Washington — House Democratic leaders Thursday abandoned a long struggle to strike a compromise on abortion in their ranks, gambling that they can secure the support for President Barack Obama’s sweeping health care legislation with showdown votes looming as early as next week.
In doing so, they are all but counting out a small but potentially decisive group whose views on abortion coverage have become the principal hang-up for Democrats fighting to achieve the biggest change in American health care in generations. Congressional leaders are hoping they can find enough support from other wavering Democrats to pass legislation that only cleared the House by five votes in an earlier incarnation.
The concession came as House Democrats attended a lengthy meeting with White House health adviser Nancy Ann DeParle, who tried to answer questions, resolve differences and calm nerves, especially for lawmakers expecting tough challenges in November. Participants said they generally embraced White House-brokered compromises on prescription drug benefits for the elderly and new taxes on generous insurance plans.
At stake is the president’s call to expand health care to some 30 million people who lack insurance and to prohibit insurance company practices such as denying coverage to people who have been sick. Almost every American would be affected by the legislation, which would change the ways many people receive and pay for health care, from the most routine checkup to the most expensive, lifesaving treatment. And most Americans would be required by law to get health insurance.
Republicans continued their fierce criticisms of the president’s efforts, vowing to make Democrats pay dearly in the fall elections if they don’t back off from what they brand a government takeover of health care. But senior Democrats predicted they can convince their colleagues that doing nothing is the worst option of all, politically and substantively.
“The stars are aligning for victory on comprehensive health reform,” said Sen. Tom Harkin, D-Iowa.
White House Chief of Staff Rahm Emanuel emerged from a meeting in the Capitol with top Democratic lawmakers Thursday night saying, “We made a lot of decisions. We’re getting towards the end.”
The end might be near, but the outcome remains uncertain. House Speaker Nancy Pelosi, D-Calif., must round up at least 216 votes when the real nose-counting and arm-twisting begin in a few days, after final cost estimates arrive from the Congressional Budget Office. All House and Senate Republicans have vowed to oppose the legislation.
With Senate Democrats no longer able to block Republican filibusters, the strategy calls for House Democrats to embrace a health bill the Senate passed in December, despite their numerous objections. Democratic senators in turn would promise to make a limited number of changes under “budget reconciliation” rules, which bar filibusters.
Comments
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merrill (anonymous) says…
Where does waste and fraud come from?
* The most corrupt expensive medical insurance industry in the world that is cheered on by so many on this board who BTW think it is so cool to pay more for less.
* By the HMO"s such as the republican Sen Bill Frist family own and operate who walked away WITH billions in taxpayer dollars. If is a republican neo conservative it is okay.
* Fraud by the insurance industry - who so many cheer on as the "Free Market"
*June 25, 2009
FRAUD - Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee.
More on this story:
http://www.washingtonpost.com/wp-dyn/...
* FRAUD and Corruption who so many cheer on as the "Free Market"
http://www.pbs.org/moyers/journal/blo...
*FRAUD who so many cheer on as the "Free Market"
Paying More, Getting Less
http://www.dollarsandsense.org/archiv...
Big government protection of the most fruadulent expensive medical insurance industry in the world is known on this board by many as the Free Market!
Charge Me More with big government protection is known by many on this board as the Free Market!
merrill (anonymous) says…
IS the Obama Insurance plan the best their is available..... NO!
Have republicans ever offered anything better... NO! They like the high dollar status quo.
The country should call off the war and allow those tax dollars to be spent on improved Medicare Insurance for ALL = Productive use of tax dollars!
Contrary to some thinkers americans are not opposed to a more constructive insurance plan. The loudest voices against and the biggest spenders are coming from a variety of profiteers be they the insurance industry, shareholders,multi million dollar executives or politicians and Teabaggers who can be shareholders and special interest money receivers.
It has been estimated that improved Medicare Insurance for ALL can provide insurance for a familiy of four for about $250 a month = full coverage. improved Medicare for All Insurance would also eliminate co-pays, deductibles and what a relief.
improved Medicare Insurance will never cancel any consumer. IT"s everybody in NOBODY out!
improved Medicare Insurance for All would also eliminate conventional medical insurance which is a good thing after more than 70 years of gouging those who they choose to insure and leaving all others out in the cold.
The medical insurance industry is about big profit using your money not about providing health care.
Most low budget insured consumers today are under insured which means if cancer strikes in very short order these consumers are on their own. It also means these consumers are paying quite a lot out of pocket before insurance coverage kicks in.
