2)State mandates? If you want to go state by state, mandate by mandate... or just give some specific examples of how a state mandate 'eliminated' something that was a valuable insurance product.
The regs vary state by state. Certain types of insurance like supplemental health insurance, short term coverage or international travel coverage - are exempt from those requirements.Wellchild care mandates, preventative screening mandates, all those things are not included with a surgical/emergency insurance plan.
They are affordable out of pocket.
Regs are there to insure quality service and coverage.
Fair enough.There is no such thing a perfectly symmetrical information, not even with the government.
With government, they make aggregated choices.
Choices on the average, as we know there are always exceptions and such many people get left out in the cold.
But minimizing those left out is the point.
They have moved toward offering a limited number of choices once you're in the plan. Competitive pricing is still not there.Private insurance offered more choice and flexibility.
Insurance company bean counters have this down to a science -- they budget for a certain number of legal claims. And they can figure out which type of claims are easiest to deny, which type of client is least likely to hire an attorney, and which type of legal action is least likely to be successful.Courts exist for any breach of contract.
Fine print is a bogus argument, you can read the document before you sign it and if you're really worried it would cost you little to have it reviewed by a lawyer.
And you missed my point about 'fine print' -- when a claims rep in some other state is making a final decision on treatment, there is no fine print. And to the extent those decisions are based on profit and not reasonable, ethical honoring of the contract, government must regulate that.
That's a very ignorant statement not backed up at all by practices over the last 3 decades.Few claims as possible means that they deny invalid claims and not claims covered by the agreed upon contract.
Again, extremely naive.If you didn't read what was covered, it's your fault, not the insurer.
Companies sell insurers computer programs and claims management protocols designed to reject as many legitimate claims as possible. Also keep in mind, that for many, once a claim is rejected, the process of an appeal is so daunting and overwhelming, that many of these claims go unpaid. This is part of the business model of the insurance industry.
A significant number of claims denials are related to medical necessity, or the lack thereof. The health plan is essentially saying that the physician or medical provider that treated you did so without a justifiable medical reason, or that it was cosmetic, experimental, or investigational. Or when a patient goes to a hospital which is contracted with their health plan and feel everything was taken care of, but then they receive out of network bills from the anesthesiologist, pathologist, radiologist, assistant surgeon and so on, which are reduced in payment due to "Usual and Customary".
Employers can get better group rates.People should be buying plans outside of their employer.
Government shouldn't be creating incentives for employer plans but they have been for quite some time.
But if a coal mining company is buying into an insurance plan that doesn't cover lung disease... That's were gov comes in.
that's nice, but here in reality under the reform that has exhausted for lifetimes any futher efforts of reform, ER visits steeply INCREASE, med advantage is GONE, the m&m's are simultaneoulsy EXPANDED massively and DEFUNDED drastically, and all 50 states are facing what dem gov of tennessee phil bredesen (speaking for bill richardson of new mexico, christine gregoire of washington, bill ritter of colorado and brian schweitzer of montana, once progressive superstars all) called THE MOTHER OF UNFUNDED MANDATES
It's called, "making a living", and if more people engaged in it, the economy would be better off. Or, let me say, if the government would get out of the way, then more people could engage in it and the economy would be better off.
One way of, "getting out of the way", would be to throw this piece-a-**** healthcare bill in the toilet and start over with a plan that makes actual sense.
yes, and any "talking point" by the party still in power which contains the words "health care" does devastating damage to the dems
just like "stimulus," just like "global warming," just like "cap and trade..."
it's simply the lay of the land
5 weeks and 4 days are all that remain
carry on, chin strokers, pose
we republicans will remain real