Seems your source that you chose not to link to are really shills for the government option.
http://www.reuters.com/article/pressRelease/idUS199277+08-Sep-2009+BW20090908
http://www.politifact.com/truth-o-meter/statements/2009/sep/18/health-care-america-now/tv-ad-overstates-health-insurance-denials/
From a study done last year by the AMA (American Medical Association), Medicare denied claims at a rate far greater than the private insurance companies studied, which included 7 of the nation’s top insurers. The average denial rate for the non-Medicare companies was 3.9%. Medicare was a 6.85%. Aetna was a substantial outlier for the private companies. Without Aetna included, the private average is only 3.4%. ONE-HALF of the Medicare rate.
I’m sure this isn’t the complete story, but it’s not the direction I want to head especially considering the plan is to cut Medicare’s funding. We need more visibility like this.
Medicare for ALL anyone?
Medicare 6.85%
Aetna 6.80%
Anthem 4.62%
Health Net 3.88%
CIGNA 3.44%
Humana 2.90%
Coventry 2.88%
UHC 2.68%
See Metric 12 – Page 2 and Page 5
So you concede that it isn't the complete story, yet you went full speed ahead with your inference anyway? Well that doesn't make a hell of a lot of sense, now does it?
Most people covered by medicare are 65+. Not to mention that private insurers are going out of their way to deny coverage to people who may actually have to file a claim. Could these very minor details explain why medicare denies a higher percentage of claims? Far-fetched, I know...
-- Modified on 10/6/2009 6:25:58 PM
My speculation should have caused me to sit on this until my doubts receded? LOL
Your second paragraph does not even come close to explaining this data. Your supposition about private insurers is actually contraindicated by this data. For months now it's been the evil private insurers that were marketed by the Dems and the Dead Free Press as those that have the "death panels", when in fact this shows the government appears to have their purse strings drawn tighter than anyone. This is just the OPPOSITE of what we were supposed to believe. What do you do? Attempt to come up with (i.e make up) reasons why the data must be wrong.
I didn't say the data was wrong, I said that your interpretation of the data was wrong. Yes, you should have considered the fact that Medicare insures individuals that private insurers would consider to be uninsurable simply because they're more likely to NEED medical care. It stands to reason that if you're legitimately insuring people instead of unjustifiably denying coverage or dropping people from your rolls, you're probably going to have to deny a few more claims. That's a conclusion that one could only come to if operating with more than a 1/4 of a fucking brain, though.
Did you really type that about death panels? LOL. Doesn't matter, though. Going off into useless tales about what Dems are supposedly saying doesn't take away from the fact that what you're inferring is complete bullshit. No matter how it gets explained, though, you won't get it. That's your MO.
First, how many people 65 or older (or percent of) do these companies insure, particularly with pre-existing conditions? Second, can someone 65 or older be denied Medicare, even with a pre-existing condition? I'm certain many of the denials by Medicare are due to surgical procedures that are not appropriate for someone of advanced age.
Your questions are irrelevant though. It only matters to the OP that Medicare denied more claims. Clearly, we've got death panels in play here and our evil President just wants to expand them.
First, private insurer’s cover all sorts of people with known pre-existing conditions. In group policies, pre-existing conditions are not excluded. There is simply a waiting period required.
Secondly, my point was quite simple and not nearly as contrived as zork assumes. Medicare and the ensuing government option plan (an outgrowth leading to Medicare for all) have been touted and marketed this past year as being SO much more generous than private industry. This is some evidence showing that’s not necessarily true.
A probable reason for Medicare’s higher rate of not paying claims is because the person wasn’t eligible (presumably due to age). Gosh, you mean the government decided a person’s life was worth it. Listen to the Dems. That’s only supposed to happen in the private sector.
p.s. the study lists the top reasons claims were denied.
What percent of the people that are 65 and over, does the health insurance industry cover, with a primary plan, not supplemental. I suspect that's a very small percentage, since most of them are unemployed and have pre-existing conditions. And, can Medicare reject someone for having a pre-existing condition? I think not. So, there you have it. Apples and oranges. Any statistician would laugh at you for trying to make conclusions based on two so differing sampling populations.
