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re: article detailing the lengths health insurance companies will go to deny coverage
Posted on 2/3/23 at 10:13 am to Taxing Authority
Posted on 2/3/23 at 10:13 am to Taxing Authority
i think the thread title is kinda ironic. While deriding insurance companies for the efforts to avoid paying their care… the reason people have insurance is to… avoid paying for their care. 
Everyone wants some magic system to stick their neighbors with their bills… Guess what your neighbors are busy doing?
Everyone wants some magic system to stick their neighbors with their bills… Guess what your neighbors are busy doing?
0
Posted on 2/3/23 at 10:17 am to tehchampion140
In one sense, I will be eternally grateful for insurance because my youngest had a heart defect when he was born and that whole ordeal ended up costing over half a million dollars that we didn't have to eat.
In literally every other sense, I hope all of the "doctors" and "nurses" that work for insurance companies and pull dishonest crap like this get a taste of their own medicine one day.
In literally every other sense, I hope all of the "doctors" and "nurses" that work for insurance companies and pull dishonest crap like this get a taste of their own medicine one day.
Posted on 2/3/23 at 10:25 am to chRxis
quote:
but the idea of shared costs is just too much for some people
Why should I be on the hook for your health decisions?
Posted on 2/3/23 at 11:45 am to chRxis
quote:A gvoernment that finds it politically unsurvivable to cut Social Security... will not ration end-of-life coverage. It's a cultural issue. And our culture wants heroic care (as long as it's 'free').
i'm saying by changing our end of life strategy/philosophy,
quote:Largely already the case. A ton of routine stuff is now mandatory covered by insurance.
as well as making preventative care free
quote:It simply doesn't work well. Mutual companies for medical coverage were pretty popular from the 50s-70s. They went away, because actuarial (risk-based) insurance was MUCH cheaper for customers.
but the idea of shared costs is just too much for some people...
And it makes sense. In healthcare, only a small minority need coverage, but they often have very large expenses. In "shared cost" models everyone put in an equal amount, but any one person can drain the entire fund.
With real risk-based insurance, those risky individuals have to put in more than healthy people. Which, seems fair to me.
Unfortunately, risk-based health insurance is a thing of the past. And the rates and ability to cover expenses reflect it.
Posted on 2/3/23 at 11:57 am to Zappas Stache
quote:
My Dad is on Medicare and has had several health issues the last 8 years including 2 cancers and he has been well taken care of. He has been able to choose what oncologist he wanted which is more than I would get with my private insurance. Overall, medicare for he and my mom has been very good
Which private insurance company does he have his Supplement or Advantage plan through? I am willing to bet he does not just have Medicare parts A and B with no other coverage.
Posted on 2/3/23 at 11:59 am to Bestbank Tiger
frick United Healthcare
Posted on 2/3/23 at 12:03 pm to grizzlylongcut
quote:
Why should I be on the hook for your health decisions?
You already are that’s literally how insurance companies work, it’s essentially a tax anyway the main difference is one goes to a for profit company and the other goes to the government. A lot of minds have just been warped to the point where anything that remotely resembles “socialism” is worse because they were force fed decades of propaganda by the media and politicians claiming that it’s the right thing to trust these companies and despite how bad it may get it’s somehow worse with the government despite no actual evidence of such
Posted on 2/3/23 at 12:04 pm to Harry Morgan
quote:
Medicare > Private Insurance
Medicare wouldn't be what it is without private insurers.
Posted on 2/3/23 at 12:20 pm to Zappas Stache
quote:
Ask anyone who is the worst insurance to deal with. 9 outta 10 are going to say "Medicare"
My Dad is on Medicare and has had several health issues the last 8 years including 2 cancers and he has been well taken care of. He has been able to choose what oncologist he wanted which is more than I would get with my private insurance. Overall, medicare for he and my mom has been very good
As someone in hospital administration...Traditional Medicare is 100% the best payor, the easiest to work with, the one that approves the most and gives the most choice to it's patients.
Medicare Advantage plans can be the devil. They vary considerably between plans on what levels of care, drugs, tests, etc. they approve and basically, you get what you pay for.
Posted on 2/3/23 at 12:20 pm to tehchampion140
The hilarious thing about all of this is that we already pay for the most expensive part of the population to have medicare/medicade. This is the part I can never wrap my head around when we start talking about medicare for all.
