[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
> http://www.annals.org/cgi/content/full/150/7/493 > > This is an excellent article regarding health care reform. Shows that there > are realistic moderate proposals out there. > : thanks for posting this excellent piece.
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
--- In FairfieldLife@yahoogroups.com, ruthsimplicity wrote: > > --- In FairfieldLife@yahoogroups.com, Duveyoung wrote: > > > > ruthsimplicity wrote: I would describe the relationship between docs > > and insurers as almost adversarial, hardly in cahoots. > > > > Ruth, > > > > You being a nurse and all, I'm hesitant to smack at the health industry > > lest I besmirch your participation therein. As I've noted here at least > > several times, you have impressed me with heartfelt values. > > > > And, nurses, as a group, (doctors far less so) generally do impress me > > with their intellects and hearts. > > > > All that said (here it comes,) I think the health industry itself is > > reflective of the profiteers that any industry finds itself infested by, > > and those profiteers are as cold hearted as Joseph Mengle. > > > > Start with the AMA's policy to keep doctors rare and rich and absolute > > rulers of the industry. It is scandalous, yet, and here's where I > > intend to put it to you, where is the outcry from the nurses and doctors > > about this policy? So far, I don't think I've heard herein about it > > from you. So far, you above are posing doctors as victims. Phihhh, as > > if. > > > > If the AMA allowed medical schools to double their production, they'd > > have all the VERY VERY SMART and VERY VERY HEARTFUL candidates they > > needed to fill up the new classes without having to lower their entrance > > requirement standards. But, noo, that would mean that doctors were > > competing against doctors in pricing, and that would mean that there > > would be ample supply of doctors such that hospitals could more easily > > dump the bad ones that continue to maraud the industry with all kinds of > > malpractice. > > > > Ask anyone in poverty whether they'd rather have a doctor who was in the > > 98th percentile (not tippy tippy top notch just top notch) or no doctor > > at all? Fuck the entrance requirements of the AMA -- a truly evil money > > making cabal. > > > > And as for doctors not being in league with the insurance companies, > > that's a lie. They're not fighting against them with any use of their > > own or the AMA's political clout. Your average surgeon will be paying, > > what?, probably well over a hundred thousand dollars a year to have > > malpractice insurance -- costs that they pass down to the clients with > > higher fees without even apologizing to the patients that they're being > > ripped off. The doctors are beleagered in many ways by how insurance > > companies prvent them from doing "all that's needed," yet we do not hear > > a peep out of the AMA -- if we did, the AMA could, overnight, get > > congress to stop the bastards -- yes, the AMA has that much power. Does > > any politician want the AMA solely supporting another candidate? > > > > Where are the doctors picketing these injustices? Where are the nurses > > confronting the physicians about this say-nothing immorality? I see no > > headlines. If there is a movement to fix all the above, it sure isn't > > grabbing any headlines from the media. > > > > I know someone who just got a $26,000 hospital bill for a stay in ICU > > for a week. At no time did anyone come to this person and explain the > > kinds of prices they'd be billed for. What other industry gets to do > > this? You buy a car and THEN AND ONLY THEN are you told the price? > > Talk about sticker shock -- and, fuck you AMA, but the stress of that > > shock must at the very least psychosomatiically harm a percentage of the > > patients enough to be a health hazzard in itself. Someone who's in an > > anxious state of mind gets the billing and, what?, suicide or the > > patient ends up constantly bathing his mind/body system with the > > chemicals that "hand wringing" can produce. There's no attempt to > > pre-handle this kind of stress. > > > > And, the above person lost over $50,000 in a retirement fund's value > > too. Two industries ripped this person off, ya see? Yet, everyone is > > standing around and not shoving the noses of these bastards into the doo > > doo of their crimes. > > > > The rich get richer, and the poor are ever more being shunted into a > > lower class status until, what?, there's no middle class and thus no > > more chance of an uppity middle classer making headlines by showcasing > > some sort of abuse. > > > > The masses are kept masses, ya see? Tended like they're in a feed lot. > > > > Obama takes money from BigPharm -- to me, he's cherry picking his > > battles, and going up against the health industry is a low priority > > compared to other issues -- Obama is still doing battlefield triage in > > trying to manage his team's use of clout, but at somepoint, he's got to > > push for cheap drugs from Canada or elsewhere (government > > manufacturing?,) bigger medical school enrollments, and, eventually, at > > least, a single payer policy. > > > > If he doesn't, if the deaths of foreigners by Amer
