Thursday, November 10, 2016

NOV 10 2016


THIS DD NEEDS A PREFACE---- BOY DID THIS GET LONG... SORRY...

A.---WRITING A DAILY DOGGIE  ON A TOPIC ABOUT WHICH I KNOW VERY LITTLE NEVER STOPPED ME BEFORE...
B.--- THERE WERE PLENTY OF REASONS TO VOTE FOR- OR AGAINST- EITHER CANDIDATE. BUT I CAN TACKLE IDEAS....
C.-  648 YEARS AGO I WAS INVOLVED IN INSTALLING A "MEDICAL BILLING" COMPUTER IN A MEDICAL OFFICE BUILDING.
D.--- WHILE A STUDENT IN SCOTLAND I NEEDED TO SEE A PHYSICIAN. 
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HAVING SAID ALL THAT..... 
BEFORE GOING TO EDINBURGH MY PARENTS WERE CAREFUL TO BE SURE I HAD  MY "STUDENT HEALTH INSURANCE" IN EFFECT FROM COLBY COLLEGE--
I HAD SOME LACCERATION WHICH NEEDED STITCHES- AND WENT TO THE  NEAREST MEDICAL FACILITY  IN EDINBURGH-- WHERE I WAS PROMPTLY SEEN BY A VERY NICE PHYSICIAN WHO SEWED ME UP... AS I WENT TO LEAVE I WENT TO THE DESK WHERE I HAD "CHECKED IN"---AND HANDED THEM MY INSURANCE CARD.  SHE SAID THEY DIDN'T TAKE IT-- AND WAS SHOCKED TO FIND  I DID NOT HAVE TO PAY.   I AM NOT SURE THEY EVEN TOOK MY NAME.   SMILE-- SAY THANK YOU AND LEAVE....DONE...
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FAST FORWARD---COMPUTERS WERE NEW- AND MEDICAL BILLING WAS A NATURAL-  OFFICE VISITS WERE $20-  BLUE CROSS INSURANCE WAS USUALLY CARRIED FOR HOSPITALIZATONS ONLY... THEN THEY  "ADDED COVERAGE FOR OFFICE VISITS" .. THIS IS WHEN THE WHOLE THING STARTED TO SLIDE SIDEWAYS....
THE DEAL WAS  ... IF THE DOCTOR "ACCEPTED ASSIGNMENT" THE INSURANCE COMPANY WOULD PROMPTY PAY 80% AND THE INS COMPANY WOULD SEND TEH DOCTOR THE CHECK... IF HE DID NOT ACCEPT ASSIGNMENT THEY WOULD SEND  100% TO THE PATIENT- WHO COULD THEN GOTO BERMUDA AND STILL OWE THE DOCTOR THE BILL.-- AND THE INSURANCE COMPANIES BRAGGED ABOUT PAYING THE ENTIRE BILL- WHEN IN FACT THEY HAD FORCED THE DR TO ACCEPT 80%.-

SOMEONE SHOULD HAVE STORMED CITY HALL AT THAT POINT- 
BECAUSE IT  MORPHED INTO....
NEEDING TO INCLUDE A DIAGNOSIS FOR THE VISIT- A 4 DIGIT NUMBER THE  SECT HAD TO LOOK UP- 
SUDDENLY SOME DX WERE NOT COVERED
DOCTORS DECIDED IF THEY CHARGED $25  THE 80% WOULD BE THE $20 THAT THEY HAD CHARGED IN THE FIRST PLACE ----WHICH TURNED  INTO 80% OF "ALLOWED  CHARGES"... AND DOCTORS AND HOSPITALS WERE ON A ROLL....NO ... A SPIRAL OF INCREASING CHARGES...  

WE HAD ONE PATIENT WHO BROUGHT IN A 1 POUND COFFEE CAN WITH HOME BAKED BEANS---  WE NEVER CHARGED HER-- WE HAD A GOOD DEAL GOING.

EVERY SMALL FACET OF THE MEDICAL "INDUSTRY" WAS NOW BEING STUDIED.  ONE SMALL EXAMPLE....
IF THE INS COMPANY  CHANGES....... THE DIAGNOSIS CODE  WENT FROM 4 DIGITS TO 10 DIGITS WITH NO SPACES OR DASHES, IT WAS FOUND THAT  THE NORMAL MEDICAL RECEPTIONIST WOULD MAKE A TYPO  ERROR 3% OF THE TIME AND THE INS COMPANY COULD REFUSE  PAYMENT- THUS SAVING BILLIONS IN THE BIG PICTURE.. BECAUSE TO FILL OUT THE  CORRECTION FORM TOOK ABOUT ½ HOUR OF SECT'Y TIME TO DIG OUT HT E MEDICAL RECORD AND GO THRU THE HORRENDOUS  BOOK OF ACCEPTABLE DIAGOSIS... WITH HOPES THEY DID NOT MAKE AN ERROR THAT TIME..  I AM POSITIVE A STUDY WAS DONE TO  SEE IF THEY    USED ALOT OF 1'S AND 7'S NEXT TO EACH OTHER, MORE ERRORS WOULD BE MADE.  

WITHIN  4 YEARS THE DOCTOR WAS RECIEVING $6.83 FOR HIS $20 OFFICE VISIT  -- THAT NUMBER IS A FACT... I REMEMBER IT.
TAKE ALL THESE  SMALL BUT SIGNIFICANT DETAILS AND YOU END UP WITH  OFFICE VISIT COSTING $180 WITH AN ADDITIONAL CHARGE   OF $3.78  FOR A  BANDAID, A $2.66 ASPRIN, $4 RENTAL CHARGE FOR SITTING ON THE CHAIR IN THE WAITING ROOM., AND $.73 FUEL CHARGE FOR HEATING IT.

