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  #1  
Old 01-28-2008, 08:18 PM
carlotta carlotta is offline
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What happens to people who cannot get health insurance? (U.S. obviously)

I know the short answer is "they're f**ked" but I want to hear some long answers.

There must be a lot of people who

are too young and not disabled enough for Medicare

do not have and cannot get a job that provides health insurance (possibly because they are disabled enough to make this difficult)

have some health condition that makes insurers who provide individual insurance avoid them like cooties(like diabetes or past history of cancer)

I imagine that such folks

A)spend a huge amount of their income (if any) on health care
B)live under the threat of financial ruin in case of big time health crisis
C)don't live so long because they can't afford A

Are there any solutions for such people? Don't some states require that you cannot turn anyone down? So you could at least move to one of those states?
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  #2  
Old 01-28-2008, 08:29 PM
madmonk28 madmonk28 is offline
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This is only one data point, but I can tell you about my friend's sister. She didn't have health insurance so she didn't go to the doctor that much. As a result, when she did go to the doctor about some pain she had been having for a long time, it turned out she had cancer and it was very far advanced. She ran up a lot of bills on her credit cards, so did her parents, and my friend, her brother. Then she died and left her loved ones thousands of dollars in debt.
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  #3  
Old 01-28-2008, 08:31 PM
Baldwin Baldwin is offline
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"They're fucked" is indeed the short answer.

Medical expenses are the leading reason for personal bankruptcy in the U.S. (a fact that people in most of the industrialized world find baffling). So, for a lot of people, it does mean financial ruin. A lot of people simply die with treatable problems. I haven't gone bankrupt or died, but I did take out a loan and max out my credit cards to get my ruptured quad tendon repaired (if you wait too long, it's too late and you're permanently crippled). Still trying to get out of that hole.

In most states, emergency rooms aren't supposed to turn anybody away, so a lot of patients with no other options show up there. ER care is expensive, and if they just can't pay, I guess it generally ends up coming from public money in some way.

And of course people without health coverage don't get the regular preventative care that can prevent or postpone major problems later on. An ounce of prevention really is worth a pound of cure, but that ain't how we roll in the States.
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  #4  
Old 01-28-2008, 08:49 PM
hekk hekk is offline
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Also, those who do not have coverage and are in dire need of medical care, can usually find help through the city/county on an as needed basis (maybe only in major cities?). Those who are eligible (poor with kids, disabled) get Medicaid help, which really rivals that of private plans.

Sometimes, though, you are just plain screwed, and will run up big bills and declare bankruptcy. Those costs are then passed on to higher medical bills/insurance premiums for the rest of us.
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  #5  
Old 01-28-2008, 08:53 PM
Broomstick Broomstick is offline
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Quote:
Originally Posted by carlotta
Are there any solutions for such people? Don't some states require that you cannot turn anyone down? So you could at least move to one of those states?
They can't turn you down - but they CAN quote you ridiculously high premiums, or refuse to cover almost anything.

Last time we tried to insure my husband outside of employer-sponsored insurance we were quote $1200/month and they wouldn't cover anything to do with his feet, legs, back, bladder, kidneys, pancreas, liver, lungs, heart, or vision. Nor would they cover medications for diabetes (which he has), heart disease, asthma, or his chronic pain. That leaves --- what?

We have been trying to get him on disability for the last 8 months. It's a long, hard slog. Then there's a waiting period before he can qualify for Medicare. Meanwhile I lost my job and our health insurance last November.

If either of us gets sick or injured we are fucked.
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  #6  
Old 01-28-2008, 09:29 PM
Sprockets Sprockets is offline
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Quote:
Originally Posted by Baldwin
"They're fucked" is indeed the short answer.
As far as I can tell, people without insurance are supposed to go die under a bridge or something. It's disgraceful that many Americans still call this the "greatest country on earth."

Quote:
In most states, emergency rooms aren't supposed to turn anybody away, so a lot of patients with no other options show up there. ER care is expensive, and if they just can't pay, I guess it generally ends up coming from public money in some way.
I would think that emergency rooms, which are generally separate corporations affiliated with hospitals, declare unpaid bills as losses just like any other business.

It's also important to realize that although they can't turn anyone away, they still do find ways to send people to crappy hospitals in another part of town, and they give the very minimal level of care to get the person back onto the street. Then they bill the person until their credit is beyond redemption, assuming they had any kind of a credit rating to begin with.

