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Why we push for healthcare reform

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posted on Mar, 27 2010 @ 10:28 PM
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Originally posted by mnemeth1
reply to post by Janky Red
 


Things are only that way because of government intervention in the markets.

In a free market, no one would do business with such a company.

Insurance would be super-streamlined.

Things would move like clockwork.

As I already pointed out, things are only that way because of the massive regulation involved.

Competition would weed out the crap companies that are inefficient and provide horrible service.


MNEM

They are that way because there are 100's of companies with exponential nuances
that come with each individual company. That is not the govenrments fault, that is
the very nature of the reality.

That you would come back with that makes me think you did not even read my post.
Many of these companies design frustration into their claims process so that they will save money by driving the contracted providers and staff crazy in hope that some will give up trying to connect.

They split payments hoping you will fail to place a claim on the balance.

On another note - here is the link to the government standardized diagnosis codes

there are 20,000 +

Could you imagine if this was NOT standardized???

www.dimdi.de...

Then Procedure codes

Then RX codes

tens and tens and tens of thousands of variations


So if this portion was not standardized by the government how in the hell would this modern system operate???

In pen and ink???

Read thru the various random records while a minute could mean life and death?

If the standard for you is NO government, well, your aim is NOT realistic, at ALL.


I'M NOT YELLING!!!





[edit on 27-3-2010 by Janky Red]




posted on Mar, 27 2010 @ 10:44 PM
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Originally posted by WTFover
reply to post by Jean Paul Zodeaux
 



Your attempts at special pleading, and arguing that everyone should have health insurance because you believe the cost of your health care will become insurmountable, and bad things will happen if we don't all just play along and buy insurance, while our legislatures continue to tinker with their legislation, (and quite probably much of the tinkering is due to the emotional nature of the crafting of the Bill), is just more fallacy. Why is the cost of health care becoming so insurmountable? This is the issue, and to a lesser extent, why is it you believe you will need to pay for this insurmountable health care?


This brings another thought to mind. The first law of supply and demand: As demand rises, price increases.


I think so, yes, provided supply is low



posted on Mar, 27 2010 @ 10:45 PM
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And again another opponent for reform misses the point.


Originally posted by WTFover
To the OP
From what I understand, the child received the proper care for his condition,


Yes the child did and thats not the point. The issue is not the quality of healthcare or the availability of doctors, nurses. The problem is cost and how it is effecting the middle and lower classes. Ofton in many cases if the cost is not paid for, surgery is refused. Baby Houston got the treated need but at a large cost to the parents. This insurance company refused to cover her treatment so now its going to cost the parents.

Last year alone 60% of banruptruptcies were the cause of healthcare costs. Its draining the middle and lower class. Its all good and all when the sufferers get treatment, its the cost after treatment that puts people in deep debt. You fail to listen and read maybe because you dont want to know the full story, maybe you cannot handle it. The is draining millions of americans, the cost of healthcare, and even those who are insured have to deal with it.


Yet, there is still a demonizing of the insurance company.


Why do you think? You people insist theres nothing wrong with a consumer driven healthcare system run by private insurers but this baby can't even get coverage. How the heck can you insist that this system works if these insurers refuse to cover some people? Tough luck you say? Demonizing the insurance company? Damn straight.


If the procedure had not been performed, due to the lack of insurance coverage, would the blame still be directed to the insurance company?


Why should parents, middle to lower class folk have to deal with the high health costs in this country? When the bulk of income earnings in this country going to healthcare and this is with coverage, while healthcare costs are rising by 16%, why should people just 'deal with it'?
articles.latimes.com...

People like you continue to insist that this government is not doing much to fix the economy and yet you wish to ignore the major part the problem.


While I agree the story of Houston Tracy is a sad one, it ends well, with the health care system working


How did the system work again? The parents could not find coverage for their newborn baby, she needed surgery, she got the surgery, but the insurance company refused to cover them. Now these two business owners are left to fit in the bill numbered in the 1000's. How the heck are they suppose to afford this? Better yet how does it effect their own business and them paying off their own employees? How does this system works when its costs parents dearly to grow a family? To make it worse, baby Houston will continue to live her life the with the big 'pre-existing condition' tag on her and she may verywell not be covered for time to come. How does that cost the country let alone the parents? She's marked for life and she cant even get coverage through this system that you claim 'works'.

[edit on 27-3-2010 by Southern Guardian]



posted on Mar, 27 2010 @ 10:49 PM
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Originally posted by Janky Red
Many of these companies design frustration into their claims process so that they will save money by driving the contracted providers and staff crazy in hope that some will give up trying to connect.


