even trying to hide it anymore (34+ / 0-)

        While driving last night, a commercial from Aetna came on, talking about a new kind of account HBO's (anyone?) that will "Cut costs for business that have to offer healthcare" while helping employees "Make fiscally sound healthcare decisions"
        I cant remember the exact quotes, but it just made me sick to my stomach. This commercial was basically saying "cheap crappy healthcare that dosent cost you much and screws your employees into staying away from the doctors office!"
        Theyre advertising this on the goddamn radio!

        Orange is the new Blue

        by SFJen on Tue Oct 03, 2006 at 07:21:51 PM PDT

        [ Parent ]

      •  Exactly... (15+ / 0-)

        I'm amazed how many people forget exactly what corporations do.  They make a profit...period.

        There are only 2 mechanisms that prevent these kinds of abuses...a full market and regulations.

        Many times, you will read about how the market will right all wrongs.  But missing from this picture (as well as from nearly all markets) are the elements of a market.  Consumers need to have "perfect" knowledge of what they are getting, there must be many competitors for the consumers business, and there must not be any barriers preventing (or slowing down) consumers from switching to other competitors.  There are more elements, but I think this is enough to understand what is going on.  Good luck trying to understand what is or is not covered (knowledge), competition is largely limited to what your company offers, and most people have limited realistic options (my company offers 2 HMO/PPOs with identical costs/benefits) for going to a competitor and pre-existing conditions severely inhibit switching.  Quite simply, all the major elements of a market are missing.  In other words, there is no significant market.

        Government regulations (or simply taking over and becoming the insurer) is the last hope at this point, and that seems to be gutted of late.

        So, with limited competition, and unenforced regulations, the corporations are doing what they are designed to do...maximize profit.  They are doing their job well.  It just happens that the consumer loses.

        "Everyone wishes to have truth on his side, but not everyone wishes to be on the side of truth" - Richard Whately

        by unbound on Tue Oct 03, 2006 at 08:23:36 PM PDT

        [ Parent ]

        •  Your opening point needs to be drilled into every (8+ / 0-)

          American's brain.  Publicly traded companies have a legal and fiduciary responsibility to show profits to their shareholders.  That's. what. they. do.  It's irresponsible in a position of responsibility to run a such a company in any other way.

          We all enjoy a measure of benefit from the economies of scale provided by large corporations.  But we constantly, habitually buy hook, line and sinker the line that the individual consumer comes first, that their provision of services is the point of the enterprise.  It isn't.  The point of the publicly held corporation is to please its community of owners with return on investment, enough so that more will buy a stake so as to allow the corporation to conquer market share.

          Your opening sentence is the best diary I've read all week.

        •  good points (6+ / 0-)
          Recommended by:
          coral, RickWn, nyceve, snakelass, walkshills, eastmt

          You get the healthcare marketplace much better than most people.

          There is actually a market at the level of employers shopping for health plans, but employers generally lack the kind of information and insight they need to make smart long-term decisions. What they want is a plan that (a) is cheap, (b) has a wide enough network that their employees won't complain about having to get a new doctor, © has benefits that are similar enough to what employees expect that they don't complain.

          They pretty much turn a blind eye to what happens in healthcare and enable the mess we have today...until the point when they find it impossible to meet conditions a-c. That was starting to happen, but now health care cost increases have subsided just enough (to 7-8% a year) that it looks like the crisis mentality is subsiding, too soon.

      •  Medical/Pharma-legal-insurance (0+ / 0-)

        These are the Triumvirate of corporate greed breeding corporatocracy.  My wife is a nurse (a Large family practice), and most people who get in to Health Care do it originally for the cause of "helping others".  It only takes a few years working in a Hospital or Doctors office to realize it's a fight between the patients needs and what the insurance companies "will allow".  My wife is one of the nurses who have to intervene/explain to insurance companies why the patient needs whatever coverage they are asking for.  The stories she tells are often outrageous.  Mainly the insurance companies' never want to cover items these poor people need to LIVE normal functioning lives.  If these POl's had to deal with the typical Health Care in America, they might grasp the true cause-rampant un regulation and greed.

