Letter to the editor: When insurance companies pocket unpaid claims, local clinics suffer

Dr. Christine EbertSantos
Ebert Family Clinic

In case your readers start feeling sorry for the insurance companies, let me make a few points.

Revenue lost to clinics and hospitals affects all of us. While the insurance companies pocket unpaid claims, our safety-net clinic, the Summit Community Care Clinic, goes back to the community for more donations and our hospital system raises their prices. This is a continuous cycle of cost shifting that is the bedrock of our health care payment system. Consumers’ time and tears are spent trying to find an insurance policy they can(not) afford that includes their trusted, local providers with deductibles and co-pays that won’t send them to bankruptcy.

The Stanford Graduate School of Business studied what it calls “health insurance sludge”: Researchers estimate “the economy loses $21.6 billion a year (due to) time employees spend on the phone with health insurance representatives. … Companies lose $26 billion per year from extra absence on the part of employees who have to deal with health benefits administrators, and $95 billion from the reduced productivity that arises because people who spend time on the phone with health insurers are less satisfied with their jobs.”

Bright Health revenue grew by 34%, totaling $1.1 billion in the second quarter of 2021, according to the Star Tribune. The two private Summit County clinics interviewed for the article by Jenna deJong on Friday are asking to get paid 0.0000011% of that for the care they have provided.

Insurance company CEO’s receive salaries over $67 million per year. The argument is that we cannot afford “Medicare for All,” but guess what? We are already spending more and getting less, along with a great deal of agony. Do the math. Read the Colorado 1176 Health Care Analysis Task Force report.

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