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Health coverage 'plan' was no insurance at all



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No. 30
from CRNA2007
Old Oct 29, 2009, 08:37 AM

Default Re: Health coverage 'plan' was no insurance at all
Not only do they deny claims they do so more often than private insurance.

http://healthcare-economist.com/2008...alth-insurers/


Originally Posted by HM2VikingRN View Post
Sources for this allegation?
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No. 31
Old Oct 29, 2009, 04:01 PM

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by HM2VikingRN View Post
I don't think the timelines support that comment....The larger issue was that this couple was a victim of fraud....
So was a government plan to the tune of $60 BILLION. That government program goes by the name of MEDICARE. Mostly because they are trying to save us money by not having enough claim representatives to process claims.
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No. 32
Old Oct 29, 2009, 04:04 PM

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by CRNA2007 View Post
But Britain itself is Bankrupt because of the "free" healthcare.

Many private citizens are bankrupt in Japan but it's such a dishonor to file that they don't. For anything. Not to mention that the Japanese are some of the highest savers in the world. Maybe Americans ought to follow that lead and then they could pay for the stuff they buy and not have to file bankruptcy. What a novel idea eh?
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No. 33
Old Oct 29, 2009, 04:15 PM

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by CRNA2007 View Post
Not only do they deny claims they do so more often than private insurance.

http://healthcare-economist.com/2008...alth-insurers/
ESRD patients tend to run high phosphorus levels. Phosphorus is inversely proportional to calcium levels in the blood. FACTS. When a patient's calcium level is low the parathyroid gland over secretes parathyroid hormone. And the body goes looking for calcium in the bones. Imagine that. Therefore, ESRD patient's get a disease called renal osteodystrophy. In previous years patient's have had to have parathyroidectomies. But BIG PHARMA developed a new drug called Sensipar. Saving $$$$$ for people and the risks of surgery for patients. Imagine BIG PHARMA and the insurance companies thinking of a patient. TIC. It keeps the parathyroid from secreting so much hormone. EVERY freaking time we file a script for Sensipar MEDICARE denies it. We have to fill out a pre-authorization for the script. Every time they need it renewed MEDICARE denies it.

If a patient is on tums to rise the calcium level and lower the phosphorus level MEDICARE requires a script to fill those TUMS. They pay $8 a bottle for a $3 bottle of TUMS. The patient's love it because they save $3 and we, the taxpayers, spend $5. Seems fair to me.
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No. 34
Old Oct 29, 2009, 04:55 PM

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by HM2VikingRN View Post
No but we do need a transparent "plain language" insurance marketplace. If nothing else health care reform and the exchanges will improve transparency of the products.

Taxpayers will end up eating the 50K if the couple goes into bankruptcy.

She did do her homework,,,,,(From the source...)




They were "bait and switched..."
This might fit your transparent need. Compare the insured and the uninsured. Interesting reading. I'll have to poke around and see if other states have a similar website.

http://www.healthweb.maine.gov/claim...uninsured.aspx

I'd be real interested in what you have to say about that, if anything.
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No. 35
from herring_RN
Old Nov 05, 2009, 10:34 PM

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by VivaLasViejas View Post
Yeah, and what I call criminal is paying $440 a month for health insurance through my employer that pays....for......NOTHING!!!

That's right. I have had this insurance for a year, paid thousands of dollars into it.........and they are refusing to cover any of the expenses for my hyperparathyroidism, which have already topped a thousand bucks and continue to mount. We haven't even gotten to the DEXA scan and the renal U/S I just had a couple of weeks ago, let alone the surgery I'm going to need. Why? Well, according to them it's a "pre-existing condition", even though I have never been officially diagnosed with the condition until now.

Somebody please, tell me how in the name of all that is reasonable can an insurance company get away with ripping off consumers, month after month after month, and NOT having to provide the services we are paying for??!! And how is that moral, or right, or even good business?? My husband and I are already in so deep from having so many medical expenses over the past year for our REAL pre-existing conditions that I don't see us ever getting out from under the crushing debt load..........of course the hospitals and doctor's offices never bill us for everything all at once so we never really know just how much we owe them, but I know it's in the tens of thousands and probably will reach six figures before this particular episode of my life is over.

I feel like I'm shoveling (insert vulgar term for 'feces' here) against the tide when I pay my co-pays at the time of service and then open up the bills two months afterwards to find that my insurance company has denied yet another claim. This is what has convinced me---a political conservative in almost every other way---that single-payer health care is the ONLY way for middle- and lower-income people to survive financially, at least if they're past 35 and have a few medical issues.

I think you all know I work hard and play by the rules; I'm not lazy, looking for handouts, or trying to cheat the system. So how is it that some folks evidently think it's perfectly OK for an insurance company to cheat ME??!!

Just venting.........I am really, really ANGRY about this and it mystifies me that anyone can possibly justify the continuation of this evil non-system in light of the fact that it's not just "the poor and lazy" who are going bankrupt here.
I am angry that this is happening to you. It is NOT fair. We need to have healthcare for everyone. But insurance does not = guaranteed healthcare.
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No. 36
Old Nov 06, 2009, 07:23 PM

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by herring_RN View Post
I am angry that this is happening to you. It is NOT fair. We need to have healthcare for everyone. But insurance does not = guaranteed healthcare.
And that my friend is what you will get. A requirement to purchase private healthcare insurance. The same insurance you have now. Except you will HAVE to purchase something.
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No. 37
from GCTMT
Old Nov 06, 2009, 08:56 PM
Updated Nov 06, 2009 at 09:08 PM by GCTMT

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by Onekidneynurse View Post
And that my friend is what you will get. A requirement to purchase private healthcare insurance. The same insurance you have now. Except you will HAVE to purchase something.

It remains to be seen whether or not we will have a mandate. I'm hoping that if a mandate is imposed, a robust public option is offered so that those of us uncomfortable with the complete and total profit driven interests controlling our health care can will finally have some common sense competition. We have some things right in the US, but, we have a ways to get yet regarding "loving thy neighbor".
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No. 38
Old Nov 06, 2009, 09:07 PM

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by GCTMT View Post
It remains to be seen whether or not whether or not we will have a mandate. I'm hoping that if is a mandate is imposed, a robust public option is offered so that those of us uncomfortable with complete and total profit-driven interests no longer control our health care system. We have some things right in the US, but, we have a ways to get yet regarding "loving thy neighbor".
A government run program is hardly a "loving thy neighbor". The government has never given us anything without us paying for it.

From the looks of things yesterday there is a mandate and it's not for UHC.
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No. 39
from GCTMT
Old Nov 07, 2009, 03:45 AM

Default Re: Health coverage 'plan' was no insurance at all
Originally Posted by Onekidneynurse View Post
A government run program is hardly a "loving thy neighbor". The government has never given us anything without us paying for it.

From the looks of things yesterday there is a mandate and it's not for UHC.

Well the government is in fact you and I, isn't it?

My desire is to make certain that each and every American citizen has access to quality health care, without breaking the bank. We are America, every other developed nation has found a way, we can find a way as well.

And that, is what Jesus of Nazareth would call loving thy neighbor.
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