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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 8:34:19 AM

meatcleaver

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quote:

ORIGINAL: juliaoceania

quote:

ORIGINAL: Dtesmoac

There are few things in the UK I would riot about but after experienceing the US health care system for nearly two years the destruction of the NHS would be one of them.

In the US once they see the insurance card the cash till just keeps going ka-ching for multitudes of tests and arse covering crap. The grand piano in the foyer was not required...etc. The invoices that then keep cominh in and the amount of time wasted determining the actual costs and money owed is ridiculous. The actual treatment and infrastructure may be very good (better than NHS for non life threatening conditions) but it is not good value for money.

I was reading another thread in which another UK citizen was complaining about the lack of coverage under the NHS system. If I were in the UK I would try to correct that, but socialized medicine is something I would treasure personally. I would not begin to argue the point with people from the UK that do not like their system, but being in a private pay system leads to many premature deaths because of lack of preventative care. I have experienced it in my own family firsthand

People complain about it but try taking it away from them and they will be complaining even more. The problem with medical care is that you could put the whole wealth of the country into it and still there will be calls for more. At some point a decision has to be made about priorities. The other problem I have with Brits that complain is that they get damn good healthcare at a bargain basement price. When people complain to me about the NHS I always say, you obviously don't mind paying more tax. The average Brit wants low taxes and first class services, for what they pay, they are quids in.

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 9:38:26 AM

farglebargle

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quote:

ORIGINAL: Archer

A large part of the Insurance Company not being responsive to the health care reciever, is that the only folks the Insurance companies have to keep happy are the Top level VP's and the Head of HR. So long as HR does not hear complaints from executive level folks and the head of HR is happy, the cances that the company will shift their Insurance provider is very much cost based to the exclussion of anything else.

I still say if you make the Insurance compensation move with the employee, By simply making a dedicated payment for insurance, and have te Employee decide which company that money goes to, and making all Health Insurance deductable not just those provided by employers. The responsiveness of the Insurance companies will inprove. Costs will come down because the Insurance Companies will have to actually compete for individual policies, and they will have to be responsive because they could lose policies to their competition.

The question I have is simple Why is Healthcare the company provides taken out pre tax, while insrance I purchase myself is not? It's a law they need to change.

Short answer: Form a LLC, and have it purchase your healthcare. Your accountant will then be able to deduct it.

Of course, check with them BEFORE you do that.

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 10:09:17 AM

Mercnbeth

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quote:

U.S. healthcare expensive, inefficient: report

This is news? What's next, President Bush's approval rating is low?

There are quite a few things to take issue with the report. The US citizens pay the most? Factor in the taxes paid in those countries that have universal coverage and the price is much higher than what comes out of the pocket of most US citizens.

No coverage? Even criminals in the country illegally can walk into an emergency room and care is mandated by law. Don't like the wait of emergency rooms? That will be standard expectation going to any National program. Not just for emergency care, but for any medical procedure not deemed "critical". Referencing a recent slice of life; beth's GP during a physical discovered a breast lump. It took 10 days to get a mammogram and ultrasound and another 4 days for the biopsy and results. Two weeks of mental anguish and not knowing. In the other thread referencing UK care, I was told the same experience would have taken months. We want that system? If care is so good and "fair" why is there a market for additional coverage? Why is the gap between the "ultra-care" received by the "ultra-wealthy" and the standard care, or even the additional care voluntarily purchased?

It comes down to money. Currently our costs are high because of the current unofficial national health coverage. The people with the ability to pay or with insurance pay $8/aspirin to make up for the aspirin given out to people who don't or can't pay. Insurance companies inefficiency are seen from the consumer side. You must remember when dealing with them, the job of any insurance company is to NOT pay a claim. As others have said, don't accept what they decide. Be proactive about your care. Go up the chain of command of the insurance company and, if employer provided, your company's HR. They are paying big bucks contributing to this employee benefit. Reporting dissatisfaction with your employer will have the clout of your employer considering a change next time the health coverage renewal comes up.

And don't forget the inalienable US "right" of lawsuits in the US. Go to the UK system for health care and you may get the UK system of "loser pays" on lawsuit issues. The better idea would be to put in a reformed tort system of loser pays and see the impact it has on the liability insurance paid by hospitals and every level of health care personnel.

Another consideration - Name one government program creating a bureaucracy managed by the US government that worked, or works? Now you want to put your health in the hands of the 'good nanny' government?

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 10:29:09 AM

Vendaval

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General reply -

Yes folks, this report does state the obvious! lol Let's keep talking about finding ways to improve the situation.
I appreciate the input from all of you, some great insights and ideas are already posted here.

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 10:32:25 AM

popeye1250

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And who said the U.S. is a "rich" country?
We're not!
We're in debt up to our ears!

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 10:36:38 AM

cjenny

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I pay cash for all of my medical care, no insurance. I lost it one week before my gallbladder burst inside of me lol. Currently I average about $1100.00 per month in prescriptions alone.
It's gonna destroy me, one day I'm going to simply run out of money.

