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Why are they in the middle, instead of at the end of the transaction?
Well, in most cases insurers are the primary payers.
Guess you could pay out of pocket and then seek reimbursement.
The ER does not treat Cancer or any disease.
Most Cancer Treatment facilities will not treat you without adequate and verified insurance and the ability to pay your deductible, upfront or the demonstrated ability to pay out of pocket.
Most businesses and people do not perform services for no compensation.
Those without insurance and the means to pay might rely on state, county, municipal programs, if available, if they survive long enough to clear the wait list for treatment, if they have transport to/ from the facility.
Now wait. I never said weight gain would not occur. Of course it will. But 80-90 POUNDS? cmon. When you are in that position you have to work HARDER to watch your diet not give in to it which is most likely what happened with that kind of weight gain.
I believe what happens is that people don't shift their caloric intake. The amount of food that would have to be eaten, on top of a maintenance diet, is pretty amazing. I can eat about anything I want in any amount when I'm training for a century ride. Off season, nope. Cut waayyyy back or weight can build fast. The scale don't lie
Back when Blue Cross was just called Blue Shield, all health insurance was non-profit. It was illegal for insurance to be for profit.
You raise a good point.
Back when, Blue was the first company to offer cross hospital sickness insurance.
While many of the big name insurers have been around for 100-200 years, their products were generally limited to fire, life, accident ( wage) insurance and re- insurance.
Aetna has been a major sickness/ healthcare insurer since the 20's. It created the first HMO in 1929. Over the decades that followed they acquired dozens of other insurers. In the 90's they acquired Prudential healthcare and dropped 8 million individual accounts when they raised premiums. In 2000 they raised premiums by 16% and again shed accounts that could not afford premiums.
Fast forward, they intend to acquire Humana, subject to DOJ approval. They made it clear if approval was not forthcoming, they would exit the Obamacare exchanges.
That approval remains iffy. Fewer insurers means less competition which typically means higher prices no matter the product or service. On the other hand an acquisistion could mean the elimination of massive redundant positions and systems ( jobs), greater investment in technology substitution ( more job loss) and increase negotiating power in many markets which might lower premiums. Or it might mean nothing more than increasing shareholder value.
Yes, Medicare-for-all is absolutely needed. The private insurance companies are acting like leeches on a system geared towards profits and not human health.
ACA capped insurer's profits.
Imagine that does not go over well in many a board room.
Insurance companies directly and indirectly have historically lobbied state and federal politicians.
I'll beg to differ having a son who needs a total knee and back surgery. Inactivity due to medical problems causes weight gain no matter what your diet it in most cases unless you have a very high metabolism. I've also been in the medical field for 40 years and see it every day.
You can't do even the routine things many times - instead of running up a few stairs - you're slowly dragging yourself up one stair at a time. You're using less calories to do just those few stairs. You're sitting more due to pain or inability to stand or walk.
Until your in someone's shoes that have these problems - count your blessings and don't comment.
I understand.
Those who have serious mobility challenges are not burning the calories they consume.
While they have no control over their mobility, they do have control over their caloric intake.
I can appreciate how those with mobility issues tend to be parked in front of TVs and keyboards and how challenging it is to eliminate something as enjoyable as eating/ drinking is, especially in absence of things most able- bodied take for granted.
It makes me wonder if the opportunity for government to pick up the full tab for healthcare only if they right sized would be adequate motivation to take back control, when the consequence of not doing so was sky high premiums or doing without healthcare.
It wasn't always like that.... Thank Richard Nixon for the change.
Insurance was never in the middle, they were always at the end, until the 1980's.
Then doctors had to hire complete staffs to handle insurance. With that came added cost.
Aetna was the first insurer to offer an HMO in 1929 in LA county.
Federal law , under Nixon, compelled employers who offered an insurance benefit to employees to make at least one HMO option available to employees. That was a game changer.
Then take into consideration the monumental advances in medical specialties, diagnosis, treatments and survival rates that have happened over the past 40+ years and how much the overweight/ obesity rate of the population has increased and here we are.
I believe what happens is that people don't shift their caloric intake. The amount of food that would have to be eaten, on top of a maintenance diet, is pretty amazing. I can eat about anything I want in any amount when I'm training for a century ride. Off season, nope. Cut waayyyy back or weight can build fast. The scale don't lie
I am a walker. If I could not walk I would likely have more time to eat and indulge in my vice, soda pop.
I could easily gain at least 50 pounds in less than a year if I did not restrict my intake. I can appreciate how challenging it must be for many who have serious mobility issues. I can also understand that excess weight can cause it's own mobility issues.
Wouldn't it be great to have a medical system where your neighbors habits and health aren't any of your concern? Oddly folks want to collectivize those bad habits.
Wouldn't it be great to have a medical system where your neighbors habits and health aren't any of your concern? Oddly folks want to collectivize those bad habits.
We live in a society ... if you would like what you think is "great", drop out of it.
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