Needy Patients ‘Caught In The Middle’ As Insurance Titan Drops Doctors

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  • #276222

    • Total Posts: 5,354

    Needy Patients ‘Caught In The Middle’ As Insurance Titan Drops Doctors

    Across the nation, business and contractual disputes are separating patients from longtime doctors. This often occurs when doctors don’t want to accept the rates insurers are willing to pay. It sometimes occurs when insurers’ business plans require having a narrower network of doctors — doctors whose practice patterns may be easier to control.

    But in this case, the cause of the exclusion goes to even deeper business connections: Wassef and other doctors say the insurer appears to be trying to shift patients to Riverside Medical Group, a 20-office physicians’ practice owned by Optum, a sister company of UnitedHealthcare, both of which are subsidiaries of UnitedHealth Group. UnitedHealthcare is essentially forcing patients to transfer to doctors it controls, the doctors allege.

    Indeed, several patients said the health plan directed them to Riverside when informing them their doctors were being dropped.

    Lawrence Downs, CEO of the Medical Society of New Jersey, said he estimates UnitedHealthcare is trying to remove hundreds of doctors in central and northern New Jersey from its network. That is the same area where Riverside Medical operates, he noted.

    Comment by Don McCanneof PNHPWho is in charge of preserving the sanctity of the physician-patient relationship? The private insurers? No, they are in charge of the flow of funds. Under their business model the physician-patient relationship is expendable.

    Think of that the next time that someone tells you that we don’t want Medicare for All because we’ll lose the right to have private insurance. (Be sure to read the last paragraph excerpted above to understand the ethical plane on which these insurers operate.)

    Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

  • #276233

    • Total Posts: 870

    even though I get the best plan available, it’s gotten so I can hardly find an in-network doc that’s got any kind of reputation with his peers.  AND, when my previous employer had us on United Healthcare, a situation arose that I could account for only if they were getting a kickback from the supplier (they were requiring me to buy an inferior piece of equipment that cost more than the alternative).

    Destruction is easy; creation is hard, but more interesting.

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