Author Topic: the new health bill?  (Read 117057 times)

lori67

  • Hero Member
  • *****
  • Posts: 3113
Re: the new health bill?
« Reply #315 on: April 28, 2010, 05:10:44 am »
Laz,

You have my vote for President!  We'll even waive that American citizen thing for you.

Phyl - get rid of that headache already, will you!

Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

ppearl214

  • Administrator
  • Hero Member
  • *****
  • Posts: 7449
  • ANA Forum Policewoman - PBW Cursed Cruise Director
Re: the new health bill?
« Reply #316 on: April 28, 2010, 05:30:40 am »
thanks all for the wishes... truly!  And 4cm..... you are right and my biggest challenge in finding a new job with health bennies... and pre-existing clauses.  Should be interesting.....

Day 5 of migraine.  Please continue to play nice in the sandbox..... my meds aren't working....  :-\

Phyl

losing my job in 2 wks,

 :o

Big Gianormous HUG ! Pearly Whites- you do NOT deserve this… nor any other citizen who is disabled  :-\ by illness… acoustic neuroma or otherwise.

Huggles.

DHM

"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Soundy

  • Hero Member
  • *****
  • Posts: 1329
  • prophetic picture done by my 5 year old, June'04
Re: the new health bill?
« Reply #317 on: April 28, 2010, 06:07:42 am »
as I have said my insurance is basically a card that gets me in the door and it is paying at this point very little ... used to have a $20 co-pay for office visits but now we are suppose to  pay the whole thing when we make the visit ...I don't always have the whole amount ...at least my doctor likes me and has allowed me to pay $20 per visit and bills the rest ...so at this point we owe him $700 on me and the girls and as I have extra money I pay him some ...usually this would be maybe $50 at most for anything the insurance didn't cover such as labs

yesterday Bo brought home a notice that insurance premiums were going up as of July 1 something that was not suppose to happen til July 1 , 2011 ... and that as of January 1 premiums  will no longer be taken out pre-tax but will come out after taxes are ... this means we will be paying more taxes and will in reality see two increases in what our premiums cost us in a 6 month time period ... they said in letter that this in anticipation of changes due to national plan ... and BCBS is not raising their premiums that company pays them ...the company is reducing the part they pay ...then in 2011 we will see the BCBS increase ... I feel the walls crumbling  :-\

Hope your head gets back on track Phyl ... hate being re-railed and staying that way for days ...
3mm AN discovered Aug 2004
Translab July 2 ,2007
3.2cm x 2.75cm x 3.3cm @ time of surgery

mk

  • Hero Member
  • *****
  • Posts: 968
Re: the new health bill?
« Reply #318 on: April 28, 2010, 08:14:11 am »
Phyl, I hope your killer headache will ease off soon and you will get to the bottom of this.

OK Pooter, I appreciate that exchanging information about what's happening in various countries is a very valuable way to get the facts straight, so I'll play  ;)

First of all, Laz explained very well that there are various types of approaches. I will call Canada an extreme example, since services are not available in the private sector at all (except for some provinces). Most of the European countries that I know of (this excludes the UK - I am not sure how the NHS system works), have a two-tier system. There are public and private services and hospitals available. Private services can be bought through insurance (like Laz explained), whereas public are accessible to everyone. This means that if you have, and are willing to pay the money you can purchase insurance for whatever service you want, and escape the waiting lists. If however  you don't have the means to do this, you still have access to medical care - no questions asked. It's something like the education system in the States, where there are prestigious private institutions, but also community colleges and public universities so everyone can get a decent education, even if not first class.

The bonus of this is that it keeps costs in check, because if private sector costs rise to unreasonable levels nobody will want to use them anymore. For example, an MRI in Europe costs about 600 Euros (one Euro is about 1.45 US dollars). In Canada at the private clinics in Quebec it costs about $650 Canadian dollars (about parity with the US dollar), a bit more with contrast I believe. The prices I heard on this forum in the States are above $2,000.  Obviously someone makes a huge profit out of this.