Excellent point! This has spawned a whole industry of claims filing services. Thus, increasing health care costs, even more.

How do you think all of the new reporting requirements, of the HCR bill, will affect costs?



posted on Mar, 27 2010 @ 10:51 PM
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Originally posted by Mykahel
I don't think you quite understand the mindset behind the majority of us who oppose the health care takeover...

The system is messed up, and it needs fixed, but the solution isn't handing it over to the government. If we had a government that we could trust to do the right thing, sure.


Well you trust them to have their greedy fingers hovering over the A-bomb buttons,
do you not???

I mean we provide healthcare to murderers in prison and terrorists who are wounded on the battlefield.

Given these two FACTS, what else???

are you on board now?



posted on Mar, 27 2010 @ 10:55 PM
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reply to post by Southern Guardian
 


Okay, slow down there. Are we talking about health insurance, now, or health care? You have to separate the two, in order to come to any realistic solutions.

And I guess you failed to read my entire post, because you (selectively?) left out the bolded part, when quoting me.


While I agree the story of Houston Tracy is a sad one, it ends well, with the health care system working, even though the health insurance system failed, miserably.






[edit on 27-3-2010 by WTFover]



posted on Mar, 27 2010 @ 11:05 PM
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reply to post by WTFover
 


And if you read I have stated it time and time again, I am refering to coverage and cost, not the quality of healthcare. To me coverage is just as much apart of the healthcare system as quality. Im glad though you made it clear that you agree the system before was not right. That means you agree with the OP for the most part.

[edit on 28-3-2010 by Southern Guardian]



posted on Mar, 27 2010 @ 11:17 PM
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As a side bar, for those not familiar with Cook's Children's Hospital, in Fort Worth, Texas, where Houston was treated...It is an outstanding facility, non-profit and supported, largely, through private charitable contributions. I believe it stands as a testament to my suggestion that many of the health care solutions lie at the local level.

I'm certain most, if not all, costs for Houston's treatment will be absorbed, by the hospital.



posted on Mar, 27 2010 @ 11:25 PM
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Originally posted by WTFover

Originally posted by Janky Red
Many of these companies design frustration into their claims process so that they will save money by driving the contracted providers and staff crazy in hope that some will give up trying to connect.


Excellent point! This has spawned a whole industry of claims filing services. Thus, increasing health care costs, even more.

How do you think all of the new reporting requirements, of the HCR bill, will affect costs?


Depends on if the employment provided is worth it in your eyes...

I would gladly retrain and find a new biz if it would fix this unholy mess.

Um, no...

Insurance really has the power on both sides,

for a doctor to sign up as a provider for an insurance company they have to meet the insurance companies minimum malpractice coverage and sign a contract stipulating
payment and other terms.

What most people do not know is the insurance company usually sets parameters
to what they WILL pay a doctor for (like preexisting conditions on the providers end).

Often times doctors do much more than they will get paid for because insurance is VERY (----------)... special


For example; the doc you see will only get paid for 4 procedures (exams, tests, etc..) via insurance stipulation, but you actually need 8 during your visit...

So doc gives you 8 procedures which would normally cost you $200.00 cash

but you have insurance and all

unfortunately for doc, your carrier only covers 4 procedures for your case, in this instance.

So for these 4 procedures that are covered, doc would normally charge $100.00 cash

BUT, Doc has that contract with your insurance that states what doc will yield $45
for your 4 procedures as 4 is the max given your diagnosis.

Doc has to report that she gave you 8 procedures when submitting the claim to your insurance because doc did give you 8 procedures.

Again, your insurance paid for 4

---------------------------------------------------

The trick is, insurance bills your insurance pool for 8 procedures at or about the $200.00 rate doc would have charged you cash.

So your insurance paid doc $45.00 - and put a $200 hit on their books - walked away
with $155.00

then they send me (the staff) a payment of $37.00 for your visit

For some reason this happens all the time

So then I have to spend 30 minutes of the Doc's overhead trying to collect the $8.00
insurance "forgot" in the payment they sent.



posted on Mar, 27 2010 @ 11:54 PM
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Originally posted by Janky Red
Doc has to report that she gave you 8 procedures when submitting the claim to your insurance because doc did give you 8 procedures.

