The July surprise:
(CNN) — The new president of the American Medical Association, which represents the interests of the nation’s doctors, said Wednesday the group is open to a government-funded health insurance option for people without coverage.
Dr. J. James Rohack told CNN that the AMA supports an “American model” that includes both “a private system and a public system, working together.”
So how do the Republicans now feel about their doctor buddies?
RNC Chairman Michael Steele “took a shot at the American Medical Association today, saying the organization doesn’t have ‘credibility’ on health care reform,” according to The Hill.
Said Steele on Fox News: “The AMA is — does not have the credibility on this health care issue, as they would like to project.”
The AMA has traditionally opposed major health care reform, but came out in favor of the Democratic proposals in the House earlier this year.
..and it just keeps coming:
AMA Endorses Largest Denier of Health Care Claims
What appears to be the official blog of President Obama’s administration is all aflutter because the President will welcome, “doctors from across the United States to the White House to share their unique perspective on the struggles that American families face every day when it comes to health care.” (They posted today’s agenda in the name of transparency!)…
Of the eight insurers listed, Medicare is most likely to reject a claim, sending away 6.85% of requests. This is more than any private insurer and double that of the private insurers’ average!
In short, the AMA is endorsing a plan whose closest existing example is the most frequent denier of claims. How the public option exemplifies “delivering care to patients” is unclear.
Nice try. First, Medicare can’t deny covering people, as private insurers do. That would be a ‘denial of claim’ rate of 100% for every person they refused…because they wouldn’t even allow the person access to insured healthcare services. Denying payment for certain services after the fact isn’t nearly as bad.
Second, if you look into that AMA report card, you’ll see the denial of claim rate for Aetna and Medicare is almost identical. And just why were they denying claims?
With Medicare, their #1 reason, at 27.8% of the time, is this: “Claim/service lacks information which is needed for adjudication. At least one Remark Code must be provided.” Incomplete paperwork.
With Aetna, their #1 reason, at 65.8% (almost two-thirds of the time!), is this: “Payment adjusted because the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.” They feel they’ve already paid enough for this type of service and aren’t going to pay any more.
There are tons of reasons why Medicare claims get denied. The essential natures of Medicare and private insurers are already well known, don’t let anybody try to fool you…