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Author Topic: Am I turning into a Democrat ;-)
brojack17
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Tongue planted firmly in cheek.

In all seriousness, I think I am ready for healthcare change. Right now, I pay $730/month for healthcare. If you can call it that. I have a Health Savings Account. This means both I and my employer put money into my HSA for me to use on medical expenses. I do not have a copay or prescription plan, I get the contracted rate for these items. This means, I pay $75 to visit my doctor and $3500/year for my wife's prescriptions. We run out of this money very quickly. Last year, I paid over $12,000 in medical bills. This is over 10% of my income. I am concerned about national healthcare, because unfortunately, the government doesn't always run things right. I know first hand, I work for NASA. But I could absorb a 10% increase in my taxes and be no worse off.

I guess the next step is to turn in my handguns (I don't have any anyway).

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Samprimary
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Naw, the party has largely abandoned gun control as an issue and most liberal reps are even shuffling to scuttle it, instead trying to present themselves as nominally gun-friendly.

as for healthcare: yes I am sure I have ranted everyone's ear off about the issue already but I suppose for good measure I should post (repost?) a delightfully grim article about the cruel level of dysfunction in our system, as experienced on a personal level.

http://www.progressivefox.com/

quote:
So you’re chugging along doing all the things you do as a responsible citizen, you work, and pay your bills and your taxes, you are there for your children, and fighting for your marriage, you even volunteer. It’s spring, 1998, and gradually you just become so tired it’s a struggle merely to climb a flight of stairs.

Oh, well, you do have two daughters in college, another nearing the end of her senior year in high school, a son in middle school, a full-time job, a house to take care of, are back in college, and have two dogs, two cats, and oodles and oodles of marital strain.

Fatigue sort of goes with the territory, and like many working moms, you just push past it. You get up, you get the family off in various directions, you go to work, you go to class, you cook dinner, you help with homework, go to games and track meets, do housework, set boundaries for the two kids at home and field frequent counseling-like calls from the two who are not, you try to work through problems with your husband, and you collapse exhausted into bed, get up the next day, and do it all over again – it’s a routine you dare not interrupt with reflections on your fatigue – there is no time.

Then one day…

You show up two weeks later than you should have to the hairstylist (pretty common when you are constantly pressed for time) and instead of the usual lecture about the color of your roots, she turns you around in the chair and says:

“I look at people’s skin tones all day long and try to decide the best coloring for their hair, and I can tell you this: gray is not a normal human skin tone. Get out of here right now and go see your doctor.”

For some reason, though she is not the first person to note you don’t look your best lately, this is the one thing that manages to penetrate the fatigue-fog and you do as you are told.

You call on the way, check in, sit down in the crowded waiting room resigned to waiting for a couple of hours, and a mere minute later the doctor, passing by the glassed in sliding windows on the other side of the wall catches sight of you, comes out, and demands to know: “How did you get so anemic?” You say, “I am?” He says, “Come with me right now” takes your hand and drags you back to an examining room.

Later that day, at the oncologist/hematologist office, this new strange doctor takes blood, orders up an outpatient transfusion, tells you that you no doubt have acute myelogenous leukemia, could keel over dead at any moment as long as you are untreated, and should now go home and call him the very minute the HMO calls you and tells you to check into some local hospital or the other – but should on no account whatsoever check into that local hospital.

You find this direction to avoid hospitalization confusing, in light of the “keel over dead untreated” stuff and say so. Whereupon oncologist/hematologist guy says HMO will try to check you into local or even regional hospital – because it’s cheaper – but in his opinion no local or regional hospital should be treating leukemia, since cure rates double in large teaching institutions. Risk of keeling over dead while he is arguing for your life with HMO is less than risk of dying in local hospital. Then he writes you a list of five hospitals in Chicago that you can allow yourself to be checked into, and says if it’s one of these ok, but it won’t be, so call me when they tell you to go to a local hospital.

Sure enough, he’s right; they do, the very next day. You call him. He works some magic you know naught of (though local rumor tells you later that he informed HMO that he will be sure to make himself available to testify at your spouse’s wrongful death suit later) and you get the referral to the large teaching institution later that day.

Telling your children…no, you won’t write the details here, beyond saying that especially for someone who lost a parent at the age of eleven, it’s the hardest thing you’ve ever done to try to be honest about the prognosis (which is grim) but reassuring about your love for them and intent to fight for your life.

Skip ahead then. On your first day in large teaching institution, you are visited by a social worker, who surprises you by demanding to know not the details of your home life, or about your state of mind on being diagnosed with a more-lethal-than-not form of cancer, but simply: “Who is carrying your insurance, you or your husband?”

You think this is rather cold for a social worker and inform her somewhat frostily that you are sure the bill will be taken care of – it’s pre-approved.

Social worker looks at you with what you interpret as pity and says it’s really, really important. So you say, spouse, as you work for small non-profit that offers no benefits, but also admit to her that you think marriage is for sure doomed now.

“Good, good!” she says.

And you wonder why, why, on top of extra-lethal form of cancer, must you also get unbalanced social worker?

She must be able to tell from your expression that you think she’s nuts, because she explains, like so:

If you worked for a company that offered insurance, if you carried your family’s insurance, next year your insurer would slap a million dollar surcharge on the company policy for carrying a leukemia patient. The company would get the bill and someone in accounting would question “what is this extra million dollars we are being billed?”

The insurance company would explain to them that the million is for you, and it is yearly, but is, ahem, “fixable.” They will say “as long as she is on your insurance (wink, wink) this charge will be there. So what you have to ask yourself (more wink, wink) is whether this employee is worth a million dollar a year salary on top of what you are already paying her.”

Social worker said she had seen small business owners go almost broke trying to cover this charge, and had even heard of one who defiantly did go broke, throwing all of the employees out of work. But more usually, she said, they just fire you.

“Wait, wait!” say you, “Isn’t it illegal to fire someone for their health history? Suppose I’m all well and working?”

She looks at you with more pity, says yes, so of course they will have to find “cause” to fire you, which any employer can always do.

“But I am a very, very good employee!” you protest.

“Yes,” she says, “but they can always find some cause.” The real problem she goes on to explain, is that you will find a new job, that company’s insurer will slap them with the surcharge, they will take their turn at firing you, until you’ve been through six or seven jobs in a year, fired “for cause” from all of them, which of course looks very, very bad to a prospective employer.

“So in a year or so of this, you will not just be uninsurable, you will also be unemployable.”

