Current Events > Trump trying to get rid of pre-existing condition protections

(+) Yeah! (+)

Darkman124 posted...

P4wn4g3 posted...

So long as your insurance policy hasn't changed and your doctor is still working with that company, getting the same procedures will be charged the same. Insurance companies change policies on a yearly basis, so you can ask about that, but generally they aren't changing standard procedures around. You should remove yourself from this and tell your doctor's office to work it out with your insurance company. Neither needs you to be involved.

insurance denied the claim and stated they no longer covered it

the procedure was a five minute discussion as to whether the medicine i take was causing adverse reactions

I promise you that physicians hate insurance companies even more than patients do.
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Coffeebeanz posted...

I promise you that physicians hate insurance companies even more than patients do.

i believe it, but does a typical physician's office do any negotiation directly with patients? unlikely to go anywhere with my insurance, unless they maybe bill it as a general checkup.
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Darkman124 posted...

Coffeebeanz posted...

I promise you that physicians hate insurance companies even more than patients do.

i believe it, but does a typical physician's office do any negotiation directly with patients? unlikely to go anywhere with my insurance, unless they maybe bill it as a general checkup.

Usually what they do is give us like 500 pages of stupid, repetitive questions we have to fill out by hand. Then we have to attach a certain number of previously documented notes. It's deliberately designed to be as tedious and time consuming as possible.
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Darkman124 posted...

P4wn4g3 posted...

So long as your insurance policy hasn't changed and your doctor is still working with that company, getting the same procedures will be charged the same. Insurance companies change policies on a yearly basis, so you can ask about that, but generally they aren't changing standard procedures around. You should remove yourself from this and tell your doctor's office to work it out with your insurance company. Neither needs you to be involved.

insurance denied the claim and stated they no longer covered it

the procedure was a five minute discussion as to whether the medicine i take was causing adverse reactions

doctor's office proceeded to bill me.

The most you can do is ask when the policy changed, they will likely say this year, meaning you are SOL. You can ask your doctor's office to resubmit the claim, there may have been an error made by insurance. Basically tell them you don't plan to pay until they try resubmitting the claim. That won't get you anywhere if the claim was processed correctly, however. So your first question to insurance really is when the policy changed and why it's different, and if they can explain that to you and justify why your bill changed there is no reason to bother with anything else, you'll have to pay up.
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wah_wah_wah posted...

I found in my experience it is very hard for a doctor ever to get let go even if they fuck up badly, and sometimes the hospital enables that.

I'm not going to pretend that never happens, because it does, but a tricky aspect about that is often times from the patient's perspective it is impossible to tell the difference between someone being at fault, and something being a bad outcome in spite of all the correct actions.

Have you ever played poker? Have you ever had pocket aces and still ended up losing the hand? Bad outcome, doesn't mean it wasn't the right course of action. Doesn't mean you should never play pocket aces again.

In spite of the perfect set of steps, sometimes it's not in our favor. Sometimes there is nothing that could be done.

And for what it's worth wah_wah_wah, my father died of a heart attack in a doctor's office during their lunch break and the receptionist did not tell my father to go to the emergency department in the building next door after he complained of serious chest pain. So it's not like I haven't walked in your shoes.

The difference between us is I decided to go to medical school to make that difference. You're sitting here and demonizing every doctor and assume we're all incompetent assholes that are denying care.

There is no perfect test. Everything is interpretation. Patient's don't understand this. Getting as many tests as physically possible actually causes more harm than good. False positives and negatives are a thing and no test or procedure is without risk. If you did that to everyone, there would be more people who suffered as a result of the work up than there would be catching disease that slips through the cracks.
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BlameAnesthesia posted...

wah_wah_wah posted...

I found in my experience it is very hard for a doctor ever to get let go even if they fuck up badly, and sometimes the hospital enables that.

I'm not going to pretend that never happens, because it does, but a tricky aspect about that is often times from the patient's perspective it is impossible to tell the difference between someone being at fault, and something being a bad outcome in spite of all the correct actions.

Have you ever played poker? Have you ever had pocket aces and still ended up losing the hand? Bad outcome, doesn't mean it wasn't the right course of action. Doesn't mean you should never play pocket aces again.

In spite of the perfect set of steps, sometimes it's not in our favor. Sometimes there is nothing that could be done.

And for what it's worth wah_wah_wah, my father died of a heart attack in a doctor's office during their lunch break and the receptionist did not tell my father to go to the emergency department in the building next door after he complained of serious chest pain. So it's not like I haven't walked in your shoes.

