RE: Before you Vote for Billary? (Full Version)

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MzMia -> RE: Before you Vote for Billary? (2/12/2008 1:40:30 PM)

quote:

ORIGINAL: LadyEllen

quote:

ORIGINAL: MzMia

Is there an age such as over 85, that they refuse to pay for operations?


There is no overt policy of refusing anyone - but there is a system at work which was brought to light whereby the cost effectiveness of treating was assessed, measuring the cost of treatment against the value of the prognosis. Under that system it can be recommended that if the treatment is not going to be cost effective in terms of providing useful extension to life and/or increased quality of life then it should not be provided.

In some ways this is fair enough if we're talking about some situations. For instance, alcoholics needing liver transplants are not likely to receive approval. Elderly patients who are terminally ill are not likely to receive approval for a hip replacement for instance. Its about making the most of the resources available to produce the best outcomes possible within those resources for as many as possible.

But it also leads to some very distressing situations as it seems that the system is predicated against the elderly in some areas - the idea being that their age and the proximity of their likely deaths means its not value for money to provide treatment, and sometimes this is applied even where there is no evidence of proximate mortality for any reason other than age. This is unacceptable of course - the elderly of today gave us the health service and paid in for decades through their taxes. Many end up selling their homes to pay for care. However, as our population ages I think we will see a change in the operation of the value for money system.

E


Thank you so much for answering my question, Lady E.
As someone that will not see the age of 40 again, that bothers me.
I just wonder if I would be the victim of discrimination, because of age down the road.
I have always paid taxes, worked hard and been a good citizen.

I have issues with not being able to get that hip replacement down the road if I need it!
Or my nerve pills, cancer treatment, or whateva.



Wildfleurs -> RE: Before you Vote for Billary? (2/12/2008 4:51:15 PM)

quote:

ORIGINAL: orfunboi

I am confused. Where did your friend go to try and get diagnosed? Was she refused treatment? Did they give her a reason why they would not look at her?


She did not have health insurance.  She did not have the money to pay out of pocket for a doctor and a physical/mamogram until the lump was so large that her husband noticed and made her.

C~



carlie310 -> RE: Before you Vote for Billary? (2/12/2008 7:14:15 PM)

In a former life I worked in medical business offices, either as an employee or consultant.  Many--I'd dare say most--doctors will see patients and put them on "payment plans" of sometimes as little as $10/month.  They are very aware how financially devastating any illness can be to the uninsured.  Doctors adjust off money for people all the time in situations like that.  They can't do it up front at the time of the visit, because insurance companies will cut their reimbursement, but it will happen.  I had patients send me checks every freaking month for "one dolar" because that was all they could pay. . .the patients refused to let me write it off as long as that payment was acceptable. 

Please, if anyone knows of anyone in any similar situation, please have them see the doctor earlier rather than later.  Most doctors actually give a rat's patootie about caring for patients, and would rather see someone for free than read this story online.

Wildfleurs, had your friend been seen and diagnosed here in my state, she would have qualified for medicaid retroactively after her expenses reached a certain point.  I'm insured, relatively well off. . .but when my youngest UM did a stint in NICU, we could have qualified if he stayed for a while.  Didn't happen, but our first night there, the social worker came to talk to us about the bills. 





GoddessDustyGold -> RE: Before you Vote for Billary? (2/13/2008 12:22:42 AM)

quote:

ORIGINAL: carlie310

In a former life I worked in medical business offices, either as an employee or consultant.  Many--I'd dare say most--doctors will see patients and put them on "payment plans" of sometimes as little as $10/month.  They are very aware how financially devastating any illness can be to the uninsured.  Doctors adjust off money for people all the time in situations like that.  They can't do it up front at the time of the visit, because insurance companies will cut their reimbursement, but it will happen.  I had patients send me checks every freaking month for "one dolar" because that was all they could pay. . .the patients refused to let me write it off as long as that payment was acceptable. 

Please, if anyone knows of anyone in any similar situation, please have them see the doctor earlier rather than later.  Most doctors actually give a rat's patootie about caring for patients, and would rather see someone for free than read this story online.

Wildfleurs, had your friend been seen and diagnosed here in my state, she would have qualified for medicaid retroactively after her expenses reached a certain point.  I'm insured, relatively well off. . .but when my youngest UM did a stint in NICU, we could have qualified if he stayed for a while.  Didn't happen, but our first night there, the social worker came to talk to us about the bills. 



This is more true than most people ever realize or will admit (if they do know).  I am so sorry that your friend did not take the buill by the horns and didn't fight for the care she needed when she needed it.  In truth, she probably didn't even need to fight for it.  It was there.  Too many people are poorly educated as to the programs and private help that is available to them.  They just assume that if they have no insurance, but they are not "indigent", they are left out in the cold.  And it is not true.
I do feel that any necessary health care for those who appropriately qualify can be handled at a state level.  The system needs a good overhaul, and the "appropriately qualify" part of things needs to be looked at more closely, but there is no need to throw out the baby with the bathwater.  People need to educate themselves as to what is really happening, and stop being victims when it is completely unecessary.    
 
quote:

ORIGINAL: LadyEllen

quote:

ORIGINAL: OrionTheWolf
Everyone keeps refering to the huge amount of uninsured, and all I am asking is where are they?


