Dr. Bob knows what he's talkinng about because he deals with this stuff as a medical professional. His most recent chapter in what he terms The Maze paints a big picture by comparing managed care with the famous internet scam letters. The Maze - Pt 6The Nigerian Health Care Plan can be read as a separate post, but the reader is advised to set aside time for homework first. The first five parts will be worth the time it takes to catch up.
As insurers increasingly got the upper hand, their business practices became ever more egregious, secretive, and nefarious. Ever striving for efficiency, they moved from individual personal claim review–the insurance clerk simply tossing your filed claim in the trash, then telling you it got lost–to computerized screens and edits, codifying their intrusive, capricious, and often unethical policies behind a digital ski mask. So while they bent, folded, and mutilated the health care reimbursement system beyond recognition, they reaped a windfall of company profits while premiums soared, physicians’ reimbursements hemorrhaged, and claims hassles for physicians and patients multiplied like guppies. State insurance commissioners and attorneys general had neither the manpower nor the motivation to respond to the countless complaints from providers about unethical insurance practices, so the carriers quickly found themselves above the law, and acted accordingly.