Don't Let the Myths About Health Care Reform Scare You. [Archive]

Sunshine@SC

08-07-2009, 03:49 PM

Very interesting and clarifying article...
You Do Not Have Health Insurance
Wednesday 05 August 2009
by: James Kwak | Visit article original @ The Baseline Scenario

http://www.truthout.org/080709A?n
James Kwak, The Baseline Scenario: "Right now, it appears that the biggest barrier to health care reform is people who think that it will hurt them. According to a New York Times poll, '69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.' Since most Americans currently have health insurance, they see reform as a poverty program - something that helps poor people and hurts them. If that's what you think, then this post is for you. You do not have health insurance. Let me repeat that. You do not have health insurance. (Unless you are over 65, in which case you do have health insurance. I'll come back to that later.)"

Unless you have that mean, bad, evil, socialised health care called MEDICARE you don't have health care. Hmmm, interesting to know since so many of you are opposed to goverment intervention into health care.

Breakingnews

08-07-2009, 05:11 PM

From the article:

Once you lose your employer-based coverage, for whatever reason, you're in the individual market, where, you may be surprised to find, you have no right to affordable health insurance. An insurer can refuse to insure you or can charge you a premium you can't afford because of your medical history.

When my expensive COBRA was reaching it's end, I converted to a private policy. First off, they ran thru the last 8 years of my medical history and slapped a rider (pre-existing condition) on every petty thing they could get away with. One example, I saw an ortho doctor 6 years previously for elbow pain, received a cortisone and waala, I had no more trouble with it. BCBS will not cover any problems with my left elbow now.

My insurance premiums have increased 50% in the last 4 years. Until last year, I hadn't filed any claims except my annual checkup. But at least twice a year I would receive notice of another premium increase. Interestingly, no increases this year and the last one I rec'd was right before the election. BTW, my health insurance premium is more than my mortgage. I figure at this rate, my health insurance will cost more than all my monthy bills combined long before I qualify for medicare.

Then this money quote from the piece:

In addition, there is the problem that even if you are nominally covered when you do get sick, your insurer could rescind your policy, or you may find out, as Karen Tumulty's brother did, that your insurance doesn't cover the treatment you need.

I live in fear of a having major illness, knowing that the insurance companies have the power to dump you or sky rocket your premium so high you can't afford to pay it.

Good article, BTW. It tells it the way it really is.

IaNsSyAlNuE

08-07-2009, 07:14 PM

If, like most people, your health coverage is through your employer or your spouse's employer, that is not what you have. At some point in the future, you will get sick and need expensive health care. What are some of the things that could happen between now and then?

"*Your company could drop its health plan. According to the U.S. Census Bureau (see Table HIA-1), the percentage of the population covered by employer-based health insurance has fallen every year since 2000, from 64.2% to 59.3%.
* You could lose your job. I don't think I need to tell anyone what the unemployment rate is these days.
* You could voluntarily leave your job, for example because you have to move to take care of an elderly relative.
* You could get divorced from the spouse you depend on for health coverage.

For all of these reasons, you can't count on your health insurer being there when you need it. That's not insurance; that's employer-subsidized health care for the duration of your employment."

http://www.truthout.org/080709A?n

:rolleyes:

Unless you have that mean, bad, evil, socialised health care called MEDICARE you don't have health care. Hmmm, interesting to know since so many of you are opposed to goverment intervention into health care.

Please! That is someones OPINION piece.

Fear mongering and people accuse repubs of such. :rolleyes:

IaNsSyAlNuE

08-07-2009, 07:17 PM

Breakingnews

08-07-2009, 07:28 PM

TruthOut.org is a political website aimed at providing an alternative to corporate news sources. It was started in the aftermath of the 2000 presidential election with the goal of, in its words, "hoping to reach a few people, have some small impact on the dialogue, and maybe try to restore a little integrity."[1] It claims to receive more than 4 million visits per month.

Some of its prominent contributors include William Rivers Pitt, Jason Leopold, Scott Galindez, David Bacon, Dean Baker, Tom Engelhardt, William Fisher, Dahr Jamail, Ray McGovern, J. Sri Raman, Norman Solomon, David Swanson and James Zogby. The organization has reported extensively on the anti-war movement and helped to put Cindy Sheehan on the map by publishing many of her writings.

http://en.wikipedia.org/wiki/Truthout.org

SO? I've stayed away from the health care threads because of the political fighting on this forum and others online. But I didn't read anything in that article that was out in left field.

Until 2003, I had employer paid health insurance. I'm now paying for it out of my own pocket. I live in a county with a 20% unemployment rate and it's been near the teens since 2002. Finding a job with insurance or any benefits is dang near impossible. So the scenarios the writer pointed out are very, very realistic.

I suggest people check into buying a private insurance policy and see what it entails. If you're over 45-50, good luck.

IaNsSyAlNuE

08-07-2009, 07:36 PM

SO? I've stayed away from the health care threads because of the political fighting on this forum and others online. But I didn't read anything in that article that was out in left field.

Until 2003, I had employer paid health insurance. I'm now paying for it out of my own pocket. I live in a county with a 20% unemployment rate and it's been near the teens since 2002. Finding a job with insurance or any benefits is dang near impossible. So the scenarios the writer pointed out are very, very realistic.

I suggest people check into buying a private insurance policy and see what it entails. If you're over 45-50, good luck.

As I said above it is fear mongering, period from a left leaning site. There are "what if's" in any circumstance or set thereof.

What if under the government plan it takes six months to get an appointment for a heart related condition ( see Canadian health care for example) and you die in the meantime? Won’t matter if you have government run heath care will it?

"What if" doctors decide they are not paid enough and leave government health care-- then you have to pay out of pocket like Canadian's do when they come there for the same reasons?

To suggest that an employer may go out of business and the rest of the examples in the article and use those tactics is nothing less than fear mongering at its finest.

Barbara2

08-07-2009, 07:37 PM

Breakingnews

08-07-2009, 07:47 PM

As I said above it is fear mongering, period from a left leaning site. There are "what if's" in any circumstance or set thereof.

What if under the government plan it takes six months to get an appointment for a heart related condition ( see Canadian health care for example) and you die in the meantime? Won’t matter if you have government run heath care will it?

"What if" doctors decide they are not paid enough and leave government health care-- then you have to pay out of pocket like Canadian's do when they come there for the same reasons?

To suggest that an employer may go out of business and the rest of the examples in the article and use those tactics is nothing less than fear mongering at its finest.

Losing your job and health insurance is not a fear mongering tactic, it's sadly, a very real fact of life today, in the US. And I'm not debating any political issues. Just stating the way it is for myself and a lot of people that live in my area of the country.

desmom

08-07-2009, 07:53 PM

SO? I've stayed away from the health care threads because of the political fighting on this forum and others online. But I didn't read anything in that article that was out in left field.

Until 2003, I had employer paid health insurance. I'm now paying for it out of my own pocket. I live in a county with a 20% unemployment rate and it's been near the teens since 2002. Finding a job with insurance or any benefits is dang near impossible. So the scenarios the writer pointed out are very, very realistic.

I suggest people check into buying a private insurance policy and see what it entails. If you're over 45-50, good luck.

:beer:

try to find a job if you are over 45.

My husband was caught up in a cut-back 12 years ago. 26 years of service - bye, there is the door. The monthly COBRA premiums were $790 a month. I thought this had to be a mistake. How could someone unemployed pay $790 a month for health insurance?

After speaking with the State Dept. of Insurance, I learned:

When COBRA was enacted, there was no cap put on the premiums.

Because our youngest had health issues, we had to keep her on a group policy. COBRA is considered a group policy. If we did not keep her on a group policy, any new employer's health insurance company could deny her pre-existing conditions.

BCBS was running a commercial at the time about insuring everyone in the family. I quickly learned they will insure everyone in the family as long as everyone in the family is healthy. I filled out the forms, sent them and received premium quotes for my husband, our son and myself, but nothing for our daughter. When I called the 800 for FAQ to ask about her monthly premium, I was told she was denied insurance because of her pre-existing conditions.

jmo

IaNsSyAlNuE

08-07-2009, 07:57 PM

Losing your job and health insurance is not a fear mongering tactic, it's sadly, a very real fact of life today, in the US. And I'm not debating any political issues. Just stating the way it is for myself and a lot of people that live in my area of the country.

I was not speaking about you losing your job, I was speaking about the article linked to in the OP that has all the things that could go wrong.. all the "What if's"

"*Your company could drop its health plan. According to the U.S. Census Bureau (see Table HIA-1), the percentage of the population covered by employer-based health insurance has fallen every year since 2000, from 64.2% to 59.3%.
* You could lose your job. I don't think I need to tell anyone what the unemployment rate is these days.
* You could voluntarily leave your job, for example because you have to move to take care of an elderly relative.
* You could get divorced from the spouse you depend on for health coverage.

There are "What If's" in government run health care and in private health care or employer health care.

The title of the Article is "YOU Don't Have health Insurance” unless you have Medicaid or Medicare--an out and out lie. It is from a left leaning site using fear tactics as I have quoted above.

Again there are What if's in private and government health insurance and for the article to claim you don’t have health insurance unless you have Medicare or Medicaid is utterly ridiculous.

MercedesV

08-07-2009, 08:11 PM

Someone I know just had a meeting this week at work about their health insurance. Big changes. Their deductible is going from $500 a year to $2500. Fortunately they are generally healthy and would likely not run up that kind of medical bills. So, keep the insurance and pay all doctor bills or drop it and risk not having any. Oh, the prescription plan they had, that's history. No more. Now what they are offering, and the employee contribution isn't that small, is virtually worthless. People with kids are between a rock and a hard place.

Health care reform is long overdue.

Breakingnews

08-07-2009, 08:11 PM

I was not speaking about you losing your job, I was speaking about the article linked to in the OP that has all the things that could go wrong.. all the "What if's"

There are "What If's" in government run health care and in private health care or employer health care.

The title of the Article is "YOU Don't Have health Insurance” unless you have Medicaid or Medicare--an out and out lie. It is from a left leaning site using fear tactics as I have quoted above.

Again there are What if's in private and government health insurance and for the article to claim you don’t have health insurance unless you have Medicare or Medicaid is utterly ridiculous.

OK you win, it's left leaning...but guess what, I don't care! I care about the state of health care and insurance for the people of this country. And I don't believe my situation is abnormal. The insurance companies under the Republicans & Democrats have been bleeding us dry and taking advantage of their power to line their pockets.

All I want is for someone to fix it. If you think status quo is working, then I disagree.

desmom

08-07-2009, 08:13 PM

Reforming American health care
http://allcountries.org/health/usa_health_care_2009_economist.html

While the U.S. Spends Heavily on Health Care, a Study Faults the Quality
http://allcountries.org/health/usa_health_care_2008_nyt.html

ExArkie

08-07-2009, 08:21 PM

IaNsSyAlNuE

08-07-2009, 08:23 PM

OK you win, it's left leaning...but guess what, I don't care! I care about the state of health care and insurance for the people of this country. And I don't believe my situation is abnormal. The insurance companies under the Republicans & Democrats have been bleeding us dry and taking advantage of their power to line their pockets.

All I want is for someone to fix it. If you think status quo is working, then I disagree.

The fact that it is left leaning was a small part of my post-- the fearmongering and the lies that one does not have health insurance unless it is medicaide or medicare is what irked me.

Thats great fix it-- and do it right not some hurry up and pass something mess-- please take at least as much time as it took the president to pick his breed of dog. :closedeyes:

IMO this deserves much more time than the six months it took him to choose Bo.

Lavinia

08-07-2009, 08:32 PM

excellent article - I hope everyone reads it.

I had the same problem as described above. When I first became self employed, BCBS went through every drop of medical history, and gave me a lenghty list of things that would not cover.

Some are just bizarre - for example I had a hysterectomy 4 years ago due to fibroids. They just refused my bill for an annual gyn exam. They reference the surgery. Tell me - if I couldn't afford the bill on my own, how am I meant to make sure I remain healthy?

I have BC/BS. I pay over 1K a month in premiums for ME. They typically pay about 10-25% on my medical bills. I will celebrate when they are no longer.

We are going broke on all my unpaid by insurance medical bills.

IaNsSyAlNuE

08-07-2009, 08:44 PM

And you speak about "Fear Mongering"..First off I have been involved in CANADIAN HC Industry for almsot 40 years..no one with any acute issues have to wait for assessment..GMAB..your link above spoke more about Karl Rove than anything else..talk about Fear Mongering..anyway..You guys have no idea about what government Insurances Canada do or dont do..only what a spin agenda driven organizations advertises!! BTW..that women on one of those adds who said she had to go to the US to get treatment for her brain tumor???remember that??..BUT what they forgot to add was..her costs could be repayed just by billing her particular Provincial Health Plan...It happens all the time..it may not be 100%..but it is better than losing your home or your life savings??...That ADVERTISEMENT really got me going and realized just what "Hate Mongers" for Governement Healthcare Plans in the USA would go at length to portray..

You must understand it before you can condem it..and all I hear is what ifs..well..there is likely half of the populations that dont even wonder..they know if they get sick..they have lost everything..

LMS

I did not condemn anything-- read the OP again, the article it did. :rolleyes:

As I said it was "WHAT IFs" and cited a possible wait time-- it was a WHAT IF-- the same as in the OP. I cited Cananian health care because people do wait.

Wait times for surgery in Canada at all-time high: study

"A typical Canadian seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high, according to new research published Monday by independent research organization the Fraser Institute."

http://www.cbc.ca/health/story/2007/10/15/waittimes-fraser.html

http://www.scics.gc.ca/cinfo05/830866004_e.html

You act as if there are no problems with Canadian Health Care. We all know that is not the case. There are problems in Canada and here. Who cares if the wikipedia article spoke of Rove? The site that wrote the article is left leaning, period-- and they are fear mongering to say you do not have health insurance unless you have Medicaid or Medicare, PERIOD.

VC2

08-07-2009, 08:54 PM

From the article:

When my expensive COBRA was reaching it's end, I converted to a private policy. First off, they ran thru the last 8 years of my medical history and slapped a rider (pre-existing condition) on every petty thing they could get away with. One example, I saw an ortho doctor 6 years previously for elbow pain, received a cortisone and waala, I had no more trouble with it. BCBS will not cover any problems with my left elbow now.

My insurance premiums have increased 50% in the last 4 years. Until last year, I hadn't filed any claims except my annual checkup. But at least twice a year I would receive notice of another premium increase. Interestingly, no increases this year and the last one I rec'd was right before the election. BTW, my health insurance premium is more than my mortgage. I figure at this rate, my health insurance will cost more than all my monthy bills combined long before I qualify for medicare.

Then this money quote from the piece:

I live in fear of a having major illness, knowing that the insurance companies have the power to dump you or sky rocket your premium so high you can't afford to pay it.

Good article, BTW. It tells it the way it really is.

For Canadians it is absolutely mind boggling. Lynday "Y" and i probably have the same head shaking disbelief.

Yes there are waits for some elective procedures (depending on the city you are in) but that happens in the states too unless you are really wealthy

More importantly, the cost issue. Canadians average tax is not much higher than what Americans pay, perhaps a percent or so. One reason for that is even though we all have free health care except dental and prescription depending on province, is that people can go to the doctor with a small pain in their chest, or think they have a lump in their breast, feeling tired - diabetes- and it costs nothing. Serious problems are diagnosed early and cost so much less because treatment starts before it becomes an emergency room issue. This dramatically reduces health care costs. If you need a heart transplant you are put on the list. If you need emergency surgery you get it and it costs nothing. The reason we can do that is the preventative value of health care for all at no cost before it becomes a 100k+ issue in emerg. Since everyone pays a little extra in taxes (but has health care deductibles for scripts etc) its not hard to cover everyone since most people don't need it every year. Paying 60 dollars for a doctors visit versus thousands for an emergency health problem that would have been picked up on regular visits drops costs dramatically.

No our system is not perfect, but no one wonders if they can go to the doctor because of cost and no one is refused treatment including some of the best in the world. e.g sick childrens hospital in toronto is world reknowned for its eye department, people are sent there from the US.

If the treatment is only available in the US then the government will pay so long as its an approved treatment, for the patient to go there.

Compare that to people being denied due to pre existing conditions :(

Barbara2

08-07-2009, 09:01 PM

VC2

08-07-2009, 09:04 PM

btw not trying to trash the states system, just trying to explain why its so unfathomable to us.

I was at the vets and had to decide on what treatment i could afford for one of the kitties...was furious at the idea that money made the decision then realized many a parent is doing the same with their children in other countries

desmom

08-07-2009, 09:18 PM

No program is perfect. IMO, they all have their problems somewhere. Heck we have wait times in the states.

http://www.usatoday.com/news/health/2009-06-03-waittimes_N.htm reported almost 8 weeks to see a physician in Boston, almost 3 weeks in Philadelphia and over 3 weeks in Los Angeles.

Locally, it is usually 6 - 8 weeks for an appointment. IMO it is not because we lack doctors. We have 2 nationally recognized hospitals, a medical school and the County Medical Society reports over a 1,000 medical physician, resident and medical student members working in the county.

If you are new to the area, then there is the problem of finding a Dr's office or clinic that accepts your health insurance. Just because the Dr's name is listed on your insurer's website does not mean they are going to accept your insurance. If they do accept your health insurance, they may not be accepting new patients.

And if you do not have an insurance...well that is another story. Good Luck! jmo

Breakingnews

08-07-2009, 09:21 PM

I'm not wealthy and I have no waits. That's not to say that there isn't merit to the opening post article. I do have health insurance but it's no guarantee that I will keep this insurance or that the conditions might not change if MY condition changes. Actually, as long as I keep this job it doesn't change, but I'm retiring in May.

I have said all along that we need changes in this country. Comparing us to other countries doesn't help. This ramrod approach of the current administration doesn't help. We need TRUE reform and not some bought and paid for plan shoved onto the general public with no TRUE debate allowed. IMO

When's it going to happen? You can't talk or debate if everyone is screaming at the other. I emailed my state rep and told him I was receptive to exploring a govt option and recounted my personal situation.

So far in the media all I've read and seen is more political fighting. It's not about the people it seems, it's about politics.

I truly fear another election cycle will go by and we'll be stuck with the bloodsuckers still draining us till we can't pay anymore. I still am too many years out from being able to file for Medicare that I can backshelf this concern. In the meantime, I pay the big monthly premium and hope good health is on my side.

blueberri

08-07-2009, 09:25 PM

You do so much critical judging of my country and the people in it. How many Haves and Have Nots do you know personally? How much time do you spend in the U.S.?
Just expressing my opinion that your critiques of America are getting tiresome.
IMOTo even try to compare Canada's health care to the chaos that BO is trying to shove on Americans is ridiculous. And, speaking from first hand experience, if you don't have supplementary medical insurance, either through work or a private plan you can go broke paying medical bills in Canada. The first time my husband had cancer we had no additional coverage, when the cancer struck the second time we did have a plan provided through my employer.

VC2

08-07-2009, 09:29 PM

TY VC for reaffirming what I am trying to say..I just cant believe all this anger..and fear....understand there is questions..but fear???..Shouldnt have to be that way..unless your get Fear Mongering Agenda Driven Groups to fuel that fire...Talk about yelling fire in a theatre..Man..Such nonsense!!

LMS

exactly!! the government has nothing to do with what doctors we see, what hospitals we go to, or our treatment plans. Well ok, we have to pay to get a note to stay home from work :laugh: I didn't know until a few years ago that people in the states were actually told they could not have a treatment :ohmy: because their insurance company said so, or were released from hospital to early bc the company would not pay for the extra days needed if it didn't fit their actuarial charts.

I can't imagine it..i know it happens but the idea of anyone telling my doctor that they can't treat me as they see fit due to some bean counter saying no is ..well just hard to believe. Why the fear? Insurance companies are so in between patients and their health it causes disasters, yet people are afraid of affordable health care for all? Governent has nothing to do with it, they pay the bills and they pay far less than they would if they had to pay all the emergency catastrophes that could have been taken care of with a prescription before the patient had no choice but to go to emerg.

ok im babbling but i just don't get the fear. the HR bill allows everyone to keep their own insurance anyway if they like being denied due to pre existing etc.

Barbara2

08-07-2009, 09:32 PM

When's it going to happen? You can't talk or debate if everyone is screaming at the other. I emailed my state rep and told him I was receptive to exploring a govt option and recounted my personal situation.

So far in the media all I've read and seen is more political fighting. It's not about the people it seems, it's about politics.

I truly fear another election cycle will go by and we'll be stuck with the bloodsuckers still draining us till we can't pay anymore. I still am too many years out from being able to file for Medicare that I can backshelf this concern. In the meantime, I pay the big monthly premium and hope good health is on my side.

