danielsangeo
Oh really???
Have you ever dealt with Medicaid before? I have, I had to get a statement from the family Dr. saying my baby HAD to have a pull through done. Then we had to get a statement from the specialist who was going to the the operation stating it was necessary, under the threat of being DROPPED!
My insurance only needs a phone call from the Dr. preforming the operation.
Yes government ran bleeep will be so much better.
danielsangeo
That would be no different then medicaid denying the claim. The point is that you are comparing one practice to another and with my experience Medicaid need written information and insurance needs a phone call.
As well with the insurance IF you do not follow through then you pay more, with Medicaid, if you do not follow through you get dumped.
cdward, yes, I saw that story; sad that a heart attack survivor can’t afford his prescriptions, including anti-clotting drug that could save his life
my tintown, I have no experience with Medicaid or MediCal, but do know that Medicaid (MediCal) used to rampant with fraud and abuse, so the program needs to be administered with sufficient oversight for all non-emergency procedures.
I think it’s great that you like your private insurance, but I can tell you physicians, hospitals and other healthcare providers don’t always find them so easy to deal with. In addition, it is by definition very costly to have to deal with hundreds of different insurance cos, all with their differing rules for prior authorizations, what’s covered and what’s not and protocols for seeking approvals. An ortho doc I saw recently outfitted his office staff with Bluetooths because the average wait time on the phone for insurance cos. was 45 minutes. Really efficient.
Medicare’s administrative fees are between three to five percent. Private health insurer’s fee range between 20 to as high as 35 percent. Fact.
There is only one way to limit health related expenses- limit access.
DrCanuck, you couldn’t be more wrong. Nobody anywhere has a handle on health care and expenses. Here in the US if you need a hip replacement you schedule it for next week. In Canada it is scheduled in 18 months.
80% of the Canadian population lives within 100 miles of the US and come here when their system doesn’t work.
DrCanuck
Ask people who really have experienced them what they think, you know the ones that are on a waiting list for a year or 2 before they can get treatment on a disease that will kill them in 6 months to a year.
Example:
A Co-worker has a very, very rare blood cancer. He talks to many people around the world. He got a treatment for it almost immediately in the USA and where the health care is socialized people are on a nice waiting list to get treatment. They will more then likely die before getting any treatment. This is also true for those who need neurosurgeons, etc. in Canada.
This is the true socialized health care.
believecommonsense
I never said I like it, but the point was contacting the insurance company before work can begin and I have true experience (on not 1 but 2 cases) of having to get information before going to the doctor. Daughter had to have a pull-through operation at 7 months old and now she has been diagnosed with celiac diseases.
It was a bigger pain then calling an insurance company and waiting 45 minutes for an answer.
DrCanuck, I don’t know if you really are a physician but I am. My stories were related to me by my Canadian physician colleagues. If you don’t believe them you have been brainwashed by the liberal MSM.
Because in our discussion you professed some inner knowledge of international health care by being a physician. I don’t believe that. If you were, you wouldn’t make foolish generalities that are inane.
“all industrialized countries have perfectly good functioning universal health care”.
No physician would write that. No mention of long waits, less current technology, defensive medicine etc just “all industrialized countries have perfectly good functioning universal health care”.
GNWachs
Maybe his name could be DrQuack?
You also forget to mention with socialized medicine you can count on Doctors being fewer in number (less people working and massively less pay) and much insanely higher taxes.
It was my PRIVATE INSURANCE company that wanted a nurse (not a doctor) to PRE-authorize an emergency room visit for a possible heart attack. There are several countries where single payer systems, WITH private practitioners still very much in business, work very well. Letting private corporations determine my medical NEEDS is like GM telling us we all needed massive SUVs, Hummers, and giant trucks the size of semis to get a kid to preschool. When the public didn’t buy it, the company died. In medicine, YOU, the patient will die.
mytintown, it’s not just waiting 45 min on phone for a doctor (not a patient, a DOCTOR) to speak to insurance staffer that is wrong with our system. I cited that as an example of inefficiency and waste and cost shifting to providers.
i’ve already given so many examples of people who’ve been denied care by PRIVATE insurers, I’m tired of citing them over and over again. Insurers make their profit by denying and delaying care. The less they authorize, the less they pay for, the more they make. That is their only incentive since we don’t regulate them in any way.
