Obama Stimulus Plan Dangerous to Your Health..CODE RED.

Sunnysideup said:

Miss the hospital can call chemotherapy elective as well. They turned away my sister....she was stage 4 ovarian cancer and somehow they deemed that elective...They do whatever they want.

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yes, well my basic point is that the medical treatments that are now performed without Govt. controls are very competitive on a dollar/performance ratio....unlike Govt. controlled medical procedures. We are moving in the wrong direction, and unfortunately we have just picked up a bit of speed.

I'm not talking about loopholes of which I am sure there are many. But in the general arenas of elective vs non elective. Elective being you CHOOSE to do it...as opposed to a doctor saying, you need to do this. K?

The free market can work, but the govt has no interest in letting it....wonder why? $$$$$$ & POWAH

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Jax, I guess it's never happened to you. A doctor can say "yes you need this done" then your insurance can say "nope it's elective".

Hospitals and insurance companies can deem anything as elective.

misshestermoffitt said:

Jax, I guess it's never happened to you. A doctor can say "yes you need this done" then your insurance can say "nope it's elective".

Hospitals and insurance companies can deem anything as elective.

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You are still very free to pay for it yourself..... no one says you can't do anything you want, just that your poicy does not cover it. Get a better policy.

Sounds harse but you are not entitled to unlimited care, just because it exists.

Insurance is a business after all, not a right.

My insurance is good, but that doesn't mean that can't refuse to cover things. Who said I was talking about my personal policy? Where is it right for a person to pay in for 10 years and never really have a claim, then when they need to have a claim they are denied?

I suppose Elf, you have 50K in your bank account, just in case?

misshestermoffitt said:

Jax, I guess it's never happened to you. A doctor can say "yes you need this done" then your insurance can say "nope it's elective".

Hospitals and insurance companies can deem anything as elective.

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mmmm, ur missing my point Miss. Perhaps i'm not being clear...everything you mentioned is Govt. controlled and reg'd and pushed and pulled by programs.

I'm talking about medical procedures not messed with by govt. intervention.

I'm not talking about insurance coverage and denial. That's one of the side effects of having the govt. drive up costs. I don't know how old you are but when I was a kid and my mom took me (kicking and screaming) to the family doctor (yes they actually existed), it was one guy and one nurse/receptionist, maybe 2 nurses. Go to that very same office today and you will see 1 nurse and 3 office personnel. GOVT.!!! Paperwork!! $$$$$$$$. Guess who pays for those clerics to push paper, even though you are just there to patch your kid up from sandlot baseball or something minor. It all adds up.



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CrackerJax said:

mmmm, ur missing my point Miss. Perhaps i'm not being clear...everything you mentioned is Govt. controlled and reg'd and pushed and pulled by programs.

I'm talking about medical procedures not messed with by govt. intervention.

I'm not talking about insurance coverage and denial. That's one of the side effects of having the govt. drive up costs. I don't know how old you are but when I was a kid and my mom took me (kicking and screaming) to the family doctor (yes they actually existed), it was one guy and one nurse/receptionist, maybe 2 nurses. Go to that very same office today and you will see 1 nurse and 3 office personnel. GOVT.!!! Paperwork!! $$$$$$$$. Guess who pays for those clerics to push paper, even though you are just there to patch your kid up from sandlot baseball or something minor. It all adds up.



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Riverbend Overview

Home » About Us » Overview

With its main headquarters in Chattanooga, Riverbend Government Benefits Administrator (Riverbend) a wholly owned subsidiary of BlueCross BlueShield of Tennessee Inc. serves as a Part A Intermediary under the Medicare program. In addition to the 955,000 Tennessee, Riverbend also serves Medicare enrollees in 45 other states. Riverbend serves as a multi-regional Rural Health Clinic Intermediary spanning both coasts. We are the nation's only Intermediary for Religious Non Medical Healthcare Institutions, Organ Procurement Organizations and Histocompatibility Labs. In addition, we serve as the single Intermediary for two large national Skilled Nursing Facility chains.
During the 12-month period ending September 30, 2006, Riverbend processed approximately 10.7 million claims and paid out $ 9.8 billion in benefits.
Riverbend has been a Medicare contractor since the program's inception in 1966. We expanded our operation to the eight southeastern states in 1977 with the addition of the Rural Health Clinic coverage. In 1993, Riverbend became the single intermediary for a Skilled Nursing Facility chain that operated facilities in over 20 states. When Aetna decided to cease their function as a Medicare contractor in 1997, Riverbend was chosen by the government to assume the role of Medicare payer for over 700 Rural Health Clinics and Christian Science Sanatorium throughout the country.


