Pearls Before Swine by Stephan Pastis for November 02, 2014

I read this entire episode thinking Rat was messing with whoever was claiming, not the other way around. The Health Care folks are more Rat than Rat!

Calling! Calling, not claiming. Spellcheck strikes again.

Oh, the agony. I can imagine the nightmare when at the doctor’s office in person on location.

There was a time when the worst Acme-related problem was getting crushed by an anvil. This is worse.

only 9 hours? Rat is lucky he did not call on the busiest time, when wait time is 14 hours

As somebody who has worked for the federal government, I don’t want government controlling my healthcare.

No, Obamacare exists because of the relentless desire of liberals to expand government to control every aspect of our lives. Administrative overreach strikes again.

People do know that insurance companies are private companies and that phone trees, long hold times, excessive record keeping and massive legal CYA are are symptoms of that, correct. As for those other responses to the earlier comment it’s amazing how stupid people always seem to do little more than repeat whatever drivel talking points they heard on Fox “news”.

If they had actually hired additional people to properly address customer concerns in a timely and efficient manner without the phone tag game being played, Rat would have abandoned their services for a cheaper policy that did not have the overhead of service personnel and coverage for existing conditions and high-risk persons.It’s just like how the supermarkets sell junk foods loaded with fat, salt and sugar to people instead of good, healthy, whole foods.The evil corporations are destroying these wonderful people.Really, I read it on the internet and people held a rally.

Sheriff Mordecai…. from yesterday…Hi! Good to see you again.And yeah, I knew that.And you know I never do that… only… Stephan never reads the comments… and besides…. this time it was Goat.

If it were Pig, or Rat or Zebra… I wouldn’t have said a word, I promise…but you know Goat just can’t stand it.LOL

Much time is spent designing systems that keep you from talking to real people.

I am so glad I live in the UK: tax-funded National Health Service, free at the point of care, and no claims to submit.

In an amazing 17 panels, Cartoon-Boy demonstrates the futility of trying to deal with a complaint by phone, especially when the opponent (yes, opponent) is Big Insurance. Rat may actually have learned a lesson today!

If Rat ever worked in billing, the delay would be even longer.

This is a little unrealistic. Real insurance companies don’t have main switchboards with flesh-and-blood operators. Other than that it was pretty accurate.

“Your call is important to us….. just not that important….”

I’m sorrySir, we have no Bill, in this department, May I help you, my name is Billy?

Heath care needs to be reformed..The HMO are sucking too much money out of the economy..No illegals aren’t covered differently than before the change.They get medical assistance when they end up in the hospital..The real solution would be to have either:a single payer plan, Medicare.have medicare available to everyone as an option Make all HMOs as non-profit..They made it too complicated because they know the opponents, the HMOs, would attack it and stop the process.Unless they got their slice it..Finally, this idea was with Nixon, Truman etc, so it’s been kicked around for a while..But it does need to be fixed, period.

Ain’t it the truth!

Canada wonders why you think single-payer health care is good for the elderly, the disabled and veterans, but bad for everyone else, giving you the highest health care costs per person in the world. http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_%28PPP%29_per_capita

Worst tech support ever is McAfee.

Calling AT&T works the same way

For those who have commented on the ACA (Obamacare)

CoverageEnds Pre-Existing Condition Exclusions for Children: Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition.Keeps Young Adults Covered: If you are under 26, you may be eligible to be covered under your parent’s health plan.Ends Arbitrary Withdrawals of Insurance Coverage: Insurers can no longer cancel your coverage just because you made an honest mistake.Guarantees Your Right to Appeal: You now have the right to ask that your plan reconsider its denial of payment.

CostsEnds Lifetime Limits on Coverage: Lifetime limits on most benefits are banned for all new health insurance plans.Reviews Premium Increases: Insurance companies must now publicly justify any unreasonable rate hikes.Helps You Get the Most from Your Premium Dollars: Your premium dollars must be spent primarily on health care – not administrative costs.

CareCovers Preventive Care at No Cost to You: You may be eligible for recommended preventive health services. No copayment.Protects Your Choice of Doctors: Choose the primary care doctor you want from your plan’s network.Removes Insurance Company Barriers to Emergency Services: You can seek emergency care at a hospital outside of your health plan’s network.

For those in doubt, try fact-checking.

Yup—that’s pretty much the exact process for connecting on many calls I’ve made to companies.

Thanks to the ACA my kid with a pre-existing condition can not only get insurance, she can pay into the system for it like she wanted to before but the companies wouldn’t let her because they didn’t want anything to do with her. That means should she ever need to file a claim now they, and not the taxpayers, will be paying her bills—which over time will be reimbursed by her premiums. Everybody wins. And she no longer has to beg for her chemo meds after the mini plan she’d been on, the only policy she’d been able to get, maxed out at two thousand a year—which she hit mid-January. Companies have programs for those who can’t afford their drugs—and they turned her down because “you have insurance.” It covered something like two doctor visits a year with those almost-no-meds, so no, in effect, she didn’t. Her meds equaled nearly all her income. Now, thanks to the new law, mini-plans like that are outlawed for the scams that they are, she’s covered—and she’s healthy.

Thank you Obama care. The very few will benefit, the very many will not. If you are young, who generally don’t need insurance, you will be paying for all us old people who need it. And how’s that keep your doctor thing woking out?

This is nothing. Try getting to where you want to go with Verizon.

This is American health care today. We vote in two days.

