Re: VT Poised to become 1st state w/ Single Payer Health Car

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Here's something to consider from the provider's side:

Texas has state insurance for low income, Medicaid. Medicaid has several groups below it to administer benefits. Those groups have managed care companies that "manage benefits."

I get a call from a person w/state insurance, I must look up their policy to see who adminsters benefits. From there I check to see who is the managed care company.

For me to get paid for that client I must contract with the state, then that particular administrating company, then also that managed care company. This requires me to have 8-10 contracts in place to cover most state combinations. (I bet I have 45-50 contracts, commerical and state, just to have a shot at being paid for seeing most people)

But wait! What if just 2 of these managed care companies are completely inept and deny claims all day long. Screw them- I can't spend more time chasing payments than I do seeing the client. So I decline to see these clients with multi-level BS that = No Winner.
TX Medicaid adminstration.jpg
TX Medicaid adminstration.jpg (10.43 KiB) Viewed 241 times
These folks pay their monthly rates for insurance but more & more providers are declining to see them because the system is like Three Card Monte.

Single payer is no real benefit for user or provider if its adminstered by a Calvin & Hobbs accounting system.
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Puffing up is no substitute for smarts but it's a common home remedy

Re: VT Poised to become 1st state w/ Single Payer Health Car

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I lived in england from the age of 10 to almost 30 yo. It's a good system, but far from perfect, the big problem being that more people are taking than contributing, or at least that are needed to contribute. This doeas lead to rationing, but at least its rationing based on need not income. I think a single payer system would work, but everyone has to pay in. No free rides. If you're on welfare (the modern idle rich) you pay out of your meagre cheque. If you're 'rich' you pay more. And a high enough co-pay to make sure people aren't at the dr for every little cough and scratch. But the big thing is get rid of the insurance companies. Take out insurance like aflac, to help with day to day bills, not to cover medical expenses.
Government is government and all government is force Left or right, right or left, it takes the same old course - CRASS

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