Judgment against Anthem for retaliating against a doctor who advocated for patients.

[eridani]

Private health insurance adds no value whatsoever and should be abolished.

http://www.latimes.com/business/la-fi-anthem-doctor-verdict-20130410,0,2796259.story

In a rare case, a Los Angeles jury awarded $3.8 million in compensatory damages to a Porter Ranch doctor who contended insurance giant Anthem Blue Cross retaliated against him for being a strong patient advocate.

The jury ruled late Monday in favor of Jeffrey Nordella, 58, an urgent-care and family-practice doctor who alleged that Anthem barred him from its network in 2010, when he applied to be a preferred provider. The damages could climb higher Friday, when the 12-person panel reconvenes and considers punitive damages against Anthem, a unit of insurance giant WellPoint Inc.

The jury found that Anthem, the state's largest for-profit health insurer, violated Nordella's right to "fair procedure," and the company did so with "malice, oppression or fraud." That latter finding prompted the hearing Friday in Los Angeles County Superior Court to determine punitive damages.

This case comes as health insurers, in a bid to hold down costs, are increasingly dropping doctors and hospitals and promoting smaller networks. Insurers typically try to negotiate lower rates with the fewer providers left in the network, who get higher patient volume in return.

Comment by Don McCanne of PNUP: The intent of today's message is not so much to use this opportunity to once again bash one of the nation's largest private insurers (even if appropriate), but rather it is to demonstrate the perversity of one more example of placing the business interests of the insurer over the interests of patients.

Even though this court decision was in favor of a physician barred from Anthem Blue Cross's network of physician providers, it confirms the principle that private insurers should be improving patient access to health care rather than impairing it, as in this now all too common instance of limiting access by narrowing their networks of health care professionals and institutions.

Once again, this demonstrates the irrationality of imposing expensive, intrusive, private third party administrators between patients and their health care professionals.

In a universal, publicly financed and publicly administered health care system, such as a single payer national health program, the third party - the government - covers all reasonable health care services and products provided by any legitimate health care professional or institution, with enough oversight to prevent deviancies such as fraud or price gouging.