The difference between us is I decided to go to medical school to make that difference. You're sitting here and demonizing every doctor and assume we're all incompetent assholes that are denying care.

There is no perfect test. Everything is interpretation. Patient's don't understand this. Getting as many tests as physically possible actually causes more harm than good. False positives and negatives are a thing and no test or procedure is without risk. If you did that to everyone, there would be more people who suffered as a result of the work up than there would be catching disease that slips through the cracks.

Depends on how far you go with the pocket aces and what prospects appear on the board. If I have pocket aces and the flop is a straight flush draw, chances are I'm not gonna risk a bluff. If I was short stacked though and close to bleeding out, I'd just all in pre-flop and take my chances. I've lost that way plenty of times, but when I'm in that position, that's the best chance I have of getting out of it.

How this relates to your argument though, I have no idea. I just like poker so I responded immediately and literally to the poker reference without reading the rest of the post >_>
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ImTheMacheteGuy posted...

If I was short stacked though and close to bleeding out, I'd just all in pre-flop and take my chances. I've lost that way plenty of times, but when I'm in that position, that's the best chance I have of getting out of it.

This context is really the heart of the analogy.

ImTheMacheteGuy posted...

How this relates to your argument though, I have no idea. I just like poker so I responded immediately and literally to the poker reference without reading the rest of the post >_>

I can respect that hahahahaha
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BlameAnesthesia posted...

ImTheMacheteGuy posted...

If I was short stacked though and close to bleeding out, I'd just all in pre-flop and take my chances. I've lost that way plenty of times, but when I'm in that position, that's the best chance I have of getting out of it.

This context is really the heart of the analogy.

ImTheMacheteGuy posted...

How this relates to your argument though, I have no idea. I just like poker so I responded immediately and literally to the poker reference without reading the rest of the post >_>

I can respect that hahahahaha

Ah okay.

My favorite (not objective best) hand I've ever played...

Flop was A 6 6

not much happened.

Turn was another A.

I hesitated and made a small bet. Another player made a small raise and I called. Everyone else was already out of the hand or folded now.

River was a K.

I bet again, other player went all in. I insta-called. He had AK. I had pocket 6s. They never saw the low quads coming when they hit the nut full house lol.

Also once I hit a royal flush on the river (already all in) and beat someone with I believe a straight? I had a better straight anyway, so I didn't need the royal to win, but a site admin had been watching and transferred $50 to my account for hitting the royal. I was thrilled until I lost all of it later that day -_-
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ImTheMacheteGuy posted...

Ah okay.

My favorite (not objective best) hand I've ever played...

Flop was A 6 6

not much happened.

Turn was another A.

I hesitated and made a small bet. Another player made a small raise and I called. Everyone else was already out of the hand or folded now.

River was a K.

I bet again, other player went all in. I insta-called. He had AK. I had pocket 6s. They never saw the low quads coming when they hit the nut full house lol.

Also once I hit a royal flush on the river (already all in) and beat someone with I believe a straight? I had a better straight anyway, so I didn't need the royal to win, but a site admin had been watching and transferred $50 to my account for hitting the royal. I was thrilled until I lost all of it later that day -_-

Yeah it's crazy how tunnel vision people get when they hit a good hand on the river, but don't take stock of the texture of the board.

Here's my story of a bad beat. I bought in at a table on a cruise ship and my first hand was 5, 7 off suit. Since I just bought into the table at least I was able to see the flop and I hit a straight right off the bat. I raise, some guy reraises me all in (I didn't buy into the table very high, so I was short stacked). I call, obviously.

He has nothing and only has 3/5 of the same suit. He needs the same suit on both the river and the turn to hit a flush. That's his only out.

Of course he hits it. I was so pissed. The chances of that were so low. He was obviously drunk off his ass and probably didn't realize how shit his hand was.
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I got a high straight flush in hold 'em once, but I won next to nothing because I did a shitty job of getting people to buy in.
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Can we all agree that surgeons are assholes
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Coffeebeanz posted...

Can we all agree that surgeons are assholes

Lol
Surprising to hear you say that. But it would seem so :/
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Coffeebeanz posted...

Can we all agree that surgeons are assholes

It's the inspiration to my username.
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BlameAnesthesia posted...

ImTheMacheteGuy posted...

Ah okay.

My favorite (not objective best) hand I've ever played...

Flop was A 6 6

not much happened.

Turn was another A.

I hesitated and made a small bet. Another player made a small raise and I called. Everyone else was already out of the hand or folded now.

River was a K.

I bet again, other player went all in. I insta-called. He had AK. I had pocket 6s. They never saw the low quads coming when they hit the nut full house lol.

