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Other than cost and pre-existing condition clauses


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So it's a cost issue and pre-existing conditions??

 

When care was provided was it good care???

 

My comments in another thread about our SHODDY healthcare system was not a slap at the medical quality issues, it was a slap at the fact the insurance companies dictate what the actual total heathcare quality is. Such as not allowing preventive care.....not allowing wellness annual physicals....an so forth.

 

As for care I have been provided I have absolutely no complaints. I come from a family with primarily 3 generations of physicians and dentists. I was fortunate to grow up in an environment where virtually all family friends name began with a Dr.

 

Hence, I always had great care and it was free until I was well into my 20s. But because I grew up getting a physical every year, well or not, my physicians have a data base on my that goes back to when I was a teen.

 

As far as having to wait for certain procedures, yes I will lodge a complaint. I had an atrial fibrilation problem a couple of years back. I had to wait for 2 months AFTER my cumidin level was where the cardiologist wanted it before I could get by heart jump started again so all medical procedures are not necessarily available on a walk in basis.

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This question really has nothing to do with whether you have health insurance or not. If Health Care was afforadable we wouldn't need to have insurance. We have some the best care and doctors in the world. Cost is the only issue keeping us from having the best health care.

 

In 1972 when my oldest child was born, we had no health insurance. I had the best OB in town, his fee was $200.00, the hospital bill was $150.00. We need to overhaul the cost of health care, not the health care our doctors are capable of providing.

 

Wonder if we just shut down the insurance companies and refuse to pay those premiums, not some of us all of us. I just see absolutely no reason to allow the costs to stay where they are. I just can't understand why everyone keeps talking about a health care overhaul and not a health insurance, pharmaceutical and hospital/lab overhaul.

 

So how many of you think the government is capable of actually reducing the cost associated with medical care??

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The thing about taking off all of those drug commercials is that sometimes patients need to bring up that they want to be on a new drug. My friend's family doctor is VERY old school. To the point that he would rather prescribe an antiinflammatory for 20 years until it shuts the person's kidneys down instead of narcotics or anything newer that is brought up. Even the depression meds he prescribes people haven't used in large numbers for atleast 10 years. My friend has severe back issues, and wants to see a specialist. Her doctor has refused to give her a refferal but he won't treat her back besides giving her an antiinflamintory that she can't take because of ulcers and telling her to stretch. Oh yea..waking up screaming in the middle of the night becuase you tried to roll over is going to be fixed by that. My friend has gotten to the point where she is refusing to see him anymore, her mother on the other day is staying with him becuase he has been there the last 20 plus years. Sometimes I think people that have insurance have to jump through to many hoops to get what they need. I literally am on antibitics and steriods about every 2 montths for sinus issues...not once has any doctor reccomened that I see an ENT even knowing my history and my dad's history(he has had sinus surgery 5 times and my sister has had it once). I went to one on my own accord and was told that unless I get an MRI he couldn't help me. My insurance has a 3,000 deductible. So the MRI would be all out of pocket....so it looks like I get to continue my routine. I also work for a DME billing company. It can take up to 3 or 4 times sending medical records or other info before the insurance gets it. Or they get it,acklowlege they have it but the next month when the new claim is denied you have to call and get the claim put in medical review when they already have everything they need. Insurance companies have gone into lock down mode on paying things.

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This question really has nothing to do with whether you have health insurance or not. If Health Care was afforadable we wouldn't need to have insurance. We have some the best care and doctors in the world. Cost is the only issue keeping us from having the best health care.

 

In 1972 when my oldest child was born, we had no health insurance. I had the best OB in town, his fee was $200.00, the hospital bill was $150.00. We need to overhaul the cost of health care, not the health care our doctors are capable of providing.

 

Wonder if we just shut down the insurance companies and refuse to pay those premiums, not some of us all of us. I just see absolutely no reason to allow the costs to stay where they are. I just can't understand why everyone keeps talking about a health care overhaul and not a health insurance, pharmaceutical and hospital/lab overhaul.

 

So how many of you think the government is capable of actually reducing the cost associated with medical care??

 

:clapping:

 

So how many of you think the government is capable of actually reducing the cost associated with medical care??

 

Um, not me.

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As long as the medical insurance industry is operated as a for profit enterprise they are going to screw the customer.

 

Most insurepip spend as much or more administrative dollars on finding loopholes so they don't have to pay or reduce the payments than they do on actually processing claims.

 

Most other countries limit what the Big Pharma's can make profit margin wise on life care drugs. They can make whatever they want on Viaga, Cialis, Sleep meds [Ambien, etc.] but cumadin, lipitor, etc. have a government mandated allowable margin. Hence why meds are so much cheaper in Canada and Mexico and they are the EXACT same pill from the same factories, but we allow carte blanche, and Big Pharma pays the millions and millions for the lobbyists to make certain this remains "As is".

