Suddenly Last Summer
A post from a guest blogger:
Suddenly last summer…
Exactly one year ago this morning, I found myself strapped into a rescue helicopter en route to UCLA Medical Center. It had been a little over an hour since a predatory black bear attempted to make a lunch of me, and I was determined to make it to the emergency room before I passed out–maybe for the last time. Both my father and my sister had gone to medical school at UCLA, and I knew that there I would be given top-notch care in a top-notch facility, with the help of the best technology in the history of the planet. But I also knew that should I somehow survive, I was in for years of hassle with the insurance companies that control the medical field– and I wasn’t entirely certain I wanted to face that.
To their apparent chagrin, and thanks in significant part to the support of the community here at HBB, I did survive, and sure enough, this past year has been one maddening battle after another. Not with my medical treatment– which has been exemplary– but with the seventy-three layers of corporate and governmental middlemen between my doctors and my wallet. Middlemen who at every turn have attempted to second guess, inhibit, or outright oppose my physicians’ attempts to fix me.
I can’t help but feel the same about health insurers and their cozy little deals with the federal government as I do about Wall Street, fractional reserve banking, and the late lamented housing industry. The parallels between what happened to these institutions last summer and what is happening to health insurance companies today are ominous–and now it looks increasingly more likely that you and I will be called upon to bail them out too.
I wouldn’t be quite so aggrieved if I didn’t feel– as do so many of us here on HBB– that I am being punished for having done the responsible thing by maintaining an ever-more-expensive health insurance policy all these years, while others simply sat back and milked the system (a system paid for by our taxes and insurance premiums,) for medical care WE ourselves CANNOT AFFORD.
Sound familiar? This blog was founded upon such resentments. How is the well-documented greed, incompetence, and chicanery of America’s health insurers any different from that of the commercial banking or housing industry? Is Wellpoint CEO, Angela Braly, any less culpable than Countrywide’s Anthony Mozillo? Is the fine print of a health insurance policy any less obfuscating or weaseling than that of a credit card agreement?
I know I’m not the only person here who postponed buying a house for a couple of decades or so because I couldn’t afford both a mortgage, AND health insurance. Nor am I the only one with a major axe to grind against the health insurance behemoths who extort our money then renege on their contract.
Read my horror story –one among literally thousands of similarly egregious examples.
Not the housing collapse, not the credit crisis….
“…Everybody acknowledges that the single biggest threat to our fiscal stability is Medicare and Medicaid. It’s not even close. That is the single thing that could drive us into long-term staggering and difficult debt.” President Barack Obama on PBS NewsHour.
Obviously something must be done before millions of us retiring baby boomers overwhelm Social Security and Medicare and bankrupt what is left of our economy. While some on this blog might applaud the idea, it would probably be a hard sell getting the country to go along with exterminating everyone who turns 65, so reforming the health care system we have now seems a more reasoned alternative. Like it or not, we’re going to have to rethink our national policies on end-of-life care, elective procedures, and coverage of treatment for preventable illness and disabilities like obesity and diabetes. Expensive and redundant programs like Medicare Advantage– a $177B subsidy to the insurance companies– will cease. Employee health benefits will be treated as taxable income, and deductions for medical expenses will be reduced for upper income earners. And that’s just for starters.
As our government attempts to craft some sort of reform bill to address this latest Gordian knot, it is increasingly shaping up to be a battle between doctors (AMA,) nurses (ANA,) hospitals (FAH,), life-long taxpayers (AARP,) major employers (WalMart,) and even some pharmaceutical research companies, VS the “free market” health insurance industry. Just whose lobbyists will prevail is still an even bet….
No matter what the outcome, though, we all know they’re going to take our money–a lot of it. This much is a given. The question is; how and to whom should it be redistributed?
ahansen (unless someone else on this blog had a battle with a bear as well)…
After reading your linked story about your troubles with insurance companies, I’m curious to ask - are you still fighting with the insurance companies, or are you ending up paying for a lot of this out of pocket? Are you racking up bills with the surgeons? Or are you simply foregoing care at the moment?
Sorry to hear it’s been such a difficult battle. One would hope that surviving the bear attack would be the hardest part. It would appear that’s not the case…
Out-of-pocket expenses so far are in the mid-five figures, and I’ve a couple more years to go in my reassembly. My individual Blue Cross policy (which I’ve paid religiously for 30 years,) has a $2500 deductible which resets every January 1. (Do-able, right?) After the deductible has been satisfied, the policy supposedly covers 70% of “reasonable and customary medically necessary expenses” excluding dental, ophthalmic, and cosmetic surgery–all of which I need. There is no coverage for drugs. Such things as X-rays and anesthesia are not deemed “medically necessary.”
Unfortunately, “reasonable and customary” does not mean the same thing to Blue Cross as it does to medical providers. So that $2500 deductible turns out to be more in the order of $7500 out-of-pocket before ANYTHING is covered. Then the 70% Blue Cross DOES cover is conditional upon whether or not THAT is a “covered expense,” “reasonable and customary,” etc. etc. They even tried to charge me $1700 co-pays for each of the five rabies vaccinations I had to have–which the public health hospital got for free from CDC! And on top of that are the monthly premiums.
Quite the con.
Fortunately, several of my physicians have provided me with “extra” services at no charge. Others have given me copious drug samples and cooperated with Project RXHope to get me specialized medications (mostly for my eyes,) at reduced cost. Mostly, I just modify my treatment plan to something affordable. (Only two bone and tissue grafts instead of the recommended four. Not replacing ALL the teeth I lost. Foregoing having the bridge of my nose reconstructed. Making my peace with being blind as a bat. Not filling all the prescriptions, etc. )
A couple of dox have offered to “do” me for free in exchange for me going on one of those Plastic Surgery Miracle shows, but as far as I’m concerned, my 23 minutes is up and it’s someone else’s turn to be the national freak show. I’m devoting my small celebrity to getting a public option in the health reform bill and spreading the word about predatory lenders, er, insurers. It’s most satisfying revenge….
Allena - I am so sorry for what you had to go through and I commend you for taking your story public so others can learn.
All this fear-mongering about “socialism” just falls flat in the face of stories like yours, hard-working Americans who thought they had health insurance only to have catastrophe strike and learn they did not.
Only the uber-healthy and accident-immune among us can afford to spout on about “socialism” in health care.
Commentators always warn that we are - gasp- turning into France. But let me tell you that if anything like this had happened to you in France you would get the care you needed and not pay a dime, and it would be the doctors you wanted b/c you had private insurance.
And no, France does not have nationalized health care, it has a gov’t run health insurance program and the vast majority of French (more than 90%) have private supplemental insurance. The difference, as Allena can attest a very important one, is that the insurance companies don’t routinely deny all claims and try to wiggle out of their contractual duty.
I’ll take the French kind of “socialized” medical care over the “freedom” to go deeply into debt, be denied care I paid for and spend years battling corporate swindlers.
Would the French have allowed the situation with outsourcing & offshoring reach this level?
Bend over and get ready for Obamacare. Of course Congress is exempt! You won’t be able to keep your current plan (page 16 of 1018) and will be fined by the IRS $2500 if you try. You can’t have an HSA (page 167-168).Rangle already had a vote to raise taxes which the Dems passed in Ways&Means.Obama has said he will ration health care and reduce Medicare reimbursements by 21% next year.25 million illegals will get free health care on our dollar.Manditory ‘end of life’ counseling for seniors. CBO says over a trillion to the deficit.
Mandatory broccoli injections! (page 223)
Facelifts for 67% of all illegal aliens!
Tax breaks for puppy sacrificers! (pages 666-9)
Sigh.
To support the US health care establishment is to never have come in contact with it as a patient. The insurance companies blow credit card cos out of the water when it comes to “creative charges”. Whatever you think your “deductible” is means nothing re what you will pay if you ever have to actually “use” your insurance.
We pay more for healthcare in the US, yet most western countries have longer life expectancies than we do. Explain this, all who oppose.
universal healthcare
Amen, sloth.
As a former NHS funder and user, my question is - what’s taking y’all so damn long….?
Its funny - one of the last bits of ‘advice’ I was given before I moved from the UK to the US is:
“America is a wonderful country, full of opportunity.
But, if you get sick, come back to the UK - the price of the plane ticket home will pale in comparison to your medical bills.
Don’t get sick there….you can’t afford to”
I must politely disagree. Socialized medicine is not the answer. Socialism is not sustainable, in any form. Eventually, those who have to pay the bill (the affluent) may leave. The only problem I have with the concept is socialism never accounts for where the money comes from to pay for it all. Coming from me isnt the answer. Our country was never meant to be a socialist utopia. You were meant to come here and take care of yourself. There are too many examples of socialism in latin american countries and african nations. Know that the line to get into most of these countries is small and our’s is still very long.
Who pays YOUR salary, son?
Move along. Nothing original here.
Are you coming to DC to testify? I’d think they would want you even if you don’t want to do the TV thing. Hey, nobody really watches c-span anyway, right?
Only us CSPAN junkies, Polly. Best entertainment on TV.
Thanks for your post yesterday, BTW. I referenced it below.
If anyone needs me to testify, I’m ready and willing to do so. So far, no one’s taken me up on my offer…most likely because they know I’m not docile or easily intimidated. You’ve my contact info if anyone asks. I consider it my civic duty to keep the debate going.
ahansen,
It’s a shame you’ve had to deal with the horrors of our medical system. I applaud you for stepping forward and making it your mission to help fix our failing healthcare system!
If there’s any way I can help, please let me know (you have my e-mail, no?).
God bless you, allena!
ahansen: I am so sorry you went through all of everything. You seem like a very strong person. To get that kind of bad luck, bears/corporation leaches, makes me feel sad.
ATE-UP
P.S. That picture of you is pretty on the link!
Seems to me that your dental or eye work would classified as medical expense as a result of cause of injury. Have you consulted an attorney in regards to bad faith liability by the carrier?
There are no words to express how terrible this all has been; I am very sorry for all the pain and suffering that you had to go through, and the predatory nature of humanity as they try to exploit you is just sickening!
Perhaps the new Health Authority should long and hard at the implications of people living in proximity to dangerous wildlife. Since you will be less of a risk to the pool of you are compelled to live in the inner city, I would propose a draconian tax on any citizen who chooses to live within 25 miles of a known habitat of a dangerous animal, such as bears, wolves and crocodiles.
This would dovetail nicely with the drive to reduce consumption of fossil fuels by eliminating the need to truck emergency services and such to the people who make the irrational decision to live in such a dangerous environment.
You can count on my support, and since I will be paying your bills under this fantastic idea, I have only one thing to say.
GET SOME BOXES!
Right, Joe.
So many more people are eaten by bears and crocs than shot by gang-bangers, and hit by drunk drivers….
The costs to society of my medical care are PRECISELY the reason I’ve maintained a private-payer INSURANCE policy all these years.
And for the record? I DO pay a draconian tax to live where I do. No public services, I supply and maintain my own water, electricity, and roads, grow most of my own food, stitch my own wounds (the nearest doctor is 67 miles away,) and rarely leave the property. Yet I am subjected to the same taxes and fees that people who DO have access to public services receive. I see it as my surtax for the beauty of living in a place with no lawyers.
btw, Ben, the link on the main page is incorrect. It goes to the anchor “#respond” rather than “#comments”.
I’ll take my freedom over socialism any day.
Way to plug this agenda.
Pray you never get hit by a drunk driver, Kenster. Or sneezed upon by a tubercular fast food worker because there’s no public health service. Or contract the new H1N1 virus that’s ravaging Great Britain. Or…
BTW. Did you drive into work on one of those socialist roads this morning? Or take a shower in that socialist water supply? How about that socialist interweb you’re posting on?
Actually, I live about a John Galtian a lifestyle as is possible in this day and age–hence (and ironically,) the impetus for this blog.
He’ll also be the 1st in line to collect “social” security.
Those are not fair comparisons, imo.
Everyone uses the roads. Everyone uses water. So everyone deserves to pay for those. and you gotta individually pay to gain access to the net afaik.
otoh, not everyone falls down an open manhole while texting.. not everyone gets hit by a drunk driver.. not everyone suffers illness or bad health due to bad luck or bad habits.
In any case, socialism shouldn’t enter this discussion. The objective is to make health care more affordable. It’s just too expensive, meaning it’s beyond the normal, average person’s ability to pay for normal, average amounts of care.
Just like overpriced housing, when the price of care is too large a percentage of income, it doesn’t allow enough left over for other necessary expenses, and something’s wrong.
Exactly, Joey.
That’s what insurance does. It makes everyone pay for what some people use. It’s socialism, only with more corruption. That’s why it sux so bad, and that’s why it has caused the price of health care to increase so much.
Imagine if employers never covered health insurance? You’d get that extra $$ on your paycheck, then do with it what you wish. You may put it in a savings account and use it when/if you ever needed it. You may use it to buy your own portable health insurance policy, in which case I guarantee you’d do a lot of shopping around before you signed a contract. Or you may use it to buy crack.
If ppl had those 3 options available to them, then the cost of insurance and the underlying health care would go down.
i posted lower down and expressed my thoughts regarding insurance’s roll in the system.. I do not tie costs to them. They are just covering a bet, and will make their money no matter if costs are high or low.
