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Doesn't have a dog in the fight?? Didn't you just read the Obama quote?

 

The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health- care bill out here.

 

That government bureaucrat won't just be paid to tell you no, he will be ordered to! The cost of this program is going to be astronomical. The Dems keep saying they are going to fund it without adding to the deficits. Look at that quote above to see where costs are going to be cut.

 

I've never been denied by my insurance company any service or proceedure requested by my doctor. My wife is half Norwegian. She has relatives in Norway who have waited over 6 months (many times much longer) for medical proceedures. Welcome to government-run healthcare.

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The whole Obama health plan is a joke! We don't need a national health plan. We just need the insurance companies to get rid of the bean counters making the decisions! Never understood how an accountant would know if my doctor's diagnosis was correct.

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Ed, in a perfect world, your solution would be sufficient. The problem is that it is highly unlikely that the insurance companies would do this on their own. Thus the need for a public option to encourage more desirable behaviors like the one you mentioned.(This message has been edited by sherminator505)

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Okay; personal experience. When still insured through the company, large, well funded, (insurance run by the company itself through hired advisors). Refused period to pay for annual physicals, even though all the factors point to them if you are over 40 as major factors in catching possibly high cost procedures later; I also have heart and diabetes histories in the family, as well as prostate cancer. Also refused the blood test for prostate as unnecessary, even with the family history. Regularly refused to pay doctor billed fees as not within their averages. Live in SC, L.A. metro; averages based on Southwest, including middle of the desert where things are far less expensive. My doctor usually wrote them off, but a few times I was stuck with additional bills. This is in a plan that already had $2000 deductible just for me, and was 80/20.

 

Then I got downsized. Oh, no problem, you can go on COBRA; right. I was in the least expensive plan at the time. But that plan was only allowed for "active" employees. My cost immediately rose to double what I paid while employed (and I no longer had a job); they also raised the deductible by $500. The next year the cost went up another $60 to $80 a month (I am now partially employed; no one hires me because of my age over 55 and "too" qualified). Well, I hang on another year with the "great" options (what the hell, at least I have insurance, right?) Goes up again by almost $120 a month; deductible is raised again. Then, I get a letter telling me that the following year the cost will more than double, and the year after that triple. So in a little over 3 years; they downsize me at 54 1/2; then they take my really great plan, which costs me about $60 a month (I have been blessed with really good health, so barely had any claims; especially since they refuse to pay for preventive stuff), it will cost me about $900, and no dental even. I cannot afford it, as I have still been unable to find full time work in retail and am subbing. At 59, I finally am working enough to simply quit looking outside of subbing, though it is tight. So, I am uninsured, sort of. I am a vet, so I was able to get VA coverage; but as a lowest level vet, I still pay some, and any serious stuff will require traveling to L.A. at my expense, about 170 mile rt. Recently, they closed all the small clinics and combined them all in one; many vets now have to travel substantial distance to see the doctor in Oxnard; I am close enough it is not too bad, but still triple the distance I was going. Turned 65 this year; guess what. Letter comes a few months before telling me that if I want medicare I need to apply now; if I don't, I will have to wait a year, and the cost will rise. Okay, since VA is a bit iffy much of the time (works for me now, as I remain healthy for the most part), I am now paying $96 a month to make sure I have it later should my family history issues kick in.

 

Now, one more thing. What two things may be most common as we age? Teeth and eyes. Guess what is not covered by either VA or Medicare? I did not take proper care of my gums; thought good teeth was all that mattered. Got irreversible gum disease and just lost most of my teeth. Had to take out a loan, as none of it is covered by these "great" programs. Have been legally blind without corrective lenses since I was 12 or so. Very expensive lenses, and of course the routine older people tests for gloucoma and so on. Is it covered? Nope!

