[gdpawel]

There is often very little relationship between the bill and the cost of providing medical services. In reality, combined hospital/doctor payment is much closer to what the services are worth. Hospital list price rates are often five to six times what they routinely accept as full payment from insurers. A friend had a surgical procedure done on an outpatient basis. The list price of the bill for the hospital, surgeon and anesthesiologist came to about $14,000. Insurance paid 18% of the hopsital charge and 31% of the doctor's fees with both accepted as full payment.

Of course, another friend had a triple stent procedure last month ($38,000). Her private insurance says it is a pre-existing condition, even though the doctor says it is not, and her insurance is not going to pay a penny!

The private health insurance industry is driven by earnings per share and the medical-loss ratio. And the best way to drive down medical-loss is to stop insuring unhealthy people. And the private health insurance industry accomplishes this by rescission, the "pre-exisiting" cop-out!

Even if I could have afforded health insurance over the last six years (which I couldn't), why would I have purchased it? So six years later they can just not pay for a medical bill by saying I had a pre-existing condition?

I've observed the insesent complaints on various cancer blogs and discussion boards about private insurers "denial of coverage" on the backs of injuried and diseased human beings during their fight with the great crab.

In one case, the patient was denied a CT scan. As the poster said, "because their private insurer is practicing medicine and deciding that such a thing is not medically necessary." Without the CT scan, there was no way for the doctor to definitively tell if a swollen leg is cancer related or a blood clot. The physician couldn't make a diagnosis based on the best avialable technique to make that diagnosis. A good case of a corporate bureaucrat coming between a patient and their doctor.

Another poster presented the case that their private insurer used to cover Pet Scans. Unfortunately, some study came out stating that Pet Scans aren't more effective than CT Sancs to find colon cancer. With that one study, the private insurer had decided not to cover the Pet Scan, even against the physician protest.

And one more described their situation while fighting prostate cancer that had metastasized to the hip bones and a clinical trial using hormone therapy and Helical Tomo Therapy was looking to be the best opportunity to fight the cancer. The studies showed that is was really helping people with bone cancer, it is very precise treatment that does much less damage to surrounding tissues. However, private insurer had denied covering the Helical Tomo Therapy treatment. They said it was just too expensive and the hormone therapy should be enough for the patient.

These are just a few of the numerous complaints happening across the United States. One poster goes on to say, "It would appear to me that we in the USA are rapidly closing in on having all of the drawbacks of socialized medicine, with none of the purported benefits. It is partly privately financed, but the controls are given over to remote corporate bureaucrats who determine who shall live and who just isn't worth it."

It doesn't matter anyway. Plans for Health Care Reform are "dead in the water." The "boogeyman" has scared the "bejeebies" out of the American public! HHS Secretary Kathleen Sebelius says it is not essential that a public option be in the legislation. President Obama said on Saturday that he won't insist on a public option. Without the public option, there will be no competition in the market. The large for-profit insurers will continue to have a huge advantage. The public seems to have no objection to that!

Access to basic health care has deteriorated terribly in this country by the free-market system, because much of the growth in expense is in procedures performed by specialists, and doctors who work in these specialty areas have the most to fear from a public option plan. Big government would be more responsive to the people than big insurance, and doctors would have worked independently, and not for the government.

But private insurers will keep placating physicians because they fit into their overall plan. Doctors will continue becoming employees of the hospitals, instead of remaining as independent contractors, and we'll continue to have a corporate bureaucrat between you and your doctor.

Looking out for "the healthcare bubble!"