I really dont know how many are uninsured, but I get the impression that there are many more who do have insurance and yet cannot access what they need because of policy limitations and exclusions or because of having to pay policy excesses which they cannot afford.

The issue is that some are uninsured - whether because they cant pay, prefer to spend it elsewhere (under a national scheme or state scheme they'd have no choice on this) or are too ill already to qualify, but the wider issue - which from what I understand impacts on almost all, is that even with insurance one is not necessarily able to get the treatment one might need. As such, it affects many more than the uninsured and can affect anyone.

E


LadyEllen, herein lies the conundrum.  I have bolded above.
I have absolutely no confidence that a federally mandated health insurance program will not be the same or worse than it is now with private companies.  Who says or guarantees that we will be able to have the coverage we need, and get the treatments we have paid for (by automatic deduction to "nanny".  We will no longer have the option (except for the wealthy) to shop around.  You pays your money and you gets what they feel like giving.  And believe me,. My experience says they will give Me as little as they can. 
For those who choose not to have coverage, they now will have it (damn it!) via an automatic deduction from their paycheck.  Of course, others who already have insurance because they do not spend it elsewhere will also have to move to this new program  or continue to pay additionally out of pocket to keep a private policy going.  I can't afford it.  I am willing to bet most average Americans cannot afford it.   But they will lose a number of choices since it will now be coming out of their paychecks.  Then we have the rest of those who aren't paying for insurance, can't afford it, and have no paychecks from which a health premium can be deducted.  But they will line up for the same less than adequate care that everyone else gets because everyone is covered for the same thing.  They already have it!  They may get a slightly improved access to more care, but the rest of the people will be settling for less in the name of the "common  good".  It just doesn't sit right with Me. 
Now what will that coverage be?  Here's one example.  Medicare already does not cover an annual mammogram for women. (However, although feminist I am not, men can get that prostate exam annually.)  My mother is on Medicare at 80% and corporate insurance (as a retiree) for the other 20%.  She has the option of transferring her medicare to an HMO (Medicare administrator) which would cost nothing extra, eliminate her deductable, and leave her with a negligable co-pay for the medical care she needs.  But she won't do it.  *shrug*  She is fortunate to have coverage, but she could do better and pay out less.  It just takes a little critical thought.  And I shut My mouth everytime the bills for the leftovers come in and she tries to get all of her "accounting" done, so she can figure out if she is getting screwed or not. 
So, should I settle for less coverage than I have now, because approximately 12% (by whatever is the latest poll?) does not have health insurance?  And why do they not have it?  Do they choose not to have it, or can they not afford it?  We already have "Access" (Arizona) at the state leval and an additional program for Children's health.  I am sure it could use some work, but no one is ever left without care unless they choose to not take the time to see what they can do to help themselves.
I am concerned that too many people are assuming that if "the "government" takes over somehow (outright or managed) that this will solve all these terrible problems.  I am not convinced the problems are that terrible (not to dismiss the personal angst of those who have found themselves caught in the middle), and I strongly feel that we will do nothing but open an entirely new can or worms. 
Overhaul what we have now, and make it more reasonable as to access of the care for those who need it, and make it optional.  No forced enrollment.  Join  the state (or federal) plan if that is what you need and you choose to afford that payment.  Or keep the private insurance you already have.  Frankly, if they can come up with something better than I have now, I would enroll.  But I am not holding My breath, and I won't vote for it or support it until I have more facts, figures and evidence of what the coverage will be.  All I hear over and over is a lot of rhetoric that tells Me nothing but "vote for me, and I will fix this problem".  They had best be telling me exactly how much it is going to cost and how much bang for My buck I am going to get before I give it a thumbs up.  No one has done that yet.  And I probably wouldn't believe them anyway!  [;)]  It always costs this reasonable amount today, but ever so much more tomorrow!  I am truly concerned for all the people I see over and over who will cast their vote because "at least they want a Univesal Health Plan".  Please, please, please, look carefully at what they are and aren't offering with this magical plan that is going to make your life all better. 
I think we will have a lot of disappointed people who currently think that "universal health care" is all that.  
Who am I?  I am a personal responsibility kind of gal.  Who I am not?  I am not a pie in the sky kind of person. 
And, please!  Don't anybody come at Me with the "lame" bit, or the "uncaring" bit.   



