The Best Health Care System in the World? (Full Version)

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dcnovice -> The Best Health Care System in the World? (4/4/2012 4:49:38 PM)

We've heard a lot about health care in recent years, and one of the concerns raised about the ACA was that it would destroy the world's best health care system. (Washington Monthly provides a few examples of soundbites along those lines.)

I've been thinking of that soundbite/meme a lot lately, because I've been having insurance adventures. They seem to be tied to the advent of my latest insurance card. It's the same carrier I've had for more than a decade. I did switch jobs in that time, but that was back in 2009.

Anyhow, since getting the new card . . .

-- My copays have gone up. One more than tripled. That meant a time-wasting call to the insurance company, who said they had no record of my ever taking the drug before. (I've been on it for at least two years.)

-- I suddenly needed a prior authorization for my insulin, which I've been on for four years. That took several calls to and from the endocrinologist's office.

-- I attempted to purchase a routine replacement for my sleep-apnea mask, which I've replaced three or four times before. This time, the insurance company needed not only a prescription from my GP but a copy of the original sleep study, done in 1999. That's meant several calls so far, and I suspect it will take quite a few more before the issue is resolved.

Through all this BS. I keep thinking, "And THIS is the system some of our politicians have sworn to die defending?!"

Anyone else have similar experiences with "the best health care system on Earth"?






SoftBonds -> RE: The Best Health Care System in the World? (4/4/2012 5:29:28 PM)

You mean the "best system in the world" that has outcomes that make us look like a third world nation?



Yachtie -> RE: The Best Health Care System in the World? (4/4/2012 5:34:23 PM)


quote:

ORIGINAL: dcnovice

We've heard a lot about health care in recent years, and one of the concerns raised about the ACA was that it would destroy the world's best health care system. (Washington Monthly provides a few examples of soundbites along those lines.)

I've been thinking of that soundbite/meme a lot lately, because I've been having insurance adventures. They seem to be tied to the advent of my latest insurance card. It's the same carrier I've had for more than a decade. I did switch jobs in that time, but that was back in 2009.

Anyhow, since getting the new card . . .

-- My copays have gone up. One more than tripled. That meant a time-wasting call to the insurance company, who said they had no record of my ever taking the drug before. (I've been on it for at least two years.)

-- I suddenly needed a prior authorization for my insulin, which I've been on for four years. That took several calls to and from the endocrinologist's office.

-- I attempted to purchase a routine replacement for my sleep-apnea mask, which I've replaced three or four times before. This time, the insurance company needed not only a prescription from my GP but a copy of the original sleep study, done in 1999. That's meant several calls so far, and I suspect it will take quite a few more before the issue is resolved.

Through all this BS. I keep thinking, "And THIS is the system some of our politicians have sworn to die defending?!"

Anyone else have similar experiences with "the best health care system on Earth"?



What was it like 5 or 10 years ago? Was it as bad as your recent experience? If not, what has changed?





dcnovice -> RE: The Best Health Care System in the World? (4/4/2012 5:44:04 PM)

quote:

What was it like 5 or 10 years ago? Was it as bad as your recent experience? If not, what has changed?


My medical life was simpler then, so I didn't have to deal with insurance issues as much. It may be that there was just as much BS then as there is now.

I did have the sleep-apnea gizmo back then, though, and I've ordered replacement parts repeatedly for more than a decade. Never had to produce the original sleep study before, though.

I'm not sure what has changed, other than that I began using the new card. It seems as if all my records from before have been wiped out. I did have a change of employer, but that was in 2009. So I'm a bit baffled as to what's going on.



SoftBonds -> RE: The Best Health Care System in the World? (4/4/2012 5:53:58 PM)


quote:

ORIGINAL: dcnovice

quote:

What was it like 5 or 10 years ago? Was it as bad as your recent experience? If not, what has changed?


My medical life was simpler then, so I didn't have to deal with insurance issues as much. It may be that there was just as much BS then as there is now.

I did have the sleep-apnea gizmo back then, though, and I've ordered replacement parts repeatedly for more than a decade. Never had to produce the original sleep study before, though.