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
--- In FairfieldLife@yahoogroups.com, ruthsimplicity wrote: > > --- In FairfieldLife@yahoogroups.com, Duveyoung wrote: > > > > ruthsimplicity wrote: I would describe the relationship between docs > > and insurers as almost adversarial, hardly in cahoots. > > > > Ruth, > > > > You being a nurse and all, I'm hesitant to smack at the health industry > > lest I besmirch your participation therein. As I've noted here at least > > several times, you have impressed me with heartfelt values. > > > > And, nurses, as a group, (doctors far less so) generally do impress me > > with their intellects and hearts. > > > > All that said (here it comes,) I think the health industry itself is > > reflective of the profiteers that any industry finds itself infested by, > > and those profiteers are as cold hearted as Joseph Mengle. > > > > Start with the AMA's policy to keep doctors rare and rich and absolute > > rulers of the industry. It is scandalous, yet, and here's where I > > intend to put it to you, where is the outcry from the nurses and doctors > > about this policy? So far, I don't think I've heard herein about it > > from you. So far, you above are posing doctors as victims. Phihhh, as > > if. > > > > If the AMA allowed medical schools to double their production, they'd > > have all the VERY VERY SMART and VERY VERY HEARTFUL candidates they > > needed to fill up the new classes without having to lower their entrance > > requirement standards. But, noo, that would mean that doctors were > > competing against doctors in pricing, and that would mean that there > > would be ample supply of doctors such that hospitals could more easily > > dump the bad ones that continue to maraud the industry with all kinds of > > malpractice. > > > > Ask anyone in poverty whether they'd rather have a doctor who was in the > > 98th percentile (not tippy tippy top notch just top notch) or no doctor > > at all? Fuck the entrance requirements of the AMA -- a truly evil money > > making cabal. > > > > And as for doctors not being in league with the insurance companies, > > that's a lie. They're not fighting against them with any use of their > > own or the AMA's political clout. Your average surgeon will be paying, > > what?, probably well over a hundred thousand dollars a year to have > > malpractice insurance -- costs that they pass down to the clients with > > higher fees without even apologizing to the patients that they're being > > ripped off. The doctors are beleagered in many ways by how insurance > > companies prvent them from doing "all that's needed," yet we do not hear > > a peep out of the AMA -- if we did, the AMA could, overnight, get > > congress to stop the bastards -- yes, the AMA has that much power. Does > > any politician want the AMA solely supporting another candidate? > > > > Where are the doctors picketing these injustices? Where are the nurses > > confronting the physicians about this say-nothing immorality? I see no > > headlines. If there is a movement to fix all the above, it sure isn't > > grabbing any headlines from the media. > > > > I know someone who just got a $26,000 hospital bill for a stay in ICU > > for a week. At no time did anyone come to this person and explain the > > kinds of prices they'd be billed for. What other industry gets to do > > this? You buy a car and THEN AND ONLY THEN are you told the price? > > Talk about sticker shock -- and, fuck you AMA, but the stress of that > > shock must at the very least psychosomatiically harm a percentage of the > > patients enough to be a health hazzard in itself. Someone who's in an > > anxious state of mind gets the billing and, what?, suicide or the > > patient ends up constantly bathing his mind/body system with the > > chemicals that "hand wringing" can produce. There's no attempt to > > pre-handle this kind of stress. > > > > And, the above person lost over $50,000 in a retirement fund's value > > too. Two industries