Health Care Your Solution?

This is a discussion on Health Care Your Solution? within the Off Topic & Humor Discussion forums, part of the The Back Porch category; Originally Posted by Firkin So, this justifies codifying the practice in the law? I don't think anyone is talking about what you suggest, codifying denial ...

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  1. #61
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    I don't think anyone is talking about what you suggest

    Quote Originally Posted by Firkin View Post
    So, this justifies codifying the practice in the law?
    I don't think anyone is talking about what you suggest, codifying denial of care.

    What I do think is being talked about is looking at what really works and what treatments really don't work. What is being talked about is determining if there is benefit to be gained from expenditures.

    It is all too possible to run up huge bills with no enhancement in longevity. You can't just give people expensive but useless treatments because that is what they think they want.

    Ultimately decisions have to be based on scientific merit, clinical opinion, standards of practice, family wishes, There are families and individuals who will fight for every second and there are families and individuals who will be realistic about expectations.

    I know I am in deep doo medically,and I have no intention of living out my life with a poor quality of life and huge bills going to Uncle; but that is my choice, and I have seen nothing proposed that would impose that on others.

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  3. #62
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    Quote Originally Posted by Hopyard View Post
    I don't think anyone is talking about what you suggest, codifying denial of care.
    No one ever talks about that because it would be political suicide. Just because they don't talk about it doesn't mean its not going to happen. There are plenty of examples in other countries where this has happened.

    It's like the EPA. No one talked about how they were going to prevent private citizens from developing their land because a rare bug MIGHT be on it, but it happened. No one ever talks about the negative aspects of a bill they propose.

    Another example is an iteration of the house bill that says you can keep your current coverage but you are not allowed to change to another private option and insurance companies can not sign up new customers. This means if you lose your job or coverage you are forced onto the public plan. No one supporting this bill mentions this fact all they say is you can keep your current coverage.

  4. #63
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    In case anyone cares to see what care is like in Canada Take look at
    This Video

    Unlike semi-popular documentarians, These people are in no way famous and do not announce their intentions. They just show up with a hidden camera and act like they are normal patients.

    Canada is just one example of this kind of stuff. There are numerous stories of the same stuff happening in Britain as well.

    The question I have is why are there no reports in our conventional media about this at all. With all the stupid hidden camera investigations they perform you would think they could try one on a huge national issue. Its obvious these guys did not spend a lot of time on this so you would think its probably pretty easy to do. The best insights are the personal opinions of the people working in the medical facilities about their great system. "You're young you have the 2-3 years to wait for a family doctor."

    All the waiting that is going on reminds me of the bread lines in the former USSR. Except instead of simple bread they are waiting for health care the end result is the same though. The more you have to wait the more likely you are to die.

  5. #64
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    I am not surprised that so many make a big issue on a subject that is extraordinarily easy.

    The government has NO ROLE in health care or health insurance. It is not as if the Founders had no medical issues that required care. That there is no right to health care is axiomatic.

    Health care is simply a service provided by experts like your financial planner, your internet provider or even the restauranteur that serves fancy meals. Or even your local McDonald's cook. There is nothing special about health care.

    The fact is that our health care is the best in the world. We have the finest doctors, the best equipment, the cutting edge research, the best and safest pharmeceuticals, and the highest diagnostic technology. That is not in dispute.

    It is also true that the vast majority of people are happy either their doctors and their insureance. The truth is THERE IS NO PROBLEM.

    Still, the liberals want to control every aspect of peoples' lives. Thus, we see this wildly unpopular legislation that will turn us into a primarily socalist nation. And liberals wonder why there is such dissent (I mean angry mobs.)

    Most people confuse the issue of health care and health insurance. Everyone has access to emergency health care. It is not an issue.

    Some people cannot afford insurance. So? Why should I pay for their health care? The entire concept of insurance is that WILLING participants contribute to assume the risk of other WILLING participants. Government 'insurance' is a complete abuse of the word and the concept.

    Insurance, by definition, is a bet against yourself. You place your bet on the pass line and you hope that you require medical care so you can be paid. You lose when your premiums go to someone else that requires a appendix transplant. The idiotic argument that insurance does not cover people with pre-existing conditions is a dumb as waiting until you are in an autombile accident, applying for insurance and expecting someone to pay your damages. Just plain dumb.