She asks who your husband works for, since they’d probably try to do this to him too. You say he is a cop working for a municipality, which pleases her. “They have all sorts of layers of officials, elected and otherwise, to work their way through to get to the decision, then once they do they have to get past his union, so it will take much longer to get him fired.” She also, though, offered sympathy for the fact that what with the police union and the municipality fighting out whatever “cause” they got him on in such a public profession, it was sure to end up in the local papers and disrupt all our lives – including the children’s – when they did get that far.

You remind her you seem headed for divorce, and she says, well, okay then, just carry the COBRA to the limit and keep on working for small not-for-profits that don’t offer insurance.

You ask her what you are supposed to do for health care and she says sooner or later the insurance companies would force you onto Medicaid – either by means of making you unemployable and broke, or by means of you being uninsured and going through any and all assets you have paying medical bills until you are broke and sick enough that you can’t work, and end up on Medicaid.

You are rather horrified, but have other things (like trying to stay alive and simultaneously on top of what your teenage children are up to from the hospital many miles away) on your mind, and besides, this all seems so uncivilized and melodramatic and “worst case scenario” and…unlikely, somehow, so you set this aside for now.

You live. In fact you are cured!

A year later you are divorced. You are struggling to get by as a single mother, and you are making the COBRA payments.

Your ex comes by to pick up your son and tells you that the municipality he works for’s administrator told him in absolute shock that the insurance company slapped a million dollar surcharge on the municipality’s insurance policy, and said it would go on yearly until you are off, but since you had exercised your right to COBRA it would “do no good” if your ex was gone. The administrator said he was so shocked and offended that he went to ALL the other carriers possible, and one by one they all gave him back a “no bid” with the proviso that they would welcome the opportunity to bid…just as soon as that leukemia patient’s COBRA rights expire. So barring leaving all the municipality’s employees naked of insurance they were absolutely trapped.

Social worker begins to seem less melodramatic to you.

Your COBRA rights expire.

You go on ICHIP, the program for uninsurable Illinoisans. It’s easy, because your disease is on the short-list of twelve or so that automatically render you “uninsurable for life.” You discuss the horrible policy benefits with your car insurance agent – who is also a trusted friend. She tells you she is also on ICHIP (though it was much harder for her to get on it - she had to get three denials from private insurers) and the entire benefit it provides is to “get you through the door of a hospital” since if you really do get ill you will get benefits so minimal that you will be forced to pay the vast majority of the bills until you are bankrupt and forced onto Medicaid.

Social worker begins to seem downright reasonable to you.

The day comes when you weigh the many, many hundreds of dollars you are paying on a monthly basis, through ICHIP, but to the very insurance company that once charged your ex’s employer a million dollars (coincidentally, the exact bill for your treatment over your year of leukemia fell just short of that million, by about ten dollars, so this company was out exactly nothing) of what is starting to smell like blood money, against your daughters continuing in college and your son eating on a regular basis.

You get a second job.

Your daughter gets sick with Type I Diabetes while uninsured and you weigh those hundreds of dollars to the insurer you now thoroughly detest and you drop that insurance and buy her insulin and syringes and test strips and trips to the doctor instead. You are now so broke that if you would just give up and quit your two jobs and collapse already you are certain you would qualify for Medicaid. But you are stubborn and you go to work.

Your mother – who though she has been a strict vegetarian since birth has very high cholesterol that will not respond to diet and who has been on high blood pressure medication for decades - survives her third heart attack and you consider the fact that your father died at 39 of a heart attack and you think that probably you are not far away from one yourself.

Your oldest sister says while visiting Mom at the hospital that she has been on high blood pressure and cholesterol medication for a decade too.

Your nearest-in-age sister, also a strict vegetarian, goes to get her cholesterol checked and sure enough is placed on high cholesterol and high blood pressure medication. She is also diagnosed as almost completely deaf in her left ear, as your father was at a very young age, and as you suspect you are too. She gets a miniscule hearing aid. You are careful to not put the phone to your bad ear.

Your little brother is diagnosed with cholesterol that doesn’t go down in response to a diet (you get hilarious stories about your sweet and gentle sister-in-law’s brutal enforcement of said diet) and high blood pressure. He goes on medication.

You go to the drug store and test your blood pressure when you wake up with the blood pounding in your ears one day and, sure enough, it’s crept up to high borderline. You try a myriad of things and finally hit on running every day and cutting all of the salt out of your diet to get it to the high end of “normal.” You check it once a week.

You struggle – much – with your weight and the overwhelming need for naps and your ridiculously dry skin and your thinning hair. Your late-twenties daughter, who has just been diagnosed with a completely non-functioning thyroid gland, goes on thyroid medication and lectures you that these are all exactly her symptoms, so you should get your thyroid checked. You know it, and are aware (as your daughter is not) that your mother and sisters have all also been on thyroid medication for years, but you can’t afford it – or the regular doctor visits and monitoring that go with it.

You go to coffee with your friends. They have not had an easy time of it lately with their own and their husbands’ health. In fact, it’s been a horrible couple of years. Your heart bleeds for them and you can think of no words sufficient to describe their courage and grace. And yet sometimes you feel jealous that they have access to medical care, and then you just feel guilty and small-minded, because they need this care, and they are wonderful, wonderful people who have worked hard for the lives they’ve built and who give much back to their communities.

But still…you hear about one friend’s breast cancer, and you remember that your oncologist/hematologist warned you that all leukemia patients who survive eventually die of some form of cancer – because the chemo drugs are “the strongest carcinogens, in the strongest doses, known to man.” And you remember that your maternal grandmother died of ovarian cancer, and your nearest-in-age sister was successfully treated for ovarian cancer at the age of 24. But you know you can’t afford a tenth of the screenings you should be having on an annual basis – not even once.

Or you hear about a husband’s heart surgery and you think you might well need that one too – your mother, her sister, and one of your own have all had that particular surgery. But since you can’t afford the surgery, you don’t bother to try to have the tests you can’t afford either.

You don’t go get your hair done any more. You can’t afford it. So you do it yourself.

But you mostly fret about that because you will love forever the hairstylist who probably saved your life – even if you did end up uninsurable for the duration of that life in the process.

diarist’s note: Yeah, ok, this is my story. If you are annoyed by my writing it entirely in the second person, please be advised that I did it deliberately, because, quite frankly, this could be you.

Anyone can be uninsurable in America.

In about as much time as it takes to get your hair done.

I’m not looking for sympathy here – I’m alive and not everyone manages to survive the insurance fiasco that masquerades as “care” in our country. Besides, I’m so stubborn I’m planning on living until I’m old enough for Medicare. So I’d like to direct your sympathy to those who are still alive, but may not make it through another decade of having their “care” rationed by the insurance company accountants.

