Doctors Sue Hospitals to Protect Patients; A University Buys Insurance that Doesn’t Protect Students; What Gay Marriage Laws Mean for Gay Coverage . . . . and More

The newest Health Wonk Review has been posted. This time around, Colorado Health Insurance Insider’s Louise Norris is the host, and it’s an excellent read.

A few highlights:

                                 Doctors Sue Hospitals, Protect Patients

Over at Healthcare Renewal, Roy Poses digs into how doctors are pushing back against hopsitals who put profits above everything else. His article describes two recent lawsuits filed by physician groups alleging that the hospital systems they worked for were sacrificing patient welfare in the name of profit. 

As Louise observes, “the details are sickening to read:  One hospital group encouraged its docs to exaggerate the severity of patient conditions and needlessly admit patients from the ER to hospital beds in order to bill more for their treatment.  Another hospital group that owns three hospitals and also partially owns an ambulance company was making patient transfers (using their own ambulance company despite slower response times) a top priority – to the extent that a doctor’s transfer rate was a factor in bonuses and performance reviews.  An admin email stated that “the performance we are looking for are transfers.”  Wow.  Transfers just for the sake of racking up revenue – patient welfare had nothing to do with it, and was likely compromised when the slower ambulance company was used in cases where the transfer was actually warranted.”

I’m just skimming the surface of the corruption Roy exposes. You really should read his entire post.

Often doctors are afraid to stand up to greedy hospital administrators.  But by banding together, physician groups can stand up for patients.

I would add that, in the past  two doctors— working at separate non-profit hospitals—have told me about hospital administrators pressuring physicians to admit ER patients, even when they did not need to be hospitalized. This is how some hospitals “put heads on beds.” 

                 When Universities Buy Inadequate Insurance for Their Students

On his blog, Duncan Cross tells the story of the Arizona State graduate student who died because his Aetna plan (a student plan purchased through the university) capped how much the insurer would pay out over the course of a lifetime at $300,000. It also didn’t cover prescription drugs.  One might be tempted to blame the insurance company,
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