Thoughts from a Yellow Dog Democrat living in Olympia, in the great BLUE state of Washington

I am a liberal because it is the political philosophy of freedom and equality. And I am a progressive because it is the political path to a better future. And I am a Democrat because it is the political party that believes in freedom, equality and progress. -- Digby

Thursday, June 18, 2009

Bureaucrats Between Patients and Providers

Congressman John BOEHNER: ... But, at the end of the day, we want to make sure that doctors and patients are making decisions about what care is in their best interest, not some government bureaucrat in between.

I have one of the most expensive plans available through my employer -- I pay $112 per month and I'm not sure what my employer pays. I also pay $750 out of pocket in deductibles.

The insurance company, states this in their annual report:
Like other companies, we faced a challenging business environment as the global financial crisis became a defining event in 2008, and our stock closed lower at the end of 2008 than the previous year. Our stock’s performance, however, does not reflect other measures of our industry leadership, including superior medical membership growth, industry-leading operating earnings per share growth and strong revenue growth. Metrics of this industry leading performance included:
􀂃 Revenue, excluding net realized capital losses, increased 14 percent over 2007 to $31.6 billion.1
􀂃 Net medical membership increased by 848,000 members, or 5 percent, to 17.7 million.
􀂃 Operating earnings per share were $3.93, an increase of 13 percent over 2007.

Staying True to Our Strategy
Our accomplishments have been the direct result of a strategy focused on segmentation, integration, consumerism and operational excellence. Over time, executing this strategy has created value for our customers and differentiated Aetna from our competitors.

Where's their concern for the patient? I have to use their preferred provider. The preferred provider has to approve any other treatment I want -- for example I have a plantars wart on my foot and I know that I need to go see a podiatrist but I have to go to the preferred provider first to get them to approve the podiatrist visit. I'm limited to generic drugs -- I cannot get covered other than generic even if that's what the doctor thinks will work best for me. If I need hospice care, they limit me to 5 days in a 3-month period -- I better die fast. My preferred provider has to call the insurance company before sending me out or preforming any procedure to get it pre-approved.

I already have many bureaucrats between me a the medical care I need but the biggest bureaucrat impacting me, the insurance company, is primarily concerned with stock price and CEO salary. He rations out care to me and arbitarily limits what I can receive whether I need it or not -- not for the my good, not for the public good and not to ensure I receive needed care but rather to preserve stockholder value.

Thanks for you concern, Boehner, but I've tried it your way and I'd like to see if the government bureaucrat can't do it better and for cheaper.


UPDATE 6-18-09 PM:

Digby (of course) puts her finger right on the issue. She has a list of what insurance company CEO's are paid. Here's mine:

* Aetna
CEO: John Rowe
2005: 22.1 mil
5-year:57.8 mil

From me: Senator Murray's 5 largest campaign contribution industry group is Pharmaceuticals/Health at $126K.



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