Here’s an example. Some nurse is half asleep and can’t tell left from right and some doctor removes the wrong kidney. He gets sued. The jury, being compassionate human beings, awards the patient $50,000,000.
Now what.. well, it’s gonna be pretty damn expensive if some doctor repeats that mistake. So, malpractice insurance coverage has to go up quite a bit. Who will pay that doctor’s higher premium costs?
It has to come from patients, since they ultimately pay for everything. The cost of medical care just went way up.
Are we gonna somehow justify ourselves in blaming this rise in health care costs on the insurance company?
Joe:
Yeah, malpractice lawsuits raise costs, but they also increase quality, so they are value-added.
Insurance raises prices by adding an entire industry (which must be paid) to the equation and by taking purchasing decisions out of the consumer’s hands.
How does a judgment of $50,000,000 ($45M of which goes to trial lawyers) increase the quality of care? Will nurses stop staying up late? Will fewer perfectly healthy kidneys be removed?
To the contrary, the higher price of malpractice insurance means that doctors, nurses and hospitals have PAID to continue to be clumsy. They are COVERED and need not worry about it. They don’t suffer if they repeat the mistake.
The insurance co might suffer a loss, the patient suffers.. all who need health care suffer from yet higher prices… but the people who are covered by malpractice insurance don’t suffer.
They WOULD worry about it, and improve care if they were NOT covered.. If not covered, a hospital or a doctor would go broke and be out of business if sued and found liable.. Under those conditions they’d be damn careful.
——-
So, lets limit, reduce or outlaw malpractice insurance.. make doctors responsible for their actions?
But no.. that can’t happen. It would mean no more huge judgments for malpractice. The wronged patient couldn’t be properly compensated.
Do you ever think the reason juries find for such high amounts is because our health care system is so expensive and so impersonal ? If people weren’t treated like commodities and shuffled through the system like slices of cheese, juries would probably have much more sympathy for the system itself. Instead, as I posted above, If any on the jury have had any experience with the US healthcare system, they are surely prejudiced against it- because it quite frankly sucks. No one else (other than a few cranks) in the western world envies our healthcare system. It’s as simple as that. Oh, except ours costs a LOT more.
Juries award huge judgments in retaliation for high health care costs?
wow.. kinda far fetched, imo but even if true, that doesn’t mean insurance companies are at fault for covering their butts when it happens (which is the subject of this thread).
Aside from jury awards, there are other reasons care is expensive. IIRC, as of a few years ago, getting a new drug past all the government red tape cost something like $100 million dollars. That’s quite an investment without a guaranteed return. A company would have to be nuts to take on these projects considering they might afterwards still be liable if the drug proved dangerous.
i once saw a list of various reasons HC is expensive.. it was pretty long.. i’m gonna try and find it again.
While you’re researching, find out why most western nations spend less on health care than we do, and yet selfishly outlive us.
“…Everyone uses the roads. Everyone uses water. So everyone deserves to pay for those.”
We all use hospitals, medical schools, research facilities, paramedic and emergency services, advanced scanning technologies, epidemic and vector control, etc. as well. None is affordable to the average community or business, but by pooling resources, they are made available to large numbers of people across broad geographic areas.
The fact that those services you list are available doesn’t mean we all use them.
The services of an attorney are also available. It might be a bit of a stretch to say we all use attorneys in one way or another.. but this POV could easily be defended if one cared to.
However, it doesn’t justify pooling our resources so anyone who needs an attorney’s services (beyond a public defender in his proper role) can have one, imo.
Of course we all use them.
In 1900 the average lifespan of an American male was 47 years. If you live past that age, YOU are beneficiary of our public health system–whether or not you ever set foot in a hospital. That you don’t have to worry about dying of polio or smallpox, that you can eat an ice cream cone or take-out pizza without fear of death by dysentery is testimony to its efficacy.
Our health care system, like our court system is a national resource supported by our taxes. We don’t pool our money to hire individual doctors. We pool our money to give them an arena in which to practice medicine and public health.
YOU are beneficiary of our public health system–whether or not you ever set foot in a hospital…
That’s like saying that because the local TV station broadcast “Gone with the Wind” last night, I saw the movie.. even though I don’t own a TV set.
—–
…Our health care system, like our court system is a national resource supported by our taxes…
Some small parts of the HC system are publicly supported. R+D in public institutions.. medicare/aid.. a few clinics.. VA hospitals.
But for the most part it’s a private industry and certainly not publicly supported. I’ll guess 95% of hospitals and their staffs are private.. medical suppliers.. drug companies.. paramedics and ambulance services.. Private research foundations.. etc.
If the health care industry were already publicly supported we wouldn’t be debating the proposed reform plans.
That’s an absurd point, joey. No one needs health care until they do. The health care infastructure was built with more than a little help from the public purse. And public hospitals continue to take care of the “non-profitable” sick and injured that the private system would, I guess, let die. Your “95%” figure for private to public healthcare ratio, if true, merely reflects the number of vampires in the private system. And argues for a public system.
..The health care infastructure was built with more than a little help from the public purse…
How is that so.. care to elaborate?
Well, I live near a state university hospital that has a top of the line trauma unit and helicopters flying in the sick and injured 24/7 , regardless of their insurance. I suspect and hope this is my tax dollars at work.
And I was once cut out of my car with publicly purchased jaws-of-life, driven to the this same state-funded university hospital in a publicly purchased ambulance, and “patched” back up (and probably kept alive) by publicly funded university doctors. So I admit I have a soft spot for them. (And I did have insurance, but no one asked me as I lay unconscious.)
I am old enough to remember my parents fussing about “socialized medicine” back when Medicare was first proposed. My father died too young to need it, but danged if it didn’t serve my mother well for almost 20 years.
She and her employer paid into the system for almost 30 years, and she reaped the benefits of the payments for 20 or so after she turned 65. Most people by the time they turn 65, would be uninsurable under a private insurance plan so the medicare system “works”.
The trick to any insurance program is to make sure that it is actuarally sound, which means facing reality with respect to the future costs of providing benefits and based on that adequately funding the system. That’s where the ugly hand of the political system enterst the picture. The majority of the populace want something for nothing, which in this case mean they do not want to pay what is really required to provide the services that they will, with all certaintly, need at some point in thier life. Most are either incapable or at best unwilling to recognize the fact that if we as a society want the ability to have expensive care when needed, we have to be willing to put money into a system before, well before, the need arises.
The politico’s exploit the masses, by either telling them that someone else should shoulder the burden (left) or that everyone should take 100% responsibility for thier own care. Neither positions is tenable.
I personally support a system with individual mandates, administered through the tax code with the burden for providing a reasonable level of insurance protection for catastrophic care shared by the individual and the employer, much like Medicare funding is handled today. I also believe that the mandate should recognize the requirement to insure members of an individuals family, the cost of which should be primarially borne by the individual. We require persons to carry basic liability insurance to drive a car, it’s not that much of a stretch to require an individual to insure himself and his family to protect society against the costs of caring for the uninsured.
The government must be involved in the administration to prevent the abuses of the insured as exemplified by the blog. Anyone who has not suffered this kind of abuse at the hands of an insurer to some degree or other has not had a major accident or illness.
Libertarians take note:
Just as we don’t have a free market economy with the Federal Reserve setting interest rates, so too do we not have a free market healthcare industry with pay for play cronyism, legislated monopolies, and various barriers to entry for competition. The current “free market” private insurers are in many ways a cartel. It would be great if this would change, but no such change is on the horizon.
Given this situation, believe it or not, government run health actually would be better than the “free market” private insurer based system that we have today. Simple examination of administration cost figures indicate this clearly. I don’t enjoy the idea of the government running anything, including healthcare, but let’s not pretend that having them do so would rob of us some freedom that we do not currently enjoy.
It does seem as though a competitive private system has the potential to be more efficient than a public system, but it’s failing miserably in the US. Ahansen, I believe you hit it right in pointing out that medical coverage is just as messed up as the rest of the corporate world right now.
A well run single-payer system can be much better than the current US private system, but medicare doesn’t appear to be the model to use.
“Given this situation, believe it or not, government run health actually would be better than the “free market” private insurer based system that we have today.”
It would be cheaper. Time will tell in terms of quality of care.
I applaude your willingness to die from lack of medical care in the name of “freedom”
Mo and others,
I am over 65 and on Social Security and Medicare. In my opinion, Medicare MUST become a provider of just the “Two P’s”: “Preventive and Palliative” care. Anything else is on your own nickel.
For the rest of the country, a publicly-funded medical care system must eliminate the 80/20 conundrum, where 80% of the care resources and dollars go toward the 20% sickest patients. The place to start: Close all trauma centers.
If you think it’s far-fetched, be aware that a government commission is already studying how to make those dollars and cents decisions and implement them on a mostly unwilling public. The alternative? Out-of-control federal budgets leading to hyperinflation leading to ultimate collapse.
When you say “preventive and palliative” are you really suggesting that only check ups and ease in dying be covered? Really? No cancer treatment after 64 unless you can pay for it yourself? No pacemakers? At all?
What about the group negotiation portion of insurance I talked about yesterday? The hospital where I had my knee surgery wanted to charge over $10K for the 5 hours or so I spent there. But they were willing to take just $1600 split between my insurance company and me. Medicare probably reimburses between $1100 and $1400. Should those on Medicare have to pay up the $10K or be able to glom on to the lower negotiated rate or try to negotiate a lower rate themselves?
“Give me freedom and give me death”
Ken, can we not agree that getting mauled by a bear is different than getting a private room during a hospital stay?
I find most of the people crying “socialism” are simply alarmists that have very little understanding or experience of what socialism really is.
“I’ll take my freedom over socialism any day.”
And make sure you personally repudiate medicare …… ya coward.
Seriously, why are we, as taxpayers, funding an institution like UCLA a “top-notch facility, with … the best technology in the history of the planet (?)”
That is clearly something the private sector should be doing…
American medical research and teaching facilities have given us the technological wherewithal to raise our life expectancy by 40% in the last century. It has eliminated or controlled most deadly childhood diseases, pioneered life-saving medical and surgical interventions, and probed the very essence of human life. We, the government have made this system possible–and funded much of it.
YOU are the beneficiary of your grandparents, parents, and perhaps your own beneficence. Thank you.
Thank you so much, ahansen!
On this week’s to-do list is a call to a doctor’s office. Time to make an appointment for a checkup, and I’m putting off making that call.
Why? Because I’m afraid that, if the doctor finds something wrong, the cost of the care will likely bankrupt me, and I’ll lose my house.
Yes, I do have health insurance, but, as we all know too well, insurance companies are very good at denying care, even to those of us who’ve paid the premiums.
So, I’m with you, ahansen.
I’ve been thinking along the same lines: Do I load up on “non-tested” life insurance (like 3-5 policies) before I sign up for one where the coverage is large enough it mandates testing- just in case an ugly result rears its head?
How much covereage is “enough”? (2 kids + wife)
Convential wisdom says 10X annual income.
Someone (Montana?) mentioned yesterday, AZ, that they’d set their own splints, stitched their own wounds, postponed treatment in favor of “watchful waiting,” etc. I’ve done all these things myself rather than have to pay out of pocket (remember that deductible,) for health care that so many (with public health service–NOT private,) get for free.
I’ve been in your position (avoiding medical check-ups) so many times I actually think it’s worked out better in the long run. I try to stay as healthy as possible and power through the smaller injuries like broken digits and non-arterial cuts I can patch myself, under the rationalization that self-reliance can be an empowering thing. Sometimes not knowing is less stressful than worrying about what cannot be remedied…and a lot of illness and injury heal themselves over time.
But every now and then, yeah. You’ve got to cough up a thou or so for a colonoscopy. Or a cardio workup. THESE are the sort of preventive screening procedures that insurers should be scrambling to cover as they are far more cost-effective than treating advanced illness and debilities. And THIS is what a public Medicare program would address. Doctors may negotiate price for cash, and a lot of insurance plans offer subsidized screenings and check-ups. Call your insurer and ask what’s available before you book an appointment. You might be surprised.
And if, heaven forfend, they do “find something,” established medical protocols are a lot easier to price than outlier events like my own. (Bankruptcy being the least of my concerns.) As with pretty much everything else in life, it’s only when you fall outside the norm that no one knows what to do with you–or what to charge.
Good luck!
Here is what I don’t get: medicine is expensive, but everyone somehow thinks we can make it cheap. If it costs 1k for a colonoscopy, and everyone needs a colonoscopy every 2 years once you hit 50, then it seems like 1 of 2 things have to happen:
1) your insurance premiums go up by $500 anually ($1k/2years) just for the colonoscopy portion of your care when you hit 50
2) your colonoscopy is not covered by insurance and you get to make the choice if you want to pay for it or not.
It seems to me that practically NO standard care should be covered by insurance, and only emergency, or highly unexpected/expensive care should be insurance related. By running your standard health care dollars through insurance, you are just adding administrative overhead to suck more of your money out of the equation of dollars meant to be spent on your health (unless you believe that insurance companies can provide you negotiation enhancement for standard care).
Think of it this way, your car insurance doesn’t pay for oil changes does it??? Why should your health insurance pay for regular checkups???