I don't see these town halls as debating the issue. They were set up to sell the plan that was developed with no input from the consumers. It was all done behind closed doors after we were promised complete openness. That angered people to begin with. The open debate needed to happen before this bill was presented as some be all/end all. And the misrepresentations about what is in the bill just reinforces the fact that what they are selling is not what we are getting. I don't want to go from bad to worse. I truly want it to get better but I don't think that our bought and paid for politicians are the best equipped to make that happen. IMO

vonna

08-07-2009, 09:39 PM

apothecary

08-07-2009, 09:43 PM

As I said above it is fear mongering, period from a left leaning site. There are "what if's" in any circumstance or set thereof.

What if under the government plan it takes six months to get an appointment for a heart related condition ( see Canadian health care for example) and you die in the meantime? Won’t matter if you have government run heath care will it?

"What if" doctors decide they are not paid enough and leave government health care-- then you have to pay out of pocket like Canadian's do when they come there for the same reasons?

To suggest that an employer may go out of business and the rest of the examples in the article and use those tactics is nothing less than fear mongering at its finest.

I don't know of anyone waiting 6 months for heart related conditions or for cancer surgery or anything serious.The long waits may be for orthopedic surgery or knee replacements or such.Nothing serious waits that long for treatment.Often the factor that causes the waits are the busy doctors and hospitals.

desmom

08-07-2009, 09:57 PM

I don't see these town halls as debating the issue. They were set up to sell the plan that was developed with no input from the consumers. It was all done behind closed doors after we were promised complete openness. That angered people to begin with. The open debate needed to happen before this bill was presented as some be all/end all. And the misrepresentations about what is in the bill just reinforces the fact that what they are selling is not what we are getting. I don't want to go from bad to worse. I truly want it to get better but I don't think that our bought and paid for politicians are the best equipped to make that happen. IMO

IMO, the town hall meetings were set up so area residents could ask questions about the health care bill. From some of the news articles I have read and videos I have watched, I do not see how that is possible.

I am confused by your statement, "It was all done behind closed doors after we were promised complete openness." :shrug:

Barbara2

08-07-2009, 10:03 PM

IMO, the town hall meetings were set up so area residents could ask questions about the health care bill. From some of the news articles I have read and videos I have watched, I do not see how that is possible.

I am confused by your statement, "It was all done behind closed doors after we were promised complete openness." :shrug:

All of the discussions in the house and senate were going to be on camera. That didn't happen. And the town hall meetings were not set up so residents could get their questions answered. I take that back. They WERE set up so that residents could get their questions answered but the answers were talking points that were fed to the representatives and had no basis in reality. The representatives holding these meetings don't even know what's in the bill. That's why that "mob" person(s) yelled out, "Read the bill!". We've read it. The people who are responsible for voting it in have not. They will vote as whoever has paid them off tells them to vote. IMO

desmom

08-07-2009, 10:20 PM

All of the discussions in the house and senate were going to be on camera. That didn't happen. And the town hall meetings were not set up so residents could get their questions answered. I take that back. They WERE set up so that residents could get their questions answered but the answers were talking points that were fed to the representatives and had no basis in reality. The representatives holding these meetings don't even know what's in the bill. That's why that "mob" person(s) yelled out, "Read the bill!". We've read it. The people who are responsible for voting it in have not. They will vote as whoever has paid them off tells them to vote. IMO

Thank you for responding. Did you check C-Span?

I am sorry the rep at your town meeting could not answer your questions.

Barbara2

08-07-2009, 10:24 PM

Thank you for responding. Did you check C-Span?

I am sorry the rep at your town meeting could not answer your questions.

I didn't go to any town meetings. I read the bill. The bill says something different than what we are being told in these public statements. The town halls are a joke because they are not honest. IMO

blueberri

08-07-2009, 10:31 PM

I have a good friend who recently went through cancer surgery, treatment, is in remission and had no additional insurance. Guess what it cost her? Not one flipping cent. Seems some Canadians are trying hard to privatize their health insurance. Like lemmings, they leap from the cliff. IMHOOJust curious, who paid for the ambulance trips, the medical equipment either purchased or rented, needed at home, the morphine, and fourteen other prescription meds, the trips to a hospital in another province, the time lost from work, both by the patient and the family member who had to stay home to take care of them, fifteen weeks of sick benefits through EI (60%of your salary) doesn't go far when you aren't able to work for two years. I am not knocking Canada's health care system at all, I am very thankful we have what we do, I am just telling the truth as it affected my husband and I when he went through cancer twice. BTW, I am also strongly opposed to privatized health care. Your friend is very fortunate that she didn't have any "out of pocket" expenses and that she was near a large hospital, therefore didn't have to travel for major treatment.

blueberri

08-07-2009, 11:10 PM

I have to assume you are in the Canadian System..and maybe you did have to pay somethng towards the expenses..however..did you ever fear for the lose of your house..or investments?...I doubt it...For some who say our HC is Free it isnt..it all depends on your circumstances at the time..But NO ONE is at risk to loose everything they own because of a Health Crisis..I think that is my point..really and compared to the US System..It all depends on your age...your Insurance Coverage and whether or not you have a health issue that can disallow you..Hummm..Wonder which system you want to place your future on?...

LMS:wub:"something towards expenses"????? Until you have walked a mile in my shoes you have no idea what I have gone through and I have no intention of discussing my financial situation on a internet message board, but you try living for a few years without any income, due to illness, and see what happens to your investments including RRSPs and how close you come to the lose of your home, not to mention the family business we owned. We as Canadians are very fortunate to have the health care system that we do, but what BO is purposing in the US cannot, in any way, shape or form be compared to ours. If I lived in the US, I would be afraid, very afraid of the "plan" he is trying to thrust on the people there.

Susan43

08-07-2009, 11:14 PM

I retired in 1996 - with full Medicare coverage and Medigap insurance (for life) from my employer, the Commonwealth of PA. Last year, the Commonwealth offered a plan which would eliminate my Medicare coverage and make them (the Commonwealth) my primary insurer. This plan eliminates the middle man and supposedly makes for only one biller. I took this plan and so far, it works for me. Does anyone know more about it than I do?

I am 78 and I have great insurance - will the new Obama plan hurt me?:confused:

I am 66 and happy with my insurance too. Thank God for Medicare. The new health reform bill will not effect us at all. Please don't believe all the BS. If I had my way we'd just junk the insurance companies and have medicare for all and the heck with the greedy bloodsucking insurance companies.

blueberri

08-07-2009, 11:18 PM

Just curious, who paid for the ambulance trips, the medical equipment either purchased or rented, needed at home, the morphine, and fourteen other prescription meds, the trips to a hospital in another province, the time lost from work, both by the patient and the family member who had to stay home to take care of them, fifteen weeks of sick benefits through EI (60%of your salary) doesn't go far when you aren't able to work for two years. I am not knocking Canada's health care system at all, I am very thankful we have what we do, I am just telling the truth as it affected my husband and I when he went through cancer twice. BTW, I am also strongly opposed to privatized health care. Your friend is very fortunate that she didn't have any "out of pocket" expenses and that she was near a large hospital, therefore didn't have to travel for major treatment.Still waiting for an answer....who paid for these expenses that aren't covered by the government plan? I would love to know; because just maybe I can get reimbursed for some of my expenses?

IaNsSyAlNuE

08-07-2009, 11:18 PM

I don't know of anyone waiting 6 months for heart related conditions or for cancer surgery or anything serious.The long waits may be for orthopedic surgery or knee replacements or such.Nothing serious waits that long for treatment.Often the factor that causes the waits are the busy doctors and hospitals.

You may not know of anyone but here you go:

Among the various specialties, the shortest total waits (between referral by a general practitioner and treatment) occurred in medical oncology (4.2 weeks), radiation oncology (5.7 weeks) and elective cardiovascular surgery (8.4 weeks).

Patients waited longest between a GP referral and orthopedic surgery (38.1 weeks), plastic surgery (34.8 weeks) and neurosurgery (27.2 weeks).

The median wait for an MRI across Canada was 10.1 weeks. Patients in Ontario experienced the shortest wait for an MRI (7.8 weeks), while Newfoundland and Labrador residents waited longest (20.0 weeks).

http://www.cbc.ca/health/story/2007/10/15/waittimes-fraser.html

Below is for heart Surgery, some who were waiting for over a year in Canada:

Time on wait lists for coronary bypass surgery in British Columbia

The opposite pattern was observed in priority group 3. Of 8,756 patients who left the lists within 52 weeks: 7,991 underwent surgery; 90 died while waiting; 176 received medical treatments; 188 declined surgery; and 311 were removed due to other reasons.

Median time on the wait list was 11 weeks.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1079832

Barbara2

08-07-2009, 11:19 PM

I am 66 and happy with my insurance too. Thank God for Medicare. The new health reform bill will not effect us at all. Please don't believe all the BS. If I had my way we'd just junk the insurance companies and have medicare for all and the heck with the greedy bloodsucking insurance companies.

How will it be financed?

IaNsSyAlNuE

08-07-2009, 11:21 PM

B.C. INVESTS $5M TO REDUCE WAIT TIME FOR HEART SURGERY

“We understand the stress and anxiety patients and their families experience as they wait for the phone call to tell them their heart surgery is finally going to happen,” said Campbell. “As a result of all the hard work our health authorities, doctors, nurses and other health care providers have done to rebuild our health system, today we are able to make a real difference in the lives of these patients.”

http://www2.news.gov.bc.ca/nrm_news_releases/2004HSER0055-000652.htm

Obviously if they are investing money to REDUCE wait time for cardiac surgery there is a wait time.

blueberri

08-07-2009, 11:22 PM

Susan43

08-07-2009, 11:23 PM

Barbara2

08-07-2009, 11:26 PM

I wonder what your wait time would be if you weren't lucky enough to have insurance. Or if the co-pay was so high you couldn't afford to see the doc even though you had insurance.

That's a hypothetical that I can't answer since it doesn't exist. Perhaps someone from this country who posts here can answer that for you.

Susan43

08-07-2009, 11:27 PM

IaNsSyAlNuE

08-07-2009, 11:30 PM

1. Chaoulli v. Quebec (Attorney General), No. 29272, Sup. Ct. of Canada 130 C.R.R. (2d) 99; 2005 C.R.R. LEXIS 76.

The Court's majority found that "waiting lists for health care services have resulted in deaths, have increased the length of time that patients have to be in pain and have impaired patients' ability to enjoy any real quality of life."3

Although the decision was specific to Quebec, it implies that provincial governments cannot ban private care unless they guarantee that the public system will meet patients' needs without excessive waits. In a 2005 opinion poll, 80 percent of physicians and 65 percent of the public thought the ruling would reduce waiting times.4 The public, however, was otherwise divided: 43 percent agreed that it "will allow individuals choice and the ability to control their own health care"; 54 percent believed "it will ultimately weaken the public health system that so many people rely on."

http://content.nejm.org/cgi/content/full/354/16/1661

Susan43

08-07-2009, 11:34 PM

How will it be financed?

The same way it is now, although I understand that there are several cost cutting proposals in the bill. You do know it's the taxpayers that pay the medical bills for those folks that end up in the emergency rooms don't you? We would save billions (yes, with a b) if people could get primary care.

Funny that the issue of money keeps coming up while we just lived through several years of extreme spending on the war and I really don't remember many people crying about that.

My opinion is that it is a moral issue, and I firmly believe in the Preamble to the US Constitition.

We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.

IMO promoting the general welfare means a healthy nation.

desmom

08-07-2009, 11:57 PM

http://www.usatoday.com/news/health/healthcare/2002-05-22-insurance-deaths.htm
More than 18,000 adults in the USA die each year because they are uninsured and can't get proper health care, researchers report in a landmark study released Tuesday.

IaNsSyAlNuE

08-08-2009, 12:04 AM

I would think you could get those answers if you attend a "Town Hall: meeting that doesnt get blocked or interrupted by yelling obstructionists.
Thats all I can suggest at this point..It seems that a handful of the screamers stop discussion and answers coming out..yet the majority who really want to know..say nothing..Now..that boggles my mind..Freedom of Speech or is it freedom to obstruct..Where does your Constituation stand on that..I would like to know...It's your right an privelege to get those answers..but when they get obstructed..then you have a right to complain..then again if you are just objecting and asking questions..and dont really listen or want to know thw answers..then guess you may never realise just what your loses will be..not to mention multitudes around you..

So I am accepting you query as an honest question...maybe do some googling..may help in info collecting..However..Looking in from the outside..I see the answers..hear many of the answers almost saily..why havent you heard ?

I am just shaking my head..LMS:rolleyes:

I guess that long non-answer means you don't know.

You criticize and point fingers while Canadians died waiting for care. Please stop the judgments. Your system was flawed enough for private care to be allowed into the fray.

1. Chaoulli v. Quebec (Attorney General), No. 29272, Sup. Ct. of Canada 130 C.R.R. (2d) 99; 2005 C.R.R. LEXIS 76.

The Court's majority found that "waiting lists for health care services have resulted in deaths, have increased the length of time that patients have to be in pain and have impaired patients' ability to enjoy any real quality of life."3 Although the decision was specific to Quebec, it implies that provincial governments cannot ban private care unless they guarantee that the public system will meet patients' needs without excessive waits. In a 2005 opinion poll, 80 percent of physicians and 65 percent of the public thought the ruling would reduce waiting times.4 The public, however, was otherwise divided: 43 percent agreed that it "will allow individuals choice and the ability to control their own health care"; 54 percent believed "it will ultimately weaken the public health system that so many people rely on."

http://content.nejm.org/cgi/content/full/354/16/1661

blueberri

08-08-2009, 12:07 AM

goodnes..Are you angry at me??..I am not even suggesting that I walk in your shoes..nor assume anything..I am only giving an over comparison to our system versus the existing sytem as of now in the US..and what could be made possible for them if cooperation amongst the ranks happen..

I have no idea where you got the feeling I was blaming you for anything..nor suggesting you didnt have ligitemite cause for stress..however..as you even said..had this happened in the US..you'd be SOL..if you know what I mean?..Sometimes a written word doesnt transmit intent..So I apologise if I offended you..Not intended at all..and BTW..Hope all is well with you and yours...

LMSI am not angry with you, I just fail to understand how you can even compare our health care with what Obama is purposing, the US will never have anything close to what we have here, and those who resist it in the US can see this. Others are blindly following false hope. It doesn't make much sense to jump from the frying pan into the fire and that could very well happen with BO's plan. Had we been living in the US and being aware there was no gov. health care we would have made damn sure we had medical insurance. Until you actually experience a medical crisis, you believe that you can get by for a short period without the extra coverage. It was just a fluke that we didn't have a private plan when my husband got sick the first time, always had it, but long story short, you could say Murphy's Law prevailed. Very sorry to have to say this, but, no, all is not well here, after five yrs, in remission, my husband, very recently, lost his battle with cancer. I have learned a lot about how our system works and one example is the fact that Canadian doctors do not have the luxury of sending every patient who they suspect may need expensive tests such as cat scans, various scopes, etc. they do have a budget they have to follow and do have to decide which patient’s needs are more urgent at the time. “All that glitters is not gold.”

Lavinia

08-08-2009, 12:14 AM

I wonder what your wait time would be if you weren't lucky enough to have insurance. Or if the co-pay was so high you couldn't afford to see the doc even though you had insurance.

Agreed. I'm supposed to have shoulder surgery but I'm already out so much co-pay money on everything else that I've had done, I can't afford it. (And hubby makes good money.) Guess how long my wait time is? Forever.

desmom

08-08-2009, 12:23 AM

I am not angry with you, I just fail to understand how you can even compare our health care with what Obama is purposing, the US will never have anything close to what we have here, and those who resist it in the US can see this. Others are blindly following false hope. It doesn't make much sense to jump from the frying pan into the fire and that could very well happen with BO's plan. Had we been living in the US and being aware there was no gov. health care we would have made damn sure we had medical insurance. Until you actually experience a medical crisis, you believe that you can get by for a short period without the extra coverage. It was just a fluke that we didn't have a private plan when my husband got sick the first time, always had it, but long story short, you could say Murphy's Law prevailed. Very sorry to have to say this, but, no, all is not well here, after five yrs, in remission, my husband, very recently, lost his battle with cancer. I have learned a lot about how our system works and one example is the fact that Canadian doctors do not have the luxury of sending every patient who they suspect may need expensive tests such as cat scans, various scopes, etc. they do have a budget they have to follow and do have to decide which patient’s needs are more urgent at the time. “All that glitters is not gold.”

bolding mine.

Not all employers offer health insurance.

Some employers who offer health insurance hold their employees' weekly work hours just shy of the full time status, so they do not qualify for the program.

The working middle class can even begin to buy private health insurance to cover for their family.

Most doctors and clinics in this country demand payment at the time of service if you do not have health insurance.

http://www.usatoday.com/news/health/healthcare/2002-05-22-insurance-deaths.htm reported over 18,000 adults die in this country every year because they did not have health insurance. This includes approximately 1400 with high blood pressure, 400 - 600 with breast cancer and 1,500 diagnosed with HIV.

Have you read the health care bill?

jmo

ETA ~ You also pray you do not have any serious illness because some employers look for ways to get rid of those employees because it makes everyone's premiums in the company go up. If you are under private pay, it is a guarantee they will cancel you. jmo

IaNsSyAlNuE

08-08-2009, 12:33 AM

Someting about glass houses...

Report finds gaps in health care for aboriginal kids
Wed. Jun. 24 2009

"There is a differential standard applied to aboriginal health care and especially kids," he told CTV's Canada AM. "On every measure aboriginal kids fall below national standards." "I don't think people really know that in terms of revenues there's 20 per cent less resources on average that go to aboriginal kids for their health care than most other kids, so even on straight numbers we need to pull that up."

Unicef is calling for the same standard of health care to be provided to all children across the country, regardless of where they live.

These kids are dying in Canada because of Health Care disputes and lack of health care.

The legislation is named after an aboriginal boy who died in 2005 after spending several years in a hospital far from his family, because federal and provincial officials couldn't decide who should pay to send him to a specialized care centre close to his family in northern Manitoba.

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090624/aboriginal_health_090624/20090624

blueberri

08-08-2009, 12:36 AM

bolding mine.

Not all employers offer health insurance.

Some employers who offer health insurance hold their employees' weekly work hours just shy of the full time status, so they do not qualify for the program.

The working middle class can even begin to buy private health insurance to cover for their family.

Most doctors and clinics in this country demand payment at the time of service if you do not have health insurance.

http://www.usatoday.com/news/health/healthcare/2002-05-22-insurance-deaths.htm reported over 18,000 adults die in this country every year because they did not have health insurance. This includes approximately 1400 with high blood pressure, 400 - 600 with breast cancer and 1,500 diagnosed with HIV.

Have you read the health care bill?

jmoYes, I would come up with the money for health insurance if I lived in the US, it would be a priority, before a new car, cable TV, eating out, or anything else that wasn't an absolute necessity. Just curious, if an American working middle class couple arrive at a hospital, she is in labour, they have no medical insurance, what happens?

AlohaRainbow

08-08-2009, 12:57 AM

To even try to compare Canada's health care to the chaos that BO is trying to shove on Americans is ridiculous. And, speaking from first hand experience, if you don't have supplementary medical insurance, either through work or a private plan you can go broke paying medical bills in Canada. The first time my husband had cancer we had no additional coverage, when the cancer struck the second time we did have a plan provided through my employer.
i think our u.s. healthcare system needs some reform, but i'm not sure what i think the reforms should be. so i'm trying to understand the canadian healthcare system... and i have a few questions.

1st - are citizens over 65 covered by the same healthcare setup as younger citizens? (i.e. is there a medicare type equivalent plan in canada?)

2nd - it was my understanding that someone would not go broke paying medical bills in canada... but you're saying it can happen. how can that happen if healthcare is covered? is that because of co-pays or certain things not being covered?

3rd - is there a "network" (for lack of abetter term) of providers that one needs to join/become a member of... or can anyone choose to see any healthcare provider?

4th - does the government in any way make medical decisions for an individual?

tia for any answers you and other canadian posters can supply :)

desmom

08-08-2009, 01:18 AM

Yes, I would come up with the money for health insurance if I lived in the US, it would be a priority, before a new car, cable TV, eating out, or anything else that wasn't an absolute necessity. Just curious, if an American working middle class couple arrive at a hospital, she is in labour, they have no medical insurance, what happens?

It would probably take more than that because you would probably need around $1,000 a month for a family of four for health insurance plus the co-pay and/or deductible charges that are required when you see your dr, have tests, treatment or hospitalization.

