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.
Wednesday, April 27, 2011
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":
Elizabeth Warren dropped by the Daily Show to discuss the continuing attacks in Congress - stealth and overt - on the Consumer Financial Protection Agency by agents of elite interests aligned against consumers, and to reaffirm the importance of the agency she initiated.
Parts 2 & 3 below the fold.
Parts 2 & 3 below the fold.
The GOP hostage takers threaten nothing less than financial crisis in order to force their political agenda
"Gay marriage is the biggest issue that will impact our nation."
Second, the debt ceiling vote has always been routine. It's been raised 75 times in 50 years - 7 times under the Bush administration, with no protests from Paul Ryan & Co. as the national debt increased by over 70% in just those 8 years.
The reason for the debt ceiling itself is obscure (it's rooted in congressional budget prerogatives versus the executive actually administering most spending) and in large measure because raising it has become so routinized, but suffice to say that not raising the debt ceiling is not a substitute for real fiscal policy that grapples with the issues of revenue and spending and debt head on and in a serious political context. This is a Kabuki power play that, I'm afraid, some of the players don't actually understand. My guess is that - the cynicism and media manipulations of a John Boehner aside - many of the Tea Party faction among the congressional GOP don't have a clue regarding the insanity of failure to raise the debt ceiling.
To get some sense of what's at stake, there's this, via New York Times "Economix", from Matthew Zanes, a director at JP Morgan Chase who chairs the Treasury Borrowing Advisory Committee. (Why should we listen to a guy from JP Morgan? Well that's always a good question, but in this case my assumption is that he's offering a pretty straightforward view from the perspective of market insiders regarding the impact of imposing Tea Party ideology over what has become standard practice for decades in managing federal debt):
Any delay in making an interest or principal payment by Treasury even for a very short period of time would put the U.S. Treasury and overall financial markets in uncharted territory, and could trigger another catastrophic financial crisis.