 

I had a threat yesterday pointing out we are paying 15% now of our GDP on healthcare, and it is shoddy healthcare compared to what the EEC countries, Japan, Taiwan, etc. are paying 6% to 9% of their GDP on. It is not sustainable for the future and will prevent us from ever regaining our position as the world's best economy. We simply cannot piss away that much of our GDP on a healthcare system that makes us all pay now for those who have no insurance and stand idly by while many of those uninsured simply die because of a lack of healthcare.

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As long as the medical insurance industry is operated as a for profit enterprise they are going to screw the customer.

 

Most insurepip spend as much or more administrative dollars on finding loopholes so they don't have to pay or reduce the payments than they do on actually processing claims.

 

Most other countries limit what the Big Pharma's can make profit margin wise on life care drugs. They can make whatever they want on Viaga, Cialis, Sleep meds [Ambien, etc.] but cumadin, lipitor, etc. have a government mandated allowable margin. Hence why meds are so much cheaper in Canada and Mexico and they are the EXACT same pill from the same factories, but we allow carte blanche, and Big Pharma pays the millions and millions for the lobbyists to make certain this remains "As is".

 

I had a threat yesterday pointing out we are paying 15% now of our GDP on healthcare, and it is shoddy healthcare compared to what the EEC countries, Japan, Taiwan, etc. are paying 6% to 9% of their GDP on. It is not sustainable for the future and will prevent us from ever regaining our position as the world's best economy. We simply cannot piss away that much of our GDP on a healthcare system that makes us all pay now for those who have no insurance and stand idly by while many of those uninsured simply die because of a lack of healthcare.

 

So you think the US government is capable of reducing health care costs?? For those that are uninsured there is always health care available, even doctor's visits can be negotiated for the uninsured. But it's easier to allow someone else to control it than We the People taking the lead on this??

 

Nothing is free, not even government run health care. I just do not see how any organization that pays over $500.00 for a toilet is capable of keeping health care costs in line. Oh yea, then there's the deal with pharmaceutical companies to allow them to keep patents on drugs for a long time so they can maximize profits.

 

The government hasn't even taken over yet and they are already wheeling and dealing to keep the costs as high as they can. ;)

 

These are the people you want over seeing 15-20% of our GDP??

 

Citizens Against Government Waste (CAGW) is recognized by the media as the leading source of information on government waste. Since our founding in 1984, CAGW has helped expose such high-profile symbols of federal profligacy as the Department of Defense's $640 toilet seat and $436 hammer and the National Park Service's $797,400 outhouse.

 

Government waste

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On another note the fear doctors have of being sued is an issue when it comes to the quality of care. My wife was having an allergic reaction but because she made the mistake of stating she was having "paing in her chest" (because her lungs were contracting) she said she was "having chest pain" all of a sudden they were treating her as if she was having a heart attack which she was not. Thousands of dollars in test later then finally came in the room and told us she was having an allergic reaction...no sheeze, that is what we told you an hour ago....and gave her a shot and sent her on her way. WHY? because the doc was afraid that IF there was ANY chance of it being a heart attack and something happened she would be sued. While I'm all for ruling things out this was not our first go around with this issue but rather then listen to the us they wanted to protect their wallet.

 

In the end it cost us 1000 for the ER visit and the insurance company much more...when all she need was a shot from the clinic at a cost of 25 to us and 200 to the insurance.

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Same thing happened when Tagamet went OTC. You could buy a generic at Walmart or somewhere and pay less than your copay would be for the Rx. Heck, most of the time you could buy the brand name at Walmart and pay less than your copay. If memory serves me correctly, some strengths of the Rx Tagamet and similar products were no longer covered by insurance. I wasn't taking them but had a friend who was.

 

What really aggravated me about prescriptions was the cost for my hormone patches. I could pay for them out of pocket and pay LESS than my co-pay. I used my Greystone Connections card and saved on the cost of the patches, making them cheaper than using my co-pay. Then my insurance company changed them to a non-covered prescription. They would cover the generic but not the brand name. I couldn't use the generics because I am allergic to the adhesive used on them. My choices were pay out of pay for the brand name (to the tune of between $50 and $55 a month) but not have a rash on my rear where the patch was or pay the co-pay (around $40) but have a rash on my rear where the patch was. I was so glad when five years after my hysterectomy came around and I could stop using the patches! My pocketbook and my rear were happy, too. :rofl:

 

 

The only antibitic that doesn't make me sick is Levaquin...it cost me over 100 bucks for 5 pills. I always thought that it was funny that pain medication would be like 15 bucks without insurance but the antibiotics that people really needed would be 100 bucks.

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So you think the US government is capable of reducing health care costs?? For those that are uninsured there is always health care available, even doctor's visits can be negotiated for the uninsured. But it's easier to allow someone else to control it than We the People taking the lead on this??

 

Nothing is free, not even government run health care. I just do not see how any organization that pays $500.00 for a toilet is capable of keeping health care costs in line. Oh yea, then there's the deal with pharmaceutical companies to allow them to keep patents on drugs for a long time so they can maximize profits.