Quote:
And of course people without health coverage don't get the regular preventative care that can prevent or postpone major problems later on. An ounce of prevention really is worth a pound of cure, but that ain't how we roll in the States.
It's not how they roll under the NHS in England, where preventive care is unknown. I asked about a mammogram while I was living there (I'm at that age) and I was asked "Why, do you feel a lump?" My spousal unit had never had his PSA levels done (he was at the right age) and when I got him to ask about it the doctor affected to not know what a PSA level was. He'd also never had a routine chest x-ray - not once in his entire life!
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  #7  
Old 01-28-2008, 09:57 PM
Ca3799 Ca3799 is offline
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The uninsured who show up at my hospital are referred to the social workers who try to get the uninsured person enrolled into a state insurance program. All our patients are pregnant, so they usually qualify for aid.
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  #8  
Old 01-28-2008, 10:01 PM
Shagnasty Shagnasty is offline
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It is actually much better if you are truly poor in these situations than if you are anywhere from lower middle-class to upper-middle class and don't have insurance. There are plenty of programs to help the poor. Most states have state research hospitals and charity hospitals that cater towards the poor and give excellent care. The TV series ER is set in Cook County General Hospital which is a cutting edge teaching/research hospital and gives a fairly accurate depiction of the care the emergency patients receive. Likewise, if you suffer a gunshot wound, New Orleans Charity Hospital is where you want to be regardless of income. Those aren't rare and serve the poor, the indigent, and everyone else. They tend to have state of the art services although the clientele may make them seem a little gritty.

There also plenty of facilities like nursing homes, cancer treatment centers, and hospices that are run by the state and will take care of the poor until they die no matter how long that is. There are also world-class private charity hospitals like St. Judes and the Shriners Hospitals that care for very sick kids no matter what their parents can afford.

The gap comes if you are middle-class and have anywhere from a moderate to catastrophic clinical loss. You really are screwed then. My wife and I are 34 and we are pushing about half a million in claims over the past 5 years mainly because of the loss of an infant daughter and I am not sure what would have happened if we didn't have top notch insurance.

The problem has to be described correctly because the truly poor do quite well under the U.S. system because they can't be turned away and they have nothing to lose.
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  #9  
Old 01-28-2008, 10:19 PM
jensbiz jensbiz is offline
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We are fortunate enough in Centrahl oregon to have a clinic run by volunteers that provides all of the services of a regular clinic and refers to specialists.
They are called Volunteers in Medicine. VIM. Look for one or something like it in your area. They deal with working people with no insurance.
The county provides a free clinic for all in most areas. Dont wait. Stay healthy.
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  #10  
Old 01-28-2008, 10:29 PM
Raza Raza is offline
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I'm not poor by any means, and I have solid consulting business that pays the bills. But I'm going to rejoin rank-and-file employment next week (giving up my business) because I can't find any insurance company to take me - at any price, even with a $10K deductible.

So, in my case, it (fortunately) has not affected my health or finances (yet), but has caused a professional change.
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  #11  
Old 01-28-2008, 11:42 PM
Harmonious Discord Harmonious Discord is offline
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You get sick and lose the insurance, while you don't recover. At some point you can't work and all the money is gone. You are financially ruined, and Medicare screws you over forever. You can't fight for your needed care yourself, because you're to sick to do anything. It's impossible to get back on your feet, because you are to deep in a hole to get out yourself. In America it's get sick, tough shit, nobody will help you, go away, because as the politicians put it, America can't afford to help sick people. You had better hope you have family member's that care or you'll die homeless in the street. The politicians will always get all the health care they need of course. You are not better off poor and sick. There are programs for children. You have very little recourse with low or no income.

Last edited by Harmonious Discord; 01-28-2008 at 11:44 PM..
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  #12  
Old 01-28-2008, 11:48 PM
panache45 panache45 is offline
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Quote:
Originally Posted by carlotta
A)spend a huge amount of their income (if any) on health care
B)live under the threat of financial ruin in case of big time health crisis
C)don't live so long because they can't afford A
I have no insurance because I'm self-employed with pre-existing conditions.
"A" and "B," already. "C" could happen at any time.
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  #13  
Old 01-29-2008, 12:14 AM
Fear Itself Fear Itself is offline
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I am self employed, but have health insurance under my wife's policy from her work. She is leaving her job on Thursday of this week forever, because she is now disabled with an incurable disease. We can afford her COBRA insurance, but at over $6,000 per year, I haven't got the money to continue my insurance. As of the first of February, I will have no health insurance. If I get sick, I plan on being a burden on society, until something is done about this mess.
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  #14  
Old 01-29-2008, 12:18 AM
groo groo is offline
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Yeah; don't want to use profanity in GQ, but they're fucked.

Shagnasty described the way I understand things to work. My under-employed cousin who has no health insurance goes to a county-run clinic; she waits around all day long to see an overworked doctor (a different one every time, she says) who makes as quick a diagnosis as he or she can, then ushers her out the door.

I'm probably the best-insured person I know, and I still pay about $4500 out of pocket for my incredibly good but too expensive dermatologist and, of course, the small team of mental health professionals who keep me going. (IME nobody covers long term counseling; you have to have an "event" that provides an excuse for limited counseling, which is 8 visits per year).

