American Health Care

[Mary19]

Hey everbody. Although I have a general idea about the American health care system, I don't really have a strong sense of what it's about, who get's it etc. It's a hot topic in the news all the time but I'm very curious about details. Please chime in if you care to educate me. If you don't buy insurance do you really get nothing? How much does decent health care cost? Why is Canada so different?

[Todash]

LOL ... Well, Mary, it's rather like the Facebook relationship status "It's complicated." There's a safety net for older adults, Medicare, and also Medicaid, which is for certain low-income adults and their children, plus people with some disabilities (although qualifying for that is quite a task, I hear). Most of us are covered by private plans through work, some of which is usually paid for by the employer as part of your benefits, and some of which is usually paid for by the employee. More and more, the employee is having to pay for a larger portion. There are plans you can buy individually, but those tend to be really expensive, easily running hundreds of dollars a month, and they may not provide much coverage. There are a few plan types, but I do not know anyone who can go to the doctor or get medication without paying something. My office copay is $25, which means I pay $25 every time I see a doctor. If I go into the hospital for any reason, I'll pay $200 plus 10% (I think), as long as it's "in network," which means that the hospital and my insurer have an agreement about how much they get paid for what services. Otherwise it, as any out-of-network service, is much more expensive. My drug copays are $10/$30/$50, meaning I pay $10 for any generic, $30 for any preferred medication, and $50 for any non-preferred medication. That's for one round of medication or a month's worth, whichever is shorter. I've had insurance before that was HSA, meaning that although I paid out of my paycheck every month, I still got the privilege of paying out of pocket for my medical expenses until I reached the out of pocket max, which typically I don't in a year. I'm still a little fuzzy on what I got out of that deal. :glare: Oh wait, that's right: "the 'freedom' to make my own choices and control my own expenses."

Unless you qualify for Medicare or Medicaid, if you don't have insurance, yes, you get nothing. Lots of people who are employed feel that this is not their problem, but the truth is that anyone can lose insurance at any time, and if you happen to be under a doctor's care at the time, that can in some instances prevent you from being reinsured. This is not hypothetical, it's a real thing. Plenty of people with cancer have lost coverage and simply died because they were unable to get insurance or afford treatment on their own. Capitalism at its finest! So hard to see how anyone thinks that might be flawed. :dunno:

Now, there is one place that care is guaranteed: the emergency room. That, of course, is where you are supposed to go if you've broken a large bone, feel chest pain, have been stabbed, have a fever that's on the verge of causing brain damage, etc. If you go to the ER, they have to stabilize you regardless of your ability to pay. Guess where people who can't pay to see a regular doctor go when they have, oh, say, a migraine? That's right, the ER. Guess who pays for that? The rest of us, through higher insurance rates.

Yeah, we don't got no problems with our current setup. It's AWESOME. Until it's not. And then you just die ... but hey, you are dying in the greatest country in the world, right? Surely that's the shiniest of all silver linings.

[GNTLGNT]

....Yikes-a-mighty!....wouldn't even know where to start 'splainin' that one Lucy!...I will only say that there are those without, and at the other end of the spectrum-those that receive pretty much free health care...and the rest with varying costs, fall in-between...

[PatInTheHat]

Simple, American health care is a profit driven commodity, no more, no less, not really.

[fljoe0]

It's not complicated

DON'T GET SICK:biggrin2:

[JordyVerrill]

I purchase my own health insurance and pay $180 a month for it. I have a $30 office copay and a $6000 deductible. I have to pay $180 a month because I have a pre-existing condition, otherwise I would only be paying $120 a month. How many people who complain about the cost of health insurance or don't think they can afford it easily spend $120-$180 a month on cell phones and cable TV?

[nygene40]

Insurance is a nightmare, especially when you get sick (and I'm talking life threateningly sick) you spend as much time undergoing medical treatments as you do having your mailbox crammed with notices from the insurance companies denying to coverage for this, that and the other thing. Filing appeals is a full time job, which isn't easy when you are sick and having reactions to the treatments. Heartless paperpushers!

