Where's my fucking affordable health care, you fucking fuck? [lame]

The BBQ Pit
281

Fear–I get the distinct impression that those folks who oppose UHC have never faced a devastating illness or even a minor trauma.

I have a coworker (we are both RN’s and have ghe same ins coverage thru our jobs) whose husband had no risk factors, but ended up having an MI. Sucks to be him, eh? He had an emergency cardiac cath which involved 2 hospitals. We were at the hospital that he started at (and where we work, btw), but our facility does not do cardiac caths that may require open heart. So, he had to go somewhere else.

As time is ticking (on a Sunday, so no case managers; attempts to call the insurance for pre-cert resulted in–I am not kidding–a voice mail), website down til Monday for “maintenance”…coworker, out of her mind with worry re: her husband is ALSO a wreck about the insurance. Noone knows if the cath at the hospital closest to us will be covered by her insurance since it is out of plan. The closest in plan hospital that does these is over twice the distance away and her cardiologist of choice (that she has worked with for over 20 years) does not have privileges at the in plan place.

Nice dilemma, huh? At times like this, one does not want to have to look at who is covered and why–and we work in the damned industry! His condition was deteriorating, so we went with the closest one, after leaving an effing voice mail at the ins company. We are all praying that that counts as “pre-cert” since we couldn’t speak to a human. HR is also closed on Sundays. We used every resource we had, as insiders and still could not get the proper info. Cannot imagine what Joe Blow off the streets goes thru. We even tried to call the oncall case managers for other plans, thinking they might know–they did not.

This is our health care system–and we have “good” insurance and bennys. My health care for a family of 5 costs me about $100 per paycheck. I am now stuck in this job b/c my husband’s plan costs over $600/month for LESS coverage. We cannot afford that, period.

So, in a way, I am lucky that I have decent insurance for such a low price (it helps that we have no major chronic conditions etc). But our coverage still sucks. She will be lucky to be covered 80%. She is probably looking at at least $3000 out of pocket.

I don’t know may families that can afford to take a $3000 hit in one blow. And that is not counting rehab, meds he may need etc. And we are middle to upper middle class. Our system sucks and needs to be changed. I see it at work all the time. People are people and are going to make bad choices and wrong decisions. The “culture of life” should mean that we support life–which means a healthy life for all.

PS-guy is doing well and came thru w/o open heart (thank God).

282

WOAH, Dave! How do you explain this huge inconsistency? On the one hand, you have criticized taxpayer-funded health care, proclaimed that people should be responsible for their own health care, and that you “have elected to do exactly that” - pay for it yourself. Here (bolding mine):

HOWEVER, here you tell us all that in fact your wife’s pregnancy and birth of your son was publicly funded:

:eek: :confused: :dubious: :rolleyes: Now I’ve seen it all! So basically, whether you utilized MHIP or MCHP, taxpayers footed the tab for your wife’s pregnancy and delivery.

What a hypocrite! What happened to people being “responsible for caring for themselves?” What happened to “I am going to make sure those things are taken care of, even if I pay for them myself?”

FYI:

The Maryland Health Insurance Plan (MHIP) is MD’s high-risk pool, a state administered (and taxpayer-funded) health insurance program for Maryland residents who do not have access to health insurance (medically uninsurable and underinsured individuals). For FY 2005, $39,399,133 was appropriated to MHIP, and the FY 2006 appropriation is $39,422,006.

The Maryland Children’s Health Program (MCHP) is a Medicaid program funded with federal and state money, and covers low-income children and pregnant women. The FY 2005 budget gives $3.9 billion to the state’s Medicaid programs. The state spends an average of $6,500 per medical assistance enrollee. For FY 2005, $124,924,725 was appropriated to MCHP, and the FY 2006 appropriation is $141,767,551.

Cites - Maryland’s budget:
http://www.dbm.maryland.gov/dbm_publishing/public_content/dbm_search/budget/toc_fy2006_operating_budget_detail/execadmin.pdf
http://www.dbm.maryland.gov/dbm_publishing/public_content/dbm_search/budget/toc_fy2006_operating_budget_detail/hlthhosp.pdf

283

I fully understand that I am currently paying for other people’s healthcare. Partially, through higher prices, because some people aren’t paying anything at all. But I guess you can’t get blood out of a turnip, and all.

What I am questioning is the claim that I would pay less under UHC, and still receive the same bennies. I don’t think it’s possible.

