Hillary Care

[MDM4AU 336]

What is reasonable to you. No one in particular, just sort of throwing this out there. What do you want out of your health insurance plan (coverages, etc) and what do you think is a reasonable price for that coverage?

[aumd03 2]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

[Tiger Al 0]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

Are Medicare patients not free to "shop around" for a physician?

[CCTAU 3,350]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

Are Medicare patients not free to "shop around" for a physician?

NO. NO and NO. Many doctors do not accept and will not file medicare.

[TexasTiger 13,029]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

Are Medicare patients not free to "shop around" for a physician?

NO. NO and NO. Many doctors do not accept and will not file medicare.

Many doctors do. There are doctors that also don't work with certain insurance companies. That's capitalism at work, too. People on medicare still have a number of choices.

[DKW 86 7,441]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

Are Medicare patients not free to "shop around" for a physician?

NO. NO and NO. Many doctors do not accept and will not file medicare.

Many doctors do. There are doctors that also don't work with certain insurance companies. That's capitalism at work, too. People on medicare still have a number of choices.

You and Al are nuts. TYhere are fewer and getter fewer the number of Drs that will accept Medicare patients. They are not accepting for the the same reasons they will not take them under NHI, cold hard cash and govt interference. Al, dont you work in the medical field? If so, that is the lamest question ever asked. Yeah they can shop around to a bunch of recent grads and about to go out of business/retire Docs. What a choice. I guess it looks like a good deal in the old Soviet block.

[DKW 86 7,441]

http://www.property-casualty.com/2007/01/w...right_abou.html

For example, one of the big problems identified by opponents in the health insurance industry was the suggestion that under Hillary's program, people would no longer be able to choose their own doctor--that some faceless government bureaucracy would tell you where you had to go for medical care.

[Tiger Al 0]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

Are Medicare patients not free to "shop around" for a physician?

NO. NO and NO. Many doctors do not accept and will not file medicare.

Many doctors do. There are doctors that also don't work with certain insurance companies. That's capitalism at work, too. People on medicare still have a number of choices.

You and Al are nuts. TYhere are fewer and getter fewer the number of Drs that will accept Medicare patients. They are not accepting for the the same reasons they will not take them under NHI, cold hard cash and govt interference. Al, dont you work in the medical field? If so, that is the lamest question ever asked. Yeah they can shop around to a bunch of recent grads and about to go out of business/retire Docs. What a choice. I guess it looks like a good deal in the old Soviet block.

You have absolutely no idea what you're talking about. Before you shoot from the hip, you really ought to do some research sometimes. Medicare has 196 physicians listed in Alabama for General Medicine alone. BCBS listed 107 General Practitioners in Alabama. All of them run the gamut regarding experience.

I have a friend who does marketing for a home health company and they are told to actively, vehemently pursue Medicare referrals. Why? In your own words; Cold hard cash.

In my business, magnetic resonance imaging, Medicare reimburses slightly less than BCBS. The number of people using Medicare is growing. So, if you are looking at paying for a million dollar-plus piece of equipment, only a fool would turn away a Medicare patient because he's holding out for the next BCBS patient. 95% of the pie is better than 100% of no pie.

For example, one of the big problems identified by opponents in the health insurance industry was the suggestion that under Hillary's program, people would no longer be able to choose their own doctor--that some faceless government bureaucracy would tell you where you had to go for medical care.

I seriously doubt that insurance executives are going to tout the benefits of anything that threatens their existence, do you?

...under Hillary's program, people would no longer be able to choose their own doctor--that some faceless government bureaucracy would tell you where you had to go for medical care.

Again, Medicare doesn't tell you where you can go any more than BCBS or BamaGrad's United Healthcare does. It's called restrictions and limitations and EVERY insurance plan has them. If you find one that doesn't, please share it with everyone because it truly is a rare breed.

[Tigermike 3,055]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

Are Medicare patients not free to "shop around" for a physician?

NO. NO and NO. Many doctors do not accept and will not file medicare.

