Please, Please Don't Change Our Crazy Health Insurance System!
Today I had an appointment with the surgeon who I expected to do the surgery on my ankle. I presented him with the second opinion from one of his colleagues, and he agreed with it.
"Yes, you really do need this surgery," he said. "But you need someone who can do an arthroscopic exam for bone fragments and a ligament reconstruction at the same time, and I can't do that. There's only a handful of people
who do."
Is there any reason why I couldn’t have those surgeries separately? I asked.
Well, no, he said. But it really didn’t make sense to separate them and the insurance company would probably dispute it. The thing is, he knows the other orthopedic group with whom I have the appointment - one of the best in the city, he hastened to add - and he knows they have a lot of restrictions about what insurance they’ll take. He said they probably wouldn’t accept the open car insurance claim in payment.
At this point, I was almost in tears. “What are my options?” I said.
There’s this one guy over at Jefferson who does both, and he might take the insurance, he said. “And there’s another guy up in Princeton, but that’s it as far as I know.” (And by way of passing, told me he had a patient that week from 100 miles away who drove to his office with a badly broken arm because he couldn't get anyone closer to accept his Medicaid.)
So I came home and called the doctor at Jefferson. The office assistant informed me they’re no longing accepting New Jersey car insurance cases. “No, no, my health insurance is Jersey. My car insurance is Pennsylvania,” I said, desperate to get a break.
Finally, I got one. The office assistant took all my information and said she had to verify my coverage and the open claim. I told her I was on COBRA, running out of money and really needed to get this surgery done ASAP.
She said she would try to help me. She called back in five minutes and now I have an actual appointment - in three weeks. (I still have another appointment I made two months ago for the week after this new one, but that's with the guy who won't take my car insurance.)
Let's recap, boys and girls. Keeping in mind the slogans of health care reform opponents (waiting lists, not getting to choose your doctor, not getting the tests you need, etc.), of course:
1) The original injury? Almost two years ago.
2) Because the original claim went through my car insurance as required by law, my health insurance company had no record of the three months of physical therapy. Because they had no record, they would not authorize the MRI until I went through physical therapy. It took me months to straighten that out.
3) Finally get an MRI authorized a year later. Former employer changes his health insurance plan (because the premiums are too high), which affects my COBRA. MRI authorization is no longer valid. Return to "Go," start over.
4) By this time, developing painful cysts in the back of my knee from hobbling everywhere. Doctor advises me to ignore it "because it wasn't in your original accident report and the insurance companies might get confused and deny payment."
5) The Penn Health System (University of Penn) gets into a fight with my insurer over reimbursement and the insurance company kicks them out of their plan coverage. Start over AGAIN.
6) Pick new doctor who turns out to be a little crazy and who's running various money-making scams. Change primary doctor AGAIN.
7) Make first visit to foot and ankle specialist, who tells me it's just a sprain. Gives me shot of cortisone, which makes the swelling go down but causes excruciating spasm in ankle.
8) Go back to specialist twice. The office is run like a high-speed assembly line and he spends barely five minutes with me. I insist he look at the MRI - he says, oh, you do have a small fracture and a ruptured ligament. Tells me to wear a brace and go to physical therapy AGAIN.
9) I make appointment at Penn (which is now back in my insurance plan, six months later) for a second opinion. The doctor confirms the diagnosis, points out it was actually on the original ER x-ray report (which no one bothered to read until then) and says physical therapy won't do a thing at this point, I need surgery.
10) She refers me to one of her partners.
11) When I call to make an appointment, his assistant tells me he "absolutely" won't see any car insurance patients if he has to split the billing. Back to square one.
12) I keep the appointment I made with the first specialist, which is where today's story begins.
There are five medical schools in Philadelphia and at least two of the teaching hospitals are in the nation's Top 10. I can't even count how many hospitals we have - 20 or more. Out of all those experts, four doctors perform this reasonably common procedure - and it sounds like it's for insurance reasons.
Now, picture this whole thing with single payer. You get hurt, you go get treated. They send you where you need to go - and there are no worries about whether or not they take your insurance. They order the MRI when you need it, and they locate the right specialist to do the surgery. They send someone to check you at home after the surgery, and they cover the physical therapy - without a copay.
Oh no, Democratic Congress! No, President Obama! Please don't throw me in that briar patch of evil socialized medicine!
I might die of happiness.
They don't give a shit about you just your money.
Just like republicans.
It should read, "Like all things in the AMERICAN medical world."
get the Hell out of this country if you possibly can. VA users & Medicare folk, can stay. If we cannot get our foot in the door now for a future National Single Payer Health Care System, while the Dems control the entire government, this country is gone. It will be here physically, but it will be a country of slaves & wholly owned corporate government. If you are young enough & wish to start a family, for the sake of your children, look north to Canada. It is a civilized nation that would never tolerate a "Katrina" aftermath of third-world treatment for its citizens. Canada is family friendly without a Fox News mentality. The most revered Canadian citizen in history is the man who brought National Health Care to Canada. The handwriting is being written on the wall right now, people. NO PUBLIC OPTION is a flashing exit sign. Each must choose according to their circumstances. Good luck...
Being an expat here in Vancouver, can't say I agree with that. Just stroll down East Hastings and you'll see a mini third world. I believe it has the worst HIV/poverty/drug use rate in the nation.
Regarding the rest of your remark, I would prefer a form of single payer, or if they want to keep the private insurers outlaw profit, though I'd really rather have single payer and get rid of the insurance parasites.
Every community has a third world segment, even the rich areas. They are just better hidden there.
Fuck insurance. Pay your own way starting with the $12-18,000 you now pay for health care coverage. If we all did this those cocksucker insurers would go broke and the govt. could expand medicare to everyone.
Both versions of the existing bill contain health care insurance mandate.
You *must* buy health insurance. If you don't you are fined 2.5% of your adjusted gross income. One version caps that at $750, so I guess it is $250 better than Mass.
I saw no caps on what insurance companies can charge for premiums, but with more rules on what they have to cover, they will be charging more.
The same mandate applies to companies too. So if one insurer like in Susie's story was raising premiums to an employer if an employee was ill, then if they could not find a cheaper coverage, they would have to pay a fine for the privilege of canceling the abusive premium raising plan.
The way they keep the mandate afloat is by offering subsidies to anyone who is poor to buy the over-priced coverage denying insurance. So tax dollars will be *subsidizing* the insurance industry. Single payer would be so much cheaper!
The "public option" in the bill has already had restrictions added so that it can not undercut private insurance premiums in price.
You should move because the fed. government will be following CA. into insolvency very soon. Congress is a sad, sad place.
I'll opt out of federal taxes before I opt into private insurance. When I pay my own way, 100% of my health care dollars go to health care - take off the insurer's cut (1/3) and I get 50% more care for my dollar. On top of that many providers give generous discounts for cash payment, and there are no network restrictions.
I refuse to live in fear and I refuse to be raped for my own well being.
Yes, you can get a discount for cash payment but it is far from "generous" -- a mere 10% where I live. But you are still being raped by the hospital/insurance collusion. This 10% is not nearly so generous as it should be. In a recent visit to the hospital, my insurance company got a 75% discount, i.e., fees completely waived (this was told to me by the billing department at the hospital after I won their confidence/sympathy), and I paid the 25% remainder out of pocket. Let me make this clear: THE INSURANCE COMPANY PAID NOTHING. And to top it off, I guessed the insurance company would raise my rates, because I had only been to a doctor twice in my life before -- and they use any excuse they can to raise rates. Sure enough, even before I got the bill, I got a letter from them saying they were going to try to raise my rates. Problem for them was, they had already raised my rates by 45% (!) three months prior because - horror of horrors! - I had the gall to turn 50 years old.
