Injuryboard Commentary - insurance

Why are Medical Bills so High?

Jon Lewis — Sat, 05 Dec 2009 13:49:34 GMT

Did you know that hospitals and physicians rarely ever receive the amount they charge for their services? Health insurance companies do not pay the actual bills invoiced by medical professionals. Why is that?

We had a client who was injured in a truck collision. His injuries were serious enough to warrant several nights in the hospital and a couple of surgeries. What were his medical bills? Approximately $72,000.00. What did the hospital and physicians get paid? $11,714.01, approximately 16% of the amount billed.

If you had a retail store, would you accept 16% of your prices? Why do hospitals and doctors? Are they over-charging, or are they getting paid too little?

What if you don't have health insurance? What happens then? Well, I can tell you that I handled collections for a hospital about 13 years ago, and if patients came in for emergency treatment and didn't have insurance, we sued them for the full amount, not 16%. Why do private pay individuals have to pay the full amount? I understand why health insurers receive a discount, but an eighty-four percent (84%) discount? What if Bill Gates doesn't want to get health insurance? He can pay any amount billed so why doesn't he receive the same discount as a company like BlueCross?

Is this a form of fraud or misrepresentation? In Alabama, BlueCross BlueShield has such a monopoly on health insurance that they dictate to hospitals and physicians what they can charge for their services. Many doctors speak poorly of BlueCross BlueShield as a result of their influence. Some won't even accept their rates as a result. Should the health insurance companies be setting the rates for medical treatment? Is that capitalism?

I don't have the answers to all these questions, but I think they need to be discussed, especially in light of healthcare reform. What are your thoughts?

Originally posted at InjuryBoard by Jon Lewis

Government Contractor's Rape Case Exposes Senators

Mike Bryant — Thu, 03 Dec 2009 09:19:00 GMT

It was nice to see recently elected and finally seated Minnesota Senator Al Franken get his first amendment passed last month. Unfortunately, it was about a very weighty topic. The amendment to the 2010 Department of Defense Appropriations Act prohibiting the government from contracting with companies who require their employees to agree to resolve certain claims, such as sexual assault, through arbitration. The amendment arises from the testimony of Jamie Leigh Jones that she was drugged and gang raped by her co-workers while working for a contractor in Iraq. When she reported the rape to her supervisor, she was locked in a metal shipping crate. She only got out of Iraq by calling her father, who got in touch with their local Congressman in Texas. When she attempted to sue her employer KBR, Inc., a subsidiary of Haliburton, she was told that she had to resolve her claim through arbitration in accordance with her employment contract. Mr. Franken's amendment was to ensure that the government does not do business with a company who would force its employees to arbitrate such a case as rape.

The bill passed but it was voted against by 30 Republican Senators. The Daily show did a good job of calling the 30 out and pointing out their hypocrisy.

http://www.thedailyshow.com/watch/wed-october-14-2009/rape-nuts

After watching this, spend a little time thinking about why these 30 voted as they did. Who are they protecting and who's side are they on? This week, this same group has been leading the floor fight against the Health Care Bill. They have been calling lawyers names, they have been calling for damage caps, and they have claimed that the change isn't for the best. Ask again who's side they are on? It's never been the consumer.

Originally posted at InjuryBoard by Mike Bryant

Arizonian Arrested After Hit And Run In Todd County

Mike Bryant — Wed, 02 Dec 2009 20:19:00 GMT

Thursday afternoon, a hit and run driver was arrested by the Todd County Sheriff. The pick up driver had hit a 71 year-old man and left the scene. Witnesses were able to describe the truck and spotted one matching the description in a driveway. The pedestrian was injured and taken to Long Prairie Memorial Hospital.

Often when the drivers are tracked down, it is determined that the driver was drunk, high or driving with no insurance. If you or a family member is ever involved with a hit and run driver, it is imperative that the police be contacted right away and they be told everything so that an investigation can be successful. All witnesses need to be spoken to and all evidence will need to be preserved.