Many doctors do. There are doctors that also don't work with certain insurance companies. That's capitalism at work, too. People on medicare still have a number of choices.

You and Al are nuts. TYhere are fewer and getter fewer the number of Drs that will accept Medicare patients. They are not accepting for the the same reasons they will not take them under NHI, cold hard cash and govt interference. Al, dont you work in the medical field? If so, that is the lamest question ever asked. Yeah they can shop around to a bunch of recent grads and about to go out of business/retire Docs. What a choice. I guess it looks like a good deal in the old Soviet block.

Medicare has 196 physicians listed in Alabama for General Medicine alone. BCBS listed 107 General Practitioners in Alabama. All of them run the gamut regarding experience.

Is that number sufficient for the entire state? Any idea how many of those practice entirely in Ala? I know three Dr's who have practices in Ala & another state.

[Tiger Al 0]

Is that number sufficient for the entire state? Any idea how many of those practice entirely in Ala? I know three Dr's who have practices in Ala & another state.

I have no idea if that number is sufficient or not and my assumption would be that a few/some/a lot/most/all of them practice in other states as well, but, your questions have no bearing on my response to David's implication that Medicare providers were few and far between. MC has more General Practitioners in Al than BCBS. Medicare has 1833 Internal Medicine physicians in Al. MC has 363 Orthopaedic providers to choose from. It has 382 Cardiac physicians, 449 Radiologists, 625 Surgeons, and the list goes on. The point is, the patient's choices aren't as limited as David would have us believe.

[Tigermike 3,055]

Is that number sufficient for the entire state? Any idea how many of those practice entirely in Ala? I know three Dr's who have practices in Ala & another state.

I have no idea if that number is sufficient or not and my assumption would be that a few/some/a lot/most/all of them practice in other states as well, but, your questions have no bearing on my response to David's implication that Medicare providers were few and far between. MC has more General Practitioners in Al than BCBS. Medicare has 1833 Internal Medicine physicians in Al. MC has 363 Orthopaedic providers to choose from. It has 382 Cardiac physicians, 449 Radiologists, 625 Surgeons, and the list goes on. The point is, the patient's choices aren't as limited as David would have us believe.

Don't get your panties in a wad, I didn't say anything about a bearing on anything you said or not. I merely asked a question.

[aumd03 2]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

Are Medicare patients not free to "shop around" for a physician?

NO. NO and NO. Many doctors do not accept and will not file medicare.

Many doctors do. There are doctors that also don't work with certain insurance companies. That's capitalism at work, too. People on medicare still have a number of choices.

You and Al are nuts. TYhere are fewer and getter fewer the number of Drs that will accept Medicare patients. They are not accepting for the the same reasons they will not take them under NHI, cold hard cash and govt interference. Al, dont you work in the medical field? If so, that is the lamest question ever asked. Yeah they can shop around to a bunch of recent grads and about to go out of business/retire Docs. What a choice. I guess it looks like a good deal in the old Soviet block.

You have absolutely no idea what you're talking about. Before you shoot from the hip, you really ought to do some research sometimes. Medicare has 196 physicians listed in Alabama for General Medicine alone. BCBS listed 107 General Practitioners in Alabama. All of them run the gamut regarding experience.

I have a friend who does marketing for a home health company and they are told to actively, vehemently pursue Medicare referrals. Why? In your own words; Cold hard cash.

In my business, magnetic resonance imaging, Medicare reimburses slightly less than BCBS. The number of people using Medicare is growing. So, if you are looking at paying for a million dollar-plus piece of equipment, only a fool would turn away a Medicare patient because he's holding out for the next BCBS patient. 95% of the pie is better than 100% of no pie.

For example, one of the big problems identified by opponents in the health insurance industry was the suggestion that under Hillary's program, people would no longer be able to choose their own doctor--that some faceless government bureaucracy would tell you where you had to go for medical care.

I seriously doubt that insurance executives are going to tout the benefits of anything that threatens their existence, do you?

