Name that worthless Healthcare Company

“Who else is having problems with our wonderful healthcare system?

1. Costs are skyrocketing (over 30% increases, I negotiate for this crap, and the increases are universal).

2. From what I understand, if you get care, the hospital sends a bill to your insurance company, and you. Then, the insurance company pays the bill, or sends you a check for the monies they are liable for, when in turn, you have to pay the total bill.

3. After either the billing agency, or bean counters for your insurance company, screw up the processing, you have to wait several months to get your money. At that point, you have to figure out who to pay, the doctor, x-ray tech, billing co. for the doctor, who friggin' knows!

4. So after all the aggrevation, you finally figure out what your bill was, and you wonder where the money went.

12 stitches, xrays, an immobilizer and crutches. $1,775

Ride in an ambulance. $300

Perscription drugs. $85

The confusion, lack of service, and over-priced services, all at a increasing rate of cost (30% this year) - priceless.



I'm starting to think Canada has a good idea. Screw these insurance a drug companies....... and I DON"T want to see some dumb friggin' ad on TV telling me to ask my doctor about some a$$ medication. Everytime I see those commercials, I know that 30% increase is not going to make the system effiecient, it's going to Bob Dole's d!ck!”

“BTW - next time I need stitches, I'm going to see Birch, it will only cost me a 6-pack, and I won't have any headaches to boot.”

“Ask your doctor about new Moldycrap (R).

They never tell you what it's for.

So men go to doctors and ask, "Shouldn't I be taking Moldycrap (R)?"

And the doctor says, "No, unless you're pregnant!"”

“See, this is exactly why I refuse to get sick or injured. I haven't gone to the doctor since I was a fetus!

I blame it on the old people. Why don't they die already?”

“Yeah,
our medical system s u c k s.

But I know people who live in Canada and it takes them 3 months to get to see a doctor.

A doctor once said to me, that we don't have "medical insurance, we have medical management." (Read cost containment.)

Sorry, you had such a costly 'incident' hope you're doing well quickly.”

“wait, so did you get hurt, BB?”

“Everytime I talk about healthcare I get labelled I Commie :o)”

“Buy it anyway Geobeet, I'm sure we all need it, that is what the commercial says..... right?”

“Yeah, I busted my knee open during an adventure race last september, and all the morphine in the world can't quell the pain in my a$$ from dealing with this healthcare crap!

ynamiynami - commie!”

“You left out the part where we pay the WonderHMO increasingly more out of pocket just to carry the insurance that leaves us in the lurch when we need it most.”

“i don't know why anyone would be against socialized health care unless they were in the medical industry. i'm sure i'll be informed in due time, though...
;-)”

“Socialized medicine is being practiced in the military and in the VA Medical System.”

“Yikes! I guess I have good insurance. We pay $10 to our primary provider and $15 to a specialist. We have to get referred to specialists, but it's never been a problem. I also never see bills, so I don't know how much anything costs.
Prescriptions are $20 for a three month supply.

Does birch have one of those staple gun things? I sliced my toes on a backpacking trip once and the guy that was doctoring me said he wished he brought his new staple gun (he's an EMT, etc) I was glad he did NOT. =D
LOL...”

“I mean don't get me wrong, I love going to see the doctor and sitting in leather seats looking at expensive art while I wait, I just wonder what would happen if I lost my job and joined the ranks of the uninsured.”

“BTW - I paid $25 out of pocket for this whole mess. It's waiting for the $2,000 from my insurance company to pay for the rest of it. It's going to screw my credit!”

“Good points, Buddha. Privatized health care is a total fiasco.

Socialized medicine is great for primary care. But it sucks for anything specialized. That is one of the main ways socialized medicine keeps costs low -- they only hire a few specialists and a whole lot of GPs/RNs/NPs, etc. and focus on preventative care. For most people, that's great. But if you need to see a specialist, you'll wait months. Of course, if can afford to pay out-of-pocket, just drive over the border to the USA or pay a private doctor in CAN.

My fvcking HMO won't even deliver my xrays to a specialist. I have to go and get them from a warehouse in bumblefvck and take them to the specialist. I realize I am lucky just to have coverage, tho.”

“Maybe a blended system of public healthcare with special insurance for specialized services would do the trick. How was it done in the past (50's, 60's, 70's)? It seems that it was much more efficient back then.”

“Back then the doctor came to you when you got sick.

Yes Rosey, dontcha just love it when you have a broken bone and they tell you to go get the x-ray films and bring them to the doctor's office. Has any orthopedist even tried to carry x-ray films when using crutches? I thought not!”