    •  i don't get it (4+ / 0-)
      Recommended by:
      jd in nyc, marjo, DaveV, churchylafemme

      what's the story here?

      my read here is that united just wanted a better deal, not something nefarious.  specifically, it sounds like they asked for a new structure of the relationship between the insurer and the lab.  it was probably something that shifted risk from united to quest and quest didn't want to set that precedent.

      it really doesn't sound like anything more than the straight business story that's getting reported.

      what am i missing?

      •  Corndog, i think you may be missing plenty . . . (6+ / 0-)
        Recommended by:
        coral, eugene, mataliandy, Rupert, DvCM, DWG

        Read the comments of the president of Quest, clearly UnitedHealth wanted to extract concessions that would have led to sub-standard, certainly inferior medical care.

        As I stated clearly in the diary and in a comment,  I'll be looking in the days ahead to see if I can find reporting on what specificially UH was demanding which Quest would not agree to.

        Sometimes you have to read between the lines.

        •  No, it isn't clear (7+ / 0-)

          It is not clear at all that United wanted to extract concessions that would lead to sub-standard care. As I mentioned in another post, Quest had a 16.6% operating profit margin in the last quarter, which is actually less than the previous quarter. (United's operating margin was 9.1%.)

          There is a huge amount of "fat" that can be trimmed from Quest before it has to cut into the quality of their tests. I think you've been taken in by the Quest P.R. on this one.

          Quest's complaints are similar to drug company complaints about importing drugs from Canada. They claimed that this would hurt their profitability, preventing them from doing critical research. Well, the big drug companies were making about 20% net margins at the time (their operating margins must have been huge...35%?), and this was on top of massive marketing budgets and executive compensation.

          In other words, they were putting us on. It is well within the realm of possibility that Quest is doing the same right now.

          •  I'm afraid I have to agree, (2+ / 0-)
            Recommended by:
            marjo, nyceve

            I don't see any clear evidence of pressure to provide substandard care. I'd say the unacceptable conditions are "business" conditions, not quality of care issues. Note the reference to fiscal irresponsibility.

            We are men of action, lies do not become us.

            by ER Doc on Tue Oct 03, 2006 at 10:16:40 PM PDT

            [ Parent ]

            •  I respect what you're saying ER Doc. . . (1+ / 0-)
              Recommended by:
              ER Doc

              But I ask you, who will be the loser? Yes, Quest loses, they refused the demand.

              Who else? You, me and your patients.

              •  I have to agree: where's the fire? (3+ / 0-)
                Recommended by:
                jd in nyc, marjo, cookiebear

                By your title, "Be warned: Now they're coming after your lab tests," I thought my lab test results were going straight to the NSA database of potential terrorist DNA. You mean the capitalists have invaded health care. Not exactly news. Doesn't make it a good thing; I see daily the a bit of the conflict of interest of for-profit healthcare. I'm a therapist in a nursing home/rehab. I thought we were there to help people get home quickly, improving their lives and saving the insurers money. But often the rehab company seems to see their mission as grabbing hold of the patients and not letting go until they've squeezed the last penny out of them. In weekly department meetings my boss asks about many patients, "Can we extend this person?" (extend their length-of-stay). Makes me sick. BUT while I think the for-profit healthcare system is harming America and must go, and I agree with the gist of your diary, I object to your alarmist-sounding headline.

              •  That's just the thing (1+ / 0-)
                Recommended by:

                Quest can lose without you losing. Quest doesn't want its business to become low margin rather than high margin, and this may be all that is motivating their public tirade.

                Quest is going to do what it can to stay in the range of 15-20% operating profits, rather than go down to 5% or so. It will engage in all kinds of negotiating and PR tactics, because if its margin goes down to 5% Wall Street will punish it severely. Quest's stock price would drop by probably 75% overnight if it became clear that they were going to earn 5% operating margins going forward. Note: operating margins are what's left after they do their R&D and quality measures, so there is no need to reduce them...unless, of course, they are trying to increase margins to please Wall Street.

