HappySqurriel said:
NinjaguyDan said:
The the whole idea of a trigger mechanism is total bullshit. Why do I say that? I'm glad you asked. The way I see it, given the current debate over health care reform, in the mid to late 19th century vernacular, "that trigger has done been pulled".
From what I've heard, $400,000,000,000 (yes FOUR HUNDRED BILLION DOLLARS) a year are siphoned out of the system for executive pay (must be nice to get money you haven't WORKED for) and dividends to stockholders.
I posted this list in another thread, these are JUST the CEOs of the six worst offenders:
Stephen J. Hemsley UnitedHealth CEO 2007 Compensation $13.2 million 2008 Compensation $3,241,042 Total Value of Unexercised Stock Options $744,232,068---WTF?!?!?!? 2009 Options Exercise $127,001,281
Edward Hanway CIGNA CEO Five-Year Compensation, as of April 30, 2008 $120.51 million Total Value of Unexercised Stock Options $28,881,000
Michael McCallister Humana CEO 2007 Compensation $10.3 million 2008 Compensation $1,017,308 Five-Year Compensation Total $15.1 million Total Value of Unexercised Stock Options $60,865,194 2006 Options Exercise $22,294,710
Ronald A. Williams Aetna CEO 2007 Compensation $23 million 2008 Compensation $24,300,112 Total Value of Unexercised Options $194,496,797
Allen Wise Coventry CEO 2004 Compensation $13,052,799 2006 Sale of Stock $14,458,251 2006 Options Exercised $2,895,000 2005 Sale of Stock $46,410,695 2005 Options Exercised $6,709,564 2004 Sale of Stock $12,826,756 2004 Options Exercised $4,798,000
Angela Braly WellPoint CEO 2007 Compensation $9,094,271 2008 Compensation $9,844,212 2006 Sale of Stock $4,858,585 2006 Options Excerise $4,566,124
(Then add in the pay and perks for all of the junior and senior executive parasites plus stockholder dividends)
Now, I'll ask YOU a question: how is that right? Those people have to be absolute sociopaths to think that they desreve what they're getting paid.
It looks like a ponzi scheme to me. The health care system is riddled with parasites. Under a government run single-payer system those expenses are eliminated thus freeing up FOUR HUNDRED BILLION DOLLARS A YEAR.
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If insurance company profit and CEO bonuses are the reason for the high healthcare costs why does medicare and medicaid cost (roughly) the same amount per person covered as private insurance?
In reality-land the statistics tell us that the cost of insurance company profit and executive bonuses are (roughly) offset by the inefficiency of a public system and the core problems with the cost in the American healthcare system lie elsewhere.
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I can answer your question in one word:
FRAUD
by for-profit institutions.
Types of Medical Fraud
"Phantom Billing" - Billing for tests not performed.
Performing inappropriate or unnecessary procedures.
Charging for equipment/supplies never ordered.
Billing Medicare/Medicaid for new equipment but providing the patient used equipment.
Billing Medicare/Medicaid for expensive equipment but providing the patient cheap equipment.
A drug or equipment supplier completing a Certificate of Medical Necessity (CMN) instead of the physician.
"Reflex testing" - Automatically running a test whenever the results of some other test fall within a certain range, even though the reflex test was not requested by a physician.
"Defective Testing" - When a test or part of a test was not performed because of technical trouble (ie: insufficient or destroyed sample, machine malfunction) but is billed for anyway.
"Code Jamming" - Laboratories inserting or "jamming" fake diagnosis codes to get Medicare/Medicaid coverage.
Offering free services or supplies in exchange for your Medicare or Medicaid number.
"Unbundling" - Using two or more Current Procedural Terminology ("CPT") billing codes instead of one inclusive code for a defined panel where rules and regulations require "bundling" of such claims. Submitting multiple bills, in order to obtain a higher reimbursement for tests and services that were performed within a specified time period and which should have been submitted as a single bill.
"Double Billing" — charging more than once for the same service, for example by billing using an individual code and again as part of an automated or bundled set of tests.
"Up Coding" - Inflating bills by using diagnosis billing codes that indicate the patient experienced medical complications and/or needed more expensive treatments. (eg., billing for complex services when only simple services were performed, billing for brand-named drugs when generic drugs were provided, listing treatment as having been for a more complicated diagnosis than was actually the case.)
"Phantom Employees" - Expensing employees or hours worked that do not exist.
"Improper Cost Reports" — Submitting false cost reports seeking higher Medicare reimbursements than permitted by actual facts.
Providing substandard nursing home care and seeking Medicare reimbursement.