I'm not sure what has changed, other than that I began using the new card. It seems as if all my records from before have been wiped out. I did have a change of employer, but that was in 2009. So I'm a bit baffled as to what's going on.


Here is a theory:
When you started with your first employer, you were healthy.
When you got sick, they couldn't say "prior condition," so they shrugged and paid.
When you got a new employer, they wiped your records so they could claim you had a pre-existing condition.
That is the way they think, anything to screw the customer for a buck.



tazzygirl -> RE: The Best Health Care System in the World? (4/4/2012 5:55:14 PM)

Not to mention health insurance premiums have risen steadily and were forecatsed to do so long before Obama got into office.



Hillwilliam -> RE: The Best Health Care System in the World? (4/4/2012 6:38:41 PM)

The last time I looked, the US was #37.

Who are they talking about when they say "The best"?



SoftBonds -> RE: The Best Health Care System in the World? (4/4/2012 6:41:55 PM)


quote:

ORIGINAL: Hillwilliam

The last time I looked, the US was #37.

Who are they talking about when they say "The best"?


Well, there is an argument that for the richest 1%, US healthcare is better than healthcare in other nations. The care the other 99% gets doesn't matter.



Hillwilliam -> RE: The Best Health Care System in the World? (4/4/2012 6:48:37 PM)


quote:

ORIGINAL: SoftBonds


quote:

ORIGINAL: Hillwilliam

The last time I looked, the US was #37.

Who are they talking about when they say "The best"?


Well, there is an argument that for the richest 1%, US healthcare is better than healthcare in other nations. The care the other 99% gets doesn't matter.


Know what's wierd?

The 1%ers frequently go to foreign countries to have procedures done.
http://www.medretreat.com/

It's called Medical Tourism.

Even the 1% thinks better care can be had for less money abroad.



Lucylastic -> RE: The Best Health Care System in the World? (4/4/2012 6:49:30 PM)

The best if you can afford it



tweakabelle -> RE: The Best Health Care System in the World? (4/4/2012 10:38:09 PM)

I wonder what the full toll of all this unnecessary hassle is on the poor patient .....

There is a completely unnecessary level of decision making involved that projects the insurance company into a position where it effectively holds a veto over the therapy offered to the patient. The attendant stress on the patient, the delays, the uncertainty, the worry must complicate the health issues involved, even if the insurance company decides in its goodness to come to the party and fork out for the procedure/medicine/therapy in question. All this happens at the worst possible time for the patients health outcome too. The effects on the patient's health can only be negative.

Even worse, the party wielding the effective veto - the insurance company - places its own financial interests first NOT the health of the patient. I'm glad I'm not subject to this regime. If I get ill or require hospitalisation, I want all involved to put my health interests at the top of their agenda at all times.

It is appalling that the financial interests of a profit-driven entity could take precedence over the health needs and priorities of the ill and the sick and be in a position to influence the quality of service offered to the ill and the sick. A situation like this would be unthinkable here. The "best"healthcare in the world???? Not by a long long shot.



joether -> RE: The Best Health Care System in the World? (4/5/2012 2:20:58 AM)

quote:

ORIGINAL: dcnovice
We've heard a lot about health care in recent years, and one of the concerns raised about the ACA was that it would destroy the world's best health care system. (Washington Monthly provides a few examples of soundbites along those lines.)

I've been thinking of that soundbite/meme a lot lately, because I've been having insurance adventures. They seem to be tied to the advent of my latest insurance card. It's the same carrier I've had for more than a decade. I did switch jobs in that time, but that was back in 2009.

Anyhow, since getting the new card . . .

-- My copays have gone up. One more than tripled. That meant a time-wasting call to the insurance company, who said they had no record of my ever taking the drug before. (I've been on it for at least two years.)

-- I suddenly needed a prior authorization for my insulin, which I've been on for four years. That took several calls to and from the endocrinologist's office.

-- I attempted to purchase a routine replacement for my sleep-apnea mask, which I've replaced three or four times before. This time, the insurance company needed not only a prescription from my GP but a copy of the original sleep study, done in 1999. That's meant several calls so far, and I suspect it will take quite a few more before the issue is resolved.