 

One more night mare I witnessed while still working. I had an employee insured by Kaiser through her husband. 3 years before she came to work for me, with a two year old in the house at the time, she lost one breast to cancer. She came to work one day really upset and said she needed more hours as they had to pay for some expensive tests out of pocket to see if she had another growth. She had found a lump in the "remaining" breast; but Kaiser said they could not get her in for 6-8 weeks. This to a woman that had already lost one breast to cancer, and gone through a year of chemo. Yes, a long time back now; but from what I have seen, the private suppliers have just gotten worse.

 

Point is; I am better off than a large percentage, yet look at the facts that have actually occurred with me. The system currently in force is broken, almost beyond repair. And that includes much of the already government run stuff. Something needs to happen. Are the current proposals the solution? Still too early to know; but before we throw it all out due to complete hysteria and misinformation, lets look at it without the input of industry paid pawns and without either rose glasses or blinders.

 

 

 

 

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BrentAllen,

 

You are almost correct. The 80% expenditure is for caring for patients in FIRST and last weeks of life. Enormous expense is associated with premature infants as well as the elderly. Simply allowing physicians to have more authority to stop care that is futile without a threat of lawsuits would make a real and enormous reduction in those expenditures. Obama and the dems are against any tort reform - he has to pay back all of his supporters, in this case trial lawyers. Obama's speech to the AMA did a good job of identifying the problems. Unfortunately, none of his or the house bill will have the desired result. We will have an ever more expensive system in a hyper-inflationary economy while cap and trade move industry to other countries. The congress will not have the backbone to repeal the national health care (though the socialist countries of Europe have had to cut back on their health care system because they don't work well and are too expensive). Can anyone spell economic collapse?

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Wow!!! I could play Devil's Advocate for both sides.

 

I don't want Big Brother dicatating my healthcare, but then again, I'm not to happy with my insurance provider either, and I work in a medical center.

 

We have had personal experience with the insurance bean counter. My wife is on one perticular medication. First time round, the pharm. company balked at having to fill the 90 day script, even though it was on their list of preferred med's. They wanted a diagnoses. Then they wanted something else, and wanted us to contact her physician. When I called in to the office, and talked with the office manager, who we have known for years, she informed me that the pharm. company wanted the office to change the script to a 30 day script. The company was loosing to much money by filling the 90 day scrip. She asked what the MD had written, then told them to fill it as written. Next time the refill came up, guess what? They wanted a diagonsis again. One other time, the same company made us go through an appeal process to get a medication approved.

 

Same insurance company refused my wife one surgery needed urgently to prevent her from becoming blind, and a second surgery for degenerative deterioration of her mandibular joints. Both were considered cosmetic. One cost us $1400 out of pocket. The other has yet to be performed. We are only in our 40's.

 

My wife wondered whether the insurance would pay for accupuncture. Oh right, no alternatives either. Someone needs to reign in the insurance and medical companies.

 

Now for the flip side.

 

Working in healthcare, and in a medical center, it literally amazes me some of the patients that are talked into and sent to surgery. The 85 to 90 year olds being sent for bypass or valve surgeries. The end stage cancer patients that are known to have only months, maybe a year. Does it prolong their life, or give them a better quality of life? The bypass and valve patients, only a hand full, and it usually is not a better quality of life. Most end up trached, with feeding tubes, and in a long care facility. The cancer patinets that are known terminal with no cure and chance, usually the same, if they even survive the surgery and hospital stay.

 

I had a grandmother who was 90 when they discovered lung cancer. They wanted to do the biopsies. My uncles, the DPOA, both pharmacists, gave consent. It was then determined that the lungs was a secondary site, and they wanted to do a bone biopsy. Why? So they could treat the pain more aggressively. We tried to talk my uncles into refusing this biopsy, and to tell the doctors to just treat it more aggressively up front, since nothing was going to be done to stop the progression of the disease. They buckled, and put her through a needless test, knowing that the outcome was not going to change anything anyway. Medicare paid for everything. In these situations, some sort of "End of Life Counseling" is needed.

 

The companies need some type of oversite, but I don't want Big Brother telling us we have to supply free healthcare for illegals, and that if my Catholic run facility wants to keep getting Medicare and Medicaid payments, that we will perform abortions.