        •  You are right, NYCEVE, to raise this concern. (3+ / 0-)
          Recommended by:
          Cassandra77, nyceve, snakelass

          Another important diary, NYCEVE.  While some might dismiss this story as one business looking to cutting costs by dumping a more expensive supplier, between the lines and trends in the industry is the Walmartization of health care by insurance companies.  That is the story because the victim in the battles to trim claims and payouts, while padding profit and executive compensation, is the consumer.  I doubt any Kosling needs to be reminded what Walmart has done to America, producing slave labor quality jobs, killing small business retail, encouraging outsourcing by demanding lower supply costs, and helping to foster economies in Asia at the expense of former American companies.  If you hate Walmart and its slimey practices, you can boycott it.  However, most employers in this country sign a contract with ONE health insurance provider for a year.  Its take it or leave it.  Which means if you are stuck with an insurance company determined to feather the nest of its executives and keep shareholders happy, you may have to accept labs processed overseas in unsupervised and controlled conditions, scans read by questionably qualified "docs" in India or China, diagnostic testing in labs with outdated equipment, and so on.  It is time, people, to wake the #$%# up.  What's wrong with profit margins since these are for profit companies?  Because it is your health, stupid, not some worthless bling you want for your family room.  NYCEVE, you are on the right track with your reasoning.  I hope others wake up and smell the rubbing alcohol before medical care is both too expensive and substandard.  Medical care is not a luxury item and should not be available only to those who can afford to pay for it out of pocket along with their vanity surgeries to plump their breasts, lift their face and ass, soften their wrinkles, replant their hair, suck their fat, or buy them a new nose.  

        •  Concessions? (0+ / 0-)

          According to this article

          The concession they wanted was for the lab test to be performed in the doctor's offices.

          A big complaint from the UnitedHealth customer was that they has to go from their Doctor's office to Quest for blood test

          The contract moved from Quest to Lab Corp.  I don't see  this big problem.

          •  From a few years back... (0+ / 0-)

            Lab Corp's local reputation as an employer was that it was where new lab techs went to get some experience before they found a job with better hours, better pay and better working conditions.

            One of my biggest annoyances with Lab Corp was that I worked for a children's hospital laboratory.  I saw so many test results that I had memorized the normal ranges on common tests.  We sent a urine sample for culture for my six month old to Lab Corp.  The results came back "positive" - which meant a course of antibiotics and hoping there was no kidney infection.  When I actually read the lab report, I saw that what Lab Corp called "positive", the children's lab would have called "negative, less than XXX CFU".  If we had sent the testing to the children's lab(not covered by insurance) then my son would have had a negative test result and no antibiotics.  Even my pediatrician was doubtful but we decided on the antibiotics because UTIs in infants are more likely to cause kidney damage than in older children.  

            I worked for children's hospital lab.  I trust that lab.  I recommend that lab, especially for blood draws.  

            We must never lose it, or sell it, or give it away. We must never let them take it from us.

            by Fabian on Wed Oct 04, 2006 at 05:38:27 AM PDT

            [ Parent ]

    •  Another homerun! Keep it up eve! n/t (4+ / 0-)

      Imagination is more important than knowledge - Einstein

      by One Pissed Off Liberal on Tue Oct 03, 2006 at 07:15:44 PM PDT

      [ Parent ]

    •  N/T (2+ / 0-)
      Recommended by:
      nyceve, arkdem

      An Example of the "Wal Mart-ization" of healthcare?

    •  nyceve, please think about this (7+ / 0-)

      I know health insurers can do no right by you, but please, do not assume that Quest is the good guy here or that they're being picked on. You are quoting a press release from them, which should set off alarm bells (press releases are always self-serving).

      Quest has a much higher profit margin than United. This is from Quest's 2nd quarter financial statement:
      "For the second quarter, operating income was $263 million, or 16.6% of revenues..."

      According to United's 2nd quarter financial statement, the company had operating income of $1.64 billion, which was 9.1% of revenues.

      This means that for every dollar paid to Quest, they take almost twice as much (16.6% vs. 9.1%) out of the health care system. United is a much bigger company, of course, so the total dollar values are higher for United.

      You can't conclude that just because United is out to make a buck that Quest isn't doing the same. In fact, pound for pound, they're even more mercenary than United....or at least more successful at it.

      United's contract was probably designed to cut into Quest's profit margin, not to eliminate it. So long as United passes those savings on (a very big "if"), this is a good thing.

      Never forget that our central problem is that we have the highest medical costs of any nation by far. Not just our insurance costs, but our medical costs. The great con job is that American's are convinced that the high costs on the provider side are justified, while on the insurance side they are not. The fact is that they are equally unjustified on both sides, when you consider what other nations are able to achieve.

      •  jd in nyc, good point . . . (1+ / 0-)
        Recommended by:

        I'm not assuming Quest is a good guy.

