wrote in message
...
Snip


You have shared just a bit of your challenges here. And I am not
being sarcastic... but just being able to understand the amount of
paperwork and levels of people to be dealt with in your situation make
you an expert in my opinion.

The health care system is a monster unto itself, no matter where you
are. At this point, I know more about M/M than I ever thought there
was to know. In the end, we still have to go to our extended care
provider for counseling on what to do to make sure the folks care is
covered. BUT... they cannot tell us what to do. They can only lay
out options. If the are caught coaching or counseling us, they can
lose the right to do business with M/M.

I have no idea what it would take to fix any of it. Personally, I
don't believe it can be fixed. I think it's too far gone.

Obviously, this is something that has been on my mind...

Robert


Robert, I think the answer is to eliminate the insurance industry from the
medical industry. Perhaps in San Antonio certainly in Houston there are TV
commercials paid for by particular "medical groups". These groups are most
often made up of select doctors, select clinics, select pharmacies, and
select hospitals. These groups DO NOT accept insurance and require you to
become a member of their group.

I never paid much attention to these commercials as they sounded like the
typical ambulance chaser attorney ad. Anyway 6 or 7 years ago I was
listening to a talk radio program that was focused on health care. A doctor
from one of these groups was the guest and they were taking listener phone
calls. The basic theme of the program that day was how to control and
afford health care. INSURANCE to the health care industry is similar to
the Labor Union and the Automobile business, they both costs through the
roof. Anyway you join the group for about $50-$75 per month for you whole
family and when you get sick you simply go to this "group". There is no
deductible or co-pay, you pay the full bill at the time of the procedure.
BUT the typical office visit is $15-$20, prescription drugs are a fraction
of the normal cost that you would normally pay if you did not have
insurance. Basically you pay a little more than an insurance co-pay but the
cost is till quite reasonable.

A listener phoned in to attest to how well these groups work out for his
family. His daughter was an up and coming tennis player, apparently she was
quite good. She injured her knee and had a persistent pain that would not
go away. They took her to their medical group and were told the bad news,
surgery would be needed, arthroscopic surgery. Long story short, $2800
later she was good to go. He indicated that he shopped around to get
competing prices from other doctors and hospitals for the same procedure and
with out insurance. IIRC the cost was going to be well in excess of
$18000.

Apparently these medical groups are doing well as I see more and more of
them in different fields, dentistry, family practice, eye care, etc,
advertising on TV more and more. From what the doctor indicated on the
radio show eliminating the insurance companies from the equation saves
everyone money. The doctors office does not need as many people to work the
paperwork to collect from insurance companies. Insurance claims are not
turned down because there are no insurance claims. Insurance rejections on
certain procedures are not turned down because there are no insurance
claims. There are no reductions of the amount paid for particular
procedures because there are no insurance claims. Cash flow is much better
as there is no longer a 2 -4 month wait for claims to be paid because there
is no insurance claim. These benefits all repeats themselves for the
pharmacies, and hospitals.
When the medical industry has to write off and spend billions to simply
deal with the insurance industry medical costs naturally go sky high.
With these medical groups you don't get treatment if you have no money so
non paying illegals crossing the border to have babies for free no longer
inflate the cost for medical care for the rest of us.

It used to work in the distant past, why not now? I suppose that the
typical citizen/ person working in the U.S. has come to expect to pay
nothing except a nothing or a small co-pay and let his employer foot the
bill for the insurance costs.