Federal programs deny more claims than private insurance
April 12th, 2010Posted: 8:11 pm by
Nate
There is a little known, little publicized fact that surrounds the periphery of the ObamaCare passage which I feel needs to be exposed. You have heard shameless politicians such as President Obama, Nancy Pelosi, Harry Reid and others make claims that private insurance companies deny coverage and cause deaths because of it.
What none of these politicians will tell you is that the largest insurance claim denier in the United States is the federal government by way of Medicare. Shocking, no? The way we’re all told, the federal government treats absolutely everyone on Medicaid and Medicare and we’re told that ObamaCare will continue this high level of treatment.
I know, you’re thinking they deny the largest number of claims because they have the most enrolled. It is true they have the most enrolled as opposed to private insurance, however, it the proportional percentage of denied claims which is astonishing since it is higher than every private insurance company.
Medicare denied nearly 500,000 claims, the most of any “insurance” program, public or private. It also has the highest percentage of denials at 6.85%, again the highest of any “insurance” program, public or private.
The source for these numbers of the American Medical Association’s 2008 report card. Available
here as a PDF.
More from
NewsBusters:
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 (99,025 divided by 2,447,216 is 4.05%; 6.85% divided by 4.05% =1.69).
You would think Medicare’s sheer size might enable it to have smoother procedures with its providers that would enable it to turn down a lower percentage of claims. But no, this is the government we’re talking about.
So who’s the most “heartless” now? And why should Americans accept the idea of gradually being forced into a government-run system when, based on documented government experience, they will be more likely to see their claims denied?
This stat has been around for a while now but it is rarely mentioned. Therefore, I felt the need to add to the available sources listing it.
The bottom line here is that even ObamaCare will deny coverage the same way Medicare does, the same way private insurance does. ObamaCare will not guarantee coverage and it will let patients down simply due to government bureaucracy and enormous cost.
Do not be fooled into thinking you cannot be denied coverage or have a claim denied by a government-run program, it will happen to millions of people under ObamaCare and yet we’ll be paying taxes every which way to afford for it.
Here is an excellent example of the travesty of Medicaid from
CBS 4 in Florida:
FORT LAUDERDALE (CBS4) ? A woman battling a cancer battle was dealt a surprise blow by Uncle Sam this month.
Diana Smith has gone through six months of radiation and chemotherapy — one week out of every month. She is in remission and had a donor for a transplant; being in remission is prerequisite for the transplant.
But her hopes of receiving the transplant were dashed in March, when she says, the Social Security Administration contacted her –without her soliciting it — and told her that her three year-old son was entitled to receive Social Security disability payments. Even though she didn’t ask for it, she signed the form and received her son’s first check check.
In April, Medicaid canceled her universal health care policy because her income level had risen with her son’s payments – making her ineligible for the insurance program.
The problem is Jackson Memorial Hospital cannot provide the procedure because the risk is too high. The universal policy from Medicaid helps shield the hospital from liability in this kind of case. Without it, they are subject to liability issues.
Even though Smith offered to cancel her son’s disability benefits, she was told it’s too late.
“She’s gone through six months worth of radiation and chemo, her body can’t take anymore. If they don’t allow her to have this transplant coming up right now next week, they’re in effect signing her death warrant,” said her friend Tom Noonan.
“I want to live to see my son grow up and get on with my life,” Smith told CBS4’s Ted Scouten.
This is a textbook case which involves much of the health care reform debate.
1) She was dropped from Medicaid during a time when she was receiving important, life-saving treatments for cancer. Sound familiar? This is what charlatans like Obama accuse private insurance of doing all the time.
2) The hospital, due to fear of lawsuits, would not offer her the procedure even if she paid cash privately. Once again, sound familiar? We need tort reform to stop frivolous lawsuits so a hospital, such as in this case, will not fear doing the procedure for cash without Medicaid’s indemnity clause.
3) Medicaid is a faceless government program run by fools following the numbers and the flow charts for how care is administered and when coverage is given or denied. Once again, this is what ObamaCare will be and it isn’t good.
The argument that we need government insurance to replace private insurance due to denied claims or dropped coverage is nonsense and this proves it.
GET READY FOR ODUMBOCARE: Federal programs deny more claims than private insurance