This is also the time when you learn how good your own insurance coverage is. Your No Fault PIP coverage will be needed to cover your medical bills, wage loss, medical mileage and replacement services. If you have more than one car on your policy, hopefully you have stacked coverage which multiplies your minimum limits by your cars. The other coverage that will come in to play is your Uninsured motorist coverage. This is the coverage that you have to protect you when the other car has no coverage or is nowhere to be found. As I pointed out previously and other members has advised, this may be a vital coverage as more people are forgoing insurance coverage in tough economic times.

Originally posted at InjuryBoard by Mike Bryant

Proposed Legislation Would Protect Consumers, Hold Insurance Companies Accountable

David Mittleman — Wed, 02 Dec 2009 16:42:55 GMT

Earlier this week, Democrats in the Michigan House of Representatives introduced a package of bills that would strengthen consumer protection and prevent auto insurance companies from engaging in unfair trade practices. The proposed law, which is made up of ten separate bills, represents a significant step toward safeguarding consumers' interests.

Under the current law, insurance companies can consider someone's credit history, education, and occupation when setting insurance rates. The new law would prohibit this practice, as well as prevent auto insurance companies from raising an individual's rate following an accident if he or she was not at fault. In addition, the state insurance commissioner would have to sign off on any potential rate increases.

The new bill package essentially adopts the recommendations put forth by consumer advocates in February of this year. Despite its brutal economic climate, Michigan ranks in the top quarter of all states in terms of total auto insurance premiums.

Until now, auto insurance companies have been able to fix rates based on irrelevant and discriminatory information. Hopefully, that is about to change and consumers will be able to enjoy a fair and reasonable method of determining auto premiums.

Originally posted at InjuryBoard by David Mittleman

Two Single Car Accidents Remind Us That Winter Driving Requires Extra Care

Mike Bryant — Wed, 02 Dec 2009 09:47:00 GMT

Wednesday night, two separate collisions in northern Todd County were reported. Todd County Sheriff personal believe that snow played a role in both incidents.:

Around 7 am a eastbound pickup on Todd County Road 73 west of Hewitt lost control 73 and rolled.
An hour later, a southbound 2003 Chevrolet Cavalier on Todd County Road 23 near Hewitt went out of control, went into the ditch and rolled.

This is exactly the type of accident, I blogged about with: Single Car Accidents: Is There A Claim? . Hopefully, all of those involved will recover quickly, but if not the help of experienced Personal Injury attorneys can make a difference in getting to the bottom of what coverages are involved.

Despite the warm November it won't be long until we see winter conditions across the state. For all Drivers winter road tips from DPS and MnDOT include:

Always use seat belts.
Accelerate and decelerate slowly on icy/snow-covered roads to retain traction and avoid skids.
Do not use cruise control.
Do not “power up” hills, which may cause wheels to spin. Build momentum before reaching a hill and don’t stop while traveling uphill. Reduce speed before going downhill.
Know your brakes. Keep the heel of your foot on the floor and use the ball of the foot to apply firm, steady pressure on the brake pedal.
Give yourself plenty of travel time. Don’t put your schedule before safety.
Clear snow and ice from vehicle windows, hood, headlights, brake lights and directional signals.
Headlights must be turned on when it is snowing or sleeting.

Most police officers asked say the key is usually to Just Slow Down.

Sgt. Jeff Wenker of the Marshall Police Department made a number of great suggestions concerning winter driving. They included:

Watch the weather, don't travel if the weather is bad
Carry extra clothing, extra blankets and extra food with you and a heat source such as Sterno or candles is not a bad idea to take along.
An empty can, such as a coffee can, can be used for bathroom breaks. Toilet paper and hand wipes could be useful, as well.
If you are on medications, always carry extra.
Don't store extra water in your vehicle because it will freeze, but take extra water with you before you leave on the trip.
Make sure your cell phone is fully charged and bring a charger with you.
Let someone know the route you will be taking and do not deviate from it.
Take your time. A four-hour trip might take five. It's easier to drive slow when you've allowed the time.
If you do slide off the road or have to pull over due to the weather or road conditions: Your car can be an effective shelter so don't leave it unless you have to. Windchills are dangerous and can kill if you are exposed for too long. A vehicle offers some protection from that.
If it's a white-out, you don't want to walk out, because you can lose your way.
Run the engine 10 minutes every hour to help keep you warm. Bundle up in the extra clothes and blankets.
Keep the windows open a crack so you stand less chance of being poisoned by carbon monoxide. Check the tail pipe periodically and clear it if necessary to keep the exhaust from coming back into the vehicle.

