The vultures descend

Here’s a little item that I find amusing. Maybe you will, too.

At yesterday’s meeting of the House Health Care Committee, Rep. Avram Patt (D-Shap’s District) brought up the subject of those long, confusing Explanation Of Benefits forms (EOBs) we get in the mail every time we see a doctor or have a covered service or procedure done. You know, the ones nobody ever reads?

Well, Avram Patt reads ’em. And he had some questions, mainly centered on the lavish “prices” for services beyond the basics. How are those prices arrived at? Do they reflect the cost of the services rendered? Does anyone — covered or not — ever actually pay that?

He had inquired about some of this with his insurer, and been told that if an uninsured person gets a whopping bill and complains, “it’s immediately negotiated down.” And the original fee? That’s an “algorithm” — a calculated starting point for negotiations.

Short answer, in other words: Nobody ever actually pays that price, and it seems to have nothing to do with cost.

The committee wanted more information on these questions and some others, and decided to seek testimony — mainly from Shumlin administration functionaries.

But lo and behold, I look at the revised committee schedule this morning, and at 11:00 a.m. I see a lobbyist clusterf**k. Lobbyists for MVP Healthcare, CIGNA, and Blue Cross Blue Shield will be lined up, one after the other, to explain those EOBs. Presumably in an industry-friendly, “No no, it really makes sense, please don’t ask us to change” sort of way.

That’s all. I just found it amusing that healthcare industry lobbyists were so quickly available on less than 24 hours’ notice, and all at the same time.

5 thoughts on “The vultures descend

  1. Kelly Cummings

    If they can be so quickly available for this, surely they’ll have no problem with disclosing their public-policy advertising over $1,000 within 48 hours.

    Looks like to me they’re quite capable of moving quickly when they’re inspired to do so.

    “MacLean makes a darn fine living representing numerous business interests. He told the committee that the 48-hour disclosure requirement would be difficult for lobbyists to meet.

    Which is, pardon my French, pure bullshit.

    The same requirement is already placed on political candidates in the last 45 days of a campaign season. If candidates can meet the requirement, surely a well-endowed lobbying firm can do so.”

  2. Walter carpenter

    Actually, Rep. Patt has brought this up before in the committee. We have had some talks about this too. When he brought it up in the past, demanding to know what these were, the medical-industrial folks did get nervous.

  3. kevin ellis

    Did you expect the health care company lobbyists NOT to be lined up ready to do their job? God, I have now checked the boxes to notifiy me of new posts and new comments. My world is now officially over.

  4. Avram Patt

    I have raised this from time to time since the session started. I had offered an amendment to one of the bills our committee voted out last week which would have said that while they could still show that high “billed” price on the EOB, they could not claim that the difference between that and what they paid the provider was some sort of discount or use words like “you saved.” To be fair though, Committee Chair Bill Lippert had invited the insurers (BCBS, MVP and Cigna) to comment if they wanted to. There wasn’t enough support so I withdrew my amendment, but I still think there oughta be a law….

    1. Kelly Cummings

      Thanks for trying Rep. Patt.

      Please keep trying. It is important to understand the lingo, aka perhaps hidden costs, of the insurance industry. Without clear and honest language the “consumer” doesn’t stand a chance at making an informed decision.

      There obviously was enough interest on the committee before the insurance lobbyist were invited to testify or the invitation would not have been extended. I am very interested to know what was said by the lobbyist that caused the committee to lose interest?

      Would you be so kind as to fill us in?

      Thank you.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s