I'll be the first to explicitly draw fire: we need universal health care, or socialized medicine, or whatever you want to call it. Libertarians and Republicans (and, sadly, many Democrats) seem to think that the only concern is "market efficiency" and that it would be less economically efficient or result in patients overusing medical resources because they'd be too removed from the actual costs. But you know what? Fuck that. I'm a human being and live in a world with other human beings, and market efficiency is not anything that humans should care about when considering medical coverage for poor people.

(Sorry; two swear words in a GQ post)
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  #15  
Old 01-29-2008, 12:18 AM
alphaboi867 alphaboi867 is offline
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I just spent the last two days in hospital with no health insurance. The hospital social worker just had me fill out some forms and told that my bill will be sent to the county and if the county doesn't pay the hospital will discount it 100% (essentially eating the costs). This includes treatment by staff doctors, but not by my so called "personal physician" .
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Last edited by alphaboi867; 01-29-2008 at 12:19 AM..
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  #16  
Old 01-29-2008, 12:26 AM
Queen Bruin Queen Bruin is offline
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When I had my car accident, the ER where I was being treated sent a billing guy 'round. He gave me some forms to fill out and I had to send in all my bills and whatnot, but charity picked up my $3k hospital bill. I had to pay the Dr., X-Ray techs, and ambulance out of pocket however. Also since I could not afford to see a hand specialist rather than the county ortho, I have permanent disability in my left (non-dominant) hand. I DO have insurance now and have seen a nice ortho. He said to fix it now would require some gnarly surgery. So I keep my funky knuckle.

I realize that I am very lucky in how this was handled.
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  #17  
Old 01-29-2008, 12:28 AM
Boozahol Squid, P.I. Boozahol Squid, P.I. is offline
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Quote:
Originally Posted by carlotta

are too young and not disabled enough for Medicare

do not have and cannot get a job that provides health insurance (possibly because they are disabled enough to make this difficult)

have some health condition that makes insurers who provide individual insurance avoid them like cooties(like diabetes or past history of cancer)
Actually, condition B will make you eligible for Medicare: Medicare comes in three basic packages, one set up for the elderly (over 65), one for the disabled and a third variety for those with end-stage renal disease. A history of black-lung will also get you access to Medicare.

Most states' Medicaid programs will also cover the disabled, and many states Medicaid programs are set up to offer coverage to children under the age of 18, and a single caretaker of those children. Some offer coverage to anyone below the poverty line.

Finally, the emergency rooms of most community hospitals are often used as replacements for primary care: ERs can't turn patients away until they've been evaluated by an MD, and usually at least one hospital in any community of any given size will admit patients irrespective of their insurance status. The problem with that is that patients are unable to follow up on ER docs instructions to see specialists (who will turn away uninsured patients if they can't pay up front).

If you're too young, too healthy, unencumbered by kids and making just enough money to be ineligible for state-sponsered insurance, most hospitals will offer payment plans to allow you to pay your bills off over the course of time without being referred to collection agencies. Unfortunately, that isn't an option for preventive care, or for treatment of ongoing conditions.

Hospital systems write off huge amounts of bad debt every year, increasing the costs of all care, which in turn jacks up costs to insurance companies, who in turn raise rates beyond affordability for those unable to be insured by their employers.
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  #18  
Old 01-29-2008, 12:44 AM
Boozahol Squid, P.I. Boozahol Squid, P.I. is offline
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Quote:
Originally Posted by alphaboi867
I just spent the last two days in hospital with no health insurance. The hospital social worker just had me fill out some forms and told that my bill will be sent to the county and if the county doesn't pay the hospital will discount it 100% (essentially eating the costs). This includes treatment by staff doctors, but not by my so called "personal physician" .

Your 'personal physician' likely is a private doctor who is not an employee of the hospital. The hospital can't write his bills off in the way they can other costs. And if the doctor doesn't charge for his services, he doesn't eat.

You received free care other than the bill from the physician? And you're rolling our eyes? Ingrate.
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  #19  
Old 01-29-2008, 02:23 AM
t-bonham@scc.net t-bonham@scc.net is offline
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Quote:
Originally Posted by hekk
Sometimes, though, you are just plain screwed, and will run up big bills and declare bankruptcy.
Ah, but they took care of that 'loophole'.

Under George Bush, they passed a new bankruptcy law that no longer allows you to file bankruptcy because of medical bills.
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  #20  
Old 01-29-2008, 04:13 AM
Icerigger Icerigger is offline
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I had to have a blood test last week so I went to an ACL lab, on the wall was a notice stating for those who don't have insurance payment is due immediately, no money no blood test. They have some humanity however they do take: cash, Visa, MasterCard and Discover.