In the 90s, the health insurance special interest lobby persuaded the California legislature to pass a law saying it was illegal to sue an HMO. Guess what? That law was rescinded rather quickly when it became obvious the HMOs were using it to deny care and people were dying as a result. That’s the way the free market private health insurers think. it’s all about profits and big numbers on Wall St. for shareholders. Shoot, some of the stocks for the largest health insurers were showing profit percentages in the thousands throughout the 90s. (That’s in the histolrical record, you can find it online.)
and AnAndy you really are blowing smoke on this one ….
there are NO mandates or regulations on private health insurers for God’s sake …. they can turn anybody down for coverage for anything … they can set any rule or protocol for coverage they choose …. they can just about get away with anything these days
if you have asthma, insurers won’t sell you an individual policy (and that admission came from the lobbyist for private health insurers).
We privatized the healthcare market to control costs and all the private free market healthcare supporters said it would be more efficient than the non-profit healthcare insurers were.
Didn’t happen, not even close. Costs soared, more medium and small employers couldn’t afford to get health insurance for their employees any longer and the number of uninsured rose astronomically. Quality indicators dropped, insurance cos. pushed for drive-by births (12-hours) causing incidence of problems for infants and mothers to rise.
The list is endless what was been wrought by unfettered healthcare based on greed and profit.
‘666’ guy you are, once again, full of it.
You remind me of my nephew who was so angry at his mother being denied a CT scan on her clogged neck artery and one month later had a stroke. He ranted on and on about government needing to get out of healthcare.
But, nephew, I said, your mother has private health insurance, there were no government agencies or rules involved. This decision was made by the private insurer, not the doctor, nor the hospital. He just glared at me and later that same day started the same rant about government needing to get out of medical care. (And this is in Louisiana which doesn’t regulate much of anything BTW)
I love my nephew, but I just don’t get why someone would deliberately choose to pull their wool over their own eyes and keep it there.
Let’s hear from everyone who is a Canadian on their health care (CF, where are you?). Are you relatively happy? Because nearly every US citizen is unhappy with their health care (unless, of course, they are rich). I have what is considered to be very good insurance and really can’t complain. But even so, premiums are going up as are co-pays, while coverage is shrinking. If my job ever decides to drop coverage, I’ll be in a world of hurt.
BTW, I’ve lived in Canada and Germany, and would prefer the care given there in general to what is given here. It’s only when it comes to big-ticket items (which only the rich can afford) that we truly excel.
believecommonsense
I said the same thing can be true about Medicaid. So it is no better.
BTW With my insurance if it is an emergency, you have so long AFTER you leave to clear it up. They only need a call if you are planning a visit. JUST LIKE MEDICAID (well Medicaid needed it in writing from the Dr.)!
In NY State every medical insurance company is mandated to cover:
acupuncture
podiatry
midwives
2 days in hospital after delivery
equal mental health coverage
in-vitro fertilization (in Illinois my 49 year old cousin just gave birth literally last month after 3 X $15,000 cycles paid for by the State)
plus dozens and dozens of others
Of course these raise the insurance premiums and force many people to forgo coverage
Blue Cross is a non profit company and charges the same premiums as for profit companies
Sorry, tiny. Regardless of what I think of your arguments, that was a cynical and unfair remark I made. Forgive me. I was in a bad mood and took it out on you.
The “patient” is sick. But the U.S. Congress shouldn’t be the doctor.
Yet, the ubiquitous “government” is forced to intercede when the private market has failed so miserably. Private interests care only for private interests. Medicine is a domain of the public. Therefore, private interests are incompatible with the needs of the public domain. There has never been in the history of the world a private company that acted solely in the public good. And there never will be.
And, so, who should be the one to cure the ills of the U.S. healthcare system and manage its symptoms? Doctors. Physicians. The practitioners themselves. But, again, that cannot happen, because the house of medicine does not have providence on reforming institutions. It has neither the clout nor the means to affect change. And, so, government must step in to correct what only it can correct.
And before we are dishonest about all of this, government must interject, for it is in its own best interest to force change. Fittingly, the changes instituted now will benefit the citizenry, private companies and other public institutions. And then, by gosh, we would have … government in action.