Considering the low budget insured are paying so much out of pocket they may as well not buy any of today's conventional insurance coverage. Cancel the premiums,stash the cash which then means more ready cash to cover medical expenses. OR invest this money in a profit bearing account for yourselves instead of supporting high rollin insurance executives.
merrill (anonymous) says…
What is improved Medicare Insurance for ALL?
In essence it is MY tax dollars that will pay MY portion of improved Medicare Health Insurance for my family.
What coverage would this buy the family?
*long term care such that cancer demands
*prescription drugs
* hospital
* surgical
* outpatient services
* primary and preventive care
* emergency services
* dental
* mental health
* home health
* physical therapy
* rehabilitation (including for substance abuse)
* vision care
* hearing services including hearing aids
* chiropractic
* durable medical equipment
* palliative care
improved Medicare for all eliminates co-pays and deductibles
improved Medicare Health Insurance is an extraordinary deal that would free up more expendable cash to be spent elsewhere thus creating new jobs. Things like birthdays, home improvements, investments,wellness programs or a fuel efficient automobile.
Last but not least improved Medicare Insurance for ALL will create an estimated 2.6 million jobs!
TopJayhawk (anonymous) says…
It all sounds good. Except the reality is that the Gov. never can seem to get the job done. We have been hearing about fraud and waste for as long as I have been alive. Has anyone on either side of the isle ever done anything? No, becuase they are innefective.
The Government can and will screw up a three car funeral.
I just trust them less than all the other theives out there.
TopJayhawk (anonymous) says…
And I trust Obama even less. The man is a cast-iron idiot IMO, and the sooner he is gone the better off all of us will be. Grid-lock is our best option for now.
snap_pop_no_crackle (anonymous) says…
The linkbot has woken. Fear his mad copy/paste skillz!
jayhawklawrence (anonymous) says…
I don't understand why the Democrats have to push so hard to include abortion funding in the health care bill. I noticed that Merrill did not really address this.
The abortion issue is such a divisive issue. Why fund it if so many Americans are upset about it?
The fact that the Democrats are pushing it so hard indicates to me that they are still being ideologically driven instead of looking for practical solutions that Americans want to support.
Ideologically driven agendas just make me wonder who is pushing the buttons.
snap_pop_no_crackle (anonymous) says…
Bump in the road?
http://hotair.com/archives/2010/03/11...
cowboy (anonymous) says…
There is no abortion funding in the bill ! Republican Propaganda
There are no restrictions preventing a woman from purchasing a policy that covers those services , not all will or do.
cowboy (anonymous) says…
There is no abortion funding in the bill ! Republican Propaganda
There are no restrictions preventing a woman from purchasing a policy that covers those services , not all will or do.
consumer1 (anonymous) says…
Sounds like a serious split among the Dems. or even total failure.
Liberty275 (anonymous) says…
"It has been estimated that improved Medicare Insurance for ALL can provide insurance for a familiy of four for about $250 a month = full coverage. improved Medicare for All Insurance would also eliminate co-pays, deductibles and what a relief."
you pay for medicare for 40 years, then get maybe 20 years of coverage after paying part b and d premiums, supplemtal insurance or deducts/copays.
All that extra paying and the trust fund is halfway belly up and will most likely be insolvent within 30 years.
And you want me to give up control of my health care to this ponzi scheme. Shove that where the sun doesn't shine. I'll keep paying through work and so will my wife. Health insurance is like everything else; it has a price. I'm will to pay the price for my coverage. Not yours.
jafs (anonymous) says…
jayhawk,
The issue is what sort of restrictions to have on abortion.
The current proposal prohibits insurance companies from using public funds (ie. subsidies) for abortions, but would allow them to use privately collected money for them.
In theory, this sounds fine. Why should we prohibit private money from paying for a legal medical procedure?
jayhawklawrence (anonymous) says…
jafs;
Thanks for clarifying the abortion issue for me.
So now I am wondering why a few Democrats are opposing this and saying it is because of the abortion issue.
Are they just grandstanding?
vertigo (Jesse Crittenden) says…
So now I am wondering why a few Democrats are opposing this and saying it is because of the abortion issue.
Are they just grandstanding?
---------------------------------------------
Because the American people are ignorant as to what is in the bill and believe what those opposed to reform are telling them- that the government is now going to pay for abortions.
Think of how stupid the average person is, and realize half of them are stupider than that.
feeble (anonymous) says…
Thar gunna take ar Medikul Insewerats! rabble rabble rabble.