I know I’m not exactly breaking news here, so please, do not tip, do not rec, go directly to your friends and neighbors and explain to them that their medical care is a disaster waiting to happen, give them their congressperson and senator’s contact info and get them to call or e-mail.


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Parkour
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quote:
Later that day, at the oncologist/hematologist office, this new strange doctor takes blood, orders up an outpatient transfusion, tells you that you no doubt have acute myelogenous leukemia, could keel over dead at any moment as long as you are untreated, and should now go home and call him the very minute the HMO calls you and tells you to check into some local hospital or the other – but should on no account whatsoever check into that local hospital.

You find this direction to avoid hospitalization confusing, in light of the “keel over dead untreated” stuff and say so. Whereupon oncologist/hematologist guy says HMO will try to check you into local or even regional hospital – because it’s cheaper – but in his opinion no local or regional hospital should be treating leukemia, since cure rates double in large teaching institutions. Risk of keeling over dead while he is arguing for your life with HMO is less than risk of dying in local hospital. Then he writes you a list of five hospitals in Chicago that you can allow yourself to be checked into, and says if it’s one of these ok, but it won’t be, so call me when they tell you to go to a local hospital.

Sure enough, he’s right; they do, the very next day. You call him. He works some magic you know naught of (though local rumor tells you later that he informed HMO that he will be sure to make himself available to testify at your spouse’s wrongful death suit later) and you get the referral to the large teaching institution later that day.

This is disgusting.

quote:
Social worker said she had seen small business owners go almost broke trying to cover this charge, and had even heard of one who defiantly did go broke, throwing all of the employees out of work. But more usually, she said, they just fire you.

“Wait, wait!” say you, “Isn’t it illegal to fire someone for their health history? Suppose I’m all well and working?”

She looks at you with more pity, says yes, so of course they will have to find “cause” to fire you, which any employer can always do.

“But I am a very, very good employee!” you protest.

“Yes,” she says, “but they can always find some cause.” The real problem she goes on to explain, is that you will find a new job, that company’s insurer will slap them with the surcharge, they will take their turn at firing you, until you’ve been through six or seven jobs in a year, fired “for cause” from all of them, which of course looks very, very bad to a prospective employer.

“So in a year or so of this, you will not just be uninsurable, you will also be unemployable.”

This is worse, and I have seen it happen.

Ug.

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Blayne Bradley
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the upper quote confuses me. isnt it a good thing to get into a local teaching hospitol?
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Lyrhawn
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quote:
Originally posted by brojack17:
Tongue planted firmly in cheek.

In all seriousness, I think I am ready for healthcare change. Right now, I pay $730/month for healthcare. If you can call it that. I have a Health Savings Account. This means both I and my employer put money into my HSA for me to use on medical expenses. I do not have a copay or prescription plan, I get the contracted rate for these items. This means, I pay $75 to visit my doctor and $3500/year for my wife's prescriptions. We run out of this money very quickly. Last year, I paid over $12,000 in medical bills. This is over 10% of my income. I am concerned about national healthcare, because unfortunately, the government doesn't always run things right. I know first hand, I work for NASA. But I could absorb a 10% increase in my taxes and be no worse off.

I guess the next step is to turn in my handguns (I don't have any anyway).

You aren't a Democrat yet. That'd make you a liberal.

To be a Democrat, you'd have to also be absolutely useless and totally ineffective at getting your positions turned into law.

As of late, I'm growing to hate Democrats for the exact opposite reasons I hate Republicans. I don't like Republicans (congressionally) because they're almost entirely wrong, but are almost entirely effective. I don't like Democrats because they've got a preponderance of better ideas, but are almost entirely ineffective at implementing them.

I'd like nothing better than to see the Democratic party die, and like a phoenix rising from the ashes, I'd like to see something new take up the liberal mantle and hammer home these ideas. If Republicans were actually stood up to on a regular basis, I think they'd be at a loss for how to proceed. They're used to winning political fights on the merits of their tactics rather than the merits of their ideas. If Democrats actually contested the battlefield, we'd be in a totally different world, and though I have some guesses, I really don't know what it would look like.

To connect this to the thread topic: Watching Democrats fumble health care when they have so many extreme advantages on the issue prove to me their utter ineptitude. They can't pour water out of a boot with instructions written on the heel. For the love of God, give me a viable political alternative to Democrats!

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Christine
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I agree, that makes you liberal, not a Democrat. I, too, am liberal without being a Democrat. In fact, I'm becoming increasingly convinced that the current health care push by the Democrats is simply not far enough.
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Mucus
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quote:
Originally posted by Lyrhawn:
... For the love of God, give me a viable political alternative to Democrats!

Oddly enough, here, the Democrats ARE the alternative to the liberals ... and yes our democrats fumble about as much as yours do.
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Lyrhawn
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Yeah, but up there isn't every one just a different flavor of liberal? Your conservatives aren't on par ideologically with our conservatives.

I guess the flip side is that every one down here is really just a different flavor of conservative. Our most liberaliest liberal still isn't far enough to the left to compete with a European liberal, or maybe even Canadian liberals.

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Mucus
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Well, yeah. Even the old name for our conservatives was the "Progressive Conservatives" and stayed like that for roughly fifty years while trading the government with the Liberals.

While our old Reform party ventured into American territory, they essentially had to jettison that to merge with the more progressive conservatives in order to get a shot at government.

We still have funky parties like the Christian Heritage Party which is effectively an anti-same-sex marriage vote as I understand it but they're nowhere near power.

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Teshi
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quote:
While our old Reform party ventured into American territory, they essentially had to jettison that to merge with the more progressive conservatives in order to get a shot at government.
Except in my constituency. I live in one of the most conservative constituencies in Ontario. :E

All the having-power Canadian parties support some version of public healthcare. I do. It means I can go to the doctor if I'm sick. Hey, I'm convinced.

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Blayne Bradley
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I think it goes like this:


Our conservatives are your democrats.

Our Liberals are your green party.

Our NDP are your Socialists.

And then it breaks down.

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Mucus
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Teshi: Where's that?
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Mucus
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Blayne: Kinda.
But I'd hesitate to map exactly like that since they don't match very well.

Liberals and conservatives do have to form reasonably large "tents" in order to govern, whereas the Green party in the US doesn't have to. So a Liberal fiscal conservative like Paul Martin was actually substantially to the "right" of *both* American parties right now in terms of the economy while being to the "left" on matters of child care and health-care.

