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Thursday, April 3, 2008

WellPoint, Aetna and Never Mistakes

Insurance companies such as Well Point and Aetna are announcing that they will no longer reimburse hospitals for the cost of never mistakes such as operating on the wrong body part and more arcane incidents of certain complications and infections from medical treatment. While the current list begins the policy Well Point has reserved the right to expand the list.

Assurance was given which amounts to a deception: Consumers won't be billed for the mistakes either, the hospital will have to absorb the cost. Yet hospitals pass on their increased costs to consumers, right? Yes, right.

The irony of an industry that speaks out of both sides of its mouth, first supporting limits in medical malpractice recoveries so that physician medical malpractice insurance can be cheaper and then withdrawing their coverage of medical mistakes requiring hospitals to cover that cost, which in turn will be passed on to consumers, reflects the consistency of insurance company thinking: Squeeze the consumer to preserve their own profits.

Never mistakes are being sold as incentive for hospitals to improve quality, but by their very name, mistakes, we know that they do happen often out of negligence rather than some intent to injure the consumer. The same cannot be said for Well Point and Aetna, their intent is to injure the consumer financially in order to increase their own bottom line.

If insurance does not cover risk it is not insurance. Reducing risk through mandated oversight and procedure as well as a strong auditing practice would be a proactive way of reducing the costs of "never mistakes", instead, the insurance industry is opting out of covering the risk. Unless the alleged cost of these mistakes is immediately passed on to the consumer as a direct reduction in premium, the "never mistakes" is just a new exclusion of coverage for consumers. Soon we'll get the list of "never illnesses and conditions"....