Re: Doctors say the strangest things...

On Dec 16, 1:49 pm, "tomor...@xxxxxxxxx" <tomor...@xxxxxxxxx> wrote:
On Dec 16, 11:39 am, Bruce Richmond <bsr3...@xxxxxxxxxxx> wrote:





On Dec 16, 10:08 am, "tomor...@xxxxxxxxx" <tomor...@xxxxxxxxx> wrote:

On Dec 15, 8:02 pm, Alan Moore <alan.s.mo...@xxxxxxxxxxx> wrote:

On Sat, 15 Dec 2007 10:12:06 -0700, Turby <turbosur...@xxxxxxxxxxxx>
wrote:
This is at the "Mayo Clinic of the West". It feels more like some
Kafkaesque socialized medicine scenario.

Some bizarre parody of socialized medicine, maybe. I got sick once in
the USSR. I told them at the desk in the lobby of the hotel, and the
doctor got to my room at about five minutes after I did.

Maybe when we get sick in ther future, we can all just go "Back To The
USSR."

On another occasion, I arrived in Bulgaria from Turkey, feeling
unwell. I was in the hospital for infectious diseases within an hour,
which proved to be a good thing, as I did, in fact, have whatever
bizarre bug had been wreaking havoc in and around Istanbul. It also
gave me the opportunity to become more fluent in Bulgarian and
Romany...

Score!!!!

With actual socialized medicine, if the doctor thinks you need it,
there's no point to getting any further authorization, or figuring out
who's going to pay, or any of that nonsense, it was all decided long
ago.

Huh. I must've been benefitting from actual socialized medicine all
these years!!!! Who'da thunk it! Should I just be forwarding these
Anthem Blue Cross/Blue Shield invoices to Moscow?

You don't think someone pays for your BC/BS coverage?

Yes. I do. Quarterly. I own the company.

See how long your "socialized medicine" lasts when you stop making the
payments.



I also have BC/BS. Years ago my employer picked up the whole tab and
all I had to do was show my card for everything to be covered. Now I
contribute toward the coverage and have to deal with deductibles. And
of course some things just aren't covered.

My employees pay 0% of their premiums, I pick up the whole tab, and
all they have to do is show the card for everything to be covered. I
provide Preferred Provided Option, so they can choose their own
doctors, and go when THEY believe that they need medical attention,
not when some insurance company or government functionary tells them
they do. The things that aren't covered can be paid for out of pre-
tax dollars depostied in an FSA.

Your plan is much better than most working stiffs have these days. It
is getting to the point where some are not able to get coverage
because they can't afford to pay their share. Then there are
deductibles and co-pay to keep them from using services unnecesarily.

A few years ago my son's school recomended he have some neurological
tests done. They said that they had a fund that would cover the
costs, but that if I had insurance that would cover the testing it
would be good since that would leave the limited funding for those
without coverage. So I wrote a letter to BC/BS explaining what
testing would be done and who would be doing it, asking if the testing
would be covered. The letter I got in response said the testing would
be covered to the limits of my policy. I assume that meant payments
would be limited to "usual and costomary" and the max pay out of my
policy. Later the bills came in and BC/BS refused to pay anything.
When I sent them a copy of their letter they replied that the testing
wasn't covered by my policy, so they were in fact covering it to the
limits of my policy. Fortunatly all this was in writing and the
insurance commision agreed with my interpertation.

Yeah, that sucks, but I'm not sure that you would find things
happening differently than if you were dealing with say, a federal
medical care program.

A few weeks ago I went in for an angiolpasty. A week after having it
done I got a letter from BC/BS saying that it was their determination
that I could have had the procedure done as an outpatient and they
were therefore not going to pay for my staying the night as my doctor
had requested. I'm kinda glad I stayed the night seeing as how my
heart stopped that night. It started back up on its own, but if it
hadn't I think my chances would be far better at the hospital than at
home. Right now I'm letting my doctor argue with them, but somehow I
get the feeling I'm going to end up going through the appeals process
and then to the insurance commission again.

Yeah, they don't want to pay for anything more than they have to. I'm
sure the government will be a lot more efficient and generous. It
usually is. Unless, of course, you have earned income, or assets, or
are employed, or are not a member of a protected or entitled group.
Luckily, there are very few people whe fall into that category!- Hide quoted text -

- Show quoted text -

Every time I get a copy of the bill it shows what the charges were,
and what BC/BS paid as "usual and costomary". The providers have
agreed to accept that as payment in full. In the latest batch of
bills I got that amounted to less than half of the original charges.
It's nice that they accept that as payment in full, but where do they
get off charging us more if we don't have BC/BS? I was in that boat
for a while, and it sucks to know that you are paying *more* because
you don't have insurance.

Agreed about your last part, there are plenty of ways they could ***
up the implementation of socialized medicine.
.

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