Through all this BS. I keep thinking, "And THIS is the system some of our politicians have sworn to die defending?!"

Anyone else have similar experiences with "the best health care system on Earth"?


Honestly, I get a bit annoyed that our politicians care more for how much money you'll give the companies that gave money to their (re)election campaign, than your vote.

I was starting a new job with a large, nationally-known company when I came down with a serious illness. During one of my many visits to the ER from it, one of the nurses got me started (by filling out the paper work) on Mass Health (yeah, Romneycare to you ignorant masses). I've found the program is pretty damn good. I met my current doctor who turns out to be both a humanitarian and very knowledgable MD. Nicest guy who strives to take pain from his patients. I've gone through literally hell, but have come out mostly intact.

But every so often, I just seriously wonder what happens to Americans, who of no fault of themselves come down with a serious injury or illness that strips them of nearly life and limb, to pay the medical bills. Someone should NEVER have to fill out paper work while their kid lies dying in another room. A person should NEVER have to worry how much something will cost while their in deep pain. No one should ever have to worry that once diagnosised with a serious illness, they'll be dropped because the insurance company isnt making a profit off their misery. Bottomline.....Americans should always be looking out for their fellow Americans.




SamuelJ -> RE: The Best Health Care System in the World? (4/5/2012 3:13:40 AM)

quote:

ORIGINAL: dcnovice

We've heard a lot about health care in recent years, and one of the concerns raised about the ACA was that it would destroy the world's best health care system. (Washington Monthly provides a few examples of soundbites along those lines.)

I've been thinking of that soundbite/meme a lot lately, because I've been having insurance adventures. They seem to be tied to the advent of my latest insurance card. It's the same carrier I've had for more than a decade. I did switch jobs in that time, but that was back in 2009.

Anyhow, since getting the new card . . .

-- My copays have gone up. One more than tripled. That meant a time-wasting call to the insurance company, who said they had no record of my ever taking the drug before. (I've been on it for at least two years.)

-- I suddenly needed a prior authorization for my insulin, which I've been on for four years. That took several calls to and from the endocrinologist's office.

-- I attempted to purchase a routine replacement for my sleep-apnea mask, which I've replaced three or four times before. This time, the insurance company needed not only a prescription from my GP but a copy of the original sleep study, done in 1999. That's meant several calls so far, and I suspect it will take quite a few more before the issue is resolved.

Through all this BS. I keep thinking, "And THIS is the system some of our politicians have sworn to die defending?!"

Anyone else have similar experiences with "the best health care system on Earth"?






During the 70s-80s I personally believe that the VA was one of the worse places to go for medical care. I had great medical insurance during that time, but through the years it got worse and worse and medical needs increased. Several years ago, I once again entered a VA and it was quite different and so much better then it use to be. They have very good care and a staff that shows it.
 



DomKen -> RE: The Best Health Care System in the World? (4/5/2012 6:23:34 AM)

FR

Before my illness I was senior developer at a smallish custom software company. We had long used a really good benefits package, including what we thought was very good health insurance, as a recruiting tool. I had made minimal use of it but had always found it to be a great plan with minimal hassles.

Then I got sick (kidney failure). This of course required appointments with specialists and fairly exotic prescriptions. Dealing with the insurance plan started becoming more and more of a hassle. Then I finally had to go onto dialysis to live. The insurance company dropped the entire group plan shortly there after (can't prove it was related but why else drop a 25 policy group plan?). Now uninsurable I was forced onto Medicare.



SoftBonds -> RE: The Best Health Care System in the World? (4/5/2012 7:01:26 AM)

You know what I'd love to see, if we have to have health insurance (vice single payer)? For large companies, hire an actuary and self-insure for health insurance. For small companies, the local hospital hires and actuary and provides insurance. Cut out Aetna/Blue Cross/etc. entirely.
Think about what getting your health insurance from a hospital would mean, they would care a lot less about what procedures you were paying for, and more about whether they were taking care of you. They get a flat fee, so they don't have to worry as much about revenue, and their expenses are pretty constant except Overtime, so the level of care doesn't really cost them more money. If they do have to provide more care than they are set up for, they can raise rates for the new hires/construction, but it won't cost as much as current rate hikes...
As for GM self-insuring, I'm pretty sure they would save money...



kalikshama -> RE: The Best Health Care System in the World? (4/5/2012 7:29:39 AM)

All my interesting health insurance stories revolve around the VA, but then, I started with the VA right before I turned 40, and the bad choices of my youth are coming home to roost.

