Quote from Free Thinker:
...something should be done about the huge cost of end of life care where huge expense is incured for a futile attempt to keep a terminal person alive. those things are easily fixable if those dam republicans would stop screaming "death panels" at any hint of someone making a decision to stop treatment.
... i have blue cross. there are many doctors who are not in the blue cross network because they refuse to accept the rate blue cross will pay. if you use those doctors you have to pay the difference. exactly like medicare.
Two excellent points in my opinion. Re the first, is it Oregon that allows physician assisted, planned death for terminally ill patients, at the patients direction of course? This is available in the Netherlands also, as far as I'm aware. What a great help that would be to many who are dying in pain and just want to end their lives peacefully. I believe this is a fundamental right that all of us should enjoy, but sadly don't.
On the second point, many insured by the Blues are unaware that the Blues (supposedly non-profit!!!) negotiate discounted rates with both physicians and hospitals, and this is the reason for the different payout "in network" and "out of network".
Unfortunately the way this was implemented was fraudulent, and may still be in some states. The blues were basing patient billing on the non-discounted charge and not revealing to patients that the actual charges were less. Thus the patient was billed for 20% of the non-discounted charge when 20% of the actual charge would have been less. Significantly less in some cases. The Blues were sued in many States and lost every suit. However because insurance is exempt, by long standing Federal law, from anti-trust, and restraint of trade regs and other Department of Commerce regulation, they had to be sued in each State separately. I'm not sure that all States pursued them. Perhaps someone here knows.
I have long been an advocate for ending this exemption of insurance companies from anti-trust, and restraint of trade regulation as well as requiring full financial disclosure as required of other corporations. Insurance companies, being sate regulated, are exempt from federal requirements. In fact, i thought that ending that cozy relationship for at least the health insurance industry was part of the Health Care Bill. Does anyone here know if those provisions made it past the chopping block? Insurance company exemption from restraint of trade laws was specifically what allowed them to reimburse less for out of network and out of State treatment even when the actual out of network costs were lower than the stated in-network cost (about which they lied of course). I corresponded with the Commerce Secretary over this very point some years ago, and everything boiled down to the insurance industry's exemption from federal regulation. End that, and a lot of abusive insurance industry practices will end as well.
In fairness, I should point out that most policies allow for regular reimbursement rates on out of network services in emergencies and in non-emergency situations where an equivalent treatment is not available in network, so long as the out of network service is pre-approved. Some companies require that any non-emergency hospitalization be pre-approved or they will not reimburse the full amount. Even in emergency admissions, some require that approval be obtained within a fixed number of hours after admission, or the reimbursement rate is decreased. There are seemingly endless hurdles to receiving full reimbursement in much of the health insurance industry. Many are living the nightmare that is the U.S. medical services delivery system everyday of their lives. These insurance hurdles are a huge annoyance to physicians as well.
