New Haven Independent

posted by: St. R's patient, Anthem subscriber on March 5, 2010  1:56pm

I have received excellent care at St. Raphael’s, and I appreciate the Hospital’s constructive relationship with its community. Anthem is a bear to do business with. Their CEO has an exorbitant salary, the rates for subscribers have just been raised, and now they propose reducing services in the area. I was very angry when I received the letter from Anthem - some of the exorbitant fees I pay are being used to fund this mass mailing - a bully tactic to hurt the reputation and standing of an important community partner during “negotiations.” Anthem has no shame. I wish there was a public option for health insurance; the private companies are irresponsible monopolies.

posted by: me on March 5, 2010  3:01pm

Episode of HOUSE dealt with this issue. Cuddy needs to stay firm!

posted by: Sabrina on March 5, 2010  3:04pm

I, too, received this letter as our HMO is Anthem. What is really startling is that Anthem BC/BS is the insurer for the many people who work at St. Raphael’s.

Now if you can’t agree to terms when your own employees are covered by the same provider, that speaks volumes to me in terms of how broad this divide must be. Not good, not good at all.

posted by: first observer not the new imposter on March 6, 2010  12:06am

Yet another example of why this country needs a single payer system, and the abolition of all private health insurance companies.  Period.  Talk about mental health—what we have now literally is insane.

posted by: blue dog dem on March 6, 2010  8:50am

Insurance companies subsidize the lower Medicare payments with higher reimbursements than what the gov’t offers and hospitals need this money from private insurance to keep treating people with state-run plans.  The money has to come from somewhere, and if the gov’t is going to pay it, then who is?  This is a negotiation tactic and should probably work itself out prior to the deadline.

Dillon admitted that the State needs to address the low SAGA reimbursements and if she was really serious about all of this, she would bring a motion to the floor to increase all reimbursements so that health providers wouldn’t have to put the squeeze on private insurance companies.  Of course this would probably mean higher state income taxes for most of the population, but if that is what it takes to keep decent healthcare in the state, then it is worth it.

This is one of the main reasons that private insurance rates increase annually.  Not because the CEO has a high salary.  A private option would close the doors of the hospital a lot quicker than tough negotiation tactics between two large entities because then there would be no privates to offset the low reimbursements mandated by the gov’t.

posted by: Concerned Citizen on March 6, 2010  1:06pm

WE NEED HEALTH CARE REFORM WITH A PUBLIC OPTION
Anthem Blue Cross is the Villian in this dispute!

What is happening right here in Greater New Haven is one of the many reasons why we need a comprehensive health care reform with a public option. It is also why the private insurance companies and the pharmaceuticals are spending millions each week to spread fear and cynicism to prevent meaningful reform. Unfortunately, our competitive mainstream media are more interested in competition, ratings and generating angst than in good investigating journalism that would give people accurate facts. As a result lies and fear have taken hold of rational, thoughtful processes.

Anthem Blue Cross is using every tactic they can to increase their profit margin. If they can blackmail St. Raphael’s and other hospitals into accepting ridiculously low reimbursement rates, they will be able to increase their profits and pay their senior executives outrageous salaries.  Hospitals will have no choice but to increase the fees they charge. We the patients will end up paying more from our pockets in addition to higher premiums.  Anthem Blue Cross in CA. just raised their premiums by 39 percent!!!  How many of us ever had a 39 percent salary increase? You might if you worked for a private insurer, or if you are a lobbyist who delivers the desired results: a congress person who supports the insurer’s position.

Anthem is a subsidiary of WellPoint. Angela Braly, CEO of WellPoint, earned over $10M in total compensation in 2009; this is the year of the worst recession and economic collapse.  In 2008 she earned $9,844,212; in 2007 she earned $9,094,271. Her compensation and those of her executives go up regardless of what the economy does. Thus the justification for trying to bleed hospitals such as HSR.

“State Rep. Dillon said she’d like the state to get involved in the dispute in two ways. She’d like regulators to examine “insurers’ behavior” (“Insurers are jawboning providers like St Raphael’s to drive down rates at the same insurers are jacking up premiums. It appears to be profit driven”). And she’d like the government to revisit how urban hospitals and Catholic hospitals like St. Raphael’s get reimbursed.” 
This is exactly right; it needs to change. It also seems a little naive if this is new to Rep. Dillon. Unfortunately, the Republicans and some Democrats are more committed to the private insurers and the pharmaceuticals than they are to the American people who elected them. This is why we NEED health care reform with a public option, and it is also why WellPoint and other private companies do not.  Reform would limit their ability to rip us off.

“Many hospitals have no breathing room, and Catholic hospitals are especially hard hit,” Dillon said. “They are all in inner cities,” have more patients on government health care assistance, and get lower reimbursements than non-religious hospitals do for mental health treatments. Dillon faulted legislators for not acting to bring Catholic hospitals’ rates up to par and the Rell administration for not acting on a bid to raise reimbursements for State-Administered General Assistance [SAGA] patients by include them in the state’s Medicaid plan [and thus receive more federal reimbursement]

All of this is true, but how hard did the Democrats fight Rell to get this done?  Rell is a Republican; her commitment (as we have all seen) is to the wealthy.  Gov. Rell refused to raise taxes on the wealthiest citizens, but had no trouble proposing to cut services to our most vulnerable populations.  She wanted to take away the small State subsidy to the LPN program that would help people to develop a skill to earn a living!