Re maternity and no insurance: It would depend on the hospital. Locally, they would admit her, deliver the baby, stabilize them and send them home.

jmo

AlohaRainbow

08-08-2009, 01:25 AM

*snipped to address one issue from VC2's interesting post*
More importantly, the cost issue. Canadians average tax is not much higher than what Americans pay, perhaps a percent or so.
*snip*

trying to sort out in my mind the way i think healthcare improvements and reform should go in the u.s., so i wanted to address the issue of cost... and your post really got me thinking.

my understanding is that basic healthcare in canada is paid for through income taxes (thus there are no separate health insurance premiums unless someone obtained supplementary insurance).

in an effort to get an idea of how much canadians actually pay in income taxes, i found this website that has a chart comparing international income taxation rates. (with the disclaimer that the data is from 2005, so i don't know if the data are still valid).
http://en.wikipedia.org/wiki/Taxation_in_Canada
according to this chart, single canadians earning an "average" wage pay 31.6% income tax, while married with 2 children pay 21.5% (compared to the same "average" wage americans who pay 29.1% (single) and 11.9% (married with 2 children).

so single with no children: difference is only a few % points:
31.6 (canadian) / 29.1% (american)

there does seem to be a bigger difference (10% points) for married with 2 children:
21.5 (canadian) / 11.9% (american)

i'm curious as to how much difference there would be for americans in amount of income taxes if healthcare was "paid for" by u.s. income tax... it would seem that the % of taxes levied on americans who are married with kids would need to increase if taxes covered healthcare (and i wonder, how much more or less that would be in comparison to what those same folks pay now in health insurance premiums).

desmom

08-08-2009, 01:34 AM

trying to sort out in my mind the way i think healthcare improvements and reform should go in the u.s., so i wanted to address the issue of cost... and your post really got me thinking.

my understanding is that basic healthcare in canada is paid for through income taxes (thus there are no separate health insurance premiums unless someone obtained supplementary insurance).

in an effort to get an idea of how much canadians actually pay in income taxes, i found this website that has a chart comparing international income taxation rates. (with the disclaimer that the data is from 2005, so i don't know if the data are still valid).
http://en.wikipedia.org/wiki/Taxation_in_Canada
according to this chart, single canadians earning an "average" wage pay 31.6% income tax, while married with 2 children pay 21.5% (compared to the same "average" wage americans who pay 29.1% (single) and 11.9% (married with 2 children).

so single with no children: difference is only a few % points:
31.6 (canadian) / 29.1% (american)

there does seem to be a bigger difference (10% points) for married with 2 children:
21.5 (canadian) / 11.9% (american)

i'm curious as to how much difference there would be for americans in amount of income taxes if healthcare was "paid for" by u.s. income tax... it would seem that the % of taxes levied on americans who are married with kids would need to increase if taxes covered healthcare (and i wonder, how much more or less that would be in comparison to what those same folks pay now in health insurance premiums).

Using your figures, the increase in income tax is less than what we pay now for health insurance and income tax. jmo

AlohaRainbow

08-08-2009, 01:43 AM

I agree that reform is a GREAT idea. I disagree that this administration is going about it the right way. Start with tort reform and go from there. We are compared to other countries who do NOT allow the lawsuits that are encouraged here. The insurance companies are out of control and taking advantage of people. Why isn't the medical establishment stepping up with an option that is non-profit and advantageous to all? I just don't believe that the government has my best interests in mind when they make these (who is in my back pocket today) decisions. Oh, can they ban lobbyists?

i agree that we need some type of reform, but i am not sure exactly how it should be done. you've raised an interesting issue - lawsuits and tort reform. i work as a nurse paralegal and spend my working hours dealing with medical malpractice claims... it would boggle people's minds to know how much is spent by both sides (patient/plaintiff and physician/defendant) on claims that are, for the most part, in my experience, frivolous

and since we have canadians on this board, i'd like to ask them about medical malpractice lawsuits in canada. is it as prevelant to sue doctors in canada as it seems to be in the u.s.? is there a system to handle adverse medical outcomes in canada other than filing a lawsuit?

AlohaRainbow

08-08-2009, 01:59 AM

Yes, I would come up with the money for health insurance if I lived in the US, it would be a priority, before a new car, cable TV, eating out, or anything else that wasn't an absolute necessity. Just curious, if an American working middle class couple arrive at a hospital, she is in labour, they have no medical insurance, what happens?

a woman in active labor without insurance would be covered under our federal EMTALA (Emergency Medical Treatment and Active Labor Act ) originally enacted in 1986
http://www.medlaw.com/healthlaw/EMTALA/statute/emergency-medical-treatme.shtml

Lavinia

08-08-2009, 02:12 AM

It would probably take more than that because you would probably need around $1,000 a month for a family of four for health insurance plus the co-pay and/or deductible charges that are required when you see your dr, have tests, treatment or hospitalization.

Re maternity and no insurance: It would depend on the hospital. Locally, they would admit her, deliver the baby, stabilize them and send them home.

jmo

Then send a bill and if they don't pay it in a timely manner, there goes the credit rating.

(It takes us almost 2K a month for 4 people. 3 of whom are healthy and I have multiple medical problems. My insurance is through a state risk pool insurance that HAS to take otherwise uninsurable people. It is a pain the the butt and pays next to nothing as it is Blue Cross/Blue Shield. The rest of the families insurance is through an individual policy because hubby is self-employed and we have a $5000 ded. AND it doesn't pay well.)

February

08-08-2009, 02:21 AM

If people trusted Bush to take us to war, they should trust President Obama to take us to healthcare.

Bush focused on death and destruction.
President Obama's plan is proactive and is attempting to insure every american will have access to medication and a doctor whenever needed.

drgnrtz

08-08-2009, 02:55 AM

i think our u.s. healthcare system needs some reform, but i'm not sure what i think the reforms should be. so i'm trying to understand the canadian healthcare system... and i have a few questions.

1st - are citizens over 65 covered by the same healthcare setup as younger citizens? (i.e. is there a medicare type equivalent plan in canada?)

2nd - it was my understanding that someone would not go broke paying medical bills in canada... but you're saying it can happen. how can that happen if healthcare is covered? is that because of co-pays or certain things not being covered?

3rd - is there a "network" (for lack of abetter term) of providers that one needs to join/become a member of... or can anyone choose to see any healthcare provider?

4th - does the government in any way make medical decisions for an individual?

tia for any answers you and other canadian posters can supply :)

its the living expenses that gets us. unless you have your loans, credit cards insured for illness. or just a policy for lost wages in case of illness, or covered under s&a through your employer, after eating up the savings you end up on welfare.

drgnrtz

08-08-2009, 03:39 AM

i think our u.s. healthcare system needs some reform, but i'm not sure what i think the reforms should be. so i'm trying to understand the canadian healthcare system... and i have a few questions.

1st - are citizens over 65 covered by the same healthcare setup as younger citizens? (i.e. is there a medicare type equivalent plan in canada?)

2nd - it was my understanding that someone would not go broke paying medical bills in canada... but you're saying it can happen. how can that happen if healthcare is covered? is that because of co-pays or certain things not being covered?

3rd - is there a "network" (for lack of abetter term) of providers that one needs to join/become a member of... or can anyone choose to see any healthcare provider?

4th - does the government in any way make medical decisions for an individual?

tia for any answers you and other canadian posters can supply :)

1 yes the same but with, depending on income, prescription drug supplements.

2 not medical bills, we dont pay medical bills out of pocket. its the other living expenses that you go broke on. no income, cant pay regular bills. smart canadians purchase insurance for loss of wages in case of illness.

3 i can go anywhere in Canada (thats the network) and pick any doctor.

4 no, any medical decision is between me and my doctor.

AlohaRainbow

08-08-2009, 03:44 AM

1 yes the same but with, depending on income, prescription drug supplements.

2 not medical bills, we dont pay medical bills out of pocket. its the other living expenses that you go broke on. no income, cant pay regular bills. smart canadians purchase insurance for loss of wages in case of illness.

3 i can go anywhere in Canada (thats the network) and pick any doctor.

4 no, any medical decision is between me and my doctor.

thanks! :biggrin:

drgnrtz

08-08-2009, 03:49 AM

thanks! :biggrin:

your welcome.

Jumbo1

08-08-2009, 04:10 AM

ellegna

08-08-2009, 10:09 AM

Still waiting for an answer....who paid for these expenses that aren't covered by the government plan? I would love to know; because just maybe I can get reimbursed for some of my expenses?

We have a program here in Ontario called Community Care Access Centre (CCAC), funded by OHIP and Trillium Foundation.

http://www.ccac-ont.ca/
http://www.health.gov.on.ca/en/public/programs/ohip/
http://www.trilliumfoundation.org/cms/en/index.aspx

My mother is now 84 and suffers from Alzheimer. I chose to keep her at home with me rather than place her in a home. She is now bedridden.

These are some of the services I receive through CCAC
15 hours per week caregiver service - no charge
Lab Technician - bi weekly INR - no charge
Nurse - bi weekly - no charge
Doctor - monthly house calls - no charge
Ambulance Service - transport to medical appointments and back - no charge
Medical Supplies - bedridden related - no charge

Before Mom became bedridden, she attended a senior day program.
She was picked up at 8 am and brought home at 4 pm. Cost was $100 per week and tax deductible. This service alone was well worth it. I was able to go to work with peace of mind knowing she was well cared for. Her caregiver was at my home to receive her when she returned from day care and stayed until I came home.

If I ever have to leave town for a few days, we have a respite care program. AmbuTrans will pick up my mother and take her to a nursing home facility. She will be cared for the duration I am away and Ambu Trans will transport her back home. Cost? $35 per day.

Mom's Alzheimer medication alone costs over $600. All I pay is a $12 dispensing fee.

Any other out of pocket expenses relating to my mother's care is claimed as a medical tax deduction on her tax return.

My neighbor (30 yrs old) recently had breast cancer surgery and chemo. She received the same services as my mom through CCAC. No charge. We actually shared the same home visiting RN.

If it wasn't for our Government Health Care System, I would not be able to afford to keep mom at home.

drgnrtz

08-08-2009, 10:49 AM

We have a program here in Ontario called Community Care Access Centre (CCAC), funded by OHIP and Trillium Foundation.

http://www.ccac-ont.ca/
http://www.health.gov.on.ca/en/public/programs/ohip/
http://www.trilliumfoundation.org/cms/en/index.aspx

My mother is now 84 and suffers from Alzheimer. I chose to keep her at home with me rather than place her in a home. She is now bedridden.

These are some of the services I receive through CCAC
15 hours per week caregiver service - no charge
Lab Technician - bi weekly INR - no charge
Nurse - bi weekly - no charge
Doctor - monthly house calls - no charge
Ambulance Service - transport to medical appointments and back - no charge
Medical Supplies - bedridden related - no charge

Before Mom became bedridden, she attended a senior day program.
She was picked up at 8 am and brought home at 4 pm. Cost was $100 per week and tax deductible. This service alone was well worth it. I was able to go to work with peace of mind knowing she was well cared for. Her caregiver was at my home to receive her when she returned from day care and stayed until I came home.

If I ever have to leave town for a few days, we have a respite care program. AmbuTrans will pick up my mother and take her to a nursing home facility. She will be cared for the duration I am away and Ambu Trans will transport her back home. Cost? $35 per day.

Mom's Alzheimer medication alone costs over $600. All I pay is a $12 dispensing fee.

Any other out of pocket expenses relating to my mother's care is claimed as a medical tax deduction on her tax return.

My neighbor (30 yrs old) recently had breast cancer surgery and chemo. She received the same services as my mom through CCAC. No charge. We actually shared the same home visiting RN.

If it wasn't for our Government Health Care System, I would not be able to afford to keep mom at home.

my hubby recently had bypass surgery for PAD, when he was release from the hospital CCAC provided all medical supplies for dressing changes, drugs needed for recovery, and daily visits from rns to make sure he was healing properly. free of charge. CCAC nurses are awesome.

ellegna

08-08-2009, 11:15 AM

Good Job Ellegna!! Good description of a perfect example what our services offer....I would also assume, no Government official told you who you had to see, and what services you had take or couldnt have either..Boy, we are so so fortunate!! arent we!!

LMS:wub:

Hi Lynda and Thanks

As long as everyone received all the necessary completed documentation from Mom's Doctors, I was provided all these services without any hassel.

Actually.....CCAC provided a service I was not expecting.
I was having a difficult time with Mom's previous Doctor. Kept getting reminders to bring mom into the office for a check up. Doctor knew mom was bedridden. I asked the doctor if they could come to the house. Nope.
CCAC contacted an agency and once mom was approved provided her with Doctor house call service. This agency took over mom's care from her previous doctor. The service Mom receives is excellent.

Which brings to mind.
Ontario also has a doctor house call service through the health care program. It's called MedVisit. If you are ill and can't make it to your own doctor or emergency, you call this service, provide your OHIP # and a doctor will come to the house. No Charge

beattherap

08-08-2009, 12:04 PM

Geesh ExArkie..I am outside of your Country and have heard over and over again..NOTHING wil change for you...However...since the party of NO keep dragging their buttocks ...and wish to go on a campaign trail of disruption for people like yourself to get such answers..well..ya never know..what will happen....and those with Private Coverages can mainatain that too..dont have to be part of the Government Plan..

Now..I just learned from a patient lately, who lived in USA..had a great HC Policy..It only cost him $10,000.00 a year ( family plan)..I say yikes..then I ask was it really worth it?..He said yes..cause I could afford it..and my company paid the other $10,000.00..and only had to pay 20% co-pay???..I said Yikes...Good thing you had a job..He says..Yes..most just have to go broke..or without healthcare..and I asked..Is that fair??..He said NO!

My above story only points out..that HAVES really dont care about the "HAVENOTS"..until they get into the position of "Not Having"...No one knows what is coming down the road as for health issues..I am still wondering the worries some are so angry about??

LMS
i'm not against single payer health care, but i want honesty as well...

one source of funding being discussed for the health care bill is cuts to medicare... it's not at all certain that "Medicare will not change one bit if a "Universal Plan" gets passed."...

repeating over and over that "those with Private Coverages can maintain that too..dont have to be part of the Government Plan," doesn't make it true... as the government mandates take hold, some, many, most ? private coverages might disapear... for instance, a coverage forced to cover preexisting conditions and eliminate its lifetime cap might vanish.

imo.

blueberri

08-08-2009, 12:50 PM

IaNsSyAlNuE

08-08-2009, 12:51 PM

To the "What iffers" ....

And "What if" none of those fear mongering tactics presented by the opposers of health care take place? We can "what if" all day long but the bottom line is all of the scenarios presented in the article are very real. If you've got company provided insurance - You DO NOT have health insurance. Unless insurers are brought to task about pre-existing conditions, high cost of drugs, high cost of health care then it all remains the same. We DO NOT have health insurance that's dependable and affordable.

LOL

EVERYTHING you present in your article in the OP is a "what if" situation, period. I already pointed that out to you. "Fear mongering", you are the one with the OP doing such by telling people all the "what if's" as I said in my FIRST post to you. ROTF.

People die in Canada while waiting for health care as I presented in the STUDYS done in Canada and UNICEF on this thread. e.g., they wait months and months for some appointments and some wait up to a year for heart surgery-- the one study showed 90 dying while waiting. So it is not a "what if" situation-- no matter how you want to try and spin it.

No one has said we do not need health care reform-- however ONCE again this bill that politicians want pushed through quicker than Obama choose the breed of dog for the White House is insane IMO.

Barbara2

08-08-2009, 12:57 PM

Forgive me if this has been posted before. If it has, I missed it. I went looking specifically for an opinion from someone in the medical field: I highlighted a couple of points. There are many others including problems that already exist in dealing with Medicare.

http://online.wsj.com/article/SB124571387059539071.html

I have heard that physicians may be mandated to participate in a government-run health plan. I sincerely hope that this is not true. First of all, it sounds unconstitutional. As free individuals and citizens of this country, physicians should not be forced to participate in any plan. We have paid for our professional training and worked hard to distinguish ourselves. We owe no debt to the government. If you want physicians to participate in your plan, give them the right incentives and they will flock toward your program.

I believe that in order to reduce costs, we must give the public incentives for preventing chronic disease, increase the reimbursement for office visits, and implement medical malpractice tort reform. With these changes, I am certain that we can provide more adequate insurance coverage for all.

blueberri

08-08-2009, 01:18 PM

LOL

EVERYTHING you present in your article in the OP is a "what if" situation, period. I already pointed that out to you. "Fear mongering", you are the one with the OP doing such by telling people all the "what if's" as I said in my FIRST post to you. ROTF.

People die in Canada while waiting for health care as I presented in the STUDYS done in Canada and UNICEF on this thread. e.g., they wait months and months for some appointments and some wait up to a year for heart surgery-- the one study showed 90 dying while waiting. So it is not a "what if" situation-- no matter how you want to try and spin it.

No one has said we do not need health care reform-- however ONCE again this bill that politicians want pushed through quicker than Obama choose the breed of dog for the White House is insane IMO.Exactly, I don't think anyone would argue that health care reform is not needed in the US, but the blank cheque that BO wants signed is not the answer.

desmom

08-08-2009, 01:32 PM

LOL

EVERYTHING you present in your article in the OP is a "what if" situation, period. I already pointed that out to you. "Fear mongering", you are the one with the OP doing such by telling people all the "what if's" as I said in my FIRST post to you. ROTF.

People die in Canada while waiting for health care as I presented in the STUDYS done in Canada and UNICEF on this thread. e.g., they wait months and months for some appointments and some wait up to a year for heart surgery-- the one study showed 90 dying while waiting. So it is not a "what if" situation-- no matter how you want to try and spin it.

No one has said we do not need health care reform-- however ONCE again this bill that politicians want pushed through quicker than Obama choose the breed of dog for the White House is insane IMO.

bolding mine...

05/22/2002 http://www.usatoday.com/news/health/healthcare/2002-05-22-insurance-deaths.htm
More than 18,000 adults in the USA die each year because they are uninsured and can't get proper health care, researchers report in a landmark study released Tuesday.

That was 7 years ago. IIRC, the unemployment rate was hovering around 5%. Today is just below 10%. How many have lost their health insurance because they have lost their jobs?

jmo

IaNsSyAlNuE

08-08-2009, 01:39 PM

Exactly, I don't think anyone would argue that health care reform is not needed in the US, but the blank cheque that BO wants signed is not the answer.

Exactly, give me one where you can explain where the money is coming from and one that is easily understood and last but not least where ALL health care is equal! Not better access for congress and higher ups-- but everyone afforded the same care.

IaNsSyAlNuE

08-08-2009, 01:46 PM

bolding mine...

05/22/2002 http://www.usatoday.com/news/health/healthcare/2002-05-22-insurance-deaths.htm
More than 18,000 adults in the USA die each year because they are uninsured and can't get proper health care, researchers report in a landmark study released Tuesday.

That was 7 years ago. IIRC, the unemployment rate was hovering around 5%. Today is just below 10%. How many have lost their health insurance because they have lost their jobs?

jmo

My contention was not that this did not happen in America-- I was told by a Canadan on this thread that "no one waited for heart care"-- "no one died while waiting". That "waits were not for things such as this-heart related conditions". Obviously that was not the truth as cited here

http://www.cbc.ca/health/story/2007/10/15/waittimes-fraser.html

and here:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1079832

That was for a specific Heart surgery in a one year period- I was told that no one waited for such and died while waiting. Again that was for one kind of heart surgery, only it did not include cancer death rates while waiting, etc. It does not include aboriginals dying because of substandard health care as shown in the UNICEF study.

The fact that people died while waiting in Canada and lived in constant pain is what opened up the PRIVATE sector health care in Canada as show here:

The Court's majority found that "waiting lists for health care services have resulted in deaths, have increased the length of time that patients have to be in pain and have impaired patients' ability to enjoy any real quality of life

1. Chaoulli v. Quebec (Attorney General), No. 29272, Sup. Ct. of Canada 130 C.R.R. (2d) 99; S

http://content.nejm.org/cgi/content/full/354/16/1661

IaNsSyAlNuE

08-08-2009, 02:04 PM

I agree, on the whole, we do have great health care coverage here in Canada, but let’s be honest...... there are wait times, doctors do have a budget to follow, there are people who cannot get a family doctor, there are hospital bed shortages, and you do need supplementary insurance coverage. These things differ, depending where you live in Canada. Sadly, United States will never in a million years have a health care coverage anywhere close to what we have here in Canada, and it is just ridiculous for some to believe they will. Obama is trying to sell “a pig in a poke” and logical Americans are not buying.

Quite right!

I wonder if you might know what the stats of paying for Illegal Immigrants heath care is there? Do you happen to know? Does Canada pay for millions who do not belong? Are Canadian Hospitals slapped with law suits when they send an Illegal Immmigrant back to his county ( his wishes) after spending millions on his care?

http://www.miamiherald.com/news/southflorida/story/1107995.html?tr=y&auid=4998317

The price of health care is raised because of thing such as this as well here in America.

