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[devilgrrl]

This message was self-deleted by its author (devilgrrl) on Sat Aug 17, 2013, 07:08 AM. When the original post in a discussion thread is self-deleted, the entire discussion thread is automatically locked so new replies cannot be posted.

[MADem]

1. What is your home state?

In some, it's income-based. The very poor in MA don't pay a dime.

[MADem]

17. Whatever you do, don't wait until the end of the fiscal year--they'll hit you twice if you are

hospitalized across the FY end/beginning.

Those charges usually are per annum!

[canoeist52]

2. Health insurance today is like "protection money" - you're not really protected.

[RILib]

3. I'm not sure what you're asking

Did you choose a plan with a $3000 deductible? Or was that the only one available to you?

Were you possibly having a heart attack, or were there more seriously ill people needing care ahead of you?

I don't think people can answer your reimbursement question unless they know your home state and your circumstances.

[SoCalNative]

15. It's likely

that, like my plan, hospitalization and major procedures are covered at 90% and you are responsible for the rest.

[BlueCheese]

24. I was confused at first.

But as I read it, the OP is not angry because he or she had to wait for an EKG. He or she had to wait for an EKG because he or she was so angry.

[sabrina 1]

30. Does it matter? In fact your very questions show the enormous problems with a Health Care

system whose main function if Profit.

Someone needs HC in one of the wealthiest countries in the world, they should GET IT!!

It is SHAMEFUL how the American people are treated by their own government. My sister was diagnosed recently with a serious cancer. She has had to quit her job, which means losing her HC. She now has to move, although she would much rather have stayed in their home where she has friends and neighbors who could have supported her.

I am sick to death of the so-called HC debate in this country. There is no debate, we need a National HC system, and we need to get rid of the useless middlemen whose only function is to use up money that SHOULD go to HC, for profit, known as Private Insurance Corps. What is their function as far as Health Care?

[NCTraveler]

60. Good post.

"There is no debate"

Well, there shouldn't be a debate necessary. But there is. Look at how hard it was for them to pass the ACA that we are suppose to be so grateful for. Such crap.

[OwnedByCats]

100. If countries like Great Britain can

provide good health care for very little cost to the patient, we can. There is no excuse for what we have now.

[geckosfeet]

127. Agreement all around here....

[JEB]

128. That's how I see it as well.

Profit over the well being of people like your sister. Like all of us. Medicare for all is needed badly in this country. Not only would it help individuals, it would also be a big stimulus to our economy.

All good thoughts for your sister. Hoping she gets all the care she needs and makes full recovery.

[sabrina 1]

156. Thank you, JEB. I appreciate very much your good wishes.

[lamp_shade]

4. What would it have cost you if you didn't have insurance?

[silverweb]

6. It gets you a "discount."

[font color="navy" face="Verdana"]Without insurance, your out-of-pocket would be more like $50,000 because that's how the system is rigged.

Yes, it's a scandalous, criminal racket.

[Occulus]

20. People who think PROpaganda makes SENSE like it, though.

I'm saying exactly what you think I mean.

[OnyxCollie]

33. !

I concur.

[Occulus]

34. I get your response, but... I'm not laughing.

In fact, I feel a little sick about it.

I'd like to point something out, here. That One was unbelieveably well-versed with every last, least, littlest particular of the ACA when it was first proposed. Immediately. Their expertise on the subject left no time period for study or familiarizing themselves with that same ocean of details, and yet, almost every post, every question, every comment, and every complaint, almost without exception, was met by That One with a long, long list of absolutely truthful, accurate, and provably true blue links. Everything- everything- That One said was 100% true.

There was too much expertise to be credible, at every hour of every day. One person, almost magically knowledgable, almost magically accurate, and almost before those same details were released? With those response times? In gaming terms, there was almost zero ping. Ha. Nobody is that good, that accurate, that knowledgeable, that perfect. Not on such a vast piece of legislation, and not to that level of detail, and certainly not so soon. But... what about a team of White House staffers? No, that's not at all credible... but That One is?

Just thought I'd point that out. "Suspicious" doesn't cover it.

I smell a rat.

[OnyxCollie]

48. What I thought was funny

was the similarity between our posts:

http://sync.democraticunderground.com/?com=view_post&forum=1114&pid=7785

You get points for bolding. I wimped out.

[dflprincess]

104. I think both you and Occulus are quite clever

and make excellent points in your posts.

[Marr]

135. That's an excellent point, and I think many here have noticed the

let's just say, very professional presentation of information. And links are always repeatedly posted, even when they aren't relevant to the discussion at hand. It helps them show up in search engines, but adds nothing to the actual forum dialogue.

A single name for a collection of individuals is, I think, a plausible explanation. I expect it originates with some Beltway think tank, selling policy.

[Art_from_Ark]

165. The information may be presented PROfessionally,

but the post titles can be quite odd, even non-SENSE-ical.

[grahamhgreen]

39. PROpaganda makes SENSE!!! I love it!!!!

[Mojorabbit]

148. + a gazillion. nt

[Myrina]

43. + 1 brazillion

I see what you did there

Glad I'm not its only detractor.

[Occulus]

45. I was clear as to why two posts later, in my next response

I think I have a solid case. That One's behavior, in retrospect, strains the very definition of 'credulity' a field too far past its breaking point.

It is possible to be too good at communicating a message. That One is a textbook example of such.

[grahamhgreen]

158. A conglomerate of think tank hookers.

[HiPointDem]

8. +1

[KansDem]

9. Somebody's gotta make money somewhere...

There's plenty swag in a person's pain and suffering.

On edit: If I had my way, there'd be no profit in helping the injured and infirmed.

[pinto]

10. CA Dept. of Health Care Services may have some leads / info for you -

http://www.dhcs.ca.gov/Pages/default.aspx

http://www.dhcs.ca.gov/Pages/Contacts.aspx

[tridim]

11. I had a failed surgery 20 years ago that at the time was covered by my parent's insurance.

20 years later, the follow up surgery to fix the failure isn't covered by insurance (because it's not life threatening). It's going to cost at least $20,000, which means I'm stuck with the botched result for the rest of my life.

Same thing with the caps on my front incisors. They were covered 25 years ago, now they're not. $2000.

[taught_me_patience]

93. You should check out Thailand

I bet the 20k operation would be 5k there and caps would be 500 or so.

[Hoyt]

110. Surgery should be covered in 2014. Caps, not likely.

[alfie]

12. Call the hospital's Social Services Department

Explain your situation and ask them what help might be available. They will know about discounts the hospital might give and what state aid might be available.

Good luck!

[MineralMan]

13. Probably not. I don't know of any such thing.

$3000 isn't a lot to get a working knee really. I assume that is your co-pay. Most health insurance has a co-pay. I don't know what the surgery involves, but I can guarantee that it costs way more than $3000.

It's not a good system, but that's the system. I'd pay that to have a working knee any day of the week.

Imagine all the people with bad knees and no insurance at all. What do they do, do you suppose?

[Occulus]

23. A dollar is too much to pay to get a working knee

and was more than anyone with medical insurance would have paid for it thirty-odd years ago.

[Ms. Toad]

76. Actually, not.

30 odd years ago my parents had a high deductible plan, and the cost would have been in that ball park. I don't know what their deductible was, but I do know that what they purchased for insurance was a high deductible plan.

They fell out of favor between then and now, and are only recently coming back into favor (although I personally had one around 20 years ago by choice).

[Yo_Mama]

92. Adjusted for inflation, not so

Most people used to have major medical insurance (80/20). I remember that's what we had when I was a kid (and that was union insurance). I think it was capped somewhere, but I forget where. Certainly not at less than $2,000.

When I first got out of school that was the type of insurance I got. You saved money in those days for medical costs. Also it didn't pay anything for doctor's visits, etc.

My insurance about 20 years ago was pretty good, but it still cost me over $2,000 for a severe bout of abdominal pain with no hospitalization, which was the last real medical care I had. Most of it for the CT scan. Insurance just gets you in - there's plenty to pay.