We need health care reform with a public option.  If Anthem members in CT could walk away from Anthem rather than from St. Raphael’s, this callous corporation would not be able to hold this institution a financial hostage. We need a national Medicare system. People who have Anthem should bombard the phone lines and send letters so Anthem knows that it is the villian in this dispute.

posted by: JDH on March 6, 2010  1:28pm

State Rep. Dillon said ...“Insurers are jawboning providers like St Raphael’s to drive down rates at the same insurers are jacking up premiums. It appears to be profit driven”.

Yet in St. Raphaels own statement, they seem to blame this on the inadequate reimbursement from the government on Medicare and Medicaid. 

This is another example of the government trying to make a bad guy out of the insurance companies to cover up the fact that they are really driving up premiums for hard working people who buy insurance.  So we have to pay for these programs in our taxes and our insurance premiums.  That’s fair, right?!?

posted by: gyuri on March 6, 2010  3:23pm

This is a quiz. Who is getting between YOU, the patient and your doctor/hospital?

A. President Obama?
B. The U.S. government?
C. Your political party and congress person?
D. Public option insurance?
E. The profit first motivated insurance company?
F. Single payer insurance?

Golly Gee Willikers! You still don’t know?

posted by: EastRocker on March 6, 2010  7:44pm

As a health care provider, of course I come down on the side of the Hospital of Saint Raphael, especially having worked there early in my career.  It is a special place in the New Haven health care system, a little more of the personal touch and TLC than YNHH and driven by a core set of values that does seem to inform the actual care and services provided on the floors and in the clinics.

Anthem sucks.  United Healthcare sucks even more.  Don’t even get me started on Healthnet. Yes yes, I know, they have to be the bad guys, the ones to keep costs down, to make the unpopular decisions about who gets what kind of care.  But still, they are private corporations put in charge of providing what should be a public good: health care.  And they do a very poor job of it.  They make more work for providers and hospitals, require higher premiums because of their own byzantine bureacracies of internal reviews and legal deliberations, and are just really really sneaky about finding ways to deny coverage.  Very sneaky. 

And now that they think they have stopped real health care reform, they believe they can act as they wish in states in CT.  Especially CT.  To the point of putting a hospital like St Raphael’s out of business. 

Wake up people.

posted by: Sportsfan on March 6, 2010  11:11pm

My hand surgeon works out of St.Raphael’s. I have had many operation’s there. The reason why I go to St.Raphael’s, is because I trust the doctor’s, nurses and all the staff that work there. I travel 30 miles to come to St. Raphael’s, because I get great, great care. I think it all boils down to greed on the part of Anthem. The CEO makes a ton of money. Anthem is my 2nd insurance. I pay over 2 thousands dollars a year for my plan. This year Anthem raised its rates again. Anthem you need to “WAKE UP”, ST RAPHAEL’S is a great hospital.

posted by: Walt on March 7, 2010  12:29pm

GRIPE—-Paul

Detailed comments   erased by   site saying I mis-copied letters at end (which may be true)

If error is seen,  makes more sense to give another chance rather than just dump whatever has been written,  as was done here.

Spellcheck   is also messed up.  Deleted first letter in at least 10 words and then declared them misspelled. 

I like spellcheck but it is often faulty. 

If you pay extra for this service, you are being gypped

Walt

posted by: Walt on March 7, 2010  1:43pm

As a recent cancer survivor (I pray) treated at St.  Raphe’s Cancer Center,  I certainly agree with EastRocker re the Hospital , but not re United Healthcare (Oxford)  which is paying for most of my expenses.

No problems with United even though the bill will top $100,000.  Do not have final figures yet,,  but no complaints from me or by United.

My Oxford/United Medicare Advantage Plan is one of the many such plans Obama/Dems are pledged to kill while at the same time falsely   proclaiming “If you want to keep your current Health Plan you can.”

Obama and the Dems also plan to take a half-trillion $$$$  from the already financially- in -trouble Medicare funds to use for   folks other than the old.

EastRocker may like Obamacare,  but it is an anathema to old folks like me who stand to lose our current good health insurance coverage.

PS Paul

SpellCheck still messed up.

posted by: Rep. Pat Dillon on March 7, 2010  1:50pm

Anthem’s jawboning of St. Raph’s here in New Haven is part of the larger struggle over health reform. This week, Ezra Klein http://tiny.cc/9pyPW
wrote in the Washington Post that Wellpoint would be a major winner of health reform fails in Congress. Wellpoint owns Anthem.

posted by: gyuri on March 7, 2010  7:43pm

Heads up for Walt - I wish you well healthwise.

Your Oxford/United Medicare Advantage Plan and you are being SUBSIDIZED by the government so that it can compete with traditional Medicare.

Your plan is the result of President Bush’s attempt to privatize Medicare by providing welfare to the insurance companies. This federal premium can increase to $2000 a month through a complex risk adjustment involving the health status of the eligible enrollee, meaning you Walt!

This subsidy is one of the problems of the health care system that makes it more expensive for everyone else and allows Anthem to play games with St Raphael. Anthem makes a lot of money on you, but does not want to share with St Raphael.

posted by: terrapin on March 8, 2010  2:27am

Gee, I thought this was only supposed to happen when Big Government took over health care. I would have thought the 29% increase in premiums I just got whacked with by Anthem would have meant an increase, not a decrease in services and options.