The USA Medical System

RockyGlen we were told that they would not cover her period, and there was one case they would but at a higher rate. Even higher than the $1000 a month.

And since you brought up the car ins. that's another thing. How many people drive without it?? We pay just over $1, 029 a year for full coverage on both vehicles. And both DH and I have clean driving records. My concern is being hit and the other driver taking off. Since that happened to use before.

Believe me, FK, I am sympathetic with your difficulty in paying for costly care for your daughter...but it sounds to me as though you resent paying for insurance that is expensive because your daughter's needs are expensive, and you also resent paying for insurance you DON'T directly benefit from. Someone has to pay for all of this stuff...I don't know why any of us think that things ought to be free.

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Things are only going to get worse for people with serious (or even possibly serious) medical conditions unless the Senate gets off their duff and passes the Genetic Information Nondiscrimination Act (GINA). Currently, many people are afraid to be tested for genetic disorders because it can lead to loss of jobs, denial from insurance companies or very, very high premiums based on the presence of a gene that may or may not cause a person or their child to have serious medical problems.

This doesn't just apply to people affected now by these disorders-- genetic information has been used to deny Jewish families insurance because they may have a child with Tay Sach's in the future or a Black person may carry the sickle cell trait and give birth to a child that needs transfusions, hospitalization etc.. People have lost their jobs after employers (who have access to their medical records) discover they carry the Huntington's or early onset Alzheimers gene.

Before anyone says-- this discrimination doesn't affect many people:

Over 30 million Americans have a rare genetic disorder. Everyone of us has 6 or 7 (maybe more) genes for lethal or debilitating disorders. If our coverage were to based on our genetic profile we'd all be paying out the ying-yang for coverage. Things such as pre-disposition to cancer could mean high premiums, loss of coverage or even loss of jobs for many Americans who may or may not ever develop cancer.

OK-- I'll get off my soapbox now...

I do feel we need to reform the system, but honestly, paying for all Americans to have healthcare doesn't seem feasible.

Michelle

Part of the problem are people who walk into the hospital or emergency room without a lick of insurance and zero in the bank and then get "free" treatment. Free to the deadbeats, I mean. The rest of us who pay or who have insurance or who pay taxes end up paying the hospital bills for the deadbeats. Thus, our insurance rates and medical treatment costs skyrocket out of control.

Junkmanme, there are a lot of deadbeats in this country (if you catch my drift).

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See that's an ASSUMPTION on your part. Never did I say I resent paying for insurance...........I just commented that its EXPENSIVE.
Nor did I say I think that it ought to be FREE.

Stop reading into posts........................and putting words into my mouth.

Trixi I understand how you say FK feels- I feel that way about college for my DD. Why should I, intelligently working hard to save enough for my retirement and for tuition at an average cost college, not be eligible for any financial aid for DD should she have the opportunity to attend a top notch college which costs much more than I have saved for paying such costs? Had I frittered away all my pay all my life (like my family of birth does) DD would get full need scholarship to such a college were she admitted (like I did). I have occasional resentful mad schemes to throw away all my money before DD applies for aid (better than making her marry or join military for 2 years just to become 'independent')

Guess I am grumpy that college costs so much that most people need financial aid to attend. Which perhaps overhigh tuition from the few ineligible for aid helps subsidize. Like health care if everyone had to pay for their own with no assistance bet tuition would be lower.

Anyway unlike college, with healthcare we can not always chose to not bother buying it- if FK neglected her child's medical care she would lose her child to death and/or protective services. Yet the costs for some unlucky ones with ailments such as FK's DD are beyond the means of almost anyone even those who've tried to prepare for it. Therefore [WARNING SOCIALIST SENTIMENTS TO FOLLOW] healthcare is not something which everyone should have to pay for all by themselves. Like hoggie off the English coast we should all expect to pay for regular 'tune-ups' so to speak but if the unpredictable (and normal childbirth perhaps should not fall into this category, but the state has a strong interest in even those unwilling to pay for proper maternity care; receiving proper maternity care) befalls us and we need more than a GP's (FP's) care just as if unusually we need the police or the fire department at our home why not have society share this risk and burden?

