Crime Pays–That’s Upsetting

We have now shown that for years consumers were consistently low-balled to the tune of hundreds of millions of dollars.

I’ve just read a story in the Times about a database run by United Health Care. IT was used by UHC and other insurance companies to come up with the “reasonable and customary” numbers used to decide out-of-network reimbursement.

UHC’s subsidiary that ran the database estimated low to the tune of 28%. New York Attorney General Andrew Cuomo said:

“For years this database was treated as credible and authoritative, and consumers were left to accept its rates without question. This is like pulling back the curtain on the wizard of Oz. We have now shown that for years consumers were consistently low-balled to the tune of hundreds of millions of dollars.”

New York reached an agreement with UHC. It’s not cirminal and it takes United Health off the hook. Cost to United Health Care–$50 million.

Hold on. Didn’t Cuomo say, “consumers were consistently low-balled to the tune of hundreds of millions of dollars.” Taking Attorney General Cuomo at his word the least UHC could have made was $200,000,000. So, at the worst they had a 4:1 return on this investment.

Where is the disincentive to be evil?

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