Are You Mad As Hell?

Friday, 15 May 2009 03:02 Written by Don White

Angry as a Grizzly I am. If you aren’t, you’re either a medical doctor or a sales person for a pharmaceutical company or a medical system supplier.

Health insurance, the backbone of our health care system, is a scam borne of Satan and his evil-doing minions. Insurance companies are not about to promote your care or mine; they’re all about returning maximum profit to the company and its investors. Their Risk Management organizations are not concerned with the risks you and I encounter; their calculations are about the risk of having to actually pay for health care services.

Consider this: If bacteria, viruses, and damaged genes didn’t exist, our potential need for health care would be drastically more manageable. However, there isn’t a human who doesn’t represent an actuarial risk to insurance companies. Each of us will need the services of a physician, dentist, anasthesiologist, radiologist, nurse, or therapist at some time. The technologies behind medical equipments will continue to progress and be costlier.

Health Care Reform

We talk and talk and talk about “health care reform.” Our government appoints so-called blue-ribbon commissions to examine the problem ad nauseum. The US House of Representatives and Senate hold hearings at every session of Congress.about health care anf health care reform. What do they mean?

Costs

They’re out to cut costs or to curtail costs or to contain costs. It’s about cost. Solons come up with all sorts of schemes to place more and more of health care costs on the so-called health care “consumer.” By the way, that’s you and me, shipmates!

The theory of health care consumerism holds that we who seek care should and must shop around for the best prices. What? Is cancer surgery a product offered by health care providers and stocked in neat boxes of your local supermarket?

“Hey, Billy Ray, you put that package right back! Omnipresent Care charges too much!! See, their knee replacement goes for $32,000 while this little box of Acme Insurance costs only $12,000!”

“But, Chrissy, this Acme stuff doesn’t include anaesthesia or therapy.”

“Oh, shut up Billy Ray. We’ve got Bourbon and you’ll get plenty of therapy goin’ up and down the steps to our apartment.”

“But, Chrissy, that’s four flights up and down! Why, with this package, I won’t even get a cane, and it says I have to go home within four hours after surgery!”

“Wimp!”

Don’t laugh too hard! This isn’t a complete fiction. Ask a new mother how many days her insurance allowed her to stay in hospital following childbirth.

The Perils of Insurance

Are you knocked about by More Rules? Do you revel in rules-filled environments? Well, the world of health care insurance has been created for you. There’s so much bureaucracy and red tape that you never know where to turn. Almost every such rule has been implemented ostensibly to control health care costs; of course, we know from anecdote and news stories that health care costs are uncontrollable…so there’s that. Consider:

If Medicare is your insurance and you have surgery to replace a shoulder or knee, which joint must be immobilized for several weeks. If you stay only overnight in hospital following your surgery, are you eligible for Medicare assistance with the costs of the rehabilitation center where you will stay until the immobilizing sling (for instance)?
- Answer: No; you must remain in hospital for three nights before Medicare can help.
Your ulnar nerve collapses because you rest your forearm on a desktop because you spend most of your working day typing or otherwise using a computer. Is there a surgical procedure to relieve this nerve and help you recover feeling in the palm of your hand and in two fingers affected?
- Yes.
Will you need therapy to assure progress and success?
- Yes.
Will your health care insurance pay for, or help with, therapy?
- No. Not unless your procedure is provided under a Worker’s Comp claim.

Can You Spell “Formulary?”

You know what a health insurance provider means when they include that word, “formulary,” in the description of your plan. It means that you’ll spend a lot more money because your physician-of-choice (maybe the choice of the insurer) prescribed powerul meds that aren’t included in that list (the formulary). Prepare to spend a lot of money if there isn’t a generic available.

Of course, some insurance “products” cover pharmaceuticals while others do not.Caveat Emptor.