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Old 06-15-2009, 05:36 PM
 
34,990 posts, read 34,755,944 times
Reputation: 6163

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Quote:
Originally Posted by Dopo View Post
Yes, I want "Socialized health insurance"

Why do republicans talk all day long about "Socialized health care"
The health care system is completely fine as it is (FYI, has been socialized=subsidized for decades).
Because they're keeping the sheepies bamboozled.

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Old 06-15-2009, 05:43 PM
 
2,105 posts, read 1,196,366 times
Reputation: 636
Quote:
Originally Posted by Cav Scout wife View Post
VERY well said, I agree 110%!

Besides, the government sucks, they are so horrible that they are the only ones I know that can screw up their OWN wet dreams, do you REALLY want those type people dictating what care you can or can't get?!
Is your husband enlisted? If so, who is paying for yours and his medical care?
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Old 06-15-2009, 05:46 PM
 
Location: On the Ohio River in Western, KY
3,388 posts, read 5,746,509 times
Reputation: 3343
Quote:
Originally Posted by ♠atizar♠ View Post
Is your husband enlisted? If so, who is paying for yours and his medical care?
My husband and I both WERE enlisted, not currently. I know ALL about Tri-Care and their BS, thanks.

That's why I am against socialized health care.

I am sick and tired of some pencil pusher making the decisions about MY health. That should be up to me and my Dr, and not a bunch of bureaucrats.

Oh, as for who pays for our medical care? We do, uninsured out of pocket. We have a family Dr. (he's my cousin, so when I say family, I mean family, lol!) that charges us reasonable rates (not $300/visit for 10 mins of actual Dr. time), and we have another family member that is a dentist for our oral care.

Thank goodness we have been lucky enough not to have serious medical problems, but if we do, we will cross that bridge when we get there.

We choose not to have insurance, since it was costing us more than we were using it. We were paying $300/month for all 3 of us, and it was only taking off $5/script for my 2 scripts, and $50/script for our DD's script. What sense does it make to pay $300/month to save only $60?! Not to mention, our co-pay (for Dr. visits) was $30, and we only went to the Dr. once every 3 months.


Instead of letting the government run healthcare, why not take a page out of the law books, literally. One of my best girl friends husband is a lawyer, and the area he lives in requires a certain number of hours of pro-bono work yearly. Why can't Dr.'s do that was well? One reason why people have such stupid expensive medical bills, is due to the fact they aren't getting preventative care in the beginning (due to cost, time, etc...). If we could ask Dr.'s (part of the AMA req's or something?) to donate a few hours a week (maybe Sat mornings?) to basic care, and prevention, I think that would make a HUGE difference in the long run.

Last edited by Cav Scout wife; 06-15-2009 at 05:59 PM..
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Old 06-15-2009, 06:02 PM
 
15,065 posts, read 19,710,115 times
Reputation: 12234
Quote:
Originally Posted by Cav Scout wife View Post
Besides, the government sucks, they are so horrible that they are the only ones I know that can screw up their OWN wet dreams, do you REALLY want those type people dictating what care you can or can't get?!
Same people that say this (rightwingers)
are the ones that think the government is so good that it can solve all the problems around the World
and we should give them a blank check while they are doing that.
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Old 06-15-2009, 06:11 PM
 
Location: On the Ohio River in Western, KY
3,388 posts, read 5,746,509 times
Reputation: 3343
Quote:
Originally Posted by Dopo View Post
Same people that say this (rightwingers)
are the ones that think the government is so good that it can solve all the problems around the World
and we should give them a blank check while they are doing that.
I disagree with that too.

If I can't afford something, I don't get it, why should the Gov be any different?

No blank checks, no BS'ing the books, if I am held accountable for my actions, the Gov should be as well.
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Old 06-15-2009, 06:21 PM
 
2,105 posts, read 1,196,366 times
Reputation: 636
Quote:
Originally Posted by Cav Scout wife View Post
My husband and I both WERE enlisted, not currently. I know ALL about Tri-Care and their BS, thanks.

That's why I am against socialized health care.

I am sick and tired of some pencil pusher making the decisions about MY health. That should be up to me and my Dr, and not a bunch of bureaucrats.

Oh, as for who pays for our medical care? We do, uninsured out of pocket. We have a family Dr. (he's my cousin, so when I say family, I mean family, lol!) that charges us reasonable rates (not $300/visit for 10 mins of actual Dr. time), and we have another family member that is a dentist for our oral care.

Thank goodness we have been lucky enough not to have serious medical problems, but if we do, we will cross that bridge when we get there.

We choose not to have insurance, since it was costing us more than we were using it. We were paying $300/month for all 3 of us, and it was only taking off $5/script for my 2 scripts, and $50/script for our DD's script. What sense does it make to pay $300/month to save only $60?! Not to mention, our co-pay (for Dr. visits) was $30, and we only went to the Dr. once every 3 months.


Instead of letting the government run healthcare, why not take a page out of the law books, literally. One of my best girl friends husband is a lawyer, and the area he lives in requires a certain number of hours of pro-bono work yearly. Why can't Dr.'s do that was well? One reason why people have such stupid expensive medical bills, is due to the fact they aren't getting preventative care in the beginning (due to cost, time, etc...). If we could ask Dr.'s (part of the AMA req's or something?) to donate a few hours a week (maybe Sat mornings?) to basic care, and prevention, I think that would make a HUGE difference in the long run.
Never mind.
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Old 06-15-2009, 09:36 PM
 
Location: Indianapolis, IN
914 posts, read 3,953,577 times
Reputation: 843
Quote:
Originally Posted by Danno3314 View Post
Every business has to account for bad debt but, that's not why I'm replying. I'm an insurance broker and all I do is health....as I read through what you copy and pasted, you kept referring to the carrier and it's network as an insurance company...then as I read more I realized all these examples are HMO's.