[freshwest]

28. I see the results of the under and un-insured daily, hobbling. That's the result.

[Flatulo]

46. You realize that to some people, $3000 is an astronomical

sum of money.

I could afford it, but to some it's like a million dollars is to me.

[MineralMan]

47. Of course. I do not have it.

I would find a way to get it, though. That is the reality. Now, people who have no insurance at all are in a much worse position. There are many people in that situation.

[rusty fender]

50. Aren't you a font of compassion!

[MineralMan]

51. No. I'm a pragmatist.

A woodchuck, if you will.

[Occulus]

66. Actually, that's a destructive and harmful psychological technique called "minimizing"

and it's a known form of actual mental abuse.

[MineralMan]

67. I see. You have misread my reply, then.

Seeya.

[Occulus]

68. No, I recognize it for what it is. Broadly speaking, it's termed "invalidation".

http://core.eqi.org/invalid.htm

Saying I misread it is also one of those same techniques. And again, it's a form of abuse, that I cannot possibly understand your point or what you were trying to say.

I understood you fine. I just know exactly what you're trying to pull here, and pointed it out for what it was.

What you do on this board is toxic, MM. I only want you to be aware that some of us do in fact recognize your little games, and see them for what they are.

[MineralMan]

70. You're wrong. But that is your opinion and you're entitled to it.

You don't know me at all. Nor do I know you. We'll both continue to post on DU, I'm sure.

[Occulus]

71. No, actually, I am not wrong.

What you do here, and we've all seen it again and again, could have been (and in fact is) taken directly from the link I provided, which is used in substance abuse and psychiatric counseling verbatim. I do not need to know you, at all, to recognize the form of abuse you give to others here. And be aware, it is abuse, the kind of mental abuse that can only be countered by one-on-one therapy and counseling if people are exposed to it often enough. That you deny you are doing so is part of the technique discussed at the link.

Again, I do not need to know you to know what you are doing. That is because what you do here is in no way unique to you. It is, in fact, so very very common that many times people who use these techniques against other are not even aware they are doing it. This is because we are exposed to these forms of mental abuse, this invalidation, so very often in our society that we internalize it to the point we're unconscious of ever using it.

Being aware of the techniques, how they are used, and what they truly are is a major step toward ending their use.

Here are some examples of invalidation commonly used on DU, copied directly from the link I provided, which again, is used professionally, verbatim (DU is rife with all of the following):

Examples of invalidating expressions. -- Each is an attempt to talk you out of your feelings.

"Ordering" You to Feel Differently

Smile.
Be happy.
Cheer up
Lighten up.
Get over it.
Grow up
Get a life
Don't cry.
Don't worry.
Don't be sad.
Stop whining
Stop laughing..
Don't get angry
Deal with it.
Give it a rest.
Forget about it.
Stop complaining.
Don't be so dramatic.
Don't be so sensitive.
Stop being so emotional.
Stop feeling sorry for yourself (Source)
Stop taking everything so personally


Ordering you to "look" differently
Don't look so sad.
Don't look so smug.
Don't look so down.
Don't look like that.
Don't make that face.
Don't look so serious.
Don't look so proud of yourself.
Don't look so pleased with yourself.

Denying Your Perception, Defending

You've got it all wrong.
But of course I respect you.
But I do listen to you.
That is ridiculous (nonsense, totally absurd, etc.)
I was only kidding.
That's not the way things are.
That's not how things are.
I honestly don't judge you as much as you think.
It's not going to happen


Trying to Make You Feel Guilty While Invalidating You

I tried to help you..
At least I .....
At least you....
You are making everyone else miserable. (Source)

Trying to Isolate You

You are the only one who feels that way.
It doesn't bother anyone else, why should it bother you?

Minimizing Your Feelings

You must be kidding.
You can't be serious.
It can't be that bad.
Your life can't be that bad.
You are just ... (being difficult; being dramatic, in a bad mood, tired, etc)
It's nothing to get upset over.
It's not worth getting that upset over.
There's nothing wrong with you. (Source)

Using Reason

There is no reason to get upset.
You are not being rational.
But it doesn't make any sense to feel that way.
Let's look at the facts.
Let's stick to the facts.
But if you really think about it....


Debating
I don't always do that.
It's not that bad. (that far, that heavy, that hot, that serious, etc.)

Judging & Labeling You

You are a cry baby.
You have a problem.
You are too sensitive.
You are over-reacting. You are too thin-skinned.
You are way too emotional.
You are an insensitive jerk. .
You need to get your head examined!
You are impossible to talk to.
You are impossible.
You are hopeless.

Turning Things Around

You are making a big deal out of nothing.
You are blowing this way out of proportion.
You are making a mountain out of a molehill.

Trying to get you to question yourself

What is your problem?
What's wrong with you?
What's the matter with you?
Why can't you just get over it?
Why do you always have to ....?
Is that all you can do, complain?
Why are you making such a big deal over it?
What's wrong with you, can't you take a joke?
How can you let a little thing like that bother you?
Don't you think you are being a little dramatic?
Do you really think that crying about it is going to help anything?


Telling You How You "Should" Feel or Act
You should be excited.
You should be thrilled.
You should feel guilty.
You should feel thankful that...
You should be happy that ....
You should be glad that ...
You should just drop it.
You shouldn't worry so much.
You shouldn't let it bother you.
You should just forget about it.
You should feel ashamed of yourself.
You shouldn't wear your heart out on your sleeve.
You shouldn't say that about your father.

Defending The Other Person

Maybe they were just having a bad day.
I am sure she didn't mean it like that.
You just took it wrong.
I am sure she means well.

Negating, Denial & Confusion

Now you know that isn't true.
You don't mean that. You know you love your baby brother.
You don't really mean that. You are just ... (in a bad mood today, tired, cranky)

Sarcasm and Mocking

Oh, you poor thing. Did I hurt your little feelings?
What did you think? The world was created to serve you?
What happened to you? Did you get out of the wrong side of bed again?


Laying Guilt Trips
Don't you ever think of anyone but yourself?
What about my feelings?!
Have you ever stopped to consider my feelings?

Philosophizing Or Clichés

Time heals all wounds.
Every cloud has a silver lining.
Life is full of pain and pleasure.
In time you will understand this.
When you are older you will understand
You are just going through a phase.
Everything has its reasons.
Everything is just the way it is supposed to be.

Talking about you when you can hear it

She is impossible to talk to.
You can't say anything to her.

Showing Intolerance

This is getting really old.
This is getting really pathetic.
I am sick of hearing about it.


Trying to Control How Long You Feel Something, or Judging You for How Long You Feel It
Are you still upset over that? It happened a long time ago.
You should be over that by now.

Explanations

Maybe it is because...
That is because
Of course, because you.... (This one hurts four ways. First, the "of course" minimizes what you feel, second the "because" explains what you feel, as if explaining it nullifies the feeling, third the "you" blames you and fourth, blaming you is a form of attack which is likely to make you feel either defensive or guilt-tripped or both.)

We all say such things to each other occasionally, but again, that is because we've all internalized the entire concept to the point we don't realize we're doing it. That follows from having al the above, and more, directed at us by others so frequently we think it is "normal" behavior and "normal" responses. They are nothing of the sort.

I strongly encourage you to visit the link and read all of it. I advise others on DU to do the same. I've done these things. We all have.

That does not make it right.

[Newest Reality]

83. So then

this assures invalidation of those who invalidate?

That seems to encompass a very large chunk of habitual and common nomenclature and does it mean that every anyone uses any of those phrases they have the implied intent?

Seems we need a reboot of language to negate our invalidation and what of our capacity to not let other people control or manipulate our feelings, (as in they are our own reaction to any situation, especially verbal communication, and therefore subject to our will) as much since we really can't control what other people will say or do to the extent that list suggests.

Otherwise, those ideas are also worthy of consideration for those who care to be more considerate an less manipulative. It's just my opinion that manipulation is a very common aspect of our entire culture, be it overt or covert.

Thanks.

[Occulus]

84. That's one of the points of the material, yes.

It explicitly states that we do and say these things to each other, because we have been exposed to it so often ourselves we don't realize when we do it to others.