“How was it done in the past (50's, 60's, 70's)? It seems that it was much more efficient back then."
Buddha Bear
03:59:57 PM
04/16/03

1) we were younger then
2) things were cheaper
3) Adventure racing hadn't been invented yet.”

“4) population has grown to an astronomical number
5) we have more diseases
6) more medications being advertised which drives up the cost for the insurance companies

Remember how we never saw prescription drugs advertised on tv when we were younger? Or how we called our dr's office which was free from voice mail & recorded messages? Aahh, the good old days!”

“Between the malpractice crisis, shortage of nurses and the financial mess with the insurance companies and healthcare providers, the system needs help. It's too confusing for me to figure out how to fix it. I only know that if you don't feel sick because of your illness, you will feel sick when you begin to deal with the finances of being ill.”

“don't forget the lawsuits

AND why is it that everyone of those medications seem to have a side effect that seems worse than what you are taking it for and all include th a$$??”

“As a percentage of inflation Oil has been the most economical bargain for years. Medical costs have increased by triple digit inflation.

Maybe the liberals are right. War for Oil is wrong. We should be fighting the Red Cross.

Instead the liberals oppose tort reform which would drastically lower medical costs.”

“and HiPAA.. it stinks! its a pain in the @$$”

“you could go Cuba and get free health care, but you would have to bring your own suplies, and don't expect anything to be sanitary.”

“I knew you were FBI!”

“1) we were younger then
Average Life Expectancy has increased way beyond most projections. Some of this is due to advances in medicine. These advances cost $$. Wanna live loinger? It costs $.
2) things were cheaper
"nuff said. Factor in inflation
3) Adventure racing hadn't been invented yet
Lot's of people end up needing healthcare because of their chosen lifestyles. We all end up paying for that.
4) population has grown to an astronomical number
Lots & lots of people need health care, that costs money, and a lot of those people don't have insurance, thus the costs are passed on to everyone else. Contrary to popular belief, a lot of thise people don't have insurance by choice, they simply don't want to spend the $.
5) we have more diseases
That's because we're living a lot longer. Growing up, we'd hear people talking about someone who had "died of old age". You never hear that anymore, theres always a "reason" someone dies; cancer, heart disease, etc. Of course you have to die from SOMETHING, but we, as a society, don't look at it that way.
6) more medications being advertised which drives up the cost for the insurance companies

This is a HUGE problem. Drug companies now sell directly to the the consumer, who usually doesn't know jack-s$it about healthcare, who then runs to his doc to demand the latest miracle cure. That really drives up healthcare costs.
7. and HiPAA.. it stinks! its a pain in the @$$
HIPAA is a result of the nature of our litiguous society, let's all sue someone, and let's all be paranoid about who has seen our medical records. This is also big government reponse to liberals who want the govt to pay to keep them safe from the big bad world out there. More govt regulation that isn't needed, it will cost us all a bundle.
8. don't forget the lawsuits
HIPAA, doctor's going out of business, unnecessary medical tests, unnecessary clinical documentation requirements... all these are a result of lawsuits.
9. AND why is it that everyone of those medications seem to have a side effect that seems worse than what you are taking it for and all include th a$$
They don't. Because of potential lawsuits, the mfgr has to list everything that could possibly happen, however remote the chance, just so that they have their a$$ covered from lawyers.
10. Socialized medicine is great for primary care
Socialized medicine is great for absolutle nothing. There is not one country in the world that offers socialized medicine that is even in the same balpark as the U.S. for access to care and quality of care. This is pure bull, but a very common misconception.”

“yeah but HIPAA is a pain for people that work in the health care industry. too many rules and regulations to follow. for instance you can no longer call people "Mrs. Smith"... you have to call them on a first name base. this is just one of the many rules that the workers in the health care industry have to now follow. Not to include the 100 rules I have to follow when coping medical records. HIPAA can fine $100 for each incident that has been violated up to $25,000 per year.”

“I strongly believe in this part of HIPAA:

The Privacy standards:

--limit the non-consensual use and release of private health information;
--give patients new rights to access their medical records and to know who else has accessed them;
--restrict most disclosure of health information to the minimum needed for the intended purpose;
establish new criminal and civil sanctions for improper use or disclosure;
--establish new requirements for access to records by researchers and others.

I think things have been running free and loose in the medical industry as far as who accesses medical records. If you're buying a house, should your medical records be open for a lender? If you look at what you currently sign as far as release of information, it can go to ANYONE. You cross off that part of the release/disclaimer -- which is right before you sign -- well, do you want to see yourself go into paperwork/medical/legal hell??

