Piedmont Fayette, United Healthcare stalemate continues

[TexasTowelie]

On July 1, thousands of United Healthcare subscribers in Fayette County and nearby areas lost medical insurance coverage with more than 1,400 physicians who are part of the Piedmont Clinic system, as well as with Piedmont Fayette, Piedmont Henry and Piedmont Newnan hospitals.

Contract negotiations between Piedmont and United Healthcare were not resolved by June 30, with each blaming the other for not coming to terms that would have continued in-network coverage for many commercial employees as well as individuals covered under three Georgia Health Insurance Marketplace commercial plans.

Individuals with United Healthcare plans can continue using Piedmont doctors and facilities, but must pay much higher out-of-network costs to do so. This leaves many people with the difficult choice of either having to find new insurance coverage or new doctors.

United Healthcare issued a statement saying, “We offered Piedmont fair and competitive rate increases that would ensure their hospitals and physicians are paid appropriately for the important services they provide. But the health system wanted significantly higher rate increases for the next three years without committing to any facility performance measures that emphasize quality care, paying for improved health outcomes, and lower costs.”

Read more: http://www.ajc.com/news/news/local/at-issue-piedmont-fayette-united-healthcare-stalem/nsD96/

[CurtEastPoint]

1. Single.Payer.Now. Demolish.For-Profit.Insurers.Now

[JayhawkSD]

2. Read the statement from UHC

They offered higher payments to the providers in the new contract. The providers demanded higher payment, larger increases than what the insurance companies were offering. Let's think logically in terms of who might be the bad guy.

Insurance does not create medical costs, they merely pass on costs created by medical providers. UHC offered to pay Piedmont more than they are currently paying and Piedmont said no, they wanted even more. Is Piedmont currently operating at a loss, such that the increase offered will not permit them to continue? Why are they demanding an even greater increase than what the insurance company is offering?

Piedmont's costs have increased? Okay, what costs? Minimum wage has increased has it? Nope, not in Georgia. There is a movement afoot to do that, but the movement has barely started and employers cannot base prices on something that has not happened yet and may not happen at all. With inflation at barely over 1% and and producer prices flat, why do medical providers need price increases at all?

As to the "for profit" picture, Piedmont is "doctor owned" and does not publicly report finances, but similar hospital groups typically operate at 35% to 50% profit margins. Meanwhile United Healthcare is operating as of June 2016 at a 6.3% profit margin, which is hardly unreasonable.

[CurtEastPoint]

3. And read my statement. Insurers add ZERO value to medical 'care'. FOR PROFIT HEALTHCARE

and for-profit insurance is what has this country in a bind. Nowhere else are people's lives ruined because of bankruptcy due to medical bills. Nowhere. We are better than this.

I use Piedmont Hospital and doctors pretty much exclusively and have no gripe about the care. I have good insurance through Cigna and it pays most of my bills.

Not everyone is so lucky.

[JayhawkSD]

4. I did read your statement.

You said, "Demolish.For-Profit.Insurers.Now." You said nothing about the evils of "FOR PROFIT HEALTHCARE" until after you read my statement.

As to your claim that, "Insurers add ZERO value to medical 'care'," I would challenge that. We have paid $6125 in health insurance premiums and my wife's employer has paid $5750, for a total of $11,875 total insurance premium cost. The insurance company has paid out, in medication and medical services, $27,685. So the insurer has added a value of $15,810 to our health care.

Note that the medical providers billed the insurance companies about $85,000 for those services, and the insurance companies discounted those bills down to about one third of the billed amount. Presumably people with no insurance would have had to pay the full $85,000.