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MysticCat 10-14-2009 01:13 PM

Quote:

Originally Posted by crescent&pearls (Post 1857266)
No one seems to be saying they have a problem with the health care they receive from their health care provider.

But some are saying that. I've heard quite a few doctors and nurses say it. People want health care providers who will focus more on preventive health, who will spend more than 5 or 10 minutes with them, who think there might be an effective treatment other than drugs, who will listen to them instead of just ordering more tests.

I'm not saying there are no health care providers like this, nor am I blaming it all on the health care providers. It's a systemic problem that involves the health care providers themselves, the insurance companies, the pharmaceutical companies, medical schools, tort litigation . . . .

Hence, the there's-nothing-simplistic-about-this-issue aspect of all this.

crescent&pearls 10-14-2009 01:15 PM

Yes, they are part of the problem that has to be addressed. Yet have you heard anyone addressing the issue of referral for profit? If your provider tells you you need an MRI, but fails to tell you he/she or his/her medical group owns the MRI imaging center does it make you question whether or not you really need that MRI?

When I was involved in an auto accident last year, my auto insurance had to disclose to me that I could take my car to any facility I chose to have the repairs done. Health insurance doesn't work that way. If we are going to pass reform, why not include a provision that your health insurance company must pay "any willing, licensed provider" in your state...not just the providers that are within their provider panels.

Of course health care providers have relationships with insurance companies. If you have Kaiser, your health care provider is employed by an insurance company. If you have Aetna, Cigna, Blue Cross/Shield etc your provider has to agree to those insurance companies "reimbursement" terms in order to get on their "provider panels." If you're an independent provider and don't currently have a "contract" with those major insurers..go try getting approved to accept their plans and see how that works out for you. And keep in mind that providers are not limited to MDs...many ancillary care providers are not represented by big lobbyists in Washington.

Whatever reform we end up with it's not gonna be simple, that's for sure.


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