OT: Health insurance

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My poor lil feelings are hurt that nobody followed up on my post (in earlie r car insurance thread which quickly became a classic example of thread dri ft).
There were many personal anecdotes of experiences with the health care syst em, military and civilian, but nobody really addressed the topic of medical care which in the U.S. is commodified as an "industry" rather than a publi c good.
Here goes:
"When I was living in Europe, a member of my family was treated, long-term, for a very serious condition, without a penny of cost, even though neither of us was a national of that country.
Allow me to reiterate that physicians in many developed countries -- I only know specifically about European countries, so am extrapolationg -- comple te their medical studies at government expense.
No sky-high tuition bills from for-profit universities. No crushing debt l oad for the first 15-20 years of practice. No wild divergence in physician -hospital fees between practitioners and institutions. No drive to special ize in big money practices like plastic surgery. In return,physician oblig ed to devote 'n' years to (more or less) government assigned practice, mean ing often working in under-served communities.
Sounds like a win-win to me. In those countries, health care is not consid ered an "industry" --I wince every time I hear that term --but a public goo d.
Those governments must have figured out that $1 spent on preventive health care and affordable care for existing conditions saves $100's of dollars do wn the line in social costs that we pay out of our other tax pocket."
The usual comments on this kind of suggestion lean heavily to "...they have to wait months/years for a procedure... whereas we in the US can get it fa st .
Yeah, sure, if you have insurance or can pay out of pocket. If not, you're basically fracked. Leaves out a large segment of the population
The public seems to have a very hard time understanding that if we don't em phasize preventive care*, and don't make medical care available to all, we pay for it ANYWAY in the form of social costs for damage done to and/or by impaired individuals who didn't get care in time.
*For just ONE example: In most "developed" countries, qualified profession als follow new mothers and babies in their homes for a period after the bir th to make sure there are no complications. In the U.S., where childbirth for a while was handled like a McDonald's drive-through until outrage force d some retrenchment, there were many cases of babies having to be rushed ba ck to the hospital because of undiagnosed post-natal problems. Enormous co st that could have been avoided by a much less expensive program as describ ed above.
(steps down from podium)
HB
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On Thu, 15 Aug 2013 22:40:11 -0700 (PDT), Higgs Boson
The problem is many fold. The biggest issue is possbily a lost cause in the US. In the same way we will seemingly never rid ourselves of the legions of lawyers who just make life difficult for everyone we will probably never get rid of the idea that health care is just 'one more industry'. And as with any industry, it's all about profit. Another problem in the US is the idea that everyone, no matter how little they contribute TO society, is OWED free room and board, free food, and free medical care and not only free medical care, the BEST the world has to offer. Anytime someone suggests "rationing", as in, if you are paying the bare minimum for your health insurance you only get the bare minimum of care. Doesn't mean you get inept care, jsut means you go to a clinic, you get standard drugs, no high priced just came on the market might be the next best thing but we don't know yet drugs, means if you been smoking for 15 years and you get a bunch of diseases that will cost $450,000 to treat you are going to be out of luck because no, you don't "deserve" the same level of health coverage as the guy who's been working and paying for a GOOD policy. The people in the "socialist" countries already are getting "rationed" health care but they seemingly are OK with it because EVERYONE gets mediocre care, not just the poor.
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Ashton Crusher wrote:

BINGO!!!! You cannot turn on the TV without seeing a commercial from a law firm suggesting "You MAY be entitled to compensation." There is much that could be done to reduce the cost of medical care, but politicians and lawyers do not want them implemented.

BINGO again! Many people save nothing, then wonder why they are broke and cannot pay bills when something unexpected happens to them. Also, there are people who must buy the latest gadget whether they need it or not, or they piss away their earnings on drugs, booze, gambling, or other items that consume their potential savings. Duh!!!
What should have been an inspiring event (the election of a partially black president) has only encouraged those making bad decisions to feel they are victims. They ARE victims, but victims of their poor decisions, not victims of someone else.
Anytime someone suggests "rationing", as in,

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I have been saying since I get an interest in this topic in the mid-80s that the only thing keeping us from HC reform is that we as a society can't agree on the definition of "minimum healthcare". Is it seeing a GP? Is it cancer treatment (and if so at what time do we decide the person is beyond salvage and should just be made comfortable)? Does the 4-pack a day smoker get a new lung or the alchoholic a new liver? "No nation would be so dumb as to say that we all want to go one point, we just don't know how to get there. What we are finding is some want to go to San Diego, some to Seattle. We are ashamed to admit this so we pretend we all want to go to San Francisco."
Uwe Reinhardt on the health care debate.
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On Friday, August 16, 2013 8:11:03 AM UTC-4, Kurt Ullman wrote:

There is obviously a whole LOT more than that one point which is preventing healthcare reform.
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On 08-16-2013 08:11, Kurt Ullman wrote:

"If she were dying, they would pay thousands to make her comfortable. But not a penny to prevent it from happening."
That's what the social worker said regarding our request for Medicaid assistance with my wife's anti-cancer drug. His intonation suggested he didn't like it any more than we did.
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Wes Groleau

Don't get even — get odd!
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On 8/17/2013 12:29 AM, Wes Groleau wrote:

I'm in hospice care right now and nothing will be done to cure me but they are keeping me alive, I'm handling the cure myself. It hurts like hell when I exert myself but I refuse to sit on my butt and die. I go out and work when I can and the pain is less every time, plus I can take stairs a lot easier each time. It's been a while since I could take the 24' extension ladder off the ladder rack on my van and that's my next goal. ^_^
TDD
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On 8/16/2013 1:59 AM, Ashton Crusher wrote:

It is a dangerous assumption to make that soc. med. is the same as rationing....I suppose it happens a lot, but healthcare sure as hell is rationed in the US. Here, you get healthcare when you can afford it, when you are much too poor to afford it, and when you are in dire need and show up in the ER.
Healthcare in the US sucks. There is no better descriptive word in my vocab. Been a nurse for a long time, my favorite field being labor/delivery until I lost my tolerance for unneeded C-sections and labor induction to fit someone's idea of convenience. New thought recently is a connection between labor induction and autism....but, the rising autism rate may be partly a factor of distorting diagnoses in order to qualify for special care and schooling.
There is NO INCENTIVE for docs, hospitals or anyone else to keep people HEALTHY. A visit to my doc is mostly an experience in selling a product than PRACTICING MEDICINE. Need something for "horrible" hot flashes? Get some hormones to take to ward off every natural function of your body and keep the doc and pharmacies in biz. Does the kid wet the bed at night? Get him into the hospital for a surgical procedure to find out that his bladder is working just as it is supposed to. Overweight, stuffing bacon burgers into your mouth, and getting out of breath if you move off the sofa? Get some arteries replaced, preferably with some veins from you legs. If you live long enough to grow some cataracts, get them replaced with plastic....a trained tech. could probably do the procedure assembly-line style like they do in Russia, but, then, an MD misses out on becoming a multi-millionaire and (of course) supporting the bottom-end of the economy with his wealth.
Working in healthcare and in insurance, I encountered far more people worried only about the amount left for them to pay than I did people concerned with whether their care was appropriate, of good quality or even what was done to them.
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It is the same as rationing. But then the current system rations, too. That is what econ systems do, they ration things because you can't spend 100% of the money on everything. The real question (and another that is being studiously ignored by all in this debate) is who do you want to make those decisions and how do you want them to be made.
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On 8/16/2013 8:54 AM, Kurt Ullman wrote:

Well, starting with basic physicals, immunizations, accident and illness coverage would do for me. Forget organ transplants, other than kidney and cornea....need other, hold a fund raiser. My logic tells me that all humans should receive basic care....when it comes to extreme measures, it seems selfish to burn huge resources on some when other people don't have anything. In a one-for-all system, I would not cover fertility treatments, esp. artificial insem. that results in litters of babies requiring intensive care for months. I could also live with euthanasia, as long as it was chosen a certain number of years prior and selected by a mentally competent adult. Who wants to live for 10 years beyond the time they lose their entire mental capacity to Alzheimers?
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On Friday, August 16, 2013 8:26:46 AM UTC-4, NorMinn wrote:

If that's the case, why do so many people when they are facing serious illnesses, come to the USA to be treated? I'm very satisfied with the healthcare that I have received. Now the cost of it, the cost of insurance, that's a different issue.
There is no better descriptive word in my

Then change doctors. I don't have mine selling products. Unless you mean telling people to take BP medication or statins. If it's that, then it's also the govt too, because they are very much behind the recommendations for most of the most popular drugs.
Need something for "horrible" hot flashes?

And what would you do? Tell those needing bypass surgery to die instead? That's your idea of good healthcare?
If you live long enough to grow some cataracts,

Good grief! Cataract surgery is one of the lowest cost. It's what, maybe $3000? And if Russia is a great model for healthcare, when people are seriously sick, why doesn't anyone go there?

Well, of course. They are worried because they have to pay for it. And they aren't worried about whether their care was of good quality or appropriate, most likely because they are satisfied with it. Do you bitch about everything or just what you think is a problem?
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More like $1000. At least that was what it was a handful of years ago when I had my left eye done. Not exorbitant but also not bad pay for less than 1/2 hour.
And, of course, the insurance paid more for the treatment for the retinal tear and macular swelling. Not blaming the doc, those things happen. ________________
A number of years ago I had an opthamologist friend who set up a clinic to do nothing but cataract surgery, all Medicare. He hired 5-6 other docs, shuffled the patients back and forth by limosine. They were rolling in money.
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wrote:

It was something like $1500 an eye (for two) last year. I don't know if it might have been slightly more expensive because of the lenses they put corrected for my nearsightedness.