It’s more than a little shocking that some folks sit on the sideline and rail about government not working; yet, when it does, these same folks only throw more derision into the public sphere.
GN Wachs said: ”Blue Cross is a non profit company and charges the same premiums as for profit companies”
No, Blue Cross is any number of different plans. It used to be not-for-profit, now it can be either. check wikipedia:
Blue Cross and/or Blue Shield insurance companies are franchisees … Many plans are administered by not-for-profit organizations, while others are for-profit companies. … The 14-state WellPoint is the largest Blue Cross Blue Shield member, and is a publicly traded company.
and
In the past Blue Cross Blue Shield has been successfully sued and fined for denying due medical treatments to their customers and underpaying doctors.
the entire health care industry is far more complex than most realize. that is one of the reasons that it is so inefficient and adds so much unnecessary costs (waste) to the actual providers because the bureaucracy of having to deal with hundreds or thousands of different insurance co. rules and protocols.
believecommonsense almost 15 years ago
and puhhleeease take care of the ailing patient so he doesn’t have to come back in a couple of years for a fix of the fix of fix
cdward almost 15 years ago
See today’s NYT. http://www.nytimes.com/2009/06/04/us/04pharmacy.html?th&emc=th
Joe Snedaker almost 15 years ago
believecommonsense Yes because Dr’s will be there to fix him up so much better after the “Obama fix” right?
danielsangeo almost 15 years ago
mytinytown: Yes. And better than now when they have to get permission from an insurance company to perform certain procedures.
Joe Snedaker almost 15 years ago
danielsangeo Oh really??? Have you ever dealt with Medicaid before? I have, I had to get a statement from the family Dr. saying my baby HAD to have a pull through done. Then we had to get a statement from the specialist who was going to the the operation stating it was necessary, under the threat of being DROPPED! My insurance only needs a phone call from the Dr. preforming the operation. Yes government ran bleeep will be so much better.
danielsangeo almost 15 years ago
“My insurance only needs a phone call from the Dr. preforming the operation.”
And if the insurance company denies the claim?
Joe Snedaker almost 15 years ago
danielsangeo That would be no different then medicaid denying the claim. The point is that you are comparing one practice to another and with my experience Medicaid need written information and insurance needs a phone call. As well with the insurance IF you do not follow through then you pay more, with Medicaid, if you do not follow through you get dumped.
believecommonsense almost 15 years ago
cdward, yes, I saw that story; sad that a heart attack survivor can’t afford his prescriptions, including anti-clotting drug that could save his life
my tintown, I have no experience with Medicaid or MediCal, but do know that Medicaid (MediCal) used to rampant with fraud and abuse, so the program needs to be administered with sufficient oversight for all non-emergency procedures.
I think it’s great that you like your private insurance, but I can tell you physicians, hospitals and other healthcare providers don’t always find them so easy to deal with. In addition, it is by definition very costly to have to deal with hundreds of different insurance cos, all with their differing rules for prior authorizations, what’s covered and what’s not and protocols for seeking approvals. An ortho doc I saw recently outfitted his office staff with Bluetooths because the average wait time on the phone for insurance cos. was 45 minutes. Really efficient.
Medicare’s administrative fees are between three to five percent. Private health insurer’s fee range between 20 to as high as 35 percent. Fact.
GNWachs almost 15 years ago
There is only one way to limit health related expenses- limit access.
DrCanuck, you couldn’t be more wrong. Nobody anywhere has a handle on health care and expenses. Here in the US if you need a hip replacement you schedule it for next week. In Canada it is scheduled in 18 months. 80% of the Canadian population lives within 100 miles of the US and come here when their system doesn’t work.
Joe Snedaker almost 15 years ago
DrCanuck Ask people who really have experienced them what they think, you know the ones that are on a waiting list for a year or 2 before they can get treatment on a disease that will kill them in 6 months to a year. Example: A Co-worker has a very, very rare blood cancer. He talks to many people around the world. He got a treatment for it almost immediately in the USA and where the health care is socialized people are on a nice waiting list to get treatment. They will more then likely die before getting any treatment. This is also true for those who need neurosurgeons, etc. in Canada. This is the true socialized health care.
