Although a bit of a read, it’s only 5 minutes of the hours this guy spent trying to simply be an educated consumer…and he gets it perfectly:
“CareFirst is not interested in cutting drug costs. CareFirst couldn’t care less how much I spend on prescription drugs each year because they’re never upping my coverage limit beyond $1500 a year – that’s all they pay, period. What CareFirst is interested in is making sure that every dollar I spend on drugs goes through them, regardless of whether that option is more expensive than alternative pharmacies. The incentive structure is totally wrong.”
And herein lies one problem with health management.
It is against federal law for doctors to have a financial stake in hospitals they refer patients to. But insurance companies CAN have a financial stake in driving their “covered lives” to pharmacies they own. Insurance companies can drive more and more dollars to their pharmacies. But doctors can’t.
We sure do know who’s got the most lobbying powers in Washington, Senator Stark.
Need to fill your CareFirst Blue Cross prescription? Good luck.