Universal health insurance

[pathia]

So the problem is not lack of insurance, but simply not enough doctors in that specialty.

Well, my insurance company denied every single test he wanted to run on me. The rate charged to me since I did not have insurance was roughly four times what the insurance company would have paid had it covered it, because they have a special deal with labcorp.

It worked out to something like this, the tests cost about $1200. If BSBS would have covered it, labcorp bills them $200. I’d owe 20% of that, $40. However, BCBS denied coverage, so I had the entire $1200 bill.

They also denied covering the visit with the endocrinologist itself. This was about $300.

This happens to pretty much every single specialist I go to, and I go to ALOT of specialists because I am a ‘special case’ as has been stated before. Specialists are the only ones that can really care for me, yet BCBS never covers them.

 

[vern_humphrey]

You didn’t answer my concern. My concern is what happens when the insurance company refuses to cover anything that happens to me, which is a current problem, and I see nothing that will stop it from continuing under MSA.

First of all, you pay under MSAs – the insurance company has no say at all until you hit the deductable.

Secondly, your catestrophic coverage is just that – for catestrophes. When you hit the cap, they have to cover you.

How do I get insurance companies to cover my illnesses when they won’t?

By paying for it.

There is no such thing as a free lunch – you may have to accept a high cap. Nevertheless, you would be better off under MSAs than you are now.

 

[pathia]

First of all, you pay under MSAs – the insurance company has no say at all until you hit the deductable.

Secondly, your catestrophic coverage is just that – for catestrophes. When you hit the cap, they have to cover you.

By paying for it.

There is no such thing as a free lunch – you may have to accept a high cap. Nevertheless, you would be better off under MSAs than you are now.

Don’t you know how they get me with this?

Non-covered medical expenses do not count towards your cap.

It’s in every single insurance contract I’ve ever seen.

 

[onetimeposter]

I agree that waiting for necessary care is difficult, but what exactly does this have to do with the debate between private medical care and government run medical care?

With all due respect Oscar, if you had been following the posts since the very beginning, you would see why Pathias`s posts are relevant.

If Pathias were a Canadian, her medical care would be covered under the Universal Health Care Program. That is why it is relevant.

Not quite sure why Vern hates our Canadian system of health care…sure it has it`s problems, but it works quite well.

My skin cancer was taken care of, no costs out of pocket.

My Mothers ridiculously rare condition that attacks her ograns has been treated successfully for the last 22 years…no costs out of pocket.

Universal health care works very well in Canada…the biggest problems are wait times for specialists and diagnostic procedures.
There are private clinics in Canada that will provide diagnostic tests at cost…mris, cat scans, ultra sounds, etc....( if you dont want to wait)

High priority testings always get bumped to the front, thats why people who need new knees or hips, have to wait longer than people will life threatening problems.

 

[whatevergirl]

Since I work in the insurance business, I too see need for reform, but I also don’t think that people should expect insurance companies to lower their premiums to a point, where they become unprofitable, nor are able to pay costly claims. Insurance companies are part of a larger pie, and I sometimes wonder why people feel that insurers should be giving free healthcare? Groceries are becoming expensive…should we ask the grocery stores to keep the prices at what they were last year or the year before? Should they be giving us free groceries? Insurance shouldn’t be thought of as the big bad wolf of all of the healthcare problems. It is in need of reform, but it shouldn’t be solely blamed for the healthcare crisis in this country.

Just my 2 cents.

 

[LCMS_No_More]

With all due respect Oscar, if you had been following the posts since the very beginning, you would see why Pathias`s posts are relevant.

If Pathias were a Canadian, her medical care would be covered under the Universal Health Care Program. That is why it is relevant.

Not quite sure why Vern hates our Canadian system of health care…sure it has it`s problems, but it works quite well.

My skin cancer was taken care of, no costs out of pocket.

My Mothers ridiculously rare condition that attacks her ograns has been treated successfully for the last 22 years…no costs out of pocket.

