Single-payer advocates disrupt Senate Finance Committee.

GCTMT · May 13, 2009

The "Blues" give us the blues wiyth their shell game of for profit subsidiaris.
http://www.putmipeoplefirst.com/pdfs/2008/04/Freep-AF-411608.pdf
They still deny needed care. Google this site to find lawsuits they lost if you don't believe me.
Premiums paid for healthcare goes to overhead including millions for individual executives.

Isn't Blue Cross Blue Shield not-for-profit?

Honnête et Sérieux · May 13, 2009

The "Blues" give us the blues wiyth their shell game of for profit subsidiaris.
They still deny needed care. Google this site to find lawsuits they lost if you don't believe me.

So will the gov't...and they do.

tntrn, ASN, RN · May 13, 2009

Isn't Blue Cross Blue Shield not-for-profit?

I don't know for sure, but we are covered by Premera, a BCBS plan. And they have many plans under their umbrella. Never have we been denied coverage for something that is covered by our plan, but if the plan we signed on to says no coverage, well, there you go...no coverage. And no surprises either. The plan outline is very clear.

And when my DH had his prostate cancer; from the first office visit, through surgery and 3 days in the hospital, plus 37 radiation treatments several months later, I think our out of pocket was no more than $300. That's for over $125K in billable fees.

I have no interest in all hospitals and health care facilities being run by one entity: the government. Where would the impetus to compete and improve be? There wouldn't be any. I can see an even great use of foreign health care facilities who provide top notch and cutting edge procedures by Americans who are disgruntled over what would be cookie cutter stuff here.

Jolie, BSN · May 13, 2009

They still deny needed care. Google this site...you don't believe me.
Premiums paid for healthcare goes to overhead including millions for individual executives.

I think there is an important distinction getting lost in the discussion, and that is this: Are insurance plans denying needed care (quite possibly) or are they denying uncovered care (likely)? Is a plan obligated to pay for something that is needed, if that item is specifically excluded from coverage. The answer, of course, is no.

I have read a number of cases over the years of private and public outrage over insurance plans denying payment for care that was clearly excluded in the language of the policy. I don't argue that some of that care was quite necessary for the well-being of the patient.

But I don't undertand the outrage over the denial of something that has been specifically excluded, and therefore not paid for. We can't go into the grocery store and take items we haven't purchased. We can get outraged, but no one will pay any attention if our auto policy fails to provide a brand new Mercedes when we wreck our 10-year old Honda Civic, on which we have been paying premiums.

Nor do we have a legitimate cause for outrage when our plan denies coverage for a specifically excluded type of care. That is the beauty of our current system. If we don't like the coverage our employer offers, we have the opportunity to change employers or purchase alternate coverage on our own. Is that expensive as hell? Of course, but the right and opportunity exist. We are not forced into a one-size fits-all plan that doesn't meet our needs.

The notion that a government mandated plan will cover all "needed" care is naive and unrealistic. Pierette recently posted a thread about 2 cancer treatments that the British NHS has specifically excluded, despite clear evidence of their benefit, because they are too expensive. Any nationalized plan here will be no different. Necessary care for someone will be excluded, because of cost. Just as we get what we pay for in the grocery store and with our auto insurance policies, we will have similar limits with any kind of healthcare insurance system. At least now, with private plans, the participants know up front what those limits are (if they bother to read their policies, which most don't), and can take steps to address them thru other sources of insurance, if they so desire.

tntrn, ASN, RN · May 13, 2009

I think there is an important distinction getting lost in the discussion, and that is this: Are insurance plans denying needed care (quite possibly) or are they denying uncovered care (likely)? Is a plan obligated to pay for something that is needed, if that item is specifically excluded from coverage. The answer, of course, is no.
I have read a number of cases over the years of private and public outrage over insurance plans denying payment for care that was clearly excluded in the language of the policy. I don't argue that some of that care was quite necessary for the well-being of the patient.
But I don't undertand the outrage over the denial of something that has been specifically excluded, and therefore not paid for. We can't go into the grocery store and take items we haven't purchased. We can get outraged, but no one will pay any attention if our auto policy fails to provide a brand new Mercedes when we wreck our 10-year old Honda Civic, on which we have been paying premiums.
Nor do we have a legitimate cause for outrage when our plan denies coverage for a specifically excluded type of care. That is the beauty of our current system. If we don't like the coverage our employer offers, we have the opportunity to change employers or purchase alternate coverage on our own. Is that expensive as hell? Of course, but the right and opportunity exist. We are not forced into a one-size fits-all plan that doesn't meet our needs.
The notion that a government mandated plan will cover all "needed" care is naive and unrealistic. H&S recently posted a thread about 2 cancer treatments that the British NHS has specifically excluded, despite clear evidence of their benefit, because they are too expensive. Any nationalized plan here will be no different. Necessary care for someone will be excluded, because of cost. Just as we get what we pay for in the grocery store and with our auto insurance policies, we will have similar limits with any kind of healthcare insurance system. At least now, with private plans, the participants know up front what those limits are (if they bother to read their policies, which most don't), and can take steps to address them thru other sources of insurance, if they so desire.

