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> in
> | > | > message
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> | > | > | > | > | > | >
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> | > | > | > | > | > | >
> news:RtednZ6SwuULMZjanZ2dnUVZ_sKqnZ2d@comcast.com...
> | > | > | > | > | > | > |
> | > | > | > | > | > | > | "David Moffitt" stompingweasels.org>
> wrote
> | > in
> | > | > | > message
> | > | > | > | > | > | > | >
> | > | > | > | > | > | > | > Walk into any emergency room tonight and see
> who
> | > is
> | > | > | > sitting
> | > | > | > | > there
> | > | > | > | > | > | > waiting
> | > | > | > | > | > | > | > to
> | > | > | > | > | > | > | > be seen. Who do you think is picking up the
> tab
> | > for
> | > | > the
> | > | > | > | > healthcare
> | > | > | > | > | > of
> | > | > | > | > | > | > all
> | > | > | > | > | > | > | > of
> | > | > | > | > | > | > | > the illegals you sitting there? You are. They
> are
> | > well
> | > | > | > aware
> | > | > | > | > that
> | > | > | > | > | > they
> | > | > | > | > | > | > | > will
> | > | > | > | > | > | > | > get their healthcare free. (to them)
> | > | > | > | > | > | > | >
> | > | > | > | > | > | > |
> | > | > | > | > | > | > | And you know what?
> | > | > | > | > | > | >
> | > | > | > | > | > | > I worked in healthcare. And you know what about it
> | > beyong
> | > | > | > | > kneejerking?
> | > | > | > | > | > | >
> | > | > | > | > | > |
> | > | > | > | > | > | Too many years covering health issues as a reporter
> and
> | > way
> | > | > too
> | > | > | > many
> | > | > | > | > | > years
> | > | > | > | > | > | working in and around the health insurance industry.
> | > | > | > | > | >
> | > | > | > | > | > I sold insurance before going to college and getting
> an
> | > honest
> | > | > | > | > vocation.
> | > | > | > | > | >
> | > | > | > | > |
> | > | > | > | > | Yet, these are the people who are currently in charge of
> | > health
> | > | > | > care,
> | > | > | > | > and
> | > | > | > | > | apparently the people many would like to see remain in
> | > charge
> | > of
> | > | > | > health
> | > | > | > | > | care.
> | > | > | > | > |
> | > | > | > | > | Curious, that.
> | > | > | > | >
> | > | > | > | > I don't like it either. You want to just change the
> | > controller.
> | > | > | > | >
> | > | > | > |
> | > | > | > | And you apparenty don't.
> | > | > | >
> | > | > | > Not to federal government control. They cannot run the VA
> Hospital
> | > | > system
> | > | > | > much less all of healthcare.
> | > | > | >
> | > | > |
> | > | > | Then, who? What you have now is effectively the same thing, and
> it
> | > just
> | > | > | might be easier (stress might) to effect pressure on lawmakers
> with
> | > some
> | > | > | semblance of federal control. Number one, the insurance
> companies
> | > are
> | > | > still
> | > | > | gonna be mostly in control, but as we've all seen they're now
> | > totally
> | > in
> | > | > | control and effecting every single bugaboo the opponents of any
> kind
> | > of
> | > | > | national insurance plan, system or whatever you want to call it,
> | > | > virtually
> | > | > | without oversight from anybody.
> | > | >
> | > | > There is a tremendous amount of federal oversight now. The federal
> | > | > government controls when and where you can open a hospital and how
> | > many
> | > | > beds
> | > | > it can contain.
> | > | >
> | > |
> | > | Yet, they've done diddly squat to force carriers to live up to the
> | > policies
> | > | they sell. Matter of fact, they've relaxed regulation to the point
> that
> | > even
> | > | many business leaders are starting to call for some semblance of
> | > regulation
> | > | again.
> | > |
> | > | > |
> | > | > | Ya really think the free market has any impact there? Not with
> the
> | > | > insurance
> | > | > | giants holding their fingers in both ears and crying, "We can't
> hear
> | > | > | youuuuuu!"
> | > | > |
> | > | > | They've effectively convinced even the providers that the whole
> | > problem
> | > | > is
> | > | > | all those sick people just overusing the resource.
> | > | > |
> | > | > | Take your pick... it's gonna either be increased federal
> regulation
> | > or
> | > | > still
> | > | > | more control by an industry that has shown clearly that it cares
> | > | > absolutely
> | > | > | nothing about its policy holders.
> | > | >
> | > | > There is no easy answer but having the federal government in total
> | > control
> | > | > is not the answer.
> | > | >
> | > |
> | > | I've never said it was. What I have specifically said is that the
> | > current
> | > | system is broken, and I don't see any evidence that any leg of the
> | > current
> | > | system is listening to much of anybody. Mostly, they're all just
> | > lobbying
> | > to
> | > | protect their own particular turf.
> | >
> | > SOP for everone.
> | >
> |
> | Sure, but not everyone has the lobby resources of the hospitals,
> insurance
> | carriers, pharmaceuticals and the AMA.
>
> Discounting unions of course.
>

