mr6666

Healthcare in America?

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"Private insurers raising Obamacare costs –> “Insurers are raising the 2017 premiums for a popular and significant group of health plans sold through HealthCare.gov by an average of 25 percent, more than triple the percentage increase of this year’s plans, according to new government figures,” Amy Goldstein reports for The Washington Post. The companies are blaming these rising rates on an influx of sick Obamacare insurance exchange customers, making it more expensive than expected to do business. In a press conference on the ailing health insurance program last week, Obama encouraged states “to create a government-run health insurance option to help US states where there is little or no competition among private insurers,” Reuters reports. In effect, that would be the public option that Democrats rejected while creating Obamacare.....

 

HHS Secretary Sylvia Mathews Burwell said that insurers are “continuing to adapt” to a new market in which they must compete for customers based on their price and quality, rather than freezing out people with medical conditions. Burwell said that premiums have been influenced by “efforts to undermine the ACA,” including a decision by the Republican-led Congress to block money intended to help buffer insurers with high-cost customers.

 

https://www.washingtonpost.com/national/health-science/average-premiums-for-popular-aca-plans-rising-25-percent/2016/10/24/3adbb734-9a12-11e6-b3c9-f662adaa0048_story.html

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'Get the Insurance Companies the Hell of Out' of Healthcare System-

 

"There is only one permanent fix—stepping up work for enactment of a humane health care system based on patient need not private profits that guarantees universal health care for all through an expanded and updated Medicare for All—the same approach that works in virtually every other country on earth."

—Jean Ross, National Nurses United

 

http://www.commondreams.org/news/2016/10/25/get-insurance-companies-hell-out-healthcare-system

 

 

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'Get the Insurance Companies the Hell of Out' of Healthcare System-

 

"There is only one permanent fix—stepping up work for enactment of a humane health care system based on patient need not private profits that guarantees universal health care for all through an expanded and updated Medicare for All—the same approach that works in virtually every other country on earth."

—Jean Ross, National Nurses United

 

 

 

I still recommend a Swiss type system;  NON profit private insurance companies.   

 

But if the choice is between a 100% government run program or a system with FOR profit insurance companies,  I favor the former. 

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I still recommend a Swiss type system;  NON profit private insurance companies.   

 

But if the choice is between a 100% government run program or a system with FOR profit insurance companies,  I favor the former. 

The American economic system does not accept NON profit corporations.  Look at the huge salaries of non-profit executives, often luxurious travel and living standards and huge staffs of well paid middle and upper level people.

There are some non-profits that are really good at fiscal management and expenditures.  But no way would American insurance companies be non-profit.  Non-profit hospitals would be the worst.

Recently went to an orthopedic group and was charged $11.00 for insoles (good price actually)  Three weeks later they had merged with largest hospital in area and insoles now cost $16.00.

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The American economic system does not accept NON profit corporations.  Look at the huge salaries of non-profit executives, often luxurious travel and living standards and huge staffs of well paid middle and upper level people.

There are some non-profits that are really good at fiscal management and expenditures.  But no way would American insurance companies be non-profit.  Non-profit hospitals would be the worst.

Recently went to an orthopedic group and was charged $11.00 for insoles (good price actually)  Three weeks later they had merged with largest hospital in area and insoles now cost $16.00.

 

Well generally the American economic system doesn't accept socialist government run programs like a national heath care system similar to that in Britain or Canada.    My point being that something has to change if the USA is to get a well run and 'reasonable' health care system.

 

If your overall point was a defense of why Obama didn't insist on a single payer system,   I agree with that: I.e. the time wasn't right for the nation to accept such a system and Obama had to accept what Congress,  especially moderate Dems, were willing to give him.

 

Maybe I'm being Pollyanna,  but with the right independent audits the Feds should be able to ensure non-profit insurers don't milk the system.   Of course one could argue there isn't much of a difference between Fed bureaucrats ripping off the public verses non-profit insurers.     