 

The government hasn't even taken over yet and they are already wheeling and dealing to keep the costs as high as they can. ;)

 

These are the people you want over seeing 15-20% of our GDP??

 

 

 

Government waste

I have said over and over I am not a supporter of the bill currently under consideration in congress. I am in favor of a public option affordable to the average Joe the plumber along the lines of medicare/medicage.

 

Hell, let the government contract out a public option to one of more of the existing insurance companies and run it as a private business like Wellstar, as a "Not for Profit" concern but offering an affordable coverage even if it is not super-duper premium insurance with all the bells and whistles. This would give the private stock hell for profit companies some serious competition. When they start losing a large enough percentage of their pool they will adjust their premiums.

 

Tort reform has long been necessary and is an integral part of most other country's healthcare. You cannot sue the doctor just "because". It has to be serious enough to be prosecutable basically as a ciminal case and to pull his license. And virtually all European countries have a "Loser pays all, and the loser's attorney is responsible if they can't" system.

 

My dad closed his practice long before he was ready to retire from Orthodontics purely because his insurance premium had reached the point it was more per year than he could net for himself. And he NEVER had a successful claim in the 50 years he practiced. His insurance never paid out a penny, but the premiums were still more than $60,000 per year.

 

I learned how much cheaper drugs were in Mexico and Brasil many years ago. When I traveled, I would take Prescriptions with me, along with a letter from the doctor's office and fill many of them cash at the local Farmacia. It was cheaper than my co-pays for Retin-A, my wife's hormones, for my Ibuprofen back when it was Rx only, and many others. I would bring back a 6 month supply of whatever I could.

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First of all, as shown in another thread, Hospitals and Medical Insurers make an after tax profit of under 4%. It's not them.

 

Second, as pointed out here, the cost of medical care is rising faster than inflation because of a number of factors, such as innovation, defensive medicine, indigent care, and as Mrs H points out, over use by persons who have low or no deductible insurance plans. Several studies have shown that persons with high deductible or catastrophic insurance plans tend to use the Medical system less often without any worse outcome. This is why the consumer must take back control and share responsibility for not only their health, but the cost of their claims.

 

The answers seem to lie in giving the consumer the choice of plans and subsidizing appropriate plans for those unavailable to afford them, as well as opening up competition by grouping small business and individual buyers and allowing them to shop for the best deals across state lines. Doctors and hospitals must also be protected from frivolous and exaggerated punitive damage suits. There also has to be incentive to maintain appropriate insurance to protect both the insurers and the patients. If everybody is insured, then there will be no need for preexisting condition clauses. The industry also should be regulated not to control profit, but to insure good business practices are used. Remember that regulated businesses are not only profit controlled, but become risk and profit insured by the regulator.

 

Medicare and Medicaid have to be fixed and brought under the same umbrella as any new plan.

 

Curiously all of this is addressed in Senate Bill 1099 that has languished in committee ignored for a year now.

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You can't be serious? You are advocating cost INCREASES to PREVENT people from seeing doctors etc. Do you have any idea how insane that is? People (men generally) already avoid the doctor which drives up the cost of health care as they wait until their condition is serious and requires more advance treatment. Please explain how HIGHER prices to the end consumer will help the issue?

 

I have not "advocated" anything, I simply pointed out the fact

that one reason costs have risen is because there is higher demand

for treatment of minor illness in today's society than in the past.

 

People use far more health care resources than just 30 years ago

primarily because insurance shields the patient from the actual cost.

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Great minds must think alike because I've said for years that is what we need an overhaul in and not necessarily health care per se. The health care we as citizens generally get is fine and dandy. It's GETTING it that seems to be the issue.

 

I think the government is pretty much incapable of doing anything. PERIOD. And yes, I have government employees within my family. FWIW, they agree with me.

 

I just can't understand why everyone keeps talking about a health care overhaul and not a health insurance, pharmaceutical and hospital/lab overhaul.

 

So how many of you think the government is capable of actually reducing the cost associated with medical care??

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First of all, as shown in another thread, Hospitals and Medical Insurers make an after tax profit of under 4%. It's not them.

 

Second, as pointed out here, the cost of medical care is rising faster than inflation because of a number of factors, such as innovation, defensive medicine, indigent care, and as Mrs H points out, over use by persons who have low or no deductible insurance plans. Several studies have shown that persons with high deductible or catastrophic insurance plans tend to use the Medical system less often without any worse outcome. This is why the consumer must take back control and share responsibility for not only their health, but the cost of their claims.