Liberty275, you've got your conservative memes crossed. It's "hands of *my* medicare" and "Social Security is a Ponzi scheme", not vice versa.
scott3460 (anonymous) says…
"I report fair and balanced, you decide. "
Never seen a scintilla of evidence to support that claim, so I decided long ago. Your claim is as bogus as the original one.
merrill (anonymous) says…
With Improved Medicare Insurance for All removing the conventional corrupt medical industry
we would be removing a section of corruption and special interest campaign money = cleaning up a bit.
cait48 (anonymous) says…
Want to seriously make heads turn like Linda Blair in Congress on BOTH sides of the aisle?
Start pushing for this amendment to the Constitution:
"Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators and/or Representatives; and, Congress shall make no law that applies to the Senators and/or Representatives that does not apply equally to the citizens of the United States".
Oh and term limits too. That would be nice.
jafs (anonymous) says…
cait,
Nice idea.
Although the first part should already be true - Senators and Representatives are in fact citizens.
ralphralph (anonymous) says…
If someone far away was going to send you a $10 Million lottery ticket -- and it had to be cashed tomorrow or it would expire and become worthless -- would you want it sent via the Government postal service or by a private carrier such as Fed Ex?
If you were going to need life-saving medical treatment tomorrow, would you want it arranged and provided by the Government or a private provider?
Government programs fail in quality compared to private programs because the people working in them have no real "skin" in the game. If it goes well, they get paid at the end of the month, and if it goes badly they get paid at the end of the month. The profit motive is a strong incentive for hard work and creativity that is absent in the public sector. Government's proper role is to oversee the system and ensure some fairness, just as it was the Government's role to do that in the financial markets, where it failed repeatedly and miserably, as it will in the health care field.
cait48 (anonymous) says…
jafs, you have no idea how much legislation gets passed in Congress where Congress itself is exempted. Exemption of members of Congress is in this health care legislation. So yes, it *should* be true but often it's not.
vertigo (Jesse Crittenden) says…
If someone far away was going to send you a $10 Million lottery ticket -- and it had to be cashed tomorrow or it would expire and become worthless -- would you want it sent via the Government postal service or by a private carrier such as Fed Ex?
>>> Either. USPS, FedEx, and UPS all offer overnight shipping.
If you were going to need life-saving medical treatment tomorrow, would you want it arranged and provided by the Government or a private provider?
>>>> Either. Whatever wouldn't bankrupt me. I've had fine government medical care while in the military. My ex-wife and one of my kids had life saving procedures at the hands of government doctors in a government hospital. They both received exceptional care and my bill was minimal. I recently took my youngest child to a private provider for an ER visit. Waited 6 hours to get seen, saw the doc for 5 minutes. Received a $1700 bill.
vertigo (Jesse Crittenden) says…
cait48 (anonymous) says…
Exemption of members of Congress is in this health care legislation.
---------------------------------------
Have a source for this? Or a copy of the text of the bill that states this?
You do realize that Congress uses the Federal Employees Health Benefits Program, which covers more than 8 million other federal employees, retirees and their families don't you?
So if Congress is exempt, that means all Federal employees, retirees, and their families are also exempt.
Therefore it's not Congress exempting just themselves. Which makes your statement false.
snap_pop_no_crackle (anonymous) says…
Ask Kent Pankow what he thinks about government-run health care.
“Kent Pankow lives in Edmonton, in a province and a country that is trying to either kill him or bankrupt him.
No sense mincing words.
Suffering from brain cancer, Kent Pankow was literally forced to go to the Mayo Clinic in Rochester, Minn. for lifesaving surgery — at a cost to family and friends of $106,000 — after the health-care system in Alberta left him hanging in bureaucratic limbo for 16 crucial days, his tumour meanwhile migrating to an unreachable part of the brain, while it dithered over his case file, ultimately deciding he was not surgery worthy.
Now, with the Mayo Clinic having done what the Alberta Cancer Board wouldn’t authorize or even explain, but with the tumour unable to be totally removed, the province will now not fund the expensive drug, Avastin, that the Mayo prescribed to keep him alive and keep the remaining tumour from increasing in size — despite the costs of the drug being totally funded by the province for other forms of cancer…”
http://cnews.canoe.ca/CNEWS/Canada/20...
merrill (anonymous) says…
No one knows if that special drug Avastin would keep any cancer patient alive.... that would be pure speculation. Pharmaceutical giants will claim most anything to make a very big buck.
improved Medicare Insurance for All is an american idea that has been used as a model world wide.
