One more time I go back to the 2 hottest words in health care today:  Algorithms and Whistleblowers, where the money seems to be:

The 2 New Hot Words in Healthcare: Algorithms and Whistleblowers

Both Wall Street and the Health Insurance Industry invested heavily with technology early on, and one thing both “had” in common was a lot of money, that is until the bottom fell out on Wall Street, but this has not happened with Health Insurance, at least no so far.  Both industries have/had CEOs making a lot of money too.  It appears that those who invested early with all the latest and newest technology to create and run complicated algorithms with business intelligence had somewhat of a strangle hold of the money.  We all know what has happened to Wall Street, but thus far Health Insurance is still not affected to a large degree.

Insurance Companies have now come out and stated that compensation packages this year will no longer match what has been awarded in the past, which is a positive, but what has been done is done.  This opinion post somewhat lines it up.  Both companies were in a service type of business, unlike the drug companies who are selling a tangible (a pill you take), but they have their issues as well with the changing world of pharmaceuticals.

By law, insurance companies are required to keep “reserve” funds to keep them from going insolvent, however some states are beginning to question how much money is being stashed in the “rainy day” funds.  It does make one stop and wonder where AIG was with their “rainy day” funds, since they were part of the massive bail out, were they not required to do the same? 

The Attorney General of New York recently settled with United Healthcare over a “corrupt” data base, with a subsidiary that made over 1.3 billion dollars last year scrutinizing claims with complicated algorithms, which ended up in denial of coverage and services to many.  Yet, we still have many with insurance that can’t afford health care or insurance.  We have balance billing issues here in California. 

Balance Billing Ban Upheld, but Who’s Going to Enforce the Policy?

In summary, just something to think about when it comes to focusing on CEO compensation packages, should we perhaps add the CEOs from health insurance companies to our list of concerns?  BD

Are you angry about how Wall Street executives have enriched themselves lately?
Well, don't be. Save your anger for health insurance executives, a greedy group that Congress and the president apparently intend to leave in place in our nation's "reformed" health care system.

According to a report published Feb. 22 in The New York Times, the plutocrats of Wall Street paid themselves an amount over 10 years eerily similar to the amount just one health insurance executive, William W. McGuire, was empowered to collect in just one year, 2006.

Yes, that's right. McGuire was set to cash in stock options he held in UnitedHealth Group Inc. in the amount of $1.767 billion in 2006. McGuire's billions are just one small part of the spoils captured by health insurance and pharmaceutical executives from the trillions spent each year for the noble cause of caring for America's sick and disabled.

To realize such money, UnitedHealth Group continues to skimp — underpay claims — and only sometimes gets caught. For example, on Jan. 15 they settled for $350 million a class action by physicians "alleging the insurer used flawed data" in paying for out of network care.

CJOnline Blogs - Roy: Health insurance executives plunder system


A couple more stories in the news today related to Healthcare CEO compensation:

Related Reading: 

Andrew Cuomo – You Have to Like This Guy – Healthcare Reform
Prescriptions risk score used to deny health insurance
What is the MIB - Medical Insurance Bureau - and how does it affect qualifying for insurance?
Will Greed lead to Meltdown of the Health System?
Health Care Insurers Suggest Algorithms and Business Intelligence solutions to provide health insurance solution
Health insurer accused of overcharging millions – United Health Care/Oxford Insurance 50 Million Fine
Algorithms, Formulas and Investigations leads to AARP suspending sales of some health plans
Health Insurance Reserves – How much is in the till, could it be 1 or 2 trillion nationwide?

Beware of Geeks Bearing Formulas


Post a Comment

Google Analytics Alternative