ripped this person off, ya see? Yet, everyone is > > standing around and not shoving the noses of these bastards into the doo > > doo of their crimes. > > > > The rich get richer, and the poor are ever more being shunted into a > > lower class status until, what?, there's no middle class and thus no > > more chance of an uppity middle classer making headlines by showcasing > > some sort of abuse. > > > > The masses are kept masses, ya see? Tended like they're in a feed lot. > > > > Obama takes money from BigPharm -- to me, he's cherry picking his > > battles, and going up against the health industry is a low priority > > compared to other issues -- Obama is still doing battlefield triage in > > trying to manage his team's use of clout, but at somepoint, he's got to > > push for cheap drugs from Canada or elsewhere (government > > manufacturing?,) bigger medical school enrollments, and, eventually, at > > least, a single payer policy. > > > > If he doesn't, if the deaths of foreigners by Amer
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
--- In FairfieldLife@yahoogroups.com, Duveyoung wrote: > > ruthsimplicity wrote: I would describe the relationship between docs > and insurers as almost adversarial, hardly in cahoots. > > Ruth, > > You being a nurse and all, I'm hesitant to smack at the health industry > lest I besmirch your participation therein. As I've noted here at least > several times, you have impressed me with heartfelt values. > > And, nurses, as a group, (doctors far less so) generally do impress me > with their intellects and hearts. > > All that said (here it comes,) I think the health industry itself is > reflective of the profiteers that any industry finds itself infested by, > and those profiteers are as cold hearted as Joseph Mengle. > > Start with the AMA's policy to keep doctors rare and rich and absolute > rulers of the industry. It is scandalous, yet, and here's where I > intend to put it to you, where is the outcry from the nurses and doctors > about this policy? So far, I don't think I've heard herein about it > from you. So far, you above are posing doctors as victims. Phihhh, as > if. > > If the AMA allowed medical schools to double their production, they'd > have all the VERY VERY SMART and VERY VERY HEARTFUL candidates they > needed to fill up the new classes without having to lower their entrance > requirement standards. But, noo, that would mean that doctors were > competing against doctors in pricing, and that would mean that there > would be ample supply of doctors such that hospitals could more easily > dump the bad ones that continue to maraud the industry with all kinds of > malpractice. > > Ask anyone in poverty whether they'd rather have a doctor who was in the > 98th percentile (not tippy tippy top notch just top notch) or no doctor > at all? Fuck the entrance requirements of the AMA -- a truly evil money > making cabal. > > And as for doctors not being in league with the insurance companies, > that's a lie. They're not fighting against them with any use of their > own or the AMA's political clout. Your average surgeon will be paying, > what?, probably well over a hundred thousand dollars a year to have > malpractice insurance -- costs that they pass down to the clients with > higher fees without even apologizing to the patients that they're being > ripped off. The doctors are beleagered in many ways by how insurance > companies prvent them from doing "all that's needed," yet we do not hear > a peep out of the AMA -- if we did, the AMA could, overnight, get > congress to stop the bastards -- yes, the AMA has that much power. Does > any politician want the AMA solely supporting another candidate? > > Where are the doctors picketing these injustices? Where are the nurses > confronting the physicians about this say-nothing immorality? I see no > headlines. If there is a movement to fix all the above, it sure isn't > grabbing any headlines from the media. > > I know someone who just got a $26,000 hospital bill for a stay in ICU > for a week. At no time did anyone come to this person and explain the > kinds of prices they'd be billed for. What other industry gets to do > this? You buy a car and THEN AND ONLY THEN are you told the price? > Talk about sticker shock -- and, fuck you AMA, but the stress of that > shock must at the very least psychosomatiically harm a percentage of the > patients enough to be a health hazzard in itself. Someone who's in an > anxious state of mind gets the billing and, what?, suicide or the > patient ends up constantly bathing his mind/body system with the > chemicals that "hand wringing" can