Captain Zombie of Woodstock wrote:
On Sun, 19 Jul 2009 03:42:42 -0400, "Eisboch"
wrote:

Health insurance, like other forms of insurance, should be to prevent the
financial wipeout of an individual and his/her family in the event of a
catastrophic injury or health problem. It should not be designed to cover
every little ailment or boo-boo that comes along that can easily and
routinely treated at home.

When my youngest boy was ineligible for our insurance, we looked
around for a strictly major medical policy for him - bare bones, just
cover any catastrophe.

It was cheap - I mean like $4-500/yr? Something like that.


Millions of Americans are employed in marginal jobs with lousy pay and
no benefits. How are these folks supposed to afford any kind of medical
insurance or doctor's office visits. I think the base price for an
office visit with my doctor is $125, plus any tests he thinks are
necessary. That's too much money for a family living off one or two
minimum wage earners.

Of course, if you are relatively wealthy, you probably have no idea how
difficult life is for those near the bottom rung of the economic ladder.

On Sun, 19 Jul 2009 11:18:19 -0400, Captain Zombie of Woodstock wrote:


When my youngest boy was ineligible for our insurance, we looked around
for a strictly major medical policy for him - bare bones, just cover any
catastrophe.

It was cheap - I mean like $4-500/yr? Something like that.

Was that recently? I'm surprised it was that low. Major medical sounds
interesting, but there is something to be said for access before it gets
to a major medical situation. Personally, I don't know what the answer
is, but this system is clearly broken. We are spending, as %GDP, nearly
twice as much as any other industrialized nation, and getting less care.
I've heard it argued that we have the best emergency care on the planet,
but when it comes to life expectancy, infant mortality, etc. we do not
have the best care.

On Sun, 19 Jul 2009 09:48:47 -0400, Gene
wrote:

On Sun, 19 Jul 2009 02:01:51 -0400, Wizard of Woodstock
wrote:

And you have to be suspicious of this Obamacare if Congress critters
aren't getting the same Obamacare as the average citizen.

I'd agree, but in Waukon Iowa on June 30, 2009 Republican Senator
Chuck Grassley (ranking senator on the Finance Committee) made the
point that, if you want insurance equal to his, the only way you are
going to get it is to go to work for the Federal Government.

http://www.youtube.com/watch?v=Sj_1y...layer_embedded.

That doesn't sound terribly compassionate, to me.....

Well, look at it from the other angle.

What he's saying that is if you work for the government, or are a
Congress critter, you will be fine.

If you don't, you're screwed.

You're right - that isn't compassionate, but that's the way the system
is being set up.

The way this is being promoted, it's the answer to everything - it
will solve all the problems.

Which is not true - it's rationed health care. Assuming that you even
qualify for a treatment, that doesn't mean you are going to get it
right away.

Believe it or not, our system works, but people don't understand the
way it works. Again, I'll use me as an example. My treatments cost
roughly $200,000/yr, 1/4 of which I pay in co-pay - not because I have
to by the way - it's just the right thing to do. The rest is paid for
by employer insurance up to $20,000 at which point a re-insurer is
involved - so the total cost to the employer is $20,000/yr plus a
$10,000 re-insurance premium.. The re-insurer is part of a large pool
of patients who require exotic treatments who pay a premium to obtain
the re-insurance - essentially it's cost neutral - the re-insurer gets
an administration fee and parcels out the money as necessary to a
negotiated price for said treatment.

Part of the reason it works is that I have a vested interest in
keeping my general costs low as it applies back to my co-pay - the
less I use general health care, the more my co-pay is reduced. This
year I've been very healthy and I'll get back about 2/3rds of my
co-pay for the RA treatments. As long as I have a general
comprehensive physical once a calendar year and adhere to the
generally accepted standard and practices for pro-active health style,
I'm golden.

The key is that you have to participate personally in your own health
care and be pro-active in maintaining personal lifestyle choices and
follow the guidelines.

H the K wrote:
RLM wrote:
On Sat, 18 Jul 2009 21:59:18 -0500, thunder wrote:

On Sat, 18 Jul 2009 19:40:49 -0700, Jack wrote:


Sounds like you need to get a job with some benefits, and rescue your
wife from having to support you and from providing you with your own
health care.
Yeah, but ... tying health care to business is the wrong approach,
IMO. Besides the anti-competitive costs to business in the world
market, if you get sick with a long-term illness, you are SOL. A
dirty little secret, most employee health insurance policies end when
you aren't collecting a pay check. Try paying for CORBA with just a
disability check, if you even get a disability check.

