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Re: I Thought It was Supposed to Get Costs
Posted by **Old Flat Top** on Apr 30, 2013 at 8:53:12 PM:
In Reply to: Re: I Thought It was Supposed to Get Costs posted by **The Duke** on Apr 30, 2013 at 7:22:50 PM:
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******The Patient Protection and Affordable Care Act — a legislation championed by President Barack Obama — mandates that a minimum set of health insurance benefits be extended to all Americans, regardless of any preexisting conditions, forcing insurers to cover even the sickest applicants. Because of these new requirements, insurers are expecting costs to skyrocket, and as a result, many are preparing to raise premiums to cover these increased expenses.
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*****It was explained to me by my good friend/family doctor, as to WHY I was turned down 2 years ago for an MRI on my torn MCL. He said ever since Obama care talk, many such requests for test of all kinds have been suddenly turned down, in PREPARATION for "all" they will HAVE to cover when forced to.
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****That makes no sense. It's not as though MRI tests are a limited resource. If you don't give a test now, that doesn't mean there'll be more available two years from now. If anything, they'd be giving more tests now, when the price is high, to balance out the tests that'll be covered under insurance in a few years.
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****If someone said to you that homeowners insurance would cover piano tuning in two years, would you stop tuning pianos today in preparation for that?
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*** You're not getting it. The insurance companies won't cover the cost now, because they want to use this money that they will later be forced to spend out in great profusion. It's not the health care workers refusing treatment, it's the insurance companies refusing to finance operations that they will be forced to later.
*** Get it?
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**That's incredibly stupid. Only an idiot would think that made sense.
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* Really? My other half is also waiting on her father's insurance check (he died in December) , it's cut and dry, and clear in court. Where's her money? Insurance company has it. Tell me why they've got her money, if they ain't using it..
* I think you fell through the looking glass. Say hi to the red queen for me.
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*** Meanwhile my other half, who has been a health care professional for twenty-six years, is having a hard time finding a job in Chicago.
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**Guess that means the predicted shortage of healthcare workers isn't happening.
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***Nope, just health care JOBS, the industry is shrinking. For Pete's sake, dude, open your eyes.
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Here's how it really is.
It's the money and who gets it. Nothing else.
I worked in health care for 28 years and watched it get nothing
but worse and worse. Insurance companies will charge higher rates and pay as little as possible for claims. Research "DRG" if you want. Diagnosis Related Groups. It means according to admitting diagnosis the insurance company is only going to pay a predetermined amount of money. It doesn't have anything to do with actual costs or needs when treating a patient it's been broken down to the least amount of money they will pay and they made it law. A long time ago. Hospitals in turn resort to paring down staffing to the fewest needed and at the lowest end of the payscale. That means you got neophyte nurses and therapists who don't have the edge to provide high quality healthcare. They can do what the job description more or less says but they don't have the expertise that comes from years of experience. You will see this only get worse and worse. I know it sounds bad to say it but people are going to get the care they deserve, well, they don't deserve it but it's what they're going to get. They didn't care enough about the care providers to fight the insurance companies. THe Docs didn't have much footing either since so many had been defrauding medicare for so long. In fact, that's how the insurance companies came up with the "we don't have to pay" plan in the first place. They saw the gov step in to stop medicare fraud by scrutinizing what services were performed and why then followed suit and took it to the extreme on the basis of that's how it's done. It says, the people cannot be accountable to practice quality medicine(thanks you medicare fraud docs. Thanks so much!) I've no idea what's in Obamacare but I do know that it follows the general communistic flow of things.
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Last updated on Apr 30, 2013