• 09-21-2009, 02:16 PM
    dean_martin
    Quote:

    Originally Posted by 3LB
    ...what would we do if I actually worked and didn't have all day to fuss with this stuff?

    get on one of those freecreditreport.com commercials?

    I guess the trick is to do what you're doing - get on it before it goes to "collections" because those folks are nasty and either don't know what the bills are for or just won't tell you.
  • 09-21-2009, 04:31 PM
    thekid
    Quote:

    Originally Posted by GMichael
    Your whole post was great, but I singled this part out because it's an actual solution. Profits need to be cut to a reasonable percentage.

    Well its good to see this thread heating up a bit.......

    G- Thanks for summarizing some of my points in half the time...

    Well you do know that when you start talking about cutting/limiting profits to a "reasonable percentage" that people start socialism or worse. Of course most of these people are in some way associated with the status quo but they drape themselves in the flag and talk of the founding fathers but I digress.....

    I guess it comes down to whether something as basic to our survival such as healthcare should be subject to the same market forces that determine the type of refrigerator or other common object that is bought in the marketplace. If someone was lying on the operating table just before that emergency surgery procedure the doctor leaned over and said "Now let's talk price" most people would be appalled. But how much profit would you consider "reasonable" at that point?
  • 09-21-2009, 04:32 PM
    All this an no one's brought up single-payer health care....

    As someone having lived in both socialized-medicine systems and private systems, I can sum it up pretty simply: Under socialized medicine, everyone gets covered but the quality is not as good - in the private system the care is very good, if you can afford it. My guess is that for every household that makes less than 125K a year, this is going to lower expenses, and for the people above that it will be more expensive.

    But that is only if (and that's a big IF) the system is well managed, and I also share the skepticism other have since our track record of other socialized programs, the ones we still have (after 40+ years of chipping away at them), is hardly exemplary. There is another factor to consider here: while we pay more in taxes than most other industrialized nations, we also spend more of our tax dollars on military pork than any other nation. Last I read we were spending something like $1.2T a year on the military. Care to guess how much we spend on Medicare/Medicaid? Education? Social Security? All of these combined?
  • 09-21-2009, 08:51 PM
    Smokey
    Thanks guys for informative discussion.
    Quote:

    Originally Posted by ForeverAutumn
    But, for the most part, our public system works. In 43 years, I have never had to pay for a doctor’s appointment or trip to the emergency room. I can see my doctor as often as I need (currently weekly, while I recover from bronchitis) and never have to worry about how the bill will be paid.

    I am free to change jobs and not worry about losing my medical insurance (although we do have employer sponsored insurance that covers prescription medication and other items that our public health care does not cover).

    I can see any doctor that I want to. No one tells me where I can and can’t get treatment.

    If I need a specialist, I see a specialist. I don’t worry about how to pay the specialist.

    If I need surgery, I get surgery. I don’t worry about how to pay for the surgery.

    If you listen to some of our media, those are the things they say we can not do with public health coverage. And to make it even more scary, linking abortion and illegal aliens issue to the mix.

    Quote:

    Originally Posted by dean_martin
    In my profession I constantly see medical bills, particularly hospital bills that vary widely based on whether the patient is insured. Typically, the person who is NOT insured is billed 3X the amount that the hospital accepts from the health insurance carrier of the person who is insured for the same services.

    Wow, I din't know that.

    GMichael said that his hospital bill was $100,000 for his child birth with insurance. So you are saying that an uninsured person might have to pay $300,000 for same service?

    Talk about headed to the poor house and ruin lives.
  • 09-21-2009, 08:57 PM
    02audionoob
    The insurance companies have set in advance what they will pay for a given service and it's well below what the doctors, labs, etc. would charge otherwise.
  • 09-22-2009, 01:54 AM
    thekid
    Quote:

    Originally Posted by 02audionoob
    The insurance companies have set in advance what they will pay for a given service and it's well below what the doctors, labs, etc. would charge otherwise.

