In the Healthcare Battle

The enemy is a bi-partisan opportunistic healthcare industry for profit. I am just going to leave you with this little excerpt from nyceve's diary to think about:

I'm not the only one concerned.

CAPITOL REPORT: Politics, Business As Usual In Health Proposals?

Those who hope the 2008 presidential election will finally bring about drastic health-care reform may well end up finding it's a case of politics and business as usual, experts say.

It's still early in the race to the White House, but right now there doesn't appear to be much in the way of strong shifts on the horizon for what many consider the nation's highest domestic priority if current proposals from the handful of presidential hopefuls are not altered.

"None [of the plans] revolutionize the system," said Roger Feldman, a professor at the University of Minnesota who specializes in health insurance. " They've kept all [of the plans] from [enacting] system redesign for the most part."


Sadly, I think we're taking a huge leap of faith to think that bold healthcare reform can be accomplished without vigorous and robust insurance industry regulation. Do you think the insurance industry which intends to buy just about all the seats at the healthcare reform negotiating table, is going to agree to tight new regulations.

This is what we're up against.

Whether or not it wants true reform, the health-care industry is giving to presidential candidates in record numbers, particularly Democrats, according to data from the Center for Responsive Politics.

Health care has poured in $41.4 million to all 2008 campaigns by the end of this year's third quarter. Among the various subcategories, contributions from health services and HMOs are up 53% while and pharmaceuticals and health products are up 47%. Health professionals and insurers' contributions are up 23% .

Roughly 54% of the current total health-care slice, or $22.5 million, has gone to Democrats. That represents the first time the majority of health-care money has gone to Democrats since 1992.

Clinton is the top fundraiser in a combination of contributions from health care and accident insurers - which includes major health carriers - taking in a combined $1.81 million through the third quarter. Clinton, though, is far ahead of rivals in overall fundraising with $91 million and ranks in the middle of the pack when it comes to the ratio of industry contribution to overall total.

Obama is second in overall health care/insurance money with $1.45 million, the center's data shows. Clinton's cut of all health-care/insurer dollars among the candidates is 23.2%, while Obama's is 18.7%.

Among other major candidates, Romney took in $1.09 million while Giuliani got $1.08 million. John McCain garnered $613,230 and Edwards got $438,726. Fred Thompson took in $177,975 from the industry.


Whether you're for or against mandates, mandates without regulation will simply throw millions into a thoroughly corrupt and broken system .

The experience of Americans with insurance in Orange County California is typical of what we all experience at the hands of the for-profit insurance industry. The insurance industry business model is to force us to run a gauntlet.

Can you really blame a beleaguered doctor who decides to throw in the towel and refuse another round of Three card Monte with a corrupt insurance company?

Doctors seek cash when insurance doesn't pay

A small but growing number of Orange County doctors has stopped accepting private insurance, saying they are fed up with low reimbursements that can take months to receive, lost claims and denials of necessary medical care.

This fall, Women's Medical Group of Irvine dropped roughly 20 preferred provider organizations after more and more staff time went to insurance paperwork rather than patients.

"We were spending inordinate amounts of time and resources on things that have nothing to do with the quality of patient care," said gynecologist Felice Gersh, medical director of the four-doctor practice. "I would be more than happy to be a member of all the health plans if they paid me reasonably and quickly."

For instance, Gersh received a letter in August from Nationwide Health Plans over a $110 charge for an office visit. The insurer refused to process the claim unless Gersh sent five years' worth of patient records including chart notes, pharmacy records and lab/X-ray results.


This morning, The Wall Street Journal is wondering which Democratic plan covers the most people. This is certainly an important question. But an equally important piece of the puzzle is insurance industry fraud and abuse. Ask any American with insurance to describe a typical medical encounter, they will present you with a chilling list of egregious insurance industry malfeasance. Routine malfeasance which has become institutionalized.

Take a hard look at the proposals put forward by any of the candidates that the media has dubbed as top tier and you will find that all of their healthcare reforms are sadly lacking on many fronts. And it is highly doubtful that this will change as long as the healthcare industry is funding any of these candidates.

1 comment:

Anok said...

My husband and I were astounded when his insurance company contacted us for "reimbursement" for health care costs related to an accident.

Reimbursement? I thought we paid them already. The idea is that they can "lower health care costs" by asking for third party reimbursements when the care was caused by an accident. If the insurance company of the responsible party refuses to pay the reimbursement, its taken out of the victim's settlement.

My husband and I paid in upwards of $7,200.00 received about $500 worth of (partially covered) medical care - and the insurance company wants us to give them back their $500.

What about our $7k? can we get that back for non-service? Can we get a refund for not receiving medical care? If we had to pay the insurance company, and then pay for the medical fees on top of our premium...why the hell do we have insurance in the first place? Why didn't we just pay out of pocket...seems that would be much more straight-forward.

I'm tired of all this health care crap. They are making money hand over fist, and still I can't get some damn tests done because of all the red tape.