BS: USmostly- Health insurance-crap-shoot?

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: katlaughing
Date: 06 Jun 02 - 09:06 AM

mg...while I agree we need something that will cover more people living in poverty, we also need something for those of us who are not...Rog makes a decent wage, too much for me to qualify for SSI, BUT we still cannot afford high insurance rates. Also, be careful of the high protein thing. I did it, in moderation, for two years and nearly lost my kidneys to it. As it was, it took almost a year to recover. The metabolic studies are interesting and I do check my blood sugar on a regular basis. So far, so good.

Mudlark, thanks, you've pretty much summed up the way I feel about alternative and allopathic. At this point, I think I will look into catastrophic, since that is most likely the only time I'd really need it, anyway.

At some point, I think we need to take a stand, each as they are able. I took one 6 or so years ago and said "no"....feels as though I will continue to do so, but not without vocalising...so members of Congress will hear from me as will state officials and others. I might even start writing my column, again. Thanks very much to everyone who has shared.

kat

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Mudlark
Date: 06 Jun 02 - 03:26 AM

I sympathise with your dilemma. When John and I left the computer industry (and the lush insurance plan provided) and struck out on our own as potters, health ins. was the first thing to go. Even back in the early 70's it was more than we could afford, even tho John had already had a heart attack.

We made alternative health care a hobby, grew all our own food, doctored ourselves. For nearly 20 years about the only real doctor encounter we had was when I broke my wrist after being thrown from a horse. We even toughed out another HA that John had in the dead of winter, when our road was impassible. Scary, but we made it.

Then, in 1988, I was diagnosed with lupus. When the doctor I went to saw what was coming she stopped all testing, etc. and said GET INSURANCE NOW! Knowing that if my kidneys went I'd be in major financial, as well as physical, hot water, we got insurance. Went w/Blue Cross on individual plan, with huge deductible...i.e., catastrophic insurance only.

I keep trying to feel that I'm lucky that I've never needed that insurance, that I've not only paid all my doctor bills (since they are always well under the $5000 deductible), but the humongous monthly ins. payment as well. Ironically, shortly after we took out insurance, John had serious heart problems and needed bypass surgery...something we could not possibly pay for ourselves (as potters our income was always below the poverty line, tho we seldom felt "poor.")

The insurance co. did try and weasel out of paying for this (the old pre-existing excuse), and ultimately succeeded. But the fact that we HAD insurance got John into a very good hospital, which ultimately forgave most of the cost when they found the ins. co. would not pay.

Now I am 6 mo. away from Medicare, and counting. I know the drug thing is still outrageous, but the thought of not having to foot all medical expenses is intriguing to say the least.

I think the whole insurance boondoggle in this country has set back good, consciencious, ethical, caring, reasonable health care 50 years. Doctoring by the dollar can only be morally debilitating, not to speak of the incredible paperwork. Still, with a one-day stay in hospital for anything running $5K, aside from doctor/surgeon costs, it's like being on the highwire w/o a net...ok as long as your balance is perfect, but if you fall, you don't bounce. Alternative medicine is always my first choice, but sometimes allopathic is what's necessary...and that's the rub. (Not that I can afford a massage either, for that matter!)

It's a tough call...good luck.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: GUEST,mg
Date: 06 Jun 02 - 01:22 AM

I vote for getting the insurance if at all possible. I wish we would get a public health system for lower income people and preserve what is good about American medicine, and a lot is..certainly emergency medicine. I also think we have to educate ourselves on prevention and home remedies because most of us won't be able to afford hospitals etc....and there are remedies for chronic ailments that are probably much better than drugs and surgery. Read up on fatty acid deficiencies and insulin resistence and don't be too swift to believe all you are told about low-fat diets, we supposedly all eat too much protein etc....I hope to get my hands on a copy of Metabolic Body Typing...I think from exerpts I have seen that they are at least on the right track to individualized prescriptions for health.

mg (hunter-gatherer type)

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Liz the Squeak
Date: 05 Jun 02 - 11:22 PM

Just as a matter of interest, were there so many bugs around that could close an entire hospital when found, when we used and re-used the same instruments?

It seems to me that since the introduction of 'single use' equipment, we've had a great many more superbugs and flesh eating bacteria identified and let loose in our hospitals.....

