Health Care

[DE]

Honestly, with all due respect, I can't ever understand how people can really believe that bullshit, moronic idea. Big business is only about one thing, big business. Everything is about making the buck, passing the buck and not doing jack shit if it's going to cost any money. Everything is outsourced and usually not only is the left hand not talking to the right hand, they fucking make you have to call the other god damned hand to get information they should already know. You get charge backs, double charges and unilateral decisions on financial policy that directly affects your life (because you are the fucking customer after all) without ever actually being consulted on this. Hell, you're lucky if they even send you a damned notice about it.

But hey, what the hell, let's pop open another Bud and put our hand on our heart and wave a fucking flag while we watch real American society ride a flaming roller coaster going down Steep Crash Mountain into bullshit hell.

[Uncle Mxy]

I have AM radio on when I'm working and I could not believe the stories of rip off artists on medicare. Some peeps were saying how they even called the gov't arm that was supposed to be watching the waste and nothing was done.

So you can call my argument lazy, if you must, I'll go ahead and call it accurate.

And amazingly, amidst all that massive fraud, Medicare coverage turns out to provide less-expensive coverage than through insurance because someone isn't taking a big whack off the top to fill the airwaves with ads for the latest pill, or just raising rates arbitrarily if their fraud prevention group had a bad year in your geography. That doesn't mean we shouldn't combat fraud, but a certain amount is inevitable, the cost of doing business. Multiply by big dollars and big institutions and you're always going to have stories that some gasbag will pull out to say how fucked up things are, playing on folks who can't see the forest from the trees.

There's some obvious problems with Medicare, and it doesn't help that the Medicare old folks are even less able to spot fraud than the average health care consumer (whose abilities in this area are dimmed by being slammed by dozens of different providers for a simple ER visit these days). A whole lot of the problems stem from the way compensation happens, often rewarding "more procedures" instead of "good process". Sanity checking is tricky.

My first experience with health insurance involved fraud, come to think of it...

I started receiving bills for a broken leg I never had. It turns out the hospital had some unpaid bills by someone with my first/last name for a broken leg. When I showed up there with a broken pinky, they assumed "broken leg" dude was me, billed my insurance, then billed me for the remainder. The easy part was getting this fixed at the hospital. I was prepared to say "x-ray my leg, you'll see it's never been broken, you have the wrong person" but it didn't have to go that far. (Fortunately, I still lived right by the hospital.) The person with my name turned out to be shorter, older, and heavier than me, with a different middle initial.

The hard part was getting the fucking insurance squared away. I tried to get a written confirmation that the insurance company no longer had the claim on my record, but was referred to either this black hole known as the fraud department, or the billing hospital. A few months after that, I changed employers/insurance and never heard from my old insurer again. Honestly, I didn't care about them, but had a fear that someone might have bad medlcal info about me and do something stupid on the operating table.

[Tahoe]

Honestly, with all due respect, I can't ever understand how people can really believe that bullshit, moronic idea. Big business is only about one thing, big business. Everything is about making the buck, passing the buck and not doing jack shit if it's going to cost any money. Everything is outsourced and usually not only is the left hand not talking to the right hand, they fucking make you have to call the other god damned hand to get information they should already know. You get charge backs, double charges and unilateral decisions on financial policy that directly affects your life (because you are the fucking customer after all) without ever actually being consulted on this. Hell, you're lucky if they even send you a damned notice about it.

But hey, what the hell, let's pop open another Bud and put our hand on our heart and wave a fucking flag while we watch real American society ride a flaming roller coaster going down Steep Crash Mountain into bullshit hell.

What a bunch of stereotypical bullshit.

[DE]

Really? Because I'm just some college kid that's never had to work or do anything for a living? Are you sure Tahoe?

Just in the past year I've had to fight with a repair company, a bank, a credit card company, an insurance company, a health insurance company and a collection agency. Now I'm not perfect but none of that was actually my fault, most of it came from their own bullshit and none of it ever got solved with just one phone call. Weeks of calling and calling and fighting and writing letters and sending faxes to get something that was rightfully mine or take away something they should never have even done in the first place.

