Shopsmith Forums

The worst thing that ever happened to healthcare was to let the insurance companies come between the patient and the doctor. I pay my insurance company what they say I have to pay them, my insurance company pays my doctor what they say they want to pay him. He has to consider what the insurance company will pay as part of his treatment.

The way I would reform it:
I think it the patient/insurance company relationship should be completely separate from the insurance company/doctor relationship. I should pay my insurance company my premiums. They maintain a list of how much they will pay for any procedure or medications. If I need a procedure, I file a claim with my insurance company. They pay me. I pay my doctor. If my doctor charges more than the insurance pays, then I pay the difference, negotiate a lower rate myself, find another doctor, or find another insurance company. If he charges less, then I pocket the difference.

heathicus wrote:The worst thing that ever happened to healthcare was to let the insurance companies come between the patient and the doctor. I pay my insurance company what they say I have to pay them, my insurance company pays my doctor what they say they want to pay him. He has to consider what the insurance company will pay as part of his treatment.

The way I would reform it:
I think it the patient/insurance company relationship should be completely separate from the insurance company/doctor relationship. I should pay my insurance company my premiums. They maintain a list of how much they will pay for any procedure or medications. If I need a procedure, I file a claim with my insurance company. They pay me. I pay my doctor. If my doctor charges more than the insurance pays, then I pay the difference, negotiate a lower rate myself, find another doctor, or find another insurance company. If he charges less, then I pocket the difference.

I remember when your method was the norm. I also remember that carriers had a far better procedure and were capable of negotiating a far lower fee schedule than individuals. I will never forget the shock on my wife face when she saw the difference between the amount due after the insurance company paid a surgery directly versus the old days when we tried to do our own agreements. I for one have no desire to return to the old arrangement.

From experience, your insurance company can deny any charges they deem not necessary, even though ordered by your doctor who has seen you on multiple visits, and the insurance board of directors has never met you. And, starting in the 1980's, if you did not get prior approval from your insurance company, an ER doctor could decide to admit you and your insurance can deny payment. All of it!

Also, with Medicare in play, who pays most of your hospitalization, insurance picks up a small portion. And, insurance wants you to use their contracted drug vendor, but I have found that taking my prescriptions to a local drug store where I pay less than through the contracted mail order. When my MS wife needed a wheelchair, the insurance board of directors denied her request. Wrote to my Representative, who just gave me a form letter and picked his nose. Wrote to my Senator and his staff went to work for me. After 6 months, got the chair. It's been a blessing to both of us. It's work for me, but is also a life saver since I am not able to carry her. And, yes, I have a government contracted insurance through Blue Cross/Blue Shield.

dusty wrote:...
This country needs what was promised four years ago - CHANGE.

What was promised was change FROM a Constitutional representative free republic, illegally.

We are getting that.

For those who hate the Constitution and America as much as obama, the choice is a simple one.

But imho this country needs an American president. The only thing close to that being offered is Not obama. Easy.

Hopefully the majority of us (We the People) will have figured out what we need before election day. Then, we have to hope that the electoral college doesn't screw things up.

It scares me to think that managing the vote in the swing states could over rule a majority vote.

dusty wrote:Hopefully the majority of us (We the People) will have figured out what we need before election day. Then, we have to hope that the electoral college doesn't screw things up.

It scares me to think that managing the vote in the swing states could over rule a majority vote.

I sure hope you're right about 'we the people'.
How could a country founded on the Declaration of Independence and the Revolution come to this? Contrast those brave and righteous people back then to the general voting population today (the embarrassing percentage that actually vote, that is). Unlike you, Dusty, most of them simply do not care. Think about it: obama thinks we have fifty seven states. We don't know where he got that idea because unlike 43 other presidents he has hidden and erased his public identification/records. And 'we the people' elected him!

keakap wrote:Think about it: obama thinks we have fifty seven states. We don't know where he got that idea because unlike 43 other presidents he has hidden and erased his public identification/records.

You're kidding, right?

davebodner wrote:You're kidding, right?

Not kidding. Actually what he said was that so far he had visited 57 states and still had one more to go. It's on a Youtube video but I don't remember which one.

BO says his father was a veteran.

http://www.youtube.com/watch?v=weQXr2UzUIE

It MAY be a slip of the tongue, but since my father WAS a veteran who served in WWII (on Iwo Jima), I take GREAT exception!

Is he just saying things to try and be popular and liked? Maybe, but if truth is the ultimate casualty of politics, shouldn't ethics have a guardian?

As I said in a different post. I don't trust either, but I trust Obama less.

Montana has term limits (I voted for them) and IMHO as someone who ran for state senate, they do not make things better.

The old hands in the state legislature would take new legislators and mentor them in how to negotiate and how to craft bills. Now the "freshly minted" think they know it all and have no clue about how to work with others or that compromise is useful. Chaos is a polite term for the beginning of each session (90 days every other year - so our legislators have to have full time real jobs to go back to).

If term limits were to come up again, I'm not certain if I would vote for them.

Both long term and short term have their benefits and draw backs.

My solutions-
1. Limit what a candidate can receive and spend in campaign contributions to one years base salary for the elected position (Now the US Supreme Court says that violates the Constitution? How I don't know but they do. Sure wish we could ask the founding fathers what they had in mind.)
2. Political parties and PACs may neither endorse nor denounce any candidate nor give any money until after the primary election. This eliminates negative campaign ads until after the primary.
3. Primary voting is an open ballot where any qualified voter can vote for any registered candidate, regardless of party affiliation. This should stop one party from voting for a candidate of the opposite party that they believe their candidate would have a more difficult time beating. Sort of like stuffing the ballot box against a candidate rather than for yours. Happens ALL the time.
4. Reduce the fees for running for office. You will get more people running for an office if they can afford the fee from their own budget rather than rely on others for donations. You will also have lots more choices so you can encourage people you believe would do a decent job to run. More candidates equals more choices.
5. A person can run under any political party affiliation without the endorsement of that party. Currently you have to have the blessings of the party powerful (those with the egos to try and run the party) to run. If your views don't match then you don't run (sort of). Just because those that are currently in charge of the party does not mean that their views are those of the majority of the party. Yes, this may cause more chaos, but I believe it's those that are in charge of the party that are causing the most grief for everyone else.
AND this allows you to run under your own party platform. The Dusty Party whose motto is "brush the dust off your brain and vote for Dusty!!"

I think that these will also reduce the power of the two party control system.

Just my thoughts,

Ben