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Healthcare run my bureaucrats in America (Rant)

post #1 of 29
Thread Starter 
I know that single-payer systems work in other parts of the world. I know that many people in other countries wonder what is wrong with the US that we don't want the same thing here. I know that a lot of people think it's just about taxes - that we don't want to pay higher taxes.

I was (and still am) against the Healthcare Bill. The reason is that it puts way too much power and authority in to the hands of Washington Bureaucrats who wouldn't know their rear end from the hole in the ground they just dug. I remember someone asking why we have so little trust in our leaders. Here's a couple of examples:

My husband's grandmother, who passed a few years ago, was put into a nursing home/hospice care (at the home) before she died because his aunt could no longer provide adequate care for her at her (his aunt's) home. When she had to be put into a home, first her entire estate was liquidated in pretty short order. That was with Medicare. When she was destitute she was put on Medicaid - both Federal and State because one or the other wouldn't cover certain services she needed. I have no clue how the nursing home actually billed; if they were creative with their billing to ensure their expenses were covered or not. This was in Illinois.

Today a friend and co-worker told me that her mother is in Stage 3 Kidney Failure. Her mom is 72 years old, so certainly on Medicare at least, possibly Medicaid. She said that "Stage 3 is manageable but expensive and she doesn't have the money so..."

How is it that this system that either has to be manipulated or lets people who can't pay the excess die is supposed to be TRUSTED with the authority and power that this healthcare bill just gave it for ALL OF US???

You want to know WHY we don't trust our government to run things? Because they will manage to make a bigger mess than you can possibly imagine, no matter how simple the task. The harder and more complex the task, the bigger the mess. That's why!
post #2 of 29
And I don't trust private companies.
Here's my example. I just got turned down for health insurance. Why? High blood pressure. It doesn't matter that it can be brought control (less than 140/90) with a low dosage of a common medication. It doesn't matter that the medication costs less than $5 / month. I am not in perfect health according to the underwriter so NO insurance for me. Oh wait I could try the state high risk pool.

I don't understand the reference to a single payer system. Not only are we nowhere near that, we didn't even get the public option, so now it will be like shooting fish in a barrel for those blankety-blank health insurance companies.

Someone please explain to me why I should trust the current system.
post #3 of 29
Insurance from a private company is what people will be forced to buy- or face fines or jail time. Nice...
post #4 of 29
What a lot of people still don't understand is there is NO free health care coming to them. I have heard of reports of people scheduling dr. appts. because they thought they could get it free since the health care bill passed.
What is in store is higher price coverage from private companies with less coverage available. I hope and pray to God that Blue Cross stays in business so I can keep the coverage we currently have.
post #5 of 29
Quote:
Originally Posted by 2dogmom View Post
And I don't trust private companies.
Here's my example. I just got turned down for health insurance. Why? High blood pressure. It doesn't matter that it can be brought control (less than 140/90) with a low dosage of a common medication. It doesn't matter that the medication costs less than $5 / month. I am not in perfect health according to the underwriter so NO insurance for me. Oh wait I could try the state high risk pool.

I don't understand the reference to a single payer system. Not only are we nowhere near that, we didn't even get the public option, so now it will be like shooting fish in a barrel for those blankety-blank health insurance companies.

Someone please explain to me why I should trust the current system.
I was able to get insurance and I had breast cancer, why would you be turned down? Have you done much shopping for health insurance, it seems like we have had this conversation before, I'm missing something I think.
post #6 of 29
Considering that the corporate bureaucracy of the insurance companies can be just as bad, I don't see that private insurance is any better. I have a co-worker who is constantly on the phone with the insurance company because of all the hassles they are giving him during the treatment of his wife's colon cancer.

The health care bill did little to fix anything. We have a perverse system that basically tells many people that if you aren't poor enough or rich enough, tough. Figure out how to do without.
post #7 of 29
I look at the Health Care bill exactly the same way as I do the Arizona Immigration law...neither one appears to actually have the potential to accomplish their proposed purpose, but both of them accomplished pulling the issue off the back burner and making politicians work on it.
post #8 of 29
Quote:
Originally Posted by ckblv View Post
I was able to get insurance and I had breast cancer, why would you be turned down? Have you done much shopping for health insurance, it seems like we have had this conversation before, I'm missing something I think.
I would be very surprised if a cancer survivor could get affordable individual coverage in NH.