Anyway, though you might get a small discount by paying cash, you are still paying on a vastly inflated rate which was calculated to get the hospital the bottom-line money they need, while ingratiating the insurance companies with a gigantic discount. When you opt to pay cash "for the discount", you will pay an additional HUGE chunk. If my case is typical, you will pay more than three times what the hospital actually gets from insurance companies and you added together! Some "discount"....
We need to DUMP the insurance racket, plain and simple.
Single payer or nothing. It is OUTRAGEOUS.
At least I didn't pay for insurance that didn't pay for my care. HR 676
dont you see...the prob is the for profit health insurance companies
tony soprano couldnt have come up with a better scam
Go top down:
Get the number of the surgeon who can do the procedure. Then ask your referring surgeon to call the other guy personally and request the consult. In many cases a surgeon who will "not take certain insurances" can bypass that office rule and bill for the procedure even if it's COBRA. There are no set restrictions on not taking certain insurances. They just don't do it because of the paperwork and sometimes a lousy reimbursement rate. But your situation is particular and the specialist who can do the whole thing should be able to bill whoever the F**k he wants.
"Someday somebody related to some of these sufferers, these victims, these collaterally damaged souls, may try to kill you. And I have to tell you, I think you’ll have it coming." - Christopher Cooper
I assume he said no, since he then referred me to the other two surgeons.
A former award-winning journalist and lifelong class warrior, keeping a jaundiced eye on the Washington elite.
Susie, I am very sorry to hear of your plight in the quest to make your ankle better. For those people that can not see this I pity them.
You sound like you will not give in to these people.. a good thing. Best wishes and a speedy and healthy recovery and solution to your situation.
Well I gave it a shot. I figured that probably happened. The MD who said no COULD very easily have said "Yeah, OK. I'll do this one" without opening any cans of worms. What a jerk. So much for professional courtesy.
I have a manila file brimming with surgeries (probably 40 or 50) I've assisted on over the last four years knowing full well I wasn't going to get a dime (I call it my "eat it" file). Many in late hours or the middle of the night for indigent emergencies. I plan to take it to court if I ever get busted for calling my local rep an asshole to his face (Issa). Maybe I can get credit for community service.
Sometimes you just gotta say to yourself, "What if this was my mother?"
"Someday somebody related to some of these sufferers, these victims, these collaterally damaged souls, may try to kill you. And I have to tell you, I think you’ll have it coming." - Christopher Cooper
Will be the eventual solution. No way around it.
It will take an overhaul of all insurance coverage (auto, workers comp, homeowners and business liability)
For now it seems the "public option" is enough of a challenge.
Off topic but check this out . . .
http://tortureteam.org/
"I know that there are people who do not love their fellow
man, and I hate people like that! " ~ Tom Lehrer (1928 - )
My 75 year old mother just went through knee surgery. I thought the process was long because it took about three months and six appointments between injury and surgery date. The process was maddening, but she did receive great treatment and got good results. probably because the word insurance was never mentioned after the initial visit.
The difference: Medicare.
PS thanks for sharing your story Susie. I hope you get past this soon and make a full recovery. Best wishes.
of the doctors who will let a patient suffer or go untreated because of money issues, either. It seems like an act of evil to me. The people who are fighting to preserve this sytem of insurance-based healthcare denial are all co-conspirators in a great evil.
This country is in the toilet.
but the doctors time is valuble also and should be paid for his time and whoever assists in the surgery's time. It is the insurance industry that is the broken link in the chain and needs to be fixed.
I've worked in medicine all my adult life - primarily in Radiology as a rad tech and now MRIs, etc. You could have better stated: 'the doctor's education is valuable.' And for what it's worth, I've met some pretty stupid ass doctors irrespective of their education.
My wife is a doctor. Her first an formost priority is the care of the patients and that they should not suffer!!!!! That's why someone should become a doctor. Not for money. Unfortunately, that sentiment has been lost over the years.
The Drs. time is valuable, along with yours and mine. And everybody's. The rate you are paid for your time does vary though, depending on your skills, education and experience.
I'm from Alberta, and seriously, my head is spinning from reading that story! Nothing like that happens here.....I really really really hope you guys can get real reform down there.
that's the bottom line. I can't think of any other business that racks up the dough so fast it makes your head spin other then Warfare.
Spend a week in the hospital and the bill comes.
Please remit. Even though you have not fully recovered and have no idea if what we did to is going to work.
Quite a scam.
What other business can you get into to extract peoples cash (willingly) other then gambling?
Insurance
That's right evet.
Except the Casino does give you a slight chance of coming out ahead.
are doing then they ask you to leave.
having worked in the casino industry, they don't ask you to leave. They will tell you that you can't gamble on certain things. And that would usually be only blackjack, and only if they think you are a (or if your a known) card counter. The rest it doesn't matter if you know what you are doing or not, the house has an edge with the odds for all games, except taking odds in craps.
I lost 20 ducats in as many minutes last saturday...
The casinos wouldn't run me out!
I like playing poker just for chips and braggin rights much better than playin for money...it takes all the fun right outta the game.
That slight chance of coming out ahead is mandated by law.
Health insurance is making a PROFIT from people suffering - THAT is pure evil.
"I know that there are people who do not love their fellow
man, and I hate people like that! " ~ Tom Lehrer (1928 - )
I am very sorry for your personal physical distress.
I am even more sorry for your emotional distress because of our BARBARIC health care PAYMENT system.
HR 676 is the least we should have, let's name it after Ted Kennedy, shall we?
Of course your title: Please, Please Don't Change Our Crazy Health Insurance System! is a snark is it not?
statusquObama, change you can only pretend in
Suzy, you are awesome.
This is such an infuriating video. This is just another example of why Fox News is not an impartial player in any debate.
Must watch!!!
http://progressnotcongress.org/?p=2700
Because of things like you went through, I went through a long period when I refused to have insurance. This was prompted by me having physical therapy for a joint problem after payment for it was approved by my insurance company, then at the end of the fiscal year the insurance company changed their mind and sent me a bill for the entire treatment along with a notice that collectors were being sent! When I called to ask how this could happen when I had prior documents saying the insurance company had authorized coverage, I was told to read the small print on one of my insurance booklets, the one that says "Terms may be changed at any time without notice." We've all seen that wording but I never thought they'd actually use it.
Then when I dropped insurance, which I'm luckily in good enough health to be able to do, I noticed that my longstanding dermatologist didn't do as thorough a checkup as he had before, and I had another specialist tell me it's probably best not to go to doctors, even though they both knew I was fully capable of paying!
And now it looks like Obama may implement a system that requires everybody to have insurance, with penalties if they don't, like for car owners who don't have car insurance. We're sunk.
When I receive my Illinois(We have mandatory vehicle ins.)State Farm auto insurance bill, what do I see? Why, there's my premium for "Uninsured motorists", followed by my premium for "Underinsured motorists". I kid you not. God, the private health care ins. companies must be drooling over mandated ins. for all without a public option.
