wrote in message
...
On Mon, 26 Oct 2009 14:40:40 -0600, Vic Smith
wrote:

And you're both most likely wrong. As I said, the article I posted
was what seemed like a pretty good examination of Medicare and the
private insurance industry. They said they could find no evidence
that there was less fraud in private insurance than there is in
Medicare.
What is the funding of Aetna anti-fraud?
Don't know, do you?
Well, why should you? After all, 60 minutes isn't doing features
about Aetna. Taxpayers aren't squawking about Aetna.
Furthermore, where is the competitive pressure that would force them
to address it? There's a sweet little oligopoly of health carriers
here, as in most states.
Fraud costs go up? Who cares, raise the premiums.
It's easy to live with mythical assumptions, but it's a lot more fun
to examine them.

Who wrote the article you read and what was the source? I am just
basing my opinion on the amount of denials you get from insurance
companies and the hoops you have to go through to get paid. That is
not the rubber stamp you have with Medicare.
I did just go through this with Aetna and I know they wanted to see
the referrals for everything I claimed . It sure wasn't anything like
that thing 60 minutes was talking about where a storefront with no
bona fides can simply send medicare a bill for something and get paid
in a few days.


Hmmm... the funding of Aetna anti-fraud is the profit motive? Makes sense.
Of course, they do everything for the profit motive, which is the problem.
That's why it takes multiple tries to get reimbursed. I don't have Aetna,
but it's the same story... send it in, wait, nothing, send it in, repeat.
It's obvious to me that neither completely for-profit nor completely
non-profit, gov't run is the answer to stamping out fraud. I believe in
competition, but I also believe in taking the fear and worry out of medical
expense issues.

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Nom=de=Plume