Pollysmum

08-08-2009, 02:21 PM

I'm hearing a lot of concern from Americans about the HC reforms being put forth. For those affected what reforms would you like to see that aren't being discussed? Thanks

p.s I'm in Alberta Canada where our Provincial government is trying to implement a two-tier system of public and private insurance by reducing coverage slowly but surely forcing individuals/families to purchase additional private insurance.

MOO

Pollysmum

08-08-2009, 03:33 PM

Hello fellow Canadian...the 2 tier system has always been around at least for the rich..as they always could/can and do get what they want or need anywhere in the world..Money does talk..but I think what is happening is some non-essential items are being deregulated..so you either pay out of pocket or do without..for example circumcisions of new baby boys was only deregulated about 8-10 years ago..so if that is desired by the new parent they have to pay upfront for that surgery..not sure of the costs there tho...

To my knowledge,no essential care will be deregulated..and funds will always be available to assist say in homecare..thus getting patients out of hospital setting decreasing that cost factor..so for govt..it is cheaper to supply homecare nursing, and treatments than to keep in hospital bed...

What I am amazed at is hearing the US premium costs to ordinary people/families..its thousands upon thousands a year..and they still get told NO or denied because of some excuse...I just cant fathom that kind of money being paid for peace of mind...then when you actually need it..it only pays a small portion of the costs..Yikes..now that scares me....and it is "Insurance Adjusters" who decide coverability of claims..and they arent even medical people...which really boggles my mind...Their system down there kept me from taking many jobs down there I had been offered over the years...Too risky..being a single parent and all...

Anyway...We really should be feeling somewhat grateful we even have a system that will not bankrupt us..Governement will always help out if your disease processes or treatments are out of your price range...So cant complain from my end at all!

LMS:thumbsup:

Thanks, Also a single mum and happy to not have the issues with health care the US folks have.

I'm fortunate that anything I've needed hasn't been affected. Same with my boys, they've always been attended to very quickly, testing or surgery.

In saying that however, I was at a local hospital last year with a "womans problem" and they told me that I would need to see a surgeon but to not expect a call until June/July of 2009 setting up the appointment. Still haven't heard from them. I'm guessing that since my problem isnt life or death I'll be waiting a while longer, particularly in light of the fiscal issues of the AB Govt.

Likely we have the same issue across the country with doctor shortages. My doctor will be retiring next year (have been with his office since 1982) and I know it'll be a problem trying to find a new one, I've searched the government database to see whats available and precious few are out there in my town.

It's not a perfect system I know but as you say at least I know I wont go broke trying to get the immediate care I need.

Regards

MOO

desmom

08-08-2009, 04:19 PM

18,000 out of 250 to 300 MILLION people in the country?

IMO, that is way too many. I think it is very sad that one would have to suffer or die from a treatable illness just because they do not have the $$$ or health insurance. We are not talking about buying a new car or taking a vacation. We are talking about human lives.

It is estimated 46 million people do not have health insurance in this country, yet the U.S. spends more per capita than any other industrialized nation and those countries provide health insurance to all their citizens. http://www.nchc.org/facts/cost.shtml

Health care costs are spiraling out of control. I know that any national health care plan is not going to be perfect. It will take time to iron out all the bugs, but at least it is beginning.

jmo

desmom

08-08-2009, 04:26 PM

Kind of O/T but hoping someone will respond.

My daughter uses two medications that are very expensive that are not covered by her health insurance (considered pre-existing condition) and hubby and I help her out and pay for her prescriptions.

I have researched this medication online and have found quite a few on-line pharmacies that offer this medication at almost half the price but I am afraid as I've never done this before?

Has anyone ever ordered their medication on-line and if so - can you refer me to a reliable site?

TIA

I have not used these sites before, but have read a couple articles about them.

http://www.pharmacychecker.com/aboutus.asp

http://www.legitscript.com/

http://www.tampabay.com/news/aging/article995187.ece article about prescription drug-assistance programs.

Lavinia

08-08-2009, 05:00 PM

18,000 out of 250 to 300 MILLION people in the country?

About 6 times The World Trade Center victims. We didn't like that much.

(And I personally think that figure is WAYYYY too low.)

blueberri

08-08-2009, 05:03 PM

Quite right!

I wonder if you might know what the stats of paying for Illegal Immigrants heath care is there? Do you happen to know? Does Canada pay for millions who do not belong? Are Canadian Hospitals slapped with law suits when they send an Illegal Immmigrant back to his county ( his wishes) after spending millions on his care?

http://www.miamiherald.com/news/southflorida/story/1107995.html?tr=y&auid=4998317

The price of health care is raised because of thing such as this as well here in America.Just read the link….. that is freekin’ unbelievable! Another huge reason why BO’s health care reform will never work! I never hear anything much about illegal immigrants where I live, but maybe a poster from another part of Canada, such as Ontario or BC could answer your question?

desmom

08-08-2009, 05:35 PM

Just read the link….. that is freekin’ unbelievable! Another huge reason why BO’s health care reform will never work! I never hear anything much about illegal immigrants where I live, but maybe a poster from another part of Canada, such as Ontario or BC could answer your question?

Here is another article. http://www.cbsnews.com/stories/2009/03/16/health/main4867791.shtml

If you read the comments below the article, I think you will get a feeling how people feel about the cost of illegals in the United States.

FurthurBB

08-08-2009, 06:56 PM

I have BC/BS. I pay over 1K a month in premiums for ME. They typically pay about 10-25% on my medical bills. I will celebrate when they are no longer.

We are going broke on all my unpaid by insurance medical bills.

BC/BS is the worst insurance and I really hope they do go under. IMO

desmom

08-08-2009, 07:07 PM

Here is a comparison with US and Canada. regarding Illegal Immigrant Health Care..Now this is one issue that will likely never be resolved..completely..such a difficult issue..

http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

Here's how we ( Canadian) deal with legal Immigratants and Health Care..

http://www.immigration-service.com/health_care_canada.aspx

Thats the best I can do to inform...I can only wish you American friends can get something done in regards to a HC System...

LMS:smile:

Thanks Linda for the links.

I hope something can be done too.

FurthurBB

08-08-2009, 07:19 PM

Here is another article. http://www.cbsnews.com/stories/2009/03/16/health/main4867791.shtml

If you read the comments below the article, I think you will get a feeling how people feel about the cost of illegals in the United States.

What would California do if 1/2 their state income was gone? People always think someone is taking their piece of the pie and seldom realize it is probably them who is taking someone else's. IMO

drgnrtz

08-08-2009, 07:41 PM

Thanks, Also a single mum and happy to not have the issues with health care the US folks have.

I'm fortunate that anything I've needed hasn't been affected. Same with my boys, they've always been attended to very quickly, testing or surgery.

In saying that however, I was at a local hospital last year with a "womans problem" and they told me that I would need to see a surgeon but to not expect a call until June/July of 2009 setting up the appointment. Still haven't heard from them. I'm guessing that since my problem isnt life or death I'll be waiting a while longer, particularly in light of the fiscal issues of the AB Govt.

Likely we have the same issue across the country with doctor shortages. My doctor will be retiring next year (have been with his office since 1982) and I know it'll be a problem trying to find a new one, I've searched the government database to see whats available and precious few are out there in my town.

It's not a perfect system I know but as you say at least I know I wont go broke trying to get the immediate care I need.

Regards

MOO

the problem with the data bases is by the time their listed, their full up. best bet visit clinics. usually clinic doctors will post on the walls of the clinics if they have open practices. know any hospital nurses ? know anyone receiving care from ccac nurses? the ccac nurse that came for my hubby gave me 3 names off the top of her head when i asked her if she knew of any docs having open practices, she also told me who to stay away from. good luck

IaNsSyAlNuE

08-08-2009, 09:29 PM

Here is a comparison with US and Canada. regarding Illegal Immigrant Health Care..Now this is one issue that will likely never be resolved..completely..such a difficult issue..

http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

Here's how we ( Canadian) deal with legal Immigratants and Health Care..

http://www.immigration-service.com/health_care_canada.aspx

Thats the best I can do to inform...I can only wish you American friends can get something done in regards to a HC System...

LMS:smile:

How can you compare how Canada deals with LEGAL immigrants and the US deals with ILLEGAL Immigrants? Apples and oranges--- another reason our health care is so high we are paying for people are in the US illegally!

Barbara2

08-08-2009, 09:31 PM

How can you compare how Canada deals with LEGAL immigrants and the US deals with ILLEGAL Immigrants? Apples and oranges--- another reason our health care is so high we are paying for people are in the US illegally!

I was reading recently that Massachusetts with their insurance for all program is thinking of dropping the LEGAL immigrants from the program because they are out of money and need to make cuts.

IaNsSyAlNuE

08-08-2009, 09:33 PM

Here is another article. http://www.cbsnews.com/stories/2009/03/16/health/main4867791.shtml

If you read the comments below the article, I think you will get a feeling how people feel about the cost of illegals in the United States.

The end of the article says she says:

I have no insurance, no resources, nothing to fall back on," said Barrios, who has one daughter. "I have no idea what I will do."

Quite simple really-- apply for citizenship and become a legal documented worker who contributes to the income taxes which pay for Medicare and Medicaid. Go through the LEGAL process as so many have done before you.

IaNsSyAlNuE

08-08-2009, 09:33 PM

I was reading recently that Massachusetts with their insurance for all program is thinking of dropping the LEGAL immigrants from the program because they are out of money and need to make cuts.

If they are legal immigrants they are so wrong!

IaNsSyAlNuE

08-08-2009, 09:38 PM

Holey moly..you were responding to Lavinia..who pays 12,000.00 a year premium for HC..and they only pay 10-20% of her HC costs..how can anyone reconcile this..Yikes..i cant understand ya Americans to stand for this!! If you pay 5 Grand a yer..and get all Hospitilizations and Doctor visists and Testings covered..I am sure you would be glad to just have to pay for scripts..Geesh..The numbers I am hearing are huge!!

LMS

I have never heard of such a situation it is outrageous.( only paying 20 percent of costs with preminums like that) Sounds like she needs to find a better policy. My daughter pays 125 a month ( employee) and hers is a 80/20 payout with a 1200 deductable. She is a cancer survivor as well.

We pay for our family ( three) 446 monthly, 80-20 payout and our deductable is 1,500 per member. Cancer survivor here and congenital diseases.

Barbara2

08-08-2009, 09:42 PM

If they are legal immigrants they are so wrong!

Here is one article:

http://www.nytimes.com/2009/07/15/us/15insure.html

IaNsSyAlNuE

08-08-2009, 10:03 PM

Here is one article:

http://www.nytimes.com/2009/07/15/us/15insure.html

I did not read where they can justify such action or even try to for that matter except if they have a had a green card for less than three years—how would that change anything I wonder? . The article says that the state pays nearly 65,000 per family for health care and the recession has made it impossible to continue. I mean how one picks which legal citizen will not longer receive care is mindboggling.

The other thing I found the article says they do not qualify for Medicare, why do these people not qualify for Medicaid if they are legal citizens

Barbara2

08-08-2009, 10:06 PM

I did not read where they can justify such action or even try to for that matter except if they have a had a green card for less than three years—how would that change anything I wonder? . The article says that the state pays nearly 65,000 per family for health care and the recession has made it impossible to continue. I mean how one picks which legal citizen will not longer receive care is mindboggling.

The other thing I found the article says they do not qualify for Medicare, why do these people not qualify for Medicaid if they are legal citizens

I found it frightening and a harbinger of things to come if this bill gets forced on the populace with no forethought to the future finances of this overwhelming plan.

IaNsSyAlNuE

08-08-2009, 10:12 PM

I found it frightening and a harbinger of things to come if this bill gets forced on the populace with no forethought to the future finances of this overwhelming plan.

It is VERY scary AND WRONG!

However the one irk that I noted in your article is the pack of smokes next to the woman who will no longer recieve heath care. IMO she needs to quit that habit at at least 7 dollars a day thats 2,604 . She has no job but taxpayers are probably paying for them through welfare and would have to pay for her lung cancer if that came about and she coud save and buy her meds with the 2,604 dollars a year she no longer spends on smokes.

trainer6

08-09-2009, 06:07 PM

It is VERY scary AND WRONG!

However the one irk that I noted in your article is the pack of smokes next to the woman who will no longer recieve heath care. IMO she needs to quit that habit at at least 7 dollars a day thats 2,604 . She has no job but taxpayers are probably paying for them through welfare and would have to pay for her lung cancer if that came about and she coud save and buy her meds with the 2,604 dollars a year she no longer spends on smokes.

Isn't that the truth. I don't think their "sympathy" examples are really going over well with many people.

Gary_Tibbs

08-09-2009, 08:54 PM

You are right, you are not American. Is Canada so perfect that there is no one there to discuss your relevant issues with? It isn't cute to put down or make fun of other posters either.
IMO

In Canada, people do not go bankrupt because they have a medical condition;

In Canada, people are not denied because they have a pre-existing condition.

In Canada, everyone qualifies and are not turned down.

Thanks for the education Lyndawitha"Y. I appreciate your posts.

Barbara2

08-09-2009, 09:09 PM

If they are LEGAL immigrants then they're either American citizens or on the way to becoming so. They have done nothing wrong, they're LEGAL. Did I misunderstand your point?

No, you did not misunderstand. Massachusetts is having a problem paying for health care and are looking to make cuts. Cutting out the legal immigrants is one plan proposed.

Here is the article again:
http://www.nytimes.com/2009/07/15/us/15insure.html

BOSTON — The new state budget in Massachusetts eliminates health care coverage for some 30,000 legal immigrants to help close a growing deficit, reversing progress toward universal coverage just as Congress looks to the state as a model for overhauling the nation’s health care system.
The affected immigrants, permanent residents who have had green cards for less than five years, are now covered under Commonwealth Care, a subsidized insurance program for low-income residents that is central to the groundbreaking health care law enacted here in 2006.

Jumbo1

08-10-2009, 02:22 AM

desmom

08-10-2009, 02:34 AM

I have BC/BS and absolutely love them. I even had a stent put in two years ago and never had to pay a penny.

I was in a health care focus group last year and the ONLY people in the room who loved their plans were BC/BS people -- almost half of them.

We have been under two BC/BS programs. One BC/BS was out of NY - home base to my husband's employer. Now those people are absolutely wonderful! Never had a problem......until..........

The 2nd was when hubby's corporate office and BC/BS worked out a deal with a nation wide BC/BS. Basically what it boiled down to was each state's BC/BS main office would handle the claims for the employees in that state.

Let the nightmares begin...Rx that were covered in Dec by the NY office were denied in January by the IL office and that was just the beginning. It went down hill from there. The following year, hubby's employer dumped BC/BS in every state but NY, home to corporate office. Thank goodness!

BC/BS of NY rawked for us. A super group of reps!

jmo

ellegna

08-10-2009, 11:12 AM

I've never heard of a single policy that pays no more than 20 percent.

Here's an example from Manulife Canada

http://www.coverme.com/LH/CoverMe/Consumer/BenefitDetails.jsp?lang=E&province=ON&MKT=Manulife.ca&module=P&webPlanId=001006&planType=FX&planCoverageType=C&ref=productInfo_comboPlus

Here are the monthly rates for a single individual

https://secure.lhplans.com/LH/CoverMe/Consumer/Step3a.jsp?lang=E&province=ON&MKT=Manulife.ca&module=P&command=load

Enhanced family rate is approx $400 per month

My extended health benefits are paid by my employer as part of our collective agreement. The % paid out and yearly max amounts are higher than what is quoted on Manulife's site. Group rates are negotiated between the employer and carrier. The more members enrolled, the greater the package.

drgnrtz

08-10-2009, 12:29 PM

Here's an example from Manulife Canada

http://www.coverme.com/LH/CoverMe/Consumer/BenefitDetails.jsp?lang=E&province=ON&MKT=Manulife.ca&module=P&webPlanId=001006&planType=FX&planCoverageType=C&ref=productInfo_comboPlus

Here are the monthly rates for a single individual

https://secure.lhplans.com/LH/CoverMe/Consumer/Step3a.jsp?lang=E&province=ON&MKT=Manulife.ca&module=P&command=load

Enhanced family rate is approx $400 per month

My extended health benefits are paid by my employer as part of our collective agreement. The % paid out and yearly max amounts are higher than what is quoted on Manulife's site. Group rates are negotiated between the employer and carrier. The more members enrolled, the greater the package.

my 27 yr old son happens not to have a dental or med plan from work. just for curiosity sake i filled out the form to see what it would cost him. the basic plan for meds, dental, vision, extended hospital coverage, travel insurance, would be $47 per month. on top of that it also includes a life insurance, dismemberment policy of $25,000. being that just a life insurance policy for $25,000 would cost him approx. $15 per month that would mean his meds, dental, vision, ex. hospital, travel would work out to $32 per month, quite reasonable i think. myself, if i had no coverage from my work the enhanced plan at $72 per month would be my choice.

Details

08-10-2009, 01:46 PM

baltoman99

08-10-2009, 01:48 PM

51%? Guess they're the same ones who don't have a clue that the government already controls Medicare. Oh well, nothing new. I guess it's easier for some to spew without actually knowing what they're spewing about.

Carol25

08-10-2009, 02:30 PM

Rassmussen - they have a really bad record on accuracy. Always several points off - and always in the same direction.

I fear insurance FAR more than government. My medical decisions today are made by a company that decides whether or not to keep me healthy, whether or not to save my life, by whether or not it will make a profit for them. That is terrifying. Give me an accountable government agency any time, any day. Burocrats responsible to elected politicians who have to keep us happy to retain their jobs - that's a far better choice to decide what is and is not covered.

I guess it what you have experienced, Details. I have had a few operations and many tests and have been denied nothing. That goes to show about the differences in health care options...especially when the options are not disclosed.

I cannot compare mine with the governmennts policy because they make the plan so amibguous and long, it difficult to sort out. With any commercial plan, you get the facts, short and sweet.

Take a look at California. The state is broke and so is the national government. Would you want the state California mandate an government policy for you? As goes California...so goes the nation...I've heard.

Scared of the government when they protect unions and Congress from their own made up plan. ABSOLUTELY!! Scared of my insurance? Definitely not. From may own experience.

Cash for Clunkers was well thought out, now wasn't it? JMO

Carol25

08-10-2009, 02:32 PM

IaNsSyAlNuE

08-10-2009, 02:32 PM

Excuse me..I am not comparing..this link
http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared
is just showing the comparisons of Canada and US and how Illegal Immigrant's use of Health Care effects each..If you dont wish to read and learn..thats your choice..but please dont accuse me of suggesting anything..

BTW..Canada is under the Universal HC..and US has their Private/Govt/and other funded HC..So read it and see how you (US) guys and us (Canadians) deal with the same drain to the system..You have to realize this strain on the system will not change regardless of whatever HC reform US adopts..

Please dont shoot the messanger..I only wish to share what I have learned..

LMS

Shoot the messenger? LOL You gave two links one to US and Canada being compared...then one to Canada Only. There was VERY little in your first link.. in fact a paragraph in the article you linked to which says EXACTLY what I CLAIMED. LOL Here it is:

Illegal immigrants, more prevalent in the U.S. than in Canada[citation needed], also add a burden to the health care system, as many of them do not carry health insurance and rely on emergency rooms — which are legally required to treat them — as a principal source of care.[62] In Colorado, for example, an estimated 80% of illegal immigrants do not have health insurance

We have an estimated 10-20 million illega immigrants, while you have 35,000. Then you quote an article how Canada deals with LEGAL immigrants, NOT illegal. Again apples to oranges. :smile:

IaNsSyAlNuE

08-10-2009, 02:50 PM

Yep.

And in ALL the versions of this bill, illegal aliens AND their families will be covered.

I wonder how Canada would pay for an influx of 10 million to 20 million illegal aliens and the strain it would put on their already overtaxed system?

Not to mention the articles and studies BY CANADA which show people dying while waiting for health care.

Seems some Canadians wants to cite the 18,000 we have dying here without health insurance. Very, very bad, however if one takes Canada's numbers of those waiting for brain, heart, bariatric surgery and cancer treatment who die while waiting it is almost the EXACT same %.

Take 18000 ( without health insurance) with a popuation of 300 million -US
And then take, 1050 dying while waiting with a population of 33 million-Canada .

http://www.vancouversun.com/health/Obese+dying+while+waiting+weight+loss+surgery/1655573/story.html

http://www.bcpwa.org/articles/news_release_aids_patients_dying.pdf

http://www.vancouversun.com/health/Obese+dying+while+waiting+weight+loss+surgery/1655573/story.html

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1728656

IaNsSyAlNuE

08-10-2009, 03:00 PM

Goody ..Humm..your numbers seem rather off..but as you said..I am NOT AMERICAN..and should keep my mouth shut..and just for you will not even bother to explain "The other side"..as you obviously have in concrete your opinion..no room for outside info..solid closed eared opinions..and why bother trying to educate yourself..Its all garbage, right?..So please for your own peace of mind..and too lessen your stressor..just ignore whatever I say..I would thankyou for that...It is really difficult to try to speak about an issue with someone who has both fingers in their ears, and chanting.."LALALALAL"..So with that..SALUT!
LMS

The grass is not "greener" on the "other side" you have people dying and living in pain while waiting for 'health care' there. The fact that you preach that your system is so much better when in FACT it is lacking and in trouble is alarming.

