G,
Didn't mean to offend you. I (and I'm guessing others) inferred that you thought 90% was an incredulous statement. Many people think it is! I just wanted to point out the math.
I believe some people have been taken in by those that use disingenuous rhetoric to advocate their agendas. If that doesn't include you, I SINCERELY apologize.
I do however, disagree (to an extent), that we are PURPOSELY being porked by some Medical Pofession/Insurance Company cartel. Having worked as a mediary between the 2 for more than 20 years, I can guarantee you that their relationship is far more adversarial than it is cooperative. Docs believe that Ins Co's try to reimburse them at unfair levels to pad their profits and Insurance Co's believe many docs perform or bill for unnecessary procedures in order to pad their profits. Both sides have legitimate complaints about the other. The padding of profits reasoning is usually false however. There are abuses by both sides, but that is the exception rather than the rule. The current reimbursement rate of the primary (necessary) procedure in fee for service practices often doesn't cover the docs' costs. That's one reason why you'll almost always have that "just in case/just to be sure" 2ndary diagnosis and procedure(s) (blood test,swab culture,vitamin shot,urine sample) done. These are almost always legitimate and justifiable. But, one reason (there ARE others) they are done is to put the doc in the black. He deserves to make a living from his services. Ins Co's are aware of this practice and legitimately question and monitor the appropriateness of a providers' professional charges. Both health providers and Insurance co's have HUGE cost outlays and (as opposed to what many think and try to villify) VERY MODEST profit margins. In order for both of them to survive as viable economic entities, they are constantly questioning,challenging and often fighting each others' decisions. The problem is that the costs and resources used to pursue this constant battle are SUBSTANTIAL and are passed on to the sole eventual revenue source: The premium payer.
Unfortunately, it is the consumer/patient/premium payer that bears the price of this battle. What is so sad, is that both parties sincerely want and believe they are looking out for and providing their customers with the appropriate quality of service. So G, in conclusion, I don't believe that the two entities are in CAHOOTS and PURPOSELY trying to give us an anal shampoo. Do we end up getting screwed and paying more anyways? YOU BETCHA!




