And if it has all come about because of the HiV potentialities, why has no-one gone back and read the bit that says 'the virus does not last long outside of the body', the usual sterilisation procedure was more than enough to kill it, or has someone discovered they were wrong all along and is trying to keep it quiet?

LTS

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Charcloth
Date: 05 Jun 02 - 10:55 PM

Kat, most folks don't know about "Physicians who care" & it's a shame the garbarge we have openly embraced. I honestly believe if we had a Government program it would be even worse yet. But that is another thread & I don't want to go there. I do wish folks would tell others about the article I mentioned above. It is really quite scary. & needs to be passed around. It shows all the more we need a Patients rights program that expidites things rapidly!
Charcloth

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: artbrooks
Date: 05 Jun 02 - 07:49 PM

There are HMOs...and than there are HMOs. If you have a choice, look for the ones that are managed as a cooperative, such as Group Health in Seattle and Madison, WI (no connection between them except the name, I think). Their primary interest is the patients, or at least it was when I worked with them. Second choice would be a physician-managed operation and WAY last would be a for-profit. The last bunch are the ones who have given HMOs their reputation for rationing care, misusing their medical (by making them act as filters) and letting suits decide what care you need rather than your doctor. I think that a for-profit HMO owned by an insurance company is the worse of all possible combinations.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: katlaughing
Date: 05 Jun 02 - 02:29 PM

charcloth, thank you very much. I didn't know about that organisation. And, what a telling article! Here's a link to it: HMO's and death of medical ethics. Doubly interesting to me as it is an HMO which we are supposed to sign up for through Roger's job.

kat

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Charcloth
Date: 05 Jun 02 - 01:59 PM

Check out Physicians who care's web site

their address is www.pwc.org they have a lot to say about it & do a search for the article HMO's the death of medical ethics on thier site
I think you will find it interesting
charcloth

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: katlaughing
Date: 05 Jun 02 - 09:42 AM

I dunno, LtS...seems autoclaving used to work just fine, at least when I worked in the field it did.

Thanks, everyone, for your comments. I've been reading along and you've all given me a lot to think about. It still seems a crapshoot and, I think, it should be top priority on anyone's list for voting, deciding who to vote for, campaigning, etc. I've had it with the Dems and GOP, so those of you who are lobbying for GREEN are getting my attention, esp.

kat

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: GUEST,ozmacca
Date: 05 Jun 02 - 03:00 AM

Jim, I wonder if the term should maybe be pronounced slightly different - "bene-fit" as in no longer...... Seems to match up with a lot of folkies I know.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Liz the Squeak
Date: 05 Jun 02 - 02:48 AM

One has to look into the figures for cross infection to make the 'disposable scalpel' system viable. Has anyone actually done a costing excercise with that in mind?

LTS

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Jim Dixon
Date: 05 Jun 02 - 12:18 AM

It must be fairly common for folkies to go without insurance. I suppose that's why you're always hearing about benefit concerts...

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Bill D
Date: 04 Jun 02 - 11:01 PM

a system that uses an entire KIT of stainless steel instruments for ANY procedure...even to sew 2 stiches in a cut thumb...and then THROWS THEM OUT, cannot be expected to care about $45 Tylenol....

my wife has had 25-30 heart biopsies in 6 years, and each kit has 8-9 instruments in it at $70-80 per kit....do the math...we demand to KEEP them and give them to friends)

when insurance companies pay, they keep raising prices...

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Celtic Soul
Date: 04 Jun 02 - 10:53 PM

Maryrrf, agreed...

There is a certain amount of recourse for those who do not have coverage, but not nearly enough. There is decent coverage for mothers and children, but everyone else (even those considered disabled) are not nearly as lucky. My sister can attest to how woefully poor the coverage is for those in circumstances where they are relying on what takes the place of socialized medicine in this country. It sucks that the system would rather pull your teeth than fill them, as a for instance.

All we can do is vote according to our consciences, protest the practice of health care only for those that can afford it, and continue to do what we must to keep our families safe until something happens for the better.

Wouldn't hurt if the pharmaceutical industry started to charge something less than 5000 times the cost of making their medicines, either. It's a damn shame that you can get the same prescription from a vet for your cat for a lot less than you can for your child.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Celtic Soul
Date: 04 Jun 02 - 10:52 PM

Maryrrf, agreed...

