Health Insurance

[Trumplestiltskin 5,791]

Its also a fallacy that the more money you have, the better off you'll be healthcarewise. That might be true for Donald Trump, but it isn't to someone on a high middle income ($100-$150K).

There are very real stories of people losing their savings, homes and credit because of healthcare expenses. That's outrageous.

That actually happened to my cousins cousin, who lives here a decade ago. Something happened to their insurance policy while they had an auto accident. They ended up having to pay over $100,000 in medical expenses.

I always thought it must be their fault or that they were not responsible enough to have the appropriate policy, now I can see they where simply screwed.

As I said this is where McCain's plan fell flat. He offered the illusion of choice - but it still meant that people have to scour 1000 page books of legalese looking for levels of coverage, conditions covered (and how much) etc.

Picking a plan is pretty much pot-luck - and how can you know at the outset that the treatment for the unforseen condition that you later develop will be covered?

If anything it encourages you to lie to the doctors - because if you say "I've had this on and off for two years", you'll be pre-existing conditioned for it.

[JimandChristy 1,689]

Michael Moore's Sicko does a pretty good job of establishing how much of a rip-off the private health insurance industry is, and how it screws its customers on a daily basis.

When I watched Sicko it really shocked me by just seeing the stories of the people who could not receive medical treatment because their insurance companies did everything in their power to deny them care. OK Moore may have twisted some stats or exaggerated in some parts but you cannot deny the most important part out of that film was the human story. It seems to me Americans have been indoctrinated into this paranoid fear about universal healthcare for a very long time and its stuck.

Thousands are dying out there every year and all of this in a democratic, Westernised country, unbelievable.

Edited May 7, 2009 by JimandChristy

[Heracles 417]

Well Obama has already said that he isn't going to ditch the private health insurance industry.

He's not proposing anything more than papering over the cracks of what we already have.

It doesn't need ditching just regulating. Either they abide by a set of rules and standards or they quit the business.

The government absolutely must buy or build their own hospitals, to operate at cost price. This will bring the much needed competition to the industry. Instead of the cable like one or two provider monopoly per region.

Edited May 7, 2009 by Constellation

[Heracles 417]

If anything it encourages you to lie to the doctors - because if you say "I've had this on and off for two years", you'll be pre-existing conditioned for it.

That should be the first change. All pre-existing conditions should be covered. Furthermore, people should not be discriminated against because of this. Be it in the form of additional fees or simply poor service. Stuff like this is what the government can and should be regulating. This would be a a no-brainer abroad. Both lefties and conservatives would riot in AUS if the most vulnerable and disadvantaged were discriminated against.

Edited May 7, 2009 by Constellation

[Trumplestiltskin 5,791]

Michael Moore's Sicko does a pretty good job of establishing how much of a rip-off the private health insurance industry is, and how it screws its customers on a daily basis.

When I watched Sicko it really shocked me by just seeing the stories of the people who could not receive medical treatment because their insurance companies did everything in their power to deny them care. OK Moore may have twisted some stats or exaggerated in some parts but you cannot deny the most important part out of that film was the human story. It seems to me Americans have been indoctrinated into this paranoid fear about universal healthcare for a very long time and its stuck.

Thousands are dying out there every year and all of this in a democratic, Westernised country, unbelievable.

Its actually very true - when I had to have a Lymphoma biopsy in '05, my (then) co-workers were appalled that I was even considering the surgery and suggested that if they were me they'd take their chances.

Same thing with my friend who had the stroke - he left hospital within 36 hours against the advice of the doctors. Bought a box of aspirin and went to see his GP instead...

If anything it encourages you to lie to the doctors - because if you say "I've had this on and off for two years", you'll be pre-existing conditioned for it.

That should be the first change. All pre-existing conditions should be covered. Furthermore, people should not be discriminated against because of this. Be it in the form of additional fees or simply poor service. stuff like this is what the government can and should regulate. This would be a a no-brainer abroad.

Morally/ethically they shouldn't be - but this is a cornerstone of how the health insurance industry works.

"Your coverage starts on this date, anything that happened before that date isn't our responsibility"

From their point of view it would be like claiming for a car accident that happened before you took out a policy with them.

It has a logic to it - but its totally against the ethos of "healthcare".

Edited May 7, 2009 by Private Pike

[TayRivers 4]

I have MS and my drug bill each month is $2756.87. My medical insurance will not cover the MS drugs until there is a generic available so I have the choice to pay for the drugs myself or become so disabled I will have to stop work and claim SSDI and that would mean losing my home and everything I have worked hard for over 30 years.

[w¡n9Nµ7 §£@¥€r 123]

Well Obama has already said that he isn't going to ditch the private health insurance industry.

He's not proposing anything more than papering over the cracks of what we already have.

It doesn't need ditching just regulating. Either they abide by a set of rules and standards or they quit the business.

The government absolutely must buy or build their own hospitals, to operate at cost price. This will bring the much needed competition to the industry. Instead of the cable like one or two providers per region.