 

The answers seem to lie in giving the consumer the choice of plans and subsidizing appropriate plans for those unavailable to afford them, as well as opening up competition by grouping small business and individual buyers and allowing them to shop for the best deals across state lines. Doctors and hospitals must also be protected from frivolous and exaggerated punitive damage suits. There also has to be incentive to maintain appropriate insurance to protect both the insurers and the patients. If everybody is insured, then there will be no need for preexisting condition clauses. The industry also should be regulated not to control profit, but to insure good business practices are used. Remember that regulated businesses are not only profit controlled, but become risk and profit insured by the regulator.

 

Medicare and Medicaid have to be fixed and brought under the same umbrella as any new plan.

 

Curiously all of this is addressed in Senate Bill 1099 that has languished in committee ignored for a year now.

Percentage wise Yes, Healthcare Profit margins are single digit. But, when subtracting out the obscene pay packages, perks, and incentives, and then factoring in the billions spent on lobbying to keep the status quo, there is a huge amount of wasted overhead and profits.

 

Plain and simply they need to be regulated out of the profit business. Pay off the stockholders and turn them into service providers who DON'T pay obscene pay packages, no lobbying fees, and cut loose the claim analysers who spend 40 hours a week, with additional bonues paid for finding loopholes to deny claims.

 

Trade off with the Pharmaceuticals that in order to protect their patents, they have to limit profit margins on life sustaining drugs. Pfizer for one is reaching the absurd stage with their potential for hiding their margins.

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I would not set foot back in that doctor's office! Old school or not, that is inexcusable. Your friend doesn't need a new drug. Your friend needs a new PCP.

 

The thing about taking off all of those drug commercials is that sometimes patients need to bring up that they want to be on a new drug. My friend's family doctor is VERY old school. To the point that he would rather prescribe an antiinflammatory for 20 years until it shuts the person's kidneys down instead of narcotics or anything newer that is brought up. Even the depression meds he prescribes people haven't used in large numbers for atleast 10 years. My friend has severe back issues, and wants to see a specialist. Her doctor has refused to give her a refferal but he won't treat her back besides giving her an antiinflamintory that she can't take because of ulcers and telling her to stretch. Oh yea..waking up screaming in the middle of the night becuase you tried to roll over is going to be fixed by that. My friend has gotten to the point where she is refusing to see him anymore, her mother on the other day is staying with him becuase he has been there the last 20 plus years. Sometimes I think people that have insurance have to jump through to many hoops to get what they need. I literally am on antibitics and steriods about every 2 montths for sinus issues...not once has any doctor reccomened that I see an ENT even knowing my history and my dad's history(he has had sinus surgery 5 times and my sister has had it once). I went to one on my own accord and was told that unless I get an MRI he couldn't help me. My insurance has a 3,000 deductible. So the MRI would be all out of pocket....so it looks like I get to continue my routine. I also work for a DME billing company. It can take up to 3 or 4 times sending medical records or other info before the insurance gets it. Or they get it,acklowlege they have it but the next month when the new claim is denied you have to call and get the claim put in medical review when they already have everything they need. Insurance companies have gone into lock down mode on paying things.

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So you think the US government is capable of reducing health care costs?? For those that are uninsured there is always health care available, even doctor's visits can be negotiated for the uninsured. But it's easier to allow someone else to control it than We the People taking the lead on this??

 

Nothing is free, not even government run health care. I just do not see how any organization that pays over $500.00 for a toilet is capable of keeping health care costs in line. Oh yea, then there's the deal with pharmaceutical companies to allow them to keep patents on drugs for a long time so they can maximize profits.

 

The government hasn't even taken over yet and they are already wheeling and dealing to keep the costs as high as they can. ;)

 

These are the people you want over seeing 15-20% of our GDP??

 

Government waste

 

Absolutely, as long as those from the GOP is not in power.

 

The reason is that prolifigate spending - 1984 was your example - was the prime policy of every GOP president since RR. They were moseying down the road with the belief if they could spend more and cut taxes, that eventually, we'd go broke and they could get rid of that communist thingy they call social security. Hence, when they'd hire someone to do a job they made sure they hated that job and thought it shouldn't be done but with the instruction, throw money at it. Why? Because the sooner we drive the country broke, the sooner we'll really get smaller government ... yep, government so small, it went bankrupt. (I think they were not only amazed but peturbed that Bill Clinton balanced the budget.)

 

Oh, and one of the prime examples of that 'attitude' was the DOD in the period cited (1984) when the political superiors were upset that they didn't pay $1,500 for that toilet seat! ... more money for the DOD contractors who helped them get elected. (Among the ways the Clinton Administration balanced the budget was to take companies that had defrauded the nation off the approved contractor list - like Halliburton aka: brown and Root. It wasn't until GWB came back in office they were allowed federal contracts again.)

 

Oh, the GOP has talked a great game but for those who believe that actions speak louder than words, their stewardship (or lack, thereof) over the nation over the past 30 years has been an utter disaster.

