Disgusted,

JoAnna is probally composing her rambling document now. It will have no facts just three pages of junk.

I am retired Assistant Director, State Managed Care. My experience is: Insurers will deny service / coverage in order to increase their bottom line. Patient health is NOT their primary concern. The most deplorable example I can site: Because costs projections were HIGH, a teen was denied service and is now a quadriplegic to save dollars. Another routinely denied basic care to increase the bottom line, one group has employed an employee who's only function: find reasons to deny service.

This was a huge mistake about to go way bad! I truly believe it is payoff to the insurance companies. What Bush did with Wall Street, Obama is doing with Health Care. We will all live/die in regret of this.

McCrystal has to go. He is in direct conflict with the UCMJ and could face a court martial (that will not happen). His mouth has put us at risk in those counries that already hate us. We have a congress that is dysfunctional and now we have this at the Military level. What are those radicals going to think now?

This man needs to be demoted in rank and sent out to pasture. PERIOD. Thank him for his service and send him on his way.

I don't know about any of you, but my group insurance rate went up this June. I am one person and my insurance is $1017.00 a month from what used to be $500.00 a month two years ago. I wonder if what President Obama has said will be retroactive. Hopefully. The insurance companies just like the credit card companies are getting in their licks before it all comes to pass.

You see JoAnna, this is what happens when you stick your head in the sand and refuse to make any effort to learn anything other than what you are spoon fed daily over the airwaves. HCR would have lowered costs, offered more coverage, and provide for a more predictable cost in the future. Only problem is, people like you that are bleeding heart supporters of big insurance whined and moaned and prevented single payer or even a public option from being legislated. As such, the only real mechanism to accomplish what was hoped for was stripped from the bill by those that would apologize to companies like BP for our anger at their destruction of one of our treasured natural resources.

If people like you want to come to the aid of BP while they destroy the Gulf, why would anyone be surprised that you support big insurance abusing the people that need the care the most? I mean, you have no problem with the rape and destruction of our natural resources and environment. Clearly you give two craps about the wildlife that is impacted or the fisherman or seafood processors that are now without a livelihood. So what that cancer patients are left to die by the insurance companies that collected premiums for years only to say that the needed treatments are too expensive so please just go away and die. We have dividend and bonus checks to issue. We cannot be bothered with your stupid claims and medical crises... Sheesh. Get a real job and then you can afford to take advantage of the best care in the world. if you can't afford it, either die or move to one of those Socialist countries that actually give a damn about the health of their citizens.

For the 80% of the public that had health insurance coverage prior to Obamacare, the number one issue surrounding health care reform was rising costs.

Obamacare does nothing to address that issue, and the public knows it.

The closest the Obama Administration came to addressing the issue of escalating health care costs was to attempt to implement (now delayed, thanks to the vigorous complaints of the labor unions) the 40% excise tax on health care providers.

The excise tax would force providers to offer less care, with more co-pays and out-of-pocket expenses for plan members, to prevent their plans from being taxed. The costs of the plans plans themselves would be capped to avoid the tax, but middle class workers would end up paying more of their own income for less care. No wonder the unions howled!

What a cruel and cynical way to "control rising costs".

No wonder most Americans don't like Obamacare.

Good morning JoAnna,

While I'm not a supporter of the current version of HCR, it might be a tad unfair to expect that the cost controls (which phase in over 10 years) should have had an immediate impact. I doubt that two months after passage is a fair timeline for that analysis. I will note that the overall cost of the bill has been rising, and that anecdotal indications are that many private employers will eliminate coverage and pay the fines for not providing health benefits, rather than try to comply with regulations that are unclear, and potentially, cost prohibitive from a compliance perspective. My firm is in that mode right now. If we cancel coverage, we eliminate not just the premiums, but also the cost of the management of the health care aspect of our package, we eliminate the need to comply with multi-state jurisdictional issues, and quite frankly, we save money, as our cost per employee is substantially higher than the $2,000 fine per employee.

Living in L.A.

Good morning JoAnna,

While I'm not a supporter of the current version of HCR, it might be a tad unfair to expect that the cost controls (which phase in over 10 years) should have had an immediate impact.

That is the problem with Obama, all sizzle, no steak. The case you outline for your company seems to be the typical one. Business decisions are being made by all companies on whether to continue private coverage of their employees, or just toss them to the government plan and pay the $2000 head tax for each employee. So much for the Obama quote "You can keep your own insurance".

In truth, ObamaCare is unimplementable. It is so complex, so contradictory, so massive, that it will fail under it's own weight. Recall that Obama initially talked about "health care reform", and it later changed to "health care cost reform". If Obama is going to make cost control the main element of his plan, you would think that would be the element that would be implemented when he put pen to paper. Yet, just like everything else with Obama, it all happens "later", and this case more then likely never.

Oh, and Good Morning to you too.

Disgusted in PA - you seem more angry today then most other days. Things not going well?