[Todash]

I purchase my own health insurance and pay $180 a month for it. I have a $30 office copay and a $6000 deductible. I have to pay $180 a month because I have a pre-existing condition, otherwise I would only be paying $120 a month. How many people who complain about the cost of health insurance or don't think they can afford it easily spend $120-$180 a month on cell phones and cable TV?
Wow, that's not too bad, actually. I think that's about what I pay as my portion through work. :) I can tell you that the people I personally know with no insurance fall into two categories:

1. Employed but no insurance offered through their employers, at an income level where the cell phone bill is often prepay, nothing fancy, and there's definitely no cable.
2. Employed, making decent money, cannot get employer's insurance because of preexisting conditions combined with being out of work just long enough to have to back pay thousands for COBRA, OR they can pay hundreds a month for health insurance on their own. (In the specific case I'm thinking of, my friend is a breast cancer survivor, which makes the insurance extremely expensive, and the problem with that is that being out of work for several months, even being careful, she ate through her emergency fund and other sources and is using what she has now to catch up to avoid losing assets like her house.)

I'm not saying that there aren't people who can afford insurance but choose not to. I'm just saying there are a lot of people who have to choose between health insurance and eating. It is a real thing.

[Mary19]

I know it's a tough question, thanks to everyone who is replying. We get taxed to death in Canada right off the hop which frustrates me but anything I need medically for the most part I get. I never pay to see a doctor and if anyone needs an operation of any kind they get it. The more we make the more we pay in taxes which supplements those who don't make anything or very little. I have been on both sides of this fence because my family had no money when I was young and my father had several medical issues. If we had stayed in the states he would have been screwed, but in Canada he got excellent care. My husband and I make decent money now but we get nailed in taxes because of it. When I get mad about that, I think of all the people out there like my father and it stings a little less.

[PatInTheHat]

I purchase my own health insurance and pay $180 a month for it. I have a $30 office copay and a $6000 deductible. I have to pay $180 a month because I have a pre-existing condition, otherwise I would only be paying $120 a month. How many people who complain about the cost of health insurance or don't think they can afford it easily spend $120-$180 a month on cell phones and cable TV?
Yeah that would be the responsible thing to do, pay every single discretionary ducat you have to the overpriced, over lauded, under performing, 24/7 butt covering, takes no responsibility (because it's the "practice" of medicine you silly gooses) American health care system, that is, and whatever's left over, go buy yourself somethin' pretty, like light maybe.
Your plan with the six large worth of a deductible (the size of which also lowered your initial premium costs I take it, not to mention your co-pay), is well beyond those I think your speaking about meager budgets, with or without electronics, thus, with a lower deductible in a range they might be able to meet, how much more would they have to cough up every single month (and we're not counting those fun fun fun for the whole family premium rate increases, which oddly do not so very often correlate with many folkens pay raises:oo:..*SN:laugh:RT!* yeah that one was a pretty freakin' good one, wuddnit:rolleyes:?) , and thus give up, hmm, well what else, perhaps shoes, refrigeration?
By the way, who is your insurer?
See I got kin up in Cincy that could really use a lower premium, and yours, even with that hard deductible, is scratch & dent bargain basement, and as for what my insurance would be right at this moment, well, I don't think even has a dollar number coined for it yet, so big kudos & props to you, and though it almost sounds like a waste of good hard earned dough, well you know, if it wasn't for that beat down of a deductible, I toast to your very good health:y:!

[hossenpepper]

Hi. Maybe I can weigh in. I used to work in healthcare and have recently been scarce here on the board as I seriously injured my left forearm near the wrist. This required surgery and a permanent titanium plate and screws to repair my shattered radius. I am also currently going through physical therapy and still require some meds. In other words, I have used my insurance to most of its extremes lately.