If I could put more than thank you at the bottom of your post, I would. Freedom, again, is what it comes down to. Will a government plan give you the freedom to pick and choose what coverage you want, or are you stuck with what they want you to have? Again, no thanks to that idea.

hypocaffeinemia, BSN, RN · May 13, 2009

Playing devil's advocate here, and I've had to fight with my insurance company too, but if an insurance company is not allowed to make a profit, somebody is not going to get paid for their work. Which you seem to think is okay.

What do you think "profit" means?

My hospital is non-profit, yet somehow we all get paid for our work.

GCTMT · May 13, 2009

But those with the stamina to endure the many exhausting steps of internal review sometimes win. Even if you lose, completing the formal written internal appeal makes you eligible for an independent external review in 43 states and the District of Columbia. State reviews overturn about half of insurers' decisions, and in most states that's final. Nancy Nielsen, president of the America Medical Association and a former chief medical officer of a nonprofit insurance plan, says, "If health insurers are making coverage decisions that are fair and compassionate, very few will be overturned by the state's external appeal process." The numbers speak for themselves.

http://health.usnews.com/articles/health/2008/08/25/how-crafty-health-insurers-are-denying-care.html

Katie Hebert, age 4, is a very sick little girl. She gets severe seizure-like attacks that can last 11 hours from an undiagnosed neuro-developmental disorder. She is deaf in one ear, has a feeding disorder and requires daily medication for asthma. In her short life, she has been rushed to the emergency room six times and hospitalized twice. Her health was put at even greater risk when she lost her health coverage -- which meant no more regular doctor's visits, weekly therapy or attention from specialists.
To deal with this crisis, Katie's father tried to buy private insurance, but he couldn't afford the roughly $1,000 a month, about 30 percent of his salary, to pay for the insurance plan offered by his employer. And even if he could have afforded the insurance, it would not have covered all of Katie's health needs. On top of that, other private insurers would not accept Katie in their programs because of her pre-existing conditions.

http://www.huffingtonpost.com/marian-wright-edelman/insurance-ceos-get-rich-w_b_201473.html

"Pacificare rejected me because I'm an expectant father. Blue Shield rejected me because I got a spider bite. And then this one rejected me because of asthma," Svonkin said.
Last year one nationwide survey, the Commonwealth Fund, found that 89 percent, or 52 million, of those looking for individual health insurance didn't get it because it was too expensive or they were turned down. "Insurers are getting double the profit that they make in the group market. Why is it so lucrative? Because they exclude anybody and everybody who has even a remote sense of risk associated with their health care," says Dr. Bryan Liang, who has studied the insurance industry for more than a decade.

http://www.cbsnews.com/stories/2007/05/23/cbsnews_investigates/main2843007.shtml

blue note · Jun 3, 2009

Now, Baucus "regrets killing single-payer" in reform discussions.

Health-care point man Baucus (D-Mont.), chair of the Senate Finance Committee, took a statewide beating last week for dismissing the possibility of a single-payer system early in the debate -- leading to the meeting with health care professionals and Sen. Bernie Sanders, the Vermont independent who is the sponsor of the Senate's only single-payer bill.
"I don't like paraphrasing other people, I don't like being paraphrased, but I think it's fair to say that what he said is that when he said something to the effect that single-payer is off the table, I think he regrets having said that," Sanders said following a morning closed-door meeting with Baucus. "I think in retrospect he thinks there probably should have been hearings, it should have been part of the process, and then it would have been rejected."

allnurses Guide · Jun 4, 2009

[color=#242424][color=#242424]today's meeting of the nation's leading single payer activists with sen. max baucus was historic, and a recognition of the power of the tens of thousands of nurses, doctors, and grassroots activists across the country who have been turning up the heat on the policy makers in washington.
[color=#242424]make no mistake - your voices are being heard. and, the protests and pressure will continue.
[color=#242424]as rose ann demoro, executive director of the california nurses association/national nurses organizing committee, told baucus, "there is a groundswell" across the country that will continue to press for single payer reform, and baucus and other policy makers in washington "are going to get to know us very well." in a later press conference, demoro blasted the conventional wisdom that single payer is not politically viable. "is it politically viable to let people die and suffer from a lack of political will?" noting the fight for women's suffrage and the civil rights movement, she emphasized, "we're going to have to turn up the heat. women did not get the right to vote by voting on it."
http://www.dailykos.com/story/2009/6/3/171427/8822?new=true

