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Politics : Formerly About Advanced Micro Devices -- Ignore unavailable to you. Want to Upgrade?

To: puborectalis who wrote (737868)	9/8/2013 12:37:20 AM
From: i-node	Respond to of 1578921

>> If you only knew how health insurers have saved a ton of money denying payment for many procedures and tests that doctors have ordered and need....e.g.PET scans. .... Cancer surgeons I know fight every day for tests they deem necessary in the care of patients with cancer.Have you checked the latest profit reports from the major health providers? I'm quite sure I'm more familiar with physician payments than you are. I would also point out that the reason Medicare is so rife with waste, fraud and abuse (100s of billions, annually) while private insurance is not, is that private insurers ask questions and Medicare does not. If a Medicare claim is submitted for a covered procedure with a covered diagnosis in an appropriate facility and with the proper modifiers, it will be paid. Whether or not it is medically necessary, whether or not it is legitimate, and whether or not it is fraudulent. Private insurance companies are more careful with their money because it is THEIR money, not some unknown taxpayer's. You said profit from "major health providers", and I think you mean "major insurance companies". And yes, I'm familiar with their profits -- in the range of 10-20 Billion ALL COMBINED. Which is NOTHING in a 2.5 Trillion dollar system, and dirt-cheap for what you get -- health care finance done effectively, efficiently, and competently. If you in fact meant "providers", we can talk about that. All hospitals combined across the country had a net profit margin of about 0.7% -- that's 0.007 x revenue. Show me another industry (other than airlines) with a profit margin that slim. In many years, it is a net loss. The last thing we need is for some government bureaucracy to rubber-stamp every physician's recommendations, no questions asked. That has proved a disaster in Medicare and Medicaid, and we don't need to broaden it. Insurers need to have some say in how THEIR money is spent, and when that is taken away, health care will deteriorate due to a lack of funding. Systems that are full of fraud do not provide for quality or longevity.