Replies to This Discussion

Permalink Reply by Judy on November 7, 2009 at 1:41pm

Because of no insurance my grandson has a crippled foot that will always be w/him due to a rollerblading accident.

And because of shoddy, bare insurance, my son has also suffered irreversible nerve damage in one leg and foot due to incompetent care and surgery too late - after his wife found a job w/decent insurance benefts.

Please don't ever think I don't realize how blessed I have been to have had good health care insurance my entire life or that I don't empathize and sympathize w/those w/no or insufficient insurance!!!

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Permalink Reply by sleepycarol on November 7, 2009 at 2:00pm

I know when I had my first baby the room rate was less than $50.00 a day, and the nursery was part of the mother's stay on a newborn. Over the course of 8 years when I had my children, I saw those rates increase at a far greater level than the rise of wages in our area. By the time my youngest was born, the nursery was billed at the same daily rate as the mother's room.

I am very greatful that we had good insurance during the time our kids were growing up. It covered accidents 100%. If it was an accident we were not out any out of pocket expense. Believe me with 5 kids we had our share of accidents.

Like Judy, I remember when one had to pay for office visits without the benefit of insurance. Our doctor charged $17.00 twenty years ago for an office visit. Prescription drugs were more affordable and used only when over-the-counter drugs were not useful. That same office visit today is over $70.00 + plus "extras". I pay out of pocket for office visits. Last time I went she had to draw blood so the visit was nearly $100.00.

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Permalink Reply by Mary Z on November 7, 2009 at 3:41pm

As someone on disability with Medicare I am very thankful for it. As of January my insurance (Medicare and supplement currently $216/month) will be $248 monthly with no dental coverage. I had to wait two years after going on disability to be covered by Medicare, thank goodness I'm a Vet and the VA stepped up to help me- all out of pocket costs on a disability paycheck, but good care none the less. I know a lot of people abuse Medicare and use the ERs as a primary care facility, but I am not one of those. I would much rather work, but I am unable to, so I am thankful for SSDI and Medicare and the supplemental policy I am able to purchase. Still I fall in a "donut hole" each year after Medicare pays so much on my prescriptions I have to pay $4,000 out of pocket before they pick up again. It's not all easy street. I really empathize with those with less.

Mary Zimlich


Andy said:

Oh-oh, Judy, I feel a major rant

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Permalink Reply by Tim on November 7, 2009 at 4:17pm

I went to the hospital ER last Monday morning because of severe pain that turned out to be a kidney stone. In the ER, I got Vicodin, an injectable pain med, Flomax, and Bactrim, a CAT scan, uraine labs, and some prescriptions. Last Friday I saw a urologist who did some more urine labs and gave me a script for for an x-ray, Flomax samples, and a script for Dilaudid (he also told me that to stop taking the Bactrim). I also have another follow up appointment with the urologist in a couple of weeks. I am lucky that I have insurance and my out of pocket expense should be less than $300. I don't even want to speculate what the rack price would be for the ER visit, CAT scan, prescriptions, x-ray, and 2 urologist visits. With any luck, the stone will resolve (pass) on its own. If it doesn't pass on it's own, I can expect to nearly double the current cost!

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Permalink Reply by Judy on November 7, 2009 at 4:43pm

You have my sympathy, Tim. I passed one whilst pregnant for my youngest daughter. One of the longest, most painful nights of my life! 3-4 years later my husband ended up hospitalized for 3-4 days until he passed a kidney stone. Doggone kidney anything can be painful!!!! May your stone pass QUICKLY.

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Permalink Reply by 99 on November 7, 2009 at 5:00pm

try pearl barley water

Tim said:

I went to the hospital ER last Monday morning because of severe pain that turned out to be a kidney stone. In the ER, I got Vicodin, an injectable pain med, Flomax, and Bactrim, a CAT scan, uraine labs, and some prescriptions. Last Friday I saw a urologist who did some more urine labs and gave me a script for for an x-ray, Flomax samples, and a script for Dilaudid (he also told me that to stop taking the Bactrim). I also have another follow up appointment with the urologist in a couple of weeks. I am lucky that I have insurance and my out of pocket expense should be less than $300. I don't even want to speculate what the rack price would be for the ER visit, CAT scan, prescriptions, x-ray, and 2 urologist visits. With any luck, the stone will resolve (pass) on its own. If it doesn't pass on it's own, I can expect to nearly double the current cost!

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Permalink Reply by sleepycarol on November 7, 2009 at 10:27pm

What is pearl barley water?

I have never heard of it. It maybe that in US it isn't a common remedy. I love home remedies as they can be effective.

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Permalink Reply by Andy on November 7, 2009 at 11:56pm

Hey, Rock.

No, I'm not self-pay. I am insured.

At a cost to me of $1,900/month.

Don't get me started!

;)

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Permalink Reply by RockRpsgt on November 8, 2009 at 9:43am

WOW $1900 that's crazy! I am assuming you are on an individual policy? I was just trying to get a feel for where everyone was coming from in this discussion. Personally I am sitting pretty well insurance wise. I have family members that are jumping through hoops though.

What really gets me is when I see people dogging the current system, as well as any new system that may take it's place. I would like to hear more about the solutions to the current problems than I would about the current problems. Those I get to see up close and personal.

Andy said:

Hey, Rock.

