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Under pressure from Dems, insurers point fingers at doctors' charges

Published on August 12, 2009 at 7:57 PM · No Comments

A new survey sponsored by the leading insurance industry group shows that its member companies received some huge bills – many times what Medicare pays for a given procedure – from doctors in many states last year. One example: a $72,000 dollar charge for a spinal fusion in New Jersey for which Medicare pays $1,628, the New York Times reports.

The 1,300-member group, America's Health Insurance Plans (AHIP), asked members to send in their highest bills. It conducted the survey "to show that doctors' fees are part of the health care problem," the Times reports. Jonathon Skinner, a Dartmouth health economist, said, "It's the wild, wild West when it comes to prices of anything in the U.S. health care system." ... But Dr. Robert M. Wah, a spokesman for the American Medical Association, said there was another side to the story: insurers' low payments to doctors who enter into contracts with them and the doctors' difficulties, in many cases, in getting paid at all."

Karen M. Ignagni, president and chief executive of the insurers' group told the Times, "As we think about the health care debate, what's been talked about is, What are the cost-sharing levels? What are the premium levels? How much do health plans pay? No politician has asked how much is being charged." Insurers have been targeted by Democrats in recent weeks, and the group said it's been unfairly singled out (Kolata, 8/11). 

Meanwhile, "To help bolster its messaging at a time when Democrats have turned their rhetoric against health insurers, the industry has stepped up its already active grass-roots operations including the Campaign for an American Solution," Roll Call reports. "AHIP has 1,300 member companies, and the group is sending out talking points and working to mobilize those companies’ employees, policy-holders and other like-minded people to spread the word" (Ackley, 8/12).

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