Those who think they do not need health insurance should consider this:

[image]http://graphics8.nytimes.com/images/blogs/economix/HealthAge480.jpg[/image]



SoftBonds -> RE: The Best Health Care System in the World? (4/5/2012 7:40:33 AM)


quote:

ORIGINAL: kalikshama

All my interesting health insurance stories revolve around the VA, but then, I started with the VA right before I turned 40, and the bad choices of my youth are coming home to roost.

Those who think they do not need health insurance should consider this:



The interesting thing is that we spend more on the 65 plus than on all years before that, which means the government pays most of the health care costs. Of course, that is costs of folks who live that long...
But the other interesting thing is that the one age group that isn't under medicare which has above average health costs is the 55-64 group. Imagine extending medicare to those folks, and raising the medicare tax to 2% to cover them. Would make the existing health insurance fiasco (er, I mean system) less important at least...



Owner59 -> RE: The Best Health Care System in the World? (4/5/2012 9:02:13 AM)

The VA is both a state and federal program.

Some states have shit holes with VA signs hanging on them.

NJ,where my mom is,the VA is a 5 star rated facility.The highest rating possible.

Every fed VA hospital I`ve been to(all NJ) are excellent.

I get jealous sometimes when my brothers get to go.But I choose carpentry and the Grateful Dead over the Air Force.

As far as the "best health care system in the world"......if it ever was that,it isn`t now.Usually the folks who claim that bit of bullshit.........good have health insurance.So for haves,it is.

But I still haven`t gotten an answer as to why it is we pay roughly double per capita(twice as much per patient) and have fewer good outcomes?

The "R&D" answer doesn`t cut it because we aren`t the only country doing research and development.....far from it..




kalikshama -> RE: The Best Health Care System in the World? (4/5/2012 9:06:52 AM)

quote:

But I still haven`t gotten an answer as to why it is we pay roughly double per capita(twice as much per patient) and have fewer good outcomes?


Health Insurer Profits Jumped 250% in Last Decade

Profits for the 10 largest U.S. insurance companies jumped 250% between 2000 and 2009 while millions of Americans have lost coverage, according to a report released Thursday by the U.S. Department of Health and Human Services. The report found that the five biggest insurance companies -- WellPoint (WLP), Cigna (CI), UnitedHealth Group (UNH), Aetna (AET) and Humana (HUM) -- saw their profits increase 56% in 2009, a year in which 2.7 million people lost their private coverage.What's more, the report found that the companies combined earned a total of $12.2 billion last year. And lest we forget, on the executive compensation, CEOs of the top five received $24 million on average in 2008, the report said.

Given the timing of the release of the report, was the document an effort by the Obama Administration to increase pressure on the insurance industry as it looks to gain the public's support for health-care reform? It's clear that health insurance companies don't seem to have a lot of friends these days.

Industry Has Drawn Heavy Fire

The industry drew heavy fire earlier this month after insurer WellPoint's Anthem unit moved to increase insurance rates by up to 39% on some individual policies in California. The HHS report showed that such premium hikes are not uncommon, even while insurers post billions in growing profits -- and pay their executives multimillion-dollar salaries.

Read more: http://www.dailyfinance.com/2010/02/18/health-insurer-profits-jumped-250-in-last-decade/



SoftBonds -> RE: The Best Health Care System in the World? (4/5/2012 9:43:07 AM)

Can we PLEASE cut the medicare age to 55 and raise the medicare tax rate to 2% to cover the increased costs? Taking those folks out of the health insurance system would save so much money!
Heck, we can even do it slowly, raise the tax rate by .05% per year, and lower the age by 1 year per year...
Why isn't some congressperson proposing this???



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