....it's beginning to look like Moses Cone Health System is becoming part of the problem rather than part of the solution.
Excerpt:
"Blue Cross rejected a request from Moses Cone to increase the fees they receive for reimbursement for health care by 18 percent immediately and more than 36 percent by July 2009, Blue Cross officials said in a press release."
Sounds like posturing on Mose Cone's part in an attempt to get BCBS labeled as the Bad Guy here.
I have a dog on both sides of this hunt.
BCBS is my carrier, and LeBauer (Mose Cone subsidiary) is my primary care provider.
I've had issues with both.
Bubba:
ReplyDeleteDo the Moses Cone demands for more bucks from BCBS surprise me? Not in the least.
Moses Cone has developed a sprawling empire over the last few decades. This hospital corporate enterprise has gobbled up Wesley Long Hospital and Women's Hospital while consistently expanding the size and scope of the original Cone Hospital.
The tremendous expansion from hospital to medical empire has greatly increased Cone's financial obligations for construction costs, medical equipment, administrative staff and fat salaries for chief executive officers.
At this point in time, there is simply no incentive for hospitals like Cone to engage in meager efforts to control costs and hold the line on the fees that are charged to patients that are admitted.
There was a time when there was no Medicare, no Medicaid and medical insurance coverage was only a small fraction of what it is today. At that time, most folks had to pay hospital expenses out of their pockets. Amazingly enough, the hospitals felt enough pressure from its customers to control their costs and keep the fees contained.
Today, the lid has been blown off and we see ever-spiraling increases in medical fees as the hospitals rush to inflate fees presented to Medicare, Medicaid and health insurance companies to bounce what are considered "customary and reasonable fees," the amounts that are actually paid by such insurers.
The folks that really get slammed by these "funny money" transactions between the hospitals and the insurers are middle class people who don't have insurance coverage because of the spiraling costs of the premiums.
When those folks shop for gasoline, they can choose the gas station down the street that charges 10 cents less that the station near their homes. But, if these same folks fall victim to a serious accident or illness, they have no choice; Moses Cone, here we come. After a couple of nights in the ICU, they are presented with a staggering bill of $20,000 or more.
Since they aren't on welfare and have incomes that preclude them from Medicaid coverage and they aren't old enough for Medicare coverage, reality sinks in when they check out of the hospital.
The first mandatory stop for these folks is the cashier's office where some helpful soul will discuss payment options. "Oh, you can't pay the $50,000 today! Well, we need a financial statement and we can prepare a little promissory note for you to sign."
If these poor, hapless souls fail to make their payments on time, it's lawsuit city and the resulting civil judgments against them will make that hospital stay just that much more of an enjoyable memory.
Government intervention in the health care industry was and is the engine that propelled us into this preposterous mess by increasing demand for medical services and enticing medical providers to blow the lid off of any fiscal restraint that they once had.
We need to bring the old "invisible hand" of competition back to the medical industry. Otherwise, the empire building, the swollen salaries of hospital CEOs and the spiraling medical fees will continue unabated. And, the left will gleefully continue to point to these problems and sing the song for socialized medicine as a cure.
"Government intervention in the health care industry was and is the engine that propelled us into this preposterous mess by increasing demand for medical services and enticing medical providers to blow the lid off of any fiscal restraint that they once had."
ReplyDeleteAgreed.
Excellent post, Wendell.
Isn't it funny how these issues are generally NOT discussed on some of our local "progressive" blogs when the talk turns to health care?
That just might undercut their constant drum beat for universal health care, wouldn't it?
Bubba, you basically beat me to it.
ReplyDeleteWhen I put my last post up on the reality of Pediatrics in Asheboro, I resolved to let it sit awhile (just below the Furry Grim Reaper) and let heads spin.
Wendell is spot-on about Moses Cone. Nobody but nobody says no to them. This situation is actually the flip side of the situation I found myself in back in 2004 . . . when I needed surgery at Baptist Hospital in Winston-Salem, and BCBSNC chose the only period of time in which I could schedule the surgery as the time to "sever" ties with NCBH.
Of course, it was just a damnable price war . . . between two "non-profit" healthcare "providers" charged to serve the public good . . . but who both, in all reality, left the public hanging out to dry while they fought over money.
While I sympathized with my alma-mater back then (in large part because my insurer's smooth move for profits delayed my surgery - and prolonged my pain - for a over a year), I am less inclined these days to feel sorry for these large "non-profit" hospitals whose "administrative costs" and competition-crushing tactics are (again, in reality) an economic black-hole.
But let's not feel too sorry for legislatively-protected BCBCNC. Their profit margins and executive perks (on the backs of the premium-paying public that buys its own health-insurance) have sky-rocketed.
For you see, all of this "non-profit" B-S is a facade. And the public buys into it hook, line and sinker (I know . . . as a naive newbie . . . I once did). These now-monstrous institutions live and breath for profit . . . and to crush competitors.
As any number of the nameless BCBC water-toters on the now-defunct ProCare blog used to tell me: once the money is in the non-profit's hands, it's the non-profit's . . . not the public's . . . even though the taxpayer is the biggest investor and "share-holder" in these organizations . . . by virtue of all the government breaks and perks. How DARE we mere peons belive otherwise?
Like many large systems, Cone Hospital, in my opinion (as both a physician and a patient who has lived in its shadow all of my life) is like a huge cancer on the face of the earth . . . eating up everything in its path.
I did not used to feel this way.
But then I got fired for cleaning up the mess of a doctor employed by a Cone affiliate. And I watched everything I had hoped that Pediatrics could be in my hometown ceded to a damned unspoken "turf war". Everyone (on all the boards from Asheboro to Raleigh) simply winked and nodded.
Ethics did not mean anything.
As for my profession's so-called medical "advocates", the ONLY thing I ever hear from the AMA and NCMS (to call my Congressman about) is reimbursement: Medicare . . . Medicaid.
Trying calling your Congressman . . . or writing your legislators . . . about something besides money . . . like quality-of-care. Of course, alleging bad care affects the bottom line and we simply cannot have that. YOU WILL NEVER GET WRITTEN BACK. Everyone greases everyone else's palm.
And no, these issues are NOT discussed on our local blogs, because to question the omnipotence behind the brand name of "Cone" is to insult the family name of our newspaper-annointed blogger-king . . . the "king", who half the time (1) does not offer his own opinion or (2) has no clue as to what he's talking about.
There is not enough space here to say what I think about John Robinson and the N&R non-coverage of the real medical situation in this area. Of couse, I guess I have to stand in line behind David Wray.
It doesn't matter how much JR moves around the reporters. He will still miss the boat EVERY TIME.
I am so sick of "Edward & the sicophants" screaming for socialized medicine that I could scream.
They don't get it. They all but have it now.
"And no, these issues are NOT discussed on our local blogs, because to question the omnipotence behind the brand name of "Cone" is to insult the family name of our newspaper-annointed blogger-king . . . the "king", who half the time (1) does not offer his own opinion or (2) has no clue as to what he's talking about."
ReplyDeleteOr (3) trolls for controversy on his very own blog.
That's why I've decided to make him my semi-permanent civic duty project.
Our local blogosphere and our civic "leaders" like to think of themselves as community oriented, and indeed, many outstanding services are performed. Look at what Cara Michelle does for a good example.
Somehow, many of the really important issues get blown off or hidden away, in favor of the more flashy and "newsworthy" ones.