Again, your insurance paid for 4


But, isn't this a chicken or egg type question? Who screwed who, first? Doctors and hospitals are, also, guilty of billing for things, which they did not provide, trying to "get even" with insurance companies.



posted on Mar, 27 2010 @ 11:55 PM
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reply to post by WTFover
 


My biggest frustration is that except for Kaiser, medicare and a couple teamster unions
all these insurance giants seem to have a policy of projecting confusion and chaos.
Some of the UHC cards don't have a phone number, so I have to call 15 different subsidiaries, go through a three minute phone "vetting/qualifying" ritual only
to find out I have called the wrong number and "sorry I don't know the correct number for that policy holder". Then the next number I call has a robot that keeps kicking me off the system... AHHHHHHHHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!!!!!!!!!!!

In the end they know that I will give up trying to collect on the $8 - $10 - whole CLAIM-
I am trying to process.

We write off $1000's because it is not worth the time to jump through the hundred different obstacles each company has worked so hard to erect. 1 UHC sub- automated phone line has the # options mixed up, so that if you press 1 for English you get EJECTED from the system




All costs money -----



WTF, its REALLY bad friend

I am a liberal, but this whole thing is abusive and I couldn't make it up if I tried.

The whole thing needs a meat tenderizer and a stick of dynamite





[edit on 28-3-2010 by Janky Red]



posted on Mar, 28 2010 @ 12:11 AM
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Originally posted by WTFover

Originally posted by Janky Red
Doc has to report that she gave you 8 procedures when submitting the claim to your insurance because doc did give you 8 procedures.

Again, your insurance paid for 4


But, isn't this a chicken or egg type question? Who screwed who, first? Doctors and hospitals are, also, guilty of billing for things, which they did not provide, trying to "get even" with insurance companies.


I guess it depends on the biller or provider

My boss does not like that, her idea is give really, really good attention and they will return.

I am certain, absolutely that some do, although one would run the risk of being exposed by a diligent patient.

The problem in the equation I cited is that, the providers take a nasty hit and the insurance pool is being hit for thing the insurance company didn't actually pay for
or even cover for that matter. This will not change naturally because doctors need patients to survive and the patients are clueless to the process. So there is no reason
to streamline costs if everyone "needs" the insurance.

They stipulate everything in their bias, this is why care is not so great or so varied.

Some doctors will shove you out the door because it is not cost effective to do what is
necessary in some cases, many cases.



posted on Mar, 28 2010 @ 12:41 AM
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Originally posted by WTFover
As a side bar, for those not familiar with Cook's Children's Hospital, in Fort Worth, Texas, where Houston was treated...It is an outstanding facility, non-profit and supported, largely, through private charitable contributions. I believe it stands as a testament to my suggestion that many of the health care solutions lie at the local level.

I'm certain most, if not all, costs for Houston's treatment will be absorbed, by the hospital.



Well thats good to hear!!!

I am glad the little one was able to get care from such an awesome facility.

thanks

[edit on 28-3-2010 by Janky Red]



posted on Mar, 28 2010 @ 01:31 AM
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reply to post by Janky Red
 


Sorry for the delay in replay Janky;

As to the option you offered, I would be open to hearing more about what you mean. When you say make a universal system which would offer basic coverage are you suggesting some sort of insurance system or medical system?

It appears you are advocating another form of insurance only under legislation that wouldn't interfere with a persons right to make their own health care decisions. It is a far more compelling suggestion than the legislation that was passed, but I am unsure how it will address the costs and other problems facing the health care field today.

I like what you say when you say it is amazing how we see each others solutions as pro industry, particularly your choice of the word solutions. Solutions are either homogeneous mixtures of two or more substances or a statement that solves a problem or explains how to solve a problem. Solutions are not answers, and without answers, how can we expect to find solutions?

I will continue to argue that it is a fundamental mistake to equate health care with insurance. They are two separate industries and should be viewed as such at all times. If we are to discuss health care reform, then by all means let us discuss health care reform. If we are to discuss insurance reform, then let us discuss it, but let us not make the mistake of confusing the two and believing that placing emphasis on reforming insurance practices will reform both industries.

You seem to have an inside tract into the financial dealings of both industries with your day job and for that reason, coupled with your usual reasonable approach to your own left leaning ideology, I keep a willing and open ear to your suggestions as they may have merit and offer real and viable solutions to a genuine concern for many people. That said, I still remain highly skeptical that insurance schemes are the best solution to health care reform, and for a number of reasons. The first reason is the dramatic rise of chronic illness and the dire predictions by health care practitioners and scientists of the continued rise of these diseases.

If organizations like the WHO are to be taken seriously then the dire prediction of a 50% rise of up to 15 million new cases of cancer world wide indicates just how much of a concern this particularly costly chronic disease is becoming. If chronic illness is on the rise and not on the decline, then chronic illness is a serious problem for speculative industries that wish to make a wager that those they insure will long healthy lives. Do you follow my reasoning here?