Now about the information on the website that you quoted, you have to be careful about information that is presented out of context. True, in a publically funded system, which is accountable for tax payers money, there will be a prioritization of services, depending on the need. Example out of my personal experience. When I went to my GP once my face turned numb, he put a priority number 2 in his MRI requisition (1 being: the patient is dying and needs an MRI right away). I got the MRI one month later, which I don't consider a long wait. A few years back I had a sore knee. My GP wanted to check it out, and ordered an MRI, but this was obviously not a high priority, so he put a number 4. It took me 4 months to get the MRI.

Example number two. Our family doctor was concerned that my 3 year old had a slight hoarseness in his voice, barely noticeable. He referred us to an ENT and it took 6 months to see the ENT. But in all my three episodes of hearing loss I got to see the ENT (at the same practice) the next day.

I will agree with Laz, that one of the biggest issues is the soaring costs - I am not sure how this can be combatted as long as health care is for profit. This is not a situation of free market setting the prices. If something at WalMart is very expensive, the consumer  can chose not to buy it and the price will go down. But if you get sick, you need the health care services so you cannot do otherwise but "buy" the expensive product.

Marianna
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

4cm in Pacific Northwest

  • Hero Member
  • *****
  • Posts: 1324
Re: the new health bill?
« Reply #319 on: April 28, 2010, 09:23:14 am »
thanks all for the wishes... truly!  And 4cm..... you are right and my biggest challenge in finding a new job with health bennies... and pre-existing clauses.  Should be interesting.....


Pearly Whites,

Check your PM box. I have sent you some links of a good corp. that is hiring that offers benefits without the  "no pre-existing" clauses. Your good on-line moderator skills, as a volunteer here with the ANA, would be considered a job asset by them...

These positive job prospects may be the headache cure you need. :-*

Signed,
 DHM
(AKA also known by Grega apparently as “Plethora”   :-\ ;) :D )
« Last Edit: April 28, 2010, 09:24:48 am by 4cm in Pacific Northwest »
4cm Left, 08/22/07 R/S 11+ hr surgery Stanford U, Dr. Robert Jackler, Dr. Griffith Harsh, Canadian fellow Assist. Dr. Sumit Agrawal. SSD, 3/6 on HB facial scale, stick-on-eyeweight worked, 95% eye function@ 6 months. In neuromuscular facial retraining. Balance regained! Recent MRI -tumor receded!

grega

  • Sr. Member
  • ****
  • Posts: 318
Re: the new health bill?
« Reply #320 on: April 28, 2010, 10:18:58 am »
Howdy DHM ..... so nice of you to mention my moniker.  But ya caught me be surprise there.  In lieu of searching thru 22 pages of this thread, I inserted plethora in the search box, and voila(sp?) .... this thread, started by you 2300 views ago, was mentioned along with one other, started in Feb 2006 by "thecakes".

Since I wasn't alive then, I must have used it herein. ???  As I don't remember ever addressing anyone by the name "Plethora" .... although we have heard worse real names in this area ..... please help me out .... give me a time or post number, if there is such a thing.

Thanks muchly! ;D
« Last Edit: April 28, 2010, 11:04:02 am by grega »
1.5 cm AN retrosig 11/04.
Drs. Henry Brem & Michael Holliday @ Johns Hopkins, Baltimore
SSD right. Tinnitus big-time, only when thinking of it.
BAHA since 7/20/10 ... really helps w/ hearing, specially after programming in subliminal message: "Hey, don't listen to your tinnitus!"

saralynn143

  • Hero Member
  • *****
  • Posts: 1822
  • Sarey Sarey Quite Contrary
    • MVD diary
Re: the new health bill?
« Reply #321 on: April 28, 2010, 10:50:02 am »
Greg, I think she is referring to this - http://anausa.org/forum/index.php?topic=12150.msg141740#msg141740 - as in short for "plethora of information."

Apparently the search mechanism leaves something to be desired.