 

PS: It is also a fact that the financial system had its two greatest crisis since 1932 during GOP rule - at great cost to the taxpayer. (1987 and 2008)

 

PPS: As far as problems with health care ... the creation of a system of competiting health care companies, each making their deal with a select panel of doctors, ultimately fails to serve the individual because businesses - those who actually make the choice of the health insurance carrier - are motivated by profit and they will deal with a new provider every two or three years. The health insurance companies and medical establishment play into this game because they know that health records are for the most part not portable or even decipherable from physician to physician.

 

So, when the health care provider changes, all the tests, blood, etc. all have to be redone and with each change, there are new charges, tests, and benefits are re-written to make sure that we, the public, have to pay again and again, just because. I've had six or eight different primary care physicians (I've lost count) in the past 20 years because each time the physician covered by this group wasn't a physician in that group and visa-versa. Right now I have no primary care physician as we changed again in January. If a system that takes a person in their 50's and rewards them with this many primary care physicians isn't broken, I don't know the definition.

 

pubby

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First of all, as shown in another thread, Hospitals and Medical Insurers make an after tax profit of under 4%. It's not them.

 

Second, as pointed out here, the cost of medical care is rising faster than inflation because of a number of factors, such as innovation, defensive medicine, indigent care, and as Mrs H points out, over use by persons who have low or no deductible insurance plans. Several studies have shown that persons with high deductible or catastrophic insurance plans tend to use the Medical system less often without any worse outcome. This is why the consumer must take back control and share responsibility for not only their health, but the cost of their claims.

 

The answers seem to lie in giving the consumer the choice of plans and subsidizing appropriate plans for those unavailable to afford them, as well as opening up competition by grouping small business and individual buyers and allowing them to shop for the best deals across state lines. Doctors and hospitals must also be protected from frivolous and exaggerated punitive damage suits. There also has to be incentive to maintain appropriate insurance to protect both the insurers and the patients. If everybody is insured, then there will be no need for preexisting condition clauses. The industry also should be regulated not to control profit, but to insure good business practices are used. Remember that regulated businesses are not only profit controlled, but become risk and profit insured by the regulator.

 

Medicare and Medicaid have to be fixed and brought under the same umbrella as any new plan.

 

Curiously all of this is addressed in Senate Bill 1099 that has languished in committee ignored for a year now.

 

:clapping: :clapping: :clapping:

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I have not "advocated" anything, I simply pointed out the fact

that one reason costs have risen is because there is higher demand

for treatment of minor illness in today's society than in the past.

 

People use far more health care resources than just 30 years ago

primarily because insurance shields the patient from the actual cost.

 

So you are suggesting that we pay MORE for health care personally so the insurance companies can pay less. This will then mean people go to the doctor LESS, which means when they are sick and could be cured with a simple antibotic they will wait and have to be hospitlized which will drive the cost up more. Really? If anything doesn't pass the common sense test this is it.

 

As for 30 years ago we have advanced in tech and know more now. People go to the doctor more because things can be discovered sooner and cured faster and better. We are smarter and know not to wait till we are on deaths bed to get the cure. For instance, I found out I was type 2 with a simple blood test and can control it with diet. Had I ignored the early signs or not gone to the doctor due to cost I would be much worse off and my care would cost much more.

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Torte reform --

 

As long as anyone can sue a doctor for just looking at them wrong and juries make awards based on the fact the the doctor's insurance will be the one paying, malpractice insurance will continue to be a major expense those in the healthcare profession pay adding to everyone's costs.

 

20 years ago, almost 1/2 of the amount paid to an OBGYN for prenatal care and delivery went directly to pay the malpractice insurance. It was because if ANYTHING was wrong with the baby, there was a good chance an ambulance chasing attorney would convince the parents to sue, even if the Doctor had nothing to do with the cause of the problem.

 

If we limit the fees an lawyer can make, they won't be taking frivolous suits.

 

 

The limit is whatever the client and attorney agree on. Top end is around 40%. Most attorneys make 30%.

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5 major issues affect healthcare,costs, and affordability.

 

1. Illegal aliens sapping the system(raises costs)

2. Fraud (raises costs)

3. Tort reform (raises costs)

4. Ability to cross state lines to look for alternate healthcare plans(but then one must be careful because then it becomes interstate commerce on the feds).(Affects costs)

 

5. People take it in the mouth for paying too much in federal/state taxes.

 

Solve these 5 points and healthcare costs would go down and affordability would rise.

Edited by PraiseThee
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Absolutely, as long as those from the GOP is not in power.

 

The reason is that prolifigate spending - 1984 was your example - was the prime policy of every GOP president since RR. They were moseying down the road with the belief if they could spend more and cut taxes, that eventually, we'd go broke and they could get rid of that communist thingy they call social security. Hence, when they'd hire someone to do a job they made sure they hated that job and thought it shouldn't be done but with the instruction, throw money at it. Why? Because the sooner we drive the country broke, the sooner we'll really get smaller government ... yep, government so small, it went bankrupt. (I think they were not only amazed but peturbed that Bill Clinton balanced the budget.)