        But I do know for a fact that UnitedHealth is as evil as Dennis hastert and Co. So I am making the educated guess that their demands were beyond the pale of even another not nce guy like Quest.

        I'm in Trusting. My. Gut. teritory here.

        Thank you JuliaAnn.

      •  I hate Quest. (0+ / 0-)

        I have had many, many problems with them trying to collect money from me that I did not owe.  One time they never sent me a bill, just went straight to a collection agency.  Every single time the charges were covered by my insurance and Quest had screwed up.  I think they were hoping I would just pay the bill rather than go through the hassle of contacting them (which you have to do by mail, they won't let you call them, so everything takes longer).  I will always believe the worst of Quest.  

    •  So important... (1+ / 0-)
      Recommended by:

      Might have my issues with Hillary, but on this she was right... as was Scientific American, whose multi-level panel concluded that Universal Health Care was the most advantageous for budget hawks and love-lorn demo-fobs. Yes, the poor, indigent and slackers would get benefits, BUT SO WOULD EVERYONE ELSE.

      Sometimes I think reality is an illusion...

      If you dance with the devil, then you haven't got a clue; 'Cause you think you'll change the devil, but the devil changes you. - illyia

      by illyia on Tue Oct 03, 2006 at 09:38:33 PM PDT

      [ Parent ]

    •  There has been (2+ / 0-)
      Recommended by:
      coral, nyceve

      a corporate free-for-all since Bush took office. Admittedly, corporations have no conscious to begin with, That is why they should be policed, like any other sociopath.

      But since Bush and Cheney took office it has been horrible. The corporations are literally getting away with murder.

      When fascism comes to America, it will come draped in the flag and carrying a cross

      by TDW on Tue Oct 03, 2006 at 11:51:54 PM PDT

      [ Parent ]

    •  Corrupt politicians who refuse to pass single (2+ / 0-)
      Recommended by:
      coral, nyceve

      payer health care for everyone.   Some things you just don't need to make a profit on.  Sick people and jailed people are two that come to mind.  All we need to do is change Medicare's eligibility to "every US citizen" and it is done. No muss, no fuss, no months of arguing about any confusing Hillary type system.  

      The two most common elements in the universe are Hydrogen and stupidity." - Harlan Ellison

      by dkmich on Wed Oct 04, 2006 at 02:14:48 AM PDT

      [ Parent ]

  •  Shit (13+ / 0-)

    You're scarin' me, Eve. I have United....

    I refuse to surrender unless it's for the common good...

    by Auntie Neo Kawn on Tue Oct 03, 2006 at 06:40:07 PM PDT

  •  Sometimes the most important stuff (9+ / 0-)

    is what goes on underneath the noise.

    a hope that may come close to despair

    by epppie on Tue Oct 03, 2006 at 06:43:20 PM PDT

  •  Russia fell (8+ / 0-)

    and so too may the US.  It is not all republicans even though most here will point to that as the most recent scenario, which of course is true.
    Fact is that government de-regulation has been doing on for a long time.  That coupled with the other fact that business operates much faster and can figure out paradigms to lessen the effects of government interference faster.
    Electronics was supposed to be the future career of choice.  Look what happened to that.
    Medical?  Ya, we don't even make most vaccines here in the US.
    Check out the emergency room closures in LA.

    •  As a practicing electrical engineer... (7+ / 0-) is my highly thorough and technical assessment of the domestic electronics 'industry':


      "You can trust the government. Just ask a NATIVE AMERICAN!"

      by bluewolverine on Tue Oct 03, 2006 at 08:41:21 PM PDT

      [ Parent ]

    •  thoughtful essay on republics (0+ / 0-)

      change management, so to speak, by mark levine up at

      France, for reasons never quite clear to me before today, has had five republics.

      perhaps then there is hope for us?

      Diversity is the key to economic and political evolution.

      by MarketTrustee on Wed Oct 04, 2006 at 04:11:38 AM PDT

      [ Parent ]

      •  We have had three already. (0+ / 0-)

        July 1776-March 1789:
        Revolutionary government/Articles of Confederation

        March 1789-December 2000:
        U.S. Constitution

        December 2000-[present]:
        Bush-eviscerated version of U.S. Constitution

        Of course, calling the latter a "republic" does stretch the point a bit, but you know what I mean.


        by bwintx on Wed Oct 04, 2006 at 05:13:06 AM PDT

        [ Parent ]

        •  yeah, i know what you mean (0+ / 0-)

          rule of law prevails, um, continuously. so maybe this isn't such a great illustration or paradigm of reformation, which is predicated, even within corporations, by crisis and "bloodshed".