Sara
MVD for hemifacial spasm 6/2/08
left side facial paresis
 12/100 facial function - 7/29/08
 46 - 11/25/08
 53 - 05/12/09
left side SSD approx. 4 weeks
 low-frequency hearing loss; 85% speech recognition 7/28/08
1.8 gram thin profile platinum eyelid weight 8/12/08
Fitted for scleral lens 5/9/13

grega

  • Sr. Member
  • ****
  • Posts: 318
Re: the new health bill?
« Reply #322 on: April 28, 2010, 11:15:21 am »
Gee Sara ..... you are good!  Finding missing threads in such a big ball of yarn .... terrific memory !!!

Well, as you and the world can see, no one actually referred to DHM as the "P" word.  Who would want to change such a sweet name, whether in initials or spelled out.  And so much info at her fingertips (as the phrase was intended) ......  ;D
1.5 cm AN retrosig 11/04.
Drs. Henry Brem & Michael Holliday @ Johns Hopkins, Baltimore
SSD right. Tinnitus big-time, only when thinking of it.
BAHA since 7/20/10 ... really helps w/ hearing, specially after programming in subliminal message: "Hey, don't listen to your tinnitus!"

Pooter

  • Hero Member
  • *****
  • Posts: 1291
  • The Official Breeze Conjurer - PBW
    • Blog Website
Re: the new health bill?
« Reply #323 on: April 28, 2010, 12:34:28 pm »
Marianna,

Thank you for the insightful information about the Canadian system (as well as a little bit about others)..  So, in your explaination of some two-tiered systems, what I hear you saying is that the services are available via taxpayer funded "public" systems and the "cost" is you have to wait a bit longer perhaps (depending on the severity "number" assigned), and also private facilities are still available whereas the "cost" is you have to pay out of pocket for it in return for little to no waiting time.  So, what that tells me is a couple of things..  a) if you can afford it, you more than likely would opt for the private services paying out of pocket, but what that means is that you actually pay for that treatment twice (once to the government who provides it whether you use it or not and the other out of pocket for the private facility), and b) one could argue that the public education system in the USA is broken, broke and ineffective, which is why many of us have no confidence that a government run healthcare system would end up in a different place than our public education system.

I can see how it might aid in keeping prices in check to a certain degree.  It largely depends on how long the waiting time (availability of services, specialist, etc..) there is.  Many people's threshold for waiting for certain things are directly proportional to how much they're willing to spend privately to get it done faster and more efficiently.  The prices you quote about MRI costs in the USA are about right, however that's WITHOUT INSURANCE; purely out of pocket.  Most Americans have insurance.  What insurance companies do (part of it) is they have a negotiated rate with the Medical Facility.  So, someone without insurance and pays out of pocket really pays for their "service" and partially towards the cost of the "service" of people who get the "service" but don't pay for it (because they can't or don't want to).  The person with insurance however, may be "charged" $1,000 to the insurance company for the same "service" and then it's up to your insurance plan on what portion of that you pay vs the insurance company..  With many HMO plans (like I used to have), my diagnostic MRI didn't cost me anything at the time of the MRI (granted, I still paid my premiums, so it really did "cost" me something but I would have paid that anyhow regardless of the MRI..  Other plans, like the one I have now has a $1,000 annual deductible and then insurance covers 80% of the cost of what's left over.  So, the same diagnostic MRI for me under the plan I'm on now (assuming I had met my annual deductible), would have been about $200.

Incidentally, it's not ALL about profit for the prices charged for non-insurance people.  As I stated, a portion of that "cost" also pays for the billions of dollars each year of services that are given away for free (either by choice or law).  Already in this country, if you go to ANY Emergency Room, they MUST treat you without regard to your ability to pay.  What ends up happening (and has to a LARGE extent) is that many people who are here illegally (and hence, don't have insurance) go to the Emergency Room knowing they can't be turned away for regular check ups, for sneezes and coughs, etc... not true "emergencies".  That, in part, raises the "cost" paid by everyone else most notably those people without insurance that ARE willing to pay for it.

