Michael Moore's Latest Target: Your HMO

[JoeRedskin]

Originally Posted by Mattyk72

I hope you've got some better sources than just a movie.

Matty - I work in insurance regulation. My agency (who shall remain nameless but is a state agency that regulates insurance in a state on the eastern sea coast probably in close proximity - or surrounding - the city in which I reside) has issued many orders against insurers who have improperly and intentionally denied claims. I will say it is not the common practice and does not occur with great regularity. It does, however, occur on both the large scale and small scale and either as an anomaly or through a systematic business plan.

What is common is for insurers to look for ways to deny coverage and interpret any gray area against the claimant. Most times it is simply not feasable for consumers to fight the denial of a $500 claim that falls into those gray coverage areas.

[Beemnseven]

Originally Posted by 12thMan

Well efficiency or lack thereof and the overall delivery system has been a major part of the existing problem, and will be a major area of focus.

I'd still take the inefficiencies of private industry over the inefficiencies of government any day.

I suppose we'll have to define our premise: I'm speaking of Moore's apparent position that gov't will completely take over, and there's NO private health care facilities period. If that's the case, then there's no one to turn to for grievances -- there is no competition. The beauty of the free market is, if someone isn't treating the consumer right, the consumer simply goes to somebody else for better service.

Can't do that when government controls everything.

[SmootSmack]

I definitely agree Beem. Competition is seen as a bad thing, but it's really not so black and white like that

[12thMan]

Originally Posted by Beemnseven

I'd still take the inefficiencies of private industry over the inefficiencies of government any day.

I suppose we'll have to define our premise: I'm speaking of Moore's apparent position that gov't will completely take over, and there's NO private health care facilities period. If that's the case, then there's no one to turn to for grievances -- there is no competition. The beauty of the free market is, if someone isn't treating the consumer right, the consumer simply goes to somebody else for better service.

Can't do that when government controls everything.

No, that's not correct, the government will not completely take over. They'll play a large role in ensuring that those without coverage will be through the national healthcare plan.

Those who are currently covered by their employer will most likely see very little if any difference in their plan. The changes will be gradual, and depending on the candidate, may take at least one full term to fully implement.

[hooskins]

Originally Posted by JoeRedskin

Matty - I work in insurance regulation. My agency (who shall remain nameless but is a state agency that regulates insurance in a state on the eastern sea coast probably in close proximity - or surrounding - the city in which I reside) has issued many orders against insurers who have improperly and intentionally denied claims. I will say it is not the common practice and does not occur with great regularity. It does, however, occur on both the large scale and small scale and either as an anomaly or through a systematic business plan.

What is common is for insurers to look for ways to deny coverage and interpret any gray area against the claimant. Most times it is simply not feasable for consumers to fight the denial of a $500 claim that falls into those gray coverage areas.

Seems like his source is a bit more legitimate than just a movie...

[Crazyhorse1]

Originally Posted by Mattyk72

Plenty, where should we start?

Let me answer with a question, what's good about our health care system?

We have one of the worse and most larcenous health care systems in the industrialized world, all reflected by its incredibly shameful stats. I'm currently looking at a forty thousand buck operation that takes a couple of hours and a week or so in the hospital. Luckily, I have insurance that will reduce the robbery to only an outrage. Many people don't.

I've never liked a Michael Moore, but he's right a lot, espicially in this case. Wait till he does one on the Justice system.

[jsarno]

Originally Posted by Hog1

Well said, I mostly agree.
The "assistance" programs in this country are ridiculous. It is a paramount component to our immigration problems as well. They desperately are in need of major change. We have created generations of people who no longer have thoughts of jobs, working for a living, etc. Care to hazard a guess at the BILLIONS that are being pissed away???
I'm sure no real number can be derived with any accuracy. It would be a................staggering sum

I'm glad I'm not the only one that sees it this way.
Thanks for expressing your opinions. I had two PM's from people that were afraid to get into this discussion.

[jsarno]

Originally Posted by Beemnseven

I think that when most people look at their failings in life, there's usually only one person they can honestly point the finger at: themselves.

couldn't have said it better myself!

[JoeRedskin]

Originally Posted by Crazyhorse1

We have one of the worse and most larcenous health care systems in the industrialized world, all reflected by its incredibly shameful stats. I'm currently looking at a forty thousand buck operation that takes a couple of hours and a week or so in the hospital. Luckily, I have insurance that will reduce the robbery to only an outrage. Many people don't.

I've never liked a Michael Moore, but he's right a lot, espicially in this case. Wait till he does one on the Justice system.

Just so I'm clear - you think it is larcenous for the doctor and the hospital to charge you 40K? If so, do you think they would charge less in a government controlled health care system? Do you advocate price controls in all areas or just health care? Who will decide the appropriate charges? How will they insure that competent people will want to enter an industry requiring long hours, extensive (years) training, incredibly high liability risk and still manage to make a good living?

[dmek25]

Originally Posted by JoeRedskin

Just so I'm clear - you think it is larcenous for the doctor and the hospital to charge you 40K? If so, do you think they would charge less in a government controlled health care system? Do you advocate price controls in all areas or just health care? Who will decide the appropriate charges? How will they insure that competent people will want to enter an industry requiring long hours, extensive (years) training, incredibly high liability risk and still manage to make a good living?

right now my insurance company dictates to the doctors how much they will pay for certain procedures. they also dictate what procedures are necessary, and those that aren't. this is definitely NOT good thing.

[Hog1]

Originally Posted by JoeRedskin

Just so I'm clear - you think it is larcenous for the doctor and the hospital to charge you 40K? If so, do you think they would charge less in a government controlled health care system? Do you advocate price controls in all areas or just health care? Who will decide the appropriate charges? How will they insure that competent people will want to enter an industry requiring long hours, extensive (years) training, incredibly high liability risk and still manage to make a good living?

Joe, you bring up another component to the problem. The "allowable", ridiculous, out of control, lawsuits that can be filed. The medical community is strapped with the burden of defending, and paying gigantic awards. Seriously driving up the cost of healthcare

[dmek25]

Originally Posted by Hog1

Joe, you bring up another component to the problem. The "allowable", ridiculous, out of control, lawsuits that can be filed. The medical community is strapped with the burden of defending, and paying gigantic awards. Seriously driving up the cost of healthcare

i disagree with this. with the kind of outrageous money the people in the medical field make, if they screw me up, i want paid. no, it wont make me better. but it might make them think twice about operating on my left leg, when the problems in my right leg.

[FRPLG]

Originally Posted by dmek25

i disagree with this. with the kind of outrageous money the people in the medical field make, if they screw me up, i want paid. no, it wont make me better. but it might make them think twice about operating on my left leg, when the problems in my right leg.

There's the misconception. For the most part DRs don't make that much more relative to the barriers to entry than do most average college graduates. Unless they specialize, lots of training, then they are getting paid pretty well but not the King's ransom that lots of people want to believe. Once you factor in liability insurance most doctors aren't making anything near outrageous money.

[dmek25]

those guys are all at least making six figures. i know it takes a tremendous amount of schooling, but they are getting paid for what they know. its their responsibility to get it right

[Sheriff Gonna Getcha]

Originally Posted by FRPLG

There's the misconception. For the most part DRs don't make that much more relative to the barriers to entry than do most average college graduates. Unless they specialize, lots of training, then they are getting paid pretty well but not the King's ransom that lots of people want to believe. Once you factor in liability insurance most doctors aren't making anything near outrageous money.

Lawsuits against OBGYNs have gotten a lot of press and they tend to make massive amounts of duckets.