4 ms·

Yes but at least, Govt. is not looking to make record profits.

rayiner 7y ago
No, but government has strong incentives to deny claims to control costs. At least at the state level, governments have gotten extremely aggressive about money collection. E.g. $50 administrative fee for not paying a $4.00 toll.
- codegeek 7y ago
  Personally, I would go for ANY system right now other than what we have. I am too pissed off at how our healthcare system is. Single Payer may or may not have the same issues but I am ready to take my chances. Status quo is not good enough for me.
  - pw 7y ago
    What problems have you had with the current system?
    - codegeek 7y ago
      Many problems. - Every visit to a doctor is a game of cat and mouse. I am never sure what bill to expect and how many bills to expect. - Price is always inflated due to the fact that insurance company has to make money on every visit to the doctor. - Every visit requires a Claim. Claims get filed incorrectly. Fun and games trying to call a bunch of different "departments" trying to understand the claim and why am I being charged ? - In network/out of network game. Ohh, I am sick and unconscious but I have to make sure that the person seeing me is "in network" so that I don't get a million dollar bill. Sorry, bad luck. While you were unconscious, we called a doctor who was "out of network" and not our problem. Have fun fighting wit the insurance company. - Why does every visit require me to show insurance ? I just wanna talk to my damn doctor. Can I not just give you some money directly ? - I visited the doctor. Doctor has to file a claim for $x while the insurance company only allows $y. So the doctor inflates the amount of initial claim knowing that they will be reduced anyway by the insurance company. Cat and mouse game continues and finally, poor me is left with a bill that I now have to figure out. Have I already paid enough (copay, deductible, out of pocket limit) ? Lucky me. - My employer changes my insurance company. Oh, I have to redo the entire paperwork with al my doctors. Ok I did it. Oops the doctor office still filed a claim with my previous company. I am now fighting to get that sorted.
      - Gibbon1 7y ago
        Two other problematic things. - Doctors have no idea how much anything costs. - Pricing has nothing/little to do with the actual cost of providing a service.
- mochomocha 7y ago
  How is that different from insurer incentives to deny coverage or to ask crazy copays because insured people can only switch plans once a year and select from a tiny menu of options that their employers have negotiated on their behalf with an oligopolistic industry? And do you honestly prefer the shady debt collectors industry to the current government money collection mechanisms ?!?
- sjg007 7y ago
  This is not a thing and if it ever became a thing it would be challenged in the courts. What is covered is all determined by the CMS and the medical associations. I would imagine some red states would try to do it. But to deny claims for cost control would be akin to the "experimental" treatment BS that insurance companies try to do. Insurers who deny for cost control reasons get hammered in the courts. In fact medicare/medicaid have an even better mechanism to route out fraud. They can jail the medical provider for doing so. Your last claim about fees for collecting tolls is unrelated.
- bduerst 7y ago
  >government has strong incentives to deny claims to control costs Which is still less incentivization than what profit-maximizing insurance companies have. The nice thing about the government is they are completely open and transparent with what they will pay and for what, so disputes are much less common.

No, but government has strong incentives to deny claims to control costs. At least at the state level, governments have gotten extremely aggressive about money collection. E.g. $50 administrative fee for not paying a $4.00 toll.

codegeek 7y ago
Personally, I would go for ANY system right now other than what we have. I am too pissed off at how our healthcare system is. Single Payer may or may not have the same issues but I am ready to take my chances. Status quo is not good enough for me.
- pw 7y ago
  What problems have you had with the current system?
  - codegeek 7y ago
    Many problems. - Every visit to a doctor is a game of cat and mouse. I am never sure what bill to expect and how many bills to expect. - Price is always inflated due to the fact that insurance company has to make money on every visit to the doctor. - Every visit requires a Claim. Claims get filed incorrectly. Fun and games trying to call a bunch of different "departments" trying to understand the claim and why am I being charged ? - In network/out of network game. Ohh, I am sick and unconscious but I have to make sure that the person seeing me is "in network" so that I don't get a million dollar bill. Sorry, bad luck. While you were unconscious, we called a doctor who was "out of network" and not our problem. Have fun fighting wit the insurance company. - Why does every visit require me to show insurance ? I just wanna talk to my damn doctor. Can I not just give you some money directly ? - I visited the doctor. Doctor has to file a claim for $x while the insurance company only allows $y. So the doctor inflates the amount of initial claim knowing that they will be reduced anyway by the insurance company. Cat and mouse game continues and finally, poor me is left with a bill that I now have to figure out. Have I already paid enough (copay, deductible, out of pocket limit) ? Lucky me. - My employer changes my insurance company. Oh, I have to redo the entire paperwork with al my doctors. Ok I did it. Oops the doctor office still filed a claim with my previous company. I am now fighting to get that sorted.
    - Gibbon1 7y ago
      Two other problematic things. - Doctors have no idea how much anything costs. - Pricing has nothing/little to do with the actual cost of providing a service.
mochomocha 7y ago
How is that different from insurer incentives to deny coverage or to ask crazy copays because insured people can only switch plans once a year and select from a tiny menu of options that their employers have negotiated on their behalf with an oligopolistic industry? And do you honestly prefer the shady debt collectors industry to the current government money collection mechanisms ?!?
sjg007 7y ago
This is not a thing and if it ever became a thing it would be challenged in the courts. What is covered is all determined by the CMS and the medical associations. I would imagine some red states would try to do it. But to deny claims for cost control would be akin to the "experimental" treatment BS that insurance companies try to do. Insurers who deny for cost control reasons get hammered in the courts. In fact medicare/medicaid have an even better mechanism to route out fraud. They can jail the medical provider for doing so. Your last claim about fees for collecting tolls is unrelated.
bduerst 7y ago
>government has strong incentives to deny claims to control costs Which is still less incentivization than what profit-maximizing insurance companies have. The nice thing about the government is they are completely open and transparent with what they will pay and for what, so disputes are much less common.