I know we're all happy about the oligarch being taken out - I certainly have no sympathy for the man who's mountain of money sat atop a pile of corpses - but anthem rolling back that policy is actually a bad thing. I will link the article that has links to their sources at the end, but here is a summary;
Anesthesiologists are some of the most highly paid physicians in america and, according to medscapes 2024 report on Anesthesiologist salary in 2023, The average salary was $472,000 and that's a $70,000 increase from the average salary in 2022.
For reference, the average physician salary in germany is $160,000, In the United Kingdom, it's $122,000, and in France, it's $93,000.
On top that, When an anesthesiologist has a contract with anthem, Which they would need to have in order to accept that insurance, What is always in that contract is the clause that "You, the provider, accept the reimbursement rules in this contract as payment in full." What that means is that the provider cannot then turn to a patient and ask for more money. You would not wake up to a surprise bill because your surgery ran fifteen minutes over.
And if surgery does run fifteen minutes over, it does not mean they won't be paid for it, just that they would need to submit an appeal to get paid for the medically necessary extra time.
What this policy was actually intended to do was to disincentivize anesthesiologists from padding the bill, which they absolutely have incentive to do because anesthesia services are billed partially based off of how long a procedure will take.
The amount of time that they were going to pay for those services? It wasn't an arbitrary number like the ASA (association of anastheseologists) claimed. It was based on data from the centers for Medicare and Medicaid services.
I know that now, of all times, nobody is viewing health insurance companies in a favorable light, but this policy was not bad for consumers.
source: https://www.vox.com/policy/390031/anthem-blue-cross-blue-shield-anesthesia-limits-insurance
insurance companies and their policies are predatory, but I don't have any issue believing that some doctors - not all, but enough - Pad the bill that they send to the insurance company in order to get a higher payout.
Hell, it's a small thing, but my brother in law recently went to the doctors and when his EOB (explanation of benefits) came in the mail, the insurance company was billed for a flu shot that he never received.
It is why so many people recommend you ask hospitals and doctors for an itemized bill to make sure that you are not being overcharged or charged for services you did not receive.
I am not saying that Anthem is a good company, I do not believe that they are, but I am saying that everyone has misunderstood this policy. It was not a bad one.
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