To the Editor:

I have become justifiably saddened after looking through your November ’14 editorial “Compliance Faces New Economic Challenges.” Seeing the proof of your points every day in the clinic, I can’t resist trying to wrap my arms around the big picture.

The big clue is that you didn’t write about how the insurers will repay our patients for their errors. Will they compensate them financially? Will they take back the pain, suffering and loss of vision to those who were denied access to their medicines? Or, more realistically, will their stockholders enjoy a juicier dividend? I think the latter.

As one who is always trying to connect the dots, I do not see this as an isolated event. It is an insidious process. The next chunk of “errors” mounting from 40 to 50 percent will come in the name of ICD-10. After all of the scare tactics imposed upon physicians, the implementation of ICD-10, on the clinical side, isn’t that tough. Diseases have codes and will use the new ones. My projection is that companies like UHC, who boast that they insure 75 million of us, will experience “technical issues” with the conversion that will translate to billions per month in profit. The Times will write an article about it as the dividend checks are being cashed. Insurance executives are already spending quality time with their architects, who are designing their new, larger, summer homes in the Hamptons.

Conversion is not that difficult, and one would imagine that companies with revenues larger than many countries should possess the wherewithal to knock this down with excellent precision and, given their scale, for a nominal cost. In the first quarter of ICD-10, they will pay 75 percent of our claims; they will sincerely apologize and then boast that, in the second quarter, that has improved to 82 percent. The profits will be immense and their penalty will be a scathing Times article.

Dear Anthem, Cigna, Aetna, Humana, United HealthCare and MetLife, please prove me wrong!
Elliot M. Kirstein OD, FAAO
Director - Harper’s Point
Eye Associates, Cincinnati