On 12-14-2013, 06:18, Robert Green wrote:
face. It's very difficult to determine what coverage you'll need
without knowing what medical maladies you're likely to face.

There are none that I'm "likely to face." I know what my
preventive/maintenance care cost last year and the cost of
treating the maladies I do happen to have. I base my decisions
on that, not on the umpteen hundred conditions that I might get, none of
which anyone is "likely" to have. (Defining "likely" as a probability
of more than twenty percent.)

still interested in whether you believe the US health care system resembles
anything like the textbook definition of a "free market."

It was closer to it before the government got involved.

The ACA *should* have been an extension of Medicare, not the fiasco that

Medicare and Medicaid pay LESS than our costs. The commercials pay
enough over to compensate. Move enough people off of commercials and
onto a government system, and see how many providers decide to find a
new career.

it's turned into. I know a lot of doctors and not one of them is happy with
the amount of extra work that dealing with a plethora of private insurers
AND Medicare/Medicaid requires. A recent article I read said that

Yes, it's hard for small outfits, but it's routine for a large one.
They're not as different as you seem to think. The "Explanation Of
Benefits" that individuals get in a zillion different formats is a
single nearly identical electronic format for us (the providers) from
almost all companies.

system that requires a dedicated employee to plow through the endless (and
different) paperwork of dozens of insurers possibly be efficient?

It's maybe five percent paperwork. A law called HIPAA forces most
payers and providers to use standardized alectronic formats, and there
are so many software packages that read those formats that anyone who
tries to sell one that doesn't will not succeed.

very minor) additional fees and co-pays? I'll be sure to try to use it in
the future even if it means using ten words where two will do. Will

Define your terms as you use them, and ignore the people who pretend not
to understand.

Also, for my edification, give us some feedback on my main proposition: that
the US health care system cannot be considered a free market for the simple
reason that the prices of the product are unknown until after they are
consumed and vary wildly depending on who is actually footing the bill - the
uninsured, private insurers, Medicare, Tricare, etc. I don't think it's a

Again, if you want to know our cost for a procedure, all you have to do
is ask. And if you want to know how much your insurance will cover,
we'll tell you that, too--and thanks to HIPAA and X12N, it usually takes
about five minutes to do so.

AND, we know without even asking what they won't cover, and if we don't
know, we assume they MIGHT not. We explain that to the patient and if
they want to do it anyway, they sign a form acknowledging that we
explained it and that they chose to do it anyway.

--
Wes Groleau

Pat's Polemics
http://Ideas.Lang-Learn.us/barrett