But then you ask, “what about people who can’t afford to pay for standard care???” Well, it seems that unless you maintain your car by giving it oil changes, your car will break down and fall apart. It’s only if you get in an accident that insurance pays off. Falling apart due to lack of maintenance isn’t covered…
I just don’t see how you can guarantee people a quality of medical care. It costs money. If they didn’t make the money, they don’t deserve the care??? Maybe people who make the money want to decide that they should donate some of their money to pay for care for those less fortunate. But to point a gun at them and tell them they will go to jail if they don’t pay the tax seems wrong.
As a side note, I am happy to donate to causes that provide medical care.
That is why they have deductibles, mathguy, and premiums. They work it out actuarily even.
Co-pays are another good idea–even if they’re minimal. Personal responsibility and all that.
Co-pays came out of the RAND health care experiment in the 1970s. The government paid premiums for 4 types of insurance and randomly assigned people to the 4 groups. The first group had totally free healthcare with no co-pays. Each successive group had larger co-pays and worse coverage. The researchers found that even a minimal copay kept people from hounding doctors for the most trivial of symptoms, with no difference in health outcomes. Thus, co-pays are an effective way to ration resources.
Yes I too have made my pereginations through the medical system.
I have come to the conclusion that even WITH top of the line coverage I cannot afford to be ill.
The last time I was nickled to death with stray charges for months afterwards.
My great fear is that I will fall into a coma outside my house and be hauled off to the hospital where, days later, I will awaken to find that I have been bankrupted by the system.
My solution? I’ll get in shape - to stay OUT of the system. At the end - off I go sunnyassi into the woods …
Oh the stories I could tell about the medical system.
But my reform solution: Laissez Faire, Laissez Passer.
Get the government totally out of this. Medical reform WILL bankrupt us.
Remember - peoples wants are infinite - their resources are not. Put politicians and the beauracrats they create to enforce the laws that they pass - and corporate beauracrats, lawyers and accountants - between us and the Doctor and we have disaster.
I rarely read the comments on this blog but today I did.
The “government” is not bankrupting households with medical expenses.
PRIVATE INSURERS are bankrupting households with medical expenses - premiums, deductibles, copays…..
Medicare (over 65 or permanently disabled and qualified for SOc Sec Disability but not those solely on SSI) was created BECAUSE private insurers would not - not ever, not at any cost - sell coverage to the elderly population.
Medicaid (below 150% Federal Poverty Level with kids or below 150% Federal Poverty Level and disabled but not qualified for Medicare) was created BECAUSE private insurers would not or could not sell coverage (premiums, deductibles, copays) that was affordable to lower income households.
The median household income is $50,000. The average cost of a non-group plan for a family is $12,000 in premiums alone with usually a $2500 -5000 deductible and 30% copays. Do the math.
PRIVATE insurers take an extra 10% of every premium $ for profits. They use another 20-25% of every premium dollar for advertising and finding ways to refuse to pay. Medicare spends 3-5% on administration as compared to private insurers 20-25%.
Medicine for profit to shareholders as practiced by PRIVATE insurers and for-profit medical centers is driving costs through the roof.
A-freaking-men, Catherine. Thanks for the post!
+100
The more you learn about private insurance - the more you know this is true. Speaking as a person with several years experience in benefits administration.
So insurance reform would seem to be the order of the day then, not nationalization of the health industry. Prescription drug prices are out of control too….we need to look into the reasons why and try to attack the problem from that direction.
Government healthcare fixes nothing that is at the root of our problems and will probably make things worse.
“insurance reform would seem to be the order of the day then”
And what exactly would this insurance reform entail?
The biggest problem is still lack of competition. Either the market can be made free and fair (no lobbying, not likely) or the government can step in as a super competitor. Either way I don’t care, I just want us all to have access to good affordable care.
Either way I don’t care, I just want us all to have access to good affordable care.
Well,
I DO care. I want the fed govt to be as SMALL as possible. I want the fed govt OUT of my pocket. One thing that hasnt been said on this blog is…Where are the states in all of this? We are a collection of FREE AND SEPARATE STATES, right? Oh, but the states pockets arent big enough, are they?
I say get rid of every govt entity besides defense, medicade and SS….
I say get rid of every govt entity besides defense, medicade and SS….
Hehehe…..get rid of everyone in Federal Govt, but don’t touch mine.
How about we cut back on the military and stop deploying our male citizens to god forsaken countries?
We could re-purpose the money to education and infrastructure.
No disrespect to your service Stpn2Me - but it always makes me chuckle when libertarians rage about Big Govt in one breath, and then hand ‘The Military’ to it on a doily-covered silver platter, in the next.
Surely - the ‘Purist’ argument goes - The States should be responsible for their own defense, and the govt should get out of the way and let them get on with it?
Any meddling from the top is detrimental to the State’s smooth operating?
Keep the Long Arm of Big Govt away from my freedoms?
What’s that, you say?
- Individual States have neither the funding, equipment, the manpower, R&D facilities, or the organization to be able to do it alone?
- Disparities in population, funding, etc.. set each State up differently, leading to a surplus here and a deficit there?
- ”National’ Defense implies some sort of structure larger and more encompassing than a State-by-State one - but that’s bad?
That the whole is always stronger than the sum of the parts?
Its funny - a lot of people feel the same way about healthcare.
That disparate State healthcare (or local Co-Op plans) are not as powerful as a National one would be….and that someone (other than for-profit health industries) needs to be in charge of it.
Like, at a Federal level….
So, if the United States Armed Services isn’t deemed to be ‘Socialist’ or unwanted meddling in State’s affairs by the Suits in Washington - why is National Healthcare deemed to be so?
Seriously, I’m not trying to poke you with a stick or anything.
Just genuinely curious as to how one thing is ‘bad’ and the other is ‘necessary’ - when they both address national needs?
Insurance is nothing but gambling.
I want to bet a monthly premium of $200 that, per year, my health care costs will be less than 12 X $200, or $2,400. If so, I come out ahead. But someone needs to take that bet. Enter an insurance company.
The insurance co runs the numbers and figures that they need $250 a month to cover my bet.. take it or leave it. I take it and off we go.
—–
The insurance co has no control over health care costs. They don’t give a rat’s butt about costs.
They are bookies covering a bet, and take their 10% cut off the top. They make even more if fewer people get sick than they calculated might get sick. They make more if they can cover only the healthiest people.. just like a bookie makes more if they can take more long-shot bets.
My point is that insurance co’s are just parasites in one part of the system and have nothing to do with costs. Their income is not tied to the cost of care. They will make money no matter if care is cheap and affordable or if it’s high.. no matter if you “bet” $1 a month or $1,000 a month. They’ll always make a profit if they are good at what they do.
We should be focusing on reducing the costs of treatment and care… the cost of a bandaid.. of a night in the ICU.
The insurance company has plenty of control over health care costs. The negotiate with hospitals and doctors and all sorts of providers over what they consider the customary charge for any given test, procedure or visit. Those charges aren’t from some sort of magic always right independent statistician. And they have NOTHING to do with the charges you see on your EOB.
In addition, the insurance company can decide which drugs to cover, which tests to cover, which procedures can be had without pre-approval and which ones require the doc to get pre-approval.
All those things affect the cost of care because they affect which care most people can get and which care they don’t.
I fail to see how an insurance company’s need to decide what they will or won’t cover means they can control costs. If anything it affirms that they can’t control costs.
If insurance companies determined costs, they would simply raise prices to the point where there would be no need to NOT cover any drug, test or procedure.
Prices would be such that they would profit from everything, and everything would be covered… everything would be allowed without approval.. but this is not the case.
Medical reform WILL bankrupt us.
It depends on the reform. Currently we spend, as a nation, enough to provide full healthcare for every citizen in the country and pay for every procedure ordered by every doctor for every patient everywhere in the nation (this according to a Harvard study). This is how much we spend currently. But instead of this Utopia we have a system of waste and graft with exhorbanent amounts of money being spent on things that have nothing to do with care. My favorite statistic: Medicare costs 3% to administer, private insurers average 20%.
So again, I say it depends on the reform.
“Medicare costs 3% to administer, private insurers average 20%.”
That is because Medicare doesn’t administer a d*** thing; they just write checks. It isn’t as if it is real money, just taxpayer debt!
This is like saying my private insurer doesn’t adminster anything, they just issue denials (and write the occasional check) - and boy are they good at issuing denials.
Your favorite statistic is comparing apples to oranges. Many administrative functions counted towards the 20% for private insurers are performed by other govt agencies and not counted in the 3% admin costs for Medicare.
Meanwhile, a lot of the private admin costs go towards trying to verify claims (and, I admit, to avoid paying them). Medicare reimburses any claim submitted, however fraudulent, then at the end of the year needs billions from general funds to cover their shortfall. Neither system is working.
Apples to oranges indeed. The government doesn’t need to pay profits, or sales, or marketing, or lobbyists, or executive salaries. It is exactly because of this that it is nothing like private insurance, and its costs are so much lower.
Ask your doctor or hospital how much they have to pay for coders and billers whose only job is trying to get their Medicare billings right.
Not a penny of those costs is counted in that ridiculous 3% figure.
They pay coders for private insurance too.
Ask your doctor or hospital how much they have to pay for coders and billers
How about instead I employ some common sense on your behalf.
Shall we pretend that coding and billing and re-billing private insurance is no less a task than it is for Medicare? The ideal solution would be to have single billing (thus, single payer) or no billing (try finding a billing department in a hospital in Britain). No doubt, a doctor or hospital would much prefer these scenarios to the current situation where numerous coding and billing systems must be maintained.
You are aware I hope that if the doctor miscodes a Blue Cross bill the worst that can happen is that the charges aren’t paid.
If he miscodes a Medicare bill he can face criminal charges and jail time. (Google “Federal False Claims Act”)
Under a single payor system I have no doubt at all the latter consequence will apply.
I was in good shape, too…just watch your six in the woods!
Eliminating the middlemen between healthcare and the patient would in and of itself bring solvency to the system. It’s amazing how few administrators are necessary to run a hospital, a clinic, or a practice when the billing is standardized.
A public policy emphasis on preventive care coupled with reasoned rationing would save a bundle, too. ( And face it, insurance company rationing is a lot more draconian than anything Medicare can come up with.)
Insurance should be available as a reinsurance policy for those who want their “lifestyle” treatments not covered by a national health service.
Reasoned rationing. Scary stuff, there.
Walk into any busy doctors office or hospital and you will see that they have 5 to 10 people taking care of billing information ,and a few nurses might be running around .
During my latest medical nightmare ,I witnessed far more people
sitting around filling out paper work ,than I witnessed direct care of the patient from nurses . Nurses are to busy filling out paper work to ever observe what might be going wrong with a patient .They work 10 to 12 hour ,and the last 4 hours they don’t want to do anything ,and they can hardly stand anymore .
I wasn’t the patient ,but I spent 8 to 12 hours a day at the hospital for weeks at the beginning of this year . This gave me time to observe what the gig was ,and boy was it corrupt .
I got nurses to admit to me that since the Insurance Companies stepped in about 15 years ago and started controlling the medical care a person was going to receive ,(didn’t matter what your coverage was ), people had to come back because the
sickness or condition wasn’t corrected in a thoughtful matter
at first . I stated in another post ,that they have these Insurance Reps hanging out at the Hospital ,(posing as hospital employees there to help the patient ,but they work for the Insurance Company .) If you watched these cats ,you would see the power they have . I don’t even want to get into approval times on needed procedures or tests .
It was common place for patients to be released to soon ,and often times acute care situations were falsely labeled as chronic care situations ,just so the Insurance Company could cut off the coverage .
The hospitals and Doctors liked the cases that were paid by welfare because apparently that resulted in a easier and bigger check .
The system is corrupt ,because of the greed and bad faith of the Insurance Companies . Insurance is Insurance and if someone pays for it and something is covered ,pay up you dirty dogs ,its not your right to kill someone just because you don’t want to honor the insurance contract . They think they can get away with it because people don’t know what health care they could of got had the doctor been allowed to do what their oath actually tells them to do ,and what the policy actually covers .
Now I don’t know if Insurance Companies were driven into this bad faith because of Doctors and Hospitals abusing the system and running up the bills when they weren’t controlled ,but now
it’s gone to a opposite extreme, IMHO.
I would have to argue with the Insurance Company shills at the
Hospital ,and I had to threatened a lawsuit if they didn’t perform pursuant the contract . Eventually they realized that their lies weren’t working with me and they had to give good care ,but the two weeks they kept dicking around trying to save money, cost my spouse her life . She got hospital germs and died of that . IMHO ,if the Insurance Company concludes that a condition is costly to correct ,that is when the jacking around starts .
Some conditions aren’t a life or death matter ,so stalling isn’t as life threatening ,but some conditions need immediate attention .The insurance Companies control making a Doctor go through a cheap remedy first ,rather than the cure they know
the patient should have . The Doctors aren’t going to admit how much the Insurance Companies impede and interfere with their practice of medicine .
I had one Doctor who fought like hell to save her life ,and that was the infection Doctor ,and this Doctor didn’t care about costs . Nurses would tell me that this Doctor would go to bat for Patients ,which in hospital language means that this Doctor is not bulldozed by the insurance Companies .
I could go on and on about how Insurance policies are written these days to trigger loopholes ,but thats a whole other
subject .