    The reason health care is expensive is BECAUSE IT IS WORTH IT. We should absolutely have a lower tier of health care for those that don't want to have the care (MRIs, thorough tests, EKGs...) that they cannot afford. But to expect others to pay for their care is unacceptable.

    I also notice language that is used even in this thread. It is language that makes it seem that the cost of near death care should be avoided because of the high cost. Nonsense. If someone wants to keep themselves alive by paying service provders millions of dollars, who is anyone to question that. Similarly, if someone cannot afford that care, too bad. Why should I pay for it?

    Tort reform? Loser pays. That is not even difficult.

    Corporations should get out of the health insurance business. Pay the employees and let them determine the insurance they want to buy IF they want to buy insurance.

    Covering illegals? The minute they show up in the emergency room deport them and their family. If they don't want to take the 'anchor baby' put the baby up for adoption.

    Did I miss anything?

    Most people are happy with their health care AND their insurance. The government should STAY OUT OF MY BUSINESS.

  6. #65
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    Not really the case at all, natticarry

    Quote Originally Posted by natticarry View Post
    In case anyone cares to see what care is like in Canada Take look at
    This Video

    Unlike semi-popular documentarians, These people are in no way famous and do not announce their intentions. They just show up with a hidden camera and act like they are normal patients.

    Canada is just one example of this kind of stuff. There are numerous stories of the same stuff happening in Britain as well.

    The question I have is why are there no reports in our conventional media about this at all. With all the stupid hidden camera investigations they perform you would think they could try one on a huge national issue. Its obvious these guys did not spend a lot of time on this so you would think its probably pretty easy to do. The best insights are the personal opinions of the people working in the medical facilities about their great system. "You're young you have the 2-3 years to wait for a family doctor."

    All the waiting that is going on reminds me of the bread lines in the former USSR. Except instead of simple bread they are waiting for health care the end result is the same though. The more you have to wait the more likely you are to die.
    This isn't really the case at all. As I have written in other threads, I do a lot of work as a volunteer running an internet help line. We get
    folks from Canada and sometimes from Europe, or Asia because the internet, well , its the internet. And when I tell them they need to see a Family Doc, or they need to go see a urologist, or they should consider seeing a shrink, they don't seem to have any problems getting care. We have a sister organization in the UK, and I look in on their help line too, and their folks get the care they need.

    OTOH, we get lots of cries for help from our side of the border in which the writer can get no care whatsoever, other than at an emergency room.

    All the waiting that is going on up north is mostly fable promoted by an entrenched insurance industry that doesn't want to lose business but can't do the job.

    The real question is how to get the job done. And right now if you can't afford high premiums, you can't get into the right group because you work for a small company, you have almost any chronic illness of whatever nature, you are just going to be out of luck.

    That has to change.

    Here's the big difference though. Lose a job here and if you happen to also be ill, you will never be able to obtain insurance ever again until you qualify for Medicare, if you aren't dead by then. Elsewhere, losing a job does not keep you from getting care.

    I also know something about the Australian system. I have two nephews and a niece who practice there, and several relatives who live there. They can not understand our mentality on this issue.

    P.S. I could easily take an "I got mine attitude" and a "why should I care about everyone else's problems." I've had generally excellent insurance all of my life, I have health insurance into retirement that is still paid for by my or my wife's former employer. I have Medicare. I don't have a problem. Well, my son does. He works for a company which offers no benefits and has had asthma
    since infancy. He can not get coverage, and didn't have meaningful coverage for several years until after he was married, because his wife's employer allowed him to join that plan. So now, they are wedded at the hip to her job. If that goes, his insurance goes, as does hers. That is just wrong and it has to change.

    I also lived in Canada in 1972-1973, and not for the reasons Patti or Sat Cong are going to assume incorrectly.

    During that year, though I was a young guy, I got sick twice. I had no problem finding a doc and getting treated. It was more difficult finding one when I lived in Ohio than when I lived in Ontario.
    My co-worker's wife got ill with appendicitis, she had no problem getting care and appropriate treatment. Granted that was a long time ago, but the Ontario Health Insurance Plan worked quite well back then, and I think it works quite well even today. People are free to buy supplemental insurance just as here with Medicare. Works nicely.