So that is good. BUT... on the other hand, it appears they want to give a person one identifying number. If someone would mess with the system, guess they could then get all your records easily.”

“Sorry to disagree Liz, but things have not been running "free and loose" in the medical industry. You're buying into the regulator's pitch. I happen to work in healthcare, and for the last 15 have been very involved in patient records. I stand by my earlier comments, but more importantly, can back them up with facts.

Miss Opie, I certainly wasn't defending HIPAA, re-read my post. I'm on your side, even though I stand to gain personally from all this BS.”

“As part of my job I work as the Medical Record Clerk. Even before HIPAA, we do not release patients health care information to ANYONE.. unless we have a signed medical record release specifically for the information that is being released. I have also been very careful about comparing the signature on the release to the signature that is found in the chart.

I know all offices aren't the same and that all offices may not have been that careful when it comes to privacy.

The only time we ever release information without consent is if we refer a patient to a specialist and we send information regarding that referal only. Even with HIPAA these same rules apply.

Some of you parents may not realize this but did you know that HIPAA considers a 14 year old an adult when it comes to releasing medical information? If your child is 14 or older they have a right to who has access to their chart including their parents. They are allowed to disclose their parents to any of their healthcare results or diagnosis. We have had some furious parents because they do not believe a 14 year old should have these rights.”

“Also Lizs even when it comes to research companies they are never allowed to receive information about patients unless they have a signed consent from the patient.

I find it funny because most of our patients write on their medical privacy form.. "who do you want to disclose from your records? telemarketers and fundraisers" I don't even know why they thought we would give this type of information out.”

“I'll give an example of something that really bothered me. I go to a doctor at a clinic that is affiliated to the world-famous Mayo Healthcare System. I live 70 miles from it.

Within the last year or so, they started having their patients fill out a pre-visit information questionaire. You would think you were filling out a form to apply for insurance! It's four pages long. It asked if a person had any symptoms for many, many kinds of things in the past year.

They say they are doing it to get doctor's up to speed on an individual that much faster (cutting down on office visit time)... and catch problems.

My problem with all that is this: Suppose I wrote, oh, I had a little cough, nothing bad. (And this is NOT what I was seeing the dr. about)

Then say, down the road, a person is diagnosed with lung cancer. I guess I am presuming an insurance company could readily get access to those records, due to the release form signed and what it states. Might your NEW insurance company then says, well, you had a cough you really didn't follow up on three years ago. That could well have been the beginning of your lung cancer. It was pre-existing; we are not going to cover it.

That's a fear.”

“All of your proposals add to health care costs.

Utopia is expensive. Let's lower costs and make health care more affordable.”

“Another example of information being shared, although this was in person.

My account at the lovely local affiliate at Mayo was behind. My company had gotten healthcare coverage in April... however, we did not get cards and official notification of policy till JUNE.

I had to see the dr. on a few things in between. My bill was sitting at near $500. I went to schedule an appointment. They said, "Oh you need to talk to Jill in our collections dept. first."

I talk, she says, OK, so your coverage was just verified and you have a high deductible. I was "allowed" to see the dr. as long as I paid for the current day's visit. Fine.

I saw the dr. Came out to pay. The account must have been flagged. Chickee immediately gets on phone when I get to the desk to pay. She says, Oh I can't get anyone in billing.

I said, Oh I talked to some in collections before my appointment was made. She told me I need to pay for today's visit.

At that point, her phone rings. There are six people in line behind me when desk chickee says for everyone to hear: "OH I HAVE AN ACCOUNT THAT'S BEHIND HERE."

I turned 16 shades of red as everyone in line heard that comment. And the whole problem was taken care of before I ever entered the building.

I was not happy (understatement there!)”

“Life insurance companies can not obtain medical records without a signed release form that they have the patients sign when they are applying the insurance. If you sign this form then you are giving them the right to obtain your records. Health insurance on the other hand works differently. When you sign up for health insurance you sign a form that says they have the right to your records when they are filing your insurance. They don't have to supply a medical record release every time they need this information unlike life insurance companies that do.

Also Lizs the only information that we provide these insurance companies with are documented records from the doctor. We never release any telephone conversation message or any misc items that the patients bring in. Health questionares are never sent to insurance companies because these are not documented health information. We also never send any information that other physicians provide us with, such as if you went to visit a speciality clinic. The only information that is released is the documented service that is performed at that specific physicians office such as office notes, labs, xrays, and ekg's never correspondences or misc information.”

