Text 15275, 75 rader
Skriven 2011-03-15 07:19:50 av Bob Ackley (1:300/3)
  Kommentar till text 15212 av Mark Hofmann (1:261/1304)
Ärende: Names will never hurt me...
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Replying to a message of Mark Hofmann to Robert Bashe :

 MH> our healthcare situation a great deal, is the following two problems:

 MH> 1)  Tort reform. (lawyers sueing doctors for everything they can think
 MH> of) - which unfortunately screws it up for the people that really do
 MH> have legitimate claims.

 MH> 2)  Allow health insurance providers to cross state lines.  More
 MH> competition is always better.

Insurors have always been able to sell across state lines.  Many small insurors
choose
not to.  Note that the various states' insurance commissioners must approve all
insurance
products offered for sale in their respective states, and the companies must be
licensed
to sell insurance by the states they choose to operate in.

The problem with buying a policy from a company not licensed to do business in
your state
is that you have no recourse if the insurance turns out to be something than
you thought
you were buying.  Your state consumer protection people have no jurisdiction,
and the
insurors' state's consumer protection people aren't interested in the problems
of people who
aren't residents of their states.  I used to work for Central States Health &
Life Insurance
of Omaha (www.cso.com - despite its name the company no longer sells either
health or 
life insurance products) and learned that they had to design their insurance
products to 
comply with the laws of the state(s) in which they intended to market the
product.

 MH> I do agree that there should be some "guidelines" that the medical
 MH> insurance providers should following - one being getting rid of the
 MH> "pre-existing condition" item.  Most of the problems with healthcare
 MH> we have today could be solved by those two things.  

Actually, the one thing that would do the most to reduce the cost of health
care to the
patients is to require that insurors pay the bills, as presented, in full
within 30 days.
No discounting (except perhaps 10% if paid within 10 days).  In this day and
age where
nearly all billing and paying is done electronically there's no reason this
cannot be done.

Fraud investigations should be handled separately.

Many insurors, specifically including Medicare, are infamous for late payments
(>90 days).
Medicare apparently puts all incoming claims in a box and then puts the box on
a shelf where
it sits for at least 90 days.  After 90 days Medicare examines the bill,
disallows all charges
it thinks it can get away with and then writes itself a huge discount on the
remaining balance.
Providers are not allowed to bill Medicare patients for the unpaid balances on
the bills.  In
2004 I had an emergency angioplasty and stent (not quite a heart attack, but as
close as you
can get to one without actually having it); the hospital bill was just shy of
$50,000.  More
than 90 days after my discharge from the hospital, Tricare (Medicare for the
military) paid
the hospital not quite $10,000 as payment in full.  My share of the bill was
$33.00.  That other $40,000 didn't go away, it got added to everybody else's
bills as general overhead.
Eliminate that sort of thing and overall the bills will come down.

--- FleetStreet 1.19+
 * Origin: Bob's Boneyard, Emerson, Iowa (1:300/3)