          1776-1861. crisis: secession ->abe defines "union"
          1865-2000. crisis: electoral coup -> shrub defines "empire"

          Diversity is the key to economic and political evolution.

          by MarketTrustee on Wed Oct 04, 2006 at 07:18:06 AM PDT

          [ Parent ]

  •  My guess ... (9+ / 0-)

    ... disclosure of patient data. The HMO slugs have been pressing for open records for everyone, as I recall.

    "We can't solve problems by using the same kind of thinking we used when we created them." - A. Einstein

    by FWIW on Tue Oct 03, 2006 at 06:45:50 PM PDT

  •  Very important diary! (5+ / 0-)
    Recommended by:
    nyceve, RiaD, Karyn, Leila, kidneystones

    He that chooses his own path needs no map. Queen Kristina of Sweden.

    by Boppy on Tue Oct 03, 2006 at 06:49:56 PM PDT

  •  Probably wanted to reduce Quest's fee to be $0. (18+ / 0-)

    We used to have UnitedHealthcare as our PPO provider.  My son had a urine sample done by Quest.  Quest messed up the billing and sent me a bill for over $70 saying the UHC only paid $3.xx (can't remember exact $$) towards the test.  I call UHC to find out why.  They told me that the $3.xx was what they had contracted with Quest to pay for urine sample tests and that they could straighten it out with Quest for me.   I don't know about volume pricing and all that, but it seems to me that there is no way that Quest could do enough tests at that price to make a profit.  

    So, what I took away from this episode is that with insurance the test cost me nothing, UHC paid $3.xx, and if you were uninsured you paid over $70 for this test.  The true cost for Quest to make a reasonable profit is probably somewhere in the middle, but since our healthcare system is so screwed up, Quest has to make a profit on the backs of the un- and under- insured.

    •  Old story-been around a long time. (0+ / 0-)

      Some states have made that practice illegal, as it should be.    

    •  A urine dip stick (2+ / 0-)
      Recommended by:
      coral, MarketTrustee

      costs between .50 and 1.00 depending on the manufacturer and volume.  You dip it in the urine, put it in a meter and out comes the numbers.  $3.xx might be a bit low to make a profit on it, but $70 is absurd.

      •  see, volume (heh, heh) (0+ / 0-)

        is where ya make your money (heh, heh). every single time yer patient visits, ya need to get that sample (heh, heh) and a CBC. that's how a we find out what's really wrong with people. so ya also gotta check his cholesterol. see, CHOLESTEROL is the leading cause of heart disease. but ya can't see it like ya can see those darn cigarettes or the big mac in yer hand. (heh, heh). testing is our first line of defense in the war against terra ... heh, heh ... ah mean, frivolous litigation, um, the outrageous cost of healthcare.

        Diversity is the key to economic and political evolution.

        by MarketTrustee on Wed Oct 04, 2006 at 04:04:09 AM PDT

        [ Parent ]

  •  Universal Heathcare (11+ / 0-)

    should be a top priority for a Democratic Congress.

    If Bush shows huge opposition, we can use it against the Republicans in '08.

  •  One Paraplegic's View (20+ / 0-)

    This is the company that refused to pay for my wheelchair when I was released from the hospital as a paraplegic...refused to pay for any physical therapy beyond six months...refused to pay for a program at University of Miami because they labeled it "experimental"...let me count the ways.

  •  Not so sure (2+ / 0-)
    Recommended by:
    churchylafemme, pop tart

    I would need to know more about the demands (I haven't checked the link to see if it's in there).  While I agree that we would be much better off and more competitive with a national health care system, and while I agree that the for-profit health industry is what is screwing us all, I can't see enough in what you ahve written to be that paranoid.  If it is just profit squeezing, that's what businesses do and with the size of a UHC, they have the power to force such concessions in contracts.  If it truly is a quality and health care issue, then we have a problem.  But, based on Mohapatra's words alone, I can't agree that UHC is looking to screw over people (anymore than anyone else in the industry, or almost any industry these days).  Mohapatra may just be throwing out a marketing line intended to get people to ask questions.

