Health care horror story #13848732

Friends of mine are friends with a couple they’ve known for nearly 20 years. I don’t know this couple well, but they are generally nice to me when I do run into them.

So the mother had a pregnancy, and the child has a variety of organ deformities which were spotted around 6 months. It had to be delivered via C-section about 2 months early. So in order to get specialty care the child needed it had to be taken to a hospital in a larger city to have neonatal care and surgeries performed.

Both of the parents work full time, and they both work in the health care field. I think one has a masters, the other with a bachelors in a specific field (PT, radiological technician, I don’t know). They are solidly upper middle class and have health care through his work.

However because they had to take their premature kid to a specialty hospital, their insurer claims it is out of network of their coverage, and refuses to cover treatment. That is despite the areas in their coverage not having the neonatal treatment needed (his health insurance plan is weird, but seems extremely limited). So their choice seems to be either deny the child needed care because it is out of network, or pay for it yourself. For all of Sarah Palin and her myths about public death panels. We’ve had private death panels for years and she (and the neocons) never lifted a finger or cared in the slightest.

So within the course of a few weeks the parents have had to go through knowing that their child is severely deformed and might die (the doctors say there will be tons of surgeries over the next few years). Now she has to quit her job to stay at home to raise the kid since it’ll be special needs. Not only that but her health was severely at risk (and may still be, I don’t know) which is one reason she had to have a C-section, to protect her health.

And on top of all that stress (both parents taking a few months off work and dealing with the finances of that, the mother’s health being at risk, the child’s health being at risk, the mother needing to stay home which will affect family finances) their insurer is looking to get out of paying. The parents claimed they might be bankrupt in 2010 if they have to pay for all of this by themselves. So a solidly upper middle class couple with health insurance through work who are young, and they still they might go bankrupt. I know its been happening for decades, but when it happens to people you know it really hits home. You can do everything right (get a good job with benefits, get an education, avoid risky behavior) and you can still get ground up in the gears of our system anyway. The Just world fallacy can’t be used to blame the victims.

I have heard several friends in Europe say things like ‘why aren’t you all protesting and rioting in the streets about health care’. And my response is, I don’t know. If this were France the health care funding wouldn’t be a problem. And the mother would get maternity leave for up to 3 years. In the US they may have to get a divorce so she qualifies for welfare.

But for one thing, I thought we did ‘riot’ by having 2 landslide elections back to back in 2006 and 2008. The goal of having a democracy isn’t to live in a nation w/o conflict, but to take that conflict, anger and frustration and direct it into nonviolent, but effective action. We tried that. People tried channeling their rage and frustration into constructive, non-violent action (writing letters, voting, registering new voters, awareness, etc). It didn’t seem to work as well as many of us hoped, but its a start.

But why aren’t the people in Myanmar or Equatorial Guinea rioting about the abuses there? I don’t know either. We put up with this crap in the US, but people in North Korea and Myanmar put up with abuses there too.

Either way.

What’s the big deal? They should just have a benefit Spaghetti dinner. It’ll solve all their problems.

[that was sarcasm, in case anyone’s wondering]

I’m sure you know that voting does not in itself mean you live in a functioning democracy, you also need - among much else - full and free information in order to make informed choices.

The reason why this healthcare lie has lasted decades longer than it should have done in the USA is because the public is not informed. Sure, the public thinks it’s informed - hell, they knew they didn’t want socialized medicine for 40 years - but they really are not. No more informed than they were about, say, WMD, or that 25% of the worlds prisoners are in the USA, or 55% of the worlds military spending, etc; many things that should be major issues aren’t even on the radar, yet they’re absurd in any international context.

Power is not with the people, it lays with the corporations through the lobby system and the funding of election campaigns.

I’d agree it absolutely looks like a functioning democracy but, if it were, the insane health care rip off of poor and middle class people would have ended in the 1950s.

That progress has been made now in relation to UHC is not a clear sign of greater democracy but is instead an acknowledgement of impact of the rip off on international competitiveness. It a function of the market, is all.

