quote:

Originally posted by Ruanne:
People shouldn't go bankrupt if they get cancer, spending all their life's savings and selling their house to pay for treatment, after their yearly (or lifetime!) insurance max has been reached, knowing that their pre-existing condition will bar them from getting coverage from any other insurance provider in the future. They will be reliant on charity health care if their cancer ever goes into remission.

What we have now is an injustice. I would personally prefer a government option, mainly because I was born into the military health care system and have had no real complaints against it in my own time in service.

But even if we don't go for a government-run option, we should do something about people who HAVE health insurance going bankrupt paying for medical treatment, about people being barred from coverage due to pre-existing conditions, as well as about people who literally can't afford insurance.

I worry about all this for personal reasons. My mother's been having seizures. Last year, we could handle it, since her insurance covered most of the expenses, and we are now repaying the balance. But this year, she's had two seizures already. We'll manage to pay what insurance covers. But if anything else happens this year, she may well go past her yearly limit.

In Europe nobody worries about these things. (I studied there in college.) Sure they pay more taxes. But they don't pay thousands of dollars for medical care a year (and MORE if something happens medically.) It balances out.

quote:

Originally posted by Icetiger22:
Rationalized health care, heavy fines for refusing to purchase the health care plan

quote:

Originally posted by ipw533:
As a welfare caseworker, I'm in a specialized field--I deal primarily with medical assistance applications submitted by medical providers. How does that work? Glad you asked.

Patient A goes to Hospital B but has no health insurance. Let's say the patient is hospitalized overnight and discharged the following day--typically this will generate a bill of several thousand dollars. The hospital knows the patient can't pay that bill, so it or its representatives submit an application to the state for Medicaid benefits--my job is to process and resolve those applications. I've been doing this for a year now, and I've noticed certain trends, none of which are encouraging.

First of all, people have a tendency to use the hospital ER as a primary caregiver, and they do do for minor ailments that can either be treated by a reasonably competent and reasonably priced GP or even by themselves. An abcess is not a hard thing to treat, folks. Clean and drain the wound and apply antibiotics--you don't need an ER MD to do that! And why the Hell are you going to the ER for a simple headache, backache or cold?

But that's what people do, and the state ends up paying the bill. Excuse me, you end up paying the bill, since you're a state taxpayer. The people for whom you are paying that bill probably never paid taxes in their lives.

Some of these expenses are covered by Medicaid and Medicare, but more often than not the remainder is either shifted onto the patient or eaten by hospital's charity slush fund. Look at your next hospital bill--you'll be charged for things like rubber gloves and cotton balls. Where does that money go? If you guessed the slush fund I'd say you were correct.

If you have private health insurance it will pay for most of those bills; if you have Medicare it will pay up to 80% of those bills--the rest either falls to you or is picked up by the taxpayers.

One thing few people seem to be aware of is that the doctors get paid cents on the dollar for such patients. More and more physicians are refusing to accept Medicare/Medicaid patients, and can you blame them--they actually lose money when they do so. Their alternative is to overcharge for things like tests, costs which get passed onto the insurance companies and cause them to raise their rates. And the cycle continues.

Now let's say that I'm a young student with an interest in a career in medicine (OK, I'm not so young and my interest is in veterinary medicine). I've got to get a normal college BA with pre-med courses and then I've got to qualify for and get into a medical graduate program. I'll rack up a mountain of debt doing that.

But wait, there's more. Let's say I get into medical school and I pass all of my classes. What happens next? I get to be an intern at a hospital and I deal with life-threatening cases while simultaneously dealing with sleep deprivation equal to that of a Ranger school candidate--except that if I sleepily screw up I've got a boatload of lawyers on my butt. And I know those guys, they partied with us but decided to take the easy road, which was smart.

OK, so I make it through my internship and am now a fully-fledged MD. I set up my own practice. That costs serious bucks, plus I have to pay to get the privledge of working at the local hospitals. And I've got to pay out the wazoo to insurance companies in case some patient thinks I didn't treat his hangnail properly, and that's before I even see a patient.

Who in his right mind is gonna go through all of that crap for a teensy government payout? And then where are we going to find the physicians who will make Obamacare work? Asylums are not a good choice and don't look at me--unless you're a cat I've no business treating you.....

quote:

Originally posted by Ruanne:
How does it balance out? You pay taxes, and you get health care in return for said taxes. Since the government is not a for-profit organization (obviously) it will be better motivated to keep costs down (you can argue this point. For instance, the military does not control costs, seemingly. But those private contractors we've hired out to replace certain military functions have spent FAR AND AWAY more than the military units ever have for the same services, ie food preparation.)