Aside from the "health insurance problem", what do you think about how the Medical System functions? Do you believe that Medical care should be controlled by MDs and Hospitals? Is "self-care" a crime? (seems to be....)

Junkmanme

Well, it sounded to me like you were unhappy paying so much for auto insurance despite your good driving record. I might just as well resent paying what I pay (or what my employer takes out of my paycheck) for health insurance I don't use but which goes to fund healthcare for people I've never met.

Point is, you know very well how expensive your daughter's care is. That money comes from somewhere, and what they're asking you to pay in insurance, while tough to manage, is just a drop in the bucket. You're being asked to pay maybe $20,000 a year for healthcare that costs five times that amount annually, and it's unfair? I just don't get it.

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"I'm not mean. You're just a sissy." - Happy Bunny

"I think you should be able to flush anything you want. Just don't call me when your toilet clogs." - BlueHeron Farm

I agree, but a republic form of government is no type of government to get involved in health care

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how do you prevent a oncogene from mutating? How do you cure it? How can you prevent that pancrease from stopping the production of insulin? How do you prevent that blood clot from forming and leading to a debilitating stroke? How do you prevent that appendix from getting infected and needing surgical removal?

The list could go on and on and these unforeseen and unpreventable things will continue to occur and if they happen to 'you' diagnosis and treatment of the condition will cost money.....and those costs can get very high very fast....for instance biopdy, contrast CT, MRI and/or PET scan for a diagnosis of cancer and determination of the extent and spread of the disease.....let alone surgery........of course the individual does have the choice to not seek medical care so they can save their money.......

I think it makes less than no sense to have medical decisions being made by people with no medical expertise, Perhaps you like having your car worked on by Anthropology professors, but I'm kinda traditional in certain ways.

In my own limited experience, it looks to me as though it's the insurance carriers that have munged things up so royally. Perhaps it would make sense to move to a system in which carriers openly compete for direct customers who choose plans based on their own needs, not who are chosen by employers with little in mind but low cost. More like auto insurance, which isn't nearly so out of control. Employers could still offer copayment as a benefit to employees they deemed desirable enough.

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"I'm not mean. You're just a sissy." - Happy Bunny

"I think you should be able to flush anything you want. Just don't call me when your toilet clogs." - BlueHeron Farm

FiddleKat - I'm not sure how much the "one case they would but at a higher rate" was but even if it was twice as much ($2K) a month - that is still a very good investment for over $100K a year in expenses. Of course I realize that you have stated that is more then your household can afford And I applaude you doing whatever it takes to makes sure your daughter has the best possible medical care.

With HMO's and such, and Medicare/Medicade, and people with insurance that negotiates costs with doctors and medical institutions, the real shame is that the working poor pay more for medical care in the U.S. then anyone one else - there is no way anyone can justify that fact in my eyes.

Perhaps the answer lies in people currently without health insurance or not enough health insurance organizing to form their own pool of funds for medical coverage. Even if it fails they will have a better understanding of what it takes to afford medical coverage?

Hugs,
Marlene

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If my history classes served me right, I remember int he Declaration of Independence that we have the RIGHT to pursue happiness. How is working a stink job just because you NEED insurance allowing you to pursue happiness?