> |
> | > |
> | > | > |
> | > | > | Hell, the pharmaceuticals (hardly known for their altruism) and
> | > Wal-Mart
> | > | > | (along with a few other pharmacies) are doing far more to help
> | > control
> | > | > | medical costs than the insurance carriers, hospitals and
> doctors,
> | > and
> | > | > | they're NOT doing it by just yelling, "Deny! Deny! Deny!"
> | > | > |
> | > | > | What you have is a system that is broken, and it's not likely to
> | > ever
> | > be
> | > | > | fixed by allowing it to police itself.
> | > | > |
> | > | > | What level of public (as in government if you prefer) is
> required,
> I
> | > | > have
> | > | > no
> | > | > | idea, but continuing to allow the fox to guard the henhouse is
> | > nothing
> | > | > more
> | > | > | than and admission that Richard Nixon was right when he said how
> | > much
> | > he
> | > | > | loved managed care plans which increased profit by giving less
> care.
> | > | >
> | > | > Managed healthcare has saved the consumer a lot of money. Would
> you
> | > like
> | > | > an
> | > | > example?
> | > | >
> | > |
> | > | Oh, I can give you hundreds of examples of how it's saved insurance
> | > | carriers, perhaps, billions. Here's one. In a work-related injury,
> even
> | > a
> | > | pre-existing condition is compensable IF it exacerbates that
> | > pre-existing
> | > | condition. Yet, carriers are getting away with calling those
> instances
> | > | age-related and simply denying the claim. Under current Tennessee
> law,
> | > | that's about the end of the line.
> | >
> | > Not really. I sued--- won--- and now retired. They said my knee
> problem
> | > was
> | > a pre-existing condition that was exacerbated. There was one problem
> with
> | > their position---- They were the insurer with the first injury to my
> knee
> | > also.
> | >
> |
> | How long ago.
>
> March 27, 2007
>
>
> Not at all likely to happen in Tennessee today.
>
> Nashville Tn. 37215
>
> Today, their
> | being the insurer in your first knee injury will likely be considered
> | grounds to deny on a pre-existing condition.
>
> Didn't work.
>

> |
> | Look, I went through this, though I fought teeth and nail. In a recent
> wreck
> | (I was a passenger) that was work-related, I banged a knee on the
> dashboard.
> | My boss made me go to a doc-in-the-box to get checked out. Well, I knew
> what
> | was going to happen. And, it did. The entire exam consisted of forty
> five
> | minutes of filling out paperwork and killing time, and precisely
> thirteen
> | seconds of the "doctor" squeezing my knee and telling me I was fine and
> | dandy.
> |
> | He even admitted to watching me from behind a one-way mirror, and
> further
> | admitted he watched ALL his workers' comp patients in that fashion.
> |
> | Further, I decided later when the knee started hurting seriously to at
> least
> | get my orthopedist to check it out a little further. Two calls to the
> | carrier to secure a referral, and to this date, three years later, I
> have
> | not yet heard from them.
>
> What Doc in the box did you go to? Did you get an MRI on the knee? You did
> have the option of seeing your primary physician for your initial care.
> Many
> people aren't aware because your company wants the cheaper Doc in a box
> they
> have contracted with.
>

> |
> | I even informed my boss of that little fact, and neither my supervisor
> nor
> | our branch manager could have cared less.
> |
> | > And it's not much of a line to begin with.
> | > | You, the injured worker, have essentially no say in what kind of
> health
> | > | care, if any, you get after being hurt. Those decisions are entirely
> up
> | > to
> | > | your employer and their insurance carrier.
> | >
> | > Not really. Lawyers love cases like that. they even advertise it on
> TV.
> | >
> |
> | Yes. I've seen the commercials. I've also read recent Tennessee law, and
> the
> | amounts they can hope to collect are miniscule compared to what they
> were
> | even three or four years ago.
> |
> | Trust me on this... you have no choice today if you're injured on the
> job.
>
> I did. Maybe you lacked the knowledge how to squeak the right way.
>