This is usually the point when the insurance carrier declairs that it was
a pre-existing condition and refuse to pay anything.
Been there for that approach.



There are lots of dirty little secrets in connection with our current
health care insurance fiasco, and some of them are not so little and not
so secretive. There are all sorts of horror stories, for example,
relating to denials of needed service, making patients and their
providers jump through hoops, reimbursement horrors, et cetera.

It's sort of humorous that those who oppose the modernizations being
discussed think everything will get "worse" when the government steps
in. I suspect the percentage of those satisfied with the way social
security and medicare are run is higher than those who are satisified
with the way medical insurance is run.

The problem most of us have is the falsehood that you push that
providing everyone with government funded health insurance will solve
the problem of access to health care. There is no access to health care
problem. The problem is that people are not paying for the health care
they are receiving and the costs are being passed onto those who are
paying via their health insurance.

When you go to a restaurant and sit down and eat a meal and get up and
walk out without paying for it you are stealing. But, when you go to the
hospital emergency room and receive medical care and leave without
paying for it nobody says anything. Both are examples of stealing.

BAR wrote:



There is no access to health care
problem.


We've been hearing that b.s. from conservatives for decades. It wasn't
true then and it isn't true today.

On Sun, 19 Jul 2009 10:49:36 -0400, H the K
wrote:

RLM wrote:
On Sat, 18 Jul 2009 21:59:18 -0500, thunder wrote:

On Sat, 18 Jul 2009 19:40:49 -0700, Jack wrote:


Sounds like you need to get a job with some benefits, and rescue your
wife from having to support you and from providing you with your own
health care.
Yeah, but ... tying health care to business is the wrong approach, IMO.
Besides the anti-competitive costs to business in the world market, if
you get sick with a long-term illness, you are SOL. A dirty little
secret, most employee health insurance policies end when you aren't
collecting a pay check. Try paying for CORBA with just a disability
check, if you even get a disability check.

This is usually the point when the insurance carrier declairs that it was
a pre-existing condition and refuse to pay anything.

Been there for that approach.

There are lots of dirty little secrets in connection with our current
health care insurance fiasco, and some of them are not so little and not
so secretive. There are all sorts of horror stories, for example,
relating to denials of needed service, making patients and their
providers jump through hoops, reimbursement horrors, et cetera.

It's sort of humorous that those who oppose the modernizations being
discussed think everything will get "worse" when the government steps
in. I suspect the percentage of those satisfied with the way social
security and medicare are run is higher than those who are satisified
with the way medical insurance is run.

" An evaluation was performed to determine the effects of managed care
on patient satisfaction, medical outcomes (as measured by functional
status), employer satisfaction, and medical and disability costs.
Approximately 7,000 employees at 120 firms were enrolled in the pilot.

PRINCIPAL FINDINGS: Workers treated under managed care reported lower
levels of satisfaction at both six weeks and six months."

http://gateway.nlm.nih.gov/MeetingAb...102234416.html

And then there's this - which, as it happens, I knew about.

"No significant difference in overall satisfaction was found between
HMO enrollees and fee-for-service beneficiaries. However, HMO
enrollees expressed less satisfaction compared with fee-for-service
beneficiaries regarding the professional competence of their health
care providers and the willingness of the HMO staff to discuss
problems. On the other hand, HMO enrollees were more satisfied than
fee-for-service beneficiaries with waiting times and claims
processing. Approximately half of the disenrollment from an HMO within
1 year was attributed to misunderstanding the terms of enrollment."

I's kind of a damned if you do,damned if you don't. :)

On Sun, 19 Jul 2009 07:40:45 -0400, "Eisboch"
wrote:


"H the K" wrote in message
om...


For everyone like your nephew's kid, there are 10 more kids who don't get
any medical attention, or the wrong sort of medical attention or the
cheapest of "patches" medical attention, or medical attention long after
whatever problem there is has escalated into something a lot more serious.


That's because health care and insurance has become unaffordable for many.
Make it more affordable for those that can work.

How?

By relieving those who pay for health insurance the costs of development of
new equipment, procedures and drugs. *That* should be the role of the
government. If we can bail out wall street corporations, we can subsidize
some of the medical industry.

Users of the health care system should pay for services rendered and not the
development costs of those systems. Make the use cost affordable, not free.
Of course those who cannot work to pay for their medical service needs
should be cared for by us, but not those who can pay, but don't or won't.

Now there's a good point and one that should be taken into account.