“and as far as what that lady said in front of other people was totally uncalled for. common sense should have told her not to have said that.”

“I'll second what Miss Opie and Wanderer are saying. They're "spot on" in their comments. I work for a private health plan on the administrative side. Healthcare costs are definitely on the rise. My premiums went up 18 percent this past year and they're going to go up double-digit again for 2004 coverage and I WORK for a health plan! I will probably opt out for next year and buy a catastrophic policy off the street for far less than I'm paying now. One of the many reasons for the signigicant increases is the payout on Medicare/Medicaid claims by the feds and state is not keeping pace with medical costs incurred by the provider and, it's an assumption, but I think the rest of the insured are subsidizing some of that difference. More and more docs are beginning to scale down, and in some cases, eliminate services to patients with this coverage. Also, many people overutilize emergency and urgent care services and use them for their primary doc. Insurance liability premimums for doctors is totally out of control. Some pay $100 to 200 thousand per year just in premiums alone. Many specialists are dropping certain portions of their services in exchange for lower medical liability premiums. OB/GYN's are beginning to stop performing births due to lawsuits when the birth doesn't go just "perfect". There are a handful of docs that are driving up the liability premiums due to negligence and impacting the overwhelming majority of docs who are ethical in providing treatment. Drug costs are very high for certain categories. Drug companies have extremely large advertising budgets to entice patients to ask for the brand by name when they visit their doc. Of course, those ad expenses are part of the drug cost. Government regs(state & fed) add lots of bureacracy for healthcare companies. The newest of these, which is HIPAA. I've personally received more training on HIPAA than I ever wanted. Most of it is common sense and already a common practice for most in the industry. Now, although, there will be ALOT more paperwork involved, hence, higher costs. The company I work for spends 87cents of every premium dollar on providing healthcare. Less than 10 cents on administrative costs. The rest is before tax profit (3 cents per dollar).”

“<Initialise Rant Mode>

I was just thinking about 'Harry and Louise'. You remember them, I'm sure. The insurance companies certainly got their money's worth out of that campaign, didn't they?

I think they dodged that regulatory bullet and were sailing along until the market tanked. Then they cried to their bought politicians and increased malpractice premiums to cover the shortfall to stockholders. The bought politicians worked to limit judgements to the victims of malpractice, but the claims of outrageous payouts to plaintiffs were not borne out by reality. No Problem! They went into a full court press on the PR angle. Again.

So... where was the CRISIS over malpractice premiums when the market was riding high? There was none!!

It makes me think of Enron, WorldCom and HealthSouth. I don't think the shakeout that began in the late 90s has run its course in the heathcare and health insurance industries.

As far as treatment goes, I think all the insurance coverage in the world doesn't alter the basic fact that if you've got the dough, you get the treatment. Otherwise, you may well be #&%!$ Outta Luck (SOL).

Remember the folks who needed kidney transplants, and even though they had been performed for DECADES, they were disallowed by their carriers as 'experimental'.

Of course a number of doctors (not all) game the system to maximize return (and the AMA is lobbying full-time) and some of the dreaded trial lawyers as well... And some hospitals... And some drug companies... There's PLENTY of blame to go around, IMHO.

I dunno... does it get to the point where they have to, to keep up with the competition? oy.

I believe it's what the Old Timers used to call a s h i t sandwich.


Stay healthy, folks!!!


(or as the crazy old #&%!$ers always used to tell me... "Live fast; die young and leave a beautiful corpse!")

<Terminate Rant Mode>


I think I need to take a nap, <G>...

If this made any sense whatsoever, I'll be mighty surprised. I can't wait to read it in the morning.


ZZZZZZZZZZZZzzzzzzzzzzzzz..........
”

“Another part of the equation is medical tests. Both my doctors do their own lab work. When they get the results, they send me out for further tests - there are MRI's and CT scans and radiography and sonograms, etc. etc. 30 years ago, none of this kind of testing was routine. You didn't get an annual mammogram, or an EKG unless you had serious symptoms. Part of it makes for better diagnosing, and part of it is CYA, because if I come down with a tumor or something that could have been diagnosed with the right test, and the doctor didn't order it in order to save money for the insurance company, I can sue for malpractice, and probably win. So, millions are spent on tests which may or may not be necessary, but that cost a lot of money.