I've been considering a very long OP detailing this material, and how it applies to DU and our posts here, ever since I read what's presented at that link. That this is actual counseling material, given in actual sessions with actual patients, only serves to underscore its validity as legitimate study.

Frankly, these materials are things Skinner, Elad, and EarlG would do well to examine and incorporate into the rules about refraining from "making DU suck". The more I look at what's provided at the link, the more I recognize it from DU posts.

We would do very well to try to incorporate a lot of this here on DU. We would do even better to try to use it in our interactions with others; I recognize a lot of what's presented at the link in my interactions (positive and negative) with other people in my own life.

And again, this material isn't something I just pulled out of my ass; this forms an actual basis for patients receiving counseling for, ,among other things, suicide attempts. I showed it to a friend who recently attempted suicide via drug overdose, and he immediately recognized pertinent portions from his own sessions. The handouts he received were direct quotes from the link. Needless to say, I was a little surprised, but this material is actually the real deal.

We would do well, all of us, to read it and take it to heart. If we do, DU will be a much better place to be.

[Hassin Bin Sober]

125. That's a lot of fancy talk to explain a jag-off statement dropped in a thread.

But I get your point.

[canoeist52]

140. Thank you so much for putting this into words.

[Hassin Bin Sober]

123. Not too long ago he talked about having to borrow a couple hundred dollars to have...

.... dental work.

I guess the OP's problem is they don't have anyone they can leech off like our compassionate woodchuck friend.

[NCTraveler]

62. I understand you a lot better after reading this post. nt.

[dflprincess]

99. $3K is a lot if you don't have it

And it's probably the deductible. I'm guessing the OP may have one of those lovely high deductible (aka "consumer driven&quot plans that doesn't pay a dime until you hit the deductible. If it's a really lousy policy the actual out of pocket amount could exceed the $3k as the insured could still be on the hook for copays. When it comes to the high deductible plans copays may be applied to an additional out of pocket annual maximum or you might be on the hook for all of them with no annual cap.

A year ago I was doing contract work which paid well, but had lousy insurance coverage - one of the high deductible plans and it's deductible was just a bit under $6,000 (the legal limit for these plans is now just over $6k but the law only allows you to put less than $4K into the health savings accounts that always accompany these scams). I took a very large pay cut to accept a permanent job with great benefits. I figured one major medical event would make up for the difference in my take home pay.

Lucky I did that.

The policy I currently have has a $1,500 annual out of pocket max that, as long as I'm in network (and nearly every medical facility in the state is in network) is pretty much made up of copays. In January I broke my wrist and did such a number on it I needed a plate put in. The amount billed my insurer (including ER, surgery, follow up visits and therapy) was over $26,000. The negotiated amount was around $14,000 - of that I paid about $500 out of pocket - all for copays. Had I had the old insurance the deductible would have been $6k AND I would have had to pay the $500 in copays (probably more, I'm not sure what the copay rate was on that policy). Not ot mention all the hassles with the for-profit insurer I was with at the time (I had had to fight with them to pay for some screening tests that the law says must be covered). The non-profit I'm currently with paid claims faster than I have ever had the most minor claim paid by other companies.

Sadly, the ACA will allow these high out of pocket plans to continue and more people will be stuck with them as the cost of health "insurance" continues to rise. The bill may require that we have insurance - but it does nothing to guarantee access to care.

[MineralMan]

119. Yes, it is a lot. I don't have that much on hand, either.

If I needed knee surgery and that was what I had to pay, I'd be looking for stuff to sell to raise the money. I could put it on a credit card, but I'd be loathe to do that.

You're right. It is the lousy nature of our health insurance that puts us in that situation. It's a real stumbling block. That's why I support cradle to grave single payer, single pool health care. I support it, but we don't have it, and it's currently an unattainable goal, it seems. If it were up to me, that's what we'd have.

So, there's the situation. I don't like it any more than anyone else does.

[Marr]

136. You don't know?

Well, no wonder you cheer for health *insurance* reform as a substitute health care reform.

[MineralMan]

145. I don't know if there's a program where the OP is that

will pay for the deductible or not. My House member says that she supports single payer, and that's one of the reasons I support her. It's a question I ask of every candidate I will vote for.

It doesn't appear that single payer is achievable at this time, and wasn't before, either. All I can do is work to help elect candidates who support it. If you have some other plan to make it happen, I'd like to hear about it. All I know is that I'm not in a position to deliver single payer health care.

What we have is far from the best system available. It is what we have to deal with, though.

[voteearlyvoteoften]

14. How bad is your knee?

I was scheduled for arthroscopic today and canceled. I saw a recent study that compared outcomes for surgery to physical therapy and the results were equal. Plus once the cartilage is removed you are one step closer to needing knee replacement. I am a bit gimpy but improving a month out from my little accident(fell off riding lawnmower lol) I am going to give it some time and try physical therapy. I tell you though that limping makes me feel 10 years older...
Anyway they wanted @2000 from me plus PT and medical devices so Im thinking if I can get better insurance through Obamacare next year I could maybe try it then.
Hope you feel better, and let me know your outcome if you can.

[Melissa G]

49. Just something to look into...

getprolo.com

Have lots of friends who have rebuilt their joints with this. It's been improving my shoulder. pm me if you want more info. Not cheap, but cheaper than 3 grand and not surgery. Usually not covered by insurance at least where I am.

[Melissa G]

63. Make sure you get a talented doctor.

The guy I go to is one of the best in the country. One of my old staff people had knees so bad she could hardly stand. Saw her a year later after prolo and I was shocked how great her knees were. She raved about her results!

I've been going a couple of months. Great results in my shoulder; bunion is coming along, but slower.

David Harris is the Doc I use. He's excellent! I go about once a month. probably just one more visit and my shoulder will be good. (4 total) probably a couple or three more to finish up the bunion.

If it's a joint related problem, this is likely to help. Not sure what part of the country you are in. My doc's office may have a practitioner recommendation.

Good Luck!

[Puglover]

56. The procedure is actually kinda interesting.

My advice is do the spinal and watch on the TV. Plus you get Rushcandy. (Oxycondin)

GO TO THE GYM AFTER AND RIDE THE BIKE! It really really helps.

[Puglover]

90. Swear to God.

It's nada. Oh you're sore after. But I certainly had no trouble getting up to pee at night and walking to the bathroom.

[postulater]

16. What's the point in having surgery if you're the same without it?

N Engl J Med. 2002 Jul 11;347(2):81-8.
A controlled trial of arthroscopic surgery for osteoarthritis of the knee.
Moseley JB, O'Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH, Hollingsworth JC, Ashton CM, Wray NP.
Source
Houston Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX 77030, USA.
Abstract
BACKGROUND:
Many patients report symptomatic relief after undergoing arthroscopy of the knee for osteoarthritis, but it is unclear how the procedure achieves this result. We conducted a randomized, placebo-controlled trial to evaluate the efficacy of arthroscopy for osteoarthritis of the knee.

METHODS:
A total of 180 patients with osteoarthritis of the knee were randomly assigned to receive arthroscopic débridement, arthroscopic lavage, or placebo surgery. Patients in the placebo group received skin incisions and underwent a simulated débridement without insertion of the arthroscope. Patients and assessors of outcome were blinded to the treatment-group assignment. Outcomes were assessed at multiple points over a 24-month period with the use of five self-reported scores--three on scales for pain and two on scales for function--and one objective test of walking and stair climbing. A total of 165 patients completed the trial.

RESULTS:
At no point did either of the intervention groups report less pain or better function than the placebo group. For example, mean (+/-SD) scores on the Knee-Specific Pain Scale (range, 0 to 100, with higher scores indicating more severe pain) were similar in the placebo, lavage, and débridement groups: 48.9+/-21.9, 54.8+/-19.8, and 51.7+/-22.4, respectively, at one year (P=0.14 for the comparison between placebo and lavage; P=0.51 for the comparison between placebo and débridement) and 51.6+/-23.7, 53.7+/-23.7, and 51.4+/-23.2, respectively, at two years (P=0.64 and P=0.96, respectively). Furthermore, the 95 percent confidence intervals for the differences between the placebo group and the intervention groups exclude any clinically meaningful difference.

