Somebody needs to explain to me how health care costs can be the reason insurers want an increase in rates? All insurers have contracts with the providers (doctors, hospitals, pharmacies, etc.) The insurance company has fixed fees it pays for services to these providers. Over the past three years some of the fixed fees have been reduced by as much as 50 percent, as with MRI's and CT scans. I do not know of one service which has had an increase in payment by insurance companies.
All of the major insurers have third party companies, which they pay to be a "watchdog" over the medical services and prescriptions physicians order. Most of you have heard of "prior authorization." It is required for MRI's, CT scans and prescription items. Other than requiring 20 hours a week of a nurses time to get these authorizations (and 98 percent get approved,) what value is it? Is this cost effective?
Maybe the insurers should look at administrative costs and stop pounding the rising health care costs drum. I will be willing to bet health care insurers are making a lot more money than 99.9 percent of the physicians.
John R. Caruso, DO
Sebring
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