There is a certain amount of recourse for those who do not have coverage, but not nearly enough. There is decent coverage for mothers and children, but everyone else (even those considered disabled) are not nearly as lucky. My sister can attest to how woefully poor the coverage is for those in circumstances where they are relying on what takes the place of socialized medicine in this country. It sucks that the system would rather pull your teeth than fill them, as a for instance.

All we can do is vote according to our consciences, protest the practice of health care only for those that can afford it, and continue to do what we must to keep our families safe until something happens for the better.

Wouldn't hurt if the pharmaceutical industry started to charge something less than 5000 times the cost of making their medicines, either. It's a damn shame that you can get the same prescription from a vet for your cat for a lot less than you can for your child.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Maryrrf
Date: 04 Jun 02 - 10:17 PM

Very good point about the horrible effect a serious illness or accident can have on you if you don't have health insurance. For many it's not an option because they can't afford the premiums whatever the case, so they have to run the risk. They will go after your house, your assets, everything. And you have no control over costs once you get admitted to the hospital. My son was in a minor accident and stayed less than 24 hours - all he had was a broken ankle (a splinter fracture, not a serious break). The bill was over $9,000 including $45 for pain medication (which was - I kid you not - two Tylenol tablets.) Fortunately the insurance did cover most of it. A friend of mine had fibroid tumors removed and was charged $15 per sanitary napkin! She said if she'd known that she'd have brought her own, but the nurse informed her that that wouldn't have been permitted. This is a desperate problem in the US and it is unbelievable that the situation is allowed to exist.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Celtic Soul
Date: 04 Jun 02 - 09:42 PM

OK, someone correct me if this differs from state to state, but where I come from, "Pre-existing condition" simply means that the new coverage will not cover any expenditures for a single year. Once you are past that year, they *do* cover any costs.

Also, I will add that, perhaps it seems cost prohibitive...but I just had to disburse a loan for a man who's son was in intensive care for 6 months, and then died. They had a sizable savings before all this, but no health coverage when the boy went into the hospital. By the time they were done, there was no more savings, their house was mortgaged to the hilt, and they had to borrow money using one of their vehicles as collateral (extending it out past it's value according to the NADA book...which means, if it is totaled, they will not get enough from the insurance to cover the loan) to bury him. No health coverage is fine if you're talking about minor health issues, or the occasional Doctors visit...but if you find yourself dealing with a catastrophic and costly health issue, suddenly, the premiums don't seem that bad anymore. And yeah, it really is a crap shoot. You have to weigh out whether you want to risk being in the shoes of the guy described. Yeah, socialized medicine in the USA would be nice, but until that happens, I for one will pay to insure that I do not lose everything just trying to keep someone in my family alive.

And Bobert? I voted green...absolutely agree that the votes have to echo the conviction. This whole "lesser of 2 evils" thing, and the "A vote for (non-democratic/republican party ballot) is a wasted vote" stuff is an insult. If everyone who said that they wanted to vote outside of the 2 major parties did, the message would have been loud and clear...pity.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Bobert
Date: 04 Jun 02 - 08:22 PM

I've read every post in this thread and must say... you are all right. I can't argue with one thing. In the bigger picture, however, the reality is that the moneied class (ruling class) is in firm control of most democratic governments and these folks have one thing in common: greed. The average worker, be it in the US, Europe, Australia or where ever is now working harder for a smaller piece of the pie. The ruling class has their collective foot on the necks of labor big time around the world. This can only change if enough folks just come to the point where there is nothing left to be squeezed from them and quit repeating the same insane behavior of voting for folks who are owned by the monied class. Even a 5 to 7% Green Party tally would send a clear and unmistaken message that labor ain't going to take any more crap. Until then, better get ready to punch another hole in your belt because the other side is winning big...

Universal health care for all...

It's doable.

Vote Green

Bobert

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Bill D
Date: 04 Jun 02 - 08:20 PM

7 years ago we were without...then a friend recommended a 'group' plan, and we tried it. 6 1/2 years ago my wife, (Ferrara) was discovered to have congestive heart failure, and the insurance covered a transplant...we continued with the company, which had a pretty good plan...until...you guessed it, they quit because they were "doing too good a job and not making enough profit"....so we had to switch.

