You Decide

There isn’t a health care crisis in this country, paying for health insurance is the crisis. Our health insurance industry is plagued by the same problem as our financial system… greed !

The health insurance companies make up rules and refuse to pay the doctors, nurses and hospitals. Take for example the ninety day rule. If a claim is not billed within 90 days, the insurance company denies payment because it was billed later than the ninety day filing limit, even if it’s billed on the ninety-first day. Imagine all the millions of people paying premiums, and the insurance companies keep the money while denying payment. It amounts to legalized stealing.

For the past two decades the insurance companies have taken over medicine, resulting in doctors and hospitals having to hire legions of employees just to call insurance companies to ask them for permission to perform surgeries; diagnostic testing; and physician visits, along with seeking approval to prescribe certain medications. The insurance companies act like they know better than doctors what is best for us, so they control all medical decisions with a maze of regulations to determine if treatment is necessary. File clerks looking at paperwork submitted by those legions of employees are making our medical and health decisions for us.

Another trick up their sleeve is something called the disallowed amount. They deduct paying one third of the billed price and call that the disallowed amount. For instance, if the doctor visit is seventy five dollars, the insurance company says we’ll only allow fifty dollars, with a discount of twenty five dollars. But a patient without medical insurance goes to the same medical professional, they have to pay the entire bill without any deductions.

Why does the insurance company decide they deserve a deduction but not the average citizen? Because they are ‘Big Brother’ and they make the rules. Their rules say they are the warranty holders and we are their rented machines, which require fixing just like automobiles. Insurance companies decide how much and what type of repairs their ‘machines’ will receive.

It was recently reported the insurance industry actually came out and said if the federal government mandates that all citizens have health insurance, they’ll drop the pre-existing clause. A pre-existing clause is where coverage is denied if the medical condition was in effect prior to the purchase of the health insurance.

Every year the cost of health insurance premiums rises faster than any raises we may receive. In effect we’re giving the insurance company our raise while receiving less coverage. This has been going on for close to two decades, no wonder people can’t save money, we never get a raise in our pay. And if you don’t receive a raise, then your pay decreases because the health insurance premium increases and you take home less. Of course, maybe if we could start employing the disallowed theory, we could save a bundle on our health insurance premiums.

They’ve even changed what we call doctors, we now call them providers. What would the new degree for a doctor be, a PR for provider? Besides, I’d rather see a doctor for medicine than a provider for healthcare any day.

This is just a glimpse of how much power these insurance corporations have over our government, how much disdain they have for us and only a few of the myriad of reasons why we need leaders who are able to stand up to the insurance industry, because as it is now, health insurance companies decide who lives and who dies.

The president is promising us health care reform by the end of the year. He should take the medical decision making out of the hands of insurance companies, whose decisions are driven solely by profits, and place it back into the hands of the people along with their treating physicians. This is what America is all about, taking the power and decision making out of the hands of the few and putting it back into the hands of the people where it belongs.

True health care reform begins with regaining our right to make our own medical decisions and realizing it is the insurance companies who make medical care overly expensive.