Insurance and Healthcare

[texas*princess]

Originally Posted by DGTess

I think everyone should be able to afford BASIC health care.

Those who want everyone to have extensive health care are trying to become a nanny state. "I pay for your insurance, and you're more likely to need care if you eat trans-fats, so I get to determine what you put in your mouth". That's scary.

While it is scary, and I agree that it has the whole "Big Brother" vibe to it, I'd have to agree with them.

I'm not in the medical field but I've read a lot about the way it works in other countries -- I believe it was Norway? or Finland or something like that, where everyone pays way higher taxes than we do here in the U.S., but their health-care is pretty much all-inclusive. They have the kind of service PhoenixAzul described. In a lot of ways, the stereotypical view of the U.S. is true. We want what we want, NOW, and lots of it. If that means a double Big Mac and some SuperSized Fries, then so be it.

I'm not a smoker. I try to watch what I put into my body because I know if I put on way too much weight, I will be at risk for diabetes, and heart failure. If I am doing all these things to try to ensure I stay healthy (and therefore probably won't use my insurance as much as others) why should I pay the same high rates as someone who smokes 4 packs a day and has a pretty high chance of developing lung cancer?

I think it's one thing if you are born with something like diabetes (because I believe people of different backgrounds/sizes/ages/etc can get it) or any other chronic illnesses and can't control it, but if you are doing things to your body to make yourself way more susceptical to things like lung cancer, then yea, I'd say you're also considered a "risk" in the health-insurer's eyes and it makes sense for you to pay a higher cost.

[bluefish81]

I have good health insurance IMO, but I know that the amount it costs every year is increasing. Co-pays are going up every year, etc.

I've been on medication to treat a pre-existing medical condition for almost 12 years. 12 years ago the cost out of pocket was $90, the out of pocket cost is now $172 for a thirty day supply - for a one/day tablet. My copay is $27.

My insurance allows me to pick who I want to see, without referral, although most specialists generally require it.

I think the availability of healthcare for a lot of people is getting worse. In this I mean, I generally have no problem calling my current primary care physician and getting in that day to see him. This is probably because he's my age and hasn't been in the area much longer than me.

However, I've been seeing neurologists for almost 12 years, and have often found that I have to schedule appointments sometimes up to a year in advance in order to see a doctor. At least six months is preferable. That's a lot of planning - especially if something happens. The fastest I've ever been able to get into a neurologist was six weeks.

When I lived in Michigan, the neurologist recommended by my Iowa neurologist required a referral from a PCP in Michigan, despite the fact that my neurologist in Iowa was more than willing to provide one as well as all my history (requirement of the neurologist not my healthcare provider). I had to wait two months to get into a PCP - because I was a new patient and they were so booked up and then another six weeks for the neurologist. I guess I just don't see how the current system is working all that great for us in some respects.

[PhoenixAzul]

Originally Posted by DGTess

I think everyone should be able to afford BASIC health care.

Those who want everyone to have extensive health care are trying to become a nanny state. "I pay for your insurance, and you're more likely to need care if you eat trans-fats, so I get to determine what you put in your mouth". That's scary.
UNRELATED, but allowing someone to dictate your very actions. This nanny-state mentality is what scares me most about the direction of our country.

But isn't that what insurance companies do? They dictate what care you can and can't have based on how harmful it is the their profit margins.

I think it's one thing if you are born with something like diabetes (because I believe people of different backgrounds/sizes/ages/etc can get it) or any other chronic illnesses and can't control it, but if you are doing things to your body to make yourself way more susceptical to things like lung cancer, then yea, I'd say you're also considered a "risk" in the health-insurer's eyes and it makes sense for you to pay a higher cost.

Diabetes has 2 types. Type 1 (the type I have) is less about genetic factors. Mine was caused by an auto-immune response to an illness I had as a child. Type 2 (previously called adult-onset, but now type 2 because more and more children are getting it), is influenced by genetic and lifestyle factors.

We're all at "risk" for one thing or another. Lift stuff all day? Back problems. Walk a lot? Hip problems. Computer work? Carpal Tunnel. Woman? Pregnancy. Some people are just genetically pre-disposed to certain cancers. Diseases are caused by thing we've really yet to uncover, and in some cases can't avoid. I wouldn't be able to look at someone with lung cancer and say, "no mate, sorry, you've done this to yourself because you didn't avoid enough". To me, it's not really on to chastize people about the choices we make (how many of us have had a drink? you're at risk for x number of diseases)...its good to encourage best practices (nutritional information, exercise information, etc)...but to just outright deny or have to determined who did enough to avoid their disease...I wouldn't want that job.

[AKA_Monet]

Originally Posted by PhoenixAzul

I have to warn you that this is a rather sore subject for me. Please don't be offended.

