Monday, September 28, 2009

Medical Journal "Health Affairs" Bends And Coughs Over For Aetna

For several years, professional medical journals have been drawing heavy artillery fire for not disclosing any conflicts of interest its authors have with the subject they’re covering, hyping faulty studies and publishing too many glowing articles about new pharmaceuticals that have questionable value.

This is why the latest issue of Health Affairs leaves me deeply troubled because the peer-reviewed health policy journal turned over the cover of a recent issue to Aetna, the nation’s third largest insurance company. That’s right, Aetna. The same behemoth with a vicious Rotweiller in the health care reform dog fight opposing any reform that doesn’t profit Aetna.

Health Affairs made a deal with Aetna to sponsor the current issue of the journal. The problem is that the theme of the edition is “Bending the Cost Curve.” This is wonk speak for “controlling or containing medical costs in ways that send shivers up the spine of Aetna.”

Unfortunately, “Bending The Cost Curve” is clever jargon that often filters into the MSM and down to the general public, where no one knows what the hell it means. William Safire, whose love of the English language and its use, and who died this weekend, must be spinning in his still-fresh grave.

In exchange for its cash, Aetna got to design a cover that was pasted on the publication, hiding the journal’s real cover. The faux cover is the one a reader sees unless they look under the hood, and this one is a doosey. It features a “Dear Colleague” letter from Aetna CEO Ronald A. Williams. In the letter, Williams enthuses about his company’s concern for patients and improving the quality of care.

We believe that the right solution will be based on what is already working in the private sector, and should include an individual coverage requirement and guaranteed issue with no pre-existing conditions. Addressing health care costs is equally important, and we must simplify the system so that doctors and caregivers can spend more time with patients.

It sounds wonderful except for four things.

First, any physician or health care worker who thinks Aetna is their “colleague” is seriously delusional.

Second, Aetna’s “right solution” isn’t working in the private sector for anyone except Aetna, and its insurance brothers-in-Satan. This is why nearly 50-million Americans aren’t insured at all with another 12-million underinsured, and why a new Harvard study documents that 45,000 people die every year because folks like Williams either cancel their coverage, deny treatment or refuse to issue a policy to them.

Third, if simplifying the system is so important, why hasn’t Aetna done it already so “doctors and caregivers can spend more time with patients”? It’s insurers that can’t figure out a way to standardize forms or how to process a claim in less than 180 days so a doctor gets paid promptly for a patient’s visit.

Fourth – and this is what really sent me over the top because Williams' letter never mentions it – Aetna and the industry will go along with “guaranteed issue with no pre-existing conditions” only if Congress mandates that everyone has to buy a policy from the insurers rather than through a public option because such a requirement means billions in additional revenue and profits for Aetna and its friends.

Aetna had no comment on the sponsorship and it’s hard to figure out whether Aetna’s funding affects editorial decisions.

In one section called “saving money,” there’s a think piece called “Opportunities To Improve The Quality Of Care For Advanced Illness.” It describes a care management program Aetna is piloting that “gives people culturally sensitive supporting information, to make informed choices and obtain palliative services in a timely manner.”

Whoa! Where are the tea baggers and cries of “Death Panels!”?

I guess someone on the right decided that it’s okay for insurance companies to help people make informed choices about end-of-life care, but not for the government to pay the cost of a doctor’s visit so a Medicare patient can have the identical discussion.

Chalk it up as example No. 3188 of Republican hypocrisy.

This whole thing makes me want to wretch. Aetna trumpeting concern for cost-control and the plight of the uninsured on the cover of a professional journal is the kind of chicanery that became so familiar this summer. The insurance industry keeps portraying itself as a good guy in this fight, all the while working behind the scenes to stop what is good for Americans.

Being on the cover of Health Affairs is a PR flack’s wet dream about burnishing the image of a badly tarnished reality.

– Hat tip to Trudy Lieberman