SugarMyChurro -> RE: Before you Vote for Billary? (2/13/2008 12:59:22 AM)

It is rare in politics that you get exactly what you wanted right up front. First they moot some good universal healthcare plans, then they moot some bullshit corporate cock-sucking versions that no one likes except the greedy insurers but its all that's left as viable. Then someone wins, and some others also take their seats, and they implement the bullshit corporate cock-sucking version of a universal healthcare plan. Of course it will fail miserably, and what they hope is that people will then give up on the idea and go back to the proper corporate cock-sucking free market plan when the insurers made real money.

But then, as we have our collective toes in the water on this one already we'll probably opt to truly fix it instead and dive in all the way.

That's how politics in America sort of works. And I do think the propaganda machine is starting to slip because you can only make people suck shit through a straw for so long until they realize its not a choco shake. I do see them backpedaling on this Bush/Cheney nightmare they voted in, maybe they can be made to understand how the world really works too.




LadyEllen -> RE: Before you Vote for Billary? (2/13/2008 1:39:42 AM)

Dusty - some good points and some interesting ones too!

Youre absolutely right - universal health care is not without its own problems. As I mentioned before on this thread, the problems of our system (the NHS) are actually not that dissimilar to the problems of your system, and ultimately they arise from the fact that sooner or later resources will run out if they are not managed.

The difference though in terms of universal access and simplicity of access is enormous. If I need to see the doctor, I call and make an appointment - I can talk to the practice nurse immediately if I need to, see a doctor within a few hours if I want to, or see my own regular doctor within a day or so, depending how busy she is. No forms to fill out, no claims to make, no checking of policies or worrying about how to pay.

If I need medicine, I get a prescription and for the standard script charge (£6-50 I think it is - I have a prepay card which makes it about £2-00 a time over a year of my medicines!) I can access a huge variety of medicines of a far higher price than the charge; my medicines for a month cost around £400-00, and depending on the treatments could be higher for others. If I need blood tests (which I need every couple of months) or minor surgery (which they do at my doctor's practice) again, no worries.

If I need to see a consultant, the doctor will refer me and this is where it can get more problematic. Underfunding by the Conservative party (roughly similar to the Republicans) in the health service from 1979 to 1997 means still (despite the huge increase in investment over ten years under the Labour party - roughly alike to the Democrats) that there are waiting lists to see specialists where this is necessary. Although these waiting lists have come down enormously, it can still mean waiting anything from a couple of weeks to a few months depending on what the suspected condition might be. This is where private insurance kicks in here - those with private insurance can at this point opt to see a specialist through their insurance - the next day if they wish. The real kicker is, the specialist one sees though one's private insurance is nine times out of ten the exact same consultant one would have seen through the health service. Important to note is, that national health services in other EU countries which did not suffer the same politically driven underfunding, do not have such waiting lists. There are some good models out there - but they must be well funded, which means all who are able to put in must do so - with no reason for additional private cover to be banned where this cover is thought useful. Total cost to the individual need be no higher than - and for some should be cheaper than, current insurance premia.

E




GoddessDustyGold -> RE: Before you Vote for Billary? (2/13/2008 3:51:01 AM)

