RE: a rant: goodbye universal health care (Full Version)

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Moloch -> RE: a rant: goodbye universal health care (2/3/2008 8:02:32 PM)

What you pay is what you get.




defiantbadgirl -> RE: a rant: goodbye universal health care (2/3/2008 8:07:07 PM)

If that were true, there wouldn't be so many middle class people people having to sell their homes  because of an illness. Regardless of how much one pays for insurance, the insurance company is always trying to find a way out of paying.




thompsonx -> RE: a rant: goodbye universal health care (2/3/2008 11:21:52 PM)

quote:

ORIGINAL: subrob1967

1) So, complain to the pharm companies about the cost of medicine, Insurance companies, negotiate how much they're willing to pay, so it benefits YOU, the insured.
You appear to have missed the point of my statement.  The point was and is that the insurance company is the one who lobbies to keep effective drugs off the market in cahoots with the pharmaceutical companies.

2) Again, vote to elect people who agree with your views, it's not my fault senators and congressmen sell out to big pharm
Or to the insurance companies.

3) Says a liberal, which means nothing to me
Are you saying that anyone who disagrees with you is a liberal and consequently their position is invalid.  It must be pretty kewel to be god.

4) You're right, I don't care how many people survive chemo therapy, it has no bearing on whats considered experimental, or the descussion here

The point that seems to have escaped you was that the "non experimental" modality does not seem to have a high efficacy rate.
 
5)Again, you are paying an insurance company to transfer RISK from yourself, to the company.
Earlier you posted that the risks were being transfered to the other policy holders now you say it is transfered to the insurance co. 

Damn right they're going to lay down some ground rules. If you pay a doctor cash for treatment, there is no insurance company involved.
6)Yes it's ethical, and legal. Running a business to make a profit is cheating?
You are the one who said the insurance company "stacked the deck" in their favor.  I simply pointed out that "stacking the deck" is called cheating.  If you are uncomfortable with cheating then why involve yourself in it?

Oh my Gawd, I guess every sucessful business, that makes a profit, is cheating...In your opinion.
You are the one who is trying to justify "stacking the deck" (cheating).  Lots of businesses make money without cheating.

7) You really need to learn how to trim quotes, you're wasting a lot of bandwith.

I suppose you are right, you don't tend to read what you disagree with anyway.





GoddessDustyGold -> RE: a rant: goodbye universal health care (2/4/2008 3:46:03 PM)

Edited:  See below




GoddessDustyGold -> RE: a rant: goodbye universal health care (2/4/2008 4:16:23 PM)

quote:

ORIGINAL: thompsonx

1) So, complain to the pharm companies about the cost of medicine, Insurance companies, negotiate how much they're willing to pay, so it benefits YOU, the insured.
You appear to have missed the point of my statement.  The point was and is that the insurance company is the one who lobbies to keep effective drugs off the market in cahoots with the pharmaceutical companies.

2) Again, vote to elect people who agree with your views, it's not my fault senators and congressmen sell out to big pharm
Or to the insurance companies.

 
I was not aware that insurance companies kept any drugs off the market.  They may elect not to cover certain ones via their annual formularies, but they don't care, as far as I know, what is on the market.


quote:

3) Says a liberal, which means nothing to me
Are you saying that anyone who disagrees with you is a liberal and consequently their position is invalid.  It must be pretty kewel to be god.

 
I'll stay out of this one...


quote:

4) You're right, I don't care how many people survive chemo therapy, it has no bearing on whats considered experimental, or the descussion here

The point that seems to have escaped you was that the "non experimental" modality does not seem to have a high efficacy rate.

 
I am going to have to agree with subrob here.  The one has nothing to do with the other.  Insurance companies can elect to disallow anything they choose for whatever reason they choose.  But they cannot disallow something because they consider it experimental.  There is a clear definition and steps to approval processes and treqtments.  If something is an approved standard of care treatment, the insurance company can certainly figure out a way to refuse to cover it, but I doubt they would give the reason "experimental".  I know that has been brought up by one poster on this thread as a direct and personal expeirence, so I would like more details on that, if possible.   The point is that certain chemo treatments are considered the standard of care.  The efficacy of those treatments makes no difference.  Other treatments are still considered officially "experimental".  I repeat, one thing has nothing to do with the other. 

 
quote:

5)Again, you are paying an insurance company to transfer RISK from yourself, to the company.
Earlier you posted that the risks were being transfered to the other policy holders now you say it is transfered to the insurance co. 

 
I understood the postings to mean that the insurance company spreads their risk among a number of policy holders.  Not that the other policy holders are assuming the risk of each other.  The number and type of policy holders is one of the considerations in figuring the premiums.  One person might become ill enough to require specialized care, but the other 49 are doing fine and didn't need to generate those medical bills. 

quote:

Damn right they're going to lay down some ground rules. If you pay a doctor cash for treatment, there is no insurance company involved.
6)Yes it's ethical, and legal. Running a business to make a profit is cheating?
You are the one who said the insurance company "stacked the deck" in their favor.  I simply pointed out that "stacking the deck" is called cheating.  If you are uncomfortable with cheating then why involve yourself in it?