    Lower insurance costs compared to the average Joe is a common practice in other idustries that involve insurance. In the auto collision industry the hourly rate and parts mark-up for the person walking in off the street is considerably higher than the rate of someone going through their insurance company. On the mechanical side of it the "warranty" labor rate at a dealership is also lower than the labor rate for the same operation. There are some legitimate reason's why a gap should exist but those reasons do not justify the large gap that does exist.

    This discrepancy is another example of why the system is broken and why at least when it comes to something as important as healthcare we should not let the traditional "market" forces determine cost and availability. Unfortunately the current political debate does not address the cost but on availability which is why both sides are retreating to their tried (tired) and true base positions. Republicans= universal healthcare will cover criminals,the lazy and promote a liberal agenda. Democrats=universal healthcare is the right thing for government to do lets pay for everyone and somehow the cost will figure itself out. What does it say about our current system when out of 100 Senators there are only about 7 (and even less in the 350+ member House) who are willing to sit down in a room together and try and solve a problem rather than run around to the talking heads screaming that the sky is falling. I know Obama wanted to avoid the mistakes of the Clinton's on this issue but to basically say to the Congress you work out the details ignores the totally disfunctionally environment that exists. He is a little late to the table about spending some political capital but he is still not addressing cost containment. If the Administration would just start putting some serious cost cutting proposals on the table such as limiting admin fees or excessive medical testing (because the doctors own the majority of the labs conducting the tests-solution prohibit doctors from owning labs...) they might start to make some headway. Without addressing cost we are just arranging chairs on the Titanic.....
  • 09-22-2009, 07:42 AM
    dean_martin
    Quote:

    Originally Posted by Smokey
    If you listen to some of our media, those are the things they say we can not do with public health coverage. And to make it even more scary, linking abortion and illegal aliens issue to the mix.



    Wow, I din't know that.

    GMichael said that his hospital bill was $100,000 for his child birth with insurance. So you are saying that an uninsured person might have to pay $300,000 for same service?

    Talk about headed to the poor house and ruin lives.

    Without insurance, GM would've been on the hook for the entire $98,000 bill. His insurance company paid only $17,000 which was accepted by the health care providers. GM had to pitch in $5,000, some of which was reimbursed to him. Therefore, with health insurance the cost was approximately $20,000. Without health insurance the cost would've been $98,000, i.e., the full amount of the bill. The amount of the bill doesn't change, but the amount the health care provider will accept from a health insurance company is much lower than the actual bill. What was the true cost of the service provided to GM? If you go through the itemized bill, you'll probably find something like a $6 charge for a single Tylenol.
  • 09-22-2009, 09:16 AM
    ForeverAutumn
    Quote:

    Originally Posted by dean_martin
    Without insurance, GM would've been on the hook for the entire $98,000 bill. His insurance company paid only $17,000 which was accepted by the health care providers. GM had to pitch in $5,000, some of which was reimbursed to him. Therefore, with health insurance the cost was approximately $20,000. Without health insurance the cost would've been $98,000, i.e., the full amount of the bill. The amount of the bill doesn't change, but the amount the health care provider will accept from a health insurance company is much lower than the actual bill. What was the true cost of the service provided to GM? If you go through the itemized bill, you'll probably find something like a $6 charge for a single Tylenol.

    How is this practice not, somehow, criminal?

    No insurance? Oh, so sorry, forget about a college fund for that new baby of yours. You can pay us all that money instead.

    Oh, you say you have insurance? That will only be $20,000 and will be covered by your insurance company. Enjoy Harvard.
  • 09-22-2009, 09:48 AM
    3LB
    Quote:

    Originally Posted by Smokey
    abortion

    I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.
  • 09-22-2009, 09:52 AM
    markw
    Quote:

    Originally Posted by 3LB
    I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.

    I'm all for it as long as they tie the breeder's tubes at the same time if they had one before or have kids paid for by the taxpayers.
  • 09-22-2009, 10:21 AM
    basite
    Quote:

    Originally Posted by Gmichael
    Hey Dean, Good to see ya.

    When my wife had our baby, the hospital billed the insurance company over $98,000. The insurance company paid them $17,000. We ended up paying a little over $5,000. Then we got reimbursed for about $3000 of it. The system is a little strange fo sure.