produce. There's no attempt to > pre-handle this kind of stress. > > And, the above person lost over $50,000 in a retirement fund's value > too. Two industries ripped this person off, ya see? Yet, everyone is > standing around and not shoving the noses of these bastards into the doo > doo of their crimes. > > The rich get richer, and the poor are ever more being shunted into a > lower class status until, what?, there's no middle class and thus no > more chance of an uppity middle classer making headlines by showcasing > some sort of abuse. > > The masses are kept masses, ya see? Tended like they're in a feed lot. > > Obama takes money from BigPharm -- to me, he's cherry picking his > battles, and going up against the health industry is a low priority > compared to other issues -- Obama is still doing battlefield triage in > trying to manage his team's use of clout, but at somepoint, he's got to > push for cheap drugs from Canada or elsewhere (government > manufacturing?,) bigger medical school enrollments, and, eventually, at > least, a single payer policy. > > If he doesn't, if the deaths of foreigners by American forces continues, > if the health industry is not confronted, if the insurance industry > pretty much is not stopped in its tracks, in the next four years, then I > think I'll waste my next vote on writing in Kusinich. > > Edg > Just
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
--- In FairfieldLife@yahoogroups.com, Bhairitu wrote: > > It's just a ride wrote: > > On Fri, Jun 5, 2009 at 4:55 PM, ruthsimplicity > > wrote: > > > > > >> --- In FairfieldLife@yahoogroups.com, "It's just a ride" > >> wrote: > >> > >>> On Fri, Jun 5, 2009 at 3:52 PM, do.rflex wrote: > >>> > >>> > >> Really? I don't know any health insurance companies that cover lost wages. > >> What company was it? > >> > >> > > > > UHC. My friend had signed up for disability insurance with UHC through his > > Fortune 5 company. > > > > Look up William McGuire, UHC's CEO. It is alleged he was given a $1.2 > billion severance package when he left UHC. He was also highly (over) > compensated in his yearly salary. Here is a record of his campaign > contributions: > > http://en.wikipedia.org/wiki/UnitedHealth_Group > > Here's a record of his campaign contributions: > http://www.newsmeat.com/ceo_political_donations/William_McGuire.php > Yes, his compensation package was a scandal.
Re: [FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
It's just a ride wrote: > On Fri, Jun 5, 2009 at 4:55 PM, ruthsimplicity > wrote: > > >> --- In FairfieldLife@yahoogroups.com, "It's just a ride" >> wrote: >> >>> On Fri, Jun 5, 2009 at 3:52 PM, do.rflex wrote: >>> >>> >> Really? I don't know any health insurance companies that cover lost wages. >> What company was it? >> >> > > UHC. My friend had signed up for disability insurance with UHC through his > Fortune 5 company. > Look up William McGuire, UHC's CEO. It is alleged he was given a $1.2 billion severance package when he left UHC. He was also highly (over) compensated in his yearly salary. Here is a record of his campaign contributions: http://en.wikipedia.org/wiki/UnitedHealth_Group Here's a record of his campaign contributions: http://www.newsmeat.com/ceo_political_donations/William_McGuire.php
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
ruthsimplicity wrote: I would describe the relationship between docs and insurers as almost adversarial, hardly in cahoots. Ruth, You being a nurse and all, I'm hesitant to smack at the health industry lest I besmirch your participation therein. As I've noted here at least several times, you have impressed me with heartfelt values. And, nurses, as a group, (doctors far less so) generally do impress me with their intellects and hearts. All that said (here it comes,) I think the health industry itself is reflective of the profiteers that any industry finds itself infested by, and those profiteers are as cold hearted as Joseph Mengle. Start with the AMA's policy to keep doctors rare and rich and absolute rulers of the industry. It is scandalous, yet, and here's where I intend to put it to you, where is the outcry from the nurses and doctors about this policy? So far, I don't think I've heard herein about it from you. So far, you above are posing doctors as victims. Phihhh, as if. If the AMA allowed medical schools to double their production, they'd have all the VERY VERY SMART and VERY VERY HEARTFUL candidates they needed to fill up the new classes without having to lower their entrance requirement standards. But, noo, that would mean that doctors were competing against doctors in pricing, and that