As Todash eloquently explained, the services for the uninsured are not the best here. Medicare is for those over 65, or in some cases those determined disabled. My mom qualifies for this as she is 60 but suffers from a disease that has kept her from being able to work. In most of those cases, however, this coverage is provided via Medicaid. Medicaid is funded via the Medicare fund, but is a disbursement given to each state. The state then funds a portion too and it is provided to low income persons, people like my mom and for some services such as nursing homes. To qualify for it, however, you have to be almost destitute or completely helpless.

If you have nothing, which often happens to those who are in the area that isn't poor enough, but too poor to afford private insurance, illegal immigrants, etc., the you can go the emergency room for serious injuries or go to the "free clinic" or "DHS" that counties (or parishes) provide via state and Medicaid funding. You can get immunizations there, women's checks (PAP, etc.) and some basic services. It is mostly free, but sometimes involves a small charge of a few dollars. A newer thing for basic cold, flu, sinus infections, etc., are "Minute Clinics" in large chain drug stores. They will diagnose basic illnesses for free via nurse practitioner and write you a prescription for basic antibiotics. Beyond that, if you are seriously injured (as I was) the options pretty much suck. You are in the hands of charity at that point.

So my recent experience: I have employer insurance, and comparatively good insurance. I have my whole family on it and pay about $200/week for health, dental and vision. It has a deductible of $500 per person and $1500 for the family. That means that for covered procedures I have to pay the first $500 out of pocket and then 20%. The coinsurance (the 20%) and the copays (like the $25 Todash mentioned, mine is $20 for regular docs, $40 for specialists) each count toward the out of pocket max, which is $2500 per calendar year for everything. That basically means that if I was to have a major illness or injury, the most I am supposed to pay for the services, etc (that are COVERED) out of my pocket is $2500 for everyone covered for the year. This does NOT include the weekly premiums I pay for the insurance in the first place. So in reality, for a major thing, with premiums, around $10K a year would come out of my pocket, but none of that includes meds on most plans. Confused yet? Therein lies the problem and the debate.

Before the health care law that was so maligned by the neocon windbags, there was almost no way to know how much something would actually wind up costing you and also very hard to determine what was covered at times.

My surgery had a retail price tag of around $35000. since my surgeon was "in network" they write off a huge portion of the cost and for everything it has wound up costing me around $1500 out of pocket. The other jacked up thing about this is the surgeon,m facility and even the surgical staff and anesthesiologist all bill separately and may or may not be "in network"!! I actually got a bill fro the anesth for $9000 for putting me out. This is because the insurance said his fee was too high and decided he was not in network, even though he works for the surgical facility that is!! HUH?!?!?!??? This can be remedied by making some calls, etc and many hours of dealing with these jokers, but imagine when you're recovering and not well trying to deal with all that crap. And this is WITH good private insurance. It's a joke frankly.

When you lay it out with a real world scenario like this, you can see why many of us are effin' sick of this sh!t and demand national health care. As a matter of fact, the simple reason that I never actually know how much it will wind up costing me in the end to see a doctor, has made me avoid the doctor for many years now. I go in for a yearly check, but if I get sick, I just tough it out typically. This is because insurance companies will do everything they can to deny anything they can. Because it's all for profit. No one has ever been able to explain how a for profit company who does better if you pay in and they don't pay out, could ever have my best interest at heart if it is less profitable for them to pay for the treatment needed. Beyond that, the only argument those opposed to "Medicare for all" essentially boils down to the providers are greedy and don't want to control their fees because that is "anti-american" somehow to do so.

In short it's all a confusing expensive mess, driven by greed first and with a low emphasis on the best thing for the consumer.

U-S-A!! U-S-A!!! U-S-A!! :unclesam:

[Mary19]

Wow Hossenpepper...I have a migraine just reading that! I guess these are the reasons why I'm so confused when I try to make sense of the system, it doesn't make any sense. I hope people are not thinking I'm trying to suggest our system and/or country is better, I know there are many things we lack as a country. I just think it's a shame that everyone can't access decent healthcare.

