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Health care companies would quickly go out of business if they approved every procedure their clients wanted. What's the solution?

Maidenrules29

Maidenrules29

Death to all but METAL!!
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Slippery slope, but aside from the federal government telling healthcare companies how much they can pay upper management and higher, which we all know won't happen, I dont see how these companies can O.K. all procedures and still stay in business. Premiums would have to skyrocket and doctors and nurses would be paid less. Besides cutting upper management pay, does anyone have an idea how to improve clients getting approved for things now being denied?
 
Maidenrules29 said:
Slippery slope, but aside from the federal government telling healthcare companies how much they can pay upper management and higher, which we all know won't happen, I dont see how these companies can O.K. all procedures and still stay in business. Premiums would have to skyrocket and doctors and nurses would be paid less. Besides cutting upper management pay, does anyone have an idea how to improve clients getting approved for things now being denied?
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Come up with a better/different business model, one where they use their "power" over the medical community and their billing, the medical equipment/supply companies, and altho they'll have less "power" over them, Big Pharma.

And if they wont cover something, it needs to be spelled out clearly in the policy. If it's not, then they cover it and eat it.

Problem is...they're expected by board members and stockholders to "produce" big profits. So unless they look for "people first" solutions, nothing will change.
 
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Maidenrules29 said:
Slippery slope, but aside from the federal government telling healthcare companies how much they can pay upper management and higher, which we all know won't happen, I dont see how these companies can O.K. all procedures and still stay in business.
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They couldn’t since that would create a system where care providers could (and likely would) treat the insurance companies like ATMs where any and all billing codes entered would result in cash being dispensed to them.

Maidenrules29 said:
Premiums would have to skyrocket and doctors and nurses would be paid less. Besides cutting upper management pay, does anyone have an idea how to improve clients getting approved for things now being denied?[/B]
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Perhaps by having some sort of neutral appeals (second opinion?) process, but how efficient, cost effective or practical that would be is anyone’s guess.
 
Maidenrules29 said:
Slippery slope, but aside from the federal government telling healthcare companies how much they can pay upper management and higher, which we all know won't happen, I dont see how these companies can O.K. all procedures and still stay in business. Premiums would have to skyrocket and doctors and nurses would be paid less. Besides cutting upper management pay, does anyone have an idea how to improve clients getting approved for things now being denied?
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Copy Finland and sweden's plan.............
 
aociswundumho said:
If the goal is to provide healthcare to as many people as possible, then the primary focus should be on reducing the price of healthcare.
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The problem is that no one wants to make less money. From the CEO's all the way down to medical equipment companies.
 
tshade said:
Copy Finland and sweden's plan.............
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Could their plans work on a macro level? We have a much higher population and our citizens are in comparatively horrible health.
 
Kaiser, I understand, has an interesting protocol.

If a doctor believes a patient requires a surgical procedure, they can recommend it, but they cannot perform the surgery. The patient is automatically referred to a second doctor in the same specialty who will or will not confirm the first doctor's diagnosis and treatment. If he concurs with the first doctor, he can perform the procedure. If not, the patient doesn't get the surgery covered.

At least it's doctors making the call, not some bean counting executive just looking at dollar signs.
 
Maidenrules29 said:
Could their plans work on a macro level? We have a much higher population and our citizens are in comparatively horrible health.
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We could do it with small moves. Lower the medicare age over 10 years until it hits age 55, etc...........go to a lower age over the next 20 years.......

We do it now for the military, age 65 and over, and other groups....................so, yeah, if we wanted to, we could......
 
Lovebug said:
Health care companies would quickly go out of business if they approved every procedure their clients needed.

Fixed that for you.
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Well said. Kinda what I meant also but well said!
 
tshade said:
We could do it with small moves. Lower the medicare age over 10 years until it hits age 55, etc...........go to a lower age over the next 20 years.......

We do it now for the military, age 65 and over, and other groups....................so, yeah, if we wanted to, we could......
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The biggest hurdle I think would be successfully raising the tax revenue needed.
 
noonereal said:
Yes i read the post and agree with you.
I am laughing at the idea that Healthcare companies would go broke by paying out claims.
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Not "broke". Merely "out of business". Sometimes two different things. Many business owners dissolve their business because they see the end of the profits they are used to coming, so they get out. Usually by selling or filing chapter 7.
 
We need to do whatever it takes to get cost down. That means people actually shop price for medical treatments. That means none or very few goverment subsidies. That means no free ER for the homeless and poor. That means quit pandering to fake mental illnesses. That means addiction is a behavior problem, not a medical problem. You can see why this problem is unique to America.
 
dmpi said:
We need to do whatever it takes to get cost down. That means people actually shop price for medical treatments. That means none or very few goverment subsidies. That means no free ER for the homeless and poor. That means quit pandering to fake mental illnesses. That means addiction is a behavior problem, not a medical problem. You can see why this problem is unique to America.
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Just close all the hospitals. No health care, no problem.
 
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