would mean that there would be ample supply of doctors such that hospitals could more easily dump the bad ones that continue to maraud the industry with all kinds of malpractice. Ask anyone in poverty whether they'd rather have a doctor who was in the 98th percentile (not tippy tippy top notch just top notch) or no doctor at all? Fuck the entrance requirements of the AMA -- a truly evil money making cabal. And as for doctors not being in league with the insurance companies, that's a lie. They're not fighting against them with any use of their own or the AMA's political clout. Your average surgeon will be paying, what?, probably well over a hundred thousand dollars a year to have malpractice insurance -- costs that they pass down to the clients with higher fees without even apologizing to the patients that they're being ripped off. The doctors are beleagered in many ways by how insurance companies prvent them from doing "all that's needed," yet we do not hear a peep out of the AMA -- if we did, the AMA could, overnight, get congress to stop the bastards -- yes, the AMA has that much power. Does any politician want the AMA solely supporting another candidate? Where are the doctors picketing these injustices? Where are the nurses confronting the physicians about this say-nothing immorality? I see no headlines. If there is a movement to fix all the above, it sure isn't grabbing any headlines from the media. I know someone who just got a $26,000 hospital bill for a stay in ICU for a week. At no time did anyone come to this person and explain the kinds of prices they'd be billed for. What other industry gets to do this? You buy a car and THEN AND ONLY THEN are you told the price? Talk about sticker shock -- and, fuck you AMA, but the stress of that shock must at the very least psychosomatiically harm a percentage of the patients enough to be a health hazzard in itself. Someone who's in an anxious state of mind gets the billing and, what?, suicide or the patient ends up constantly bathing his mind/body system with the chemicals that "hand wringing" can produce. There's no attempt to pre-handle this kind of stress. And, the above person lost over $50,000 in a retirement fund's value too. Two industries ripped this person off, ya see? Yet, everyone is standing around and not shoving the noses of these bastards into the doo doo of their crimes. The rich get richer, and the poor are ever more being shunted into a lower class status until, what?, there's no middle class and thus no more chance of an uppity middle classer making headlines by showcasing some sort of abuse. The masses are kept masses, ya see? Tended like they're in a feed lot. Obama takes money from BigPharm -- to me, he's cherry picking his battles, and going up against the health industry is a low priority compared to other issues -- Obama is still doing battlefield triage in trying to manage his team's use of clout, but at somepoint, he's got to push for cheap drugs from Canada or elsewhere (government manufacturing?,) bigger medical school enrollments, and, eventually, at least, a single payer policy. If he doesn't, if the deaths of foreigners by American forces continues, if the health industry is not confronted, if the insurance industry pretty much is not stopped in its tracks, in the next four years, then I think I'll waste my next vote on writing in Kusinich. Edg
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
--- In FairfieldLife@yahoogroups.com, Bhairitu wrote: > > And what the selfish "me people" don't realize is that the uninsured > cost them tax dollars anyway. And probably far more than if they had > coverage. > > Kennedy has proposed a sweeping universal coverage plan: http://www.nytimes.com/2009/06/06/health/policy/06health.html
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
--- In FairfieldLife@yahoogroups.com, "It's just a ride" wrote: > > On Fri, Jun 5, 2009 at 4:55 PM, ruthsimplicity > wrote: > > > --- In FairfieldLife@yahoogroups.com, "It's just a ride" > > wrote: > > > > > > On Fri, Jun 5, 2009 at 3:52 PM, do.rflex wrote: > > > > > > > Really? I don't know any health insurance companies that cover lost wages. > > What company was it? > > > > UHC. My friend had signed up for disability insurance with UHC through his > Fortune 5 company. > > > > > > > I would describe the relationship between docs and insurers as almost > > adversarial, hardly in cahoots. > > > Most of the people I know have UHC. UHC is very heavily into diagnostics. > Whereas most insurance companies will pay for one of a certain test a year, > UHC will pay for as many as the doctor wants to order. Want