If you have Health Insurance Coverage through your Employer or on your own, then Health Insurance Companies decide when you need a CT Scan. Health Insurance Policies limit the amount of payment or coverage or both. As anyone who has submitted a Health Insurance Claim or preapproval request has learned, Health Insurance Companies will decide whether you need a CT Scan, or not.
Physicians complain about Medicare's payment rates. However, Medicare apparently pays for the CT Scans the physicians order. See Walt Bogdanich and Jo Craven McGinty, "Medicare Claims Showing Overuse For CT Scanning" p. A1, col. 6 (New York Times Nat'l ed., Saturday, June 18, 2011)(using evidence available from Medicare Claims records to document apparent incidences of CT Scan "Double Images in 2008").
We are not expected to notice the "product placement" of anti-Medicare stories, I suppose. Who could possibly benefit from collecting Health Insurance Premiums for less coverage than Medicare provides -- and for a much greater overhead (including bonus and salary) expense than Medicare incurs?
The Author is Co-Chair of the Health, Life and Disability Insurance Subcommittee of the American Bar Association Insurance Coverage Litigation Committee.
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