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View Diary: Obama Administration Delays Out-Of-Pocket Caps To Grant Insurance Companies Transition 'Relief' (308 comments)

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  •  How do they get around it? n/t (2+ / 0-)
    Recommended by:
    james321, enhydra lutris

    That's one more thing to add to my long list of small problems. --my son, age 10

    by concernedamerican on Tue Aug 13, 2013 at 08:36:42 AM PDT

    [ Parent ]

    •  One method we've noticed (17+ / 0-)

      is including a lot of padding of their patient related payrolls with nonsensical services related to "prevention" and "quality", ie calling people and giving them health tips, calling doctors and making them go through extensive questionnaires and file reviews to justify existing prescriptions for patients, etc.

      The cost formulas for employing the likely low paid staff hired to do this work can be massively inflated to include costs of excessive salaries and benefits for top management, offices, etc.  

      The trick is to hire these employees under the guise of their work being defined as delivering health care services as opposed to those employees who work on processing insurance claims.

      "The international world is wondering what happened to America's great heart and soul." Helen Thomas

      by Betty Pinson on Tue Aug 13, 2013 at 09:02:57 AM PDT

      [ Parent ]

      •  Yep, my health keeps being "improved" by (3+ / 0-)
        Recommended by:
        SingleVoter, Betty Pinson, schnecke21

        these stupid phone calls, postcards and other useless things like "walk a mile a day."  Also, lots of letters questioning one drug or another and suggesting variations. Automatically being sent, it appears. Just random because the information often doesn't match up with the reason for the prescription, etc.

        Naturally, those are written up as huge expenses in preventing illness and improving the quality of my care.

        Then that's in the base of "health care" and they get to keep the profits between the booked value of sending a postcard "$100 health care consultation" and the real cost of sending a postcard "$0.60".  

        $99.40 in profit created and all within the 80-85% cap (which is it? does someone know?).

        "The law is meant to be my servant and not my master, still less my torturer and my murderer." -- James Baldwin. July 11, 1966.

        by YucatanMan on Tue Aug 13, 2013 at 12:49:57 PM PDT

        [ Parent ]

    •  I also think they reclassify their PR and (2+ / 0-)
      Recommended by:
      concernedamerican, YucatanMan

      advertising as medical education for patients.

      The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

      by accumbens on Tue Aug 13, 2013 at 10:36:36 AM PDT

      [ Parent ]

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