[Pulp_Cutter]

Pelosi & Obama have to be chomping at the bit to release some of the early positive results from govt-managed healthcare. However, positive early numbers are largely the result of sucky economy (people have no money), and that muddies the waters too much. It's coming, though. In Mass & VT (which have had universal plans longer), the data are coming in, and the track record looks good.

[artv1]

Ha! If my ins. premium hikes are any indication, wait until the numbers for 2011 and 2012. Starting in April my costs will be up 27% from Jan. '11.

[Pulp_Cutter]

artv1, on 10 February 2012 - 09:58 AM, said:

Ha! If my ins. premium hikes are any indication, wait until the numbers for 2011 and 2012. Starting in April my costs will be up 27% from Jan. '11.

If you were in Mass or VT, you wouldn't have that problem.

You're the one who wanted a free-market system. Insurers get to rook you for all they can get - even though their costs are going down.

Govt-run Medicare, which handles the vast majority of sicker Americans (those 65 and older), is run way more efficiently than the private side. You know what else? They pay clinicians (me) more. Used to be that Medicare paid at a lower rate, but for the past several years, the insurers have moved to pay a % of the Medicare free structure (and that % is under 100).

I can't understand how Americans can continue to be so stupid - truly amazing.

[artv1]

You're the one who wanted a free-market system.


Not me. I'd be fine with government run health care.

[Pulp_Cutter]

artv1, on 10 February 2012 - 12:32 PM, said:

You're the one who wanted a free-market system.


Not me. I'd be fine with government run health care.

My apologies.

So - my experience with MassHealth (the state-run program that everyone gets for 'free' - that is, on the state taxpayer - if they can't afford health insurance:

1) I don't need to call in to verify what they'll cover, they give me a printed sheet that says what they'll cover. There have been a few slipups, but basically, if it's on the sheet, they'll cover it. In contrast, here's what happens at some of the "reputible" big-name health insurers. My gal calls up, waits a bit on hold (while I'm paying her), gives the information, gets approval, we bill, the insurer denies payment. This happens "only" 10% of the time or so, but you're talking > 1/3rd of my businesses profit, if we don't appeal it - and by the way, the patient is legally on the hook for it. We spend a lot of time going back & forth, filling out paperwork that is only tangentially related to the matter at hand - it's clear some jerkoff at the insurer is trying to wear us out - and then generally we get paid. This happens day in and day out, and I'd say it costs me my 3-clinician practice about 0.5 FTE office staffer to handle it. AND remember again that the patient is on the hook. About twice a month we end up with something that seriously IS denied, and somebody is out several thousand dollars, which they didn't anticipate paying. My practice ends up 'eating' most of these, but obviously it adds a tremedous amount of friction and inefficiency to the process - all the more irritating since we went through the process to get approval beforehand. Again, with MassHealth & Medicare - pretty much cut & dried automatic, you & the patient know upfront what's going to be covered and what isn't. And they both cover virtually everything. If what they cover in my niche of healthcare is typical, I'd have zero problem if Medicare (for under 65) was my family's sole insurance. Mass Health is just a hair tighter - still pretty good. In non-lifethreatening stuff, they don't cover the very last inch of fancy bells & whistles.

[Pulp_Cutter]

artv1, on 10 February 2012 - 12:32 PM, said:

You're the one who wanted a free-market system.


Not me. I'd be fine with government run health care.

My apologies.

So - my experience with MassHealth (the state-run program that everyone gets for 'free' - that is, on the state taxpayer - if they can't afford health insurance:

1) I don't need to call in to verify what they'll cover, they give me a printed sheet that says what they'll cover. There have been a few slipups, but basically, if it's on the sheet, they'll cover it. In contrast, here's what happens at some of the "reputible" big-name health insurers. My gal calls up, waits a bit on hold (while I'm paying her), gives the information, gets approval, we bill, the insurer denies payment. This happens "only" 10% of the time or so, but you're talking > 1/3rd of my businesses profit, if we don't appeal it - and by the way, the patient is legally on the hook for it. We spend a lot of time going back & forth, filling out paperwork that is only tangentially related to the matter at hand - it's clear some jerkoff at the insurer is trying to wear us out - and then generally we get paid. This happens day in and day out, and I'd say it costs me my 3-clinician practice about 0.5 FTE office staffer to handle it. AND remember again that the patient is on the hook. About twice a month we end up with something that seriously IS denied, and somebody is out several thousand dollars, which they didn't anticipate paying. My practice ends up 'eating' most of these, but obviously it adds a tremedous amount of friction and inefficiency to the process - all the more irritating since we went through the process to get approval beforehand. Again, with MassHealth & Medicare - pretty much cut & dried automatic, you & the patient know upfront what's going to be covered and what isn't. And they both cover virtually everything. If what they cover in my niche of healthcare is typical, I'd have zero problem if Medicare (for under 65) was my family's sole insurance. Mass Health is just a hair tighter - still pretty good. In non-lifethreatening stuff, they don't cover the very last inch of fancy bells & whistles.