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2 Lawsuits, plenty of money, hop ...

Posted Nov 10 2008 4:18pm

2 Lawsuits, plenty of money, hopefully to put to good use, but they are projecting a profit on 81 billion dollars.  They are also cutting 4000 jobs to curb costs, maybe this is still the leftovers from the PacifiCare purchase and merge.  We all know by now what happens when mergers and buyouts take place and this is not anything different here. 

Also in a related article it states they are paying out more than expected for Medicare Part D prescription drug expenses.  A couple questions come to mind, is this timing due to the ongoing potential physician pay cuts for Medicare, as the Senate used this as their rationale for not wanting to dip in to the till as they felt it would hurt the carriers. image

When it comes to paying for prescriptions I have asked around and I have found that there are many of my friends, associates, etc. that still pay a co-pay of $10 or $15 for drugs that can be had (generics) at other retailers for $4. Just something to me that doesn’t make sense, why not work on that end of things and bring some of this down to the same levels.  Why does a patient have a co-pay of that amount and the insurance company picking up the rest of the tab, let’s say an additional $30.00 or so just for a simple figure. So now we have a generic drug at a store costing $40.00, whereby at another location it could be had for $4.00.   Does this make sense?  Add up a bunch of those and yes, prescription drug costs will be more.  I have not seen any of the insurers make any efforts in this area to keep costs down. 

But there’s a second side to this too in the fact that if the patient goes and pays $4.00 cash it doesn’t go in to the files, so it comes back and hits physicians in the area of pay for performance as it gives them distorted figures on not meeting their goals, so add this on to the problem and we have unhappy physicians next that have to prove they are prescribing their targeted number of generic drugs

So I ask, is the extra money being spent to be able to have the additional patient data on what medications they are taking and so they can have the numbers for physician pay for performance reports?   Just something to think about when it comes down to hearing the insurers talk about the increasing costs of medications for a point of rationale.  And let’s not forget aboutthe expense of setting up shop in China and India too.  I have wondered too  how much revenue really sits in the coffers in the “reserves”, and I’ll probably never know the answer to that one, but one can speculate it is a lot…from earlier this year from the state of Washington in the year 2006, 3.2 billion, one state and 3 carriers only in the report, so that’s a very small report.  In summary, I can’t buy the rationale of the medications in Part D working a hardship, it just doesn’t make sense.  BD 

UnitedHealth Group Inc. has reached an agreement with the California Public Employees Retirement System (CalPERS) and Alaska Plumbing and Pipefitting Industry Pension Trust, and will pay $895 million to settle a lawsuit. The company also announced a second, $17 million settlement for another suit. The suit was filed in 2006 in Minnesota district court, against the company and some of its current and former officers and directors related to historical stock options practices.

UnitedHealth to pay $900M to settle suits - Sacramento Business Journal:

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