Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How a dispute with an insurance company can affect patients

Donald H. Taylor, PhD
Policy
June 2, 2011
14 Shares
Share
Tweet
Share

8,000 patients will no longer be able to receive care from UNC Hospitals and their affiliated physician practices because of a dispute between UNC and the insurance company Aetna.

The bottom line is that Aetna does not want to pay as much for care provided by UNC as UNC wants to be paid for providing this care. No surprise there, as the interests of the two parties (health care provider and insurance company) are in opposition. However, UNC has taken the unusual step of no longer accepting Aetna’s insurance, forcing 8,000 persons to receive care elsewhere (some can get exceptions). And Aetna hasn’t backed down and increased the pay rates.

And patients are upset, because their preferred pattern of health care delivery has been upset.

There are numerous examples in everyday life in which one party wants to get paid more than the other would like to pay, and a business decision is made. I would rather Duke pay me more for being a professor than they do, but my desire is not such that I am looking for a new job. Likewise, I would rather not still drive a minivan because my kids are a bit older, but the van is paid for and I don’t want to pay as much for a new Honda Accord as the local dealer wants for it. Similarly, I am a season ticket holder for the Carolina Hurricanes, but I have upper level seats instead of lower level ones, simply because I am not willing to pay the difference in ticket price between the levels. I would rather sit in the lower level, but not that much.

All of us make innumerable tradeoffs and choices in deciding how much we are willing to pay for goods and services, and we don’t think much about it. Many people claim they want more competition and sensitivity to price of this type in health care. However, whenever you get a story like the dispute between UNC and Aetna, people get very upset because they no longer get to keep their doctor, or receive care from the hospital of their choice. I don’t know any details about how far apart UNC and Aetna are, and there are many unstated reasons that one or both of the sides in this negotiation may not want to strike a deal. It doesn’t really matter, because this is simply a story of two organizations seeking to do business in their best self interest.

If your reaction to this story is ‘but health care is different from those other examples you gave’ then you probably don’t think that health care is just another good.

Increased competition and market forces brought to bear on health care and in health insurance would increase, not decrease disruptions such as this one. That might be good or bad depending upon your perspective. And of course health insurance is not the same as health care, but very few could hope to afford care if they got sick without insurance, so a third party being involved in the patient/provider relationship is virtually inevitable, and likely to increase if we are to address health care cost inflation.

Donald H. Taylor Jr. is an associate professor of public policy at Duke University and blogs at The Incidental Economist.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Why are sore throats cultured, and why are antibiotics administered?

June 2, 2011 Kevin 39
…
Next

Why cognitive doctors need to be paid more

June 2, 2011 Kevin 50
…

Tagged as: Patients, Public Health & Policy

Post navigation

< Previous Post
Why are sore throats cultured, and why are antibiotics administered?
Next Post >
Why cognitive doctors need to be paid more

More by Donald H. Taylor, PhD

  • a desk with keyboard and ipad with the kevinmd logo

    The root cause of why our health system is unsustainable

    Donald H. Taylor, PhD
  • a desk with keyboard and ipad with the kevinmd logo

    Slowing health costs requires answering 3 simple questions

    Donald H. Taylor, PhD
  • a desk with keyboard and ipad with the kevinmd logo

    What health reform compromise could look like

    Donald H. Taylor, PhD

More in Policy

  • Pediatricians grapple with guns in America, from Band-Aids to bullets

    Tasia Isbell, MD, MPH
  • Health care wins, losses, and lessons

    Robert Pearl, MD
  • Maximizing care amidst provider shortages: the power of measurement-based care

    Tom Zaubler, MD
  • Unveiling excessive medical billing and greed

    Amol Saxena, DPM, MPH
  • Chronic health issues and homelessness

    Michele Luckenbaugh
  • The impact of certificate of need laws on rural health care

    Jaimie Cavanaugh, JD and Daryl James
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance
    • The pros and cons of whole life insurance for high-income earners

      Shane Tenny, CFP | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Exploring disfigurement and self-worth

      Kathleen Watt | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • CDC Advisors Endorse Maternal RSV Vax to Protect Newborns
  • Amoxicillin Alone for Acute Sinusitis Holds Up Against Broad-Spectrum Cousin
  • Despite Taboo, Med Students, Doctors Use Substances Too
  • White House Opens Gun Violence Prevention Office
  • Nurses Step Up to Bat on Educating Patients About Climate Change

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance
    • The pros and cons of whole life insurance for high-income earners

      Shane Tenny, CFP | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Exploring disfigurement and self-worth

      Kathleen Watt | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How a dispute with an insurance company can affect patients
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...