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Switch to Forum Live View Sandra Fluke's Testimony...and the Bureacrats who Second-Guess Our Doctors
3 years ago  ::  Mar 05, 2012 - 11:51AM #11
Unworthyone
Posts: 3,077

Mar 5, 2012 -- 11:03AM, Jasr wrote:


Mar 5, 2012 -- 10:54AM, Unworthyone wrote:


The fact is, because of medical privacy laws (HIPAA) only the prescriber and patient are supposed to know 'why' a particular medication was prescribed. 




The prescriber, the patient, and the private insurance carrier.


That is the truck-sized hole in the HIPAA law that nobody wants to talk about.




Even if the insurance carrier is privy to the information, the employer is not supposed to be.  Nevertheless, if the doctor writes "to mitigate menstrual pain" who is the insurance company to override the decisions of a duly licensed physician?


I'l share an amusing personal story.  When my daughter was about three years old, she fell and fractured her two upper front primary teeth.  The pediatric dentist said, based on her age, small size, and low weight, he wanted to perform his treatment with the benefit of an outpatient setting and an anesthesiologist in attendance.  I got insurance approval over the phone, and the work was completed without complications.


A few weeks later, I received the EOB from the insurance company, and the claim was denied.  The stated basis for the denial was "submitted procedures are not medically necessary."  Can you flippin' believe it?


Within moments I was on the phone to the insurance company with a strategy and the conversation went like this:


Me: I see here you denied this claim because the procedures were not medically necessary.


Insurance Rep:  Yes, that was our determination.


Me: First, let me thank you. I don't know what I would do if you weren't there looking out for me and my family.  Now, how do you spell your last name?


Insurance Rep: Why do you need the spelling of my last name?


Me:  That's just for the subpena.


Insurance Rep:  Subpena?  Why?  Are you going to sue me?


Me: Sue YOU?  Of course not!  I'm going to sue the dentist!


Insurance Rep: Sue the dentist?  Why?


Me:  Because the dentist presented the case to me as 'medically necessary.'  And clearly, based on your determination, it was 'not medically necessary.'  Any healthcare provider who would have the gall to present treatment as medically necessary when clearly it is not has got to be guilty of malpractice.  I intend to sue the dentist for malpractice and you are going to be my star witness.  I can't wait to get you on the witness stand so you can explain to the jury why this dentist's treatment was not medically necessary.  Are you ready to do that?


Insurance Rep:  Let me get back to you.


Three days later I received a check in the mail for the entire denied amount from my insurance company.

I never consider a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend.  Thomas Jefferson

Science without religion is lame, religion without science is blind.
Albert Einstein

You can get anything you want out of life if you will just help enough other people get what they want. Zig Ziglar

http://www.nytimes.com/1991/03/29/opinion/why-i-m-for-the-brady-bill.html
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3 years ago  ::  Mar 05, 2012 - 12:07PM #12
rabello
Posts: 22,031

I can't wait to see if, when all is said and done, if birth control pills or any other contraceptive method that requires a prescription by a physician turns out to really be "free"

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3 years ago  ::  Mar 05, 2012 - 12:08PM #13
Bodean
Posts: 9,703

Mar 5, 2012 -- 11:45AM, Jasr wrote:


Because preventive care is good policy; it improves populational health, it improves quality of life, and it saves money in the long run.





I know you probably already know this, but here is the rub in this issue for me.


There ARE many preventive care actions that ARE FREE!! ....


- eating a healthy diet and limiting calories to maintain a healthy weight


- exercising [which doesn't require a membership at the gym].


- refraining from smoking and excessive alcohol intake [can actually save money]


- reserving sexual interaction to within the context of a committed relationship where you can be certain both partners "care".


- "destressing" your life, by not overcommitting [I mean really, we NEED down time]


- "destressing" you life, by living within your means and staying out of debt.


The only PROBLEM with all of these, is they depend on Personal Responsibility.  All they demand is "caring cost" on the part of the person, no money necessary. 


But the American Public will have none of that.  All of the above FREE measures are shunned by the American Public, but then, the Pubic wants to turn around and demand that the measures that "cost money", ... more specifically,  .... The Measures that allow them to be Personally Irresponsible, but cost money .. be free of charge.


Do you not see the hypocrisy of that??!! 


Do you not see why a person like me who sees this hypocrisy cries "foul"??!!

