Re: TAX rate and universal health care
From: art fougner, md (evsono@pipeline.com)
Mon Mar 10 16:07:40 2008
It's time the Monopsony of MCO's is treated the same way the so-called
Monopolies of Physicians' groups would be treated. With unchecked MCO
mergers, we'll have single payor eventually, just not the single-payor
everyone envisaged.
Art
At Mon, 10 Mar 2008, James Smeltzer wrote:
>
>Insurers dictate all the time what they pay for - the wash their hands by saying you are free to get the service, they don't want to pay for it. You are right, you are paying for all this gamesmanship. The time they take getting your Dr's staff to waste their time justifying a treatment is part of their overhead, so we pay for it in the Dr's costs and in the insurance overhead. Medicare is much more a straight-up system. Learn the rules. Live by them and get paid. Appeal when the rules don't apply and you will probably get paid eventually.
>
>THAT and profits for the CEOs, stockholders etc are why Medicare is 3+% overhead and private insurance is around 18% or more. So you are actually PAYING for them to mess with you...
>
>JSS
>
>>>> "BettyTX" <bhamilt@hughes.net> 3/9/2008 6:16 PM >>>
>
>Because we are away from our home base sometimes for over a month at a time, we *must* have the 90-day prescription in order not to run out while we are gone. Also, it's cheaper because it's one co-pay while a 30-day supply is also one co-pay (same amount) so purchasing every 30 days equals 3 times the cost.
>
>In order to get the 90-day supply with one co-pay, we must use mail-order service and there is only one that our plan allows. I called my insurance people in Austin and "she" said that Caremark mail-order is the only one they deal with. I asked if I could go to Costco or Wal-Mart or Walgreens or any of the widely scattered pharmacies and she said, "No, not for the 90-day supply." I also asked if this is a pharmacy rule or an insurance rule. She said, "Insurance."
>
>The last three times we have tried to fill new prescriptions, they have held our order up because they questioned the doctor. He (or his nurse) has had to call or re-fax more information. I explained to them that our doctor has been treating us for 10 or 15 years and he has all of our records prior to that. They still would not fill our orders until they talked to the doctor. (We finally received what he originally prescribed.)
>
>We feel fortunate that we can afford a good insurance plan with good prescription allowances (better than Part D), but I do get frustrated when an insurance company questions the treatments that my doctor prescribes. I have asked others who use the same service, and they have had similar problems. One even had her antibiotic held up for 19 days while she waited for them to get everything straighted out. Now ...... how's that for treatment? Mine was delayed for only 8 days.
>
>I don't want an insurance company telling my doctor how to treat patients. We, as patients, don't have nearly the amount of problems with our Medicare (but I can't comment on how they reimburse practitioners). BTW, there is no competition because my teacher retirement service contracted with that one pharmacy. If insurance companies can dictate prescription services, can they not also dictate other medical services as well?
>
>Surely we are a resourceful enough society that we can figure out a better way.
>
>Betty
>
>>> ----- Original Message -----
> From: Terry DuBose
> To: Multiple recipients of list ULTRASOUND
> Sent: Sunday, March 09, 2008 4:17 PM
> Subject: Re: TAX rate and universal health care
>
> I do not accept the premise that big business is better than big government. It will not be simple, but I do believe we can do better. The system of corporate insurance does not "allow competition" in the real sense. It simply convolutes the admonition of Hippocrates to "First do no harm" into "Your money or your life."
>
> We can do better. Terry
>
> Claudia Benge <bengecaj@iquest.net> wrote:
> 1.. Our tax rate is already at 50% (take your time and add up all the taxes you pay)
> 2.. Universal health care to even come close to what is available now will add 20% to our taxes
> 3.. Universal health care will cost more that we can possibly pay OR people will be denied healthcare based on their age and other health risks
> 4.. Can you imagine if your child is injured in an accident and someone states their chance of recovery is less than 30% SO they are therefore denied care???
> 5.. Or if your spouse is diagnosed with cancer and someone decides there is no chance for survival.
>
> The only way good health care can survive is to allow competition and quality improvement. We as sonographers need to learn all we can and mentor good replacements. Quality improvement can track what really works for the least amount of expense and saves the patient money.
>
> Health care does not need to be part of the government, it just needs to be available so that the everyone can be covered on a "pool rated" basis. Can you imagine the same people who run the postal service and medicare now would be capable of running something which is our largest national product??? I cannot.
>
> Claudia Benge
>
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--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
