Tuesday, March 20, 2007

UnitedHealth Declares "The Health Care System Isn't Healthy" - But Is the Company Part of the Problem?

Those who read the print version of the Wall Street Journal opened it yesterday (19 March) to find a full page advertisement from UnitedHealth Group, with a dramatic red background. The advertisement is not on the web, as far as I can tell, but its text is below:

The health care system isn't healthy. There's no denying it. A system that was designed to make you feel better often just makes things worse. Costs are out of control, access is inconsistent, quality is too variable and the entire process has become unwieldy.

Every day, more Americans are added to the rolls of the uninsured. This is an epidemic and it's time we found a cure.

At UnitedHealthcare, we are committed to improving the health care system. We aim to take what's wrong and make it right.
> Simplifying everything and eliminating red tape.
> Ensuring access to the right care anywhere in the U.S.
> Empowering you to make better decisions about your health 24/7.
> Providing information to doctors to better support people.
> Rewarding first-rate physicians for first-rate medicine.

All while making your health care more affordable.

Will all this be simple? No. Simple doesn't mean simple-minded. Sometimes simple means ingenious. Sometimes it means revolutionary. And no one is better prepared to lead this revolution with you than the strongest, most commited health care company in the nation. Simpler process, smarter solutions, better results for you.

UnitedHealthcare Healing health care. Together.

Say what?

On one hand, the advertisement's statement of the problem in the first two paragraphs is hard to argue with, although it did leave out demoralized health care professionals as one of the primary manifestations of the problem.

The rest might be barely credible if UnitedHealth were a brand-new company.

Instead, it is a company that has been around a long time, and there are plenty of reasons to think that up to now it has been part of the problem, not the solution. UnitedHealth's claims about affordable health care are particularly suspect.

For example, we have discussed the amazingly generous compensation awarded to UnitedHealth's previous CEO, Dr William McGuire, at a time when the company's mission statement already included the goal of "making health care more affordable." Later, we discussed how McGuire had become more than a billionaire, at least on paper, due to the value of the stock options the grateful company bestowed upon him, while the company pursued an ever more concentrated health insurance market. Then it turned out that these stock options were back-dated (see post here), and McGuire was eventually forced to resign (see post here). Meanwhile, it turned out there have been allegations of conflicts of interest affecting the UnitedHealth board, and that at least one of the members of the board's compensation committee. Note that one member of that committee who had been most gushing in her support of McGuire and his outsized compensation was also the Dean of a major US nursing school (see post here).

Of course, McGuire has left, and so it's possible that UnitedHealth has changed its ways. But I should note that in the last few days, the American Medical Association is trying to block UnitedHealth's acquisition of Sierra Health Services Inc., charging that the acquisition would give UnitedHealth a near monopoly in the state of Nevada (see AP story via the Houston Chronicle); and here in Rhode Island, UnitedHealth is being criticized for trying to transfer a big chunk of profits out of state, given that it already spends less of its total revenue on actual health care than is typical (see story in the Providence Journal).

Meanwhile, beware of full-page advertisements bearing hype, much less vividly red advertisements touting revolution.


Anonymous said...

This is just typical company doublespeak:

"simplifying and eliminating red tape" = putting your personal records on easy-to-access electronic databases (for them, of course)

" Ensuring access to the right care anywhere" = making sure you go to the place that's cheapest for them (you can figure our where they've made the deals)

"Empowering you to make better decisions about your health" = this is the one where they hit consumers with "education" to direct them to what the company wants them to do; hounding you to death to do what they want is "empowering" you

"Providing information to doctors to better support people" = this is where they believe they should stand between members and their doctors, they report those members who haven't done what the insurer prescribes and the doctors better make them comply or their P4P will be affected

"Rewarding first-rate physicians for first-rate medicine" = P4P for doctors who do what the insurer wants, not what is necessarily best for the member

You labeled it correctly: "managed care"

John Nail said...

This ad strikes me as utter nonsense when confronted with consumer and provider surveys and facts.

When added to the obvious points you made on Dr. McGuire's comp. (which we also have tracked and commented on since last spring), and the backdated options, and you look at the recent survey results from both JD Power and the NRC survey that we have featured at The Industry Radar (http://www.theindustryradar.com). UHC clearly has grown and profited at the expense of employers, employees, families and the healthcare provider community.

They have failed in my opinion the main constituencies that they should be serving as customers not simply as a mechanism to generate profits and wealth for executives. You can either profit serving your customers or profit by taking advantage of the system. I fear the latter has been the case here.

Another great source of the truth on their real performance for providers is- http://www.athenapayerview.com/ - where they pay late and require more phone calls than most plans which simply adds cost to employers and consumers and hassles for us all.

Why are they so average to below average in all the rankings if they are truly a leader in finding solutions to better health?

Their service is rated low by both employees and providers and they are constantly in conflict with the care systems we all rely on. You can see a list of the news on these at: http://www.theindustryradar.com/Home/?currentHome=/Accounts/IndustryRadar/layouts/Hospital%20Disputes.xml.

As we truly have transparency for consumers I suspect that this discussion for UHC and others will become even more interesting especially as the CEO pay debate in general continues.

Anonymous said...

OUTRAGEOUS!! I have UHC as my provider. They are, by far, the worst provider I have ever had - billing for visits they should have covered, extremely poor customer service, etc. The list goes on and on.

Anonymous said...

UHC is much too big of a company as it is and obviously cannot handle the business they have. They are my provider and I've had nothing but problems with them from claims not being processed to receiving different information each time you call for customer service. They also take over 21 DAYS to process any type of flexible spending account claim and then an additional 4 DAYS to process payment.

Anonymous said...

Insurance companies are all alike. UHC is the provider at my workplace but I am insured by my husband's provider since he is retired. Our coverer is AETNA. I need medical equipment due to a physical problem. AETNA pays only 1% of the cost of this equipment and, as a result, no health care pharmacy will order the equipment for me unless i am willing to pay over $400.00. AETNA's reimbursement schedule has been declining over the past few years. Two years ago they paid about 7% of the cost. And they call the reimbursement schedule "reasonable and customary." I wonder if their top management would like to receive 1% of their last year's pay.

Jim C said...

Simply look at the J.D. Powers survey of consumer satisfaction with HMOs and notice that in the Northeast UHC is last. Nuff said.

Anonymous said...

UHC does pay for what they say they will in the plan. My husband was admitted to the hospital after an ER visit and we are not, according to the plan, required to pay the $50 co-pay. They refuse to tell the provider that this si the provision in the plan and we are still getting bills by Nashoba Valley Medical Center - an Essent company -that is also a screwed up mess when it comes to billing...

Anonymous said...

UHC refuses to follow the provisions of their plan for ER visits. Nashoba Valley Medical Center's billing department is not better. They keep billing us $50 for an ER visit that we are not required to pay according to the provisions of the plan - because he was admitted to the hospital.