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Physicians and Insurance

Have you ever heard of a physician/dentist  not getting paid because they used the wrong “code” when sending in a claim to the insurance company?  Have you ever heard of a physician or dentist waiting 3 months to be paid by an insurance company and considering this the “normal” amount of time to wait?  I have, and I don’t think it is fair!

I don’t know about you, but I like my chosen doctor and dentist and I would like them to get a fair wage at the time they do the service.  Why have we, as a country, allowed the insurance companies to bully us around so much?  It is time that we start looking at alternatives to insurance.  Let’s have a discussion of thinking outside the box and then call our Federal representatives with our ideas.  It seems like they are stuck in a rut because all they can think of is to nationalize our healthcare.  It seems like an easy fix, but easy is not always right or good.

We are a nation of individuals.  That is what has made our nation great in such a short time.   We need to be able to choose what type of healthcare is good for us.  We also need to be able to choose how best to pay for it.

When I go to the gas station, I can see exactly how much money I am going to pay for gas.  When I go to the grocery store, I can see just how much my milk, bread, pizza, eggs, etc. is going to cost.  When I buy an airline ticket on-line, I can see exactly how much my ticket will cost.  I can see the cost before I buy.  Healthcare is the only area where I cannot know the cost until after everything is done with.

I have learned that the hospitals, doctors, etc. charge based on who the customer is.  If the customer is a big insurance company they get the biggest discount.  If the customer is an individual with no insurance they get the smallest (if any) discount.  Certainly, when I have a health emergency I will not be checking the costs.  But most healthcare decisions are not emergencies.   If the consumer can know costs ahead of time they can decide which hospital based on the costs.  They can decide if the hospital that charges more is really worth it, or not.

If the government is going to make changes, I would ask that they mandate healthcare facilites to post their charges up front.  This may sound crazy to you.  If it does, then ask yourself “Why?”.  I think it is because we are not used to asking about the costs of healthcare, but we should.  We ask about the costs of everything else in our lives.  Once we know the costs, then we can look at how to pay for it.  Is insurance really doing what it is supposed to do?  What about discount plans like http://www.noinsurance.us  , where we make the decision with our provider instead of looking for an “o.k.” from an insurance company?

I threw out a few options, now let me know what you think . . .

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Health care crisis?

Do we have a health care crisis here in America?  I understand that there are a lot of people/families in America that don’t have health insurance, but does that equate to a health care crisis?  The quality of care in the United States is very good.  The health care education is also very good.  In fact, people come from all over the world to be trained in the United States for a medical profession.  I don’t see a crisis there either.

So where does this crisis come from?  The current administration would have you believe that it is the greedy physicians and hospitals.  From what I understand the people in Washington (our “representatives”) want to provide health insurance that would put caps on the costs, and put everyone on the government’s insurance plan.  Will that help?  Iwould like to suggest that it is the way insurance works that has caused the health care crisis in America.

I think the problem is that the patient and physician have been taken out of the equation, and insurance has put itself between them as a dictator.  Who doesn’t know someone who was denied coverage because the insurance company deemed it unnecessary?  The way I see it, the health care crisis has been caused by insurance protocol, and I mean all things that act as insurance, including the government run programs.  Will Obama have an answer?  Not if it is just more government insurance.

We need to put the power back in individual’s hands.  The patient needs to be made aware of all costs up front.  These costs should not be on a sliding scale based on what insurance the patient has.  We need to stop the insurance games.

There is a company, called Ameriplan, that does just that.  Costs are listed up front.  There are no deductibles or co-pays.  You don’t even have to “ask permission” before going ahead with a procedure.  The physician and patient decide what is deemed necessary, and Ameriplan is there to provide the discount.  Insurance companies get huge discounts from physicians, labs, and hospitals.  It is time that patients get those same discounts without also paying huge sums of money each month to insurance companies. 

