Health Insurance and the 'Racketeer Influenced and Corrupt Organizations Act' {RICO}

originally posted by: syrinx high priest

Obama care is an unmitigated disaster. We desperately need single payer

Also, we do NOT need "single payer" (socialism). What we need is to have the insurance rackets oulawed and return medicine back to an honest and straightforward business where you go to a doctor and you get a bill and you pay the bill. Doctors will have to deal with the backlash if they charge prices people can't afford and competition will do it's thing.

The middle man is usually the source of the trouble and the insurance mafia is the middleman. This middleman allows doctors and hospitals to charge whatever they want and people don't care because the insurance company pays the bill.

But what will happen is this healthcare mafia will take over your life eventually if you let it. "Single payer" will not change the prices. It will just turn the government into an insurance company. And they will still try to avoid having to pay for "unnecessary" expenses. Which in plain English means if they think your lifestyle is unhealthy, they will try to ban it and/or punish you for it. Which is (in plain English) totalitarianism in the flesh.

You see. It actually turns out that "The greater good" means you're personally screwed if you're not a team player.

a reply to: BrianFlanders

Our government, AKA the mob.

a reply to: BrianFlanders

by law it has to have the same active and inactive ingredients. It is the same compound without the advertising budget.

a reply to: BrianFlanders

lol. It is not socialism. it is not a form of government or economic policy. Don't be intentionally obtuse. It is leveraged volume buying, a cornerstone of capitalism

originally posted by: syrinx high priest
a reply to: AlienView

thank you for that explanation.

That seems like the dreaded coding mistake. It seems like the providers status changed, and the claims are being processed with the old, incorrect information.

I wouldn't go to crazy with RICO and mail fraud angle, what you need is a claims rep to kick this up to a manager. My suggestion would be to gather all the relevant EOB's and bills and ask for an in-person review or appeal hearing.

My experience is you can get much further along in-person.

I know its a hassle but it seems like a correctable issue.

Also, you also said: lol. It is not socialism. it is not a form of government or economic policy. Don't be intentionally obtuse. It is leveraged volume buying, a cornerstone of capitalism

So he receives a call from the company agent in charge of Medicare complaints - Again [this has been going on for over
six weeks] assuring him it is just a mistake and when he mentions coding error she assure him yes that is the problem and
all will be strraightened out - And he asks for it in writing - Soon she says, when we straighten it out !

Of course he has become quite cynical and still feels obligated to reply to a 'denial of coverage' letter - feels obligated to use a third party mailing service for mailing reply - companies that make mistakes can easily lose letters can't they?

Now let's say you are right and that it is not a RICO or fraud issue - Just one of those convenient mistakes that allows for
the delayed payment of a valid claim? - And then he thinks he sees the light

Obama was right - the medical system was [is] unsustainable - Costs of medical care are too high - most people can't
afford them - So Obamacare bails out the insurance industry by giving it a new cash cow - everyone must have health insurance and therefor must contribute to the system - but does it work

Maybe not - Now you have millions of more people in the system - requiring healthcare and even with the new payees in the
system there is still not enough money - So now what do you have ? A huge amount of what amounts to bad debt
- the only way the insurance companies can sustain themselves is by floating bad debt as mistakes - the more mistakes the
less money has to be paid out while they sort out the mistake

Now I ask you, could he be right And is this system sustainable

a reply to: AlienView

I hope your friends problem is resolved.

Everybody in the industry knew ACA would be a disaster. It was classic "adverse selection" which is a fancy way of saying the only people who buy insurance need insurance.

I fully expect it to go into the premium death spiral and collapse

originally posted by: syrinx high priest
a reply to: BrianFlanders

lol. It is not socialism.

LOL

Actually, it is. But I understand you have to avoid the S word. People will do anything to avoid calling it what it is. They even came up with this nonsensical "single payer" crap. I initially found it funny, as I did not think people were foolish enough to not see it for what it is. But I was wrong. They are not foolish enough to call it what it is. They just pretend they don't know any better and they just ignore and argue with anyone who tries to say different.

Putting the government in control of healthcare is socialism. And it is totalitarian. And those who want to control every aspect of our lives absolutely WILL use it against us.

Turning the government into the world's biggest monopolized health insurance racket is the worst idea in modern history. Well, I shouldn't say it's a bad idea FOR THEM. Because most governments are inherently totalitarian at heart and will gradually gravitate more and more in that direction as they have the opportunities. It's a horrendous idea for anyone who cares about their rights.

You want the right to have the government pay for your medical bills? In exchange for that, you will trade every other solitary right you think you have. They will own you. They already own a large portion of your life but they will own you so completely that you will not be able to have a thought about not enjoying how bad you're getting screwed.

BrianFlanders wrote:

You want the right to have the government pay for your medical bills? In exchange for that, you will trade every other solitary right you think you have. They will own you. They already own a large portion of your life but they will own you so completely that you will not be able to have a thought about not enjoying how bad you're getting screwed.

And the alternative is to allow a corrupt group of racketeers/mobsters get you in debt, bankrupt you, and make the Mafia look like a benevolent organization.

Anyone who does not believe basic healthcare is a basic Human right is an ideological criminal of the first order.

You who say let the strong survive, and the hell with everyone else, survival of the fittest, are more of a threat to the
Republic of the United States of America than all the terrorists in the world combined.

This type of ideology is the enemy of good people anywhere in the world - A world where all developed civilized nations [except the US] supply basic healthcare to its citizens - And you think you should live because you can afford to pay and I can't - this type of thinking, not Socialism is the enemy of the United States, a Nation that states - ALL MEN ARE CREATED EQUAL