...under Hillary's program, people would no longer be able to choose their own doctor--that some faceless government bureaucracy would tell you where you had to go for medical care.

Again, Medicare doesn't tell you where you can go any more than BCBS or BamaGrad's United Healthcare does. It's called restrictions and limitations and EVERY insurance plan has them. If you find one that doesn't, please share it with everyone because it truly is a rare breed.

You should realize in your business, or maybe you don't because you run the business end and not the medicine end, but that most imaging is done by a physician, esp primary care to cover his a$$. You have someone come in with headaches and you are fairly sure of your diagnosis, but because you could get sued if you missed a brain cancer. I don't know if you have the numbers, but I would be interested to know, of head MRI's, how many have positive findings. Very few I would guess. And that opens up a whole other field of having radiologists to view imaging thats all a safety net for lawsuits. How much do you pay your radiologists Al? I think they are getting about $500 an hour around here for an experienced radiologist.

Medicare isn't that bad, but medicaid is. You can't compare either to BCBS. As one colleague calls it, BC is the "cadillac" of insurances. There aren't many major carriers much better. However, even they are restricting imaging now because imaging is one of the greatest costs these days. You have to get pre-certification which is a nightmare. It requires more staff, both for the physician and insurance company. Its difficult to get imaging for those that really need it.

[rexbo 104]

We just need a health care system that let's the lawyers die in the streets; then we won't have a system that is unaffordable due to liability and malpractice insurance costs...

I'd settle for one that euthanizes idiots.

Litigation

Contrary to popular belief, malpractice lawsuits do not account for a large portion of American healthcare spending. A study in Health Affairs found that the cost of defending and settling malpractice lawsuits in 2001 was approximately $6.5bn, or 0.46% of total health expenditures (reference: http://content.healthaffairs.org/cgi/conte...stract/24/4/903

You didn't mention the cost of liability insurance, and you didn't mention the extra procedures and tests that are now ordered by Dr.s afraid of all of the ambulance-chaser lawyers standing at the ER doors. But, I will admit that lawyers are not the primary reason health care costs are so high. This CATO study below points out the most obvious reason we are spending so much on health care; so many of us see it as basically 'free' and don't take the time to make health decisions based on economics or cost/benefit.

Back to the lawyer thing; it is definitely the fault of lawyers that I have to get rid of my diving board, they have all homeowner insurance companies scared to death of frivilous lawsuits. I spent $20,000 plus for my nice swimming pool, and the lawyers are making me dismantle one of the primary things my family enjoys in the summer. What's next, my jet ski? Are we all going to be walking around in bubble wrap?

Well, believe it or not, I could care less about your pool without a board. Perhaps you should have looked into insurance costs before you dug the hole.

In your world, I'm sure you never considered that doctors can use this "blown out of proportion" fear of malpractice to fatten their wallets with their fees for unnecessary tests and evaluations. Of course, that fattens the insurance company wallets too, but you should of course blame the lawyers. It's way too much to ask that medical doctors treat you properly and only to the extent reasonably necessary.

I think you should talk to your surgeon before your child has his or her next surgery. I suggest you sign a waiver not to collect any damages from the surgeon, hospital, etc. in any amount over $100,000 should they happen to kill or permanently paralyze your kid because of their gross negligence. Perhaps they would give you 10% off. My kids and wife are worth more than the price you place on your next of kin, so I'll just pay the full cost of surgery and expect them to perform competently. Should they not, I want a jury to tell them how much my child's life and future was worth. Problem solved.

Of course not you don't care about an individual and them enjoying basic entertainments of life, lawyers only care about their next big litigation payoff. And I did look into the insurance costs, it was not a problem when I put in my pool in 2001. Last, no doubt everyone is concerned about the competency of their Dr and should do some basic research; but there is a price to a completely risk free world, not one I can afford...

[Tiger Al 0]

The problem with socialized medicine is that it doesn't work in a capitalistic society. People shop around for the best doctor and someone whom they like.

If you have a socialized health care plan, there will be a black market because some people will have the money to pay for it. You'll also have the best doctors move to places where they can practice fee for service medicine.