The aging population is also a big part of it. People used to die fairly young - in childbirth, or TB, or typhoid or measels -- long before most chronic diseases could begin developing. Many cancers and heart and lung diseases are more common if you are over 70 - and our population is increasing the number of those over 70 and 80 and 100. Treatment is available to prolong life, but it costs a lot. That's good if you want to live a long time, but bad if you have to find the funds to pay for it.”

“I have pretty good health insurance, dental, prescriptions, glasses etc, but would still like to see national health care. We take care of the poor & elderly, why not the middle class? What surprises me is to hear a few right wingers want to talk about socialism in services.”

“I work for an HMO. I'd like to see a national healthcare regulatory agency with real teeth.

Include research grants, new drug price regulation, and a universal editing software for incidental costs, and you'd end most of the woes we're hearing about here. You'd also do away with a great many of the uber-drug company profits, so something like that may never come to pass.”

“OK, now I have to say something nice about that danged Mayo affiliate here in town.

After discussing an upcoming... errrrr... "annual exam"... they said I could indeed put it off till July 1 -- which I am switched to much better health insurance -- "if I felt ok to put it off"

YES INDEEDY! Mucho gracias”

“Instead the liberals oppose tort reform which would drastically lower medical costs."
bacpac
05:01:12 PM
04/16/03

I am willing to wager a considerable sum that tort reform will not result in drastically lower costs. It might however result in drastically higher profits for Insurance companies.”

“I guess I can't complain too much about HIPAA.. I just went to their website and emailed them to ask if they have any employment opportunites.

Soon they will be sending people around to make sure all the health care organizations are compliant.

They emailed me back and said "We are actively pursuing relationships with third party vendors who with do help companies become HIPAA compliant. There is a tremendous opportunity for us to work together, as our web based tools can work as a back-end application to a consultant who wants to bring people through the process of compliance. We also have a commission structure already in place for that, so you could charge for your time, but also create earnings by selling our services."

I ask them to write me back and give me more detail because from the email I couldn't tell if these third party vendors are independent contracters or an actual organization.”

“I've been in the insurance business - providing, among other products, health insurance to those who want/need and can afford to pay for it. But my post here is from personal experience...

There are over 7500 reps in the field force, most with dependants, and all of whom pay 40% of the total premium cost. For me, that cost isabout $130 a month for single coverage. Our group plan is "self-insured", meaning that benefits are paid out from premiums collected, with a major insurer backing up the administrative side.

Our premiums increased January 1st, by about 20%, and company reports show that more than 54% of all costs/benefits paid out were allocated to prescription drugs.

YOU figure it out.”

“>> I thought that 'HIPAA' acronym looked familiar.... <<


SANS Free Webcast, Wednesday, April 23 at 1pm EDT (1700 UTC)
Legal Liability For Information Security: Ask the Experts


A few weeks ago SANS broadcast our first web briefing on this
topic. More than three thousand people signed up and their near
universal response was, "More, Please!"

SANS is happy to bring you a complimentary webcast on Wednesday,
April 23rd at 1pm EST (1800 UTC) entitled Legal Liability for Information Security: Ask the Experts. Register at http://www.sans.org/webcasts/042303.php


this caught my eye...

For years, security professionals have claimed that "one day people
will be held liable for weak security." That day may have arrived, with class action lawsuits, and HIPAA, and California's new disclosure
law and more.

On Wednesday, April 23, three of the nation's top experts on civil
liability for cyber crime will be online to provide a brief overview
of important cases and trends and to answer your questions:

Marc J. Zwillinger, Chair of the Information Security & Anti-Piracy
Practice Group at Sonnenschein Nath and Rosenthal

Gregory P. Schaffer, Director of Cybercrime Prevention & Response
for PricewaterhouseCoopers

Orin Kerr, Professor of Law at George Washington University

The experts will first provide an overview of new developments that are reshaping the legal landscape in the area of cyber liability. Then you can ask questions on the topics they discussed or any others that you feel are related. In addition, Hal Pomeranz of the Center for Internet Security will give you an update on the newest Gold Standards for safe configuration agreed to by the US government and industrial leaders,
and the legal experts will discuss their potential applicability in
limiting liability. As well as Charles Woods, Independent Information Security Consultant & Researcher, InfoSecurity Infrastructure, Inc. will be discussing Clarifying Responsibility For Information Security.”

“One of my clients was upset because their med claims had skyrocketed. On looking into it, it was found that one of their employees had been approved, and had had, a penile implant.

WTH?? Now why in the world should this even be covered!!!???”

“ouch.”

“Because it is a necessary enhancement (excuse the pun), to help your body as a tool (excuse the pun) last longer (excuse the pun).”