Health insurers have learned to delay non-elective surgeries (often leaven patients in pain) in hopes of aging an individual into Medicare or hope that person switch insurers (about half of those on Obamacare, chance insurers within a year). They’re using the pre-approval process to extend the wait times and frustrate both surgeons and patients.
If you’re diabetic they want your A1C in line for 3 months, if you’re over weight you must lose X amount of weight, and any lab value out of whack is reason to wait …indefinitely…
“INSURERS GAME THE SYSTEM”……WELL, SLAP MY ASS AND CALL ME BEAUREGARD!…
I Believe, we all knew Obama Had Put Lipstick on a Pig. We Understood it would Explode as it was Written to Do so ! So we’re sadly Proved right about Health Care, and we Saw it Coming.
Now for the Lefties that Called us Uncaring and Uneducated Screw You !
However they Will Problably Never Hear about it, or Understand it…Sad Ass Liberals !!!
This is largely the result of ignoring incentive management. If you want certain behaviors those doing the behaving have to see that it is personally advantageous to act the way you want. If, stupidly, you want compassion and ethics, you need to offer more than simply dollars. Many people will act compassionately and ethically because that’s simply they way they are. But some individuals will act simply to maximize their money income. And…here’s the kicker…if you are looking at a publicly traded company they are obligated to look only at return on shareholder investment; public companies subject themselves to very expensive shareholder lawsuits if they do anything else, compassion and ethics be damned.
Is this really new? Cook book medicine, HMOs have always had gate keepers, bean counters. Medicare has even more gate keepers and bean counters which has forced hospitals to create whole departments of their OWN gate keepers and bean counters.
@ Plantsman….It ain’t just Obama….this shit has been going on for more then 40 years….it is and always will be the insurance industry , trying to get in between the physician and the patients cure…..all the while all they want is a cut of the profit and it’s only about profit for the insurance industry….Tell me Plantsman, why aren’t some of the most aggressive insurance companies in the world (Progressive/Geico) dealing in health care?….profit, only profit…
@ Zonga….Why do you settle for this?….It’s nonsense….
Willy, that’s the way it works.
Another thing,
DRGs, diagnosis related group. Enjoy!
https://en.wikipedia.org/wiki/Diagnosis-related_group
DRGs calculated by using
ICD – 10 https://en.wikipedia.org/wiki/ICD-10
Here is a free copy of ICD – 10. Knock yourself out.
http://www.icd10data.com/
Medicare “Observation” is a good one too, because Medicare doesn’t cover observation. Read it and weep.
https://www.usatoday.com/story/news/2017/03/09/kaiser-law-hospitals-now-must-tell-medicare-patients-when-care-observation-only/98967470/
The Congressional oss wipes are ignorant of the Bill of Rights, Amendment 10,
Any power not assigned to duh Fudds belongs to the States. The Founding Fathers never wanted an all powerful Fudd government. They were very much in favor of States Rights!
Thank you Zonga, but my question is …why do you settle for this?
What do you mean Willy, apparently I don’t understand the question.
Yeah Zonga, I’m a dumb dumb…..but, tell me why we should settle for any of this nonsense….There is a better answer and it involves the loss of the insurance industry (insurance companies only exchange paper) and a complete refinancing of the Medicare industry….Will it happen?. HELL NO, but we have too many people/businesses making BIG money off pushing paper…..It’s got nothing to do with making people well….
I’m actually pretty sure Dr Tar covered this in his book. (Which I’m really enjoying, btw…)
From Zonga….I had to chew this a minute or 10…”That’s the way it works”………I have nothing but vomit for that comment….we should expect better and demand more….
I can’t do anything to the change Medicare, HMOs, insurance companies.
A person can opt out of all that mess though.
I have heard that doctors and hospitals bill self-pay clients less money than those with Medicare or other insurance for the same exact services.
There ya go Zonga….you surrendered….
lol willy
It’s all one big game to the insurer who has the job of making $$$$$$$ for their stockholders…screw the insured. It’s a vile business and this has been going on for a long time. Now, they don’t hide at all.
@Zonga It’s called prompt pay. Anyone coming from another country without insurance can self pay and get YUGE discounts because the hospital, doc, etc. don’t have to waste time or energy to collect payment. All facilities have cash pay prices, and many physicians have great discounts if you pay cash.
The worst part?
Hospital care is at a new low from my recent personal experience.
And home health care appears to be another obamacare make-work scam sold to us on the false claim of saving money .