Something needs to be reformed ,don’t know exactly how that can be accompolished . I don’t think that you can mix a private system with a public system either . The welfare patients are taking up the emergency rooms ,and most hospitals are zoos today because of it . So, go ahead and think your private system is real good until you have a real emergency or a costly
procedure needed .
Thank you for this post, Wizard. It made me weep for your loss. Again.
Hugs,
a
Housing,
I’m so sorry to hear how your wife died.
Have you thought about testifying about your ordeal with the insurance companies? I know Moveon.org is pushing hard for health care reform. You may want to contact them or someone else about your ordeal with the insurance industry.
A big hug Housing.
I’m sorry too Wiz.
They mess with the medical records ,they know how to cover their asses ,they aren’t dumb . Why do you think they spend all that time filling out paper work .I also had the added complication of having the original emergency room Dr. screwing up a bit .
It’s just that I was at the hospital for hours and hours and
hours and hours ,so I had a lot of time to observe . I also talked to other families and patients and got other stories . I had great insurance ,in my case , and that was part of the problem . I ended up telling the Insurance Rep that they were so penny wise /pound foolish in how they approached my case . They ended up spending far more money than they would of had to had they done right to begin with ,and they lost the patient .
Beats the unreasoned rationing I’m getting with my private insurer. No anesthesia for a bone graft? No diagnostic x-rays?
C’mon.
“Reasoned rationing” is a lovely phrase and in fact I don’t disagree that we need something of that sort.
But just wait until the first few hundred octogenarians are told they can’t get that new hip, or their Viagra, paid for by a lien on their great-grandkids incomes. Do you really think that Congress will tell them no??
Oh for God sakes ,the medical industry is already practicing unauthorized Euthanasia anyway ,in part due to private insurance companies pressure . If you think that the Medicare crowd is getting the full measure of life saving treatment or costly surgery your crazy .
Medicare is ok as long as you only need some blood pressure medicine or a minor surgery or some drug . Once it gets into
the more expensive realm of treatments ,the industry
cops out by saying the persons age makes surgery a risk ,or they deem a condition chronic instead of acute care and squeeze out of paying for it all together . Sure you have some Doctors that will go to the max for a patient ,and some doctors will perform surgery knowing that the patient has no chance ,but much of your treatment depends on
your insurance company ,or how good faith your Doctor is .
I knew a guy that survived 35 years with Cancer and just died
at 96 . They have a lot of treatments for cancer that will extent the life ,but this guy had a government job supplemented medical insurance . This guy was active almost
right up to the time he died . My point is this guy lived a active life ,in spite of advanced age ,but he did get the full measure of good medical treatment .
My problem is ,who are insurance companies to decide who is to live and who is to die . If the insurance companies cut off that old guy I was talking about 35 years ago ,he would of been denied a lot of life . The man did a lot of charity work for
the vets and all kinds of constructive things .
I don’t know the answers ,but the medical care issue is really heating up . I don’t know if I like the concept of cutting off care of the 65 year or older because i know to many people that age and even a lot older who are very active and enjoy life .
Great editorial, but short of the soylent green option how can we get a grip on costs? The issue in my mind is just as much about money grubbing corps and ambulance chasers as it is about expensive and life saving care that just didn’t exist yesteryear.
“No matter what the outcome, though, we all know they’re going to take our money–a lot of it. This much is a given. The question is; how and to whom should it be redistributed?”
This is not a given and that is not the question. I will not pay for your medical care. This is not negotiable. I will not pay for your medical care. Laws Congress passes without reading or, really, thinking about, are irrelevant. I will not pay for your medical care. That there are bureaucrats who want your money is not my problem. I will not pay for your medical care. That your care is expensive is not my problem. I will not pay for your medical care. That you wish it would cost less is not my problem. I will not pay for your medical care.
If you want medical care, pay for it yourself. If it is “too expensive”, tough sh*t. We all make hard choices in life.
If you were a neighbor and a friend and you asked for charity, I might devote whate effort I judge I can spare. Regardless of whether you are a neighbor or a friend or not, the moment you attempt to employ the force of law to compel me to pay - to the point of impoverishment - for your medical care, you become my deadly enemy. This is the line. Don’t cross it.
Hi Allena, I hope you’re doing well. I remember you posting about the dental portion of your nightmare. IIRC, you couldn’t receive treatment because they were basically labeling it as “superficial” or some such nonsense. Not trying to be funny, but it seems like this operation was in the “boob job” category. I remember thinking this was particularly awful.
If there is anything we can do, please, let us know. It’s so ridiculous that you survived a freaking bear attack, and now have to deal with all this. Seriously.
It’s been one year today, Mugs, and I’m happy as a clam. (Made myself a pitcher of fresh Mexican limejuice and anjeo tequila and just celebrating being out here on the screen porch in this lovely summer day. (Here’s to you, and Mugster–and Mugette!) All is…not bad. Not bad a’tall.
As a Canadian living in Vancouver, I am appalled at the recent TV commercials on American cable stations that slam the Canadian health care system.
Those ads are a bunch of nonsense. We are able to treat all Canadians in a timely manner and at a reasonable cost.
Thank God the “Canada Health Act” OUTLAWS private insurers.
That’s what I’ve been screaming for years. I don’t have insurance because I can’t afford it. I’ve also always wished my employer (when I had one) would just give me the extra $$ on my check instead of using it to buy overpriced insurance on my behalf. Health insurance premiums are way too high; they don’t seem justified by the cost of health care.
I figure that, if I get attacked by a bear, I’m going to have to file BK whether I have insurance or not, so why bankrupt myself ahead of time by paying $500/month to insure a healthy body?
Insurance sux.
“…so why bankrupt myself ahead of time by paying $500/month to insure a healthy body?”
Because if you DO suffer a catastrophic illness or injury, no one will treat you (past the immediate emergency,) without some guarantee of payment. And (practically,) no one takes Medicaid. Insurance gets you in the door. That’s why we need a public option.
BTW, V, I can attest to the blog that you are indeed one healthy lady!
So, basically, the insurance card is just to trick the doctor into thinking he’s going to get paid. Kind of expensive for $500/mo. Wonder how long that can last?
Well, in my case, V, long enough.
It’s not the doctors so much as it’s the corporations that own the hospitals and billing facilities. Most of my doctors (the ones practicing outside of a hospital setting,) have been more than willing to modify their fees on my behalf.
With some serious caveats (see my post,) if you pick through the various available insurance options and choose a high deductible, no maternity benefits, no pharma, bla bla bla, you can get individual coverage for under $200/month. Some HMO’s charge even less. Not insignificant, but it IS insurance against being shuttled from ER to ER if you’re faced with a medical catastrophe.
Yesterday Polly had a great post outlining her recent hospital experience. Because she had insurance, she was billed at the preferred/negotiated rate, and a 14K surgery ended up costing her less than two thousand, IIRC.
The “charged” amount was $14K.
The insurance negotiated rate for all the services included in that $14K was just under $3K.
I paid my $300 annual deductible and 15% co-payments on most of the rest of the charges for a total of $625.
Since I guessed reasonably well on the amount to put in my flexible spending account, I got to pay it out of untaxed money for a marginal savings of another 35% or so bringing the effective cost to just over $400.
Ridiculous, especially the hospital charge. They asked for over $10K but were willing to accept just over $1600 for payment in full. Try getting that kind of discount if you don’t have insurance.
Boombust,
I was just in Canmore Alberta a week ago and was watching the news about how some Albertians can’t get cataract surgery done, because Alberta has already reached its quota. I also heard people from other Canadian providences were able to come to Alberta and have cataract surgery performed. I also heard from the same news segment, some Albertians are almost blind from cataracts before they are eligible for surgery.
Is this typical? Are there quotas on what type of surgery or examinations are performed for each providence?
I heard similar horror stories from the locals some years ago when I was working in Alberta. This was around the time that a private insurance option was being debated. They also claimed that some rich people already used private doctors to get around delays and poor service. One fellow was claiming he was being forced to wait months to have routine knee surgery that would have taken place in a matter of days in the US. In the meantime he had to use crutches. I realize Alberta is considered a much more “conservative” area of Canada, so I took it all with a grain of salt.
I don’t have a dog in the fight (unless my facial surgery claims go unpaid), but I’m in favor of a public option at the very least for those who can’t get normal insurance for a reasonable cost. In my business we spend absurd amounts of money paying for employee health insurance.
bink,
I’m not asking for a fight. I was just wondering if each of the providences have their own set up for what is deemed necessary for surgery, examinations etc. It was a local news station that had interviewed people who were waiting for the cataract surgery, ones who had received the surgery, and ones who were able to come from outside Alberta to get the cataract surgery, while there were Albertians on a waiting list.
providences = provinces
Those ads are a bunch of nonsense. We are able to treat all Canadians in a timely manner and at a reasonable cost.
My sister worked as a doctor for years at a for profit US based medical center that did a booming business treating the Canadians your system wouldn’t/couldn’t treat. She gets a kick on holidays in pointing out health problems that are rampent in socialized medicine countries that are unheard of here in the US (as they are just treated).
Our system is far from perfect… The problem is the insurance, not the practicers. But we cannot afford unlimited coverage for everyone, unfortunately.
Thank God the “Canada Health Act” OUTLAWS private insurers. Yep, it was a cash only business.
Got Popcorn?
Neil
Hey Neil:
The fact that a cash-only business was needed to provide care deemed “unaffordable” by the state provides evidence that cash-ony systems cost less than those covered by third parties (lenders, insurance companies, etc).
I find it interesting that Obama is meeting with Nouri al-Maliki today, and is then having a health-care press-conference tonight. That’s some grade-A multitasking.
Makes me think that Obama has some ace in the hole somewhere. Would he be going all-in like this if he didn’t?
Ace in the hole? LOL! The man’s clueless!
I’m with Bill here, unfortunately.
I read your story and agree, the only end result that fixes things is either single payer or a free and fair market (which is not possible given the corrupt pay for play structure of our democracy) - so single payer it is.
While your story is unique, it is typical in how perfectly it illustrates the failure of our private insurance system. Short of true, fair competition in the market, the best we can hope for is that the government comes in and sets a much lower floor for costs. It’s not perfect, but it’s much better than where we are today.
Opponents of government healthcare ask, do you want your health decided by a beaurocrat? Having read Alena’s story I ask do you want your health decided by a profit motivated corporation?
There is no way to have true and fair competition in the market.
Most of us chose NOT to buy a house, or NOT to buy an expensive car. But we can’t NOT choose healthcare.* In many states there are only 1 or 2 insurers, who are then free to play like a monopoly. Employees have no choice in their insurance; they have to swallow whatever HR decides on — resulting in the need change their doctors every 2-3 years (how that’s NOT “getting between a patient and his doctor?”). For some reason, the actual cost of a procedure is totally hidden from the public, making comparison shopping impossible. And for some reason I totally don’t get, some providers pay less than others for the SAME service.
A few weeks ago Obama said: If government can only screw things up (as private business like to say), then why are private insurers so afraid of the public option? If private insurance is so great, then all the people would choose them, right?
———
*except for a very few like Ken, who has the freedom to wear a bracelet that says “don’t treat me, I’d rather die here in the street.”
Based on how Medicare is doing, I’ll take a profit-motivated corporation (competing with many other profit-motivated corporations for my dollar) any day.
Try going into a grocery store where you’re forced to buy stuff, prices go up 20% a year, there are no price tags, no ingredient lists, there’s someone next to you constantly taking stuff out of your cart, sometimes there’s only one brand of food to choose from, you pay a different price for a product depending on who you are, and you don’t know what you paid until the bill comes in the mail. Not exactly a Free Market.
Good analogy, oxide.
Andrew, Medicare is no utopia, but overall the standard of care it provides compares favorably with private insurance–at a fraction of the cost.
If Medicare is adopted as the “basic” health coverage standard for the country, private reinsurance could be made available by existing health insurance companies to cover any “extras” not deemed medically necessary by a panel of health care policy and medical experts.
I never thought I’d be saying this, but in my metaphoric experience the USPS provides better day-to-day service than UPS.
“in my metaphoric experience the USPS provides better day-to-day service than UPS.”
In my actual experience, based on years in the “stuff” biz, USPS does provide better service than UPS. I can attest to the fact that breakage was rare with USPS. UPS, however, was horrible in that department. Unfortunately, sometimes due to the size of the package, I have had no choice but to use UPS ever since DHL folded up its tent.
I miss DHL, it was wonderful.
In my actual experience, based on years in the “stuff” biz, USPS does provide better service than UPS. I can attest to the fact that breakage was rare with USPS. UPS, however, was horrible in that department.
I’ve had the same experience. I’ll take USPS over UPS every time if there’s an option.
Andrew, you seem to be missing the point, so I’ll spell it out again. There is no free market in healthcare. Private insurers have a monopoly hold on the industry. Barriers to entry are massive. Cronyism abounds. Ultimately, your premise of companies competing doesn’t hold up because there is very little competition to be seen.
Excellent article and kudos to you for recovering from such a horrible trauma.
I filed bankruptsy several years ago due to health woes. And yes, I had insurance at the time. Despite insurance paying thousands and thousands to hospital, surgeons and assorted other white coats, they still wanted more money. But what really killed me was what the insurance * wouldn’t* pay for because they deemed it not “standard” care. Also, since I had not been working, I had no paycheck to hold me over while I was home recuperating. 20 years of excellent credit wiped out. God bless the USA.
