An interesting article at the Daily KOS brings up some good questions and puts the Health Care Debate into Focus. They propose 3 different forms to bring us out of the “Health Insurance Crisis”

1. Medi-care like Plan
Run by the Department of Health and Human Services
2. Third Party Administrator
Run by third party administrators
3. State-Run Public Option
Administration is up to the states.

Notice I have only put the details pertaining to who runs the operation. That is really the main argument…who gets to profit or be burdened by this new system coming into play. It is not a burden if its generates a profit, but if there is no profit then it is a burden to maintain such as system. The perception of Healthcare, and being paid for it whether it is administrative services or actual bedside care, is very skewed. The consumer is left out, its all about who is going to boss the consumer around or allocate the funds. One way we are managed by greed and the tendency to deny payment, the other we are managed by laziness and the tendency not to care due to lack of motivation.

In all reality, I don’t think the consumer really cares about who runs the operation. The consumer would prefer something he or she could control, with options that could be tweaked and managed on their own. Forget WHO gets to administrate this mess, what is it going to do, whether its any of the three choices, for the consumer?

After a big ordeal between Obama and Health Industry Representatives, it was found that the promise to reduce the growth of health spending is to be a gradual one, not an immediate one. It seems counter intuitive to have a 10 year target for reduction in growth when our economy is in peril now. It can be assumed that both the President and the Health Industry Representatives have an Agenda to promote, people to please. The President wants answers now that he can present to the American People as a whole. Health Industry Representatives want to assist in this but at the same time be able to appease their stockholders, investors, etc. A huge drop in projected spending does not look good on the books…

So…where do we fit in as consumers anyways? Seems to be that all these meetings, wheeling and dealing should be a bit more public, that way we can be informed consumers, allowing us to avoid the need for Universal Health Care, and not go bankrupt at the next doctors visit.

More than 30 % of medical claims are improperly denied. You should always fight if you have been denied coverage by your provider. It takes a bit of personality and tenacity to get this done. It is unfortunate, but it is the way the system has grown to work. Be firm in your resolution that you have been improperly denied and voice it over the phone, email, and written letters. Written letters are the best way to get through to companies, they almost always get answered whereas phone calls and e-mails do not. Keep hard copies of those letters and their responses. They may come in handy if your company claims it did or did not say something.

If you’ve just lost your job don’t hesitate to start looking for new coverage. Use your old plan to its fullest extent, but don’t overdo it or it could effect your new coverage. Your new coverage will be higher than before of course, unless you find a new job, but it will be significantly less if you avoid overspending your accounts when you lost your job.

Make SURE to spend you FSA’s (Flexible Savings Account) because it will not transfer to another account like an HSA (Health Savings Account). Don’t let your employer take off with your hard earned money!

According to Ray Hainer

Under HIPAA, if you go without health insurance for 63 days or more, you will be subject to a preexisting-condition exclusion. When you enroll in a new health plan, the insurer can exclude from coverage any health condition—cancer, heart disease, diabetes—for which you received treatment in the six months leading up to your enrollment. This exclusion period can last for up to 12 months (or 18 months if you join the health plan late), but you can offset it by producing your certificate of creditable coverage, which you remembered to ask for on day 1. If you can prove that you’ve had continuous health insurance for more than 12 months without a gap of 63 days or more, the new health plan will not be able to impose a preexisting-condition exclusion.

Make sure not to waste time getting that coverage! If you need help talk with a licensed health insurance agent and they can guide you through any of the frightening or tedious decisions you will need to make for your coverage.

It seems as if some major Healthcare companies may have been paying its customers less based on botched, faulty research. It is very odd that this has occurred, and that so many other companies have used the same Research Group, Ingenix, for its Data. There really is no reason a health insurance company should not pay out its proper share. Health Insurance companies are payed by consumers, and should receive their service without hassle.

Unfortunately, the health care industry is odd. It is not suprising that Health Insurance companies want to pay less, due to sometimes crazy and unknown hospital charges that the consumer did not have any control or say over. There are so many technicalities in a hospital bill, and so much abuse going on internally, that it is getting out of hand. The left hand doesn’t know what the right hand is doing.

Doctors have overcharged patients, created further complications, prescribed unneccesary medications, the list goes on and on. It may seem that Health Insurance Companies are being “the bad guy” but if you were to see the prices the company had to pay versus the consumer, you wonder why if you dont have health insurance you can easily go bankrupt with just a hospital visit.

Why do we make this so complicated? Maybe Health Insurance Companies and the Institutions that they deal with are so caught up with each other playing the numbers game that they have forgotten they are actually providing health care services to real living people. Hospitals and Doctors asking for huge amounts of money combined with Health Insurance Companies trying to protect their assets leaves little room for the health of the consumer…It should not be this way.

Well maybe because we are talking about your health period. Your health should come in very high within any set of priorities. We all like to take vacations, drive expensive cars, eat at the finest restaurants, etc. These are all fun things, but along with basic needs is taking care of your health. This is not an area to take chances on, because as life teaches us, incidents are impossible to time as with respect to when they might occur.

I understand there are also many other things that are important in our daily lives that we absolutely need to also take care of. There are expenses that we cannot live without, but right at the top is healthcare and health insurance. Within health insurance there are many types of plans that one can review to see if it would fit their needs based on their financial situation.