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Teshi
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quote:
Teshi: Where's that?
Near Ottawa. Half the constituency is a suburb full of self-made techies, the other is farming and small villages. It's a deadly combination.
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Mucus
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Oh, I'm currently in Waterloo/Kitchener. There's a similar odd dynamic.

In the provincial Liberal sweep two(?) elections ago when most of the Harris conservatives were kicked out the area retained some of the few conservatives that survived.

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Teshi
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Pretty sure that was three elections or more ago. My area was one of the few that had an Alliance MP.
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scholarette
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quote:
Originally posted by Lyrhawn:
Yeah, but up there isn't every one just a different flavor of liberal? Your conservatives aren't on par ideologically with our conservatives.

I guess the flip side is that every one down here is really just a different flavor of conservative. Our most liberaliest liberal still isn't far enough to the left to compete with a European liberal, or maybe even Canadian liberals.

I currently identify myself as a European socialist, as I believe that American liberals are too conservative to fit my beliefs. [Smile]
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Christine
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I've been trying to decide if I'm a socialist, but if I am it's an odd, conflicted sort of socialist. I'm very much in favor of the government taking over health care, for example, but I think the government needs to stop buying up failing companies and in fact, I'd love to see these poorly run giants crash and burn.

I think I'm a capitalist, but that I believe the government should be the one to pay for community services such as police, fire, and roads. In that vein, I see it this way: If medical care is a universal right, then the government should step in and make sure we all have it, and that we're all paid for. Trying to legislate around insurance company profit motives and greed that seeks out to find and exploit new and annoying loopholes is a never-ending and expensive proposition.

If, on the other hand, medical care is not a universal right then get out and let people die when they get sick...or let charities cover the expense when they deem it worthwhile.

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Mucus
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quote:
Originally posted by Teshi:
Pretty sure that was three elections or more ago. My area was one of the few that had an Alliance MP.

Two provincial elections ago, not two federal elections.
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MrSquicky
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quote:
In all seriousness, I think I am ready for healthcare change. Right now, I pay $730/month for healthcare. If you can call it that. I have a Health Savings Account. This means both I and my employer put money into my HSA for me to use on medical expenses. I do not have a copay or prescription plan, I get the contracted rate for these items. This means, I pay $75 to visit my doctor and $3500/year for my wife's prescriptions. We run out of this money very quickly. Last year, I paid over $12,000 in medical bills. This is over 10% of my income. I am concerned about national healthcare, because unfortunately, the government doesn't always run things right. I know first hand, I work for NASA. But I could absorb a 10% increase in my taxes and be no worse off.
brojack,
I'm not sure, what is your reasoning here? Are you thinking that some sort of government sponsored health-care will be more efficient/effective/cheaper than what we have right now? Or is it just that you see personal benefit for yourself because other people will have to pick up some of your costs?

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fugu13
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I'm pretty sure NASA has a real health insurance program available that would cover substantially more of your medical care.
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Orincoro
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quote:
Originally posted by brojack17:
This is over 10% of my income. I am concerned about national healthcare, because unfortunately, the government doesn't always run things right. I know first hand, I work for NASA. But I could absorb a 10% increase in my taxes and be no worse off.

And yet despite your reservations, you are clearly coming to the realization that the government, simply by regulating health care, has a much better opportunity to make your health care needs affordable. The story you share with us is atrocious, really- I'm surprised you're worried at all about your situation getting worse under regulation. How could this be less favorable an option for you?

That's the whole thing that makes me wish this wasn't a politicized issue. It shouldn't be drawn up on ideological grounds, and this subject should not be used as a battlefield for principles- especially when the battle will be fought (and lets be completely honest with ourselves here), by people who do not stand to lose what they are willing to risk in order to win. When you let politicians play poker with your health care, you pay the price, and that comes down to a problem with both parties.

I'm quite saddened that this hasn't long been an argument about *how* the government is going to assure the availability and reliability of health care for its people, and not whether such a thing should even exist. To be clear, both parties disappoint me here, and the individual politicians who control these matters are, unlike in problems of education or national security, sealed off and safe from the effects of this long neglect.

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BlackBlade
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quote:
Originally posted by Parkour:
quote:
Later that day, at the oncologist/hematologist office, this new strange doctor takes blood, orders up an outpatient transfusion, tells you that you no doubt have acute myelogenous leukemia, could keel over dead at any moment as long as you are untreated, and should now go home and call him the very minute the HMO calls you and tells you to check into some local hospital or the other – but should on no account whatsoever check into that local hospital.

You find this direction to avoid hospitalization confusing, in light of the “keel over dead untreated” stuff and say so. Whereupon oncologist/hematologist guy says HMO will try to check you into local or even regional hospital – because it’s cheaper – but in his opinion no local or regional hospital should be treating leukemia, since cure rates double in large teaching institutions. Risk of keeling over dead while he is arguing for your life with HMO is less than risk of dying in local hospital. Then he writes you a list of five hospitals in Chicago that you can allow yourself to be checked into, and says if it’s one of these ok, but it won’t be, so call me when they tell you to go to a local hospital.

Sure enough, he’s right; they do, the very next day. You call him. He works some magic you know naught of (though local rumor tells you later that he informed HMO that he will be sure to make himself available to testify at your spouse’s wrongful death suit later) and you get the referral to the large teaching institution later that day.

This is disgusting.

quote:
Social worker said she had seen small business owners go almost broke trying to cover this charge, and had even heard of one who defiantly did go broke, throwing all of the employees out of work. But more usually, she said, they just fire you.

“Wait, wait!” say you, “Isn’t it illegal to fire someone for their health history? Suppose I’m all well and working?”

She looks at you with more pity, says yes, so of course they will have to find “cause” to fire you, which any employer can always do.

“But I am a very, very good employee!” you protest.

“Yes,” she says, “but they can always find some cause.” The real problem she goes on to explain, is that you will find a new job, that company’s insurer will slap them with the surcharge, they will take their turn at firing you, until you’ve been through six or seven jobs in a year, fired “for cause” from all of them, which of course looks very, very bad to a prospective employer.

“So in a year or so of this, you will not just be uninsurable, you will also be unemployable.”

This is worse, and I have seen it happen.

Ug.

A doctor I know told me that after doing some unrelated medical tests she strongly suspected her patient had prostate cancer, the insurance company balked on paying for the tests as there were no actual symptoms to indicate cancer, I watched in sadness as this doctor made up a symptom on her reports that would force the insurance company to act.