There are three hospitals within a stones throw of my home. One is for-profit and private. That one has good doctors, bad nurses and a billing department full of snakes. The other two hospitals are both university hospitals, one catholic and the other state-run. Both university hospitals have good doctors, amazing nurses and both billing departments are nice to deal with. Of the three, the state-run hospital is routinely ranked the highest by most measures. The catholic hospital is a close second, the private facility never makes it into any rankings at all.

All that said, it's no surprise that patients prefer the catholic and state-run hospitals to the for-profit one. You can tell when you enter, the private hospital is a ghost-town compared to the other two.

Personally, I prefer the catholic hospital because parking is more convenient

From their point of view it would be like claiming for a car accident that happened before you took out a policy with them.

It has a logic to it - but its totally against the ethos of "healthcare".

Yup, from a purist insurance POV it makes perfect sense.

Which is precisely why the insurance model is such a bad model for healthcare.

[JimandChristy 1,689]

Well Obama has already said that he isn't going to ditch the private health insurance industry.

He's not proposing anything more than papering over the cracks of what we already have.

It doesn't need ditching just regulating. Either they abide by a set of rules and standards or they quit the business.

The government absolutely must buy or build their own hospitals, to operate at cost price. This will bring the much needed competition to the industry. Instead of the cable like one or two providers per region.

Absolutely, regulation is the only way to stop insurance and pharmaceutical companies milking/bleeding money out of their customers. Under the current system they can charge what they want and I might have mentioned before on here, a small bottle of Cleocin (which is used to treat pneumonia cost $500 in the USA), in England cost you what £6.50 and where I live in Wales no charge.

Wasn't it one of the 9/11 volunteers on Sicko who was being charged $120 for an inhaler for her lung condition but when they went to Cuba the same inhaler only cost 5 cents.......daylight robbery and its a disgrace.

[Heracles 417]

I have MS and my drug bill each month is $2756.87. My medical insurance will not cover the MS drugs until there is a generic available so I have the choice to pay for the drugs myself or become so disabled I will have to stop work and claim SSDI and that would mean losing my home and everything I have worked hard for over 30 years.

It's a bloody disgrace. How can they justify that?

Speaking of ridiculous drug cost. A family friend of mine recently told me how she went to buy an acne cream prescribed by the dermatologist but didn't buy it because the insurance did not cover it. She is a teacher and cannot afford it. So I asked how much does it cost? $200.00

I had a look for the same cream from a pharmacy in Australia. $21.95 which includes tax

[Trumplestiltskin 5,791]

That's common - there are actually TV ads showing people queuing up at the pharmacy and paying wildly different amounts of money for the same thing.

Shows how "normal" it is.

I've heard the reasoning for the high cost is that the drugs are mostly researched and manufactured here - so we're essentially paying the premium for that (while other countries subsidise).

Of course it doesn't explain why drugs researched and developed overseas are subject to huge price mark-ups.

Edited May 7, 2009 by Private Pike

[trailmix 77]

I have to say though, while the whole insurance industry here is corrupt - the doctors do have to take some responsibility.

I guess they are just used to people paying ridiculous money for insurance, therefore there is very little 'low-key' medicine practiced.

Example. My Husband had a swollen foot last month, so he went to a clinic. The first thing they did was 2 x-rays. Then they did a blood sugar test. Then he saw the Dr. who said it might be gout (doubtful). They booked him in for an ultrasound for the following week.

He got 2 different kinds of pills. His foot is now fine - who knows, maybe it was a bug bite. We cancelled the ultrasound appointment. (We paid for all this by the way - our insurance has a very high deductible)

My point is, in Canada, he would have been given the pills first, he would not have had the needless test and the 2 x-rays unless it didn't improve over a week or so.

Edited May 7, 2009 by trailmix

[Trumplestiltskin 5,791]

There are doctors who take the ethics of their job seriously and will (so far as is possible) battle with the health insurance companies to give a patient the best treatment.

But given that the different health insurance companies have vastly differing plans, levels of coverage and general rules - it necessitates Doctor's practices having these huge numbers of admin staff to manage the bureaucracy.

[Heracles 417]

Heck we don't even get our medication (tablets) in factory sealed blister packs here as we do abroad.

I remember the first prescription vial I saw here and was like ####### is this povo stuff.

PS I forgot to mention that for another $20 they would UPS the cream here. So for $41.95 you get the same cream delivered to your door, that you would pay $200 for here.

Edited May 7, 2009 by Constellation

[w¡n9Nµ7 §£@¥€r 123]

But given that the different health insurance companies have vastly differing plans, levels of coverage and general rules - it necessitates Doctor's practices having these huge numbers of admin staff to manage the bureaucracy.

One of the features of the Wyden plan (which there was a thread about some weeks ago) was to require all insurance companies to provide the same level of coverage with the same rules as the current BCBS plan for Federal employees.

[Heracles 417]

Better get back to work. God help me if I am fired and then get injured.

Actually I shouldn't be laughing at all.

I'd rather I receive all health care money both I and my employer pays in cash. This way if I am ill, I can fly to AUS and receive both treatment and a holiday, without having to worry about what is or is not covered.

Edited May 7, 2009 by Constellation