We do not have much choice in NH so there is not a lot of shopping we can even do. We are limited to the five companies allowed to do business in NH who offer individual coverage.

The company we had is the one that raised our premiums to $13000/yr (I don't think they paid out as much as $200 in the six years we were with them.) This is the one that just lost a $37 mil lawsuit. Not a nice company to deal with from our experience.
http://www.cbsnews.com/stories/2007/...n2850054.shtml

The company that just turned me down pegged me as someone who runs to the Dr all the time (agent's words) - and all because the nurse practitioner wanted me to come in frequently so she could monitor the effect of the BP medication. I hate to think what would happen if I had had a serious illness! However this same company was the subject of a cooperative investigation by the attorneys general of 36 states. They were ordered to pay a $20 mil fine and are prohibited from doing business in Massachusetts.
http://www.usatoday.com/money/indust...nsurance_N.htm

So maybe it's a blessing in disguise that they didn't want to insure me.

One is the company we were insured with through my husband's last employer. This is the one that forced us to go through an incompetent nurse pracitioner at the local clinic in order to be able to see a doctor.

The two that are left are the ones with the worst ratings in our area.
http://www.jdpower.com/healthcare/ra...me,-nh,-ri,-vt)

So it looks like we have no choice but to go back to the one that my husband used to be insured with. If we were in Maine things would be easier, that state looks out for their consumers.
post #9 of 29
I'd be interesting in knowing what insurer issued an individual policy to a cancer survivor, and what exactly it covered - as well as the premiums and limits in place when issued.

I bet a lot of type 1 diabetics would have loved that carrier - at least before the new law was passed.

Also, to the OP - just because someone is 72 doesn't necessarily mean they're utilizing MedicAid - depends on the individual financial situation. And, even saying that, I'd be interested in what the health care provider actually said regarding treatment and the individual's total health picture. There may be details that could change the picture, but right now I don't think any of us know them.
post #10 of 29
Quote:
Originally Posted by valanhb View Post

My husband's grandmother, who passed a few years ago, was put into a nursing home/hospice care (at the home) before she died because his aunt could no longer provide adequate care for her at her (his aunt's) home. When she had to be put into a home, first her entire estate was liquidated in pretty short order. That was with Medicare. When she was destitute she was put on Medicaid - both Federal and State because one or the other wouldn't cover certain services she needed. I have no clue how the nursing home actually billed; if they were creative with their billing to ensure their expenses were covered or not. This was in Illinois.
I'm not sure what you are trying to say. Medicare only covers acute nursing care, meaning you have to enter an approved nursing home within a month of a hospital stay (IIRC, it's a minimum 3-day stay), and there has to be some prospect of recovery from the condition. There's a certain period (c. 3 weeks) when coverage is 100%, followed by a period of co-payments for about three months (sorry, it's been a couple of years, so I don't remember the exact number of days), and then the patient is responsible for all costs. Custodial care isn't covered, which is why the patient's assets are used.
post #11 of 29
Quote:
Originally Posted by darlili View Post
I'd be interesting in knowing what insurer issued an individual policy to a cancer survivor, and what exactly it covered - as well as the premiums and limits in place when issued.

I bet a lot of type 1 diabetics would have loved that carrier - at least before the new law was passed.

Also, to the OP - just because someone is 72 doesn't necessarily mean they're utilizing MedicAid - depends on the individual financial situation. And, even saying that, I'd be interested in what the health care provider actually said regarding treatment and the individual's total health picture. There may be details that could change the picture, but right now I don't think any of us know them.
I don't believe I ever said I was issued a "individual policy" as a cancer survivor.
post #12 of 29
Quote:
Originally Posted by jcat View Post
I'm not sure what you are trying to say. Medicare only covers acute nursing care, meaning you have to enter an approved nursing home within a month of a hospital stay (IIRC, it's a minimum 3-day stay), and there has to be some prospect of recovery from the condition. There's a certain period (c. 3 weeks) when coverage is 100%, followed by a period of co-payments for about three months (sorry, it's been a couple of years, so I don't remember the exact number of days), and then the patient is responsible for all costs. Custodial care isn't covered, which is why the patient's assets are used.
Yes, that is how it was for my father.