284

Actually, other people are just as likely to be paying for your healthcare, as you might need more medical care than your co-insured, especially since you’re a smoker. Would you like for them to have control over your personal habits, lifestyle choices, etc, that could possibly affect your health? Want them to tell you to give up smoking or pay for your medical care, hospital treatments, etc., as you use them, instead of relying on insurance? Perhaps they don’t like the way you eat, how much you drink, or that you get angry a lot. It’s their money, after all.

285

How can people be pro-life yet against universal health care? How can they blather on about Terry Schiavo yet push a bankruptcy bill that punishes sick people?

When it comes health care the Republican party almost makes me physically ill.

I saw this Krugman column that summaries the problem as well as I’ve seen it done:

All our current system does is screw over poor people and line insurance company profits. It’s evil.

286

Aw, c’mon! The Republicans can’t be that bad, they even call it “compassionate conservatism,” right in the name! :dubious: :wink:

287

Does that mean that if you became convinced that you’d get the same bennies for a lower price or better bennies for the same price in a socialised health care system, then you would change your stance and be in favour of socialised health care in USA?

288

Question for the UHC folks:

How would you deal with the vast rise in demand for medical services which would inevitably result from the implementation of a Universal Health Care system? See, there’s no such thing as being too healthy, so if price is not a consideration the demand for health care is pretty much infinite. In a single payer system demand is controlled through the price of medical insurance. Since wasting medical resources on trivial complaints hits you American’s directly in your wallets, there’s less incentive to overuse the service.

I’m from the UK, where everyone gets free medical care through the National Health Service. Well, it’s not technically free, we Brits pay for our health care through our income taxes. However, since the amount of income tax we pay is tied directly to our earnings, the amount we pay is not proportional to the amount of medical care we use. What I mean by this is that an Englishman would contribute the same amount to the National Health Service were he to use medical care once a month, once a week or once a day.

This removes any incentive he may have not to go to the doctors. As you would expect, this has driven the demand for health care in England through the roof. People book doctors appointments for trivial ailments which could be cured by a couple of paracetamol and a day’s bed rest. Needless to say, this has a hugely detrimental effect on both the National Health Services financial resources and its human resources cite.

So what happens to the sparse medical resources when they’re being wasted on hypochondriacs, unnecessary treatments for the sniffles and lonely old people just who want a chat? Specifically, what happens to the Doctors and Nurses, the human resources? Well, there’s never enough of them. They have only a few minutes to see the people who are genuinely ill, who have to wait very long times. In other words, quality of service suffers. When quality goes down and the service is health care, people die.

What then do you do? Hire more doctors. That shoots up the cost of the government program, the taxpayer burden. Who pays that? The taxpayers. To cover that extra burden you have to raise people’s taxes thus making them poorer. Consequently they’re more dependent on the government provided services that they can no longer afford to pay for themselves. What are you forced to do now? Hire even more doctors. Do you see the problem?

The National Health Service in the United Kingdom is a disgrace. Thousands of people die every year from infections acquired on hospital wards because doctors and nurses are so rushed off their feet that they don’t have time to observe the proper hygiene guidelines. Cite

This, combined with the adverse ratio of doctors to patients due to the uncontrollable demand, has a detrimental effect on the waiting lists which plague the NHS. Cite. People have to wait weeks or even months for operations which could be provided privately in days.

Case in point, my father was diagnosed as having gall stones in November last year. He decided to have the operation on the NHS and was informed that he would receive an operation to remove his gall bladder in three weeks.

Three MONTHS later, after the operation had been cancelled four times and my father had almost died from an attack of pancreatitis brought on by the gall stones, he decided to bite the financial bullet and pay for the operation privately. He was operated on six days later.

Why the disparity in the quality of service? Because in the private sector demand is controlled. How would the advocates of Universal Health Care deal with the detrimental effects of the stratospheric increase in demand brought on by the implementation of such a program?

289

Be less like the UK, and more like Japan, Canada, or France.

290

These are kinda weird cites, I think.

I don’t see anything in the cite that says the reason is that “doctors and nurses are so rushed off their feet”. Did I miss it?

From what I see, there is nothing about any “adverse ratio of doctors to patients”, nor “uncontrollable demand”. The article, as I read it, is saying that patients need to stay longer and be isolated due to the “superbug” MRSA. You may read the things you mention into it, but they’re just not there as far as I can tell.

Perhaps, as mentioned in the second cite, there is more information floating around that I’m not aware of as it seems this is an “election-year issue”. I’m still not sure how this plays into the debate about UHC…

291

Nyctea, I am going to clarify this just once for you. My wife was covered by MHIP insurance, a plan that we paid for, to the tune of over $400/month, which did not including coverage for myself and our other son. We paid a premium, Gingy and the sprout were covered by insurance. I expect your apology for misrepresenting our situation forthwith.