Hopefully, all of the suggestions will lead to lives being saved and people making it home safe this winter.

Originally posted at InjuryBoard by Mike Bryant

Health Insurance Is A Life Or Death Issue

Pete Mackey — Tue, 01 Dec 2009 08:53:23 GMT

A recent study by researchers based at harvard has found that the lack of health insurance causes almost 45,000 deaths annually in the U.S. The American Journal of Public Health first published the study in its Septemeber, 2009, online edition. The statistics cited by the study's authors are disturbing:

Dr. Steffie Woolhandler, study co-author, professor of medicine at Harvard and a primary care physician in Cambridge, Mass., noted: "Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives."

Dr. David Himmelstein, study co-author and an associate professor of medicine at Harvard, remarked, "The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance. Even this grim figure is an underestimate - now one dies every 12 minutes."

Do you think that any member of Congress would be willing to admit that they could not help an accident victim because they did not have health insurance? Of course not. Now that there are bills to consider, the opponents' cry is "we are for health care reform, but just not what is proposed." The debate over the best solution has been raging for a long time. It's too late in the game to pull out the "we can do better" card at this late stage. Opponents of health care reform have had plenty of time to put forth their own proposals, but decided instead to backseat drive. Time has run out, on the naysayers and on the 45,000 Americans who will not be alive next year without insurance.

Originally posted at InjuryBoard by Pete Mackey

Health Care Shouldn't Be Politics As Usual

Mike Bryant — Mon, 30 Nov 2009 16:47:00 GMT

After the vote to send the health care bill to the Senate floor, there was a round of Republican tweets that predicted that the vote would end the careers of Senators that voted for the bill. That is the way to many of the misguided Senators see this issue. It's simply a political game.

They don't care about the 98,000 people that die each year due to medical errors. These are injuries that are preventable. They don't want to talk about the medical errors, or medical negligence, and the resulting medical malpractice.

Instead, they call for people to trade away their rights to get quality, affordable care. The CBO and GAO have stated time and time again that tort reform will do practically nothing to lower costs. They also found evidence that tort reform could lead to worse patient care. Less accountability will never mean better health care. Forty-six states have already passed some kind of tort reform, and costs continue to skyrocket. It clearly doesn’t work.

It all comes down to the old Bush/Rove anti lawyer mantra. The goal should be to lower costs and insure more people. But, it requires leaders that really want to fix the problem and not just use it to grandstand.

Originally posted at InjuryBoard by Mike Bryant

As Heath Care Bill Goes To The Senate Floor Focus Needs To Be On The Consumer

Mike Bryant — Mon, 30 Nov 2009 09:35:00 GMT

This week, the U S Senate will be debating the Heath care bill. It is expected that the usual Republicans will spend most of their time trying to add amendments to change the civil justice system. To cap damages and bar the courtroom door to the average American. It's the old Bush/Rove plan to attack the lawyers.

They will not want to talk about what is really going on. There is no question that America’s health care system is in crisis. Over 40 million people are without health insurance and costs are skyrocketing. Harvard researchers published a paper that concluded that illness or medical bills contributed to 62 percent of bankruptcies in 2007, up from about half in 2001. More than three-fourths of those with medical debt had health insurance.

The focus should be on how to fix the system. How to lower costs and cover the uninsured. So-called tort reform, or limiting patients’ legal rights, will not accomplish either of these goals. It will only make it harder for those injured through no fault of their own to seek recourse.

According to the Institute of Medicine, 98,000 people die every year from preventable medical errors, with countless more severely injured. Congress must put patients first, and not bargain away people’s legal rights.