Are Medicare patients not free to "shop around" for a physician?

NO. NO and NO. Many doctors do not accept and will not file medicare.

Many doctors do. There are doctors that also don't work with certain insurance companies. That's capitalism at work, too. People on medicare still have a number of choices.

You and Al are nuts. TYhere are fewer and getter fewer the number of Drs that will accept Medicare patients. They are not accepting for the the same reasons they will not take them under NHI, cold hard cash and govt interference. Al, dont you work in the medical field? If so, that is the lamest question ever asked. Yeah they can shop around to a bunch of recent grads and about to go out of business/retire Docs. What a choice. I guess it looks like a good deal in the old Soviet block.

You have absolutely no idea what you're talking about. Before you shoot from the hip, you really ought to do some research sometimes. Medicare has 196 physicians listed in Alabama for General Medicine alone. BCBS listed 107 General Practitioners in Alabama. All of them run the gamut regarding experience.

I have a friend who does marketing for a home health company and they are told to actively, vehemently pursue Medicare referrals. Why? In your own words; Cold hard cash.

In my business, magnetic resonance imaging, Medicare reimburses slightly less than BCBS. The number of people using Medicare is growing. So, if you are looking at paying for a million dollar-plus piece of equipment, only a fool would turn away a Medicare patient because he's holding out for the next BCBS patient. 95% of the pie is better than 100% of no pie.

For example, one of the big problems identified by opponents in the health insurance industry was the suggestion that under Hillary's program, people would no longer be able to choose their own doctor--that some faceless government bureaucracy would tell you where you had to go for medical care.

I seriously doubt that insurance executives are going to tout the benefits of anything that threatens their existence, do you?

...under Hillary's program, people would no longer be able to choose their own doctor--that some faceless government bureaucracy would tell you where you had to go for medical care.

Again, Medicare doesn't tell you where you can go any more than BCBS or BamaGrad's United Healthcare does. It's called restrictions and limitations and EVERY insurance plan has them. If you find one that doesn't, please share it with everyone because it truly is a rare breed.

You should realize in your business, or maybe you don't because you run the business end and not the medicine end, but that most imaging is done by a physician, esp primary care to cover his a$$. You have someone come in with headaches and you are fairly sure of your diagnosis, but because you could get sued if you missed a brain cancer. I don't know if you have the numbers, but I would be interested to know, of head MRI's, how many have positive findings. Very few I would guess. And that opens up a whole other field of having radiologists to view imaging thats all a safety net for lawsuits. How much do you pay your radiologists Al? I think they are getting about $500 an hour around here for an experienced radiologist.

I have experience with both the business side as well as the medical side. I can't speak as to the reasons why a clinician does or doesn't order diagnostic tests, my hope is that it's guided by his or her desire to arrive at the correct diagnosis. I think that, more often than not, if the physician evaluates a patient thoroughly then their exposure to lawsuits decreases regardless of whether they ordered 50 diagnostic tests or just the 3 they really needed. Hopefully you're not sending a patient with headaches for an MRI solely because you don't want to miss a metastatic brain lesion. If, however, that patient has been diagnosed with lung ca, then shame on you if you don't.

As for radiologists, my understanding as to why they exist is not as a safety net to prevent lawsuits but because the field of radiology is vast, complex and would take years of additional training for a med student to complete to even begin to understand what he or she was looking at, much less what it meant. The same goes for surgeons, oncologists, pathologists, etc. I know neurologists who are very competent at reading c-spine MRI's, but show them a renal MRA and they're almost clueless.

Medicare isn't that bad, but medicaid is. You can't compare either to BCBS. As one colleague calls it, BC is the "cadillac" of insurances. There aren't many major carriers much better. However, even they are restricting imaging now because imaging is one of the greatest costs these days. You have to get pre-certification which is a nightmare. It requires more staff, both for the physician and insurance company. Its difficult to get imaging for those that really need it.

And, the rest of the analogy is that it's the "Cadillac" because it's more expensive.

