[lit-ideas] Re: The flu

 
<<But some pretty serious  economic diddling went on in the early 1990s, and
suddenly I was among the 45  million Americans who were deemed "uninsurable"
because of an underlying  health condition.>> 
Private  insurance companies will do anything to avoid paying out.  My 
husband had  by-pass surgery a few years ago.  His Blue Cross Blue Choice 
insurance  
pre-approved the surgery.  After it was done, when they were sent a claim,  
they said it was a pre-existing condition and refused to pay.  We'll be  paying 
the hospital bill long after our natural lives. 
<<But  why have MDs raised their rates so dramatically? Why can't MDs afford  
to
maintain small private practices the way they used to--and as many  still
want?>> 
Most people would point to high  medical malpractice insurance (more 
insurance .....it's all a con game, you see)  which comes back to egregious 
errors on 
the part of Dr's who are over-worked and  working unbelievably long shifts in 
hospitals.  Our previous pediatrician  cut her costs by refusing to bill any 
insurance companies at all, requiring that  her patients pay in cash up front 
and try to recoop their losses directly from  their insurance.  Saved her tons 
in man-hour secretarial/billing  hours.   I have some experience in billing 
insurance companies and  there are a hundred different hoops you have to jump 
through for each one.   The chance of an average patient successfully billing 
one of them without  spending hours reading up on the rules?  Slim. 
Julie Krueger 


========Original  Message========     Subj: [lit-ideas] Re: The flu  Date: 
11/21/04 1:56:10 AM Central Standard Time  From: _carolkir@xxxxxxxxx 
(mailto:carolkir@xxxxxxxx)   To: _lit-ideas@xxxxxxxxxxxxxx 
(mailto:lit-ideas@xxxxxxxxxxxxx)   Sent on:    
> The thing that I don't understand at all, is  how you
> can spend that much on healthcare and still not have
>  universal coverage?

ck: I hope some thinktank is working on this one. In  the meantime, I'll
proffer a few guesses related to corrupt fat cats, lack of  regulation, and a
astonishing amount of unchecked greed. For one thing,  prescription drugs in
the US are more expensive than anywhere else in the  world. (How much more?
Double, triple, etc. Depends on the drug.) Other  factors are the extremely
well-nourished insuranceb(health and liability) and  pharmaceutical
industries themselves, which enter into the overall healthcare  costs in many
studies.

The issue of health insurance coverage used to  be separate from actual
healthcare in the US, to some extent. That  distinction collapsed in the
early 1980s, with the advent of health  maintenance organizations. Many
people used to pay out-of-pocket for a  doctor's visit and prescription
drugs. The wealthiest people in the US still  do that, eschewing health
insurance. (By contrast, my parents were  middle-class, never had health
insurance, and didn't seem to lack for health  care as needed. I didn't have
health insurance either...)

In pondering  my answer to Teemu's question, I'm realizing that I really
don't know why  health care costs are so high. Paul Starr's book, "The
Transformation of  Modern Medicine," did a pretty good job of explaining how
medicine was  practiced and paid for in the US, to the brink of the 1980s.

But some  pretty serious economic diddling went on in the early 1990s, and
suddenly I  was among the 45 million Americans who were deemed "uninsurable"
because of  an underlying health condition. More to the point, a visit to the
doctor,  with standard lab work, cost me $800--compared to the $50 to $100
I'd been  used to paying. And the costs have been uphill since then. (Same
with  dentistry, only more so. Nice-looking, functional teeth in middle age
will  soon be a status symbol, if it isn't already.)

But why have MDs raised  their rates so dramatically? Why can't MDs afford to
maintain small private  practices the way they used to--and as many still
want? True, some  technological advances are awfully expensive...Okay, why
so? (Why should an  in-office ultrasound cost a patient more than a few
bucks, for  instance?)  What's really driving up US health costs, such  that
unwealthy, uninsured people aren't fixed up for nominal costs--or  at
all--when they have lower-tech infections or broken bones? Somehow, I  don't
think the real answers are all that  fancy.
Best,
Carol




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