An MIT professor colleague, an expert in computers, writes:
The last couple of months have been very heavy duty bad medical stuff for me. Horrendous. So, I've been able to see the dysfunctional medical insurance system in action. Do you understand how Blue Cross/Blue Shield actually works? Out of, oh, maybe 80 transactions over 2 months -- they managed to get one, as in the number 1, correct. The rest are mistakes, mis-billings, computer errors, everything one can imagine. And the only reason I can ever figure it out is because I am dogged and know something. I can't even begin to imagine the bone-head database that lurks behind all of it, along with inept programming, but whatever it is, the people running the place (sorry if I tread on toes) -- up to and including all the executives, are simply, sorry to say, totally bonkers. And they are just middlemen. They aren't providing services, just managing to extract rents. Badly.
P.S. BTW, my running statistics on them, is that out of 540 transactions with them over the past 1.8 years, they have gotten two, as in the number 2, correct. Not a good batting average. Why are they so inept?
Let's see if we can correlate this description with this recent earnings report in the Boston Globe:
The state’s largest health insurer boosted its earnings in 2012, while three other Massachusetts health plans reported net income declines from the previous year as they absorbed a new state assessment to fund initiatives under a cost containment law.
Blue Cross Blue Shield of Massachusetts recorded net income of $163.9 million for the 12 months ending Dec. 31, a gain of 20.4 percent from the $136.1 million it earned in 2011. The better showing was powered by a sharp increase in fourth-quarter earnings and higher operating income in 2012, offsetting a modest drop in investment income for the year and a $65 million accounting charge taken to cover the cost of the new state assessment.
After a $149 million net loss in 2009, financial results at Boston-based Blue Cross have climbed steadily over the past three years as the insurer has focused on strengthening its business and introducing products aimed at slowing the growth in premiums.
“We’ve made a concerted effort to grab hold of our company and get costs in line with revenues,” Blue Cross chief financial officer Allen Maltz said.
The last couple of months have been very heavy duty bad medical stuff for me. Horrendous. So, I've been able to see the dysfunctional medical insurance system in action. Do you understand how Blue Cross/Blue Shield actually works? Out of, oh, maybe 80 transactions over 2 months -- they managed to get one, as in the number 1, correct. The rest are mistakes, mis-billings, computer errors, everything one can imagine. And the only reason I can ever figure it out is because I am dogged and know something. I can't even begin to imagine the bone-head database that lurks behind all of it, along with inept programming, but whatever it is, the people running the place (sorry if I tread on toes) -- up to and including all the executives, are simply, sorry to say, totally bonkers. And they are just middlemen. They aren't providing services, just managing to extract rents. Badly.
P.S. BTW, my running statistics on them, is that out of 540 transactions with them over the past 1.8 years, they have gotten two, as in the number 2, correct. Not a good batting average. Why are they so inept?
Let's see if we can correlate this description with this recent earnings report in the Boston Globe:
The state’s largest health insurer boosted its earnings in 2012, while three other Massachusetts health plans reported net income declines from the previous year as they absorbed a new state assessment to fund initiatives under a cost containment law.
Blue Cross Blue Shield of Massachusetts recorded net income of $163.9 million for the 12 months ending Dec. 31, a gain of 20.4 percent from the $136.1 million it earned in 2011. The better showing was powered by a sharp increase in fourth-quarter earnings and higher operating income in 2012, offsetting a modest drop in investment income for the year and a $65 million accounting charge taken to cover the cost of the new state assessment.
After a $149 million net loss in 2009, financial results at Boston-based Blue Cross have climbed steadily over the past three years as the insurer has focused on strengthening its business and introducing products aimed at slowing the growth in premiums.
“We’ve made a concerted effort to grab hold of our company and get costs in line with revenues,” Blue Cross chief financial officer Allen Maltz said.