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On 8/16/2013 2:57 PM, Kurt Ullman wrote:

It's been well over $3000 per eye in my neighborhood for a long time, but there is a local monopoly.
http://www.allaboutvision.com/conditions/cataract-surgery-cost.htm
http://www.nytimes.com/2012/01/22/opinion/sunday/the-money-traps-in-us-health-care.html?_r=0
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I wonder how big a part insurance plays in that attitude? For example, a visit to a specialist doesn't put much in his pocket unless he does "procedures". The more procedures the more $$.

I wish people would also concern themselves with how much their insurance company is paying the docs.
A few years back I needed epidural steroid shots for my back. The pain doc (who said he had done 40,000 of them) used a local, then the shot by feel. NP, easy peasy. Cost, $100; good pay for 10 minutes but not unreasonable IMO.
A couple of years later I needed some more. New insurance company, new doc. His procedure...
1. PA from Ecuador sets up an IV. When "the great one" (main doc) is ready, PA gives me a general via the IV. 2. While I'm out, main doc does the epidural using a fluroscope to guide him. 3. PA wakes me up with something else through the IV.
This doc collects $500+ from the insurance company. I have no objection to the fluroscope but a general?? Doing so allows him to collect for more "procedures". Did I mention he didn't bother with a bandaid and I bled through my shirt? Or that I was punchy for 2-3 hours from the anesthesia? I won't be going to him again.
One more example...stress test (chemical, not treadmill): all told, it took about 3 hours, 80% waiting for this and that, the other 20% with PAs. At the end, I saw the cardiologist for maybe 10 minutes top to to hear his interpretation of the results. He billed the insurance company almost $10,000, no idea how much they actually paid but I haven't been back and won't be.
It seems to me that the medical practioners have an inflated idea of what they are worth; it also seems to me that insurance companies should be saying (to the docs) things like, "You want HOW much??" and, "Whoa, bubba, just a minute there..."
One thing for sure: if there were no insurance the doctors would be getting a lot less.
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wrote in message

Yep. Of course, that was over his entire career thus far (he was about 50 I'd judge); still a bunch.

I don't recall how long but a few months. Felt like someone had whacked me across the lower back with a bat. Initially, I went to my internist thinking I had nephritis, he said not, wanted me to wait a bit to see if it got better; when it didn't he ordered an MRI and after seeing it referred me to the pain doc.
I had three shots a week apart. The pain diminished with each, totally left shortly after the third. That lasted for 15-18 months. After it returned, I had three more from the other, $500, doc. Those lasted about 15 months. When the pain returned it wasn't as severe as initially and since I knew I was changing insurance plans and since I didn't care for doc #2 I decided to wait 3-4 months for the insurance plan change. Glad I did as the pain left all by itself. No idea why as I'm sure the stenosis still exists.
Same thing happened with my neck; for several weeks/months I could barely turn my head. It too resolved itself. ____________________

A tetanus shot is at least as bad as an epidural. ____________________

I have a childhood friend in KC who is a doctor. He opted for the surgery, now regrets it, is as bad or worse than he was. Between knife and needle, I'd take needle everytime. __________________

I don't care where he is, $10K is way too much for what was done.

Well, the PA was all aghast, wanted to schedule me for an immediate balloon angioplasty. Scared the bejeezus out of me. Fortunately, the cardiologist pooh-poohed the idea, said there was some blockage but not enough to worry about it. He still isn't worth $10k :)
No angina, PCP wanted the stress test when I first became borderline diabetic, said diabetics were automatically heart patients too.
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<stuff snipped>

surgery,

A friend's cousin opted for surgery and by the *seventh* revision she could no longer walk. She eventually became so despondent about the downward spiral that she took her own life.
Back surgery, IMHO, is highly overrated and over-recommended.
http://abcnews.go.com/WNT/PainManagement/story?id 96365&page=1 <<Dr. Richard Deyo of the Harborview Medical Center said in many cases when comparing spinal fusion to nonsurgical therapy it "wasn't clear there was any advantage of surgery over the nonsurgical treatment." . . . So why are so many back surgeries performed in this country? . . .It could be a combination of too many surgeons who are too eager to operate and the impatience of many patients who want results quickly. . . The truth is that 90 percent of back pain can be resolved without surgery if both doctors and patients are willing to try other treatments that basically help the back to heal itself. >>
Lots of people (raises hand) get into back trouble through stress. I often wonder if the back isn't some sort of biological circuit breaker that trips when stress levels become intolerable? In my experience stress makes what might have been sore spot turn into a serious problem. Once the discs bulge and a nerve gets pinched, the downhill slide begins rapidly.
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Bobby G.





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There are three subjects doctors know nothing about and should be
ignored when they pretend to: sex, diet and lower back pain.
Joel N. Shurkin on the NASW mailing list
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<stuff snipped>

Sort of like going to a celebate Catholic priest for marriage counseling. (-"
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On 08-16-2013 21:51, Robert Green wrote:

Getting it from a non-celibate Catholic priest may be worse. :-)
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Wes Groleau

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