No insurance company will pick up my wife because she is clinically depressed.

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brojack17
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quote:
Originally posted by fugu13:
I'm pretty sure NASA has a real health insurance program available that would cover substantially more of your medical care.

I'm a contractor and not a civil servant. So my insurance is provided by my company. That comment was meant to point how inefficient the government can be. And don't get me wrong, I love NASA, but they do some real bonehead things sometimes.
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brojack17
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quote:
Originally posted by MrSquicky:
quote:
In all seriousness, I think I am ready for healthcare change. Right now, I pay $730/month for healthcare. If you can call it that. I have a Health Savings Account. This means both I and my employer put money into my HSA for me to use on medical expenses. I do not have a copay or prescription plan, I get the contracted rate for these items. This means, I pay $75 to visit my doctor and $3500/year for my wife's prescriptions. We run out of this money very quickly. Last year, I paid over $12,000 in medical bills. This is over 10% of my income. I am concerned about national healthcare, because unfortunately, the government doesn't always run things right. I know first hand, I work for NASA. But I could absorb a 10% increase in my taxes and be no worse off.
brojack,
I'm not sure, what is your reasoning here? Are you thinking that some sort of government sponsored health-care will be more efficient/effective/cheaper than what we have right now? Or is it just that you see personal benefit for yourself because other people will have to pick up some of your costs?

I haven't researched Obama's plan yet. I am not asking anyone to pay my medical bills. I have paid thousands in medical bills over the past few years. We were in such bad shape at one time, I considered bankruptcy. Not for credit card debt, but for medical debt. So no, I don't want anyone to pick up my bill.

I'm one of the lucky ones in the country, I HAVE insurance. I'm tired of paying almost $1000/month and still having medical collections calling me because I can't keep up. I hate that my wife has to go without pills for a few days because we don't have enough money to pay for her $350 prescription. I hate that I have stomach problems that I haven't gone to the doctor for, because I can't afford to.

I have to say, that I am a little offended by your comment.

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DarkKnight
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quote:
So no, I don't want anyone to pick up my bill.
if you are currently paying over 10% of your income in medical expenses but you only want to pay 10% then someone else must be paying the part above 10% that you are currently paying
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Paul Goldner
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"if you are currently paying over 10% of your income in medical expenses but you only want to pay 10% then someone else must be paying the part above 10% that you are currently paying "

Or a system be implemented that doesn't drive costs artifically high.

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Orincoro
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Paul beat me to it. Yeah. Like a system that doesn't take 30 odd percent of that 10% as overhead, and makes due with a respectable 2% instead.
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Dogbreath
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quote:
Originally posted by DarkKnight:
quote:
So no, I don't want anyone to pick up my bill.
if you are currently paying over 10% of your income in medical expenses but you only want to pay 10% then someone else must be paying the part above 10% that you are currently paying
http://www.bizjournals.com/dayton/stories/2004/04/05/daily19.html

I remember (but can't find a link) a few years back when Anthem gave their CEO a $90 million bonus.

Brojack mentioned $12,000/year in medical bills. (which seems very high to me) You could pay the bills of at least 3541 with his level of medical expenses from that $42.5 million. In reality, without drastically inflated rates, you could pay much much more.

I really don't think the issue is about getting other people to pay my medical bills, it's that the government can't get away with blatant greed quite so often. Obama makes around $400,000/year, IIRC, and as far as I know he's the highest paid government official. Obviously, some money will be lost due to government inefficiency, but compared to the obscene amount of money CEOs pay themselves?

Edit: Did some research, and apparently, the highest paid government official is the head coach of the Army football team. Crazy.

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King of Men
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How do you know what is the correct amount to pay for medical services?

You might want to remember a bit of history here: Every so often, someone digs into the inner workings of some industry or other, and finds that middleman X is being paid what seems like a rather large amount; and they decry the injustice and call for laws to regulate it. This is not a development of the twentieth century; the Catholic Church was setting just prices before the Black Death, and the Romans were also known to set maximum prices. And every time this happens, the trade in question dies, or is limited to a really tiny amount, because it turns out that middleman X is actually doing quite a bit of work, thanks kindly, and nobody will do it if they won't get paid.

Now, in the case of medicine, that leads to one of two options: Either poor people do not get medicine, and they suffer from all the horrors of the past; or else someone else pays for them. Either straight out, as cash paid by taxes, or in some concealed form like healthy young people paying huge health-insurance premiums because the companies are not allowed to sell at the actuarially fair price. Take your choice.

With that said, it's clear that part of the problem is the American health insurance model, which is silly. People expect to pay for doctor's visits on a sort of subscription plan, instead of, as is sensible, saving up for a rainy day and paying full price when you have the flu or need the pill, or whatever, and carrying insurance against real disaster.

Take the case of contraception; practically every woman in America these days buys some at one point or another. Well, you can't 'insure' against that. Insurance is a means of spreading risk; you insure against your ship going down, and so no shipowner goes broke even if he has a wreck, and the lucky ones are a little less rich than they would otherwise be. But if every shipowner is going to have a wreck, they're all going to be broke no matter what. 'Insurance' that pays for contraception is just a hidden redistributive tax; everyone pays a premium so that the total covers contraception, which the young couples that use it benefit from. If there were any justice, no insurance would cover contraception, the people who actually use it would pay, and everyone else would pay a much lower premium. (Not picking on women, here; contraception is just about the only case where the subsidy helps young people. Generally speaking the subsidy flows from young and healthy to old and sick and wealthy, and you can't tell me that's fair.)

The current model is a bit like having "auto insurance" that (by government mandate!) covered gas costs! You pay X dollars every month, and in return, you're only out a few dollars' worth of co-pay when you fill your tank or change the oil. Nobody would think this a reasonable model, but that's exactly what we've got for health insurance.

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Mucus
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The insurance model IS a strange one for health care. I saw a post on this earlier today.

quote:
Right now, it appears that the biggest barrier to health care reform is people who think that it will hurt them. According to a New York Times poll, “69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.” Since most Americans currently have health insurance, they see reform as a poverty program – something that helps poor people and hurts them. If that’s what you think, then this post is for you.

You do not have health insurance. Let me repeat that. You do not have health insurance. (Unless you are over 65, in which case you do have health insurance. I’ll come back to that later.)

The point of insurance is to protect you against unlikely but damaging events. You are generally happy to pay premiums in all the years that nothing goes wrong (your house doesn’t burn down), because in exchange your insurer promises to be there in the one year that things do go wrong (your house burns down). That’s why, when shopping for insurance, you are supposed to look for a company that is financially sound – so they will be there when you need them.

