"dpb" wrote in message ...
Leon wrote:


They might; then again they may not. Most likely the selection criteria
were made when you were enrolled in the group. What if you had been 70+
and in need of serious heart care when first applied? Think you'd still
have been accepted?

It would really be a waste of time to simply speculate how something would
work with out actually getting the details.

Given that comment, there would be no screening necessary, remember you do
actually pay for treatment. The cost would be less than "normal" because
there would be no losses caused by non-payment, slow to pay, or reduction of
item costs by an insurance company.


I'd wager it's the latter--every one of those groups I've ever seen have
very selective membership criteria.

Have you seen them all?

Of course not--but I've seen enough to have a pretty good understanding of
their business model.

It does not sound that way to me.


It's quite selective, not universal.

Why would that be, you are obligated to pay for any and all procedures.
They are not selling or operating like an insurance company. They are
simply charging what they consider a fair and profitable amount less the
huge cut that the insurance company gets. Think about insurance companies
as being something limilar to a labor union. While all car companies except
Honda and Subaru are hurting in the US, the big 3 are mostly hurting because
of the burdon that most all other car companies have been able to avoid.
Today's union literally brings nothing more to the customer than the
Japanese do.



I don't understand the 30% example--typically insurance carriers are
covering 80% or "standard and normal" for any particular procedure.

I see my medical bills and what portion that is actually paid by the
insurance companies. Often the insurance companies cut up to 90% off and
often will not cover a procedure. The doctor writes that off, I don't
get billed for the difference.

...
That's doctor's choice then--I've seen some that do, some that pass the
cost on and some that are in between. Some carriers have contracts that
say what is/isn't passable; some physicians choose not to accept patients
with those carriers.

The fact remains, the costs are inflated to make up for Insurance loss
costs.

What we have now is not working and is soon to break down, lets not crap on
new ideas. Can't never could do anything.