Insurance companies will eat you for lunch

[raggedykat]

There are more people in this country who have health insurance than don't. And this is a "me" society. I have health insurance and I really don't care if you don't.

[Autopapdude]

http://1.bp.blogspot.com/_RB4pRZNeh8E/R ... ld+Map.jpg

This says it all--the United States is the ONLY country in the industrialized world that doesn't have some sort of universal health care.

[PST]

I wonder how much would/could be saved if hospitals were no longer required to treat illegal aliens? But, then, of course, to do that would be totally out of character for the American way, to let someone die because they couldn't pay for that medical care.

A recent RAND Corporation study concluded that about 1.3 percent of public health expenditures are for illegal aliens. The study was limited to non-elderly adults, so it is probably a little on the high side, since illegal immigrants form a higher percentage of non-elderly adults than of other groups. The study found that illegal immigrants consume health care at lower rates than the population at large. They pay 83 percent of their healthcare costs out of pocket or through private insurance. The other 17 percent is paid from public sources. This was about $1.1 billion in 2000, the year of the data the study used, and is surely more now. The RAND study is at http://content.healthaffairs.org/cgi/reprint/25/6/1700.

The only reason I know about this is that the study was cited in a story in the NY Times this morning about how Grady Memorial in Atlanta, a big public hospital with severe financial problems, just told 50 illegal aliens getting kidney dialysis there that it can't afford to continue. I guess we'll find out soon if it is out of the American character to let people die if they can't pay. The moment of truth comes pretty quickly with kidney dialysis.

[aka fuzzy96]

i think somewhere along the line the constitution was changed from "we the people" to "us the congress"

the fundamental premise that elected officials can competently and unbiasedly represent us as a constiuency is something that wemt out the provebial window years ago.
only an HONEST person can do that and the greed (the american way) has corrupted those individuals, weather it be greed for money,power,or whatever.

our system has not changed with the times and is antiquated. why not all us vote electronically on all the bills the congess cooks up? the technology is here today? why not ONE term term limit. cancell the congressional reitrement fund and save us billions.

they pass laws the average american can't understand. so how can we abide by them? and if we don't we get punished.(sounds like a dictatorship by proxy)

i think the governnent of the rich, by the rich, and for the rich,: has the average american trying to figure where the next bill or house payment is coming from that they really aren't worried what the fools on capital hill are doing. there is nothing they can do about it. the individual in this country has been cast out and the "groups"of individuals fight amongst themselves for control. i'm sure this is not the way the founding fathers envisioned thier new creation.

(steps down off the soap box))

have a nice day

[elg5cats]

Death Panels have been in existence for sometime in the US...........it's in the layers of managed care or preauthorization requirement within the insurance industry. When Humana was the huge powerhouse and the forerunner of restrictive health care, I lived in it's corporate city at the time. Decisions are made to allow or not specific treatments. It's been publicized many times how medical professionals reviewed the need for treatment, approved or denied coverage and received large bonus when "saving money" by denials for treatment. Approximately 10 years ago, Humana was sued violently after denying authorization for a woman with cancer to have a hysterectomy. She paid for her own hysterectomy, sued Humana and the jury was so outraged at Humuma they awarded 13 million . This case was viewed as public retaliation to insurance companies for rationing health care. Death Boards are present in self insured companies, many health insurance companies and I suspect is entering the medical providers decision making because of the financial crisis medical institutions are beginning to experience. Hospitals are now in a financial crisis just as the auto industry, as this financial crisis grows, treatment options for individual patients and likely groups of patients will be effected. If the government health care reform aggravates the challenges which began developing with "managed care," we may watch the medical industry collapse. It's a leaning tower!!!!


http://www.trc-law.com/articles/pdf/mc_v2i1.pdf


elg5cats

[Leongirl]

"Death Panels"! Sister Melissa at the ICU counseled my very ill husband (and me) to always get a living will.
It was clear she has seen too much pain and agony at times when plans should have been made. Sister must be just another one
of those murdering commies. ( Where do your overlords pour this dreck down your throats? And why do you believe such
blatant garbage?)

If nationalized health care is going to kill us, why aren't the citizens of the advanced countries ( Europe, Nordic countries)
all dead and/or suffering and bleeding --like most Americans? Health care is too expensive?? Every study shows Europeans as
healthier and happier for half to a third cheaper. CHEAPER. LONGER LIFE SPAN. LESS PAIN AND SUFFERING. LOWER INFANT MORTALITY.

Why is this so difficult for some americans to understand? Do you think it is amusing that even Slovenians are healthier
than we are? Yes, if i could afford to get to Europe i would. I am sorry i returned to the US only to get screwed with
no university tuition, little health care.... My relatives and friends in Europe are better educated, have a higher standard of
living, do not go broke trying desperately to send their kids to college or to get medical treatment. shock: cry:

[Patrick A]

Well guys, when we don't understand, or even know, what is in the bill, all we can do is sling mud.

Carry on.

What makes you think I was "slinging mud"......my question was why did they accept only a little more than $400.00, when they billed a little less than $3000.00?

[Slinky]

Thanks for that info, PST.

[JohnBFisher]

If Congress succeeds with the current health-whatever bill, the established insurance companies will become ever more entrenched, what little competition there is today will go away, rates will go up and benefits will decline.

Rooster, you hit my fears on the head. I hear one thing then find another reality exists when you read the bills. They want a public option that very, very few can join.

Let me share a couple stories that scare me silly about our current healthcare system.

We can afford to enrich ourselves - but not cover our patients!

