health care and insurance commisioners

[karrma]

Hi All,

This is my first post so bear with me. I am a doctor, small business owner, wish I made enough to get in the 39% tax bracket. Last debate, I just realized a big concern in McCain's health care package, and that is decreasing regulation of the health insurance, and decreasing states rights, by letting consumers pick health insurance from other states. Please let me know if I am off base or right on.

When a patients health insurance company refuses a medication/procedure that I feel is necessary, our state insurance commissioner's office is the final area for negotiation. The insurance companies do not want to have to go there, and just the threat of this helps with negotiations beween my office and the insurance company.

We elect our state insurance commissioner, and have some oversight, and as voters, can have some say. We will not have near as much clout with an insurance commisioner from another state.

This has happened to me with long term disability insurance. One patient has lupus, and could not work full time. She and her employer paid into long term health insurance out of state, as it was cheaper. Her doctor(me) and patient and employer agreed that half time work, and long term disability to pay the other part, was best. Her long term disability insurance denied it, said she could work full time.

She saw her lawyer, who said it would have to be protested in the state where the insurance was based, somewhere across country, and that the cost of this is prohibitive, and the insurance commision in that state would not be interested in any out of state protest. The lawyer also stated that that was why out of state disability insurance is cheaper. Sounds to me as if it is much less regulated.

And we know where too little regulation in the banking industry got us. I do strongly recommend that we do not decrease the oversight and regulations on the health care insurance companies, as I really don't want to decrease the ability to negotiate for my patients. We would need to either change to federal regulation of health care insurance (I do not think this is a good idea, too big) or keep it in the individual states, which McCain is trying to change.

Karrma

 

[BigRob]

Hi All,

This is my first post so bear with me. I am a doctor, small business owner, wish I made enough to get in the 39% tax bracket. Last debate, I just realized a big concern in McCain's health care package, and that is decreasing regulation of the health insurance, and decreasing states rights, by letting consumers pick health insurance from other states. Please let me know if I am off base or right on.

When a patients health insurance company refuses a medication/procedure that I feel is necessary, our state insurance commissioner's office is the final area for negotiation. The insurance companies do not want to have to go there, and just the threat of this helps with negotiations beween my office and the insurance company.

We elect our state insurance commissioner, and have some oversight, and as voters, can have some say. We will not have near as much clout with an insurance commisioner from another state.

This has happened to me with long term disability insurance. One patient has lupus, and could not work full time. She and her employer paid into long term health insurance out of state, as it was cheaper. Her doctor(me) and patient and employer agreed that half time work, and long term disability to pay the other part, was best. Her long term disability insurance denied it, said she could work full time.

She saw her lawyer, who said it would have to be protested in the state where the insurance was based, somewhere across country, and that the cost of this is prohibitive, and the insurance commision in that state would not be interested in any out of state protest. The lawyer also stated that that was why out of state disability insurance is cheaper. Sounds to me as if it is much less regulated.

And we know where too little regulation in the banking industry got us. I do strongly recommend that we do not decrease the oversight and regulations on the health care insurance companies, as I really don't want to decrease the ability to negotiate for my patients. We would need to either change to federal regulation of health care insurance (I do not think this is a good idea, too big) or keep it in the individual states, which McCain is trying to change.

Karrma

McCain's Healthcare Plan.

I guess my initial question is how common is this situation you describe? Is this your only example of this happening or is it a regular thing?

It also seems to me you could just call a lawyer in the state you want to file the complaint. Does it not work that way?

 

[Andy]

Typically regulations increase cost. Instead of demanding that out of state insurance be regulated to cost as much as your own, why not cut regulations and reduce cost of insurance in your state, so people are not going out of state to get insurance. That would solve the problem.

By the way, deregulation had nothing to do with bank problem. The government enforced the sale of sub-prime loans. Government caused the problem. Saying we need government regulations to stop the banking problem, is like complaining about chickens disappearing and hiring foxes that ate them, to guard them. Bad plan.

 

[Mr. Carpenter]

I would have thought that as a doctor, your primary concern (aside from your patients), would be TORT REFORM, since, if you're like most doctors, it's your malpractice insurance that is THE major cost in your business. I have several physicians as clients, and all of them have said repeatedly that if it weren't for the cost of the malpractice insurance for themselves and all of their nurses, that they could cut their costs by more than half.

