Imagine you are one of the hundreds of thousands of Marylanders with health insurance coverage from CareFirst BlueCross BlueShield and you received a letter from Johns Hopkins Medicine. So far, we have not been able to reach an agreement on specific payments.
The clash of giants — the Hopkins healthcare system is Maryland’s largest provider and CareFirst its largest insurer — was revealed last month and continues today with no clear signs of a resolution. is bad enough. But it’s here that it becomes particularly painful for the average Marylander. For many employers, it’s health insurance open season. That means you have to make a decision about your coverage. Either stay with CareFirst or switch to a potentially more expensive in-network insurer. I don’t even know if there is a solution yet. For example, state officials say he has until Nov. 4 to select coverage for 2023, while the deadline for Hopkins-CareFirst negotiations is Dec. 5.
As William Shakespeare once wrote, “Like flies to capricious boys, we to the gods. They kill us for sport.”
Let’s count how infuriating this is. First, both of these organizations are non-profit organizations committed to acting in the public interest. Second, both appear to believe they are acting in their capacity in this controversy. Hopkins wants a reimbursement rate that keeps doctors and other health care providers working. Kevin Sowers, president of Hopkins Health System, calls this a “sustainable” business model. But CareFirst’s management has a similar cry. They want to keep premiums from rising. For example, if they don’t use their market position to lower rates, how do they ultimately prevent healthcare from becoming unaffordable? What if I am not covered?
But the third is where is the government oversight?
Last week, Gov. Larry Hogan urged both parties to act together and reach an agreement as soon as possible. He also told reporters in Annapolis that he would put pressure on them. But how exactly? Using the regulatory functions of state governments to put pressure on the private sector was not Hogan’s trademark during his two terms in office. Maryland Insurance Commissioner Kathleen A. Billane, DLA’s Piper lawyer, said she was only a member of the University of Maryland Health System’s board of directors before being appointed two years ago, she said. I have not.
Frankly, Hogan administration officials could be hopeful that the issue will be resolved soon. they are probably right. Both sides have so much at stake that they can’t find anything in common. But the damage the impasse has already done is significant. People in Maryland are already making choices without fully knowing what will happen in the future. No doubt some, perhaps thousands, of people are in poor health and rely on Hopkins healthcare providers for cancer treatment, chronic pain relief, or many serious ailments. How much are they suffering now because of the uncertainty of what it means for their finances?
Here’s what we’d like to see — a more aggressive response from the state government than just hand-wringing and tsk-tsking. You can start with About how this ridiculous stalemate happened in the first place, and what regulatory reforms would be needed to prevent it from happening again. This could include making the Maryland Department of Insurance’s rate review process significantly more transparent and involving far more citizens than it currently does. Why not open the book a little wider on both CareFirst and Hopkins? Let’s hear them justify their medical bills and premiums. I would love to hear some testimony as to why they are paying a million dollars. Maybe there is waste to cut.
Without a doubt, this has to be a painful procedure done without anesthesia.Both of these institutions have benefited Baltimore a lot. But with this fiasco, they’re showing that they can do some harm, too. let’s
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