Good morning LadyEllen!,
 
You will be getting your dinner soon (1PM?) and I have yet to go to bed! 
I absolutely agree that from everything I read, we in the USA are about equivalent to the UK and possibly Canada also when discussing availability of doctors, potential wait times, and typical things that are capped or not covered.
Here is My situation:
I am part of an HMO plan and My premium is a lttle less than $100 per month.  I have no deductable.  The premium went down about $30 per month 3 years ago, while My benefits increased.  It is holding steady for the last three years.  If I go out of the network, I will pay more.  I have no need (unless traveling and having an emergency, and that is covered as an exception) since the network is huge and there is little to nothing that is not covered in some manner. 
I saw My doctor last week.  The co-pay was $5.00.  (Note that when I have My annual well woman's physical,  I have no co-pay.)  I waited about 3 days for an appointment, but I had no emergency and I chose a time that was more convenient for My schedule, such as it is.    In the past, I have called in the morning in need of quick attention, and I have been seen in a matter of a few hours or less.  In the past year I have had some medical issues that have been worsening.  So I have been referred to a Neurologist.   Again I worked with My current schedule which is quite hectic right now, and I saw him in 4 business days (last Friday).  Co-pay $30.00.  He scheduled Me for some tests.  Two have already been completed, one yesterday and one today (A Somatosensory Evoked Potential Testing and an EEG).  No co-pay.  I am aware that My share of the MRI/MRA will be $150 when I have that.  I do not have word yet on the "Sleep Dysfunction Study" which in scheduled for Feb 21st. (I am, apparently, dysfunctional as to My sleeping habits or abilities, since I am typing this at 4:30AM!)   I am sure I will have to pay something, but I also get to sleep over!  Yippee!  I need some additional bloodwork.  My bloodwork costs Me nothing.  I have regular medication (three of them) I take which costs Me nothing.  There is a cap of $2520 per year (More than $200 average per month covered!), but I do not exceed it at this point, so I am home free on the meds.  One that I am taking temporaily is not completely covered on the formulary, so I pay about $6 every three months for that one. There are 5 pharmacies in My small town, and all five are in the network for this HMO. So I can go to any one of them to get My perscriptions filled.  Therefore, if they want to collect from My insurance company, they had better be johnny on the spot.  Because I can truly go right on down the road.
If I need to be hospitalized it would cost Me $992 for the first 60 days.  Granted I wouldn't want to be in the hospital for 60 days, but even 3 days would be a hell of a lot more than $992!  And there is always that "what if" worry.  
Specialists are $30.  Surgeries are covered with the hospitalization or so I have been advised. I haven't needed any surgery!    ER visits would cost Me $50.  Urgent Care is $35.  I have access to podiatry, dental, vision, mental health, health and wellness education, telephone counseling, hearing, in home nursing, hospice, alternative medicine (such as acupuncture, chiropractic and massage therapy).  I do not need or take advantage of most of these benefits, but they are available if and when I do.  My mammograms are free, as is a male's annual prostate cancer screening.  My flu shot is covered as well as the pneumonia shot I need every 5 years.  If I needed a Hepatitus B vaccine, I would not have to pay for it.  I do not have to pay for a bone mass screening.  I can join a health club for free to work out.  (hmmmm, .maybe that is why they are checking My brain right now!  No work outs! [8D] )
Frankly, when HMO's first came about, I was scared of them.  I was not a part of that kind of insurance system when they first came into being .  And they were a real mess for the first several years.  I opted out of that choice when they were being offered to employees as an alternative health plan.  Cheaper, but not better, with lousy networks and never seeing the same doctor more than once, etc.   But they straightened out over the years when they realized that their customers were not happy and they were going to lose them.  However, at that time, I was in a private group policy with My husband's company since he covered the family and we paid a bit more, but we had the comfort of being on solid ground with the more traditional (at that time) family health policy. 
When My divorce was a final 13 years ago, I was worried about health insurance.  I had a friend who was a phrmaceutical rep and he explained the options to Me, assured Me regarding the soundness of the HMO's (by then they had long worked out all the kinks), and helped Me check out the plans available in My state.  I chose this one, and I have never switched.  The UM's continued to be covered under My ex's group policy.  They had worse coverage than I did, but it was something, and I was not in a position to pick up their health benefits.    I would go to the doctor and pay $5.  I had to take them to the doctor and I paid at least $35 out of pocket and a pretty penny for the medicine if they needed it. 
Maybe I am just lucky in My state.  Each year I go through the new packet and I feel fine.  It could all end tomorrow, or I could die, or the world could end.  But, for now, I am not willing to trade what I have so that 46 million Americans, some of whom are sitting in front of 45 inch Plasma screen tvs and driving 12 mile per gallon SUVS, can have free health care, that isn't really free. 
I can't get past the fact that I would pay more for less, and I just ain't gonna go there!



LadyEllen -> RE: Before you Vote for Billary? (2/13/2008 4:12:40 AM)

Thats the thing though Dusty - if everyone pays in, then there is no reason for what you pay to go any higher than where it is now, and those who choose to spend their money elsewhere and then complain about having no insurance wouldnt have that money to spend elsewhere. Meanwhile, those who truly cant afford or get insurance would have treatment - and it would all be through the same physicians and facilities as now - no one after all, would fund a nationwide building of an alternative hospital system.

I also see no reason why private insurance cant go hand in hand with a national system like we have here. The insurance premium would be very low, marginal in fact, since most of the system would be funded from taxation - the private treatment being used only for speed where this is necessary.

And the insurance companies? Well, I'm of a mind to think they reinsure their possible liabilities in the world market? This way, they get to reclaim some of what they pay out on the "risk" of your health deteriorating. In this case, a group policy "USA Inc" or some such could be presumably reinsured in the same way - so that if a national health system needed to, it could claim back spending through its reinsurance schemes? This would give all those people in the insurance industry something with which to occupy their time and earn a living, within the evolved system.

E



SugarMyChurro -> RE: Before you Vote for Billary? (2/13/2008 4:13:02 AM)

Except that no one else really gives a shit about your particular case.

[8|]

Some things you do because it's good for everyone. I don't gripe about my tax monies going to educate your UMs. No I don't. Nor do I complain about the thousands of other things we do collectively for the good of all even if and when I do not specifically benefit myself.

What if you died? Would the UMs be covered? For how long? With a proper universal healthcare plan you wouldn't even have to think about it.

Welcome to civilization. Leave the your intolerable personal greed at the gates.