292

A (small) payment for using public health care strikes me as an obvious, easy solution. Big enough that you don’t rush off to the doctor for something trivial, and small enough that you don’t break your back financially on it. The last time I visited a doctor, I paid – um, something in the neighbourhood of 25 Euro, I think. For more serious stuff, like the operation when I broke my elbow, or the two times I gave birth, I paid nothing.

I would imagine the private insurance companies in USA face the same problem, and that they solve it the same way. However, from what I gather the copayment in US is tied to the cost of the treatment, so that copayment for something serious/expensive is higher than copayment for a simple doctor’s visit. (Please correct me if I’m wrong, someone.) That doesn’t make sense from a “keep a lid on hypochondriacs” point of view. I’ve no problem believing that some people would visit the doctor for every stubbed toe if it was free, but it’s not as if someone would break a limb on purpose or get pregnant just to enjoy the luxury of free health care.

293

Um, Dave, let me explain again. MHIP is a state-subsidized (as in taxpayer-funded) program. You being an insurance broker, I am really surprised you did not know this. Cites:

From here (it’s a big document, but I even linked to the very exact page for you…) http://www.dbm.maryland.gov/dbm_publishing/public_content/dbm_search/budget/toc_fy2006_operating_budget_detail/execadmin.pdf#page=157
“The Maryland Health Insurance Plan (MHIP) provides subsidized health insurance benefits to uninsurable individuals.” Its mission is to “decrease uncompensated care costs by providing access to affordable, comprehensive health benefits for medically uninsurable residents.”

The taxpayers will be contributing $39,422,006 to MHIP for FY 2006. Take a look for yourself: http://www.dbm.maryland.gov/dbm_publishing/public_content/dbm_search/budget/toc_fy2006_operating_budget_detail/execadmin.pdf#page=162

Also I don’t know why you were paying $400 a month. According to the current chart of MHIP premiums here: http://www.marylandhealthinsuranceplan.state.md.us/premium.pdf
For someone age 30 to 34, the premiums range from $168 to $279. So I don’t understand she would be paying $400…

MHIP is the state’s high-risk pool. Which basically means to qualify, you have some sort of condition which makes it impossible to get coverage from a private insurer. From here: http://www.marylandhealthinsuranceplan.state.md.us/eligibility.html
Eligibility requirements:
–Have exhausted all available group coverage
–Have, or have been offered, health insurance that provides limited or restricted coverage, or that excludes coverage for a specific medical condition
–Have been refused individual health insurance for medical reasons or have a specified medical condition

Again, you being an insurance broker, I am really surprised you couldn’t find any coverage for your wife, thus necessitating her to join the state’s high risk pool.

HRPs are expensive. They’re basically a pool of people that no other insurers would cover, so the state steps in (as it should) to take care of them. Right now, only 32 states have them, but hopefully more states will start them. They’re a very important safety net for people (like your wife).

I just found it very contradictory that you bash UHC, but yet your family is benefiting from a form of it (which you tried to deny, but how can you refute all the proof I have given? I am surprised that you didn’t know any of this.)

I’ll be waiting here for MY apology.

294

By the way, Dave, I am not trying to be nasty with you. I am just trying to make a point: you are benefiting from the same thing that you are criticizing. So maybe it’s not such a bad thing afterall? Think about it.

I think it’s a good thing your wife could get coverage through MHIP. I’m glad you don’t live in a state without a high-risk pool, because what would you have done?

However, it would be nice if we didn’t have to have high-risk pools. The reason they exist is because greedy insurance companies refuse to cover certain people. Why? Because it might affect their profit potential. So therefore the burden falls on everyone else - the taxpayers have to pick up the tab. But that is OK with me, because that is what a good society does - it takes care of its less fortunate people. A good society doesn’t just say, too bad! You can’t get health insurance because you have a chronic disease, so you just deserve to go without and die! Survival of the fittest!!! <evil laugh>

Basically though, that is what it seems like you have been saying: Can’t afford coverage? Can’t get coverage? Well too frickin’ bad for you! Have a nice short life!

How would you feel if society had said that to your wife? Think about it.

295

griffen2-you know that doctors and nurses in the USA work longer hours with less time off than the average doctor works in the UK, right?

You are also aware that every “trivial” reason someone visits a GP may actually be:

  1. an opportunity for opportunistic healthcare eg BP monitoring, smoking cessation advice
  2. a person in need of psychiatric or psychological support whose needs are not otherwise being met
  3. an educational opportunity to prevent a further visit for the same condition

Also, that an early presentation to a free service may be more cost-effective in the long-term than a late presentation to one which the patient has to pay for.