And there's an additional issue - Americans are actually paying for
costs of other nations for drug treatments. Did you know that I can
get Retuxin in France, paying for it myself, for about 1/4 the cost of
obtaining the same treatment in the US? In Germany, if I paid for it
myself, it's about 1/3 the cost. Same in Spain.

It's almost worth flying to France every couple of months to get it.

The only drawback is that it's France. :)

I do like Spain though.

But I don't speak Spanish.

And I don't like German food.

On Sun, 19 Jul 2009 11:44:00 -0400, BAR wrote:


The problem most of us have is the falsehood that you push that
providing everyone with government funded health insurance will solve
the problem of access to health care. There is no access to health care
problem. The problem is that people are not paying for the health care
they are receiving and the costs are being passed onto those who are
paying via their health insurance.

It can be argued that those very same health insurance plans aren't
paying their fair share. You do know that health insurance plans get a
*very* discounted rate, don't you? There is also a new trick many are
using. If the hospital is in the network, they pay the pre-negotiated
discounted rate, but here's the trick. When the hospital is not in the
network, many insurance plans still will only pay the discounted rates.
That also leaves the health care professionals SOL.

Add to that, if you don't have insurance, you pay through the nose, far
above normal rates.

When you go to a restaurant and sit down and eat a meal and get up and
walk out without paying for it you are stealing. But, when you go to the
hospital emergency room and receive medical care and leave without
paying for it nobody says anything. Both are examples of stealing.

On Sun, 19 Jul 2009 05:38:33 -0500, Vic Smith
wrote:

On Sun, 19 Jul 2009 02:01:51 -0400, Wizard of Woodstock
wrote:

On Sat, 18 Jul 2009 21:59:18 -0500, thunder
wrote:

On Sat, 18 Jul 2009 19:40:49 -0700, Jack wrote:


Sounds like you need to get a job with some benefits, and rescue your
wife from having to support you and from providing you with your own
health care.

Yeah, but ... tying health care to business is the wrong approach, IMO.
Besides the anti-competitive costs to business in the world market, if
you get sick with a long-term illness, you are SOL. A dirty little
secret, most employee health insurance policies end when you aren't
collecting a pay check. Try paying for CORBA with just a disability
check, if you even get a disability check.

I believe there is a need for a national system for situations like
this.

What I don't like about this Obamacare is that it's going to force
choices on people and that bothers me.

From what I've been reading, if your job status changes (like changing
jobs/companies, etc.) or there are benefit changes (like an increase
in co-pay), you and/or your employer are forced into the "qualified"
system rather than just pay the increased co-pay. The "qualified"
plans are run by Federal bureaucrats who are going to tell you what is
and what isn't acceptable.

Additionally, if would appear that treatments will be rationed by
"cost effectiveness". Meaning that, to use me for example, if the
Feds decide that the Retuxin treatment isn't effective because of cost
vs my age (I'll be 63 on Monday), that I'll be forced into a
different treatment that is cheaper and not as effective - but it will
cost less.

Personally, I don't want to be taking percocet for the rest of my life
because some douche bag bureaucrat decides that my treatment isn't
worth the money being spent on a costly, but very effective treatment
regime. If what I"m reading is correct, I can't even pay for the
treatment myself - that's not an option.

And you have to be suspicious of this Obamacare if Congress critters
aren't getting the same Obamacare as the average citizen.

"In the health debate, liberals sing Hari Krishnas to the "public
option" -- a new federal insurance program like Medicare -- but if
it's good enough for the middle class, then surely it's good enough
for the political class too? As it happens, more than a few Democrats
disagree.

On Tuesday, the Senate health committee voted 12-11 in favor of a
two-page amendment courtesy of Republican Tom Coburn that would
require all Members and their staffs to enroll in any new
government-run health plan. Yet all Democrats -- with the exceptions
of acting chairman Chris Dodd, Barbara Mikulski and Ted Kennedy via
proxy -- voted nay."

http://online.wsj.com/article/SB124786946165760369.html

That right there has got to tell you something and as I understand it,
Federal employees will get the keep their very generous plans - paid
for by the taxpayer.

It's got to say something when even Bernie Sanders wants to stay out
of the very system he is to hot to trot on. Personally, I agree with
the general consensus on this - if it's good enough for me and you,
it's good enough for them too.

Dollars to donuts, Obamacare wouldn't even make it out of comittee if
the Congress critters were forced to accept the same system as the
American citizen.

Do we need some kind of health care system for those who can't afford
it or protect them and their families? Yes - absolutely - I agree.

Do I need it or want it? Absolutely not.