Universal health care works very well in Canada…the biggest problems are wait times for specialists and diagnostic procedures.
There are private clinics in Canada that will provide diagnostic tests at cost…mris, cat scans, ultra sounds, etc....( if you dont want to wait)

High priority testings always get bumped to the front, thats why people who need new knees or hips, have to wait longer than people will life threatening problems.

Last night, I was talking to someone from Canada as we were in line at Disneyland and asked her about health care in Canada. She said that she’s happy with it and has had no problems.

 

[vern_humphrey]

Thanks for posting. While some of the points you make here I would agree with I’d have some major concerns about this. While I agree that administrative costs would be lowered, and that it would be a benefit to those in urban areas or areas with a good selection of docs.

I don’t know how any system can deal with a shortage of doctors without:

1. Paying them more, or
2. Drafting people and forcing them to go to medical school.

Or to put it another way, Universal Health Insurance, by creating a monopsony can under pay doctors and drive them out, but cannot create additional doctors.

However, the first thing that I see is that this is a program that primarily caters to the healthy. While it no doubt would cause people to be more particular in their healthcare choices (which is good) it seems like it would also tend to encourage people to not take preventative care which is one of the major problems with those who currently have no insurance or sub-par insurance.

Most people are healthy – and most people spend about half their lifetime total medical payout in the last six months of their lives.

One feature of this system is it allows people to save while young and healthy, so as to have plenty put aside when they are older.

And yes, I have annual checkups. But that’s because I choose to. Other people may choose not do – and that’s their right.

Also what happens to those who have poor health and so would benefit more from traditional health coverage when people with good health start leaving traditional insurance to get into a MSA program? Rates are likely to go up for those who need health coverage most.

They take out MSAs, too.

People who cannot afford MSAs can apply for assistance, based on their most recent tax return, and would receive proportionate assistance – not an automatic 100%. They would get help with insurance premiums and with each payment from their MSA – so they would always have the chance to save something by bargaining and not over-consuming.

Also, since deposits into them and qualified spending from them are not taxable would this have a dramatic impact on tax revenues if the MSA program were to take off? This one is more just a potential problem that I see.

Not nearly the impact that Universal Health Insurance would have!!

 

[whatevergirl]

Last night, I was talking to someone from Canada as we were in line at Disneyland and asked her about health care in Canada. She said that she’s happy with it and has had no problems.

that is probably the case for minor things, but I have read that many people from Canada come to the USA for major treatments…is there truth in that…anyone from Canada?

 

[Oscarthecat]

They state that there is no waiting under private medical care and that under government run it will spiral out of control into hideously long waits.

It certainly has not been the case in my experience. I have had plenty of waits for care under this system, extremely long ones in fact. That is to say, the claim that our private care system works faster is not a 100% fact.

There will always be extreme examples in any debate, but I’m sure you understand that an argument against one thing is not necessarily an argument for the alternative, right?

There are waiting lines in our system, especially when seeing specialists. But that is just the nature of supply and demand-the patient:doctor ratio in specialities would remain roughly the same in UHC. That is, in your area, the market demand for doctors with that particular specialization is low because the number of people needing that kind of doctor is low. This would not change under a government controlled system. The ratios might even get worse because under UHC the government would dictate how many specialists were assigned to each area- doctors and patients would have little say about what services are available in their community-it would all be a numbers game played by politicians.
While it might not mean much in your circumstance right now, the affect of market forces in most communities means the possibilty that a doctor in your area might see a need for a particular speciality and get training for it so that he can serve his community better.

 

[pathia]

Since I work in the insurance business, I too see need for reform, but I also don’t think that people should expect insurance companies to lower their premiums to a point, where they become unprofitable, nor are able to pay costly claims. Insurance companies are part of a larger pie, and I sometimes wonder why people feel that insurers should be giving free healthcare? Groceries are becoming expensive…should we ask the grocery stores to keep the prices at what they were last year or the year before? Should they be giving us free groceries? Insurance shouldn’t be thought of as the big bad wolf of all of the healthcare problems. It is in need of reform, but it shouldn’t be solely blamed for the healthcare crisis in this country.