I have come to believe that our medical system is not about healing people for the most part. While trauma care is first-rate here, managing chronic illness has become a money making scam.
Attention needs to be on diet, exercise and going back to eating food from local farmers who do not use pesticides and abuse/torture their animals.
We need to stop paying Big Pharma to over vaccinate our kids and the ADA to stop poisoning us with mercury “silver” fillings in our teeth.
I had several relatives back in the day who lived into their 80s and 90s without relying on surgeries and bottles of pills. They required minimal health care.
Attention needs to be on diet, exercise and going back to eating food from local farmers who do not use pesticides and abuse/torture their animals.
+1
Agreed, but in the real world, things happen. Look at ahansen. Out on the ranch, minding her own business, then, bam! Bear attack.
Diet, exercise, and locally grown food were of no help.
Actually, the fact that I was in damned good shape DID help me make it through the whole ordeal. I’ve ridden 100 mile endurance races that were less taxing physically, mentally and spiritually. Good diet, strong body, disciplined mind=better survival odds. (The best efforts of BC to wear me down subsequent to the attack, notwithstanding.)
“abuse/torture their animals”
Where’s the fun in that?
“…We need to stop paying Big Pharma to over vaccinate our kids…”
Ooooooh, let’s go there.
If you live in the States, I’ll bet you don’t have any relatives or acquaintances who have ever had a child die of pertussis, measles, or diptheria.
Do you know why??
And, I don’t believe dentists have used “mercury “silver” fillings in our teeth” for many years.
dc_renter,
I’m in a similar situation right now, I go for my first creditors hearing in less than a month.
I found out 2 years ago that I had a congenital heart defect and needed to have my aortic valve replaced within 5 weeks, While I did have insurance I wound up with several thousand dollars of uncover expenses. In addition I was out of work for two months and when I did return my boss made my job miserable enough that I quit, I couldn’t stand the stress any longer. I did try and get these bill paid but eventually I gave up as my income was going down and it became to much to keep up with all of the payments needed.
Also to add to the fun, I can’t get private insurance at any price, they reject me on the grounds of a pre-existing condition. So when I lose my job in another 3 months I will have to pay COBRA rates and hope that the unemployment insurance will pick up 3/4 of the premium like they are doing now, otherwise I’ll be without insurance with a heart condition.
So, yes to the others, I am in favor of a public insurance program. My other option is no insurance and at this point in my life I’m not willing to take the risk of major complications, including death, just because some people think it’s ’socialist’ to have public healthcare.
Hang in there, maus. A whole lot of us are pulling for you!
+1
My health insurance is so lousy, that I don’t care if my $2500 - $9000 goes to the Feds or to private practice. It’s a tax either way as far as i’m concerned. And I’m healthy! At least until I get bitten by a bear.
Hey Allena, you are my model for courage, and I don’t mean just the bear fight.
A number of years ago, I was approached by a doc to help him start a medical publishing company, which I did for several years, taking it from ground zero to a viable company (theoretically, and I say that because he got family involved, big mistake, they started bleeding it). The gist of the business was creating specialty-specific manuals on how to code appropriately for Medicare reimbursed procedures. You’d be amazed at how fussy Medicare is and how hard it is for docs to get their money from them. A number of docs have quit the business because of the paperwork.
Medicare is a huge behemoth and isn’t getting any smaller. It’s created an entire caste of workers doing nothing but coding for docs to get reimbursed. Some claims have to be filed numerous times before Medicare will accept them.
And the govt is going to make things better? I say get rid of insurance and government both and go back to the days when we just paid for things ourselves. Prices would crater and we’d quit getting sold things we don’t need. People would take better care of themselves if they knew no one would bail them out - or they wouldn’t, and die. Expensive surgeries would be for those who really need them. I have a friend who was basically talked into an expensive knee surgery he really didn’t need, he’s now partially disabled. When my dad was dying of congestive heart failure at age 85 the docs tried to pump him full of medicine and keep him alive a bit longer in ICU, though basically comatose. We said no way and let him die at home with dignity, which he wanted. The system used to work fine until we got capitalism/cronyism involved.
Mutual Admiration Society, Lostie.
Most of my family are MDs, and all agree Medicare is as big a PITA as private insurers. Medicaid (for the poor,) is even worse.
Moreover, government programs tend to withhold payment for months at a time when things get tight–or else issue IOU’s.which may or may not be honored. But the recent federal push (financial incentive,) to computerize/standardize all hospital and private practice medical records and billing is making a huge difference in cost savings and despite privacy concerns, seems to
be the new standard of care.
The problem with simply letting the market set itself is that with all the new and modalities used today–hugely expensive technologies like MRI, neonatal intervention, genetic modification protocols–it is simply not possible to charge a “one size fits all” price or negotiate with the dozens if not hundreds of individuals and labs involved in any given treatment. In my case, the highly specialized diagnostic modalities that have been used in my treatment– ophthalmologic ultrasound, Gadolinium scans, made-to-order attenuated rabies gamma globulin for example– defy negotiated pricing. And what private practice or local hospital could afford to have these on hand? “Socialized” medicine in the form of major medical teaching centers, makes modern technology available.
The judicious use of co-pays and patient/provider reviewed treatment plans seems to me to be the best way of ensuring that the system is not used frivolously. But the days of trading a couple of laying hens for a home delivery are not practical for most (urban) Americans.
That having been said, I did trade two gallons of my organic honey and some blackberry starts to a neighbor for his having set my fractured metatarsals a few years back. And another neighbor trained and boarded his trail horses in exchange for periodic Botox injections. Such are the joys of the underground economy.
I see that right here, but in the vet clinic. If bloodwork or x-rays are needed, off to the nearest “city” 115 miles away. They can’t afford the equipment here, too small a town, I guess.
“Medicare is a huge behemoth and isn’t getting any smaller. It’s created an entire caste of workers doing nothing but coding for docs to get reimbursed. Some claims have to be filed numerous times before Medicare will accept them.”
None of whom appear in the federal budget, which is why the idea that “Medicare’s administrative costs are 3 percent” is arrant nonsense.
You think people don’t have to code procedures properly to get reimbursement from private insurance?
If you want to lump a doctor or hospital’s costs into the cost of Medicare, you’ll need to do the same with private insurance, which pushes that 20% administration figure higher. This is the cost FOR THE ADMINISTRATOR, not for the care providers.
Who would pay for injuries due to an uninsured motorist? Wouldn’t that totally bankrupt a person?
Can u say “UM coverage”?
Not being smart potential, but this is the cheapest insurance on earth. The most bang for your buck. I have 500K it costs me 47 every six. UM and UIM.
The trick is, don’t get a sub-standard company, and don’t get Allstate. State Farm is best.
I do litigation for a living. (Plaintiff Atty)
And how is Medicare any different from private insurers?
I recently had a routine physical. I went for some labwork, and the idiots keyed in the wrong number, and when it bounced from the Insurance company they billed me for the entire amount. I think I straightened them out, but haven’t heard.
I went elsewhere for a different test. This one got the right number, but the insurance company rejected the claim because “the plan is no longer in effect”. WTF. I have been at the same job over 10 years now. So I call them up and complain, and I got a human on the phone who agreed that this didn’t sound right so they would “resubmit”. No word on that one either..
“…some Albertians are almost blind from cataracts before they are eligible for surgery.
Is this typical? Are there quotas on what type of surgery or examinations are performed for each providence?”
No, it’s not true.
And, it’s “provinces” by the way.
From the Canadian Oxford Dictionary
Providence 1. Christianity, the protective care of God or nature. 2. Christianity, God as exercising prescient and beneficent power and direction 3. timely care or prparation; foresight; thrift
An interesting spelling error given the topic.
Thanks Boombust.
My mistake with the spelling of provinces. I spelled the word incorrectly again in a post further up. This was on a local news station coming from Calgary. Here’s a couple of links to news articles. I couldn’t find the local news report I heard on television:
http://www.allheadlinenews.com/articles/7015182637
http://www.chtv.com/ch/chcanews/story.html?id=1605816
“it would probably be a hard sell getting the country to go along with exterminating everyone who turns 65″
That might not be a bad idea afterall as many late boomers, 1956 upwards will suffer dearly in the future years. The majority in this group do not have enough saved for retirement as their wages have been flat or mostly declining over the past several years. Add in their mounting debt and this group faces a nightmare of not being able to retire. Most will not have or will be able to afford the gap coverage for their healthcare.
That’s what I’ve been thinking. What’s the point of living until eighty (or even 70), if you are forced to live a “Lord of the Flies” existence? (Of course, we may be heading there anyway, no matter what happens).
As many of us fifty-somethings are finding out, a lot of HR people view us as “economically non-viable”. Throwing the age-45 and older population under the bus, because “they cost too much to insure” seems ridiculous to me (but I’m biased).
The plain fact of the matter is that the current system is totally FUBAR, and will bankrupt the country and/or it’s citizens at the rate it is going. Where the money is going, your guesses are as good as mine……but I’m betting the entities crying most about “socialized health care” are the ones who have a “candy-crapping unicorn” that they are trying to keep hidden in the stable.
What is not mentioned by anyone is the time wasted/lost by the doctors gaming they system, requiring multiple office visits for minor problems, referrals to “specialists” for stuff that used to be handled in the General Pactitioner’s office, who then require multiple visits of their own.
Also not mentioned is the time wasted arguing with the insurance companies over their weasely “item not covered by plan” or “charges in excess of plan” cost-shifting to their customers.
We are at (or close to) the point where any kind of major medical event (or even a visit to the emergency room) is putting 90% of us into the poorhouse/bankruptcy, WHETHER YOU HAVE INSURANCE OR NOT. And to me, there is something fundamentally wrong with a system that can cost you a lifetime of savings for just 2-3 days in the hospital.
Solent Green anyone? What was the Sci Fi movie where your palm turned red when you reached 30 ? They then wacked you or fed you to the underground monsters?
I believe you are referring to Logan’s Run.
The palm of their hand is implanted with a “life clock,” a penny-sized lamp that looks like a crystal. At age 30, the life clock flashes red, and the bearer must report for a ceremony where he is told he is “renewed” but is in fact incinerated. Those who wish to avoid the 30-year-limit must become what is called a “runner.” Runners are considered criminals, and hunted by policemen known as “sandmen.”
Men and women live in a society where you can only live until you are 30-years old (due to population control and limited resources), the people have two choices: They can either take part in a extermination ceremony called “Carousel” where they are promised of being reborn or they can go on the run and escape to outside the domed city.
“That might not be a bad idea afterall as many late boomers, 1956 upwards will suffer dearly in the future years.”
At least you don’t call yourself “warm and fuzzybear”!
Why is every answer to a govt problem to tax the higher income taxpayers?
When approximately one-half of this nation pays little to no taxes, the answer is always to increase the cost on the higher income taxpayers.
I agree the health care system is a mess but a solution that does not penalize the people paying all the costs.
Govt continues to penalize those who save and work hard, but reward those who speculate, fail to pay, and do not produce income.
comeith-
You make in excess of 350K per year and you’re complaining?
Higher income “earners” have generally used the American business and social infrastructure, labor pool, technology, and services to amass and keep that income. Making money does not happen in a vacuum, nor spending it. One’s monetary fortune don’t mean squat if the system to use and enjoy it doesn’t exist.
As to paying for public health care, tens of millions of poor people with TB, cholera, influenza, chronic flatulence, etc. don’t make for a pleasant or terribly productive society.
I wish I made $ 350k plus, want to but don’t.
But how much is too much. You make valid points about the health care system and its costs are out of whack.
Presently for a couple of self employed taxpayers who earn $ 350k in a year, they pay over $ 125k in federal taxes per year. This amount does not include state taxes (5-6%) nor sales,use, ad vol., etc.
Your response is indicative of society’s response that “I don’t care how we pay for it, as long as it does not apply to me”.
But it DOES apply to me. After a lifetime of paying through the nose for services I’m not getting, I want some public accountability. WE are the government. WE pay the bills.
That’s why I’m advocating for reform.
I do not disagree with you. I have my own family horror story involving medical care (nursing home abuses, lawsuits, loss of small fortune). I am for reform on several fronts.
I am afraid of big govt as much I as I am big business. No trust of either. But thinking govt is the answer to problems is fairy land thinking. I work in govt and the inefficiency and abuse would boggle the mind, particularly in medical care.
We need some real relief from medical costs but until we decide that everyone should not live to 100 no matter how much they eat, drink, smoke or otherwise live, medical costs will continue to soar.
Problem is, if you took every penny that every millionare makes you still don’t come close to being able to pay the bills that Uncle Sam is running up.
Sooner or later we either have to take a meat axe to the entitlement payments, or (what will happen) define “the rich” for tax purposes as anyone who hasn’t missed a meal in the last three days.
Good points dog. I do think reform is needed, but to make it affordable everything must be on the table, including tort reform. There should also be some out-of-pocket costs for everyone, even the poor. When something is free, it gets abused. Has there been a study on how much malingerers and hpyochondriacs cost the system? How about nose jobs paid by ins. (aka deviated septums)? or any cosmetic surgery, not remotely tied to health ( aka boob jobs and lipos) ? I remember my Mom telling me how some old women treat going to the Dr as a social event. I understand and agree with most of the arguments for a single payer system, but why did Obama leave tort reform off the table? that is totally partisan and political.
