Free Universal Healthcare

[AceLuby]

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Insurance companies often have more say over what doctors can do than do doctors themselves.

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Not really. Insurance companies pay other companies to audit the doctors, but the bill has to be high enough and the hospital/doctors usually have a history of inflating the bill. 90% of the time the bill goes un-audited if it gets accepted as a true claim. (Part of my work is developing auditing software right now)

Granted, claims do get denied, but who is responsible for that. Doctors? No, it's the patient. Doctors don't have to worry about insurance companies that much.

[Blarg]

Yes really. Your post is absolutely amazingly way off, and your "if" is a really bad one, as is the conclusion you draw, but I'll let others elaborate.

[AceLuby]

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Yes really. Your post is absolutely amazingly way off, and your "if" is a really bad one, as is the conclusion you draw, but I'll let others elaborate.

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I work w/ insurance companies, I kind of know how they operate because they pay my company to do these sort of things. Do you have any examples of doctor's/hospital's not able to do something due to insurance comapnies policies or procedures?

[Blarg]

Yeah, I used to work in the biggest workers' comp law firm in California. Everything unfolded according to endless wrangling with insurance companies over every little thing. Many denials aggravated patients' conditions and sometimes put them at great risk.

The general insurance company policy was to keep denying coverage as long as possible. Denial costs an insurance company virtually nothing, compared to paying a bill or admitting a bill should be paid or admitting a condition exists from which a bill could even possibly arise or admitting that if a condition did arise, it fell inside the limits of the coverage, etc. Insurance companies bank interest on the money they delay paying, and use it to get returns on investments. They make money by not paying, not by paying. It is standard practice that they try to get out of paying what they know perfectly well they are liable for. And I don't mean that they guess or hope; they are trained professionals who deal with similar cases many thousands of times over. What they hope is that a patient caves in, or even dies before a bill can be paid or a treatment approved or prescribed or enacted, or that a doctor doesn't even try the appropriate treatment because it will mean far too much expensive paperwork and maybe even time in court and giving depositions instead of doing his real job of being a doctor; or that an attorney will slip up in the crush of cases you need to make a living in workers' comp, or miss a deadline, whatever.

Most of these attorneys know each other and know this game inside and out. They expect the routine denials of what there is zero doubt are legitimate claims, and the weeks, months, and years of delays and denials. It's the way the game is played.

The public thinks this is a health game. They are dead wrong. This is a money game. With rare, career-endangering exceptions, the insurance companies are in it for the money. They are not charities or public service institutions in the slightest, let's not kid ourselves. They will do everything possible to prevent or delay paying a claim.

This has been shown in state after state, decade after decade, coverage type after coverage type(auto-insurance shenannigans are famous here in California, flood and storm coverage in Florida and the gulf states).

Insurance is a very cold-blooded business, and health insurance the coldest of all. The idea that insurance claims are routinely paid without a fight, and that doctors are allowed to do what they will, can only be put forward by wilfully ignoring history and the present-day operations of the medical and insurance industries.

It's the willfullness of that sort of thing that makes it clear to me that discussing it further is pretty much a pointless exercise, so I'll try to stay out of this thread from here on out.

[JPinAZ]

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MODS PLEASE LOCK THREAD OR MOVE TO POLITICS BEFORE BLOOD STARTS SPURTING OUT OF MY EYES PLZKTHX

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I hope you have insurance to take care of that.

[daveT]

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my out of pocket expense for medical not counting dental and vision is around $500 per month.

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When we had to make multiple trips to the ER for IV's for my wife, we waited endless hours each time behind a horde of illegal aliens who had stopped by to use the ER for their free clinic.


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Wow, chipwrecked, I wanted to point this out as well. Why is it that some sick migrant can walk into our hospitals, get fixed and go home? I wish I had their coverage.

[jjshabado]

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Let's also not forget that the U.S. is subsidizing the cost of new premium drugs for the rest of the world. We pay the highest prices, allowing the researchers to recover the development costs, while countries like Canada with universal care negotiate a reduced cost for the same drug in their country.

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Not true: Pharmacetical Research

Seriously, the biggest hurtle towards Universal Health Care in the US is overcoming the enormous amount of ignorance that is out there. I haven't seen Sicko yet, but I suspect Micheal Moore doesn't actually do much to help this problem. I agree with a lot of his politics but his sensationalism and distorting of facts generally does more damage then good.

[ChipWrecked]

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Why is it that some sick migrant can walk into our hospitals, get fixed and go home? I wish I had their coverage.

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EMTALA

Emergency Medical Treatment and Active Labor Act

If a hospital accepts Medicare payments and has an ER, it is legally bound not to turn anyone away from its ER.

So Mexicans drop in for free treatment by the tens of thousands, those of us paying through the nose for coverage wait for hours behind them, and hundreds of hospitals go bankrupt and close.

If you complain of chest pain, you will be moved to the front of the line. Lots of deadbeats know this angle shot too.

[MrMon]

I have often wondered what the effect of medical personnel salaries are on the cost of U.S. healthcare vs. the rest of the world. I finally found my answer in a 2006 issue of Spiegel, the German newsmagazine.



Well there's your problem! If we enslave all the doctors as government employees, capping their salary at about $125K per year, look how much money we'll save!

[Jamougha]

There is a good book, The Undercover Economist, which explains why health care in the US private system is so much less efficient than in the publicly funded system in the rest of the developed world. Supposedly it comes down to a market failure, where the lack of objective, transparent information about the state of someone's health wrecks the market.

In practice everyone but the richest would pay less and have much greater peace of mind under a universal health system. Why would you not do it?