Just my 2 cents.

All of one of my bankruptcies and about half of the other were all from medical bills, and all from medical bills the insurance company, Anthem BCBS, refused to cover. I understand that the company needs to make money, but they didn’t pay for ANYTHING. I had APPENDICITIS and they said this was due to my lifestyle and REFUSED to pay for it. I had to get a lawyer to write them a nasty letter before they covered it, but it took so long I had already declared bankruptcy and the bill was purged anyway.

 

[onetimeposter]

Since I work in the insurance business, I too see need for reform, but I also don’t think that people should expect insurance companies to lower their premiums to a point, where they become unprofitable, nor are able to pay costly claims. Insurance companies are part of a larger pie, and I sometimes wonder why people feel that insurers should be giving free healthcare? Groceries are becoming expensive…should we ask the grocery stores to keep the prices at what they were last year or the year before? Should they be giving us free groceries? Insurance shouldn’t be thought of as the big bad wolf of all of the healthcare problems. It is in need of reform, but it shouldn’t be solely blamed for the healthcare crisis in this country.

Just my 2 cents.

Insurance companies need to make a profit. So long as insurance companies sole aim is to make profit, some consumers will suffer in the name of the almighty dollar.

If a person needs million of dollars in treatment, the insurance company will make an effort to find a way out of that payment…it makes for good business to do so.

Under a Universal Health care system, there is no emphasis on profit for the share holders or business owners.

 

[LCMS_No_More]

that is probably the case for minor things, but I have read that many people from Canada come to the USA for major treatments…is there truth in that…anyone from Canada?

I wonder how a person, like me, with Type II Diabetes does in Canada. Fortunately, I have decent coverage and get my testing supplies free and drugs at a decent price (I’m working to get off them, though - don’t like having to take pills except supplements). If I lost my job (unlikely), I’d be up the creek without a paddle.

 

[whatevergirl]

I don’t know how any system can deal with a shortage of doctors without:

1. Paying them more, or
2. Drafting people and forcing them to go to medical school.

Or to put it another way, Universal Health Insurance, by creating a monopsony can under pay doctors and drive them out, but cannot create additional doctors.

Most people are healthy – and most people spend about half their lifetime total medical payout in the last six months of their lives.

One feature of this system is it allows people to save while young and healthy, so as to have plenty put aside when they are older.

And yes, I have annual checkups. But that’s because I choose to. Other people may choose not do – and that’s their right.

They take out MSAs, too.

Not nearly the impact that Universal Health Insurance would have!!

I don’t think a shortage of doctors is the problem, as much as what they are teaching in med school. I have a good friend who is now a doctor, and I remember her telling me that a lot of her studies revolved around reactive measures to symptoms, and not proactive measures to teaching people how to GET HEALTHY AND MAINTAIN THEIR HEALTH. I think that we see more shows now on tv, talking about the need to exercise, eat heart healthy foods, eat more fiber, etc…but not until I went to my recent ob/gyn, did I experience a dr who actually was proactive in my health, as opposed to reactive. There’s big money in this country, in not helping people to take care of themselves, and become enslaved to their doctors for script after script. There’s no money in people staying well. Sad,but true.

 

[vern_humphrey]

Insurance companies need to make a profit. So long as insurance companies sole aim is to make profit, some consumers will suffer in the name of the almighty dollar.

If a person needs million of dollars in treatment, the insurance company will make an effort to find a way out of that payment…it makes for good business to do so.

Under a Universal Health care system, there is no emphasis on profit for the share holders or business owners.

Which is what makes them so incredibly expensive, with rationing introduced by cutting doctors’ salaries, long waiting periods and so on.

 

[onetimeposter]

that is probably the case for minor things, but I have read that many people from Canada come to the USA for major treatments…is there truth in that…anyone from Canada?

NO, maybe a few multi-millionaires or billionaires.

There absolutely are times when Universal Health care will make the determination that a specific specialist is required and they are located in the USA, in which case, the bills are paid by the Universal health care system.