I work at a small savings & loan company and run credit reports every day, you would be surprised to know how many bankruptcies, collections and civil judgments there are because of medical bills. We tend to overlook medical collections because so many people can not afford or get coverage.
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  #21  
Old 01-29-2008, 04:48 AM
The Them The Them is offline
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I usually just lurk, but this hits a nerve, pun intended.

The raw horror of what happens if you're uninsured is amazing. I'm still being chased for medical bills incurred a decade ago, for the aftermath of a near-fatal car accident. Luckily, my disability came through after a year and a half of legal wrangling by an attorney who specializes in such cases, and took a mere 25% of my benefits for the service. Being crippled sucks; being homeless sucks; I got to experience both at once.

So, I'd say, "you're fucked" is a very good description of what happens.

Now, I get to survive on less than the official poverty level for as long as I want. (An aside- Medicare is actually pretty good for most things). Keeping cheerful isn't easy, though the SDMB helps a lot

Perhaps that wasn't so much an answer, as a rant. My apologies to the OP. I can get emotional about it. Maybe because if I'd gotten treatment immediately, instead of waiting years, the damage might well not have been permanent.
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  #22  
Old 01-29-2008, 05:32 AM
si_blakely si_blakely is offline
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Quote:
Originally Posted by Sprockets
It's not how they roll under the NHS in England, where preventive care is unknown. I asked about a mammogram while I was living there (I'm at that age) and I was asked "Why, do you feel a lump?" My spousal unit had never had his PSA levels done (he was at the right age) and when I got him to ask about it the doctor affected to not know what a PSA level was. He'd also never had a routine chest x-ray - not once in his entire life!
Not in my experience - the NHS has a wide range of preventative programs - including Breast Cancer Screening. However, the program has to be cost effective - I know that PSA level tests are not generally considered a good diagnostic tool or value for money (I asked). This site explains why. Cervical cancer checks are regular and very good, and they are looking to be offering scans for aortic aneurysm this year. My wife and I got free flu shots before winter, and have missed some nasty bugs going round.

So there is a very good range of preventative healthcare going on in the NHS.

Si
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  #23  
Old 01-29-2008, 05:39 AM
Szlater Szlater is offline
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Quote:
Originally Posted by Sprockets
It's not how they roll under the NHS in England, where preventive care is unknown.
Simply bollocks.

Quote:
Originally Posted by Sprockets
I asked about a mammogram while I was living there (I'm at that age) and I was asked "Why, do you feel a lump?"
Funny, we have a national screening programme for breast and cervical cancer.
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  #24  
Old 01-29-2008, 06:24 AM
Aspidistra Aspidistra is offline
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Quote:
Originally Posted by Sprockets
He'd also never had a routine chest x-ray - not once in his entire life!
Ok, I'll bite on this one.

Why would one have a chest x-ray routinely, and what problems would you find with it?
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  #25  
Old 01-29-2008, 07:09 AM
Icerigger Icerigger is offline
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I keep hearing we have the best system in the world, if you have enough money I guess it's true. Just as an example my medical coverage at work has almost tripled in cost in the past four years. The monthly premium for medical coverage is now $346.00, that's $4152.00 per year. This amount is only because I am in a pool with other employers, the same coverage if I were to loose my job and have to pay it myself outside the pool is $7500 per year for one person! How can anyone afford that out of pocket with a low paying job? It is impossible.
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  #26  
Old 01-29-2008, 07:15 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by Szlater
Simply bollocks.
Once again with the mindless hostility in response to an opinion.

Quote:
Funny, we have a national screening programme for breast and cervical cancer.
Goody. I'm talking about my own experience, and I have no reason to lie.

Last edited by Sprockets; 01-29-2008 at 07:15 AM..
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  #27  
Old 01-29-2008, 07:17 AM
Sprockets Sprockets is offline
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Originally Posted by Aspidistra
Ok, I'll bite on this one.

Why would one have a chest x-ray routinely, and what problems would you find with it?
I should also have mentioned that he had never had a chest x-ray for his several bouts of bronchitis. A routine chest x-ray - every several years - can show many things. I don't really understand your question.
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  #28  
Old 01-29-2008, 07:17 AM
Szlater Szlater is offline
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Originally Posted by Sprockets
Once again with the mindless hostility in response to an opinion.
What's opinion doing in GQ?

You posted a non-fact... there's no other response.
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  #29  
Old 01-29-2008, 07:20 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by si_blakely
I know that PSA level tests are not generally considered a good diagnostic tool or value for money (I asked). This site explains why.
I can't agree with the sentiments on that website, although I do understand that is the NHS party line. Short of digital examinations, PSA levels are the only good indicator of possible prostate cancer. I worked for a urologist in the US for many years so I do have a basis for that opniion. I regard the NHS position on this - as in so many areas - to be nothing short of brutal.

