Employer paid health/life insurance?

[Thalermade]

A few years ago I cut my thumb and needed 19 stitches.
We went to the appropriate emergency room/hospital according to health insurance plan.

Insurance originally denied paying for attending physician because said physcian was not associated with said insurance plan. She was a temp hired to fulfill minimum staffing requirements at the facility. After 6 months of bills and rebuttals, insurance company finally said they would cover it "this time".
Maybe there should be a menu board at doctors offices and emergency rooms so when we are in need of services it will be easier for us to make the correct choice and save the precious health insurance providers all the hassle of doing their job.
the health care industry was pretty good when it was a service, now that it has become a business it is lousy.

[JR]

We had an insurer about 10 years ago that rejected every single claim we made. Every one. 100% of them. Expeditiously, too!

It's clear their policy was to reject the claim, forcing the patient to appeal. Some percentage of those claims would go un-appealed, increasing profit for the insurer.

For LOML and I we pay $240/biweekly paycheck for PPO ($20 copay, $200 deductable). $46 dental.

Is there anyone from Mass. out there who will tell us how the reforms are working in that state? We're about to emulate those schemes here in Cal.

JR

[MilDoc]

For those of you going to an ER, I'll bet your bill was huge.

A few years back I was in Sweden on a trip with friends. Youngest daughter cut her lip, needed sutures as it crossed the border. Went to the ER.

1. we were the only ones there 'cause swedes don't run to the ER for colds.

2. doc came in, did the job very professionally. Talked to her all the time, kept her relaxed. I was impressed.

3. total time in the ER - 40 minutes.

4. total charge - $100.00. And we were out-of-towners!

[MilDoc]

It's clear their policy was to reject the claim, forcing the patient to appeal. JR

Not unusual. Even hospitals. Had a Texas hosp. CEO proudly proclaim they they would dun people without insurance forever, even knowing they couldn't pay. All in the hope that they would never come back!

[MilDoc]

In all fairness it is harder (cost more) to get things through the USFDA than it is to get approved in other countries.

Partly true. But BigPharm proclaimed years ago that it cost $800 million to get a new drug to market. From a Tulane study paid for by - TaDa! - BigPharm! Pure garbage folks. They used this to justify to Congress high prices, longer patents, etc. The true cost from other unbiased studies may be as low as $100M in some cases, and probably nver more than $300M. Still a lot, but not $800M.

Also, we're the only country in the world that still allows direct to consumer advertising

Yep. Congress bought and paid for. Worst idea ever. Get the patient to ask for the latest and greatest and most expensive drug 'cause he needs it. The truth is that new drugs are compared to placebos in studies. Never head-to-head with older effective medications. And the studies are paid for by - TaDa! - BigPharm! In many cases the newest drug is as effective ( or even less effective ) then the old standby, has more side effects, may even kill you more often - but costs a lot more. If what you are on works, stay with it!

[maxparot]

Partially paid by the wife's employer. Choice of a number of plans. What we have (Cigna) has worked well for us. We do see our contibution to the plan increasing each year either by higher initial costs or higher copayments.