There are plans such as high-deductible HSA health insurance plans that at least provide coverage for more catastrophic type incidents. These are the incidents that we concern us most since other type of healthcare services are a lot more affordable and we probably in all fairness do not need our health insurance plan to cover us for those type of expenses.

In any case, health is important, and may you be healthy.

How valuable is your health to you? I bet your thinking, “What kind of question is that?” Your health is invaluable, right? Now here’s a little insight, if you should ever experience any health problems there are doctors that will quickly put a price tag on how much your health is worth. If for any reason an illness or accident should send you straight to the hospital you could end up spending your lifetime savings on treatment. Luckily, for these types of situations there is health insurance. Although choosing the right one can be overwhelming.

There are several factors that have to be determined before you can choose the best insurance that meets your specific needs. When searching or even considering any type of health insurance take the time to consider you and your family’s current lifestyle first. Then take in account how much you can afford for monthly premiums and co-payments. Make sure you consider a premium that will not increase at least for 12 months just so when it does you can be prepared. Take your time and understand the basics of health insurance, you have to understand that every year you get older and as you get older more risks are taken by your insurance carrier that’s the reason for your premium increase.

There are also many other benefits from taking just a couple minutes out of your day to really sit down and think or speak to your spouse about. Always remember that there are hundreds of health insurance agencies, or at least that’s what they’ll call themselves these days. It’s always better to have an insurance agent, someone you can talk to if you don’t understand something about the policy you are considering to purchase. I know trusting someone that you deal with over the phone is very hard, but you always have to remember that by law you have 10 days from the receipt of your policy (meaning the day you receive it in the mail) to cancel any policy and get a full refund with no penalties attached. Last but not least take a look at the type of plan you are purchasing.

What type of plan are you purchasing?

Is it an HMO or a PPO? Take in to consideration that although an HMO can have low monthly premiums they do not cover as much and you are looking to spend more money out of pocket. Usually with an HMO you would have to stay in network and/or get a referral if you have to see a specialist. A PPO on the other hand sometimes has the same monthly premiums of an HMO but allows you more benefits and you don’t need to stay in network, and depending on which insurance carrier you are purchasing the plan with you won’t need a referral to go see a specialist. You may have heard the term “You get what you pay for!” So if you are searching for quality health insurance why settle for less.

There are certain things in life that we cannot time, and one of these is needing healthcare services. Aside from managing basic healthcare services such as doctor visits, simple examinations, etc., catastrophic accidents or illnesses are unpredictable. This is why we all need health insurance, so that we transfer this risk to the carrier. The carrier distributes the risk amongst a large pool of insureds in order to effectively manage healthcare costs for all of the policyholders.

Everyday that passes without being insured is a day in which we run the risk of suffering from a catastrophic incident and not having the finacial support of health insurance. Health insurance coverage should be viewed as what it is, protection for our health. There are many people thatt complain that they have paid years of health insurance premiums and have only used it to go to the doctor twice a year. My response to that is that they should be very thankful for maintaining their health. The opposite would be the unfortunate perosn that suffered a catastrophic illness or accident and although they were covered by their health insurance, they would have much rather not have to have suffered such an illness or accident.

It is like the person who may be upset because they haven’t collected on their life insurance!

Be healthy and wise, get health insurance through a licensed and experienced health insurance agent.

Individual health insurance whether funded through an employer or not, allows us to weigh in the decision making process and get the type of coverage that best fits our needs. Whether a low-deductible, high-deductible, co-pay, maternity, co-insurance amount, etc., we can decide. The problem arises when our employer makes the decisions for us and we are stuck with whatever they decided that is right for us.

There are so many factors that apply when looking for health insurance that it is truly somewhat unfair to place all employees under the same plan. This is the very reason why there is such a growing trend from group health insurance over to individual health insurance.

More and more people are getting their healthcare coverage through individual policies. This is creating a need by consumers to be educated and well informed. Up until recently, consumers didn’t have to because they were not purchasing directly their health insurance. They basically just had to agree to whatever their human resources director would provide.

Health insurance is an individual need, it is a familiy need, it is not a common decision for a one-size-fits-all approach.

If you are one such consumer, get informed, do your research, and get affordable quality health insurance from a trusted licensed insurance agent.

How much do they charge for a short fifteen minute visit? Is it more if you are a new patient? Doctors vary both in quality and in cost, therefore it is important to know whether the services being rendered are in line with the costs. It is a problem with our healthcare industry that prices charged by doctors and hospitals are not as transparent as we would typically see in many other industries. This lack of transparency prevents us from being better consumers because we simply cannot gauge the value of a doctor and/or a hospital based on their pricing.

Imagine going to different restaurants and not knowing before hand the cost of the meal. Then, when the bill arrives, that it would be too difficult to understand. This is what happens today under our healthcare system. It is specifically designed to disengage the consumer from being a good consumer.

Now we understand that many of these bills and charges are paid through our insurance company, but as more and more health insurance plans have higher deductibles, co-insurance, or exclude various services, it is becoming ever more important that we as consumers are involved. It is very easy to understand that an individual consumer will always tend to want to be a good consumer and get their money’s worth.

Health insurance is an important part of our family budget, we need more transparency from our medical providers.