> | The doctors are presented to you in a panel of usually three, and those
> are
> | the ONLY doctors your workers' comp carrier will even consider paying
> for.
>
> True. I recommend TOA of orthopaedic problems.
>
> |
> | The one good thing is you can opt out of the system and actually get
> better
> | care and better payment going through your private insurance.
> |
> | > |
> | > | In one case here, a guy was treated with nothing but physical
> therapy
> | > for
> | > a
> | > | torn rotator cuff, only to be told after that year that HE had
> waited
> | > too
> | > | long and there was nothing they could do for him. He was released
> from
> | > care
> | > | and his employer immediately fired him..
> | >
> | > Yep! I'm collecting from an employer right now for that very thing.
> When
> I
> | > was 22 I got 4 ribs broken welding on some of those Apts you see on
> Due
> | > West
> | > that back up to I65. The doctor returned me to work for light duty and
> my
> | > employer laid me off. After contacting my lawyer I collected my pay
> for
> 6
> | > months until my ribs were completely healed. Lawyers love cases like
> that.
> | > they even advertise it on TV.
> | >
> |
> | When you were 22. The case I cited occured less than five years ago, and
> | it's what current Tennessee law (and most other states for that matter)
> | allow.
>
> My last one was in March.
> |
> | The days of a workers' comp injury resulting in a lifelong gravy train
> are
> | over, even in completely legitimate cases. I could cite you fifteen or
> | twenty cases where a person is totally disabled and the carrier is still
> | coming back, looking for ways to pay for less and less care.
>
> That's typical business for any company.
>
> |
> | > |
> | > | Yes, I'm quite aware of what "managed care" has come to mean all too
> | > often.
> | >
> | > Managed care also prevent hospitals from running un-necessary tests.
> In
> | > the
> | > 80's a person over the age of 50 going into the hospital got a full
> blood
> | > profile, an upper GI study, gallbladder and a barium enema. When I
> worked
> | > in
> | > the hospital in the early 80's we has an elderly man come in who had
> fell
> | > on
> | > some ice outside his home. He substained a partial fracture of his
> right
> | > elbow and was to be kept overnight for observation. He got out of the
> | > hospital 3 weeks later without his gallbladder. He never had a problem
> | > with
> | > it but his scan showed he had stones. I've got a whole stack of
> examples
> I
> | > saw over the years. Are you aware that the government healthcare
> system
> | > called Medicare is managed care?
> | >
> |
> | Yes, I'm well aware of that as well. It's another one of those promises
> to
> | veterans that has never been kept. Actually, there's a very good
> military
> | retiree program called CHAMPUS, but the day you become eligible for
> | Medicare, you get kicked off.
>
> Correct.
>
> |
> | And, of course, managed care can be most beneficial, especially in
> avoiding
> | unnecessary tests. Unfortunately, it's also become most beneficial in
> | helping carriers avoid paying for completely necessary tests, and to
> deny
> | coverage because you're simply "too old" to waste the resource on.
>
> That is a commonly occurs in socialized medicine. People are found to be
> too
> old for dialysis and it is withdrawn.
>

> |
> | >
> | >
> | > |
> | > | > |
> | > | > | And the folks who continue to oppose national health care
> because
> | > they
> | > | > fear
> | > | > | not being able to choose the doctor they want really need to
> read
> | > their
> | > | > | policies. It's entirely possible right now that this will happen
> to
> | > you,
> | > | > | even with a doctor you've spent years doing business with.
> | > | > |
> | > | > | Frankly, I'd be satisfied with legislation that simply requires
> | > | > insurance
> | > | > | carriers to live by the words in their policies. I'd even allow
> them
> | > to
> | > | > | continue to write those policies in the impossibly convoluted
> | > legalese
> | > | > they
> | > | > | have employed for years. There are lawyers who can read that
> crap
> | > and
> | > | > will
> | > | > | gladly oppose them in court that already know how to beat them
> at
> | > their
> | > | > own
> | > | > | game.
> | > | > |
> | > | > | Of course, much of our governmental effort these past several
> years
> | > has
> | > | > been
> | > | > | to pass legislation limiting your ability to fight your carrier,
> | > even
> | > | > when
> | > | > | it can be proven beyond even a shadow of doubt, never mind the
> legal
> | > | > terms,
> | > | > | "preponderance of the evidence" or "reasonable doubt," that
> either
> | > the
> | > | > | carrier, the doctor, the hospital or some combination screwed
> the
> | > pooch.
> | > | > |
> | > | > | And even the "get something for nothing" argument has now
> carried
> | > over
> | > | > to
> | > | > | patients expecting their policies to cover what they say they'll
> | > cover,
> | > | > so
> | > | > | I'm guessing the current plan is to pay your premiums and never
> mind
> | > | > getting
> | > | > | anything paid for, as stipulated in the policy, at all.
> | > | > |
> | > | > | Why would one NOT want to change that controller?
> | > | >
> | > | > I'll make it simple: Under the current system if the hospital or
> | > doctor
> | > | > makes a mistake can you sue them? Yes. Your insurance company will
> | > even
> | > | > supply a lawyer. Under the current system if the VA hospital or
> doctor
> | > | > makes
> | > | > a mistake can you sue them? No. Do you really want to lower
> healthcare
> | > | > costs? Push for tort reforms. (the lawyer lobby will not hear of
> it)
> | > | >
> | > |
> | > | Yet, there was a recent court ruling that held punitive damages
> could
> | > not
> | > be
> | > | used to punish a company that had been found liable in a particular
> | > claim.
> | >
> | > Do you mean the lady that was paid just 6 million last week or the one
> who
> | > collected millions from McDonalds because she was stupid enough to try
> and
> | > hold a hot cop of coffee with her crotch and drive?
> | >
> |
> | No. This one was from a hurricane case. But, interesting that you bring
> up
> | the Mickey D's lady. Are you aware that she was simply one of 800
> potential
> | plaintiffs in that particular case? Or, that the customers of that
> | particular Mickey D's had been complaining about the temperature of that
> | coffee for quite some time before taking their complaints to the Health
> | Department, who measured the temperature at just under 200 degrees at
> time
> | of serving.
>
> Gosh and just think coffee is made by boiling water.
> |