Although I know there are insurance policies a person can take out that will cover nursing home expenses, my aunt and uncle has that. They have had the policies for years.
post #13 of 29
Got that right - the government can't even run what they have now without making a mess of things....and people ACTUALLY believe the lies in Washington that their Healthcare will be good!
post #14 of 29
Quote:
Originally Posted by ckblv View Post
I don't believe I ever said I was issued a "individual policy" as a cancer survivor.
Frankly if you have never had the experience of trying to get individual coverage or submit a claim as an individual, I sincerely doubt that you can appreciate why reform is needed and why some of us think a public option is necessary. If you get bored and have time go through the procedure of getting individual coverage for yourself - it might open your eyes.

ETA: I assume you get the AARP bulletin, so check page 22, bottom left. That person "shopped" around and was turned down by five insurance companies even though all he needs is a lousy $5/ month for his meds. If you have even a mild form of diabetes or high BP the insurance companies won't touch you with a ten foot barge pole. If you are a cancer survivor they probably wear rubber gloves when they toss your application into the trash. The only option left is the state "high risk" pool.

Anyone who is covered by an employer plan has the closest thing anyone in the US can get to free health care, and yet this is usually the group of people who are moaning the loudest about change. It's the old "I've got mine, see to it where you get yours" mentality.
post #15 of 29
Quote:
Originally Posted by 2dogmom View Post
Frankly if you have never had the experience of trying to get individual coverage or submit a claim as an individual, I sincerely doubt that you can appreciate why reform is needed and why some of us think a public option is necessary. If you get bored and have time go through the procedure of getting individual coverage for yourself - it might open your eyes.

ETA: I assume you get the AARP bulletin, so check page 22, bottom left. That person "shopped" around and was turned down by five insurance companies even though all he needs is a lousy $5/ month for his meds. If you have even a mild form of diabetes or high BP the insurance companies won't touch you with a ten foot barge pole. If you are a cancer survivor they probably wear rubber gloves when they toss your application into the trash. The only option left is the state "high risk" pool.

Anyone who is covered by an employer plan has the closest thing anyone in the US can get to free health care, and yet this is usually the group of people who are moaning the loudest about change. It's the old "I've got mine, see to it where you get yours" mentality.
Exactly on your last point. My mother had a terrible time getting any coverage after my dad died because she had to go to the individual market with the pre-existing condition of having breast cancer in 1976. If our state (the big bad government!) hadn't set up a high risk pool, she wouldn't have had any insurance for 10 years until she was eligible for Medicare. But as you've mentioned before, the high risk pool is expensive.

Employer covered insurance is slowly being eliminated and will disappear more quickly as health care gets more and more expensive. The health care reform tried too hard to preserve this employer based schema and so it really didn't do anything but make everything more expensive. Everyone cries about choice, but how much choice do you really have with the employer based schema? You get stuck with what they decide on.
post #16 of 29
Just had to do my annual re-enrollment for coverage where I work. It took a $1000/year jump with no changes in coverage for Dottie and me.

On the other hand, the skin surgery she just had cost $3500, and we paid $40 out of pocket.

But a little horror story. When we were company drivers, we had BC/BS health insurance and used it occasionally, including one time when I had some pain the doctor though might possibly be gall bladder problems, or possible something else. He had an ultra sound on it. The operator put in her notes, "slight signs of small fatty liver deposits." No problems found.

When we went became owner/operators, we tried to get health insurance. We applied to BC/BS, because that's who had been covering us. Despite the fact they had been paying all along, they insisted on a full copy of our medical records. They found that little item I mentioned above, and said they would not sell me insurance for any price.

Once you get a rejection like that, you can apply to the state's assigned risk pool. I checked that out, and they were more than happy to sell me the same coverage for exactly twice what it would have cost otherwise. And the carrier? BC/BS!!!!
post #17 of 29
You didn't say you were issued an individual policy, but you asked about shopping around for coverage and why it would be difficult to find an individual policy for a cancer survivor. The inference clearly is shopping as an individual, since one does not really 'shop' for employer-based coverage, right?

