I am usually an informed consumer. I am having a hard time following the progress of this vote.
First of all when I go to whitehouse.gov the information there is about the original proposal not the current version.
My understanding Senate bill is a dumbed down bill with provisions for student loans, it has tax of medical devices, it cuts the benefits current Medicare benefits. It does away with the popular Medicare Advantage Program. There is a huge grant given to Nebraska to pay for all the Medicaid Issues. Not to mention the abortion issue. I am sure their are more.
To me, the most important issue is covering all uninsured, and single payer would be my preferred option. I got my hopes up only to be crushed again on several occasions, so I'm just waiting to see what will be in the final bill.
If this is an important issue to you, then please research it carefully. The bill under cnsideration will not accomplish 100% coverage. An estimated 10-15 million will remain uninsured, even after this plan is fully implemented at great cost.
My understanding is that taxes will maybe be introduced for a high-end plans (so called 'Cadillac plans'). Medicare 'cuts' will, as I understand it, not affect customers, but are eliminating loopholes that had government overpaying for services. Again, who the heck knows. Right now, there are two plans, that are still being discussed, and have to go through a committee to be merged. I'm holding on to see what the final product will be. I agree to ItsTheDude: whatever we get it will be better than we have now, and it will take us all to the healthcare standards that the rest of the developed world has had for decades.
If this is an important issue to you, then please research it carefully. The bill under cnsideration will not accomplish 100% coverage. An estimated 10-15 million will remain uninsured, even after this plan is fully implemented at great cost.
No reason for scolding on this fine Sunday. You catch more flies with honey than vinegar .
I agree to ItsTheDude: whatever we get it will be better than we have now, and it will take us all to the healthcare standards that the rest of the developed world has had for decades.
I agree that nearly anything would be better than what we have now, but IMHO we will still be far behind the other developed countries.
* Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Example: A code described as an outpatient service would not be valid if billed with an inpatient POS. - http://medicare.fcso.com/Wrapped/161028.asp
* The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Collection of a blood specimen is usually conducted during a patient encounter, and therefore is not separately payable. Extended hours codes (common after-hour codes) are not separately payable in a facility which operates 24-hours a day (e.g., inpatient/outpatient hospital). - http://medicare.fcso.com/wrapped/158913.asp
* Payment is adjusted when performed/billed by a provider of this specialty. Physicians should never bill Medicare for laboratory work done outside their office. The laboratory performing the service will bill for the laboratory procedures. - http://medicare.fcso.com/wrapped/159530.asp
Specializes in Critical care, tele, Medical-Surgical.
California Insurers Denied Over 26% of All Claims in 2009
...According to new data now announced by CNA/NNOC from its research arm, the Institute for Health and Socio-Economic Policy - also based on publicly available data from the California Department of Managed Care denial rates for the last six months of 2009, averaging 26 percent for seven large insurers.
Claims denial rates by leading California insurers, second half of 2009:
"The Medicare denial rate found in the study was, on a weighted average basis, roughly 1.7 times that of all of the private carriers combined (99,025 divided by 2,447,216 is 4.05%; 6.85% divided by 4.05% =1.69).
You would think Medicare's sheer size might enable it to have smoother procedures with its providers that would enable it to turn down a lower percentage of claims. But no, this is the government we're talking about.
So who's the most "heartless" now? And why should Americans accept the idea of gradually being forced into a government-run system when, based on documented government experience, they will be more likely to see their claims denied?
And I didn't even get to the idea of refusals to treat in the first place, something that is present to some degree in virtually every state-run system, but is currently against the law in hospital emergency rooms in the U.S."
As a case manager I wonder was the CA nurses counted as a denial. For example, some patients feel that an insurance company not paying for remodeling a bathroom is a denial. That not providing endless hospital days is a denial. My favorite was went a women who had a normal healthy baby needed a nanny that would be provided by the insurance company.
And I didn't even get to the idea of refusals to treat in the first place, something that is present to some degree in virtually every state-run system, but is currently against the law in hospital emergency rooms in the U.S."
People say this all the time, but it's not true. It is not "against the law" for emergency rooms to refuse to treat people -- US (EMTALA) law only requires emergency rooms to evaluate everyone who requests services and stabilize emergency conditions. There is no requirement that emergency rooms treat non-emergent conditions.
I have no statistics on this, but I wonder if the supposedly higher rate of Medicare/Medicaid denials (if that's even true -- it's hard to tell with so many different groups presenting conflicting figures) has something to do with the huge amount of fraud that people attempt to perpetrate on Medicare and Medicaid. It's a v. brisk business in some parts of the country. Obviously, a lot of the claims they get are bogus; perhaps the denial rate is the part of the fraud they're actually catching up front.
I can't understand why anyone would believe that a private-for-profit corporation has more interest in her/his well-being and best interests than her/his elected representative government. A private insurance company is only interested in your well-being to the extent that it can make a profit off of you.
Medicare Advantage is not disestablished. What is being taken away is the 14% overpayment that achieves no better care at higher cost. Medicare Advantage plans will still exist. They will just have to be on a level playing field.
BTW newsbusters is not a credible source. I just read one of their stories and I could debunk 90% of their claims with 5 min of research.
Middle-class households would suffer most without reform, with the percentage of these families without health coverage rising from 19 percent today to 28 percent at decade’s end
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Jolie, BSN
6,375 Posts
If this is an important issue to you, then please research it carefully. The bill under cnsideration will not accomplish 100% coverage. An estimated 10-15 million will remain uninsured, even after this plan is fully implemented at great cost.