Ameriplan, a discount program, is a new concept in health care, even though they have been around for 16 years.  The way I see it there will soon be a paradigm shift in the way people think about paying for their health care.  What we have right now is not working, and if Obama and the rest of our representatives in Washington D.C. just give us another insurance program, that would be like putting another “Band-aid” on a 10″ slash in the middle of someone’s abdomen.  We need to fix the problem by taking off all of the Band-aids, cleaning up the wound (it will get bloody), and then stitching up the problem in a new way.  Yes it will hurt for a while.  That’s o.k. because in the long run we will all be healthier as a nation.

www.noinsurance.us (Ameriplan information)

One perk to home schooling my children is that I get to relearn things that I forgot (or never really learned the first time). I went to a public high school, and I don’t think I ever learned anything about Ancient Rome. When I taught Roman history to my children, I saw many similarities between Ancient Rome and America. I think it is essential for every person to understand the rise and fall of Rome. If we don’t know what happened in the past, we tend to repeat it. Take a look at my daughter’s thoughts on what happened before the fall of Ancient Rome:

Why Ancient Rome Fell and How America Could

1. Rome’s political disorder – Rome couldn’t boast about a strong and stable government by the 3rd Century.

2. Inefficiency and waste increased as the size of government increased.

3. Unstable leadership.

4. Economic problems – the treasury was drained by a huge army and a huge government bureaucracy.

5. Raised revenue by increasing tax burdens.

6. Reduced the silver content in coins and replaced them with cheaper metals.

7. Inflation occurred because of Rome’s one-sided trade with India and China, henceforth further depleting the treasury.

8. Money became useless and the barter system was used.

9. Trade slackened.

10. Shops closed.

11. Moral decay was on the rise.

12. People looked to the government to supply all of their needs – basic and luxuriant.

13. People became ridiculously greedy.

14. Family life disintegrated.

15. Divorce became commonplace.

16. Immorality was rampant.

17. Superstition was accepted as normal.

18. In the end, gave leadership of Rome to a non-Roman.

Once the backbone of Rome, a hard-working, patriotic citizen was now hard to find.

Does any of this sound familiar?  There are a lot of places to learn about Ancient Rome.  I urge you to look at a few of them, because one source will never be enough to help you understand the complexities of the Ancient Roman Empire.  Rome was a Republic at one time, just like the United States of America is today.  By the way, did you know that America is not a democracy, but is actually a republic (say the pledge of allegiance and you will realize what you are pledging to).   I will leave that for another post. 

“My people perish for lack of knowledge.”

Honesty in finances

When I was very young, the first thing I remember my dad deliberately teaching me was honesty.  Some things I learned almost by default, but honesty was talked about often and on purpose.  When I was a little girl I would find myself in double trouble if I ever told a lie.  Lying was not to be taken lightly, and yes, my dad believed in corporal punishment for extreme crimes.  

My dad referred to himself as “Honest John”.  Some people may have disagreed with him, but they always knew where he stood on a subject.  When I was older I knew I could count on my dad for an honest opinion.  Believe me, sometimes his honesty hurt, but it saved me true heartache in the future (when I listened to him). 

I think we need some honesty in America again.  I think we need to be honest with our own selves.  I think Americans have been dishonest with themselves thinking they could afford more than they could.  I am speaking specifically of the mortgage/housing crisis we are in right now.

The mortgage sales people should have been honest with their clients and told them the reality of taking out a mortgage that they couldn’t really afford.  The mortgage companies could have helped both their clients and themselves by making sure the mortgages could be paid back.

Which brings me to wonder why these mortgage companies would have given out such risky loans in the first place, if their business could be adversely affected.  Hmmm . . .    From what I have found, the government forced these companies, by law, to ultimately make bad loans.  Oh, it didn’t say specifically to go out and make bad loans, but it did require the mortgage companies and banks to make it easier for disadvantaged people to get home loans.  In the past these people were prevented from getting loans because they were a high risk.  No one was being mean to them and preventing them from living in a home (renting is always a way to go), but they were prevented from getting themselves into more debt than they could afford. 

This brings me to the people that I think are most responsible for these bad loans, which are the mortgagees.  These people knew how much money they had to live on, and if they were honest with themselves (and not just listening to the salesman) then they would know that they couldn’t afford the loan that was being offered to them.  In reality what happened is that we had a lot of people falling in love with the idea of home ownership and they did whatever they could to get themselves into those homes.  Many have blamed this on predatory lenders.  I don’t think so.  I think the borrowers should accept some of the blame for this problem we now face as a nation. 