Quote:
So there is a very good range of preventative healthcare going on in the NHS.
I believe you've had good experiences, but I can only relate my own experiences.
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  #30  
Old 01-29-2008, 07:22 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by Szlater
You posted a non-fact... there's no other response.
Oh for God's sake, what's a "fact" but someone else's opinion? I thought we were having a discussion. Other people are posting their experiences, but I'm not allowed to post mine?
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  #31  
Old 01-29-2008, 07:24 AM
Szlater Szlater is offline
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Originally Posted by Sprockets
Oh for God's sake, what's a "fact" but someone else's opinion? I thought we were having a discussion. Other people are posting their experiences, but I'm not allowed to post mine?
Not when they're pure bollocks.

"No preventative care on the NHS" is a libel against the system.

Last edited by Szlater; 01-29-2008 at 07:25 AM..
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  #32  
Old 01-29-2008, 07:33 AM
Sprockets Sprockets is offline
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Originally Posted by Szlater
Not when they're pure bollocks.
I see a lot of things on this board and elsewhere that I don't agree with or I think are just silly, but I don't have the urge to be abusive. And you really should learn another word.

Quote:
"No preventative care on the NHS" is a libel against the system.
Now I'm scared. And I would never say "preventative" because the proper word is "preventive."
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  #33  
Old 01-29-2008, 07:38 AM
si_blakely si_blakely is offline
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Quote:
Originally Posted by Sprockets
I can't agree with the sentiments on that website, although I do understand that is the NHS party line. Short of digital examinations, PSA levels are the only good indicator of possible prostate cancer. I worked for a urologist in the US for many years so I do have a basis for that opniion. I regard the NHS position on this - as in so many areas - to be nothing short of brutal.
No, just pragmatic.
Quote:
Originally Posted by wikipedia
PSA is false positive-prone (7 out of 10 men in this category will still not have prostate cancer) and false negative-prone (2.5 out of 10 men with prostate cancer have no elevation in PSA).
For an expensive test, the results are not looking good, whereas a digital exam costs a rubber glove, some KY and a bit of dignity (check out the Ricky Gervais prostate awareness radio ads). I know where my tax dollars would rather go - along with my doctors digit.

There are differences in approach based on the surgery you attend, but on the whole, NHS doctors are pretty proactive. I even get requests to attend a cardio check if I haven't been in for a while.

Si
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  #34  
Old 01-29-2008, 07:45 AM
Szlater Szlater is offline
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Originally Posted by Sprockets
Now I'm scared. And I would never say "preventative" because the proper word is "preventive."
No, you just make stuff up and post it.
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  #35  
Old 01-29-2008, 07:47 AM
Quartz Quartz is online now
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Sorry, Sprockets, but your experience with the NHS does not tally with my own, either. And they don't like to do X-rays not to save money but because excessive X-rays are unhealthy for the patient.

To take another example: they've been red-hot on the flu vaccine for those at risk.

While the NHS comes in for a lot of stick, from myself included, to say that it provides no preventive care is simply not true.
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  #36  
Old 01-29-2008, 07:56 AM
Sprockets Sprockets is offline
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Originally Posted by Quartz
Sorry, Sprockets, but your experience with the NHS does not tally with my own, either. And they don't like to do X-rays not to save money but because excessive X-rays are unhealthy for the patient.
And I believe that you believe that, but from what I've read the radiation you get in a chest x-ray is equivalent to what you get in one transatlantic flight. I don't advocate x-rays where they aren't indicated, but they certainly are indicated in many instances.

Quote:
To take another example: they've been red-hot on the flu vaccine for those at risk.
Yes, they sure have - just as they have on this side of the pond. It's something doctors and clinics can do and be seen to be doing something, although there is a lot of debate about whether flu vaccines are really worthwhile, since they only target a few strains of the flu at best.

Quote:
While the NHS comes in for a lot of stick, from myself included, to say that it provides no preventive care is simply not true.
Apparently everyone would have been more comfortable if I'd said "In my opinion they provide no preventive care," or "I never experienced any preventive care while I lived there," or "No one I've spoken to who lived under the NHS ever related having any preventive care to speak of," or something like that. I really feel it should be obvious that anything anyone posts here or anywhere is just opinion.
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  #37  
Old 01-29-2008, 07:56 AM
samclem samclem is online now
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Sprockets. You're in General Questions. Your first post was nothing but your opinions. You've done nothing to back them up. Others have offered evidence to rebut your opinions. If you have something more to add other than your personal experiences, do it.