But yes, all stereotypical bullshit.

[Tahoe]

And amazingly, amidst all that massive fraud, Medicare coverage turns out to provide less-expensive coverage than through insurance because someone isn't taking a big whack off the top to fill the airwaves with ads for the latest pill, or just raising rates arbitrarily if their fraud prevention group had a bad year in your geography. That doesn't mean we shouldn't combat fraud, but a certain amount is inevitable, the cost of doing business. Multiply by big dollars and big institutions and you're always going to have stories that some gasbag will pull out to say how fucked up things are, playing on folks who can't see the forest from the trees.

There's some obvious problems with Medicare, and it doesn't help that the Medicare old folks are even less able to spot fraud than the average health care consumer (whose abilities in this area are dimmed by being slammed by dozens of different providers for a simple ER visit these days). A whole lot of the problems stem from the way compensation happens, often rewarding "more procedures" instead of "good process". Sanity checking is tricky.

My first experience with health insurance involved fraud, come to think of it...

I started receiving bills for a broken leg I never had. It turns out the hospital had some unpaid bills by someone with my first/last name for a broken leg. When I showed up there with a broken pinky, they assumed "broken leg" dude was me, billed my insurance, then billed me for the remainder. The easy part was getting this fixed at the hospital. I was prepared to say "x-ray my leg, you'll see it's never been broken, you have the wrong person" but it didn't have to go that far. (Fortunately, I still lived right by the hospital.) The person with my name turned out to be shorter, older, and heavier than me, with a different middle initial.

The hard part was getting the fucking insurance squared away. I tried to get a written confirmation that the insurance company no longer had the claim on my record, but was referred to either this black hole known as the fraud department, or the billing hospital. A few months after that, I changed employers/insurance and never heard from my old insurer again. Honestly, I didn't care about them, but had a fear that someone might have bad medlcal info about me and do something stupid on the operating table.

bcuz you say its still cheaper it seems you are willing to look past corruption in another Gov't program. I can't.

[Tahoe]

No, it was all your 'hand on your heart, pop a bud, wave the flag stereotypical bullshit.

[DE]

Oh. Well. Yeah. Oh. Ooops. Sorry.

Honestly though I don't think it's too stereotypical (well the Bud part was) but I really do think there's a lot of people who really do wave a flag and just use that to actually not listen to things.

[Tahoe]

It's nothing personal, some peeps just don't want the morons in DC to take over 1/6th of our economy. They WILL fuck it up.

Wait till they won't get the revenue they THINK they will on this payroll scale tax. The rich will divide their companies, or a multitude of other ways to get around the tax, and woking peeps will foot the bill.

Obama and Pelosi are idiots.

[Uncle Mxy]

bcuz you say its still cheaper it seems you are willing to look past corruption in another Gov't program. I can't.

There's corruption in all sorts of non-government programs. People will use to to say "government is bad" or "big business is bad" or whatever, ignoring a lot of other good things about scale advantages in the process. Forests, not trees...

The idea is to spend enough on fraud control such that spending more doesn't get you more bang for your buck. The problem is that there's an awful lot of indirect costs to fraud control. It's somewhat easy to count "claims not paid due to fraud". It's much harder to count:

- higher claims to account for payee-side compliance costs
- fraud not even attempted -- the "security guard" effect
- lost business from doctors not accepting PITA insurers
etc.

Even with private insurers, fraud is 10% or so and growing -- a lot. It's not like they do fraud prevention dramatically more efficiently than the Medicare system. The question I don't have a good answer to: Is 10+% the actual cost of doing business, or insurers simply deciding the easiest approach is to pass the costs along to the customer? How much fraud is enabled by the mess that is piecemeal medical billing?

[UxKa]

Mxy pwns the last couple pages.