Disgusted in Pa,

You're hitting a little too close to home when you reference cancer patients. My carrier has been nothing short of magnificant in the care and treatment of my wife as she worked her way thru three separate incidences of cancer over the past 13 years. I know that the general feeling on this site is that insurers are evil, they have a profit motive, and that they'll cancel your coverage in a heartbeat. I, for one, disagree with that assessment. Blue Cross, (yes that firm) has been heroic in my opinion, and has stepped up to the plate in a major fashion. I know that doesn't meet the test of "gosh, let's pound the insurance carriers because they're so mean to all the poor little people", but for every tale of woe that's laid out for public consumption by the press, there's at least one tale of gratitude from someone like me, that never gets mentioned. Why is that do you think? Do you think the carrier's treatment of me was an exception, or do you think the tales of woe are the exception? You can obviously tell what I think.

My wife's medical costs have been huge. Total dollars billed by the doctors, hospitals, home nursing care, etc, have been in excess of $400,000 (yep, fourhundred thousand dollars), not one complaint from Blue Cross, for which I will continue to be eternally grateful. If they wanted to raise my rates, I'd pay whatever they ask, without complaint, but they'll never be able to recoup the money they spent on my wife. I'm grateful that I have a good insurance plan, but if you'll note the prior posting, my firm is considering eliminating that benefit, and here's the kicker, the basic reason is because of HCR and it's unknowns. I doubt that my wife would have gotten the care and treatment she did, if we had been in a government plan, but thankfully, I don't have to find that out, yet.

Not entirely sure why you went into the Louisiana / BP issue, it doesn't seem to have relevance here, but it's your post, you obviously can do as you please.

Living,

My thoughts and best wishes for your wife's continued recovery. I am pleased to hear that there are stories like yours out there and I am surprised that the insurance companies do not try to put more stories like yours out there for public consumption. While I am pleased for YOU that Blue Cross (or insert any other large health care insurance firm) made the decision to honor your policy and paid your claims without question. While I cannot speak to the numbers of people in your situation, as opposed to those that are denied care or face obstacles that have (fortunately for you) not been placed in your wife's path to full recovery. There may well be many thousands more like you, however, it is the people that do NOT have your positive experience that drives this debate. I am not begrudging your wife's care or that of anyone that is fortunate enough to have coverage and is lucky enough not to have a carrier challenge and question every bill.

Living, what do you say to those who, like you, have a loved one that is stricken with an illness or a disease? What do you say to someone that is told they need $400,000 worth of medical care and treatment or they will die? When that individual either has no coverage or limited coverage, what do you say to them? What do you say to the patient that needs a $250,000 procedure that the insurance company is unwilling to pay for? What do you do for the cancer patient that loses their job due to illness (and their insurance coverage along with it) and is now no longer able to obtain coverage at ANY price?

Yes, it is nice to know that there are times when an insurance company (or any other major corporation) actually does the right thing and does not live up to their "evil empire" reputation. Unfortunately, the reality is that the executives and principals in the insurance companies do not earn fat paychecks, receive obscene bonuses, and generate large dividend checks to their stockholders by actually agreeing to pay for every procedure that is deemed medically necessary. When a bureaucrat bean counter has the ability to overrule the medical decision of my doctor because of the impact to their profit margin, there is something seriously wrong with the system.

I am sorry to hear that your company is considering eliminating your coverage. Obviously, that would be a devastating blow to you and your family. But, it is no different than those that have already faced this situation either because of a pre-existing condition or other catastrophic medical condition. Had the protectors of big insurance not been out to protect those that line their campaign coffers, they would have done the right thing and made single payer the law of the land and NONE of these problems or challenges would be obstacles to getting where we really need to be. Until we pull our collective heads out of our butts and see what the rest of the free world sees regarding the ridiculous system of medical insurance and compensation, we will be doomed to pay ever increasing amounts for ever more elusive medical care.

As for why I brought BP into the issue, it is similar in the sense that those that would stick up for and apologize to the corporation responsible for devastating the gulf are the same people that defend the insurance companies' ability to cherry pick what claims to pay and what claims to deny, all the while knowing that these decisions can (and DO!) have mortal consequences.

JoAnna,

Everything is fine on this end. Sorry if I am enjoying pointing out your utter lack of reason, logic, or facts this morning a bit more than usual. You are in rare form today and it must be killing you to have to wade through all of my responses to your posts so you can continue to ignore my facts, points, and logic. Yeah, please don't strain your little brain trying to come up with your little retorts to my points. While I deal in facts, you deal in denial and talking points. What's that I hear? I think your water is boiling, better go grab another tea bag and turn on Glenda. It's time for your afternoon talking points forcefeeding...

Disgusted in Pa,

I think my point was that I don't believe that the treatment options afforded me in a private insurance plan are going to be afforded to the general populace in the plans required under HCR, which means that unless you are wealthy enough to afford private coverage such as mine (which by the way, I doubt I could afford if it wasn't subsidized by my firm, thankfully, I still don't have to choose), you won't receive that level of care in any case.

