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Saturday, August 29, 2009

Health Care Public Vs Private

RALEIGH, NC - JULY 29:   President Barack Obam...Image by Getty Images via Daylife

From the Hoss's Mouth

Why does health care cost so much? Forget all you hear about the high cost of developing new equipment and drugs, over-utilization, increased salaries for health care professionals, and an aging population. Money Magazine Hoss can give you the answer for the high cost of health care in one word: GREED.

Greed by health insurance companies who are in the business for the sole purpose of generating a profit. They could care less about providing affordable health care insurance for companies and individuals.

How does Money Magazine Hoss come to this conclusion? He does so by reading private for profit insurance horror stories posted all over the Internet and by reading private insurance whistle blower testimony given before Congress.

Health insurance companies are notorious for denying valid claims, using excuses such as claimant had a pre-existing condition, claimant provided false information on their application form (even if it was an honest mistake). Testimony before Congress indicated for-profit insurance companies employ the following strategies:

  • Regular meetings to identify high cost areas and how to redesign benefits to control them.
  • Multiple exclusion clauses which are unknown to doctor or patient until used by the insurance company to deny a claim.
  • Pre-existing condition exclusions which enable the plan to take steps to link a patient’s current diagnosis with some prior diagnosis and thus deny the claim
  • Misleading advertising which only highlights the benefits of the plan with no mention of the plans restrictions.
  • Denials on the grounds the treatment is not medically necessary--this is the insurance companies' ultimate cost control tool.
The above examples are by no means a complete list of all the methods used by insurance companies to reduce their costs.

For more info, see the testimony of LINDA PEENO, M.D.

Perhaps the most disturbing tactic Money Magazine Hoss has come across is when a terminally ill patient’s health care claim is denied. The health insurance company knows full well that the claimant will die before s/he can process an appeal, and thus they avoid paying for any treatment prior to death. Of course they always claim they had legitimate reasons for denying the claim.

Money Magazine Hoss resides in Canada, and we have a public health care system which, although not perfect, does take the profit incentive out of health care. The premiums are minimal and provisions are made for those with no or very little income. We do experience some delays but emergency cases are given priority.

Money Magazine Hoss supports President Obama’s public health care option, in fact he would like to see health care totally removed from for-profit companies.

Stay on Track,

Money Magazine Hoss

Next Hoss Cents Free Financial Money Magazine Post: September 06, 2009
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