  •  I worked in the lab at Quest in a temp job (4+ / 0-)
    Recommended by:
    coral, churchylafemme, pop tart, awesley

    it was a real sweat-shop operation. If they did anything ethical I would be amazed.

  •  Hmmm... (5+ / 0-)
    Recommended by:
    coral, Xan, nyceve, pop tart, althea in il

    Would this be the same Quest Diagnostics where I got blood drawn last Friday because it was the only place UHC said I could go on their tab?  I sure hope they aren't making this retroative.

    Where do I have to go now, Singapore?

    We can have democracy in this country, or we can have great wealth concentrated in the hands of a few, but we cannot have both - Louis Brandeis

    by dsteffen on Tue Oct 03, 2006 at 07:17:47 PM PDT

    •  As a matter of fact (3+ / 0-)
      Recommended by:
      coral, nyceve, dsteffen

      I have had medical examinations done in Singapore.

      Top-notch medicine. Polite, highly competent physicians and staff. Equal to or better than the very best Stateside doctoring I have experienced. Far beyond average American levels. No mad, terse, abbreviated, in-and-out rush by an MD on a managed-care billing clock with quarter-second gradations.

      US healthcare is not only extremely expensive and hard to obtain, it's just not very good. Yet another important industry driven to declining second-rate status by the bean counters.

      I occasionally interact with a US physician who genuinely impresses me with his or her competence. That has always been rare. It's becoming more rare by the day.

  •  even the hint (13+ / 0-)

    or suspicion that our medical records are not private diminishes quality of care received by the patient.

    I for one have quit being open and honest with my medical providers. They are on a need to know basis - and I have to make decisions about what they know and what they don't. Not just because they may sell this info, or give it to the feds, but also how it may affect future insurance coverage.

    There is no such thing as privacy anymore. It's a quiant notion.

  •  Further proof (9+ / 0-)

    That the private sector does not provide superior quality to the public sector.

    In fact, the profit motive pushes companies to sacrifice quality.

    Your health care, that is.

    This needs to be shouted from the rooftops: it is time to get health care OUT of the marketplace. The market and the profit motive have no place at all in health care. The two need to be separated as firmly as church and state, as firmly as oil and water.

    This sort of thing goes on all the time, and it is killing people.

    I'm not part of a redneck agenda - Green Day

    by eugene on Tue Oct 03, 2006 at 07:33:44 PM PDT

    •  eugene, (3+ / 0-)
      Recommended by:
      RubDMC, nyceve, MarketTrustee

      Healthcare as we know it is not sustainable. For example, the National Coalition on Health Care says:

      In 2004 (the latest year data are available), total national health expenditures rose 7.9 percent -- over three times the rate of inflation. Total spending was $1.9 TRILLION in 2004, or $6,280 per person. Total health care spending represented 16 percent of the gross domestic product (GDP).

      This is consistent with CBO data, which says:

      Increases in Health Care Spending Between 1970 and 2002

      Total Health Care Spending per Capita (2002 dollars)

      1. 1,313   2002: 5,449  

      Total Health Care Spending as a Percentage of GDP

      1.  7.0    2002: 14.9  

      HHS budget for Medicare and Medicaid is $545.5 billion, with $56.0 billion or 11.4 percent increase over FY 2005.

      The House "Veterans Affairs’ health care system" subcommittee says that the VA’s health care budget currently exceeds $30 billion per year.  

      That's coming up on $600 billion per year for government total spending on healthcare.

      If you go to this GAO report (Fairly large pdf file) and look at Figure 1, it is obvious that total government expenditures exceed revenues by about 2016, and that's assuming that Bush's tax cuts expire.

      So, something is going to change. The question is how and when.

      It seems to me that the government could expand the VA system to include uninsured people with the $545 billion per year that it's currently paying. Of course, the hospital/insurance/et. al. lobbists would oppose this to no end. (Yet another reason for publically financed federal elections.)

      Regardless, things are going to change.

