Scan Medical Insurance

I thought private health insurance was the enemy?

According to the AARP, Medicare rejects more people than anyone else. In other words, the government denies more claims than the private sector. http://www.aarp.org/community/groups/displayTopic.bt?pageNum=1&groupId=1162&topicId=4635892 From 3/01/2007 to 3/10/2008 Insurer - # of Claims Denied - % of Claims Denied Medicare - 475,566 - 6.85% Aetna - 43,317 - 6.80% Anthem - 11,546 - 4.62% Health Net - 193 - 3.88% CIGNA - 9,060 - 3.44% Humana - 4,142 - 2.90% Coventry - 590 - 2.88% UHC - 30,177 - 2.68% Total number of claims denied by the public (government) sector - 475,566 (6.85%) Total number of claims denied by the private sector - 90,025 - 4.05% So who's the real enemy of the American people, the private sector, which denies 4.05% of claims, or the public sector, which denies 6.85% of claims. For all those who are using the "claims not people" argument, what is the point of paying for health insurance if they are just going to deny your claims. Face it, you just can't accept that your precious government is the problem. @ Proud Texan: Go take a high school economics course, one of the first things they teach with the laws of supply and demand is that higher regulations and taxes INCREASE prices, NOT decrease them.

Public Comments

1. start over from scratch. the whole thing is a mess!
2. Don't confuse Liberals with facts and reality.
3. Thank you. I've been saying this for a long time.
4. Actually Medicare isn't rejecting people, it's rejecting claims. Trust me, I've been rejected as a person by all major health insurers as I had cancer at 14. That's very different than a claims rejection.
5. No one said private health insurance is the enemy they just need some regulation to get the cost under control.
6. great point, there is another motive to this push other than helping people, it's called bigger government, and anybody who denies that are ignorant to the facts.
7. claim denials is only part of the equation. You need to consider pre-existing condition exclusions, dropping coverage due to job loss, and perhaps most importantly, premium rate increases.
8. CLAIMS not people... You are also neglecting that fact that Medicare has millions of records submitted to it compared to the mere hundreds of thousands private insurers have submitted to them. You FAILED big time with this post.
9. Did you look at your numbers? According to THEM, medicare had 7 million claims compared to Aetna's 6.4 hundred thousand. And yet the difference in rejections is 5/100 of one percent. The largest gap is only 4%, despite the volume being astronomical. Not only that... Health Net only received 4,974 claims? That sounds kinda low.
10. It's like school. The private schools can take whom they wish, and the public schools have to take everyone. Same with Medicare and private insurance. Older people are sicker on average, and all qualify for Medicare, while private insurance can restrict who can get insurance. Therefore it is not unusual to have a higher reject rate for Medicare. Really makes sense when you know all the facts. I agree this is claims, and often the problem is a clerical error. That is why the coding is being expanded during 2010 (which all insurance companies will also voluntarily use) so that precise information is provided. Coders make mistakes.
11. First, few people consider "private health insurance" per se the enemy. The ABUSES of private insurers are. Medicare has NEVER rejected anyone for having a medical condition when they sign up, and has NEVER dropped anyone because they became sick. Percent of claims denied -- with NO indication of what, exactly, was denied and why -- isn't a meaningful criterion, nor is truly wrongful denial of claims the ONLY criterion for judging insurers. If the claims Medicare denied were for name-brand drugs, because an equivalent generic is available, for instance, that's a GOOD thing. Similarly, claims for unnecessary tests and proceedures should also be denied. We'd need details to know whether Medicare or private insurance wrongly denies more claims. But then there are all the other considerations, such as profit-margin (Medicare's is ZERO); people refused coverage or dropped; total cost to the insured; and other criteria.
12. You used statistics from an obscure unknown so-called think tank that has no prestige or recognition, The Show Me Institute. It was not approved by AARP. The article was repeated from some blog called retiredaarp.org. Any right-wing think tank can create statistics that are not true. The article itself is a mish-mash or repeated quotes from unknown sources. There must be a million disreputable blogs and sources on line. Anyone can invent a chart with statistics and make it look authoritative and tweak the information.