health

Doctors in U.S. say insurers increasingly interfere over patient care

22 Comments
By TOM MURPHY

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22 Comments
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Glad we have socialized medicine in Japan. We don't have these problems. Why is it that a worker at an insurance company who is not a doctor can overrule a doctor?

13 ( +13 / -0 )

For years I have heard that the United States of America has the best health system in the world. I have said that the most expensive health system is not necessarily the best health system.

As a Citizen of the United States of America living in the USA I have experienced a com- plicated and expensive system, not a caring system.

10 ( +10 / -0 )

USA medical system is an absolute mess. Before I retired, as self employed, I paid $1,250 per month insurance, then blood pressure rises when you have to fight insurance companies to pay their part! It was still the typical 20% I pay up to $10,000 ($2,000) plus a $1,200 per year I had to pay for deductible. Then the stupid insurance company just MIGHT pay, after you have been turned over to a collection agency.

Yes, that describes USA medical system. I loathe it.

10 ( +10 / -0 )

If you have oodles of dosh, the US is probably great.

If you’re an average joe, a system like Japan’s is more likely your best bet.

11 ( +11 / -0 )

In the US, every patient is viewed by the insurance companies and hospitals as a profit center.

7 ( +7 / -0 )

My dad had a relatively good policy from his place of employment that covered him and my mom even after his retirement, and her after his death. But in their final years, when I had to help them through some major health issues, it was a real nightmare, locking them into being able to see only certain doctors, confusing as all get out to understand, etc. In a way it was fortunate their final declines were relatively swift.

I would never want to deal with that system again.

4 ( +4 / -0 )

Forgot to say that was in the USA.

2 ( +2 / -0 )

The article isn't telling the whole story. It seems to be talking only about HMO insurance, not PPO, and so are some of the comments here about their experiences.

For those that don't know, HMO is the cheaper insurance, which requires the approvals by the insurer that the article talks about. It also limits you as to which provider you can go to.

PPO on the other hand, while more expensive, gives you freedom to go to any provider in the country, any specialty you want, any time you want, no approvals are necessary. The never meddle in the care you receive.

If you work for a decent employer, the cost isn't that much. I've compared mine to a Japanese friend of mine, who worked at a top tier company in Japan, and he was surprised at the low cost I was paying.

0 ( +0 / -0 )

Mine's PPO btw

0 ( +0 / -0 )

good ol USA only those who can afford medical care need apply doesnt matter if your poor or disadvantaged when it comes to medical care your treated as a second class citizens, pillar of modern democracy, land of the free home of the brave, socialism be damned, capitalism is king the rest well ,can die.

3 ( +3 / -0 )

who worked at a top tier company in Japan, and he was surprised at the low cost I was paying.

the Japanese health system is very good and probably similar to the AMerican top tier cover and your only charged a percentage of your salary depending on how much you earn. The amount I pay each year that covers my whole family is actually pretty good. My wife spent 6 week in hospital for a car crash about 15 yrs ago, couple broken ribs and ruptured kidney, the cost of that alone probably wiped away a few years premiums I was paying

1 ( +1 / -0 )

I prefer the British Canadian and French health care system, basically free heath care.

Insurance companies are corporations and corporations are into making profits not paying for healthcare treatments and medicine. It’s a conflict of interest.

6 ( +6 / -0 )

I prefer the British Canadian and French health care system, basically free heath care.

it isnt free why do you think UK and France have 20% VAT its being paid for every time they buy something

1 ( +2 / -1 )

I was talking with a doctor friend at my home last night who is senior surgeon tells me there are many pressures from the bureaucrats on what healthcare they can provide.

1 ( +1 / -0 )

If someone is paying 12,000 dollars/year for health insurance they might consider just moving to Mexico where you can live off that the entire year. When I got sick in Mexico my friend took me to a pharmacy (not a doctor) and it was clear I had an ear infection and he sold me the antibiotics for a few bucks. In the US you would have to visit a doctor for 150 or more dollars then pay who knows what for the medicine.

0 ( +1 / -1 )

A lot of people here must have Trump genes in them. They criticize the POTUS for not being more PC then they go & slander whoever they feel deserves it. We're talking about interference by pharma in medical issues. I avoid going to the doctor as much as possible & pray hard I never have to go. We're pawns of people whose prime concern is their pocket, practice, etc. We're somewhere down the line.

1 ( +1 / -0 )

The purpose of the checks is to prevent and delay costs. Nothing more.

Someone is going to pay for health care. In the US, it is a for-profit business by everyone involved. Health care is about 20% of the US GDP, so getting that changed when so many people's paychecks are involved will have endless legal battles. With record profits, thanks to ObamaCare, the insurance companies will not go quietly.

1 ( +1 / -0 )

Why is it that a worker at an insurance company who is not a doctor can overrule a doctor?

Because doctors in the USA are caught all the time padding procedures, overselling medications, to help increase their own profits, not for the patient's benefit.

I don't want to say that the insurance company is always correct or that they aren't money grubbing most of the time, but doctors are far from the ideal healers many people picture.

1 ( +1 / -0 )

gokei_wo_maneku:

Glad we have socialized medicine in Japan. We don't have these problems. Why is it that a worker at an insurance company who is not a doctor can overrule a doctor?

Japanese national health does not cover everything, nobody talks about "a worker at an insurance company who is not a doctor", and nothing was said about "overruling". They are talking about guidelines for what sort of treatment to pay for. How many wrongs can cone squeeze in one short comment?

-1 ( +0 / -1 )

Here in the states, EVERYTHING revolves around money. No matter how much bickering among politicians you see year after year over the medical system, it will never get better here in the states, as long as the industry is allowed, (yes I said "allowed") to charge whatever the hell they want for anything and everything medical related. I expect the next ruling generation here in the states to be able to fix the system, but right now, with the majority of voters still being older, more conservative thinking people, it won't change, it will just get more expensive.

People complain about the insurance companies, but in reality, they are not the root of the problem. The raw cost of everything the insurance companies have to pay for is the problem. The ONLY way to fix it is to limit the cost of all things medical, be it tools, medicine, facilities, etc. People scream doing that will stifle innovation. Whatever. People will still want to be healthy, the demand will be there.

It's funny how people here are dying because they can't afford insulin and the drug companies get away with it, but if there is some sort of emergency and the gas station down the road charges a dollar more for gas than the next gas station and they will go to jail for price gouging. Don't ever believe the big companies aren't paying to keep things the way they are. It's all smoke and mirrors, but it's there......

1 ( +1 / -0 )

Here in the states, EVERYTHING revolves around money.

Extreme capitalism.

1 ( +1 / -0 )

wtfjapan, the principle is that it is free at point of use. Of course there is a cost to be paid but that cost is not over burdened on those least able to pay it or most in need. Any system where the profit motive is at the core will of necessity fail to provide adequate outcomes for any save the wealthy.

0 ( +0 / -0 )

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