State launches Aetna probe after stunning admission

by Larry Emmott on February 19, 2018

in Health Care Politics

From CNN: Stunning?

California’s insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients’ records when deciding whether to approve or deny care.

Source: State launches Aetna probe after stunning admission – CNN

This is not stunning to anyone on the “provider” side of the insurance struggle.

The linked article refers to the insurance commissioner and does quote some physicians who were “shocked”. Never the less as a dentist I see arbitrary denial of claims all the time. I was not “stunned” in the least. It is cute when patients implore us to tell the insurance company that the proposed treatment is “necessary” as if that mattered in the least.

The article then makes the common yet deceitful claim that denial of coverage means denial of service. They present the case of a poor soul who almost died because he did not receive a treatment because Aetna denied payment. Why does it never occur to people that the  patient could simply pay for the service himself and save his life?

The only people who should be stunned by this are those naive individuals who still believe the insurance company has the patients best interests at heart and act as a protective barrier between unscrupulous doctors and helpless patients.

Quick thought experiment:

As a general rule who is most ethical and likely to act with integrity?

Physicians?

Insurance Executives?

Just sayin’

BTW look at the previous posting. Aetna did not make the list of most ethical companies.

 

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