Insurer Conflict of Interest on the Rise
Here is something that will make you want to puke:
The venture capital arm of five Blue Cross and Blue Shield plans has partnered with global primary care provider Sanitas USA to open medical centers in Texas as a precursor to a U.S. multi-state rollout.
How is this not a conflict of interest? Remember the whole “If you like your doctor then you can keep your doctor” Obama line? Well, we are so far past that point:
CVS Health, which operates pharmacies and retail clinics, bought the health insurer Aetna last year and for years now UnitedHealth Group has been buying up doctor practices and clinics through its Optum health services business.
My favorite line from this Forbes article was this:
Closer ties between insurers and providers allows the combined entity to more closely monitor the delivery of care, those involved say.
You lying sack of shits. You mean cut back on the delivery of care! This is about money and control. The country should be up in arms over this. Doctors should be up in arms over this. The AMA and AAFP and ACP should…write a stern letter with no consequences behind it.
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I’ve yet to figure it out, but the culture seems to despise human beings and worship these artificial, nonliving entities called Corporations and Departments and whatnot.
When real human carbon-based doctors engaged in blending their local work with hospitals, clinics and labs, the ferocious pursuit of those who stood to profit from more than their labor, was called “kickbacks” and criminalized and stomped out of existence, along with many local hospitals. Pete Stark was ruthless on the trail of conflict of interest.
But now, corporations can own doctors and hospitals and insurance companies, and shuffle money indiscriminately from one to the other. Since they are not carbon-based life forms, we seem to intrinsically trust them, even when they employ CEO’s who make more than a year than many of the county medical groups and hospitals of the old days, were worth in total.
We seem to despise carbon-based life forms as slaves. These people who insist that there are Space Aliens Among Us, undetected and striving to enslave humanity, might be correct. One can identify them as people with a closet full of $20,000 suits.
Which is why our society hates doctors.
Yesterday, in our clinic, I saw a patient who was Bound For Glory. I had to go back and brush up on the difference between deCORticate and deCEREBRATE. (Tip: The upper extremities are flexed towards the CORE midline, and the fists are overlying the COR, the heart.)
One of the members of the caregiver team lit off the panic button. She was seeing the patient in her office. He was a seventy-something diabetic. He was dead when I first met him, so no introductions were in order. I barged in, followed by an entourage whom together wouldn’t be worth a plugged nickle in a code.
I firmly patted his face, and loudly said “Hey! You!” I was surprised to see his grey-yellow eyelids flutter open a little. I asked him “Hey, what happened?” in my best grampa-forgot-his-hearing-aids clinical interview volume.
He responded more coherently than most of my patients, and slumped back into his wheelchair. His wheelchair had been tipped back rakishly at a 45 degree angle, and he had been bridged across the back of the chair and the foot-rests, in a stiff supine deCORticate posture. Opisthonos, I think it is.
I surmise that his heart had given up on the longstanding perfusion-rhythm habit, and he was pulseless, I’d guess from about 20 or 30 seconds of VF or VT; then converted into a perfusing rhythm perhaps 10 seconds before I got in the room. Wasn’t my doing.
But I demonstrated the arrogance and hubris of a doctor, something that is more distasteful in society than standing around and giving the Stare of Life, or not getting involved in the first place. I didn’t even know what his name was – and there I was slapping an elder in the face! There was no explicit informed consent.
Doctors are trained to be bossy, and take charge. If I had to code him, which I should have had to, I would be running the code unauthorized. Without even checking for a DNR or advance directives!
Thanks to our improved, scan-code secured inventory systems, we no longer carry intravenous fluids or tubes or infusion catheters in the clinic, as they cannot be easily tracked for expiration, which is a sure JHACO violation.
A finger-stick glucose showed 160; a BP monitor showed 80/? EMS was called, and came promptly. My efforts made no difference between whether he was driven to the ER in an ambulance, or borne by Charon’s Ferry, into which he already had one leg at the time.
But the modern American Helot society cannot tolerate any biological who has the arrogance to take charge, do things and give orders. Had he not stopped being dead on his own, I suspect that I’d be on the outs with a number of my clinical colleagues who don’t appreciate getting ordered to do things.
If Blue Cross & Blue Shield is the Great and Infallible leader of healthcare, we are doomed. Now that the corporations own the hospitals, doctors, nurses and drugs, and supplies, how much better is the DELIVERY of healthcare now? Not? Don’t blame a carbon-based entity.
And yet if a doctor wants to refer to an MRI suite he invested in …
Oh bullshit Pat. Have fun in the new corporate driven prior authorization denying healthcare world and keep spewing propaganda about greedy doctors