Also once I hit a royal flush on the river (already all in) and beat someone with I believe a straight? I had a better straight anyway, so I didn't need the royal to win, but a site admin had been watching and transferred $50 to my account for hitting the royal. I was thrilled until I lost all of it later that day -_-

Yeah it's crazy how tunnel vision people get when they hit a good hand on the river, but don't take stock of the texture of the board.

Here's my story of a bad beat. I bought in at a table on a cruise ship and my first hand was 5, 7 off suit. Since I just bought into the table at least I was able to see the flop and I hit a straight right off the bat. I raise, some guy reraises me all in (I didn't buy into the table very high, so I was short stacked). I call, obviously.

He has nothing and only has 3/5 of the same suit. He needs the same suit on both the river and the turn to hit a flush. That's his only out.

Of course he hits it. I was so pissed. The chances of that were so low. He was obviously drunk off his ass and probably didn't realize how shit his hand was.

Yeah that would be annoying. My biggest skill in poker is being hard to read. I'm not great at reading others, but I'm very self-aware, so I'm very good at being consistent in some ways so as to avoid giving tells but wildly inconsistent in other ways to throw people off and confuse them. I like to switch up tactics between things like slow playing, limping and pre-flop folding to aggressive play and big betting, as well as in less tangible ways, like looking at my cards every round to looking at them just once and then acting without re-looking for the rest of the hand. I could possibly play at the pro level of I a) was better at reading others, b) memorized odds like a lot of pros have, c) had more confidence d) had more mental stamina for longer tournaments and e)... enjoyed playing sober as much as I enjoy playing drunk >_>
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Obama's pre-existing conditions rule was one of the few things I thought he actually did right. If what the title of the thread suggests is true, that's very unfortunate.
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Vindris_SNH posted...

Obama's pre-existing conditions rule was one of the few things I thought he actually did right. If what the title of the thread suggests is true, that's very unfortunate.

theres over 100 posts explaining why obamas idea was dumb.

kayoticdreamz posted...

Vindris_SNH posted...

Obama's pre-existing conditions rule was one of the few things I thought he actually did right. If what the title of the thread suggests is true, that's very unfortunate.

theres over 100 posts explaining why obamas idea was dumb.

That's not exactly what's being said.
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P4wn4g3 posted...

kayoticdreamz posted...

Vindris_SNH posted...

Obama's pre-existing conditions rule was one of the few things I thought he actually did right. If what the title of the thread suggests is true, that's very unfortunate.

theres over 100 posts explaining why obamas idea was dumb.

That's not exactly what's being said.

seems like it? obama wanting to cover preexisting conditions would basically blow up the whole "we only have limited resources" argument that has been put forth so wonderfully.

so yeah, obama care's preexisting conditions must be covered thing would end badly. exceptions to this probably exist, but by and large, just tossing everyone onto the healthcare insurance system would overload it.

kayoticdreamz posted...

seems like it? obama wanting to cover preexisting conditions would basically blow up the whole "we only have limited resources" argument that has been put forth so wonderfully.

so yeah, obama care's preexisting conditions must be covered thing would end badly. exceptions to this probably exist, but by and large, just tossing everyone onto the healthcare insurance system would overload it.

Not exactly. Whether or not pre-existing conditions are covered doesn't seem to curb rising premium costs. Just compare pre and post ACA. You could argue covering pre-existing conditions does help control costs because less patients are defaulting on bills that place the burden on either hospital or insurance, who as a natural reaction to that burden raise their prices or deny legitimate claims, respectfully.

The ACA in its original conception was actually a pretty clever way to control costs given the cultural stalemate of americans not wanting single payer. Except even that got politicized and by the time it passed, it was a shell of its original self that obviously wouldn't work. Half the states didn't expand medicaid/medicare, which still led to the issue of defaulting on bills. The other half of the equation was that the ACA was a bit idealistic. They thought more access to insurance meant more established patients with a primary care and less utilization of EDs as "seeing a doctor without an appointment." This didn't happen because people are people.

So it was a bitter-sweet lesson that no insurance-based system will work on the premise that since every insurance policy is different and independent, you require an entire artificial industry to determine what services and treatments are covered and what isn't. It's billions of dollars of red tape and bureaucracy getting in the way of something as simple as providing care. Single payer is attractive in the sense that remove that middle man and all those resources can go to direct medical costs (supplies, staffing, administration, delivery, etc) as opposed to an entire industry in between receiving care, and the face of the medical industry that interfaces with the insurance industry.

The republican's only chance at a "free market" solution was trying the ACA as it was originally planned. Politics ruined the only shot, single payer is really the only logical way forward.