Where I live, car insurance is state-mandated as well, and you can be jailed if you're caught driving without it. If a mandated-insurance-system-without-a-public-option is implemented, will people, particularly blacks and people who look poor, be stopped on the streets frequently by cops and forced to show proof of health insurance as part of their ID, on penalty of arrest? I hope not.
It would not be anywhere near that complicated in Yukon Territory Canada.
Deny, Delay and Defend............all in the name of profit. the appetites of health insurance co. shareholders will never be satisfied. it will always be what have you done for us lately. all people need to look beyond their own nose. health care ins. premiums are forecasted to double in cost in 10 yrs. that's a serious concern. this is a unsustainable pace for our economy.
is going to keep pushing their stuff on people hailing and trumpeting pills as the cure all to all our ills.
I'm sorry for all the pain you've suffered. Wishing you speedy recovery.
As Bowie sings - "This is Not (MY) America"!!!!! Why just last night I watched John Q again and came away with the same gut wrenching feeling as in 2002 - WTF is wrong with this country!?! Washington is so full of corrupt politicans, in the pockets of the Insurance industry...talk about "the Mob". Ain't that where they got their start? "You pay us, we wont breaka yer FACE!!!"
JOhn Q
http://www.imdb.com/title/tt0251160/
this is not a failure of the system.
It is a failure of your neighbors to assist you.
Vote GOP and move forward to the 18th Century.
Two bottles of whiskey and a scalpel.
Yeah, Susie, this "is a failure of your neighbors to assist you."
Did you ask your neighbors for help? Did you go to your church? Did you send this story to Michael Moore yet?
Seriously, I hope you get the surgery and that all is corrected very soon!
You left off, "Did you pray hard enough? Did you think positive enough? Did you go to the right motivational seminars? Did your attitude and less-than-fashionable dress sense cause caregivers to reject you, through no fault of their own? Did your choice of hairstyle cause people to overlook you or judge you harshly?"
It's all about "personal responsibility", y'know.
Also, has Susie perhaps "stayed alive too long," making her a bad business risk, not "cost-effective"? Is her skin too dark or her ethnicity too laden with bad associations to allow her full access to health care?
Did you pay enough for your motivational seminar?
Stay right on top of both the bills and claims process after your surgery - it's likely to get more complicated not less. Best of luck.
And the repubs still maintain that there's no reason to change the system as long as there's still a single person out there who's happy with it.
take 50% and you get 50% it made Elvis a rich man.
But nowhere in your long list did I see:
13) Ask neighbors for help
14) Call Senator/Doctor/Deacon Coburn
“Why would anyone with a functioning brain believe this guy?”
Some guy with an eating disorder
I'll call him now. If nothing else, I'm sure he'll pray with me.
A former award-winning journalist and lifelong class warrior, keeping a jaundiced eye on the Washington elite.
due to the Deacongressional Obstetrics Shield law.
“Why would anyone with a functioning brain believe this guy?”
Some guy with an eating disorder
I can't do it, as much as I'd like to.
So I'm posting their link here.
http://www.democracyforamerica.com/activities...
"You know, that limp is kind of sexy. You sure you want to fix it?"
"That limp is an act of God. There's nothing anyone can do about it."
"...and now I have an actual appointment - in three weeks."
Want to know what your "wait time" is under the standard academic way to measure wait times?
Three weeks.
Assuming things go to plan that will be the time from scheduling treatment to getting treatment.
They use that because it is an easy statistic to collect, and it works pretty well in most of the world. If you read academic papers that have wait time data for the US and other countries they will specifically mention that the US data isn't very comparable to other wealthy countries because there is lots of waiting that isn't captured in the measurement.
However while going through the CATO institute or Heritage foundation the disclaimers tend to go missing.
Suzie -
Several years ago I had what sounds like the same surgery you need. I've posted this story under at least one other thread in the past, but it's relevant here.
After many ankle sprains over 10+ years, the ligaments in my right ankle were pretty much blown out and I had bone fragments in the joint where the ligaments had torn away from where they attached to the bones.
I was referred to a orthopedic surgeon by my GP. This guy was good - at the time he was the team doctor for the Vancouver Canucks hockey team. I waited three weeks or so to see him. He immediately saw that my ankle needed surgery and scheduled the operation for six weeks later. This wasn't a problem, as I was not in pain and could walk. Had it been an emergency, I would have gone in sooner.
The surgery went well - except for a bad reaction to a painkiller post-op, remedied by a change of medication. I spent a day in a hospital bed under observation, 6 weeks in a cast, had a follow-up visit to the surgeon and was prescribed a couple of months of physio.
The result was excellent and my ankle has given me no problems since.
Everything was covered by the provincial medical plan. As always, there was no discussion of cost whatsoever. Under single-payer, you deal with your doctor, not insurance drones. The doctor prescribes treatment based on need - not cost, not the convenience of a private insurer, not on some bureaucratic tap dance necessitated by small print in an insurance contract.
At about the same time, a relative of mine in the US had to have surgery to remove painful bone spurs in her heel. She's uninsured, so paid cash for the initial operation to remove the growths, install a metal pin in the heel bone, and put on a cast.
Six weeks later, she couldn't afford the follow-up procedure to remove the cast and the pin. The clinic refused to do it on credit, only cash. She went home and proceded to try to get the money together. Her foot became quite painful. A month or so later, she had the cast off and the pin cut out of her heel. By this time, the bone had become infected around the pin. Had she waited much longer, she would have suffered permanent damage to her heel due to the delay. As it was, her recovery was prolonged and painful.
Her experience could not have been more different from mine.
Single-payer isn't perfect, but it's the only way to go. There is no substitute for efficient, cost-effective, patient-centered public health care.
it should be one of numerous options.
Personally I'm interested in seeing this concept get support.
http://www.vancouversun.com/travel/Seattle+do...
(Just trying to expand things beyond Black/White . . Either/Or and think outside the box)
Here in Michigan, any move toward a fair and just system of health care that involves people and not how much money they or their employers have is a step forward. Somewhere along the line the dollar got substituted for empathy. I for one would like to have the coverage that any one of our elected politians have at the price they pay for it. After all my life is just as important as theirs. Single payer is a dream for now, too many payoffs have been made, but the public option is a start.
plethora in choices of cars, televisions, gadgets, clothes, etc,
why not Medical Services?
single payer do. Varied supplemental policies are available privately. Like Medicare here too.
The insurance companies can still make money then too.
Even in single payer, costs are an issue. Economies of scale are not to be overlooked. Economies of bureaucracy too. Health providers have to spend so much money filing forms now. The doctors in this plan avoid that, but only by acting like insurance companies and limiting what they cover. Note the requirement to get catastrophic care.
What if a member needs to see a specialist for something that is not common, so no doctor in the co-op can provide that care? Does the required private catastrophic cover it? I suspect not. So even for the consumer this is still pricy, and leaves them still uninsured for complaints that are not mundane, but not catastrophic.
The program will not be large enough to negotiate any other savings based on scale, so it will be relying only on the reduction in billing costs for savings.
The doctor's have less paperwork overhead, but an employer trying to work with them will have more. It is an incremental improvement, and better than the bill currently in Congress at least.
That's exactly the same injury.
A former award-winning journalist and lifelong class warrior, keeping a jaundiced eye on the Washington elite.
I dunno if I've ever seen Brer Rabbit before looking so tan.
Diabolus est Deus Inversus
(9) "I make appointment at Penn (which is now back in my insurance plan, six months later) for a second opinion. The doctor confirms the diagnosis, points out it was actually on the original ER x-ray report (which no one bothered to read until then) and says physical therapy won't do a thing at this point, I need surgery."
