United Healthcare has shown that it can be thuggish with its providers in the past by threatening to fine them $50 if patients decide to get testing done at facilities other than Laboratory Corp. of America or other United Healthcare selected labs.
Readers have commented that the “AMA could of course advise physicians not to contract with any insurance company. Many physicians are doing just that. They are then be free to treat (and refer) however they wish, and bill their patients whatever they like. Their patients have to pay directly – mastercard comes to mind – and are then responsible for obtaining reimbursement from their own insurance. In fact, wasn’t this very arrangement called “insurance”, back in the day?”
I pointed out that the issue really isn’t about physician profits, but rather a conflict of interest. But even if it were, antitrust laws are supposed to keep a single corporation from getting powerful enough to bully everybody it does business with.
Now the AMA is nervous that United Healthcare may be making “a blatant grab for dominant market power“.
The AMA said UnitedHealth would have 43 percent of Nevada’s commercial health insurance market after acquiring Sierra, compared to its current 14 percent market share. In the Las Vegas market, the combined company’s share would be 56 percent, compared with 18 percent now.
With a grasp over that much of the market, it’s highly likely that we would see United Healthcare try to intimidate its providers in Nevada like we saw with HCA in Colorado last summer. Doctors should be nervous about this because United would have enormous power over contract negotiations with them. And I don’t think we can trust United to be ethical in those negotiations if they have no other incentive.