I can assure you, it's a whole different ballgame between individual and group health coverage and, as mentioned, far too many people who enjoy employer-based coverage now literally have no idea what it's like in the real world, and why health-care reform was so pressing, because they haven't had the experience as an individual. Go ask any parent of, let's say, a type 1 diabetic who did not have access to group insurance funded by employers, and see what they say about how easy it is to find even minimal coverage.

Long-term care insurance is available, and of course is less expensive if you begin paying premiums at a young age - but you have to be careful of what it covers, when it kicks into action (usually it's something like three of five major health problems have to be present), daily coverage, and cap. Things will be changing under the reform act, but the devil will be in the details.
post #18 of 29
A few years after my cancer treatment I changed jobs and did the COBRA thing which ensured that I couldn't be turned down for coverage based on my pre-existing condition.

As I have said many times on this forum, Obamacare is not REFORM, it does nothing to help bring down health care costs. Why is that?
post #19 of 29
Quote:
Originally Posted by ckblv View Post
A few years after my cancer treatment I changed jobs and did the COBRA thing which ensured that I couldn't be turned down for coverage based on my pre-existing condition.

As I have said many times on this forum, Obamacare is not REFORM, it does nothing to help bring down health care costs. Why is that?
COBRA prohibits denial of care when you had employer health care. If you had expired your COBRA and did not get another job with health care, you could have easily been denied any insurance anywhere.

The costs of health care are going to go up with the reform because the insurance companies cannot deny you coverage should this happen to you. There are few incentives in the way we do insurance through our employers to cut costs. And any suggestions to cut costs like HMOs, higher deductibles to make everything cost sensitive are being rejected by those who have premium health care under the employer system.
post #20 of 29
Thread Starter 
My point of Earl's grandmother's story wasn't so much that she was bankrupted before she got any assistance (although wasn't that one of those heartwrenching commercials plying us to contact our Congressional Leaders to support those bills?). It was that once she was solely medically supported by government programs for the poorest of the poor the nursing home had to basically manipulate how they billed whom for which service (state or federal) in order to get paid.

I've seen this facility. It certainly ain't the Ritz, they aren't swimming in extra luxuries they get by defrauding the system. Thankfully they gave Christine very good care regardless of whether she was paying for it from her estate or if they had to claw and scratch for every dime that was approved to pay them.

I know there is fraud in the system, but more than that there are bureaucrats who have no clue what medical care is necessary who approve or deny on a whim it seems. Not to mention that every person who I have talked to about billings say that private insurance is a pain, but government billing requires 10 times more paperwork to cover far less cost.

Funny that no one has said anything about my friend's mother. She's on Medicare and will likely die because SHE can't afford treatment for renal failure. I guess that wasn't included in the retirement plan she had.
post #21 of 29
I am truly sorry for your friend's mother. It sickens me that these cases abound. I don't know know if a single payer system is better. But I do know that there were many opposed on the right to any efforts made on behalf of the poor. One columnist basically said that access to health care was a privilege. If someone was too sick, the emergency room could take care of them and send them back out to the streets.
post #22 of 29
Quote:
Originally Posted by katachtig View Post
COBRA prohibits denial of care when you had employer health care. If you had expired your COBRA and did not get another job with health care, you could have easily been denied any insurance anywhere.

The costs of health care are going to go up with the reform because the insurance companies cannot deny you coverage should this happen to you. There are few incentives in the way we do insurance through our employers to cut costs. And any suggestions to cut costs like HMOs, higher deductibles to make everything cost sensitive are being rejected by those who have premium health care under the employer system.
You are right, that is why I made sure I paid my COBRA each and every month, on time for 16 months.

Believe me, it made me see the other side because I WOULD have been denied coverage for cancer as a pre-existing if I had let my COBRA lapse.

But think about it. Say you pay 1,000 a month for coverage, 12,000 a year.
I think we all know how quick a person can rack up 12,000 in medical expenses, don't we? How can health insurance companies stay in business UNLESS there is a law that EVERYONE has to buy coverage?

If the law changes that you cannot be denied for pre-existing then the law HAS to be that everyone has to buy coverage. How can it be anything else?

