Hospitalized with no insurance....a true story

Miscellaneous and Personal Stuff I Must Share
121

Do keep in mind that the social safety net does vary from state to state, though compared to the UK it’s pretty threadbare everywhere.

In my state, you’d qualify for food stamps when your assets dropped to $2,000 or less, you could get onto the Section 8 subsidized housing waiting list which is 10 years long to get subsidized housing. Since, presumably you would lose your home prior to reaching the top of that list you’d be referred to local homeless shelters. You would not qualify for Medicaid until you were officially decreed permanently and completely disabled - which might never happen if you can walk at all, use your hands, and talk no matter how messed up you are otherwise. No, let me rephrase that - you can be missing body parts and/or in a wheelchair and still be told you don’t meet the requirements for disabled because in theory you can do job A, B, or C, nevermind there might not be any such position in a hundred miles or it requires training you don’t have. The process of being decreed disabled generally takes 2-3 years, and often multiple appeals before final determination. At that point, you’d get a monthly stipend, your food stamps would then be slashed to $50 a month, you’d get on Medicare, where you have to come up with 20% of all medical costs, which comes out of your stipend, and maybe Medicaid would pick up some of that 20%. As the stipend isn’t nearly sufficient for monthly rent in many areas of the country you’d probably either half to find a roommate, be homeless, or wind up in a nursing home, a condition of which is signing over all your income to them except a token amount so you can purchase things like “toiletries” and hope to god no one steals what few possession you have left from your room.

Until you qualify for Medicaid (state level medical assistance) or Medicare (Federal level), if you are in immediate danger of death you can get treated at an ER to the point you are no longer actively dying, at which point you will be put back on the street. If you aren’t actually dying - just in a lot of pain, for example, or just gradually losing a body function - you’re out of luck unless you can find a free clinic or manage to beg some charity.

122

Sorry, missed the edit window -

Want to add that, of course, people who have family frequently don’t wind up homeless - they wind up living with relatives, who then take on the burden of feeding and housing and perhaps even helping to pay the medical bills of the destitute invalid. This, of course, impacts the ability of those relatives to save funds for their own needs, so that if the caregiver in turn develops a serious or chronic problem that person is at a disadvantage over the more selfish. Instead of being praised for such self-sacrifice such people are called stupid and foolish and criticized for not having adequate resources, having “wasted” them on another person.

I get this from time to time, having chosen to keep and support my spouse rather than divorcing and abandoning him when he could no longer work. It was “my choice”, after all, to spend the money on him rather than squirreling it away for my own future needs and leaving him to become even more debilitated or die.

This can also impact children in such a household - someone taking care of a chronically ill spouse, or a chronically ill child, might have a six figure income but be unable to save money for emergencies or education or retirement simply because of crushing bills. At which point the children in such families, upon reaching college age, are told how horrible their parents are for NOT starting a college fund for them but rather spending the money on healthcare for a parent or sibling, to, you know, keep that person alive.

123

So if everyone exercised instead of getting falling down drunk, that would make no difference to their hospital bills.

I believe that, in general, [ul][li]actions have consequences[/li][li]adults should be responsible for themselves[/li][/ul]

As I have said before, Americans want three things from their health care.
[list=One][li]They want the best care available[/li][li]They want it to be available to everyone[/li][li]They want it at a reasonable cost.[/list]They may have, at most, any two of those three. [/li]
In order to get anything close to what we want, we will need to ration health care. That means we let people die, or suffer outcomes that are worse than we might be able to achieve, in order to save money. I would support any system that includes rationing.

We need to say “No, you can’t have an MRI. No, your grandmother is eighty and she has Alzheimer’s, so we will not treat her pneumonia. No, you don’t get any money from the obstetrician’s insurance just because your baby was born sick.” Etc. If single payer can do that, single payer is fine. If single payer means that Democrats say “now the sky is the limit because we can just raise taxes on the rich and pay for every hangnail” then single payer is not fine.

The cuts mandated by the Medicare Sustainable Growth Act have been voted down every time they have come up, no matter what party controls Congress. The government is not going to say No.

I know, I know - we just do what the Canadians do, and we will all be sitting on beds of roses. But as the Shah of Iran said when asked why he didn’t run his country like Switzerland - “When my people behave like the Swiss, then they can be governed like the Swiss.” IIRC health care costs are going up nearly as fast in Canada as they are in the US. Health care costs are going up in the US pretty much unchecked, even as Obamacare is implemented.