> | That particular Mickey D's refused requests of even their customers, so
> that
> | lawsuit was about the only recourse left, and the lady that so many have
> had
> | so much fun with over the years got third degree scald burns in her
> crotch!
>
> People also complain that their coffee is too cold. Holding a cup of
> coffee
> in your crotch is stupid any way you look at it.
>

>
> |
> | > |
> | > | Say what?
> | > |
> | > | The abuses of tort law abound, but tort reform that severely limits
> an
> | > | injured party's ability to collect damages is like using a sixteen
> pound
> | > | sledge as a tack hammer.
> | >
> | > I'm talking about limiting what you can sue for. Ok a sterilized
> mouse
> in
> | > a
> | > can of green beans is gross but shouldn't be worth 10 millon to the
> person
> | > who found it.
> | >
> |
> | And for every case where a ridiculous sum of money is litigated, another
> | several hundred very similar cases are flat thrown out of court. And,
> many
> | of the settlements are made simply because the corporation doesn't want
> to
> | be bothered with fighting the battle.
>
> Lawyers depend on it.
>
> |
> | A much better method of limiting frivilous lawsuits, IMHO, would be
> | legislation that allows a counter-suit on those grounds. If you, the
> | original plaintiff, lose, you not only lose your lawsuit, but you get to
> pay
> | the corporation's legal bills.
>
> Give the man a cigar!
>

> |
> | Might even include the plaintiff's lawyer in there too while you're at
> it,
> | and with that consideration, the number of just flat-out ridiculous
> lawsuits
> | would disappear overnight without limiting anybody's right to sue at
> all.
> |
> | If ya wanna take up the court's time, you best bring a good case, or it
> | might wind up costing you big time.
> |
> | >
> | > |
> | > | As you noted in another post, the simplest way to avoid a long wait
> in
> | > the
> | > | ER for a dog bite is to avoid getting bitten by a dog. Same could be
> | > said
> | > | for the docs, hospitals and pharmacies that get sued over and over
> and
> | > over
> | > | and over, and lose more often than not, driving up the cost of
> insurance
> | > for
> | > | docs that are doing business in a forthright and professional
> manner.
> | >
> | > Go and try and find an OB doctor. There are very few. Why? Because
> people
> | > sue them daily if little Suzy is born with a hangnail.
> | >
> |
> | Oh yes, I've heard all the crodocile tear stories. I also know several
> | OB/GYNS still in thriving practices, in spite of the high cost of
> | malpractice insurance, who don't get sued at all.
>
> Ask them what their fee is and what their malpractice insurance is.
>
> |
> | > |
> | > | Wanna avoid a lawsuit? Don't screw up and leave crap behind in a
> | > surgical
> | > | wound.
> | >
> | > True.
> | >
> | > Don't give a patient the wrong drugs, causing her skin to slough off
> | > | and ending in her death (a fairly recent Nashville case).
> | >
> | > Yep that was a nasty one. Hidden allergies can be nasty. Medical
> people
> | > are
> | > human also and all humans make mistakes. Our mistakes are more messy
> and
> | > mean deep pockets.
> | >
> |
> | But, this one wasn't hidden. If memory serves, the drug in question was
> | Sulfa, and her doctor knew about it. Her pharmacy, Walgreens, knew about
> it,
> | and apparently none of them bothered to check their lists and by the
> time
> | she knew what was going on it was way past too late.
>
> Sad case. That one deserved a law suit. Personally I wouldn't have taken
> the
> medicine. I've been prescribed the wrong medicines myself and refused to
> take them. Being informed never hurts.
>