Thus other major industrial countries realized the benefit to their economies then talked Reagan-Bush into forking over OUR american jobs....it appears.
The bottom line is improved Medicare Insurance for ALL would reduce the cost of insurance across the board. Thus reducing the cost of city,state and Federal Governments = fewer big government tax dollars that now support conventional medical insurance to the tune of about $1.2 trillion. Plus improved Medicare Insurance for All would reduce substantially the cost of managing school districts again fewer big government tax dollars.
Isn't a reduction of big government tax dollars a worthy goal?
headdoctor (anonymous) says…
I can't help but shake my head when people crawl out of the wood work to cry fowl about a National health care plan. Where are all you people at voting time or even to cry fowl when Congress throws billions away every year on much more stupid stuff? I know where you will be. At the polls voting the same bunch of worthless thieves back in office. The result wont be any different at the State level either.
Liberty275 (anonymous) says…
"improved Medicare Insurance for All is an american idea"
A cigna card will get me the absolute next doctor's appointment and the copay will be $25. A medicare card might get me an appointment sometime next week if the doctor even accepts medicare. And the copay will be 20% How much is 20% of my usual $300 dr visit?
I went into the emergency room with flu-like symptoms at 10 pm one night last week. Total copay, $50. Medicare copay, $100 plus the price of the drugs and a percentage of the xray.
Also note, medicare doesn't cover dental. My first and only root canal retailed at over $1500. My out of pocket then was about $500. My out of pocket now would be zilch with our shiny new secondary.
IOW, I don't want your crappy coverage. I'm an American. If I want something, I'll buy it.
notajayhawk (anonymous) says…
jafs (anonymous) says…
"The current proposal prohibits insurance companies from using public funds (ie. subsidies) for abortions, but would allow them to use privately collected money for them."
Your insurance company wants $500/month for premiums, which you can't afford. You get a $300 subsidy from the government, bringing down your out-of-pocket premium to $200/month. Now you can afford to add $100/month for optional coverage for abortions.
How is that *not* the government using tax dollars for abortion?
*********************************************************
vertigo (Jesse Crittenden) says…
"Because the American people are ignorant as to what is in the bill and believe what those opposed to reform are telling them- that the government is now going to pay for abortions.
"Think of how stupid the average person is, and realize half of them are stupider than that."
Isn't it strange, it's always the *other* side that doesn't know what's in the bill, or doesn't understand it, or is too stupid, or whatever.
I assume, Jesse, you've read all 2,200+ pages of the Senate bill, and the full 'reconciliation' proposal (which isn't available yet)?
"Either. USPS, FedEx, and UPS all offer overnight shipping."
That wasn't the question. Who do you really trust to be more dependable?
"Either. Whatever wouldn't bankrupt me."
Great choice. You'd rather have something affordable that is of lower quality than something of higher quality that's harder to afford? Good for you, you good little coupon-clipper, you. However, you don't have the right to make that choice for me.
notajayhawk (anonymous) says…
By the way, maybe one of you 'reform' supporters could explain to the rest of us how changes to the student loan program qualify as 'budget reconciliation' for a healthcare bill?
vertigo (Jesse Crittenden) says…
That wasn't the question. Who do you really trust to be more dependable?
>> Either. I've had great experiences and not so great experiences with both.
-------------------------------------
Great choice. You'd rather have something affordable that is of lower quality than something of higher quality that's harder to afford?
>> So you're saying that medical care paid for through my tax dollars is less quality than medical care from the same doctor/er/hospital when it's paid through a private business.
I guess doctors check the patients insurance first before treating. "Ah! This one is on government insurance... better give him substandard care!"
Next patient, same doctor "Ah! This one carries Cigna... let me treat him as royalty!"
---------------------------------
However, you don't have the right to make that choice for me.
>> But it's ok for you to make that choice for me? You're saying that I shouldn't have the ability to use a government option. That if I want insurance I MUST use a private insurer.
notajayhawk (anonymous) says…
vertigo (Jesse Crittenden) says…
">> Either. I've had great experiences and not so great experiences with both. "
Yeah, I got that part when you said 'either' the first time. Again, not fully responsive - the question was, if it was critical and you only had one chance to get it right, who would be your first choice? Are you saying that with millions of dollars on the line, you'd flip a coin?
">> So you're saying that medical care paid for through my tax dollars is less quality than medical care from the same doctor/er/hospital when it's paid through a private business."
Well, I didn't actually say that. *YOU* said you'd pick the option that was cheaper, apparently regardless of other concerns. (Why, you're a free-marketer and didn't even realize it!)