 

Oh, and one of the prime examples of that 'attitude' was the DOD in the period cited (1984) when the political superiors were upset that they didn't pay $1,500 for that toilet seat! ... more money for the DOD contractors who helped them get elected. (Among the ways the Clinton Administration balanced the budget was to take companies that had defrauded the nation off the approved contractor list - like Halliburton aka: brown and Root. It wasn't until GWB came back in office they were allowed federal contracts again.)

 

Oh, the GOP has talked a great game but for those who believe that actions speak louder than words, their stewardship (or lack, thereof) over the nation over the past 30 years has been an utter disaster.

 

PS: It is also a fact that the financial system had its two greatest crisis since 1932 during GOP rule - at great cost to the taxpayer. (1987 and 2008)

 

PPS: As far as problems with health care ... the creation of a system of competiting health care companies, each making their deal with a select panel of doctors, ultimately fails to serve the individual because businesses - those who actually make the choice of the health insurance carrier - are motivated by profit and they will deal with a new provider every two or three years. The health insurance companies and medical establishment play into this game because they know that health records are for the most part not portable or even decipherable from physician to physician.

 

So, when the health care provider changes, all the tests, blood, etc. all have to be redone and with each change, there are new charges, tests, and benefits are re-written to make sure that we, the public, have to pay again and again, just because. I've had six or eight different primary care physicians (I've lost count) in the past 20 years because each time the physician covered by this group wasn't a physician in that group and visa-versa. Right now I have no primary care physician as we changed again in January. If a system that takes a person in their 50's and rewards them with this many primary care physicians isn't broken, I don't know the definition.

 

pubby

Ok this is way off subject but I'll play. My example was acutally 1972, not 1984. And those prior recessions you spoke of, who controlled the house and senate during those years?? I'll make it easy it was Dems. The President does not make or pass laws, last I remember that was the job of Congress.......the Senate and House of Representatives.

 

Now you mention you have had several PCPs over the past 20 years, we just fired our insurance company because they didn't have our PCP and our employee's PCPs in their network. They didn't renew their contract with Well Star. ;) Kiaser is short at least one company because of that. We have absolutely more power than we use as the folks footing the bill. It's so much easier to complain about what's wrong instead of trying to fix it. We didn't have to change our PCPs only our insurance company. It felt great to tell them to stick it. :)

 

Now back to the subject, as far as care you were given was it adequate or perhaps even good???

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We're in the situation now where my husband has had three or four visits to a specialist and they failed to get precertification for the visits. We will be responsible for those visits--something between $500 and $700 for the four visits. We're certainly willing to pay for them BUT if we do will the insurance company approve it if my husband has to have any kind of procedure done by that doctor or will they say since we paid for the visits we should pay for any procedure, too.

 

 

we had an issue where my hubby had a colonoscopy and the anesthesia was kicked back. First, they said precert, but, I knew the doctor had called for the precert. Then we found out the real reason was because the doctor chose to hire/use a certified person to monitor the anesthesia to ensure no lawsuits. Our insurance company determined that they would not pay for the person saying that a nurse assistant or the doctor could have monitored. Well, long story short, I called the insurance commissioner. My insurance paid.

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Absolutely, as long as those from the GOP is not in power.

The reason is that prolifigate spending - 1984 was your example - was the prime policy of every GOP president since RR. They were moseying down the road with the belief if they could spend more and cut taxes, that eventually, we'd go broke and they could get rid of that communist thingy they call social security. Hence, when they'd hire someone to do a job they made sure they hated that job and thought it shouldn't be done but with the instruction, throw money at it. Why? Because the sooner we drive the country broke, the sooner we'll really get smaller government ... yep, government so small, it went bankrupt. (I think they were not only amazed but peturbed that Bill Clinton balanced the budget.)

 

Oh, and one of the prime examples of that 'attitude' was the DOD in the period cited (1984) when the political superiors were upset that they didn't pay $1,500 for that toilet seat! ... more money for the DOD contractors who helped them get elected. (Among the ways the Clinton Administration balanced the budget was to take companies that had defrauded the nation off the approved contractor list - like Halliburton aka: brown and Root. It wasn't until GWB came back in office they were allowed federal contracts again.)

 

Oh, the GOP has talked a great game but for those who believe that actions speak louder than words, their stewardship (or lack, thereof) over the nation over the past 30 years has been an utter disaster.

 

PS: It is also a fact that the financial system had its two greatest crisis since 1932 during GOP rule - at great cost to the taxpayer. (1987 and 2008)

 

PPS: As far as problems with health care ... the creation of a system of competiting health care companies, each making their deal with a select panel of doctors, ultimately fails to serve the individual because businesses - those who actually make the choice of the health insurance carrier - are motivated by profit and they will deal with a new provider every two or three years. The health insurance companies and medical establishment play into this game because they know that health records are for the most part not portable or even decipherable from physician to physician.

