Obama care, sticking it to the insured!

[Cohim]

This policy I have been paying for, for the last 18 years has been awesome! This is my first hiccup with it. When the surgeon said he didn't accept insurance, I was taken back.. I called around and this is now become protocol. When he gave me a bill and said they wouldn't schedule anything till it was paid, again normal protocol. I asked why, and he told me the insurance company's have been sticking it to the medical field and not paying the total bill. For instance, this surgery. The bill is $6000 + any other occurring charges. The insurance company might pay him $900. I don't like it, but I sort of understand it now.  ???

[Pole Lock]

My wife's family is largely medical in profession.

Insurance companies in USA NEVER pay what a doctor or hospital charges for a service.  They always pay less.  A doctor would have to sue the insurance company to get the remainder if he's ready for a knock-down drag-out fight over perhaps a few thousand dollars.  This puts a tremendous pressure and financial risk on the doctor who is running the show.  He has to pay the hospital to use their facilities and this is above and beyond overhead for what ever office he maintains for regular appointments.

Although Canada's health care system is the target of derision from many Americans, I have family up there as well as good friends.  My old roommate comes from a medical family.  His grandfather was a heart surgeon in Toronto and rolling in lucre because of it - I would say about as upper-middle to lower-upper as a successful heart surgeon in the states.  All of this is paid with tax dollars.  Doctors are prevented from refusing service OR charging exorbitant rates and there is no pressure - Canada is a prosperous nation that pays its bills.

Even poor "2nd world" countries like Cuba and Poland have socialized medicine, as does most of Europe.  With the intense private in$$$urance lobby, things are unlikely to change in the US.  They're simply acting like any other pigs at the trough.

[RNaka]

[quote author=preston link=topic=31395.msg133536#msg133536 date=1419950470]
Self insured literally means no insurance as you're assuming all of the possible risks for in this case health.

[color=red]I think the term "self-insured" used in the context of the OP original post means paying for one's own insurance as opposed to relying on Medicaid, Medicare, or employer sponsored plans. "Uninsured" means having no insurance[/color].

Obama care isn't the reason these rates suck and they want cash up front. It's people who are literally self insured (no insurance) as well as underinsured that can never afford to pay the tens of thousands of dollars for surgery, etc that force rates up to compensate for lost money.

[color=red]Obamacare IS the reason rates are up by mandating individual insurance and subsidizing those who can't pay by those who can. Simple economics[/color]

private insurance like the ppo, hmo or whatever you are purchasing must not be covering this and that sucks. Obamacare and Medicare will pay regardless if it's a necessity unlike private insurance. Though they will only pay70% in case of obamacare or 80% in case of Medicare. So you get stuck with the remainder which isn't bad until you have hefty hospital stays and surgery...  Private insurance is a whole other beast that doesn't necessarily  have to pay for anything depending on what you bought.

[color=red]I really don't think you understand the statistics underlying insurance[/color]

Obamacare is the excuse everyone uses now when they want to tell you the sad story of being underpaid and won't provide you with a service you need. Sadly it's all of the self insured that cost hospitals and doctors so much.

[color=red]Not an excuse, a fact[/color].

Best of luck and sorry to hear about your son.

self insured and insurance companies sticking it to us all day, in and day out ftw
[/quote]

[mrmagee]

The entire "subsidizing people who can't pay by people who can" already happens, and is a big reason why I'm in favor of mandated universal coverage.

A system where you're not required to have coverage, but hospitals are required to provide service to you in an emergency, is doing that same subsidizing. It's just not as easy to tally up.

[dubleuhb]

''Mandating'' coverage doesn't change the fact that those who don't have the means or fortitude to pay aren't still leaching of those of us that do.

[Cohim]

I must say, that was an awesome explanation RNaka.  :bigup:

(No sarcasm)

I pay out the nose for this awesome policy, but in this instance, no surgeon will accept any insurance. I pay the cash, and I have to fight with the insurance company to give my money back. It sucks, but I gotta suck it up and deal with it.

[RNaka]

[quote author=mrmagee link=topic=31395.msg133627#msg133627 date=1420014336]
The entire "subsidizing people who can't pay by people who can" already happens, and is a big reason why I'm in favor of mandated universal coverage.

A system where you're not required to have coverage, but hospitals are required to provide service to you in an emergency, is doing that same subsidizing. It's just not as easy to tally up.
[/quote]

And somehow turning over 1/6 of our economy to the federal government is going to "fix" the system. I don't think so.

I don't see people crossing the borders to Canada or Cuba or Poland seeking medical care.

Universal coverage is not a system intended to provide better medical care just equal, which is the ultimate goal of the progressives.

"The inherent vice of capitalism is the unequal sharing of blessings;
the inherent virtue of socialism is the equal sharing of misery."
-- Churchill

[Pole Lock]

[quote author=RNaka link=topic=31395.msg133633#msg133633 date=1420027256]
And somehow turning over 1/6 of our economy to the federal government is going to "fix" the system. I don't think so.

I don't see people crossing the borders to Canada or Cuba or Poland seeking medical care.

Universal coverage is not a system intended to provide better medical care just equal, which is the ultimate goal of the progressives.

"The inherent vice of capitalism is the unequal sharing of blessings;
the inherent virtue of socialism is the equal sharing of misery."
-- Churchill
[/quote]

You might not see it, but people have gone to Canada and Cuba for medical services and continue to do so, so much so in fact that Canada had to tighten the controls on verifying eligibility before rendering services.  I know someone who married a Canadian for the coverage after he was diagnosed with cancer.

The inherent vice of capitalism is the highjacking of public institutions by the industrialists.  The virtue of socialism is we've already been living under it since FDR's New Deal.

Churchill was a pig.

[RNaka]

[quote author=Pole Lock link=topic=31395.msg133636#msg133636 date=1420032667]

The inherent vice of capitalism is the highjacking of public institutions by the industrialists.  The virtue of socialism is we've already been living under it since FDR's New Deal.

Churchill was a pig.

[/quote]

Well, comrade, I guess we'll just have to disagree.

The New Deal was/is certainly a move towards socialism but hardly a "virtue".

The meddling of the big business in public institutions is not capitalism but, rather, crony capitalism or, when ideologically driven, economic fascism.

You're right, capitalism is a horrible economic system, just better than any other.

[Pole Lock]

[quote author=RNaka link=topic=31395.msg133640#msg133640 date=1420035046]


You're right, capitalism is a horrible economic system, just better than any other.


[/quote]

I don't know... I've been pretty impressed with some of the local economies I've been fortunate to be around, Ithaca, NY, being one of the more robust.