Anyone surprised at how badly Pelosi cucked Donald yesterday?

[tarheel0910]

I don't disagree with this. Insurance has inserted itself into the patient/provider relationship, carved out a profit for itself, burdened providers with cumbersome regulations, and created a confusing labyrinth for people seeking care. There's a reason some doctors have stopped accepting insurance entirely and instead allowed their patients to make a modest monthly payment in exchange for basic services like wellness visits, etc.

Insurance is bad until you need it. I would literally be dead without insurance.

 

[nctransplant]

I'm not unsympathetic to your situation. This really sucks, and I hope you're able to get some relief. However, stories like yours have been around as long as health insurance has existed. There are literally dozens of variables that could've affected their policies. You're angry and looking for someone to blame, so your political leaning predispose you to blame the ACA. That's fine. It's likely the culprit for your premium increases, but I think you're way off base about the rest.

I'd like to know why a group of radiologists get to decide what treatment I can get rather than my physician. I understand that BCBS is supposed to make money but they can all go to hell as far as I'm concerned.

 

[nctransplant]

I'm not unsympathetic to your situation. This really sucks, and I hope you're able to get some relief. However, stories like yours have been around as long as health insurance has existed. There are literally dozens of variables that could've affected their policies. You're angry and looking for someone to blame, so your political leaning predispose you to blame the ACA. That's fine. It's likely the culprit for your premium increases, but I think you're way off base about the rest.

If it's likely responsible for my premium increases then it stands to reason it's also likely responsible for them denying treatments. They save money both ways.

 

[Terror Beard]

I don't disagree with this. Insurance has inserted itself into the patient/provider relationship, carved out a profit for itself, burdened providers with cumbersome regulations, and created a confusing labyrinth for people seeking care. There's a reason some doctors have stopped accepting insurance entirely and instead allowed their patients to make a modest monthly payment in exchange for basic services like wellness visits, etc.

There's one here in Lynchburg doing that and he is getting a ton of publicity for doing it.

I don't understand why more doctors don't do it. Maybe you can tell me the downside to it from a physician's perspective. I would think that the majority of doctors would prefer to cut out a difficult-to-work-with middle man. Any insight?

 

[Raising Heel]

I'm not posting in this thread because I don't know enough about healthcare. Some should follow my lead.

This is why I don't participate much in political threads. It's never an exchange of ideas, and it sure as hell isn't an effort to actually learn something. Too much talking, not enough good faith inquiry.

 

[Terror Beard]

You said the government subsidized providers. Now you're talking about subsidizing customers. These are not the same thing.

You said the government subsidized providers. Now you're talking about subsidizing insurers. These are not the same thing.

You can say that again.

 

[Raising Heel]

If it's likely responsible for my premium increases then it stands to reason it's also likely responsible for them denying treatments. They save money both ways.

Again, insurance companies have been denying claims/treatments as long as they've existed.

How do you buy your insurance? Do you get it from work, or do you buy privately as an individual? The reason I ask is I'm wondering what sort of recourse you have for the run-around you've been getting from BCBS. You might have better options available if you're part of a large group like in employer-sponsored insurance.

 

[Raising Heel]

There's one here in Lynchburg doing that and he is getting a ton of publicity for doing it.

I don't understand why more doctors don't do it. Maybe you can tell me the downside to it from a physician's perspective. I would think that the majority of doctors would prefer to cut out a difficult-to-work-with middle man. Any insight?

Would you think less of me if I admitted I don't know? That doesn't seem to be very popular here.

I'm joking around but I really don't know the answer. If forced to make a guess, there are probably two reasons. One, the rates they're paid by insurance is probably more than they would be paid by an individual (individuals are also more likely to default on their bill). Two, insurance probably drives a higher volume into their practice than the physician could manage on their own. This is especially true if the physician is "in-network" for that particular insurer's customers.

 

[nctransplant]

Again, insurance companies have been denying claims/treatments as long as they've existed.

How do you buy your insurance? Do you get it from work, or do you buy privately as an individual? The reason I ask is I'm wondering what sort of recourse you have for the run-around you've been getting from BCBS. You might have better options available if you're part of a large group like in employer-sponsored insurance.

Through my employer. The pain specialist is writing a letter to the insurance commissioner. Not sure if that will help. We never had issues when we first moved here. But it has progressively gotten worse.
In the case of my daughter I feel they should be held responsible for requiring PT before the MRI and her ending up basically disabled.