Congress gave themselves a 7% this last month and they are exempt from the ( Rod Emanuel wrote it) new health plan. Another Chicago Thug.
What causes the insanely high healthcare costs in the first place? That question needs to be asked and studied but it isn’t. Instead we just point out the problem and demand the government take it over. It’s a bad approach that will burden us with an anchor that will sink us and drown us in the long term.
It’s the politics of the moment though so we’re going to be stuck with it(whether it works or not, because it will be an entitlement and you can’t take away an entitlement), while the powers that be arrogantly tell us it is for our own good.
Actually, it has been studied and they are starting to come up with answers. An article in The Atlantic recently discussed a comparison of health care costs between two locations in Texas. Same state so the same laws about suing doctors for malpractice (hightly restricted), same approximate mix of socio-economic class, etc. yet the cost for one was twice as high as the other.
Primary difference was the culture of the doctors - the community “standard of care.” In one place, a person presenting with back pain was examined and most often sent home with a few muscle relaxers and exercises and told to come back if it didn’t get better in a few days. In the other location, the patient was most often sent immediately for an MRI or other tests. In the more expensive place, the doctors were more likely to have an ownership interest in the testing centers and the day surgery centers, but even the ones who didn’t still tended to prescribe more expensive care than doctors in the other location. The study also found that the health care outcomes were the same for both places.
When doctors are paid to “do” stuff and all their peers are telling them that doing more stuff is fine even if it doesn’t help the patient, what do you expect will happen?
It has been studied many times recently, and there are many problems. The Economist had a good article recently:
http://www.economist.com/world/unitedstates/displaystory.cfm?story_id=13899647
“What causes the insanely high healthcare costs in the first place?”
Four things really.
(1) Demographics. The older the population, the higher the cost. No way to solve this other than the Soylent Green route.
(2) Technology. Sixty years ago you died of a heart attack. Cost, one ambulance ride and six hours in the ER. Today, you get an AICD implant at $50,000 plus and probably two or three replacements before you die. Is the new way better? Certainly, as long as you don’t give a flip about costs.
(3) Preventative care. The better we get at preventative care, the greater the chance that you won’t die suddenly at 51 but will instead die a prolonged death of a degenerative disease at 91, after a decade or so of costly treatment. (”Why are coffins nailed shut? To keep the oncologists out.”)
(4) The linkage of healthcare to employment. This is the one clusterf**k which is most unique to the US. Screws up every cost incentive in the worst way possible.
Add “increased demand” for #5…
High fat diets result in increases in diseases such as diabetes, high cholersterol and heart disease, at younger and younger ages. Pollution has pushed up the number of allergy and asthma sufferers. Increased globalism and immigration comes with the spread of diseases that might not otherwise reach a foreign shore. We don’t really know why autism rates are up.
I’m not crying in my iced tea for $350K+ earners, but going by this list, it might make sense first to tax junk food, polluters and foreign travel to pay at least some of the healthcare bill. Just sayin’.
I’d add #6 - lack of competition.
Big Pharma and Heath Insurers basically run a cartel. They pretty much get to set the price of equipment, drugs, treatments etc…because they’re the only game in town.
Sure, prices vary between providers and manufacturers, but in the Big Scheme of Things, higher prices mean more profits, and keeping costs high is profitable. They’re no more moral, or less interested in profits than the guys in OPEC.
Which is why when the govt steps in to be a competitor (and they will, scary words like ’socialism’ aside), they all get aboard the Whambulance…… if some outside force starts asking awkward questions like “why are you guys charging $20 a pill for Brand X, when we can bulk-buy a generic for $5 a pill”, the whole thing comes unglued.
Which is why the Health Insurers, Equipment Manufacturers, Big Pharma etc are literally fighting for thier collective lives at the moment - they’ll do anything, say anything, block anything, because they don’t want competition.
speedingpullet is dead on. All of this other crap is just a distraction from the fact that lack of real competition allows private insurers and big pharma to get away with murder.
Maybe they should take away the HUGE tax deductions enjoyed by homeowners and parents. Then the rest of us could afford to pay the taxes that would eventually replace our current health insurance nut.
I’ll give up my mortgage int. deduction to pay for healthcare for all. How many people would agree? How many politico’s?
Question, why is there a shortage of doctors? open up gov’t med schools in exchange for gov’t service. Why is that a problem? and why have they not addressed it as part of the solution? Could it be the university system lobby?
Big V, don’t forget the 25 million illegal aliens YOU are going to cover !!!
Pismo:
I don’t see how illegals relate to my comment about tax deductions.
Inyhow, we are paying for illegals right now too.
A simple rule: when it comes to public money forcibly extracted from people, if we can’t afford it for everyone indefinately, we shouldn’t be providing it to anyone today.
That includes Medicare, Medicaid, public hospitals, VA hospitals, the uncapped tax subsidy for employer provided health insurance, and the private health insurance purchased on behalf of active and retired public employees using tax dollars. These front door and back door government subsidies account for 75% of all third party health care spending today, a share that is certainly soaring.
So how can people who pay for this get nothing? How can younger people, to whom costs are getting deferred, get nothing now and, let’s face it, probably get far less when they themselves are old?
We can disagree with what health care people should be forced to pay for in taxes so everyone can have it, and what people should merely be permitted to pay for on their own. But what we have now is unjust.
VA medical care is payment for service rendered.
Well stated, WT.
What our taxes pay for is the system itself. A viable system that is available and running when our turn comes to need it…and at some point that time will come for you, too.
Eliminating the redundancies, the inefficiencies, and the outright graft and corruption are what the health care reform movement is all about. Thanks for your voice in making it happen!
I would like the French or Canadian system. Right now I have none. If I got sick, they would drop my coverage anyway or I would not be able to pay for it. It all sucks.
If we forced those (congress, etc) on retirement plans, health plans to have to live with what everyone else gets, they would implement something fast.
The majority against health care have government funded or other funded health care or retirement through multiple channels.
+1 JustSayNo.
I have been saying this for years. Take away all the perks and medical, retirement benefits from our Congress critters and they wouldn’t be playing all of these games.
YES. I have been obsessing on this point (about the medical that is) for days - so glad to see it bouncing around out there….
I found this very interesting:
http://market-ticker.denninger.net/categories/16-Health-Reform
“Look folks, you want to know why we have the health cost problems we have? I’ll lay it out for you - in a way you can’t refute or argue with:
There are no published prices. In no other line of work is it legal to do this. Nowhere. You can’t sell someone a hot dog and tell them after they eat it what it just cost them. You can’t hire a lawyer and have him tell you “I’ll tell you what this will cost when we’re done.” You can’t hire an electrician and have him tell you “I’ll make up a bill when I’m done.” In every line of work except health care, this is illegal. There are even laws for “major” consumer work (e.g. contracting, auto repair, etc) where they must give you a binding written estimate before beginning work!
Robinson-Patman makes it illegal to discriminate against like kind purchasers of goods in pricing decisions when the effect of doing so is to lessen competition. While it does not apply to services, it darn well should. Whether you are paying privately, you have private insurance or you’re a Medicare patient if you need to have a breast reconstructed due to cancer the complexity of the procedure does not change. Yet it is a fact that the privately-billed amounts for uninsured (”rack rate”) patients are often ten times or more that billed to insurers or Medicare. Try charging a cash purchaser 10x more for a TV than someone who finances that TV on your in-house credit facility and you would be shut down and thrown in jail.
#1 and #2 exist because of explicit efforts by the “health care” industry to exempt themselves from the laws that every other merchant of every other good and service in the United States must adhere to.
To put this bluntly the medical industry has intentionally put forward a system by which it can screw you with impunity, obtaining exemptions from the laws that cover every other area of commerce, thereby effectively forcing you to buy overpriced services you do not want to purchase lest an unexpected life event literally wipe you out.
This is an extortion racket and absolutely none of the proposals being put forward have done a thing to address any of it.”
+ 1,000,000!!!!
That is absolutely true. And the prices should be on the internet, to boot.
Very good points. The practice of charging different rates for different patients (insured/uninsured) is indeed a form of discrimination.
Different people heal (and disintegrate,) differently. The human body cannot be standardized, nor can complex medical treatments like cancer protocols or bear attack remediation.
yes, there is a discussion in congress going on to this direction about, hmm, i cannot remember the term. but the idea is to pay a standard amount for *curing* a sickness/ailment/problem or whatever, it is up to the doctor to determine the steps/test/treatment are required.
For any country to be considered civilized, 2 things need to be provided to the populance, IMO: ‘free’ education and medical coverage.
The United States was not civilized at anytime since its founding? How absurd! We were the first society that had rule of law, not rule of man. Now it’s turned to rule of man.
I thought law was based on the UK system, in which case we weren’t the first society, were we?
I think he’s referring to our system of checks of balances, as opposed to their old way of having a monarch.
At any rate, I don’t think we can exactly say that we haven’t been “civilized”. If we weren’t civilized, then we couldn’t be having this discussion right now. The question is what our civilization should do about Ahansen’s recently coined health-price bubble. Let’s short it!
c’mon the romans had checks and balances before they gave the augustus caesar emperor absolute power.
Rule of law went out the window when the bond holders and dealers at GM and Chrysler got hosed by the Dems.
Yeah. Rule of law was going strong when we were waterboarding afghan peasants.
what history books are you reading?
I appreciate all you have been through and I wouldn’t wish it on anyone. With that said is this really an appropriate blog to be peddling this agenda? I guess my question is more to Ben than to ahansen because he allowed you to start this thread.
This blog is as popular as it is because of the great knowledge of both Ben and the people who post on here and the fact that other than exposing the housing bubble and it’s effect on the economy and our lives, it does not seem to have an agenda….especially not a political or partisan one. A thread like this taints that image a bit, in my opinion(which I realize may not count for much, since I lurk much more often than I post).
I have asked a few posters to contribute as guest bloggers, mostly because I am working at hot, empty foreclosures like the one I’m at now, and can’t post as often. Nobody is getting paid, and this is a favor to me and the HBB. That said, ahansens story is a HBB story, not so much a housing bubble one. I first met her last year at the meetup in Pasadena. It was just a few weeks before this happened to her. I remember when I was told about it that I was sick inside for days. Then we got to talk and she was able to tell her story here and we commented and talked about it a few weeks later. So this is HBB related, and the topic is relevant to one of the big issues of the day.
So, what harm does exploring this topic do? I may not agree with this position or that, but I could say that about 90% of the stuff I see here at times. Besides, I think after 4 plus years of constant blogging on housing, I’ve managed to cover those bases and a diversion on something that was near to most of us here doesn’t constitute an agenda, etc.
Ben, Do you have a property preservation business? If so, how is it going? Thanks, Carl.
Yes among other things foreclosure related. Actually, if you look up the industry I’m in on google, my foreclosure blog is near number 1 with a post from 2006. See, you slackers should have been paying attention over there!
I don’t see why we shouldn’t have the occasional “off-topic” thread. If nothing else, we can all get our health care frustrations out in the same place, rather than scattering it over several bits buckets.
I don’t see why we shouldn’t have the occasional “off-topic” thread. If nothing else, we can all get our health care frustrations out in the same place, rather than scattering it over several bits buckets.
Exactly. It’s not as if we always stay on topic in many of the housing threads.
If there’s an agenda here, as always there’s a comment box below where anyone can feel free to oppose it.
The healthcare topic comes up all the time on this blog. It’s another one of those bubble thingies.
Has anyone read Obama’s sickness care plan? If so can anyone splain it?
Also I have read that it is not designated to start until 2013, be that the case then why this huge push to sign it in the next week?
Barry has admitted that there are parts of his plan that he is not familiar with.
Awful big hurry to push something through that few if any have read, let alone understand. Be careful what you wish for, you just may get it, good and hard.
Obama’s plan is irrelevant - only what comes out of Congress matters. Since the health insurance lobby managed to make it such that single payer was not even considered by Congress, and the public option has been torn to shreds, the likely result is that we may get some sort of universal or mandated coverage that goes through private insurers. The result is that the fat insurers get fatter, cost to the average citizen is higher, quality of care continues to go down (with no real check on private insurers) while costs continue to rise. We’ll probably have been better off without this “reform”.
What patient renter said. I couldn’t have said it better myself.
Give me what Congress gets, or leave things the way they are.
I was thinking, let Congress have what I pay over $9,000 a year for (self & spouse) if we are going to leave things the way they are.
I don’t mind large co-pay, large deductible, basically taking responsibility for my health through lifestyle. But I don’t appreciate that if we ever have to use the coverage that we have paid premiums for - we will soon be cut out and completely vulnerable.
So I would revise: give us what Congress gets, or let Congress get what we get stuck with / screwed by.
If that’s the case, I’ll have to buy calls on the insurance companies. hahahahahahaha
Indeed.
wmbz:
It seems like every time some Democratic initiative comes up on this blog, you always say that “no one has even read it”. How do you know who’s read it and who hasn’t? Were Republican initiatives read more often than the Democratic ones? I never saw you complain about this until the Repubs were pushed out of office. Are we to believe that the standards of reading and not reading suddenly changed as soon as the Dems won? I kinda doubt that’s the case.
-Big V
I’d rather see bills read by legislators and not written by lobbyists.