 

[Dr.Who]

Hi All,

This is my first post so bear with me. I am a doctor, small business owner, wish I made enough to get in the 39% tax bracket. Last debate, I just realized a big concern in McCain's health care package, and that is decreasing regulation of the health insurance, and decreasing states rights, by letting consumers pick health insurance from other states. Please let me know if I am off base or right on.

When a patients health insurance company refuses a medication/procedure that I feel is necessary, our state insurance commissioner's office is the final area for negotiation. The insurance companies do not want to have to go there, and just the threat of this helps with negotiations beween my office and the insurance company.

We elect our state insurance commissioner, and have some oversight, and as voters, can have some say. We will not have near as much clout with an insurance commisioner from another state.

This has happened to me with long term disability insurance. One patient has lupus, and could not work full time. She and her employer paid into long term health insurance out of state, as it was cheaper. Her doctor(me) and patient and employer agreed that half time work, and long term disability to pay the other part, was best. Her long term disability insurance denied it, said she could work full time.

She saw her lawyer, who said it would have to be protested in the state where the insurance was based, somewhere across country, and that the cost of this is prohibitive, and the insurance commision in that state would not be interested in any out of state protest. The lawyer also stated that that was why out of state disability insurance is cheaper. Sounds to me as if it is much less regulated.

And we know where too little regulation in the banking industry got us. I do strongly recommend that we do not decrease the oversight and regulations on the health care insurance companies, as I really don't want to decrease the ability to negotiate for my patients. We would need to either change to federal regulation of health care insurance (I do not think this is a good idea, too big) or keep it in the individual states, which McCain is trying to change.

Karrma

No time now. I'll look into it. Meanwhile I am going to go see Sarah on SNL now. Then bed.

 

[Dr.Who]

Hi All,

This is my first post so bear with me.

Welcome.

I am a doctor, small business owner, wish I made enough to get in the 39% tax bracket.

I hope you do and I hope you get to keep what you work hard for.

Last debate, I just realized a big concern in McCain's health care package, and that is decreasing regulation of the health insurance, and decreasing states rights, by letting consumers pick health insurance from other states. Please let me know if I am off base or right on.

the question is not so simple as more or less regulation. Some regulation is needed. But it needs to be the right regulation. This means that it should be both smart and in line with our constitution. The role of government is to stop people from harming each other -that is what good regulation does. It does not seek to shape society or decide who gets what.

When a patients health insurance company refuses a medication/procedure that I feel is necessary, our state insurance commissioner's office is the final area for negotiation. The insurance companies do not want to have to go there, and just the threat of this helps with negotiations beween my office and the insurance company.

What you mean that the doctors and patients can't just talk to their friends and decide to go to another insurance company? I would think that insurance companies would want to abide by their contractual obligations rather than to lose customers. Unless of course our congress made it so that patients don;t choose their own insurance carriers. McCain will return the patients ability to choose their own carrier thus making medical decisions much more between a doctor and patient with less influence from insurers.

We elect our state insurance commissioner, and have some oversight, and as voters, can have some say. We will not have near as much clout with an insurance commisioner from another state.

Boycotts work across state lines - well if one has the ability to boycott at all.

This has happened to me with long term disability insurance. One patient has lupus, and could not work full time. She and her employer paid into long term health insurance out of state, as it was cheaper. Her doctor(me) and patient and employer agreed that half time work, and long term disability to pay the other part, was best. Her long term disability insurance denied it, said she could work full time.

I have to admit that just now I started to question this. If she can work part time then why can't she work full time? Is the difference a matter of preference?

She saw her lawyer, who said it would have to be protested in the state where the insurance was based, somewhere across country, and that the cost of this is prohibitive, and the insurance commision in that state would not be interested in any out of state protest. The lawyer also stated that that was why out of state disability insurance is cheaper. Sounds to me as if it is much less regulated.

Beats me. But this does prove that regulation causes costs to increase. So clearly regulation should only be enacted when it is necessary.

And we know where too little regulation in the banking industry got us. I do strongly recommend that we do not decrease the oversight and regulations on the health care insurance companies, as I really don't want to decrease the ability to negotiate for my patients. We would need to either change to federal regulation of health care insurance (I do not think this is a good idea, too big) or keep it in the individual states, which McCain is trying to change.

Karrma

Actually too much and too much of the wrong kind of regulation in the banking industry is what caused the problem.