James Kwak of “Baseline Scenario” has written a wonderfully lucid entry on healthcare non-insurance. I enthusiastically recommend that you read it.
Short Takes
- Lip Reading Babies: Utter nonsense!
January 17, 2012 | 8:54 pmSays psychologist David Lewkowicz of Florida Atlantic University, who led [a] study published yesterday…
’The baby in order to imitate you has to figure out how to shape their lips to make that particular sound they’re hearing,’’
Can you “figure out” why this is utter nonsense? I should as obvious as monkey see, monkey do. With this sort of thing passing for science, we are surely doomed.
- The Mark of Cain
November 9, 2011 | 3:13 amWatching Herman Cain duel with his female accusers is like watching the Jerry Springer Show. Not a pretty picture. If you partake, be sure an wash you hands afterwards.
- The Truth About Sovereign Debt
November 1, 2011 | 4:01 pmDuring the housing bubble people bet on rising home prices by taking out loans on to-good-to-be true terms and investment banking made bets on the rising home prices by lending on to-good-be-true terms. Everyone drank the Kool Aid. Prices went down. Having made bad bets, home owners should default on their loans and bankers should take their losses. This is the simple-minded logic of every-man-for-himself market economics.
The nations that joined the EU placed bets on rising economic prosperity that would come from joining the EU and adopting the Euro and borrowing from the EU banks on to-good-to-be-true terms. The EU investment bankers made speculative bets on EU member nations by lending them billions on to-good-to-be-true terms. The borrower economies went down not up. Everyone drank the Kool Aid and having made bad bets the borrowers should default on their loans and the bankers should take their losses. This too, is the simple-minded logic of every-man-for-himself market economics.
So how do the bankers hold the world hostage to their bad bets? They claim they are too big to fail. In other words, the only game they know is heads they win, tails we lose.
-
Archive for Short Takes »
- Lip Reading Babies: Utter nonsense!
Good points are raised by Kwak. The insurance companies are equal opportunity misers. They routinely screw providers as badly as they screw their claimants. Simply put, they don’t pay the claims. First off a high percentage of claims (even though they have been ‘authorized’) are denied. It happens to often with some companies that it is clearly a pro forma delaying tactic. The provider has to then stop and prepare an appeal in order to get paid at all.
Round two is that the insurer only pays a portion of the amount due. The portion paid depends on the insurer but it is virtually never (never) 100% and is often less than 75%. In two years working in a providers billing office I can count the number of ‘paid in full’ claims on one hand. It just doesn’t happen.
If a particular insurer has paid an egregiously low percentage of the claim (and these are often the same companies that start with a flat denial), then an appeal is necessary and finally after much back-and-forth between the provider, the claims administrator, and the bill payer (Not the same person and often not the same company), the bill is paid with an incremental increase….still not 100%.
That’s how the system really works. Ask any provider.
Agreed!
The insurer’s balance sheet shows that they can maximize their return by investing their resources in complex procedures that make the claims process increasingly onerous to claimants. Given their profit motive, they are only doing what makes dollars and sense.
Marc