At this point you need a Lawyer.
"To me, truth is not some vague, foggy notion. Truth is real. And,
at the same time, unreal. Fiction and fact and everything in between,
plus some things I can't remember, all rolled into one big "thing."
This is truth, to me. "
-Jack Handy
It's like someone who is diagnosed with early onset Alzheimer's when in fact it's the pill regime and the side effects they've been on that's destroyed their mental faculties and neurological integrity.
That has already happened once in my family under the U.S. system. Some places prefer certain brands of medicines. Another side effect of the for-profit motive.
Not everyone can afford a lawyer, especially with mounting and still unknown medical bills.
love to take medical malpractice suits on a contingency basis. They know the insurance co. will most likely settle without a court fight because it is cheaper to pay rather than fight. Whether they are at fault or not.
I think everyone who is currently having a fight like this one should call/email Coburn's office and ask for help. Maybe if 500 or 1000 people contact him he might begin to see the light. If nothing else if this action gets publicity all the better.
Was gonna say, I bet Susie's sad she's not an Okie, and can call upon Sen. Coburn (but NOT the "GUMMINT") for help...
Until the "mean streak" of the 'white majority' is diluted by their decline into a minority.
That's 30-40 years, depending...
we'll just end up with the same overpriced Medical "Products" only marketed and packaged with a populous image.
Then at some point the system will collapse like all the rest of the to big to fail rackets.
That's what I think, too. I sometimes wonder if Canada's "white majority" would have allowed the implementation of a stellar healthcare system if there were more people of color living there. But then I think of Cuba, where a person of European ancestry (Ernesto Guevara) was instrumental in making universal, free healthcare a priority, even though it was a majority Afro-Caribbean population. There's still room for optimism.
"compassionate" part of compassionate conservatism is now history.
Susie,
I feel for you and wish you luck working this out. I've worked in health care for 25 years, most recently at Penn so maybe we'll cross paths some day. Your story sounds familiar. In fact, for all the bad stories people come up with about Canada or England (and its always just those two, never France the #1 rated health care system in the world ) I can counter with many of my own.
I can only say I'm doing my best to try to counter the lies that are really making a dent in people's perseptions about this whole debate. I'm afraid the fear-mongering is working, folks. This is based on the conversations I have every day with patients.
I recommend this article by J.R. Reid, 5 Myths About Health Care Around the World, August 23,2009, Washington Post
Good luck Susie
Do you have any luck getting through to patients who believe all the fear-mongering? I've found in talking to people about this that many Americans can't tell the difference between assertions and evidence, can't distinguish between informed and uninformed sources, don't know a fact from an opinion, truth from lies.
An apolitical American friend of mine knows nothing about the health care debate other than that "Obama's program will require old people to be put to death." This is someone who does not keep up with politics at all but has somehow heard on the streets about the "death panels" and believes it. And my ostensibly liberal haircutter was recently lamenting her horrible healthcare situation, but when I advocated a Canadian or European-style single-payer system, she said, "But then I wouldn't be able to choose my own doctors," even though she'd just told me that her insurance company limited her to doctors way out of her area and that her previous insurance company had limited her so much she had to switch companies, which took a while because she is elderly and has "preexisting conditions." Aaaaahhhh!
He just wants your dead corpse back in his comforting arms that much sooner.
Will Obama's health plan include mental health?
That the repugs will be all for, since they can all be checked in for a nice long rest gratis.
Diabolus est Deus Inversus
I live near at town of 30,000 in costal British Columbia. 1 year ago I had knee replacement surgery.
Here's how it went:
After years of trying different things to repair my very painful knee, my Doctor of 25 years(casual friend, who delivered my son) referred me to a orthopedic surgeon (one of 4 or 5 in town), I waited 12 weeks to see him, He was the sweetest, most willing to talk and explain, general nice guy of a doctor, who is considered a world class surgeon by the local medical community) who recommended an MRI. 12 week wait, drive 150 miles to a fancy big city hospital. Out of there in 45 minutes. See surgeon again, He wants to do one more different x-ray, one month wait. He attends the x-ray with me at the hospital. Puts me on the list for knee replacement. 16 weeks later, get a date for surgery, 4 weeks away. Have the surgery in our local very good, but no frills hospital. Of the dozens of people I dealt with not one was anything less then extremely helpful, friendly caring. My only negative comment would be that the food was awful, but it didn't matter, because I had no appetite for a couple of days. Released in 48 hrs, with weekly physio therapy, a six week post-op visit to the surgeon.
Never once did I see a bill in this year or so. Yes we pay high tax's, but everyone in this country can get health care.
For the general record:
We certainly get to pick our own doctor and clinic. You can change anytime you want. Though we had a family Dr. for 27 years, who retired and we picked a new Dr., who is funny, easy to talk to and willing to explain things, so it's always been easy for us.
You can usualy see your family doctor within a few days. Things often slow down when he refers you to specialists.
General in the office medicine is quick and available. If you have a life threatening situation the system kicks in a move very fast and everything that can be done, is.
The parts in the middle that require specialists and hospitals are slow. If this is something that can wait, it will.
In closing, I can't imagine living a life, raising a family and now getting older without our healthcare system. You can call it "socialism" or anything else, but you guys are crazy not to have it!
...sigh...
State of the Culinary Healing Arts
http://4.bp.blogspot.com/_XU9x8G7khv0/SiWtunz...
It took at least year from initial visit to the surgery? 3mo to see the surgeon, 3 mo for the mri, ? on how long to see surgeon after mri, 1 mo for x ray, ? wait to see surgeon again, 4 mo for wait on list, 1 mo for date of surgery. And how long did it take you to get an appointment with your GP?
My mother in law just had her knee replaced, except for her wanting to wait(she didn't want to go through it in the summer) it would of taken her 2-3 mo. That is in the US with private insurance.
My wife had to have her gall bladder removed, it took under a mo from the initial visit. Initial visit they did an exam, and a sonogram, then scheduled her for the surgery. Again US with private insurance.
My longest wait for an X-ray has been a less than a day(usually and hour or less).
I think you'll find the story a bit less fucking breezy.
me-oww!
Timjoebillybob:
Read the 2nd last paragraph of Hilroy's post again:
"General in the office medicine is quick and available. If you have a life threatening situation the system kicks in a move very fast and everything that can be done, is. The parts in the middle that require specialists and hospitals are slow. If this is something that can wait, it will."
Waiting times are highlighted constantly in the US media with regard to Canadian single-payer health care. It's a valid fact to point out, but misleading without the context of how well the system works as a whole, how cost-effective it is, and how easy and fast it generally is to get basic, common medical services.
I've been in for X-rays twice in the past year. Wait time: zero. I got a scrip from my doc and went to the local walk-in x-ray clinic down the street. Cost: zero, aside from my monthly public insurance premium ($54/month).
Ultrasound, waiting time: zero.
Blood work, waiting time: zero.
MRIs and CAT scans take a little longer. I had an MRI a couple of years ago, for which I waited 2 weeks. Not a big deal - if it had been an emergency, I would have gone right in.
Yup, we wait for joint replacements. Don't pretend that isn't an issue at HMOs in the US - or that insurance companies don't cause needless and lengthy delays in care that rival or exceed what Canadians sometimes endure.