Until your system is perfected without people dying while waiting for heart surgery, bariatric surgery, brain surgery, etc then please stop acting as if Canada's system is so much better than here. Since Canadians are dying while waiting and suing for the RIGHT to obtain PRIVATE sector insurance so they can be treated there are problems. BIG problems with your system, period.

http://www.vancouversun.com/health/Obese+dying+while+waiting+weight+loss+surgery/1655573/story.html

http://www.bcpwa.org/articles/news_release_aids_patients_dying.pdf

http://www.vancouversun.com/health/Obese+dying+while+waiting+weight+loss+surgery/1655573/story.html

Patients Sue for Private Health Insurance in Ontario

http://www.canadafreepress.com/index.php/article/936

Chaoulli v. Quebec (Attorney General)

http://www.healthcoalition.ca/2006CSS-CHC-e.pdf

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1728656

IaNsSyAlNuE

08-10-2009, 03:03 PM

I've never heard of a single policy that pays no more than 20 percent.

Quite, neither have I. Depending on if it is a PPO, HMO or whathaveyou. It goes from anywhere from 50 percent paid up to 80% and if you want to pay higher premiums then it can pay 100 percent.

desmom

08-10-2009, 03:03 PM

Rassmussen - they have a really bad record on accuracy. Always several points off - and always in the same direction.

I fear insurance FAR more than government. My medical decisions today are made by a company that decides whether or not to keep me healthy, whether or not to save my life, by whether or not it will make a profit for them. That is terrifying. Give me an accountable government agency any time, any day. Burocrats responsible to elected politicians who have to keep us happy to retain their jobs - that's a far better choice to decide what is and is not covered.

I fear them too Details and I think we have good reason to fear them

Insurance Won't Pay NorCal Mom's Cancer Treatment
http://cbs5.com/local/cancer.treatment.denied.2.1007394.html

Treatment Denied; Woman Fights On
http://abclocal.go.com/wpvi/story?section=news/health&id=5401022

They authorized back surgery but denied his $148,000 claim
http://www.chicagotribune.com/news/columnists/chi-tue-problem-insurance-0721jul21,0,5666288.column

Report: UnitedHealth/PacifiCare faces state fines of up to $1.33B
http://www.bizjournals.com/losangeles/stories/2008/01/28/daily16.html
the state Department of Managed Health Care alleges that 30 percent of the medical claims at PacifiCare it reviewed were improperly denied.

PacifiCare fined $3.5 million for claims-processing violations
http://healthcare-economist.com/2008/01/31/pacificare-fined-35-million-for-claims-processing-violations/

Details

08-10-2009, 03:08 PM

I guess it what you have experienced, Details. I have had a few operations and many tests and have been denied nothing. That goes to show about the differences in health care options...especially when the options are not disclosed.

I cannot compare mine with the governmennts policy because they make the plan so amibguous and long, it difficult to sort out. With any commercial plan, you get the facts, short and sweet.

Take a look at California. The state is broke and so is the national government. Would you want the state California mandate an government policy for you? As goes California...so goes the nation...I've heard.

Scared of the government when they protect unions and Congress from their own made up plan. ABSOLUTELY!! Scared of my insurance? Definitely not. From may own experience.

Cash for Clunkers was well thought out, now wasn't it? JMOHave you read your health care plan - really? It's a phone book! It's not short and sweet - you only get to see a small part of it for sign up, because after all, with work, you really have little enough choice.

I've had little enough trouble - but I know of plenty of people who have had trouble. Of course - I'm a valuable computer programmer - businesses put on a good plan to secure my services. My sisters, their husbands - they work at ordinary jobs, smaller stores - and when you need services, they will do anything they can to gouge you for it.

And you can't have missed the REAL stories of REAL people who were dumped when they needed their insurance most, who had delays in vital treatments that caused either worse problems or death - right? The woman who had acne once, and they tried to deny treatment for breast cancer because of it? The delay let the breast cancer spread, made the operation more risky, increases her odds of future cancer by a lot. Others who were flat out dumped when they needed expensive medical care. Industry executives testified about the practice - it's no secret. They don't bother doing it when you are healthy - but if you get sick, something long term that will cost money, they go over your initial application - any little thing they can find incorrect, any typo - and they dump you.

This is the reality for those of us who don't have good work medical insurance. And that's a lot of people. Lose your job - and you'll be right there with them. Cobra is unaffordable - costs more than a mortgage payment. You have to get something individual, and the costs are obscene, the coverage is flimsy, and any real problem and they'll do all they can to make you pay. I know someone who will literally die if his wife ever loses her job - because COBRA is unaffordable (really - you would not believe what it costs), no private insurance would ever cover him (they decline you outright, or offer emergency only coverage at a price in multiple thousands a month), and ER care alone would kill him - he's got a congenital heart defect being managed with medication and occasional open heart surgery. Who do I trust with his life? NOT some idiot who wants to cut costs and make profits. They've been enough trouble already, even with good health insurance.

That's for profit medical insurance. You are worth what money they can get from you. That's all there is to it.

Cash for Clunkers was very well thought out. So well done that tons of people LOVED the program. It was designed and intended to be a limited program - and because of it's popularity, hit the limit very fast. California is having it's problems - but essential services remain funded - my kids still go to school, everything is still working fine.

Mimi428

08-10-2009, 03:30 PM

If our current health care system is such a disaster and one of the root causes for our economic woes, then why is Obama so adamant that the vast majority of us will be able to keep our current healthcare plan if we want to do so?

You are combining two different things & then pretending they are one.

The problem is that there are so many UN-insured & UNDER-insured.

Has not got a blessed thing to do with those who have sufficient insurance at a reasonable cost.

And since those with sufficient health insurance at a reasonable cost are not part of the problem - there is no need for them to be forced off their current plans.

IaNsSyAlNuE

08-10-2009, 04:19 PM

If you'd like to know about truthout.org it would probably be more informative to GO TO truthout.org rather than wikipedia.

http://www.truthout.org/about

I wonder why you keep addressing this minute portion of my original post to you Why not the bigger picture. It's not going to change the fact it is a left leaning site promoting fear mongering...

IaNsSyAlNuE

08-10-2009, 04:24 PM

Here's an example from Manulife Canada

http://www.coverme.com/LH/CoverMe/Consumer/BenefitDetails.jsp?lang=E&province=ON&MKT=Manulife.ca&module=P&webPlanId=001006&planType=FX&planCoverageType=C&ref=productInfo_comboPlus

Here are the monthly rates for a single individual

https://secure.lhplans.com/LH/CoverMe/Consumer/Step3a.jsp?lang=E&province=ON&MKT=Manulife.ca&module=P&command=load

Enhanced family rate is approx $400 per month

My extended health benefits are paid by my employer as part of our collective agreement. The % paid out and yearly max amounts are higher than what is quoted on Manulife's site. Group rates are negotiated between the employer and carrier. The more members enrolled, the greater the package.

Do I understand this correct? You have the government insurance (which is financed through tax revenue and other avenues) then your employer pays an additional 400 dollars a month for health insurance for your family or somewhere there about? If your employer did not pay that additional money would you make those additional dollars in your paycheck?

Why would you need the additional insurance through your employer?

drgnrtz

08-10-2009, 04:39 PM

Do I understand this correct? You have the government insurance (which is financed through tax revenue and other avenues) then your employer pays an additional 400 dollars a month for health insurance for your family or somewhere there about? If your employer did not pay that additional money would you make those additional dollars in your paycheck?

our government insurance does not cover dental, meds(out of hospital)or vision(glasses). if we want insurance for those things we pay it ourselves or the employers supply it. employers get it at a better rate than if we purchase it on our own, the $400 is an example of privately purchasing it for a family.

if the employer supplies it, the premiums paid are added to our income and we pay taxes on it, if we pay for it ourselves privately we can use it as a deduction.

Susan43

08-10-2009, 04:45 PM

Except for the seniors and disabled on Medicare whose plans will be cut by billions.:rolleyes: What are they to do?

http://www.whitehouse.gov/realitycheck/?e=10&ref=image

IaNsSyAlNuE

08-10-2009, 05:15 PM

our government insurance does not cover dental, meds(out of hospital)or vision(glasses). if we want insurance for those things we pay it ourselves or the employers supply it. employers get it at a better rate than if we purchase it on our own, the $400 is an example of privately purchasing it for a family.

if the employer supplies it, the premiums paid are added to our income and we pay taxes on it, if we pay for it ourselves privately we can use it as a deduction.

Okay, thank you, I understand now. So I pay 446.00 for a family of three monthly for health insurance. This includes, 3 dollar generic scripts, 18 dollar brand name scripts, vision screenings ( not the cost of glasses) The payout is 80-20-- meaning I pay 20 percent up to the deductable of 1500 dollars per person with a 2 million dollar cap. It does not cover dental, but I buy a separate policy and that is 56 dollars a month covers orthodontics as well. So I pay 502 a month for everything -- about a hundred dollars more than one would pay for just supplemental insurance in Canada?

Do you have a co pay with the supplemental does it pay one hundred percent of dental, vision and drugs? Or do you pay a % up to a certain amount like I do?

Thank you for the information!! it is much appreciated!

drgnrtz

08-10-2009, 05:21 PM

http://www.whitehouse.gov/realitycheck/?e=10&ref=image

i see more crap flying, something else to throw and see if it sticks.

Susan43

08-10-2009, 05:40 PM

Obama is lying to the American people!! JMO

Right now I have a great health insurance yes medicare/medi cal MEDIcare and medicaid need to be for elderly and disabled..

Because of my medicare through my dad because i m disabled I was able to go back to a medical group I waas belonged to when i had my parents' health insurance. my parents are retired..

Yesterday, I had to uregent Care @ the medical group. I thoughtI had to wait 2 to 3 hours to see a dr.. I was out of there by 3:45 with all my tests being done and with my prescription. I got there at 1:20 PM.. They have a system where you can call ahead and let them know that you are coming to uregent care.. they gave me "time" to show up..

Imagine if we have a gov health care!!!

We do have gov health care. Medicare and medicade and SCHIP and as far as I know no one is willing to give it up. Just think no pre-existing conditions, no one questioning what doctor you can see and no one questioning our tests and meds. Now name me one insurance company that guarantees that?

ETA I just reread your post. And I think it is wonderful that you are able to get insurance through your parents policy. But how about the rest of the people your age that are sick? Or are you one of those that has yours and the heck with everyone else? And lets hope your dad doesn't get sick and/or lose his job.

IaNsSyAlNuE

08-10-2009, 05:45 PM

drgnrtz

08-10-2009, 05:53 PM

Okay, thank you, I understand now. So I pay 446.00 for a family of three monthly for health insurance. This includes, 3 dollar generic scripts, 18 dollar brand name scripts, vision screenings ( not the cost of glasses) The payout is 80-20-- meaning I pay 20 percent up to the deductable of 1500 dollars per person with a 2 million dollar cap. It does not cover dental, but I buy a separate policy and that is 56 dollars a month covers orthodontics as well. So I pay 502 a month for everything -- about a hundred dollars more than one would pay for just supplemental insurance in Canada?

Do you have a co pay with the supplemental does it pay one hundred percent of dental, vision and drugs? Or do you pay a % up to a certain amount like I do?

Thank you for the information!! it is much appreciated!

sounds like you have a really good plan. ya, if we have to pay for supplemental on our own they really soak us for it. group plans are soooo much cheaper.

i pay 3.49 per script, generic if available, otherwise brand name.
dental 95%, yearly limit $2000
vision script covered 100% with $200 towards frames every 2yrs.

IaNsSyAlNuE

08-10-2009, 06:07 PM

sounds like you have a really good plan. ya, if we have to pay for supplemental on our own they really soak us for it. group plans are soooo much cheaper.

i pay 3.49 per script, generic if available, otherwise brand name.
dental 95%, yearly limit $2000
vision script covered 100% with $200 towards frames every 2yrs.

I should have been more clear on the dental. My dental pays for 2 cleanings a year and one panoramic ( every three years) and I can't recall how many bite wings. Fillings are almost covered at 100 percent for silver fillings ( white is extra), sealing a childs tooth is covered 100 percent ( their molars so they do not get cavities). , floride treatments etc, Now move onto bridge work, root canal, that sort of thing. I pay 50% of cost. And only up to 1500 a year.

R~O~S

08-10-2009, 06:09 PM

If our current health care system is such a disaster and one of the root causes for our economic woes, then why is Obama so adamant that the vast majority of us will be able to keep our current healthcare plan if we want to do so?

Because he's confident that once the plan goes into place, it will bring down the cost of private insurance because they'll be losing customers on the profit side by maintaining multimillion dollar salaries and refusing covered care on technicalities like failing to mention you had acne when you were 14 to avoid paying for the removal of a brain tumor when you're 60.

Details

08-10-2009, 06:10 PM

If our current health care system is such a disaster and one of the root causes for our economic woes, then why is Obama so adamant that the vast majority of us will be able to keep our current healthcare plan if we want to do so?Because it's a scare tactic used by the Republicans - that you'll be forced into socialized medicine (never mind that our socialized medicine program is hugely popular, has lower overhead than private medical insurance, and works) - so emphasizing that this is a choice diminishes that fear - irrational as it is.

And, as others have stated - if you have current healthcare - you're one of the lucky ones, and not one of those with the most urgent need. People who are uninsurable with preexisting conditions, people who are uninsured, people working for small companies that can hardly get any type of insurance at all - those are some of those who most badly need this.

Our current health system IS a disaster. Just look at the stats. We have WORSE - by far - medical outcomes - lower survival times for cancer patients, infant death rates that are far too similar to third world countries. We pay MORE, per American citizen, for that worse health care that does not cover every American citizen, than other first world countries pay for their BETTER health care that covers EVERY citizen - and often more than that.

There's no question our health care system is a disaster. Hospitals bankrupted by uninsured having to use them as a medical plan, people bankrupted by medical issues (one of the most common reasons for personal bankruptcy), bad medical outcomes, lower numbers on any measure of how good your medical system is, than any country with universal health care.

We pay more, to get a lot less. That is a disaster.

drgnrtz

08-10-2009, 06:14 PM

So I went to this website that was listed by someone else in the thread and it says:

CoverMe Health And Dental Insurance

http://www.coverme.com/knowledge-centre/faqs.jsp?MKT=Manulife.ca

What does my government plan cover?

Every province and territory has a different health plan. However, the following are usually not covered by government health insurance plans:

Prescription drugs
Dental checkups and treatment
Hospital stays
Specialized care, including speech therapists or pathologists, physical therapists, chiropractors, and many more
Homecare and nursing
Medical supplies and equipment
Emergency medical health treatment for travellers
Personal emergency response
Hearing aids
Accidental death and dismemberment
Catastrophic coverage

So what does the government insurance cover?

not sure why it says hospital stays are not covered.

it covers doc visits, specialists visits, hospital care & meds while in hospital, tests, non elective surgeries, dialysis, in hospital cancer treatments. ontario has ccac which helps with care after hospital stays.

Hospital stays
i think i figured it out, the government plan covers ward, not semi or private rooms.

Susan43

08-10-2009, 06:21 PM

They're going to question your tests and meds. They gov't will even decide if you can be re-admitted to a hospital.

I think you are being naive.

imo

And I think you are being just a tad disengenious. I also think you are mixing up the insurance companies with medicare.

Of course you are probably believing someone on the right that said this. But honestly, it should be obvious by now that they have been lying through their teeth. Probably because the insurance companies are spending millions to fool people.

desmom

08-10-2009, 06:26 PM

They're going to question your tests and meds. They gov't will even decide if you can be re-admitted to a hospital.

I think you are being naive.

imo

Insurance companies do that now. jmo

drgnrtz

08-10-2009, 06:26 PM

I should have been more clear on the dental. My dental pays for 2 cleanings a year and one panoramic ( every three years) and I can't recall how many bite wings. Fillings are almost covered at 100 percent for silver fillings ( white is extra), sealing a childs tooth is covered 100 percent ( their molars so they do not get cavities). , floride treatments etc, Now move onto bridge work, root canal, that sort of thing. I pay 50% of cost. And only up to 1500 a year.

same here 2 cleanings and 1 panoramic every 3 yrs. i always get white. shes trying to get rid of all my old silver fillings. dont have lil kids so dont know bout that.

Mimi428

08-10-2009, 06:30 PM

They're going to question your tests and meds. They gov't will even decide if you can be re-admitted to a hospital.

I think you are being naive.

imo

Are you referring to Medicare? They are proposing to make hospitals absorb the costs for readmissions that are caused by the patient being discharged too early. That is not even remotely close to denying you the opportunity to be readmitted.

What 'factual information' were you relying on for the false claim that the government will decide IF you can be readmitted?

Mimi428

08-10-2009, 06:38 PM

Obama is lying to the American people!! JMO

Right now I have a great health insurance yes medicare/medi cal MEDIcare and medicaid need to be for elderly and disabled..

Imagine if we have a gov health care!!!

<snipped>

You have government health care - & by your own admission, you are happy with it.

R~O~S

08-10-2009, 06:39 PM

I form my own opinions based on factual information, thank you.

I don't "think stuff" because someone said it. :rolleyes:

Is that how you form your opinions? Because Obama said so?

imo

Apparently not, otherwise you'd be able to point to that "factual information" rather than telling us we need to "read between the lines" in order to find your interpretations.

Details

08-10-2009, 06:42 PM

Are you referring to Medicare? They are proposing to make hospitals absorb the costs for readmissions that are caused by the patient being discharged too early. That is not even remotely close to denying you the opportunity to be readmitted. ...Yeah, I love that one. Right now, with insurance companies, there's pressure to kick you out as fast as possible. This will put a contrary pressure on - if they kick you out sooner than is medically appropriate, they'll pay a price for it.

Mimi428

08-10-2009, 06:52 PM

Except for the seniors and disabled on Medicare whose plans will be cut by billions.:rolleyes: What are they to do?

Everything I have read about Medicare indicates cuts are being proposed whether or not any healthcare reform is enacted.

desmom

08-10-2009, 07:05 PM

Here's a link so you can get informed. :smile:

http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/Kennedy-Lets-Ration-Health-Care-51145997.html

The link is based on one paragraph of the Newsweek article and is an opinion piece. You can read the article here: http://www.newsweek.com/id/207406/page/1

Mimi428

08-10-2009, 07:06 PM

Here's a link so you can get informed. :smile:

http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/Kennedy-Lets-Ration-Health-Care-51145997.html

Thanks for that link, much appreciated.

Kristol is entitled to his opinion, but that does not make it a fact.

Medicare & other insurers have ways to kick out claims if certain factors are present. With a traditional insurance company, the claim is denied & the burden is on the patient to cough up the money. Not so with Medicare - that denial would have to be absorbed by the hospital.

In order for Kristol's scenario to have even the possibility of coming true, Medicare would have to enact a pre-certification program (like insurance companies have). When you read or hear of that, that's the time you can begin to imagine that the possibility will exist that Medicare enrollees will be denied admission. Until then, what Medicare will do is deny PAYMENT to the hospital AFTER the readmission, if they determine that the readmission was due to premature release.

JMO

R~O~S

08-10-2009, 07:31 PM

Wait, let me get this straight---per Susan43, the right is lying and the left is being truthful?

So, what do you say to the majority of Americans who do not want this health reform bill? Do their voices not count?

I would doubt a majority of Americans are against this health reform bill, mainly because there isn't yet a bill presented for vote.

That's kinda what all this discussion is about. I'm surprised you didn't know that.

Not Telling

08-10-2009, 08:24 PM

They're going to question your tests and meds. They gov't will even decide if you can be re-admitted to a hospital.

I think you are being naive.

imo

What insurance company doesn't question or demand rationalization from doctors as to why they order tests, treatments, hospitalizations and meds and maintain their right to refuse payment for any of those if they disagree with your doctor and they (without medical degrees) decide it's unnecessary? Many people are unaware of this because it is automatically taken care of by the service provider at the time of billing... Medical billing must provide diagnosis, testing and procedure codes for every individual service they expect to receive payment for...The provider must have proper documentation and test results (when appropriate) to justify their diagnosis and treatment available for insurance companies to review if the provider submits a claim to insurance.