samclem Moderating
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  #38  
Old 01-29-2008, 08:00 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by si_blakely
For an expensive test, the results are not looking good, whereas a digital exam costs a rubber glove, some KY and a bit of dignity. . .I know where my tax dollars would rather go - along with my doctors digit.
I wasn't thinking primarily of cost but of effectiveness and the health of the patient. Serial PSA levels are the best indicator of trouble in the prostate, and they need to be backed up by digital exams. However, digital exams only detect significant abnormalities, and it's important to catch prostate cancer early since it's such a nasty metastasizer.
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  #39  
Old 01-29-2008, 08:02 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by samclem
Moderating

Sprockets. You're in General Questions. Your first post was nothing but your opinions. You've done nothing to back them up. Others have offered evidence to rebut your opinions. If you have something more to add other than your personal experiences, do it.

samclem Moderating
You want links to other people's opinions? What is it you require? I'm also confused about why others are giving their experiences and opinions but I'm getting the "don't do it" message from you. Is it what I'm wearing? Am I holding my mouth wrong?
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  #40  
Old 01-29-2008, 08:35 AM
MarcusF MarcusF is online now
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Sprockets, Wikipedia is not the best source but do you have a cite that contradicts the figures given:

Quote:
Originally Posted by wikipedia
PSA is false positive-prone (7 out of 10 men in this category will still not have prostate cancer) and false negative-prone (2.5 out of 10 men with prostate cancer have no elevation in PSA).
and to go with that do you have evidence that

Quote:
Originally posted by Sprockets:
Serial PSA levels are the best indicator of trouble in the prostate ...
I don't think anyone is denying your personal experience in the UK - the disagreement is with using the fact that your husband did not get a PSA test and you did not get a mamogram (as noted above the NHS definitely does have a comprehensive screening programme for breast cancer) to support your sweeping statement that:

Quote:
Originally posted by Sprockets:
It's not how they roll under the NHS in England, where preventive care is unknown.
I don't think anyone in the UK would deny that the NHS has its problems but a complete absense of preventive care is not one of them.
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  #41  
Old 01-29-2008, 08:38 AM
Subway Prophet Subway Prophet is offline
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The health insurance problem has hindered me in seeking a better-paying job, because my daughter has had cochlear implant surgery.

I was looking at leaving my job and going into consulting work, which has the potential of much better pay. But I would be leaving my excellent health benefits (thank you Half Price Books) and would need to find my own insurance. No insurer would give me an individual plan that covered anything related to my daughter's ears. We're talking denial of services beyond mere lack of support for her cochlear implants: no coverage for ear/nose/throat infections, or problems involving balance, or speech therapy related to her disability. Issues that would be covered in an individual plan had our daughter not received the implants.

I've also been told by two insurers that getting into a new group plan through a different employer would be complicated by the implants. I'm still trying to figure out how this works.

I recognize that I'm extremely fortunate in that I have great coverage now, and that I enjoy my current job (thanks again, Half Price Books!) but this job doesn't pay what we really need to earn and it's frustrating that I'm essentially locked into it because of otherwise unrelated issues.

On the flip side of that coin, my wife and I figure that our daughter has cost upwards of $250,000 in medical expenses due to her surgeries and hearing-related therapies, so it's difficult to complain about our situation. But the system truly sucks.
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  #42  
Old 01-29-2008, 09:03 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by Subway Prophet
I've also been told by two insurers that getting into a new group plan through a different employer would be complicated by the implants. I'm still trying to figure out how this works.
Not true and not "complicated." They can't turn you away because of a pre-existing condition if you can show a continuity in health care coverage. They can, however, charge you pretty much whatever they want to for coverage, which is in effect denying coverage.

Quote:
this job doesn't pay what we really need to earn and it's frustrating that I'm essentially locked into it because of otherwise unrelated issues.
But it does in fact pay what you "need," because you need affordable health care coverage. You say you figure your daughter's care has cost $250,000, so divide that amount by the number of years you've had this job and add it to the annual salary. You have to consider the whole picture.

It does seem odd to me that health care coverage is tied to employment. It seems as arbitrary as saying where you live is determined by shoe size. But that's how it is in this country and until we find a better system (which IMO does not exist) we're stuck with it.
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  #43  
Old 01-29-2008, 09:05 AM
lisacurl lisacurl is offline
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Quote:
Originally Posted by Shagnasty
Likewise, if you suffer a gunshot wound, New Orleans Charity Hospital is where you want to be regardless of income. Those aren't rare and serve the poor, the indigent, and everyone else. They tend to have state of the art services although the clientele may make them seem a little gritty.
Of course, it doesn't exist anymore.
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  #44  
Old 01-29-2008, 09:29 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by MarcusF
Sprockets, Wikipedia is not the best source. . .
No, there are definitely better sources out there, although (once again) there is no ultimate authority and every source is just someone else's opinion. This is a "good" source:

http://64.233.167.104/search?q=cache...lnk&cd=1&gl=us

There are certainly false positives and false negatives, and it is also true - as I stated before - that serial PSAs are what doctors mainly pay attention to. As the site above points out, though, doctors still recommend a PSA for any man at age 50 and for men with risk factors at earlier ages. These tests are performed in conjunction with digital exams.

