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  1. #21
    JoanieL's Avatar
    JoanieL is offline Senior Member
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    Quote Originally Posted by magnolia1973 View Post
    I don't believe access to health care is a right. I have sympathy for people who have huge expenses, but if it were not a profitable business, your treatment would not be available.

    When my husband had a brain tumor, because we have a profitable system, he was treated immediately and in surgery with a top notch surgeon within 24 hours. We did have some extra expenses, but wow, the system works. Was it a bit of trouble to get everything approved, making sure MD's were in network, yup.

    I'm not sure why I should subsidize care for other people or expect other people to subsidize my care. You do realize that if the "government" pays for care, that the government=taxpayers.

    The heart of the problem is we can now do some amazing things to keep people alive, and simply can't afford to provide that for all citizens.
    I like you also, Magnolia, but I'm afraid on this issue, you've been brainwashed by Corporation-think. In this country, the people with access to the least hassle health care are the richest and the poorest. Used to be you got a cheap policy based on your age and general health, chose your max out of pocket (one, two, five etc., thousand per year), picked your own doctor, who by the way didn't have to consult a bean counter to get approval to refer you to a specialist. Things got done just as quickly if not more quickly. My understanding is that due to the vast increase in administrative work (read: bullshit paperwork hoops through which insurance companies make doctors jump), the costs have risen largely because of the insurance companies, who then charge the end user for those increases.

    So, just in my lifetime, I've watched accessible healthcare in this country turn into "the national debate." And while access to good healthcare isn't defined as a right by law, surely it's a subset of either Life or the Pursuit of Happiness. IMO, this country has a lot to be embarrassed about when it comes to the health of its citizens.

    And while I can't prove this, it seems to me that now that a large majority of doctors are salaried workers, the quality of GPs is probably diminishing because why spend 8+ years in school to make the same money a tax accountant or plumber makes?
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  2. #22
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    Used to be you got a cheap policy based on your age and general health, chose your max out of pocket (one, two, five etc., thousand per year), picked your own doctor, who by the way didn't have to consult a bean counter to get approval to refer you to a specialist.
    This is how it worked for me last year, except I had to choose from a list of MD's and need a referral for a specialist. It's really not that big of deal, and considering the prices of healthcare services I can understand some oversight on behalf of the insurer to control costs. I can't imagine they want you getting even sicker.

    Things still work quickly. My husband was having trouble walking. First step, went to Immediate Care at 11 am per his insurer. They referred him to the ER. The ER got him his MRI by 3:30. The MRI was read and interpreted by 5:30. By 7:30 he was in neuro ICU. By 8 am the next day he was scheduled for surgery by 11 am THAT DAY.

    He paid his premiums, on time, in full. He called and got "permission" when he needed it. He used in network doctors. He paid his deductible. Boom, done.

    You never hear about the people that the system works well for. Works great for my dad. Worked for my neighbor. Worked for my co-worker when she had a baby. Works for my friend with diabetes, but her premiums are higher.

    Do people get whacked with crazy bills? Yup, but a lot of times they are uninsured or did not follow the process. Do people get dealt a shitty hand of illness every so often, Yup. It's bad luck and a lot of money, but considering that what, 15 years ago, their kid might have died or something...maybe a couple thousand a month in drugs isn't such a high price.

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  3. #23
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    Magnolia, I realize that if the Gov't pays for the health care = tax payers. But there are a lot of things our gov't pays for that I have no say in and I don't want to pay for: killing people in foreign countries,spying on citizens, bank bailouts, subsidizing commodities to name just a few. Personally I'd rather pay for your health care than those things.

    I'm glad the system worked for your husband. We too pay our premiums and deductibles on time and take responsibility for our health. But are there any in network physicians within 130 mile radius of where we live? No. Boom not done. How about an in network hospital with the standard of care prescribed w/in 130 miles? No. Boom not done. My son is alive and he eventually did get the care he needed. But I can't say the system works all that well. I don't think a doctor or patient should have to consider what the insurance wants them to do, they should do what is medically necessary. BTW while we were in the hospital we kept getting letters from the insurance company saying that they determined that 1 week in the hospital was all that was needed. You think an insurance company somewhere in the midwest, that never met my son, never listened to his lungs or anything is capable of determining what is medically necessary?

    The truth is this system of health care we have is not the best of all possible worlds. I'm sure someone will chime in and say that in those countries that have nationalized health care their taxes are sooo much higher, and that's true but if you combine the amount we pay in taxes along with the amount we pay for health insurance and medical costs I doubt you will see much difference.
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  4. #24
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    Quote Originally Posted by Urban Forager View Post
    On one of my outings from the hospital I ran into young couple visiting from Sweden, we got to talking about health care, they could not believe that my husband and I pay generous premiums and deductibles and could still have to pay more. When I told them that the hospital charged for parking they were beyond flabbergasted! Anything for a buck!
    You should have asked that couple what the wait times are like for surgeries in Sweden. I don't know what it's like over there, I admit, but I'm from Canada and the wait times here can be awful. Rich people from Canada go to the States when they don't want to wait a year for their hip transplant and are willing to pony up. Honestly, I think I like our nationalized health care better than what the US has, but I'm not going to pretend it's all beer and skittles. There is a downside.