 

So who should we let play doctor, the bean counters for the insurance companies that screw us to make a profit for their investors, some of the greedy medical professionals who order ridiculous tests and procedures, or Big Brother who wants to take us to a socialized style system. Any way you look at it, I think we are all screwed.

 

 

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The answer is simple. Just look outside our borders at what is working for other nations. Be it single payer or a hybrid system, there are working options out there. If our system is so enviable, why is no other nation racing to emulate it?

 

Of course it will never happen. Americans are to arrogant to think another nation's solution is viable. And we are too afraid to change anything. Couple that with a deep resentment in losing the last election and we are exactly where we are and will be.

 

To tell the truth, if Canada weren't so dang cold, I'd seriously consider emigrating.

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Scoutldr said: "Just like the upcoming Swine Flu shot campaign. Wait till all the seniors realize that they are at the bottom of the priority list. (The top of the list is school kids, pregnant women, and healthcare providers). That's healthcare rationing and it's already coming to a neighborhood near you."

 

H1:N1 or a close relative virus has been in the wild before around 40-45 years ago, therefore, "boomers" and seniors have a certain amount of resistance having already been exposed to the virus. No big conspiracy to keep anyone from getting vital treatment, rather it is an example of placing the emphasis on getting the limited treatment available to the potentially targeted age groups that will be most affected by the virus; babies, toddlers, school-age children, and pregnant mothers.

 

I have also seen the juggernaut of managed care make nonsensical decisions in my care. My insurer had no qualms in paying for a sleep study to determine why I had difficulty sleeping but they would not pay for a prescription of Ambien. I understand there may be no perfect way to proceed in this health care mess but the current process is not working. We are proceeding too quickly in this debate, but can you imagine the national psyche if we were to drag this debate out over months. Nothing would come of it. Everyone would throw their hands up in disgust and go home defeated.

 

I am not a big fan of Presidential Press Secretary Robert Gibbs, however, he made a good point the other day responding to a reporters question: the reporter asked something to the extent of how does the President feel about the anger being expressed by the public at the town hall meetings. Here Mr. Gibbs stopped her and said, with all do respect have you been to all the meetings or have you only seen the clips on the media shows? We are only seeing the sensationalized clips, the ones that sell commercials, that keep people tuned in. We are not being told about the invitational only meetings, like the one held in Macon, GA by Senator Saxby Chambliss. Don't imagine there was a whole lot of screaming and finger pointing in that meeting (and we did not see a news clip about it either.)

 

By all means "We, the People" need to be involved in this most vital decision. However, we need to step away from the big-top circus environment being spun by both sides of the aisle and make calm informed decisions. We need to not allow ourselves to swayed by those who are in position to make the most money from this; the insurance companies, the trial lawyers, and even the AMA. There are serious and moral decisions affecting everyone and all sides of the issue must be examined rationally. Not sure we are being served well by any media outlet on this matter.

 

Send an email to your Representative in Congress (citizenship in the nation) they will not respond but their point man will. You can even establish a dialog if their person is good.

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I hear a rumor that Sarah Palin and Chuck Norris will be announcing the discovery of the true intent of the health care reform proposals - which they divined when they investigated the "Death Panels" more closely. Allegedly, they will announce that they have discovered that:

 

All citizens, and all resident non-citizens (legal or illegal) will, upon the 40th anniversary of their birth, be required to participate in a new government program called "Carousel". Groups of people will enter a cage and when the countdown clock reaches zero, will be bathed in a special anti-gravity field allowing them to float in the air. They will have 5 minutes to try to reach the top of the 5-story cage and capture a special medallion, all the while attempting to avoid touching the electrified sides of the cage, and random death beam laser fire. If they succeed, they will be allowed to live out their lives in full retirement on a Hawaiian Island of their choice at government expense. If they fail (and failure = death), they will be provided with a free burial.

 

Anyone who refuses to answer the summons on their 40th birthday will be hunted down by a special group of government law enforcement officers called "the Sandmen". Once cornered by the Sandmen, the offender will be summarily executed with no trial or appeal and the body will be disposed of in a special processing plant run by India, soon to be the most populous country on the planet.

