"THERE IS NO JOY IN MUDVILLE."
Sadly, this week saw a couple of client deaths. And more botched
diagnoses.
The latter, in one case, resulted in a prescription for a drug costing $60,000/month . . . . . . . ‘conveniently’ marked up from $4,000 by the presiding charlatan. I mean, physician.
Kudos to my client for getting a second opinion and then reporting the case to his (former) Health System, for whom the doctor no
longer works! (Although odds are he’s practicing in another state, included in a different PPO. See below.)
Insurance by definition guarantees compensation for loss (e.g., illness) to a risk pool of policyholders large enough to make premiums ‘affordable.’ On your scorecard, give ‘em a solid base hit.
Affordable however becomes problematic
when consumers (and policymakers) push back on loss control tools, like requiring a second opinion, or pre-certification of (expensive) drugs (‘cause you ‘guaranteed’ coverage)! Score that, a strike out.
We ask our Insurers to credential the docs in their Networks, too. And then we kvetch when some Providers are excluded. Another ‘out.’
A .333 batting average gets a baseball player into the Hall of Fame.
Not many of us are ready to ‘enshrine’ our Health System.