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by sportsTAKES 5604 days ago
I find it absolutely impossible to believe that her coverage was denied for the reasons she described - I have been approved for and paid for my own insurance for years (including my family's insurance) with medical issues far more serious than those.

I concede that the system is totally messed up and the new health care bill makes it even worse.

Employers shouldn't be required to provide health benefits - eliminate the necessity of group plans.

Open up the state lines, allow insurance companies to compete for your business and watch prices drop dramatically. I'm certainly in favor of some basic oversight but not the egregiously burdensome regulation of the current system.

Anecdotally speaking, I have several friends, colleagues and family from various backgrounds that are doctors and nurses in different states and I have yet to find one of them that agrees the new health care bill is a good idea. They all think it dramatically complicate how they treat patients and ultimately marginalize the overall quality of care they will be able to provide. (Again, this is anecdotal but has definitely influenced my opinion. I have been shocked to find out that not one of these people I know actually support the new bill. Having said that, I know there are those that agree with the new bill.)

2 comments

Your success in getting private health insurance may be due to the fact that you have "been approved for and paid for my own insurance for years". Bear in mind that the OP had group health insurance through her employer, and then tried to get private health insurance. I had much the same experience with minor things from the time I had group insurance being considered "pre-existing conditions" and justifying a denial of coverage.

After many long hours of paperwork and going through the appeal process (including getting letters from doctors certifying that my minor ailments were unlikely to require expensive surgery) I now have private health insurance. I never would have imagined it would be this hard.

To clarify, I have been approved for private insurance at different times (three times actually) over roughly twelve years with intermittent times of receiving benefits from employers - I have worked off and on as an independent contractor during that time.
Funny. I have plenty of family and friends in the medical field (doctors, nurses, and hospital administrators), and I have yet to find one who believes the health care bill is a bad idea. In fact, most of them agree that its long overdue.

You know what they love most about the bill? It would prevent insurers from dropping coverage. Insurer-instigated billing disputes are the biggest obstacles to health service provider getting paid.

Also, allowing insurance companies to sell across state lines without adhering to the laws of the states in which they are selling coverage violates states rights to control insurance coverage within the state. Insurers can already sell across state lines; the only impediment is that they adhere to the laws of each state.

It doesn't surprise me that your friends and family differ in opinion (I have been surprised to not find one in my circle that supports the bill).

That said, one family member in particular is a nurse practicioner at a major trauma center. Her primary concern is not the billing disputes as much as the actual quality of care. She feels that her hospital is already inundated with somewhat reckless medicaid requests. She believes that 60% of medicaid patients at her hospital seek medical care that they don't need (e.g., person has a basic headache that some rest or an aspirin would surely cure but instead they actually seek professional medical attention). If that visit were to come at a slightly greater cost, there is no way that person would go to an emergency room for a headache.

It sounds like a dramatic example but she says crazy incidents like this happens every single day, w/o fail. So much so that they track and keep a monthly log that helps them measure their performance. As such, the hospital's resources are strained and their ability to treat seriously ill or injured patients is somewhat compromised. So I think the concern on her part is that the new health care bill actually exacerbates this problem.

I understand that selling across state lines could violate states rights. At the same time, it's too bad that many (myself included) wouldn't trust the fed to be in charge of interstate oversight. In reality, it might be better to have one consolidated standard of mandates but I just can't imagine fed efficiently and accurately providing that type of oversight.