I pasted that link so that you (and others) could see the story in it's entirety.  Not what *I* said, but the full story about what was out there.  I, and many other Americans, feel that waiting 1 month for an MRI (for example) is far too long to wait, let alone 4 months.  In our current system, I can schedule and have an MRI done in a matter of days.  When my AN was diagnosed, I had my MRI done within a week of when my doctor asked me to get one, that was on a WednesdayI believe.  By the next day, the doctor had called me on my cell phone and said something was found and to call his nurse on Friday to get a referral to see a specialist.  I called Friday and by the following Tuesday, I was in speaking to a Otologyst.  Another example recently was when I saw a doctor about a knee problem.  He asked me to get Xrays and within a week I had them done.  He told me that I needed to see an Orthopedic specialist.  Within 10 days of seeing the doctor that told me to get xrays, I was in seeing the specialist.  Was it life threatening?  No...but, within a system like you described, I would have to wait 1-4 months to get the xrays that the doctor needed me to have done.  For many of us, that's entirely too long even for non-emergencies.

I agree with you that costs are a major factor in the Health sector right now..  Things are just too expensive.  So, that begs the question (I've been begging a lot of questions lately.. ;) ), how do you control the costs?  For many of us, we think it's small, targeted legislation aimed specifically at lowering the cost...  For example, tort reform (the amount that you can sue a doctor or hospital) is a MAJOR contributer to the cost of things.  Another example, forcing hospitals/doctors to treat non-emergency patients who can but do not pay or who are not here legally and have no intention on paying.  There are other needed "changes" to our system, like removing the lifetime cap on coverage (for those insurance plans that have it), doing away with the "pre-existing condition" that allows insurance companies to NOT cover someoone, not allowing the insurance companies to drop someone because of how many claims (or how much), etc..  Some have the potential to affect the costs (either up or down) while others do not.

What many of us object to is ramming this monstrous law into place when it was very plainly against the will of the people of this country.  I saw poll numbers in the range of 75% of people who are/were against this law as a means for "fixing" the problems in the current system.  Most people do not feel that THIS law is going to do what the politicians say it will.  And, many of us object to the way that it was put into law (back room deals, behind closed door meetings, secretive about the actual content of the bill, parlimentary procedures typically used for budgetary only items, etc..).  It was absolutely aweful how it was made into law AND against the will of the people they claimed to represent.

Regards,
Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

Omaschwannoma

  • Hero Member
  • *****
  • Posts: 777
  • Life is a journey, not a destination
Re: the new health bill?
« Reply #324 on: April 28, 2010, 12:38:55 pm »
Wow, I thought this died a while back and just checking in I see it started up again.  Glad for that too as censoring speech in America, last I checked, is not a good thing.  Isn't hijacking a crime?  

There are many, many good talking points here debating each countries form of health care.  I said it earlier before what was crammed down our throats is not about health care, but is about $$'s and power!  We do not need to debate about government run anything as the facts stand for themselves, they don't run anything well and this United States is being run into the ground (perhaps their plan?).  If this is plan, then those in other countries should sit up a take notice.  

If those in the United States wants what Canada, Australia, Europe, or Asia has then move there to enjoy what they have and leave us to what we want--a country with limited government that abides by our Constitution.  I dare anyone to move to another country and try to change them.  You'll be branded the 'pushy' American, you'll be accused of trying to transform their country into America.  So, why on earth should we not be up in arms over those trying to transform what was originally intended with the implementing of the Constitution of These United States?  Seriously!  If you don't like the idea of a 'free' society then move out.  You can do this AND take all of your money, whereas some countries, you know the ones that aren't free, will not allow you to take all of your money.  If our Constitution is not good enough, don't try to change it, move to where your needs and desires are met.  