 

[Raising Heel]

Through my employer. The pain specialist is writing a letter to the insurance commissioner. Not sure if that will help. We never had issues when we first moved here. But it has progressively gotten worse.
In the case of my daughter I feel they should be held responsible for requiring PT before the MRI and her ending up basically disabled.

I would talk to your HR department or whoever administers your benefits at work. Contacting the insurance commissioner is also a good idea. Have you had your doctor talk to BCBS? Generally speaking, doctors hold a lot of sway about the proper treatment of their patients (for obvious reasons). Sometimes the insurance companies will listen to them when they won't listen to anyone else.

We're going through a similar situation with a family friend who had a major stroke last summer. BCBS of North Carolina discontinued coverage for his physical, occupational, and speech therapy, which can obviously have devastating consequences for his recovery. We got the doctor to contact them and he read them the riot act about how they were harming his patient. They finally relented but it was ridiculous to have to ask in the first place.

 

[nctransplant]

I would talk to your HR department or whoever administers your benefits at work. Contacting the insurance commissioner is also a good idea. Have you had your doctor talk to BCBS? Generally speaking, doctors hold a lot of sway about the proper treatment of their patients (for obvious reasons). Sometimes the insurance companies will listen to them when they won't listen to anyone else.

We're going through a similar situation with a family friend who had a major stroke last summer. BCBS of North Carolina discontinued coverage for his physical, occupational, and speech therapy, which can obviously have devastating consequences for his recovery. We got the doctor to contact them and he read them the riot act about how they were harming his patient. They finally relented but it was ridiculous to have to ask in the first place.

My doctor has had a conference with them. His next option is the Insurance commissioner.

 

[Raising Heel]

My doctor has had a conference with them. His next option is the Insurance commissioner.

Damn.

The reason I mentioned your employer's HR is strength in numbers. Do you work for a public school? If so, you're probably part of the same employer group as the city, county, etc. That's a lot of customers. If that employer group approaches BCBS and says, "Our employees are dissatisfied with the cost and quality of your product, and we're looking for a new insurance partner" it might get their attention. Obviously it would take several complaints to get there, but you're probably not the only one having this problem.

Good luck to you. I hope you get some relief.

 

[NoleSoup4U]

Damn.

The reason I mentioned your employer's HR is strength in numbers. Do you work for a public school? If so, you're probably part of the same employer group as the city, county, etc. That's a lot of customers. If that employer group approaches BCBS and says, "Our employees are dissatisfied with the cost and quality of your product, and we're looking for a new insurance partner" it might get their attention. Obviously it would take several complaints to get there, but you're probably not the only one having this problem.

Good luck to you. I hope you get some relief.

This is why I've always thought that a law that made it easier for people to join groups would have been a better move than the ACA. With the ACA it's still just you against the insurance company. It doesn't fix the leverage problem.

 

[Raising Heel]

This is why I've always thought that a law that made it easier for people to join groups would have been a better move than the ACA. With the ACA it's still just you against the insurance company. It doesn't fix the leverage problem.

There are no obstacles to joining a group plan. There are dozens to choose from. Alumni associations, AARP, unions, healthcare co-ops, industry groups, professional organizations, Costco, state or local chambers of commerce, etc. all offer them.

You might be a good candidate for an association health plan. Just be aware they typically offer less robust benefits and fewer consumer protections than an ACA-compliant plan.

https://www.healthinsurance.org/blog/2018/06/01/the-problem-with-association-health-plans/

 

[NoleSoup4U]

There are no obstacles to joining a group plan. There are dozens to choose from. Alumni associations, AARP, unions, healthcare co-ops, industry groups, professional organizations, Costco, state or local chambers of commerce, etc. all offer them.

You might be a good candidate for an association health plan. Just be aware they typically offer less robust benefits and fewer consumer protections than an ACA-compliant plan.

https://www.healthinsurance.org/blog/2018/06/01/the-problem-with-association-health-plans/

But wouldn't those plans have to follow the ACA guidelines? If so, I'm not sure how much cheaper, if any, they would be than the exchange.

 

[chickenhunter]

 

[Hark_The_Sound_2010]

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That guy gets it.

 

[Raising Heel]

But wouldn't those plans have to follow the ACA guidelines?

No

 

[chickenhunter]

 

[uncboy10]

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Has anyone here said anything about white privilege or are you just talking to yourself?