If, like most people, your health coverage is through your employer or your spouse’s employer, that is not what you have. At some point in the future, you will get sick and need expensive health care.

...

For all of these reasons, you can’t count on your health insurer being there when you need it. That’s not insurance; that’s employer-subsidized health care for the duration of your employment.

http://baselinescenario.com/2009/08/05/you-do-not-have-health-insurance/
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Dogbreath
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King of Men: Not disagreeing with your points entirely, but:

I have a friend who's a doctor who told me over 50% of every dollar he makes goes towards paying liability insurance. At the moment, the fact you can sue a doctor hundreds of thousands, or even millions of dollars is, ironically, driving up the price of medical care. There simply needs to be a reasonable cap placed on the amount of money that can be sued - I can't think of any other country with such ridiculously high lawsuits. If my friends rates are anything indicative of all doctors (he's an OB/GYN), then just removing the constant pressure of enormous lawsuits could drastically lower the actual cost of health care.

I also understand your argument with overpaid middlemen - but is $42.5 MILLION dollars necessary? Couldn't you get someone to do the same job for, say, a million a year? That's more than anyone would be able to spend and still have every conceivable luxury. (barring owning your own country or something)

Totally and completely agree with you about using insurance to pay for things that aren't really insured against. Insurance should be for that heart attack, or unexpected serious illness, or serious medical issues that your average person can't reasonably afford, not for ordinary every day things.

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Lyrhawn
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I have a feeling that if health insurance didn't cover doctor's visits or prescriptions, the already fragile state of health in America would be even worse.

A lot of the focus is hinging towards preventative care. Theoretically, if we placed serious caps on law suits, and put incentives out there for doctors to become PCPs instead of specialists, then the price of a visit to your doctor wouldn't be that big of a deal, and you COULD save insurance just for when the big stuff hits. Also, if some serious curtailing of the insurance red tape were achieved, doctors could spend less time on the phone and more time in their exam rooms, which would also drive the cost down.

But without that crucial element, people will avoid their regular doctor, just like now, until problems become too big (and thus more expensive) to handle. And the segment of the population that does that would only increase.

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King of Men
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quote:
I also understand your argument with overpaid middlemen - but is $42.5 MILLION dollars necessary?
This problem is hardly limited to insurance companies. If 40 million is the going rate, then no, you likely can't find someone good for less.
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King of Men
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quote:
I have a feeling that if health insurance didn't cover doctor's visits or prescriptions, the already fragile state of health in America would be even worse.
Sure; when you've got problems that fundamentally come from a bad model that's been in place for sixty years, the problems are going to be really well stuck-in. Identifying the source of the problem may not help you in such a case.
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Lyrhawn
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It will if we make some fundamental revisions. Assuming the problems I just identified were remedied, I'd have no problem with curtailing medical insurance to not cover more than a yearly physical. Some might even want to do away with that, but a yearly physical isn't like getting the oil changed in your car. If your car breaks down on the highway, it only costs you. If your body breaks down due to neglect, it costs everyone.
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rivka
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quote:
Originally posted by Dogbreath:
If my friends rates are anything indicative of all doctors (he's an OB/GYN)

IIRC, OB/gyns have the highest rate of malpractice suits (and therefor highest rates for malpractice insurance).
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ClaudiaTherese
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They are out on the thin edge of a very, very long wedge. You can't extrapolate about general malpractice issues from the Ob-Gyn situation, although it's bad enough all around. It's just that it is well beyond the norm in that corner.
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St. Yogi
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quote:
Dear Mr. President: I am writing you today because I am outraged at the notion of involving government in healthcare decisions like they do in other countries. I believe healthcare decisions should be between myself and my doctor.

Well, that is not strictly true. I believe healthcare decisions should be between myself, my doctor, and my insurance company, which provides me a list of which doctors I can see, which specialists I can see, and has a strict policy outlining when I can and can't see those specialists, for what symptoms, and what tests my doctors can or cannot perform for a given set of symptoms. That seems fair, because the insurance company needs to make a profit; they're not in the business of just keeping people alive for free.

Oh, and also my employer. My employer decides what health insurance company and plans will be available to me in the first place. If I quit that job and find another, my heath insurance will be different, and I may or may not be able to see the same doctor as I had been seeing before, or receive the same treatments, or obtain the same medicines. So I believe my healthcare decisions should be between myself, the company I work for, my insurance company, and my doctor. Assuming I'm employed, which is a tough go in the current economy.

Hmm, but that's still a little simplistic. I suppose we should clarify.

I also believe my healthcare should depend on the form I fill out when I apply for that health insurance, which stipulates that any medical problems I ever had previously in my life won't be covered by that insurance, and so I am not allowed to seek further care for them, at least not at my insurance company's expense. That seems fair; otherwise my insurance company might be cheated by me knowing I needed healthcare for something in advance.

And if I didn't know about an existing condition I had, but I could have known about it, had someone discovered it, I suppose it doesn't make much sense for my insurance to cover that either.


But let us assume that all hurdles have been cleared and I am allowed to see my doctor, chosen from a list of available doctors, about a health problem, except health problems I have previously been treated for. After that, I believe my healthcare decisions should be between myself, my insurance company, my insurance plan, my employer, and my doctor.

Oh -- and the doctors at the insurance company, of course.

They will never actually meet me, or even speak to me on the phone, and in fact I couldn't tell you the name of a single one of them, or what state they were in, or whether or not they've just all been outsourced to a computer program somewhere in Asia at this point -- but they're in charge of determining which treatments might be "effective" for me, and which will be a waste of money, er, time. They do this by looking not at my case, which is individualistic and piffling and minor, but at the statistical panoply of treatments on the insurance company spreadsheet and their statistical cost vs. effectiveness. My doctor may think one treatment or another might be effective for me in a particular instance -- but he may be a little too closely involved with my personal case, and unable to make these decisions nearly as well as my less involved, more dispassionate insurance company can.

And then there's the claims office. When my doctor sends a bill to my insurance company, it must travel through a phalanx of people and departments and procedures in order to determine whether or not it is, in fact, a valid medical complaint to be treated for, done the right way, at the right time, by a doctor on the right list. If the paperwork is not done on time, or not done completely, or not done to the satisfaction of the right people, or if I did not receive the proper prior approval for the medical treatment administered, or if that approval expired, or if the insurance company rescinded the approval months after the fact, my medical care will not be covered. While my doctor has had to sometimes forgo payments because the 30-day window for receiving "all requested documentation" somehow slipped by, I myself have received notes from the insurance company denying coverage for treatments from twelve full months beforehand. It can't be helped: sometimes it takes twelve months for their computers to process the paperwork and determine that I owe them more money. They like to be thorough.