1) if we are talking about the standard of care in the states, then from my perspective, it's stayed about the same. I've got a chronic illness that requires dr visits and the whole nine every 3 months, so I guess I'm a frequent consumer. If we are talking about the standards of health INSURANCE in the states, then it is abysmal. It isn't the very poorest and it isn't the very rich getting squeezed out, it's working class and middle class families getting blocked from quality care, being priced out.

And the system of "pre existing conditions" is absolute and complete bullocks. I've got to pay double what someone else pays because of something that I couldn't control? And then pay more for medications? My rates were $900/ month without prescriptions to keep my insurance. Medications were probably another $200+/- a month. And then rent. And food. And gas. If I hadn't gone to graduate school, I'd have been bent over the table...I don't know anyone who can make the $1700/month right out of school, and few who had health care right out of school.

2) Pharm reps. Oh how I hate them. I want to chuck eggs at their cars. Before I left for Glasgow, I had to go and get a TB test and a meningitis shot at my GP. So I go in, and the waiting room is PACKED. So I sign in, present my card. And I sit...and wait....and wait....and wait. Finally I got up to check and make sure my appointment was on the right day/time. And through the window, I see that all of the Dr's and nurses are enjoying sanwiches, coffee, cake and such with a drug rep sitting there with his case open....

The waiting room itself has an LCD monitor that just constantly flashes direct-to-consumer drug adds. We're one of only two countries in the world that allow direct to consumer advertising, and it costs the pharmaceutical companies BILLIONS of dollars a year. I'd really rather they kept that money for research or, *shock* reduced the price of the medication. I've got zero sympathy when they lose a patent and a generic comes available.

3) The absolute cluster-f*ck of red tape associated with health care does my head in. Why am I paying someone the above $900/ month to DENY ME CARE? And it isn't the Dr that makes that decision, it's some paper pusher in an office somewhere that says, "nope, can't have that procedure". I pay you to WORK FOR ME, not to put up barriers to my care. That's not the way this system works....you pay, you receive services. We wouldn't accept this type of abuse from any other industry, but health insurance gets away with it because we've got to have it.

When I was getting ready to leave for Glasgow, we were trying to get the insurance company to give me a year's dispensation of my medication at one time. This was a nearly 4 MONTH process of phone calls, faxes, letters, complaints, threatening legal action (I owe my lawyer friend a nice bottle of Scotch for that one), in order for them to say, "oh! ok." (I should note that this is the only time that I have dealt with one person on a consistent basis and she was fantastic...it was a pharm services person in my health insurer, who said to me, "yea this system is shit, we'll get you that med one way or another")

4) The fear-mongering surrounding countries with national insurance is ridiculous. I've lived in the UK for a while now, and I've got a phenomenal GP who is literally 100 yards from my front door. I was immediately given an appointment, physical, podiatrist (which my old insurer wouldn't cover even though I'm diabetic), diabetes specialist, and a prescription waver form. The standard rate of prescriptions in the UK is 6.18 GBP...about $12 USD with exchange rate. But if you've got a condition that requires constant medication/monitoring, or if you're in a couple of other situations, the prescriptions are absolutely, positively, free. I don't pay a pence for them. And it isn't just insulin, it's flu shots (weren't covered under my old insurance), biohazard bins, they'll pay a good portion of orthotics should I need them....

And I've never waited to see a Dr. here. I've always gotten prompt appointments and treatments. My flatmate (also american) had a stroke (she's 22) the third week of us being here, and she was given treatment at no cost, and she continues to recieve treatment for the blood thinners and other things she takes, again at no cost. She might even be able to apply for transport funds, because the neurology clinic she has to attend is cross town from our flat.

But I guess my point is that treatment is no good if it is only for the rich. It would make more sense to me to given EVERYONE access, especially the working class. If you've got a healthy person who isn't having to scrape and decide between medicine and food or medicine and rent, then surely they'll be a better employee. Surely if they've just got a GP to go to for a blood test, that can prevent them from being disabled later. I don't know, to me it seems that if we make an investment in the health of EVERYONE then we should see the economic gains in productivity.

PhoenixAzul-- PM me... I can teach how to "work" this system and get what you need... It might take me some time, but I can do it...

(((((Hugs))))) for you though your dealing with this BS...

[madmax]

Originally Posted by DaemonSeid

What is your opinion of healthcare as it stands now in the US?

Is it getting better or worse?

How do you feel about pharmacy companies and research agencies?

Are they making money to bandage symptoms of the populace or do you feel that they really are pushing forward to cure illnesses?

For those that work within the medical community what concerns do you have about how our healthcare treats the general populace?


What would you change about your insurance carrier if you had a chance to rewrite your policy?

What are some things in your policy that you feel is harmful to you as a patient and conversely what are somethings that you have in your insurance that you really like, especially when it comes to covering your children from both aspects?

I don't have any problems with our healthcare system.

If the Dems can all afford $2000 rims, then they should be able to afford healthcare.