We are working on the wrong problem, and it shows.

Regards,
Shodan

124

How much of Obamacare has been implemented?

125

Fear Itself, I applaud your bravery in facing the wave of words to come. I thought about it, but I just don’t have the energy today.

126

About Medicare and Medicaid.

I make about $10/hr, and am not eligible for Medicare. I had my daughter on state Medicaid until I managed to save up enough money for 1st/security deposit and they dropped her, because I had too much in assets.

At the same time, a prescription I could get from Canada for $20 costs me $107 here, a month. Not to mention the $145 doctors visit (specialist).

There is no healthcare for people like me, until I’m an emergency.

I went to Planned Parenthood yesterday for abdominal pains I’ve been having for about a month. I figured I’d start with the female parts, since that’s the only type of “testing” I can afford. $100 for a pelvic, and that’s far far cheaper than any ob-gyn in town. They didn’t find anything out of order, so now I’ll just have to live with the pain because I cannot afford another doctors visit and the tests they’ll need to do.

And by the way…I don’t drink or smoke. I don’t have cable television, I don’t even own a television. I drive a $1500 beater that needs brakes and has a constant engine light on. I don’t eat fast food, I don’t go to movies, I don’t eat out at all.

I’ll just prepare to drop dead quietly when the time comes.

127

Don’t worry. Folks in this thread will find SOMEthing about your lifestyle to criticize. You see, according to them, it has to be your fault somehow.

To admit otherwise would be admitting that they are not right, and that the system is screwed up. They might have to admit that this situation can happen to anyone, and one day might even happen to them. People like to think they’re in control of their lives. Your example illustrates that we are not, and this makes them uncomfortable.

128

Thanks Brookstick- really, having been brought up in the system I am, that reads like some horrifying alternate history… It’s scary to realise that is what can happen in a ‘first world’ country, and somehow some of the residents just don’t think it’s a problem.

129

Complete and utter rubbish. In Canada, urgent matters are dealt with immediately.

130

Possibly not. We are covered for medical but not dental unless the dental matter is of such urgency that it requires a visit to the emergency department. Just as the OP did not go to a dentist in the USA for financial reasons, I expect that if he were in Canada he also would not go to a dentist for those same financial reasons, eventually resulting in his being treated in the hospital at a far greater expense than had he received treatment when it was still only a minor dental matter. This lack of dental coverage is a flaw in our system.

131

Again, complete and utter rubbish. In Canada, almost all doctors are not government empoyees. They run their own private practices, or get together and run their own private clincs. When they treat a patient they then either get paid by the government, or by a private insurance company, or by the patient.

The government does not cover everything – it only covers what it generally deems to be medically necessary. If a treatment is not listed as being medically necessary, then the doctor goes to private insurance (if the patient has it), and if private insurance refuses to pay, then the doctor collects against the patient directly.

Part of the misconception over Canadian health care has arisen out of the requirement that doctors not charge more for a listed treatment/service than the government rate. This has been misinterpreted by many Americans to mean that we can not chose our own doctors – in fact, we can and do; and it has been misinterpreted by many Americans that our doctors can only perform listed treatments – in fact they can practice as they chose within the bounds of professional competence as self-regulated through their own professional College of Physicians and Surgeons, not by the government.

The simple facts of the matter are that Canadians live longer than Americans, we live in a healthier state for a longer period than Americans, we pay less per capita out of our own pockets than Americans, and we pay less through the public purse than Americans. Bottom line: we live healthier and longer for less private and less public cost. That, in a nutshell, is what results from universal health care. Check out the World Health Organization stats: World Health Report 2002 Statistical Annex http://www.who.int/whr/2002/annex/en/

Is our system perfect? Of course not. We constantly try to improve it. Most first world nations have universal health care, but institute it differently. We try to learn from each other.

132

Ah-HAH!!

<sarcasm ;)>

133

Yet again, complete and utter rubbish. In Canada if you do not think you are getting the best care possible from a particular doctor or clinic or hospital, you simpy go to another one, without restriction.

Macgiver, how about you stop spreading nonsense about the Canadian health care system. This place is supposed to be about fighting ignorance, not spreading it.

