Word: hmos
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...time to publicly admit that the health-care system in America is broken. Costs are rising at an unacceptable rate - more than doubling over the last 10 years, which is nearly four times the rate of wage growth. Too many patients feel trapped by health-care decisions dictated by HMOs. Too many doctors are torn between practicing medicine and practicing insurance. And 47 million Americans worry what will happen to them or their children if they get sick...
...allow - but not require - insurance companies to provide coverage for practitioners, nurses and nursing facilities. During the 1980s, when fee-for-service plans were more prevalent, Davis says Christian Scientists had riders that allowed them coverage with more than 300 carriers. But with the rise of health maintenance organizations (HMOs), they have found it more difficult to convince insurance companies to cover their "spiritual care...
...Medical-Billing Industry It costs a typical doctor about 10%, right off the top, to collect fees from the HMOs and other insurance companies he or she has to deal with. This is due to the ultra-complex set of rules and regulations those companies have established to "control costs" (read: to pay us less while their executives take home more) and the billing staffs we have to hire to deal with them. This money does nothing for patients; it's a health-care expense that produces no health care. It could easily be eliminated with simple, intelligent, centralized payment...
...There are problems: the byzantine system of Continuing Medical Education, medical advertising, the HMOs themselves and our top-heavy system of hospital administration, to name a few. More on these during growing season...
...patients in need of medical care. This is particularly true of hospitals, whose emergency rooms are mandated by federal law to provide treatment regardless of a person's ability to pay. That leads to millions of dollars in unpaid medical bills each year. Thus, when providers negotiate contracts with HMOs, for instance, they try to recoup some of those losses by raising prices for insured patients, which in turn leads to higher premiums. Because insurance markets are state-by-state entities with disparate regulations, residents of certain states - such as Montana, West Virginia and Texas - pay a higher hidden...