As a libertarian, I believe it would be immoral to force other people to pay for their healthcare. IMO healthcare is a service and a luxury, not a “right.” But on the other hand, what if someone doesn’t have the money to pay a large and unexpected medical bill? One idea is to offer low-interest, government-backed loans, similar to students loans. These loans can only be used for healthcare expenses.

Well, good luck with that parochial ideology. I’m sure you wont be surprised if it’s not a vote-winner in that great democracy, unless the corporations can buy enough votes in Congress, of course.

69 zillion years ago nothing was a right. Food wasn’t a right, you had to go and hunt it. Health wasn’t a right, if you got hurt you got fucked.

All the years between then and now, many millions of human beings worked hard to progress our race. We pushed forward constantly in the unspoken aim to create civilisation, to create a better world to live.

So if, in 2009, when we have the capacity, we still dont have the ‘right’ to eat, and the ‘right’ to get help when we are sick, then I ask, what was the fucking point of it all?

Is America not civilised?

Nice try, but there are still millions of liberty-minded folks who believe in individual freedom and responsibility. We believe is it wrong to force people at gunpoint to hand over their property to someone else for their individual consumption.

If you want to acquire a product such as education or healthcare, fine. Purchase it. It’s wholeheartedly immoral to use the police power of government to force your neighbor to buy it for you.

“Millions”? Where are they hiding?

The parents in this case did purchase it. They’re still pretty much screwed.

Who cares, so long as they hide.

Well then why should you pay for anything? Why should your neighbour pay for the socialised fire brigade to show up if your house burns down? Society decides where to draw the line and right now polls indicate that a clear majority of Americans would be willing to pay higher taxes for universal health care, let alone for the meagre provisions in the anaemic Senate bill. If you don’t like it, emigrate.

As was made clear in the OP and as Ferret Herder reiterated, these people did purchase health care. I don’t know how many thousands of dollars they poured into their insurance companies coffers before some corporate apparatchik on a private death panel told them it was all for nought, but I would imagine it was quite a substantial sum.

I agree that it certainly isn’t a right, and it is a service. I wouldn’t call it a “luxury” though - I think that’s pretty absurd. It’s more like a necesary product/service like food and clean water.

That said, I object to all arguments for or against UHC based on “rights” - it’s a red herring. Of course it isn’t a right. It doesn’t need to be in order for us to have a smarter, more efficient medical system.

I look at it from a utilitarian perspective. I think, for example, having the roads built and run by the government has benefited society greatly over the years - a private road system would be much more complex and less efficient with a worse experience for the user. Government damages most of what it touches, but not all - there are some projects for which government is suitable and actually best for the job.

So look at the evidence - the idea that the US health care system is the envy of the world is a total myth. Statistically, pretty much every other first world country provides universal health care for less per capita and as a fraction of their GDP than we do, while delivering on average similar or better care.

I too lean libertarian, but I form my ideology based on the evidence, not twisting the evidence to fit my ideology. The current system is based around a government price fixing and wage fixing intervention in the market that ultimately stuck around. Employer-based health care is pretty much the result of government interference in the market. The assumption that our current system is the best, and the most free, is fallacious.

That said, your arguments also respond to straw men. No one has serious proposed single payer, and the entire “you want government to control the whole health care system!” as a response to the current proposal is dishonest. You can argue with more finesse and address the actual issues at hand. Additionally, these people DID buy health insurance. They are, in your view, exactly the sort of responsible people you are attempting to instruct others to be. And yet they got screwed. And here you come saying that it must be their fault. On what basis?

The fact that you came into this thread rehashing talking points and attacking straw men that weren’t even close to what anyone in the thread says suggests you’re not exactly putting much thought into this.

Do you feel this way about the public road network? “Taxes are theft!” only being applied selectively to issues you oppose is not the height of ideological consistency.