The goal of some kind of national healthcare plan isn't to provide people with "Cadillacs", but just give them some basic coverage that beats what they already have which is nothing. As BamaGrad pointed out, an uninsured person WILL get treatment at an ER for life/limb-threatening conditions, but you know as well as I do that that treatment only goes as far as STABILIZING that patient. After that, he's out of there. A minor wound to the foot won't get him anything. No insurance means he probably won't get treatment for it until it progresses to osteomyelitis and he has to lose a leg.

Sorry, it's just my opinion that as a country we can and should do better.

[LegalEagle 22]

Of course not you don't care about an individual and them enjoying basic entertainments of life, lawyers only care about their next big litigation payoff. And I did look into the insurance costs, it was not a problem when I put in my pool in 2001. Last, no doubt everyone is concerned about the competency of their Dr and should do some basic research; but there is a price to a completely risk free world, not one I can afford...

Mmmm, I just hope Big Government never makes us wear seat belts or get vaccinated!!

For a "Bogus" report on diving board litigation see:

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=902029

It is interesting that of the 11 million dollar judgment that started the big scare not one dollar was assessed against the property owner.

Could it be that your pool was measured and determined to be unsafe for a diving board? Seems that you'd put the board in and say the hell with insurance and quadraplegia!

Oh, I would advise you consider water wings if you venture out of the wading pool.

Just curious. If your kid, say 12 years old and full of promise went to a friend of a friend's place and dove off of their diving board into a clearly inadequate depth of water, reducing him to a permanent vegatative state requiring constant 24/7 care costing you and the Mrs. $400,000 per year, what would you do? Keep in mind that punishing your son would not teach him any meaningful lesson at that point.

Question 2 - How would you feel about diving boards?

[MDM4AU 336]

And, the rest of the analogy is that it's the "Cadillac" because it's more expensive.

This is not always true.

I am a benefits consultant in Birmingham and handle group coverage (Health, Dental, Life, AD&D, Disability, LTC, Section 125's) all over central Alabama, parts of Mississippi, Tennessee, and Georgia. Each BCBS plan is a totally different company from the other plans (BCBSAL, BCBSMS, BCBSTN, etc.). What connects them is being a part of the BCBS Association. I am not licensed in the other states so I can't comment on what they can offer. I do know that the people I have talked to that have MS and TN do not like their coverage.

I see other companies come in with lower rates than BCBSAL but most of the time they can't. BCBSAL has it in their contracts with providers that no one gets a better discount than BCBSAL customers. Having that in there, they still have 100% of the Hospitals and 96% of the Physicians in AL in their network. BCBSAL generally has lower Admin. fees as well. They have one of the lowest operating costs of anyone in the country (40% lower than industry average).

They don't always make everyone happy, but they do a better job than most insurance providers can.

[AFTiger 282]

Here is $12 million that will not go into reducing healthcare costs.

Brookwood loses suit in patient's suicide

Friday, February 16, 2007 RUSSELL HUBBARD News staff writer

Brookwood Medical Center was to blame for the 2003 suicide of a psychiatric patient who jumped to his death from a hospital parking deck, a Jefferson County jury found Thursday when it awarded $12 million to the man's family.

The Circuit Court jury decided the hospital, owned by Dallas-based Tenet Healthcare Corp., was responsible for the death of Vaughn Hollon, who was 53 in October 2003 when he was admitted as a suicide risk. Brookwood spokeswoman Debbie Hollenstein said the hospital did nothing wrong and intends to appeal the verdict.

Hollon died after he scaled a fence in an outdoor area of a psychiatric ward at the city's second-largest hospital. He broke both legs after the initial fall onto a parking deck. He was killed by a second jump that sent him plunging 80 feet to the ground after escaping the grip of a nurse who tried to restrain him.

"They admitted him for suicidal ideation, and they knew exactly how dangerous of a condition this man was in," said Glenda Cochran, whose Cochran & Associates law firm represented Wollon's family. "He was emotionally, physically and spiritually spent."