Doctors recommend a course of treatment, the insurance company decides what they will pay for... Insurance companies decide which doctors, hospitals, tests, and medications they will cover...not your doctor.... Unless your insurance provides 100% coverage, which is rare these days and almost unaffordable, even if your doctor recommends that you need the best services available but they are out-of-network, and adequate services are available in-network, the insurance company will only cover the services at the out-of-network rate... Many insurance companies require pre-authorization for services for any non-life-threatening conditions... Many insurance companies have limits for the maximum amount of coverage they will provide...

No one can deny you the right to be hospitalized or reasonable and customary medical care if it is needed and ordered by a doctor... Can insurance companies deny payment for services, yes they can... Can medical providers refuse to provide services based on the patients inability to pay, yes they can, unless your condition is immediately life threatening...and then they are only required to provide enough care to stabilize your immediate condition... jmo

blueberri

08-10-2009, 08:25 PM

I suppose you have links to prove all of this. TIAThe health care system we have in Canada is NO COMPARISON to the blank cheque BO is trying to force on Americans. Some of the posts by a fellow Canadian are full of half truths, Canadians can be, and are denied medical insurance because of pre-existing conditions, anyone who thinks for one minute that Canadians don't need to carry additional medical insurance, are wrong. http://www.cbc.ca/canada/nova-scotia...ey-cancer.html

Barbara2

08-10-2009, 08:31 PM

same here 2 cleanings and 1 panoramic every 3 yrs. i always get white. shes trying to get rid of all my old silver fillings. dont have lil kids so dont know bout that.

We helped out a poverty student several years ago. She was on Medicaid and needed a root canal. Medicaid wouldn't pay for a root canal, only an extraction. The girl was 14 years old. So we paid the dentist anonymously and told him to do the root canal. That so far has been my only experience with government funded medicine.

Susan43

08-10-2009, 10:13 PM

Wait, let me get this straight---per Susan43, the right is lying and the left is being truthful?

So, what do you say to the majority of Americans who do not want this health reform bill? Do their voices not count?

LOL This post is rich coming from the very people that have tried to disrupt any healthcare meetings where the facts might come out.

Maybe I'm crazy but it seems to me that the people spoke last Nov. It was no secret that Obama planned to overhaul our healthcare system and yet he still got 10 million more votes. So it seems to me that you just might be wrong when you say that the majority of the people are against reform.

But what you really seem to be missing is that if you like your insurance you will not be forced to change.

Linda Douglass of the White House Office of Health Reform debunks the myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.

http://www.whitehouse.gov/realitycheck/3

MiamiNice1

08-10-2009, 10:29 PM

Maybe you are crazy and maybe you aren't! I would certainly never be presumptuous enough to believe that I know for sure and I admire you very much for admitting the possibility. If it is a real concern, though, I would suggest that you take care of yourself first!

But there may well be other reasonable explanations for why you believe the things that you believe in!

I think with a little more open and honest discussion we may get many of these issues behind us. Or at least I hope so!!!

:wub:
Sigh. Too bad the boycott seems to be over. ;)

imo

MiamiNice1

08-10-2009, 10:46 PM

It is funny. That is the problem when the fringe on either side think their information is the absolute truth.
Very true and good observation. The truth always lies somewhere in the middle of left and right.

imo

MiamiNice1

08-10-2009, 10:50 PM

Breaks my heart but give it time.

Some have a tendency to go charging headlong out of the penalty box only to fall over their skates!

:laugh:
Love those sports analogies! :lol: Certainly seems this is what has happened to Obama's healthcare plan.

imo

Susan43

08-10-2009, 11:45 PM

Don't Let the Myths About Health Care Reform Scare You.

http://aarp.convio.net/site/PageNavigator/Myths_vs_Facts

Here is some excellent info. :thumbup:

IaNsSyAlNuE

08-10-2009, 11:53 PM

Don't Let the Myths About Health Care Reform Scare You.

http://aarp.convio.net/site/PageNavigator/Myths_vs_Facts

Here is some excellent info. :thumbup:

First thing I would like to ask AARP "link please". They make all kinds of statements but do not link to the actual bill itself and each line in question.

So again AARP, link please. :glare:

daniel green

08-10-2009, 11:54 PM

Don't Let the Myths About Health Care Reform Scare You.

http://aarp.convio.net/site/PageNavigator/Myths_vs_Facts

Here is some excellent info. :thumbup:

Thanks and it's so good to see you!!!!

From the link:

Myth: Health care reform is too expensive – we can't afford it.
Fact: The President and Congress have committed to producing legislation that will be paid for so it won't saddle our children and grandchildren with debt.

Fact: If we do nothing to fix health care, families with Medicare or employer-based health coverage will likely see their premiums nearly double again in the next seven years.

Fact: If we do nothing to fix health care, the share of your income spent on health care will nearly double in the next seven years.

Bottom Line: When one in three Americans say someone in their family skipped pills, postponed or cut back on needed medical care due to the cost; when countless bankruptcies are related to medical expenses; when the number of uninsured approaches 50 million; when government spending on health programs rises so rapidly that it jeopardizes other priorities; and when employers struggle to pay for the costs of health care, the fact is, we can't afford not to fix health care.

juliekan

08-10-2009, 11:55 PM

Gary_Tibbs

08-10-2009, 11:59 PM

Don't Let the Myths About Health Care Reform Scare You.

http://aarp.convio.net/site/PageNavigator/Myths_vs_Facts

Here is some excellent info. :thumbup:

I am glad that the health care myths are coming to light as they should. We need health care reform for the health of our country!

IaNsSyAlNuE

08-11-2009, 12:01 AM

from the article by AARP:
"There are special interest groups trying to block progress on health care reform by using myths and scare tactics. Like the notion that health care reform would ration your care, hurt Medicare or be a government takeover. Actually, these are false statements.'

"Help us fight the myths and demand health action now"

Funny, I just saw the spokesperson from AARP on tv tonight, and he absolutely denied that they were backing ANY plan.

Which special interest groups are trying to "block progress" on health care reform? Hmmm....AARP, let's get specific with your accusations. jmo

Strange, eh? Seems they have an agenda.. but are hiding it! Say it ain't so!! LOL

Susan43

08-11-2009, 12:01 AM

Thanks and it's so good to see you!!!!

From the link:

Nice to see you too!!!

I have been going to the AARP message boards and most of the intelligent posters don't seem to be as afraid as some of the people here. It kind of amazes me that people seem to think that AARP would just lie about things, but :shrug:

I was able to use some info from Media Matters to go directly to the bill to show that there is NO mandate that people have to be "counseled." Since I now know how to navigate the bill via Thomas if I can get the number of an issue I can easily find it so we can read it for ourselves.

Susan43

08-11-2009, 12:04 AM

from the article by AARP:
"There are special interest groups trying to block progress on health care reform by using myths and scare tactics. Like the notion that health care reform would ration your care, hurt Medicare or be a government takeover. Actually, these are false statements.'

"Help us fight the myths and demand health action now"

Funny, I just saw the spokesperson from AARP on tv tonight, and he absolutely denied that they were backing ANY plan.

Which special interest groups are trying to "block progress" on health care reform? Hmmm....AARP, let's get specific with your accusations. jmo

Of course they aren't backing any one plan. There are several versions so far and they are not taking sides. That is what I would expect them to do. But they are backing healthcare reform.

And I think they think we are smart enough to understand that the insurance industry is paying big bucks to try and derail the plan. But again, they are not taking any sides.

Lady_Jean_La

08-11-2009, 12:08 AM

Don't Let the Myths About Health Care Reform Scare You.

http://aarp.convio.net/site/PageNavigator/Myths_vs_Facts

Here is some excellent info. :thumbup:

It isn't the myths that scare people. imo

MercedesV

08-11-2009, 12:11 AM

Of course they aren't backing any one plan. There are several versions so far and they are not taking sides. That is what I would expect them to do. But they are backing healthcare reform.

And I think they think we are smart enough to understand that the insurance industry is paying big bucks to try and derail the plan. But again, they are not taking any sides.

Exactly. And the lobbying groups who don't want things to change because they have been making money hand over fist are all to happy to keep using scare tactics. What is really sad is the amount of misinformation being pushed on the public, and in some cases by public figures like former Gov's. Why not have an honest debate, why push false information?

Susan43

08-11-2009, 12:15 AM

Exactly. And the lobbying groups who don't want things to change because they have been making money hand over fist are all to happy to keep using scare tactics. What is really sad is the amount of misinformation being pushed on the public, and in some cases by public figures like former Gov's. Why not have an honest debate, why push false information?

The one thing that has made me so crazy is the lies. If they are so right about this, why do they keep lying? It's just nuts. Euthanasia and death squads...that is so nuts that if someone told me those lies I would never believe anything they ever said again. I despise liars.

BTW your inbox was full so I emailed my answer to you. LOL.

Susan43

08-11-2009, 12:45 AM

After you have read the proposed bill for yourself you will know whether someone is lying or not.
The section pertinent to seniors begins on pg. 425.
IMO

Will you please post the section number. I would appreciate it. TIA

IaNsSyAlNuE

08-11-2009, 01:02 AM

just using these "bullet points" and calling them facts is hardly reassuring to most of us imo.

What i would like to see is taking each of these points and not just reading them, and not even just reading the language in any proposed bill. I would like to have them take these proposals and take them down the path of how they will be implemented and what they will look like in real life. Many things that sound good on the surface have what are called unintended consequences. I think there could be a lot of unintended consequences that in practice could lead us into disaster.

exactly! ........................

Not Telling

08-11-2009, 01:08 AM

Exactly. And the lobbying groups who don't want things to change because they have been making money hand over fist are all to happy to keep using scare tactics. What is really sad is the amount of misinformation being pushed on the public, and in some cases by public figures like former Gov's. Why not have an honest debate, why push false information?

I heard tonight that the profits of the top ten insurance companies have increased 428% in the last seven years....Reason for this is they are paying a lot less in claims... How do you pay a lot less in claims...you deny them.... And raise premiums...

The average salary of the CEOs of the top ten insurance companies, is $11.9 million. But the CEO of CIGNA made $25.8 million in salary for 2007...and the CEO of United Health Care, the largest health insurance provider, has $774 million in unexercised stock options plus his salary...

Susan43

08-11-2009, 01:39 AM

I heard tonight that the profits of the top ten insurance companies have increased 428% in the last seven years....Reason for this is they are paying a lot less in claims... How do you pay a lot less in claims...you deny them.... And raise premiums...

The average salary of the CEOs of the top ten insurance companies, is $11.9 million. But the CEO of CIGNA made $25.8 million in salary for 2007...and the CEO of United Health Care, the largest health insurance provider, has $774 million in unexercised stock options plus his salary...

The CEO of Aetna was compensated $24M in 2008.

http://www.fiercehealthcare.com/story/aetnas-ron-williams-ceo-compensation/2009-05-14

Someone is probably going to ask for a link to the profit figure so I went and found one, but there are plenty of them.

http://food.change.org/blog/view/7_years_428_percent_profits

It's no wonder they are fighting so hard and spending so much lobbying.

daniel green

08-11-2009, 02:00 AM

Republicans have been trying to defeat health reform by scaring seniors that their Medicare benefits will be cut if the bill passes. House Minority Leader John Boehner (R-OH) and House Minority Whip Eric Cantor (R-VA) have made the false argument in recent weeks. Today, Rep. Marsha Blackburn (R-TN) repeated the myth in a phone interview with Memphis’ ABC affiliate. She offered a host of vacuous, Frank Luntz-approved talking points before making this statement: "Our seniors are saying, look don’t diminish Medicare. We have been paying into Medicare. That is pre-paid for us. It’s been coming out of our paycheck for 40 years. And they don’t want that Medicare to be diminished."

Watch it:

http://thinkprogress.org/2009/08/10/blackburn-medicare-myth/

daniel green

08-11-2009, 02:08 AM

http://www.huffingtonpost.com/2009/08/10/obama-reality-check-websi_n_255698.html

beattherap

08-11-2009, 09:07 AM

LOL This post is rich coming from the very people that have tried to disrupt any healthcare meetings where the facts might come out.

Maybe I'm crazy but it seems to me that the people spoke last Nov. It was no secret that Obama planned to overhaul our healthcare system and yet he still got 10 million more votes. So it seems to me that you just might be wrong when you say that the majority of the people are against reform.

But what you really seem to be missing is that if you like your insurance you will not be forced to change.

http://www.whitehouse.gov/realitycheck/3
i watched the douglass video and it's basically her and obama saying don't worry, if you like your insurance, you can keep it... no facts at all...

i still believe the 'myth'... at least Some people, in the millions, will lose insurance they like because government mandates will force those plans to close.

imo.

drgnrtz

08-11-2009, 10:31 AM

desmom

08-11-2009, 10:45 AM

i watched the douglass video and it's basically her and obama saying don't worry, if you like your insurance, you can keep it... no facts at all...

i still believe the 'myth'... at least Some people, in the millions, will lose insurance they like because government mandates will force those plans to close.

imo.

I think government mandates are needed.

Too many people have had claims denied. One should not have to call their health insurance company to argue over a denied claim that is clearly covered in their contract.

Health insurance companies are in it for the $$$. Denied claims = more profits. i.e......

United HealthCare fined $800,000
http://www.newsobserver.com/news/story/1152663.html

United Healthcare fined $364,750
http://www.azstarnet.com/allheadlines/119565

California fines two health plans $13 million
http://articles.latimes.com/2008/jul/18/business/fi-blue18

Health insurer fined $20,000 for improper claims denials
http://insurance.oregon.gov/news_releases/1996-1997/mrpacare.html

Empire Blue Cross Is Fined $1.1 Million, Setting Record
http://www.nytimes.com/1996/03/02/nyregion/empire-blue-cross-is-fined-1.1-million-setting-record.html

Mimi428

08-11-2009, 11:06 AM

ITA We need reform but I don't think this present plan is it. There are too many vital areas missing. The govt is broke and taking on more debt. Why haven't they mentioned coverage for catastrophic illnesses? Does anyone here know people who can pay for their own chemotherapy, radiation treatments, bone marrow transplants, etc.? There are so many people alive because insurance companies have covered these events, I don't think the govt can no matter how they "tweak" it.
Don't get me wrong, I do not like the profits or premiums of insurance companies, but there are so many alive now who have benefited from their coverage.
IMO

Until one proposal or another gets through both the House AND the Senate - there is no 'present plan'.

The proposal that has been referred to several times does not overlook catastrophic illnesses. The UNDER insured folks HAVE been poorly treated because of the lifetime limits that are in place. If legislation passes that eliminates those low maximum limits, the catastrophic illness problem is also eliminated.

Where is your concern for those who have no possibility of obtaining life-saving treatment because they have NO insurance at all?

Mimi428

08-11-2009, 11:19 AM

i watched the douglass video and it's basically her and obama saying don't worry, if you like your insurance, you can keep it... no facts at all...

i still believe the 'myth'... at least Some people, in the millions, will lose insurance they like because government mandates will force those plans to close.

imo.

What government mandates do you think will be put into place that will force insurance companies to stop selling policies that people like?

I can see a 20 year old male deciding that he 'likes' the cheap insurance policy that has a $100,000 lifetime limit. A person in that age group is very low risk, it is easy for someone like that to not have a clue that a policy with such a low limit would bankrupt them if they were to contract a serious illness.

So let's just say that one of the government mandates is that insurance companies can no longer put such a low lifetime limit on any policy. His insurance company will still be able to create & offer him a policy with NO lifetime limit - which would be different than the plan he has.

What, exactly, is wrong with telling insurance companies they must offer comprehensive coverage (which is what that mandate would be doing) & stop selling policies which offer very little protection?

beattherap

08-11-2009, 11:38 AM

tell me why those that cannot meet minimum standards, should not be forced to close.
let's take the preexisting condition coverage mandate... most insured don't have a preexisting condition ... if those insured like their coverage, why should the gov't. force the insurer to change the policy, possibly cancel the coverage, and effectively put the lie to obama's promise that if you like your insurance you can keep it...

the same for a mandate to eliminate lifetime caps...

or the mandate to cover well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under age 21... [the last place i worked years ago, that was offered as a rider to the basic coverage]...

i'm not against a gov't. plan; i am against falsehoods used to support or oppose such a plan.

imo.

R~O~S

08-11-2009, 11:48 AM

i watched the douglass video and it's basically her and obama saying don't worry, if you like your insurance, you can keep it... no facts at all...

i still believe the 'myth'... at least Some people, in the millions, will lose insurance they like because government mandates will force those plans to close.

imo.

If those plans close, it will be because they're offering an inferior product or something comparable to the "public option" at an elevated price.

Insurance offered through your employer is group coverage, when people drop from the group changing the dynamics of the group, re risk/cost to the insurer, the insurer has the right to withdraw the plan or not renew.

If the public option is less expensive with comparable benefits, you can be certain those plans will eventually be dropped unless the insurer regroups and puts a stop to the overhead costs that do not involve medical care such as management compensations that are obscene.

That's only good for both sides, costs go down for those currently in a plan. If and when this reform is actually passed, insurers will have to mend their ways, otherwise they won't have a consumer base. The insurer themselves will be out of business due to their own business practices.

Of course a lot of the insurers non medical overhead is lobby efforts, those will disappear completely since there won't be anything to lobby about any longer.

Mimi428

08-11-2009, 11:49 AM

You're right, he should not be allowed tomake his own choice. The government must save him from himself.

Since when is consumer protection a bad thing? Who is going to pay for his choices when he is diagnosed with testicular cancer? (something that typically strikes a very young age group) He's going to find out that the great insurance policy he THOUGHT he had isn't worth a bucket of spit for treating his malignancy.

The government does have a right to be interested in the general welfare & well being of all their citizens, as a whole. That doesn't amount to saving the 20 year old from himself, that amounts to saving the rest of the citizens from paying for his care AFTER he finds out that what he thought was a good policy was, in reality, a penny-ante excuse for health insurance that wasn't worth the premiums he paid.

Consumer protection. In this case, a 'lemon law' against paying for insurance that is completely ineffective.

R~O~S

08-11-2009, 11:54 AM

Mimi428

08-11-2009, 12:02 PM

You are so right! None of us should be allowed to make our own choices about what is best for ourselves and our families. We should place all of our choices and decisions firmly in the hands of the government so that we never have to fear making "mistakes".
I am so glad this is still a free nation and I am still free to make all of my own choices....... At least for now.

OK, let's just do away with any & all consumer protections. I'm sure you will have no problems whatsoever being able to ascertain whether the car you buy can or cannot withstand a 40-mph crash. You'll just have to use your superior abilities to know ahead of time if the house you buy has been built to proper codes or whether the foundation is going to collapse, or an electrical fire is going to start or the plumbing is going to hold up.

And who gives a crap whether your drinking water is fit to consume or your basement is full of radon - after all, you are smart enough to make your own choices, aren't you? Just yank out your crystal ball & consult it before you buy.

And if the kid sitting next to your child in school shows up with untreated TB, because his parents don't believe in modern medicine, you sure wouldn't want the health department to get involved, would you? Oh nooooooooooooo. That would be the baaaaad, baaaaad government, trying to protect your interests. Can't have that. Tsk, tsk, tsk.

beattherap

08-11-2009, 12:03 PM

Is there a no pre-existing condition mandate for the private insurer in any of the currently being discussed reform bills?

It was my understanding Obama is insistent the public option would not have a pre-existing condition clause. That's not a mandate for private insurers, it just means people who currently can't get coverage because of pre-existing conditions will now have the ability to get coverage through the public option.
i think sec. 111 of the house bill prohibits the use of preexisting condition exclusions.

MiamiNice1

08-11-2009, 12:06 PM

It isn't the myths that scare people.

imo
(bolding mine) Perfect rebuttal to this thread!

Once again, the supporters are choosing to ignore all the actual FACTS. Instead of thinking for themselves, they join the administration and attack people who are rightly concerned and trying to obtain clear explanations.

If "the plan" cannot withstand the light of truth shining on it, then there is something seriously wrong.

imo

Mimi428

08-11-2009, 12:20 PM

let's take the preexisting condition coverage mandate... most insured don't have a preexisting condition ... if those insured like their coverage, why should the gov't. force the insurer to change the policy, possibly cancel the coverage, and effectively put the lie to obama's promise that if you like your insurance you can keep it...

the same for a mandate to eliminate lifetime caps...

or the mandate to cover well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under age 21... [the last place i worked years ago, that was offered as a rider to the basic coverage]...

i'm not against a gov't. plan; i am against falsehoods used to support or oppose such a plan.

imo.

Sorry, I am not following your premise that most insured people don't have a pre-existing condition. Anyone who gets anything OTHER than a simple physical every so often could be considered to have a pre-existing condition should they lose their insurance coverage.

We heard just last week that about 250,000 people lost their jobs in the month of June.

Let's just say, for the sake of theory, they all had group employer health insurance before they lost their jobs.