The idea that Canadians line up for everything is a myth, which has become a useful means of distorting the facts about how cost-effective, accessible and efficient single-payer health care is.
You don't like the idea of one single health plan for all, with few private alternatives? Fine - most single-payer systems in the world allow optional private insurance. Every country is different.
But to give you an idea of how efficient single-payer can be, consider this: The biggest province in Canada, Ontario, has a population of 11.5 million people, roughly the same as Ohio. All of them are covered by OHIP, the provincial health plan. Guess how many people OHIP employs to handle the billing for 11.5 million clients? Keep in mind, they are handling the same forms, with none rejected because of 'pre-existing conditions', or other such phony reasons to deny care.
According to a recent article I read (sorry, I don't have the source), OHIP employs 22 people to process billing and pay doctors in Ontario for the care of 11.5 million people.
22 staff members. That's wasteful government bureaucracy for you. The smallest insurance company in Ohio probably employs several times as many people to harass its clients for payment of deductibles.
Yes I read the second part of her comment, in office care is pretty quick in the US also, we do have waits for appointments, but there are also walk in clinics where you are seen without an appointment, I'm sure the situation is the same in Canada.
About the x-rays, yes my wait time has usually been zero also, the one instance that there was a wait was because the Rad tech was off for the day at the clinic(it was late in the day), I could of went immediately to the local hospital, but it was after hours and it wasn't an emergency.
Yes there may be 22 people processing claims, but how many other govt employees are there? In the US we would have a health care "czar" his staff, and keep going down from there. While it may be efficient in Canada I can't see it being so in the US, the bureaucracy would be so bloated it wouldn't be funny, just like other govt ran programs.
And I have stated before that I most likely wouldn't have a problem with a Govt ran public option, if it was wholly supported by premiums and not tax revenue. Like the Postal service.
The HUMONGOUS deficit in the PO? My Little Pony?
Why do you not support premiums for roads, fire, police and public education?
I never understand why you people don't get it. Plenty of Euro countries w/ socialised healthcare. People are healthier, happier, have a higher standard of living than in the US and a longer healthier life span than we do, and less poverty.
They have better healthcare than we do, and pay less for it on the whole, and no one goes bankrupt over medical bills, or has to decide if they buy food for the kids, or pay the outlandish premium on their ins. Like $1100 a mo for a $5000 annual deductible.
ONE THIRD OF MEDICAL COSTS IN THE US GO TO PRIVATE INSURERS. THERE SHOULD BE NO PRIVATE PROFIT FROM HEALTHCARE
Oh wait. Too sensible. Not fucked up and Randian enough for the NRA.
me-oww!
humongous deficit? The PO has been running a surplus the past few years. Yes they have lost 80 mill on second class mail,but that includes having to eat the cost for all the politicians franking privileges which usually go by 2nd class.
http://query.nytimes.com/gst/abstract.html?re...
And by law they it has to pay for itself. Tax funds are not allowed to be used by them.
No, you won't be seeing me in that chain mail now, bucko!
:D
me-oww!
http://usgovinfo.about.com/od/consumerawarene...
And disregard the nyt post that is an old article real old.
that on the Canadian system, Bill Clinton would have had to wait past death to get his emergency heart surgery. No. Really. They are that god damned stupid here. My brother, included. He said I never would have lived long enough to receive cancer treatment.
I explained to him that under the Canadian system, my cancer would have been found about 2 years earlier, taken care of tout de suite, and I'd still be able to work, and not have a bnky on my credit record.
People like this need to experience this first hand, either themselves, or through a close family member or a friend. I actually wish that on these people now. So they see what it's like. It's the only way they'll understand how awful this system is.
Oh and speaking of wait times, I was diagnosed with a t3 tumor (big) on the hairy edge of stage 3 cancer (the metastatic stage), and I had to WAIT 6 weeks after diagnosis to start treatment. So it's not all instant medicine down here either. And in May, I had to leave the ER, because I was to sick to handle the wait time (It would have been over 10 hours, when I had symptoms of an intestinal blockage.)
me-oww!
but why do you think it would have been better in Canada? Except for the bnky? Depending on what type of cancer(and treatment) it is the chance of hitting the recommend 4 week start of treatment can be as low as 30% The 4 weeks starts when the patient is deemed ready to treat. "but according to Dr. Pickles, doctors regard it as that time after which a patient has seen a radiation oncologist and had further tests ordered, and a treatment plan has been devised and agreed upon." So it was 6 weeks after diagnosis, how long after you had visited the oncologist, had the tests done, and had treatment been decided?
http://www.theglobeandmail.com/archives/artic...
http://www.pulsus.com/cddw2009/abs/145.htm
Both are Canadian sites.
It took God six days to create all this. When your time is up, it is up. No waiting. No bureaucrats between you and your Maker.
If Eve hadn't listened to the snake we wouldn't have health troubles or the insurance hassles that go with it.
See Timjoebillybob. If you want to tell a whopper, it is easier to stick with the big one.
“Why would anyone with a functioning brain believe this guy?”
Some guy with an eating disorder
God six days to create all this.
But our politicians aren't gods, although some of them think they are :)
Heck it took Obama 6 mo. to just decide on a dog. But they wanted to ram a 1000+ page bill though in a couple of weeks?
I'll take it, even though that was a half-witted question.
What, in your legions of personal experience with the Canadian health care system, and all your Canadian experience, makes you think it would be worse than this costly pile of FUBARd shite we deal with, I'VE dealt with on nearly a daily basis since July 2001? Tell me about your deep personal years-long experience with uninsured illness, as experienced by some mug Stateside.
Really, Tim etc. How close to Canada are you, and how many countries with socialised medicine have you lived in, or spent a great deal of time in?
I am very close to Canada. I see Canadian news, and if you think they might be covering anything up, there are a couple of fake news shows (This Hour Has 22 Minutes, The Rick Mercer Report) that would have pointed out all this grave shit you seem to be an expert on.
me-oww!
it's incredible to me how many Americans claim to know all about our Canadian healthcare system, especially when many of them have never even left the U.S.
I won't go into all the details of my healthcare issues over the years (I'm 58), but to spotlight...after diagnosis of IBS was scheduled for tests...was a wait time, but my doctor called the hospital (state of the art hospital, no less) to have the tests moved up due to the pain I was in...no problem.
I've changed doctors three times in my life so far...no problem.
Two years ago I was diagnosed with lymphoma...within two months, I had consultations, tests, radiation therapy & (thankfully) given the all clear. All done in two months...and again at another state of the art hospital.
My wallet only went with me because I must present my health card...no other reason.
Why are so many people fighting tooth & nail for the greedy insurance companies in the U.S....I'm truly shocked & saddened.
And I am personally tired of these arseholes who ain't never been nowhere, saying they're "sorry for what you've gone through but..." These fuckers have NO IDEA.
Fuck them. I represent MILLIONS of citizens in the US who got sick w/o healthcare ins. And I am sure millions have suffered a great deal more than I have, and even died, because of this bullshit and the never ending string of smug arsehole apologists for the most regressive shite in the world.
me-oww!
A few weeks ago I wasn't feeling well - as in not being able to walk across the lounge room due to shortness of breath.
I called an ambulance, was taken to hospital, given open-heart surgery and discharged after 10 days. When I left they gave me some medication and a bill (for the pills), and also some referalls for post-op care.
Total $150. No other questions or charges. I'm insured but I did this on the public option as it wasn't elective and there is no advantage to going private.