What I referenced in terms of limited healthcare resources was more about these poorly compliant patients costing us millions more. Any single payer system will need to be set up such that the coverage of acute care services is linked to compliance such that when you are first diagnosed with something like COPD, as long as you are regularly following up with your doctor, getting preventative screenings, and making a good faith effort on taking your meds, all of which these visits and meds are covered in single payer, should therefore allow the coverage of acute inpatient management of exacerbations.

The occasional missed appointment, the medication noncompliance issues intermittently, etc, these ought not to affect one's coverage of inpatient services. It's the consistent pattern of missing appointments, not following up, not following treatment for chronic conditions over periods of years to decades that ought to limit care to a bare minimum. Stabilization. Eliminate as many barriers as possible to receiving that preventative care. And include means of exceptions when they apply to avoid innocent collateral.
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But really, the dirty fact remains. A lot of Americans are really bad at managing their chronic conditions. It's specifically this that leads to expensive inpatient care that doesn't help the patient other than delaying death. Has nothing to do with pre-existing conditions in the sense that most people with some health condition aren't the biggest burden. Getting diagnosed with a serious illness for the first time in a hospital kind of is, but any system can't afford that reality. But with other cost control measures in place, this is an acceptable cost to provide coverage for.

Much like taxes on cigarettes prevented a lot of smoking, you need to link a single payer system with a reasonable minimum standard of compliance on chronic conditions. Otherwise a subset of patients will continue to be a disproportionate burden and never seek that preventative care. And the system is specifically geared to give them every opportunity to do it right, over a very long period of time, before it ever came to wah_wah_wah's fear of "killing patients."
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kayoticdreamz posted...

P4wn4g3 posted...

kayoticdreamz posted...

Vindris_SNH posted...

Obama's pre-existing conditions rule was one of the few things I thought he actually did right. If what the title of the thread suggests is true, that's very unfortunate.

theres over 100 posts explaining why obamas idea was dumb.

That's not exactly what's being said.

seems like it? obama wanting to cover preexisting conditions would basically blow up the whole "we only have limited resources" argument that has been put forth so wonderfully.

so yeah, obama care's preexisting conditions must be covered thing would end badly. exceptions to this probably exist, but by and large, just tossing everyone onto the healthcare insurance system would overload it.

It's a good, moral idea that is fundamentally incompatible with private insurance.
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Coffeebeanz posted...

kayoticdreamz posted...

P4wn4g3 posted...

kayoticdreamz posted...

Vindris_SNH posted...

Obama's pre-existing conditions rule was one of the few things I thought he actually did right. If what the title of the thread suggests is true, that's very unfortunate.

theres over 100 posts explaining why obamas idea was dumb.

That's not exactly what's being said.

seems like it? obama wanting to cover preexisting conditions would basically blow up the whole "we only have limited resources" argument that has been put forth so wonderfully.

so yeah, obama care's preexisting conditions must be covered thing would end badly. exceptions to this probably exist, but by and large, just tossing everyone onto the healthcare insurance system would overload it.

It's a good, moral idea that is fundamentally incompatible with private insurance.

It's not exactly, but the truth of it is really that private insurance is incompatible with the world.
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What do you guys think about bacon and ice cream? I've tried it and it's delicious.
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That sounds terrible.
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The 'protections' for pre-existing conditions are the primary impetus for the major spikes in insurance costs since its inception.
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darkjedilink posted...

The 'protections' for pre-existing conditions are the primary impetus for the major spikes in insurance costs since its inception.

No, Trump's volatility over the issue is.
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BlameAnesthesia posted...

kayoticdreamz posted...

seems like it? obama wanting to cover preexisting conditions would basically blow up the whole "we only have limited resources" argument that has been put forth so wonderfully.

so yeah, obama care's preexisting conditions must be covered thing would end badly. exceptions to this probably exist, but by and large, just tossing everyone onto the healthcare insurance system would overload it.

Not exactly. Whether or not pre-existing conditions are covered doesn't seem to curb rising premium costs. Just compare pre and post ACA. You could argue covering pre-existing conditions does help control costs because less patients are defaulting on bills that place the burden on either hospital or insurance, who as a natural reaction to that burden raise their prices or deny legitimate claims, respectfully.

The ACA in its original conception was actually a pretty clever way to control costs given the cultural stalemate of americans not wanting single payer. Except even that got politicized and by the time it passed, it was a shell of its original self that obviously wouldn't work. Half the states didn't expand medicaid/medicare, which still led to the issue of defaulting on bills. The other half of the equation was that the ACA was a bit idealistic. They thought more access to insurance meant more established patients with a primary care and less utilization of EDs as "seeing a doctor without an appointment." This didn't happen because people are people.

