December 19, 2009

Denied!

Supporters of increased government involvement in health care — such as Michael Moore, as seen in his film Sicko — are always keen to show private insurers denying legitimate claims for medical care. That does happen, but it’s less than half the story. As Mary Theroux at the Independent Institute points out, Medicare denies claims at a far higher rate than private insurers:

According to the American Medical Association’s National Health Insurer Report Card for 2008, the government’s health plan, Medicare, denied medical claims at nearly double the average for private insurers: Medicare denied 6.85% of claims. The highest private insurance denier was Aetna @ 6.8%, followed by Anthem Blue Cross @ 3.44, with an average denial rate of medical claims by private insurers of 3.88%

In its 2009 National Health Insurer Report Card, the AMA reports that Medicare denied only 4% of claims—a big improvement, but outpaced better still by the private insurers. The prior year’s high private denier, Aetna, reduced denials to 1.81%—an astounding 75% improvement—with similar declines by all other private insurers, to average only 2.79%.

Maybe there’s something to be said for the need to keep your customers satisfied in order to make that profit after all.

And not only is Medicare more likely to deny claims, it is also driving up health care costs for everyone. Our August policy study on health insurance reform shows that Medicare and other government health care expenditures drive a wedge between consumers and producers that fuels price inflation.

Government interference in health care markets only gives Missourians higher costs while leading to coverage of fewer claims. Effective health care reform must go in the direction of markets, but now that the Senate seems set to vote for cloture on the health care bill, that seems very unlikely in the near future.

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