That's what a real health system looks like. If you're sick you get treated and your ability to pay isn't in question.
Country? Australia. The UK is similar in my direct experience from when I used to live there.
Think about the MILLIONS of hours in lost productivity our labrynth of a system cost the economy. Most of this running around, calling doctors, calling insurance companies happens during work hours. Hourly workers don't get paid while jumping through these hoops. Employers have to make do with missing workers. All for what?
I was in New Hampshire with my family hoping to enjoy a nice weekend at the beach.
My youngest starts to run a fever and seems to be coming down with croup. Not exactly life threatening but should be checked out.
Rather that get myself tangled up in your system (I did have travel insurance), I drove 6 hours back to Montreal to get medical attention for my daughter.
What was required of me? My daughter's medicare card.
Waiting time? 30 minutes to be admitted into the children's hospital emergency (this is quicker than usual I'll admit).
I've accepted medical care in the Dominican republic, Cuba and Italy but I don't think I'd ever try my luck in the US. I don't doubt the quality of care, I just doubt that my interests really matter. All they'll see is a guy with travel insurance and run up the bill with useless medical procedures and tests.
know our system blows, from the sound of it you didn't even try it.
"Rather that get myself tangled up in your system (I did have travel insurance), I drove 6 hours back to Montreal to get medical attention for my daughter."
about the Canadian experience?
“Why would anyone with a functioning brain believe this guy?”
Some guy with an eating disorder
Watch Sicko, TJBB...
Then you may change your tune regarding healthcare.
That is...if you're not a paid troll.
works on commission. Ever since he got a box of golf balls from the McGramps Campaign he realized being salaried would not be the way Galt wanted him to do things.
“Why would anyone with a functioning brain believe this guy?”
Some guy with an eating disorder
Canadian system by reading Canadian sites, and reading Canadian govt./medical associations reports.
And I wish I got paid to sit on the computer and debate. And I haven't received anything from McCain's campaign. And the golf balls wouldn't have mattered too much I don't golf very often. A case or two of 9mm rounds would be a different story. :)
Oh and I missed this in RD's comment.
"I don't doubt the quality of care, I just doubt that my interests really matter. All they'll see is a guy with travel insurance and run up the bill with useless medical procedures and tests."
Most of the Drs. here don't try to run up the bill with procedures and tests, they do it to for CYA reasons, if they miss something no matter how small it opens them up to lawsuits from hell. Even if it wasn't their fault. I could give you my ideas of how to fix that but it would be off topic.
I'm coming to the States next month for a reunion...first thing I did, along with my airline tickets, was to pay for medical insurance.
There is no way I would ever travel to the U.S. without it!!
with the concealed carry permit or the one without?
“Why would anyone with a functioning brain believe this guy?”
Some guy with an eating disorder
If it is a US based company you just threw your money away, you'll be back home before you even get a doctor to see you.???
But how would single payer have been different?
1) The original injury? Almost two years ago.
How was this caused by your insurance? And how would single payer have been different?
2) Because the original claim went through my car insurance as required by law, my health insurance company had no record of the three months of physical therapy. Because they had no record, they would not authorize the MRI until I went through physical therapy. It took me months to straighten that out.
Medicaid requires that you use any insurance you have first, so you still would of had to go through the auto insurance first.
3) Finally get an MRI authorized a year later. Former employer changes his health insurance plan (because the premiums are too high), which affects my COBRA. MRI authorization is no longer valid. Return to "Go," start over.
The change of insurance, you have a point there.
4) By this time, developing painful cysts in the back of my knee from hobbling everywhere. Doctor advises me to ignore it "because it wasn't in your original accident report and the insurance companies might get confused and deny payment."
Again you might have a point there, but why not file it under a different case instead of linking it to the original? To avoid confusing the insurance co.?
5) The Penn Health System (University of Penn) gets into a fight with my insurer over reimbursement and the insurance company kicks them out of their plan coverage. Start over AGAIN.
You might also have a point here, except if Penn got into a fight with the Govt. Penn could of dropped accepting coverage, and I'm not sure but I don't think Medicare has to allow any Dr/clinic into the program.
6) Pick new doctor who turns out to be a little crazy and who's running various money-making scams. Change primary doctor AGAIN.
Sounds like a problem with the Dr. not the insurance.
7) Make first visit to foot and ankle specialist, who tells me it's just a sprain. Gives me shot of cortisone, which makes the swelling go down but causes excruciating spasm in ankle.
See #6
8) Go back to specialist twice. The office is run like a high-speed assembly line and he spends barely five minutes with me. I insist he look at the MRI - he says, oh, you do have a small fracture and a ruptured ligament. Tells me to wear a brace and go to physical therapy AGAIN.
See #6
9) I make appointment at Penn (which is now back in my insurance plan, six months later) for a second opinion. The doctor confirms the diagnosis, points out it was actually on the original ER x-ray report (which no one bothered to read until then) and says physical therapy won't do a thing at this point, I need surgery.
How does this have to do with insurance?
10) She refers me to one of her partners.
See #9
11) When I call to make an appointment, his assistant tells me he "absolutely" won't see any car insurance patients if he has to split the billing. Back to square one.
How would this have been different under a public option? Drs. do not have to accept any patients usually. There are a few exceptions to that but I don't think they would of applied in your case.
12) I keep the appointment I made with the first specialist, which is where today's story begins.
Good luck, and I mean it.
This is well beyond your cognitive abilities.
Don't try to confuse the issue with half-truths and gorilla dust.
argue any of my points, or just attempt to insult?
1). Who said the original injury was caused by the insurance company? It's the fucking starting point: Susie suffered the injury 2 years ago.
2).Susie doesn't have Medicaid, and I don't see her proposing Medicaid for all. The point is Her health insurer didn't take the simple step of obtaining Susie's pre-existing records- physical therapy that hadn't helped a thing.
3). So easy a cave man can get it.
4). The ankle injury caused the cysts. If Susie had the cysts treated but not the ankle injury, new cysts would develop.
5). And in the UK single-payer system this isn't an issue.
6). But the doctor is approved by the insurer, and Susie would still get stuck with the co-pays. Good lookin' out, health insurer.
7). & 8). This is a problem with the doctor, but could be corrected through regulation. As it is, doctors are rewarded financially by treating as many patients as possible.
9). It was her health insurer who didn't accept her x-ray from the auto insurer 2 years ago.
10). Susie should have been sent to this surgeon by her health insurer when her original physical therapy accomplished nothing, but, again, the health insurer treated Susie's case as if she hadn't had any treatment previous to them taking over the responsibilities.
11). First Medicaid, then Medicare, then Public Option...You are the one who keeps bringing up everything but single-payer.
12). Oh, aren't you sweet?
Why do you defend a system that costs so much but doesn't work?
Don't try to confuse the issue with half-truths and gorilla dust.
1) were agreed it had nothing to do with the insurance.
2) I was using medicaid as an example, most of the people who are for single payer, use medicaid as a starting point. See HR. 676? medicaid for all. And medicaid requires you to use other insurance first, under single payer she would of had to have gone through her auto insurance to begin with.
3)I agreed she had a point there.
4)Yes the ankle injury cause the cysts, the Dr. advised ignoring it not because they would re-occur but to avoid confusing the insurance co. I asked why the Dr. didn't advise billing the treatment under a new case.