The alternative is, you pay premiums, and deductibles, and the price of both go up every year FAR BEYOND the rate of inflation, until it takes up half of your income, or your employer quits offering insurance at all. This is assuming your employer even OFFERS health coverage, or that you are even employed.

I think it irresponsible that we have cut taxes in a time of war. That worked fine when the economy was booming. But the economy can't boom forever, that is a given. The bill will come due. We may as well start paying it now. The interest will pile up if we put it off another few decades.

quote:

Originally posted by Yooper_tj:

quote:

Originally posted by ipw533:
As a welfare caseworker, I'm in a specialized field--I deal primarily with medical assistance applications submitted by medical providers. How does that work? Glad you asked.

Patient A goes to Hospital B but has no health insurance. Let's say the patient is hospitalized overnight and discharged the following day--typically this will generate a bill of several thousand dollars. The hospital knows the patient can't pay that bill, so it or its representatives submit an application to the state for Medicaid benefits--my job is to process and resolve those applications. I've been doing this for a year now, and I've noticed certain trends, none of which are encouraging.

First of all, people have a tendency to use the hospital ER as a primary caregiver, and they do do for minor ailments that can either be treated by a reasonably competent and reasonably priced GP or even by themselves. An abcess is not a hard thing to treat, folks. Clean and drain the wound and apply antibiotics--you don't need an ER MD to do that! And why the Hell are you going to the ER for a simple headache, backache or cold?

But that's what people do, and the state ends up paying the bill. Excuse me, you end up paying the bill, since you're a state taxpayer. The people for whom you are paying that bill probably never paid taxes in their lives.

Some of these expenses are covered by Medicaid and Medicare, but more often than not the remainder is either shifted onto the patient or eaten by hospital's charity slush fund. Look at your next hospital bill--you'll be charged for things like rubber gloves and cotton balls. Where does that money go? If you guessed the slush fund I'd say you were correct.

If you have private health insurance it will pay for most of those bills; if you have Medicare it will pay up to 80% of those bills--the rest either falls to you or is picked up by the taxpayers.

One thing few people seem to be aware of is that the doctors get paid cents on the dollar for such patients. More and more physicians are refusing to accept Medicare/Medicaid patients, and can you blame them--they actually lose money when they do so. Their alternative is to overcharge for things like tests, costs which get passed onto the insurance companies and cause them to raise their rates. And the cycle continues.

Now let's say that I'm a young student with an interest in a career in medicine (OK, I'm not so young and my interest is in veterinary medicine). I've got to get a normal college BA with pre-med courses and then I've got to qualify for and get into a medical graduate program. I'll rack up a mountain of debt doing that.

But wait, there's more. Let's say I get into medical school and I pass all of my classes. What happens next? I get to be an intern at a hospital and I deal with life-threatening cases while simultaneously dealing with sleep deprivation equal to that of a Ranger school candidate--except that if I sleepily screw up I've got a boatload of lawyers on my butt. And I know those guys, they partied with us but decided to take the easy road, which was smart.

OK, so I make it through my internship and am now a fully-fledged MD. I set up my own practice. That costs serious bucks, plus I have to pay to get the privledge of working at the local hospitals. And I've got to pay out the wazoo to insurance companies in case some patient thinks I didn't treat his hangnail properly, and that's before I even see a patient.

Who in his right mind is gonna go through all of that crap for a teensy government payout? And then where are we going to find the physicians who will make Obamacare work? Asylums are not a good choice and don't look at me--unless you're a cat I've no business treating you.....

Insurance companies, a draconian residency 'hazing' for new doctors, hospital overhead, and patients.

Lots of culprits today--we don't disagree.

Much comes down to our 'right' to see any doctor, any time, for any reason, with some other party carrying the burden, and hospital administrators and insurers deciding how the money's divvied up.

Throw in those who won't leave the doctor until they have a script for an antibiotic that won't treat their viral infection, or an expensive scan that only proves that nothing's there that can't be treated at home with rest, ice, compression, and elevation--maybe some tylenol if you don't take too much.

Others get their narcotics at the ER, and someone making minimum wage will give up half a week's pay to see a doctor on a cash basis.

We can do better.