Ok, Americans are noted for wanting everything to be cheap, to be present in large quantities and to be of the finest quality. Of course these goals are mutually exclusive. Some in England and Canada rave about their government health care systems because they are cheap, which they are, but the ravers are usually the ones who have not had to use these systems. Those that have are subject to interminable delays and endless red tape. When HMOs came along many, especially governments and large companies, were chortling with glee at the low premiums. I always wondered how do you take a health care system, consisting of physicians, hospitals, etc. and pile on a large very well paid insurance bureaucracy where the CEO gets a seven figure salary and save money. The answer is: bully providers into signing on at penurious rates by telling them that they will make it up on volume, plus if they don’t sign they will be put out of business by those who do sign. At first it worked after a fashion, people got health care (usually by the office nurse) and the insurance companies got filthy rich. But being filthy rich was not enough so the insurers kept going back to the employer/government saying that costs had risen and they needed more money. It worked, they got more money. Now they have done it so many to times that there are no more savings to be had, but everyone seems to be fine with that. Any blame for the rising costs is not blamed on the greed of he insurance companies but are tossed on to the backs of the physician and hospital providers. Most physicians have not seen a raise in reimbursement in 20 years and many specialists have taken 50 – 70% cuts over the same time period. Hospitals are being burden with more and more paper work, mainly so insurance companies and the government can find reasons not to pay for things. Currently, most hospitals have way more employees who defend claims, fulfill the onerous burden of endless reports and in general push papers around in a circle. The insurance companies do their best to fortify their business so that no one can find out what, exactly, is going on as in Rat’s situation. Will it get better? Unlikely.

However bad customer service is now, it will only get much, much worse as more of Obamacare is implemented. And you will have you recourse.

I hate how true this is.

xxx

This is where basic math skills are handy.If you are operating a business worth billions, with millions of customers, a dollar from each one is millions of dollars. Similarly, a dollar to each is also millions of dollars. Now, if your top executives make a total of $1B in salaries, benefits and bonuses, and you took that away and applied it to coverage for millions of people, it might add up to nearly $1K each, but probably much less if you have a sizeable slice of the industry, which is practically nothing in terms of the cost of medical care.Here is the fun part. Premiums are calculated on actuarial data and projected costs of outlays given an average population segment.Profits are calculated on what actually happens, which can be very good if things go well, and can be devastating if things go poorly. You have to charge enough to cover potential outlays over the premium period.The use of single-payer by select portions of the population requires that care providers charge higher rates of all customers, since only the paying customers will actually be meeting the cost requirements and paying the full freight. Your insurance premiums not only pay for your care and that of everybody in your risk group, but for a portion of the costs of all of the single-payer plan participants, since their per-treatment costs are calculated separately by the payer, who does not recognize the payment structure of the provider as valid and sets limits. Insurance companies also do this, but they negotiate a trade-off where they provide business by network plans against cost reductions for care. Single-payer does not negotiate, however. It dictates, which is much better for the consumer, obviously, where a slave population of health care providers who receive only a fixed government compensation would be ideal for the customer.

This might be a dumb question, but I’ve always wanted to know: What does ACME stand for?

On the positive side, the mind-numbing inefficiency in health care is subsidized now so some of us pay only a fraction of what we’d ordinarily have to shell out for the level of malpractice we’re getting. Good times.

Our drug plan was changed from Caremark to a company that made us order all continuing prescriptions by mail, where we’d receive a 90-day supply. No picking them up at a pharmacy. We were forever having to call them, and had to give them our name, case number, etc., and tell our stories, mentioning that they were going to transfer us to a “dedicated representative.” Sure enough, they’d transfer us to a dedicated representative, where we had to repeat the same info. Argggh! Thank goodness, just got the news that we’re getting Caremark back in January. Maybe the Powers that Be were tired of dealing with all that stuff, too.

Does Rat know there is something called email or online chat? And I think that last time, Rat used to like surfing web on his smartphone? Why is it difference this time?

Soapbox time:

It’s the same Acme that manufactures all those products that Wile E. Coyote bought in MANY attempts to nab the Road Runner… none of them worked. And now they’re selling health insurance? Sheesh… It’s all conglomerated.

Oh, and if I were the Coyote, I wouldn’t buy health insurance from these guys.

But, KNOWING the Coyote, that’s just what he WOULD do…

The Coyote may claim to be a genius, but he has zilch for street smarts.

End soapbox.

Rat, it’s not a problem with health care, it’s a problem with health insurance.

We are in our early 60’s. On our $17,000 actual income (as opposed to the IRA withdraws we make to get by) our medical insurance was $1500 a month in 2013. It was to go to $2,000 a month in 2014 (and that was through a business association group plan, I hate to think what an individual plan would have been). We took a platinum level plan under ACA for 2014. The premiums dropped to $1100 a month for the plan. The credits bring it to $700 a month. Even the $1100 a month is almost half the $2000 we would have to pay for insurance without the ACA.

Is it perfect or the best idea? No, but combining everyone in Medicare with payments by those under 65 or another version of a system without the for profit insurance companies was not allowed to be put into effect. If the other side is upset at what we have – it is what was designed by a Republican for MA and they would not allow anything else through.

Those of us who are not covered through work and have to pay our own premiums could not afford the insurance. We had to keep it as we both have prior conditions and could not chance not having insurance. We have both worked our entire teen and adult lives. We are not slackers and both even have college degrees. Husband had to leave work because of burnout. We planned on staying on the insurance through his job as no one had ever been asked to leave the plan before as long as they paid their premiums. Unfortunately, when he left the new director did not know how to continue this and we were stuck.

Medical Ins cos used to be non-profit. They should never have been allowed to become for profit. Since they only have to put 80% of income to coverage and have 20% for dividends, the costs would be at least 15% less if they were nonprofits.