5)In the UK a Dr. can't refuse to accept govt insurance? I don't think that would quite fly here in the US. At least it hasn't under medicaid(again using it as a existing example)
6)Every insurance I have ever had, had multiple approved Drs. there is a chance of picking a bad one, even under single payer.
7&8) Drs are already regulated. And under single payer there wouldn't be a financial incentive to see as many patients as possible? Or do you think that Drs. will get a flat fee regardless of how many patients they see?
9) the insurance co did not have records of the of the physical therapy, not the x-ray, and it was the Drs. or other health care providers who missed it on the original report. Not the insurance company.
10)She should of been refereed to a surgeon by the original Dr., but I don't remember anything in her blog about how the insurance treating part of the case as if she hadn't had any prior treatment. The part you are talking about is the MRI, not the referal.
11)No matter what you use, how does it effect this? He refused to split billing, a Dr. can refuse to accept a new patient for just about any reason.
12) Yes I am.
Because I don't agree with a public option/single payer etc. under what is currently being proposed.
#2
HR 676 is Medicare for all. Medicaid is a very different beast. So your point is still non-relevant.
You miss a few points in the general track of the argument. Under a single-payer system there is no referral to some other doctor for an arbitrary reason (aka I don't like your insurance). Referrals are up the "food chain" of specialists only, so about 1/4 of Susie's doctor visits under our system were wasteful and expensive.
Under a unified system, there is only one record system. So, all the multiple visits due to someone not having records are also currently wasteful and expensive.
I also, btw, disagree with the currently proposed public option, but unless it is large (closer to single-payer) enough to enjoy the economies of scale that Medicare does, it too will be expensive. Our medical system is already the most expensive on the planet. Much of Susie's story does explain why, but it isn't obvious at first glance.
We have two choices: reform it, or have the inefficiencies take our economy down. The whole system is inefficient. That is precisely why the nationalist systems (and I vastly prefer Canada's national insurance to Britain's socialized medicine for the U.S.) are so cost effective.
Your right, I used the wrong term. But medicare does require that you use any other insurance you have before it kicks in. So she still would of had to use her auto insurance first.
A unified record system would help, I agree. Only problem I might have with it would be privacy concerns, who has access to the records.
This wouldn't have been billed through my car insurance. There wouldn't have been a delay in getting the MRI. And The specialists wouldn't have turned me down because they didn't want to split the billing.
Do you really not understand how all this is connected? Do you really not understand the part insurance and profit motives play in all these problems?
The Penn system wouldn't have had the dispute with the health insurance company because they'd all be part of the same health CARE (not insurance) system.
Each time you change a primary care doctor through an HMO, there's a delay and you have to be processed as a new patient. Not all doctors will accept new patients, I had to find one. With single payer, I could have gone to the very good and highly-recommended family practice doctor a block from my house - and not one 15 miles away in another state, where I don't know anything about them. But he doesn't take my out-of-state insurance.
A former award-winning journalist and lifelong class warrior, keeping a jaundiced eye on the Washington elite.
if we had single payer, you don't think you wouldn't still have to have medical coverage on your auto insurance? All current govt plans require you to use your other insurance first. So there would be no change on that. Heck Obama put forth a proposal that veterans would have to use their private insurance before the govt would pay for treatment for injuries/illnesses caused by service, although that got shot down pretty quick.
And I said you might have a point about that, but Drs. and Hospitals don't have disputes with the Govt over the current Govt plans? And I know of some that do not accept them because of problems with them.
Every time I've changed a primary care Dr. through a HMO or otherwise, I was considered a new patient. And yes there was a delay to get an appointment, how would this single payer change this? And for the Dr who was close to you see below.
And unless you force Drs. and other health care providers to accept the Govt insurance or ban private insurance they still won't have to accept the Govt plan.
Would auto insurance companies want to force customers to use a private system that has a 30% overhead, when they could have customers using a system with a 3-6% overhead?
Single-payer is a boon to auto-insurance premiums and payout!
If only people would see how this was all connected.
nm - edit previous post did go through - double post - Sorry!
Susie would receive coordinated care from the get-go, managed and paid for by the health care regime. The liability of the auto insurer would be handled through the legal process of subrogation ... the government would take an assignment on the claim and be reimbursed up to the limit of the coverage in the auto policy.
Susie shouldn't need to have anything to do with the auto insurer as far as her medical bills are concerned (and I assume it was the other driver's insurance company, under medical payments coverage).
Were talking about the Govt here. :)
"Now, picture this whole thing with single payer. You get hurt, you go get treated. They send you where you need to go - and there are no worries about whether or not they take your insurance. They order the MRI when you need it, and they locate the right specialist to do the surgery. They send someone to check you at home after the surgery, and they cover the physical therapy - without a copay."
I really just can't believe people support this system the way it is, but I guess those people aren't like you and me, they are still riding on that luck. I really could give a shit what happens to the Ceo's, I don't care about their Porsche's, the 500,000 dollar homes, I dont give a crap about them. They should find another way to rob us not the health care.
I think that, if the public health care option fails, all insurance to Congress should be cut off, and treat them as temporary employees, and let them get their own self employed insurance. If I can't have what they have they they can't have it, either! Let them pay their own way. The Goopers sit in their ivory towers with not one lick of common sense and real world experience, just a bunch of gas bags trading opinions.
The insurance companies would just give them sweet deals and discounted coverage without limitations. Better to make lobbying a felony and violation of the public trust a capital offense.
and abolish corporate personhood, and the concept that campaign contributions by corporate lobbyists are free speech.
............off people's life and health!!! Parasites.
I think they should at the very least pass a law to the effects of "No person shall be refused basic health insurance no matter their personal medical history." And there should also be some sort of pricing regulations enforced by government. Maybe eliminate the "in network" and "out of network" bullshit and force any medical provider/hospital to accept whatever form of insurance the person has. I'm not expecting America to completely transform overnight, but that would be a good start at least...
I'm from Canada, but lived in the states for over 6 years. I just moved to the Netherlands and what I understand from it so far:
-Everything is private insurance, but regulated by government.
-No one can be refused for basic care and no one can be dropped... When I say basic care, I mean doctor visits, ER, specialists, prescriptions, etc. The optional care is alternative treatments, massage therapy, chiropractor, covered for injury while practicing risky sports i.e. skiing, scuba diving, etc.
-There's a basic price for your age group for each coverage, not a price based on your history. One of the first questions was my age, I responded 31 and right away they told me that my basic coverage is 86 Euros/month. They didn't ask anything about my history; although I've had no major issues.
I pay 143 Euros per month, but I got the highest optional insurance, dental care and it includes my damage liability (if I would scratch a car while riding my bike for example, lol), apartment belongings for theft, fire, flood, etc. and travel health insurance. It's funny (not really) that typically medical insurance like this covers you everywhere in the World except the USA; because it's so expensive of course.
Although I've only had 1 experience with the Dutch healthcare system, it wasn't bad. I had passed out during a business trip here so I got checked out at the hospital ER before flying overseas to make nothing was wrong. I figured if anything, better caught here than a bad experience 35,000 feet in the air... I saw the doctor within 30 minutes. It was in and out in less than an hour. They didn't charge me on the spot, but they did send me a bill for 135 Euros. That's 135 Euros without any insurance. I think the same at an American ER would be over $1,000!! Technically, I could've gone home and never paid it, but I did. Good thing since I moved here afterwards, lol... I actually had travel insurance, but I still need to file the paperwork to get reimbursed.
i am sorry you have to deal with this. but i admire the heart with which you greet it.