    Editing to add... the other downside is the taxation rate. We are FAR more heavily taxed up here. You pay one way or the other.

  5. #25
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    The truth is this system of health care we have is not the best of all possible worlds.
    I do know people in many places come to the US for more immediate service. It doesn't come cheap to have a system with the capacity to provide an MRI for someone within hours. And a world class surgeon within 24 hours. And room in an ICU with a specialized nurse immediately. Someone has to pay for it.

    I have no idea why you have no access to MD's within 130 miles. Before I committed to my policy I was able to see what physicians/hospital systems I have access to in my county. Most policies in our state are written by county and some insurers do not write policies for certain counties, which I assume has to do with a lack of providers they do business with in those places. I imagine someone writes policies that allow you to use local providers. I imagine also that you are in a more rural area and hence, going to have limits in access to services already due to the nature of less dense development.

    At some point, costs have to be contained. In the US private insurers do end approving treatments and thus limit their costs. In different systems, they just offer less availability. So maybe your son doesn't get seen by a specialist or they don't have enough rooms etc. At least in the US, you can say screw it, I want my kid to have the best and will pay any price...and can buy that care.

    I've seen my own father's care "cost controlled"... it sucks, but it is what it is. We can't just realistically have an open check book for healthcare in the US or we will be bankrupted.

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  6. #26
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    Quote Originally Posted by magnolia1973 View Post
    I do know people in many places come to the US for more immediate service. It doesn't come cheap to have a system with the capacity to provide an MRI for someone within hours. And a world class surgeon within 24 hours. And room in an ICU with a specialized nurse immediately. Someone has to pay for it.

    I have no idea why you have no access to MD's within 130 miles. Before I committed to my policy I was able to see what physicians/hospital systems I have access to in my county. Most policies in our state are written by county and some insurers do not write policies for certain counties, which I assume has to do with a lack of providers they do business with in those places. I imagine someone writes policies that allow you to use local providers. I imagine also that you are in a more rural area and hence, going to have limits in access to services already due to the nature of less dense development.
    Hubby's insurance comes with his job. We live in rural area. Son was diagnosed after we moved to this area and after hubby had been working at his job for 4 yrs.

    You are right we could say the heck with it I want the best care for my son. Gosh how could I have overlooked that? I will pay for it myself, no matter that one hospital stay costs more than our house!

    My eyes have been opened I now realize I have the freedom to buy!
    Life is death. We all take turns. It's sacred to eat during our turn and be eaten when our turn is over. RichMahogany.

  7. #27
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    My insurer's discount scheme is pretty elaborate. There are small reimbursements for non-smokers, using a pedometer or bicycle odometer, submitting cholesterol and glucose test results, shopping at the farmer's market, etc.

    I support nudging these ideas onto folks' radars, but in the grand scheme medical expenses are such a colossal mess I'm not sure how to sort my thoughts other than "avoid avoid avoid". Just yesterday our paper had an exposť on which local clinics and hospitals charge 400~800% more for identical services compared to their neighbors a half mile away, and patients have basically no prior access to this information.
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  8. #28
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    Hubby's insurance comes with his job. We live in rural area. Son was diagnosed after we moved to this area and after hubby had been working at his job for 4 yrs.

    You are right we could say the heck with it I want the best care for my son. Gosh how could I have overlooked that? I will pay for it myself, no matter that one hospital stay costs more than our house!

    My eyes have been opened I now realize I have the freedom to buy!
    Exactly- you kid's stay in the hospital cost more than house. Your premiums are what- $1200 a month for the family? So maybe $15,000-$20,000 a year. So you got a hell of a deal from your insurer when you figure they paid out over $100,000 for your services. They have to have some form of limits or they go out of business. That means contracting with providers, and in a rural area, you have more limited providers due to less demand. Your area can't support two hospital systems with state of the art everything like a city the size of Charlotte can.

    And when you consider that in some places, your kid would have died or been made to wait, it sounds like you came out pretty well in the end, albeit with some stress and inconvenience, which is going to be hard to minimize in any circumstance.

    I mean, what do you want? Free healthcare, with no limits, no restrictions, no delays and equal geographic access to services for all citizens?

    And at least in my state, you can negotiate bills with providers and work out payment plans and there are some programs that help in certain circumstances just like yours. A friend of mine works for a medical collections agency, and they are able to help a lot of people with huge bills. In the worst case, yeah, you get a lien on your house, but they try and avoid it.

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  9. #29
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    Just yesterday our paper had an exposť on which local clinics and hospitals charge 400~800% more for identical services compared to their neighbors a half mile away, and patients have basically no prior access to this information.
    Which is why your insurer doesn't always do business with every hospital in town.

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  10. #30
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    The last thing I will say is that if you compare the level of health care to other RICH countries the US does not fare so well. Sure if want to compare it to say Mali then yeah we are doing great; compared to Australia not so.

    I agree with picklepete for myself I take care of my own health and avoid the system as much as possible.
    Life is death. We all take turns. It's sacred to eat during our turn and be eaten when our turn is over. RichMahogany.

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