    There went my upgrades

    Quote:

    Originally Posted by dean_martin
    Without insurance, GM would've been on the hook for the entire $98,000 bill. His insurance company paid only $17,000 which was accepted by the health care providers. GM had to pitch in $5,000, some of which was reimbursed to him. Therefore, with health insurance the cost was approximately $20,000. Without health insurance the cost would've been $98,000, i.e., the full amount of the bill. The amount of the bill doesn't change, but the amount the health care provider will accept from a health insurance company is much lower than the actual bill. What was the true cost of the service provided to GM? If you go through the itemized bill, you'll probably find something like a $6 charge for a single Tylenol.


    You paid WHAT?
    GM, If I might ask you, could you give us an idea of how much you pay for your insurance, monthly, or annual?


    Here in belgium (yes, we have healthcare organized by the government, and a pretty good system, I do have to mention that)

    well, If you were to have your baby here in Belgium, it'd be free. only thing you would have to pay is if you used your phone in the room, and extra drinks you order apart from the ones you already get (except water - that's always free), or when you insist on having a bigger, more comfortable, maybe a single-bed room.
    and on top of that, the mother gets a paid 'parental furlough', and this for a couple of months, and the father gets a paternity leave, for a shorter period, also paid.

    If I were to visit a doctor, I'd pay him like, 20 or 25 euro's, but the health insurance refunds most of it, so eventually, I end up paying 2 euro's. Pretty much every medication is refunded to a certain percentage of the original cost (pretty much most of it).

    basically every necessary surgery, or visit to the hospital is refunded, and costs us basically nothing. Plastic surgery is almost never refunded, because, let's be honest, even though your your nose can be pretty big, and your breasts might be too small, and that little bit of fat that disturbes you, won't actually kill you.

    ok, no, not all this comes free.
    here's what my dad, for example pays for himself, my brother and me (parents divorced)

    €6 a month for each kid, which makes €12 a month for hospitalization insurance, he has this insurance sponsored by his employer, so he gets it for free.
    a small amount (a couple of euro's I don't exactly know how much, but really, it's not much.) for the health insurance, also organized by the government.

    and every working citizen here in belgium pays a percentage of taxes on his monthly loan, The government uses this money to pay the pensions for the retired, benefits for the workless and disabled, and the health bills (hospitals are also government sponsored here)

    But, and this is a major concern:
    As dean martin pointed out, what's the actual cost of the service provided to GM?
    Indeed, much less (and very very much less) than that $98.000 bill. Most of it is pure profit, profit to such degree that those who demand such sums of money should be ashamed to ask it.

    Universal healthcare is a must, not just in the USA (even though you're basically the only 'rich western country' that doesn't supply it to it's citizens), but everywhere in this world.
    but maybe you should start by pointing towards the doctors, specialists, as well as the insurance companies. If they'd ask reasonable fees, you'd be better of already.

    Keep them spinning,
    Bert.
  • 09-22-2009, 10:24 AM
    dean_martin
    Quote:

    Originally Posted by ForeverAutumn
    How is this practice not, somehow, criminal?

    No insurance? Oh, so sorry, forget about a college fund for that new baby of yours. You can pay us all that money instead.

    Oh, you say you have insurance? That will only be $20,000 and will be covered by your insurance company. Enjoy Harvard.

    All I can say is thanks to GM for providing this real-world example. When you hear about sky-rocketing health care costs, it should raise an eyebrow. When you hear about the cost of a universal health care plan in Congress . . . well, you get the point.

    The parent with no health insurance will more than likely get the service for delivery of the baby, but it will be on an emergency basis and the mother will more likely than not have had little or no prenatal (is that the word?) care which in turn increases the likelihood of complications with the mother and/or child at delivery which in turn increases the cost.

    The hospital is never going to get its $98,000 out of the family with no insurance, but the bill will follow them the rest of their lives. And, the $98,000 (rather than the $20,000) will be used to the advantage of the medical community and others (including politicians) in statistics.