I was talking with my SIL last night. She has depression. Her husband works and they have crappy insurance. The company they work for can't change it for another year. She went to a therapist who accepted her insurance (very few would even though it's a mainstream insurance co.). The insurance paid half. My SIL has to come up with the other $95 a week to get therapy. They're already paying $600 a month for the insurance at work and since they have a child who is asthematic (likes to turn blue), they are reluctant to give up the $600 a month insurance because they fear the next time the asthma flares up. One hospital stay alone could cost them $15K. They tried to get private insurance, but between the depression and the fact that she's of child bearing age, they were denied, or were going to be charge $1,200 a month. My SIL has to suffer from depression for at least another year when the insurance can be switched (but they've been warned it probably won't be as it's cheap for the employer.), or she waits 6-8 months to get an appointment at the free clinic where they'll shove drugs at her. She went on drugs last time and had some very negative reactions-reactions so bad my MIL had to move in with them for a few months. Either way, she's in a deep pit and sees no light out.

My BIL WORKS AND THE HEALTH CARE SYSTEM IS STILL LETTING THEM DOWN. WHAT ARE THEY TO DO?


Folks assume that because someone works they have ACCEPTABLE health care. They don't realize that an employer can't afford the good insurance anymore or that they are not adequately covered.

We own our own small company. We have 5 employees. We resent having to pay $5,000 every other month to cover our people. That bites into our earnings. We've had to miss paychecks to keep the insurance going. We'd gladly pay more out of pocket for taxes if it meant that our company could be more profitable.

I could not possibly agree less. You have the freedom and the right to PURSUE anything you want. No one deserves a guarantee that they will not fail. If you believe at all in freedom, then you MUST believe also in the freedom to fail as well as to succeed.

Ayn Rand makes a distinction between "life" and "survival." The first is a right that we all have upon birth, and which no person has the right to take away from us (thus, murder is wrong). "Survival" is another matter, and requires that individuals go out and get what they need for themselves. No one has a "right" to that. No one has a God-given right to a job they love. No one has the right to take things away from people who have succeeded, using nothing but their own failure as their "moral" validation.

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"I'm not mean. You're just a sissy." - Happy Bunny

"I think you should be able to flush anything you want. Just don't call me when your toilet clogs." - BlueHeron Farm

Well, I live in the Lucky Country, Australia, where everybody gets medical care of the highest quality, whether they can afford to pay for it or not. People who have jobs are encouraged to take out private insurance, and when needed, to go to private hospitals, of which there are many more than Public hospitals, though there are a lot of those, too.

Anybody (including unemployed, sick, elderly, disabled, war veterans and their spouses) who receives assistance from social security is eligible for free medical and dental care, spectacles, prostheses, hearing aids and assorted equipment as required (granny pushers, wheelchairs, commodes, shower chairs etc). The equipment isn't always the very best and most expensive available, but they are adequate and that's the main thing.

I have been on a disability allowance for many years, and my experience just recently illustrates the help I've received (and still receive), as an example.

I attend my GP for free. I get blood tests, assorted scans and other tests for free. I get free spectacles (2 pairs every 2 years for different purposes) - but if I want extras like tinting or hardening, or bifocals, I pay the difference). I get free rides in an ambulance (including transport to and from hospital or doctor for appointments - I have to give 2 days' notice, however, and might have to await their availability after the appointment if they're busy). Any time I spend as an in-patient in hospital is free, as is all treatment and drugs I need while there. Most of the drugs I get on prescription (when leaving hospital or at home) are heavily subsidised. In my particular case, all the drugs I've needed have been covered by this scheme. Any surgery I've had has been carried out by specialists, free.

Cosmetic surgery, liposuction and other elective procedures are not free, though some specialists will 'bulk bill'. That is, they'll accept a prescribed amount which is paid by the govt, and forego any extra costs which an insured person might have to pay.

If I have a condition that my GP can't handle, any specialist he sends me to will 'bulk bill' ie will be free to me. Some specialists do not take 'bulk bill' patients, so the GP picks and chooses. In hospital, I have been treated by renowned consultants (as in my latest illness). Free.

Not all GPs accept 'bulk bill' patients, either. Doctors have this personal choice, but there is usually at least one doctor in each practice who does. S/he is usually a very busy person!