"I guess doctors check the patients insurance first before treating. "Ah! This one is on government insurance... better give him substandard care!""
Um - yes.
At a recent doctor's visit, the doc accidentally left his appointment list mixed in with our discharge paperwork. The list had the patients' MR numbers, their names and a small amount of other identifying information - and their insurance carriers.
At my current doctor's office (and the two I used before that), there were plainly posted 'cheat sheets' in the exam rooms, listing the various places patients should be referred for labs, x-rays, etc., based on - you guessed it - their insurance carrier.
Try going to two different ER's for the same complaint. Give one of them your insurance information, and tell the other you're self-pay. (If it were possible, I'd suggest giving one a private insurance card and the other a Medicare card.) See if they order the same number of tests and other procedures. Or if the same medications are prescribed.
[continued]
notajayhawk (anonymous) says…
[continued]
The following excerpt is from the website of a physician who recently wrote an LTE to this paper arguing for passage of the 'reforms':
http://www.lfmo.com/FAQs.htm#_I_work_...
>>> "The doctors of Lawrence Family Medicine and Obstetrics understand and share the concern of many about declining health insurance coverage for many Americans. Our professional organization, the American Academy of Family Physicians, has worked hard to promote the passage of universal health insurance coverage in our nation for many years. (We urge you to help us by making your needs known to your elected representatives in Washington and Topeka.) Until legislation mandating insurance coverage for all Americans is passed, we will continue to try to help our patients who are not insured or who are underinsured get the care they need. For instance, we offer a 20 percent discount to cash- or credit-card paying patients. And, although we require payment at the time of service, we will work with you to set up payment plans for large medical expenses. If you let your doctor know about your financial constraints, he or she often can reduce your testing and drug costs, such as by prescribing less expensive generic drugs or, if possible, by supplying you with free samples of drugs. In cases of extraordinary or ongoing medical needs, we can refer you to Health Care Access, a clinic manned by volunteer doctors (including our own), which is able to provide markedly reduced-cost medical care."
In other words, if you can't afford that doctor's fees, write to the government and get them to pay for it. But in the mean time, we'll offer fewer tests and cheaper meds if you're paying out of pocket. The very existence of such a two-tiered system is heinous - either they're withholding care from those that can't pay, or they're soaking insurance companies for unnecessary treatment. (As a last resort, if you can't afford their fees, they'll be happy to dump you on HCA.)
Yes, Jesse, healthcare providers routinely make care decisions based on which, if any, insurance the patient carries.
">> But it's ok for you to make that choice for me? You're saying that I shouldn't have the ability to use a government option. That if I want insurance I MUST use a private insurer."
The slight difference being that you don't have to pay for my choice.
vertigo (Jesse Crittenden) says…
The slight difference being that you don't have to pay for my choice.
>>> Ah but I do. If you become sick and you're in my pool my rates go up. Oh hell... it's a for profit company, my rates are going to go up anyways- regardless if you become sick or not. Moot point.
FYI, I pay taxes too. I'm all for helping a fellow American out. I guess others don't share my unselfish spirit. But hey, I'm also the type of guy that if I see someone broken down on the side of the road, or stuck in a snow drift I stop and help. I'm guessing you just drive on by oblivious to those around you? Or does your generosity stop at the pocketbook?
Nota, just because one place is charging $500 for an MRI and the one up the street is charging $2500 for the same MRI doesn't mean the one charging more is 5 times better than the cheaper one. It just means they're charging more for the same care. The cheaper one isn't substandard... it's just less money!
If I sell you a can of Coca-Cola and charge you $0.50 and the machine behind me is selling cans of Coca-Cola for $1.00 guess what... the Coca-Cola I'm selling is not substandard to the Coca-Cola in the machine.
notajayhawk (anonymous) says…
vertigo (Jesse Crittenden) says…
">>> Ah but I do. If you become sick and you're in my pool my rates go up. Oh hell... it's a for profit company, my rates are going to go up anyways- regardless if you become sick or not. Moot point."
Except nobody's telling you that you have to be in my pool, and as it stands now, the insurance companies can charge me - not you - more if I get sick.
All of which is a moot point, as you say - because we choose not to carry insurance, and pay out-of-pocket, meaning you don't pay one dime for my care. But as you alluded to, if I'm forced to join your pool, then I am paying for yours.
"Nota, just because one place is charging $500 for an MRI and the one up the street is charging $2500 for the same MRI doesn't mean the one charging more is 5 times better than the cheaper one. It just means they're charging more for the same care. The cheaper one isn't substandard... it's just less money!"
