Back when doctors made big bucks people began to complain. They looked at unions and their medical 'insurance' and said 'that's what we want.' Now insurance carriers are making big bucks, building buildings with their names on them and people are saying we must get rid of these money suckers and find a better way. American's health and wellbeing should be a public social service paid by our taxes. It should be rendered as a program and called Medicare For All. Insurance companies should not exist but their clerical function should be a government service and all medical services and doctors should be fairly paid for what they do. Money is the villain and our taxes and the Medicare system should replace it.
I can tell you that having seen a few of these claims handled for self-funded clients, even using a national PPO network, the arbitration process resulted in a standalone ER being paid 4x the QPA for its services. So I don't think that anyone can credibly claim that the "independent" process is biased in favor of insurers or looking out for the ultimate payers of health benefits: employers.
That is bad but the collusion of Medicare trustees, including Janet Yellin, with Advantage Plans in defrauding Medicare of over $25 billion/yr per NYT and $50 billion/yr per PNHP is even worse. Of course the Trustees are doing this under the direction of the persons appointing them--the Presidents of the US including Joe Biden and Donald Trump.
I'm assuming this is, in part, the reason in my state Oregon, Regence BlueCross Medicare Advantage has withdrawn from contracts with major hospital providers. Providence Medical and LegacyHealth, the two major hospital providers in the city of Portland and major providers for the entire state, have terminated their contracts with Regence. (Providence and Regence just recently reconciled), but nonetheless hospital options and PCP providers for customers of Regence have been, or soon will be, significantly reduced. Regence has recently been in disputes throughout the state, disengaging from contracts with hospital facilities that are the only major hospitals in the area.
Is there something we, the public, can do to influence this?
No wonder every time I try to schedule an appointment to see my doctor, all they have available are appointments with nurse practioners.
Back when doctors made big bucks people began to complain. They looked at unions and their medical 'insurance' and said 'that's what we want.' Now insurance carriers are making big bucks, building buildings with their names on them and people are saying we must get rid of these money suckers and find a better way. American's health and wellbeing should be a public social service paid by our taxes. It should be rendered as a program and called Medicare For All. Insurance companies should not exist but their clerical function should be a government service and all medical services and doctors should be fairly paid for what they do. Money is the villain and our taxes and the Medicare system should replace it.
Why must we have a for profit healthcare system? All medical care should become non profit, period!
I can tell you that having seen a few of these claims handled for self-funded clients, even using a national PPO network, the arbitration process resulted in a standalone ER being paid 4x the QPA for its services. So I don't think that anyone can credibly claim that the "independent" process is biased in favor of insurers or looking out for the ultimate payers of health benefits: employers.
That is bad but the collusion of Medicare trustees, including Janet Yellin, with Advantage Plans in defrauding Medicare of over $25 billion/yr per NYT and $50 billion/yr per PNHP is even worse. Of course the Trustees are doing this under the direction of the persons appointing them--the Presidents of the US including Joe Biden and Donald Trump.
I'm assuming this is, in part, the reason in my state Oregon, Regence BlueCross Medicare Advantage has withdrawn from contracts with major hospital providers. Providence Medical and LegacyHealth, the two major hospital providers in the city of Portland and major providers for the entire state, have terminated their contracts with Regence. (Providence and Regence just recently reconciled), but nonetheless hospital options and PCP providers for customers of Regence have been, or soon will be, significantly reduced. Regence has recently been in disputes throughout the state, disengaging from contracts with hospital facilities that are the only major hospitals in the area.