Oh my Gawd, I guess every sucessful business, that makes a profit, is cheating...In your opinion.
You are the one who is trying to justify "stacking the deck" (cheating).  Lots of businesses make money without cheating.

 
They are not cheating, thompsonx.  I fear you are taking a figure of speech and extrapolating it into something that was not intended.  The insuracne company is there to make a proft while perfomring a service.  They take all the risk as well as the other business expenses into consideration and then they charge for their product,service, accordingly to ensur that they are a sound business that is still able to make a profit for their shareholders.  The race track still makes a proft after paying off the win, place and show ticket or the daily double or the tri-fecta.  DoO you think that they should just take all the money that is paid in and pay it all back out?  Or do they get to have some profit for themselves along with enough to keep the track open?  They stack the deck too.  So do the legal casinos.  The odds are always in thier favor.  Else they would not be able to stay in business.  But if we had an epidemic of some sort and suddenly 80% or mroe of the policy holder needed hospitalization and/or emergency and follow up medical care at the same time, they could go broke.
 
Snipping #7. 

When you think about it, any health care plan is already a kind of socialistic form of sharing.  Companies are in business ( for a profit) to take and hold your money against the time you might need it for certain medical services.  If you don't need it, then you lose.  If you do need it, then you win.  The only difference between the current private health insurance and the much touted universal health care, is that people seem to be convinced that it will be cheaper, and those who can't afford it now, will suddenly be able to afford it (all that will happen is that their taxes will be raised and they will never see that part of their paycheck again).  In reality, those who cannot afford it now, or choose not to have it now, will not have a choice to have insurance or not to have insurance. Those who can't afford it now, will just pay for it in the form of an additonal deduction from their already scant paychecks.   Those who elect not to have it now, will be forced to have it.  The coverages will be the same or worse, and we will have less choices.  (geez, this sounds an awful lot like SS!)
Oh yes...and the people who are not paying anything now because they do not have taxable income, will not be paying for it then either.  They will just switch from one state sponsored program to another.  *shrug*  But they can be proud because they will now be equal.
 
Edited for tags 




GoddessDustyGold -> RE: a rant: goodbye universal health care (2/4/2008 4:26:53 PM)

quote:

ORIGINAL: defiantbadgirl

If that were true, there wouldn't be so many middle class people people having to sell their homes  because of an illness. Regardless of how much one pays for insurance, the insurance company is always trying to find a way out of paying.


How many?  Do you have a statistic or a percentage of the population that this is specifically effecting?




thompsonx -> RE: a rant: goodbye universal health care (2/4/2008 6:41:38 PM)

quote:


They are not cheating, thompsonx.  I fear you are taking a figure of speech and extrapolating it into something that was not intended.  The insuracne company is there to make a proft while perfomring a service.  They take all the risk as well as the other business expenses into consideration and then they charge for their product,service, accordingly to ensur that they are a sound business that is still able to make a profit for their shareholders.  The race track still makes a proft after paying off the win, place and show ticket or the daily double or the tri-fecta.  DoO you think that they should just take all the money that is paid in and pay it all back out?  Or do they get to have some profit for themselves along with enough to keep the track open?  They stack the deck too.  So do the legal casinos.  The odds are always in thier favor.  Else they would not be able to stay in business.  But if we had an epidemic of some sort and suddenly 80% or mroe of the policy holder needed hospitalization and/or emergency and follow up medical care at the same time, they could go broke.

 
GDG:
It was subrob who said that the insurance companies "stacked the deck"  I pointed out that that was cheating.  "Stacking the deck" is a synonym for cheating.  If he meant that the insurance companies use the "odds" (actuarial tables) to insure a profit that is a different story.  Since he works for the insurance company it would make sense that he would  know the difference between one and the other.
I would suggest that insurance companies are dramatically different than casinos and race tracks.  Race tracks and casinos cannot "hedge" their bets by selling off aspects of any given bet to other casinos or race tracks.  Then again there is the very nature of race tracks and casinos in that they can change the odds.  If a casino or track looses a bet they must pay off.  If an insurance company finds itself in a position that it cannot pay off its liabilities it simply files bankruptcy and opens up its doors with a new name.
thompson





 




SugarMyChurro -> RE: a rant: goodbye universal health care (2/5/2008 8:15:30 PM)

Oh wow, I didn't realize healthcare insurers could be so helpful!

http://www.health.com/health/article/0,23414,1663353,00.html

I'm sure the information at the link is all wrong though, right?