Originally posted at InjuryBoard by Mike Bryant

Use Social Networking Sites With Caution: You Never Know Who's Looking

David Mittleman — Sat, 28 Nov 2009 16:26:53 GMT

In a world where it has become increasingly more popular to post every aspect of our lives online through social networking sites such as Facebook, Myspace, and Twitter, Natalie Blanchard hardly realized that her seemingly innocent Facebook photos would change her life as much as they did. Blanchard, like the millions of other Facebook users posted photos of herself on a beach vacation, at a birthday party, and posing with Chippendale dancers at a bar. However, Blanchard like a few other Facebook users, has become a poster child for caution during the social media age.

In fact, Blanchard suffers from severe depression and has been on long-term disability from her job at IBM for over a year-and-a-half. Her insurance provider, Manulife, has paid her disability benefits since she left her job after her depression became severe enough to hinder her daily life activities. Thus, when she suddenly stopped receiving the checks in the mail from Manulife, she called the company to see what was wrong. She was shocked when the company informed her that they had cut her benefits off because they had viewed her photos on Facebook and no longer believed that she suffered from depression.

Publicly, Manulife claims that it “would not deny or terminate a valid claim solely based on information published on website such as Facebook.” However, the company does admit that it checks the profiles for its clients. Blanchard’s situation offers an important lesson in protecting privacy while utilizing social networking sites: while Facebook offers users an opportunity to share a “slice” of their life with friends and the world, it is important to remember that employers, and apparently insurance companies, use seemingly harmless posted information, too. However, it is too late for Blanchard to heed this privacy advice: instead, she has filed a civil suit against Manulife for $275,000 and is scheduled to appear in Quebec Superior Court on December 8.

Originally posted at InjuryBoard by David Mittleman

Tiger Woods Crashes Car after Rumors of Sexual Affair

Joe Crumley — Fri, 27 Nov 2009 15:34:56 GMT

News services Friday afternoon reported that Tiger Woods, the best golfer in the world, was seriously injured in a car wreck outside his Florida home early in the morning. Later reports indicated the injuries were not serious.

Woods apparently left his suburban Orlando driveway atand struck a tree and fire hydrant, causing serious facial injuries. Woods, who at 33 has consistently matched and exceeded all golfing records, may have heard recent internet and tabloid reports that he was having an affair with Rachel Uchitel.

The news reports regarding the crash did not intially reference the infidelity stories, but the blogosphere soon began questioning a link.

The police report, above, indicates the one-car crash occurred just outside Woods' driveway.

The Orlando Sentinel reported:

Woods was transported to Health Central Hospital in Ocoee in serious condition, FHP said. No other information about his condition has been released.

A Health Central hospital employee said at 2:30 p.m. that Woods was not a patient. A hospital operator would not say if Woods had been treated and released.

FHP said the airbags in Woods' Cadillac Escalade did not deploy, which means the vehicle was traveling under 33 mph.

Orange County Fire Rescue received the call for aid at 2:28 a.m. Woods was transported from his Windermere-area neighborhood by the hospital's own ambulance.

An Orange County Sheriff's Office official said his agency received it's call for assistance at 2:27 a.m. An operator was told the driver was injured and still inside the vehicle.

FHP did not report the accident until just after 2 p.m. today. The agency said the crash remains under investigation and charges are pending.

Golf fans the world over are hoping for the best for Tiger.

http://www.youtube.com/watch?v=Zb2qJpDR6PQ&feature=player_embedded

http://www.youtube.com/watch?v=FUnNq1lFFbU

In any car wreck with injuries, assesing damages can be an issue. Wage and income loss, in particular, can be difficult to assess. Tiger Woods, the richest athlete in the world, would be an extreme example. How much would Tiger lose if he couldn't golf?

Tiger crashed his own car, and it sounds like he won't be seriously injured. If another driver were involved, insurance coverage would be a major issue. No one carries enough insurance to fully compensate Tiger, should he be unable to work.

For Tiger, and anyone else injured in a car accident, getting a lawyer who will be able to calculate and argue for full and fair lost earnings would be crucial. My partner Mike Bryant, and I have been representing such people for years, and have written many articles and taught many classes to other lawyers on these subjects.

Originally posted at InjuryBoard by Joe Crumley