The Shit Is Going to Hit the Fan, Starting in NY

As NY Attorney General Andrew Cuomo subpoenas health plans including Aetna, Cigna, Empire Blue Cross Blue Shield, Excellus, UnitedHealth, WellPoint, and the combined GroupHealth and HIP Health Plan, what will be uncovered.

He's serious about this. He's even requesting all email correspondence at the senior levels of these companies (CEO, CFO, COO, Presidents, as well as employees that supervise the claims process).

What started this? Here's the gist:

• Ingenix is a company that provides the data to help insurers determine rates, including out-of-network rates.
• United Healthgroup owns Ingenix.
• There is suspicion that United Healthcare and other insurance companies may have colluded with Ingenix to manipulate the data in a way that benefits them and hurts consumers (for example, the rates may have been set artificially low for out-of-network reimbursement so that the patient's out-of-pocket portion is much higher).

You might say (or I might say) that this is what you get when you turn health care into a for-profit industry.

But I don't accept that conclusion--bullshit. Business ethics is the fundamental problem, and although companies like Enron took center stage, corporate responsibility needs to be more important across the board.

Let's just say, I'm betting that the shit's gonna' hit the fan. Let's hope I'm wrong.