They did. And no one in this thread has suggested the government buy people’s health care. In fact, now lacking the public option, most of what’s in the current bill is reforms aimed at taking down certain unethical insurance practices against the very people who bought and paid for insurance in good faith. (That’s what the PR is, at least. I haven’t read the bill, so it may be a clusterfuck)

The people in the OP are the responsible people you refer to that bought their health care. They were screwed by the fine print on page 742 of their health care contract. The current reforms are aimed at stopping this sort of practice. Libertarian ideology is compatable with the government regulating the markets in such a way that consumers can be informed and get what they’re paying for, so what’s your big beef with this? The most obvious conclusion is that on this subject you a talking points spouting robot who responds to any argument that relates to health care in any way with the same stuff.

Something is fishy here, since when do you go have surgery at a hospital without them and you checking and getting insurance company approval first? No one here noticed that? Wouldn’t they have to do that to get the co-pay amount and all that before the operation? And they did multiple ops without even talking to the insuror?

I wonder if this was some herb and chant kind of rinky dink treatments now? They should have let their covered local hospital do any transferring to this larger one. I certainly do support national health care but even under any private insurance it would have you still would need to go to a participating hospital in that plan I would think.

Just like education, fire departments and police services.

Strinka, right on correct, why anyone does not seem to know it works in all these other countries, and not one dreams of using our system instead, ought to be self-convincing. Oh, and to the guy above saying to just go BUY it, does he realize they won’t insure you if you are sick at all in many cases, and if any do it is a year before coverage where you waste all that premium and get nothing while still paying your medical bills? Yeah, great idea, just go buy it…

Greedy doctors afraid of slightly lower income are the source of all this mis-information. But that greed is also what is wrong with this story, because no way would a real hospital do multiple operations without checking insurance and getting an approval, and it won’t be buried on page 729 if they are not in the network, they would reject the card right away.

They are always much more concerned with greed than health, something that makes me mad at the TV shows where the docs all act like collecting money is just totally out of their goal. It is their goal from the time they begin training. No way is an out of network place going to do that operation unless it was cash up front.

Libertarians cling to their mountain man philosophy even though it is atavistic and sophistical. It is so illogical and unworkable, yet they proudly proclaim it as if it has great insights into solving problems. It offers nothing but an immature feel good philosophy. When a Dopers states that as a guiding theory ,they drop in esteem. Get real. Greenspan and his financial pros provided us with proof of what destruction it can cause. A self correcting market that requires no regulation will result in a stronger and better financial system. What BS. You had your chance and blew up the world economy. Let it go.

I am not a proponent or supporter of government schools. As for fire and police, I do not have a problem with supporting their fixed costs. But I think people should be fully charged for any and all individual services.

I agree. This doesn’t sound right, especially for such major care.

Wesley, what is the nature of the care they’re looking for? I think that part of the problem with our health care system is that every one expects that every possible measure, no matter how realistic the benefit, no matter the cost, is something their loved ones are entitled to. Everyone else needs to be practical, though, or we’ll never contain these rising costs. We’re all guilty of this to some extent.

Are they looking for care they truly didn’t pay for, or is their insurer playing games? What is the nature of the care? Did they follow the protocol for their policy (e.g., checking first for non-emergency care)? Maybe they did.

You know Crafter, it always amazes me people will talk about making citizens pay for every use of something, especially if it is a bad use, but with one huge exception. Remember how mad everyone is at the “balloon boy” father for faking the distress? They want to bill him for all of that. OK, I do not disagree, bill him.

But where is the same outrage when a prisoner escapes jail, is dangerous, but when caught never has to pay a dime of the cost? Why doesn’t he leave jail with a judgment on him like good people get, and why do we also give them only FREE medical care? No forms, no deductible, and never a judgment to pay, and NO ONE seems to ever get mad about THAT? How do you feel about that? Have you ever even suggested someone other than good people ought to pay for services too? I bet not, it never seems to enter their minds.

Why do we not have free care for crime VICTIMS, instead, and the criminals only get care if they pay for it or some liberal decides to give money for it? If more criminals died in jail, the rate of re-offending would sure have to go down, and out expenses, so what is the downside? Think about this next time you want more people to pay for individual services. The way I see it if they will give it to a criminal, then why should I pay for it, let them collect there first.

You’re right SB. And I should have read some of the details in the OP more carefully. But I also interpret the OP as a rant for European-styled socialized medicine. Which we both agree would be horrendous.