ONTD Political

Nevermind that Medicare does not deny people coverage for pre-existing conditions, and 6 times as many covered as the next leading insurer.

Also, lol @ the source. So I'm taking this with a grain of salt. Several, in fact.

I'll bet you dollars to doughnuts that a big part of that is because Medicare tends to cover people who are more sick and more elderly.

If the covered populations were the same, the numbers would be different.

Gah, Medicare just can't win! One day, conservatives accuse it of massive fraud, and now they're aren't paying for enough procedures...You can't have it both ways.

This is probably because people don't realize Medicare, just like every other insurance plan, doesn't cover absolutely everything. There are certain categories of products and procedures that aren't covered because they may not be medically necessary (e.g., plastic surgery or certain drugs belonging to classes where both generics and incredibly expensive brand names are available; they will always cover the generics but not necessarily the brands). This is true of ALL insurance plans, but people seem to think Medicare covers every drug/device/procedure under the sun and so file for it even if it's not covered. Those claims all have to be denied. The fact that Medicare covers so many people means there are many, many more such claims filed. Seniors covered by Medicare most likely are NOT being denied if the claim is legitimate.

There is also the matter of the "doughnut hole" that our wonderful Congress voted in a few years ago, where seniors get screwed until they meet a certain (very high) level of prescription drug costs in a 12-month period. Those claims are probably all showing up in the "denied" column as well. Talk to your Congressperson about that if you don't like it, don't blame Medicare.

Biggovernment.com is generously supplying this info, huh?

Welp, nothing to do now but join the Libertarian Party I guess. :/

I'd need to see this study controlled for... like a lot of stuff. Medicare does not cover the same population as private insurance. It's like comparing an inner-city elementary school to a suburban private high school and saying the elementary school is failing because the kids can't read Jane Austen.

gmth pretty much made the point I was going to ask (my initial reply was about what was being rejected... through some really dumb stuff on my part I tried to use my insurance to pay for a basic dental checkup — the rejection was totally because I forgot if my plan covered dental and my dentist figured it couldn't hurt to check. But that would probably show up on this chart as much as when the same insurance said I didn't need anesthesia for surgery).

THAT said, I'll laugh if the Republican party tries to use this as a new talking point, right after Michael Steele said the AMA has no credibility.

One quick afterthought too...

I notice the chart says that a denial means anytime they're not charged $0. I wish that partial coverage and outright denial was separate.

When you read a summary of another report, it's really in your best interest to look at the original report instead of accepting what the summary says. For example, if you look at the AMA report's breakdown of the reasons for each insurers denials, you'll see that Medicare's distribution is quite different from the others'. Medicare's top reason for a denial was information is missing. This is not a real denial, it is a denial with a request for more information. There was no follow-up done to see if the claim was actually denied at the end of the process.

This table above is the metric 12 table. The metric 13 table is where the real information is. Look at the distributions starting on page 6* and the following table to get a real idea of what's going on.

* These are some badly done histograms but you can at least get the basic idea of the differences in denial reasons for the various insurers.

meanwhile 100% of uninsured people remain uninsured and cannot claim jack shit.

yeah i know, gmth did it better.

Once the claims are approved, does Medicare put people through the same stalling/nickel-and-diming/gotcha-on-a-technicality bullshit that private insurance companies do?