Twinkies and Insurance Companies
I've thought about all of the conventions my grandchildren may never know: newspapers, landline phones, records, books made of paper, and magazines -- to name a few. But never, not once, did I think my grandchildren might never taste a Twinkie.
There are two schools of thought about Hostess' demise. One school says greedy unions are to blame. Another school says corporate mismanagement is to blame. These opposing perspectives remind me of the positioning going on by an insurance company and a local hospital. Both the hospital and insurance company are saying the other one won't agree to terms. An insider tells a different story.
The hospital is tired of dealing with this particular insurance company. The insurance company reimburses at a considerably lower rate than the other insurance companies. The hospital employs eight times the personnel to handle this insurance company's claims. This particular insurance company is costing the hospital money: The hospital is being reimbursed less and has to pay out more in employee costs. So, the hospital set terms on the table hoping to force the insurance company's hand into decline.
The hospital's plan worked. Effective Jan. 1, 2013, hundreds of people will be transferring their care from this hospital's network of physicians. My guess is few will ever know the truth behind why they had to change providers or why they lost clients.
So, I wonder. Is there someone inside Hostess privy to an unequivocal truth that won't become common knowledge? More relevant to this blog, I wonder how many healthcare decisions -- from insurance to pharmaceuticals to the daily operations of healthcare providers -- are made surreptitiously with cover stories we accept all too willingly.
Perhaps there is a bigger question. How did we get to a place where we allow others -- others who aren't directly affected by the decisions they make -- to make decisions that significantly impact our lives?