[8|]





GoddessDustyGold -> RE: a rant: goodbye universal health care (2/5/2008 10:45:43 PM)

quote:

ORIGINAL: SugarMyChurro

Oh wow, I didn't realize healthcare insurers could be so helpful!

http://www.health.com/health/article/0,23414,1663353,00.html

I'm sure the information at the link is all wrong though, right?

[8|]




No, it is not all wrong, and I say kudos to the e-zine for printing an article that is supposed to edcucate people,.  But all these things are pretty much common sense, a talent that many Americans lack.  They are lazy and expect everything to be done for them.
I make it My personal responsibility to educate Myself regarding what is covered and what is not.  I will find information or check with a watchdog agency if I have a question.  And I do not pay for anything that I do not need to pay for.  I already paid for the insurance.
Years (and I mean years) ago, I fought for and got a private policy for home care to cover My Aunt when she needed in home care.  They tried to pull a fast one and claim that the wording did not mean what it meant.  I was persistant, however, and the company backed down and covered what they were supposed to cover.  I am sure they did not cover many others who simply said, oh too bad, so sad that we misunderstood. 
I also used to follow up every time Medicare (Medicare!) refused to pay the ambulance charge for My grandmother.  They always covered it due to the special circumstance, but I had to go through a new battle each time it occured.  I never let up, and I always got the benefit.  that was the almighty governemnet health plan. 
So if you think that the automatic denial of claims only happens in the private sector you are sadly mistaken.  It is a personal responsibility to keep these companies (and the government) on the straight and narrow.  The example of the "out of network" antheseologist is very typical.  Things like this go through an automatic denial at first.  It is built into the system, not really to make sure that people get ripped off, but because it is an automatic efficiency step.  Out of network:  Denied.  They don't stop the process to check each one to see what the circumstances were on that particular surgery. 
Write the letter and don't pay the bill.  It may take a little time, but I do get tired of people who immediately cry unfair and raise a ruckus instead of using their heads and taking care of the matter.  If enough people would do that, I'd bet the companies would realign their systems to stop all the refusals to pay. 
But people don't. 
Instead they put all their energy  into the bitching and moaning. 
 




Estring -> RE: a rant: goodbye universal health care (2/5/2008 10:52:42 PM)

quote:

ORIGINAL: GoddessDustyGold

quote:

ORIGINAL: SugarMyChurro

Oh wow, I didn't realize healthcare insurers could be so helpful!

http://www.health.com/health/article/0,23414,1663353,00.html

I'm sure the information at the link is all wrong though, right?

[8|]




No, it is not all wrong, and I say kudos to the e-zine for printing an article that is supposed to edcucate people,.  But all these things are pretty much common sense, a talent that many Americans lack.  They are lazy and expect everything to be done for them.
I make it My personal responsibility to educate Myself regarding what is covered and what is not.  I will find information or check with a watchdog agency if I have a question.  And I do not pay for anything that I do not need to pay for.  I already paid for the insurance.
Years (and I mean years) ago, I fought for and got a private policy for home care to cover My Aunt when she needed in home care.  They tried to pull a fast one and claim that the wording did not mean what it meant.  I was persistant, however, and the company backed down and covered what they were supposed to cover.  I am sure they did not cover many others who simply said, oh too bad, so sad that we misunderstood. 
I also used to follow up every time Medicare (Medicare!) refused to pay the ambulance charge for My grandmother.  They always covered it due to the special circumstance, but I had to go through a new battle each time it occured.  I never let up, and I always got the benefit.  that was the almighty governemnet health plan. 
So if you think that the automatic denial of claims only happens in the private sector you are sadly mistaken.  It is a personal responsibility to keep these companies (and the government) on the straight and narrow.  The example of the "out of network" antheseologist is very typical.  Things like this go through an automatic denial at first.  It is built into the system, not really to make sure that people get ripped off, but because it is an automatic efficiency step.  Out of network:  Denied.  They don't stop the process to check each one to see what the circumstances were on that particular surgery. 
Write the letter and don't pay the bill.  It may take a little time, but I do get tired of people who immediately cry unfair and raise a ruckus instead of using their heads and taking care of the matter.  If enough people would do that, I'd bet the companies would realign their systems to stop all the refusals to pay. 
But people don't. 
Instead they put all their energy  into the bitching and moaning. 
 




What, you mean take personal responsibility and refuse to be a victim? What a concept. 




GoddessDustyGold -> RE: a rant: goodbye universal health care (2/5/2008 10:56:39 PM)

Yeah...I never was a very good victim. 
But I am damn good at concepts!  [;)]




SugarMyChurro -> RE: a rant: goodbye universal health care (2/6/2008 7:07:47 AM)

10 Myths About Canadian Health Care, Busted
http://www.ourfuture.org/blog-entry/mythbusting-canadian-health-care-part-i

-----

More to chew on.




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