CONCLUSIONS:
In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure.

http://www.ncbi.nlm.nih.gov/pubmed/12110735

Of course, you might have a different problem.

[Warren Stupidity]

65. Um, yeah, a competent clinic will not recommend surgery for knee arthritis.

But if she has cartilage or ligament damage surgery is generally a good choice.

[Egalitarian Thug]

18. The point is for you to be required to keep propping up corporate thieves.

The Health Insurance Industry Profit Protection Act is, just as predicted and warned about, a slow-motion disaster that we are all now going to witness as it explodes.

Wait until we learn how may hundreds of thousands of people we kill each year in order to protect these parasites comes out. I can hear the rationalizations now.

[Occulus]

25. With long lists of blue links, because PROpaganda makes SENSE.

I'm going to keep saying that. If anyone wants it stopped, ban me. Nothing less will shut me up.

[BlueCaliDem]

80. Naw, Not ban. Just giving you more rope...

By the way? ObamaCare has NOT been implemented yet, that is, the exchanges have not yet opened and the U.S. supported policies are not yet available. You're still under the old system - pure ProfitCare.

I hope you at least know that before you start attacking ObamaCare.

[haele]

27. Lack of insurance/insurance shenanigans were killing people before -

Now it's only insurance shenanigans killing and bankrupting people.

It's better than the way it was before with the hypocrisy of "the uninsured getting free health care at the emergency room", but still akin to hopping out and hoping the require insurance plan allows one to land on the yet-to-be ignited coals rather than in the flames in an effort to exit both the frying pan and the fire.

The healthy people who avoided getting health insurance before now have to carry it, and employers who weren't offering health insurance before now have to offer it because the "government" can no longer continue to carry the tab for those who weren't paying into the system when they got sick before. The bad part - the fire - is that they're stuck with a "government" health care insurance requirement that was created and pushed through congress by corporate lobbyists instead of actual informed government studies and a congress interested in the welfare of the American people and economy.

That's not a rationalization. The system sucks, because it's the one the hysterical "OMG, it's communist!" small-government thinktanks, talking media conglomerate heads, and other greedy and apologetic corporate suck-ups across all the classes of citizenry would rather have.

The truth is an unregulated free market kills, by withholding needed services to those who can't pay for them, or by overcharging and cheating the system.
In an unregulated free market, wealth becomes it's own - and the only - virtue.
Compassion, pride in quality, innovation - if it don't make money for the people that sit on top of the heap, those are now sins in the free market.

Single payer is the only way to go if the private sector has any involvement in health care, and hopefully, with as more people get tired with how expensive it is allowing a business to regulate itself (could there be competition when the same parasitic board members and hedge fund "investors" simply rotate their way through all the major corporations that have anything to do with health? ha!), it will come into being within the next ten years.

Haele

[Fumesucker]

29. We were already spending enough per American to have top flight health care for everyone

Now we're going to be spending even more and there will still be people who won't get needed health care for a variety of reasons.

[haele]

32. I know - Before wasn't "better" and was untenable, but now is not good enough and more expensive.

There are some people - the ones who needed insurance for medical service but were unable to even get access to it who are seeing a better situation, but those people are too few in number for the price.

We have our own deductible issue with a "new consumer choice/healthy living" policy that was cheaper and the company I work for jumped on it.

If I didn't have a disabled dependent, it would be cheaper to us, but oye - $9000 deductible for specialty mail order prescriptions, but the $3000 over-arching "pay full negotiated price until you hit it" family deductible apparently includes the "go to Walgreens/Costco/Longs and pick up a month's worth of meds"? And the new FSA/HSA plan sucks; we spent most of it getting up to the deductible already.

So now, that dependent has to find another drug to alleviate the chronic pain and slow the physical degeneration - until he can get on Medicare during the open enrollment in October because he is currently collecting SSDI - that expensive medication he was taking before is much cheaper under Medicare - 75% cheaper. Which is sad, because the reason we kept him on my company insurance policy is that it used to be pretty good PPO policy; a bit high on the premium, but they allowed the doctor and prescription co-pays to kick in immediately and the network was fantastic.

Damn corporate bloodsuckers.

Haele

[Occulus]

36. Do they use cannabis? They don't have to smoke it and it may help.

Maybe a little... maybe a lot. A vaporizer can cost ~$300 or more (for the best, a Volcano), but that's not much in light of the scrips.

And if they have a hangup about using cannabis, please help them get over that enough to at least try it a few times, enough to be certain it isn't helping either (unless they're one of the few who have bad reactions to cannabis, which can happen to some; I know a couple such, personally).

There are several reasons for cannabis prohibition, and the pharmaceutical industry is one of the larger ones, because rest assured they already know that it works and have probably scientifically established as much in-house (but won't ever release their own findings) that it is mildly to wildly effective, depending on the patient and the medical condition, and is a direct and even existential threat to their vast profits.

It might help. It has for many others, with a wide array of conditions both transient and chronic.

[cbdo2007]

19. Who would you rather have pay for it? It is your knee.

Sounds like $3000 is your out of pocket max for the year, so hopefully after that your health insurance will cover more of it for you.

That's why I prefer HMO much more than PPO is that the costs all seem to be less on something like this.

[Fumesucker]

21. The insurance company to whom the OP is likely paying a hefty premium?

[Occulus]

37. The taxpayers buying weapons and vehicles the military SAYS it doesn't want or need?

[ForgoTheConsequence]

152. Why are you posting here?

www.freerepublic.com

Rugged individualism and Ayn Rand are masturbation material over there, you might feel more at home.

[cbdo2007]

159. HAHAAHHAHAHA

Thinking doctors perform surgery for free is "rugged individualism" now?? I'm sure in your utopia you'll have lots of doctors signing up to do medical care when they don't get paid for it. Good luck with that!

[colsohlibgal]

22. The Culprit Is For Profit health Care

That's what changed starting with the HMO concept. Before that insurance was mostly quite affordable because there was no array of CEOs and Boards skimming off multi millions - which now comes off your care and/or bottom line. BTW you can read of HR "Bob Haldeman filling in Tricky Dick about this new health care plan to shift more cost to consumers in the "White House Transcripts". So the start of this mess was in the 70s.

Most or all other industrialized nations, one way or another, do not allow for profit heath care. We do and it's obscene.

Many on the right claim we have the best health care in the world - maybe we do but only if you can access it and afford it.

[Cal Carpenter]

26. Profit for shareholders and sky-high salaries for executives

at private insurance companies.

It is very simple.

[JDPriestly]

35. Did you go to an emergency room?

That can really be expensive.

Have you talked to the hospital social worker?

Call the Insurance Commissioner's office in California if you think you have been overcharged.

A knee operation can be expensive, I suppose.

I'm so sorry.

[raouldukelives]

38. To make money for Wall St investors. It hurts the shareholder when you are treated like a person.

Our role is to be treated as an expendable commodity to be squeezed until the last drop of blood and last tear of pain has fallen into the cash register.
At least we can sleep comfortably knowng our suffering lines the pockets of those who rely on our pain for expensive handbags, fancy homes and luxury cars.

[smirkymonkey]

40. No kidding. Every year I have to fork out more and more money

out of pocket for just PREVENTATIVE medical care! And I only go to in-network doctors. They just cover less and less. And charge more and more. It's such bullshit.

[grahamhgreen]

41. Medicare For All. Where is the FIX for Obamacare we were promised when it passed????

[Honeycombe8]

87. First it has to be fully enacted. Another year and a half before that happens.

Then have to see what's what. Then we have to elect a new Democratic President who wants to tackle health care, but I don't see any candidate wanting to go down that path, since it caused such a ruckus for the 8 preceding years.

I don't recall any "promise" of medicare for all. Although we here on DU discussed the possibility of gradually enlarging Obamacare over the years so that it ends up being Medicare for all-like. But when I spoke of that, I was talking decades down the road for the final fix. I will be dead by the time it happens.

