The real reason Obamacare has Failed us all?

[GoodWitch58]

a big part of the conditioning that Skunky speaks of comes directly from the marketing departments of the insurance companies; their lobbyists regularly contribute to most of the members of Congress re-election campaign; the problem is not that we do not have good health care; it is that an insurance executive is standing between the patient and the docs, making life decisions..for everyone.

it is beyond me why so many people are worried about a government employee being there; but, are perfectly content to have an insurance company executive making those decisions.

 

[GoodWitch58]

Can any of these US Healthcare haters name one drug in the last 20 years that was not developed in the United States? Also there are very large differences in how countries tally their life expectancy and infant mortality. In the US if a child is delivered and takes a single breath and then dies they count against both. In most of those countries ahead of us that child must survive 24 hrs. Considering the age of death, that skews the data quite dramatically.

Speaking of skewed data, did you guys know that of those 46 million uninsured in America: 12 million are illegal immigrants and 9 million are under 35, can afford health insurance and simply choose not to carry it. That really leaves only 25 million without it. There is not an exact number for those that qualify for public assistance but have not taken the time to do so. Even at that number, it is about 9 percent of the population. Personally, I do not understand why we are willing the screw up healthcare for 90% of Americans to cover the very few.

I agree with removal of pre-existing condition exclusions and a windfall profits tax on the insurers, but a public healthcare option is the 1st step to Socialized Medicine, and this is why the Florida Medical Association and 18 other State Medical Associations oppose HB 3200 and are urging its members to speak to their patients in efforts to abort this legislation. If the President and Congress was serious about health reform, they would include medical malpractice reform which increases the cost of every medical visit. Unfortunately, they are owned by the Trial Lawyers Association and will not even consider it.

What is the problem with Socialized Medicine? The rationing of healthcare. After age 75, most medical procedures improve quality of life, but don't on average extend life. Heart valves, bypass surgery, cancer treatment, joint replacement are quite the drag on healthcare costs. Without a doubt costs are going to soar initially and when the central planners look where to cut costs it will be with the elderly. I am advising all of my older patients who think they might need joint replacement soon, to go ahead with it because there is a good chance in 2 years they will not be allowed to do so without paying for it themselves.

Interesting information. Can you cite your source. (apparently your are an MD; I'm not questioning your opinion/professional thoughts, just would like to know the source of your data/statistics.)

 

[30ashopper]

It's my understanding that child health care available by the "government" or individual States is based on income, and it's usually close to the poverty line.

These catastrophic plans you speak of, who determines what is catastrophic? Is it an automobile accident, cancer? What about chronic disease? My sister has had to be rushed to the hospital several times in the past year and a half, has seen numerous specialists, and none of them, until recently, was able to diagnose her with a rare, but manageable disease; one that she was able to punch in all her symptoms into Web MD and figured out herself. Yes, it is rare, but give me a break. Had the physicians had looked at ALL her charts, they would have easily figured it out, but rush them in and rush them out seems to be the mantra these days.

I'm guessing a catastrophic plan would have been catastrophic for her financially after doling out $300 a visit, ambulatory services, blood work, emergency room and hospital stays after the "plan" determined that nothing was really wrong with her prior to be diagnosed. Chances are she would have been one of the Bankruptcy cases that 2/3rd's of the cases are which are related to medical financial hardship.

"catastrophic plans" are just regular health plans with high deductibles. My HDHC from BCBS of Florida was 110 a month, 7.5K deductible with 5 million in coverage beyond that.

Take a look at BCBS's options -

BCBSF - Health Coverage for Individuals & Families Under 65

Make the assumption that exclusions become outlawed and government regulation insures all insurers provide at least one low cost plan with basic coverage for the poor and I don't see why we need to change anything.

I just went through their screening and found an HDHC -

$124 a month
3.5K in network deductible
0% in-network copays after deductible is reached
coverage: up to 5 million

The only issue I could find with a plan like this is that it didn't cover maternity, but I'm sure there are plans out there that do. If not, maybe we could regulate that as well. Can anyone give me good reasons why a plan like this isn't acceptible for most everyone?

 

[30A Skunkape]

And can I just say, better you than me....:leaving:

To clarify, I was the drainer, not the drainee

Someone has to do it

 

[30ashopper]

a big part of the conditioning that Skunky speaks of comes directly from the marketing departments of the insurance companies; their lobbyists regularly contribute to most of the members of Congress re-election campaign; the problem is not that we do not have good health care; it is that an insurance executive is standing between the patient and the docs, making life decisions..for everyone.

it is beyond me why so many people are worried about a government employee being there; but, are perfectly content to have an insurance company executive making those decisions.

I don't understand this claim people keep making. When I have a medical issue, I go to my doctor, and he hooks me up with whatever treatment I might need if it's warrented. I have never in my life had to go through an insurance executive in order to get treatment. Can you cite some examples of how this manifests?

 

[30A Skunkape]

"catastrophic plans" are just regular health plans with high deductibles. My HDHC from BCBS of Florida was 110 a month, 7.5K deductible with 5 million in coverage beyond that.

Take a look at BCBS's options -

BCBSF - Health Coverage for Individuals & Families Under 65

Make the assumption that exclusions become outlawed and government regulation insures all insurers provide at least one low cost plan with basic coverage for the poor and I don't see why we need to change anything.