How many do you believe will realistically become employed again in a short period of time? (less than 3 months, for example)

How many of those people do you believe will be able to afford the COBRA premiums for those 3 months they are unemployed?

How many will be able to keep paying their COBRA premiums for the 3-6 months on their new job, working through their probation period, the time their new employer will make them wait until they are offered insurance at the new job?

All those unemployed people need is a gap in coverage of around 50 days & they will ALL be denied insurance coverage for any pre-existing condition.

The refusal to cover any pre-existing condition is one of the things that is burying people. If the law was passed today that said insurance companies could no longer deny coverage for pre-existing conditions very few people could afford to get health insurance for any price, unless there was a public option to compete with the insurance companies.

I just read an article on Sunday in the Austin American Statesman & it mentioned that the average cost per insured family in Texas is just under $12,000 a year. That is WITH the rules that allow insurance companies to deny coverage for pre-existing conditions. How much MORE do you think they would charge, if they were no longer able to deny coverage for pre-existing conditions?

Mimi428

08-11-2009, 12:23 PM

I think we will all be horrified at how many "unintended consequences" will be discovered if it is passed as is.

Such as?

What 'unintended consequences' do you think are the most likely to happen?

R~O~S

08-11-2009, 12:34 PM

All the govt has to do is say '..all pre-existing conditions accepted..", then when your kid comes in with his pre-existing bone tumor say; "....we don't cover the kind of chemo he needs..."

10,000 ways around their flimsy promises.

Which is no different than the current private system that says you didn't tell us you had acne at age 14, so we can't cover the removal of that brain tumor you were diagnosed with at 60.

desmom

08-11-2009, 12:37 PM

Once enacted the govt can change the law anytime they chose, raise the cost, withdraw or withhold drugs, tests, care.

They're champions at blowing smoke up our patoots. I'm not impressed with their wordy speech-talk.

IMO, we experience that now with health insurance companies.

Mimi428

08-11-2009, 12:39 PM

I wasn't addressing the problem of people who have no insurance, rather insurance companies and catastrophic illness coverage. I was also referring to the present proposed health reform plan.

You jumped right on my post and asked where my concern was. How typical.
A question for you. How high do you think the govt. can afford to go when setting lifetime limits? I personally know of an oncology patient whose treatment costs were over 500K in a two year period.
IMO

I have two oncology patients in my immediate family. One was (& still is) covered by Medicare. The other was diagnosed when a minor & under her mother's insurance plan at the time.

I have no idea what lifetime limits may be imposed in the future.

There is actually a whole lot I don't know about the future. I don't know if either of the oncology patients will relapse. I don't know what my car insurance premium will be in 6 months. I don't know what the price of a gallon of gas or a gallon of milk will be in 6 months. I don't know what my property taxes will be, what my income taxes will be, what my health insurance premiums will be in 6, 12, 24 or 36 months. I don't know what our country's defense budget will be during that time either.

But I do know that I am not going to demand that we all sit on our collective butts & do nothing about every freakin' thing just because I can't see into the future & know with perfect certainty what costs will exist 6, 12, 36, 48 months from now.

The cost of health care has been onerous for years & is getting worse by the day. Sitting on our butts & doing absolutely nothing to turn that reality around isn't a viable option, IMNVHO.

MiamiNice1

08-11-2009, 12:41 PM

IMO, we experience that now with health insurance companies.
BUT, then we can always switch to another insurance company - OUR CHOICE.

(please don't repeat the myth of how we will still be able to choose or stay with our own insurance company if this Obama Healthcare plan succeeds, tia)

imo

Clearintent

08-11-2009, 12:55 PM

Is anybody talking about how the Government is going to get the money to pay for Health Reform? The House version according to my local paper says there is essentially two sources of funds:

Higher taxes on higher income people and cuts in Medicare and Medicaid. So half of the money to pay for people who don't have medical insurance will come from the benefits of the elderly?

There is definitely something wrong with this picture. Will Obama sign that kind of bill? I don't remember him saying this during his run for office. I could be wrong about that, anybody know?

MiamiNice1

08-11-2009, 12:57 PM

The people shouting and shutting down the meetings are "the light of truth" to you?
They are there to keep an actual discussion from happening, aren't they? I don't hear these people looking for facts. So frustrating! I want to see a question asked and an answer given - with even, if possible, a reference to the section in the bill. If the supporters holding the meetings are not sufficiently informed about the facts of the bill then they need to bring people who are informed. But the anti-reform tactics being used would preclude any facts from getting out anyway.
As a matter of fact, I am very grateful for what the concerned citizens are doing. They wouldn't have to shout if they weren't stopped from being heard. .......Chicken or the Egg?

Regarding the supporters knowing facts before the meetings, I don't think even the supporters have them. What they're (everyone's) getting are a lot of pie-in-the-sky promises and vague information.

This is what is causing all the concern, imo.

MiamiNice1

08-11-2009, 01:25 PM

http://businessandmedia.org/commentary/2009/20090715132741.aspx

http://news.newamericamedia.org/news/view_article.html?article_id=9ebc80de3b21b5d405405 08adb2bb990
These articles are excellent reading! Thanks.

AlohaRainbow

08-11-2009, 01:28 PM

Health reform idea: Put down the doughnut
Critics say consequences of individual choice missing from reform debate
[ ... ]
"Having health insurance coverage doesn't make a person healthy. It's what you do with that coverage and your personal choices that make the difference," she added.
Critics say members of Congress who've headed home for summer recess leaving no fewer than five Democratic health reform plans up in the air should be as concerned about encouraging individual accountability as they are with extending insurance coverage to 46 million Americans. [ ... ]

http://www.msnbc.msn.com/id/32306655/ns/health-health_care/

AlohaRainbow

08-11-2009, 01:32 PM

Sen. Specter Says He'll Pitch 'Fascinating' Option of Health Care Referendum
Asked by one town hall participant about the idea of a national referendum on health care reform, Sen. Arlen Specter called the option "fascinating" and said he would take the idea to Washington, though he noted that the federal government currently lacks any mechanism for doing so.

http://www.foxnews.com/politics/2009/08/11/sen-specter-says-hell-pitch-fascinating-option-health-care-referendum/

desmom

08-11-2009, 01:39 PM

BUT, then we can always switch to another insurance company - OUR CHOICE.

(please don't repeat the myth of how we will still be able to choose or stay with our own insurance company if this Obama Healthcare plan succeeds, tia)

imo

There is no choice. We have to stay with a group plan because of pre-existing conditions in the family. How do you switch? jmo

desmom

08-11-2009, 01:52 PM

The HIPAA Law.

http://www.residual-rewards.com/hipaa.html

Thanks for the link, but it will not work for her. jmo

Hey Paula

08-11-2009, 01:57 PM

There is no choice. We have to stay with a group plan because of pre-existing conditions in the family. How do you switch? jmo

Are you dissatisfied with your group plan, Des? If so, what part of the plan is unsatisfactory?

Details

08-11-2009, 01:59 PM

A very nice fact check:
http://www.cbsnews.com/stories/2009/08/11/health/main5233968.shtml?tag=cbsnewsSectionContent.7

Debunking the death panel:

The bill blocks funding for counseling that presents suicide or assisted suicide as an option, is supported by the AARP, AMA, Consumers Union, and others. The government is already involved in this issue - it requires hospitals to ask patients about their living will or advance directive, and requires the hospital to provide assistance for the patient to create one. This mandate, BTW, was added in 1992, by President Bush.

Mimi428

08-11-2009, 01:59 PM

Well, you better make sure that 20 year old doesn't smoke, doesn't drink, doesn't eat at McDonalds, doesn't sky dive, doesn't drive a car, doesn't rock climb... etc

Nope. Those are his choices to make.

I just want enough consumer protection in health insurance laws so that he isn't bamboozled into buying a worthless policy with a low lifetime limit that won't help him should he ever need actual medical care. Let him choose between plans that are actually worth the paper they are written on & the amount in premiums that is charged.

Heck, if we ever get rational health care reform going, there might actually be mental health benefits, to include covering the cost of the psychotropic meds used to treat the sort of paranoia that causes a person to believe that one individual is or will be responsible for all the real & imagined woes of this country, past, present & future.

It would almost be funny to witness all the extreme, irrational & completely off-the-wall claims that are being made against the current POTUS, if it was not so downright bizarre. To read some of the posts here, you would get the notion that he is such an omnipotent being that he will be able to single-handedly overcome every federal, state & local law, legislator & citizen.

Between the various & sundry declarations that he is a fascist AND a communist AND a socialist AND he is a plant who was not actually born in this country AND he is going to take away all our guns AND he has a Machiavellian plan to euthanize the disabled & the elderly - well, it is enough to make a body wonder how anyone in their right mind could even begin to imagine that one, single person could ever have such powers. I thought all the ridiculous claims made about the Clintons were preposterous. Little did I know they would pale in comparison to the irrational, fearful claims made about Obama.

JMO

desmom

08-11-2009, 02:05 PM

Are you dissatisfied with your group plan, Des? If so, what part of the plan is unsatisfactory?

We have 3 choices through my husband's employer. We pay the higher premiums for better coverage.

Every claim is always paid at the lesser coverage amount and I have to call them. They admit in the lst call that it should have been covered differently, but it still requires several phone calls before they will pay. In the meantime, I have to pay the difference out of pocket at the Rx and the hospitals/clincis send me a bill for the unpaid balance. This happens with every office visit and Rx.

..and that is just the beginning. jmo

Details

08-11-2009, 02:09 PM

The HIPAA Law.

http://www.residual-rewards.com/hipaa.htmlDid you read that? It still allows exclusions for preexisting conditions. It just changes how much they can exclude - and for particular types of insurance plans and individuals only. It's a mass of exclusions and limitations - better than nothing, no doubt - but it does not solve the problem.

Mimi428

08-11-2009, 02:12 PM

I know. This whole economic meltdown has really brought it home how some people think that people can act irresponsibly and it is the taxpayer's responsibility to make them whole.

So describe your perfected scenario. We have the 20 year old who has bought what he perceives to be a reasonable health insurance plan, not realizing that the lifetime limit is so low that it would be woefully inadequate to actually take care of significant medical needs. Now let's say he gets sick & he finds out that his insurance coverage has run out.

With further treatment, he can be expected to make a full recovery & go on to be a productive citizen. Without treatment, he will die.

What do you suggest should be done with him? You have stated that you do NOT want any taxpayor money to be spent to make him whole, since he was so irresponsible at age 20 to be fooled into thinking his health insurance was good. By your way of thinking, it seems he would be SOL. No doubt it would serve him right, for being too dumb to not pick a better health insurance option.

Hey Paula

08-11-2009, 02:22 PM

We have 3 choices through my husband's employer. We pay the higher premiums for better coverage.

Every claim is always paid at the lesser coverage amount and I have to call them. They admit in the lst call that it should have been covered differently, but it still requires several phone calls before they will pay. In the meantime, I have to pay the difference out of pocket at the Rx and the hospitals/clincis send me a bill for the unpaid balance. This happens with every office visit and Rx.

..and that is just the beginning. jmo

I think this happens to many of us. Speaking for myself and my family, it has happened to all of us. As in any business, most companies will attempt to pay the least amount possible. However, its impact can be more troubling and frustrating when it involves our health. Thankfully, you are able to recover the temporary expenditures until you are reimbursed. Sometimes incorrect treatment codes are used by the provider which result in consumer billing errors. Re Rx: Are they co-pay errors or physician errors in marking DAW in lieu of allowing a generic to be dispensed?

theal3

08-11-2009, 02:28 PM

R~O~S

08-11-2009, 02:30 PM

The HIPAA Law.

http://www.residual-rewards.com/hipaa.html

HIPAA allows you to carry your current policy for a time and guarantees you can't be denied an individual policy when the time limit expires. It does nothing to allow you to leave one job, take another and have your child with pre-existing conditions covered under the new coverage provided by your new employer.

Since the individual policy would undergo underwriting they get to set the price, which will be rated due to the pre-existing condition.

How exactly does that help? TIA

Lady_Jean_La

08-11-2009, 02:31 PM

Thread title = Don't Let the Myths About Health Care Reform Scare You.

ROFL - from reading I think it's the TRUTH About Health Care Reform that is scaring people. MO

Don't Let the Facts About Health Care Reform Scare You.

ladeebug565

08-11-2009, 02:37 PM

BUT, then we can always switch to another insurance company - OUR CHOICE.

(please don't repeat the myth of how we will still be able to choose or stay with our own insurance company if this Obama Healthcare plan succeeds, tia)

imo

Switch to another insurance company? Are you kidding?

True story. I am employed and I have health insurance through my employer. I pay a portion of the premium. If I lost my job or if my employer could no longer afford their portion, I'm screwed. I have serious health problems that would not pass muster with an insurance carrier in the private sector.

Even with health insurance, my out of pocket expenses are great. A hospitalization last year was $33,000. My out of pocket was $28,000. I was given three choices: 1) talk to their finance department; 2) pay the balance in three payments; or 3) pay in full and get a 10% discount. I did the latter, but, it was quite a blow to my pocketbook.

Great country, America. Work all of your adult life, pay your taxes, but if you get sick, you can lose your home and your savings. Just gives me the warm fuzzies.

Mimi428

08-11-2009, 02:38 PM

I think this happens to many of us. Speaking for myself and my family, it has happened to all of us. As in any business, most companies will attempt to pay the least amount possible. However, its impact can be more troubling and frustrating when it involves our health. Thankfully, you are able to recover the temporary expenditures until you are reimbursed. Sometimes incorrect treatment codes are used by the provider which result in consumer billing errors. Re Rx: Are they co-pay errors or physician errors in marking DAW in lieu of allowing a generic to be dispensed?

Let me tell you a little secret. Back in the days when the guiding principles of insurance companies were that they would pay every just claim, those sorts of mistakes were not made very often.

As soon as that changed, then all sorts of "mistakes" started happening. But here's the real rub - with the advent of electronic processing & adjudication of healthcare claims - those mistakes should actually be happening less & less. In desmom's case - her claims should be electronically tied to her plan reimbursement - & those claims should automatically be processed to pay what her specific plan calls for.

If they aren't paid correctly once or twice, that might be excused. It's sort of like having the price label on the grocery aisle for a can of pinto beans being marked at 59 cents, but the scanner showing they are 63 cents - the program was not been updated to reflect the latest change, but as soon as it IS updated, it will scan the pinto beans properly at 59 cents.

When claims are consistently processed using the wrong reimbursements, that is deliberate. If 1000 claims are paid at a lower reimbursement, the company keeps more money. If 500 claims are protested, the insurance company has kept funds for their own use for longer, even if they eventually make an adjustment for the proper reimbursement. Plus they get to keep the money for the 500 claims that aren't protested.

Clearintent

08-11-2009, 02:55 PM

http://pol.moveon.org/truth/lies.html?rc=tw

The health care fight has turned ugly, fast. And lies about reform are spreading via anonymous email chains. Here are the real facts that you need to know:
Top Five Health Care Reform Lies—and How to Fight Back

I agree there is a lot of misinformation being spread deliberately by people who want no health care reform whatsoever.

From the move on web site above this doesn't ring true to me either.

Lie #4: Obama is secretly plotting to cut senior citizens' Medicare benefits!!!

The truth: Health care reform plans will not reduce Medicare benefits. Reform includes savings from Medicare that are unrelated to patient care—in fact, the savings comes from cutting billions of dollars in overpayments to insurance companies and eliminating waste, fraud, and abuse.

The House version is looking for $500 billion in Medicare and Medicaid. It doesn't say how much is coming from Medicare benefits but that is a lot of money to cut from a program without affecting benefits. I'd like to know how that's going to be accomplished.

desmom

08-11-2009, 02:55 PM

Lady_Jean_La

08-11-2009, 03:10 PM

Switch to another insurance company? Are you kidding?

True story. I am employed and I have health insurance through my employer. I pay a portion of the premium. If I lost my job or if my employer could no longer afford their portion, I'm screwed. I have serious health problems that would not pass muster with an insurance carrier in the private sector.

Even with health insurance, my out of pocket expenses are great. A hospitalization last year was $33,000. My out of pocket was $28,000. I was given three choices: 1) talk to their finance department; 2) pay the balance in three payments; or 3) pay in full and get a 10% discount. I did the latter, but, it was quite a blow to my pocketbook.

Great country, America. Work all of your adult life, pay your taxes, but if you get sick, you can lose your home and your savings. Just gives me the warm fuzzies.

Why would you lose your home?:confused:

R~O~S

08-11-2009, 03:16 PM

Bingo Mimi428! You nailed it.

Then throw in those HMO/PPO/network providers that accept your co-pay, accept the insurance company's payment and then turn around and bill the patient the difference.

With our policy, the medical facility is supposed to write-off/eat the difference. It is part of their PPO contract with the insurance company. I was shocked at the number of people that have said they paid the bill from the medical facility because they thought they owed it.

Oh, and the billing for services hospital patients never received. i.e. My supervisor's mother passed away 3 days after she was admitted to the hospital in a coma. Several months after she passed, the family receives a statement from the hospital for the balance after insurance. She was billed for services that listed the service date 3 weeks after she died. Fifteen months after she died, the family receives a bill for her ER treatment 4 weeks before. She had been dead for over a year and the hospital insisted she was treated. The family had to provide the hospital with a death certificate to prove they did not treat her in ER on that date.

The medical industry is totally out of control. jmo

Double bingo! I posted a week or so ago about the $335.00 in bills I'd received as a result of an annual physical I only underwent because my general practitioner insisted.

Turns out they tried to once again charge me the $20.00 co-pay I paid at the time of appointment & the difference between what BCBS paid and their standard charge for routine tests associated with an annual GYN visit which they can't do because they're in network.

If I didn't have my receipt for the co-pay, I'd be stuck for that, but I do.

The one test I'm paying for is considered a diagnostic. It was a bone density test. I had a full cardiac work up not long ago, they had to do the echo cardiogram nuclearly because my bones were so dense they couldn't see through them. I'm thinking if they'd told me that, I may have passed on having that test done. Imagine that, I wasn't told it was optional.

I wonder how many people would have paid that bill without finding out why they were being charged, especially now when medical bills have a negative impact on your credit rating.

Lady_Jean_La

08-11-2009, 03:21 PM

lol -

http://www.charter.net/news/read.php?id=15774277&ps=1010&srce=news_class&action=3&lang=en&_LT=UNLC_NKNWU00L3_UNEWS

I swear I think someone from the WH reads here daily. Take a look........;)

http://www.charter.net/news/read.php?id=15774277&ps=1010&srce=news_class&action=3&lang=en&_LT=UNLC_NKNWU00L3_UNEWS

Obama says health care critics use 'scare tactics'

Read and post here, says I. :scared:

R~O~S

08-11-2009, 03:22 PM

Why would you lose your home?:confused:

Because they can sue you for failure to pay your medical bills. You can't get blood from a stone. Pay the medical bills, pay the mortgage, the heat, the electricity, buy food, decisions, decisions, decisions.

Do you have that kind of money laying around waiting for an unexpected medical bill to come in? Or might that hurt?

R~O~S

08-11-2009, 03:25 PM

:laugh: Suppose you tell us what I'm wrong about.

imo

I already did, but it wouldn't have been necessary if you'd read it before you posted it.

Lady_Jean_La

08-11-2009, 03:25 PM

If you are bankrupted by high medical bills and cannot pay your mortgage, you lose your home. It happens every day in this country.
I guess it depends on the state. I know bankrupt people who didn't lose their home or car. imo

Lady_Jean_La

08-11-2009, 03:27 PM

Because they can sue you for failure to pay your medical bills. You can't get blood from a stone. Pay the medical bills, pay the mortgage, the heat, the electricity, buy food, decisions, decisions, decisions.

Do you have that kind of money laying around waiting for an unexpected medical bill to come in? Or might that hurt?

I don't understand. Who gets the home? Do they kick you out?

R~O~S

08-11-2009, 03:27 PM

Huh? Where did you get that from?

HIPAA does cover dependents - even dependents with disabilities.

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

HUH? What part of you have to convert to an individual plan which will be rated didn't you understand?

Do you know what a rated premium is?

Hello, if they price that individual policy so high it's not affordable, which they will, it's useless.

The new employers plan is not required to accept the child with pre-existing conditions.

Mimi428

08-11-2009, 03:29 PM

I personally, love my private insurance that costs me $200 a month for family coverage and $20 per doctor's visit and $3 for each lab test. I know down to the penny how much I will pay for any and all procedures.

<snipped>

Well for goodness sakes - if you know of & have such magnificent private insurance at such a reasonable cost - why the heck are you keeping it a secret?

I know people who would dang near give an arm or a leg to have insurance that affordable, much less that generous. So where did you find it? What is the name of the insurance company? What specific plan is it that you have? Surely they have a website of some sort, where a person can apply online or see an outline of benefits.

