Each state government regulates their health insurance industry’s rates and performance. If the rates are high, they have to be justified to the State Insurance Commissioner.
BTW, Medicare has a higher denial rate of claims than the private insurers.
Treered, are you familiar with mandates?
Mental health expenses must be covered, plastic surgery that is medically needed, burn victim care, geriatric care. California passed that sex change operations had to be covered by insurance. Physical therapy, occupational therapy, speech therapy, hearing disorders and the surgery or physical apparatus to improve hearing. INSURANCE pays. It is also a business, not a non-profit.
A lot of things need to be preauthorized for insurance to pay for it. Sometimes they reject it, so the doctor has to submit again substantiating the need. You have to pay the people to read it, act on it.
You hit the nail on the head when you said “Insurance is a business, not a non-profit.” So long as we have for-profit insurance companies in the health care area, we’ll have the problem. For-profit companies need to have, as their first obligation, make a profit that can give a return to investors. We need to take them out of health care and have non-profit companies instead. Kaiser Permanente is an example. Sure they have to cover costs and have funds set aside for future needs, but they don’t have to pay stockholders. We need more non-profit insurance companies in health care, not fewer, and not with conversions to for-profit as occurred with Blue Cross, Humana, and others. Let them insure in other areas such as auto and home, where people who are insured have a lower chance of needing that insurance. Health insurance has to be first and foremost, for those needing coverage.
treered about 14 years ago
and he should trust Anthem/Blue Cross with a 39% premium increase? or denials of claims? or 20 year delays in court for contested coverage?
HEALTH CARE REFORM NOW! WE CAN’T AFFORD TO WAIT!
parrotthead2009 about 14 years ago
Each state government regulates their health insurance industry’s rates and performance. If the rates are high, they have to be justified to the State Insurance Commissioner.
BTW, Medicare has a higher denial rate of claims than the private insurers.
Imajs Premium Member about 14 years ago
Treered, are you familiar with mandates? Mental health expenses must be covered, plastic surgery that is medically needed, burn victim care, geriatric care. California passed that sex change operations had to be covered by insurance. Physical therapy, occupational therapy, speech therapy, hearing disorders and the surgery or physical apparatus to improve hearing. INSURANCE pays. It is also a business, not a non-profit.
A lot of things need to be preauthorized for insurance to pay for it. Sometimes they reject it, so the doctor has to submit again substantiating the need. You have to pay the people to read it, act on it.
Yes something needs to be done, this isn’t it.
rekam Premium Member about 14 years ago
Imajs:
You hit the nail on the head when you said “Insurance is a business, not a non-profit.” So long as we have for-profit insurance companies in the health care area, we’ll have the problem. For-profit companies need to have, as their first obligation, make a profit that can give a return to investors. We need to take them out of health care and have non-profit companies instead. Kaiser Permanente is an example. Sure they have to cover costs and have funds set aside for future needs, but they don’t have to pay stockholders. We need more non-profit insurance companies in health care, not fewer, and not with conversions to for-profit as occurred with Blue Cross, Humana, and others. Let them insure in other areas such as auto and home, where people who are insured have a lower chance of needing that insurance. Health insurance has to be first and foremost, for those needing coverage.
davesmithsit about 14 years ago
The jack@sses in congress shouldnt be trusted with a popsicle over carpet much less health care.
oneoldhat about 14 years ago
you will soon find out why i did not pay in
James Lindley Premium Member about 14 years ago
Sure, what could go wrong?
Justice22 about 14 years ago
I did not see the GOP turning down any of the SS surplus while they were in charge.