If health care reform fails, expect...

...to see more articles like this one in the Times today (all emphasis mine):

A front in the national health care battle has opened in New York City, where a major hospital chain and one of the nation’s largest insurance companies are locked in a struggle over control of treatment and costs that could have broad ramifications for millions of people with private health insurance.

The fight is between Continuum Health Partners...and UnitedHealthcare, which includes Oxford health plans and has 25 million members across the country, one million of them in New York.

While Congress has been haggling over covering as many as 15 million uninsured Americans, the prestigious hospitals and the major health insurer have been in bitter contract negotiations, not just over rates but also over UnitedHealthcare’s demand that the hospitals notify the insurance company within 24 hours after a patient’s admission. If a hospital failed to do so, UnitedHealthcare would cut its reimbursements for the patient by half.

The hospitals say that having their reimbursement cut in half is too much to pay for a clerical error, and that the revenue drain would ultimately hurt their patients.
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UnitedHealthcare has sent letters over the last few weeks to tens of thousands of patients, warning that they could be cut off from coverage at Continuum hospitals and affiliated doctors, and advising them to start shopping for new ones.
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Dr. Sam Ho, UnitedHealthcare's chief medical officer...said that UnitedHealthcare’s push for notification was not motivated by money and that it would be happy if it never had to impose a penalty.

"Absolutely, honestly, sincerely, this is a genuine attempt to try to improve outcomes for patients,” he said.

Uh-huh.

Integris Health, an 11-hospital system based in Oklahoma City, has tried to meet the notification requirement and has been frustrated by the administrative burden, even using electronic notification, said Greg Meyers, vice president for revenue integrity. “That doesn’t feel to us like cost control, it feels like a revenue stream enhancement to the insurance companies,” Mr. Meyers said.
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Dr. Gary Burke, a doctor affiliated with St. Luke’s-Roosevelt Hospital Center, said the letters warning that coverage with Continuum doctors could be cut off left some of his older patients panicked at the prospect of losing a long-term relationship with a doctor they trusted.

“They’re kind of like, ‘If I get sick, does this mean I can’t see you?’ ” Dr. Burke said.

“It’s an example of the insurance company getting between you and your doctor,” Dr. Jeffrey Rubin, an economics professor at Rutgers University.

Absent health care reform (and given last week's Supreme Court decision lifting the limits on campaign spending by corporations), do you think health insurance companies will be better, or worse, corporate citizens?