Friday, July 18, 2008

Steve in Accounting will be determining your treatment

The South Carolina legislature just passed a law, over-riding the Governor's veto, basically saying that determining whether a medical treatment is necessary or not isn't a medical decision. So for example if your doctor determines you need a liver transplant say, whether or not you got one wouldn't be up to a doctor, it would be up to an insurance company bureaucrat. The Governor's overridden veto can be read here.

Well I don't see how anything could possibly go wrong with leaving that kind of decision up to the insurance companies.

The law was originally designed to force insurance companies to pay up faster - it's an ongoing struggle for patients and doctors in the US to get insurance companies to pay up what they owe - and make them justify their decisions in front of the South Carolina Board of Medical Examiners. After being hijacked by the Republicans in the statehouse it now does the exact opposite.

The insurance industry by the way, is one of The Fraser Institutes most generous sugar daddies, helping to pay for Der Institutes long battle to convince Canadians that what our healthcare system really needs is more of the private sector.

Meanwhile the American healthcare non-system, the most expensive in the world, just scored almost dead last, 15th out of 19 industrialized countries in health outcomes, quality, access and efficiency.
Americans waiting longer to see doctors and more likely to die of preventable or treatable illnesses than people in other industrialized countries, a report released on Thursday said.

Americans squander money on wasteful administrative costs, illnesses caused by medical error and inefficient use of time, the report from the nonprofit Commonwealth Fund concluded.

"We lead the world in spending. We should be expecting much more in return," Commonwealth Fund senior vice president Cathy Schoen told reporters.

The Commonwealth Fund, a private foundation, created a 100-point scorecard using 37 indicators such as health outcomes, quality, access and efficiency.

They compare the U.S. average on these to the best performing states, counties or hospitals, and to other countries. The United States scored 65 -- two points lower than in 2006.

This is the system that, despite all their denials, the proponents of more private sector involvement in Canada's system seek to emulate.

UPDATE: In California Los Angeles City Atty. Rocky Delgadillo has filed a lawsuit on behalf of the residents of Los Angeles against Blue Shield, claiming the insurer routinely looks for flimsy excuses to deny care.
The suit also accuses Blue Shield of falsely advertising its coverage, alleging that the company often reneges when its members need substantial medical care.Dr. Richard Frankenstein, (No, really - Cliff) president of the California Medical Assn., and Dr. Robert Bitonte, president-elect of the Los Angeles County Medical Assn., praised Delgadillo's efforts to stop the practice known as rescission."Having health insurance does not mean you will receive healthcare when you need it," Frankenstein said. "Insurance companies may promise you the moon and a thousand doctors, but if you really need your medical care you can bet they will be looking for a way to deny treatment or cancel your policy."

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