[Todash]

As Todash eloquently explained ... Ooh, I love it when I'm accused of eloquence. :biggrin2:


So my recent experience: I have employer insurance, and comparatively good insurance. I have my whole family on it and pay about $200/week for health, dental and vision. It has a deductible of $500 per person and $1500 for the family.Just to clarify, my $200 a month is just for me. My husband pays for his own through his work, and it's about the same. This means we have different insurers, but since both our workplaces penalize heavily if you need to cover more than just yourself, I am not complaining about the minor inconvenience. I feel fortunate that we have the option so that instead of paying $600 a month, we are just paying $400.


This is because insurance companies will do everything they can to deny anything they can. Because it's all for profit. No one has ever been able to explain how a for profit company who does better if you pay in and they don't pay out, could ever have my best interest at heart if it is less profitable for them to pay for the treatment needed. THIS. The more ways an insurance company can find to deny your claim, the better for them. They make money by refusing to pay for your treatment. It's revolting. It's GHOULISH. And I'm disgusted, DISGUSTED, that so many in our society can't imagine there could ever be anything more important than the almighty dollar.

Those who don't have insurance are in a precarious position. Those who do are mostly fine--as long as they don't ever actually need it for more than routine health care.

[Autumn Gust]

Wow. Reading all of your entries makes me appreciate my insurance carrier, Kaiser Permanente, a heck of a lot more. President Obama always cites Kaiser as a model for all insurance providers with good reason. Unfortunately, it's only found in California, Oregon, Arizona, Colorado, Maryland, Virginia, Georgia, and Hawaii and then only in the big metropolitan areas of those states.

[JordyVerrill]

Yeah that would be the responsible thing to do, pay every single discretionary ducat you have to the overpriced, over lauded, under performing, 24/7 butt covering, takes no responsibility (because it's the "practice" of medicine you silly gooses) American health care system, that is, and whatever's left over, go buy yourself somethin' pretty, like light maybe.
Your plan with the six large worth of a deductible (the size of which also lowered your initial premium costs I take it, not to mention your co-pay), is well beyond those I think your speaking about meager budgets, with or without electronics, thus, with a lower deductible in a range they might be able to meet, how much more would they have to cough up every single month (and we're not counting those fun fun fun for the whole family premium rate increases, which oddly do not so very often correlate with many folkens pay raises:oo:..*SN:laugh:RT!* yeah that one was a pretty freakin' good one, wuddnit:rolleyes:?) , and thus give up, hmm, well what else, perhaps shoes, refrigeration?
By the way, who is your insurer?
See I got kin up in Cincy that could really use a lower premium, and yours, even with that hard deductible, is scratch & dent bargain basement, and as for what my insurance would be right at this moment, well, I don't think even has a dollar number coined for it yet, so big kudos & props to you, and though it almost sounds like a waste of good hard earned dough, well you know, if it wasn't for that beat down of a deductible, I toast to your very good health:y:!

I get my insurance from Medical Mutual. I had 90% of my deductible written off by the hospital (I had to have a few expensive tests done) because I have a low income. Get tests done at the hospital instead of private offices and you won't have to pay your deductible if you have low income.

I have a family of 4 and we live off of $29,000 a year, BTW.

[hossenpepper]

Just for the record, when my accident happened I was on Humana for health, dental and vision. My company switched at the first of the year to a large group Blue Cross/Blue Shield plan that is essentially the same as the Humana plan. I also live in Florida... God's waiting room. I basically pay more for less coverage than I would someplace else like California because younger, healthier folks take up the cost of insuring older people that tend to use much more of the healthcare resources than I, or those like me, would. It is also much harder to get in to see a doc, etc. due to the huge elderly population here.

This is caused not only by the demographic of this state, but by another effed up things about our health care system; the laws and coverages vary and are governed differently in each state. This is yet another reason we needed a national health care law.