GoddessDustyGold -> RE: Before you Vote for Billary? (2/13/2008 5:27:34 AM)

Ya know, SMC, I really didn't direct that at you.  If you cared to read it, that was your choice.  I was directly replying to LadyEllen showing a comparison to what she was giving examples for as to her coverage.  And, if I am not mistaken, I have seen a figure of what she pays to the NHS via taxes and it is much more than the less than $1200 per year I pay privately right now.  In addition, it seems she also elects, and can afford, to pay for an additional private policy if she needs something quicker or it is not covered by the NHS. 
When My UMs were in shcool, I was paying property taxes like everyone else.  They are no longer in school and I still pay for it.  It is mandated and the system was already in place.  (Like most things governemnt, it started out as a fine thing for all concerned and turned into the pile of sh*t we have today).  When I was unhappy with the education they were getting and elected to remove them, I did not get My school taxes back, and said not one word.  It was the established system for the largest percentage of Americans, and I sucked it up.  I could not afford a private school, but I did invest each year in a private curriculum and taught them Myself.  And they are very well educated! 
A Universal Health Plan is not an established system to benefit the majority of the population at this time.  Most people have insurance, but they are unhappy because it may not cover everything the want or need, medical care is too expensive and the premiums are often more than they care to afford.  I am lucky! I admit it!  But I have to wonder how many people are not aware that they might have more options that they realize?  Everyone can't be a sole proprietorship stuck with the most expensive plan. 
If I am unhappy with the state of American schools, I can't imagine that I would be pleased with turning over My very health to the "government".  Not to mention all the additional personal information they could start databasing about Me.   I don't feel like paying more in taxes for health insurance that I am sure will lower the quality of care I have now, when the people who cannot afford it already have access to healthcare paid for with tax dollars.  It may not be a limosuine, but they are not going to do without unless they choose to be uneducated nad become a "victim".  . 
Spare Me your "doing the right thing for all concerned" speech.  You go to your church and I'll go to Mine. 
 
Edited to add:  My UMs are grown adults now as you would know if you ever absorbed any of the things I write of, or even if you had attempted to comprehend the post you are slamming.  Yes, they would have been covered by their father, and if he died, they would have been covered in another way.  Most likely all the social security benefits he paid in for oh so many years.  For a few years they would have had some extra help from "that collective".  That is how that system works.  And I would not have been opposed to accepting back what was his (and theirs) anyway.  It is called taking personal responsibility, as opposed to looking to the collective to take care of your most basic needs. And the basic needs are taken care of by " the collective" for those who cannot take care of it any other way.   I am not greedy.  I am practical and I have worked hard to find the best I can for Myself and My family, without assuming that "the collective" should share in the costs. 
And what do you mean that you don't give a shit about My personal case?  Isn't "the collective" supposed to care about everyone?  Or is it that My personal case does not fit in with your preferred anectdotal information about those who haven't figured out another way to stand up and get what they needwithout crying to nanny? 
 I have less than most, and more than some.  I am okay with that.  Why aren't you? 



GoddessDustyGold -> RE: Before you Vote for Billary? (2/13/2008 6:26:42 AM)

LadyEllen,
 
This is where I disagree, or perhaps I should say have have no confidence.  Everyone will not pay in, or they will pay in on the typical sliding scale if they have a paycheck or report income that is taxed under the current system.  I also realize that I have it pretty damn good, but I have a feeling that there are plans out there that people might be able to find, but they take what is offered and then bitch and moan.  They are lazy and prefer to be victims.  I see no difference with a National Health Plan.  I am already part of a large group in the private sector.  I am doing well with that plan. 
The bloat in our federal governemnt is unbelievable.  People are screaming all day every day about how the rich get richer and the poor haven't the chance of a snowball in hell.  "Make them pay more taxes" they yell!  Yet the wealthiest people are already paying most of the collected taxes.  It's still not good enough.  It's still not fair.  This country was not created to be "fair",.  It was created to give everyone equal opportunity,.  That does not mean that everyone should be able to buy the cadillac they want.  It means they have the equal opportunity to go out and make the most with what they have available, that they have choices and make wise or bad decisions and then reap the reward or the consequences of that decision. 
I am sure the rich, according to the average joe, will not be paying enough to suit them, and they (average American) will still be paying too much to get the same or less coverage than they have now.  For some, those currently dependant on our social welfare programs, the care may improve (in some states).  For those who are not paying anything now, and not on welfare, they still get free care at any county hospital or clinic, as well as private free clinics.  No emergency room anywhere can turn away anyone who needs care.  That still isn't good enough for the "bleeding hearts".  They must have better care.  We must make everyone equal.  So they will lower our standard of care while raising their standard of care, but it is for the common good, so we should all be happy about it.  That is not what equality is about. 
I am telling you right now that the same people who are complaining and want this plan, will be the very ones who will start screaming and yelling if they expect to have a perfect little life with anything they need healthwise and find out that it just ain't gonna happen.  We will pay more for less.  I will never believe that I would have the same coverage for $1200 per year.  SS tax is 7 1/2% to the individual and is matched by the employer.  Or a self employed person is to pay 14% "self employment" tax.  That's a set in stone deduction or required quarterly payment to the IRS.  Yet we hear complaints all the time about how the social security system is in a mess and it's going to go broke.  More taxes!  More taxes!   With the costs of medical care (set by Medicare, by the way) I will never believe that they can give Me the same coverage, and manage it well, or have it managed well, for less than 3% of My gross income.     I could lose it tomorrow.  My prem iums could go up next month or next year.  But I, at least, have choices and can shop around if it gets out of hand.  If the government is in charge, and they don't have enough, they will borrow more, and raise taxes to cover it, and I have no place to go.  I have to pay the taxes, but I can't afford the additonal private policy to cover My ass.  I am probably very typical in that instance.  I am sure most Americans are not and would not be in a position to maintain supplemental policies after they are already paying for a required national health plan.  The very reason most people retire broke in this country is because they either do not bother to save (we are not rewarded for saving) or they cannot afford to as they are already, supposedly, paying a percentage of their income into social security.  Which will not net them enough, upon retirement, to more than barely scrape by.  But they spent an entire lifetime consuming and enjoying things not completely necessary, with no real thought to the future.  Gotta have those "doodads"!    97% retire in this predicament!  So why do we assume that they will be able to afford two health plans? 
I do understand where you are coming from, and I agree with the idea of a collective spreading out the costs.  You are used to the NHS as it is pretty much all you have ever known, from what I gather throughout your posts.  I just believe that the private collective I choose, as I still have that choice, is doing a more than satisfactory job for Me as it stands, and I don't want to rock the boat and turn it over to a government that has already proven, time and again, that they can't manage "our" money. 
I have no faith in our bloated beauracracy.  And I cannot vote for anything that gives the federal government more power than it has already taken.  



