Thursday, March 31, 2011
Patient Conan M. is able to dodge the surgeon's knife!
Conan M. was referred to us by his chiropractor, Dr. Cindy Summers of Burbank, CA. His MRI revealed a 8mm x 12mm x 22mm disc herniation at C6/7. His neurosurgeon recommended he have spinal fusion surgery without delay. Conan completed his seven week program of care, and NO MORE PAIN, NO DISABILITY, AND THANKFULLY, NO SURGERY. A couple of months later his post care MRI revealed the herniation was gone! Watch this video to hear his story and how happy this guy is.
Friday, March 25, 2011
Aetna outraged?
Aetna Insurance Co. is suing six New Jersey doctors for what it calls “unconscionable “ medical bills. One example was some alleged billing of $56,980 for a bedside consultation, another for an ultrasound alleged to have been charged at $59,490.
Of course those charges, if true, were ridiculously high. But what’s really going on between the lines. It’s the large insurance corporation trying to gain control over “out of network” physicians. You see for all the political ranting about the importance of our “free market” system, the insurance corporations believe that only applies to them. They should be able to double their premiums every three to four years and lower the coverage at the same time.
When managed care hit the pick your own doctor policies in the 1980s the insurance companies were in effect forcing doctors to join as member physicians. That meant that doctors had to agree to the insurance company’s determination of the value of their service. If the doctor agreed they were then listed in the directory and patients knew that their only financial responsibility would be their deductible and copayment. If you went to an out of network doctor the co pay amount could be higher because the out of network doctor could charge at a higher price and the patient would be responsible for the difference between what the insurance paid and the doctor’s charge. But along the way somehow it became okay for the insurance company to pay a smaller percent of their allowed charges to the out of network doctors.
Think about that for a moment. Two licensed physicians performing the same service but one gets paid more than the other because they are “in network”. The insurance companies were allowed to blackmail the doctors into signing up as “in network” and give up their rights to free market pricing. In fact, former California Governor Pete Wilson passed a bill that allowed doctors to have different prices for the same service. Previously it had been illegal to have different charges for the same service so that doctors couldn’t charge less to their cash patients and charge the insurance companies more. But that had to change to allow the doctors to begin charging the insurance companies less than cash patients.
Of course once the insurance companies got the doctors under their thumb, they started lowering their reimbursements for procedures each year. This is all part of the decline in the quality of health care that has occurred over the last few decades.
In 2007 Aetna tried to impose caps on out of network doctors and the New Jersey Department of Banking and Insurance said, “No.” They were fined $2.5 million. In 2009 Aetna, UHC, Cigna and WellPoint were forced to pay $90 million to settle underpayments to out of network physicians by the New York Attorney General.
So what this amounts to is Aetna and the other big insurance companies are fighting back by trying to take the offensive. Claiming that out of network doctors are ravenous scoundrels taking advantage of the poor insurance companies and their insured. And, that they must be controlled—by the insurance companies who will be best able to determine a fair price (is my sarcastic tone coming through?).
First off, anyone who doesn’t ask in advance what a service will cost is silly. You do it with the auto mechanic or with a home contractor, why wouldn't you do it with medical services. If the doctor has an outrageous price, fire them and go somewhere else. But, to put the insurance companies in charge of the value of the doctor’s services is akin to putting the fox in charge of the chicken coop. Remember, corporations are solely motivated by their own bottom line profit. Ask any CEO what his fiduciary responsibility is to the shareholders. The fact is that they have taken advantage of us, the premium payers, doctors, employers, everyone, in every opportunity they could. And will continue to unless they are stopped.
Health care reform could make things better, but most citizens have been bamboozled into thinking that the government can’t be trusted with the administration of health care. But if you stop and think about it, neither can the for profit insurance companies. At least we can vote politicians out of office. Can you vote the CEO of Aetna out of office? Well I suppose you could if you were a wealthy elite and owned many millions of shares of Aetna stock, but then you probably wouldn’t want to because it would hurt your portfolio earnings.
Also, sometimes the value of something extends in ways that can’t be measured with numbers. If health care isn’t profitable but provides greater health and productivity to our community increasing the quality of individuals’ lives how does one measure that in terms of corporate profit? You can’t, but the corporation’s mandate doesn’t care, because bottom line profit is the goal.
I for one will be interested to see if those doctors were really charging the outrageous fees claimed, but if they were, and it was legal to do it, is that any different than the big insurance companies doing whatever they want because they can get away with it.
At some point it’s my hope that we can get back a sense of fairness in our culture instead of the “if I can get away with it, why not” attitude. That applies to corporations and individuals alike.
Peace and keep reading between the lines.
for more information about my practice, go to http://www.818NewBack.com
Of course those charges, if true, were ridiculously high. But what’s really going on between the lines. It’s the large insurance corporation trying to gain control over “out of network” physicians. You see for all the political ranting about the importance of our “free market” system, the insurance corporations believe that only applies to them. They should be able to double their premiums every three to four years and lower the coverage at the same time.
When managed care hit the pick your own doctor policies in the 1980s the insurance companies were in effect forcing doctors to join as member physicians. That meant that doctors had to agree to the insurance company’s determination of the value of their service. If the doctor agreed they were then listed in the directory and patients knew that their only financial responsibility would be their deductible and copayment. If you went to an out of network doctor the co pay amount could be higher because the out of network doctor could charge at a higher price and the patient would be responsible for the difference between what the insurance paid and the doctor’s charge. But along the way somehow it became okay for the insurance company to pay a smaller percent of their allowed charges to the out of network doctors.