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3 years ago  ::  Mar 05, 2012 - 12:17PM #14
johndavid23
Posts: 4,324

It appears that Rush Lamebrain got his own Viagra regieme (he was busted for bringing 29 Viagra back from a trip to the Dominican Republic) mixed up with birth control.  Thus, he assumed that the coed was a "slut" because she took pills to prevent birth, just because he was a "slut" by taking pills to have sex with strangers in the DR.  The point being that a woman needs to take the pills daily for them to work, though she doesn't need the sex daily.  Why do the ignorant listen to the ignorant?

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3 years ago  ::  Mar 05, 2012 - 12:22PM #15
Bodean
Posts: 9,703

Mar 5, 2012 -- 12:07PM, rabello wrote:


I can't wait to see if, when all is said and done, if birth control pills or any other contraceptive method that requires a prescription by a physician turns out to really be "free"





rabello ... of course is not going to be "free".  Free in the context of this discussion is "Free of Charge".  Someone is going to pay for it.  And here is who. ....


- the women who use b.c. pills, through their premium


- the women who do not use b.c. pills, through their premium


- the men who have sex with women who used b.c., through their premium


- the men who do not have sex with women who use b.c., through their premium


- old people who no longer have use for b.c. .. through their premiums


- children [parents] who are not even sexually active .. through their premiums


- employers, who will then pass the cost on to consumers, or cut jobs, thus transferring the cost to the public or tax payers.


- tax payers .. through all government programs.


So .. out of all those groups ... only TWO will benefit from the cost they will pay, so that the women who use B.C. pills, and the men who have sex with them, can be free of worry that they not get pregnant.


Oh .. and as I've said, the real groups who NEED to be on B.C., won't use them.  So you are not going to see a decrease in unwanted pregnancies ... in fact, in Hawaii, pregnancies increased.



So .. no .. it's not going to be "Free" .. it's going to be "free of charge" to the individual, who will saddle on a small, ... very small fraction of the cost for their convenience.

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3 years ago  ::  Mar 05, 2012 - 12:25PM #16
Fodaoson
Posts: 11,162

Who is talking about free birth control ?  (from the link in the OP )


“If my body indeed does enter early menopause, no fertility specialist in the world will be able to help me have my own children. I will have no chance at giving my mother her desperately desired grandbabies, simply because the insurance policy that I paid for totally unsubsidized by my school wouldn’t cover my prescription for birth control when I needed it.”.


 


The person in question, not the  person giving a testimony but her friend ,  was paying for the health insurance and  most probably had a co pay.  “Birth control” pills have several medical applications and were developed and marketed for those applications ,  with contraception being a side effect.

“I seldom make the mistake of arguing with people for whose opinions I have no respect.” Edward Gibbon
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3 years ago  ::  Mar 05, 2012 - 12:32PM #17
rabello
Posts: 22,031

Mar 5, 2012 -- 12:22PM, Bodean wrote:


Mar 5, 2012 -- 12:07PM, rabello wrote:


I can't wait to see if, when all is said and done, if birth control pills or any other contraceptive method that requires a prescription by a physician turns out to really be "free"





rabello ... of course is not going to be "free".  Free in the context of this discussion is "Free of Charge".  Someone is going to pay for it.  And here is who. ....


- the women who use b.c. pills, through their premium


- the women who do not use b.c. pills, through their premium


- the men who have sex with women who used b.c., through their premium


- the men who do not have sex with women who use b.c., through their premium


- old people who no longer have use for b.c. .. through their premiums


- children [parents] who are not even sexually active .. through their premiums


- employers, who will then pass the cost on to consumers, or cut jobs, thus transferring the cost to the public or tax payers.


- tax payers .. through all government programs.


So .. out of all those groups ... only TWO will benefit from the cost they will pay, so that the women who use B.C. pills, and the men who have sex with them, can be free of worry that they not get pregnant.


Oh .. and as I've said, the real groups who NEED to be on B.C., won't use them.  So you are not going to see a decrease in unwanted pregnancies ... in fact, in Hawaii, pregnancies increased.



So .. no .. it's not going to be "Free" .. it's going to be "free of charge" to the individual, who will saddle on a small, ... very small fraction of the cost for their convenience.




