A Little Bird Told Me
- Thread starter somarco
- Start date
- 1,896
To add to this, I saw a local billboard for a hospital yesterday that almost gave me an aneurysm. It said "Annual Heart Test? We Do It!"
Everyone doesn't need an annual heart test as part of their physical. It's not recommended by any physician unless you actually NEED it. Yet they offer it up out of the goodness of their heart? Oh, wait, they actually charge the insurance, then your claims go up.
Then I get bitched at the next year because of stupidity.
Everyone doesn't need an annual heart test as part of their physical. It's not recommended by any physician unless you actually NEED it. Yet they offer it up out of the goodness of their heart? Oh, wait, they actually charge the insurance, then your claims go up.
Then I get bitched at the next year because of stupidity.
- Thread starter
- #13
- 215
It is truly amazing how little the people in charge of so much know about how things work in the real world.
My honest opinion, Newt was on point when he was talking vouchers and he got slammed for it.
We are paying for the uninsured now anyway through free emergency care, etc. Why not structure it so as to reintroduce some competition?
I REALLY liked the idea he put forth in the Herman Cain debate where benefits reduced each time someone used "emergency care" when they are chronic utilizers of the emergency room.
We've got a broken system and these morons in DC are making it worse instead of better. Truth is, though, we've got to tackle utilization, personal responsibility, cost of care, etc. in the fix. The doctors and Pharma are going to try to game the system as much as the people are.
We're already seeing that with "generic" drugs costing $300/mo. so they can be on the lower copays, and yes, heart screenings for all. Some of that is CYA from the lawyers, some of it is making money, but we are waaay over tested and over drugged in this country.
Weird thing is, market forces are finally starting to work, since premiums are getting too high from cost of care, and all we see are news reports of how tragic it is people aren't utilizing care because it is too expensive and instead of letting the downward pressure on pricing create efficiencies, people are looking to the government to step in and provide "insurance" coverage for all.
IMO, putting everyone on an insurance plan so they pay less attention to costs instead of more will explode the problem. The individual mandate would be a boondoggle. Creating a system where competition is in play and people start paying attention to their own cost//benefit of care makes much more sense in my book.
My honest opinion, Newt was on point when he was talking vouchers and he got slammed for it.
We are paying for the uninsured now anyway through free emergency care, etc. Why not structure it so as to reintroduce some competition?
I REALLY liked the idea he put forth in the Herman Cain debate where benefits reduced each time someone used "emergency care" when they are chronic utilizers of the emergency room.
We've got a broken system and these morons in DC are making it worse instead of better. Truth is, though, we've got to tackle utilization, personal responsibility, cost of care, etc. in the fix. The doctors and Pharma are going to try to game the system as much as the people are.
We're already seeing that with "generic" drugs costing $300/mo. so they can be on the lower copays, and yes, heart screenings for all. Some of that is CYA from the lawyers, some of it is making money, but we are waaay over tested and over drugged in this country.
Weird thing is, market forces are finally starting to work, since premiums are getting too high from cost of care, and all we see are news reports of how tragic it is people aren't utilizing care because it is too expensive and instead of letting the downward pressure on pricing create efficiencies, people are looking to the government to step in and provide "insurance" coverage for all.
IMO, putting everyone on an insurance plan so they pay less attention to costs instead of more will explode the problem. The individual mandate would be a boondoggle. Creating a system where competition is in play and people start paying attention to their own cost//benefit of care makes much more sense in my book.
Sorry, Bill, those books have already been written. THE ***'S GUIDE TO OBAMACARE by Nancy Pelosi and HEALTH CARE REFORM FOR DUMMIES by Barack Obama were best sellers last year. Too many people bought it, I'm afraid.
G
Guest
Guest
Sorry, Bill, those books have already been written. THE ***'S GUIDE TO OBAMACARE by Nancy Pelosi and HEALTH CARE REFORM FOR DUMMIES by Barack Obama were best sellers last year. Too many people bought it, I'm afraid.
Haha! This forum should have a "Like" button.
- 313
People will definitely manipulate the system as best they can if it means saving money. I like the idea of a high risk pool and think the 6 month waiting period is a good deterrent, but 2014 will really tell us what role we have going forward if any.
- 4,096
Back on Topic
I have seen two carrier completely reorganize their service department along with underwriting.
One carrier now has a small group customer service rep for 6000 accounts.
One renewal underwriting in small group for the entire state.
There is no way. Come January unless you are juiced in you will get nothing done. Lucky for me the underwriter likes me.
Individual is even worse. I have one sales rep for the entire state. There is no way he can provide any real service with that case load.
Networks are about to get hit hard. I know my Doctor clients that are 50+ are all talking about retiring or dropping treatment for medicaid and medicare.
Past 2014 if you have a true private insurance plan you will be seen first. All the subsidized plan will wait in line at the clinic to have resident doctors treat them.
I have seen two carrier completely reorganize their service department along with underwriting.
One carrier now has a small group customer service rep for 6000 accounts.
One renewal underwriting in small group for the entire state.
There is no way. Come January unless you are juiced in you will get nothing done. Lucky for me the underwriter likes me.
Individual is even worse. I have one sales rep for the entire state. There is no way he can provide any real service with that case load.
Networks are about to get hit hard. I know my Doctor clients that are 50+ are all talking about retiring or dropping treatment for medicaid and medicare.
Past 2014 if you have a true private insurance plan you will be seen first. All the subsidized plan will wait in line at the clinic to have resident doctors treat them.
- 1,896
Lots of articles on CNNMoney lately about how doctors are unable to run their private business with the lagging reimbursement rates. We're going to be lucky if there are any private doctors around to accept our private insurance.
- 10,275
As previously mentioned...our role right now is "na." It might become "ni" or worse yet ""ex." I still believe there will be a role but getting out now is what you should be doing.
