Scoring healthcare insurers and getting campaign spending right

February 21, 2012

1. When health insurers say no:

Like probably every other family in America, ours regularly has claims we submit to our health insurer rejected — with little or no explanation and no recourse from the company’s always-on-hold telephone hot line. Yet lately I’ve been seeing ads from health insurers projecting friendly, caring images. My favorite is the television and print campaign from United HealthCare featuring a girl who develops asthma but is shown swimming and even surfing because United, which sells insurance under the Oxford and other brands, has gotten her “specialists, lots of doctors, lots of advice…that help her pediatrician coordinate your child’s care and make sure all doctors are on the same page….” The ad trumpets United’s “more than 78,000 people looking out for 70 million Americans. That’s HEALTH IN NUMBERS,” the ad concludes.

Speaking of numbers, what percentage of customer claims for medical care or prescription drugs does United HealthCare reject? How does that compare with its competitors? Why can’t some reporters ask?

A cursory search on Google turns up little more than a 2009 Huffington Post piece reporting that: “Data on how often insurance claims are denied — and for what reasons — is collected and analyzed by the insurance companies themselves. But except in California, the companies aren’t required to provide those records to any state or federal agency.” The article quotes Karen Pollitz, a professor at Georgetown University’s Health Policy Institute, as saying: “The number is knowable, but not known by regulators or policy makers or patients.”

For starters, I’d like to see a story describing what must have been the ferocious lobbying to prevent the Obamacare legislation from requiring that this information be made public. Which members of Congress were pivotal in keeping this basic consumer information suppressed? Don’t they believe that free, competitive markets work best when consumers have this kind of data? It would seem that the Republicans who say they want to strengthen the private health insurance industry would be leaders in ensuring that this market information is available to their constituents.

Second, there should be more stories like this one from the Los Angeles Times in 2009, which reported the numbers that California requires be made public.

Most important, reporters should ask the insurance companies for their acceptance and rejection numbers and report which insurers provide them and which won’t. (They might as well start by pestering United HealthCare, the most aggressive feel-good advertiser.)  Assuming most or all won’t reveal the rejection stats, why not use social media or an online survey tool to gather estimates of rejection percentages for the largest insurers? Or an ambitious, resource-rich news organization like Reuters or Bloomberg could even hire pollsters to use statistically valid sampling to come up with rejection rates for each company. If the companies then dispute them, ask them to supply their numbers in some kind of verifiable form.

2. Super PACs and the law:

We’ve read everywhere that super PACs aren’t allowed to collaborate on strategy, messages, or anything else with the candidates they’re supporting. But what happens if they break the rules? Mitt Romney said during an MSNBC interview that if he crossed the line he could “go to the big house.” But that was quickly dismissed as drastic overstatement of the actual consequences. Someone needs to talk to the right lawyers and report whether the penalties are, in fact, limited to the small, after-the-fact civil fines that the relatively toothless Federal Election Commission can levy. Or do campaigns and the super PACs have to file any documents with the FEC or anyone else attesting or otherwise claiming or implying that they do not collaborate? If so, and if those statements are found to be false, could there be criminal prosecutions for fraud and conspiracy to commit fraud?

3. Mainstream media’s screwup on super PACs and the law:

While we’re on the subject of super PACs and the law, my friend and former Court TV colleague Dan Abrams has just written a long-overdue piece on his Mediaite website about how the mainstream media — he singles out the New York Times, Washington Post,  and MSNBC — regularly and routinely misstate the meaning and impact of the Supreme Court’s Citizens United decision on campaign finance rules. They and other media, Abrams points out, repeatedly refer to Citizens United as having enabled people like casino magnate Sheldon Adelson to become Newt Gingrich’s multimillion-dollar sugar daddy. In fact, as Abrams explains, Citizens United only had to do with freeing corporations and unions to contribute unlimited amounts to supposedly independent PACs; individuals like Adelson have had a right to do so long before Citizens United, as demonstrated by the way in which a bunch of rich donors swift-boated John Kerry six years before Citizens United was decided.

This basic misreading of an easy-to-read Supreme Court decision is so egregious — and fits so nicely into a political riff that holds the Roberts Supreme Court responsible for elections gone wild — that I’d like to see more on this than Abrams’s blog post. Someone needs to ask the reporters involved — Chris Matthews at MSNBC or Dana Milbank of the Washington Post are among those whose bald misstatements Abrams documents — how it is that they and their colleagues keep making this obvious mistake and why no one has corrected it. And what does Adam Liptak, the highly regarded New York Times Supreme Court reporter, think about all this? Has he tried to get his paper to correct itself? Someone needs to shove a microphone or pad and pencil in front of a bunch of people who are usually the ones asking the gotcha questions. Let’s play hardball, Chris.

PHOTO: Patricia Relling shows what her new monthly rate for medical insurance with Anthem would have been after her insurance was canceled following her breast cancer diagnosis, at her home in Louisville, Kentucky, April 21, 2010. REUTERS/John Sommers II

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