Reply #17: Here's one story:

[snot]

But before I forget, what company do you work for, and who's your insurer???

I too have been relatively "well"-insured by private insurers.

For a few years, my company had insurance from United Healthcare. It seemed like everything I needed, they routinely denied. I had to waste time appealing, my doctors had to waste time writing more letters, U.H. always ended up agreeing the care was needed; but not 'til I and my doctors' had wasted hundreds if not thousands of dollars'-worth of our time arguing about it.

Then my company changed insurers every year for several years -- I'd guess 4 to 6 years in a row -- trying to contain rising premiums. Each time they changed, whatever doctor(s) I was seeing at the time fell off the new plan, and I spent hours finding and starting over with new, basic doctors. It's not like I had major health problems; I've been lucky, they've been trivial for my age; but I've been paying health ins. premiums for decades; and now, every little thing I had, that shd have been paid without question, became a time-and-money-wasting ordeal.

My company ended up back with United Healthcare. By this time, they'd changed strategies. I and my company paid much higher premiums and deductibles. On the other hand, U.H. had stopped arguing about claims; instead, they simply required that claimants obtain everything needed from "preferred providers" who charged much more than necessary for whatever was needed -- I can only infer that United Healthcare received kickbacks? Or perhaps they were just terminally stupid and inefficient, bec. they were getting it all back in premiums?

Last year I had surgery on my foot. I had to stay completely off it for a solid month, and my doctor prescribed a knee-walker to help me get around. The manufacturer my doc recommended said they could ship one for under $500 and get it to me in 3 days.

U.H. said they'd cover it, but only if I got it through an "in-network provider."

Now, you might think the point of dealing with "in-network providers" would be that the insurer could negotiate cheaper prices; but apparently, no.

They gave me a list of over a dozen in-network providers, and I called them all. It turned out only one could provide the item – and it would take at least two weeks, partly because special authorization was required from the insurer, because this in-network provider's price to procure the item was over $1,000.

I called the appeals people at the insurer and I told them hey, we can get it quicker from the manufacturer and you'll save $500. They couldn't have been less interested. They'd pay the $1,000, and I'd have to wait two weeks.

When the knee-walker finally arrived, it was an inferior model from a different manufacturer.

I have to at least ask whether the insurer and its in-network provider weren't splitting the mark-up at my employer's and ultimately all of our expense – i.e., they require me to accept an inferior product at twice the cost, then the insurer recovers the cost through premiums, plus collects a kick-back from the "preferred provider." (Not to mention the delay and other detriment to my well-being).

The VA is running a great single-payer system, and Medicare is running a great public option. I would gladly trade my private insurance for either.

(I'd rather have a bureaucrat between me and my doctor than someone who views my illness as a looting opportunity.)

Meanwhile, I'm afraid to speak frankly with my doctor for fear something I say might be used as an excuse to deny coverage.

Our healthcare money isn't lengthening our lives (we in the U.S. pay twice as much for healthcare than people in 26 other nations, yet our life expectancies are much shorter; see chart at http://c-cyte.blogspot.com/2008/01/healthcare-costs-in-us.html from ucsc.edu).

So, where is the money going?

Private insurers in the U.S. have had decades to show they can provide decent healthcare coverage, and have failed. Surprise! – they won't do it unless they HAVE to.

Theoretically, yeah, government could regulate private insurers into decent coverage. But as any "free marketeer" should concede, that would be the LEAST efficient way to do it! We'd have to actually regulate, we'd have to staff up enforcement, etc.

I'm pretty sure, the MOST efficient way is to give private insurers some COMPETITION!