[GREENBACK]

Originally Posted by EEinNJ

Snafu, your last example is the kind of thing insurance companies are getting away with, financially screwing sick people. Yet so many people are blind to this and argue against anything being done about it because they've been frightened into believing that it would be "Socialism" or "Nationalized HealthCare"

I work for a very small company with Cigna health insurance. My boss was treated for prostate cancer last year. He obtained the necessary precertifications and was told the codes to list, etc. After his surgery, they refused to cover $9000 in charges. Eventually the doctor settled for a lower amount, and he ended up paying $3000. Then, even though it is illegal in NJ, our group rate went up 40%. I ended up with a lesser plan because the company could not afford it.

My first wife had breast cancer, at the time I worked for J & J and had very good insurance. Generally everything was handled ok, but I learned a little bit about how hospital billing works. Hospitals bundle claims together, submit to insurance company, they kick out some, settle for lesser amounts, then they come after the patient. The patient has to fight to get the coverage they are paying for. I spent several months getting claims covered, and a year after she died, a collections agency was still trying to get payment on an MRI bill that was incorrectly denied.

Knowing government bureaucracy, I don't know if they can do any better, but the insurance system must be fixed. To me it's not a health care issue, it's a consumer issue.

I am familiar with gov't bureacracy. I guarantee the mess we have will be tripled with their intervention. Insurance companies need to be reigned in but that needs to be the extent of it. It's somewhat dangerous to look at other systems and say that we could just plug that in here and everything will be fine. Lot's of dynamics to consider.