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twitterLETTER TO THE EDITOR:
Health insurance worthless when the sick can’t get it
Tuesday, Nov. 10, 2009 | 2:02 a.m.
Congratulations to Michael Pravica for his Monday letter to the editor, headlined “Denial of claims can have ripple effect.”
His letter gets to the core of the dysfunction in the way in which we handle health care in this country. We embrace the healthy and throw the sick to the curb. Insurance companies deny coverage to the sick and every year turn down a huge number of claims for essential medical services.
People talk about how health care reform will bankrupt the nation and take away from future generations. They’re missing the point. The current system has contributed to the financial ruin of countless millions of people for more than a generation now.
If costs keep going up the way they have been, our children and grandchildren won’t be able to afford even the most basic care.
There is a spinal surgery clinic in Florida that treats spinal cord injuries in a unique way. I was contemplating going down there to get an old back injury fixed.
I called my insurance company in Nevada and asked what my reimbursement would be on the $40,000 surgery. The representative here said she didn’t know exactly but it would probably be in the $200 to $250 range because the Florida center was out of network.
I’ve paid into insurance for 40 years and never had a serious claim. The first time I want to use it they offer me the above reimbursement.
People who prefer private insurance to government-sponsored insurance better read the small print in their contracts. Insurance companies that refuse medical bills are useless. Get rid of them!
Discussion: 33 comments so far…
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"Congratulations to Michael Pravica"
Michael Pravica turned a fraudant claim into the insurance company.
The Doctor checked the wrong "code" and hence the wrong charge was made.
What was the cost of the real service was it $50 more or $20 dollar less.
Michael Pravica thinks his insurance should pay what ever he turns in even when it is wrong.
The doctor could have made a $200 mistake what then.
Because Michael Pravica is unaccountable for his own service we all pay.
it really is very simple...
you either support the public option...
or...
you support the greedy pig insurance companies and their very real death panels and the money grubbing whore doctors...
period...
end of story...
but now the administration is caving, and there will probably be no public option. we'll get some bull&%^$ compromise that might be worse than what we have. the pigs in congress won't go against the hands that feed them.
by the way, sun, how do i change my name? i don't regret voting for obama, because i would not want sarah palin in line for the presidency, but i hope not to have to vote for him again - unless he gets his head out of his butt and makes some real change happen that benefits the average americans who have been screwed during the past decade or two
You can buy a policy without limitation to in network providers (those with contracted rates) you simply have to pay more to receive more. Do you think you should pay the same to insure a volkswagon as you do a BMW? Should fire insurance be the same for a condo as a 6,000 ft home in the forest?
We don't care what the policy says when we buy it (or have it provided for us) yet we don't think there should be any exceptions when we want to use it. You get what you pay for, it is all available, it just costs more before you think you need it.
35 per cent of health care cost is the administration of health care. That is to say, we need to have the paperwork and copies in triplicate at every station of the care. Every doctors office has 2 or 3 people handling paper. Mistakes are made , claims refused, people die because wrong kidneys are removed or wrong medicines applied. It is really deplorable. Who has the answer? I think doctors offices are plugged up with really old people that either don't take advice from doctors or they don't understand the doctor. Maybe we're keeping people alive too long. I really don't know. I'm just on a rant. Forgive me if I offend you.
What just baffles me is that the people who are getting behind Obama's nonsense are supporting a system that does not provide health care to anyone who needs it. Yes, you still will have to pay for that chemo and if you can't, you will die because they did not want to help you because you are poor. That is what the dumbocrats are doing. Nothig has changed.
Sounds like the wailer is referring to selective or experimental surgery that is usually not covered under most health insurance policies.
This is probably not the case, but there are a lot of fraud out there. Doctors and clinics performing operations for extreme amount of money.
Actually, the more I hear about this Florida clinic, the more of a skeptic I have become.
If the wailer would produce the name of the clinic, we could do a little research on the clinic...
insurance company denials are a problem for individuals, doctors and hospitals. The insurance contracts are incomprehensible. This issue landed me in court for 4 years when my wife got sick and insurance refused payment many years ago. The lawyers argued amongst themselves as to what certain clauses meant.
Hospitals are getting fed up with being burned by the uninsured as well as insurance companies. Some of the best are turning to "pre-pay contracts". Payment in advance for cancer treatments and transplants. 250k-1 million in advance before they will talk to ya. The days when you can pop into a hospital for expensive treatments and skip on the bill are fast coming to an end!!!!!!Save your pennies it's going to be an expensive ride.
So zippert, what's the option? Fix the health care system or throw it away and replace with a government managed system?
One thing about a government system, you won't have to worry about getting attorneys to represent you. It will be done by a bureaucrat...
Fix it!!! With 100 trillion in med bills coming due in the next few decades and hospitals and top physicians demanding payment up front it's no joke. Congess is trying to build a new system from the ground up. Way to complicated.
If you want a government model copy England or France. If you like the private sector model copy Switzerland.Put it to a national vote. None are perfect but all are much cheaper than ours and they get the job done. My older relatives who live in Europe tell they have been working on getting the kinks out of their health care models since these models were developed after WW2. We don't have time to come up with something new that will take 70 years to properly implement. It will take me 70 years just to understand the new health bill.
Government health care is worthless when it denies you care.
Zip, half of our expenses on medical care in the US are paid for by the government already.