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Just seen this I-Team report on NBC4 New York.  Senseless his health insurance dragged their feet on Conner's prosthetic leg.

 

http://www.nbcnewyork.com/investigations/Central-Park-Explosion-Connor-Golden-Amputate-Foot-Hospital-Insurance-Investigation-405221845.html

 

Hope the police find the person responsible for leaving that explosive device, the reward to $25,000

 

Original story..

http://www.nbcnewyork.com/news/local/College-Student-Prosthetic-Operations-Central-Park-Explosion-Homemade-Bomb-Connor-Golden-387317692.html

 

 

firework-foot.jpg

 

 

crwsv5gwiaan8n7.jpg?quality=85&strip=all

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I had a surgical procedure in May of this year.  Seven months later, I have yet to receive a bill for said procedure!  I guess I could call the hospital where the surgery took place or my insurance company, but it shouldn't be my job to keep track of how those nabobs do their billing, right?  Sad thing is that the surgery spurred my decision to retire from my job.  I got a fairly decent severance package, but I can't enjoy spending it or putting it to good use for needed repairs around my house since I have absolutely no idea what my portion of the procedure will be.  I'd love to see a rule or regulation that says if a patient can't get a bill for any medical, dental, or vision matter within 90 days...it's free!  Maybe that would get the 'bean counters' on the ball with this stuff.  I've heard a couple of horror stories about people who never got a bill for their medical care, but they DID receive a collection agency notice for not paying their bill on time.  I hope those instances are rare...nobody needs the aggravation of waiting for something like this.

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I had a surgical procedure in May of this year.  Seven months later, I have yet to receive a bill for said procedure!  I guess I could call the hospital where the surgery took place or my insurance company, but it shouldn't be my job to keep track of how those nabobs do their billing, right?  Sad thing is that the surgery spurred my decision to retire from my job.  I got a fairly decent severance package, but I can't enjoy spending it or putting it to good use for needed repairs around my house since I have absolutely no idea what my portion of the procedure will be.  I'd love to see a rule or regulation that says if a patient can't get a bill for any medical, dental, or vision matter within 90 days...it's free!  Maybe that would get the 'bean counters' on the ball with this stuff.  I've heard a couple of horror stories about people who never got a bill for their medical care, but they DID receive a collection agency notice for not paying their bill on time.  I hope those instances are rare...nobody needs the aggravation of waiting for something like this.

 

In Canada and most of the rest of the world health care is free.  You pay for some prescription drugs unless you are on an insured health plan, maybe through work but anything to do with a hospital is free.  I can't understand why American with all of its wealth can't do this as well.  Major operations or health scares could bankrupt people.  Of course, the rich 1% don't have to worry about this stuff.

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In Canada and most of the rest of the world health care is free.  You pay for some prescription drugs unless you are on an insured health plan, maybe through work but anything to do with a hospital is free.  I can't understand why American with all of its wealth can't do this as well.  Major operations or health scares could bankrupt people.  Of course, the rich 1% don't have to worry about this stuff.

 

The main issue here in America is how to compensate those that provide care,  make the drugs,  do research on the creation of new drugs etc...     Having a 'tax' of citizens so they get healthcare without a 'fee for service' type of system is easy to implement, BUT,  determining what medical providers, drug manufacturers,  researchers etc.. should receive as 'reasonable' compensation for services can be very difficult.     

 

Note: I'm not saying the above is a reason NOT to move ahead with a Swiss type healthcare system (my preference), but the US is so brainwashed that everything needs to operate within a 'free market' system that it makes it difficult to make what is viewed as a radical change.

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In Canada and most of the rest of the world health care is free.  You pay for some prescription drugs unless you are on an insured health plan, maybe through work but anything to do with a hospital is free.  I can't understand why American with all of its wealth can't do this as well.  Major operations or health scares could bankrupt people.  Of course, the rich 1% don't have to worry about this stuff.

