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Discussion in 'Too Hot for Swamp Gas' started by floralagator, Apr 9, 2014.
I'm guessing the DOCTOR ordered the procedure...
sounds good, but i prefer to deal with the reality of the situation, where humans have been irresponsible since the very beginning, and therefore create solutions, not hope they just fall in-line with an expected behavior
You're making my point Ben, I'm not in favor of mandates period end of story. IMO the government stuck it's nose where it doesn't belong. Then again that has happened way back when they decided it needed to get involved in the insurance industry.
No he's not.
Sounds like she got a crap plan. The ACA plan I got for my wife lets us pick the doctors we want. Then the doctor orders the tests and procedures he deems necessary. After the procedures are over, they send a bill to the insurance company. The insurance company then pays them.
That just seems like the logical way to do it. The insurance company pays for what you need, but they don't decide what you need. The plan lays out what's covered and then pays for it. Anything the plan doesn't cover, such as cosmetic surgery, would not be covered, but there shouldn't be any pre-approval necessary for anything.
So let irresponsible humans create irresponsible solutions at another's expense?
Sounds like a bad idea.
Now if you start requiring people to be responsible we might get somewhere. Like if one wants the government to pay for the birth of ones child the parents should be required to perform 100 hours of community service each or forfeit the child tax credit. Then they might actually get responsible and not have sex if they don't have that unaffordable condom...
Therefore, using your "logic", since irresponsibility is inherent in humans, the Responsible tax payer should also pay for the Irresponsible's consequences as follows:
(1) Car insurance
(2) AA treatment
(3) College, irrespective of GPA, etc
(4) Vacations (lack of money? no problem, everybody deserves a vacation)
If you cant afford car insurance due to your bad driving record, let others pay for it. Your irresponsible behavior is thus passed on to the Responsible! A Solution!
You drink too much, all docs, treatments, even the heavy booze to vino should be paid by the Responsible. Problem Solved !
You peed away your high school years, your GPA is bad. You made 475 on SAT, no problem, go to college, on the Responsible's dime. Solution ! It also means you are given an "opportunity". And who doesn't like 5th chances?
You spend all your income on nonsense, those cool rims, that Fri-Sat $15 martinis, no problem, come summer. You are maxed out on CC debt. No problem, go on vacation on the Responsible person's income. Solution to a problem !
ACA. Had great BCBS Family Plan. What we wanted. Due to 0bamakare, it was deemed bye bye. Replacement plan is what we did not want.......2.75 X the Cost of the former plan.
Yeah that worked out well.
If the insurance industry hadn't pooped the bed, ACA would have never been necessary.
You're a greedy bastard not willing to pay your fair share to help poor inner city kids get cancer treatment. You also obviously hate women and their need for free contraceptives.
Ha Ha.....great one.
The Fred Sanford - "If the insurance industry hadn't pooped the bed, ACA would have never been necessary." WOW!
Let's sink that ship of illogical thought:
> If Joe Smith had not gotten drunk at home and woke up with a headache, he would not have been beheaded.
> If banking industry had not lent money to companies, some of which failed, then the nationalization of all banks would not be necessary.
When is over reaching taking of Control of individual lives, from birth to death, "necessary" ?
It is necessary when one wants to control a country's capital, labor, and production all the while under the guise of "helping."
Remember: When the Soviet Union fell, there were people (like many here) who marched in Moscow to bring back Communism. They wanted no part of liberty and a free market !
You already pay for the uninsured. You do it in the least cost effective way possible. ACA bends the curve in the other direction.
No amount of your Fox talking points changes any of that.
I dont do Fox talking points because I dont watch Fox (or CBS etc) for info.
FredS, you may like and believe that ACA is good. You may like the bending of the curve as you say.
But I have seen first hand ACA after years of incorporation in a country. Cuba. That is the ultimate goal of ACA....and if you live long enough, you may remember, as you stand in line outside a filthy Govt run hospital, to hopefully get treatment for you serious ailment, that ACA did not work out so well.
The Libs believe that if a problem exists, the best solution is to create a Monster Govt Program to solve it which only creates even more problems which in turn are solved by another Monster Govt Program.
But again, some people did march in Moscow after fall of Soviet Union for a return to Communism. Some like a System that does not reward Merit, but picks and chooses winners and losers.
Fox, Limbaugh, Breitbart--they get all of their talking points from the same RNC fax machine.
And how slightly different private plans sold by the same old insurance companies = Soviet rationing, I'd need a full lobotomy to comprehend.
I am also one that has had the UNaffordable Care Act aka Obamacare decided I could not keep the good insurance plan I had. No one has a any idea what I have gone through, or probably doesn't care or even know about Obama's war on us Seniors! Seen nothing at all posted on TH about it. Nothing!
corp, you are naïve when it comes to insurance.
While I don't disagree with anything you've said about how it SHOULD be, the industry has not been run this way for many years. All of us with insurance have been at the mercy of bureaucrats for decades. I suspect your "non-crap" plan that you've bragged about is no different, you just haven't encountered it yet. Certain tests, like MRIs and PET scans, will not be scheduled by hospitals unless they have an "authorization" first, which is where the bureaucrats come in. Sometimes, speaking as a doctor now, it is like pulling teeth to get these things approved. Again, you wouldn't necessarily know this b/c it's handled behind the scenes.
Your second paragraph is essentially word-for-word the cornerstone of my idea of healthcare reform that I posted years ago on here. Pass a law stating that insurance must cover any test deemed medically necessary by one's treating physician. That gives you the benefits you think you have while doctors have less paperwork and bureaucracy to deal with.
In the interests of fairness, florala, this is an insurance issue, not a political issue. Those of us with insurance have been living under these rules for a decade at least.
The last time I had an important test denied for a patient, I called the person that denied it (Blue cross et al usually hire some old geezer doctors to sit in an office for a small fee and deny these requests). I asked that guy for his name and license number because "I'm going to give this information to my patient so she knows who to sue when she gets cancer". Boy, that got the guy livid, but I at least got the test approved for my patient.
These doctors working for insurance companies are no different than these "expert witnesses" lawyers hire- no morals, usually last in their graduating class, just out for a paycheck no matter who gets hurt.
Anyway, the only thing that sounds like an Obamacare issue is the fact that, again, this lady had the impression that insurance was a "blank check", like some kind of exclusive club the rest of us belonged to for free. See corpgator's rosy posts for more examples. Those without insurance have no idea how much the rest of us pay nor do they understand the system. I have a feeling they will be surprised when (1)they get their new premium rates next year and/or (2) the system collapses from its own bankruptcy. Either way, I do agree with those that say your friend's anger is misplaced. Her beef isn't with Obamacare.
You lie. The uninsured pay for themselves. The trend in physician practices prior to Obamacare was AWAY from insurance, more towards "concierge" or cash pay only practices. I was always happy to see self paying patients and charged an extremely low price to care for whatever the problem was- stroke, heart attack, cold, seizure- $67. There were many stories in all the national publications of doctors charging $40 and not taking insurance. Unfortunately, thanks to the changes your President made in the system, I now see far fewer self pays, meaning I had to raise my prices.
Love the tactic to get the procedure approved!
While not exactly on point, I was amazed this week when my doctor's office notified me that, since I've moved from private pay to insurance, the cost of a B12 shot goes from $12 to $56. Since I have a high deductible plan (thanks to my new employer) I have to pay the full $56... or I can just pay cash and get it for the $12. I understand a discount for cash but, charging more than 4x the cash rate because of insurance seems a bit crazy.