 

So, when the health care provider changes, all the tests, blood, etc. all have to be redone and with each change, there are new charges, tests, and benefits are re-written to make sure that we, the public, have to pay again and again, just because. I've had six or eight different primary care physicians (I've lost count) in the past 20 years because each time the physician covered by this group wasn't a physician in that group and visa-versa. Right now I have no primary care physician as we changed again in January. If a system that takes a person in their 50's and rewards them with this many primary care physicians isn't broken, I don't know the definition.

 

pubby

Oh please, give it up. :rolleyes:

 

The libs want a socialist government takeover, yeah, that will work out just dandy. :rolleyes:

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I'll go you one better. On December 18, 2009 I had a mammogram. My insurance company paid Wellstar for the procedure but denied payment to the radiologist saying that I was ineligible. WTF??? In 2008, the radiologist used the incorrect ID number and the claim was denied on the first go-round. It was paid on the second go-round. I thought that might have happened again but that wasn't the case in 2009. I ended up writing a check for that.

 

we had an issue where my hubby had a colonoscopy and the anesthesia was kicked back. First, they said precert, but, I knew the doctor had called for the precert. Then we found out the real reason was because the doctor chose to hire/use a certified person to monitor the anesthesia to ensure no lawsuits. Our insurance company determined that they would not pay for the person saying that a nurse assistant or the doctor could have monitored. Well, long story short, I called the insurance commissioner. My insurance paid.

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The way I see it if the Republicans can't get something out of it for them they are against it. If they can get the government to pay for it they like it.

 

The republican party is the true tax and spend party.

 

The problem with our government is the two party system and those that can get into congress for a life time and push their own agenda. Term limits for all jobs would eliminate all the crony crap.

 

I will always vote the incumbent out unless they are someone as scary a Palin. Then the village idiot gets the vote. :rofl::rofl::rofl:

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So you are suggesting that we pay MORE for health care personally so the insurance companies can pay less. This will then mean people go to the doctor LESS, which means when they are sick and could be cured with a simple antibotic they will wait and have to be hospitlized which will drive the cost up more. Really? If anything doesn't pass the common sense test this is it.

 

As for 30 years ago we have advanced in tech and know more now. People go to the doctor more because things can be discovered sooner and cured faster and better. We are smarter and know not to wait till we are on deaths bed to get the cure. For instance, I found out I was type 2 with a simple blood test and can control it with diet. Had I ignored the early signs or not gone to the doctor due to cost I would be much worse off and my care would cost much more.

 

I have not "suggested" anything of the sort,

you might try reading what I actually wrote

instead of deliberately distorting my position:

 

I have not "advocated" anything, I simply pointed out the fact

that one reason costs have risen is because there is higher demand

for treatment of minor illness in today's society than in the past.

 

 

:rolleyes:

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I have not "suggested" anything of the sort,

you might try reading what I actually wrote

instead of deliberately distorting my position.

 

:rolleyes:

 

How else would one take this statement? The only way to bring people closer to the actual cost is to charge them for it, unless I am missing something. What are you suggesting if that is not it? Rather then spin fragments of ideas why not post your opinion so we don't have to guess what you are attempting to say? Or is it because by posting these types of short burst you can agree/disagree with any posisition out there because the statements are so obtuse?

 

You will also notice I was asking you questions...and I was serious.

 

You may not like/agree with my opinion - but you know where I stand after I make it. ;)

 

Over use of limited health care resources because patients

are so far removed from the actual cost due to insurance...

Edited by MotorCity MadMan
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How else would one take this statement? The only way to bring people closer to the actual cost is to charge them for it, unless I am missing something. What are you suggesting if that is not it? Rather then spin fragments of ideas why not post your opinion so we don't have to guess what you are attempting to say? Or is it because by posting these types of short burst you can agree/disagree with any posisition out there because the statements are so obtuse?

 

You will also notice I was asking you questions...and I was serious.

 

You may not like/agree with my opinion - but you know where I stand after I make it. ;)

BINGO.... ZING...

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Torte reform --

 

As long as anyone can sue a doctor for just looking at them wrong and juries make awards based on the fact the the doctor's insurance will be the one paying, malpractice insurance will continue to be a major expense those in the healthcare profession pay adding to everyone's costs.

 

20 years ago, almost 1/2 of the amount paid to an OBGYN for prenatal care and delivery went directly to pay the malpractice insurance. It was because if ANYTHING was wrong with the baby, there was a good chance an ambulance chasing attorney would convince the parents to sue, even if the Doctor had nothing to do with the cause of the problem.

 

If we limit the fees an lawyer can make, they won't be taking frivolous suits.

What you're saying is the justice system doesn't work? How many of these frivolous cases actually see a court room and go to trial? Very few. This argument is old and fairly tired. The media publicizes a few cases that fall through the cracks and then panic sets in as this is branded the norm.

Edited by COWA
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Right now my family has the bottom tier of Health plans offered by my employer.

