With all this talk I do about Baucus and the Democrats and their many failings, there is this: Obama, unlike most of the aristocrats who run for national public office, has had personal experience with health insurance companies. While his grandmother was dying, insurance companies were trying to deny her care.
The president is not all-powerful – there is concentrated wealth in this country than can bring him down – him or anyone that gets out of line. But there is this – that he is a man of common origins, and he has experienced the health insurance that all of us ordinary people have to deal with. If he is the leader that his PR people projected on us in the last election, we may have hope of getting something positive our of the health care debate.
It depends on that, it depends on organizing, it depends on dealing some pain on Democrats who jump ship. But Obama might be able to deal on them a bit. He might be useful.
Piece of Mindful 
But how is he going to browbeat the Mayo after their reality check? http://healthpolicyblog.mayoclinic.org/2009/07/16/mayo-clinic%E2%80%99s-reaction-to-house-tri-committee-bill/
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Although there are some positive provisions in the current House Tri-Committee bill – including insurance for all and payment reform demonstration projects – the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.
In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.
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Until you come to grips with the systemic failure of the private health insurance model, your outlook is not useful. You are hidebound in your unworkable ideology.
Address it, please: Private insurance, by its very nature, is unable to deliver universal coverage and must deny insurance to sick people, rescind policies after people get sick, and dump costs on government, patients, doctors, hospitals and other insurers.
Address that matter specifically, point by point, please. Or retire to the anteroom.
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The Mayo doesn’t even know that I exist. Deal with their concerns.
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Also, you continue to demonstrate a completely distorted view of insurance. There is NO risk transfer in the burning layer, only risk funding where possible.
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There is investment return, and fulfillment of that objective is directly at odds with providing health care.
It is internally contradictory. Now, would you please deal with it?
In Europe it is illegal to run a for-profit health insurance company. Perhaps they are not stupid?
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Mark, deal with what insurance ‘IS.’ The ultimate risk underwritten is irrelevant to the process. Understand what loss ratios,IBNR’s, law of large numbers,accuarial analysis, burning cost and such mean to the process.
Is dealing with an insurer on a claim easy? Hell no! from my personal experience. Is it doable, absolutely.
Take the situation with your mother that you wrote about:
1. Get a copy of her unsuring agreements including drug benefit if any.
2. Read those agreements, and if necessary, get help decoding the provisions.
3. Where you disagree with insurer, get them to quote chapter and verse where they are pinning their position.
4. If you disagree and they won’t come around, ask them if they have alternatives that they will pay for like Mohs surgery for skin cancer.
5. If they still will not cooperate, and you truly believe you have a covered claim, ask them whether they are licensed to practice medicine in Montana in order to ignore the doctor’s prescription.
6. Lastly, if you are still not satisfied tell them you will report them to the State Auditor who oversees insurer matters including their state license and further advise that you will report them to the state medical association and the BBB.
I have never gotten to DEFCON 6, but I have achieved success at 5. At any of the levels outlined, ask for a supervisor on up the chain.
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Hence, the incredible burden insurers put on us, all unnecessary. Deal with what insurance IS – a business designed to yield an investment return, which is by design a self-contradictory system.
We don’t need them, they have leeched on us. Can’t you see that? You just game me a whole list of unnecessary private sector bureaucracy.
Single payer would just pay the damned cost. That’s why it is so efficient and widely used.
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After getting your mother’s affairs in order deal with your own insurance issue from “pre-existing conditions.” In CO you can form a group of one. http://www.statehealthfacts.org/comparetable.jsp?ind=350&cat=7
From CNN: http://www.cnn.com/2009/HEALTH/05/14/preexisting.condition.insurance/index.html
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Become a group of one.
In about a dozen states, you can be a group all by yourself for insurance purposes. What this means is that you become, in effect, just like any other company, and insurers can’t deny you insurance or charge you higher premiums because of your pre-existing condition, according to Lembo.
“You’d be surprised at the number of folks who open their own landscaping business” to get the group of one, he says.
To find out whether your state will allow you to become a group of one, see this list from the Kaiser Family Foundation (look at the column headed “Definition of Small Group,” and look for “1-50”).
For more information on becoming a group of one, see this advice from the American Diabetes Association.
In states where you can’t become a group of one, you can become a group of two.
“You can hire your brother-in-law to become a subcontractor for your landscaping company,” Lembo said. “It’s horrible, but what else are you going to do?”
An important note: Under these rules, an insurance company might be allowed to exclude coverage for your specific condition for a short period of time, usually about six months.
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See also: http://www.diabetes.org/advocacy-and-legalresources/healthcare/healthinsurance/groups_of_one.jsp
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So get off your nuts and take charge of your situation.
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Craig- All I have to do is get off my nuts! If only I knew! To be so young,so innocent. You’re adorable!
Montana has such a program. It is called “Insure Montana”. It has a waiting list, and is, of course, subsidized.
But you cannot fool the health insurance salesmen. The people who enlist in these plans are, by definition, people who have been denied regular health insurance due to preexisting conditions, what have you. Regular insurance would be cheaper, and ergo people who were accepted would not be looking for a program like this.
So it is true you can form your own “group” of one, but the prices are ‘COBRA’ level – so high as to be unaffordable for all save a select few. The last premium we were quoted was $2200 per month.
It’s the old insurance bugaboo at work – adverse selection. It’s why private health insurance does not work.
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Not so fast, there might be rationing. Right, there’s rationing now, but right-wingers seem to ignore that in fear the government might ration care to end-of-lifers wanting expensive surgery. Until side-by-side detailed plans can be compared in daylight, the status-quo wins.
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Mark, my last comment is stuck in your filter. Do with it what you will.
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It is posted above.
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