134

So, just to be clear on what you are saying - if I am Canadian, and I go to a government-paid doctor for a hip replacement, and he puts me on a waiting list, I can go to a different government-paid doctor and get my hip replaced immediately?

Regards,
Shodan

135

You might be able to find one with a shorter waiting list, sure.

As has been mentioned repeatedly in this thread, there are waiting lists in the US to access medical care.

That same study found that the shortest wait times for procedures were in Germany, which has universal health care.

Not to worry, the US is still the best:

Waiting is a hell of a lot better than no care at all.

Contrary to the misinformation in this thread, urgent care is not rationed or delayed. So if you broke your hip and landed in hospital, you’d get your hip replacement done the next day. If your hip has been gradually deteriorating for years due to arthritis, then your doctor will have put you on the list when he thought you were reaching the point where surgery is necessary.

136

Well, you can’t buy your way up the list if you have bags of money. But yes, you’re more or less correct. Maybe not immediately, but sooner.

Because you (the public) can check out the provincial lists of surgical wait times!

Example from British Columbia

From this list, I can see that 90% of patients had the procedure within 31 weeks for the province. If I wanted to get it done faster, I would ask my GP to refer me to Dr. Duncan Adam Jacks, who has under 5 patients on a wait list, and has 90% of patients done in under 9 weeks.
I challenge you to find a website that shows similar wait times for your state. For EVERYONE in your state, not just those with insurance.

137

Yes. It is just a matter of finding a doctor with the time available and a hospital with the operating room time availble.

The way surgeons and hospitals work around here is that the hospital will have a fixed number of operating room hours available. The surgeons in the region each book a certain number of hours on specific days (just as patients make appointments to visit their doctors, doctors make appointments to use operating theatres). There is no restriction what so ever on patients jumping from one doctor to another or from one hospital to another so as to get treated faster. If one doctor has too many patients at a given time and another has an operating room booked, then the patient can jump over to the non-busy doctor and get the operation done.

The big difference between Canada and the USA is that in Canada there is far less spent on administration, for in Canada most of the payments are made from the government to the private doctors at a fixed rate per treatment, whereas in the USA the private doctors have to deal with any number of individuals paying (or not paying) cash, and a large number of insurance companies, many of which will have diffferent rate schedules, resulting in one hell of a lot more administrative overhead.

I am being treated by an orthopedic surgeon who is a wizz at diagostics (I have worked under a medical malpractice specialist, so I’m up on who the good and not so good doctors are in my region), but who is getting on in years, so if/when it gets to the point that my back requires surgery, I will simply call about the doctors whom I believe to be better in the operating room and pick the one with the earliest available operating room date.

A couple of my outrigger crew have had non-urgent hip replacements with minimal waiting time, and they were both careful to shop about for surgeons. One of them found the surgery date too early for her schedule, so she had it postponed.

One of my clients was not happy with the wait for her back surgery, so she switched to another doctor so as to get the work done earlier.

Another of my clients did not want to wait until next month for non-urgent knee surgery, so she is having it done next week in another community where there happens to be more operating room time available. In this case, it is the same doctor who will perform the operation due to his regularly rotating out that way.

I coach a 22 person canoe crew of breast cancer survivors. MRIs, chemo, radiation, mastectomies, and on and on and on. They jump about to which ever doctors they believe to be the best for them, and get treatment all over the province, including a thousand miles away.

The waiting time problems arise from it being difficult to ensure that the right number of doctors in the right areas of practice are in a given region at the right time, and that each region has enough hospitals at the right time. That can be challenging for areas with rapid population growth (e.g. Toronto and Calgary), and areas that are not appealing to doctors (e.g. small towns in the north). Bear in mind that in Canada, just as in the USA, doctors are free to set up shop wherever they like, so at any given time, a community might be over or under serviced.

138

Can I move to Canada? lol

139

Here’s a simple way to look at it. In both the USA and Canada, the doctors are mostly private practioners, and the patients can go to whomever they want. In the USA, most of the payments are made by corporations that first and foremost are out to maximize their own profits for their shareholders. In Canada, most of the payments are made by governments whose first and foremost concern is the health of the patients, and which are elected by the people who at one point or another in their lives are patients.

140

If you have a serious pre-existing medical condition, then probably not. Otherwise, welcome.