a second, > third, fourth opinion at say Mayo, Hopkins, Menninger? UHC will pay. > > I would hardly consider it adversarial where the doctor just happened to be > on call (and officed in the hospital complex) and made all the arrangements > with the insurance company for pre-authorized coverage before visiting my > friend with the option of having my friend surrender his drivers license to > the officer outside or sign the paperwork for a week worth of wasting a bed, > a bunch of nurses and 3 shifts of EEG technicians shared with one other > patient (who's insurance wasn't as good so she didn't get an executive suite > with a DVD player or Wii in it). > > The doctors and their staffs in my area have learned how to play the > insurance companies. They know just the words needed to get those > pre-authorizations out of the major insurance companies in my area. It > appears Obama's gotten to the likes of UHC. People get calls at the > hospital or home while recuperating from UHC asking if there's anything more > UHC could do to help. I know of one case where the patient was having a > problem adjusting to her illness. UHC offered to locate a counselor for > her, as her company provided counseling as a benefit administered by UHC. > I'd suspect that if you've got UHC through a Fortune 50 million company > YMMV. > > > > > > > > > We aren't going to get a single payer plan this time around. There aren't > > the votes. At best, if we have enough legislators with balls, we will have > > a federal option plan to go along with the private plans. Too soon to tell. > > > > > I see nothing but disaster. We need Evidence Based Medicine. My friend's > trip to the ER, let alone his one week work up violated EBM all 4 miles > round trip of the way. Then in another part of town there are all these > people who use the ER out of necessity as though it were a local nurse > practicioner. My town only has a few nurse practioners and they provide > anesthesia survices at the high dollar day surgery clinics in town. > > If we were to get EBM, nurse practicioners performing triage and giving care > as needed, we'd save a bundle in the aggregate. It's estimated that every > trip to the ER in any part of town here starts at $2,000. Cut out a bunch > of unnecessary $2,000 visits, cut out my friend's $38,000 boondoggle and > after a while you're talking some real money saved. Saved by the taxpayers, > saved by the insurance companies, saved by employers and their employed. > > Instituting electronic medical records interchange isn't going to save any > money. My friend told his story to EMS technicians, a triage nurse, a bunch > of ER nurses, a bunch of different ER doctors, the neurologist and then to > nurses, EEG techs, a pharmacist and some doctors when he got upstairs. It > turns out that though the hospital has one of the finest records systems in > the country and everyone is walking around with PDAs or PC tablets, the > records are organized so poorly that staff would rather blow the time to ask > the patient for a history, meds, etc. rather than consult the MRS. > > The one good thing I see that might save a little money is the > doctor/hospital/lab proposal to insurance companies and the governments to > be able to submit a single bill. Right now a single week stay in the > hospital will generate a hundred or more different bills which have to be > settled by the insurance company, the governments, those billing and the > patient. > > Another good thing which might come out is if the insurance > companies/governments start refusing to pay for 2nd and 3rd admissions to > hospitals because the hospital didn't get the care right the first time. > > This is all a far cry from universal $300 per person per month insurance > premiums. $300 a month per person would easily cover everyone's medical > needs if EBM were truly put in practice. At $300 per person companies, > individuals and governments could pay for everyone in the US out of petty > cash. > Makes more sense; it wasn't that health insurance paid it was the disability insurance. Often short term disability is paid by the
Re: [FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
And what the selfish "me people" don't realize is that the uninsured cost them tax dollars anyway. And probably far more than if they had coverage. off_world_beings wrote: > Re: Get Rid of the For-Profit Health Insurance Industry > > Absolutely > Almost 50 million people in the USA have no health insurance ! ! ! > That is more people than the whole population of Spain ! > > The US state of Health Care system is a National Security threat to the > USA. > > OffWorld > >
