Friday, May 27, 2005

Whiling away the time in Rhode Island

Maybe someone with more insight than I can explain to me why the government needs to get between the hospitals (and individual providers) and the insurance companies in this manner? In Rhode Island, there is a bill going through the state legislature mandating that insurance companies function as collection agencies.

Hospitals and providers have always had problems collecting co-payments from patients for hospital admissions, emergency department evaluations and office visits. This has gotten worse as high deductable policies have become more popular. It has apparently led to some solvency problems that some lawmakers feel can be solved by putting the health plans in charge of collections.

Obviously, this bill has its advocates in the hospital associations and its detractors in the insurance industry. Given the superior strength of the latter, I estimate the probability of passage at somewhere around 0.0% (it's my risk averse nature that prevents me from adding a few more significant digits).

But seriously, what business is it of the government? If there's a conflict here, can't the hospitals, providers and insurance companies deal with it themselves? Do Rhode Islanders really need yet another layer of bureaucracy to manage and pay for?

Don't get me wrong. I'm no fan of insurance companies and as a physician, I can surely identify a self-interest when I see one but I can't see an overriding government concern here. There are no issues of patient safety. Tax dollars are not at stake. Patients certainly don't care.

As politically appealing as such a plan might be, I have to side with UnitedHealthcare of New England CEO Stephen J. Farrell who states that

"Collection of co-pays and deductibles is 'standard practice for every hospital' nationwide, and because those items aren’t part of a member’s covered benefits, it would be 'inappropriate' for an insurer to have to collect them."
Democratic representative Steven Costantino outlines his agenda: The measure is "an idealistic kind of bill," introduced not with the expectation of passage, but to "at least start a discussion about the difficulty hospitals are having in collecting co-pays."

Aside from providing work for some insurance company lobbyists, it's hard to imagine what will be accomplished here.

I have to assume that RI has some politicians with too much time on their hands.


Blogger Henry Stern, LUTCF, CBC said...

Thanx for the post; I got a nice chuckle out of it.

I think you're far too generous in your risk assessment as regards the passage of this bill, but I'll let it slide ;-)

Aside from the obvious contractual considerations between providers and insurers, there's the underlying issue of personal accountability.

Seems to me that the providers here have chosen to go the more complicated route, when there's a much simpler solution:

The deadbeat patient received services for which he didn't pay. A 1099 at the end of the year -- filed, of course, with the IRS -- should take care of that fairly promptly.

A couple of those hit the papers, and I suspect that folks reneging on their co-pays will become a thing of the past, quickly.

Have a great -- and safe -- Memorial day weekend!

May 27, 2005 6:08 PM  
Blogger Fred Mangels said...

I think you said it best. This is a case of a legislator with way too much time on his hands.

May 28, 2005 6:40 AM  
Blogger Darth Medicus said...

I think once again the goverment thinks we do not know how to take care of ourselves and must make rules to protect us. The more regulations they put on insurance comapines the harder and more expensive the become.

May 28, 2005 4:43 PM  

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