Until a few years back, I had United Healthcare which provided fairly good coverage in our area. Then in the same year they decided to award an outgoing CEO almost 1 Billion dollars (yes, it really was almost $1,000,000,000) in stock options. That very same year they decided they could not reach an agreement with a hospital in our area. So, they informed us we had to go to another county for any hospital related coverage. I could live with that until I discovered that meant they would no longer covery ANYTHING that was related to our local hospital. They would not cover our doctors who had privileges at the hospital. They would not cover diagnostic tests done at labs that were loosely affiliated with the hospital.

Why did that become such a big deal? Well, at the time they decided to NOT cover that hospital, unfortunately my wife had some skin cancer we were in the process of working with her doctors. We suddenly found ourselves stuck with several thousand dollars of medical expenses. And we had fairly good coverage! Now we are very careful about our finances, so could manage to cover the expense. But why should we have to do so? If they can afford to enrich themselves, they should be able to cover the patients they contractually are obligated to cover.

There went the job. What now?

Of course, anyone who uses an xPAP machine understands how critical insurance coverage can be for their ongoing well being. Imagine how critical that becomes when it includes a serious chronic condition. In my case, I have type 2 diabetes and a neurological problem. The type 2 diabetes is being kept in check with fairly expensive oral medication. The neurological problem is progressive. Getting the AutoSV unit will be just one of the first steps I need. Without it, the progression will be much swifter.

Of course with those two conditions without a job there is no way I could get coverage. (COBRA - or continued insurance - will be very expensive and runs out after a while). Now add to that horror stories of companies that are laying off expensively sick employees. There are even stories out there of companies dismantling complete groups to eliminate employees on long term disability. So, what happens to the average person with a chronic "pre-existing" condition when they are ousted from their job?

So, what's needed?

Certainly, we as average citizens need to be heard. It seems that higher competition would help. But we can no longer rely on the old "Trickle Down" plan. From my own experience, it sure seems as if everything heads up and nothing down. We as a society should decide to help everyone. I don't mind paying for insurance if I am able. But lack of insurance should not mean a significant increase in poverty and death.

Doubt that? A very large percentage (well over 50%) of the bankruptcies in this country are due overwhelming medical expenses and a large percentage of those people had insurance! And recent studies showed that someone who visits an emergency room without insurance is twice as likely to die. Yes, there are many reasons behind this. But if we truly care about one another we should do what we can to help one another.

[PST]

Rooster, you hit my fears on the head. I hear one thing then find another reality exists when you read the bills. They want a public option that very, very few can join.

I agree that the Senate bill is a lot less good than it could be. The public option is radically curtailed, as Mr. Fisher points out, and other pro-insurance-company compromises have been made. Unfortunately, it appears clear that at least 39 and maybe 40 Republican senators will vote against cloture, which would prevent the bill from even coming to a vote, so it will take at least 59 and maybe 60 Democratic and Independent senators to pass a bill. That means that the bill will have to be compromised to the extent demanded by the most pro-industry Democratic senators: Lieberman, Bayh (both of whose wives have worked as lobbyists for health insurers), Nelson, and a few others. Some of them have threatened to kill the bill if there is any public option at all. These compromises do not reflect the wishes of he proponents of the bill; they had to be made to bring the laggards along. The alternative is no bill. But even in its current form, the bill does the two things that matter most: it requires insurers to take all comers and not exclude pre-existing conditions, and it gets most of the population on the insurance rolls, reducing the current system where way too much care is provided only when patients are sick enough to go to the emergency department, the one place they cannot be turned away. I even think that the insurance exchanges will foster competition, despite success by the insurance industry in keeping more vigorous measures out.

[Scents]

rooster wrote:
If Congress succeeds with the current health-whatever bill, the established insurance companies will become ever more entrenched, what little competition there is today will go away, rates will go up and benefits will decline.

1. There is virtually NO competition NOW. Vermont has two companies: Blue Cross Blue Shield and MVP--both out of control expensive and they love to deny.

2. Rates have been going up consistently ALL THE TIME! Have you not noticed the small print on your weekly pay stub? Take a look-see at some old stubs of last year to now. It's out of control!

3. Benefits? What benefits.

I paid BCBS $400/month with a $7,000 deductible. Yes, $7,000 deductible.

I have real bad sleep apnea and have been battling it for three years. I applied for a sleep study and was denied. My doctor wrote to BCBS but still was denied. I appealed, got denied. I appealed, was denied. Went on for awhile and I realized I wasn't getting a sleep study. I paid out of pocket for one. That cost me $3,600.

I started experiencing chest pain. Didn't know if it was related to the sleep apnea. Went to a cardiologist. Guess what? Blue Cross Blue Shield denied me the visit. They said I had a pre-existing condition.

I cancelled my insurance.

I now have severe depression along with my sleep apnea problem. (No sleep=depression).

I am the face of no insurance. I am a 48 year old white woman, born and raised in America. I have my own small business. Paying a health insurance company $5,000 a year and getting denials for THINGS I NEEDED didn't make any sense to me.

I pray for healthcare reform.

People who make $250,000 or more are against this reform because they will be taxed. They haven't had to pay taxes for the last eight years and are now mad they might have to. The rich want to stay rich. Take a look at California. The state is broke, yet millionaires live there. That will eventually be the way the rest of the states will be if nothing is done.

[roster]

.

People who make $250,000 or more are against this reform because they will be taxed. They haven't had to pay taxes for the last eight years and are now mad they might have to.

Do you really believe that people who make that much or more pay no taxes?

Here is the truth. The top 0.8% of taxpayers, who make $200,000 or more, paid 26 percent of the total Federal income tax bill in the U.S.

[leejgbt]

PatrickA:

You asked.......What makes you think I was "slinging mud"......my question was why did they accept only a little more than $400.00, when they billed a little less than $3000.00?

This question is easily answered. The Medicare allowable for this procedure is too low so the self-pay people and the non-prefrerred provider insurances have to make this up. The real price needed to be charged is somewhere in between.