    Any health care reform plan must address and establish the TRUE cost of health care. If everyone is covered, then it doesn't matter what the health care provider bills, the cost will be what the insurance company (and/or government) is willing to pay for the service and the provider is willing to accept.
  • 09-22-2009, 10:26 AM
    basite
    Quote:

    Originally Posted by 3LB
    I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.


    we have one.
  • 09-22-2009, 10:53 AM
    Rich-n-Texas
    Quote:

    Originally Posted by 3LB
    I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.

    :yikes:

    It's gonna get ugly!
  • 09-22-2009, 10:55 AM
    ForeverAutumn
    Quote:

    Originally Posted by 3LB
    I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.

    Quote:

    Originally Posted by basite
    we have one.

    So do we.
  • 09-22-2009, 12:02 PM
    kexodusc
    Quote:

    Originally Posted by ForeverAutumn
    I
    I’d be very interested in hearing opinions from someone who's lived with both systems (Kex?).

    What do you want to know? I've made good use medicare...concussions, broken hand, herniated disc, muscle tears...I don't have any complaints - had to wait a few hours in the emergency room to get stitches once.

    I got a $1700 bill for food poisoning my last year in Bangor (ultrasounds aren't cheap I guess)...they sent me home with some antacids...was glad I had insurance. Other than that eye-opener, I can't say I had any horrible experiences with private health care. I was fortunate to get employment with health insurance though...I kind of took it for granted maybe.

    My family has a long military history so my values lean more towards "no man left behind" rather than "every man for himself". But, I guess there isn't a more socialist concept than military so I'm probably not the best person to ask.
  • 09-22-2009, 12:46 PM
    Sir Terrence the Terrible
    Quote:

    Originally Posted by ForeverAutumn
    I've been following this thread because I knew that, at some point, someone would drag Canada into this.

    The Canadian healthcare system is largely misunderstood by Americans from what I can tell. And if you think that you’re going to learn about it by watching a Michael Moore movie, think again.

    Dental is not covered by our public healthcare system (with the exception of Quebec, I think). And I seriously doubt that there are any Canadians that “won’t touch Canada’s public healthcare with a ten-foot pole”.

    Our system is far from perfect. And there are extreme cases where Canadians may hop the border and pay to have certain tests run or receive certain treatments faster than they can be done here. In fact, I'm even aware of a few situations where Canadians have been sent to the US for treatment and our gov't paid for it (usually it's to receive a drug or treatment not yet approved here...red tape). But, for the most part, our public system works. In 43 years, I have never had to pay for a doctor’s appointment or trip to the emergency room. I can see my doctor as often as I need (currently weekly, while I recover from bronchitis) and never have to worry about how the bill will be paid.

    I am free to change jobs and not worry about losing my medical insurance (although we do have employer sponsored insurance that covers prescription medication and other items that our public health care does not cover).

    I can see any doctor that I want to. No one tells me where I can and can’t get treatment.

    If I need a specialist, I see a specialist. I don’t worry about how to pay the specialist.

    If I need surgery, I get surgery. I don’t worry about how to pay for the surgery.

    I don’t have to designate any of my income to paying for medical insurance. Yes, I pay taxes but I’m willing to bet that the per cent of my tax going to medical coverage is less than many of you pay for private insurance.

    I admit that I don’t know a lot about your private health care system or the proposal being put forward for a public system. And if I've said anything here that is incorrect, I apologize and welcome the correction. But don’t bad mouth the Canadian system with anecdotal bull****. 3LB, if you have specific examples then lets hear them. But so far your post sounds like nothing more than the ignorant fear mongering that I’ve been hearing in your media.

    I’d be very interested in hearing opinions from someone who's lived with both systems (Kex?).

    P.S. If you have any questions about living with universal health care in Canada, I'm happy to answer them to the best of my knowledge. Also, this post is not intended to be interpreted as an opinion for or against whatever happens in the US. I don't really care what y'all do. I just had to respond to 3LBs post.

