A view on the Paul Ryan and House GOP's "Kill Medicare" plan from a health care provider

From a commenter "Taylor 16" at Ta Nehisi Coates' (excellent) blog, venting on the Congressional GOP's vote to kill Medicare under the "Ryan Plan":

I do billing for an orthopaedic surgeon's office in a hot ski vacation region of the country.

I am getting so tired of arguing with insurance companies over whether it was "medically necessary" for patients who fall on the ski slopes and have unstable fractures/dislocations of their wrists/legs/shoulders/hips/whatever, or bleeding open wounds, to seek treatment in our office immediately after they are injured.

I spend weeks/months on each of these claims, sending appeal letters back and forth. The waste in time and money (in my salary, and frankly, the reams of paper sent back and forth) for what should be paid immediately under any reasonable health care system is ridiculous. I am, literally, sending back my third appeal letter today to argue that a guy who broke his hip on the slopes deserved to get it treated in the state where he was injured, rather than going home first. Can you imagine flying or driving home with a broken hip??? But this is what his insurance is insisting he should have done.

This only happens with private insurance, by the way. Never Medicare. They have a nationwide system of providers and clear rules that apply to everyone.

This is what I argue about with these companies every day. About whether people with acute medical injuries should crawl, bleeding, onto their flights and go home to seek "in-network treatment" based on the arbitrary rules of their insurance companies ... rather than getting medically necessary treatment in a timely fashion. And your insurance premiums pay my salary to do this.

Our healthcare system is so broken. 

Further:

I literally - literally - cannot even discuss the Ryan plan with anyone. Because I just CANNOT have a conversation with someone who does not work in the industry, does not deal with this crap on a daily basis, and does not understand the literal, honest-to-god truth that Medicare is far superior to any private health plan out there. And that putting our elderly, of all people, in the hands of these private insurance companies is going to bankrupt or kill them. Literally. This is not an abstract, ideological argument. There are already private Medicare plans out there. They are more costly, and cause more problems for patients.

Medicare pays bills. Private insurances find every way possible to deny or underpay bills. This is not my ideology talking ... it is literal, concrete truth.

And I just cannot even bring myself to discuss the Ryan plan as if there is any ounce of good there. It actually makes me so upset that I can feel my blood pressure rising.