The $12 million in punitive damages is the largest civil judgment in Alabama so far this year and would have ranked second among all Alabama circuit court verdicts last year, according to the Alabama Jury Verdict Reporter, a research journal. It is the first medical malpractice victory for an injured party in Jefferson County in a long time: Out of 10 trials last year, doctors and hospitals won every one.

Hollon, who lived in Florida, was referred to Brookwood by relatives in Birmingham, said Stephen Becker, a Cochran & Associates attorney who also worked on the case. He needed help because he was depressed, had just lost his job and showed suicidal tendencies, Becker said. Hollon had been in Brookwood's care for about 48 hours when he climbed the fence, court documents said.

The attorneys presented evidence and testimony during the two-week trial that attempted to show Brookwood breached the accepted standard of care for worker training, staffing levels and security procedures. They also argued the wrought-iron fence with metal bars that Hollon climbed was not within the accepted standards for a mental-health center.

"He did not receive the proper care," said Mary Ellen Hollon, mother of Vaughn Hollon. "If a dime had not been awarded, the important thing is that Brookwood corrects its mistakes so not another person has to die from their negligence."

`Acted heroically':

Brookwood extends its sympathies to the Hollon family, hospital spokeswoman Hollenstein said. She also said the hospital workers "acted heroically" to save Hollon's life, which included putting their own lives in danger to keep him from killing himself.

"We strongly believe that this verdict is not a fair reflection of the care provided at Brookwood Medical Center," Hollenstein said. "The amount of the award is not appropriate, and we will appeal it to a higher court."

Brookwood's 586 beds make it the second-largest hospital in Birmingham, behind UAB Hospital's 900. Brookwood is owned by Tenet, the second-largest hospital chain in the country with 66 hospitals and about $10 billion a year in revenue.

The $12 million award in the past 12 months is eclipsed only by a $19 million Tuscaloosa County verdict in favor of Family Dollar Stores employees who objected to how their wages were calculated, the Alabama Jury Verdict Reporter's 2007 annual summary says.

Traditionally, medical malpractice claims have been hard for injured parties to win in Alabama. The injured won 12.5 percent of medical malpractice cases statewide last year, and prevailed 27 percent of the time 2002-06, the Jury Verdict Reporter said.

"The 1987 Medical Liability Act set hurdles that are higher than other states," said Ralph Cook, former Alabama Supreme Court justice and current president of the Alabama Trial Lawyers Association. "Over time, it has favored defendants."

[LegalEagle 22]

lawyers only care about their next big litigation payoff.

You'll need to bring this up w/ AUEsquire - he's more of a full-time plaintiff's attorney with an obscene income.

Me, I got 4 wrongful criminal charges against an American citizen dismissed today. Two of the charges were felonies. And. . . drumroll, my client stiffed me for over 60% of the fee he agreed to pay me.

Also, this week I have been gathering school records on two young boys who the court found to be dependant and neglected by their meth addicted mother (imagine that). I have also reviewed numerous reports on them this week. It's a court appointed case so I receive 40% of my normal rate of pay.

Lastly, I have been appointed to appeal a murder conviction where my maximum pay is $2,000. The court reporter will get around $9,000 just for typing the transcript of the 6 day trial. My client paid another attorney to represent her at trial, now she's broke, so I get the pleasure.

Thanks for the tip, I think I'll get into swimming pool law. Shucks, strike that. I just did computer-aided legal research search of the Tennessee Appellate Court cases since the 1940s. Seems we haven't had any diving board suits where damages were appealed yet. Mmmm, maybe someone will call this afternoon. . .

[Tiger Al 0]

And, the rest of the analogy is that it's the "Cadillac" because it's more expensive.

This is not always true.

I am a benefits consultant in Birmingham and handle group coverage (Health, Dental, Life, AD&D, Disability, LTC, Section 125's) all over central Alabama, parts of Mississippi, Tennessee, and Georgia. Each BCBS plan is a totally different company from the other plans (BCBSAL, BCBSMS, BCBSTN, etc.). What connects them is being a part of the BCBS Association. I am not licensed in the other states so I can't comment on what they can offer. I do know that the people I have talked to that have MS and TN do not like their coverage.

