On Sat, 08 Aug 2009 06:13:23 -0500, thunder
wrote:

On Fri, 07 Aug 2009 20:39:41 -0400, Wizard of Woodstock wrote:


This, however, ain't the answer. Growing health care from 18% to 30% of
GDP isn't sound either.

Want an example? My daughter treat a lot of Medicare/Medicade, Plan B
people along with her regular patient load.

She and her partner have to hire what is called a "coder" - Medical
Coding Specialist - just to fill out the paperwork properly to send in
for reimbursement which takes it's sweet time getting back to her - as
much as six to eight months in general and it's just about covers her
expenses - as a rule.

At least she does get paid. Have you ever asked her about dealing with
private insurers? If she's like most doctors I know, she won't have
anything good to say about them, either. I have a sister that worked in
one of the larger, well known, health insurers, until she couldn't deal
with the ethical strain. The standard practice was to deny, deny, deny,
approve. The company figured that at every denial, a percentage of
clients would stop, saving the company $$$. For someone dealing with an
illness, or a loved ones illness, fighting an insurer is stress that is
not needed.

$85,000/yr for a Medical Coding Specialist.

Her practice is her, her partner (a surgeon), an NP and a PA. Four
direct care providers supported by 2 nurses, 4 clerks, an office manager
and this coding specialist.

That's what's broken about health care.

You know, Medicare's overhead is @ 3%. That compares quite favorably
with the 15-25% of the typical HMO. Personally, I haven't seen anything
overly onerous in H.R. 3200. What exactly are your concerns about it?

When my wife was in the hospital I spent hours on the phone when I
started getting bills from providers that should have been covered by
my private insurance. Blue Cross Illinois - a major HMO.
Some were "coding errors." Who said they were coding errors?
Why, Blue Cross Illinois of course.
BTW, most of time on the phone was with a company salaried insurance
"ombudsman." I suspect she made a good salary.
There were other stalling tactics beyond coding errors.
The private bureaucracies passing the buck were legion, and made any
gov office, even the DMV, look like a model of efficiency.
If it hadn't been for the company woman handling most of it I could
have gone postal.
Standardization and computerization of coding should eliminate this
bull**** right away. Should be part of any plan of reform, however it
goes.

--Vic

On Sat, 08 Aug 2009 11:46:59 -0500, Vic Smith
wrote:

Standardization and computerization of coding should eliminate this
bull**** right away. Should be part of any plan of reform, however it
goes.

Your assuming that the insurance companies want to fix it.
Unfortunately there's a lot of circumstantial evidence that they
regard the delays as a business opportunity.

On Sat, 08 Aug 2009 13:35:15 -0400, Wayne.B
wrote:

On Sat, 08 Aug 2009 11:46:59 -0500, Vic Smith
wrote:

Standardization and computerization of coding should eliminate this
bull**** right away. Should be part of any plan of reform, however it
goes.

Your assuming that the insurance companies want to fix it.
Unfortunately there's a lot of circumstantial evidence that they
regard the delays as a business opportunity.

No, I don't assume that. My post made pretty clear I was skeptical
about the so-called coding errors.
Reform is also unwanted by the major providers.
The scumbag doing the scare tactic ads opposing reform led the company
that was fined $1.5 billion by the gov for medicare fraud.
Yes, $1.5 billion. Might be a record there.
I have no illusions about the business end.

--Vic