Good points. One of my brothers was for changing the health care
system before he got some rare ailment. Now he's reaping many, many
of times more in benefits than he's paying for insurance, and wants to
keep his plan. Just the drug costs are a kazillion dollars.
Makes sense to me. Doesn't address the problem though.
And a sticky one it is.
I see the main issues as not everybody kicking in - for whatever
reason, defensive medicine, inefficient treatment by medical staff,
excessive insurance company vigorish, excessive drug company vigorish,
essentially dishonest medical practices (eg., the insurance company
will pay for those $10 12 ounce bottles of water when we bill them)
and the list goes on. I'll bet about 10-20% of medical costs are
outright fraud by medical providers. Then you got your "want to live
forever at whatever cost" syndrome.
Sticky indeed.

I would agree with you on almost everything with one exception.

Not enough people take charge of their own health - Obama is right on
that score, but his solution isn't.

You have to be pro-active and not reactive meaning that if a Doctor
says - we have to run this test or that procedure, you need to ask
questions - of if you don't have the base knowledge of your own
physiology, anatomy and pharmacology, find a advocate who can explain
it to you.

In my case, I'm a licensed paramedic/trauma specialist and while I'm
not a Doctor or NP, I'm the next best thing and I can ask pointed and
detailed questions. My internist learned her lesson very early in our
relationship - don't ever try to bull**** me on a course of action.
Same with my RA doc and the osteopath I see regularly.

The funny part is if I have a funky blood test and they want to
"consult" a GI doc or another RA doc (specialist) they usually set
aside additional patient contact time because they know they are going
to get the third degree rubber hose treatment. And if they do answer
my questions properly and explain it so that I agree to see the
specialist, they call ahead and speak personally to the physician and
tell them to watch out because, while I'm never a wise guy or a
difficult patient, I tend to be fully prepared to ask questions and
get appropriate answers. :)

And believe it or not, my providers are very good about it - they
appreciate the dialoge and it even works out that by questioning them,
they get different ideas about what may or may not work - it helps
them think outside the box.

Granted that my condition is extremely rare (1 in 300 million men) and
it's interesting from that aspect, but still. :)

Captain Zombie of Woodstock wrote:
On Sun, 19 Jul 2009 10:49:36 -0400, H the K
wrote:

RLM wrote:
On Sat, 18 Jul 2009 21:59:18 -0500, thunder wrote:

On Sat, 18 Jul 2009 19:40:49 -0700, Jack wrote:


Sounds like you need to get a job with some benefits, and rescue your
wife from having to support you and from providing you with your own
health care.
Yeah, but ... tying health care to business is the wrong approach, IMO.
Besides the anti-competitive costs to business in the world market, if
you get sick with a long-term illness, you are SOL. A dirty little
secret, most employee health insurance policies end when you aren't
collecting a pay check. Try paying for CORBA with just a disability
check, if you even get a disability check.
This is usually the point when the insurance carrier declairs that it was
a pre-existing condition and refuse to pay anything.

Been there for that approach.
There are lots of dirty little secrets in connection with our current
health care insurance fiasco, and some of them are not so little and not
so secretive. There are all sorts of horror stories, for example,
relating to denials of needed service, making patients and their
providers jump through hoops, reimbursement horrors, et cetera.

It's sort of humorous that those who oppose the modernizations being
discussed think everything will get "worse" when the government steps
in. I suspect the percentage of those satisfied with the way social
security and medicare are run is higher than those who are satisified
with the way medical insurance is run.

" An evaluation was performed to determine the effects of managed care
on patient satisfaction, medical outcomes (as measured by functional
status), employer satisfaction, and medical and disability costs.
Approximately 7,000 employees at 120 firms were enrolled in the pilot.

PRINCIPAL FINDINGS: Workers treated under managed care reported lower
levels of satisfaction at both six weeks and six months."

http://gateway.nlm.nih.gov/MeetingAb...102234416.html

And then there's this - which, as it happens, I knew about.

"No significant difference in overall satisfaction was found between
HMO enrollees and fee-for-service beneficiaries. However, HMO
enrollees expressed less satisfaction compared with fee-for-service
beneficiaries regarding the professional competence of their health
care providers and the willingness of the HMO staff to discuss
problems. On the other hand, HMO enrollees were more satisfied than
fee-for-service beneficiaries with waiting times and claims
processing. Approximately half of the disenrollment from an HMO within
1 year was attributed to misunderstanding the terms of enrollment."

I's kind of a damned if you do,damned if you don't. :)


Yeah, well, insurance company HMOs are on their way out, as they should
be. Most HMO's are private sector managed no-care options.

We're in a PPO. It's great. Whatever care you need, and fast.