So that's getting a bit more complete. I believe my healthcare decisions should be between me, my insurance company plan, my statement of preexisting conditions, the claims adjusters at my insurance company, my insurance company's doctors, my employer, and myself.

And the separate claims review team that will be looking over my treatment.

My health insurer might have flagged me as someone who needs a lot of healthcare, and who is therefore costing the company money. Needing to use the insurance you paid for is naturally a suspicious activity: that means that a special review team will look over my paperwork, seeing if there is any vaguely plausible reason for the company to be rid of me. They will look for loopholes in my application, irregularities in the paperwork my doctor filled out or any other situations which, like magic, mean that all the money I have paid for health insurance premiums was in fact irrelevant, null and void, and they don't have to pay a single cent of claims because I defrauded them by neglecting to remember that I had chicken pox in sixth grade, not fifth, or that what I presumed was a bad cold in 1997 was in fact maybe-possibly-bronchitis, and I can't possibly expect to be covered for any lung-related complaints since then. I suppose I cannot complain too much; after all, this is a crack squadron of employees whose pay is determined by how much they can reduce the healthcare costs incurred by the company. It would be irresponsible for them to not look for such loopholes.

And then there is the board of directors at the insurance company, of course. My personal healthcare is irrelevant, when considered in the abstract; a health insurance company exists to make a profit, and the pay of every executive in the company and every board member is dependent on squeezing out the maximal amount of profits from every dollar.

This is where "experimental" and/or "preventative" treatments come in. New-fangled treatments, things that have only been around for a decade or two, are usually the most expensive. For example, when I complained of chest pains I could have had an CT scan to determine the state of the arteries around my heart, and it would have shown exactly where the problems, if any, lie. This is what the specialist recommended -- but using a CT scan in this way is considered "preventative" treatment, not "diagnostic" treatment, so it is not covered, and I am not allowed to have one. Instead, less accurate tests were used to get a "feel" for what the arteries might look like; these tests are covered. Problem solved; as it turned out, my chest pains were probably a preexisting condition, most likely caused by me having bones. And if it's not, I suppose we'll find out in another ten years or so, when no doubt I am covered by another insurance company and not this one.

These may seem like arbitrary determinations, but they are not. They are based on a rigorous study of how well the treatment works, how much it costs, and how likely it is that the company will have its corporate ass sued off if they do not provide it. This is weighed against the desired profit announcements for the insurance company during that quarter in order to determine how much care must be denied to customers, in aggregate, in order to meet the appropriate financial goals.

Let us not forget the obligations to the stockholders, after all. Of every dollar paid in premiums, currently eighty cents it paid back out for actual medical claims; the rest is administration and profit-taking. Fifteen years ago the number was 95 cents: in other words, the insurance companies themselves have gone from taking five cents of every healthcare dollar to taking twenty cents of every dollar, all since the Clinton presidency.

The stockholders require healthy profits. The executives require personal profits for providing those profits. And since people for some reason aren't getting any healthier, those profits can only come from one place -- reducing what the company pays out when people do become sick.


I recently heard a radio interview with a health insurance company whistleblower; he was describing his trips on the company jet. Gourmet meals were served on china, and the forks were gold plated.

I was pondering this, while looking over the letter from my insurance company informing me that they were switching the coverage of my most expensive monthly medication -- those expensive allergy/asthma shots now count as a "procedure", not as "medicine", and so therefore those vials are not covered by my pharmaceutical plan anymore. It must be very difficult to balance all the tasks of an insurance company CEO. If the corporate jet has inferior place settings, imagine the corporate shame. If a new medication or treatment is no longer considered "experimental", or a treatment classified as actually useful, as opposed to "preventative" nonsense, consider how many millions of dollars the company would have to pay out to give people that treatment. It seems reasonable indeed for the president of my insurance company to have personally pocketed a few hundreds of millions here or there -- I cannot imagine the stress of keeping up with proper utensil etiquette during a time when those you insure are doing you the constant insult of actually getting sick.

So, Mr. President, I write to you with this demand: we are not a socialist country, one which believes the health of its citizens should come without the proper profit-loss determinations. I believe that my healthcare decisions should be between me, my insurance company plan, my insurance company's list of approved doctors I am allowed to see and treatments I am allowed to get, my insurance company's claims department, the insurance company doctors who have never met me, spoken to me or even personally looked at my files, my own preexisting conditions, my insurance company's crack cost-review and retroactive cancellation and denial squads, my insurance company's executives and board of directors, my insurance company's profit requirements, the shareholders, my employer, and my doctor.

Anything else would be insulting.

I thought this was pretty funny [Smile]

quote:
Source
© Kos Media, LLC
Site content may be used for any purpose without
explicit permission unless otherwise specified.


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brojack17
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KOM,

I don't pick the rate. I go to the Dr. and get a bill. I basically have a net 30 setup with them. The prescriptions are the crazy priced items.

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Mucus
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Hmmmmm, thought this was interesting:
quote:
The House hearings on rescission – the retroactive cancellation of individual health insurance policies – were over a month ago, but after its initial run through Daily Kos it seems to have waited a bit before popping up on Baseline and Slate. James Kwak at Baseline described the practice as rare, affecting only 0.5% of the population. The faint light bulb above my head began to flicker: could that be true…that’s not rare – that is amazingly common.

...

It should be fairly clear that the people who do not file insurance claims do not face rescission. The insurance companies will happily deposit their checks. Indeed, even for someone in the 95th percentile, it doesn’t make a lot of sense for the insurance company to take the nuclear option of blowing up the policy. $11,487 in claims is less than two years’ premium; less than one if the individual has family coverage in the $12,000 price range. But that top one percent, the folks responsible for more than $35,000 of costs – sometimes far, far more – well there, ladies and gentlemen, is where the money comes in. Once an insurance company knows that Sally has breast cancer, it has already seen the goat; it knows it wants nothing to do with Sally.