Joe Snedaker almost 15 years ago
believecommonsense I never said I like it, but the point was contacting the insurance company before work can begin and I have true experience (on not 1 but 2 cases) of having to get information before going to the doctor. Daughter had to have a pull-through operation at 7 months old and now she has been diagnosed with celiac diseases. It was a bigger pain then calling an insurance company and waiting 45 minutes for an answer.
GNWachs Thank you for backing up my point!
GNWachs almost 15 years ago
DrCanuck, I don’t know if you really are a physician but I am. My stories were related to me by my Canadian physician colleagues. If you don’t believe them you have been brainwashed by the liberal MSM.
GNWachs almost 15 years ago
DrCanuck, where do you practice? What newspapers do you read? What is your specialty?
GNWachs almost 15 years ago
DrCanuck
Because in our discussion you professed some inner knowledge of international health care by being a physician. I don’t believe that. If you were, you wouldn’t make foolish generalities that are inane.
“all industrialized countries have perfectly good functioning universal health care”.
No physician would write that. No mention of long waits, less current technology, defensive medicine etc just “all industrialized countries have perfectly good functioning universal health care”.
Joe Snedaker almost 15 years ago
GNWachs Maybe his name could be DrQuack? You also forget to mention with socialized medicine you can count on Doctors being fewer in number (less people working and massively less pay) and much insanely higher taxes.
edrush almost 15 years ago
For once, I agree with Ms. Benson – the US health-care system is very ill and needs surgery now.
Dtroutma almost 15 years ago
It was my PRIVATE INSURANCE company that wanted a nurse (not a doctor) to PRE-authorize an emergency room visit for a possible heart attack. There are several countries where single payer systems, WITH private practitioners still very much in business, work very well. Letting private corporations determine my medical NEEDS is like GM telling us we all needed massive SUVs, Hummers, and giant trucks the size of semis to get a kid to preschool. When the public didn’t buy it, the company died. In medicine, YOU, the patient will die.
believecommonsense almost 15 years ago
mytintown, it’s not just waiting 45 min on phone for a doctor (not a patient, a DOCTOR) to speak to insurance staffer that is wrong with our system. I cited that as an example of inefficiency and waste and cost shifting to providers.
i’ve already given so many examples of people who’ve been denied care by PRIVATE insurers, I’m tired of citing them over and over again. Insurers make their profit by denying and delaying care. The less they authorize, the less they pay for, the more they make. That is their only incentive since we don’t regulate them in any way.
In the 90s, the health insurance special interest lobby persuaded the California legislature to pass a law saying it was illegal to sue an HMO. Guess what? That law was rescinded rather quickly when it became obvious the HMOs were using it to deny care and people were dying as a result. That’s the way the free market private health insurers think. it’s all about profits and big numbers on Wall St. for shareholders. Shoot, some of the stocks for the largest health insurers were showing profit percentages in the thousands throughout the 90s. (That’s in the histolrical record, you can find it online.)
and AnAndy you really are blowing smoke on this one …. there are NO mandates or regulations on private health insurers for God’s sake …. they can turn anybody down for coverage for anything … they can set any rule or protocol for coverage they choose …. they can just about get away with anything these days
if you have asthma, insurers won’t sell you an individual policy (and that admission came from the lobbyist for private health insurers).
We privatized the healthcare market to control costs and all the private free market healthcare supporters said it would be more efficient than the non-profit healthcare insurers were.
Didn’t happen, not even close. Costs soared, more medium and small employers couldn’t afford to get health insurance for their employees any longer and the number of uninsured rose astronomically. Quality indicators dropped, insurance cos. pushed for drive-by births (12-hours) causing incidence of problems for infants and mothers to rise.
The list is endless what was been wrought by unfettered healthcare based on greed and profit.
‘666’ guy you are, once again, full of it.
You remind me of my nephew who was so angry at his mother being denied a CT scan on her clogged neck artery and one month later had a stroke. He ranted on and on about government needing to get out of healthcare.