other articles and opinions:

http://www.politico.com/news/stories/0609/23293.html

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/06/03/mnf417voaq.dtl&type=science

http://www.minnpost.com/ericblack/2009/06/03/9270/baucus_to_single-payer_health_care_advocates_sorry_i_excluded_you_but_not_sorry_enough_to_include_you

http://washingtonindependent.com/45580/sanders-the-lone-senate-voice-for-single-payer-health-coverage

http://www.wickedlocal.com/marshfield/news/lifestyle/columnists/x1175998360/marshfield-from-the-editors-desk-a-little-bit-of-tortured-logic

http://www.opednews.com/articles/extraordinary-baltimore-he-by-diane-wittner-090602-451.html

allnurses Guide · Jun 5, 2009

[color=#333333]single payer advocates in the news

[color=#333333]augusta, maine: http://morningsentinel.mainetoday.com/news/local/6407921.html

[color=#333333]san diego, california: http://www3.signonsandiego.com/stories/2009/jun/05/1n5health23162-htk/?health&zindex=111325

[color=#333333]new hampshire: "i'm not a radical. i like taxes low and limited government spending, but health care should be a right and not a privilege," clairmont said. "we are hearing talk about reform and fears about socialized medicine or single-payer being politically unfeasible -- but our plan is simple and it will save money because it focuses on health care and not making money for the insurance industry. and we are frustrated because it's not being taken seriously." portsmouth physician thomas clairmont md.

[color=#333333]stockton, california: http://www.recordnet.com/apps/pbcs.dll/article?aid=/20090605/a_news/906050319/-1/a_news03

[color=#333333]new jersey[color=#333333]: http://hudsonreporter.com/pages/full_story?page_label=home_top_section&id=2647160-got+health+care-+-local+residents+propose+single-payer+system-&article-got%20health%20care-%20-local%20residents%20propose%20single-payer%20system-%20=&widget=push&instance=jersey_city_story_left_column&open=&

[color=#333333]montana: http://missoulian.com/articles/2009/05/29/news/local/news02.txt

CRNA2007 · Jun 5, 2009

can't have low taxes and a government run health care system. now if everyone is required to pay the same amount then lets start the debate. but since the majority of the people receiving and abusing the system at little to no cost. these are the typical free loaders who contribute nothing to improve the american way of life but instead constantly eat at the tax paying trough and complain when the trough starts to run dry.

[color=#333333]single payer advocates in the news
[color=#333333]augusta, maine: http://morningsentinel.mainetoday.com/news/local/6407921.html
[color=#333333]san diego, california: http://www3.signonsandiego.com/stories/2009/jun/05/1n5health23162-htk/?health&zindex=111325
[color=#333333]new hampshire: “i’m not a radical. i like taxes low and limited government spending, but health care should be a right and not a privilege,” clairmont said. “we are hearing talk about reform and fears about socialized medicine or single-payer being politically unfeasible -- but our plan is simple and it will save money because it focuses on health care and not making money for the insurance industry. and we are frustrated because it’s not being taken seriously.” portsmouth physician thomas clairmont md.
[color=#333333]stockton, california: http://www.recordnet.com/apps/pbcs.dll/article?aid=/20090605/a_news/906050319/-1/a_news03
[color=#333333]new jersey[color=#333333]: http://hudsonreporter.com/pages/full_story?page_label=home_top_section&id=2647160-got+health+care-+-local+residents+propose+single-payer+system-&article-got%20health%20care-%20-local%20residents%20propose%20single-payer%20system-%20=&widget=push&instance=jersey_city_story_left_column&open=&
[color=#333333]montana: http://missoulian.com/articles/2009/05/29/news/local/news02.txt

blue note · Jun 6, 2009

But since the majority of the people receiving and abusing the system at little to no cost. These are the typical free loaders who contribute nothing to improve the American way of life but instead constantly eat at the tax paying trough and complain when the trough starts to run dry.

Source(s) for that claim? Any studies you can cite to support that? Otherwise, it is nothing more than the same old tired conservative canard about how the free loading poor will abuse the system if health care were actually affordable for all. You know, as opposed to the fraud perpetrated by the health insurance companies, sometimes as often as 185 times a day, every day, for 2 years like PacifiCare did in California, or hospital corporations who defrauded the government (i.e. taxpayers) to the tune of $840 million. Oh no, let's not blame those people for abusing and costing the system. Let's blame those nameless poor free loaders!