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Healthcare reform was the topic of coverage on NBC and CBS: NBC was optimistic, CBS admonitory. Randall Pinkston on CBS described how health insurance companies decide what to pay patients who undergo out-of-network treatment. They consult a schedule of purportedly "customary and reasonable" fees compiled by a firm called Ingenix. The problem is that Ingenix happens to be a subsidiary of United Health Group, a major healthcare insurer with a vested interest in keeping out-of-network compensation as low as possible. New York State's Attorney General Andrew Cuomo sued over such conflict of interest, winning a $50m judgment and shutting Ingenix down. Ingenix "lowballed a medical provider's average fee by as much as 28%," Pinkston reported.
The optimism was found in the Commonwealth of Massachusetts, where NBC's Robert Bazell completed a two-part survey (here and here) of the state's two-year-old program to provide universal coverage. Only 3% of the Massachusetts population has no health insurance, he found, as opposed to 16% in the rest of the United States. "The healthcare reform effort has exceeded the expectations of those who backed it." A statewide poll finds 69% approval for the scheme. Problems? The extra patients who can now afford to visit the doctor have "swamped" family practice clinics; and the worsening economy is liable to divert premium payments away from employers onto the state healthcare budget, already $750m annually.
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