If the top 5% is the absolute largest population for whom rescission would make sense, the probability of having your policy cancelled given that you have filed a claim is fully 10% (0.5% rescission/5.0% of the population). If you take the LA Times estimate that $300mm was saved by abrogating 20,000 policies in California ($15,000/policy), you are somewhere in the 15% zone, depending on the convexity of the top section of population. If, as I suspect, rescission is targeted toward the truly bankrupting cases – the top 1%, the folks with over $35,000 of annual claims who could never be profitable for the carrier – then the probability of having your policy torn up given a massively expensive condition is pushing 50%. One in two. You have three times better odds playing Russian Roulette.

http://tauntermedia.com/2009/07/28/unconscionable-math/

It also seems unclear whether that is 0.5% in ever or 0.5% per year as here:
quote:
The insurers claim that rescission is very rare; at the Congressional hearing, two of three industry representatives said it happens to less than 0.5% of policies per year. But that is a deeply misleading number. That means that if you are in the individual market for twenty years, you have a 10% chance of your policy being rescinded; 30 years, and it goes up to 14%. There is a big difference between health insurance and a 90% chance of having health insurance. And remember, insurers only try to rescind policies if you turn out to need them; so the percentage of people who lose their policies when they need them is even higher. (The denominator should exclude all those people who never need expensive medical care, at least not before 65 when they go onto the single-payer system.)
http://baselinescenario.com/2009/07/27/health-insurance-innovation/
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Mucus
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Hmmmm, I guess the actual industry representative transcript really IS per year.
quote:
And, as I indicated, our use of rescission is rare. Less than one half of one
percent of all of our individual insurance contracts in 2008 were tenninated or rescinded.

http://energycommerce.house.gov/Press_111/20090616/testimony_collins.pdf
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Farmgirl
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quote:
Originally posted by ClaudiaTherese:
They are out on the thin edge of a very, very long wedge. You can't extrapolate about general malpractice issues from the Ob-Gyn situation, although it's bad enough all around. It's just that it is well beyond the norm in that corner.

I was really really hoping CT would weigh in on this whole "medical care reform" issue,... but I was hoping for a bit... more.

Aren't you practicing now where there is a single-payer system, CT? So you can give a better comparison of the two systems (from a physician's standpoint) than anyone else here has any idea of?

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Farmgirl
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quote:
Originally posted by brojack17:
Tongue planted firmly in cheek.

In all seriousness, I think I am ready for healthcare change. Right now, I pay $730/month for healthcare. If you can call it that. I have a Health Savings Account.

An HSA is not actually an insurance plan, technically. An HSA is like a major savings account, the way it is set up. It is like you putting money into a cookie jar to save up for major rainy day things -- except that these funds are to be only used for medical expenses, etc.

So I'm not sure we are talking apples to apples when comparing "insurance" problems to your HSA account.

Whereas, I'm covered by insurance (which I'm happy with), if I have a major medical issue come up, my insurance company may be forced to pay far more than I have ever paid in in premiums, to cover a major medical issue. I think you might be more limited in that way, plus the high deductible that comes with HSA's, which is causing a lot of problems for you.

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Brinestone
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This is not really related, but I have always thought that lawsuits for medical malpractice made little to no sense. I mean, if someone murders your sister, you don't get a penny from them, even if they are convicted. They just go to jail so they can't kill anybody else. But a doctor, who is trying to help your sister but makes a mistake, gives you millions of dollars to make up for it? Does that really help you to feel better about losing your sister?

Likewise, if an auto mechanic messes up your car while trying to fix it, you would do one or both of the following things: a) you would never use that mechanic again and tell your friends not to either, and b) you might ask the mechanic to fix what he broke or pay someone else to do so.

I can understand asking a doctor to pay if her mistake costs you a lot in medical bills you wouldn't otherwise have had. I can also understand keeping track of which doctors make lots of mistakes and maybe driving them out of business. Making everyone in America pay high premiums so that all doctors can get liability insurance, meanwhile keeping bad doctors practicing, doesn't make sense.

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Bokonon
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quote:
Originally posted by Brinestone:
This is not really related, but I have always thought that lawsuits for medical malpractice made little to no sense. I mean, if someone murders your sister, you don't get a penny from them, even if they are convicted. They just go to jail so they can't kill anybody else. But a doctor, who is trying to help your sister but makes a mistake, gives you millions of dollars to make up for it? Does that really help you to feel better about losing your sister?

That's not completely true. People can certainly bring civil cases separate from criminal cases. The one prominent example I can think of is that of OJ Simpson. He was acquitted of all criminal charges, but was found guilty in a wrongful death suit (I think), and forced to pay his ex-wife's family some money.

The civil case isn't about revenge (though no doubt many people who bring them feel this way), it's about repairing real damages incurred by the applicable act.

-Bok

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King of Men
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quote:
Originally posted by brojack17:
KOM,

I don't pick the rate. I go to the Dr. and get a bill. I basically have a net 30 setup with them. The prescriptions are the crazy priced items.

I don't understand what I said that this is a response to.
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brojack17
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quote:
Originally posted by King of Men:
How do you know what is the correct amount to pay for medical services?

I thought you were asking me the question about what I'm supposed to pay. I see now it is more rhetorical. Sorry.
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King of Men
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Ok, now I see. Well, the point remains: You don't pick the rates, but if you did, what price would you pay? Bearing in mind that if you answer 'zero', pretty shortly there won't be any drug industry to do business with you.

Any statement of the form "Amount X is too high for good Y" is an implicit claim to have a better way to evaluate what the amount ought to be. Maybe such a better method exists, but I'd like to see it made explicit before rushing off to implement it by legislation. In the past, it has generally boiled down to "Whatever some committee or bureaucrat thinks is reasonable, after all the interest groups have bought them dinner".

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Dogbreath
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quote:
Originally posted by ClaudiaTherese:
They are out on the thin edge of a very, very long wedge. You can't extrapolate about general malpractice issues from the Ob-Gyn situation, although it's bad enough all around. It's just that it is well beyond the norm in that corner.

Eh?

I know OB/GYN's get some of the highest liability rates, but they're also a pretty large group of all doctors. I mean, everyone here has depended on one at least once (save for those who had crazy parents who hated doctors), and most of the females here will be in need of one at least several times.

4,315,000 children were born in the U.S. in 2007, for example. (source. That's more cases just in babies for OB/GYNs than all heart surgeons combined. (heart attacks being the #1 killer, IIRC) A podiatrist might not have nearly as much malpractice suits, but what percentage of the population ever even sees one? (what percentage knows what one is [Razz] ) And how much "work" is done by one.

Seeing as having children is something most people go through, and the enormous costs and risks associated with doing so, I'd say OB/GYNs are a sizable chunk of doctors (if not the largest chunk) and are certainly a good example. I actually mention it because I figure it's the one doctor everyone has had some experience with. (even if it was as a newborn)

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