This trails into another fundamental American debate about states' rights. I am just of the opinion that I shouldn't have to be under a different set of basic laws as I go from state to state. It's one country and since it isn't 1825 anymore, maybe it's time to grow up as a society and act like it's only one.

[atomicinchworm]

When we actually get our insurance cards in, my husband works for an insurance company, and has spectacularly good insurance. It's 300$ a month for the two of us with 10$ regular doctor, 25$ specialist, and 50$ emergency room visits. My brother-in-law works for the same company and he and my niece are pretty sickly (really severe allergies), and they haven't denied anything yet.

I had no insurance for a long time because the insurance that was offered by my job was terrible, and I was mostly healthy until the last year or so (beyond the depression anyway). I also just simply couldn't afford it. There are free clinics and other organizations (like Planned Parenthood which hyper conservatives seem to forget offer a lot of very important services for a modest fee beyond abortion) though these only offer very basic care with hit or miss quality. If you do happen to go to the emergency room with no insurance, they treat you like a second class citizen (I was bitten on the face by a brown recluse a couple of years ago, no necrosis fortunately). It's really depressing.

In order to get government assistance for more chronic conditions, you literally have to be so sick you can't work.

Best country evah, amiright?

[hairyfairy]

Iv`e always heard horror stories about us healthcare, about ambulance attendants asking sick & injured patients if they have health insurance, & leaving them to die if they say no. Iv`e also heard that even if you have health insurance, the companies rufuse to pay up. We in england are always complaining about the nhs, but at least we get health care no matter if we have money or not.

[Tim D.]

The American health care system is really quite simple. If you have money or insurance you get taken care of. If not, they pack you out of the hospital and lay you on the sidewalk.

[Todash]

Iv`e always heard horror stories about us healthcare, about ambulance attendants asking sick & injured patients if they have health insurance, & leaving them to die if they say no. Iv`e also heard that even if you have health insurance, the companies rufuse to pay up. We in england are always complaining about the nhs, but at least we get health care no matter if we have money or not.
Well, I believe all emergency services (which would include ambulances) have to stabilize you, which means taking you to the ER if need be, but it's after the emergency has passed that you are hanging in the wind.

[PatInTheHat]

I get my insurance from Medical Mutual. I had 90% of my deductible written off by the hospital (I had to have a few expensive tests done) because I have a low income. Get tests done at the hospital instead of private offices and you won't have to pay your deductible if you have low income.

I have a family of 4 and we live off of $29,000 a year, BTW.
Medical Mutual, got it and muchos appreciate it, thanks ever so much:y::love::y:!

[Mary19]

I feel I must point out the flaws in our health care, because they are there. Equal health care for all also includes long wait times. Depending on what city you live in you can wait weeks or months for certain tests such as MRI. You are not allowed to pay for services. People wait a year or more for certain operations. There are also people who are above the system such as athletes and politicians..they don't wait for anything. People who are rich, go to the states to have their tests/operations to avoid our lists. Doctors don't wait because they know other doctors who put them ahead of everyone else. It's frustrating as a middle class person who can't afford to cross the border and pay for services but who might pay a little extra to be put on a shorter list. We are all equal unless we are rich..then, not so much!

[Todash]

Those who don't have insurance are in a precarious position. Those who do are mostly fine--as long as they don't ever actually need it for more than routine health care.

Dang. I just realize this means we're all screwed if we get really sick. Well, poop.

[GNTLGNT]

Well, poop.

...that'll be $195, with $100 going toward your deductible....

[Todash]

I feel I must point out the flaws in our health care, because they are there. Equal health care for all also includes long wait times. Depending on what city you live in you can wait weeks or months for certain tests such as MRI. You are not allowed to pay for services. People wait a year or more for certain operations. There are also people who are above the system such as athletes and politicians..they don't wait for anything. People who are rich, go to the states to have their tests/operations to avoid our lists. Doctors don't wait because they know other doctors who put them ahead of everyone else. It's frustrating as a middle class person who can't afford to cross the border and pay for services but who might pay a little extra to be put on a shorter list. We are all equal unless we are rich..then, not so much!