A single payer plan is the only plan that won't bankrupt the US. If you cut out the Middleman ( insurers) we would save 4 trillion in ten years and 50% of the cost of treatment per patient. States have tried the public option and have failed. The only successfull national plans are single payer plans.
I urge you to go to PBS under Bill Moyer or klick on this link
http://www.pbs.org/moyers/journal/08282009/pr... And see what doctors have to say about the biggest cost to healthcare and Medicaid.
True problem is our polititions ..like common prostitutes sell their ass to the highest bidder..we need to correct that before We The Peeps will ever get a fair shake.
I had one of those old-person, not-so-serious skin cancers removed. The dermo said come back in 6 mos. Returned, looked OK, but found another spot. "Should I take care of it right now, as long as you are sitting on the table?" "Sure."
Big mistake. The new "spot" was a new diagnosis, 6 months gone by (missed it by 6 days), and the referral had expired. Insurance Co. says they won't cover it because I should have made an app't with Dr. #1, to get a new referral.
"What!?" says I. I need to go see a Dr. to tell me to see a previously-referred-to specialist who has already seen me and says I need the procedure I am asking to have approved? "No" says the Ins Co. "You wouldn't really have to see the Dr. They usually just give you a referral over the phone."
And, no, it doesn't result in lower costs to get actual medical care accomplished. Quite the contrary. It may save the system money if this sort of runaraound gets the victim to just give up, or better yet, die. But that ususally isn't the case, and that eventuality is far outweighed by cases in which the condition gets worse and more expensive to treat while the dance of cost-shifting goes on. What this system is good at is getting costs off the books of the most ruthless, Oh, I guess I meant to say "competitive", payer. Only the strong survive.
Last summer I went to a clinic about my thumb. They took an xray and determined that I had a bone spur, sent me to a orthopedist. I went to the orthopedist to make an appointment, I was told I would have to wait a month because I wasn't a current patient. Made the appointment for the middle of July. Finally got in to see them they then told me I needed to see a doctor that specialized in hands. So made an appointment with the new doctor, by this time my hand was going to sleep when I slept, it would wake me and had to shake it to wake it. Finally got in to see the hand doctor in August complained about hand going to sleep, gave me a brace and told me to wear it at night, if it still bothered me to give them a call. Thumb still bothering me. Called made another appointment they did a test for carpol tunnel and wanted to do surgery immediately. Made surgery appointment for Oct. I started all of this the the 3rd week of June and finally had something done the 2 week of Oct. And guess what country I live in? NOT CANADA......
Susie - not sure if you're on NJ Family Care or not but it covered my kids as soon as my old work insurance expired (i was laid off in Dec. 08). The strange thing was that after 3 mos. still on the company plan till the end of March 09, the company let me get April for my "old" rate instead of the better, but still exorbitant COBRA rates (something like $1250/month now for families). So of course my daughter has to go to the emergency room in April and we assume it's covered until last week when the ER said that the HC co. said we WEREN'T covered. I contacted my old company and said I have a copy of the check i mailed for April and once again, I was right and my daughter was covered. I have a feeling the issue will pop up again because claims never seem to be settled because there are lab tests, Xrays, prescriptions, follow-ups and on and on...
So this begs the question, WHY THE F(CK IS HEALTH CARE STILL TIED TO ONE'S EMPLOYMENT STATUS? totally absurd. Even when I had insurance there was always a billing problem or a "you didn't get that procedure authorized first" We're too advanced to have a system from the dark ages.
@Thu, 08/27/2009 - 13:11 — noah (I clicked reply under your message...)
No one will be raising your taxes because of the public option, unless you're making over $250,000. If you are making that much, you can afford to keep paying your own way. Private doctors will remain available and will continue to take and prefer cash payments, as they already love to do here in socialist Austria. And many of them do provide better care than the state run sources of care - and besides that the wait time is shorter.
The new system with the public option will be better for those doctors who are in it for the money and have good PR skills, because they can market themselves as private providers of "premium" health care, just like they do here in good ol' socialist Austria. It will become a perfect two-tier system much to the dismay of the people who wanted reform in the first place (just like it is here in Austria - did I already mention socialism?). Costs will go down for all routine doctor visits, but many privately run companies will open up providing "better" CAT scans, MRIs, etc. with little to no waiting time. It's just like FedEx vs. the Post Office...
The public option may end up destroying the health insurance companies, but it will increase competition among doctors and hospitals and improve health care for those who are already well off. At the same time it will provide decent care (similar to current VA standards) for everyone else and finally some health care for those burdening the system - those currently without any health care.
That has got to be worth the 2% tax increase.
My advice is to treat anything orthopedic as an exercise in hoop-jumping. As in, yes "Dr., an operation might be necessary, but can't we first try something non-invasive." Get a referral for OT or PT and head to your local rehab hospital (where you'll probably get a more informed opinion from the OT/PT.) Also: don't be surprised during the follow-up visit when the Dr. can't seem to remember what he told you the last time and/or that his treatment advice is contradictory. The guy is probably seeing what 40-50 people a day, day in day out. That's reality. We can argue about whether it's right or wrong, but that's the system we have.
She said I wasn't getting better, and she thought I might have a bone fragment that was causing the pain. I still think she's right.
A former award-winning journalist and lifelong class warrior, keeping a jaundiced eye on the Washington elite.
I am a nurse practitioner working in a private neurology office that takes LOP's (letters of protection) for MVA (motor vehicle accidents). It is a system that puts people in permanent suspension. Often, the individual loses their job because they are unable to continue working. If they are able to maintain their private health insurance, it may refuse to pay for treatment until the law suit under their MVA is settled. If the patient needs surgery and they are able to find a surgeon that will perform the surgery under a LOP, they can’t find a hospital that will accept the LOP. When the case finally settles, the lawyers are paid first, the physicians that agreed to treat are given a portion of the money they spent to treat the individual and the victim of the accident is often vilified, left with an untreated or under treated injury, and a minimal settlement. This is not the exception; the exception is the individual who is able to get the treatment they need and return or maintain gainful employment.
To put this in economic perspective, the average cost of the anterior-posterior fusion (back surgery) is over $50,000. This does not include the cost of conservative, non-invasive treatment. It does not include the cost of pain management or pre and post surgical treatment. Certainly, there are fraudulent abuses – this is a system that is designed for easy abuse by unscrupulous individuals, insurance companies, lawyers, and medical providers.
When I hear people complain that “socialized medicine” would force people into a prolonged waiting period for treatment - I want to scream. Even if some had to wait for non-emergent treatment they would still be treated. Our current system is to wait and possibly be denied or canceled if you have private insurance or wait and never be treated if you don’t have insurance. No one knows the true cost of a procedure or surgery; no one knows the amount covered by insurance until after it is completed.
I used to work in an emergency room and our goal was to treat the emergency and send the client home – “treat and street”. It is an appropriate goal for an emergency room. If you fell causing a tear of the rotator cuff in your shoulder, after the emergent care and diagnostic tests, you would be sent home with the name of a surgeon – a surgeon that you could never afford without insurance. If you made your living playing the piano, you would be unemployed. I ask all who would deny a public option: What is the cost of an unemployed and uninsured individual to our society?
We need a single payer system for all Americans. We deserve a system that treats our health care needs, not a system that is concerned about their profit margin. We need the option of Medicare for everyone.
lana
Comments are closed on this entry