So it was a bitter-sweet lesson that no insurance-based system will work on the premise that since every insurance policy is different and independent, you require an entire artificial industry to determine what services and treatments are covered and what isn't. It's billions of dollars of red tape and bureaucracy getting in the way of something as simple as providing care. Single payer is attractive in the sense that remove that middle man and all those resources can go to direct medical costs (supplies, staffing, administration, delivery, etc) as opposed to an entire industry in between receiving care, and the face of the medical industry that interfaces with the insurance industry.

The republican's only chance at a "free market" solution was trying the ACA as it was originally planned. Politics ruined the only shot, single payer is really the only logical way forward.

What I referenced in terms of limited healthcare resources was more about these poorly compliant patients costing us millions more. Any single payer system will need to be set up such that the coverage of acute care services is linked to compliance such that when you are first diagnosed with something like COPD, as long as you are regularly following up with your doctor, getting preventative screenings, and making a good faith effort on taking your meds, all of which these visits and meds are covered in single payer, should therefore allow the coverage of acute inpatient management of exacerbations.

The occasional missed appointment, the medication noncompliance issues intermittently, etc, these ought not to affect one's coverage of inpatient services. It's the consistent pattern of missing appointments, not following up, not following treatment for chronic conditions over periods of years to decades that ought to limit care to a bare minimum. Stabilization. Eliminate as many barriers as possible to receiving that preventative care. And include means of exceptions when they apply to avoid innocent collateral.

This is all Communist propaganda.
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Stfu darkjedilink. Go get warned again, you're a much better poster that way.
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darkjedilink posted...

BlameAnesthesia posted...

kayoticdreamz posted...

seems like it? obama wanting to cover preexisting conditions would basically blow up the whole "we only have limited resources" argument that has been put forth so wonderfully.

so yeah, obama care's preexisting conditions must be covered thing would end badly. exceptions to this probably exist, but by and large, just tossing everyone onto the healthcare insurance system would overload it.

Not exactly. Whether or not pre-existing conditions are covered doesn't seem to curb rising premium costs. Just compare pre and post ACA. You could argue covering pre-existing conditions does help control costs because less patients are defaulting on bills that place the burden on either hospital or insurance, who as a natural reaction to that burden raise their prices or deny legitimate claims, respectfully.

The ACA in its original conception was actually a pretty clever way to control costs given the cultural stalemate of americans not wanting single payer. Except even that got politicized and by the time it passed, it was a shell of its original self that obviously wouldn't work. Half the states didn't expand medicaid/medicare, which still led to the issue of defaulting on bills. The other half of the equation was that the ACA was a bit idealistic. They thought more access to insurance meant more established patients with a primary care and less utilization of EDs as "seeing a doctor without an appointment." This didn't happen because people are people.

So it was a bitter-sweet lesson that no insurance-based system will work on the premise that since every insurance policy is different and independent, you require an entire artificial industry to determine what services and treatments are covered and what isn't. It's billions of dollars of red tape and bureaucracy getting in the way of something as simple as providing care. Single payer is attractive in the sense that remove that middle man and all those resources can go to direct medical costs (supplies, staffing, administration, delivery, etc) as opposed to an entire industry in between receiving care, and the face of the medical industry that interfaces with the insurance industry.

The republican's only chance at a "free market" solution was trying the ACA as it was originally planned. Politics ruined the only shot, single payer is really the only logical way forward.

What I referenced in terms of limited healthcare resources was more about these poorly compliant patients costing us millions more. Any single payer system will need to be set up such that the coverage of acute care services is linked to compliance such that when you are first diagnosed with something like COPD, as long as you are regularly following up with your doctor, getting preventative screenings, and making a good faith effort on taking your meds, all of which these visits and meds are covered in single payer, should therefore allow the coverage of acute inpatient management of exacerbations.

The occasional missed appointment, the medication noncompliance issues intermittently, etc, these ought not to affect one's coverage of inpatient services. It's the consistent pattern of missing appointments, not following up, not following treatment for chronic conditions over periods of years to decades that ought to limit care to a bare minimum. Stabilization. Eliminate as many barriers as possible to receiving that preventative care. And include means of exceptions when they apply to avoid innocent collateral.

This is all Communist propaganda.

Imagine being you hahahaha lmfao
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Coffeebeanz posted...

What do you guys think about bacon and ice cream? I've tried it and it's delicious.

i gave it a try and it is good
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