All went 'tolerably' well for several months, then the NEW one raised rates $150 a month!...so, we are glad we had some, but KEEPING it is month to month *sigh*....if we can manage till I'm 65, we may survive!

There are SO many issues...malpractice costs, exhorbitant drug prices, political manuverings....The U.S. really does NOT face it all, and it's gonna be a VERY big problem one day.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: GUEST,Melani
Date: 04 Jun 02 - 07:44 PM

We are lucky in that my husband works for UCSF and therefore is part of a very large group with open enrollment. We started years ago with a local co-op group that no longer exists, and several times have been bought and sold to some other company like a herd of cattle. We currently have a pretty good HMO, but they wait as long as possible to pay for stuff they have pre-authorized, sometimes over a year. This is why the only orthopedist I can now see is the guy who takes Medi-Cal patients and has twenty people in his waiting room and you get five minutes. The guy I used to see won't take my insurance any more.

Since our son was born with neurological problems, we would be in big trouble without health insurance. Not to mention our daughter's serious accident and week-long hospitalization at the age of seven months. Not to mention surgery after my husband stuck a pocket knife into his left hand while trying to cut something. (It required surgery because of a botched job of treatment at the county emergency room. We went there because it was close and he was bleeding from an artery.)Without health insurance, all this would have been beyond our means to pay for. So I don't think you should just assume you're going to stay healthy--except for Daniel's condition, all our hospitalizations have been because of accidents.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: GUEST,maryrrf
Date: 04 Jun 02 - 11:33 AM

I currently have good coverage, too. But the point is - your access to decent health care shouldn't depend on how big your employer is. Everybody can't work for a big corporation. Do those who are self employed or who work for smaller companies have inherently less right to health insurance than those who work for big companies? And a lot of times you don't know how good or bad an insurance company or policy is until you've already signed up, or until you develop an illness that they won't cover.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Mrrzy
Date: 04 Jun 02 - 10:56 AM

Some HMOs aren't as bad as others. I finally found one that really works for my family, and now I've found a doctor who kowtows to the insurance company and won't do what I want, so I'm switching doctors, not HMOs. You need to find a combo that works. And they are rare... the only issue I have with my present HMO is, well, there are 2. One is that there is a law in VA that HMOs have to cover chiropractic, but mine gets around that by covering the office visit but not the treatment. So I can GO to a chiropractor, but all we can do is look at each other. And they have this thing where PT is covered at 100% for acute conditions, but as soon as you start using PT they say it's chronic and stop covering it. But I can get around that one, I just pick a different "incident" each time I need to go (lessee, today, yeah, I picked up Timothy. Last time it was William, so this is a different "accident" and I can get my chronically bad back helped). And it isn't fraud as usually, although I have a bad back, it doesn't hurt enough to need PT unless I've done something like pick up a 50lb kid wrong. But you really have to SHOP for coverage. My firm has a CHOICE of HMOs and a choice of regular coverage and no pre-existing exclusions allowed, whoopee!

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: GUEST,maryrrf
Date: 04 Jun 02 - 10:36 AM

The health care system in the United States is a disgrace and it makes my blood boil to think about it. Well, I should say - the health care itself is fine, but it's getting access to it that has become a complicated, nightmarish procedure. It's been said several times in this thread - in the United States health insurance is for the well, who won't use it, and not for the sick, who need it. It's insane.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Mary in Kentucky
Date: 04 Jun 02 - 10:11 AM

kat, my advice is to get insurance. At our age, things start to happen ;-) and the insurance companies have a way of "cherry picking" only young and healthy members who only pay premiums and then of dumping sick people. But what most people don't consider...they don't take on new people after the age of 40 or so unless they are forced to. Your case is different, however, since Rog has insurance.

Friends of ours moved to Colorado last month and were told to wait until they got there to get insurance instead of trying to fill a 2 month gap while unemployed here in KY. Our insurance system is an unbelievable mess, and until more people in other states (younger folks especially) realize how bad things are, they won't change. Hopefully in 20 years things will be different, but that may not be soon enough for us.

