What Happens When a Health Plan Has No Limits? An Acupuncturist Earns $677 a Session.

If you are a taxpayer in NJ, you should read this full story. While this is about NJ, the generosity and mismanagement of government workers benefits is widespread.

The root cause in most cases is the relationship between public employee unions and the politicians who are supposed to negotiate with them.

About fifteen years ago I was on the board overseeing these benefits. I lasted three meetings before I resigned in face of the mismanagement. First the board ignored their own actuaries suggested premium increases, thus insuring a deficit the following year. Next it was recommended that the co-pay for the retiree Rx plan be raised from $0 to $1.00 and that too was rejected. That was enough for me. In the following years some changes have been made, but not nearly enough to align these workers benefits with the benefits available to the taxpayers footing the bill.

New Jersey’s health plan for school employees pays out-of-network providers virtually whatever they want. Dozens of acupuncturists and physical therapists earned more than $200,000 in 2018 from school staff alone. One brought in $1 million.

Source: What Happens When a Health Plan Has No Limits? An Acupuncturist Earns $677 a Session. — ProPublica

One comment

  1. I wished that I could say that I am surprised, but I am not. I am not even mad at the providers either since they found a legal way to rip off the taxpayer. I am not surprised at government offering such plans since the public unions have bought the politicians here in New Jersey.

    What I am mad about is the lack of transparency. The lack of a posted price list. Until reading the article, I had no idea what the treatment should cost. Until I saw that they were getting away with charging more 10x the in network rate, how could I be mad, I didn’t know. As an employee, I would care what the cost was if it was covered. As a taxpayer, that is just one more thing that makes me resent our government.

    But the whole medical billing system makes me mad. I know that I am going to pay more at Whole Foods vs. at ShopRite, but I don’t expect to pay 10x difference at the register from the shelf price depending on a card in my wallet everyday. As much as I hate insurance companies, they do service a purpose and they do control costs so that I can afford their premiums. But blank checks by government plans run up the costs for everybody since when the costs are aggregated among all plans, the average cost in NJ is artificially high. Then the insurers will be forced to pay more to even in network providers because the costs are higher in NJ.


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