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RE: Your baby is too fat - 10/12/2009 7:37:41 PM

Sanity

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Are you suggesting that no one has ever been mistreated by a bureaucrat?

quote:

ORIGINAL: Lucylastic

you mean like this???
Hilda Sarkisyan went with supporters to Cigna's headquarters in Philadelphia in 2008, seeking an apology for her daughter's death. While inside the building, she said, some employees heckled her at one point and one person made an obscene gesture at her.
http://www.latimes.com/business/la-fi-cigna8-2009oct08,0,5656637.story

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RE: Your baby is too fat - 10/12/2009 7:39:18 PM

tazzygirl

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quote:

ORIGINAL: Sanity

Profits hinge on efficiency and customer service and company image. Profits aren't evil, they're incentives to produce, to work your ass off in order to succeed. The profit incentive is what built this country, not government. Bureaucracies are horribly inefficient and waste tremendous amounts of tax dollars. They're not accountable to anyone...

quote:

ORIGINAL: tazzygirl

They also dont care if they turn a profit, because they, themselves, wont make a single dime more if they all or deny a claim. They work by the rules they are given... much more than i can say about the insurance companies who always have their eye on the bonus line

So you agree with the policies to deny coverage to a woman who has been beaten... or a woman who has had a c-section?

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RE: Your baby is too fat - 10/12/2009 7:40:50 PM

Sanity

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I've never quit beating my wife. Well, until after the divorce, at least.

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RE: Your baby is too fat - 10/12/2009 7:44:17 PM

tazzygirl

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and you find this funny

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Post #: 44

RE: Your baby is too fat - 10/12/2009 7:54:20 PM

Sanity

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I suppose I shouldn't expect you to understand the play on words... but the point is that government insurance and government doctors would let people die too. Its inescapable, there are finite resources. And government is horribly, monstrously inefficient. We would end up paying more for worse care then if we just take the proper steps to fix the care that we have now.

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RE: Your baby is too fat - 10/12/2009 8:08:21 PM

tazzygirl

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Im curious. Now, in all honesty, explain to me something, Sanity. Because this has confused me a great deal... and i want you to explain it.. no one else.

We have finite resources. I agree with that.

Medicaid/Medicare can only be billed so much... its almost like a flat rate for services. I know very few hospitals who turn down guaranteed money. Medicare can only charge a small portion, Medicaid pays nothing.

Now, dont forget, i am also an RN, Labor and Delivery... so i know a little about what im talking about here... medical coverage and such. The only time we needed to know what insurance they had was when a patient wanted to stay longer, or the baby needed home care.

Now, having said all this, and knowing how patients with private insurance paid more than public insurance.. and knowing the standard of care did not differ between them...
and knowing the lady who does intake at the local Social Services Center does not have a million dollar bonus at the end of the year....
and the CEO's and high paid executives are given huge bonuses to "save" money at all costs...

Why would i want a private company deciding my health care?
Why would i not want a company who determines my health care on what i can afford?
Should i chose someone who has profit on their mind... or someone who has a set of rules and must follow those rules for every client that walks through the door?

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Post #: 46

RE: Your baby is too fat - 10/12/2009 8:31:02 PM

Sanity

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The answer to your question is in your post. "patients with private insurance paid more than public insurance.."

Even while refusing to pay their fair share as you yourself admit, Medicare is going broke. Worse than broke, beyond broke. So broke that its breaking us, Obama even recently said something to that effect in a speech.

What do you think is going to happen if we expand the already bottomless Medicare money pit, and for the most part do away with private insurance.

Private insurance which apparently (judging by what you yourself wrote) pays more so that the patients whose Medicare insurance doesn't pay can still be treated decently.

The country is going broke, taz. I saw three different articles today talking about the dying dollar. When we're really hurting and government finally starts to come to terms with the fact that it can't just print the money it needs and it starts to make drastic cuts to all of its programs, who do you want insuring you.

Personally, I really want to keep the private plan I currently have.

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RE: Your baby is too fat - 10/12/2009 8:36:35 PM

rulemylife

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quote:

ORIGINAL: einstien5201

Y'all do realize that insurance is a for-profit industry, right? The only way for insurance companies to exist is to bring in more in premiums than they pay out in benefits. Nobody throws a shit-fit when other insurance companies (fire, auto, homeowners) do the same thing. If the insurer decides that it's probable that they will pay out more in benefits than they will take in in premiums for a particular potential client, it makes sense for them to not enter into a contract with that individual. Heck, auto insurance companies make pricing decisions based partially on statistical measures that are unrelated to a specific driver. A 24-year-old driver with a perfect record will pay more for insurance than a 40-year-old with the same record, just because he's statistically more likely to have an accident and cost the insurance company money. Why is this accepted as a normal business practice, while health insurance companies are vilified for similar practices?