Any one want to believe that the corporations aren't the ones that would really benefit from a move to a "single" payer system?


There's BCBS (Anthem), Med. Mutual of Ohio would probably be a big beneficiary in Ohio, Aetna would be another giant winner under a SPS.


The question is who would be the losers?


The answer to that is, thousands of small to medium sized insurance companies that do not waste millions of dollars lobbying DC Politicians to help them establish a monopoly.

The entire health care through employees was NEVER intended to continue, but to sunset. How did health care occur through employers? Why a CAP on salaries by FDR. Sound familiar? Employers gave benefits since it was a loophole on salary caps. This helped the corp's keep the talent from leaving.

Health care should be personal.


out.

Great article. Thank you for sharing this!

Health care is monopolized where I live, we have 2 choices and there isn't a doctor within 60 miles that isn't a part of one of those networks. You can have the best insurance ever, but if it isn't their network insurance they raise the cost to an unbelievable level for the basic cost. The percentage the patient ends up paying as their part is nearly what the service would has cost if the patient paid cash.

A service through their network, $80. Same service if your insurance is "out of network" $400. Which makes the patients percentage to pay if their plan is 80/20 = $60.

There should be one cost for the service, no matter what a person's provider is. This constantly rotating cost of service should not be allowed, and the real kicker is, if you ask, "how much does this cost" they can't tell you. Nobody knows until later when it goes through billing.

Then they pull little bullshit to jack the cost, do you have a uterus? yes you do, sorry we can't prescribe anything without charging you for a pregnancy test and that's gonna cost you. What do you mean you are sure you aren't pregnant? Sorry, we can't take your word for it, if the urerus is there, we have to test. Then the bill comes in, WTF is this? $40 for a pregnancy test that I didn't need and could have bought myself for $5.

I'm actually going to start taking my own stick tests to the doctor with me, just to avoid a bullshit charge for something that I know I don't need. The really bad thing is that my insurance can look at my medical history and see that there is no need for a pregnancy test and they can in turn deny payment, they haven't..... yet..... but I bet sooner or later we'll get there.

misshestermoffitt said:

Health care is monopolized where I live, we have 2 choices and there isn't a doctor within 60 miles that isn't a part of one of those networks. You can have the best insurance ever, but if it isn't their network insurance they raise the cost to an unbelievable level for the basic cost. The percentage the patient ends up paying as their part is nearly what the service would has cost if the patient paid cash.

A service through their network, $80. Same service if your insurance is "out of network" $400. Which makes the patients percentage to pay if their plan is 80/20 = $60.

There should be one cost for the service, no matter what a person's provider is. This constantly rotating cost of service should not be allowed, and the real kicker is, if you ask, "how much does this cost" they can't tell you. Nobody knows until later when it goes through billing.

Then they pull little bullshit to jack the cost, do you have a uterus? yes you do, sorry we can't prescribe anything without charging you for a pregnancy test and that's gonna cost you. What do you mean you are sure you aren't pregnant? Sorry, we can't take your word for it, if the urerus is there, we have to test. Then the bill comes in, WTF is this? $40 for a pregnancy test that I didn't need and could have bought myself for $5.

I'm actually going to start taking my own stick tests to the doctor with me, just to avoid a bullshit charge for something that I know I don't need. The really bad thing is that my insurance can look at my medical history and see that there is no need for a pregnancy test and they can in turn deny payment, they haven't..... yet..... but I bet sooner or later we'll get there.

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There was a lawsuit in NY that was just settled about that...

Though I personally think that all this crap is a result of our government dictating to everyone that we must all have gold plated insurance coverage.

I don't need insurance that covers pregnancy tests (mostly cause I don't have a uterus.)

Or sex changes (Don't want one, or plan on ever wanting one.)

It's totally absurd for the government to mandate that some one that can't get pregnant, or knows their not pregnant (probably through intelligent use of contraceptive measures) to subsidize the costs of those tests for those that can get pregnant. Especially considering the fact that these "subsidized" costs are, what is that 8x, higher?

