How much money should an insurance company pay back in claims--75%? 85%? 99%?
How much profit should they make?
Remember, the companies call the payback their "medical loss ratio."
Land of The Free
Home of The Knave
Dr. Butler
of CA
@
Mar 28, 2009 15:33:12 PM
Change is on the way
This is just a sign of the times. Relationships that once were thought to be too tough to break are falling apart as the dollars for the model they used are drying up. It is abuout time the AMA stood up like this. It is unfortunate that it is only happening now.
The payment model must change from a third party to a two party system for basic and specialty care. Programs are emerging, but not mature enough to take on the big insurance companies yet.
As the insurers lose market share due to high premiums and other practices that leave poeople out in the cold, the reform models will fill the gap.
Anyone who believes they are "covered" by health insurance has taken a very shallow look at their policy and ignored the practices of these companies for the last 30 years. Health insurance is no assurance at all, it will pay some of the bills not all of them. It is time for the Equity Health Plan and the Retail Medical Home Model to repalce this antiquated system of "insurance"
Daniel P. Francis, CEO, Medical Homes of America
of GA
@
Mar 27, 2009 11:20:00 AM
BLUE CROSS HMO
BLUE CROSS HMO PAID ZERO DOLLARS FOR PHYSICIAN OFFICE VISIT OR ANY LAB TEST .
THERE SHOULD BE A OUT OF NETWORK PAYMENT EVEN IF IT IS REDUCED PAYMENT
DRFIAZ
of LA
@
Mar 26, 2009 17:44:44 PM
Perscription drugs
what about the rising cost of perscription drugs that Wellpoint and HMO's charge patients? HMO"s every so often change the cost of drugs and we the patients who need them in order to survive have no choice except to pay for them. The explanation we are given for the change is that certain drugs are placed on another tier. Whatever that means. These are the drugs that have no generic and are already out of sight!
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Bihskazv of AZ @ Jun 22, 2009 18:31:02 PM
Dr. Butler of CA @ Mar 28, 2009 15:33:12 PM
Daniel P. Francis, CEO, Medical Homes of America of GA @ Mar 27, 2009 11:20:00 AM
DRFIAZ of LA @ Mar 26, 2009 17:44:44 PM
Nancy Bielik of OH @ Mar 26, 2009 14:07:26 PM
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