For many years Hubby and I had double insurance coverage from both of our jobs. So naturally the insurance companies both stalled trying to make the other one pay. Then KY passed the birthday rule...the spouse with the first birthday in the year had the primary insurance. Still, the companies tried not to pay and the hassle was a constant fight. So we dropped his insurance, after being assured that my job was secure. (in the US at that time insurance was tied to employment) Three months later I lost my job. And his company wouldn't take us back, surprise, surprise. I got another job, but lost it also. This job had "self contained" insurance so when my 18 months of COBRA was up, they were more than happy to dump me. (especially since I'd been diagnose with MS in the meantime.) Of course with MS, no one would insure me or hire me. Out legislators thought this was highly unfair, so they passed a law which said insurance companies had to take sick people. So 16 of 18 companies left the state! One year I got on a state sponsored plan, but they went bankrupt and sabotaged the records. Then I got on Blue Cross (subsidized by the state) but they just raised my rates to $900 per month. Now I have another state plan which most doctor's offices have never heard of, and every claim is a fight.

I've heard of lawsuits in some states where a person (like happened to me) was told by a doctor that they did not have any chronic diesease, dropped or lost their insurance, then were diagnosed with something, and couldn't get insurance. Times are changing, but slowly.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: GUEST,ozmacca
Date: 04 Jun 02 - 02:03 AM

Liz, the first question is still, "Where does it hurt?" But the first answer is now in "In the hip-pocket nerve." Hey, I signed the official secrets acts twenty four years ago. Do you think I could get free health cover if I moved back there now? Mind you, if I moved back there, I'd need it - for pneumonia and frostbite......

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Liz the Squeak
Date: 04 Jun 02 - 01:16 AM

I cannot conceive of a health care systems whose first question is not 'where does it hurt?' but 'can you afford this?'.

I have several private options; I could opt to join one Civil Service healthcare plan, or stay with the one we get automatically (one of the few advantages of signing the official secrets act....) as an employee of the government, or I could opt to use the family cover Manitas gets through his employer with another private healthcare provider. Or I could stick with my GP, whom I have reason to believe is too busy to really pay a great deal of attention to any one person (average appointment time from date of call = 2-3 weeks). I made a sort of decision a while ago that I would stick with my GP, rather than 'queue jump' with private healthcare. Besides, we still have to pay one way or another. My employer takes back enough of my wages in National Insurance contributions every month to make me feel I've already paid once and shouldn't need to again.

LTS

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: GUEST,ozmacca
Date: 04 Jun 02 - 12:57 AM

katlaughing, it's kind of like this... Better sit down, it'll take a while... We once had private health insurance with a couple of big specialised insurers and a whole raft of smaller companies providing optional services for your choice of PUBLIC (covered costs of a bed in a public ward in a public hospital, staff doctors etc), PRIVATE (costs of bed in a private hospital, your choice of doctors, etc) and INTERMEDIATE (your choice of doctor and a bed in the private ward of a public hospital etc.. you get the idea)This also included costs of consultations with GP, and extended cover also offered cover against optical and dental etc etc.. It could be expensive, but you chose what you could afford, and you did get what you paid for, and it generally seemed fair. Oh, and some states had free hospitals, so you could have most procedures without any hospital insurance, depending where you lived. Emergency attention was always available at no cost anyway, although we always had to have insurance or pay for the ambulance service.

Now, a long time ago in what seems to be a galaxy far away, a more enlightened govt saw that insurance costs were rising - so when did they ever come down? - and set up a thing which became known as Medicare. Now originally, this provided every person in Aussie with free health service from your GP or public hospital. Sort of like the UK National Health Service. Then, If you couldn't afford any insurance, no worries. You could see your GP or get your teeth or glasses and go into hospital for nothing. The private insurers were still offering the options so people who wanted private hospital accommodation could still pay for it. However, succeeding govts were determined (or persuaded) to bring in the concept of pay-as-you-go, and they reduced the benefits so that the fees were not covered by Medicare. This was the "gap" which you paid yourself. See a doctor, get a bill, pay the bill, make a claim against your insurer or Medicare, get some money back - but less than the bill.

