Thursday, May 21, 2009

Insurance companies want you to die

Ok, so the title may be a tad much, but think about it.....if you're dead they don't have to pay anything for you anymore. What also leads me to believe that they want you to die are statements like this, found on the Medicare website:
"Under the Medicare program, chiropractic maintenance therapy is not considered to be medically reasonable or necessary, and is therefore not payable. Maintenance therapy is defined as a treatment plan that seeks to prevent disease, promote health, and prolong and enhance the quality of life; or therapy that is performed to maintain or prevent deterioration of a chronic condition."

You're probably thinking, "But April, not getting chiropractic maintenance therapy isn't going to KILL someone." And you're right. However, his statement isn't limited to chiropractic care. They will not cover maintenance services across the board. They'd rather wait for you to get sick or injured before they'll pay for anything.

And let's look at that statement. Medicare is saying that it's not medically reasonable to prevent disease, promote health, and enhance the quality of your life. I've worked for many reputable physicians who would highly disagree.

Most of you reading this do not have Medicare and you may think that your health insurance isn't like that. Think again. Read the fine print. Most insurance companies base their plans on Medicare guidelines. Why? Because Medicare has a very strict set of guidelines of what they will and won't pay for. The more guidelines, the less money they have to pay out. And that's what it comes down to, money. The less they'll pay for, the more money they have. The more money they have, the less you'll go to the doctor. The less you go to the doctor, the more time you go by not knowing if something bad is going on inside your body. The more time that goes by without knowing is something bad is going on inside your body, the less your chances are of surviving.

This is one of the biggest reasons why universal health care scares the shit out of me. Medicare is a government owned entity. If the government creates this universal health plan, putting us even more into debt, they'll certainly make those strict guidelines even more strict. If they decide to tax employers and employees who choose to keep their private insurance rather than go with universal, then private companies are going to have to put the squeeze on their guidelines too.

I can see it now, the only way they'll pay for anything is if you're gushing blood at a pint per minute, have bones visibly protruding from your body, or you're foaming from the mouth.

Deep Throat of the Day: I still can get over how it's not medically reasonable to promote health. Fucking idiots!


Bunnylord said...

I don't find the thought of universal healthcare automatically scary. My company provides insurance through various insurance companies, and it's bad because they switch carriers and coverage frequently. Sometimes you can go to the doctor only to realize a) a new company covers you, b) nobody has told you or them who it is, and c) once you find out, it may be a plan they don't accept.

Some countries have shown that socialized medicine can work well, if the government regulates it as a non-profit industry. Our country chose to do the opposite with HMO's - give them government funding and then let them run themselves for profit. Like you said, it's generally cheaper to let people die.

Anonymous said...

Anyone who thinks socialized medicine can or will work can not read and surely have never ever studied it. It works NOWHERE. Every rich person in every country that has socialized medicine comes to america for serious care.

There is little going on right now that doesn't scare the hell out of me. But then I can read.

Kira said...

Actually, Southern Sage is wrong--I've personally seen socialized medicine work in France. Not so much in England or Canada (friends and family there have shown that to be the case), but in France it works. Why? They still make you pay a copay, just like any other private ins. co. does, and I think that discourages random "I'm going to the ER because my tummy hurts" visits. The French system has been ranked as high as the fourth best health care system in the world...and they even offer house calls. Since I was raised in a very Republican family, nobody could have had the shit shocked out of her more than myself to find out that something like universal health care could work.

Now, that being said, their program is going to suffer just like our social security system, etc. now that the baby boomers are retiring (fewer doctors to take care of aging public plus more money needed to take care of aging public). I don't forsee it staying where it is in another decade. But it HAS worked for several decades before this critical juncture. So, I know it's possible. Doesn't mean I'm advocating *MY* gov't doing it, though. I have no faith that we'll manage to do it right. That's another issue entirely....

DDgirl said...

Hehe I have lived in Switzerland, in the UK, in France and Italy.
I only needed medical assistance in France and Italy, and most times I was really satisfied with everything.

Socialized medicine is great, because you know you'll always have it, even if you lose your job and then need expensive treatments like chemo.

Of course, it's hard to set up the perfect system.... but still having universal health care feels great!

April said...

Everyone: I should've written that I think the idea of universal health care is GREAT! But the idea of universal health care ran by OUR Federal Government is what scares the shit out of me. Corruption is what I see. Someone is going to have to make money, because that's just the way this works. Not only that, but like I said, if you look at the insurance companies that ARE ran by the Federal Government (ie Medicare & Medicaid) and all the things that they DON'T pay for, I can only imagine how much more they won't pay for if it goes universal. The cost of starting a universal program is going to put our country in a HUGE debt for decades. Someone's going to have to pay for it..........

Maine said...

Socialized medicine works if it's supplemented by a robust private healthcare system. The one they have in India is a decent example. And really... whether it's socialized or not is less of an issue than whether or not it's properly managed. We'll see.

But to your point? Preventative health care?

It doesn't exist because the benefits are long term. And the people that are hired to write policy are judged short term. They have to show positive results on a balance sheet today or lose their jobs tomorrow. If they had ten year contracts or some amount of security, you'd see more long term health care strategies. That's the same reason you rarely see long term solutions out of politicians, network executives... anyone. We're judged immediately.

R said...

I'm sick and tired of the Conservative mantra that the USA has the best health care system on the planet. How are these jackasses measuring "best"? By any objetive measurement, we suck.

10 Seconds of research:

USA: 45th in Life Expectancy

The USA has an infant mortality rate of 5 per 1,000, the same as Poland, Hungary, Slovakia and Malta. Of 33 developed countries, America is just above Latvia, the bottom of the group.

There are 27 other countries that exceed the United States in healthy life expectancy, including Australia, Greece, United Kingdom, Italy, Germany and France.

The U.S. health care system ranks last compared with five other nations on measures of quality, access, efficiency, equity, and outcomes, in the third edition of a Commonwealth Fund report analyzing international health policy surveys.

The United States is 23 points behind five leading economic competitors: Canada, Japan, Germany, the United Kingdom and France. The five nations cover all their citizens, and though their systems differ, in each country the government plays a much larger role than in the U.S.


Let's get real, folks.

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Judy B said...

Oh great, of all times not to be able to interpret Chinese!!!