[cyclezealot]

42. A suggestion

Consider a foreign medical vacation. You'll have to pay out of pocket, but should you choose your country well, the cost might be 1/5 of US' costs..

[matt819]

44. How's this for another thing to bitch about

Spouse just had $70,000 operation. Hospital billing office, which is run by a bill collection agency, calls to ask how I plan to pay for the deductible. AND I HAVEN'T EVEN RECEIVED THE BILL YET!!

[Cleita]

52. None, whatsoever.

This is why in the years before I qualified for Medicare I didn't have any insurance. I figured out that I would never really meet the deductible in a year, unless I had something really catastrophic happen to me like cancer, so I was paying for my health care out of pocket anyway. I reasoned why did I need to throw good money at a parasitic insurance company for premiums on top of that? My husband was concerned about what if I did get a big disabling and expensive disease. I told him it was a chance we were going to have to take being I was in good health at the time I made the decision. So I did it and I was able to hang in there until I qualified for Medicare which is the best insurance I ever had. I wish everyone had Medicare. They should. A pox on the Max Baucuses of Congress for keeping this from the public for their personal gain.

[csziggy]

105. I lived without insurance for decades

Paid for my doctor's visits, injuries, visits to emergency rooms - all out of pocket. Even paid to have my left shoulder completely rebuilt out of pocket (1993 - ~$14,000).

Then my husband got a job with really good health insurance that kicked in his first day at work. Three weeks later I tore and folded the medial meniscus in my left knee. Since I've had a hysterectomy, another torn and folded meniscus in the right knee, right shoulder surgery, and last year total joint replacement on both knees and carpal tunnel surgery. My out of pocket (deductible and co-pays) just for last year was as much as the left shoulder operation twenty years ago - but if I had to pay the complete cost for the new knees, it would have been over $100,000.

I've still got several years to qualify for Medicare so my best hope to let my husband retire early is the Obama health care exchanges.

[MineralMan]

53. In 1991, I spent two weeks in a hospital, part of it in a coma.

I had contracted viral encephalitis. Before I was done, the amount I had to pay, after my health insurance paid its part, was $22,000. I am alive, still, today. It took me five years to pay that $22,000 off, and had to take a loan against my house to do so. Had I not had health insurance, as is the position of so many, I would not be typing this reply.

Was it worth it? I think so.

[graham4anything]

54. I agree, doctors make far too much money.There are 1000s of drs in other countries that

are just as good and would work longer hours, make house calls and if they were away,
leave someone to replace them and work alot cheaper.

Doctors should not be paid one penny more than teachers

If one would lower their pay, then all the other costs would drop considerably.

of course, without a hospital, where a doctor would operate i don't know

If one takes a policy with a $3000 deductable, well, it goes without saying $3000 is out of pocket.

It would cost a helleva lot more if one didn't have insurance.

[graham4anything]

124. No it wasn't. Healthcare starts and ends with doctors.

as Jimmie Dale Gilmore sang (c)Butch Hancock- "Just a wave, not the ocean".
insurance is just a wave in an ocean
the ocean starts and is populated by doctors first and foremost

why only blame President Obama and his 100% beneficial to everyone in America health care?

when in fact an Octopus has all the arms and the Octopus itself is the Doctor.

[Xithras]

64. What an odd position.

My wife is a teacher. My daughter is premed. The skills required for the two jobs aren't even remotely comparable.

[yawnmaster]

74. 1000s of doctors that are just as good at knee surgery? link? eom

[Posteritatis]

81. Uh, yeah, try again. (nt)

[slipslidingaway]

96. What??? Are you living in your own world while ignoring what happens under a ...

for profit HC system vs. a not for profit system?

Surely looks that way!

And you know the ACA has lots of out pocket expenses for many people who will soon find out that having HC insurance does not mean they will be free of financial problems because of HC expenses.

[dflprincess]

101. It's not the doctors it's creeps like the CEO at UnitedHealth Group

who makes way more than either the internist or surgeon I saw this year do.

At least a practicing physician provides a service you need - Stephen Hemsley and other insurance executives do not.

[graham4anything]

122. Without a doctor there would be no insurance companies. Without a teacher, no doctor

health care after a problem starts and ends with the doctor and his diagnosis/prescriptions/actions

A doctor to be honest, could afford to GIVE their services for free to anyone who can't afford it, and to give drugs to clients who can't afford them.
Give, meaning per person based on need a waiver or even cash back.

OR a doctor could accept something other than money for services(barter).

Doctors start and end the matter of health.

Why do people protect the doctor?Without them, none of the other stuff exists.

The doctor answers the qustion which came first, the chicken or the egg.

[Puglover]

129. "OR a doctor could accept something other than money for services(barter). "

Wow one of the biggest RW trolls got booted out of the Republican primary in 2010 in Nevada for suggesting the same thing. (Chickens I believe it was) She was basically laughed out of the race. Sharon Engle took her place. How odd you would come up with the same idea.

[graham4anything]

130. Doctors are rich. A doctor needs a car mechanic, needs a plumber, needs whatever

barter is a bonafide method of trade in the world

and teachers are MORE important than a doctor and get paid 1/ 100th of a doctor

Why put down teachers?

Maybe the doctors kid needs a tutor?
Trade

however, today it seems like most doctors most need MONEY to continue their lifestyle
and if you don't have, they could care less.

A GOOD doctor will just take what the insurance gives them, and wipe out the rest of the cost of others knowing they can't afford it.

Why protect doctors and ad hominem me?

Lawyers by the way do free work all the time. Doesn't our get based on same legal help for all regardless of salary?And yet lawyers have to have insurance themselves, and can be sued for the equal of malpractice.(and corrupt lawyers that break the law get jailed like that one that is famous).

[graham4anything]

131. answer #2-I bet 1000s of the richest doctors would quit if there was a limit they could charge

If you change all the rules, then only charge $xx number of dollars for this surgery or that.
anywhere in the nation.No higher price

So, are you advocating that?

I bet there are a million good doctors worldwide that would gladly fly here and become doctors here to replace the greedy ones.

it starts and ends with the doctor. Greed starts with them.

If you want socialized medicine, the prepare the doctors to have set price and not one stinking penny more.

Doctors I have used, some have written off all $$$ that the insurance didn't pay, and accepted just the insurance.

Last year alone I had just from a hospital a $51,000 bill. Insurance paid over $40,000 of it.
And then about 50% of the rest was bargained off.
Yeah, I paid about $6000 out of pocket, but was damn happy to not have paid $45000.

What, is it all suppose to be free?If so, start with the doctor, have them work for FREE.
(with NO back from insurance).

[graham4anything]

133. BTW-a football team owner makes more than the quarterback who makes more than a defensive back

[OwnedByCats]

114. Doctors are not the problem generally

Besides, do you have any idea how much student loans are for doctors? I can't imagine doctors being able to pay those, along with their cost of living, on a teacher's salary. Not to mention their malpractice insurance, which they have to pay for, is outrageously expensive.

[Puglover]

55. I had my knee scoped in the States.

I have great insurance. 1500.00 out of pocket for MRI and scope. I had the same thing done in Ecuador where I now live.
EXACT same quality of care and results. 300.00

I have never regretted for one nanosecond our decision to leave the states.

PS Same thing with a root canal and a crown. USA out of pocket 1000.00. Here 150.00.
.
PS I am so sorry. The health insurance cartel up there is disgraceful. Yeah, Ecuador is such a 3rd world country.

[truedelphi]

94. I see according to your profile info, that you live roughly

Somewhere in here:

http://en.wikipedia.org/wiki/File:Otavalo_Imbabura_nina_urkuwan.jpg

That looks really nice (As long as that mountain behind the town is in a very dormant volcanic stage.)

[Puglover]

118. Yep.

Our home is roughly between Otavalo and Cotacachi. We are in the country about 3-5 miles from each city. This is Cotacachi from the courtyard in the rear of the house.


And this is Imababura from the side and front of the house. Both have behaved themselves for 14 thousand years. I figure the odds are good. Now Tungurahua is a different story down south. It is grumbling constantly.