    Thank you for this FA. I go to Hawaii every year for one of my vacations. Every Canadian that I have spoken to on this issue (very friendly and kind people, and they come to Hawaii by the droves) have said this very thing.
  • 09-22-2009, 12:48 PM
    GMichael
    I've spent most of my day in meetings so I haven't been able to comment as much as I'd like here. Looks like we are changing insurance companies so everything I knew will be changing.
  • 09-22-2009, 12:52 PM
    3LB
    Quote:

    Originally Posted by Kex
    My family has a long military history so my values lean more towards "no man left behind" rather than "every man for himself". But, I guess there isn't a more socialist concept than military so I'm probably not the best person to ask.

    My only experience with "socialized medicine" is the US Navy, but that particular branch of service has the most stodgy cast system in place of any of the other branches, so my feelings on that are prolly too skewed to be subjective. My experience was, in the Navy, that the system bred complacency and incompetence...coulda just been a Navy thang.
  • 09-22-2009, 01:44 PM
    Sir Terrence the Terrible
    I have a very strong opinion on this issue, because somebody very close to me doe not have very good insurance, and a major illness almost killed him twice.

    I am very angry at what I am hearing from the news, and on blog sites as well. One of my buddies company was doing very well financially, but the BOD and stockholders wanted more money to line their already rich pockets. So they decided to make almost everyone in the company part-time so they could kill their benefits package. My friend has a pre-existing condition, so combined with a major cut in salary, and the fact he could not obtain a reasonably priced insurance(or nobody would cover him) he developed a major illness that almost killed him, something that with insurance he was able to afford the meds to control it. After being in the hospital for two weeks, he was promptly sent a bill for over 100k, something he would not have faced when full time employed.

    I have seen my health insurance premiums go up about 7% a year for the last 7-8 years. This coincides with the explosion of the salaries of the CEO's of the health insurance companies. Over the last 5 years, one particular insurance company has made $300 million for dropping people when they get ill. I imagine their are other that have had the same result from doing the same thing. Insurance providers raise premiums at will, drop folks at will, sponsor too many expensive employee junkets, line too many politician pockets, and pay their CEO's far too much money with insurance premiums that I pay. They turn around and say they cannot compete with a not for profit government insurance plan, so why are they just not allowed to fail if they cannot? The major cause of bankruptcy in this country comes from medical bills. One county in the bay area where I live has one emergency room in the entire county because the others have all been closed as they were losing too much money.

    I was watching television the other day and I heard this gentleman(a rather selfish one at that) say that he does not want to pay for somebody elses insurance. This man lives in tornado alley, and his house has been destroyed several times. I do not want to pay for this man's to rebuild his house after a storm if that is the attitude he is going to take. Things the way they are is going to bankrupt this country, and the free market way of handling insurance is just not working. In this world, everything needs checks and balances and ying and yang. A very strong public option goes a long way to providing a balance, and if the private insurance companies cannot compete, allow them to fail. Isn't that the Republican way? The fact they are afraid of this option, shows that they are not willing to check CEO's salaries, and tackle the waste that permeates throughout their system. If this is the case, they should fail.

    What I find ironic about this whole thing, is that the very people who are the most uninsured (the south) are the very people that rile against the public option. How stupid are you to protest against the very thing you need the most? When are people going to stop supporting parties that work against their best interest?

    I could go on forever on this, but when fear makes you selfish and paralyzes a process that would actually help millions of Americans, then the country itself deserves to fall from grace into a third world country.

    So folks understand. I have a GREAT health insurance plan, and I would gladly pay more in taxes to cover others that are either under-insured, or have none at all.
  • 09-22-2009, 01:45 PM
    The above post notwithstanding, this question needs to be asked: why do we need an overhaul of the health care system in this country at all? We're so damn proud of our privatized system, why don't we fix it so that we don't have the kinds of abuses we are all too familiar with ($98K for a pregnancy - are you friggin' kidding me?).

