Insurers Could Become Medical Gods and Deny What is Due Their Customers

In “Mistakes to cost hospitals: To boost quality and cut costs, insurer won’t pay for medical errors called ‘never events’” (Page 1, Aug. 7), Tribune reporter Bruce Japsen. tells the story about the state’s largest health insurer suddenly refusing to pay for so-called “never events” committed by health care providers – medical errors that should never happen. 
But the Chicago Tribune’s naive spin on the story tells it strictly from the insurers’ side with the insurers admitting they are implementing this new policy without even knowing how much money would be saved.
“The idea is that forcing hospitals to absorb those costs will create an incentive to improve quality of care in a business where money typically rolls in regardless of patient outcomes,” Japsen writes.
Wrong.
What will really happen is that it will put the injured patient in the uncomfortable position of still being forced to pay the bill. After being tragically injured or killed in events such as mixing up a patient’s medication, the patients or their families then will become embroiled in a war with their insurers and medical providers. What will certainly come of that is forcing the patient to collection lawyers or personal injury attorneys to try to figure it all out and just how the injury occurred.
That is not consumer activism. It is a selfish attempt by greedy companies looking to save a buck by sticking the little guy with the bill, the guy who has been paying those huge premiums all those years for the comfort of knowing that her medical bills will be paid at the end of the day. That, heaven forbid, even if something goes wrong, the injured patient can try to get her life together while the insurer and medical provider figure out the financial end of it.
But that is no more, according to the latest Tribune report.
Under the guise of “accountability,” the employees of Blue Cross and Blue Shield of Illinois will become the new medical gods    determining when they won’t pay anything at all if they don’t like the result.  The real “accountability” issue is with the insurers that are using their muscle to deny what is due their customers instead of standing up for them just when they need help the most.