For controversial treatments such as autism, I personally know a man who pays for his son to undergo hyper baric ( spelling error) treatments in California.

If you hear about Canadians going to the States for medical treatment, what the Canadians are doing is there are attending diagnostic centres to pay for ultra sounds, mris, cat scans etc... themselves, so that they dont have to wait a long time in Canada.

This will start to dwindle, as the health care system is starting to allow private diagnostic clinics to open up shop on a pay per use system.
For non-life threatening problems, the diagnostic wait times could be a lot better.

 

[whatevergirl]

All of one of my bankruptcies and about half of the other were all from medical bills, and all from medical bills the insurance company, Anthem BCBS, refused to cover. I understand that the company needs to make money, but they didn’t pay for ANYTHING. I had APPENDICITIS and they said this was due to my lifestyle and REFUSED to pay for it. I had to get a lawyer to write them a nasty letter before they covered it, but it took so long I had already declared bankruptcy and the bill was purged anyway.

I don’t work in claims, but I will say that I know there needs to be reform. I marvel that they denied your claim, how would they know what your lifestyle is about? I’m sorry you went through this.

 

[vern_humphrey]

I don’t think a shortage of doctors is the problem, as much as what they are teaching in med school.

That’s the problem Pathia raised.

I
I have a good friend who is now a doctor, and I remember her telling me that a lot of her studies revolved around reactive measures to symptoms, and not proactive measures to teaching people how to GET HEALTHY AND MAINTAIN THEIR HEALTH. I think that we see more shows now on tv, talking about the need to exercise, eat heart healthy foods, eat more fiber, etc…but not until I went to my recent ob/gyn, did I experience a dr who actually was proactive in my health, as opposed to reactive. There’s big money in this country, in not helping people to take care of themselves, and become enslaved to their doctors for script after script. There’s no money in people staying well. Sad,but true.

Pathia, to whom I was replying, was complaining about a long wait to see a specialist – because there weren’t enough specialists.

As for healthy living, we are bombarded night and day with ads and commercials about healthy living. I find it hard to believe there’s anyone in America not in a coma who doesn’t know cigarettes, drugs, alcohol, obesity, lack of exercise and so on are bad for you.

 

[Verisimilitude]

Insurance shouldn’t be thought of as the big bad wolf of all of the healthcare problems. It is in need of reform, but it shouldn’t be solely blamed for the healthcare crisis in this country.

Just my 2 cents.

If they did not lobby Congress to pass specific legislation to favor them or limit their risk while making the individual risk it I would dagree. If Congress was not talking about mandating each person pay a insurance company a premium regadless of interest or need I would agree. It is already mandatory in many places to have auto insurance and home insurance. Failure to do so can result in fines and denial of a loan and that is not the business of the federal government to make the rules and then be judge and jury. It is a stacked deck against the individual.

As a private business insurance companies should operate like the grocery stores and that is at risk like everyone else.

 

[Oscarthecat]

With all due respect Oscar, if you had been following the posts since the very beginning, you would see why Pathias`s posts are relevant.

I think that your rudeness is uncalled for. I was not rude in my post to Pathia, and Pathia responded to my question respectfully and charitably. I got the impression that Pathia understood that I was asking specifically about the geographical concerns.

I have read Pathia’s posts. My question had to do with the availability of specialists in Pathia’s area, and I was asking for clarification on Pathia’s understanding of the relationship of waiting times to UHC versus the status quo.

 

[whatevergirl]

NO, maybe a few multi-millionaires or billionaires.

There absolutely are times when Universal Health care will make the determination that a specific specialist is required and they are located in the USA, in which case, the bills are paid by the Universal health care system.

For controversial treatments such as autism, I personally know a man who pays for his son to undergo hyper baric ( spelling error) treatments in California.

If you hear about Canadians going to the States for medical treatment, what the Canadians are doing is there are attending diagnostic centres to pay for ultra sounds, mris, cat scans etc... themselves, so that they dont have to wait a long time in Canada.

For non-life threatening problems, the diagnostic wait times could be a lot better.

thanks for shedding some light on that…I really didn’t know.