Denying Healthcare

Dr. Obama - head of USSA Medical ServicesIn the course of President Obama and his Liberals’ ongoing war to nationalize the health insurance industry we Americans have been subjected to countless rants about how those “evil insurance giants” keep denying people’s insurance claims and withholding coverage from them in the “selfish” pursuit of shareholder value.

To the Leftists only a Public Option will save us.

So let’s look at the data provided by the American Medical Association (AMA) itself in order to see which health insurance providers seem eager to deny patients’ claims:

Insurance Provider % of Claims Denied
Medicare 6.85%
Aetna 6.80%
Anthem BCBS 4.62%
Health Net 3.88%
CIGNA 3.44%
Humana 2.90%
Coventry 2.88%
United Healthcare 2.68%

Much like President Obama’s lies about ObamaCare covering abortions and illegal immigrants, his and his followers’ sob stories and angry rantings about insurance companies denying patients’ claims veer very far from a true and objective account of the situation.

Medicare, America’s best known nationalized health insurance program, denies a higher percentage of claims than any other health insurance provider monitored by AMA in their annual National Health Insurer Report Card (NHIRC).

This is not something that the Liberals, enamored as they are of government controlled, administered, and regulation healthcare, want Americans to hear. Their agenda can’t survive the truth.

At first glance it would seem that the private health insurance company, Aetna, runs a sadly close second in denying people’s health insurance claims. A slight bit of research in the AMA’s 2008 NHIRC shows that this initial opinion is wrong though. 65.7% of the claims that Aetna denied were denied because the benefit for the service was already included in the payment for another service or procedure that had already been adjudicated. If one factors out these duplicate claims, Aetna’s overall percentage of denied claims is only 4.47%.

Medicare’s claim denial figures have no similar amelioration to be found within the AMA’s annual scorecard. Indeed, the top 5 reasons – which together total 76.8% of the total denied claims – Medicare has given for denying patients’ claims are far less than soothing.

Reason For Denial % of Denied
Paperwork error in Claim 27.80%
Claim deemed as not a “medical necessity” 20.90%
Claim not covered by this payer/contractor 13.80%
Non-covered charge(s) 8.50%
Patient couldn’t be identified as insured 5.80%

Paperwork errors, flat-out denial of coverage, and the inability to identify and track enrollees – these are the government’s primary reasons for denying healthcare benefits to the American citizenry.

…And yes, this is exactly the sort of Hope and Change that Obama threatened America with during his campaign for the Presidency. Americans’ were duly warned of the Reconstruction.

Judging by how the federal government administers Medicare, ObamaCare would be, “A medical system with the compassion of the IRS, the efficiency of the U.S. Postal Service, and the financial solvency of the Social Security system.” That is something that Americans can and should do everything and anything within their power to prevent from happening to us, our children, and our children’s children.

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7 Responses to “Denying Healthcare”

  1. J.D.F Says:

    Good afternoon Jonolan! I hope you are well.

    One reason I am in favor of a public option is so that people like my partner can get health insurance. Because I cannot be legally married, I cannot have her on my policy, she is does not meet the requirements of medicare / medicaid, and is a student. She could go to the ‘free’ clinics, and it is definitely an option, however, that option comes with a variety of problems itself. Or we could go to a doc-in-box, but the costs are so outrageous… just to visit, step through the door and say hello to the doc is nearly $200 then add medication and labs and it quickly can get out of hand. Getting private insurance without employer help / pre-tax benefit – the cost is even higher per month.

    I respect what you are saying about nationalized medicine, and I do understand the fears and concerns associated with it. However, something has to be done, especially when more and more people cannot get or keep insurance.

    But hey, an easier thing would just to allow us to get married… then all would be well! – at least for 2% of the population (rough estimate).

  2. jonolan Says:

    I suppose that, for those without such insurance, a poor plan is better than nothing. My fears are that ObamaCare’s Public Option will be exactly what Obama said it would be – a first step towards fully nationalizing our healthcare, or at least health insurance.

    Given the government’s track record, I’d rather not harm so many (250+ million) to benefit so few (30+ million).

    As for the homosexuals, your numbers are off. I’d estimate the Public Option being truly useful for only a minority of gay couples since you all have very high dual income family statistics. So it’d be “all is well” for roughly 0.5% of the population. 😉

  3. J.D.F Says:

    I am not sure I see your line of thinking on how it would harm people, when if you already have insurance you wouldn’t have to participate in the public option (whatever that option consists of).

    For my partner and I, right now, there is no way for us to afford for her to see anyone unless it is ‘free’ clinic. Which means she may or may not get the care needed, and god(s) forbid she has an emergency. I just think it is not as scary a plan, and that it can help where medicare has failed.

    0.5% 2%… tomato taamato. LOL 🙂

  4. jonolan Says:

    My reasoned thought and profound fear is the in a matter of a few years the Public Option won’t be optional. The combination of frankly harsh and punitive regulation upon the private insurers combined with a government offering that not only doesn’t have to show a profit, but can – as does Medicare and Medicaid currently – hide its costs in other budgets will likely drive the private insurers out of the general market.

    Also, what happens when any of our employers, facing rising health insurance costs, find that paying the federal penalty is cheaper than providing coverage?

    Since I firmly believe that ObamaCare’s Public Option will be no better than Medicare & Medicaid, I class this as harming the many to help the few.

    BTW: The Public Option is not needed for your spouse to be covered. The rest of the proposed legislation would grant her access to health insurance – and, if needed, provide tax dollars to subsidize her purchase of it.

    Hmmm…You and she might actually realize a net benefit from NOT being married, much like many other people receiving various federal subsidies…

  5. ichabod Says:

    Hi Jonolan;

    “HmmmYou and she might actually realize a net benefit from NOT being married, much like many other people receiving various federal subsidies”

    You are not far off 🙂

  6. J.D.F Says:

    I am not sure any benefits out weigh the costs of all of the potential medical bills we have to pay for up front and out of pocket. To be honest, I want to be able to care for my spouse, see that she can get medical care she needs, and live a long and happy committed life with her. Then at the end of my days, know all we created, supported, and built will be left to her and take care of her. So in the end, if the public option is nixed but there is another ‘option’ for lack of a better word, then great.

    To me, it matters that so many people suffer. I have lived in a socialized medicine country and in all honesty it was wonderful! I don’t see the fearful monsters under the bed that so many seem to be screaming about. We need reform, we need to help those who are in so desperate need of care, and we need to do it efficiently and effectively. I will support a bill that does that.

    BTW: Hope you are having another great day! 🙂

  7. jonolan Says:

    J.D.F.,

    My point was that, because you’re not married, your incomes aren’t combined and you don’t legally count as a means of support for your spouse. That would allow might her a greater subsidy (Affordability Credit) than you would receive if you were married.

    Sadly, most of our government subsidies are setup that way.

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