Sag Harbor Long Island

Rewards Increased Again in LI Wildlife Attack Probes

Rewards have increased to more than $10,000 for information leading to an arrest in each of five brutal attacks on wildlife on eastern Long Island last month, Suffolk County SPCA officials said.

A turtle was found with a nail driven through it in Sag Harbor on July 5, someone shot an arrow through a swan in Riverhead on July 22 and a guest at the Royal Atlantic Hotel in Montauk stoned a seagull to death between 2 and 4 p.m. Saturday, July 23, officials said.

United Healthcare | The Sag Harbor Express

By Karl Grossman

The other day I noticed a small, six-paragraph article in the New York Times, tucked away next to a spread on the Murdoch phone-hacking scandal, a piece headlined: “Profit Up 13%, United Health Raises Outlook.” And I thought of the stand-off between United Healthcare/Oxford and the East End Health Alliance.

The contract between United Healthcare/Oxford and the alliance which represents the three East End hospitals, expired on July 15. This has meant 3,000 residents who use Oxford’s self-insured plans have to pay costlier, out-of-network rates or go up-Island for care. And if no settlement is reached by September 15, an additional 12,000—those enrolled in other Oxford plans such as Oxford Liberty and Oxford Freedom—will be in the same situation. United Healthcare/Oxford, after Empire Blue Cross Blue Shield, has the most health insurance subscribers on the East End.

It’s playing hardball with the alliance which represents Southampton Hospital, Eastern Long Island Hospital in Greenport and the Peconic Medical Center in Riverhead.

“Our goal is to simply have the reimbursement rates reflect our costs,” says Paul Connor III, president and CEO of Eastern Long Island Hospital and spokesperson for the alliance.

In other words, the three hospitals, all non-profit entities, are seeing to be fairly reimbursed by United Healthcare/Oxford which, as the Times piece chronicles, is very much a for-profit entity.  The “good news” for the private health insurance industry “appears likely to continue,” said the Times article. With its “double-digit increase in profits,” United Healthcare/Oxford has “raised its estimates for 2011 earnings…Its net income rose 13 percent, to $1.27 billion.”

In addition to seeking fair reimbursement, the three East End hospitals are trying to achieve equivalency with what health insurers pay western Suffolk hospitals. “We know what the market rates are and we are looking to get parity,” said Mr. Connor.

Health insurers have given East End hospitals less because they regard this area as rural, similar to upstate New York where costs are lower. That, of course, isn’t the economic reality of the East End.

Dr. Martha Livingston is an expert on health care—indeed, she teaches about it as professor of health and society at the State University of New York/College at Old Westbury (where for 32 years I’ve taught journalism)..She is also co-editor of the book, 10 Excellent Reasons for National Health Care. And she is on the board of the New York chapter of Physicians for a National Health Care Program.

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