Gee, if they’re not denied, then maybe that means people can actually get the care that their insurance plans actually claim to provide. From the moment you file a claim for care that actually costs money, the insurance companies immediately start working to deny you benefits, from only partial care, to claiming that your care is “experimental” to the charming tactic of trying to get the money back from you even after the claim has been paid.

But then, guess what the plan they support and the government program they demand does:

As an example, Medicare will not pay for an annual wellness physical.

Now watch them both start to spin and whine about how it’s a GOOD thing that Medicare denies that, that it doesn’t cover that.

Every hospital would love to cut costs and remain legal and protected from trial lawyers. Please suggest where these cuts could take place without negatively affecting the care being given or exposing the institution to the law or the lawyers.

In what areas are the hospitals exclusionary except in the areas of abortion, elective plastic surgery or experimental treatments? (You might spend a night in the emergency room…..I suggest Thurday….to test your exclusionary theory.)

Many places have “PromptCare” type private storefront 24/7 medical clinics. The bills from those places are far higher than from the average doctor’s office or out patient hospital. Their insurance risk and deadbeat risk is enormous. Therefore, those who can pay must carry the losses. Operating a medical practice on a “for profit” basis is a tough business.

When it comes to serious medicine, everyone has an anecdote. My sister has huge bills for her MS. My wife has had continuing expense and partial cures for her pancreas problem. My nephew can not afford his AIDS cocktail. My mother was fighting breast cancer, bone cancer and depression before a heart attack killed her.

The human body is a complex machine and we have some very exotic and expensive procedures that few can afford. I can not forsee the day when the average Joe can walk into Sears and get a heart transplant or even kidney dialysis on sale. (In the case of heart transplants, we must consider the “black market” from the third world and whether we are interested in bending our ethos to accept “donors” from places where life is a commodity.)

so, 6 years and 4day on from 9/11/01, why is it our kick-ass President and cronies still havent’ captured Osama Bin Laden?

Pop quiz, Kevin:

Did the British, with 40,000 soldiers, capture or kill the Faqir of Ipi? Why or why not?

Anyone? Anyone?

BTW, if Bush is the kick-ass president, does that make BJ the half-assed president? Or would that be the kiss-ass president?

Aren’t we supposed to be intertwining global warmism with government so we can bilk the average family out of $10,800 annually so Algore and the limo libs can jet around the world with a clear conscience???

#58
to claiming that your care is “experimental”

Huh? That’s a new one. Why don’t you add the claim that the care doesn’t exist in this space/time continuum??

As an example, Medicare will not pay for an annual wellness physical. However, there are ways to get the testing done, but the doctor has to “fiddle the system” which ends up being far less efficient and more expensive in both time and dollars for the doctor and for Medicare.

Actually, it’s WORSE, TL.

After all, under Ian’s magic system, no healthcare claim can be denied or not paid in full for any reason — since he screams about private insurance companies being evil for doing so.

Therefore, there’s no incentive at all to take care of yourself. Furthermore, under our private system, you pay more if you are a higher risk and less if you are a lower risk; in comparison, under Ian’s system, those who take care of themselves are penalized and those who don’t are rewarded.

Other countries don’t allow unlimited lawsuits and settlements.

If Johnnie Edwards and the rest of the Democrat left truly want to lower healthcare costs, they could start by imposing a system like Sweden’s, in which claims are reviewed by qualified professionals and paid out based on a fixed scale by injury.

Instead, they want to force businesses to pay taxes to increase the number of potential claims — and keep unlimited lawsuits so they can sue the GOVERNMENT, who will then have to raise taxes to pay their judgments and settlements that they milk out of juries.

All businesses are about mitigating risks. What makes you think a central healthcare system is any better?

A former Insurance CEO once said “We’ll cover anything, you just have to pay the premiums.” It’s true. The PFFS plans, along with other managed care program, try to strike the best balance for everyone. The doctor, the patient, the company paying for the patient’s insurance. no one gets everything they want.