In a twisted way, I think the "powers that be" here want America to have enough enemies so as to justify more spending on the Defense Department.  Throw in all kinds of subsidies for all kinds of industries, plus the aspect of perpetual welfare because people realize getting government assistance (while not lucrative for the recipient) is about as good as working a full-time, low-paying job, that leaves very little left for something as frivolous as affordable health care.

 

I never liked the term "Affordable Care Act".  It should have been called "Inclusive Care Act" since the idea was to get everyone in America covered.  Before ACA went into effect in 2014, my monthly contribution for insurance spiked up 53%!  In October, it went up about 12%.  The 12% increase represented an extra $11 a month on my part, which was not problematic to my fixed-income budget.  Where I am feeling the pinch is the fact that my former employer stopped coverage for vision and dental insurance, even though the costs for that insurance did not rise at all!

 

Fortunately, I'm in relatively good health, and the prescription drug empire is not getting richer off me.  Remember in the early 2000's when North Border senior citizens were threatened with fines and possible jail time for heading to Canada for generic prescription drugs that were much, much cheaper than what they could get in their home states?  Well, the government put a stop to those bus trips to provincial border towns for that purpose.

 

I agree too with jamesjazzguitar that too many people in the U.S. have been brainwashed into thinking that the free market is the only way to make healthcare issues work in this country.  There are many aspects to good healthcare used by other countries that work for them.  Every medical procedure in Japan, for example, costs the same amount of money, regardless of the patient's age, gender, or location where they have the procedure done.  The German government will pay for a doctor or specialist's medical education, with conditions about what they can earn, how much (or this case, little) they pay for malpractice insurance, and where they can practice the first few years of employment (many are steered to places in Germany that may have a lack of general practitioners or specialists).  I'm not familiar with the Swiss system, but I think I heard that drug companies there are allowed to raise prices for their products, but the increases are not so astronomical as to financially strap an individual or an insurance company.

 

Prior to the ACA, the number 1 reason for household bankruptcies in America was an unexpected medical bill for a family member.  Since the adoption of the ACA, that sad statistic still holds true.  Insurance will cover a lot, but not everything.  The out-of-pocket expenses for many people is still far too high, commensurate with their income, and the medical-industrial complex likes it that way. :(

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Truly from what I've experienced since my wife's stroke was that it ISN'T healthcare INSURANCE that's a problem, but the healthcare the DOCTORS provide, or rather DON'T in her case.  They all seem to follow what I call "chart medicine".  For instance, they treat any and everything the same DESPITE what may have caused the problem to begin with.  To whit:

 

She had a stroke.  OK, but LONG before it, she was showing signs of a depleted appetite and disinterest in eating.  She DID however, manage to eat enough to maintian what her doctor felt was a sufficient weight and level of health.  But after the stroke, the appetite problem was KICKED UP a notch.  She wasn't eating anything and lost a lot of weight.  But, THEIR only solution was to implant a PEG-tube and place her on a regimen of Jevity.  It was needed at the time, but my biggest frustration was everyone's seeming disinterest  to consider that the stroke wASN'T the only issue in her appetite trouble, and there was no indication that once on Jevity, they'd then investigate what might have been causing the diminished appetite to begin with.  They just fell back on the ease of blaming it ALL on the stroke and letting it go at that.  It was the same with her diabetes.

 

Now, I KNOW that diabetes CAN lead to many other health problems, and she has dealt with a few, but I also hold that not EVERY heath issue a diabetic suffers is ALWAYS caused by their diabetes.  But for years it seemed, that whenever my wife went to the doctor with ANY complaint, even a sore knee, once they learn she's a diabetic, it's GAME OVER!  "Just get your sugar under control and it will all get better"  they'll say, and IGNORE the fact that when the pain in the knee started, her sugar WAS and IS under control.

 

I've since lost ALL faith and belief in modern medicine.

