I certainly agree with the efficiency angle, but I don't think that overspending is that simple. The entire structure needs to be looked at. In some areas, employment needs to be cut. In others, it needs to be INCREASED.
And I do not agree with timeframes for benefits to expire; to me, a solid set of parameters for them to continue needs to be developed, and then needs to be re-evaluated from time to time by professionals. My brother is on SSD, and they handle his case VERY efficiently.
All true, I was intentionally keeping it simple as a starting point. Louisiana has overhired in various agencies for years and the bill is past due, we are in a cutting period for non-essential government employees ourselves, I do agree it's a structure due for a complete overhaul. As for the timeframe argument there are potentially better options, that I'll concede. What I think needs to happen with re-evaluations is an establishment of some effort towards recipient independence where possible. If someone is permanently disabled or if they cannot be reasonably found otherwise to be capable of providing for themselves for a very narrow array of factors, I see no problem with them drawing on services.
I agree with this, but it needs to go MUCH further than that. Insurance companies use every loophole imaginable to NOT pay the provider, and to make it more difficult for the patient. These abuses must be addressed, and the fraud laws won't cover them.
There are good and bad companies, the most abuse I've seen or heard about from the private sector was in certain group policies and HMO's, although individual insurance in the form of indemnity insurance(which is outdated, these should be outlawed) have happened. I will say there was a h.i. company I worked for a total of 4 days, I was physically ill at the end of my tenure there. They sold the big promise of a model where I had a desk, shot at management, and could retain independence. All lies, they did not offer flexibility in sales technique and prefered the "sell hard and misrepresent" approach and had multiple policy loopholes created in the contract, however these companies are not the standard, they are the exception. I think though we could agree, close the loopholes and hold insurance providers to the ethics standards absolutely.
It's not fraud when the insurance company repeatedly tells you that you are sending the authorization to the wrong fax number... and they have 16 fax numbers. These kinds of abuses need to be regulated right out, with reforms that force the insurance companies to use some sort of standard or centralized system.
Ah, the departmental shuffle, this happens with many big financial companies, including creditors, insurers, banks, etc. Actually, pretty much every big corp. I will agree it's annoying, but will also say it is due to departmental incompetence and not necessarily misrepresentation. Trust me, if you don't have a direct line to a high ranking mid to upper manager your day will be ruined trying to put out a fire, been there, done that. One of the biggest problems with departmental incompetence is that everyone wants to show the person above them they can do the next level job when actually they can't even do their own correctly, the misinformation and misdirection is frustrating.........especially when you have a client ready to physically harm you for the company's mistake.
Most doctors I know that have left the field have left because of malpractice insurance costs, or poor or lack of insurance reimbursement. I haven't heard that regulations are the issue at all, these days.
It could be a regional thing, Louisiana doctors that left at the time left because of state regs, but all of those things ballooned their mpi costs, and reimbursement from medicare, not specifically insurance companies here.
I don't, but you're right... we'll have to wait.
I'm gonna watch the market when I get time tomorrow. I see one of two things happening. Either the market will spike tomorrow because something finally was decided and people will be speculating on the gains the health insurers will see because of the mandates or the market will go into full blown collapse mode. If the former happens we will see a huge bubble that will burst beyond anything we've seen in our lifetimes as more things are added or if the latter happens the market will blip along with minor spikes on occasion but will never fully recover, and in fact recede as things are added. Hate to be the pessimist here, but these are the only two economic possibilities I see with this bill.
Staff shortages I absolutely agree with and I agree with CYA costs. I think regulatory compliance cost are problematic, but because they are not efficient or do not address the real issues. I'd like to see more regulation, but more efficient regulation... which would probably mean some regulations cut.
I think we're in agreement but hanging on the general idea of regulation. I would probably be a libertarian if I could trust everyone, knowing some people would jeapordize their own mother to save a buck I can see the merit of having appropriate regulations. Where the end and beginning of such is I am more than happy to discuss.