Thursday, November 20, 2008

Health Care Costs: Part of the Story

As mentioned previously, health insurance biggie Humana has begun producing some interesting videos as a sort of "Newby's Guide to Health Insurance." We'll continue to post the ones we feel most relevant to our readers. This one is pretty good, although I had some reservations about it. Take a look, and then I'll share some of my co-bloggers' reactions:
As I said, I have some reservations, chief among them being the implication that simply choosing a network provider will generate a discount. As we've learned, this is not always true.
Bill's concern was that "IPA’s [Individual Practitioner Associations] are not mentioned and the implication is that a sole practitioner is always more expensive." On the other hand, he noted that, while "(i)t may not be 100% technically’s a good way of presenting things in an understandable way."
And Bob said that he "wouldn't use the word "discount" but apparently the attorney's don't care. One could also infer that network docs are "better" (certified) than out of network docs, but lets not go there."
Finally, Mike had no major objections: "The only thing that sounds off-key to me is the statement (actually made twice) that network doctors agree to lesser fees in return for more patient volume. Doctors may acquiesce to lesser fees, but I think it's mainly because they are afraid that if they don't go along, they will lose patients. If additional volume were the whole story, no doc would sign with any but the insurer having the greatest membership - and that clearly isn't true.
And based on conversations with our family docs I doubt docs see a net gain of new patients - if they do, it's small. What Humana is not saying is that sometimes docs lose patients to other networks and some of the patients they "gain" thru a particular network were already their patients anyway."
We'd be very interested in our readers' thoughts on this.
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