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<blockquote data-quote="1 Day At a Time" data-source="post: 60121" data-attributes="member: 3704"><p>I currently work as a mediator and rehabilitation coordinator in my state's Workers' Compensation system. I deal with insurance companies and adjusters on a daily basis. My observation, for what is is worth, is that profit is the bottom line - always. Without our oversight I shudder to think exactly how many of these adjusters would treat the catastrophically injured workers with whom I work. Unfortunately in the world of regular health insurance, there is little to no oversight. I constantly observe adjusters and their attorneys work to delay and stall needed treatment for injured workers in the hopes that they will die and prevent a huge cost for "lifetime" care. Or, they will lowball a settlement of a case and tell the poor (often unrepresented worker) that is the best they're going to get - so they might as well go ahead and take the money. Even worse, are claimant's attorneys who are just looking at a quick 25% portion of a settlement and encourage injured workers to take a lower settlement than they will truly need to manage their future health care. This is a HUGE problem, because Medicaid and Medicare will not cover treatment for Workers' Compensation injuries - and so folks are potentially left with no rememedy whatsoever. My colleagues and I try our best to educate and inform the folks we work with, but so many never come to us with questions. I personally believe that the only answer is to seperate health care from profit all together. I don't have the answer for how to do that, and I'm probably talking myself out of a job. But, as long as profit is a motive, people will receive substandard care.</p></blockquote><p></p>
[QUOTE="1 Day At a Time, post: 60121, member: 3704"] I currently work as a mediator and rehabilitation coordinator in my state's Workers' Compensation system. I deal with insurance companies and adjusters on a daily basis. My observation, for what is is worth, is that profit is the bottom line - always. Without our oversight I shudder to think exactly how many of these adjusters would treat the catastrophically injured workers with whom I work. Unfortunately in the world of regular health insurance, there is little to no oversight. I constantly observe adjusters and their attorneys work to delay and stall needed treatment for injured workers in the hopes that they will die and prevent a huge cost for "lifetime" care. Or, they will lowball a settlement of a case and tell the poor (often unrepresented worker) that is the best they're going to get - so they might as well go ahead and take the money. Even worse, are claimant's attorneys who are just looking at a quick 25% portion of a settlement and encourage injured workers to take a lower settlement than they will truly need to manage their future health care. This is a HUGE problem, because Medicaid and Medicare will not cover treatment for Workers' Compensation injuries - and so folks are potentially left with no rememedy whatsoever. My colleagues and I try our best to educate and inform the folks we work with, but so many never come to us with questions. I personally believe that the only answer is to seperate health care from profit all together. I don't have the answer for how to do that, and I'm probably talking myself out of a job. But, as long as profit is a motive, people will receive substandard care. [/QUOTE]
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