Because a person's health should not be viewed as a business commodity.

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RE: Your baby is too fat - 10/12/2009 8:40:51 PM

rulemylife

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quote:

ORIGINAL: Sanity

Personally, I really want to keep the private plan I currently have.

Which, much to your surprise, you will be able to under every single health bill being proposed.

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RE: Your baby is too fat - 10/12/2009 8:41:19 PM

tazzygirl

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Im glad you have a private plan available to you Sanity. I do not. Nor do alot of people just like me. Nor will many if the job market keeps going as it is. What will you do if you have to join us?

Part of why medicaid doesnt pay because they are below poverty level. These are typically women and children who have no money... no point in charging them. Medicaid is truly a charity by the government. Those of us wanting a public option have repeatedly said we would pay... just give us the opportunity. When i did have insurance, it was sick day insurance... only paid if i was sick... no preventative.. and i still paid over 10 percent of my check for that little bit.

Sure, it was better than nothing... its not enough. Thats what people are saying... what we are given is not enough. Pre-existing conditions keep us off many policies... its not enough.

Everyone talks about the country going broke. Then allow 30 million people to pay into this program. Give it a chance. What can it hurt?

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RE: Your baby is too fat - 10/12/2009 8:48:34 PM

Sanity

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Initially, sure. But with a public option out there, private plans won't be able to compete with "free" and I can post video if you would like of Obama as well as some other Liberals on the national level saying very candidly that that's exactly the plan, eliminating private and employer paid insurance altogether.

I have other problems with it, too. I don't want Big Brother feeling like he owns my health and therefore my body and I don't want Big Brother assuming ownership my medical records or the records or the bodies of my progeny. Obama already says I have to pay a special tax because it costs the government extra to treat me if I smoke, and they're starting to look at fat taxes. Taxes on sodas and things.

There are a lot of reasons to throw rocks at anyone who says they're from the government and they're here to help.

quote:

ORIGINAL: rulemylife

Which, much to your surprise, you will be able to under every single health bill being proposed.

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RE: Your baby is too fat - 10/12/2009 8:56:08 PM

Sanity

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If you don't have access to a plan do what you have to do to gain access, get a better job or apply for medicare. Go to free clinics, treat yourself the best that you can and take care of yourself the best that you can. Campaign for better laws, laws that make it easier for insurance companies to compete across state lines, for example.

No one gets out of life alive regardless of how heroic Obama's efforts are... we all die in the end, and giving our lives over to the government in exchange for a little security is a huge mistake.

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RE: Your baby is too fat - 10/13/2009 12:28:42 AM

rulemylife

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quote:

ORIGINAL: Sanity

Initially, sure. But with a public option out there, private plans won't be able to compete with "free" and I can post video if you would like of Obama as well as some other Liberals on the national level saying very candidly that that's exactly the plan, eliminating private and employer paid insurance altogether.

Now wait, you're a big believer in free-market principles and the inefficiency of government. Get where I'm going with this?

If the government-run health care proves to be as incompetent as you claim then would that not create an even bigger demand for private insurance?

quote:

I have other problems with it, too. I don't want Big Brother feeling like he owns my health and therefore my body and I don't want Big Brother assuming ownership my medical records or the records or the bodies of my progeny. Obama already says I have to pay a special tax because it costs the government extra to treat me if I smoke, and they're starting to look at fat taxes. Taxes on sodas and things.

Too much Fox News and conservative websites.

Produce some of those "facts" and I'll be happy to shoot them down for you.

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RE: Your baby is too fat - 10/13/2009 4:29:56 AM

Louve00

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RML, you took the typed words right off my fingers. Logic vs Paranoia is what this sounds like to me.

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RE: Your baby is too fat - 10/13/2009 5:00:08 AM

sirsholly

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i haven't read any other posts here, so forgive me if i repeat anything. My son would have been refused, as he has consistently been in the high 90th percentile with his weight. He is a rather thin lil dude though. His height, which matters too, is at the 99th percentile.