But, nephew, I said, your mother has private health insurance, there were no government agencies or rules involved. This decision was made by the private insurer, not the doctor, nor the hospital. He just glared at me and later that same day started the same rant about government needing to get out of medical care. (And this is in Louisiana which doesn’t regulate much of anything BTW)
I love my nephew, but I just don’t get why someone would deliberately choose to pull their wool over their own eyes and keep it there.
cdward almost 15 years ago
Let’s hear from everyone who is a Canadian on their health care (CF, where are you?). Are you relatively happy? Because nearly every US citizen is unhappy with their health care (unless, of course, they are rich). I have what is considered to be very good insurance and really can’t complain. But even so, premiums are going up as are co-pays, while coverage is shrinking. If my job ever decides to drop coverage, I’ll be in a world of hurt.
BTW, I’ve lived in Canada and Germany, and would prefer the care given there in general to what is given here. It’s only when it comes to big-ticket items (which only the rich can afford) that we truly excel.
Joe Snedaker almost 15 years ago
believecommonsense I said the same thing can be true about Medicaid. So it is no better. BTW With my insurance if it is an emergency, you have so long AFTER you leave to clear it up. They only need a call if you are planning a visit. JUST LIKE MEDICAID (well Medicaid needed it in writing from the Dr.)!
tpenna almost 15 years ago
Hey, I like this Canuck guy!
Joe Snedaker almost 15 years ago
DrCanuck Are you living in lala land? Some fake utopia? In the real word it is like that no place.
tpenna almost 15 years ago
Haha! I get it, tiny! That’s good! Cause it means you’ve run out of real arguments and you’re down to a couple of salvos of feigned incredulity.
Joe Snedaker almost 15 years ago
tpenna Actually I made me point earlier a few times. I have nothing more to say.
GNWachs almost 15 years ago
In NY State every medical insurance company is mandated to cover:
acupuncture podiatry midwives 2 days in hospital after delivery equal mental health coverage in-vitro fertilization (in Illinois my 49 year old cousin just gave birth literally last month after 3 X $15,000 cycles paid for by the State)
plus dozens and dozens of others
Of course these raise the insurance premiums and force many people to forgo coverage
Blue Cross is a non profit company and charges the same premiums as for profit companies
tpenna almost 15 years ago
Sorry, tiny. Regardless of what I think of your arguments, that was a cynical and unfair remark I made. Forgive me. I was in a bad mood and took it out on you.
BirishB almost 15 years ago
The “patient” is sick. But the U.S. Congress shouldn’t be the doctor.
Yet, the ubiquitous “government” is forced to intercede when the private market has failed so miserably. Private interests care only for private interests. Medicine is a domain of the public. Therefore, private interests are incompatible with the needs of the public domain. There has never been in the history of the world a private company that acted solely in the public good. And there never will be.
And, so, who should be the one to cure the ills of the U.S. healthcare system and manage its symptoms? Doctors. Physicians. The practitioners themselves. But, again, that cannot happen, because the house of medicine does not have providence on reforming institutions. It has neither the clout nor the means to affect change. And, so, government must step in to correct what only it can correct.
And before we are dishonest about all of this, government must interject, for it is in its own best interest to force change. Fittingly, the changes instituted now will benefit the citizenry, private companies and other public institutions. And then, by gosh, we would have … government in action.
It’s more than a little shocking that some folks sit on the sideline and rail about government not working; yet, when it does, these same folks only throw more derision into the public sphere.
believecommonsense almost 15 years ago
GN Wachs said: ”Blue Cross is a non profit company and charges the same premiums as for profit companies”
No, Blue Cross is any number of different plans. It used to be not-for-profit, now it can be either. check wikipedia:
Blue Cross and/or Blue Shield insurance companies are franchisees … Many plans are administered by not-for-profit organizations, while others are for-profit companies. … The 14-state WellPoint is the largest Blue Cross Blue Shield member, and is a publicly traded company.
and
In the past Blue Cross Blue Shield has been successfully sued and fined for denying due medical treatments to their customers and underpaying doctors.
the entire health care industry is far more complex than most realize. that is one of the reasons that it is so inefficient and adds so much unnecessary costs (waste) to the actual providers because the bureaucracy of having to deal with hundreds or thousands of different insurance co. rules and protocols.
believecommonsense almost 15 years ago
tpenna, nice that you apologized for an intemperate remark.
ConnorP almost 15 years ago
There is no money with the tools. That’s what they’re probably going to try and fix him with.