Tuesday, June 16, 2009

Let's be clear about rationing of healthcare...

Ooooooh, that scary word... "rationing". The fear that the anti health reform groups are trying to make us all feel.

I think most individuals that look at papers from the insurance company realize that rationing already takes place.

1. Insurance companies deny covered procedures, tests, surgeries all the time. They make the decision on what is covered. It might be something that you read is covered, but if the insurance company decides that it isn't... you get to foot the entire bill.

2. You hear about how Medicare/Medicaid reimburse for procedures at under the market cost. So do insurance companies. Most times, they pay only 40-50% of what the doctor bills them. That either leads to the doctors needing to see more patients to make up the costs, or billing artificially high amounts to get what they deserve.

Insurance companies set the rules right now. We need a public health care option that gives them some competition. The consumer gets the choice. They can go with the public plan, or pick a private insurance company. The gov't isn't going to force you into anything either way.

We need to allow people to have regular checkups. Preventive medicine needs to be in the forefront. There is no better cost savings than prevention. We need for people to be able to get affordable health insurance if they have a pre-existing condition. It's not fair for someone to have had bad luck and then not be able to get insurance. Pregnancy is a pre-existing condition as well.

Don't fall for it people. They are counting on the fact that you may not know much about how the health care system works. As someone who works in it, I can tell you that we NEED this public plan. Please call your Senators and tell them that we need it.


Monkey Girl said...

Last year, a major hospital in Seattle was threatening to cut UnitedHealthcare from their "we take their insurance list" based specially on how little they pay and how long it takes to get the $$$$.
Of course, being a UnitedHealthcare user (I use that word loosely) I was already WELL AWARE of their lousy service.
Basic check-up at network approved doctor, doctor charged $177 & some change, United agreed to pay $9.

The hospital in question went to the news station with the story, stating that when a 'supposedly' good healthcare plan (i.e. UnitedHealthcare) pays A LOT less than even Medicaid/Medicare pays, they'd had their fill of shitty service.

Luckily, for me they managed to come to some kind of deal, because it's the only hospital I trust in the state of Washington.

My point is:
When insurance companies are making the decision of:

1. How much to pay doctors/patients
2. What services the doctors can provide you
3. When they'll even pay a bill
4. Anything they damn well please

Isn't it time we throw these assholes to the wind, and come up with a health care plan that actually gives a shit about a patients health care?

Just my little humble opinion.

cancer mommy said...

Thank you, Jen and MG, for stating so clearly what's wrong right now. Since I have a "pre-existing condition", I may never be able to get another healthcare plan in my life. And I'm 34! Imagine the pickle we're in if my insurance company suddenly decides they don't want to pay for me anymore.

The idea of having a public option is brilliant, because it will force the insurance companies to compete to keep their business. There is absolutely no competition right now. They charge whatever they want for premiums, pay whatever they want to the docs/hospitals, and refuse to pay for anything they damn well please. I have several friends whose insurance company won't pay for routine mammograms! Trust me, cancer treatment is way more expensive the longer you wait, and if paying for mammograms means finding it earlier, that also means paying less for less treatment. A win-win for everyone. Too bad insurance companies don't see it that way.

And yes, preventive medicine should be the forefront. It would be cheaper for everyone long-term, and our country would be healthier, too.

Call your Reps/Senators. Let them know you expect healthcare reform-- REAL healthcare reform-- this year. If enough constituents speak up, they might actually stand up to the insurance lobby and the AMA (American Medical Association)-- who, by the way, should be fighting for everyone to have medical access.

Monkey Girl said...

I hear you, honey. Since my cancer diagnosis at age 19/20(unheard of at that age, dr. wrote paper on it) I'll never be able to get health care on my own. Always has to be through my husband's work. And since he's considering doing his own consulting work, i.e. self-employed, I have no idea how I'll get coverage.
You'd think that insurance companies would WANT to do preventive healthcare because it saves them money, but nowadays that just don't want to pay anything period.
I understand I'm a health insurance nightmare, but I still have to live my life regardless of whether I have insurance or not.

Michelle said...

Great post!

What stumps me is the argument from the right that big government needs to stay out of health care...but they're perfectly fine with big business holding all the cards. I would personally prefer that my doctor and I be the ones to make the ultimate decisions regarding my family's care. I think competition from a public option is the best shot we have of getting patient care back into the hands of doctors and patients.

cancer mommy said...


My husband co-owns his own business, and at the time I didn't have cancer. His partner talked us into a comprehensive insurance plan, instead of a catastrophic one that we wanted (because it was less money and we were healthy young adults). Thank goodness we listened! And you're right, we do have our lives to lead, no matter what.

Here's to a major reform of healthcare in the US this year, so we can both rest a little easier!

Jen said...

It really is sickening what the insurance companies get away with. A human life is worth paying for a lifesaving treatment... oh wait, only if you are a fetus does that apply.