I see other companies come in with lower rates than BCBSAL but most of the time they can't. BCBSAL has it in their contracts with providers that no one gets a better discount than BCBSAL customers. Having that in there, they still have 100% of the Hospitals and 96% of the Physicians in AL in their network. BCBSAL generally has lower Admin. fees as well. They have one of the lowest operating costs of anyone in the country (40% lower than industry average).

They don't always make everyone happy, but they do a better job than most insurance providers can.

I meant cost relative to what Medicare customers pay.

[MDM4AU 336]

And, the rest of the analogy is that it's the "Cadillac" because it's more expensive.

This is not always true.

I am a benefits consultant in Birmingham and handle group coverage (Health, Dental, Life, AD&D, Disability, LTC, Section 125's) all over central Alabama, parts of Mississippi, Tennessee, and Georgia. Each BCBS plan is a totally different company from the other plans (BCBSAL, BCBSMS, BCBSTN, etc.). What connects them is being a part of the BCBS Association. I am not licensed in the other states so I can't comment on what they can offer. I do know that the people I have talked to that have MS and TN do not like their coverage.

I see other companies come in with lower rates than BCBSAL but most of the time they can't. BCBSAL has it in their contracts with providers that no one gets a better discount than BCBSAL customers. Having that in there, they still have 100% of the Hospitals and 96% of the Physicians in AL in their network. BCBSAL generally has lower Admin. fees as well. They have one of the lowest operating costs of anyone in the country (40% lower than industry average).

They don't always make everyone happy, but they do a better job than most insurance providers can.

I meant cost relative to what Medicare customers pay.

My bad.

[aumd03 2]

You'd get in more trouble for not picking up a primary tumor earlier. Any patient with a large enough tumor to suspect mets is going to get a CT and probably PET for primary staging before any surgery is attempted, so missing a met is less of an issue.

I agree, there is a subpopulation is going to bankrupt our health care system. We spend about 90% of our funds on about 5% of the population. For example, I saw a patient that had 25 CT's for abdominal pain after visits to the ER over a two year period. No one wants to miss the appendicitis, although this patient routinely abuses the system. The hospital eats those costs and passes it along to other patients. You can't tell me that after the 3rd or 4th CT, the sole motivation is protection from a potential lawsuit.

I didn't mean to imply that radiologists have no role other than a safety net. But much of imaging is a "just in case" type of deal. I think its difficult to understand being scared of being sued until you are in that situation. And don't realize how much that thought enters your mind during decision making. Imaging is a quite lucrative business. I'm surprised you are supportive of govt healthcare. I have discussed cases more than once with the hospital or nursing home lawyer in my short time trying to avoid a lawsuit. It does impact care and costs. I don't think lawyers or evil or bad, its just that punitive damage cases have gotten out of hand. Lawyers protect us from things that are unsafe and from abuses. But sometimes bad and unexpected things happen. They aren't always someone's fault. It doesn't entitle you to tens of millions of dollars. And in our society, in places where people have a victimistic point of view, jury trials are don't always see the facts of the case as they really are.

[TexasTiger 13,029]

You and Al are nuts.

That's like a frog calling you ugly.

[TexasTiger 13,029]

So are you really a doctor, or do you just play one on the internet?

You'd get in more trouble for not picking up a primary tumor earlier. Any patient with a large enough tumor to suspect mets is going to get a CT and probably PET for primary staging before any surgery is attempted, so missing a met is less of an issue.

I agree, there is a subpopulation is going to bankrupt our health care system. We spend about 90% of our funds on about 5% of the population. For example, I saw a patient that had 25 CT's for abdominal pain after visits to the ER over a two year period. No one wants to miss the appendicitis, although this patient routinely abuses the system. The hospital eats those costs and passes it along to other patients. You can't tell me that after the 3rd or 4th CT, the sole motivation is protection from a potential lawsuit.