Go and search these boards for people trying to get free medical advice for sometimes serious medical issues because they can’t afford to visit a doctor, and imagine what will happen to some of them if they don’t see a doctor, but let their problems worsen to the point where they’re taken into hospital.

No-one is saying the NHS is perfect, we’re saying that as a system it gives the consumer more bang for their buck and provides a more equitable system of access.

Oh, and see the way your dad had the option of paying for his operation privately, that’s a good thing. 90 days wait for a minor elective surgery (which is what a gall bladder removal is classified as) is not terrible. Not pleasant, but not terrible. Because if he’d needed a major emergency surgery it would have been done there and then, whether he could pay or not.

Swings and roundabouts, isn’t it.

296

Wouldn’t that statement have been just as true in the US?

I thought life-saving emergency care (even surgery) was performed regardless of ability to pay? The bill may bankrupt you, but you’d live to be bankrupt.

297

The corollary of your statement is that people who need treamtment have an unfortunate incentive not to get it in the USA. And that happens a lot, especially when the person has no health insurance of any kind.

Same thing in the USA: "Health care in the United States is not as safe as it should be–and can be.At least 44,000 people,and perhaps as many as 98,000 people,die in hospitals each year as a result of medical errors that could have been prevented,according to estimates from two major studies."To Err Is Human: Building a Safer Health System

But of course, we’re spending far more on health care in the US, while excluding about 45 million people from coverage. And apparently not even getting better quality than the UK. There isn’t any data that I’m aware of that shows the US has a more efficient health care system than the UK or anyone else. If anything data shows that isn’t true, we’re less efficient.

298

No, it isn’t true. EMTALA is the law that requires hospitals that receive Medicare payments not to turn people away from their ER. Here’s a description of what is required:

In essence, then, the statute:

* imposes an affirmative obligation on the part of the hospital to provide a medical screening examination to determine whether an "emergency medical condition" exists;

* imposes restrictions on transfers of persons who exhibit an "emergency medical condition" or are in active labor, which restrictions may or may not be limited to transfers made for economic reasons;

* imposes an affirmative duty to institute treatment if an "emergency medical condition" does exist.

Frequently Asked Questions

Treatment does not mean cure. It means stabilize. If it’s not even an “emergency medical condition” they don’t have to do anything. If a patient presents with a brain tumor, if it won’t kill them in the next hour they can give the patient an aspirin and send them home. Or transfer them to a hospital that believes it has a moral obligation to help people who need treatment even if they can’t pay. Don’t think it doesn’t happen because it does. Which hospital do you think will be able to stay in business?

299

Because there’s a “Culture of Life!”*
*But only if your cerebral cortex has turned to mush.

300

You may not be trying to be nasty, but you are being seriously misleading in your posts. A HRP is not even remotely like UHC, in fact, it’s the opposite. If your point is that under a UHC system a HRP would be unnecessary, fine, that’s true, but stop saying that they are the same thing because they are most definitely not.

#1. Gone with a private carrier
#2. Self insured for the birth. Complications were covered under our insurance, it’s just routine maternity that we had elected to omit. We weren’t planning on a baby, Jimmy was a surprise. It was our choice to set things up that way, if it had come down to it, that choice could have resulted in our paying for the delivery and pre-nat care ourselves. No big deal. We had a routine delivery. Worse case scenario, I would have paid the $7,000 that it cost off over a couple of years, and not thought twice about it. Before you start in on me about how lucky I am that I could do that, lots of people can’t, yadda. yadda, yadda, consider that it’s not that I am rich, I am not, it’s that I have no problem prioritizing in my life. People buy cars over several years all the time and they are hunks of steel that will be next to worthless when they are paid off. Jimmy is one of the three most valuable things in my life and will be forever.

[QUOTE=nyctea scandiaca]
A good society doesn’t just say, too bad! You can’t get health insurance because you have a chronic disease, so you just deserve to go without and die! Survival of the fittest!!! <evil laugh>

Basically though, that is what it seems like you have been saying: Can’t afford coverage? Can’t get coverage? Well too frickin’ bad for you! Have a nice short life!/quote]

I have never said anything of the kind. In fact, my position has been and is consistent: Government should sponsor programs for low income people, and offer plans like MHIP for those with conditions that preclude them from private coverage. Everyone else should pay for themselves. I invite you to find one post where I’ve said differently in the 6 years I’ve been on the SDMB.

Well, if I lived in a hypothetical society where that kind of attitude was the norm, I’d probably feel pretty awful. Since I don’t, it’s a pointless question and a complete strawman besides.