Indeed, money does confer some privilege, as really it should. What's the point of earning it if it doesn't? I mean, as long as they are not burdening the Canadian health care system, it's one of those things you can file under "life isn't fair," I guess. And I really think you could make an argument for doctors getting treated first if it helps them to continue providing care themselves.

So now I have to ask you: how does your system work? I imagine there has to be some sort of "triage" that goes on, right? So if you show up at the emergency room with a burst appendix, they don't just put you on a waiting list ... I hope.

[Amphiaraus]

So now I have to ask you: how does your system work? I imagine there has to be some sort of "triage" that goes on, right? So if you show up at the emergency room with a burst appendix, they don't just put you on a waiting list ... I hope.

You know, frankly, our current system of health care continues to rival that of the United Arab Emirates (UAE), who likely operate the best-funded national health strategy imaginable (it helps to have a strong petroeconomy). It easily surpasses the UK's faltering system, and compares favorably to the health care systems of other "socialist" countries such as Cuba, Nicaragua, China, Sweden and Norway.

The greatest issue Canada's healthcare system is facing is continual de-funding by Conservative-leaning governments who continue to believe (without any evidence to actually back up this belief) that free-market systems of healthcare delivery are more cost efficient than publically-funded systems. To demonstrate the outcome of this belief in action, I'll briefly mention what's recently occurred in Alberta.

Until fairly recently, Alberta's economy was floating in petrodollars, and through the 80's and 90's, the government had embarked on an ambitious plan to have full service hospitals offering 24/7 Emergency services in practically every community. It was amazing to see these small but state-of-art hospitals pop up everywhere, seeming overnight. And for this, most Albertans were charged a monthly insurance fee that was about $30 per person (subsidies were available to those individuals and families that could not afford this fee). This fee gradually increased to $44 per month per person, but in January 2009 it was entirely eliminated: Albertans would now pay nothing; the Province could afford this... or so the Premier of the Province, Ed Stelmach, led people to believe.

Predictably net costs began to increase; when the price of oil dropped, net costs increased dramatically. Typical of Conservative thinking, these costs were held up as evidence of the indicative of the inefficiency of socialized medicine, and now there's some discussion of integrating "user pay for certain services" (i.e., where private for profit medical service corporations - many of them American - could make a go of it). Costs will predicatably continue to increase... as they did when other publically owned and operated services and utilities were privatized (from AGT to energy ultilities, the government insistented services would improve and consumer costs would decrease as free-market competition would increase. In actual fact, the opposite occurred).

I'd like to point out, however, that world’s first system of socialized medicine was established in the early 1920s by the former Soviet Union. Like most things in the Soviet Union, it soon fell apart. Whereas the Canada's current system demonstrates that socialized medicine can coexist within a free-market economy, the dismal failure of Soviet medicine demonstrated how corruption within any society can distort any system. And you'd think, with the recent revelations about how big pharma is deliberately manipulating the costs of drugs, people would've caught unto this. But they apparently haven't.

Further, while we all hear annecdotes about how Canada's system failed on this and that occasion, we rarely hear hear about the tens of millions of times annually wherein the system did what it was designed to do: deliver access to the world's best health care to each and every Canadian.

Me, I dread what's coming in the future - every day that a Conservative government is allowed to effect its foolish, self-destructive ideology is another day that brings the failure - if not the complete and utter collapse - of Canada's healthcare system that much closer to reality.

[Amphiaraus]

... (from AGT to energy ultilities, the government insistented services would improve and consumer costs would decrease as free-market competition would increase. In actual fact, the opposite occurred).

"insistented" <==== what the hell word is that?

*sighs*

That sentence ought to read, "(from AGT to energy ultilities, the government *insisted* services would improve and costs to consumers would decrease as free-market competition would increase. In actual fact, the opposite occurred)."