 

The cost of the middle plan is over $3000 a year in premiums more. And still the coverage isn't that great.

 

Premiums has gone up so much in the last 5 years it's ridiculous. Co-pays have also increased.

And coverage has gone down.

 

This is the type of plan I currently have:

 

http://www.tasconline.com/businessresourcecenter/hra.html

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How else would one take this statement? The only way to bring people closer to the actual cost is to charge them for it, unless I am missing something. What are you suggesting if that is not it? Rather then spin fragments of ideas why not post your opinion so we don't have to guess what you are attempting to say? Or is it because by posting these types of short burst you can agree/disagree with any posisition out there because the statements are so obtuse?

 

You will also notice I was asking you questions...and I was serious.

 

You may not like/agree with my opinion - but you know where I stand after I make it. ;)

 

My response to Naturegirl was a simple statement of fact

explaining one reason for the rising cost of health care.

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My response to Naturegirl was a simple statement of fact

explaining one reason for the rising cost of health care.

 

Fine. Care to give us your opinion? How about answering the questions I asked? You know, have a conversation, deabate the issue, discuss the issue.

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Torte reform --

 

As long as anyone can sue a doctor for just looking at them wrong and juries make awards based on the fact the the doctor's insurance will be the one paying, malpractice insurance will continue to be a major expense those in the healthcare profession pay adding to everyone's costs.

 

20 years ago, almost 1/2 of the amount paid to an OBGYN for prenatal care and delivery went directly to pay the malpractice insurance. It was because if ANYTHING was wrong with the baby, there was a good chance an ambulance chasing attorney would convince the parents to sue, even if the Doctor had nothing to do with the cause of the problem.

 

If we limit the fees an lawyer can make, they won't be taking frivolous suits.

 

Georgia has capped the maximum award for punative damages at $250,000 in all instances of medical malpractice.

 

According to a med-mal attorney - I suppose I should say former Med-mal attorney - there is no longer such a thing as medical malpractice in Georgia due to the 2006 law setting those caps.

 

This is because to successfully prosecute a plaintiff's med-mal claim the attorney is going to have to invest at least $50,000 in the investigation, in preparing the depositions, in obtaining expert testimony that supports his clients claim as well as the filings, etc.

 

The painful truth of the matter is that plaintiff's only win about one in ten medical malpractice cases. Hence, the economics - ten cases each with an investment of $50,000 means $500,000 investment nets one case one (maxim5,000um return 30 percent of $250,000 or $75,000 in revenue).

 

Not too many Republican or Democrat attorneys are inclined to invest that kind of money only to figure the odds that they'll lose $425,000 for the effort.

 

The cap on med-mal has worked in Georgia ... although I'm sure the insurance companies haven't cut their rates. But then they are known for greed that surpasses even that of the Bar.

 

pubby

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Any before and after photos? :rofl:

 

On topic the issue I have is the cost of meds. They make money hand over fist by colberating together to artifically raise the price of something that has unlimited demand - you have to have it to live. Bust the monpolys that is the drug industry and that will be a good start.

 

There are issues, and the system needs to be fixed but we don't need it run by the gov't.

[sarcasm]Sorry buddy, it's supply and demand only. There is no such thing as market manipulation. Any reference to anything other than supply and demand is a conspiracy theory.[/sarcasm]

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Almost a year ago, my wife had emergency spine surgery. During pre-surgical tests, we also found out she has Multiple Sclerosis. Needless to say we were devastated but her insurance covered a good portion of the 143,000 bill for surgery and hospitalization. However, there was still about 10,000 to pay for miscellaneous medical bills, rough to handle but slowly we could pay it back. Finally, we started to address the M.S. issue and went to the MS Center of Atlanta and her doctor prescribed Copaxone which is sold by one company, Shared Solutions. Without insurance, Copaxone costs 2,200 dollars monthly and with insurance, 500.00 monthly. Most people I know cannot afford an extra 6,000.00 a year on top of other bills. We've worked hard and tried to live within our means but this will ruin us financially.

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I know what you mean. I have a friend who has had two bouts of breast cancer. Even with insurance (high deductible but at least it IS insurance), the costs are astronomical. Coupled with the downturn in the economy, they are hurting very badly.

 

Almost a year ago, my wife had emergency spine surgery. During pre-surgical tests, we also found out she has Multiple Sclerosis. Needless to say we were devastated but her insurance covered a good portion of the 143,000 bill for surgery and hospitalization. However, there was still about 10,000 to pay for miscellaneous medical bills, rough to handle but slowly we could pay it back. Finally, we started to address the M.S. issue and went to the MS Center of Atlanta and her doctor prescribed Copaxone which is sold by one company, Shared Solutions. Without insurance, Copaxone costs 2,200 dollars monthly and with insurance, 500.00 monthly. Most people I know cannot afford an extra 6,000.00 a year on top of other bills. We've worked hard and tried to live within our means but this will ruin us financially.

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