 

In order to catch up with the number of people currently in the country over the age of 40, the government will limit the time allowed in Carousel in the first two years to 1 minute in an accelerated program designed to further reduce costs in the long run. Nursing homes will be used as practice fields for the training of the Sandmen.

 

"Carousel" will be broadcast 24 hours per day on a government owned television station that all cable and satellite companies will be required to carry. Richard Dawson will be made exempt from the Carousel requirements so that he can host the Carousel programs on government television. The television show will include special reports on the carefree lives of the winners of Carousel.

 

In related news, I hear a rumor that India will be announcing a new type of soylent curry which meets all the nutritonal needs of humans and which will be offered in a package not unsimilar to granola or energy bars, though they are still trying to get the shade of green right before they release it into wide circulation.

 

 

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With all of the other "important" issues out there, why must this be done right now, right away and without much debate. Dems seem to suggest that without this so-called reform, the world will stop turning.

 

Health insurance is a PRIVELEDGE, not a RIGHT. Where does it say that everyone MUST be insure, and that it is tied to your job?

 

Here's a viable public option: Buy your own stinking insurance! Gee, that way you can BUY what YOU want and not have other taxpayers pay for it.

 

Gonzo1

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Calico,

I want the white diamond also. And beware of the dentist and the ferral cats in the oval office!!!

 

Interesting item on "Talk of The Nation" this afternoon. The discussion was about End Of Life Counseling. The person being interviewed nailed several things that we have been discussing about when is treament to much, and overdone.

 

tonight I was involved with two codes. One over 90, and one who was terminal, both with no family. Both initially survived and ended up on ventilators. At least someone, MD, distant relative, whoever, had the common sense to know that neither were going anywhere, except to lay around in an ICU to die maybe tomorrow, or next month, and asked that they both be removed from the blower and left to die quickly, and with dignit, which they both did.

 

Gonzo my old friend, nice to hear from you. I'm surprised that you don't want everyone to have insurance, and a policy that covers unlimited chiropractic visits. LOL.

We'll be coming Carla's way Sept. 11th, or has she moved over to Louiseville? Email me.

 

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I gotta tell ya. All this talk about national health insurance is interesting! Ya think that maybe, just maybe that the cost of some of these tests & procedures is way over priced? Did ya ever take a look at what your insurance pays for tests & services versus what the actual charge was? Hmmm........

 

And why not make it mandatory that employers who employ 25+ people must offer health insurance? Hmmm ............................

 

Bring our your dead~

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The pricing structures of a hospital is about as arcane as it could be, I am not sure one could have come up with as complicated a system if they tried. Right now, the National Payment for an Abdomen CT with and without contrast is $340.96. Some hospital may get more, most less. If you know abybody who has had a CT, what were they charged?

 

Medicare pays a Nationally $44.70 for a 2 view chest x-ray. How does that compare with charges you have seen?

 

For Knee arthroscopy Medicare pays nationally $1,943.12.

 

These are all outpatient amounts. For inpatients the reimbursement is different. The amount reimbursed is dependent on the discharge diagnosis. Say you have difficulty breathing and go to the hospital. After a week you get out and the doctor says you had Congestive Heart Failure but are fine now. The hospital gets a lump sum payment regardless of the number of tests they did or didnt do.

 

Just like when you buy a car, the peole who pay sticker price aer being taken advantage of.

 

 

 

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I had diverticulitis surgery last year...an abdominal CT with contrast was billed at $1500. And every time I had one, I got charged for two views..."abdominal" and "pelvic", or $3000. My co-pay with Blue Cross/Blue Shield was 10% or $300. During the 3 month ordeal, I was on the CT table 4 times...or $6000 ($600 out of pocket). Not sure what the hospital accepted as payment, but it wasn't nearly what they billed. I'd have to go back and check my statements.

 

Was it worth it? Well, I'm alive and feeling good, and it didn't bankrupt me. I pay nearly $400 a month in premiums.

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