How I despise the current, corrupt system that requires constant raising of campaign funds. I’d rather see our legislators spending their evenings reading the legislation than attending endless fundraisers.
Not every legislator is corrupt, but the system certainly conspires against legislation that might be in the public interest.
“Obama’s sickness care plan”
Is there a remedy for nacissism?
No matter what the outcome, though, we all know they’re going to take our money–a lot of it. This much is a given. The question is; how and to whom should it be redistributed?
I dunno. But I think a solution is somewhere in buying gold bullion in cash only transactions, and “burying it” for a few years until this socialist cycle is replaced by the next individualist cycle.
+1
The precious outlives bankruptcy.
Even though this is satire, some clown at the NYT today actually compares sickness ins. to auto ins. shows just how off track so many folks are.
Obama: Mandate Health Coverage Just Like Car Insurance
by Scott Ott
(2009-07-22) — The federal government should require everyone to purchase health insurance, President Barack Obama said today, just as car insurance is mandated.
Like auto collision plans, the president said his health plan would allow reductions in coverage amounts with age as “the condition of the body just doesn’t matter as much anymore.”
“If you’re driving an ‘82 Plymouth Reliant K, you’re not going to carry as much collision coverage on that clunker as you would on a 2009 Lexus GS,” the president said. “Likewise, my own health insurance should be the top of the line GS plan because I’m in the prime of life, but my mother-in-law, who has already lived her best years, could get the K-plan…you know, less coverage on body work.”
Mr. Obama said a mandated universal medical coverage plan could reap huge cost savings “if only Americans would cast away the antiquated notion that all human life is equally valuable.”
“Most health care expenses come during the final years of life, when it’s too late anyway,” he said. “If we looked at people as we look at cars, we’d all understand that you just don’t care as much about dings and dents and leaky oil pans on the older models.”
wmbz,
Satire or no, this makes a huge amount of sense to me. If my liver makes it to ninety, transplanting it with a new one would likely not be of as much value to society (which after all, would be ultimately be paying the bills,) as would the same liver transplanted into a needy 45-year-old pediatric cardiologist.
The only reason I’m screaming so loud about getting adequate treatment for my injuries at this stage of my relatively useless life is because of the paid legal contract I signed with my insurer.
What a clown I am sometimes….
The reason I referred to the writer at the NYT as a clown is because, their point was, since auto ins. is mandatory so should sickness ins. be. That comparison is just not correct, the reason for auto ins. is not the same.
I can not stand the system, and have members of my family in the medical profession who can’t follow it’s many twists either. My point is simple, changes need to be made, but over and over again some ‘lawmaker’ pitches a new system that they can’t explain and wants everyone to fall all over themselves to sign on.
No one has outlined the current proposal,so that the general public has a clue as to what it really is. The pitchmen don’t understand it, or have not even read it, so here we stand preparing to trust politicians to take ‘care’ of us, when they will NOT be signing on to it.
So it’s good enough for us but not good enough for them, it must be really sweet! Lets make it law ASAP.
ahansen…This is why I felt like I was entitled to good care ,I paid extra bucks for that policy for years and the contract stated that I had it coming . Why should I be victimize by a profit motive Insurance Company who didn’t want to honor their contract .
ahansen please see previous post re my proud thoughts about you.
Also, my liver looks like Fred Flintstone’s landscaping, and I am only 50.
Everbody brags up Granite counter tops. I keep my pride to myself re my liver.
i really don’t know enough about this subject to comment. i do know that i save about 80% of what i make so that:
- i want be first in line for social security.
- i will be able to pay for a catastrophic health event to me or anyone in my immediate family.
i was raised to understand that life ain’t fair…nobody “deserves” anything and to work my ass off and save.
nothing personal for or against the OP.
that’s all i got to say about that.
“i was raised to understand that life ain’t fair…nobody “deserves” anything and to work my ass off and save”.
Man that’s ancient!
Everyone’s a winner baby, this the new no score society. All gain no pain!
Of course that’s the way I was raised also.
A few million more like you, and Barack Obama would be a second-rate lawyer in a firm with a quota to meet, instead of having been elected President.
It’s not clear whether your comment implies that the OP is not “deserving” of the care that she paid for, and that her insurance company is now denying her. I hope not.
did not mean to imply that at all. i said nothing against or for the OP.
Michael:
Good for you that you save 80% of what you make. It’s not reasonable, however, to expect everyone else to do the same, mainly because most people don’t earn enough to cover their basic expenses on a mere 20% of their salary. Furthermore, if we have gotten to the point where a person has to spend 80% of their income on health care, then health care has clearly gotten too expensive.
i said i am saving for retirement as well…and i have a strong desire to make sure my parents…two brothers and their families will be ok.
call it the middle child syndrome i reckcon. i don’t mind socialism in a population of 10 or less…maybe 15. anymore than that and it falls apart.
In my opinion “a well defined plan is half solved”. So I can make a moral argument that perhaps every body will get sick at some point in their lives and medical coverage is necessary. I also understand that the number of uninsured is a staggering 50 million.
However I would like to know who will pay for this plan. Where will the money come from? If we make it mandatory for employers to fund medical coverage how will it affect hiring new employees? There are thousand of small businesses across the country that would truly love to give health care benefits to employees but just can’t afford to do so.
to suGuy - who will pay?
you mention the small companies can not afford it - the large companies can - instead of giving them tax breaks while they put their companies off shore and pay no taxes - they would pay for it - if they move their company out of the country, they would pay to sell product or services in the country - the corporations can not continue to be on government welfare - they are not paying their fair share - they take the profits but give little back -
if we stop building castles in other countries and calling them embassies, there is a ton of money, if we close over half the military bases around the world, that is a ton of more money, if we stop being imperial invaders into other countries, that is a ton of money saved. There are many areas that would pay for health care 30 times over while making it affordable for the non-corporate or non-government employee.
Why not do it like other countries with ’socialised’ medicine do, and eliminate the need for employers to be responsible for thier employee’s healthcare?
Everyone pays a contribution taken at source - it goes into the national fund for healthcare.
You are fully covered, and a small part of your deduction goes towards covering others without a salary.
If you leave your job and go to another one, nothing changes, your medical expenses are between between you and your doctor (who is reimbursed by the govt for the care they give you).
Because everyone pays a little, there’s a lot of money available and the deductions are relatively cheap. Economies of Scale work in healthcare.
Sadly, the single payer system has died on the vine, and the health insurers in the US are pretty happy about that.
But, paying for it isn’t Rocket Science - many countries have figured out how to do it, and do it effectively.
You just need to think about it in a different way than the paradigm current in the USA.
Allena, I’m so glad to hear you are still on the mend, but unhappy to see how badly you’ve been treated by your insurance company.
I used to marvel at how I could take my pets into just about any veternarian and have them efficiently, effectively and inexpensively examined/treated. IIRC, a decade ago it cost me about $30-$35 for each one’s annual checkup. My own annual checkup cost many times that amount and I had less time with my doctor than my pets did with theirs! Then “pet insurance” came along, (the vets themselves began pushing it) and now I can’t seem to get them through an annual for less than $120.
I think that the rise in prices in vet visits may have more to do with the credit bubble in general (isn’t your furry family member worth a $100 check up?, if a visit to me costs more, I must be a better vet than the one up the street who costs less) and especially the rise in borrowing to get through vet school. Seriously, if you have $200K in student loans to pay off, do you think you can do that only charging $35 for a visit?
Why is med school 50-60 thou a year? and why can’t we have gov’t run med schools for free, in exchange for gov’t service? It seems to me that countries w/socialized medicine have caps on lawsuits and gov’t paid schools therefore, lower paid doctors/lower costs for healthcare. Come on, you people keep talking about the ins. lobby. What about the education lobby and the American Bar Association?
You’re paying $120 because your dollar is only worth 30% because of the government’s and the Fed (read Rothchild) caused inflation.
You’re obsessed with the Rothschilds aren’t you? Maybe you should expand on your concern with Rothschilds instead of just poking around. Let us know exactly what the Rothschild problem is please.
Tell us about your concerns, if not here, in tomorrow’s bits. Concerned minds want to know.
Please watch the following for a primer and for your homework:
http://video.google.com/videoplay?docid=-515319560256183936
Thanks.
Here’s the difference between health CARE, and health care for profit. Which do we choose?
http://videocafe.crooksandliars.com/heather/bill-moyers-essay-influence-money-health-c
EVERY industrialized country can provide health coverage for its populace - and we can’t? Come on. There’s no good argument for the lack of coverage here.
But those countries have a very different attitude as exhibited by some of the posters here. In Europe and Canada there is an attitude that everyone’s in this thing together. Here - it’s all about me. Just read some of the selfishness in this thread. It’s what’s wrong with America and until our attitude changes we’ll keep fighting over the little crap while people continue to lose everything they’ve earned - because they got sick? That’s wrong on so many levels.
Hear Hear
I dunno, selfishness is probably what’s pushing so many people to want a change. We’re all selfishly worried that Ahansen’s experience will happen to us. We don’t really care about Ahansen at all (just kidding).
Botox injections for everyone. Coming soon to America.
llcarlos (the same llcarlos who was calling for assassinations recently?)
I refer you to above:
I appreciate the “jaws of life” providers - fire depts usually. I’ve never needed them personally, but saw them in action years ago at different times.
MD’s are taking down their shingles left and right in NY. My own primary care MD no longer accepts insurance and closed his office. He will come to your house for $100 and any treatment is additional. My daughter pediatrician? Same thing. Shutdown operations completely and is cash only (she is in Connecticut).
Our premiums have quadrupled since 2000, copays have tripled, many necessary surgical procedures have been declared elective by our HMO…. And guess who that is? Empire BC/BS.
The barking moonbat minority who I’m certain are wage slaves of the inexpensive type can squeal till the fat lady sings, even at their own economic peril but something WILL be done about the insurance company scalping and defrauding of their policy holders. 30 years of rhetoric, lies and demonizing is your cross to bear. Now step up and carry it while I enjoy watching collapse under its weight.
I wonder if that’s what it will take. Doctors becoming independent subcontractors, written proposals for work performed. Competitive bidding. No more insurance companies. Hmmm
Yes - I think that the first time your insurer denies you care that you have paid for and that your policy clearly states you are supposed to receive is a seminal moment for anyone. It was for me. As it stands today, I can hire a lawyer and send them to battle an army of lawyers from Blue Cross or just deal with it. This isn’t how it should be.
And this has nothing to do with New York State being the lawsuit capital of the world? and the highest malpractice ins in the USA?Why no mention of tort reform Ex? doesn’t fit into your anti-big business agenda?
All the empty rhetoric and phony strawmen doesn’t seem to work anymore now does it……
Worked for me.
And at the end of the day, they still don’t work. Nor will they work tomorrow.
Let go or be dragged.
ahansen,
Right now I have members of my own family who are worried about their jobs and worried about the lack of medical insurance if they should lose their jobs. I worry about my twenty something nephew who is no longer covered under his parents medical insurance. People period shouldn’t have to worry about medical coverage at all.
I strongly believe we need this reform.
I’ve admired your courage, tenacity and give them hell on this blog Allena.
Thank you so much for posting this subject.
SanFranGal: Now, this is not what it sounds like…
But, who in the heck is entitled to anything on this planet, just because they were conceived on earth? I mean oxygen, food, water, blah,,etc.?
Where does this right to anything come from?
What should it sound like Ate-Up?
Well Ate-Up according to your way I guess no one. I mean who do you think you are. Who gives you the entitlement to post on this blog, who gives you the entitlement to take up any space on this planet? Just curios.
Also, as far as as taking up space, well I didn’t ask to be born.
San Fran Gal: I got to thinking about your family worries and of course ahansen’s bad experience.
So I want to apologize for my comments. I hope you will accept my sincere apology.
Greg
Ate-Up,
I accept your apology.
Please accept my apologies for lashing out the way I did. My mom is going through another round of chemo-therapy for her cancer and it’s just hard to see her have to do this again. My emotions are a little raw at the moment.
Take care
Lynn
Under “this” reform, your twenty something nephew will be fined for failure to buy insurance. It will not automatically be made available to him.
It’s not an entitlement to post here, it is a privilege.
“But, who in the heck is entitled to anything on this planet, just because they were conceived on earth? I mean oxygen, food, water, blah,,etc.?
Where does this right to anything come from?”
Good question. I’ll say if no one is “entitled” to anything we should just throw out that Constitution of ours. The whole thing is built on the concept of entitlement.
What one man calls an entitlement another calls a right.
Or girl. It could be a girl talking about it.
I think something has to be done. It will not be perfect. With all these people who want to sabotage this, how can it be perfect.
There are some here and elsewhere who will shoot down anything positive for the whole. Socialism is used as a fear instead of the positives it has already had in our society in shared roads, Internet, schools, libraries, parks and recreation, and numerous good things for the whole of society.
Health care for all has been good for the people in Canada, France and other counties with more concern for their people than the usa has had for their own. Are their systems perfect, probably not but none of them would trade for our system.
No one knows when they will get a disease, shot, hit by a car, or food for a bear - having a safety net for people is important. Losing your house because of paying for treatment is ridiculous. Other countries have systems where that would not happen.
I would like to see health care for all today. I would like to see the system improved. I would like to see congress get less until they were willing to give more to others.
Some industries should not be for profit industries when their numbers make the difference between life and death - the corporations only care about numbers.