Any person who goes to the Casualty Department at any hospital is entitled to free treatment, whether they are wealthy or poverty-stricken. A treating doctor will ask if you are covered by insurance, and will refer the patient to the appropriate specialist if needed.

In addition to all that, I am entitled, when necessary, to other assistance. I currently have a cleaner (free) once a fortnight because I cannot even make my bed yet. I could have a nurse come in every day to shower me, or give me injections, if I needed it. (I have a shower chair.) I am provided with a counsellor (free) who will make house calls when needed, or if not who rings me regularly. I am entitled to certain fittings to be installed at my house - like grab rails in the bathroom, or if I had a wheelchair, I'd get help installing ramps if needed, or a chair-lift up stairs. Some of the more expensive items are not free, but they are subsidised. If I needed somebody here to look after me full-time, that person would be entitled to a Carer's Allowance, and we'd both be entitled to have me attend respite care on a regular basis. If I had absolutely nobody at all to help me, I'd be provided with somebody who could do my shopping, drive me to the hairdresser, pay bills for me, post letters - that sort of thing.

In short, if I need help, I get it. My consultant would not discharge me until a social worker had arranged for things like the cleaner, and Meals on Wheels, and was assured that I had a friend or family member who could help, and a GP prepared to make home visits. The services of the social worker come free, too.

Of course, follow-up services are also available - free - such as physiotherapy, occupational therapy and whatnot.

My chemist delivers my medications to me at my home. My friend withdraws small amounts of cash from my bank account for the purpose of paying for these. I prefer to do it this way, rather than to have an ever-increasing debt on account. The chemist collects the doctor's prescription and keeps it for repeats, so all I have to do when running out of one drug or other, is to ring and ask for them. The service is free, and so far they've always been on the same day as my phone call.

BUT - the system isn't perfect. Far from it. We have an aging population, and hospital beds aren't always available to others. I spent 10 hours on a trolley parked in a corridor in Casualty before a bed was found for me recently. I was too sick to care - and I received all the necessary attention while I waited. One room was kept free for the purposes of privacy for any patients who didn't have a cubicle.

One of the major hospitals locally (the one I was in) has a policy of putting men and women in rooms together. I strongly object to this, but I can see that any bed in hospital is better than none when there is a shortage.

We also get free dental care, however there are chronic long waiting lists for routine checks and simple procedures. In an emergency, however, we'll get help if we attend the Casualty Dept at any public hospital. Free dentures are available, too, but you might have to wait a while for them.

For some people, once you're 'in the system', it's easy. For others, 'getting in' can be a lengthy process - except in an emergency, and except if you're a victim of a violent crime - rape, muggings, etc - or an accident victim. In which case, all stops are pulled out for you.

People complain all the time about a nationalised health service - shortages of hospitals, doctors, equipment, funding - and long waiting lists, but honestly I have no cause to complain at all. I might not have a private room, but I do get top-of-the-tree doctors when needed, and nursing, and medications, and surgery, and subsidiary assistance as required, and after-care, and what more can a person really want?

People who are employed pay a small percentage on their income tax to cover the costs of our health service. I'm not sure how much, but I think it's about 1-3%. I don't consider that unfair. I paid for it when I was working, and now I can no longer work, I reap the benefits.

I don't know a lot about the American system, but it does make my blood curdle to read so many posts here at HT from people who cannot afford even basic medical care. America is a wealthy country, many times wealthier than Australia, but I get the impression that the American Powers-That-Be don't give a hoot about the state of health of its citizens. The poor ones, especially. All people are entitled to have proper medical care when needed. I regard it as a basic right.

Perhaps America should stop playing war games and play Happy Families instead.

Problem started with caving into the blackmail of our politicians by GM, GE etal. In order for the group of businesses to 'buy into Social Security', they wanted to self-fund healthcare. See recent news as to how these very same companies whine the longest and loudest about healthcare costs. Insurance, be it P&C, health etc. CAN make a reasonable (this is a key word here) profit and still meet the contractual obligation of their policies. BUT in order for insurance to "work", the pool of insureds must be large enough to share in the risk. Our pools are small (and shallow sometimes). A policy covering 6 people is doomed to fail.

