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RE: British health care - 7/28/2010 6:49:46 AM   
thishereboi


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quote:

So "dad" is on a Company paid policy?


What do you consider a "Company paid policy"?


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RE: British health care - 7/28/2010 6:55:14 AM   
DomYngBlk


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Status: offline 		A policy that anyone that is working for a company that provides an insurance policy. Or if you are getting money out of your check that goes to the company to partially offset your benefits.

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RE: British health care - 7/28/2010 6:56:49 AM   
thishereboi


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quote:

ORIGINAL: DomYngBlk

A policy that anyone that is working for a company that provides an insurance policy. Or if you are getting money out of your check that goes to the company to partially offset your benefits.


Ok, just wanted to make sure I understood the question. And the answer is nope.

I also should add that I had insurance through work for many years and the insurance company never prescribed medicine and the doctors never asked a nurse if I could have surgery.


< Message edited by thishereboi -- 7/28/2010 6:58:35 AM >

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Profile   Post #: 43
RE: British health care - 7/28/2010 6:57:29 AM   
DomYngBlk


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quote:

ORIGINAL: thishereboi

quote:

So "dad" is on a Company paid policy?


What do you consider a "Company paid policy"?



Still Tazzy pretty much nailed it at the top of the page. Can order all the tests you want but when the claim comes back from the Insurance company what counts is on the line for allowed claim. That one isn't up to your Doctor and try asking him to pay for it!

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Profile   Post #: 44
RE: British health care - 7/28/2010 6:59:32 AM   
DomYngBlk


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Status: offline 		[quote]ORIGINAL: thishereboi

quote:

ORIGINAL: DomYngBlk

A policy that anyone that is working for a company that provides an insurance policy. Or if you are getting money out of your check that goes to the company to partially offset your benefits.


Ok, just wanted to make sure I understood the question. And the answer is nope.



Then I think we are agreeing to the same thing. Any coverage that is taken away from a "Company" decision whether it is Insurance or the Company you work for is good for the patient in the long run. Neither the Company you work for or the Insurance company have a vested interest in you getting well if it is a catastrophic case. In fact, both would prefer you die fast...

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RE: British health care - 7/28/2010 7:01:42 AM   
thishereboi


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quote:

ORIGINAL: DomYngBlk

quote:

ORIGINAL: thishereboi

quote:

So "dad" is on a Company paid policy?


What do you consider a "Company paid policy"?



Still Tazzy pretty much nailed it at the top of the page. Can order all the tests you want but when the claim comes back from the Insurance company what counts is on the line for allowed claim. That one isn't up to your Doctor and try asking him to pay for it!


Yes, but that really has nothing to do with your claim that ins companies prescribe medicine and nurses make surgical decisions.


_____________________________

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This here is the boi formerly known as orfunboi


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Profile   Post #: 46
RE: British health care - 7/28/2010 7:17:36 AM   
DomYngBlk


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Status: offline 		Do you have a company health care managed plan? Go and have say a spleen operation. Go on and check into the hospital and try to have it done. Oh wait! Sorry mam, you can't get that operation until your insurance company says so.....And yes, the phone call made will be to a nurse since they wouldn't pay a doctor to actually make that choice for you. And hey, the added bonus is if they don't think you need the operation you have to go on home and wait till it actually bursts and kills you!

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RE: British health care - 7/28/2010 7:49:53 AM   
DCWoody


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quote:

ORIGINAL: willbeurdaddy


quote:

ORIGINAL: joether

DomKen is quite correct. The UK system was never considered for use here in America. The San Fran system and the Commonwealth of Massachusetts 'Mass Health' system were the basis of frame work used. Besides which, didn't Britain sent troops to Iraq, like the USA? Takes alot of cash to fund a war. The Brits paid for it with cash, we Americans just put all of it on the national debt. Ironic isnt it? A bunch of 'fiscal responsible' conservatives, plunging the USA deep in to debt.


You and Kendoll are quite wrong. Obamacare was declared by several Dems to just be the first step toward single payer, and Obama is on the record as saying single payer is his ultimate goal.



That is not the same as the NHS. I like the NHS, but it's by far the minority option for UHC....it's cheaper, but...very communistical....most nations go with providing govt insurance to pay for private/semi-private docs/hospitals...NHS, it's govt provided docs/hospitals.



@PeanutTiger, I disagree...we get a higher standard of care, considerably cheaper :p


EDITED:'quote' function on this site is seriously screwy.


< Message edited by DCWoody -- 7/28/2010 7:50:48 AM >

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Profile   Post #: 48
RE: British health care - 7/28/2010 9:32:06 AM   
tazzygirl


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quote:

ORIGINAL: thishereboi

quote:

ORIGINAL: tazzygirl


quote:

ORIGINAL: thishereboi

quote:

ORIGINAL: DomYngBlk

Don't worry about most here. They've no idea of the reality of their own personal situations. The truth here is that the US system is now a totally managed system and your ability to get care is based on whether your insurance company feels like it could be a coverable expense.  Add to that you will take the medicine that they proscribe to you rather than what the doctor may or may not want. Any type of operation has to be run by a "nurse" on duty by telephone to see if you "qualify". Add to this any company provided plan can and is adjusted by price and service at the whim of the employer.