The private insurers starting offering cover for the "gap". Then Medicare cover was reduced further, and the insurers started offering much more complex policies, and the "gap" cover started to disappear. Quite a lot of practices used "bulk-billing" which meant that they submitted their fee charges to Medicare direct and made the claim on your behalf, so it didn't cost you anything up front. A couple of years back, Medicare became in efect just another private insurer. As people were staying away in drove from private insurance, the govt introduced their incentive scheme. If you took out a recognised level of insurance, they offered a rebate on the cost which could be deducted from personal income tax. If you didn't take out the insurance, there was no rebate. So, naturally enough, heaps of people took out insurance. Then the companies gradually increased the premiums, reduced the payable benefits, increased the "gap". And not unnaturally, a whole lot of people started to drop out of insurance again. So we're back with more pressure from the govt to take out insurance or get hit with paying the tax. All this on top of the Medicare levy which is applied to every tax-payer - or at least the honest ones.

Now a few weeks back, the biggest insurance company which provided nearly all Aussie doctors and hospitals with their professional liability cover went belly-up, because of increased costs, reduced income... the usual sort of stuff, leaving around 80% of the doctors unable to practice. Neat, huh? So then the govt steps in and offers to guarantee that all insurance for doctors will be guaranteed by the govt (using guess who's money. All this time, the actual health insurance companies are happily sitting back coining money - which makes their shareholders happy. Funny that the heads of these bigger companies are buddy-buddy with our present PM and his team of sycophants, and a whole lot of the smaller insurers have quietly been absorbed. Oh, and almost every GP in the country has had to stop "bulk-billing" and now charges an increased fee for consultations because of the new "guarantee" conditions, so you pay at the GP, then go cap in hand to the insurer and ask for some of your money back... It's as bad as the banks.....

OK, enough already.. I shall sit quietly and come off the boil. All of the preceding may be coloured to a certain extent, but it's a reasonable explanation of the situation as seen by the average aussie-in-the-billabong.No further correspondence on the subject will be entered into 'cos it's bad for the blood pressure.

It's not as bad as the situation you've got in the US, but we're doing our best to catch up.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Deda
Date: 04 Jun 02 - 12:06 AM

I'm lucky to be covered by my husband's insurance currently, but it really does seem like a total crapshoot to me. My son only has insurance when he's enrolled in a college that offers cheap insurance, which he's not going to be anymore in a month or less because I don't have the money for his VERY expensive tuition, and neither does his father. I think our medical care system (it's far from health care -- more like illness care), or lack of it, sucks, frankly -- not to put too fine a point on it-- and it aggravates me that in public discussions about it NOBODY seems to ask the questions that knock me upside the head -- like "How come the CEOs of the damned insurance companies can make so many millions a year in salaries plus stock options, and have fat profits, while they DENY coverage to anybody who's actually really SICK?" What? Hello??? How do we as a society live with ourselves? They get golden parachutes that could solve hunger in several African nations, and the public get a lot of "sorry" phone messages. The scam is this: "Everybody needs health care -- it's the perfect product because they literally can't live without it. So let's soak them for all we can!" Not the doctors, mind you, not the actual healing professions -- it's their "managers". The whole business makes Enron and the old S&L scandals look like an innocent game of checkers in the park. And it reduces me to having to focus too much of my time and attention on money, which is NOT what I really want my life to be about, thank you very much. I miss the old system, where if my kid got sick I went to the pediatrician, and I paid for it, because I could, because it was quite reasonable. What was wrong with that system, anyway?

Reminds me of the "what won't there be in heaven?" thread -- my answer included money and greed. But of course, there also wouldn't be illness or doctors.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: paddymac
Date: 04 Jun 02 - 12:00 AM

Most US practioners who accept insurance patients are prohibited by the insurance companies from providing services at a lesser rate to patients who pay cash. The rationale, I presume, is to prevent "over-charging" the insurance company. The reality is that anything involving third-party-payors has a higher overhead cost factor for the practitioner than cash patients. The result is that those who do, or would prefer to pay cash, are made to pay more for a service which cost less to deliver.

The same phenomenon governs the credit card industry. In addition to the buyer and the seller both paying a transaction fee (and the buyer paying interest as well), the seller is prohibited by the credit card companies from offering "cash discounts." Thus, the cash buyer pays more for a service/product that actually costs less to deliver.

Perhaps more accurately, cash customers are forced to subsidize credit transactions to which they are not a party. If you don't like getting screwed in this fashion, raise hell with your elected representatives at every level of government.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: katlaughing
Date: 03 Jun 02 - 11:53 PM

Comments welcome from all corners, Ozmacca! Do I read you right, your gov't. taxes you if you DON'T buy private health insurance?!