And, ya you're right, a 300lb. person, age 75 or older, who is asks his doctor for a hip replacement, will most likely not have it approved due to the risks involved in the surgery, and the low probability that it will be successful due to the extremely weight (laws of physics). S/he would most likely be approved for one of those little motorized carts you see advertised on TV.
My point wasn't the same as yours. It wasn't even barely related. My remarks were not intended to sway you from your points, only to show more clearly, mine.
BTW, your example of of a hip replacement dealt with the decisionsbetween the 75 YO and his Doctor. The denial statistic is about the insurers not paying. If I'm a 6' 8" 300 lb 75 YO that runs 5 miles a day, then fell and injured my knee and can no longer walk, only to have Medicare deny me the replacement INSPITE of my doctor's diagnosis that I could return to full activity, then that's an example of MEdicare or any insurer being WRONG.
I didn't put this hypothetical forward to claim you are flat wrong. Obviously, my example would be very rare in happening. It's just that your example was directed in the wrong place.
My point (as was my part of original point) is that Medicare (and ALL insurers) make decisions based on statistics and averages alot more than doctor's opinions straight up.
I think it should be noted that the AMA has been opposed to publicly funded health care (like Medicare) since 1918. The reason for this, is because the AMA has acted as an organization to limit the number of doctors in the US, so that doctors receive obnoxiously high wages.
Medicare denies people from joining Medicare for a verity of reasons, and this is because there are specific limits of who can join, mainly the extremely poor, the disabled, and the elderly. If you don't fall into these groups Medicare won't let you in. So, are you conflating who Medicare will allow to join, with denying claims?
Private health insurance companies on average deny 1 in 5 claims.
So...how many people have Medicare denied for a pre-existing condition?
If you are interested then read the report. It's in there.
BTW, what is your source for 20% denial from private insurers? I don't believe it and the AMA doesn't either.
The California Nurses Assocation. Some HMOs, such as PacifiCare has a denial rate as high as 39.6%.
There are two parts to Medicare, Part A, and Part B. Part A covers office visits, routine exams, etc. Part B covers hospital admissions, surgery, etc. Part A is paid for by the Medicare payroll taxes you have paid on your salary. Part B has a monthly premium, depending on personal income. Mine is $134.00/month. You can enroll in Part A at no cost. Not everyone enrolls in Part B because of the monthly premiums. The Part B premium is automatically deducted from Social Security benefit monthly payments. In the past year, I have had 3 procedures denied by Medicare under Part B, until I proved to them I was enrolled. What a pain in the ass they are.
And that would be a problem that would be eliminated if.....EVERYONE was on medicare. Problem solved.
Are you saying the universal Medicare would eliminate any and all denials?
Seems your source that you chose not to link to are really shills for the government option.
http://www.reuters.com/article/pressRelease/idUS199277+08-Sep-2009+BW20090908
http://www.politifact.com/truth-o-meter/statements/2009/sep/18/health-care-america-now/tv-ad-overstates-health-insurance-denials/
...and NEVER had a claim denied. While the left and right argue from the comfort of their ivory towers, no one bothers to find out what goes on in the real world.
-- Modified on 10/7/2009 2:05:36 AM
All of them. HUNDREDS OF THOUSANDS OF CLAIMS surveyd, ALL WRONG, based on your statical sampling of 2 people.
What logic?
I agree, personal anecdotes are useless. However, as I understand it, people on Medicare have the highest rate of personal satisfation with their health care in the U.S.
"people on Medicare have the highest rate of personal satisfaction with their health care in the U.S.".
You might rephrase that a tad. I would bet my next 6 months Part B premium that the members of the House, the Senate, the POTUS, and the Judicial Branch have the highest rate of satisfaction with their health care. Medicare may be a close second.
So there you've just made part of my original point for me. Many, such as yourself, market Medicare as the BEST form of health insurance. Yet we just saw data from the AMA that Medicare has the highest rate of denial. People here have raised reasons and excuses for why that higher rate is true (i.e. primarily the age of the insured). But these excuses miss the mark.
As reasonable as that rationale is, it doesn't 'splain away the discrepancy that those experiencing the highest rate of denial are also the happiest with their care. How can that be. Maybe it’s because they realize they are old and are willing to suffer or die for the good of humanity?
...RWU laps up their study with a spoon.
Lies, damn lies, and statistics.