 

 

Sepiatone

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Question why should tax payers front the cost of people that make bad health decisions.  Imagine the (LOW) cost of health care if people simply stop high risk activities.  A guy smoke, gets lung cancer and the ACA should cover it??

 

man-smoke-and-drink.jpg?auto=format&q=40

 

 

The problems caused by fat ___ people over eating.  Is the excuse, someone put a gun to their head?

 

Junk-Food-Addiction.jpg

 

 

 

Why would ANY health insurance cover these idiots,

 

rock-climbing-mark-engelbrecht-2.jpg

 

...or cover the next generation?

 

650213-children-s-rock-climbing.jpg

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Question why should tax payers front the cost of people that make bad health decisions.  Imagine the (LOW) cost of health care if people simply stop high risk activities.  A guy smoke, gets lung cancer and the ACA should cover it??

 

man-smoke-and-drink.jpg?auto=format&q=40

 

 

The problems caused by fat ___ people over eating.  Is the excuse, someone put a gun to their head?

 

Junk-Food-Addiction.jpg

 

 

 

Why would ANY health insurance cover these idiots,

 

rock-climbing-mark-engelbrecht-2.jpg

 

...or cover the next generation?

 

650213-children-s-rock-climbing.jpg

save the babe! :D (in the 3rd pic)

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In a twisted way, I think the "powers that be" here want America to have enough enemies so as to justify more spending on the Defense Department..

 

That's why they create them.

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Ham, you are tragically naive if you think healthcare costs will go DOWN if all  Americans  adopt a healthy lifestyle.  Like for instance---

 

I have a chronic ringing in my ear( the right).  That stuff LIPO FLAVANOID helps but, in order to determine what caised the ringing, I had to undergo a test by an ENT  that cost me, AFTER the insurance coverage, a co-pay of $500!

 

That was AFTER going to my primary, who simply stuck a otoscope looking device in the ear and pressed a button that caused it to make a "beep" sound, and ask if I could hear it.  HIS charge to my insurance?  He gave it a six-inch long sounding name and charged them $388.  THEN referred me to the specialist.

 

My brother in law hurt his shoulder on the job.  His boss sent him to a local emergency room, where they pronounced it a "strain" and then a nurse entered the stall and handed him ONE Motrin 800 and a little shot glass sized plastic cup of Maalox.  He at first declined, saying he had plenty of Motrin that strength at home and he'll just take it when he gets there.  They refused to discharge him until he took THEIR Motrin tablet, and he said he'd just leave.  They told him if he left without a doctor's formal discharge then they'd bill HIM instead of his insurance.  So, he reluctantly took it.  A month later, while looking over his insurance "summary", he noticed they charged them $400 for "dispention of medicine"!    FOUR BILLS for ONE Motrin and a shot of Maalox.

 

Now, I ask you....Where's the REAL expense in "healthcare"? 

 

If insurance companies had some  OVERSIGHT, they'd probably refuse to PAY such exhorbitent charges, and then the doctors and hospitals would bill the PATIENT, who probably CAN'T afford them, and possible legal entanglements would ensue.

 

And these incidents happened BEFORE the  "Affordable Care Act".  To think repealing "Obamacare" would make things better means ANYone who thinks so is a solid citizen of  "FOOL'S PARADISE".

 

That to require a SEPERATE policy for DENTAL care grinds me that since your teeth are a part of your BODY means , to me, that it SHOULD be covered by your regular health insurance to begin with.  Especially since in recent years they've been able to link several other physical maladies to poor dental health. 

 

I could tell you other stories about this sort of thing that would curdle your blood.  Just ask.

 

 

Sepiatone

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That to require a SEPERATE policy for DENTAL care grinds me that since your teeth are a part of your BODY means , to me, that it SHOULD be covered by your regular health insurance to begin with.  Especially since in recent years they've been able to link several other physical maladies to poor dental health. 

 

I could tell you other stories about this sort of thing that would curdle your blood.  Just ask.