Re: [FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
On Fri, Jun 5, 2009 at 4:55 PM, ruthsimplicity wrote: > --- In FairfieldLife@yahoogroups.com, "It's just a ride" > wrote: > > > > On Fri, Jun 5, 2009 at 3:52 PM, do.rflex wrote: > > > > Really? I don't know any health insurance companies that cover lost wages. > What company was it? > UHC. My friend had signed up for disability insurance with UHC through his Fortune 5 company. > > I would describe the relationship between docs and insurers as almost > adversarial, hardly in cahoots. Most of the people I know have UHC. UHC is very heavily into diagnostics. Whereas most insurance companies will pay for one of a certain test a year, UHC will pay for as many as the doctor wants to order. Want a second, third, fourth opinion at say Mayo, Hopkins, Menninger? UHC will pay. I would hardly consider it adversarial where the doctor just happened to be on call (and officed in the hospital complex) and made all the arrangements with the insurance company for pre-authorized coverage before visiting my friend with the option of having my friend surrender his drivers license to the officer outside or sign the paperwork for a week worth of wasting a bed, a bunch of nurses and 3 shifts of EEG technicians shared with one other patient (who's insurance wasn't as good so she didn't get an executive suite with a DVD player or Wii in it). The doctors and their staffs in my area have learned how to play the insurance companies. They know just the words needed to get those pre-authorizations out of the major insurance companies in my area. It appears Obama's gotten to the likes of UHC. People get calls at the hospital or home while recuperating from UHC asking if there's anything more UHC could do to help. I know of one case where the patient was having a problem adjusting to her illness. UHC offered to locate a counselor for her, as her company provided counseling as a benefit administered by UHC. I'd suspect that if you've got UHC through a Fortune 50 million company YMMV. > > > We aren't going to get a single payer plan this time around. There aren't > the votes. At best, if we have enough legislators with balls, we will have > a federal option plan to go along with the private plans. Too soon to tell. > > I see nothing but disaster. We need Evidence Based Medicine. My friend's trip to the ER, let alone his one week work up violated EBM all 4 miles round trip of the way. Then in another part of town there are all these people who use the ER out of necessity as though it were a local nurse practicioner. My town only has a few nurse practioners and they provide anesthesia survices at the high dollar day surgery clinics in town. If we were to get EBM, nurse practicioners performing triage and giving care as needed, we'd save a bundle in the aggregate. It's estimated that every trip to the ER in any part of town here starts at $2,000. Cut out a bunch of unnecessary $2,000 visits, cut out my friend's $38,000 boondoggle and after a while you're talking some real money saved. Saved by the taxpayers, saved by the insurance companies, saved by employers and their employed. Instituting electronic medical records interchange isn't going to save any money. My friend told his story to EMS technicians, a triage nurse, a bunch of ER nurses, a bunch of different ER doctors, the neurologist and then to nurses, EEG techs, a pharmacist and some doctors when he got upstairs. It turns out that though the hospital has one of the finest records systems in the country and everyone is walking around with PDAs or PC tablets, the records are organized so poorly that staff would rather blow the time to ask the patient for a history, meds, etc. rather than consult the MRS. The one good thing I see that might save a little money is the doctor/hospital/lab proposal to insurance companies and the governments to be able to submit a single bill. Right now a single week stay in the hospital will generate a hundred or more different bills which have to be settled by the insurance company, the governments, those billing and the patient. Another good thing which might come out is if the insurance companies/governments start refusing to pay for 2nd and 3rd admissions to hospitals because the hospital didn't get the care right the first time. This is all a far cry from universal $300 per person per month insurance premiums. $300 a month per person would easily cover everyone's medical needs if EBM were truly put in practice. At $300 per person companies, individuals and governments could pay for everyone in the US out of petty cash.