Of course he weight is higher than most...but it is due to his height.

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RE: Your baby is too fat - 10/13/2009 5:14:53 AM

OrionTheWolf

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Well I do remember from other readings that the improper billing codes attribute for almost 10% of denied claims. So reduce that percentage I gave by 10%, and it is probably more accurate. Another artificle inflation may also be that Medicare requires every item to be on a seperate line, even if those items are put together to make up a whole, which I do not believe private insurance companies require. This would mean billing a motorized wheelchair to Medicare would be 1) Wheelchair 2) Cushion 3) Batteries 4) Options - such as leg brace, O2 tank carrier, etc).

quote:

ORIGINAL: tazzygirl

Actually, i am curious to know if the problem stems from the billing errors we have heard so much about, Master. With so many companies, and so many billing codes, the wrong code can kick out a denial. Was just curious as to how many of those percentages were attributed to that. Thank you for the link, Master.

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RE: Your baby is too fat - 10/13/2009 5:45:20 AM

sirsholly

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quote:

Medicare requires every item to be on a seperate line, even if those items are put together to make up a whole, which I do not believe private insurance companies require. This would mean billing a motorized wheelchair to Medicare would be 1) Wheelchair 2) Cushion 3) Batteries

in the event that something is needed that falls under the same heading, the patient is screwed.
My dad was a medicare patient and his motorized chair required a bit of extra padding for the back of the seat. Medicare refused because the "cushion" was already supplied.

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RE: Your baby is too fat - 10/13/2009 10:17:38 PM

OrionTheWolf

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Yep but hey they will replace his batteries annually whether they are needed or not. So what you do is get the new batteries, sell them, and buy the cushion yourself. Yeah it was technically fraud but I did it, because I was in the field and saw what a patient really needed. The invoice would say batteries, but they may have actually gotten extra cushioning because of sores or other medical things, or their old O2 holder may have broke before medicare would replace them. I believe tires may be every two years. This is not really fraud, it is working a broken system to get what the patients really need.

Also, many items must be medicare approved in the "specs" they have. This makes it so you can charge more for them, and medicare pays more. Take two cushions, one marked as medicare approved and one that isn't, and tell me the difference in them. There isn't one, except the Medicare approved one is about 4 or 5 times the cost.

quote:

ORIGINAL: sirsholly

quote:

Medicare requires every item to be on a seperate line, even if those items are put together to make up a whole, which I do not believe private insurance companies require. This would mean billing a motorized wheelchair to Medicare would be 1) Wheelchair 2) Cushion 3) Batteries
in the event that something is needed that falls under the same heading, the patient is screwed.
My dad was a medicare patient and his motorized chair required a bit of extra padding for the back of the seat. Medicare refused because the "cushion" was already supplied.

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RE: Your baby is too fat - 10/14/2009 6:12:35 AM

Sanity

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I wonder if certain people are getting kickbacks. Some here claim there is no profit motive with government run bureaucracies, but that isn't necessarily the case.

quote:

Also, many items must be medicare approved in the "specs" they have. This makes it so you can charge more for them, and medicare pays more. Take two cushions, one marked as medicare approved and one that isn't, and tell me the difference in them. There isn't one, except the Medicare approved one is about 4 or 5 times the cost.

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RE: Your baby is too fat - 10/14/2009 6:28:51 AM

Sanity

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quote:

ORIGINAL: rulemylife
Now wait, you're a big believer in free-market principles and the inefficiency of government. Get where I'm going with this?

If the government-run health care proves to be as incompetent as you claim then would that not create an even bigger demand for private insurance?

I find it strange that you don't realize this on your own, rule. Unlike a real business, tax payer funded bureaucrats can be totally incompetent and still keep "functioning". We just go trillions deeper in debt, that's all.

Put it on plastic, let the great, great, greatr grandkids pay the Chinese back for it.

quote:

Too much Fox News and conservative websites.

Produce some of those "facts" and I'll be happy to shoot them down for you.

Do you deny the Obama tobacco tax increase, rule? Do you deny that various governmental agencies are looking at fat taxes?

Shoot those down, buddy. Go ahead, I'm waiting.

Why these special taxes? Because when government (or anyone else) has to pay our medical bills, rightly or wrongly they begin to feel that they have at least part ownership. "Ownership" in the same sense as a business unit has ownership over the results of their department...

And so they begin doing things to make sure we stay healthy. Laws, regulations.

Special taxes.

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