This time I'll not blame my iPhone for the dozen or so curious lapses contained within my previous post; instead, I'll pin the blame on Eric the Wonder Moose, the typist I've recently hired to handle my e-mails and general correspondence. For those curious, yes, Eric is a moose. He has antlers, and you'd be surprised at how many words per minute Eric can type out...


True those words are often questionable efforts such as 'insistented', 'operantsdnt' and 'antidisestablishmentarianism'.... (and let's not even discuss Eric's questionable punctuation, word duplications, word skips and frequent lapses in tense and grammer... not to mention the use of "it's" when its not correct)... but I think readers, generally, get the idea of what me and Eric are going on about. If not, there's always much hilarity to be found in discovering yet another on-line fail :wink2:

(Next up, watch me and Eric in a hilarious new YouTube video wherein we attempt moose-enabled paragliding and prove once and for all that a moose's antlers can - or maybe cannot - defy gravity...)

[Todash]

I'd like to point out, however, that world's first system of socialized medicine was established in the early 1920s by the former Soviet Union. Like most things in the Soviet Union, it soon fell apart. Whereas the Canada's current system demonstrates that socialized medicine can coexist within a free-market economy, the dismal failure of Soviet medicine demonstrated how corruption within any society can distort any system. And you'd think, with the recent revelations about how big pharma is deliberately manipulating the costs of drugs, people would've caught unto this. But they apparently haven't.


Right you are. No system works unless people make it happen. But there's no way private markets reduce overall costs. I guarantee that if Canada goes to a "buy your own" healthcare system, people not used to paying the hundreds of dollars to make that happen simply won't be able to rapidly adjust, sending insurance costs skyrocketing.

The thing is ... however much people bitch about the government (like it's somehow drawn from a pool populated by a different species of semi-intelligent bipeds, not by people just like the rest of us), there are all kinds of hidden costs in the free market health care system that are there in part because of the inefficiencies caused by said system.


Someone has to pay for the people who cannot, e.g., my husband's younger sister who has gone to the ER at least three times because of migraines, despite the fact that she can usually head hers off with ibuprofen. :eyebrow: Any known cost is much more easily controlled for.
Doctors' offices, hospitals, etc., have people specifically devoted to billing because it's all a nightmare. Every insurance company has different rules, different coverages, etc., and that adds HUGE inefficiencies into the system.
Doctors hampered by insurance company constraints, making health care choices based on, not their experience and observation, but what an insurance company requires.

[Todash]

(Next up, watch me and Eric in a hilarious new YouTube video wherein we attempt moose-enabled paragliding and prove once and for all that a moose's antlers can - or maybe cannot - defy gravity...)
So. I guess up there in the Great White North, you get gubmint wacky tobacky instead of gubmint cheese?

[fljoe0]

Right you are. No system works unless people make it happen. But there's no way private markets reduce overall costs. I guarantee that if Canada goes to a "buy your own" healthcare system, people not used to paying the hundreds of dollars to make that happen simply won't be able to rapidly adjust, sending insurance costs skyrocketing.

The thing is ... however much people bitch about the government (like it's somehow drawn from a pool populated by a different species of semi-intelligent bipeds, not by people just like the rest of us), there are all kinds of hidden costs in the free market health care system that are there in part because of the inefficiencies caused by said system.


Someone has to pay for the people who cannot, e.g., my husband's younger sister who has gone to the ER at least three times because of migraines, despite the fact that she can usually head hers off with ibuprofen. :eyebrow: Any known cost is much more easily controlled for.
Doctors' offices, hospitals, etc., have people specifically devoted to billing because it's all a nightmare. Every insurance company has different rules, different coverages, etc., and that adds HUGE inefficiencies into the system.
Doctors hampered by insurance company constraints, making health care choices based on, not their experience and observation, but what an insurance company requires.