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: GUEST,ozmacca
Date: 03 Jun 02 - 11:30 PM

Can a foreigner stick an oar in? This is what OUR government in Oz wants to do to us. And they seem to be getting away with it.

I recall somebody a little while back in our govt saying that when you pay for Health Insurance, what you actually buy is a sense of security. And this is true.... but you don't get real security, just a sense of it. Try putting in a claim for something when you've been paying premiums for years and think you're covered for the relevant costs, and see what happens. This is all part of the trend that sees public money NOT going to the common weal. When public expenditure goes towards all those little benefits that our elected representatives and their high-level friends and supporters enjoy, and not towards protecting the health, education and security of the whole public, then you've got to start wondering why we continue the support the system by buying the insurance at all. Can you imagine what would happen if the population stopped paying private health insurance? I can. It happened here. The govt introduces taxation penalties for not having it.... Sound familiar, or am I just getting paranoid about the economic rationalsim which seems to be intent on making every person an entry on a big-business balance sheet?

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Maryrrf
Date: 03 Jun 02 - 10:14 PM

This is a sore spot with me, I have a son who has a chronic, expensive illness (hemophilia) I've had too much experience with insurance companies and the screwed up health care system in the US. My solution was to always work for big companies - I had no choice. Otherwise, because of his preexisting condition, his policy would run me at least $1200 per month - yes, that's what I was quoted. That's almost twice my mortage payment on a small house. He's always gotten treatment and I've always managed to hang on to an insurance policy, but others have not been so fortunate. For a country like the United States, the convoluted, unjust, overly complicated and frightfully expensive system that we have is inexcusable. And yes, if you don't work for a big company you're screwed. If you develop an expensive illness they'll raise the premiums for all the employees of a small company to the point where they won't be able to offer insurance any more. I've also known of people who paid for individual policies, developed cancer or some other serious expensive illness, and whose policies were either canceled or their premiums were increased to the point where they couldn't afford to make the payments. Of course if you have an accident or illness and you don't have insurance they will go after your assets to pay the astronomical bills. I've heard the horror stories about the British NHS, and I'm sure they have their problems, but I'd gladly trade it for the one we have here, which isn't a system at all but more like a dog eat dog jungle.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Robin2
Date: 03 Jun 02 - 10:14 PM

kat,

I sure feel for you, darling... health care in the good ole US just plain sucks sometimes.

Hubby and I both have what's called "pre-existing" conditions. Which means that health coverage for us is way beyond what two folk musicians can stand. We have a great doc, who charges a minimum fee for office visits, and gives us free meds when he has them. Still, meds and office visits can run 200-400 dollars a month, which is still cheaper than the insurance. Heaven forbid we become seriously ill....

Crossing my fingers, and hoping to see Medicare...

Robin

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: artbrooks
Date: 03 Jun 02 - 09:58 PM

It all depends on your group. As Kat implied, the bigger the group the better off you are, since there is more opportunity for the employer to negotiate with the insurance carriers. I'm lucky enough to belong to the largest (I think) group in the US (current and retired Federal employees); I pay about $200 per month for Jenn and myself, and the government (ie, the taxpayers, which includes me) pays about $400. There is a $500 per year deductable, all pre-existing conditions are covered immediately, and the plan covers almost everything. This is under Blue Cross, and there are other carriers available. I also used to do this sort of thing (health insurance advice) before I retired.

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Bobert
Date: 03 Jun 02 - 09:37 PM

You know, Kat, it is kindof a crap-shoot since there is no "Patients Bill of Rights". Like you, the monthly premiums are around $700 for the two of us who are both is reasonably good health. But then you wonder what the company would say it you really got sick? "Hmmmmm, we're sorry Mr. Bobert. We only insure the non sick." That is mu biggest fear. I mean there is no law protecting folks from getting cancelled because they get real sick and for most of us that is the only reason we buy the danged stuff in the first place, ain't it. The bumps and bruises, we're more than happy to pay for, if it doesn't mean forking over $700 a month for what, when push comes to shove, ain't worth anything more than the paper it's printed on.

