"If you like your current Bureaucrat, you can keep him."
There are three very vocal groups in the current health care debate: Those who want to do nothing; those who want to do everything and a large group who know changes need to be made, but would like some honest debate. No matter the resulting legislation, we have bureaucrats now and more are coming.
I received messages from two individuals with different situations and questions. One was from Australia and was happy with their subsidized care and had been following the great American debate and wondered if anyone could explain what kind of system we have. The other from Canada was unable to obtain care and was going to sell what she has and move to a different Province that had more favorable, and available doctors. If she were wealthy enough, she would certainly come to the U.S. to get care.
I don't have any answers for our Canadian neighbor, but am thankful that we have not gone that far as yet. As to our Australian question; our system depends upon what coverage one has and each companies' policies. Here are two examples:
I am in my first year of Medicare. Just one of my more minor procedures that have had this year was billed for $1,450.00. Medicare discounted the bill by more than $1100.00 and paid $290.00. My supplemental plan kicked in $62.00. So the doctor received $352.00. The patient, me, is not responsible for the rest and that is good for me. But, I would like to know where we are to cut costs on Medicare beyond the above example. I actually feel guilty when I make appointments with my family physician because I know that he will not even cover his costs for an office visit.
My wife is still a few years from Medicare and has a private insurance policy. Her recent visit to our hospital radiology department was billed at $2,035.00. The insurance company paid $790.00 and took a discount of $550.00. The balance of almost $700.00 will be our responsibility. That portion was not "medically required.according to documentation."
The above examples are a tiny fraction of our costs for this year. So for those who are trying to scare me into doing nothing because a bureaucrat will come between me and my doctor can save their advertising money. I already have had my fill of private insurance bureaucrats in the last 20 years and am not going to miss any sleep because of a few more.
For those who are asking me if I want "affordable" health care; ....not sure, let me think....absolutely, but at what cost? We don't really know.
What I really want is for the insurance companies not to change coverage by reinterpreting phrases like "Reasonable and Customary" and deciding what tests are necessary by simply telling the hospital and not contacting my doctor. Also, I really want to see some changes in regulations of insurance companies to eliminate the bonuses paid to employees for "dumping" seriously ill policy holders. There is a place in the market for insurance companies, but even they are aware that change is coming and are beginning to understand the public frustration.
But, most of all, I really want to have a law passed that all politicians must actually read any bill upon which they are voting. I am sure that the last version will be thousands of pages long and may not even be available before the votes are cast.
So for the Congressional members:
1. Do something.
2. Read and understand that upon what you are voting.
3. Know how much it will really cost - and tell us.
I don't think that is too much to ask from a bunch of bureaucrats.
TVP tvp@dyingforinsurance.com
Posted by The Virtual Patient at 7/18/2009 9:22 PM 
Categories: Reasonable and Customary, Insurance, Universal Healthcare, Costs, Pre-approval
Tags: universal health Appeal reasonable and customary Private Policies coverage preapproval costs
Categories: Reasonable and Customary, Insurance, Universal Healthcare, Costs, Pre-approval
Tags: universal health Appeal reasonable and customary Private Policies coverage preapproval costs
I do believe that the bureaucrats read all the legislation but most of them pick and choose bits and pieces of information that they can debate on to make their point supporting their point of view. I do not see that numbers are being assessed with the kind of examples that you have provided. That really is how it should be done but sadly, i don't see that they will bring forth the same kind of outcomes.
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Insurance is a minefield - there are so many "get outs" for insurance companies. Universal health care is needed for this alone.
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Interesting topic
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I am a regular reader of this blog and most of the posts here helped me a lot in getting aware about the need of medical or health insurance and its importance. It’s really an interesting piece of information that there are three very vocal groups in the current health care debate: Those who want to do nothing; those who want to do everything and a large group who know changes need to be made. The three requests you have put forward to the Congressional members through this post is really valuable and brilliant. It’s the same requests that arise in all of us mind.
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