Monday, July 28, 2008

Do doctor owned health insurance companies cover for bad doctors?

I am wondering whether the health insurance companies know that doctors are negligent and are covering for them by paying the claim.

It is a pretty basic analysis when considering the issue of a physician or surgeon that is part of an HMO. It is even more basic when considering a situation where the physician or surgeon actually owns the insurance company.

So in the situation of Chris Dangles, MD of Carle Clinic Association (Urbana, IL) and Health Alliance Medical Plans (HAMP), at some point during the course of Dr. Dangles treatment of me, HAMP must have noticed that something was wrong. But, HAMP kept paying the insurance claims. HAMP never suggested that I obtain a second opinion after three (3) failed surgeries.

If Dr. Dangles is a partial owner of HAMP then who at HAMP would be in a position to suggest Dr. Dangles deviated from the standard of care? This is the inherent problem when the doctors have a financial interest in the health insurance company.

As patients, we purchase insurance coverage to make certain that medical bills will be paid. We do not purchase insurance coverage as additional liability coverage for bad doctors.


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