 

 

SepiatoneA few months back I had an abcessed tooth and went to dentist who prescribed pain pills and antibiotic and set up appointment for another dentist to do a root canal.  She was not comfortable doing it with the tooth's location and condition.  No problem with that.

However, the pain pills did not work and in fact the pain spread to jaw and even neck.  She referred me to my FP as she could not give the anitbiotic shot that I needed per state law.

MD examined me and concurred with the anitibiotic shot.

Medicare rejected and my supplemental rejected it because Medicare rejected it.  Dental work.

Called MD's insurance clerk and she rebilled as infection of jaw and neck.  No problem with Medicare or supplemental.

Do have dental insurance and they may have covered part of shot, but only about 60-70% based on past experience.

 

Mentioned this earlier, but Medicare is now advocating Chronic Care Mangement (code 99490) if you have two or more chronic conditions.  MC covers part of it, but supplemental carriers may not cover the rest.  Mine is billed at $58.00 with MC covering $38.  However you may be billed for less than this due to rules.

 I cancelled it as soon as I found out supplemental would not cover the rest.  FP's staff said it would.  

Jan 01, 2017 all MC beneficiaries with Part B will automatically be enrolled through your primary physician.  The billing is every month since you receive the servcice each month, either via a T/C from some stranger or a computer entry.

You can opt out of it, but you have to complete a form for your primary provider.

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Truly from what I've experienced since my wife's stroke was that it ISN'T healthcare INSURANCE that's a problem, but the healthcare the DOCTORS provide, or rather DON'T in her case.  They all seem to follow what I call "chart medicine".  For instance, they treat any and everything the same DESPITE what may have caused the problem to begin with.  To whit:

 

She had a stroke.  OK, but LONG before it, she was showing signs of a depleted appetite and disinterest in eating.  She DID however, manage to eat enough to maintian what her doctor felt was a sufficient weight and level of health.  But after the stroke, the appetite problem was KICKED UP a notch.  She wasn't eating anything and lost a lot of weight.  But, THEIR only solution was to implant a PEG-tube and place her on a regimen of Jevity.  It was needed at the time, but my biggest frustration was everyone's seeming disinterest  to consider that the stroke wASN'T the only issue in her appetite trouble, and there was no indication that once on Jevity, they'd then investigate what might have been causing the diminished appetite to begin with.  They just fell back on the ease of blaming it ALL on the stroke and letting it go at that.  It was the same with her diabetes.

 

Now, I KNOW that diabetes CAN lead to many other health problems, and she has dealt with a few, but I also hold that not EVERY heath issue a diabetic suffers is ALWAYS caused by their diabetes.  But for years it seemed, that whenever my wife went to the doctor with ANY complaint, even a sore knee, once they learn she's a diabetic, it's GAME OVER!  "Just get your sugar under control and it will all get better"  they'll say, and IGNORE the fact that when the pain in the knee started, her sugar WAS and IS under control.

 

I've since lost ALL faith and belief in modern medicine.

 

 

Sepiatone

Sorry about your and wife's situation.

It often boggles me how complex the human body is and how easily a vast multitude of serious things can occur.  Perhaps we do expect too much of modern medicine and the mere mortals who practice it.

Makes you wonder if whoever created us wasn't having a bad day.

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In Canada and most of the rest of the world health care is free.  You pay for some prescription drugs unless you are on an insured health plan, maybe through work but anything to do with a hospital is free.  I can't understand why American with all of its wealth can't do this as well.  Major operations or health scares could bankrupt people.  Of course, the rich 1% don't have to worry about this stuff.

Nothing is "free," somebody is paying for it.  In Canada, it is the taxpayers.

 

On a similar note, I worked in a disability program and amazing how many people receive checks and medical care for life for doing dumb things.  Not to mention, their dependents may receive both as well.

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Question why should tax payers front the cost of people that make bad health decisions.  Imagine the (LOW) cost of health care if people simply stop high risk activities.  A guy smoke, gets lung cancer and the ACA should cover it??