THEN THE SYSTEM FOUND IT COULD CHARGE  FOR THE EXTRA INSURANCE TO COVER THE 20% NOT COVERED BY THE 80%  FOR MEDICAL COVERAGE EVERY SECOND THURSDAY ON  MONTHS WHICH DO NOT HAVE A HOLIDAY IN  THEM.
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IN AN EFFORT TO TRY AND GET COVERAGE FOR EVERYONE, THE CURRENT OBAMMA CARE HAD TO ADDRESS AN  IMPOSSIBLE COLLECTION OF  TWISTS AND TURNS BY A VERY CREATIVE INSURANCE INDUSTRY DETERMINED TO CHARGE  MAXIMUM FEE BECAUSE EVERYONE HAS BEEN TRAINED TO FEAR THE $2.66 ASPRIN CONCEPT.

 SDP "PROVIDES" MEDICAL INSURANCE  FOR $322 PER MONTH--- WHICH WE DISCOVERED - WOULD COVER ONE HEALTHY PHYSICAL EXAM A YEAR.  AND ANY HOSPITALIZATION - AND WAY DOWN THERE IN THE FINE PRINT- IT WAS ONLY AFTER $5000 DEDUCTIBLE.
EVEN THAT IS TWISTED... BECAUSE THERE IS RARELY ANYTHING LIKE HOSPITALIZATION ANY MORE-- THEY ROLL YOU OUT THE DOOR WITH IV'S STILL ATTACHED.
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SO THERE IS AN ELEMENT IN ME THAT SAYS LET ME PAY $6.83 A MONTH MORE IN TAXES AND HAVE THE PHYSICIAN BE WELL PAID-- SO THAT WE HAVE ENOUGH STUDENTS WANTING TO BE PHYSICIANS...
CURRENTLY  I DO NOT KNOW OF A DOCTOR'S CHILD WHO  IS STUDYING TO BE A PHYSICIAN...
THAT-( ALONG WITH TERRIBLE TUITION) IS  A HUGE ON GOING PROBLEM....  SUPPLY OF PHYSICIANS.
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I WOULD LIKE TO KNOW.... WHAT IS TEH RATIO OF SQUARE  FOOTAGE OF OFFICE SPACE  USED FOR ACTUAL  MEDICAL CARE AS OPPOSED TO THE MANAGEMENT OF  MEDICAL INSURANCE.
THAT IS A VALID QUESTION... 
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 HISTORICALLY  THE MOST SUBSTANTIAL BUILDING IN  ANY TOWN WAS THE HOSPITAL-----
IN BOSTON THE  SKYLINE HAS LONG BEEN DOMINATED BY THE HANDCOCK AND PRUDENTIAL TOWERS....  AND I DON'T THINK THERE WOULD EVEN BE A HARTFORD CONNECTICUT  WITHOUT INSURANCE COMPANIES... 
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 COMPARE THE BRITISH PHYSICIAN TREATMENT OF MY LACERATION  TO THE LAST LACERATION I NEEDED TO GET SEWED UP- FROM THE ELECTRICAL ACCIDENT- WHERE I WAS ROLLED IN ON A GURNEY AND WAS HELD UP BECAUSE I DIDN'T HAVE MY MEDICARE AND MEDEX CARDS WITH ME,-- THE ONLY WAY I COULD GET A NURSE'S ATTENTION WAS TO DRIP BLOOD ONTO THE FLOOR ONLY TO BE SEWED UP BY  THE ASSISTANT TO A PHYSICAN'S ASSISTANT WHO'S STERILE TECHNIQUE  WAS COMICAL..  THE ENTIRE EMERGENCY ROOM  WOULD BE A STUDY FOR LATE NIGHT COMEDIANS... IF IT WAS FUNNY.  THERE WAS ONE DOCTOR THERE--- I  ONLY  SAW HIM SITTING AT A DESK-
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 THERE IS SOMETHING WRONG.. IF NOTHING ELSE... THINK OF HOW MANY TREES WOULD BE SAVED BY NOT HAVING TO USE  ALL THAT PAPER...
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WHEN YOUR  HOUSE IS ON FIRE YOU  CALL TEH FIRE DEPARTMENT.. THEY COME AND GO AWAY-JUST LIKE TEH BRITISH  MEDICAL SYSTEM WAS-- AT LEAST WHEN I WAS THERE...
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 I SEE THE VETERNARIANS OFFICES  FALLING FOR THE SAME LINE OF LOGIC... INSURANCES   SOUNDS  LIKE SUCH A PERFECT SOLUTION... IT MAY HELP AN IMMEDIATE PROBLEM... BUT IT CAN ONLY BE VIEWED AS AN "INVESTMENT CONCEPT" FOR THE INSURANCE INDUSTRY.
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I THINK THE EXPRESSION  "CUT BAIT"  JUST MIGHT WORK---  REMOVE THE PROFIT MOTIVE FOR INS COMPANIES TO MAKE MORE PROFIT BY  GIVING LESS COVERAGE...
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I THINK WE ARE IN  FOR A ROUGH RIDE ON HEALTH CARE ALONE....
BUT THE RIDE WAS GETTING TOO ROUGH ANYWAY...
SO HANG ON !!!

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