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My brother worked in Seattle as a doctor for a while.  As a European he was amazed that he had to spend half his time negotiating with insurance companies on behalf of patients as to which tests/procedures he could authorise that they would pay for.  He ended up having to do a lot of horse trading - I won't do test X if you let me do Y and z.  

He said it was incredibly inefficient in terms of doctor time.  In Ireland health care, whether public or private, simply doesn't involve a prior conversation with an insurance company.  If a doctor authorises a test/procedure, its covered in terms of the general provisions of the policy.  There is no individual negotiation.

Vote McCain for war without gain

by Frank Schnittger (mail Frankschnittger at hot male dotty communists) on Sat Aug 30th, 2008 at 06:14:24 PM EST
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Overhead for Medicare is somewhere between 1/7 and 1/2 of   similiar costs for private insurers.

And I'll give my consent to any government that does not deny a man a living wage-Billy Bragg
by ManfromMiddletown (manfrommiddletown at lycos dot com) on Sat Aug 30th, 2008 at 06:24:27 PM EST
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I know the feeling.  I grew up watching my mom, who managed a cardiologist's office, fight insurance companies all day.

The doctors are getting fucked constantly, which is why you've seen the AMA switch allegiances -- going from strong opposition to reform (they blasted Hillary back in the '90s) to support for universal care.

Be nice to America. Or we'll bring democracy to your country.

by Drew J Jones (pedobear@pennstatefootball.com) on Sat Aug 30th, 2008 at 06:27:31 PM EST
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Demutualization, Drew.  Demutualization drove a lot of this, because it took mutually owned insurance and turned it over to the market.  I think that a remutualized insurance industry where the company is owned by policyholders not shareholders would be almost as good as  a government run plan. It's the imperative to make money that makes insurance companies do evil things.

If they owed their loyalties to policyholders instead of shareholders they wouldn't be putting profits over people.

And I'll give my consent to any government that does not deny a man a living wage-Billy Bragg

by ManfromMiddletown (manfrommiddletown at lycos dot com) on Sat Aug 30th, 2008 at 06:33:56 PM EST
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