PNHP

Insurer and hospital fight while children suffer

CT Childrenā€™s, Anthem provider pact expires

By Greg Bordonaro
Hartford Business Journal Online, April 16, 2012

Anthem Blue Cross and Blue Shield in Connecticut confirmed Monday morning that its provider contract with the Connecticut Children’s Medical Center has expired.

The two sides have been in contract talks for more than a year but failed to come to an agreement on new terms.

Children’s Medical Center is asking for higher reimbursement rates than Anthem is willing to offer. As a result, Anthem customers will be forced to pay higher, out of network rates or be forced to choose a different hospital.

http://www.hartfordbusiness.com/news23523.html

Comment: 

By Don McCanne, MD

Anthem Blue Cross and Blue Shield and Connecticut Children’s Medical Center have a hissy fit, Anthem walks away, and the children suffer.

What is the policy flaw that led to this? Simply that we allow a private, administratively wasteful, intrusive intermediary to create an artificial  product that serves its own business interests by taking away our choices of health care professionals and institutions. We have granted them the right to selectively contract with the health care delivery system as providers of health care, and with the patients as consumers of health care.

Wouldn’t it be far better for us to dump the wasteful, intrusive private insurers and fund Children’s with a global budget administered by a single payer national health program? We can still do that.

Insurer and hospital fight while children suffer

CT Childrenā€™s, Anthem provider pact expires

By Greg Bordonaro
Hartford Business Journal Online, April 16, 2012
Anthem Blue Cross and Blue Shield in Connecticut confirmed Monday morning that its provider contract with the Connecticut Children’s Medical Center has expired.
The two sides have been in contract talks for more than a year but failed to come to an agreement on new terms.
Children’s Medical Center is asking for higher reimbursement rates than Anthem is willing to offer. As a result, Anthem customers will be forced to pay higher, out of network rates or be forced to choose a different hospital.
http://www.hartfordbusiness.com/news23523.html

Anthem Blue Cross and Blue Shield and Connecticut Children’s Medical Center have a hissy fit, Anthem walks away, and the children suffer.
What is the policy flaw that led to this? Simply that we allow a private, administratively wasteful, intrusive intermediary to create an artificialĀ  product that serves its own business interests by taking away our choices of health care professionals and institutions. We have granted them the right to selectively contract with the health care delivery system as providers of health care, and with the patients as consumers of health care.
Wouldn’t it be far better for us to dump the wasteful, intrusive private insurers and fund Children’s with a global budget administered by a single payer national health program? We can still do that.