As to your point #2, I've had this idea that the government should write a plan and make all the insurance companies handle the exact same plan (lets call it plan A). Now I'm a free market guy so the companies can charge whatever they want for plan A and they can offer all the other plans they want but every company has to offer Plan A and it is the exact same plan no matter what company you use. Buying insurance is so confusing and if there was a Plan A, it would at least be a good starting point and a way to compare companies. The way it is now it is impossible to compare rate between companies because no two plans are the same.

[Amphiaraus]

So. I guess up there in the Great White North, you get gubmint wacky tobacky instead of gubmint cheese?

*nods*

You got that right: B.C.'s economy is resource- and export-based. While we're all proud of our shale gas production, hydroelectric and softwood exports, it's BC bud that really finances the Province's economy.

Does this knowledge depress me? Is Eric a quick typist? Does it rain in the Pacific Northwest? Stay tuned for these answers and many more...

[Tery]

Todash, I used to do billing and handle insurance for a large medical clinic. I cannot tell you how spot on this is:


Doctors' offices, hospitals, etc., have people specifically devoted to billing because it's all a nightmare. Every insurance company has different rules, different coverages, etc., and that adds HUGE inefficiencies into the system.

When I worked at this clinic, it was in 1989-90 - just before it all went to HMOs with their Preferred providers, referrals and the like. I witnessed them beginning to do what they do so well now: turn down charges for one jacka$$ reason or another. I would spend a lot of time on the phone with said HMOs trying to pin them down on why such-and-such wasn't covered. It was like nailing jello to a wall. And this was before they got really, really good at it. They didn't appreciate me advocating for our doctors and patients so they had me fired. They pulled strings and had me fired.

So, yeah, I know all about all the codes and paperwork and every other damned reason they squirm out of paying. :evil:

[Sundrop]

I purchase my own health insurance and pay $180 a month for it. I have a $30 office copay and a $6000 deductible. I have to pay $180 a month because I have a pre-existing condition, otherwise I would only be paying $120 a month. How many people who complain about the cost of health insurance or don't think they can afford it easily spend $120-$180 a month on cell phones and cable TV?

I used to purchase my own health insurance......I started out paying 98 dollars per month, this was in 1996. My per month premium rose a little every year whether I used the coverage or not. It finally rose to 567 dollars per month in 2011, at which time I had to cancel it. I had no pre existing conditions. Since I worked 3 jobs in 2012 and earned only a little over 12,000 total, I can't believe you just asked that question. I cannot afford anything easily.....muchless overpriced health insurance. Believe it or not, there are hard working people out there who earn less than a living wage, and seriously cannot afford the high premiums.

[guido tkp]

sundrop...agreed...it's amazing how many people hear stupid ****e bleated out by pol's and hacks and repeat it all as if it were gospel 'n true...

my co. offers two distinct programs: one for part-timers...one for full timers...each sucks badly: i get my ins. thru my wifes employer, which offers a far better program at better rates and better premiums

people should realize that just because you've found a pot of gold, doesn't mean everyone gets to share...

i have a long time mgr leaving me next week...where she'll go, they offer fully paid ins.

that is 100% better than the best plan our co. currently offers...sure, she'll have to work within their system...go to their drs...and have some minimal copays...but it'll be far better than what she gets thru us...

just by switching jobs...i shouldn't have to worry about losing good people just because of ins., but i do.

ins. should be pretty much the same...but as tery so brilliantly pointed out..it ain't now and its never gonna be as long as there is profit to be made...

we already exist, and always have, in that shady, grey/black world of death panels that palin dunce whined about...only they've always been run by the ins. co.'s...

[Tery]

Amen, guido!

Right now, I belong to a co-operative and it's much like having socialized medicine (gasp!). The docs all work for a salary, they are not paid by procedure or diagnosis. This keeps it affordable. We pay a $30 office visit co-pay (up $10 over the past 10 years) and have a small deductible. It's a lot better than what I read about. I'm glad we have such a good health insurance company but I'd be happier of everyone had similar coverage.