Wildfleurs -> RE: Before you Vote for Billary? (2/13/2008 9:32:25 AM)

quote:

ORIGINAL: carlie310

In a former life I worked in medical business offices, either as an employee or consultant.  Many--I'd dare say most--doctors will see patients and put them on "payment plans" of sometimes as little as $10/month.  They are very aware how financially devastating any illness can be to the uninsured.  Doctors adjust off money for people all the time in situations like that.  They can't do it up front at the time of the visit, because insurance companies will cut their reimbursement, but it will happen.  I had patients send me checks every freaking month for "one dolar" because that was all they could pay. . .the patients refused to let me write it off as long as that payment was acceptable. 

Please, if anyone knows of anyone in any similar situation, please have them see the doctor earlier rather than later.  Most doctors actually give a rat's patootie about caring for patients, and would rather see someone for free than read this story online.

Wildfleurs, had your friend been seen and diagnosed here in my state, she would have qualified for medicaid retroactively after her expenses reached a certain point.  I'm insured, relatively well off. . .but when my youngest UM did a stint in NICU, we could have qualified if he stayed for a while.  Didn't happen, but our first night there, the social worker came to talk to us about the bills. 



I don't disagree with you one bit in terms of many doctors being flexible and willing around seeing people for physicals.  But there is still medication, tests, and treatment which the pricing is out of the individual doctors hands (I've found that personally to be true at least).  I've almost always had health insurance, but in between jobs I did find my doctors were very clear about being willing to see me no matter my financial situation and also giving me free samples (which is why I've stuck with the same doctors).  Unfortunately she didn't live in my state when this happened (nor did she live in your state). 

quote:

ORIGINAL: GoddessDustyGold
This is more true than most people ever realize or will admit (if they do know).  I am so sorry that your friend did not take the buill by the horns and didn't fight for the care she needed when she needed it.  In truth, she probably didn't even need to fight for it.  It was there.  Too many people are poorly educated as to the programs and private help that is available to them.  They just assume that if they have no insurance, but they are not "indigent", they are left out in the cold. 


Nice assumptions about what she did and did not do (and also at what was or was not available in the state she lived in) - which is precisely why I hesitated at even mentioning a personal and recent experience.    Definitely my last post on this thread.

C~



GoddessDustyGold -> RE: Before you Vote for Billary? (2/13/2008 10:05:17 AM)

quote:

ORIGINAL: Wildfleurs

quote:

ORIGINAL: orfunboi

I am confused. Where did your friend go to try and get diagnosed? Was she refused treatment? Did they give her a reason why they would not look at her?


She did not have health insurance.  She did not have the money to pay out of pocket for a doctor and a physical/mamogram until the lump was so large that her husband noticed and made her.

C~



I am truly sorry if you were offended.  You are right that I drew a conclusion.  Since you simply stated that she had no insurance and no money available to pay out of pocket that it took until her husband noticed at the point her lump was so large and then he made her seek treatment.  I took that to indicate that she did not seek treatment, since her husband made her when he finally found out.  And I assumed that the situation hadn't changed...there was still no insurance or money for out of pocket?  Yet it got done...but too late?
I am sincere here...it is a shame.   



carlie310 -> RE: Before you Vote for Billary? (2/13/2008 11:16:05 AM)

Anecdotally, it wouldn't be many doctors--it would be every doctor I've ever worked with.  And hospitals as well as labs and even within the last couple of years big pharm are making more of an effort to work with the under-insured or un-insured.  From a very cold-hearted viewpoint, it would make poor business sense to cut off that segment of the market. 

