It’s always nice to see
At least, that’s the impression fans of Fox’s “House M.D.” got from the show’s Feb.8 episode. Detailing a hectic day in the life of Princeton Plainsboro Hospital Administrator Dr. Lisa Cuddy (Lisa Edelstein), three of the episode’s four story lines involved insurance.
In one story line, a former patient was suing the hospital for reattaching his severed thumb. The surgeon who had done it explained that, “his insurance only covered 60 percent of his in-patient expenses,” so the patient wanted only the least expensive option. The surgeon reattached it anyway. “I wasn’t going to let him throw his thumb away over a few dollars.” Owing the money for the procedure to the insurance company, the man protested to Cuddy that he was in danger of losing his house.
In another scene, Cuddy was consulting a patient with cancer who was convinced that human breast milk was his only cure. When she refused to write him a prescription for it, he accused her of being “some type of shill for the insurance company.” He had paid premiums all this life, he said, and never been sick a day, but was now being denied the only thing that would save him. Cuddy assured him her refusal had nothing to do with insurance, and the scene ended.
But in the main story, Cuddy was renegotiating the terms of the hospital’s contract with a major regional insurer. Because her hospital was small, it couldn’t get the same reimbursement rates that larger, though less prestigious institutions received. “It’s about leverage,” said the insurance company negotiator. “They have it. You don’t.”
Going above his head, Cuddy burst in on the head of the insurance company at lunch in suitably exclusive-looking restaurant. “Princeton Plainsboro has the highest rated ER in the state,” she said, “the most advanced ICU, “and the most innovative diagnostic medicine department in the entire country.”
When the CEO tried to dismiss her, she said, “While Atlantic Net Insurance has a marketing budget that’s more than our pediatric ICU and transplant units combined. Your PGA sponsorship could pay for our walk-in clinic, and the money you spend to fuel your two private jets could fund our air ambulance service for the next three years.”
Cuddy’s point, she explained, was that “Your growth may be good for your bottom line but ours allows us to save lives.” She then threatened to go public with Atlantic Net’s … well, the show never really explained what exactly the company had done wrong. But it’s an insurance company, so it must be something.
Had he had a black mustache, the CEO would have twirled it while delivering his response: “You can portray me as a rich bastard in the press all you want … just as long as I stay rich.”
“House” is far from the first