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Health insurance is a poor measure of health care.


Posted: Sep 14, 2011

On Tuesday, the Census Bureau released its annual report on health insurance coverage in the United States. News media widely misconstrued the data and presented the problems facing the nation's health care system through a distorted lens.

Many major news outlets made a basic error when reporting on the Census Bureau study. The Los Angeles Times wrote that "the number of Americans with no health insurance rose in 2010 to 49.9 million from 49 million the year before." But the figure cited by the Times included 9.7 million people who were not U.S. citizens.

In addition to noncitizens, the cumulative number included people who were eligible for government health insurance programs before Obamacare but simply never bothered to do the paperwork. The Census Bureau itself cautioned that "research shows health insurance coverage is underreported" by the survey, which "more closely approximates the number of people who were uninsured at a specific point in time during the year than the number of people uninsured for the entire year." Far fewer Americans were chronically uninsured than the headline number suggested. While the exact number of people who fit into this narrower category is hard to pin down, a BlueCross BlueShield study determined that it was 8.2 million in 2003 (that year, the headline census figure was 41.9 million). Of course, proponents of bigger government like citing the highest uninsured number possible to push the case that massive intervention is needed to get people covered.

But the larger problem with the focus on health insurance is the assumption that coverage guarantees actual access to health care. It doesn't. As the government adds more and more people to government programs like Medicaid and Medicare, it becomes harder and harder for those enrolled in the programs to get actual care. This problem has been made worse by the Democrats' insistence on "saving money" on Medicare by cutting doctor reimbursement rates. According to a recent Government Accountability Office study, while 79 percent of health care providers are currently taking privately insured kids, only 47 percent are taking new child Medicaid enrollees.

The broader issue facing the nation is not a lack of health insurance, but rising health care costs. And that is something that needs to be addressed through market-based reforms, not the massive government expansion envisioned by Obamacare.

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I have military medical and can tell you this is true. - It took me over 1 year

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to find a specialist who would take my insurance. Although the insurance guarantees that I will see a specialist within 30 days of referral, what happens is that when I complain that the doctor that they referred me to cannot see me within 30 days, they refer me to a different one. We do this over and over and over again until most people probably give up. I finally have an appointment next week, but actually had to go back to my PCM because in the time it took me to finally find an approved doctor who would take my insurance, my original referral expired and I had to get another one. Many of the doctors on their list do not actually accept TriCare from active duty enrollees, only retired. Government health care at its best. Is everyone really sure that they want to be relegated to this level of "care?" Also, keep in mind that if you have to go to a military hospital, customer service is essentially nonexistent because there is no reason to keep you happy. There is no choice to go somewhere else and they are not paid by the patient, so they really don't care. Some things to think about. Of course, there are military health care professionals who are in this profession because they really do care, but there are far too many who do not.

Our local hospital will not take our private insurance - sm

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It is supposedly a "good name" insurance. When I get my remittance advice from a more distant hospital/care center, it includes the cost charged by the hospital, the amount covered under the insurance contract, and my co-pay. If you believe the remittance information, anyone paying privately out-of-pocket is really getting ripped off. With the private insurance, my husband had to wait 3 months for a cancer screening, I have had to wait 2 months for a physical, 6 weeks for a mammogram. This is private insurance in the U.S. For-profit hospitals can choose to serve only the highest paying insurances/individuals. Yes, there is something wrong with our health care system that needs to be fixed. The path we were on certainly wasn't doing it. Hopefully, as Obamacares is implemented starting in 2014 and the process is tweaked, things will improve.

3 months for cancer screening beats the heck - out of my year to have the skin

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cancer on my back addressed. I'd take that private insurance over socialized health care any day.
I have also waited 3 months for a Pap, only to - show up to my appointment
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to be told that someone should have called me to cancel (I live an hour from the military hospital and had to find childcare for my young child). They then rescheduled me for another 3 months out and would not give me a new prescription for my birth control pills. That is why we now have child #2. Would have probably been cheaper for them in the long run to just squeeze me in, but I guess I am thankful for that mess because without it, I wouldn't have my sweet child.
They really should increase care at the military hospitals with all the vets - sm
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An area that needs an increase in government funding.
If you knew you weren't using birth control... - sm
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...why didn't you use condoms and/or the contraceptive cream of your choice?

This is NOT the fault of the doctor's office. The blame lies squarely on your shoulders!
Condoms break, honey, - but I did say it was a happy
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With the outcome and I am a responsible married adult, but thanks for putting me in my place. I hope you feel better now.
Abstinence works! ;) - Glad you are happy. Really.
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Anyone know any statistics on how often condoms fail?
"Abstinence works". What a truly uneducated, - backwoods belief THAT is.
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That would be why we would add the winky, winky ;) - nm
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Just can't help myself. When does - abstinence not work?
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Name one OTHER time in all of history.
Were there more than 1 Immaculate Conception? - hmm
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If so...I missed them.