Perhaps if you read more carefully; the point is that one person is getting the MRI and the other isn't. Or one person is being sent for a CT scan and the other an x-ray. One person is getting the latest 'wonder drug' being pushed by the pharmaceutical rep this week, the other is getting a 20-year-old generic. Either the ones without the best insurance are getting substandard care, or the ones with the high-dollar insurance are getting soaked. Actually, those two are not mutually exclusive.
Again, in answer to the question you posed, doctors and other providers do indeed look at a person's insurance before making decisions on tests, medications, referrals, and other aspects of treatment. Maybe you'd like to try explaining how that can be justified in terms of quality of care?
"If I sell you a can of Coca-Cola and charge you $0.50 and the machine behind me is selling cans of Coca-Cola for $1.00 guess what... the Coca-Cola I'm selling is not substandard to the Coca-Cola in the machine."
Maybe, maybe not. If your grocery store is selling the same package of lunch meat for half the price of what it costs at that expensive store, maybe you'd better look really close at the expiration date.
vertigo (Jesse Crittenden) says…
Either the ones without the best insurance are getting substandard care, or the ones with the high-dollar insurance are getting soaked.
>> I lean towards the soaking side of the equation. I just have a hard time believing that if a person actually NEEDS a CT scan then the doctor will order a x-ray just because they have cheaper insurance. If an X-ray will do but they have a premium insurance but a more expensive CT scan will also work... then sure they doc is going to order it. If that's the case it's not a situation of one receiving substandard care. It's a case of one got sent for treatment that was superfluous.
All the doctors I know and work with don't operate in way that those on government insurance receive substandard care to those with private insurance. If a person on Medicaid comes in and they need a stent put in they get a stent put in. They aren't given medication and then told to "go home and exercise". They receive the same care that a person on private insurance who presented with the same symptoms would receive.
notajayhawk (anonymous) says…
vertigo (Jesse Crittenden) says…
">> I lean towards the soaking side of the equation."
At least we agree on something.
Now - please explain to me how the Democrats' attempts to reform the insurance business is going to change that. As a matter of fact, why not take a crack at explaining how giving more people insurance is *not* going to make that worse.
It's difficult at times to figure out which side of this argument you're on, Jesse. All I keep hearing about from the 'reformists' is how those big, bad, evil insurance companies are raising their premiums with no justification, then you can admit that medical providers pad the bill solely because the patient has insurance? If that's the problem, then why are we trying to 'reform' health insurance at all? Aren't we tackling the wrong end of the problem?
"All the doctors I know and work with don't operate in way that those on government insurance receive substandard care to those with private insurance. If a person on Medicaid comes in and they need a stent put in they get a stent put in."
Did you know that with Kansas Medicaid, most injections (like flu shots) won't be paid for at the doctor's office, the patient has to go to the health department?
"Substandard" is a pretty arbitrary term, because "standard" itself is. You could argue that the Medicaid patient that has to go to the health department for their flu shot after going to the doctor's office for their checkup is still getting the same care. Unless you're that patient, and you have to ride the bus, dragging the kids along, taking yet another day off work.
[continued]
notajayhawk (anonymous) says…
[continued]
You didn't answer my question. What justification is there for posting lists of where to refer patients based on their insurance carrier? Yes, I realize you want to send the patient somewhere that their insurance will pay for - but that's not a quality of care issue. If one lab is across the street and the other's across town (or in another town); if one specialist is a renowned leader in his/her field and another has several disciplinary actions against them by the medical board; if one office can get the patient in the next day and the other has a two-month waiting list; if the doctor sitting in front of you has the injection you need sitting on their shelf but refers you out anyway; shouldn't decisions based on 'best practice' principles be determined by factors such as those, not whether the patient has Humana or Medicare? You can argue all you want that none of the above options constitute "substandard" care - again, unless you're the one that has to take another day off from work, two months from now, to see a specialist who just isn't as good.
Again, it's hard to see which side of this you're on. Another mantra I keep hearing from the reformists is how those evil insurance companies are routinely denying care, that medical decisions are being made by the insurance companies instead of by doctors. How can that be the case when, according to you, doctors always deliver quality care regardless of how the patient is going to pay for it? Medical providers deliver the care they're going to get paid for. Don't get me wrong, I'm not saying there's anything wrong with that. But don't think for a second that if a private insurer will pay for a CT scan and Medicare says an x-ray will do, the hospital is going to give that Medicare patient a CT scan and eat the cost.