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Forums - General - Medicare denies more claims than all private insurance combined

Mmm, Mmm, Mmm. 

The Medicare denial rate found in the study was, on a weighted average basis, roughly 1.7 times that of all of the private carriers combined.

http://newsbusters.org/blogs/tom-blumer/2009/10/06/deny-guess-who-has-highest-medical-claim-rejection-rate

Wow that really makes me want a public insurance plan.  Looks like another taliking point for the democrats has blown up. 

Aetna seems to be second worse.  I have noticed some of my doctors dropped Aetna.



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So they took an average and then use the word 'combined' to make it look like it's the sum?



Somehow, that doesn't suprise me. Everything the government does is a bloated, overregulated, over priced mess.



Past Avatar picture!!!

Don't forget your helmet there, Master Chief!

Rath said:
So they took an average and then use the word 'combined' to make it look like it's the sum?

added chart for you to study



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My point still holds. The use of the word combined is both misleading and incorrect. I believe what you meant was that it is 1.7* higher than the average of the private insurers.

Also Medicare provides coverage for 43M Americans. Approximately 250M Americans have health insurance. Why are all the other insurers on that list's total claims only a third of medicares total claims?



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ironman said:
Somehow, that doesn't suprise me. Everything the government does is a bloated, overregulated, over priced mess.

Anyone who's been to the DMV should know this.



Rath said:
My point still holds. The use of the word combined is both misleading and incorrect. I believe what you meant was that it is 1.7* higher than the average of the private insurers.

Also Medicare provides coverage for 43M Americans. Approximately 250M Americans have health insurance. Why are all the other insurers on that list's total claims only a third of medicares total claims?

It looks like they only counted a certain number of records from each source and calculated a percent from that.

I wonder how they decided how many to count.



makingmusic476 said:
Rath said:
My point still holds. The use of the word combined is both misleading and incorrect. I believe what you meant was that it is 1.7* higher than the average of the private insurers.

Also Medicare provides coverage for 43M Americans. Approximately 250M Americans have health insurance. Why are all the other insurers on that list's total claims only a third of medicares total claims?

It looks like they only counted a certain number of records from each source and calculated a percent from that.

I wonder how they decided how many to count.


Though it only covers 20% of the population... Medicare is the largest insurer in the US.

Hence why it has the biggest numbers. 

So the report is accurate.  Though the title is misleading. This is done by the AMA afterall.  They can't afford to doctor reports.  Right now they're actually the group without a political backer.  Also I think it would be illegal.

They'd like to see an end to the governments helping of insurnce companies but they also don't want government run healthcare.  They just want all the regulations taken out that make it so insurance companies don't have to really compete with each other as much as other buisnsesses.

Something like  "Medicare most likely to deny claims" would be more accurate.... but there is some other interesting stuff in the report i'll get to in a next post... little bit of reading to go over first.



Also... it's not surprising... I mean medicare isn't run to make a profit.

So of course they have to deny more claims. They have more of a budget. They eventually "run out" of money.

While insurance companies always have their profits to eat into... which while bad short term, is better for the companies long term.



Don't most private healthcare have to accommodate your needs, even if they are extremely frivolous? Because if so, then this is expected.

On another note, as far as I'm aware medicaid is only geared towards serving 60% of the US population. In which case I imagine that some people who belong in the 40% who have not been served have tried to use the system, only to be turned away because they don't qualify. A system that will accommodate everyone would overcome having to turn away this 40%.

Either way I can't say I'm surprised by this result, but if anything it just seems to justify to me that the USA needs a healthcare overhaul (running a healthcare service for just 60% seem a bit wasteful to me).

I don't know though, this is just an external view of Medicaid as I'm British.