Like I said:


"I can't wait to see if, when all is said and done, if birth control pills or any other contraceptive method that requires a prescription by a physician turns out to really be "free"


and will add..


or if men will get to continue to have responsibility-free and worry-free sez like they get to, now, where all they have to say is "she didn't MAKE me be responsible"




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3 years ago  ::  Mar 05, 2012 - 12:51PM #18
Bodean
Posts: 9,703

Mar 5, 2012 -- 12:25PM, Fodaoson wrote:


Who is talking about free birth control ?  (from the link in the OP )


“If my body indeed does enter early menopause, no fertility specialist in the world will be able to help me have my own children. I will have no chance at giving my mother her desperately desired grandbabies, simply because the insurance policy that I paid for totally unsubsidized by my school wouldn’t cover my prescription for birth control when I needed it.”.


 


The person in question, not the  person giving a testimony but her friend ,  was paying for the health insurance and  most probably had a co pay.  “Birth control” pills have several medical applications and were developed and marketed for those applications ,  with contraception being a side effect.





IF the young lady's body indeed does enter "early menopause", there is no birth control pill that is going to prevent that.  If having grandbabies is so important.. she better get busy if she is at risk of going into early menopause.


The argument that her "chance" of giving her mom grandbabies is dependent on birth control pills is just pure uninformed nonsense.


BTW ... B.C. pills were developed for synchronizing cattle herds for artificial insemination.  In the mid 50s., studies were undertaken on women in peurto rico for the sole purpose of contraception.  Contraception was not a side effect of the development.  It was the primary effect.

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3 years ago  ::  Mar 05, 2012 - 1:19PM #19
Girlchristian
Posts: 11,552

Mar 5, 2012 -- 12:25PM, Fodaoson wrote:


Who is talking about free birth control ?  (from the link in the OP )


“If my body indeed does enter early menopause, no fertility specialist in the world will be able to help me have my own children. I will have no chance at giving my mother her desperately desired grandbabies, simply because the insurance policy that I paid for totally unsubsidized by my school wouldn’t cover my prescription for birth control when I needed it.”.


 


The person in question, not the  person giving a testimony but her friend ,  was paying for the health insurance and  most probably had a co pay.  “Birth control” pills have several medical applications and were developed and marketed for those applications ,  with contraception being a side effect.




The new mandate under the ACA makes insurance companies cover the cost of birth control at no cost (i.e., no co-pay either).

"No matter how dark the moment, love and hope are always possible." George Chakiris

“For those who believe, no proof is necessary. For those who don't believe, no proof is possible.” Stuart Chase
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3 years ago  ::  Mar 05, 2012 - 1:26PM #20
Jasr
Posts: 12,060

Mar 5, 2012 -- 12:08PM, Bodean wrote:


- eating a healthy diet and limiting calories to maintain a healthy weight




True, but a desire to take responsibility for one's own weight and cholesterol level can be leveraged and enabled by the services of a dietitian and a yearly lipid scan.


Mar 5, 2012 -- 12:08PM, Bodean wrote:


- exercising [which doesn't require a membership at the gym].




True, but when I discussed the topic of exercise with my orthopedist he told me my knees were too damaged to keep playing soccer (which would have been my first choice) or even run but that cross country skiing, skating, and swimming would be fine.


Mar 5, 2012 -- 12:08PM, Bodean wrote:


- refraining from smoking and excessive alcohol intake [can actually save money]




True but there are some pretty effective medical technologies that can help with these, and they are not cheap.


Mar 5, 2012 -- 12:08PM, Bodean wrote:


- reserving sexual interaction to within the context of a committed relationship where you can be certain both partners "care".




Absolutely! And since you are in this type of relationship I suspect you will agree with me that monogamous sex is good for a couple and their relationship, even when it is not for procreation! And that part of caring and being responsible is not reproducing beyond your ability to provide!


Mar 5, 2012 -- 12:08PM, Bodean wrote:


- "destressing" your life, by not overcommitting [I mean really, we NEED down time]


- "destressing" you life, by living within your means and staying out of debt.




Agreed...see my comment about procreation.


Mar 5, 2012 -- 12:08PM, Bodean wrote:


The only PROBLEM with all of these, is they depend on Personal Responsibility.  All they demand is "caring cost" on the part of the person, no money necessary. 


But the American Public will have none of that.  All of the above FREE measures are shunned by the American Public, but then, the Pubic wants to turn around and demand that the measures that "cost money", ... more specifically,  .... The Measures that allow them to be Personally Irresponsible, but cost money .. be free of charge.





We are talking about measures that leverage the individual's efforts to be responsible...not measures that allow them to be irresponsible.

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