 

man-smoke-and-drink.jpg?auto=format&q=40

 

 

The problems caused by fat ___ people over eating.  Is the excuse, someone put a gun to their head?

 

Junk-Food-Addiction.jpg

 

 

 

Why would ANY health insurance cover these idiots,

 

rock-climbing-mark-engelbrecht-2.jpg

 

...or cover the next generation?

 

650213-children-s-rock-climbing.jpg

Let's add in DUI, distracted driving, speeding, motorcycles, etc.  

You might also add parachuting out of aircraft - both military and civilian.  Far, far too many people in the military are in parachutists' positions when there is no need for it.  Generals, colonels, sergeants major, logisticians, administrators, ad infinitum.  Been there, done that.

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Nothing is "free," somebody is paying for it.  In Canada, it is the taxpayers.

 

On a similar note, I worked in a disability program and amazing how many people receive checks and medical care for life for doing dump things.  Not to mention, their dependents may receive both as well.

 

Thanks for making me feel better.   In another thread I said a sports figure was a dump jock.   Yesterday I went to a friend's house and said 'what a dumb'.      :lol:

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Ham, you are tragically naive if you think healthcare costs will go DOWN if all  Americans  adopt a healthy lifestyle.  Like for instance---

 

I have a chronic ringing in my ear( the right).  That stuff LIPO FLAVANOID helps but, in order to determine what caised the ringing, I had to undergo a test by an ENT  that cost me, AFTER the insurance coverage, a co-pay of $500!

 

That was AFTER going to my primary, who simply stuck a otoscope looking device in the ear and pressed a button that caused it to make a "beep" sound, and ask if I could hear it.  HIS charge to my insurance?  He gave it a six-inch long sounding name and charged them $388.  THEN referred me to the specialist.

 

My brother in law hurt his shoulder on the job.  His boss sent him to a local emergency room, where they pronounced it a "strain" and then a nurse entered the stall and handed him ONE Motrin 800 and a little shot glass sized plastic cup of Maalox.  He at first declined, saying he had plenty of Motrin that strength at home and he'll just take it when he gets there.  They refused to discharge him until he took THEIR Motrin tablet, and he said he'd just leave.  They told him if he left without a doctor's formal discharge then they'd bill HIM instead of his insurance.  So, he reluctantly took it.  A month later, while looking over his insurance "summary", he noticed they charged them $400 for "dispention of medicine"!    FOUR BILLS for ONE Motrin and a shot of Maalox.

 

Now, I ask you....Where's the REAL expense in "healthcare"? 

 

If insurance companies had some  OVERSIGHT, they'd probably refuse to PAY such exhorbitent charges, and then the doctors and hospitals would bill the PATIENT, who probably CAN'T afford them, and possible legal entanglements would ensue.

 

And these incidents happened BEFORE the  "Affordable Care Act".  To think repealing "Obamacare" would make things better means ANYone who thinks so is a solid citizen of  "FOOL'S PARADISE".

 

That to require a SEPERATE policy for DENTAL care grinds me that since your teeth are a part of your BODY means , to me, that it SHOULD be covered by your regular health insurance to begin with.  Especially since in recent years they've been able to link several other physical maladies to poor dental health. 

 

I could tell you other stories about this sort of thing that would curdle your blood.  Just ask.

 

 

Sepiatone

 

What I stated is only a small part of the problem, Yours, (the cost of a couple of pills and Maalox) are doctors and insurance being greedy.

 

Hospitals and clinics should post this sign at the entrance or front desk...

 

We're Not In

This Business

For Our Health.

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What I stated is only a small part of the problem, Yours, (the cost of a couple of pills and Maalox) are doctors and insurance being greedy.

 

Hospitals and clinics should post this sign at the entrance or front desk...

 

We're Not In

This Business

For Our Health.

 

The healthcare industry is just another clog in a capitalistic system that's on steroids, in a country soon to be run by the Frankenstein of capitalism --Donald Trump.

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