Those unable to work and the poor + olds have medicare/medicade. The people that are supporting it all from a payroll perspective are shut out of that system and fleeced by billion dollar private insurance companies. On top of that they've convinced all of you that this is a good thing. This is some Debeers level marketing bullshite.
Those unable to work and the poor + olds have medicare/medicade. The people that are supporting it all from a payroll perspective are shut out of that system and fleeced by billion dollar private insurance companies. On top of that they've convinced all of you that this is a good thing. This is some Debeers level marketing bullshite.
Posted on 2/3/23 at 12:23 pm to Ric Flair
quote:
Managed Medicare/Medicare advantage/Medicare ppo patients get denied routinely for inpatient rehab, or you have to jump through hoops with peer-to-peer review to even get admitted to inpatient rehab, even despite a compliant diagnosis (60% rule) like a stroke. Even with multiple medical comorbidities. If they are approved for rehab, their approved are typically less than recommended by the IRF-PAI. They never get approved for SNF/subacute rehab if needed after a course of acute inpatient rehab.
100%!!! This!!!!
If you can get your parents to go with traditional Medicare with a supplement, that's what they need to do. It gives the most choice and coverage.
Posted on 2/3/23 at 12:28 pm to grizzlylongcut
quote:
Why should I be on the hook for your health decisions?
You shouldn’t, and that was his point. The way our system is set up, the healthy subsidize care for the unhealthy. It was the whole idea behind Obamacare - get young, healthy people on insurance so it increases the pool of money for care, and hopefully drive down the cost of premiums.
Posted on 2/3/23 at 12:43 pm to TomJoadGhost
But it’s had the opposite effect. Premiums have been soaring ever since it was enacted.
Posted on 2/3/23 at 12:59 pm to TomJoadGhost
quote:
It was the whole idea behind Obamacare - get young, healthy people on insurance so it increases the pool of money for care, and hopefully drive down the cost of premiums.
This didn't work. The young and healthy could not afford it, they didn't buy policies, and it wound up increasing the price for everyone. I am talking about plans on the ACA individual market, of course.
The only young and healthly that can afford individual market plans are the poor and get the subsidy, which pays for part or most of their premium.
Posted on 2/3/23 at 1:05 pm to Bjorn Cyborg
quote:Hell, just a month ago there were several cases of Canada's healthcare system recommending and sending out suicide kits in response to resolvable health issues.
Is it your insinuation that a government system would be better and wouldn’t also deny coverage?
There is no utopia when it comes to healthcare.
Posted on 2/3/23 at 1:06 pm to tehchampion140
Idk what the answer is but healthcare is so beyond fricked in this country
My only liberal position is that everyone should be covered and a medical issue shouldn’t bankrupt anyone
My only liberal position is that everyone should be covered and a medical issue shouldn’t bankrupt anyone
Posted on 2/3/23 at 1:42 pm to frogtown
quote:
This didn't work. The young and healthy could not afford it, they didn't buy policies, and it wound up increasing the price for everyone. I am talking about plans on the ACA individual market, of course.
Correct. And the ACA set up coverage requirements for all policies. Therefore, you can no longer purchase major medical only, or eliminate certain types of items from your coverage. It was determined that these policies were considered "substandard" and therefore should not be sold. This is what created the lie of "if you like your coverage, you can keep it." The policies many people liked and used were suddenly not allowed to be sold.
Posted on 2/3/23 at 2:00 pm to Ronaldo Burgundiaz
quote:
There is no utopia when it comes to healthcare.
True however under our current system it is designed to make profits for the insurance companies and pharma companies first. With government funded healthcare there is no middle man and no profit incentives, strictly care of the patients. Is it perfect? Nope, especially if it’s not properly funded. But it won’t turn out to be like our current system where you have people going into debt or getting denied coverage just because of their history or income
Posted on 2/3/23 at 2:01 pm to VerlanderBEAST
A
what alternative do you think will benefit the individual more?
quote:
hhhhhh nothing like some good ole capitalism
what alternative do you think will benefit the individual more?
Posted on 2/3/23 at 2:15 pm to dawgfan24348
quote:
With government funded healthcare there is no middle man and no profit incentives
This is correct, there is only an extremely inefficient government.
This post was edited on 2/3/23 at 2:18 pm
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