I didn't mean to imply that radiologists have no role other than a safety net. But much of imaging is a "just in case" type of deal. I think its difficult to understand being scared of being sued until you are in that situation. And don't realize how much that thought enters your mind during decision making. Imaging is a quite lucrative business. I'm surprised you are supportive of govt healthcare. I have discussed cases more than once with the hospital or nursing home lawyer in my short time trying to avoid a lawsuit. It does impact care and costs. I don't think lawyers or evil or bad, its just that punitive damage cases have gotten out of hand. Lawyers protect us from things that are unsafe and from abuses. But sometimes bad and unexpected things happen. They aren't always someone's fault. It doesn't entitle you to tens of millions of dollars. And in our society, in places where people have a victimistic point of view, jury trials are don't always see the facts of the case as they really are.

[aumd03 2]

So are you really a doctor, or do you just play one on the internet?

You'd get in more trouble for not picking up a primary tumor earlier. Any patient with a large enough tumor to suspect mets is going to get a CT and probably PET for primary staging before any surgery is attempted, so missing a met is less of an issue.

I agree, there is a subpopulation is going to bankrupt our health care system. We spend about 90% of our funds on about 5% of the population. For example, I saw a patient that had 25 CT's for abdominal pain after visits to the ER over a two year period. No one wants to miss the appendicitis, although this patient routinely abuses the system. The hospital eats those costs and passes it along to other patients. You can't tell me that after the 3rd or 4th CT, the sole motivation is protection from a potential lawsuit.

I didn't mean to imply that radiologists have no role other than a safety net. But much of imaging is a "just in case" type of deal. I think its difficult to understand being scared of being sued until you are in that situation. And don't realize how much that thought enters your mind during decision making. Imaging is a quite lucrative business. I'm surprised you are supportive of govt healthcare. I have discussed cases more than once with the hospital or nursing home lawyer in my short time trying to avoid a lawsuit. It does impact care and costs. I don't think lawyers or evil or bad, its just that punitive damage cases have gotten out of hand. Lawyers protect us from things that are unsafe and from abuses. But sometimes bad and unexpected things happen. They aren't always someone's fault. It doesn't entitle you to tens of millions of dollars. And in our society, in places where people have a victimistic point of view, jury trials are don't always see the facts of the case as they really are.

I just play one. My real name is George O'Malley.

[TexasTiger 13,029]

So are you really a doctor, or do you just play one on the internet?

You'd get in more trouble for not picking up a primary tumor earlier. Any patient with a large enough tumor to suspect mets is going to get a CT and probably PET for primary staging before any surgery is attempted, so missing a met is less of an issue.

I agree, there is a subpopulation is going to bankrupt our health care system. We spend about 90% of our funds on about 5% of the population. For example, I saw a patient that had 25 CT's for abdominal pain after visits to the ER over a two year period. No one wants to miss the appendicitis, although this patient routinely abuses the system. The hospital eats those costs and passes it along to other patients. You can't tell me that after the 3rd or 4th CT, the sole motivation is protection from a potential lawsuit.

I didn't mean to imply that radiologists have no role other than a safety net. But much of imaging is a "just in case" type of deal. I think its difficult to understand being scared of being sued until you are in that situation. And don't realize how much that thought enters your mind during decision making. Imaging is a quite lucrative business. I'm surprised you are supportive of govt healthcare. I have discussed cases more than once with the hospital or nursing home lawyer in my short time trying to avoid a lawsuit. It does impact care and costs. I don't think lawyers or evil or bad, its just that punitive damage cases have gotten out of hand. Lawyers protect us from things that are unsafe and from abuses. But sometimes bad and unexpected things happen. They aren't always someone's fault. It doesn't entitle you to tens of millions of dollars. And in our society, in places where people have a victimistic point of view, jury trials are don't always see the facts of the case as they really are.

I just play one. My real name is George O'Malley.

Sorry that Burke is so mean to you.