I'm surprised MSNBC didn't cover it.
That's what I said. Name one OTHER time. - I was referring to the
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immaculate conception as the one and only time that abstinence didn't work. No need to jump me. I'm on your side. :)
I wasn't jumping on you - I was agreeing with you. - hmm
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and reinforcing your point.

Other than disagreeing with us, the only things these libs would like better is for us to disagree amongst ourselves.

They may be loud and somewhat unruly, but what they don't realize is there is more of us than them.
Sorry then. I thought we were having a - non-argument.
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:D
??????????????????????? - nm
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I would suspect you missed ALL of them, unless... - sm
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...you're claiming you were present during Jesus' birth.
What is... - JS
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the Palin family, Alex?

They can preach it all the way to the bank. It doesn't change the fact that teaching abstinence only as a method of birth control does not work. Period.
It works if you practice it, rather than just preach it. - Just because Sarah Palin
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told her daughter to be abstinent does not mean that she was. Clearly, she was not. Abstinence works 100% of the time for birth control and STD prevention. Talking about abstinence and having sex does not.
About 1.5 percent fail. - sm
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http://wiki.answers.com/Q/What_percentage_of_condoms_fail
Don't they have a phone number you can call? - sm
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I can easily find out which doctors take our insurance. Did you wait until the appointment to find out if your insurance was good? I would have checked up front. Just saying.
This was at the military hospital. My insurance was fine. - Their customer service was not.
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I have only recently been released to go to a private doctor. As far as the dermatologist, all referrals have been to TriCare participating doctors, they just won't take it, anyway.
There is a number and a list, but until I call the doctor's office - I can never really be sure.
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Then, TriCare referred me to the VA hospital, who will also not see active duty members or families. The local military hospital apparently does not have a dermatologist, or I would have automatically been kicked back there for the referral. It's all a big huge mess. There are lists on the internet of participating doctors, but they don't always comply with their participation, or they are too busy to see anyone for 9 months or whatever else. This last place that I finally did get an appointment with did not answer their phone or return my calls for 2 weeks straight.
Dermatology--That apparently is the area to go in to - for a career.
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I have heard the same thing about dermatology here. The family physicians have been "chewed out" for sending too many patient to the dermatology specialists--that they need to be very selective about who they refer for emergency care versus routine care. You cannot privately call a dermatologist around here and get an appointment at all. No wait for colonoscopies though!
Sounds like apples and oranges, then - sm
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If this is a military hospital, shame on the government for letting things get so backed up for our military. As I said, our health care system needs improvements. The old ways sure are not working. Hopefully, the coming changes will be begin to address some of these needs.
This is my concern for allowing the government to - take over our health care.
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Many people view Obamacare as a first step toward a single-payer system. That is when everybody ends up with the substandard level of care that our military gets now. I am not the only complaint. The government does not run anything efficiently. I think that people should be careful what they wish for.
No, the military is underfunded/understaffed - sm
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Single payer is so far down the road it is not even visible. The problems you are having now have nothing to do with a future single payer system. The military hospital system is simply too small to meet the needs of the expanded military that has been created over the last ten years (and from before). However, single payer would eliminate the profit that the private insurers give to their CEOs. I think the more people that have health care the better for people who work in health care. People providing actual care and supportive services (MTs) would have jobs and the economy would improve and more people would be healthier. It would be a nice change instead of spending on that money on "insurance" so the corporations can spend it on lobbying their political flavor of choice, advertising, and denying care to the sick.
I disagree. The military is being cut back - and the ranks are being culled.
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This is a trend that has been happening for awhile and is picking up. Military numbers are not growing. Look into PTS and retention boards for Navy, if you are actually interested. This is a look into the future of a single-payer system. It is government run healthcare at its finest. I disagree with you about insurance and since I am the one of us who has actually experienced government run healthcare in the U.S., I'm going to go ahead and trust my own opinion. The saving grace for our country is that single-payer is so far down the road that we might be able to stop it.
Anybody read the news about the Postal Service lately? - hmmm
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Not the most efficient or cost effective system in the world, it is? And yet Obamacare is expected to be both.