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 12:16:32 PM

minnetar

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quote:

ORIGINAL: cjenny

I pay cash for all of my medical care, no insurance. I lost it one week before my gallbladder burst inside of me lol. Currently I average about $1100.00 per month in prescriptions alone.
It's gonna destroy me, one day I'm going to simply run out of money.

i know i am probably going to state the obvious. Make sure all your medicines are generics and if not ask your physician if they can find an equivalent. Wal-Mart in my area has $4 perscriptions on some generics. 2 of the meds i am taking are on the list.

minnetar

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 12:18:08 PM

minnetar

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quote:

ORIGINAL: cyberdude611

quote:

ORIGINAL: farglebargle

Well, we have the Insurance COMPANIES to blame.

And illegal aliens...

Look at all the ERs that are closing because these illegals go in there, get care, and then never pay a dime. That's just like shoplifting, when someone takes something without paying, what happends? Everyone else has to pay more. That's what is happening.

Also in the US we have a problem with an aging population (baby-boomers) who are getting old and living longer than any of the previous generations. This is putting enormous strain on the entire system.

Most of the illegal aliens in indy are on some form of public aid which covers emergencies and then we have a locally funded hospital which they also pay insurance for to pay for their other costs.

minnetar

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 12:21:28 PM

minnetar

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quote:

ORIGINAL: farglebargle

Well, we have the Insurance COMPANIES to blame. The waste TRILLIONS of dollars just making Physicians jump through hoops to get properly filed and valid claims paid.

With 3 Trillion Dollars, EVERYONE could get care.

SO, the solution really *IS* a single payer system.

That and a nationwide deployment of VistA EHR systems.

i have to agree as i only deal with medical claim denials. i also see it from the physician side. my dad was a doctor and my little brother is one. my dad is retired and they have the total opposite mindset. my little brother believes in test, test, test. Whereas my dad will give me a recommendation and try that to see if it will alleviate the problem. i am sure my little brother does it for two reasons. The tests are available, and probably most importantly to avoid any problems with a malpractice suit.

minnetar

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 7:03:12 PM

feylin

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quote:

ORIGINAL: farglebargle

I specified PROPERLY FILED AND VALID, and since the billing backend is integrated, these are all electronically filed, so the "Legibility" issue isn't really a valid objection.

Sure, there are a lot of idiots who can't properly code, but that's not what we're discussing. We're discussing the practice of routinely denying once or twice properly filed, valid claims simply to hold onto the float longer.

Yes, you were specific and I was less so. Most of the electronic claims are auto-adjudicated so I never get to see them. What I do see are the messy ones, the ones without pre-authorization and no notes to send it for review right away. So, I have to create more paperwork and request more information. My company works for the companies that hire them and facilitate the plans they choose. It is a competitive market, so they will push the cheapest routes in order to come in with the best numbers. All true. But to blame only the insurance company is quite a narrow view in my mind. There will always need to be regulation, a review board, because a good deal of claims that I see are providers trying to double bill (I do mostly medicare coordination). They do A because of B and we do C because of A. Its all feeding upon itself.

There was some great advice in some posts about taking charge of your own healthcare. In order to keep my job, I need to do one medical claim every three minutes. Also, a lot of our work was sent to two other countries last year. That's just the claim side. I am sure everyone is aware of where America's call sites are going. So, it is great advice to understand your benefits, do your own legwork and follow up and definitely do not accept that EOB denial at face value. I cannot send a short note to the member saying, "Look, if that second diagnosis was first, we would pay." Members have to ask.

Best wishes,
Christine

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 7:07:02 PM

sweetnurseBBW

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Being a nurse I see alot of people coming back sicker than they were before. We send them home on meds they have to take and then the insurance companies cap them out. So they don't take their meds and end up in CICU with me racking up a more expensive bill than if the insurance company would have just paid for their meds. Doctors are run by insurance agencies. This is why heathcare is so expensive here. The insurance companies run things. It is horrible.

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 7:27:03 PM

cjenny

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quote:

ORIGINAL: minnetar

i know i am probably going to state the obvious. Make sure all your medicines are generics and if not ask your physician if they can find an equivalent. Wal-Mart in my area has $4 perscriptions on some generics. 2 of the meds i am taking are on the list.

minnetar

Oh I do get generics. One is just over four hundred bucks & another is three hundred. Unfortunately these aren't things I can mail order from Canada either. This is something that really angers me, the state of healthcare and our pharmaceutical industry.

But thanks for the tip anyway.

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RE: "U.S. healthcare expensive, inefficient: repor... - 5/15/2007 8:42:06 PM

dreamygirl

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Greetings Vendaval,

It also states with a little more research, that health care is turning to Consumer Driven Health Care. Blue Cross Blue Shield (not sure which one the PPO or the HMO) pulled out of some of the East Coast States and are beginning to go the road of the Consumer Driven Health Care.

The Doctors have jacked up the prices to cover the extra cost of Insurance But there are alternatives

. i know of a few different ways. But i will not post that information here. if You wish to know let me know privately and i will search it. Especially with Poly Households covering Everyone..

dreamy

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