I read your post the same way that GDG did--that your friend hadn't sought out medical care.  If she looked for resources and didn't get help finding them or was turned down for medical care, that's horrible, and I firmly believe that whatever state she was in should have a better system in place for helping those in her situation.  But that's the governmental body to handle it--not the federal one.  (See my first post on this thread--national health care violates the 10th amendment.)

I forgot to add earlier that I was sorry for your loss.  Having this debate on a national level probably adds to your pain, if that's even possible.  I hope you don't still regret posting on this thread, as it's important to remember that every statistic has a name and a face.  Maybe someone will read this part of the conversation and realize that getting medical help & fighting for your options, possibly going into bankruptcy is a better option than ignoring what could be a life-ending disease--and if they do, that's someone you've helped by sharing your story.



SugarMyChurro -> RE: Before you Vote for Billary? (2/13/2008 11:26:48 AM)

There are many things that I as an unmarried and childless member of society don't benefit from one jot. It doesn't stop me from being interested and supportive of the welfare of others that do need the services from which they benefit. If you take a different political approach all you are doing is rejecting the fundamental purposes for which we even organize ourselves into societies as we do: the general welfare of others. It's in the preamble of the U.S. Constitution.

But I can't fault you for protecting what you perceive as your own interests. Hell, that's better than most Americans manage.

And I won't go into details about it but I get low-cost and excellent dental services. In other areas I might wish for more coverage but its not really an issue as I am in incredibly good health and always have been. The people that are close to me are generally well covered themselves. Cost is a factor, but people pay to their comfort level.

But none of that is the point anyway.

I expect, as I think LadyEllen has already indicated, that coverage over and above the basics in a universal healthcare setup would probably be available anyway. What people resist is change. But that change is coming however long it takes. We can do it right, or we can hamper ourselves substantially by clinging to outmoded business models of "how things have to be" or "how things have been."

I have mentioned more than once on this topic (while not specifically in this thread) the notions of personal health catastrophe, pandemic, and costs to employers. The way we have this set up now makes very little sense both strategically if you really care about the overall health of our society and economically if you care about employment levels and a robust marketplace.

Right now there are several big business areas that just sponge from the U.S. economy and our politicians are generally in bed with it all and perpetuate it - the health insurance industry is one of the bigger sponges. If you abhor corporate welfare as much as I do - and any decent fiscal conservative should - then you have to be against the waste represented by the health insurance industry.

We are propping up a wasteful business model for the benefit of some very few members of society. The insurers are a middleman we don't even need. I say that for the good of society they must be reduced or eliminated in that role.

And that's exactly how I'll vote, even if I am not in love with either Dem candidate.




DedicatedDom40 -> RE: Before you Vote for Billary? (2/13/2008 11:44:44 AM)

We have reached the sorrowful point in our private system because of the influnece of money in politics.  If anyone is going to stand up against government run healthcare, they have to equally stand up against money in the political system that tilts the playing field in favor of corporate agenda.

A businessperson who is unskilled in the medical sciences has no right to trump a doctor's determination with regards to medical necessity.  And any doctor who provides the medical expertiese for that purpose should have their license pulled for failing the oath of "Do no wrong to patients", because every stroke of the pen they make to deny treatment to patients and generate financial savings to the HMO is precisely doing wrong. And yet we have precisely that situation in our private system.  This need to do well for the stockholers is trumping the fundamental purpose of insurance in our overall system.

Just like our foreign policy that has been hijacked by political extremists in this country, the same can be said for our economic policy. It, too, has been hijacked by extremists, and our healthcare costs are a casualty of the hijacking.

When we were a nation of $30/hr jobs which actually built and made things in this country, we were content with a 5% return on our passbook savings account (and our industrial production could absorb paying such dividends). Now, we dont make a damn thing, we just barbarically "consume" through debt and extraction of housing equity, and as a nation of armchair investors in early retirement we expect 20% returns from just sitting on our asses. Those numbers simply dont add up in the long term, we simply dont have the industrial base anymore to support such unwarranted earnings expectations, and recklessness is in the air. The only way to pay these new dividend demands is the wholesale replacement of $30/hr workforces with $3/day workforces. Globalization is simply being used to financially prop up the multi-nationals which feed the dividend appetites of such financial extremists. With globalization comes the loss of employment, and the loss of insurance coverage.