Please don't misunderstand, I'm not a fan of HCR, but I don't begrudge the opportunity for coverage for whatever the number is, sometimes 30 million, sometimes more. Perhaps I'm misreading you, but do you think that everyone is going to suddenly have the opportunity for total health care? If you think that everyone will be entitled to the same level of care, I expect that will be incorrect. If I understand HCR correctly, there is a minimum threshold of insurance that we individually have to maintain. If I can only afford the minimum of insurance, how will I be able to obtain sufficient coverage to avoid a catastrophic illness. Do you think that the carriers will be required to cover conditions that cost hundreds of thousands of dollars, while only collecting premiums based upon minimal care? I suspect that anyone that is in a subsidized insurance pool will not have access to the care my wife has had, you simply can't expand the coverage to that many people, there aren't sufficient primary care physicians, nor are there enough oncologists, or whatever specialist may be needed. Time will tell the tale. I'll happily be wrong if that's the case, but I doubt seriously that we'll see total care for all, without significant cost (premium) increases, or potentially, and I believe that Dr.Berwick is an advocate of this, rationing of health care, either by cost, or by availability limitations.

Thanks for the discussion, lucid and rational beats vitriolic anyday.

Joanna

All current oil industry regulations, prior to the spill, were put in place by good ole GWB & Slick Dick! You expect Obama to fix everything the F'd up in less than 2 years. He is President, Not God!

Living,

I think you did somewhat misunderstand my main point. I agree that HCR, as it was passed, is not likely the panacea that we might hope for. My point was that, to have ANY chance at providing full coverage to all, what was needed was the single payer option. We get way too bogged down on the talk of health CARE reform when what is REALLY needed is health INSURANCE reform. We do not have a problem obtaining top quality medical care in this country IF you are wealthy and can afford it OR are lucky enough to have the kind of coverage you have. If we had done the right thing and expanded Medicare to all, it would STILL not be a perfect solution by any means, but it WOULD address many of the issues and provide a framework to tweak and tune things better as we go.

What we have in the meantime, is the same old system of collecting premiums and then the mad scramble to find ANY reason to deny payment. We have a for-profit motive in place that controls those that can either grant coverage or deny it with a wave of a hand. The patient's affected by these decisions are powerless to appeal or overturn these economically (not MEDICALLY) decided issues. The insurance companies do not provide care or even give a damn about who lives and who dies. They are in this ONLY for the benefit of their shareholders and to generate the cushy salaries and bonuses of their executives. They run a business.

On the other end of the spectrum are the medical providers and their patients. Medical providers enter this profession as much because they want to help people as they want to earn a good living. What we have are medical providers doing everything they can to help their patients and make them better. Instead, they spend their time fighting with an insurance company bean counter that wants to deny payment because it is almost time to cut those dividend checks again. As for the medical providers making a good living, the insurance companies try to squeeze them as well since it is not only claim payments that are denied that add to their fat bottom line.

Now, before you go off about how Medicare is also screwed up and a big problem, at least the 30% that the FOR-PROFIT carriers skim right off the top as ROI to their investors would be immediately put back into the system. Medicare does not deny payments for medical care and there are NO death panels. In fact, the for profit carriers are the ones making life and death decisions now, not based on medical fact or need, but for purely economical reasons. At least with a single payer system, your bills WILL be paid without question. Then, we can spend our time and effort looking for ways to improve that system rather than try desperately to figure out how to coerce a for profit company into giving a damn about human beings and their medical care.

Yes, lucid and reasoned discourse beats the typical banal regurgitation of talking points that is all too prevalent here. Yes, I will wallow in the mud if my debate opponent feels the need to do so (or their history of brain dead posting precedes them in reputation), however, I would much rather engage in the type of positive and meaningful discourse as we have had here.

MACIN ok, can you give us a fact check on "all" regulations were put in place by Bush? I believe you're wrong on that.

Disgusted in PA: Medicare DOES deny payments.

Dirt,

My apologies. You are correct that Medicare does deny some claims. Most often because they are submitted with invalid or incorrect diagnosis codes or were submitted beyond the deadline for submitting claims. Is it your contention that Medicare routinely denies claims for necessary (as opposed to cosmetic) care? DO you really want to compare the denial rates of Medicare with that of ANY for profit carrier or HMO?

I do not have the current statistics at my disposal, but I believe that medicare operates with something like a 3% overhead cost of doing business and administering claims. Compare that with the average 30% the for profit carriers are skimming off the top to their profits. Please identify another industry (with the exception of oil/gas) that routinely makes a 30% ROI for their investors?

If that roughly 27% of EVERY SINGLE PREMIUM DOLLAR was not spent on dividends and fat bonus checks (based essentially on the number of claims were NOT paid), how much better do you think the system would operate?