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NEW HMO STRATEGY: PAY HEALTH CLAIMS

Analysts Skeptical; Doubt Insurers Equipped to Handle Job

MINNEAPOLIS, MINN. (SatireWire.com) – Moving into what insurance executives concede is “uncharted territory,” five of the nation’s leading HMOs announced yesterday they will begin paying health insurance claims for sick and injured people.

Health care advocates immediately cried foul, noting the insurers plan to significantly increase premiums to offset claim losses. Higher premiums are unnecessary, watchdogs argued, because consumers already pay insurers with the expectation they will be covered. However, Cigna HealthCare president William Pastore disagreed with that assessment.

This is, arguably, tangential
Theoretically, this golden retriever could turn nasty and bite this little girl. But it would be punished.

“In the past, what consumers really have been paying for is hope, as in, ‘I sure hope my insurance covers this,’” said Pastore. “Now, consumers will be paying for health, as in, ‘I’m glad I have my health because my insurance company has all my money.’”

Exactly how much premiums will rise is undetermined, said Dr. William McGuire, chairman and CEO of UnitedHealth Group. “We’re still doing cost-benefit analysis and revising our cash-flow models,” said McGuire, “but our initial estimates call for premiums to increase, on average, fuckin’ astronomically.”

Regional discrepancies will exist, however, as consumers in the Northeastern U.S. and in California incur higher-than-average premiums because, he said, “they have more money.”

“But hey, if you’re really sick,” McGuire added, “what’s money, right?”

Also undetermined is whether the insurers will allow ailing and injured people to see physicians. “We have an inter-company committee studying what service it is that physicians and hospitals provide,” said Pastore. “It’s not really something we’re familiar with.”

Under the existing system, a patient is treated, a claim is submitted, and the insurer refuses to pay based on one of the following criteria:

1) Illness/Injury not covered under patient’s current plan.
2) You’re annoying us.

Under the proposed system, health care providers will actually pay claims. However, the HMOs insist losses will be equalized, not just by increased premiums, but by “tremendous savings” in personnel costs.

Kaiser Permanente, for instance, said it will cut 65 percent of its staff, eliminating its entire “Complaints,” “Repeated Complaints,” “Are You Complaining Again?” and “I Was Shot in the Head Six Times Last Week and You Don’t See Me Running to the Doctor” departments.

Despite the rosy profit picture painted by HMOs, however, Wall Street analysts reacted to the announcement with skepticism.

“I’m afraid these are foreign waters they’re barking up,” said Goldman Sachs analyst Lisa Kepler, utilizing a stunning mixed metaphor that had them standing three deep around her cubicle just to get a glimpse of her. “These companies simply don’t have the people and procedures in place to provide this service. It’s like trying to teach an old dog new tricks when the horse is already out of the barn,” she added before being mobbed by admiring colleagues who lifted her onto their shoulders and carried her off for a well-deserved celebratory luncheon.


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