Details

08-11-2009, 03:29 PM

I guess it depends on the state. I know bankrupt people who didn't lose their home or car. imoMost states - maybe all of them - they cannot take your home or your car - within some limits (many places have exceptions for mansions and the like). However - when you've had a medical problem, lawsuits, bill collectors, and your remaining medical problems put you out of a job, or into a lower paying job, take all your savings and everything else of value that you have - indeed, many then cannot continue to pay their mortgage - and there goes the house.

You save your money, to have a cushion for being out of work - but when you get taken to the cleaners by being sick and having your insurance, if any, find excuses not to cover you - that goes away, goes to the hospital and bill collectors - then were does your mortgage payment come from? All that money you saved, to be smart and have a cushion won't cover much of anything when we're talking a serious problem - even a fairly minor problem that is 'merely' a hundred thousand dollars of medical expenses to cure would eat up my savings account pretty well.

R~O~S

08-11-2009, 03:29 PM

I don't understand. Who gets the home? Do they kick you out?

Who'd get your home when you default on the mortgage?

Or do you file bankruptcy, get court ordered to pay XXX amount of dollars to your creditors, only to wrack up more unexpected medical bills, which will not allow you to pay the mortgage (the house was protected by the bankruptcy, but it's dependent on you continuing to pay the mortgage), and you can't ignore the medical bills because you're already court ordered to pay them.

This isn't rocket science. Yes, when they foreclose on your house they kick you out.

Details

08-11-2009, 03:32 PM

<snipped>

Well for goodness sakes - if you know of & have such magnificent private insurance at such a reasonable cost - why the heck are you keeping it a secret?

I know people who would dang near give an arm or a leg to have insurance that affordable, much less that generous. So where did you find it? What is the name of the insurance company? What specific plan is it that you have? Surely they have a website of some sort, where a person can apply online or see an outline of benefits.Just watch out for the lifetime benefit - that's where they sometimes get you. You think you've got good insurance - but if you have anything more than the occasional cold and flu, any serious problem, cancer, heart attack, etc. - you'll suddenly find out you're no longer really covered. Or of course, there's the standard procedure of looking to your application for the slightest typo or flaw, anytime you need care, to dump you.

Lady_Jean_La

08-11-2009, 03:32 PM

Most states - maybe all of them - they cannot take your home or your car - within some limits (many places have exceptions for mansions and the like). However - when you've had a medical problem, lawsuits, bill collectors, and your remaining medical problems put you out of a job, or into a lower paying job, take all your savings and everything else of value that you have - indeed, many then cannot continue to pay their mortgage - and there goes the house.

You save your money, to have a cushion for being out of work - but when you get taken to the cleaners by being sick and having your insurance, if any, find excuses not to cover you - that goes away, goes to the hospital and bill collectors - then were does your mortgage payment come from? All that money you saved, to be smart and have a cushion won't cover much of anything when we're talking a serious problem.

Thank you, it sounded like the hospital was making people homeless. imo

Mimi428

08-11-2009, 03:33 PM

I guess it depends on the state. I know bankrupt people who didn't lose their home or car. imo

It depends a whole lot more on whether they can continue to make the mortgage or vehicle payments.

If you can't pay your mortgage or car payment, you will lose your car &/or your house - has nothing to do with what state you are in.

R~O~S

08-11-2009, 03:34 PM

And you were wrong!

imo

No, unfortunately not. Your new employers plan does not have to accept your child with pre existing conditions. You're stuck with a rated individual policy or no insurance for the child.

Details

08-11-2009, 03:35 PM

Thank you, it sounded like the hospital was making people homeless. imoYeah, homes are protected. But with all that frequently does happen - many people end up losing it anyway - even if you are responsible, save money, work hard, etc. All it takes is a medical problem, doesn't have to be that huge, where you have no insurance, no effective insurance, or they find a way to deny the claim or dump you as a member.

Separate from anything else - I want to see a new law on that dumping practice. They take insurance payments from you for year after year - then you need coverage - then they suddenly find something on your application that was wrong in any way, and use it to drop you as a customer. I think if they've taken your premiums for long enough - 3-6 months - they've accepted you as a client, and should no longer be allowed to dump you - if your money was good enough for that long, it should be good enough AFTER you get sick.

Lady_Jean_La

08-11-2009, 03:36 PM

It depends a whole lot more on whether they can continue to make the mortgage or vehicle payments.

If you can't pay your mortgage or car payment, you will lose your car &/or your house - has nothing to do with what state you are in.They may not have a mortgage or car payment. imo

Lady_Jean_La

08-11-2009, 03:39 PM

Yeah, homes are protected. But with all that frequently does happen - many people end up losing it anyway - even if you are responsible, save money, work hard, etc. All it takes is a medical problem, doesn't have to be that huge, where you have no insurance, no effective insurance, or they find a way to deny the claim or dump you as a member.

Separate from anything else - I want to see a new law on that dumping practice. They take insurance payments from you for year after year - then you need coverage - then they suddenly find something on your application that was wrong in any way, and use it to drop you as a customer. I think if they've taken your premiums for long enough - 3-6 months - they've accepted you as a client, and should no longer be allowed to dump you - if your money was good enough for that long, it should be good enough AFTER you get sick.

Okay. It just sounded like a poster was saying a hospital could take a home for medical bills.

R~O~S

08-11-2009, 03:40 PM

They may not have a mortgage or car payment. imo

Indeed, those of us that are fortunate enough to not have a mortgage, certainly wouldn't find ourselves needing to take a second to pay $28,000.00 in annual out of pocket unexpected medical bills while living on a fixed income.

How many people do you know that are still working but are mortgage free?

Ya think maybe the folks with those kinda bills may not be working either due to disability or age?

Mimi428

08-11-2009, 03:48 PM

They may not have a mortgage or car payment. imo

Oh, I'm sure there are plenty of people who did not have a mortgage at the time they were buried under medical bills.

And after they have a huge judgment against them for all those unpaid medical bills, they sure won't be qualified, credit-wise, for a mortgage or a vehicle payment.

That scenario is the one I think we are seeing more of every day - the people who are literally ruined, credit-wise, due to medical bills.

Our country is not economically well served when the number of folks in financial ruin keeps going up. If we do nothing to reform our current system of health insurance & health care, those numbers are going to keep going up.

Mimi428

08-11-2009, 03:52 PM

Mimi428

08-11-2009, 03:58 PM

IOW your employer pays the bulk of the premiums. You are not paying the full cost of the policy.

Yep, you are absolutely correct. It is not private insurance, it is an employer group plan.

And you can bet the farm that should the occasion arise that she wants to keep the plan under COBRA & pay the full cost of that policy, it sure wouldn't be $200 a month.

JMO

desmom

08-11-2009, 04:04 PM

You can lose your home to medical debt.

http://www.illinoislegalaid.org/index.cfm?fuseaction=home.dsp_Content&contentID=2614

Details

08-11-2009, 04:09 PM

Surely, you aren't asking for personal information, which is a big NO NO, are you?
I have had this plan for 8 years, and it is part of a very lovely benefits package through my job. I have the same insurance that every other person I work with has. It is also the plan that our retirees are covered under.
Other than that, how and where I receive my insurance is none of your business.So - it's a work plan. That's not the same as insurance anyone can get. Work plans are an entirely different breed. They do not sell to individuals.

And the name of an insurance company really isn't personal information - it wouldn't identify you even a little - IMO. As with any question though - it's your choice to name it or not. But - given that it is a work plan - which means not open to the public, which means your employer likely pays half or more of the premium - the stats about how much you pay and get aren't necessarily what they seem.

I used to have a plan I paid zero for - to cover me, hubby, kids - and there were no co-pays on anything other than the ER. Zero deductible doctors visits, no copay prescriptions, etc. That plan is not available to the public. It was a very nice benefit of an employer who wisely knew that such a plan would tend to retain the employees they wanted to keep.

Mimi428

08-11-2009, 04:10 PM

And we have thousands of people, both working and retired across the nation who enjoys this wonderful benefits package.
Why in the name of all that is good and Holy would I want to change what I have?
And all it will take, according to the proposed bill (page 16), is for ONE LITTLE CHANGE after the enactment of the bill, and I will lose this wonderful coverage.

Do you have no confidence whatsoever that the company would keep that fabulous package in compliance with the minimum standards? Large employers are more often than not far more generous in what they can offer because of their purchasing power. I would expect that your employer plan offers benefits far & above what any minimum standard would be.

snookums1

08-11-2009, 04:11 PM

No ‘death panel’ in health care bill

http://www.sharonherald.com/local/local_story_222190606.html

It answers a lot of questions and shows the lies being told for what they are.

desmom

08-11-2009, 04:12 PM

I am so glad that you know more about my personal life and my current insurance than I do. Whatever would I do without you? :rolleyes:
In order to COBRA my plan it would be roughly $680 a month, which I would gladly pay to keep this great insurance.
I am so sorry that what I have is not available to everyone, but I can't do anything about that. If people think my coverage is good, they should job-shop for benefits. That is what I did. I work in a highly sought after specialty field, and I could have taken a higher paying job with crappy benefits, but the benefits were more important.

Wow that is cheap. 12 years ago we paid $790 a month for COBRA.

snookums1

08-11-2009, 04:13 PM

I am so glad that you know more about my personal life and my current insurance than I do. Whatever would I do without you? :rolleyes:
In order to COBRA my plan it would be roughly $680 a month, which I would gladly pay to keep this great insurance.
I am so sorry that what I have is not available to everyone, but I can't do anything about that. If people think my coverage is good, they should job-shop for benefits. That is what I did. I work in a highly sought after specialty field, and I could have taken a higher paying job with crappy benefits, but the benefits were more important. Well, aren't you the lucky one? Millions of people, both working, have no coverage at all.

Mimi428

08-11-2009, 04:21 PM

You set a good example. Instead of people whiniing and complaining all the time they should do some leg work and find the best employer plan for themselves and their family.

I certainly hope your plan remains staus quo.

imo

OK, so all the folks who are currently laid off/unemployed have done their homework. They now know which employers in their area have the best benefits. How do you propose they get jobs if the companies have few or no openings?

My daughter works for a municipality in Texas. Not too small, not a giant one either. Just medium-sized, but it does offer good benefits. They had 3 openings last year in the fire dept. They received over 200 applications, over 85% were from people with experience.

I guess the 197 who didn't get the jobs just didn't do enough legwork.

Details

08-11-2009, 04:23 PM

I have no confidence that the government will not make arbitrary rules that will eliminate my plan no matter what my company does to keep in compliance.Myth - you imagine something might happen - so you wish to stop the good that can happen? All the people without insurance are meaningless? The people killed by their insurance companies just collateral damage?

I really don't understand this perspective. There's a good new plan. It IS optional. There's no reason for the government to WANT to grab everyone onto the new plan, let alone any reason to think they'd change requirements, nor any reason to think that if some idiot proposed it, that people could not stop it - we ARE the government after all - we can and do stop them.

A little girl died recently - from for-profit health insurance. She needed a transplant, an organ was found - and the insurance company stopped it - said no - she's too sick, we won't pay. By the time they were done fighting - it was too late - she was dead. Cigna sure dodged a lot of costs by fighting that one - they don't have to pay the surgery, nor the after care for a lifetime - the lifetime they denied the little girl. This is not a rare nor unusual story. http://www.latimes.com/news/opinion/la-oew-delpriore3jan03,0,5149977.story?coll=la-opinion-center

But - because there's an imaginary idea that maybe someday in the future the government plan will include MORE benefits than what you currently get, and require that, and that maybe in this imaginary future, your plan will fail to cover those benefits, and be changed - for that imaginary future, you fight this? Fight the imaginary future - but how about we work with what is REAL here, in the REAL plan?

Mimi428

08-11-2009, 04:43 PM

beattherap

08-11-2009, 04:44 PM

Sorry, I am not following your premise that most insured people don't have a pre-existing condition. Anyone who gets anything OTHER than a simple physical every so often could be considered to have a pre-existing condition should they lose their insurance coverage.

We heard just last week that about 250,000 people lost their jobs in the month of June.

Let's just say, for the sake of theory, they all had group employer health insurance before they lost their jobs.

How many do you believe will realistically become employed again in a short period of time? (less than 3 months, for example)

How many of those people do you believe will be able to afford the COBRA premiums for those 3 months they are unemployed?

How many will be able to keep paying their COBRA premiums for the 3-6 months on their new job, working through their probation period, the time their new employer will make them wait until they are offered insurance at the new job?

All those unemployed people need is a gap in coverage of around 50 days & they will ALL be denied insurance coverage for any pre-existing condition.

The refusal to cover any pre-existing condition is one of the things that is burying people. If the law was passed today that said insurance companies could no longer deny coverage for pre-existing conditions very few people could afford to get health insurance for any price, unless there was a public option to compete with the insurance companies.

I just read an article on Sunday in the Austin American Statesman & it mentioned that the average cost per insured family in Texas is just under $12,000 a year. That is WITH the rules that allow insurance companies to deny coverage for pre-existing conditions. How much MORE do you think they would charge, if they were no longer able to deny coverage for pre-existing conditions?
you're actually agreeing with me that obama misleads the public when he says, if you like your insurance, you can keep it...

with the gov't. mandated coverages, private insurers will be priced out of the market and unable to compete against a non-profit, tax-funded plan...

imo, the obama myth is as bad as the death panel myth.

imo.

Details

08-11-2009, 04:47 PM

Unless you can prove that it is a MYTH, then it is only your opinion. All of these links that "PROVE" all of the so called "MYTHS" are just supposition based on the words of the president. And I don't trust him at all.
How can you expect people to place trust in a man who wants neighbors to "inform" on neighbors (flag@whitehouse.gov)?
I didn't vote for him, wouldn't vote for him, and I will not trust the well being of my husband and children to him.

You can blindly follow the Pied Piper's flute and promises if you want to. I will not.It is a myth - you admitted it. You said "I have no confidence that the government will not" - in other words - this is nothing that is currently in the bill, nothing that is planned - something merely that you think could potentially happen. Myth. Pure imagination.

The stories of people being killed, denied coverage, and hurt by for-profit insurance companies - those are REAL. What the bill ACTUALLY says - that is REAL.

You don't have to use their plan - your company can stay on whatever plan it thinks is best, just as it does today. You don't have to trust a thing. And no doubt nothing I say would change your mind - like many of us, you'll see it when it happens to you - and with luck, it won't. With luck, your job and your company is secure. With luck, your insurance company will not see a point when it is more profitable to dump you than to keep you.

I simply don't understand though, ignoring all those who do not have such luck. The people who have been hurt, those who will be hurt. Those dying of preventable diseases, those being neglected into an early death, those working in fear that one layoff, one company failure will leave them without insurance and uninsurable - and dead (I know this person). But hey - if I've got mine, whatever - fight everything, because of who it comes from, never mind what the bill really says.

Details

08-11-2009, 04:54 PM

Who's angry? I can have a HUGE amount of distrust for a person, and not feel a twinge of emotion.
I have a huge distrust of all liberals who think that you should take from the haves (people who actually work for what they have) and give to the have-nots.
1600 Pennsylvania Ave is not a place to have a Robin Hood in the Oval Office.I can be quite sure the person I know who is one layoff away from watching her husband die works for what she has - she works very hard, at more than one job. But if she ever loses that one primary job with the health insurance to cover her husband - a have-not who works hard too - harder than his doctor says he should - someone you don't want to get help - her husband will die. His medical condition cannot be covered by ER care. Of course, they'd have a choice - they could choose to divorce, lose their house, stop working, to become poor enough to qualify for Medicare. That's the only choice they have. Either she keeps a job - or he dies. Is this really something you see as OK? She's a hard worker, and a good worker, but companies fail, layoffs happen, even to the best.

Yeah - tar her as merely a "have-not" who doesn't work hard enough, so it's OK to watch hubby die. Me - I care about people, no matter how much they have. And I know that many of those with less than I have, still work hard. I'm not willing to let them die, leave them to chronic sickness, early death.

And worst of all - this is all so stupid - every other civilized country simply has universal health care. For LESS than we pay to cover a fraction of our citizens, they cover EVERYONE. They have better health care by all measures (lifespan of cancer patients, infant mortality, etc.), they pay less for it - and they look at ours, and shudder. Per capita, they pay less - to cover everyone. So - out of jealousy and the idea that covering a 'have-not' is a bad thing - we waste money.

R~O~S

08-11-2009, 05:00 PM

Link, please.

lol, you already provided the link. Where in there does it say your new employer needs to provide coverage? It doesn't, it says you have to be allowed to convert to a private individual policy.

:rolleyes:

As has already been suggested, actually reading the links before you post them would prove beneficial to you.

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

Under HIPAA, a plan is allowed to look back only 6 months for a condition that was present before the start of coverage in a group health plan. Specifically, the law says that a preexisting condition exclusion can be imposed on a condition only if medical advice, diagnosis, care, or treatment was recommended or received during the 6 months prior to your enrollment date in the plan. As an example, you may have had arthritis for many years before you came to your current job. If you did not have medical advice, diagnosis, care, or treatment – recommended or received – in the 6 months before you enrolled in the plan, then the prior condition cannot be subject to a preexisting condition exclusion. If you did receive medical advice, diagnosis, care, or treatment within the past 6 months, then the plan may impose a preexisting condition exclusion for that condition (arthritis).

Clear enough?

beattherap

08-11-2009, 05:02 PM

[snip]
You don't have to use their plan - your company can stay on whatever plan it thinks is best, just as it does today. [snip]

myth...

even the cbo stated that millions of employees would be affected by employers dropping insurance because of the house bill.

imo.

Details

08-11-2009, 05:13 PM

snookums1

08-11-2009, 05:21 PM

Hannity falsely claims under reform bill, "you can't get" private insurance through employer

http://mediamatters.org/research/200907210014

Details

08-11-2009, 05:22 PM

>snipped for relevant part<

http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

The bill says that the plan can not change ANY term or condition. Are you going to try and say that the bill isn't set up to arbitrarily eliminate a person's current insurance policy?
That link is to the entire 1018 page bill. Read it. I did, and I don't like it.How do you dislike this?

First - it's only about grandfathered INDIVIDUAL plans - the bit you quoted - those that don't comply with the regulations about preexisting condition coverage and such. Second - it's saying they cannot bait and switch - drastically change their coverage after having lured people into the grandfathered plan with low rates, high coverage. And it says they cannot suddenly decide to start raising the rates on any subgroup of insured - they have to work with the entire group - no costing out those who are sick.

5 year grace period for any requirements - more than flexible - a bit more so than I'd like, considering the very common sense and humane restrictions on health insurance being suggested - for any employer based plans.

Great stuff in here.

The next pages are great too - all about what is required to be health insurance. Lots of stuff that sets health insurance up to be REAL health insurance again. No preexisting condition exclusions. You cannot refuse to renew for any reason other than someone failing to pay or committing fraud - no more dumping the sick. Premiums are not allowed to be set sky high to discourage the sick. That is what insurance should be.

Susan43

08-11-2009, 05:23 PM

Mimi428

08-11-2009, 05:23 PM

Details

08-11-2009, 05:32 PM

Haven't ever had that happen. If fact, with my current policy, after I bought it, I found out it covered much more that I first thought.
Sorry, but I can read, and I know what I read. You can say it means anything you want to, doesn't change what it says.You haven't had that happen - so why worry about a provision that says it shouldn't happen?

It's talking about grandfathered plans - those who do not have to follow the very REASONABLE rules made for new health insurance plans. And it's saying they cannot change their conditions or coverage or premiums massively after the bill takes effect.

What you quoted is about INDIVIDUAL plans - so that has nothing to do with your employer plan - if you read - you'd know that too.

Lady_Jean_La

08-11-2009, 05:32 PM

Indeed, those of us that are fortunate enough to not have a mortgage, certainly wouldn't find ourselves needing to take a second to pay $28,000.00 in annual out of pocket unexpected medical bills while living on a fixed income.

How many people do you know that are still working but are mortgage free?

Ya think maybe the folks with those kinda bills may not be working either due to disability or age?

Many who are renting.

Susan43

08-11-2009, 05:32 PM

Hannity falsely claims under reform bill, "you can't get" private insurance through employer

http://mediamatters.org/research/200907210014

Another college dropout heard from.

Lady_Jean_La

08-11-2009, 05:34 PM

Oh, I'm sure there are plenty of people who did not have a mortgage at the time they were buried under medical bills.

And after they have a huge judgment against them for all those unpaid medical bills, they sure won't be qualified, credit-wise, for a mortgage or a vehicle payment.

That scenario is the one I think we are seeing more of every day - the people who are literally ruined, credit-wise, due to medical bills.

Our country is not economically well served when the number of folks in financial ruin keeps going up. If we do nothing to reform our current system of health insurance & health care, those numbers are going to keep going up.

I don't think medical is the main cause of financial ruin.