Time to do something better.
People fear socialism because of where the road ends. The road is pretty nice at first.. very nice in fact.. but the further you go down that road the less comfortable it is. It soon starts to turn upwards.. and then it gets rocky.. pot holes appear.. and it gets steeper and steeper, to the point where rising further becomes impossible.
Then the pyramid collapses..
Why the Slippery Slope metaphor, Joey?
Isn’t there room in our society for some things to be a little ’socialised’ and some others to be a little ‘free market’?
All societies run on a mixture of both, because some ideas are practical in some situations, and some don’t work in others….
Why so Black and White?
All of this talk about socialism.
I’d like to take this opportunity to again point out that for the incredible amount of money that we currently spend on healthcare as a nation we could afford to pay for every treatment prescribed by every doctor for every patient everywhere in the nation. This is how much we spend now, no more money needed. Only a single payer system gets us to this. Would it be socialism? Maybe, but could we achieve full care for everyone without spending a dollar more as a nation? Yes. If that’s socialism, I’m not sure exactly what so many are afraid of.
It’s time for me to start cooking my Trout Bacalao. Now what should I drink with it. Since I don’t like Chardonay it comes down to Sierra or Pinot. Help me out here HBs.
No, no.
Go to the store and get a fruity yet dry pinot grigio. Buy two. If I’m coming over, then you’re going to need three.
Make it four. I’ll be over also.
Big V,
When I first read your post I thought you wrote be fruity, instead get a fruity.
BTW, have you heard from Combo? I haven’t seen him post for quite some time.
Fume Blanc, pismo. Unless you’ve smoked the trout over fruit wood, in which case I’d go for a nice Gewurztraminer. Yum! (hic.)
The only reason I remain in my current career is for the benefits. Now I can quit and go work a couple of part time gigs, maybe some contract jobs and enjoy life for a change. Its my turn to live off of the system, good bye cubicle life. I will make sure to thank rich people every time I see them.
Thanks rich people!!!!
Of course I’m going to agree with you JustSayNo ,because I had good Insurance Coverage that I paid extra for ,and I still got screwed because of the profit motive of the Insurance Company .
Why is medical coverage this costly anyway ? I have friends that are
about 60 (who don’t qualify for medicare yet ) who are paying 600 each a month for insurance . When I was young I remember paying 15 bucks a month for full coverage ,and I got full dental thrown in for another 10 bucks a month with my employer . The cost was a very small % of my gross income at the time .
I think in the case of some families with children ,to get full coverage
you would have to pay 30% of your gross income to get good coverage .
Since when did medical coverage take up that much of the monthly nut
in a household budget ?
And what do you get but a lot of antibiotics you don’t even need . Notice on the boob tube they are always saying go to your doctor for everything .Go to your doctor to get approval if you want to exercise or want to change your diet ,get permission from your doctor ,if you have a sniffle
go to your doctor and get some drug . When I was a kid we would only go to the Dr. if we thought we were dying .
I’m not saying that medical science isn’t needed ,or that it isn’t life-saving ,but come on ,the medical profession has fostered over-dependence .
I’d place the blame firmly at the door of Big Pharma on that one.
Nowhere else in the world (and I’ve lived in a few countries) is it possible - or even legal - for pharmaceutical companies to directly advertise to citizens.
It still horrifies me to see the crazy amount of Big Pharma commercials on TV, even after living here for a decade.
Basically, they’re putting the responsibility on the consumer (and I use that word deliberately) to suggest a treatment option that they saw on TV, to their doctor.
“Ask your doctor about BlahDeeBlah and see if its right for you?
So, 12 years of studying to be a doctor is thrown out the window because a patient saw an ad telling them what drugs they should ’suggest’?
And you better do it, coz a 30-second love fest on FNC has convinced a patient that they know better than you, and you’d be ‘denying’ them care if you suggest a generic, or another brand?
Noooo…. thats…..Rationing….. o_0
Way to go Big Pharma, get your customers to pimp your products to their practitioner - money for nothing and the promotion is free?
And some people complain about Big Govt?
Big Pharma and its limpet-like hold on profits and provision scares the bejeebus out of me a he!! of a lot more.
I have little hope that anyone’s going to read the bottom of this long post, but as I’m in the biz and have little to post here normally other than obscure Dune references and other bits of useless trivia, I’ll give my two cents. There were a lot of good comments already made, the reason I love reading this blog (when I can) is that there are truly some very smart guys and gals here that really think about these issues. I wish a lot of you were in the political business.
Disclaimer: I am a primary care doc in a private group in Chicago.
Anyhoo, here’s how I see it.
I generally hate government getting into anything. But the current system we have is so broken (much like our financial system, IMHO) that some things need to be regulated.
a) We need to pool insurance so that self-employed folks can get insurance and you are not penalized with higher premiums if you are a small business. If you’re self employed and have ever seen a doctor for a problem, good luck getting insurance. I had a patient today who was denied insurance because he was on an anxiety medication for a month after some trouble at work. He’s 37. One month he took Klonopin to help him sleep, and he was unable to get insurance from ANY carrier in the private sector. Unacceptable.
I’m a member of a group of 10 docs and we have about 30 employees. We pay about 3 times the amount for the same health coverage compared to Megahospital across the street. That makes it harder to compete for employees, heck it makes it harder for us to make a buck. It does work well if you want megacorporations taking care of everybody in the future.
b) National health care has its benefits, and I could be persuaded to accept that, but at the very least we should be covering preventive medicine and covering for catastrophic care (which at this point is probably anytime you’re stuck in a hospital). There’s actually few things that actually have been proven to be cost effective in preventing disease–so the guy who comes in to see me demanding “every lab test” ain’t going to get his way, but the physical, the diabetes check, the cholesterol check, the mammograms, the colonoscopy, etc. should be covered. Preventing disease saves money in the long run–it’s a heckuva lot cheaper to pay for this and have healthy people working and paying taxes, rather than having your limbs cut off from undiagnosed diabetes and stuck on disability.
For the rest of the stuff, you pay. I guarantee costs go down with this. Let the docs post their charges, and then give people the opportunity to comparison shop. Maybe you decide that downtown chicago doctor ain’t worth the 100 bucks to see and you see local doc for 75 bucks. Let economics work.
The catastrophic stuff, the hospital stuff should be covered. I do find it abhorrent that you can go bankrupt in America because you get sick. Even if you have insurance, as mentioned by many posters above.
Of note, someone mentioned that docs hate medicare because of the paperwork. Actually, in my experience, that’s not the case–they’re pretty easy to deal with and they’re pretty good about quick payments electronically. It’s just that they pay pretty lousy.
Anyhoo, I don’t think the overall cost for the above type of plan would be as bad as what they’re recommending now, and the benefits would be huge. How much of our taxes goes to BS like Argentinian trysts right now? This would actually benefit everybody if it keeps people healthy and productive.
c) Fix malpractice. If I come in to work drunk and give you a treatment that kills or maims you–darn right I deserve to be sued, and hopefully disciplined. But the vast majority of the cases are total BS–essentially a bad outcome (with good intentions by the caregivers involved) that leads people to try to make some money off it. There’s a reason that 80-85% of cases are won by the doctor–but the costs to defend yourself are astronomical. One thought–you can come up with a system like workman’s comp–if something bad happens send it to a panel and keep the costs down.
d) Help primary care. Oh, I’m quite biased on this, but I really think that having good primary care docs out there will save tons of money. Specialists are great for what they do, but if you see a specialist for a problem, you’re automatically getting a bunch of expensive tests done. A good primary care doc (and I pray I’m decent) should be able to tell the 95% of the time that something is nothing and will go away on its own and know the 5% of the time when something is really bad and needs to see a specialist (and get the million dollar workup) right away.
Right now, the system is skewed to pay for procedures and tests, stuff primary care docs don’t do. We think about the problem and figure out the overall plan, and that is simply not compensated the same. I’ve been in the biz 10 years and it’s become more and more skewed–to the point where nobody wants to do what I do anymore. You can train the same amount of time (or a year or two extra), you can work the same amount of hours as I do (or less), and make 4 times or more the salary as a specialist. What would you do? I guess I’m the moron. You have to come up with some plan to get people back into this. Pay for good, inexpensive care–it’s worth it in the long run.
There’s probably more to it than the above, I’m probably way off on some of my thinking, but it’s been a long day at the office and I’m going to have a single malt scotch and watch the White Sox lose again. It’s a pain in the butt but I love what I do, I just hate to see what the medical business has turned in to and what it has done to people who get sick or hurt outside of their control.
Stay healthy, my friends
thanks for that
Thank you so much for this post, Steve. Good information, good ideas and obviously a good heart. Please keep posting these suggestions wherever and whenever you can. This debate is far too important to leave to our “elected representatives.”
I find it interesting that these ideas were being tossed around back in the ’70’s as fixes for the Malpractice Crisis, and before that during LBJ’s Medicare Mess. Maybe we’ll get it right this time?
When 99% of our elected officials are lawyers, do think malpractice will ever get fixed?
Steve -
Have you and your partners discussed the possibility of dropping out of the insurance/Medicare grid entirely?
Charging your patients a reasonable rate for the time you actually spend consulting with them, and forgetting all the E&M nonsense?
Eliminating all the costs of insurance billing, compliance, and coding?
Just curious.
I’d imagine it’s hard to do when you actually do need to refer a patient out to a specialist. At this point the patient’s insurance would need to kick in and the denials would ensue since the patient wasn’t referred by a participating doctor.
We need to pool insurance so that self-employed folks can get insurance and you are not penalized with higher premiums if you are a small business.
This and an end to the practice of charging everyone differently when you do go to the doctor. I personally would like to see a world where Insurance covers things like catastrophic accidents / illnesses (100%) but you pay CASH for everything else. Let insurance do what it is supposed to do. The problem is that if any of you have ever tried going to your doctor and paying out of pocket, they would have charged the insurance company say $50, but you will pay $220 because you are a “cash” patient. This is essentially fraud and makes it impossible to carry only catastrophic coverage and pay cash for the basic stuff.
That - and I would like to see funding bought back for what we used to call community clinics, which used to do a great job serving the poor.
What we DO NOT need is a system which levels fines against the working poor because they cannot afford coverage. Here in San Diego, a person who makes $50K can barely afford rent, utilities, groceries and a car payment, let alone insurance, especially if that person is self employed. Fining them like a common criminal will not help them get coverage!!!. For this reason alone I fully oppose all the supposed plans I see. That and the reliance on private insurers.
“For this reason alone I fully oppose all the supposed plans I see. That and the reliance on private insurers.”
Ditto. Mandating that someone get coverage, and forcing that coverage to go through a private insurer is an outrage. It’s basically a legislated monopoly. I hope that the “reform” bill doesn’t turn out like this, but it may.
Thanks Allena. You’re awesome.
Sleep tight, all.
After traveling extensively, and seeing the diseased wasteland that is Canada and Europe, with everyone living in wood huts and no teeth thanks to socialized…..Oh, wait, no, that backwards.
Stop believing the lies the business of health insurance is telling you.
This reminds me of a recent Bill Moyers interview with Wendell Potter, a former executive for Cigna. Wendell gave a clear insider’s account into how big health insurance uses fear tactics, lies and propaganda to scare people from health reform.
Whether you like the idea of public health or not, we’re all best served by keeping the debate honest, something that profit motivated corporations are not capable of.
http://www.pbs.org/moyers/journal/07102009/profile.html
Just a few things we get in exchange for our tax dollars:
1. The development of the internet was a result of government spending:
http://www.davesite.com/webstation/net-history.shtml
2. The government provides most of the funding for the development of new medical technologies through various goverment enterprises (including the NIH, government grants to public and private universities and hospitals, and other medical research laboratories). The private market usually steps in AFTER the basic, **govt-funded** research is done, and they believe the technology can return a profit:
Government is No. 1 financial source
http://www.post-gazette.com/pg/06133/689900-115.stm
3. Most of our agricultural technology (this includes some health tech, like the ability to mass-produce penicillin) is also government-funded:
http://www.ars.usda.gov/AboutUs/AboutUs.htm?modecode=36-20-00-00
4. How about all the technology developments done on the govt’s dime over at NASA?:
http://www.howstuffworks.com/framed.htm?parent=ten-nasa-inventions.htm&url=http://www.sti.nasa.gov/tto/
———————————-
The reason government is usually involved in the development of new technologies (I’d say the vast majority of what we atribute to “American innovation” is due to government funding) is because very few investors will invest in an idea that is not proven and has little obvious commercial viability. Also, they don’t want to invest in something that won’t pay off for many years in the future. The government has a longer-term horizon and can be less picky about what will or will not end up being a viable technology. Many times, researchers have to try a thousand different things before they hit on that ONE truly miraculous discovery that can change life forever. Who wants to fund the 999 times it doesn’t work out?
BTW, the govt already covers the most expensive patients: the young, the old, and the poor. Basically, what we’ve done is socialized all the expensive patients and offered up the most profitable (19-65 year-olds who are not disabled or sick) to the private insurance companies. Anyone else see something wrong with this picture?
Good post Ca Renter .
I think I had a bad medical outcome because of private Insurance Company interference ,and the result should of been better ,based on the kind of Insurance I had .
I now believe that reform is needed ,just to stop the corruption .