  7. #66
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    Quote Originally Posted by natticarry View Post
    Another example is an iteration of the house bill that says you can keep your current coverage but you are not allowed to change to another private option and insurance companies can not sign up new customers. This means if you lose your job or coverage you are forced onto the public plan. No one supporting this bill mentions this fact all they say is you can keep your current coverage.
    Natti-- if you have the text I'd like to see it. I will attempt to authenticate that assertion, and if you are correct, I would contact my critter about it. If people want to buy private insurance they should be free to buy private insurance. So, please give me a copy of the portion of the bill that you think holds the limitation you have mentioned. I want to see exactly what it says, and where it is in the legislative process.

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    Quote Originally Posted by natticarry View Post
    Another example is an iteration of the house bill that says you can keep your current coverage but you are not allowed to change to another private option and insurance companies can not sign up new customers. This means if you lose your job or coverage you are forced onto the public plan. No one supporting this bill mentions this fact all they say is you can keep your current coverage.
    Natti-- if you have the text I'd like to see it. I will attempt to authenticate that assertion, and if you are correct, I would contact my critter about it. If people want to buy private insurance they should be free to buy private insurance. So, please give me a copy of the portion of the bill that you think holds the limitation you have mentioned. I want to see exactly what it says, and where it is in the legislative process.

    Oh, as I pointed out in a previous post, it is my private insurer who is forcing me to take Medicare part B. They are the ones who are forcing me into a government program, and not the other way around.

  9. #68
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    Quote Originally Posted by Hopyard View Post

    Here's the big difference though. Lose a job here and if you happen to also be ill, you will never be able to obtain insurance ever again until you qualify for Medicare, if you aren't dead by then. Elsewhere, losing a job does not keep you from getting care.
    This is not true. It has been a couple years since I switched insurance but I am pretty sure that there is a law at least in my state that so long as you have not been uninsured for 6 months and have preexisting conditions you are basically grandfathered into your new plan. If this law were not in place you could never switch insurers after you have had a medical issue and I know that people switch frequently to get the best rates.

    One question, if universal health is so good then why does almost every leader or dictator come to america when they need serious medical attention?
    The Second Amendment ...... Because crime SHOULD be a hazardous occupation.

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  10. #69
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    Hopyard,

    It's illegal for the doc to balance bill you if he is taking a medicare payment for your treatment.

    More things -

    My office manager spends at least 30% of her time trying to get us paid for legitimate claims.

    There is tremendous competition between hospitals to get customers. They get govt payments to take care of people in rural areas and treat underserved areas. We ( the physicians) don't so they are now flying people in from up to 150 miles away and we get the privilege of taking care of them for free. They even OVERFLY closer hospitals that would be a better closer to home choice for the patient because they have an agreement with the referring hospital.

    So, there is a lot to fix in the whole system. Most docs do not get to set prices unless they are part of an extremely large group and there are no other choices around. Then they have leverage against the insurance companies. There is no negotiating of medicare or medicaid fees though. The latest trend (what's old is becoming new again) is for the hospitals to buy up all the subspecialists in their area, particularly the "lucrative" subspecialties. I refused. I like being king of my own little office because even though I may struggle, I can still set my schedule. If I need to be home monday afternoon to accept a delivery at our farm I can be there with a little planning.

    The fact is, if there are more people getting health insurance than there are paying for it ( bubble of older people) then the costs will go up for a while until the bubble is gone.

    The more cool stuff we come up with, the more health care will cost because we can to more things to more people to make them live longer and prolong their life during the part that they are not paying into the system. It's just simple economics.

    That means, I think, at some point, we will have to say no, the general society cannot afford that, but if you have your own means to pay, go right ahead. As it stands now, the current health care bill as proposed will not allow that option and I think that's wrong.

    As far as end of life goes, families and doctors need to hash that out, not someone from miles away at a desk who hasn't seen a patient in 20 years if ever. Hell, I help people with that decision all the time. Sometimes I gently steer them, sometimes I am not so gentle. I never BS anyone, but lots of docs do. Many are very uncomfortable about talking about D.d..d..death. As a friend of mine says, the minute you are born you are given a death sentance. It's up to you to fill in what's between.

