audtatious wrote:Insurance companies are all evil and Gov option is much better. That's what Pelosi and gang want everyone to think. But, how good is Gov "insurance"? Let's look at Medicare as Medicare can provide us a glimpse into what the Gov option will be like from a claims perspective.
The 2008 AMA National Health Insurer health card report can give us a glimpse into the future based on the number of claims denied. Who was the worse? Was it Aetna, Anthem, CIGNA, others? No, it was Medicare who had the highest percentage of claims.
Isn't that special
http://www.ama-assn.org/ama1/p...d.pdf
Denials in that of themselves are not a reliable metric for such an analysis. A simple thought into this is that any services determined to be fraudulent or not covered are denied. Perhaps even incorrect documentation can cause a denial. Hard to say without knowing what the data behind it actually is. But another major factor is that healthcare companies can essentially pick and choose who they insure. And by charging more for someone with poor medical history, they do exactly that. This would skew the number of denials they would need to issue as less of their insureds will need to submit claims for procedures. Not to mention most network doctors are set up to be able to see what benefits are available for each patient so many claims aren't even submitted as they already know. Case in point, my GF was seeing a chiropractor for a while. She had a certain number of chiro visits available to her. The chiro knew exactly how much based on access to her claim history. So there is no need to present a claim that they knew would not be covered.
Lastly, I'm not sure how Medicare supplemental claims works, but if its like secondary medical insurance for auto claims (in CA), the claim still has to be submitted to the primary health carrier. The supplemental picks up the covered portion of any services not paid by the primary. But for them to make that determination, they need the explanation of benefits which is only created after a claim is reported to the primary. Few people carry supplemental insurance for private healthcare. My understanding is many do buy supplemental coverage for medicare. I can't see using denials as a basis for a comparison between private and public insurance unless you understand and make adjustments for factors that would naturally skew the results.
AZhitman wrote:How about talking about the other side (the OTHER 99% of people)? The ones who work hard, retire, and live happily ever after?
We don't write legislation for the 1% or for the 'theoreticals'. Sorry Steve.
Somehow the only people who seem to be uninsured are lazy SOB's? What about the many many small business owners who can't afford to pay for their insurance. You know, the people who get no vacations, for whom there are no sick days, disability (unless shutting down their business is a viable option) or worker's comp. Those who have worked hard but can't afford health coverage because of "previous conditions" or poor history? My parents fit this description...
While I won't say that universal healthcare is a perfect soution or the one we should go with, consider that insurance has been private for sometime. And its left a lot of people out in the cold. And its only gotten worse. From my observations its gotten more expensive and provides less coverage. Something is clearly broken. Yes, even Medicare. But rather than seek out solutions, the issue has always been polarized. It seems moreso now than ever before. Where was the right when powers in office were more balanced and we could take a more critical look at a solution? Oh that's right. "There wasn't a problem."
And 1%? Conservatively, I calculate its more like 13% of people who are uninsured. 15% is probably closer to reality.