It is so odd. Among the many wonderful expats down here there are more then a few RWers who came down to escape the tyranny of Obama et al. Makes sense huh? Move to a socialist country where they think they can live like kings and queens on their social security.

Speaking with my Ecuadorian friends just take a wild guess who are acting like assholes,treating the locals like crap and generally whining about the states if affairs here.

[truedelphi]

146. Actually i rather prefer that the RW A-holes

Sit around and whine about thing, rather than go out and shoot up the flora and fauna.

But it is abysmal that they will move to another country and then complain about that country's inhabitants.

Like of friend of mine's mom once said, "Italy would have been delightful, if only so many of them didn't speak Italian!"

[abelenkpe]

57. My Aunt and Uncle are both retired federal employees

Supposedly with good health care coverage. (one retired from dept of agriculture, the other from dept of state) Told me recently they average around 10,000 a year in out of pocket medical expenses. And this is with health insurance. Yay for profit health insurance! Freedum!

They can barely afford this. They both have pensions and receive ss. What will the future be like for the generation with no pensions?

[Honeycombe8]

88. They don't get Medicare? nt

[abelenkpe]

91. I'll ask

Whatever they have it doesn't cover everything and they have additional costs.

[graham4anything]

132. Should the doctor work 100% for free? If one wants free, then the doctor should be free

btw, France has the best healthcare in the world, however, the doctor still makes a decent salary.

so do all the other healthcare workers.

I will love to have the French system, but alas, the republicans hate the French, therefore anything French, will be American at this moment in time.

[abelenkpe]

138. Who said anything about expecting doctors to work for free?

People in the US contribute thousands to their healthcare plan during their working years, still pay thousands (like my aunt and uncle) in out of pocket expenses on top of their health care contributions, and are still denied some treatments. It's the number one reason families are pushed into bankruptcy. Doctors in countries with single payer and nationalized healthcare still make good money. So I'm not sure where you get this notion of wanting something for free from.

Honestly, it sounds like something my freeper mother would say.

[graham4anything]

139. starting last month, for 2013-14, thanks to President Obama, I have saved $19,200 in premiums

straight out of pocket

no lifetime cap
no not being accepted because of prior

last year $3000 a MONTH with a 50/50 co til family limit,

this year only a $2500 per/5000 family 70/30 with $1500 a month

out of pocket BEFORE BEING SICK of $19,200


YES, one has to pay

In France, they pay more now when sick nothing, then get better and pay again

Yes, you seem to be asking for FREE(i.e. NO cost after insurance.)

Do you have an insurance plan
A
B
C
D
there are plans where almost nothing is paid

does it have a lifetime cap?
if so, it sucks

thanks to President Obama-NO more lifetime caps
NO exclusion for prior

and one gets what they pay for.

It never is free.
Nor was it ever.
FDR did not make it free
LBJ gave us the best prior

Where were the voters to rally the repulbicans and protest democratic voters when Hillary tried in 1993?

and it took 10 years after.

an dplease don't ask again for me to be more specific. I already did that five times in the past

[abelenkpe]

143. Can you do me a favor?

Please don't respond to any more of my posts. Ever. I don't want to talk to you. I write you a response telling you people are still going bankrupt, still paying thousands in out of pocket fees despite paying for health care and you are so delusional you twist that into thinking I'm asking for something for free. People in the US still pay more than anywhere else in the world and do not get the same quality of care. People who are poor pay more than those who are wealthy because they have no one to negotiate for them. How is that fair or just? We need single payer here in the US. The Obama administration has made steps in the right direction but it isn't enough and it hasn't all gone into effect.

I'm so glad you've saved money. I personally saved as well but that doesn't change the fact that many of the people I know and worked with for the past 13 years are now unable to find coverage and are being actively denied after our company went bankrupt because the new law has not completely gone into effect. It doesn't change the fact that my aunt and uncle are paying thousands each year in out of pocket expenses despite having health insurance. Just because you are fortunate to have a good life doesn't mean that many more aren't still struggling. I don't understand why you refuse to acknowledge that or think that those less fortunate are somehow doing something wrong. Your insinuation that expecting health insurance to actually cover medical expenses is somehow asking for a handout is insulting in the same way that Romney's 47 percent of the people are moochers asking for a handout is insulting.

[LWolf]

69. The point? To keep insurance companies profitable.

It works like this:

First you pay enough in premiums to equal a moderate mortgage.

Then you pay 100% of all care until your deductible is met.

Then you pay a certain percent of "covered" care as your "copay," and you still pay 100% for anything not covered in the policy.

A national non-profit health care system would pull a whole bunch of people out of poverty and into the middle class, and improve all of our lives.

[Cleita]

108. It seems. n/r

[Comrade Grumpy]

72. Insurance companies should be eliminated and replaced by national health care--not insurance.

That whole industry is nothing more than a parasite.

[truedelphi]

73. Making a small comment so I can get back to this

OP with citations. The Wall Street Journal has been running articles in April and May saying that once people understand that the Big Insurers Profit Assurance Bill, that will take total effect by 2014, is nothing but pain and more pain for consumers.

Your case illustrates the point. And thinking of getting a job so you can have help via employers? Think again. Many employers will be hiring people to work 29 hours or whatever to avoid having to pay for the ever escalating insurance premiums.

[still_one]

85. I suspect they are right. With insurance a bill I got was 3800, and I needed to pay 800 of that

Now that may sound reasonable, but it was not for surgery. It was an Ed visit, a few lab tests and out. Spent about 2 hours there

Real problems will only be worse

[bike man]

75. $3000.00 is what percentage of the total? Did you have to pay that total, or just the $3K?

Was the repair successful? Can you now walk?

[morningglory]

78. I am old, and have noticed a trend. When I was a child a tooth filling cost $5.

Then when insurance came into play, a filling cost $10, 5 for the dentist and 5 for the insurance company. Seems like a scam.

[Honeycombe8]

89. I noticed that, too. Dental ins. is a fairly recent thing. I held out for a long time.

But I noticed the jump in dental costs...it was when insurance was becoming more common for people. I didn't get the ins and cont'd to pay out of pocket. Until it got too expensive, and I was forced to get insurance. The care providers just increase their fees so they get at least close to what they need to pay for their expenses and make a profit.

There used to not be ins. for maternity. Maternity costs were up front and reasonable. The dr charged a flat rate for 9 mos of visits. The hospitals charged a flat rate for birthing (not counting any problems). Then people demanded that ins. cover maternity. The care costs sky rocketed, so people have to have ins. to pay the bills, now.

Now, people have demanded coverage for birth control. We know what will happen. The costs will sky rocket, the ins. cos. will have to pay, and ALL of our premiums will go up to pay for that, just like they did for maternity benefits, dental insurance, etc.

There's a good side and a bad side to having something covered by insurance.

[Ms. Toad]

97. I had dental insurance from 1978 - 1989, and again from 1998 - 2000.

My spouse has it currently. It really isn't a recent thing. Unless you call the last 35 years recent...

(And FWIW, even though I did not need maternity care - it was part of what was covered in the first insurance I had on my own in 1978.)

[Honeycombe8]

112. Maybe in your area it's been around. Dental ins. here (dallas) started in a big way...

in about...let me think....the 1990s, I think. Now, some people had it before then, of course. But most did not. It wasn't even necessary, really, because dental bills were reasonable.

I have crowns in the back of my mouth. The cost of crowns skyrocketed in the 1990's...maybe the late '90s. That's when more people started getting dental ins. My employer, a somewhat large company, offered it for the first time somewhere between late '90s and early 2000s, I think.

I cont'd to pay out of pocket for dental care until the mid 2000s. That was about the time that for the first time a dental receptionist asked me if I had ins., and I said no, and she said, in disbelief, "You don't have dental insurance?" The ins. cos. had, by that point, accomplished a total takeover. No dentist office questioned my ins. status before then, because many, if not most, people didn't have ins.

Dental ins. was rare here in the 1980s. No one I knew had it (adults - dunno about kids). No other patients at the dentist office had it (I could hear them when they checked in).