    Sometimes we have families that don't get it, refuse to get it, or just can't face that someone is terminally ill. They may want CPR and ICU for a comatose terminally ill metastatic breast cancer patient etc. I am almost never the primary doctor here, so it's a little easier for me to come in and say no, I'm not fixing that but I certainly see what I consider inappropriate excessive care to prolong someones dying for days weeks, or a month. It is a gray area, where do you make the decision between appropriate and futile care. One of my medschool classmates believed in life at all cost. Life here meant any living cell on the body. I think there is a little more dignity and practicality that should be applied. Just because we can doesn't mean we should. Where and how do you draw that line? I really don't think it can be legislated though, it's more of a negotiation.

    I'm lucky, my family is very straight forward about what each persons limits are and we are all on the same page now.
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  11. #70
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    Quote Originally Posted by docdozer View Post
    Hopyard,

    It's illegal for the doc to balance bill you if he is taking a medicare payment for your treatment.

    More things -

    My office manager spends at least 30% of her time trying to get us paid for legitimate claims.
    .
    First, thanks for another great post on this topic.

    Yes, balance billing is illegal and I was aware of that. I had to make it plain I was going to call CMS before that particular charge disappeared.

    Your office manager spends 30% of her time trying to get you paid for legitimate claims. The insurance company spends X amount of bucks trying to find creative and not so creative (fraudulent) ways to get out of paying claims. The constant battle that goes on is costly, wearing on your staff, wearing on the patient, and adds nothing to medical care.

    I think we need single payer, Medicare for all, but if we can't do that we at least should impose uniform statutory policy language, implement a uniform billing system, and set up a mechanism for quickly and easily sorting out denials of payment.

    It is insane to be diverting so large a chunk of the premium dollar and the doc's fees to claims processing. This is something that would quickly end as a problem with a single payer system. Medicare's claims processing costs and overhead are known to be a very tiny fraction of that of the private insurance industry's expenses.

    Insurance companies vary widely in their honesty on claims processing. I was with one company which literally never paid appropriately and seemed to randomly deny claims; and I have been with another company which processes things so efficiently that they deserve a national contract. In the end, it is a matter of basic honesty and decency. Frankly, I trust Uncle's employees in the honesty department a lot more than I do management of for profit companies.

  12. #71
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    Quote Originally Posted by farmerbyron View Post
    This is not true. It has been a couple years since I switched insurance but I am pretty sure that there is a law at least in my state that so long as you have not been uninsured for 6 months
    Laws vary from one state to another, but basically for most folks if you have been uninsured and have a pre-existing condition, you are out of luck. You may be able to buy some coverage, but it will certainly exclude what you need the most.

    In the specific instance I cited, my son worked for an employer who provided no benefits. He had to go out into the private market but could not find a policy because of his pre-existing asthma. When he did find an issuer, it was very high deductible, very poor coverage, and excluded anything related to asthma. Only by marrying, and getting onto his wife's employer's plan, was he able to get the coverage he needed. And in the meantime, for about 8 years, we lived in dread that if he had a severe asthma attack and needed to be hospitalized, we would have our retirement savings drained to pay for
    his care.

  13. #72
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    Despite the early warnings of it being to political, I've actually enjoyed reading the posts the saw some of the different angles/concerns that people have about health care. also, for a "gun forum", the posters I thought had a fairly rational, sophisticated understanding of the issues.

    I work in medicine. I am torn with my ethics that everyone should get health care but I am also apprehensive on government intrusion in medicine, the need to make a living, litigation, and being able to provide quality care to patients. I don't have a solution but here are some of my concerns:

    1. Tort reform - with all this talk of rapid institution of universal health care, nobody is talking about limiting frivolous lawsuits in medicine. why? the governing party is in bed with the lawyers. defensive medicine and huge payouts are one of the reasons for our expensive health care system. We are litigating to extinction Obstetricians and neurosurgeons to the detriment of our society.

    2. physicians inability to police themselves - not all doctors are smart or competent. the outliers who screw up results in malpractice that hurts patients and drive the costs of health care for everybody. docs must police themselves accordingly.

    3. lack of support and more stress for our primary care colleagues - pediatricians/family practice docs/internists probably affect the health of the nation by instituting a lot of preventive measures to keep a healthy populace. these docs have to deal with a mountain of paperwork, insurance hurdles, patient overload, and lack of reimbursement. do you really want your work to be paid 20-30 cents to the actual dollar amount that you work for? why would the gov't and insurance companies undervalue these docs' work. We need to pay these docs accordingly so they can keep the country healthy. again, we are forcing these docs to retirement/extinction by overworking them and underpaying them.