      "We can't solve problems by using the same kind of thinking we used when we created them." - A. Einstein

      by FWIW on Tue Oct 03, 2006 at 08:32:51 PM PDT

      [ Parent ]

  •  how about an alternative, separate medical system (4+ / 0-)
    Recommended by:
    marmoset, joynow, nyceve, kck

    i'm serious.  it'd have to start small and local.  but how about establishing networks of physicans, clinics, patients, nurses, equipment providers, etc that operate completely outside of the established system and are not beholden to it.

    sort of a patients' union.

    beyond the initial idealism, could it be done and could it be a model that could be spread at the grassroots level to bypass normal marketing channels (i.e. the MSM)?

    for instance, i just got a bill from a lab that's not in my network.  it was a comprehensive GI exam and cost 450.  Blue Shield said "tough shit" we only pay within our guideliness and i was stuck with a $300 bill when i thought i'd only have a $15 bill.

    small potatoes compared to some of your other stories, but i'm HIV+ and trying to decide now if i should cut back on food to keep myself healthy or charge my groceries for the rest of the month and pay it off down the road when i can.

    Reality has a well-known liberal bias.

    by m00nchild on Tue Oct 03, 2006 at 07:40:28 PM PDT

    •  unfortunately, as in most 'professional' industry (1+ / 0-)
      Recommended by:

      the barrier to entry is setup so that the only way to make it is to play the game. In other words if you went to medical school and want to open a practive or work at a hospital, you have little choice about paying off your education or going with who the hospital goes with. I'm with you though. I'm all for nationalisation of medicine and energy.

  •  In the words of Chris Rock.... (1+ / 0-)
    Recommended by:

    That ain't right!!!

    It wasn't the greatest of movies I'll admit, but the message is right on.

    It is time for universal health care, NOW! I'm praying for a great November 7th so we can restore order to our country and provide for the health of everyone in our country. you know why George Bush is so pissed off at Arabs? They brought us algebra. --Kurt Vonnegut

    by proudprogressiveCA on Tue Oct 03, 2006 at 07:44:45 PM PDT

  •  UHC and SmithKline (2+ / 0-)
    Recommended by:
    nyceve, MarketTrustee
    When my company was with UHC I had a couple of run-ins with their then testing lab, SmithKlineBeecham. In two out of two instances SK billed me for tests UHC had paid for, to the tune of over $700 when the UHC negotiated rate was in the $20 range. (Both of those numbers have the correct number of zeroes.) In both cases it took stern letters from my company's comptroller to UHC AND SKB, and letters from UHB TO SKB, to get the creditors off my ass. In both cases SKB referred me to collection agencies before I was even aware that there was a bill I was supposedly liable for.

    No doubt Quest finds it hard to meet the contractural obligations which they are used to when their previous contractees were used to using such tactics.

  •  Stay away if you can: all insurance companies are (2+ / 0-)
    Recommended by:
    nyceve, yoduuuh do or do not

    not created equal.

    A friend learned the hard way: her first--and often most convenient--choices for doctors or other health services would not accept this insurance company.  (Many of the doctors have dropped this company in recent months. I feel bad for all of those people who are getting money deducted out of their checks to pay for...this?)

  •  asfd (2+ / 0-)
    Recommended by:
    nyceve, MarketTrustee

    Image Hosted by

    "Injustice wears ever the same harsh face wherever it shows itself." - Ralph Ellison

    by KateCrashes on Tue Oct 03, 2006 at 08:25:29 PM PDT

  •  Lab veteran speaks out: (11+ / 0-)

    I completed my college degree in 1980 and began my career in a hospital lab. Plenty of employees, emphasis on quality care and competence.  By the time Reagan was done, the nails were in the coffin.  When I gave it up in 1998, it was about production and nothing else.  How many tests can you do in an hour and by the way you damn well better not make a mistake.  I was so sad to see a profession I was proud of reduced to a money making proposition.  When I could no longer provide the level of care I expected of myself, I knew it was time to leave.
    Your only hope, when you need medical care, is to read, read, read, and learn as much as you can before you begin treatment.  I am my family's first line of defense against shoddy medical care.  It makes me so sad to know that there are so many patients out there being harmed because they have no protection.  And I don't mean to demean the dedicated health providers out there, however, for many of them, the sheer volume of care they are required to provide in order  that their organizations can make maximum profit, means that they can't possibly fufill all their responsibilities to the degree they were trained to do.  It's so very sad.