Birdie,
It is just that simple,
You either support the public option or you understand actually economics, human interest, incentives, and the fundamental problems with our current health care system which are caused by government itself - aka the facts.
Regarding Future's bizarre unintelligible comment about my "fraudulent claim." If you can't see why a person who develops a contagious disease and who has insurance (with out of network coverage) merits reimbursement (minus copay) for the costs to rapidly treat the condition to prevent the spread of the contagion, you are missing the forest for the trees. This is the key problem. Our business leaders don't see the humanity - they only see profits and by nickel and diming their patrons, they are hurting all of us as we are seeing daily the effects of epidemics within the population due to poor health care.
Hypothetical: You have been a very productive employee for your company for 25 years that pays for your health insurance and you become sick and need a major operation, but is being denied by the insurance company. Who gets screwed if you do not have the operation-You, your family, your employer, or all of the above?
ummm, hmmm... this one is tough; I'll go with C, Bob, and in just that order! Do I win a trip to a foreign country to have life-saving surgery that won't cost an "arm & a leg?"
OK, let me see... I have been an employee for a company for 25 years and never read my health insurance policy or talked to others in the same company about the company's health insurance package. -- Now, that's not very smart of me...
The last "company" I worked for 20 years did not have any dental coverage in their health insurance package. Employees who thought they needed dental coverage, purchased a dental rider on their own. Some employees purchased extra cancer insurance because of a family history of cancer. Others purchase catastrophic riders.
Somewhere in this equation there needs to be a little bit of self responsibility...
Patrick, My wife is on medicare after a lifetime of paying into private insurance. She has never been denied anything and can go to any doctor she chooses.She gets preventative care,physicals,colonoscopies, hospitaization,prescription drugs all either paid for or at a low price. It's fantastic! I am not old enough yet to qualify. I have to pay for everything through the nose with my "Sierra Health and Life" All the old people screaming at the town hall meetings didn't want medicare eliminated, they were protesting cuts in the proposed plan. Medicare is strictly voluntary. People don't have to participate. Currently about 44 mil people are eligible and all participate. Surveys show 94% of recipients like the program as is. If you think people in this country hate govt. health talk to people that have it. They like it just fine.
But zippert, Medicare as we know is going to change under the reform that is proposed by both the House and the Senate. You can't take 500 billion out of Medicare without reducing care...
It's not going to take Medicare out really, the new health system would improve that. Don't think it's going to affect it, it's just going to improve it if all.
It may be just me, and I consider myself a trusting person, but how in Gods name could anyone think that there won't be cuts in Medicare services by cutting 500 billion from it's budget?
You can't make drastic cuts to a program and expect the same level of services.
Why do supposedly intelligent people believe the crap that is being served to them?
Obama doesn't have a clue about either the USA or his fellow Americans, assuming he really is a citizen. One Term!
I personally don't believe politicians. They gave the banks until Feb 2010 to get their house in order. Meaning "if you're gonna hose these people do it by Feb." sure enough the banks all increased their rates and cut back your credit limits and increased your payments. All in the name of helping the people. Harry Reid takes credit for that too.I will never vote for Harry.
Little people don't have a chance. You are never going to win and you will all die in misery. I leave you with that good thought.
Thanks Phargo... I will sleep with one eye open and my billfold under my pillow...
Larry...........that's the first place they'll look.
"Obama doesn't have a clue about either the USA or his fellow Americans, assuming he really is a citizen. One Term!"
I haven't seen George W. Bush's birth certificate, he could be from EUROPE.
I thought that George W. Bush was French. You can tell by his accent...
From the Horses Mouth;
"I didn't grow up in the ocean -- as a matter of fact -- near the ocean -- I grew up in the desert. Therefore, it was a pleasant contrast to see the ocean. And I particularly like it when I'm fishing." --George W. Bush, Washington, D.C., Sept. 26, 2008
LarryVegas:
The only crap being served is right-wing crap.
Health care reform will pass without you.
Thank you Harry Reid and Nancy Pelosi.
Hey teamster:
Pull up a chair and join us at the table.
You will be served shortly.
Do you want right-wing crap or left-wing crap???
Harry and Nancy are whipping up some special desert for you...
When I was a little kid my grandparents all disparaged FDR. They said he was a socialist too. The difference between FDR the Socialist and BO the Socialist is FDR's first proirity was get the country off it's ass and back to work. Fixing old systems, building new systems, municipal pools that are still in use. The CCC which built roads and National Parks. etc. This guy BO is diddling around with Health Care. which employs no one new. Just the same old pirates that will manage to steal more money from us.
Eventually when these current bills fall by the wayside maybe this President will start working on the promises he made last year. Promises that will help us regain jobs and self-respect. Instill faith and pride in ourselves. All of us, not just the 53 per cent that elected him. Those 53 per cent can find no wrong in him but I think sooner than later they will tire of chewing on his old tired rhetoric.
Phargo, your grandparents didn't know what socialism is. Nor do you.
meowmeow.....I know what socialism is. We're knee deep in it already. Every lil kid gets a free breakfast, lunch, and if their momma can't pick them up till later , we give 'em a supper too. The schools send sandwiches home with them for over the week-end. We pay for homeless people's health care now and we have Medicare and Medicaid and Unemployment checks and food stamps and WIC and on and on and on it goes. That sir, is Socialism.