The cost of a crown was about...maybe $400 in 1990? I think. By the late '90s, it was over $900. The cost of an exam pre-insurance (1990s) was about $50. It's now about $200.

My dental insurance isn't very good, but my employer provides it free of charge, so that's good.

[Ms. Toad]

113. Around here there are dentists who accept insurance -

And those who don't. I had very bad experiences with dentists who accept insurance the last time around - the dentist recommended to me by a friend touched 3 teeth which resulted in catastrophes in 4 teeth. Mucking around with one created a need for a root canal in the adjacent tooth & she improperly filled cavities in the 3 she did touch. She did an onlay, rather than a crown in the root canal - fortunately I got to a competent dentist before it resulted in a shattered tooth - but I had to pay twice to cap off the root canal. One of the others (where she left decayed matter below the filling) nearly resulted in a second root canal. And the two remaining fillings required replacement way before their natural time.

So - I now see a dentist who doesn't accept insurance (and his client list is so long he is not accepting new patients). It may be that you weren't asked before because that office didn't accept insurance. My current dentist doesn't ask for that reason - but my spouse's dentist asks everyone (since they accept insurance).

[Honeycombe8]

116. Oh, now you've reminded me. That's it! Not many Dentists would TAKE ins.

That's why it took so long for the ins. companies to get hold of that health care area.

I remember that my employer did try out dental ins. early on.....mid 1990s maybe? We employees had to partial pay for it. I did try it. But it was an HMO with a very short of list of dentists who would take it. I went to a dentist who did some damage to a back tooth (ins. wouldn't pay for a crown - it didn't pay much, anyway) so he did something else. I went back to my regular dentist after that tooth started hurting intensely. It needed a root canal. I was through with insurance for dentists! Until it just got too darn expensive...and now I might not get it, but it's provided for free. It's lousy...don't get me wrong. But it's free, so it basically pays for my exams and cleanings twice a year. It would pay more if you go to in-network, but the list of dentists (again) is lousy. So I go to my regular dentist...I've been down the road of going to desparate dentists.

[Ms. Toad]

117. My spouse is happy with her insurance dentist -

But I had such a lousy experience I'm not willing to take the risk again. My spouse's insurance costs less than her two visits a year would. Doesn't cover much more, but the covering the exams make it essentially free - so whatever she gets in the way of a reduction in costs for fillings is a bonus.

[morningglory]

144. I'm talking about 1957. nt

[Ms. Toad]

147. In that era any kind of medical insurance

was much less common. The first medical insurance we had was for me when I went to college 1974 - the family got catastrophic insurance sometime after that & by the time I moved into my first job as a teacher in 1978 it was fairly common.

[Egalitarian Thug]

121. This is how the insurance industry works. It is how they get us to pay more for less. n/t

[Marr]

137. I have a friend who is an insurance lawyer, and the stories he tells would get your blood boiling.

He says it's all down to numbers. They refuse claims out of hand, whether they're covered by the policy or not, because the numbers show that a certain percentage of people will not contest it (probably because they're too sick or too broke). Very often, they roll over at the first hint of legal pushback, because they know very well that they're in the wrong and legally obligated to provide coverage.

Other claims are contested in court because they feel they can get out of providing coverage on some bizarre technicality.

It's all a matter of percentages and hitting the sweet spot for profit. It has nothing to do with providing health care at all.

[truedelphi]

79. After the Big Insurers Profit Assurance plan starts operation,

The middle class will wake up to the deception that has been at hand.

Just as the Obama Administration and our beloved Congress critters have had a pretty much "no regulations for the banks," Obama and Congress have not felt any compulsion to have any regulations for insurers.

Of course, neither the Obama family or the Congress critters have any insurance worries - they basically have Single Payer Universal HC, platinum edition!

From Daniel Kessler's article in the WSJ, earlier this year:

According to consultants from Oliver Wyman (who wrote on the issue in the January issue of Contingencies, the magazine of the American Academy of Actuaries), around six million of the 19 million people with individual health policies are going to have to pay more—and this even after accounting for the government subsidies offered under the law. For example, single adults age 21-29 earning 300% to 400% of the federal poverty level will be hit with an increase of 46% even after premium assistance from tax credits.

Determining the number of individuals who will be harmed by changes to the small-group insurance market is harder. According to the Medical Expenditure Panel Survey, conducted by the Department of Health and Human Services, around 30 million Americans work in firms with fewer than 50 employees, and so are potentially affected by the small-group "reforms" imposed by ObamaCare.

The full article is here:
http://online.wsj.com/article/SB10001424127887324874204578441032081716170.html

And there were over 1,000 comments.

[Boomerproud]

86. During the holidays I had cataract surgery that I'm still paying for.

My PPO that I pay $380 a month for is for shit. I can't get major medical since I got downsized almost two years ago because of pre-existing conditions (I don't even take any meds for ulcerive colitis since it's $200 a month). The world is a screwed up place.

[slipslidingaway]

95. Even with insurance many people file for bankruptcy ...

so the idea that having insurance is the answer is wrong. Some people claim that the ACA is the path towards a national HC system and that is a nice dream, but there is nothing written in stone that this will happen in a certain number of years. Personally I hope those dreams come true, but there is no sure path.

Of course this surgery will cost less than if you did not have insurance, that does not mean it does alter your current finances substantially.

Often the focus is on the annual deductible, not on the annual out of pocket maximum, which is what counts in the long run, year after year after year. That is when people who have insurance get into trouble, so just having insurance is not the answer, which many knew before the ACA was introduced.

Happy to hear the tests went well and that you are well enough to have the surgery ... that counts for something!!!

It just does not pay the bills

[dflprincess]

102. Most medical bankruptcies are filed by people who have (or had) insurance

this will not change with the ACA.

[slipslidingaway]

106. Exactly and as you say this will not change with the ACA ...

and people will find out for themselves what happens year after year with the out of pocket expenses and how long they can pay these expenses.

[Hoyt]

120. I suspect most of those did not have a $6250 cap on out-of-pocket expenses.

That still leaves some folks at risk, but I think a lot of people who could not make some reasonable payment plan, will be eligible for Medicaid (assuming their state is not too stupid/red to expand Medicaid).

Not perfect. But even under Medicare for all, we'd still have coinsurance and deductibles that can exceed $6250 very quickly.

[dflprincess]

149. A person with a chronic condition may hit that $6250 cap every year

and it won't be long before those bills add up. Ahd the law does allow the amount of the cap to increase every year as well.

Also, the law only allows a person to put just over $3,000 a year in a health savings account (HSAs are suppose to make these scams palatable) so even if you can afford to do it, you aren't allowed to save enough pretax dollars to pay the out of pockets.

[Hoyt]

150. I don't think you would want the out-of-pocket cap to increase.

Point is that insurance under Obama care will protect a lot of people from bankruptcy by having insurance pick up 100% after those with chronic diseases hit the maximum. Expanded Medicaid will help a lot of others. Obviously it doesn't help all, but it is infinitely better than what we had before.

[dflprincess]

160. The Affordable "Care" Act allows the cap to increase every year

and your insurance carrier will only pick up 100% of what it deems to be "covered" and some policies do not apply copays to the annual out of pocket so a person may be stuck with those even if they hit the max out of pocket (which is often just the deductible).

There is growing evidence that these high deductible, "consumer driven" scams actually cost everyone more money because people who have them and have chronic conditions start avoiding periodic screenings (like A1c tests) and trying to stretch medication so they don't have refill it so often. Improper use of medication and avoiding screenings can only make things worse.

People without a chronic condition may put off seeing the doctor hoping whatever ails them will just go away and waiting longer to attend to something usually winds up costing more.

We will continue to be a country when people - even those with "coverage" are driven to financial ruin by medical bills and where people die before their time because they could not afford timely access to care.

[Hoyt]

161. Use an in - network provider and they can't charge you extra.

Last edited Tue May 14, 2013, 09:17 AM - Edit history (1)

Maybe we will luck up and they will use Chained-CPI so that increase will be small. It will be in any event.

