Originally Posted by jeanb

"Bring out your dead ..." (Monty Python)

Originally Posted by hiptothat

I have been following this thread with interest. I am an ob-gyn in practice for 27 years and trust me, our system is seriously broken, and anyone who doesn't see this is not looking. My patients are losing insurance coverage along with jobs, can't afford Cobra (which is temporary, expensive extension of your health insurance from your recent employer) or finding that any policy they are able to afford covers very little. Heaven forbid there should be a pre-existing condition! The insurance companies are profit-driven which translates into denial of legitimate claims or endless appeals and delays until you are paid. Usually 1/3 to 1/2 of your billed services. The percentage drops every year. In 2008 I made the least profit I have ever taken out of my practice. This is with very little change in my billing amounts. Even with PD I am working hard and would love to cut back but can't afford to. And if anyone thinks there are "free market" forces somehow applicable here that is some kind of nostalgic fable. I sign a contract with your insurer that says that I will accept their reimbursements and I cannot bill my patient for services that are denied by their insurer. So I am out the cost of the bone density study that I ordered for my post-menopausal breast cancer patient who can't take estrogen and whose mother died of complications of osteoporosis. Her insurer claims that the bone density study is "investigational"!!! That's it, case closed, I eat the unpaid bill. After a lengthy appeal no doubt.

My best friend from medical school works in the VA system. She has been there a while so makes a generous salary, 5 weeks paid vacation, 1 week paid CME, she will have a pension, great benefits, Federal holidays, etc etc. So what exactly is it about the government-run system I am supposed to be afraid of? She likes her practice and takes care of patients who need her.

I have to hire an extra person to spend the day begging the insurance co's to pay for legitimate services. It is hard to budget when you don't know when or if you will be reimbursed. And yet the insurance companies make a profit--why?? What service does a bureaucrat from BCBS provide for my patient, and why does that entitle them to large executive pays and profits?
I don't doubt that a public plan will not be without its drawbacks but the current system with no checks on insurance co. power is not superior. Lucky you if you are happy with your current plan but I see a bigger picture of many hard-working people who aren't able to obtain or afford coverage and they aren't all illegals or deadbeats.

I'm sorry to be so lengthy but I don't post too often and it's mainly when I feel strongly about something. One last thing: another of my med school (Duke) classmates practices in Canada, and the system works pretty well in her viewpoint. She is a psychiatrist who has practiced in both countries. I see the propaganda about how terrible the Canadian system is and I think it is all being funded by ins cos and big pharma and they have the clout to get whatever they want I'm afraid. Sigh. The status quo.