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See your ASSUMING again........................

I didn't say I thought it was unfair. Who doesn't complain about the high cost of insurance? Whether it be car, medical or whatever??

YOUR the one who's saying its unfair. I didn't. Obviously you don't get it.

And yes, I know how expensive my daughter's care is, and I am THANKFUL that the gov. is covering her, and I have had no problems whatsoever. They covered her $7000 wheelchair she got three years ago, and we just had it adjusted for growth, and probably will last her another three years. She just had her AFO's (leg braces) approved.

But please, I ask you not to turn my words around to try to start something. Because I feel that that is what your doing.

Well, I guess I will jump into this fray. My opinions are based on my experiences and I am sure that they are not going to be popular... but oh well. Before I start, let me state for the record that I am very aware that life is full of choices and the consequences of those choices.

John (late dh) worked for Home Depot. It was one of the highest paying jobs he had ever had. They did offer insurance. If he were to have it... meaning if he signed up for it at exactly the right time (they only allowed you to sign up for it once a year) it would have cost him $100 a month. Now that doesn't sound like much to most of y'all, but to us it was more than we could afford. That was just insurance for him... not me or the kids too. So he did not have insurance. If he would have had it he would have been more likely to see a doctor and perhaps have his high blood pressure diagnosed. As it was, when he got sick he refused to go to the hospital because he was afraid to run up a bill that we could not get out from under. We had an appointment for the local free clinic but the wait was so long, he didn't make it. After he died from complications of high blood pressure, I wrote a letter to President Bush. I knew it would never reach him but it was something that I just had to do. The gist of that letter was that if we could somehow make insurance for people that do work affordable, tragedies like our would not happen. Not to mention that I think that it would have made more sense for the government to make insurance available for a larger part of the income bracket... as it was they had to pay the $85,000 hospital bill through a retroactive medicaid card for John after he died. Wouldn't it have been cheaper for them to give him a medicaid card for doctor visits and medications?

Right now my kids have Medicaid (state insurance) but I am not covered. Again, my choice to not work due to taking care of John (son) and as such this is my consequence. (long story that would need another thread to talk about) We are blessed with some fine doctors. Their pediatric nurse practitioner is great... we have been with this office for 17 years now. Their psychiatrist is hard to get in to see but he is wonderful and gracious. The specialists that we have had to see have been great too. Perhaps we are just blessed, I don't know. John did have one crappy doctor that was very full of himself during one ER visit, but I just gave him the "stink eye" and he backed down rather quickly. But that is only one in a number of doctors. Recently I have been going to the local free clinic and again I was blessed to get a fantastic gyno. I just love her too!

With the state insurance there are some hoops you have to jump through for medications... like John had to wait a month on one med, and it not work before he could get another one. I thought it was rather stupid to ask a suicidal child to use a med that we all knew was not going to work, for a month before they would give him the one that would. But it was worth it because by having Medicaid the $1000 a month that our meds would cost, it paid for. So, while I see that there are some things that could be better, I try not to grumble too much.

There, that is one opinion from a different demographic... FWIW.
God bless you and yours
Deb

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I realy mean no disrespect but I am floored by what you stated. In BOLD.
Why would you think you should have anything if you are not willing to earn it? Food, medical, a roof over your head? All these things are not rights they are earned.
I have always felt they should be anyway.
Now to clarify I KNOW many work but still cant afford medical and this is a reality that sucks but it is not my point.

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And for the person who said they have the right to pursue happiness and something about a stink job and insurance.

Please realize, only you have the power to be happy. NO ONE can MAKE you that way. NO JOB can give you happiness.
Its all about how you choose to see life. You can choose to be happy in ANY situation.

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