Category Archives: Insurance

To add to those revealed in  James Sherlock’s excellent posts about nursing homes and the health care industry generally, here is another culprit–private equity firms.  They buy up medical practices in an area, creating great bargaining power with insurance companies, and begin raising prices.  The fight is between giant, merged insurance companies and giant, merged medical practices.  The losers are patients and the winners are the private investors.

Today’s Washington Post has a long article describing how this happened with anesthesia practices in the Denver area.  The company, U.S. Anesthesia Partners, which calls itself a physician-owned company, was, in reality, created by the private equity firm, Welsh, Carson, Anderson & Stowe, which owns 55 percent of the stock.

by Dick Hall-Sizemore

Here is another example of the utter inanity of this country’s medical care system and its financing.

First, some background.  I am covered by Medicare.  I also have a Medicare supplement insurance policy issued by the Commonwealth of Virginia for retirees, administered by Anthem. (Good deal, by the way.)  I chose to include the vision and dental coverage on the Anthem policy.

Like almost everyone my age, I have developed cataracts.  A couple of years ago, an ophthalmologist told me that I qualified for cataract surgery, but that the cataracts had not progressed to the point that such surgery was highly recommended.  I chose to put it off.

Today, I went in for my annual eye exam.  As I was checking in, the staff at the Virginia Eye Institute (VEI) went to great lengths to explain that a refraction (the process of determining whether I need the prescription of my glasses changed) was not covered by insurance and that I would be responsible for the $70 if I chose refraction.  I even had to sign a form acknowledging that I had been informed of this. Continue reading →

Colonoscopy
Image credit: Johns Hopkins University

by Dick Hall-Sizemore

I just had an experience that illustrates the bewildering complexity of the finances of the American health care system.

Yesterday, I had a colonoscopy. I’m a veteran of this procedure, having had several because there is a history of colon cancer in my family. (No polyps this time, by the way.)

The protocol for the dreaded “prep” time has changed. No longer does the patient have to consume a gallon or two of sickening sweet liquid (others who have had this procedure know what I am talking about). Now, one has to take 24 pills in two stages between 6 p.m. the night before and 6 a.m. the day of the procedure, along with a lot of water. Continue reading →