The other party I think is to blame is the educators of our country.  We need to be teaching our high schoolers some basic accounting and economics.  Who needs Algebra if you don’t know how to balance a checkbook?  My son, Taylor, brought to my attention this need for financial education in America.  You can check out the Financial Course he is starting at http://taylormarek.com/blog/ .  As a bank teller Taylor has seen the mistakes people make.  He can also tell a lot about a person by the way they handle their money. 

We can come back much stronger financially as a country if we would just be honest with ourselves and start taking responsibility for our own actions.  Another place that could use some honesty is our media, but that is for another post.  Stay strong and leave your stocks alone for now.  In fact, I hear there are some real good deals in the stock market right now.

Welcome to “Whatever Is…”.  In this blog I will try to focus on whatever is true, whatever is right, whatever is noble, etc.  In other words, I won’t be just blogging on whatever comes to mind, but the focus will be on positive information.  I have noticed a void in information coming to my home, and I hope to fill that void for some of you.  Please let me know what you think about the things I bring up, and also let me know of topics that you would like to discuss.

The first topic is regarding the older generation and their usefulness.  I was reading a blog by Helen Philpot, an 85-year-old woman   http://margaretandhelen.wordpress.com/2008/10/07/maverick-my-ass/   .  She said that John McCain is essentially too old to run the country and he should move out of the way so that Barack Obama (the younger man) could have his time in office.  What a shame!  and coming from an older woman too.  In the blog she talks about her husband watching  a lot of TV (his shows).  Unfortunately the older generation has been fooled into thinking that their time is over and the only thing they can do now is watch the world go by (on TV). 

This all reminds me of a story that I read to my kids called “The Law of Life” by Jack London .  The story is about Eskimoes, and the struggle that the young man had because it was time to leave his father out in the woods because he wasn’t useful anymore.  This was the custom of this tribe.  They lived as a group of people that moved from area to area during the seasons to be near a food source.  When people got old and “became a burden” on the others then it was time to go.  This meant giving a few pieces of meat to the elderly gentleman (that had to go), sitting him in front of a fire, packing their bags and leaving.  The elderly gentleman would eventually freeze to death when the fire went out, and then be eaten by wolves.  Is this what we think about the older generation, or can we, as Americans, realize that the experience and wisdom of the older generation is above value.  They have been through things that we have only heard about and their input is invaluable.  Helen is writing a blog and contributing to the conversation of the country.  That is wonderful.  We need more people like her that aren’t wasting their retirement days.  But it breaks my heart that even Helen thinks that the experience of older individuals is not as valuable as youth.

I am a 43-year-old woman.   I understand the world better now than when I was 20 something.  Although I thought I knew alot back then, it is only now that I know what I didn’t know then.  Maybe that is the problem with the older generation.  They know and understand that there is a lot that they don’t know.  But that is a better place to be than the younger generation that thinks they know a lot.  It is dangerous to think you know something, but in reality you don’t.  Only experience can teach you that.

In the end, I know that John McCain can do a much better job at running the country than Barack Obama because of his record.  Helen Philpot also said in her blog that John McCain kept talking about the past, and she said, essentially, to get over it because it is in the past.  I remember my kids watching “The Lion King” and at one point after the rightful king ran away from his duties thereby leaving his kingdom to be run by a ruthless dictator, he said to the lion that was sent to get him back that the past “didn’t matter anymore”, “leave the past behind you”.  Well that Lion King learned that the past is very important, and what happened in the past will dictate how you will react to the future.  To relate this to McCain and Obama:  I can know McCain through his long past record.  Looking at Obama’s record I have a lot of questions.  Actions always speak louder than words.

I do agree with Helen on one point, though.  I am not sure who won the debate either.  I am not sure that the ability to win a debate should be the reason to vote someone into the highest office in our country.  People need to do their own homework and find out about the person they are voting for.  I think that Helen was not paying attention to the fact that no one in the Republican arena wanted John McCain to win the primary because he didn’t tow the party line.  He tells it like it is and if he has to tell the Republicans that they are wrong, he will, as he has in the past.  Take a good look at the voting records of both candidates and don’t just listen to the media and their opinions.  Make up your own opinion after looking at the facts.  Facts are hard to come by during a campaign because everyone always plays up their good traits and plays up the opponents shortcomings, but we need facts nevertheless.  And we need the experience and wisdom of the older generation to help us remember those facts of the past.