If chronic illness continues to rise and the only solution to that rise is the current model where expensive technological procedures and chemistry is used to radically attack the cancer and do little to support the biological immune system that in all likelihood failed the cancer victim to begin with, then is it so unreasonable to suggest that perhaps we're heading in the wrong direction in regards to cancer, and the solution lies somewhere outside of the current model?

When we begin asking these sort of questions in regard to health care, when we begin to ask health care practitioners if diabetes can be cured using natural methods, why is the AMA still pushing less natural chemical methods, i.e. tablets or insulin injections, that seem to create a dependency upon the method and quite probably destroying any chance of curing the disease naturally, or why the psychiatric field keeps inventing new mental illnesses at an alarming rate, and advocating prescription drugs to handle these newly invented diseases, then we are asking questions that have answers. Once we get those answers then we can get to the business of finding solutions to reform the industry and fix the problems.

As long as chronic illness remains the spectre it is, the financial reality of health insurance is a bleak one. Couple that with genetic defects and other illnesses, combined with accidental injuries and other forms of disease, and it is unimaginable to me, under the current model of health care, how any insurance agency could realistically expect to make a profit, if the dire predictions made hold true. If chronic illness were not so prevalent in this nation today, then perhaps the capital venture of health insurance would make sense, and ironically, when one traces the history of health insurance in the private sector, when that industry began speculating on health, chronic illness was not as problematic then as it is today.

The serious problems of health care can not be handled by insurance schemes alone, and any involvement by the insurance industry should not effect the relationship between a doctor and a patient. In fact, in my humble opinion, there should not be a relationship between the insurance agency and the doctor, and only between the agency and those they insure. What ever expense that is covered by insurance can be paid to the patient, who can either use that money to pay the health care practitioners or be reimbursed for any payments all ready made in full by the patient.

The whole concept of "third party players" in the decision of health care seems to be one of the problems, and it doesn't make sense to do business with companies that offer you a risk management scheme, and then insist they have authority to decide what type of medical coverage is appropriate. However, if insurance can help to reduce the overall cost of health care I am open to hearing how that can be done.



posted on Mar, 28 2010 @ 03:49 AM
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apathy is even sickening than that situation.

Problem is the kid might have been denied heal care coverage. But they got healh care for free its the law.



posted on Mar, 28 2010 @ 08:51 AM
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reply to post by Benevolent Heretic
 

Let's keep it real. You do not support health care REFORM. You support NATIONAL HEALTH CARE. There are many ways to reform health care but like Obama this is the only one you support.
All of you health care supporters seem to hate the insurance companies. Well do some research because they are not absent in Obamas new plan. They play a major role. Pull your head out of the sand and check it out.



posted on Mar, 28 2010 @ 12:22 PM
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Originally posted by TaxpayersUnleashed
apathy is even sickening than that situation.

Problem is the kid might have been denied heal care coverage. But they got healh care for free its the law.


What law is that? I have many bills I need to dispute if they were supposed to treat me for free.



posted on Mar, 28 2010 @ 12:39 PM
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reply to post by Southern Guardian
 


Ok for one there is no middle class anymore, it has really become the haves and have-nots.

Secondly, am I the only one that finds the timing of this piece of news a litttle weird? Hmm the argument for repealing this bill is starting to gain some momentum and now all of a sudden this stroy comes out. Hmm that has to be the most perfect timing if I must say so.



posted on Mar, 28 2010 @ 12:40 PM
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reply to post by mnemeth1
 


I have known plenty of people who became doctors who want to do plenty of pro bono work such as doctors without borders, or do work in third world countries, but can't because of the cost of medical school. It is hard to do pro bono work when you have 150k of school bills to pay.

I also have heard from doctors who do not wish their children to become doctors, because they are enslaved to what the insurance companies dictate,and cannot practice true medicine.



posted on Mar, 28 2010 @ 02:47 PM
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reply to post by Janky Red
 


When did I ever say I trusted them with the military might that they have? I think a standing federal army is a terrible thing. Each state should have their own militia. I don't trust them with the weapons, or health care!

When did I ever say it was right for criminals and terrorists to receive health care at the expense of the taxpayer? That is wrong too! Committing more wrongs is not the way to fix a problem.

Obviously, I'm not on board. This ship is more dangerous than the shark infested waters its sailing through.

[edit on 28-3-2010 by Mykahel]



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