Think about that for a moment. Two licensed physicians performing the same service but one gets paid more than the other because they are “in network”. The insurance companies were allowed to blackmail the doctors into signing up as “in network” and give up their rights to free market pricing. In fact, former California Governor Pete Wilson passed a bill that allowed doctors to have different prices for the same service. Previously it had been illegal to have different charges for the same service so that doctors couldn’t charge less to their cash patients and charge the insurance companies more. But that had to change to allow the doctors to begin charging the insurance companies less than cash patients.
Of course once the insurance companies got the doctors under their thumb, they started lowering their reimbursements for procedures each year. This is all part of the decline in the quality of health care that has occurred over the last few decades.
In 2007 Aetna tried to impose caps on out of network doctors and the New Jersey Department of Banking and Insurance said, “No.” They were fined $2.5 million. In 2009 Aetna, UHC, Cigna and WellPoint were forced to pay $90 million to settle underpayments to out of network physicians by the New York Attorney General.
So what this amounts to is Aetna and the other big insurance companies are fighting back by trying to take the offensive. Claiming that out of network doctors are ravenous scoundrels taking advantage of the poor insurance companies and their insured. And, that they must be controlled—by the insurance companies who will be best able to determine a fair price (is my sarcastic tone coming through?).
First off, anyone who doesn’t ask in advance what a service will cost is silly. You do it with the auto mechanic or with a home contractor, why wouldn't you do it with medical services. If the doctor has an outrageous price, fire them and go somewhere else. But, to put the insurance companies in charge of the value of the doctor’s services is akin to putting the fox in charge of the chicken coop. Remember, corporations are solely motivated by their own bottom line profit. Ask any CEO what his fiduciary responsibility is to the shareholders. The fact is that they have taken advantage of us, the premium payers, doctors, employers, everyone, in every opportunity they could. And will continue to unless they are stopped.
Health care reform could make things better, but most citizens have been bamboozled into thinking that the government can’t be trusted with the administration of health care. But if you stop and think about it, neither can the for profit insurance companies. At least we can vote politicians out of office. Can you vote the CEO of Aetna out of office? Well I suppose you could if you were a wealthy elite and owned many millions of shares of Aetna stock, but then you probably wouldn’t want to because it would hurt your portfolio earnings.
Also, sometimes the value of something extends in ways that can’t be measured with numbers. If health care isn’t profitable but provides greater health and productivity to our community increasing the quality of individuals’ lives how does one measure that in terms of corporate profit? You can’t, but the corporation’s mandate doesn’t care, because bottom line profit is the goal.
I for one will be interested to see if those doctors were really charging the outrageous fees claimed, but if they were, and it was legal to do it, is that any different than the big insurance companies doing whatever they want because they can get away with it.
At some point it’s my hope that we can get back a sense of fairness in our culture instead of the “if I can get away with it, why not” attitude. That applies to corporations and individuals alike.
Peace and keep reading between the lines.
for more information about my practice, go to http://www.818NewBack.com
Tuesday, March 22, 2011
Pre and Post MRI Success Documented!!
These images are the key pre and post images of a 30 y.o. male patient of ours. His original disc herniation in his neck measured 7mm x 12mm x 22mm. The post MRI demonstrated virtually a complete reduction in the herniation. All the patient's pain and neurological deficits are gone. I love this stuff!!
Blue Shield -- Warm and fuzzy?
Last week Blue Shield announced they would not be raising premiums. They got notice on the front page of the L.A. Times and looked to be trying to make things better in light of our current health care crisis in the U.S. But, reading between the lines, it turns out that this premium freeze only affects the private pay policies. The Employer sponsored policies will go up. Private pay policies only make up 8% of the health insurance policies in the U.S. The other 92% are employer sponsored. So it looks like Blue Shield isn't really giving up much but still got a lot of positive corporate press.
Meanwhile the health insurance premiums that basically double every three to four years, cover less and become increasingly more difficult for people to obtain continue to spiral out of control. The medical cartel is doing just fine. Insurance, Big Pharma, and certain physician specialties (unfortunately, me not being one of them :>)) are doing great. But Americans are going broke. 75% of all bankruptcies in the U.S. are over health care bills and 2/3 of those HAD INSURANCE.
People worried about the Health Care Reform Bill. Like an abused child reaching out to their abusive parent as the child protective services are taking them away, Americans fell prey to rhetoric like: "death panels" "higher taxes" and the likes. Well, I for one can pay extra taxes if I don't have to pay insurance premiums. To the tune of $12,000 a year to be exact. That's exactly what I pay for health insurance for my family, and that's with a $10,000 deductible!!
Death panels? They are already here. The insurance companies routinely deny coverage for what they claim are "investigative services". Yet, they pay for other procedures that are proven not to work. A girl at my daughters' high school was denied a liver operation all her doctors recommended, but could not get approval for. She died the day after the insurance company was finally beaten into submission.
Read between the lines.
Meanwhile the health insurance premiums that basically double every three to four years, cover less and become increasingly more difficult for people to obtain continue to spiral out of control. The medical cartel is doing just fine. Insurance, Big Pharma, and certain physician specialties (unfortunately, me not being one of them :>)) are doing great. But Americans are going broke. 75% of all bankruptcies in the U.S. are over health care bills and 2/3 of those HAD INSURANCE.
People worried about the Health Care Reform Bill. Like an abused child reaching out to their abusive parent as the child protective services are taking them away, Americans fell prey to rhetoric like: "death panels" "higher taxes" and the likes. Well, I for one can pay extra taxes if I don't have to pay insurance premiums. To the tune of $12,000 a year to be exact. That's exactly what I pay for health insurance for my family, and that's with a $10,000 deductible!!
Death panels? They are already here. The insurance companies routinely deny coverage for what they claim are "investigative services". Yet, they pay for other procedures that are proven not to work. A girl at my daughters' high school was denied a liver operation all her doctors recommended, but could not get approval for. She died the day after the insurance company was finally beaten into submission.
Read between the lines.
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