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
Re: Get Rid of the For-Profit Health Insurance Industry Absolutely Almost 50 million people in the USA have no health insurance ! ! ! That is more people than the whole population of Spain ! The US state of Health Care system is a National Security threat to the USA. OffWorld --- In FairfieldLife@yahoogroups.com, "do.rflex" wrote: > > > > "Private insurers necessarily waste health dollars > on things that have nothing to do with care: overhead, > underwriting, billing, sales and marketing departments > as well as huge profits and exorbitant executive pay. > Doctors and hospitals must maintain costly administrative > staffs to deal with the bureaucracy. > > "Combined, this needless administration consumes one-third > (31 percent) of Americans' health dollars." > > + + > > -Single-Payer National Health Insurance- is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private. > > Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. > > Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 45.7 million completely uninsured and millions more inadequately covered. > > The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. > > Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. > > Combined, this needless administration consumes one-third (31 percent) of Americans' health dollars. > > Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do. > > Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. > > Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care. > > Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards. > > A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. > > Modest new taxes would replace premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing. > > ~ ~ Much more at link including Single Payer Facts and Myths & FAQ that debunk the usual self-serving for-profit Insurance Industry talking points > ~~ Physicians for a National Health Program http://www.pnhp.org/facts/single_payer_resources.php > > > ALSO at link: > > The Case Against For-Profit Care > > Overview: The High Costs of For-Profit Care > Editorial by David Himmelstein, MD and Steffie Woolhandler, MD in the Canadian Medical Association Journal > > > For-Profit Hospitals Cost More and Have Higher Death Rates > Devereaux, PJ "Payments at For-Profit and Non-Profit Hospitals," Can. Med. Assoc. J., Jun 2004; 170 > > Devereaux, PJ "Mortality Rates of For-Profit and Non-Profit Hospitals," Can. Med. Assoc. J, May 2002; 166 > > > For-Profit Hospitals Cost More and Have Higher Administration Expenses > Himmelstein, et al "Costs of Care and Admin. At For-Profit and Other Hospitals in the U.S." NEJM 336, 1997 > > > For-Profit HMOs Provide Worse Quality Care > Himmelstein, et al "Quality of Care at Investor-Owned vs. Not-for-Profit HMOs" JAMA 282(2); July 14, 1999 > > > For-Profit Medicare Plans Cost 11 Percent More Than Traditional Medicare > MedPac Report, Jun 9, 2006 >
[FairfieldLife] Re: Get Rid of the For-Profit Health Insurance Industry
--- In FairfieldLife@yahoogroups.com, "It's just a ride" wrote: > > On Fri, Jun 5, 2009 at 3:52 PM, do.rflex wrote: > > > > > > > "Private insurers necessarily waste health dollars > > on things that have nothing to do with care: overhead, > > underwriting, billing, sales and marketing departments > > as well as huge profits and exorbitant executive pay. > > Doctors and hospitals must maintain costly administrative > > staffs to deal with the bureaucracy. > > > > > Sometimes hospitals (which are now for profit conglomerates though > theoretically they are non-profit), doctors and insurance companies are > running a scam together. A few months ago a friend of mine lost his balance > on a stair case, tumbled and bruised himself a bit. EMT (a public service > which cost him/his insurance company $600 for a 2 mile ride) took him to the > diagnostic hospital nearby. After about 6 hours in the ER and running up a > $7,000 ER bill as they performed every expensive scan they could on him, my > friend was getting dressed to go home. In walked a neurologist. He told my > friend that by law my friend could not drive until six months had passed or > he underwent one week of observation, tethered to EEG leads and under video > camera surveillance for a week. My friend told the neurologist that he did > not have a convulsion, no one in his family had ever had one, and anyway his > company would not pay for him to take off a week for such a thing nor would > his insurance company pay for it. Plus his EEG was as flawless as a TMSP > flier's could be with those gamma delta tau waves and all. The neurologist > assured my friend that he had contacted the insurance company. They would > foot the entire bill plus pay my friend's salary for the week. The > neurologist told my friend that he picked out a nice executive suite for my > friend, with DVD, WII, Wi-Fi, gourmet meals ordered off a menu, just sign > here. Just a coincidence that these accommodations were the max the > insurance company would cover, remember. > > Total cost for losing balance? One week tethered to EEG leads, privacy only > in the bathroom, one hour of strobe lights aimed at him every day, one week > lost on an important project and $38,000 in medical bills, all paid for by > my friend's insurance company. My friend was released when the week was up > and since his wife dropped the car off outside, he drove the 2 miles home, > scratching his head all the time. The biggest insult was getting a thank > you note from the hospital conglomerate's CEO a week after he got back home. > > Get this. The insurance company also paid for guest meals. So visitors > were immediately given a menu when they/I went to see my friend. > > Now, President Obama, tell me how this $38,000, including visitor's meals at > $16 a pop, fits in with Evidence Based Medicine? > > Meanwhile in another part of town at the city hospital where people without > fabulous insurance go... Really? I don't know any health insurance companies that cover lost wages. What company was it? I would describe the relationship between docs and insurers as almost adversarial, hardly in cahoots. We aren't going to get a single payer plan this time around. There aren't the votes. At best, if we have enough legislators with balls, we will have a federal option plan to go along with the private plans. Too soon to tell. >
