[Info-vax] Just how much is 30, 000 pounds in US dollars? Basic programmers wanna know.

[Doug Phillips]

On Feb 1, 11:29 am, seasoned_geek <rol... at logikalsolutions.com> wrote:
> On Jan 26, 12:43 pm, hel... at astro.multiCLOTHESvax.de (Phillip Helbig---
>
> undress to reply) wrote:
>
> > The idea with any insurance, of course, is that one pays a small amount
> > in regularly and most people end up paying more than they get out of it.
> > The unlucky ones, though, don't have to worry about costs.  For years, I
> > paid in more than I used, until I got cancer.  I'm going back for a
>
> Well, as one who has worked in the healthcare world multiple times, I
> would say you are quoting the propaganda, not the reality.  The
> healthcare business is entirely about killing patients for profit.
> I've never worked for a single provider that didn't actively engage in
> it.
>
> As a general rule, the only reason U.S. citizens aren't killed off the
> instant a long term or costly diagnosis hits their file is that the
> health care workers know how to work the system to override automatic
> denials.
>

I've always wondered, if a person has both health insurance and life
insurance with the same company, does the company check to see which
policy would cost them less to pay out on?


> If you happen to live long enough to get on Medicaid/Medicare, the
> number of things which can be denied drops dramatically and your life
> expectancy improves greatly.
>

Of course, with the government's current financial problems causing
slow payment to providers, fewer and fewer doctors are accepting
Medicare/Medicaid patients.

> I have watched, time and time again, kids under the age of 25 with
> nothing more than a High School Health class deny treatment to people
> who could otherwise be saved and lead productive lives because it was
> more cost effective to kill them.  Murder for profit was legalized
> when they created the HMO.

The heath care problem in the U.S. is a many headed beast. The health
insurance industry is a middle man that contributes nothing to the
quality of health care and a great deal to its cost. The health care
providers, with some outstanding exceptions, spend as much time
worrying about paperwork and competition as they do treating patients.
The insurance industry adds nothing to the quality of health care but
adds significantly to its cost.

Doctors are practicing medicine defensively. The legal system needs
reform. High tech equipment is expensive and it must be used in order
to pay for it. Too often it is used needlessly. Health providers must
be allowed to cooperate instead of being forced to compete. Competing
hospitals in my metro area were not allowed to merge because of anti-
trust laws. So, the "they have one so we need one too" game continues.

The "normal" hospital/clinic that I've had contact with use billing
patient billing procedures that are insane.

I wonder if this sounds familiar to anyone:

You feel like something is wrong so you go to your primary doctor, who
examines you and refers you to a specialist. S/he orders some tests
and says you need inpatient surgery, which s/he schedules after
talking to the hospital and your primary.

You call your insurance company and give them the information about
the procedure, the date, hospital and the names of your primary &
specialist. They look it all up, it's "in network" and they approve
it.

A hospital billing person calls you (or you have to call them) and you
verify your insurance information. You have the procedure done and
after a couple of days you go home and maybe have to start some
therapy.

A month or more later, you get a bill from the hospital that's
slightly shorter but a bit scarier than a Steven King short story. It
says it's been submitted to your insurance company. Your primary
doctor sends a bill and so does the specialist. A few weeks later,
another bill comes from some doctor you've never heard of who says he
was your anesthesiologist. A few weeks later, another bill comes from
some lab you've never heard of. A few more bills trickle in, all from
people and places you don't know.

Eventually, your insurance company sends you a statement showing what
was covered and what wasn't, your deductible and co-pay, and some
adjustments because of provider agreement (or some such) .

The hospital sends a statement showing how much the insurance company
paid, and what you owe. The numbers don't match.

Insurance company statements arrive over the next few week. Some are
denied and marked "out of network." Some are marked "not covered."

You call the insurance company and they tell you that the radiology
lab isn't one of their providers, and some of the other items billed
don't match what they allow for that type of procedure. So, you call
the doctor, the hospital, the insurance company, the doctor again...
who finally says he'll call the insurance company himself... and the
maybe that helps or maybe not. In any case, he and his staff have
wasted a lot of care-giving time.

In the mean time, therapy bills and statements are flowing in and the
paperwork is piling up and even though you're supposed to be getting
better, your stress level is rising faster than your body is healing.

After maybe a year, if you're lucky, you start to live almost normally
again and you're almost ready for the next round of the "stress that
sick person" game we call a health care system.

That's one "healthy" person's experience. We've all heard and read the
stories of people with chronic illnesses, and I know some of you have
some amazing tales to tell, but do we really understand the stress
they and their families must go through in dealing with this madness?

A friend's mother died last year after suffering from cancer for
months. Eight months after she died, she was still getting bills from
the hospital and clinic for visits during the months before she died.
Really? They can't do better than that?

The health care provider system does have a few outstanding examples
of how efficient and affordable care can work. I'm most familiar with
the Mayo Clinic. Outstanding in every way.

A typical procedure at Mayo can cost half of much as at one of the
local hospitals, and it will be done with less wasted time and will
have better results. And you get one bill, and it's ready when you
check out. Oddly enough, this more efficient and affordable health
care is often considered "out of network" in many insurance policies.

There are other hospitals/clinics in the U.S. that work just as well,
so I am told, so with good models available there's no excuse for the
system to be as inefficient as it is. Other nations have health care
systems that work. The U.S. system is generally broken, and my
comments have only touched a few of the cracks.

Sorry for the novella. Must have hit a raw nerve there ;-)