All content, of both the original and this blog, is written from my point of view and is my opinion. I believe it to be accurate at the time it is written. ~ Kyle Prast, Brookfield resident since 1986

Tuesday, October 06, 2009

Quiz: Which health insurance provider rejects more claims? Private or Government?

Here is a little quiz to start your day: Which mainstream health insurance provider rejects the most claims?

Would it be those evil private insurance companies that President Obama and the Democrats criticize? Or Medicare, the one ObamaCare's public option will be modeled on? The one the AMA* supports?


From BigGovernment, AMA Endorses Largest Denier of Health Care Claims

"Beverly Gossage, Research Fellow for Show-Me Institute and founder of HSA Benefits Consulting wondered which insurance companies rejected the most claims. She found her answer in the AMA’s own 2008 National Health Insurer Report Card. The chart below appears on page 5 of the 16-page report."

Chart from BigGovernment:AMA data on biggest deniers of claims

"Of the eight insurers listed, Medicare is most likely to reject a claim, sending away 6.85% of requests. This is more than any private insurer and double that of the private insurers’ average!"

The big question for seniors seeking medical treatment is, will Medicare cover it? Even when retirees purchase supplemental plans to cover the portion of their bill that Medicare does not pay for, they are still at the mercy of Medicare coverage, not even the supplement will step in. Bottom line: If Medicare doesn't approve of it, it is an out of pocket expense.

The number of claims Medicare receives is much higher than the private sector providers, but outside of Aetna, with it's 43,317 denials (6.8%) on 637,239 claims, the remaining 6 private insurers with their total of 55,708 denials on 1,805,002 claims scored better.

At least when a claim is denied under private insurance, you still have the option to appeal or to provide more information. (I have had to do that at times with mixed results.) But if the government provider rejects you, who do you go to to appeal?

By the way, not all in the AMA support the public option. “...some member physicians at the group’s annual meeting [in June] likened the notion to communism.”

If we are to reform healthcare, shouldn't we be improving the current system instead of making it worse? Shouldn't we be allowing more choice in treatment options, more control over price of treatment, and lowering the cost of treatment?

The Senate might push the healthcare bill through soon by doing some maneuvering. They certainly don't want us or even their own legislators to know what is in the bill. If it is such an improvement, why hide it and sneak it through without time to read it?

More reading: *The AMA represents less than 1/3 of all doctors, yet Obama trots them out every time he wants to promote his health care reform bill.

Doctors Protest Obama's Plan for Health Care Reform

Heard about the BigGovernment article on Mark Levin's show last night.

Links: Practically Speaking, Fairly Conservative, Betterbrookfield, RandyMelchert, Jay Weber, Vicki McKenna, The Right View Wisconsin, CNS News, Mark Levin, Breitbart BigGovernment, The Heritage Foundation

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