    I'm not saying our system the best system, but we sure as hell can make it better. And frankly, I don't have any faith that the politicians in Washington are going to be able to hammer out something actually useful; there's just too much money passing hands for that to happen. So instead of going at this with a blunt ax, why not use the proverbial scalpel, apply some judicious rules curbing abuses (from doctors, insurance companies, and patients), and follow that up with appropriate enforcement? The system needs to be fixed, no doubt, but an overhaul? Good luck getting Republicans and Democrats / progressives and conservatives to agree on anything meaningful - that's just not our way of doing things, unfortunately.
  • 09-22-2009, 01:57 PM
    When...
    Quote:

    Originally Posted by Sir Terrence the Terrible
    When are people going to stop supporting parties that work against their best interest?

    ...they stop being one-issue voters. Apologies for being crass about this issue, but the formula is very clear: anti-abortion politicians are against the national option. So while it defies logic, those voters will be anti-national-option too. It's what's the matter with Kansas, remember? Free, fair and public education is one generations-long way out of this quagmire, but who's got the time to wait that long? Certainly not the stock market.

    Quote:

    Originally Posted by Sir Terrence the Terrible
    I could go on forever on this, but when fear makes you selfish and paralyzes a process that would actually help millions of Americans, then the country itself deserves to fall from grace into a third world country.

    I disagree with that sentiment. We should never wish for the sky to fall, because it could fall, and then it won't be health coverage we'll be fighting over anymore.
  • 09-22-2009, 02:33 PM
    Sir Terrence the Terrible
    Quote:

    Originally Posted by nightflier
    ...they stop being one-issue voters. Apologies for being crass about this issue, but the formula is very clear: anti-abortion politicians are against the national option. So while it defies logic, those voters will be anti-national-option too. It's what's the matter with Kansas, remember? Free, fair and public education is one generations-long way out of this quagmire, but who's got the time to wait that long? Certainly not the stock market.

    It's not just Kansas, it's the entire south. The most Ironic thing is I hear people on Medicare and Medicaid saying keep the government out of my health care.



    Quote:

    I disagree with that sentiment. We should never wish for the sky to fall, because it could fall, and then it won't be health coverage we'll be fighting over anymore.
    Then so be it. It's about time this country pays for its ignorance and backwards thinking. Part of the reason we are in this mess is because we haven't had to pay the price of our bad collective decisions.
  • 09-22-2009, 02:44 PM
    Sir Terrence the Terrible
    Quote:

    Originally Posted by nightflier
    The above post notwithstanding, this question needs to be asked: why do we need an overhaul of the health care system in this country at all? We're so damn proud of our privatized system, why don't we fix it so that we don't have the kinds of abuses we are all too familiar with ($98K for a pregnancy - are you friggin' kidding me?).

    Fixing the private systems is also labeled as a government instrusion. They are certainly NOT going to fix themselves, ask the workers in the stock market about that!

    Quote:

    I'm not saying our system the best system, but we sure as hell can make it better. And frankly, I don't have any faith that the politicians in Washington are going to be able to hammer out something actually useful; there's just too much money passing hands for that to happen. So instead of going at this with a blunt ax, why not use the proverbial scalpel, apply some judicious rules curbing abuses (from doctors, insurance companies, and patients), and follow that up with appropriate enforcement? The system needs to be fixed, no doubt, but an overhaul? Good luck getting Republicans and Democrats / progressives and conservatives to agree on anything meaningful - that's just not our way of doing things, unfortunately.
    The thing you seem to forget is it will take Washington's might to fix the current system. Do you really believe they (the insurance companies) will respond to the private citizen? We have been howling over the continued increases for years, has that stopped them from increasing their rates?

    If we did what you propose, it would just be called another government instrusion.
  • 09-22-2009, 03:16 PM
    Call it what you will, but something clearly needs to be done. To be honest, I don't know why the insurance companies are so successful in challenging change. It's either reform yourself or the government is going to do it for you.

    Right now, Obama's efforst are dead in the water. And this is a big problem because his opponents are saying this is the line in the sand - if he fails here, it will be curtains for the filibuster majority in the midterm elections, and quite possibly his second term. I don't see this passing, and I think Obama should just drop that anchor and move onto calmer waters where he has firm command of the ship like foreign affairs.