    Parent of college student: This space for rent.

    by althea in il on Tue Oct 03, 2006 at 08:29:12 PM PDT

  •  Below-Cost Capitation (8+ / 0-)

    My guess is that they wanted Quest to bid below their costs - sort of Wal-Mart style.  Not that your insurance premiums go down - they go up, and your insurer's CEO adds another zero to his salary and stock options.  

    The government has worked this way for years - generate "savings" by cutting Medicare reimbursement rates.  Now the private insurers are doing it, too.  Before long, there won't be enough people falling in the "not rich enough to hire a personal doctor but too rich for Medicare" slot to make up the difference between what health care costs and what the government and the insurance companies are willing to pay.

    Think peak oil wearing a white coat and stethescope

    •  Screwing the suppliers (2+ / 0-)
      Recommended by:
      TiaRachel, MarketTrustee

      You've got it. Apropos of "Wal-Mart style", that firm has badly damaged or destroyed the balance sheets of dozens of supplier companies.

      General Motors tried it too, under Jose Lopez as their director of purchasing. Instead of forging productive partnerships with their suppliers, he shoved them up against the wall and demanded ludicrous cuts in price, or else. Those cuts were provided, along with corresponding declines in quality. Hasn't worked out all that well for GM.

  •  If you take the high road in America, (3+ / 0-)

    watch out for the Republican snipers.

    They get all the highroaders eventually.

    Morality is like church for Americans. It's meaningless once Americans put on their tie on Monday morning; absolutely meaningless.

    •  It's systemic to market economies (1+ / 0-)
      Recommended by:

      if you take the high road and someone else takes the low road and generates better returns, your investors will leave you for them. The investors in the capital class just care about profits. The investors in the middle can't afford to take the high road and invest in the company that's taking the high road (at the cost of lower returns) because they need to maximize their returns in order to be able to afford the more expensive services offered on the high road. Paradoxically, therefore, the low road wins.

      Wash, rinse, repeat. Private healthcare in a market economy is doomed to this sort of thing. You can regulate all you want, but the market will find ways around it, the pressure to deliver investor value will see to it.

  •  Here's what you can do (3+ / 0-)
    Recommended by:
    mataliandy, nyceve, Fabian

    if you think you need blood work and don't have the money. Participate in a medical study. During the phone screening remember you are normal, have no food allergies or any other kind, no addictive past, were never a smoker, never hit on the head getting a concussion. Get the idea!

    Normal everything is fine because you want an appointment to screen with them. They will actively look for something wrong with you to protect their liability. So they will give you a page or two of blood work which you can ask for later. If you get in the study then you know you are ok in everything. Then get a copy of it.

    If something is wrong they will tell you. If you ask. They will just not take you in the study and then you have to ask enough questions to get the info and get a copy of the blood tests.

  •  quest is like the HCA of labs (3+ / 0-)
    Recommended by:
    nyceve, churchylafemme, awesley

    they were never the best the were just the cheapest and they're reliability is often in question. this is just a question of who is going ot get how much of the pie. the whole system is in revolt. Hospitals refusing to contract with certain insurers. the whole field is starting to catch on and are fighting the insurance companies for profits. this is just a money fight between 2 big corporations, that both suck.

    To sin by silence when they should protest makes cowards of men~~ Abraham Lincoln

    by Tanya on Tue Oct 03, 2006 at 09:33:34 PM PDT

  •  They're coming after my meth lab!!?!?!?! (0+ / 0-)


    by Intercaust on Wed Oct 04, 2006 at 12:26:16 AM PDT

  •  Heard this before (1+ / 0-)
    Recommended by:

    Except replace UnitedHealth with Wal-Mart and Quest with any of the companies that got fucked by Wal-Mart.

    We'll see how this one plays out, and I'm sure rubbermaid will be watching too.

  •  UHC (2+ / 0-)
    Recommended by:
    coral, nyceve

    and the local hospital couldn't come to a deal, probably the same thing, they wanted them to come in at cost, so now people with UHC coverage have to go out of county to a hospital, for lab work etc.

  •  Duh... (0+ / 0-)

    Welcome to capitalism. Did you really think it was about doing nice stuff for people just because you can? National health is the only way to change the healthcare trend, there is no "private" soluiton to the value-motivated marketplace.

  •  Just as a cautionary tale (0+ / 0-)

    When you try to do a close reading of a PR piece, it's still a PR piece. I don't think this story stands up at all without additional information that isn't supplied here.

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