Under pressure from Dems, insurers point fingers at doctors' charges

A new survey sponsored by the leading insurance industry group shows that its member companies received some huge bills – many times what Medicare pays for a given procedure – from doctors in many states last year. One example: a $72,000 dollar charge for a spinal fusion in New Jersey for which Medicare pays $1,628, the New York Times reports.

The 1,300-member group, America's Health Insurance Plans (AHIP), asked members to send in their highest bills. It conducted the survey "to show that doctors' fees are part of the health care problem," the Times reports. Jonathon Skinner, a Dartmouth health economist, said, "It's the wild, wild West when it comes to prices of anything in the U.S. health care system." ... But Dr. Robert M. Wah, a spokesman for the American Medical Association, said there was another side to the story: insurers' low payments to doctors who enter into contracts with them and the doctors' difficulties, in many cases, in getting paid at all."

Karen M. Ignagni, president and chief executive of the insurers' group told the Times, "As we think about the health care debate, what's been talked about is, What are the cost-sharing levels? What are the premium levels? How much do health plans pay? No politician has asked how much is being charged." Insurers have been targeted by Democrats in recent weeks, and the group said it's been unfairly singled out (Kolata, 8/11). 

Meanwhile, "To help bolster its messaging at a time when Democrats have turned their rhetoric against health insurers, the industry has stepped up its already active grass-roots operations including the Campaign for an American Solution," Roll Call reports. "AHIP has 1,300 member companies, and the group is sending out talking points and working to mobilize those companies’ employees, policy-holders and other like-minded people to spread the word" (Ackley, 8/12).

President Obama's town hall meetings this week are designed to "zero in" on certain insurance industry practices, USA Today reports. On Tuesday in New Hampshire, the topic was excluding people from coverage because of pre-existing conditions; "On Friday in Bozeman, Mont., Obama will discuss rescission, the practice of dropping people while they are sick. The president travels to Grand Junction, Colo., where he discuss protections against "exorbitant out-of-pocket costs" for the insured. ... The insurance industry says it's already proposed plans to address those issues" (Jackson, 8/11).

Separately, some patients are trying to escape climbing health care costs, unaffordable charges and insurance companies through an old-fashioned technique, the Associated Press reports. "Health care bartering has risen dramatically since the recession began, as people lose their health insurance and consumer spending drops, said Allen Zimmelman, a spokesman for the Bellevue, Wash.-based trade exchange ITEX Corp." Patients exchange goods and services, either directly, or through exchanges like ITEX, for health services they couldn't otherwise afford (Murphy, 8/11).

Related KHN stories:

Bartering For Health Care Increases Amid Economic Woes

Checking In With Health Insurers' Chief Lobbyist Karen Ignagni