Most americans know this but as with most other things reality is a bit too tough and they'd rather type on about the founding fathers and how "free" they supposedly are.


So the insurance companies are prescribing medicine and the nurses are making the final decisions on surgery? That's odd, because my dad just had surgery and they never bothered to ask a nurse if it was necessary, they just took the doctors word for it. And yes it was the same doctor that prescribed the medicine he took. I guess they forgot to ask the insurance company about that one too.



Your doctor can prescribe anything he wishes, order any test or procedure. That doesnt mean the insurance company will approve the coverage... and its been well documented that they dont.


That is not what he said. He said insurance companies prescribe medicine and that doctors go and ask nurses for approval on surgeries.



But this IS what i said...

quote:

Your doctor can prescribe anything he wishes, order any test or procedure. That doesnt mean the insurance company will approve the coverage... and its been well documented that they dont.


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Profile   Post #: 49
RE: British health care - 7/28/2010 9:45:40 AM   
tazzygirl


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quote:

ORIGINAL: thishereboi

quote:

ORIGINAL: DomYngBlk

quote:

ORIGINAL: thishereboi

quote:

So "dad" is on a Company paid policy?


What do you consider a "Company paid policy"?



Still Tazzy pretty much nailed it at the top of the page. Can order all the tests you want but when the claim comes back from the Insurance company what counts is on the line for allowed claim. That one isn't up to your Doctor and try asking him to pay for it!


Yes, but that really has nothing to do with your claim that ins companies prescribe medicine and nurses make surgical decisions.



Perhaps this may shed some light on the "nurse" aspect of his post.

Nurses who work for insurance companies need the same education, practical clinical experience, and judgment as those nurses working in medical facilities. These nurses play a crucial role in the managed care process by applying their clinical background and expertise to the constant interaction they have with patients, physicians, specialists, and other healthcare providers. They use their clinical knowledge and internal resources to analyze whether a member is being given the right care, in the right setting, for the right cost. There are a variety of nursing career opportunities in insurance, including precertification, concurrent review, discharge planning, and case management.

When a member needs the services of an inpatient or outpatient facility, the care is approved through a precertification nurse. These nurses analyze proposed medical procedures for members. Then they determine if hospitalization or some other type of care is needed and the appropriate length of stay. Precertification nurses use clinical data and national standards to approve procedures, and if necessary, may confer with one of the company physicians to override standard criteria.


http://news.nurse.com/apps/pbcs.dll/article?AID=200010020388

So, by saying a nurse decides if you get surgical approval, its true.

_____________________________

Telling me to take Midol wont help your butthurt.
RIP, my demon-child 5-16-11
Duchess of Dissent 1
Dont judge me because I sin differently than you.
If you want it sugar coated, dont ask me what i think! It would violate TOS.

(in reply to thishereboi)
Profile   Post #: 50
RE: British health care - 7/28/2010 10:57:00 AM   
thishereboi


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Joined: 6/19/2008
Status: offline 		Well in this area they have medical assistants http://www.michigan.gov/healthcareers/0,1607,7-221-39742-64789--,00.html and while it is their job to check the insurance and let the patient know what will or will not be covered, it is not her job to decide if a surgery is necessary.

_____________________________

"Sweetie, you're wasting your gum" .. Albert


This here is the boi formerly known as orfunboi


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Profile   Post #: 51
RE: British health care - 7/28/2010 11:02:26 AM   
tazzygirl


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Joined: 10/12/2007
Status: offline 		That is from the point of service... rather... the MA is employed by the Dr's office. Im referring to nurses who are employed by insurance companies to make such decisions. The MA would call the insurance company, talk to the nurse who works for the insurance company.

_____________________________

Telling me to take Midol wont help your butthurt.
RIP, my demon-child 5-16-11
Duchess of Dissent 1
Dont judge me because I sin differently than you.
If you want it sugar coated, dont ask me what i think! It would violate TOS.

(in reply to thishereboi)
Profile   Post #: 52
RE: British health care - 7/28/2010 11:44:27 AM   
DomYngBlk


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Status: offline 		Which sort of blows away the whole wringing of the hands during the health care debate about "nationalized" medicine will take doctors out of the decision. They are already out....

Reminds me of the supposed doctor shortage. Which is about as ludicrous an idea as I have ever heard. The AMA purposely keeps the amount of doctors at certain levels on purpose. MONEY. Are all qualified people allowed into med school? LOL hello no. If they were there would no shortage and doctors would make far less than they do now.

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Profile   Post #: 53
RE: British health care - 7/28/2010 12:00:54 PM   
tazzygirl


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Joined: 10/12/2007
Status: offline 		In that, you are partly right.

Just as with nursing schools, there are limited number of slots for entrance each year. Each school has their own method of determining who gets in and who doesnt.

However, i dont believe its the AMA (Medical) or ANA (nursing) who is keeping the numbers low. There is a required student to teacher ratio. Beyond that number, its illegal, not to mention hazardous, to have more students per teacher.

_____________________________

Telling me to take Midol wont help your butthurt.
RIP, my demon-child 5-16-11
Duchess of Dissent 1
Dont judge me because I sin differently than you.
If you want it sugar coated, dont ask me what i think! It would violate TOS.

(in reply to DomYngBlk)
Profile   Post #: 54
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