Happy New Year

Happy new year to All!  There is hope this year that President elect Obama will do something to fix the healthcare system.  A feel a battle ensuing.   The insurance companies want universal healthcare..... everyone has to get insurance or be fined!   I don't think that is the idea of insurance for everyone.   In Massachusetts, the law states everyone has to have insurance.  However, the cost is high and the services are limited.   It can put a stress on families.  Deductibles are high.   I don't know what the solution is but it has to have a clause that doesn't allow insurance companies and hospitals to make private deals for higher reimbursements.  In Boston, Partners healthcare recently was busted for making a private deal with Blue Cross/Blue Shield for compensation at a higher rate.  According to the article in the Boston Globe, the CEO's were told by their respective lawyers NOT to put anything in writing, just to do a handshake!   what it all meant was the other insurance companies and their doctors got less money for the same procedures.  In the end BC/BS rates went up and many companies had to change insurers.  Two days later after the article in the GLobe, Partners Healthcare placed a full page ad in the Boston Globe, denying the charges.  I have to think for a second.... who do I believe?    Again, we find the back room deals do nothing for the consumer but raise rates and continue to experience denials for needed procedures, surgeries and medications.   As an Advocate, I deal daily with many insurance companies, questioning refusals of service, filing appeals and speaking with state insurance boards.   What I find is the insurance companies just want to hold on to the money to get the most interest before releasing it.  The bottom line is, they are hoping the consumer will give up! 

You can view the article
http://www.boston.com/news/health/articles/2008/12/28/a_handshake_that_made_healthcare_history

 

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