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Showing posts from August, 2014

Insurance: Physician's Perspective

Hi.  My name is Emily Dalton. I am a local pediatrician and  I have had the misfortune of dealing with the health insurance system from 3 different perspectives:   that of a patient who uses an insurance plan, that of a small business owner who purchases insurance for a group of employees, and that of a physician who contracts with and gets paid by various insurance companies.  Our system is profoundly dysfunctional, and we need to completely rethink how we deliver healthcare to the nation’s population.  Previously I spoke about my experiences as a patient and an employer.  Today I will share my opinion as a physician.   I have had no end of problems dealing with the 9 different insurance companies with which our office contracts.  After one of our doctors has seen a patient, we submit a claim to that patient’s insurance plan requesting payment.  Three full time employees work to make sure the claims we submit get paid correctly.  It seems that any reason is good enough for an insurer …

Insurance: Employer's perspective and Heath Sharing Ministries

Hi.  my name is Emily Dalton, and I am a local pediatrician.  I have had the misfortune of dealing with the health insurance system from 3 different perspectives:  that of a patient who uses an insurance plan, that of a small business owner who purchases insurance for a group of employees, and that of a physician who contracts and gets paid by various insurance companies.  I am here to tell you that the system is broken, and that what is going on today in medicine is so dysfunctional that we need to completely rethink health care in our country.   Previously I spoke about some of my experiences as a patient, struggling to get medical expenses covered by my insurer.   Today I am going to talk about what I deal with as a small business owner who provides insurance for the 30-odd employees of my medical practice.   Over the past decade, our medical office dreads the arrival of each new year because the insurance plans offered previously are cancelled and replaced by more expensive plans wi…

Insurance: A Patient's Perspective

Hi.  my name is Emily Dalton, and I am a local pediatrician.  I have had the unfortunate experience of dealing with the health insurance system from 3 different perspectives:   that of a patient who uses an insurance plan, that of a small business owner who purchases insurance for a group of employees, and that of a physician who contracts and gets paid by various insurance companies.  I am here to tell you that the system is broken.  What is going on today in medicine is so ineffective that we need to reinvent our nation’s healthcare system from the ground up. As a patient, I am tricked by the insurance plan I bought.  Even though the plan is called “HSA 2000”, the deductible for my family is actually $4000.  When we bought the plan we were told the insurance would cover 80% of the charges after the deductible, but after signing up that percentage was changed to 70%.   Despite the deception, I am stuck with this costly plan for the rest of the year and I have no options to change it. …