I just went through their screening and found an HDHC -

$124 a month
3.5K in network deductible
0% in-network copays after deductible is reached
coverage: up to 5 million

The only issue I could find with a plan like this is that it didn't cover maternity, but I'm sure there are plans out there that do. If not, maybe we could regulate that as well. Can anyone give me good reasons why a plan like this isn't acceptible for most everyone?

This is exactly what I am talking about. People of modest means gladly spend $125 monthly on cell phone service, cable and freaking cigarettes, but boy, if you try to point out that there is health insurance out there that most likely will provide what they need, at a price they can afford, look out! True, it does not allow for twice monthly doctor visits for self limited conditions, endless bloodwork and imaging-and that is a good thing, in my opinion.

 

[GoodWitch58]

30A Shopper, we have discussed this before, but the easiest and most common example is the company that refuses to cover a certain procedure regardless of what the doctor says; the lack of coverage for pre-existing conditions; the fact that insurance companies (or the underwriters as they always say) refuse to pay for a mammogram if it has been less than 366 days since one was administered, regardless of what the doctor says; that if you have two eye exams that need to be done, they have to be done on separate visits, or the insurance won't cover them...bone density scans that are needed according to the doctor, for baseline information, but will not be covered unless there is a "medical necessity", at which time, there is already a problem that could have been prevented; all too often, it seems to me, the insurance company is making the decision for the doctor.
Perhaps some of this is that more procedures are covered for men than for women and children...I don't have any data for that, but I do know that many of the tests that are regularly covered for men as it has to do with heart disease, are not covered for women--I could go on and on, but those are just what come quickly to mind.
I have been fortunate to have good health; have always managed to have decent insurance, which I have paid for myself most of the time, as a self employed person; but there is little importance given to preventive health measures and for those people who may be sicker, or not as fortunate as I have been to have access to insurance, life can be pretty miserable when dealing with insurance companies; I think we should be able to do better in America for all people--not just for the most fortunate or the ones who are able to understand the deliberately confusing insurance world. I do not believe that making health care more accessible and more affordable for more people will take anything important away from me--a healthier society should benefit all of us. While there will always be those who make choices that do not make sense, and result in bad outcomes, I do believe the majority of people will do what they have to do to provide health care for their family--there are many right here in our area who daily must make a choice between food, mortgage or rent payments, and doctor bills--they survive from one day to the next and work everyday--I would much rather see some reform that would give these folks a break, rather than continue to see huge profits going into the insurance exec's bank account--when they already make $65 million a year, what's a few thousand here and there!

 

[TooFarTampa]

I don't understand this claim people keep making. When I have a medical issue, I go to my doctor, and he hooks me up with whatever treatment I might need if it's warrented. I have never in my life had to go through an insurance executive in order to get treatment. Can you site some examples of how this manifests?

I don't think the extreme scenario happens to everyone or maybe even most people. My problem is that once the care is provided, premiums escalate because the insurance company still needs to make a profit for the shareholders. And it's not much of a "free market" because for many people options are limited.

 

[GoodWitch58]

I don't think the extreme scenario happens to everyone or maybe even most people. My problem is that once the care is provided, premiums escalate because the insurance company still needs to make a profit for the shareholders. And it's not much of a "free market" because for many people options are limited.

And the premiums have gone up at least 10% each year, for at least the last 20 years, from what I read, the docs are not making that much more money--so where is the profit going?

 

[30A Skunkape]

30A Shopper, we have discussed this before, but the easiest and most common example is the company that refuses to cover a certain procedure regardless of what the doctor says; the lack of coverage for pre-existing conditions; the fact that insurance companies (or the underwriters as they always say) refuse to pay for a mammogram if it has been less than 366 days since one was administered, regardless of what the doctor says; that if you have two eye exams that need to be done, they have to be done on separate visits, or the insurance won't cover them...bone density scans that are needed according to the doctor, for baseline information, but will not be covered unless there is a "medical necessity", at which time, there is already a problem that could have been prevented; all too often, it seems to me, the insurance company is making the decision for the doctor.
Perhaps some of this is that more procedures are covered for men than for women and children...I don't have any data for that, but I do know that many of the tests that are regularly covered for men as it has to do with heart disease, are not covered for women--I could go on and on, but those are just what comes quickly to mind.
I have been fortunate to have good health; have always managed to have decent insurance, which I have paid for myself most of the time, as a self employed person; but there is little importance given to preventive health measures and for those people who may be sicker, or not as fortunate as I have been to have access to insurance, life can be pretty miserable when dealing with insurance companies; I think we should be able to do better in America for all people--not just for the most fortunate or the ones who are able to understand the deliberately confusing insurance world. I do not believe that making health care more accessible and more affordable for more people will take anything important away from me--a healthier society should benefit all of us.

I'm not sure of the specific incidents that you are talking about, but my experience has been that insurance companies will pay for just about anything that can be reasonably justified. In a few cases this involves your physician speaking to the insurance company's physician. It usually works.

I am also unaware of any company that will not cover routine screens when they are performed consistent with a schedule that is accepted as being of benefit. Women actually have more screenings than men, and there are no screenings for heart disease for either sex, save an EKG done for a 'welcome to medicare' exam.