You take a plan that doesn’t cover DME? Well understand it doesn’t and buy a used C-pap, or get one over the internet. You want Name Brand Drug instead of Generic x? going to pay more for it. You want a plan that covers everything under the sun? Don’t gripe at me if your premiums are sky high. You want us to cover A B and C? Then make sure you and your doc follow steps X Y and Z.

I can take pride in my company, because they do give a damn and do react fairly fast. We initially didn’t cover the Wound Vac devices. I had a member call and point out they’re FDA approved. I forwarded it on. a month later we were covering it. Me, a lowly guy on the phones, got that started. When’s the last time you got anything changed from the government in a month?

Does everyone get what they want in their policy? Hells no. If they did, it wouldn’t exist. But if you honestly think the Government can do it faster, better, and cheeper than the Private sector can, you’re smoking something heavy.

Helitrope, please correct me on this if I’m wrong, since I don’t work on the contract side of the field. But when an insurance company sits down with a doctor or a hospital it’s a give and take, or what we on the right like to call a negotiation. When Medicare rolls in and talks to the hosptial it’s a ‘take this or nothing’ arrangement. What the left likes to call a negotiation, yes?

Ian S imagines a risk free system where you can present any health problem to the government and it will be paid for without significant cost to the patient.

Where have I suggested any such thing? I have simply pointed out that our current health care system is far more expensive and exclusionary than it has to be. And that stems from the fundamental nature of the private insurance system itself: high overhead combined with financial incentives to not make payouts and to not insure anyone at risk. Other countries have less costly systems with better health outcomes than we do. It can and should be done here.

On the other hand, governments do insure themselves against those problems for which sovereign immunity can’t give them relief. They buy fire and hazard insurance on their property, they pay for health insurance on their employees, they provide workman’s compensation insurance, and so forth.

Now if government really had a clue on how to streamline the insurance industry, it would do a great deal of self-insuring. After all, the taxpaper can always be squeezed to pay the bill.

But isn’t it passing strange that time and time again, government plans for self-insurance have failed? Have you examined the stats on Social Security or Medicare recently? If any insurance company were running a Ponzi scheme like those programs, their “fat cat” execs would be in prison.

Ian S may hate the insurance industry and he may even be one of those ubiquitous uninsured motorists who blow everyone else’s auto insurance rates sky high. But when he thinks the government (we the taxpayers) can provide quality health care for every man, woman and child in America without restriction, he is dreaming the impossible dream.

The insurance industry is nothing more than an amalgamation of underwriters who are willing to take a risk with their money. Ian S imagines a risk free system where you can present any health problem to the government and it will be paid for without significant cost to the patient. Of course, people who love this plan never consider how the bills are paid.

The biggest subsidies — averaging 19 percent above cost — go to private fee-for-service plans… these plans ride on the coattails of standard Medicare, typically providing access to the same doctors and paying them at the same rates.

Add the Walter Reed kerfuffle and it makes even less sense.

Referring to her primarily (or at all) as “Hillary” conforms to one of her biggest calculations: her *deliberate* repackaging, post-2000, as “Hillary.” It’s soft but strong, unique but generic, etc. “Ms. Rodham Clinton” is a sterner and shrewder moniker. Even “HRC” is better: remind readers of who she is, where she comes from, to get where she is.

So, people, please start to do your part: stop calling her “Hillary”!

All in all, good post. Harsh criticism delivered in a moderate tone will stand the best chance of winning over those 3 or 5 or 10% of “Undecideds” at the polls next November.

I have to wonder how we can look at the colossal failure of a multi-trillion dollar “war on poverty” and say to ourselves “By damn! I want the government to handle my healthcare too!”

Yeah. It really makes no sense.

Does anyone else find it at all significant that Michael Moore’s “Sicko” earned less than one-fifth of what “Fahrenheit 9/11″ did?

It’s my understanding that it’s not the Bush bash-fest that Farenheit was. I suppose, since that’s all liberals live for, aside from absolute power, they wouldn’t be interested.

I have to wonder how we can look at the colossal failure of a multi-trillion dollar “war on poverty” and say to ourselves “By damn! I want the government to handle my healthcare too!”