Still orders of magnitude better than what we had before. Many, many less will be driven into bankruptcy.

[dflprincess]

162. They can continue to charge copays

Out of pocket maximums generally refer to deductibles, not copays unless you have a really good policy but that will cost you in premiums. And, they can continue to decide something is "not covered" whether you are in network or not.

The for-profits (maybe some nonprofits as well but my experience has been that the for-profits are always worse), like UnitedHealth Group, will also continue to play games with paying claims knowing that most people might make one or two calls when a claim is denied but after that give up and pay the bill themselves.

And don't kid yourself that they don't have plenty of ways to hide that they're exceeding the MLR. The odds that they won't get caught are in their favor and when it does happen, the fines will be considered part of the cost of doing business.

Given that most medical bankruptcies are filed by people who thought they were "covered" I have no doubt that the number of people having to do that will continue to climb. It's the uncovered costs that drive people to it.

I used to work at UHG and one thing that would shock the executives in the Taj Mahal (as headquarters was called) is the number of employees that became believers in a single payer system after seeing how they operate.

[Hoyt]

164. No they can't once you pay $6250. You will be much better off than before m

It's still better, and more people will have coverage. Jeez, it's much better than I had, and apparently you. Let's be happy for awhile. It's good for your health.

[Ms. Toad]

163. Any eligible expense you pay out of pocket

is applied toward your out of pocket maximum for the year. That includes co-pays, coinsurance, and deductibles. If your insurance company is charging you co-pays and not counting them toward the out-of-pocket maximum you need to start filing appeals. That is true now, and once the ACA kicks in.

You may have layers of covered expenses with separate out of pocket maximums (currently we have in-network and out of network), and you may have expenses which are not eligible to be covered (even when performed by an in-network doc) - those won't apply toward any out of pocket maximum.

(And premiums are not considered out of pocket expenses.)

[Ms. Toad]

98. I don't know what options you had when you obtained insurance -

but when I choose insurance I take into account what I expect to need.

For everyone in our family currently, we would buy a high deductible policy - with the deductible approximately the same as the out of pocket max. We know that we'll hit it during the year and the premiums are WAY cheaper than policies which start paying earlier. Like hundreds a month instead of around 1000.

If any of us ever gets to the point where we don't need much care we'd have to re-evaluate that. But for us there is no benefit to paying more for premiums on top of lots of out of pocket expenses.

I'm only mentioning this here, since it is the kind of evaluation everyone will need to do who buys from one of the exchanges - teasing out whether it is worth the increased price on premiums to get a policy that pays out earlier.

[slipslidingaway]

109. We had a choice of two policies from a fortune 100 company ...

and chose the policy which included some of the best providers, but with a higher deductible and with a much higher out of pocket annual maximum.

We never expected to hit the annual out of pocket maximum year after year, that being said my husband would never have received the care he did if we had chosen the other policy. Financially things could have been better, but would he still be alive is the big question.

Unfortunately you roll the dice in our for profit system ... health vs. finances. A sad commentary on our system and those who blocked any discussion of a national HC system to perpetuate the For Profit system.

[Ms. Toad]

115. Unfortunately, we know we will hit the max every year.

We have a $6000 family cap, and a $3000 per person cap. We hit $3000 for one of us in January, and for the family in March this year. Last year it was January and April. Fortunately, we have an HRA (but no options - we're a small firm).

If we had options we'd be calculating premiums + annual out of pocket max for each plan, since we know we'll hit it and, assuming our providers are in network, choosing whichever is cheaper.

[slipslidingaway]

153. We now know we'll hit the annual max each year as well ...

but did not know when we chose the policy the year before, just looked at the difference of the "in network providers" vs. out of network providers. Decided on taking a chance for the better providers in case something happened and it did, it really is rolling the dice between better care vs. the financial hits one takes. Five figures for our annual out of pocket maximum, but there really was not much of a choice.

Hope your daughter is doing well

[Ms. Toad]

154. Physically - holding steady.

But emotionally she seems to have turned the corner - and is finally starting to plan for the future again - figuring out what she will be able to do in the near future & what will (at a minimum) have to wait until later.

[slipslidingaway]

155. Sounds like a net positive ...

and so happy to hear she is planning for the future, even though it comes with some measured moves.

Happy Mother's Day!

[JVS]

103. Unless you absolutely cannot pay, it's worth it.

I'd even say it's worth some debt. Knee problems become mobility problems and then cascade into bigger weight, mobility, and cardiovascular problems. It's hard to be active with bad joints. If I could go back 20 years and tell my mom to get her knee replacements then instead of trying to cope, I would. Her knees are good now, but in the run up to getting the knee surgery and its immediate aftermath (the surgery itself requires some rehabilitation, especially when you get both done at once), she's put on a good amount of weight that has been hard to make headway against.

Best of luck with it.

[Bonobo]

107. I hear you.

When I was forced to pay $5,000 for a hernia operation after paying nearly $1,000/month for health insurance, I just said "fuck it. I can't keep doing this without going broke. The game is rigged."

So I packed up and, with plenty of other reasons, left the US.

[treestar]

111. You've got to pay up to the deductible and 20% of the remaining

Or whatever the contract says. It's not that you never have to pay for any of it, just that if it goes to a price so out of control for a very serious matter that it kicks in to cover that.

That doesn't sound like that much. I had to pay $1500 out of pocket for what amounted to routine tests. Mammogram showed something, they aspirated, and it was OK but cost $1500.

So a knee operation for which you could "walk again" - I'd think that would be way more than 3K and so the insurance is covering a lot of it.

[geckosfeet]

126. 3k sounds like a co-pay for that surgery.

Lots of insurance has high co-pays. Surgery co-pays are of course highest. Depends on insurance though. Mine is $1500.

All I can say is, if you have enough deduction to itemize at the end of the year, that goes in the list.

[Zorra]

134. The point is this: unscrupulous capitalists are ripping us off so that they can get as rich as

they possibly can off of our health related misfortunes.

Healthcare is an absolute necessity. It is a captive market. People will do anything, will pay anything, to be healthy. And the capitalists fucking know it, and, of course, they capitalize on it ~ it's what unscrupulous capitalists do. If they could, they'd privatize all our water and make us pay $1 a quart for tapwater.

Not only do they get to take all of our money when we have health related misfortunes, at the same time, they get to beat us down into a lifetime of crushing debt and wage slavery, grinding us under the boot heels of their inequitable wealth based authoritarian control, which is exactly where they want as many of us "little people" as possible to be.

They want us to be completely powerless to challenge their authority, control, and their profit making systems.

I'm really sorry for your misfortune. You're certainly not alone. I have several acquaintances who need medical attention who are trying to hold out until 2014, because either they do not have the means to pay for it, or would have to take measures that would put them in overwhelming debt for the rest of their lives.

[Texasgal]

141. I'm really surprised by some of the responses in this thread.

It's clear the poster doesn't have three grand laying around! I certainly don't, some of us are insured and do our best to keep food on the table.

Damn.

[ForgoTheConsequence]

151. I'm not.

There is a terrible disconnect between the upper middle class "left" and the lower middle class or poor "left". I've seen it before on here, people being told to "suck it up".

I made a thread about it a few months ago after being disgusted when a poster on here said that the poor don't have it so bad.


The center has definitely shifted there is a center-right party and then there is a far right/neo-fascist party, take your pick.

[MisterP]

142. 1) pay off the insurers that are a part of the System (doesn't even have to be for campaign funds)

2) increase party cohesion and submission to conservative policy since the Other Guys will oppose it arbitrarily even though it's their own plan
3) increase party loyalty to the party since it's another chance for big-picture-ignoring feel-good stories like "5 trillion lives saved by ACA this year alone" or "60 vigintillion jobs added"

[kenny blankenship]

157. Because, Prrrrofits Baby!!!

They can only go up...
Oh, what's the point for you, you mean? 'Cuz now it's the law. So you get to stop wondering if there's any point - or about having a choice.

[lonestarnot]

166. Insurance corps can't give up any premium monies on you. They may go bankrupt.

I hate those fuckers.