It seems that health insurance companies in New York are trying to persuade their customers to go to doctors who have excelled at the little game entitled "Popularity Contest." Say, what makes a physician popular with insurers? Is it high intelligence? Untiring diligence? Compassion, empathy and a soothing bedside manner? A really great soap-opera-doc head of hair?
"Some health insurers are abandoning the goal of providing patients with honest physician comparisons based on valid quality criteria," said AMA President Ronald M. Davis. "A growing number of health insurers have unwisely pushed ahead with unproven economic criteria to rank physicians. These flawed ranking[s] are often financially motivated to inappropriately influence or restrict a patient's choice of physician."
Say that again? Insurers might use economic data to influence their customers' decision on which doctor to hire? Are you telling me that if I'm a cheapskate when it comes to spending the insurer's dough they just might rank me as the greatest doctor in the Empire State?
The Attorney General for the state of New York is not happy.
Warning that physician-ranking schemes may be deceptive and driven by financial motives, New York State has demanded that three large health insurers justify their programs before implementing them.
"Consumers need to be aware that doctor ranking programs as currently designed may steer patients to the cheapest, but not necessarily the best doctors, letting profits trump quality," said Attorney General Andrew M. Cuomo. "Transparency and accurate information are critical when making health care decisions and should not be clouded by conflicts of interest."
It's one thing to rank physicians on the basis of their intellect, innovation, leadership, work ethic, communication skills, surgical talents, creative vision, courage, movie-star coiffure [Editor's note: he's just jealous, the bald-headed fart], but announcing to the world that certain doctors are the best because they spend less of the insurer's money than the next guy or gal seems rather strange to me. Is this any way to practice medicine?
Oh, I forgot- the insurers are not practicing medicine, just giving out a friendly suggestion to their customers about which doctors they might enjoy seeing.
[Attorney General Cuomo] also expressed concern that inaccurate physician-ranking programs may cause financial harm to consumers. "Some employers steer employees to the doctors preferred by the insurer by lowering co-payments or deductibles," he noted. "Consequently, employees who choose not go to the preferred doctors could pay more."
Cuomo specifically questioned Empire's Blue Precision strategy to steer consumers to preferred doctors. The model described by Empire in public presentations "pressures consumers to switch doctors by imposing financial penalties," he said.
Mother Machree, we've been down this road before, or at least I have. Restricting access to physicians is an obstacle to proper medical care in my opinion. Maybe it saves money, but tell that to someone with metastatic renal cell carcinoma who is denied the chance to prolong their life with one of the new targeted therapies for this disease. Actively courting bad publicity is an unusual strategy for insurers, but perhaps they know something I don't.
As for the new, more effective, expensive treatments for cancer that insurers cringe over when presented with the bill for services rendered - we oncologists call this the price of progress in a free society that is committed toward eradicating deadly health problems such as cancer.
After all, if we harbor ulterior motives when professing to help the sick, who knows down what dark roads our imagination might take us?
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What is really perverse about this, is that specialists with good reputations among other physicians, tend to get the toughest referrals. I don't know for sure, but I bet they end up spending more per patient. So the system the insurance companies want to use could end up steering people in exactly the wrong direction.
Bald like Bruce Willis or bald like Homer Simpson?
There is a difference, you know.
This new health care policy sounds "creepy, crawly, chilly, scarry." I want to live, not die. There is only one go around; therefore, insurance companies and their money should not mismanage this opportunity.
Last time I looked Oncologist weren't on the list of doctors who were considered for preferred status. Also, while it's always nice when the insurance company so deems one of my physicians as preferred provider, I do not chose doctors on that basis. Usually I don't get that much of a choice. Dr. X calls and tells me I need to see this ologists and makes an appointment for me with Dr. Y. Dr. X likes him and thinks I need to see him, is usually the only thing I know about a new doctor. I certainly wouldn't ever consider leaving a practice that I'm already with over a break in the co-pay.
One (little) reason more for Europeans like me to stand totally aghast at the merciless penny-driven health care in the US. I mean, we didn't need Micheal Moore's Sicko to become aware of this awful situation.
A big issue that has become a juggernaut. My comments at:
http://healthcaremoney-newsblog.blogspot.com/2007/10/md-concerns-on-new…
BTW: for those comparing European medicine with U.S. medicine -- the U.S. isn't Europe. European medical crises (e.g., blockbuster drugs, surgical techniques) seem to have been dropped in the USA's lap -- great. And mockumentarian Mr. Moore's sick movie has been so thoroughly discredited (e.g., treatments unavailable anywhere in the world, praising Castro, phony graphics), his name equals "laughter."
bakalim
Thank you
There is a difference, you know.