The tests are not perfect, but as the site points out they are currently the most accurate test we have. If I were a man I'd certainly want one on a regular basis.

Here's a site that details some of the differences between the UK and US health systems:

http://64.233.167.104/search?q=cache...lnk&cd=3&gl=us

And quoting from the above site:

"Preventative medicine is not practiced to ensure the nations overall health "

I'd love to throw more links around, but I have to go let the Canada Geese know they are not welcome on my pond. Geese are extremely slow learners.
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  #45  
Old 01-29-2008, 09:43 AM
Broomstick Broomstick is offline
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Quote:
Originally Posted by Sprockets
Not true and not "complicated." They can't turn you away because of a pre-existing condition if you can show a continuity in health care coverage. They can, however, charge you pretty much whatever they want to for coverage, which is in effect denying coverage.
Uh-huh

I lost my job in November. My employer dumped about 50 people before the holidays in the name of "efficiency" or whatever. We could NOT afford COBRA. By that I mean it would have cost more than our rent, food, and all other expenses combined per month. This is because we had a very, very good policy that cost a lot a money (paid by my employer). You have to pay COBRA on the policy you were already on, you can't opt for a cheaper policy. So there I was - no income beyond unemployment benefits - 1/4 of my prior income - and we have to dip into savings just to pay the bills. Paying COBRA would - that is, for certain - have bankrupted us in under 4 months (no money left + continuing debt).

So, we've had a coverage gap of over 2 months now.

No one ever has to cover anything pre-existing on us ever again.

AND they can charge us whatever they damn well please.

We are even less able to afford coverage now.

To say "I am not happy" would be, needless to say, an understatement. But there's not a goddamn thing I can do about it.

We have, effectively, been denied coverage. By making it too expensive for us to buy we have been shut out of the system. So don't bullshit me by saying "you can't be denied". Yes, you can, through the legal loopholes in place.

Quote:
But it does in fact pay what you "need," because you need affordable health care coverage.
You can't eat health insurance and it won't keep the rain off your head or the heat on in the winter. You NEED food, clothing, and housing. Our society, however, has decided that only the people who are either young-and-healthy or rich deserve health insurance.

Quote:
It does seem odd to me that health care coverage is tied to employment. It seems as arbitrary as saying where you live is determined by shoe size. But that's how it is in this country and until we find a better system (which IMO does not exist) we're stuck with it.
Bullshit. There are dozens of countries that manage to cover basic medical needs for ALL their citizens, without bankrupting the ill and disabled. How can you claim our system is better? For the 47 million shut out of the system, and the millions more with only partial access, our system sucks.
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  #46  
Old 01-29-2008, 09:59 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by Broomstick
Bullshit. There are dozens of countries that manage to cover basic medical needs for ALL their citizens, without bankrupting the ill and disabled. How can you claim our system is better? For the 47 million shut out of the system, and the millions more with only partial access, our system sucks.
Just wait a freaking minute here. I know you're upset and I understand why. The system does suck and I never said it didn't. I never claimed our system was better than other systems, and I'd appreciate it if you'd read what I posted before you go off on me. There's too of that on these boards to begin with without you adding to it.

There is no free lunch, though. If you study other systems you will see there is no "free" health care for anyone. National health care schemes are financed through huge taxes and by rationing care in various ways. It is not uncommon in the UK for an elderly disabled person to wait years for a hip replacement - although the surgery does eventually take place.

As horrible as your current situation is, you are only "shut out" of the system because you didn't know how the system works. If you had, you would have realized that you needed to take a job - any job with healthcare - as soon as possible after losing your last one, for continuity of coverage. It's true COBRA is prohibitively expensive, but that's how it is. We have to work within the system because that's the system we have, and the fat cats in Washington have no real incentive to change anything.

Don't flame at me, though. I'm more on your side than you could know. I grew up under military medicine in the US, I was married to a doctor for several years here in the US (so I know how well patients CAN be treated when they're part of the "in crowd") and I've worked in many medical offices in both the US and the UK. I lived in the UK for several years. I have not seen any system that puts the needs and welfare of the patient first.

Last edited by Sprockets; 01-29-2008 at 10:00 AM..
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  #47  
Old 01-29-2008, 10:05 AM
tagos tagos is offline
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Quote:
Originally Posted by Sprockets
You want links to other people's opinions? What is it you require? I'm also confused about why others are giving their experiences and opinions but I'm getting the "don't do it" message from you. Is it what I'm wearing? Am I holding my mouth wrong?
Facts, despite what you seem to think, are not the same as opinions.

FACT: The NHS has many preventative programmes.
OPINION (False and easily checked): The NHS does not have preventative programmes.