8x higher. That's insane, but apparently, by not having insurance people are placed at a "disadvantage" to those that do.

It's a giant scam. A way for the doctors to make money, and the insurance companies to make money, by screwing over the average American, and a SPS won't fix it.

There should be one set price for a service. You can't call and say, how much is a physical exam and get a price quote, it's do you have insurance, what kind of insurance, blah, blah blah, it should be, "the service costs X amount of dollars and then depending on your insurance it will cost you Y amount of out of pocket"

I also bet cash money that if I whipped an EPT out of my purse and said I'll pee on this and then we can both determine that I'm not pregnant even though I've given you a list of reasons why I know I'm not already, 2 of them being surgical, they'd say no they can't accept that. It has to be their test.

I wan't some milf and cookies.

Ok then JR, good luck with that.......

misshestermoffitt said:

There should be one set price for a service. You can't call and say, how much is a physical exam and get a price quote, it's do you have insurance, what kind of insurance, blah, blah blah, it should be, "the service costs X amount of dollars and then depending on your insurance it will cost you Y amount of out of pocket"

I also bet cash money that if I whipped an EPT out of my purse and said I'll pee on this and then we can both determine that I'm not pregnant even though I've given you a list of reasons why I know I'm not already, 2 of them being surgical, they'd say no they can't accept that. It has to be their test.

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I don't know about one set price, but doctors should be consistent in their own prices (not to prevent them from setting prices their own), just preventing them from charging different prices for different insurances, or lack thereof.

Though, some of the insurances have wildly disproportionate reimbursement rates, so even the insurances can't agree on how much a given service is worth.

I think more autonomy should be given to the doctors.

If a doctor thinks an office visit is worth $50, it should be $50 regardless of insurance, and the insurance companies, medicare/medicaid/schip/so and so forth, should have to accept the price that the doctor charges. If it is disproportionate compared to the prices other doctors charge then the market will force the doctor out of business, or to lower his prices (or raise them.)

Of course, if the insurance companies are crazy enough to believe that that same $50 office visit is worth $100... then people also have a responsibility to do something about their insurance companies.

Caveat Emptor

That's what I mean by one set price. It should be the same price no matter what, then your insurance pays their part and you pay your part. Anymore "what kind of insurance" seems like a loaded question.

Doctors no longer set the price folks, there's your problem......


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I had a root canal done five years ago and my sister in law reccommended a doctor and she went thru her insurance. Her bill was 1500. I went in and told the doc I had no insurance (i had plenty), but would gladly pay cash. he said wait here and came back in and said can you come back at 4:00... sure... he did it after hours with an assistant for 700. What does that tell you about socialized medicine as to efficiency?


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CrackerJax said:

I had a root canal done five years ago and my sister in law reccommended a doctor and she went thru her insurance. Her bill was 1500. I went in and told the doc I had no insurance (i had plenty), but would gladly pay cash. he said wait here and came back in and said can you come back at 4:00... sure... he did it after hours with an assistant for 700. What does that tell you about socialized medicine as to efficiency?


out.

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It tells me the doctors are subsidizing your 700.00 root canal by bilking the insurance companies out of 800.00 while the insurance companies are bilking their participants out of outrageous amounts and co-pays that would equal that 700.00, so CEOs and high paid staff can sit around making decisions about your health. The dentist told me that an implant would be around 3500.00 and the ins., would pay about 700.00. My Buddy got his implants done for 2200.00 cash each. What this tells me is we need not for profit medical and dental paid for by taxes on us and our employers, wiping the greedy insurance companies and dental co-ops and HMOs off the face of the earth. Scum sucking pigs all. Anyone that makes a living from other peoples misery deserves the fires of hades. Socialized medicine would eliminate that for the most part. Yeah we'd have to pay a few mor buckaroos in taxes, but the money we'd save in insurance and co-pays would more than make up for it. the age old dillema is that the healthy youth don't want to pay for the unhealthy seniors, not realizing I guess, that someday they will be old and in need of more medical.

No, it means that he took the money under the table and the taxpayers saved 800 bucks. that's the amount placed on top by Govt. induced insurances.

Meaning if you didn't have insurance requirements everyone would pay a whole lot less. You would also get better doctors because the real talent doesn't go into practice anymore....they go into research.


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