No, I'm not self-pay. I am insured.

At a cost to me of $1,900/month.

Don't get me started!

;)

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Permalink Reply by Judy on November 8, 2009 at 10:21am

Yeah, well, as of 7 PM or so last night we are one step closer to health care reform. The closest we have ever been. I'm not sure how I feel about that. Admittedly I haven't read the entire 1900+ pages of the proposed bill but I certainly have NOT heard one solid cost cutting measure from the media or our politicians.

Simple things like standardized claims forms across all insurances would reduce costs drastically. Let the insurance companies absorb the cost of coming to agreement on standardized claim forms. All billing is done by one code or another, HCPCS, ICD 9, CPT, etc. so where is the big problem other than getting a "committee" to agree on where to place what code when on the claims form?

Maybe a standard $10 or $20 copay for an office call would seem to be a reasonable measure to cause one to think a bit before trotting off to the doctor.

A close look at the patent life on new medications, especially these new biologicals. Restrict patent life on minor changes on an already approved drug. Biologicals should have no longer patent lifes than current drugs. The patent life should NOT be extended from where it is now. Pharmaceutical advertising should be legislated back to pre-1987 levels, let them advertise their companies but NOT the products. For that matter, reapply the restrictions on physician and medical facility advertising to pre-1987 levels as well. Who doesn't know the nearest hospital or hospitals to where they live?

Before any drug approval that drug should have to undergo one last clinical trial pitted against an approved drug in its class. This final trial wouldn't have to involve a huge number of patients, but a large enough number to establish that it is as or more effective than the already approved drug and w/less or the same side effects. This testing a drug against a placebo is not particularly impressive. This final clinical trial should also have to use a current EFFECTIVE monitoring or diagnostic test rather than something as asinine as the CDAI score for Crohn's disease, etc. This might raise the cost of research and development but it WOULD result in more effective, safer new drugs than are being approved now and hasten the approval process of the best drugs.

And then take a close look at upper level salaries, perks, benefits and bonuses of insurances and medical treatment facilities as they are w/the financial institutions and bail out companies.

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Permalink Reply by sleepycarol on November 8, 2009 at 10:30am

I had thought it would be great to have a system more like Canada or many of the European countries, but their systems are plagued with downfalls as well. No plan is going to be perfect. What is a good plan for the masses? What about those that fall through the cracks? What about Medicare and Medicaid (with all the different states playing into the latter)? Many find themselves needing supplemental insurance with Medicare, premiums that stretch their already thin retirement dollars even more.

We had a local doctor decide several years ago that he wanted to start a truly "free" clinic for those unable to afford health care. The local Salvation Army gave him permission to use their facility until something else could be found. He took it upon himself to man the clinic every spare moment he had. He was able to entice some of the local nursing staff, and local doctors, even some of the specialists to donate their time as well. When a local doctor retired he ended up allowing them to use his office building. They were able to get prescription medicine through various means and could often give the patient the medicine without costs. They did a lot of good for this community and saw many patients.

All of this was done without government money. Then we had an influx of aliens into the community, both legal and illegal. It became harder to get appointments and they were turning away many locals that had lived here for long periods of time. There were plenty of hard feelings among the community. The original doctor moved away leaving a void. Many of the doctors that were donating their time decided that they no longer wanted to be part of clinic. The few that did remain started thinking and decided to apply for grants and such. Then of course the government became involved. Now they have a shining new office out in the ritzy part of town, away from the vast majority of “poor” patients that they treat. Of course they have rent and overhead now, in a high rent area, (remember before they didn’t have this as the retired doctor was donating his building, upkeep, and utilities). The clinic hired nurses, doctors, dentists, and others. Someone has to pay their salaries. Yes, they received some grants, but not nearly enough to pay for all the outgoing expenses. They use a sliding scale fee, with most patients on Medicaid. Others with little or no resources are turned away when trying to get appointments. All in the name of “progress with the governments help.”

I think the above is why many in our community is leery of government ran health care.

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Permalink Reply by Andy on November 8, 2009 at 10:41am

Yes, it is crazy. I must pay for my own insurance because:

I'm not a city worker.
I'm not a state worker.
I'm not a federal worker.
I'm not a congressman.
I'm not a senator.
And I don't work for one.
I'm not a state rep.
I'm not a mayor.
I'm not a city councillor.
I'm not a policeman.
I'm not a fireman.
I'm not a rescue worker.
I don't work for the railroad.
I'm not in a union.
I'm not in the military.
I'm not a veteran.
I'm not an immigrant, legal or otherwise.
I'm not an unwed mother.
I'm not an addict.
I have a social security number. And it's mine.
I'm not disabled.
I'm not on welfare.
I'm not on Medicaire, Medicaid, or Medi-Cal.
I'm not a teacher.
I don't work for Fannie Mae or Freddie Mac.
I'm over 18, but under 60.
I'm not a priest, minister, or nun.
I'm not an air traffic controller.
I don't work for a bank.
I'm a natural-born US citizen.

HOWEVER I have to pay for the health insurance for ALL OF THE ABOVE, through taxes and higher prices on everything I buy with what little money I have left over after paying for my own health insurance.

And for all of my co-pays.

I don't get a discount on my insurance because I'm not a member of a "group."

I'm just one of the minority of people that has to take care of themselves.

But I'm not bitter....

:)

.

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