I don't think we can expect anyone, whether private or govt, to cover a person that cruises along not paying a dime, not getting coverage UNTIL they get sick and THEN go get coverage knowing they can't be denied. That's insane.
post #23 of 29
Quote:
Originally Posted by katachtig View Post
I am truly sorry for your friend's mother. It sickens me that these cases abound. I don't know know if a single payer system is better. But I do know that there were many opposed on the right to any efforts made on behalf of the poor. One columnist basically said that access to health care was a privilege. If someone was too sick, the emergency room could take care of them and send them back out to the streets.
I don't believe that is true. There is Medicaid, that is for the poor. What I am not in favor of is give aways, everyone except for the poorest of the poor MUST pay something, that is all there is to it.

I have a huge problem with people that blow all their money then expect others to cover their medical care.
post #24 of 29
Here is a big surprise for everyone.
http://www.politico.com/news/stories...#ixzz0nltU4oeu

Quote:
CBO ups health care cost projections

Congressional Budget Office estimates released Tuesday predict the health care overhaul will likely cost about $115 billion more in discretionary spending over ten years than the original cost projections.

The additional spending — if approved over the years by Congress — would bring the total estimated cost of the overhaul to over $1 trillion.

Read more: http://www.politico.com/news/stories...#ixzz0nm9tBITr
Gee, who would have thought THIS would happen. Watch this amount quadruple or more before it is over.

Hey, hey, hey Greece, here we come.
post #25 of 29
Quote:
Originally Posted by ckblv View Post
But think about it. Say you pay 1,000 a month for coverage, 12,000 a year.
I think we all know how quick a person can rack up 12,000 in medical expenses, don't we? How can health insurance companies stay in business UNLESS there is a law that EVERYONE has to buy coverage?

If the law changes that you cannot be denied for pre-existing then the law HAS to be that everyone has to buy coverage. How can it be anything else?

I don't think we can expect anyone, whether private or govt, to cover a person that cruises along not paying a dime, not getting coverage UNTIL they get sick and THEN go get coverage knowing they can't be denied. That's insane.

Well, exactly - but many conservatives seem quite upset by that concept as incorporated in the reform package. I've even seen people here post that why 'make' people to buy something? You know, I think you're really not that far from common ground with the reform package, but may not realize how many items you might agree with. Actually, I bet a lot of Republicans would agree with many many of the items, but so many people, on both sides, felt pressured to be on one extreme or the other, they wouldn't acknowledge the sun was hot, if asked.

Re the friend's mother - I don't think we got enough details on the situation to find out why she wasn't getting treatment? Is she end stage for some other condition? I don't think I even saw what her specific financial situation was.
post #26 of 29
I part company with conservatives on this part, I admit.
On forums and in real life.

I just want some real reform. Barack got up and made this big old speech before Congress on health care and went on about removing existing regulations that prevent health insurance companies from being competive,
which would have lowered health care costs. He also, in that speech, said he was in favor of Tort Reform and those are two HUGE things that would go a long ways to lower hc costs and they weren't even in the bill signed.
In fact, in Pelosi's Bill, that evil woman made it illegal for a State to have Tort Reform.

I don't know if any here are aware of the huge medical scandal in LV with regards to this guy that owned several Endoscopy centers, where people get Colonoscopy's. The dude was having his staff re-use syringes and not properly cleaning the instruments and DOZENS of people got Hepatitis.


http://www.lvrj.com/news/jury-finds-...-92917464.html

Quote:
The Chanins' lawyers argued that the drug companies endangered public safety by producing vials of propofol that were much larger than necessary for typical endoscopic procedures, which enticed nurse anesthetists to reuse the vials among patients instead of throwing away leftover sedative.

Local health officials said the outbreak was caused by nurse anesthetists reusing vials among patients after the vials had become contaminated by the nurses reusing syringes on the same patient.

Henry Chanin's case was one of nine linked to the two Las Vegas endoscopy clinics by health officials, who in 2008 notified 50,000 patients about possible exposure to hepatitis, HIV and other blood-borne diseases because of unsafe injection practices at the clinics run by Dr. Dipak Desai.
http://www.lvrj.com/news/jury-awards...-93130004.html

500 MILLION dollars in Punitive Damages. Since Nevada has Tort Reform I am not sure why this is happening, I need to find out, maybe because it is a national drug mfr and not a Nevada doctor, not sure.

