The once again amazing arrogance of the health insurance industry.

[Guest guest]

I wanted to share with this group a letter I emailed recently to the director of provider reimbursement for one of the health plans I participate in here in southern Colorado. I have edited out names. If any one has similar experiences, they are welcome to use any or all of my letter to respond.

Dear [Mr Head Honcho of Insurance Company X], I am writing as a primary care physician in response to your letter dated Jan 25, 2008 regarding provider reimbursement. You letter to me included the following quote:

" ...For the seventh year in a row, [insurance Company X] is proud to announce that for our Commercial and ASO lines of business, we will carry forward the 2001 conversion factor for the 2008 calendar year... "

Can you imagine getting a letter like this from your employer that states they are not only going to continue to not give you a raise for the seventh year in a row, but that they are PROUD of it? Basically, your letter starts out telling me (as if I did not know) how dismal the Medicare fee schedule has been, and how Congress has scheduled us for a 10% pay cut the end of June this year. The inference is how " lucky " I am that your company is not cutting my reimbursement rate.

My costs of providing care have continued to rise, just as in every other business. I have continued to run a leaner and more efficient business. As your letter so beautifully laid out in no uncertain terms, I am expected to provide the same level of care and services for my patients as I did seven years ago, but without any increase in payment, and in the face of annual rising costs.

I am certain in this seven year time period, premiums charged to your subscribers have risen, so your company's income has increased in response to higher costs of doing business. I suspect all employees of [insurance Company X] have received some form of increase in their salaries over the past seven years. I suspect bonuses have been paid to various higher ups on the power ladder at [insurance Company X] over the last seven years. Please correct me if I am wrong in these assumptions. I really would like to know if the people involved in your particular company have been living a lean life on stagnant salaries for the past seven years, and if that fact makes them " proud. " If so, I will owe you an apology.

I do not expect or anticipate any form of helpful response to this letter, but I do hope to not see such amazing callousness in future letters regarding stagnant payment for my services. Sincerely,

, MDSolo Family PhysicianDurango, Colorado

I wish I could say this company had been overpaying form my services for the first 4-5 years of this fee schedule, but they have not.

It will be interesting to see if I get a response and what it is.