Insurance companies generally market PPO plans, which with the exception of BC/BS (which is not a insurance company any way), don't have a network of their own.....they pay a per person monthly fee to a network for the service it provides. The network negotiates the contract with providers and also takes care of pre-authorization (which BTW, is not required in advance in the case of an emergency). Before they got serious about the patient rights to privacy with HIPAA, I used to see copies of all my clients EOB's and I never saw any problems like your talking about. The discounts were some were around 25-33% usually.....many were a lot less. Sometimes they did pay zero on a code but, in those cases it was because it was already included as part of and paid under another code (not often though and athey were usually small amounts).

I also enroll people and companies on an HMO when it's a good fit for the client. I don't see any paperwork from HMO's except my commission check each month (and the statement that goes with it showing me which clients paid that month.....and they all usually completely screw it up with mistakes). It doesn't surprise me to hear what you said when it comes to HMO's. There are reasons an HMO will work better for people in some cases (which I won't go into) but, minus those reasons a PPO is always the way to go.

They get away will a lot of things because, you can't sue them like you can an insurance company and the DOI doesn't even treat them the same way they do insurance companies. Unfortunately if we do get UHC, it's going to be like an HMO .

BTW, that example with Secure Horizons, that's secondary to Medicare part A (hospital coverage) which is administered by United HealthCare...they (meaning Secure Horizons) get what normally is paid to the government for part B (the doctors bill) so it replaces part B and eliminates all the deductibles so it's alternative to a Medi-gap policy.....so that $9,000+ was the surgeon's bill for a hernia operation? Even as a Medicare supplement, I always go with the Medi-gap policies (which pays like a PPO and sometimes even has a network (BC/BS does that) which reduces the premium a little).

Oh, Aetna was the last company to administer Medicare before United HealthCare won the contract and took it over.
WAIT! I realized doing the dishes why were are on different pages here. It seems you ARE mainly talking about physician billing. That is what you describe here, and that would explain why you wouldn't have really seen what I was talking about in the EOBs and why you were seeing a lot of incidental denials! (Dr's bills related to facility claims often to get denied as incidental to the primary procedure. In fact, with many isnruance companies, everything is denied as incidental to the primary procedure.) It would make sense that this is primary what you would see because there are way more profee claims than hospital claims.

I am sorry if I don't the the correct phraseology for every type of plan. To be honest, the way all types of claims are billed is basically the same from my end. I know funding comes from different places. And while I have done limited physician billing (ER and radiology), I don't verify correct payment or follow up on physician billings anything beyond status checks for completely ignored balances. I have never done verification of payment or physcian denials (except if they were denied as part of my facility claim). So if you are drawing a lot of experience from physician claims then I wouldn't really be able to speak to what is going on with those, other than I hear with certain types of plans, they are underpaid.

To be honest I don't think underpayment of physician billing is bringing down the system. Not that docs don't get screwed over, and not that there aren't large doctor bills (anesthesia anyone?), but you don't get the same kinds of denials that facility claims do, and you don't get quite ratio of high dollar claims. It is things like denials for MRI's and hospitals stays that really, really add up to increased healthcare costs.

Oh, and I forget to mention, yes, obviously insurance companies can't require pre-authorization for emergencies, but if those emergencies become inpatient stays, they require notification of admission and regular clinical updates, which, if they don't feel they have received, the deny with a "no authorization" denial. I apologize if I wasn't clear on what I meant there. No PRE-auth was required, but there are still authorization requriements. I don't think I've ever seen any plan, regardless of type, that didn't require this.
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Old 06-15-2009, 10:24 PM
 
Location: Unperson Everyman Land
30,470 posts, read 20,115,817 times
Reputation: 8385
Quote:
Originally Posted by SLCPUNK View Post
The Republicans crack me up. On one hand they denounce the government as inefficient and bloated. However during the Bush era if we dare question the validity of their assertions we were labeled as traitors or worse as the government clearly knew what it was doing.

Always want to have it both ways.

Should we assume since you've declined to answer the question and have gone off topic that you have no answer?
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Old 06-16-2009, 01:40 AM
 
Location: Avondale, Chicago
14,419 posts, read 26,249,742 times
Reputation: 9459
Actually SLC, they were denouncing the government as inefficient and bloated while they were creating more bureaucracy and expanding surveillance in the name of "homeland security," not all of which actually did anything to make anyone secure besides more bureaucrats in their jobs and folding FEMA into the new bureaucracy making it completely useless. And this was done while the GOP was in control of the White House and Congress.
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Old 06-16-2009, 02:26 AM
 
Location: Prepperland
13,738 posts, read 9,852,840 times
Reputation: 9854
The choice is not "socialized" health care versus private sector healthcare.
Since 1935, we've been living under socialism - gradually implemented.

Frankly, you will never see costs GO DOWN if government "gives" us all access to medical care.
When has anything that the government was responsible for, go DOWN in cost?

If you want UNIVERSAL Health care, you need to reduce costs, maximize the number of care givers, and eliminate bureaucracy.
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