I dont think a private system is "broken" just because its private.  Its the "broken capitalism", this expectation of something for nothing, that has taken over our economy as a whole.  It's what a good system has evolved into and not the system itself, thats the problem. To me, medicaid and mediwhatever isn't socialized medicine and it did fill a need. At one time, yes it did. Private/grp insurance did it's own part and yes it did too. But it all seemed to have broken down with the advent of HMOs.  Providers see the insurance money as "more revenue to buy more equipment with", lawyers see it as a gold to mine, laid off factory workers see a new career in nursing as higher paying government-funded job, and nobody seems to know how to make the system honest again. We all want the same thing in the end and that is a system that is accessible and affordable and accountable. I don't think you can find any satisfaction in fixing the system until the insurance money is seen for what its meant to be and not something to pad the pockets or beef the staff or gold to mine.







carlie310 -> RE: Before you Vote for Billary? (2/13/2008 1:00:27 PM)

To be accurate, the Preamble says that the Constitution is set up "promote the general Welfare."  The meaning of the word has shifted slightly during the intervening years; the writers of the Constitution were concerned with the welfare of the country as a whole.  This phrase does not mean that the federal government has the obligation to care for each citizen, to provide a chicken for every pot, a cure for every disease, housing and shelter for every storm victim. 

To imply that the framers intended that phrase to be expanded to include a federally managed universal health-care is simply wrong.  This country was founded on that different political approach of individual responsibility that you seem to marginalize. 

I am not disagreeing that there are problems in the industry.  But I don't believe for one moment that government involvement is the savior. 



carlie310 -> RE: Before you Vote for Billary? (2/13/2008 1:03:27 PM)

quote:

ORIGINAL: DedicatedDom40

Providers see the insurance money as "more revenue to buy more equipment with",



Please clarify this statement.  Most insurance money paid to providers goes to things like payroll, rent, and yes, some new equipment.  It's payment for a service rendered, just like paying the auto mechanic pays for his time, equipment and expertise.

I'm just not seeing the problem here. 



DedicatedDom40 -> RE: Before you Vote for Billary? (2/13/2008 2:29:22 PM)

quote:

ORIGINAL: carlie310

It's payment for a service rendered, just like paying the auto mechanic pays for his time, equipment and expertise.

I'm just not seeing the problem here. 



That type of comparison is EXACTLY the problem.

Caring for a person's health is not the same as caring for a person's car.  And the medical industrial complex shouldnt be run as if it does. People who are into healthcare should be into it for very different reasons than why a mechanic becomes a mechanic.  The fact that providers do treat the money element just like a mechanic who views income as a way to buy that new wrecker, IS the problem. Too many in healthcare have been blinded by the finances. Too many newbies flock into the industry now, as some sort of high wage government-funded employment safety net. These same people wont go into government-funded teaching roles, because they dont pay as much. Their reason for being in healthcare is totally (and inappropriately) focused on the dollar, and thats not what service in the healthcare industry was historically about.

And thats not how healthcare is viewed in the socialized systems either. Here's a news piece by Alan Greenspan promoting the relaxation of immigration laws to flood the medical staffing market with lower cost immigrants to bring US costs down to european levels.

http://www.usnews.com/blogs/capital-commerce/2007/3/16/greenspans-inequality-fix-free-trade-for-lawyers.html#read_more

Pretty soon, if the industry doesnt re-grow that non-financial conscience that it used to have, it just might be out of their hands as we take drastic steps to financially save the republic from debt-related self-destruction.

This piece on David Walker, the Comptroller General of the US (the nations top accountant), lays a good portion of the blame on helathcare costs.

http://www.youtube.com/watch?v=OS2fI2p9iVs




LadyEllen -> RE: Before you Vote for Billary? (2/13/2008 2:31:36 PM)

quote:

ORIGINAL: carlie310

To be accurate, the Preamble says that the Constitution is set up "promote the general Welfare." 

(snip)

To imply that the framers intended that phrase to be expanded to include a federally managed universal health-care is simply wrong.  This country was founded on that different political approach of individual responsibility that you seem to marginalize. 



Perhaps, but when the Constitution was framed, the general welfare of the people did not include education for all but did include slavery for some. Yet both those instances have been reexamined.

To follow the individual responsibility theme as you see it (and as indeed the constitution may intend - but it is an old document now), it is unconstitutional to have education, to have standing armed forces, provide public roads or have recourse to a police force. To pursue it further, it would not be beyond the realms of possibility to justify the enslavement of those unable or unwilling to fulfil the requirement for individual responsibility; bankrupt? then we'll sell you off to settle your debts.

Individual responsibility is important - its vital in fact to the proper functioning of the greater society; each is individually responsible to fulfil his obligation to be entitled to the benefits of the society. Perhaps then, the question is really about what benefits one would wish to derive from society, and whether one is willing and able to fulfil one's obligation.

That many people do not have school age children and yet contribute towards education, is indicative that the people see that the benefit of education to the society in which they live is important enough for them to undertake individual responsibility to pay towards it.

I really do not see how anyone, even those blessed with perfect health, could not see healthcare in the same light. If it is an individual responsibility to fund the education of someone else's children so that the society is improved for all, then surely it is an individual responsibility to similarly contribute to healthcare to the same ends.

E





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