And, yes, Obamacare is a FIRST step toward single payer. Obama, himself, was recorded on video as saying that a "single payer system is what I'd like to see."
So what is the answer then if the government - cannot run anything SM
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efficiently? The way it is now, only those who can afford health insurance have health insurance and the poorest of our country receive Medicaid. Those of us in between (middle class poor) are in a real predicament. I have my own insurance but my deductible is so high I can't afford to see a doctor anyway, it is basically for a catastrophic event. I admit to not knowing a lot about the changes coming, but I thought that people could see the doctors of their choice (those with insurance would not have to change doctors), and the government would give a stipend to people who couldn't afford the insurance. I thought people like me might get some help with it as well.
Great post. - sm
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It seems that many posters on this board believe that health insurance is affordable. Maybe they only pay one or two hundred a month for family coverage that they get through their employers.

Nobody, it seems, addresses what I believe is the majority of cases: People who simply can't afford health insurance premiums, and often those health insurance plans DO have very high deductibles and co-pays.

Instead those uninformed people on this board want to blame the person who is uninsured, apparently not knowing that premiums can approach $1,000 a month and still have very high deductibles and co-pays, and while you're busy trying to pay what your insurance DIDN'T pay, you still must pay that astronomical monthly insurance premium.

I truly think that Obamacare will help people who are in the position you are in, at least I hope so.

Just ignore those ignorant people who have convinced themselves that the uninsured are just bums who don't WANT to pay for insurance. These people aren't living in the real world.

Best of luck to you.
re: Great post. - puzzling
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People are quick to tell folks that complain about poor-paying MT jobs that they should "get a better job."

Did anybody here have a gun held to their head while they were told to work as an MT, or else? Why should people who planned for the future, got a good education, took out student loans and paid them off, worked a couple of jobs, ate ramen for a few years, and landed a good job with good benefits have to subsidize the health care of those who didn't?
From what I have seen, the insurance premiums - are going up because insurance
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companies are being forced to keep higher reserves and pay out on preexisting conditions. If the insurance companies can stay in business, which is not looking good, maybe people will be able to keep their doctors, but the President, himself, has stated that he wants to see a single-payer system and that is what this whole bill is designed to start a move toward, which is what I am REALLY against. Besides that, why on earth did you think that middle class families were going to get help with insurance payments? I never heard that at all. All that middle class families are going to get is a bill if their plan doesn't qualify.
Insurance companies don't want to lose any - profits. nm
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Fair enough. Do you want to see a loss in wages? - Are they supposed to operate as
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charities? I am not really sure why we have decided that it is a bad thing to make a profit. Maybe that's why we are in this financial mess?
Actually, if employers didn't have the burden - sm
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of paying for some or all health insurance premiums, maybe they'd be more willing and able to give raises to their employees.
Did it ever occur to you that health insurance is part - of the compensation for work?
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Benefits are not things that are "given" to employees. They are earned. People with health insurance through their jobs earn the health insurance. Yes, employees could get raises, but that money would just go to purchase health insurance, right? Especially since it is now mandated by law that you have it.
Ahhh. Turns out that Humana Care and UnitedHealthCare administer Tricare - sm
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Well, there's the problem! The government needs to take this contract back from those private insurance adminstrators. Private contractors screw it up all the time while grabbing their profits.
Yes, Humana and Champus and United Care - ADMINISTER TriCare.
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They do not negotiate the VERY low rates that doctors are paid, nor do they decide what is and is not covered. They do not decide what gets kicked back to a military hospital and what goes out to private doctors. I can pretty well guarantee that nobody is getting rich off of TriCare. Do you really think it would be better if civil servants administered it?
Well, hon - sm
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I think your complaints and problems are all misguided. We ALL have to manage our health care within our insurance limitations--public or private. Your complaints about government mismanagement looks to me like your problems are more caused by dealing with private contractors. The problem is with the CURRENT medical system. Wouldn't it be better to fix it then let things continue the same? I think you are really just trying to bend the story to your political agenda, and as the good Dr. Phil would say, "That dog don't hunt."
My problems are certainly more than with - private contractors.
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While my problem with the dermatologist is a common insurance thing, my problems with the military hospital's lack of customer service are very much a government run healthcare problem. They don't have any regard for patient's happiness with service because they don't have to. There is no other choice. I cannot choose to get a second opinion. I cannot go to another provider. I have to deal with whatever I get. That is not a problem in a private insurance setting. I hear horror story after horror story about births in military hospitals and actually have one of my own that I am not going to get into on a public forum. As far as bending the story, I don't need to, hon. Did it ever occur to you that my personal experience might just have shaped my political beliefs?

Apparently your problem is an exception - not the rule

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I went to another forum and the reports were practically glowing there. It seems there are some hoops you have to jump through, which are comparable to the hoops I have to jump through with my private insurance. My BIL has been very happy with his care, too, through the military.

I could get you a laundry list of people who are - unhappy with military care, but

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you wouldn't want to listen. Good luck to you, if you ever do manage to get your single-payer system.

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