Re: [MBZ] Big Brother is Nearby --- WAS---- W140 Vs W126, and now health care costs ....
I am not up on current figures, but back when I was [10 - 12 years ago] the US cost of determining who would pay [or not] for medical care, and processing those payments and arguing about it, was about the same as would have been the cost for providing health insurance / care for every uninsured person in the US with a single payer system. Not that it doesn't keep me in a reasonable standard of living, but it keeps a lot of people in misery. BillR Jacksonville 1981 300SD 282k miles, and rather suddenly developing blue smoke on morning start ups. Probably valve seals, but why the sudden onset, and any suggestions on what to do about it? Replace seals the only answer? -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of David Brodbeck Sent: Thursday, November 30, 2006 8:22 PM To: Mercedes Discussion List Subject: Re: [MBZ] Big Brother is Nearby --- WAS W140 Vs W126 Rich Thomas wrote: If you come here illegally you get free health care, as much as you can use, any ER has it. Well, sort of. They'll give you emergency care. They won't give you anything else. If you have a chronic disease, like diabetes, you're pretty much out of luck...except that they'll amputate your foot after your circulation quits and it turns gangrenous. Even if you're lucky enough to have health insurance from an HMO, you'll probably have to convince some insurance company bureaucrat that you really need that specialist you've been referred to. And remember, he's being paid a lot of money to find a reason to deny your claim. ___ http://www.okiebenz.com For new parts see official list sponsor: http://www.buymbparts.com/ For used parts email [EMAIL PROTECTED] To Unsubscribe or change delivery options go to: http://okiebenz.com/mailman/listinfo/mercedes_okiebenz.com
Re: [MBZ] Big Brother is Nearby --- WAS---- W140 Vs W126, and now health care costs ....
-BEGIN PGP SIGNED MESSAGE- Hash: SHA1 Have you noticed a significant change in your oil consumption? On Dec 1, 2006, at 7:09 AM, BillR wrote: 1981 300SD 282k miles, and rather suddenly developing blue smoke on morning start ups. Probably valve seals, but why the sudden onset, and any suggestions on what to do about it? Replace seals the only answer? -BEGIN PGP SIGNATURE- Version: GnuPG v1.4.5 (Darwin) iD8DBQFFcEq1t178NxI/higRAmasAJ91osCf8xilelGtvHG9wmHZehZQ1wCglke0 cYZM62wyBa3xafsf3q3LAUs= =w3IU -END PGP SIGNATURE-
Re: [MBZ] Big Brother is Nearby --- WAS---- W140 Vs W126, and now health care costs ....
BillR wrote: I am not up on current figures, but back when I was [10 - 12 years ago] the US cost of determining who would pay [or not] for medical care, and processing those payments and arguing about it, was about the same as would have been the cost for providing health insurance / care for every uninsured person in the US with a single payer system. Not that it doesn't keep me in a reasonable standard of living, but it keeps a lot of people in misery. That sounds about right. I worked in the area of healthcare finance for nearly 20 years. A health care provider of moderate size in the USA has to - -Identify the appropriate primary payor out of several which may be involved. Not as easy as it sounds, and there are frequent disputes in which although the patient may be covered by several insurers, all insist that the other one pays first before they will consider the claim. -Identify whether or not they are contracted with those payors, or with any of a veritable spiderweb of PPOs, IPAs etc which both they and the payors may participate with, in order to identify what discount is to be applied and how much of the billed charge must be written off. -Identify and comply with the pre-authorization or precertification requirements of the payors. -Identify the idiosyncratic billing requirements of the particular payors. This all should be done before the claim is mailed. Pre-authorization and precertification must be done, except in emergency situations, before the service is rendered. Then comes the mailing or electronic transmission of the claim, the numerous calls to the insurance company to politely inquire as to whereinthehell the check might be, the endless time on hold. The disputed claims. The appeals, the claims resubmissions, the adjusted payments, etc. You can case your money with an insurance company literally for years in some cases. I have. One of my uglier cases involved roughly $800,000 in billed charges and dragged on for about four years before the insurer finally gave up and cut the check. I would guess that any moderate to large size healthcare provider could cut their billing and collections staff by 80% if the status quo were replaced with a well-run single-payor system. Likewise, looking at the monstrous clusterfuck which is the US healthcare payment system as a whole, probably 95% of the administrative overhead could be eliminated by conversion to a single payor system. I figure I really spent close to 20 years being paid to do what in a sane world would be unnecessary. Lee