End of Bobert's "Health Care in America" rant. Hey, at least it eas a lot shorter than some of them. Right?

Bobert

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: harpgirl
Date: 03 Jun 02 - 09:12 PM

..that isn't fair now is it? If you were eligible for SSD in two years you could get Medicare but still no drug benefits. Peg has the right idea. I consider myself to be a victim of the belief that one NEEDS health insurance for most of one's life when the evidence is otherwise. So I go on paying....I wonder if buying a cancer policy and paying cash for everything else is really cheaper and more sensible...

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: katlaughing
Date: 03 Jun 02 - 08:55 PM

My thoughts exactly, Peg, but of course I am betting on improving some fairly serious things, BUT I feel so much better when I choose the alternative.

HG...I think you are right, catastrophic is what we all hedge about, isn't it? Maybe I'll look into getting that only for me. We will go ahead and get coverage for Rog because his employer will pay half and it will only cost us about one hundred per month, then.

Here's what really pisses me off. Because his employer has less than 51 employees, there is no open enrollment. Pre-existing conditions must wait for six months before coverage, so in teh emantime we'd be paying out not only my usual expenses of about $200/month, but also another almost $250, just to add me. I don't go to the doc for anything, ever, except what is related to what they consider pre-existing because otherwise I am in good condition (wanna kick my tires and look under the hood!?**BG**) Anyhow, what PO's me about that is any employer with MORE than 51 employees and there is NO WAITING PERIOD for pre-existing. So...let's punish the little guy who's trying to do right by his employees, eh?

Thanks for your comments,

kat

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: Peg
Date: 03 Jun 02 - 07:34 PM

nope don't have it. Had it for a year when I had a real job and didn't use it.

Shore hope nuthin bad happens to me! ;~}

One reason I have put a lot of time into learning about holistic and alternative modes of healing is to lessen my dependency on western medicine and especially on this fucked-up health care system...

Cold/flu? Essential oil inhalations and herbal tea.

Headache? Peppermint or rosemary essential oil, or aspirin.

Sore throat/upper respiratory infection? Gargle with tea tree oil solution. (Get possible strep infection checked out if it does not respond to tea tree; but it usually does).

Muscle pain? Essential oils in the bath, steam compresses, and maybe some ibuprofen if desperate.

Stomach bug? Herbal infusions and grated raw organic apples.

Yeast infection? tea tree or lavender oil clears it up almost immediately.

Menstrual pain? Raspberry leaf tea and cut out the salt and sugar for a bit.

Now, if I get cancer or something I'm in trouble...

Subject: RE: BS: USmostly- Health insurance-crap-shoot?
From: harpgirl
Date: 03 Jun 02 - 07:32 PM

...one piece of advice, kat...find out if the available insurance companies have "open enrollment" and when. It allows you to have any "pre-existing" conditions covered with no waiting period. If you have ongoing medical expenses, you might save some money that way. I do think that catastrophic medical insurance is probably more cost effective than paying monthly premiums when the healthcare you do use is less than the monthly premiums...having said that I buy my family insurance as a small group and pay $375 a month for myself and Nathan. harpg

Subject: USmostly- Health insurance-crap-shoot?
From: katlaughing
Date: 03 Jun 02 - 07:25 PM

Sorry that this will probably not apply to all, just US-Catters mostly, I think. I know we've talked about health coverage available in different countries, but I am interested in how many in the US have health insurance and if they think it is worth it.

It seems ever more expensive, esp. if one has what the ins. co's. term "a pre-existing" condition (I always want to say, "No, I haven't existed at all until I signed up for your service!"), plus it just seems to be a crap-shoot. Everyone's betting on whether a person will need it or not. I hate that kind of thinking. And, I hate that this country does not have any kind of universal health care plan.

Can you tell I am trying to decide, once again, whether to sign up or not, thorugh Rog's employment?*bg* Five or six years ago, we said enough is enough and declined coverage when it went to over $600 per month for two of us. We have managed okay and are thankful. It almost seems it would be better to put what they want for premiums in the bank and take care of ourselves.

On a related subject, another 'catter told me a doctor in their town has just dumped all insurance companies and gone to all private pay AND the patients get a solid hour, with all kind of treatments, for the the set fee. I admire that doc's courage!

Thanks for your input.

kat