And I am no Propofol fan by any means, it is the drug that killed Michael Jackson, but come on now, 500 million dollars? That is ridiculous.


http://www.lvrj.com/opinion/greed--n...-93224319.html
Quote:
May. 09, 2010
Copyright © Las Vegas Review-Journal

EDITORIAL: Greed, not justice

Another winner in the lawsuit lottery A Clark County jury has proved beyond any doubt that the American civil court system is in desperate need of reform.

After awarding more than $5 million in compensatory damages Wednesday in a product liability case, on Friday the jury ordered a pair of drug makers to cough up $500 million in punitive damages.

It would be a staggering sum in a class-action case where the defendant deliberately caused direct harm to scores of plaintiffs. But this was no such case.

It was the first trial to address the valley's hepatitis C outbreak, an inexcusable public health crisis that resulted from intentionally unsafe practices at the now-closed Endoscopy Center of Southern Nevada. Clinic employees reused syringes and single-use vials of the sedative propofol on patients undergoing endoscopic procedures, which contaminated the vials of propofol and, in one horrible instance, spread the blood disease from one patient to several others.

The blame for those infections lies with the center's employees and its owner, Dr. Dipak Desai, who cut corners to maximize their earnings at the expense of patient safety. Many people, including Henderson resident Henry Chanin, now 62, were harmed by the endoscopy center.

But the pockets of Desai, his employees and his business run only so deep. So after settling with those parties Mr. Chanin and his attorney, Robert Eglet, went after the deepest ones they could find: Teva Parenteral Medicine and Baxter Healthcare Services, which made and sold the propofol.

Mr. Eglet argued that because the single-use vials of propofol contained more of the sedative than was needed for any endoscopic procedure, the drug makers should have put warning labels on the vials and sold smaller doses to Desai and his group.

Not doing so somehow tempted Desai's employees to abandon infection-control practices taught to first-year medical and
And people wonder why drugs cost so much. Cases exactly like this is why.

Where is the Reform?
post #27 of 29
Well, the thing is, how to determine what sort of financial hit will actually make a company sit up and take notice without going overboard? Perfect world, and for many of us, personally or business, mistakes can happen and we'll fix it because it's the right thing to do.

But, sometimes the only thing that makes a person, or company, think, is something that actually hurts. An awful lot of companies will just write off what seem to me to be huge fines as simply the 'cost of doing business'.

Certainly, a lot of litigation these days is just ridiculous - but, there are still far too many corporations that cut safety issues for the sake of 'profit', and just hope they don't get caught. How do you stop this sort of behavior? If money is the only thing they seem to understand?

It'd be nice for some sort of compromise to be worked out - or for people to try to 'do the right thing', no matter what a cliche it sounds.
post #28 of 29
That does look like deep pockets mentality to me. They couldn't get enough money from the responsible party so they tried to put the blame on the drug manufacturer. If Desai actually did order his staff to resuse syringes and endanger the lives of thousands of patientst then no amount of money would make up for what he did. As a matter of fact he is the argument against tort reform - unless it wouldn't apply in cases of criminal negligence.
post #29 of 29
Quote:
Originally Posted by 2dogmom View Post
That does look like deep pockets mentality to me. They couldn't get enough money from the responsible party so they tried to put the blame on the drug manufacturer. If Desai actually did order his staff to resuse syringes and endanger the lives of thousands of patientst then no amount of money would make up for what he did. As a matter of fact he is the argument against tort reform - unless it wouldn't apply in cases of criminal negligence.
Desai is Doctor Death for sure. And you are right, he IS the argument against Tort Reform and I also agree it should not apply to cases of criminal negligence, because that is exactly what it was.

He did, actually, order his staff to reuse syringes. He also has ties to prominent people in Nevada, VERY prominent people, doctor's on the Nevada State Medical Board.

My mother had a colonoscopy at Dr Death's Endoscopy Center, 4-5 months before this news broke. She had to be tested for Hep C. She said the Endoscopy Center was dirty and they were herding people in and out like cows. She also said propofol is like no anesthesia she has ever had before.

The link below tells the entire, sordid story.


http://www.lasvegassun.com/news/2009...e-report-says/
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