    4. the Gov't. I like the point that our Gov't really did not do a good job with SS, Medicare/medicaid, amtrak, etc. and we want these guys to run our universal health care. In the UK, the gov't rations care. if you have cancer, there are cases where people have gone to the US to get timely care because the NHS will not fund the money to save people with severe illness or you are to old to be treated. this system is not kind to sick people with poor prognosis or to the elderly. I don't want to see my parents nor any other elder citizen to not get the care they needed because some gov't agency deems that it is hopeless and not worth the expense.

    health care is huge dinosaur. the politicians want an easy, quick fix but we really need to stop and think and thread carefully. do we really want to be like California instituting social policies that sound great but bankrupted their economy? we don't want our federal gov't handing out IOUs to pay for their bills.
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  14. #73
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    Physicians policing themselves?

    Quote Originally Posted by Raider39a View Post

    I work in medicine. I am torn ...

    1. Tort reform - with all this talk of rapid institution of universal health care, nobody is talking about limiting frivolous lawsuits in medicine.
    2. physicians inability to police themselves - not all doctors are smart or competent. .
    Lets see. If we have the kind of tort reform most talk about, of the sort here in TX, the patient can't get into court. Not that this has brought down either insurance premiums or fees. And, since the physicians can't or won't police themselves, what protections would be left for patients if we had tort reform? The admission that not all docs are smart or competent (a refreshing tad of honesty) really begs the question. How do we protect patients under these circumstances?

    As for the argument that the government can't do anything correctly, I will just repeat that from the patient's point of view (my point of view) Medicare works rather well. In the 18 months I've had them as primary I have had no problems, and that is significantly better than what I usually went through trying to get claims paid by The Blues.

    As for the argument that things should be slowed down to be looked at carefully, we have had only about 60 years of looking since the Truman administration. It is time to do something.

    As for the comment on being surprised by the sophistication of comments on a gun forum, uh, what did you think about gun owners? Most here are quite sharp and many are rather clever and downright creative sorts.

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    Quote Originally Posted by Hopyard View Post
    Natti-- if you have the text I'd like to see it. I will attempt to authenticate that assertion, and if you are correct, I would contact my critter about it. If people want to buy private insurance they should be free to buy private insurance. So, please give me a copy of the portion of the bill that you think holds the limitation you have mentioned. I want to see exactly what it says, and where it is in the legislative process.
    .
    House Health Care Bill (Full Text)

    Type in page 16 on the little thing in the middle of the page and start to read.

  16. #75
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    I think the basic argument is clearly coming down to who you trust. Clearly Hopyard does not trust insurance companies more than the government.

    I do not trust the government for the most part.

    Here is where things break down. If Hopyard is correct in his mistrust of insurance companies he can always look for another company or even start his own, which would be wildly popular if it practices more honestly than he and some others perceive the current ones do.

    If I am correct and the government creates laws effectively crippling private insurance and leaving the government as the only option I am SOL. I can't start my own company. I have no other choice but the government plan. I can go complain to my representatives but as in the tax code those who have the most friends in the lawmaking process will win.

    I frankly think that many of the people you talk to in other countries do not realize that their healthcare quality is so different from our own. My father had a contract with Scotia Bank in Toronto and the people there told him about their regularly scheduled doctors appointments IN CASE they got sick. They did not say they thought the system was bad though. I am sure some of their opinions are fueled by media that tells how terrible our system is and all the people who don't get care in the USA.

    You may want to say the video is not typical but they did not round people up or set up the situations. They just went to Canada. Talked to some friends that lived there and went with them to the medical facilities. The staff at these facilities gave their honest opinions and notice how they didn't really bad talk the system either. They thought it was normal to wait for 4-9 hours. They thought it was normal to wait years to get a family doctor. They thought it was normal to wait 6 month to a year to get surgery.

    Another part of my reasoning is this. The larger an organization gets the less efficient it is able to perform tasks. Large corporations save money through bulk production but they waste a lot of money on paper pushing, poor price shopping, and time reshaping direction. Not to mention the ability of bad employees to go unnoticed. Anyone who has worked for one knows this is true. The largest organization you can find is the government.

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