You see how the two differ? I know it's very subtle but if you look long and hard it becomes clear.
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  #48  
Old 01-29-2008, 10:17 AM
Sprockets Sprockets is offline
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Quote:
Originally Posted by tagos
Facts, despite what you seem to think, are not the same as opinions.
That's very patronizing.

Quote:
FACT: The NHS has many preventative programmes.
OPINION (False and easily checked): The NHS does not have preventative programmes.
The NHS does indeed have many preventive programs on the books, which may or may not translate into preventive care for the majority of patients. As I said, my experience was that I was denied preventive health care when I asked for it and that no one I knew while I was there had received the most elementary levels of preventive health care. I really don't feel like belaboring this, because it is so obviously a matter of opinion and experience and it has been pointed out to me that neither of these has the least value, especially for people who desperately need their opinions and experience to be "fact."

Last edited by Sprockets; 01-29-2008 at 10:18 AM..
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  #49  
Old 01-29-2008, 10:39 AM
Broomstick Broomstick is offline
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Quote:
Originally Posted by Sprockets
JThere is no free lunch, though. If you study other systems you will see there is no "free" health care for anyone. National health care schemes are financed through huge taxes and by rationing care in various ways. It is not uncommon in the UK for an elderly disabled person to wait years for a hip replacement - although the surgery does eventually take place.
Spiffy. I pay taxes right now and I don't have health care insurance. Rationing? Waiting lines? Do you understand I can't even get into line? I have no health care - RATIONED health care would be an improvement on my situation. Do you not understand that?

My husband needs surgery for carpal tunnel syndrome. We found that out just a month before I lost my job. Sure, in the UK or Canada he might wait a few months or years - but under our system he will NEVER get that surgery! How can you claim that our "system" is even as good as UK, Canada, Australia, various European systems....?

Quote:
As horrible as your current situation is, you are only "shut out" of the system because you didn't know how the system works.
I worked for a health insurance company for 13 years. I am well aware of how the system works, thank you very much.

Quote:
If you had, you would have realized that you needed to take a job - any job with healthcare - as soon as possible after losing your last one, for continuity of coverage.
How nice of you to suggest that. Perhaps I could could go to Wal Mart and buy a job? No?

I have been averaging 2-3 job interviews per week since I lost my job. I have not been hired. WTF do you suggest? No one is hiring At least no one offering benefits. Nor am I limiting myself to just one area. I have applied for every job I could find that I am even remotely qualified to do. I have picked up some work to bring in money but nothing with benefits of any sort. Do you not realize how stupid, immoral, and EVIL a system is when a person can work and work hard and STILL not get needed medical treatment?

I can hunt for jobs, submit resumes, go on interviews (I have yet another one this afternoon) but I do not make the hiring decision - someone else does. I have contacted two employment agencies and although I am highly qualified both have told me that there are lots of OTHER highly qualified people who have lost jobs in the past few months and very few companies hiring. Have you never been unemployed before? Perhaps you've noticed the economy is not doing well right now? Seasonal work over the holidays, yes - but no benefits. Part time work - but no benefits. Quite a few full- time jobs - but no benefits.

Quote:
It's true COBRA is prohibitively expensive, but that's how it is. We have to work within the system because that's the system we have
I understand that. However, it really grates on me that if I lived in almost any other civilized nation in the world this would not even be an issue.

Quote:
Don't flame at me, though. I'm more on your side than you could know. I grew up under military medicine in the US, I was married to a doctor for several years here in the US (so I know how well patients CAN be treated when they're part of the "in crowd") and I've worked in many medical offices in both the US and the UK. I lived in the UK for several years. I have not seen any system that puts the needs and welfare of the patient first.
Ah, but under OUR system my husband and I aren't even allowed to BE patients - we are shut out entirely unless we are actively dying of something - at which point we will receive just enough to keep us alive and a bankruptcy.

YES, I would rather pay higher taxes and live under a single-payer system with lines and rationing because that's more than I have right now.
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  #50  
Old 01-29-2008, 11:58 AM
alphaboi867 alphaboi867 is offline
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Quote:
Originally Posted by Diomedes
Your 'personal physician' likely is a private doctor who is not an employee of the hospital. The hospital can't write his bills off in the way they can other costs. And if the doctor doesn't charge for his services, he doesn't eat.

You received free care other than the bill from the physician? And you're rolling our eyes? Ingrate.
I'm rolling my eyes because in the five years since he technically became my personal physician I've never met him. Not once. The 4 times I visited his office in that time I was seen by his PA. I didn't even see him in the hospital. The closest I came was speaking to him on the phone last night to get discharged because he was too busy to some upstairs. He appears to have done nothing more that review information collected by hospital staff and write my a prescription for antibiotics which a staff physician could easliy have done.
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