I do hope Texas has room for me and my dog!  
1/05 Retrosigmoid 1.5cm AN left ear, SSD
2/08 Labyrinthectomy left ear 
Dr. Patrick Antonelli Shands at University of Florida, Gainesville, FL
12/09 diagnosis of semicircular canal dehiscence right ear

Kaybo

  • Hero Member
  • *****
  • Posts: 4232
Re: the new health bill?
« Reply #325 on: April 28, 2010, 01:15:36 pm »
Did I miss something - are you moving to Texas?

K   ???
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

Pooter

  • Hero Member
  • *****
  • Posts: 1291
  • The Official Breeze Conjurer - PBW
    • Blog Website
Re: the new health bill?
« Reply #326 on: April 28, 2010, 02:45:48 pm »
Omaschwannoma for President 2012!  Come on over to Texas, we have plenty of room..  Just swing by and pick up LADavid on the way because he was considering a move here also..  ;)

I agree that the "healthcare" bill was not about healthcare at all but more about power and money ultimately.

Regards,
Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

Larry

  • Hero Member
  • *****
  • Posts: 1464
  • Scallywags Rule
    • Chronologer of the PBW
Re: the new health bill?
« Reply #327 on: April 28, 2010, 07:07:45 pm »
Interesting discussion.

I lived in New Zealand for a number of years and I actually think their system has a lot of merit. They are similar to Australia with a public and private health care but with an important twist. They do have legislation that prevents suing medicos. They did away with lump sum payouts for major injuries etc and have a weekly payment process instead. It keeps costs down significantly but the side effect is that because salaries are reasonable, doctors don't earn the $10-$50m per year that U.S doctors (surgeons) earn and attracting the bet doctors is difficult other than for the relaxed life style.

In essence, i think the U.S system is far too capitalist (even though i am one) and we don't have to look past Phyl - unfortunately. You lose your job through no fault of your own and your whole medical coverage position changes. medical coverage should not be empoyer based. that in itself, lowers competition and the need to drive costs down. If the health funds decided to set a realistic payment for surgeons then you'll find some surgeons will lower their fees to get the business - simple economics.

I still reckon - get rid of the right to sue and you will have a significantly cheaper and affordablle model.


laz
2.0cm AN removed Nov 2002.
Dr Chang St Vincents, Sydney
Australia. Regrowth discovered
Nov 2005. Watch and wait until 2010 when I had radiotherapy. 20% shrinkage and no change since - You beauty
Chronologer of the PBW
http://www.frappr.com/laz

Pooter

  • Hero Member
  • *****
  • Posts: 1291
  • The Official Breeze Conjurer - PBW
    • Blog Website
Re: the new health bill?
« Reply #328 on: April 29, 2010, 12:02:26 am »
Laz,

True, if you get (or drastically reduce) people's ability to sue for absurd amounts of money, then you'll automatically reduce the overall cost.  Likewise, if you open it up so that Insurance Companies can sell products across state lines, you INCREASE the competition which will lower the cost.  One (or two) simple bills could accomplish that without them being 1000+ pages long and creating a mess of new buracracy, in my opinion.

Personally, I think you can have your cake and eat it too.  Meaning, I think you can reduce the costs AND have a "for profit" system.  It's because of that profit motive that most of the new innovations in techniques, new drugs and a host of other things are created in the USA.  If there's no profit in it, then where's the motivation for anyone to spend the millions/billions of dollars necessary to bring a new procedure, a new drug, a new device, a new ANYthing if there aren't any hopes of recovering that cost?  My answer is there is none.  Innovation and R&D will suffer across the world if you take out the profit motivation.

True, by default in an employer-based insurance system, competition is stiffled.  IF, however, employers could shop for insurance to providers outside of their own state (which, right now they aren't allowed to by law), THEN competition rises and the employees benefit from the lower premiums, better coverage, etc..  Right now, there are basic monopolies in each state with only a handful of major players in the insurance game for a given state.  Employer-based is fine, I think, but open it up for more intra-state competition.

All of the things that I've been talking about would only require small, targeted legislation to accomplish without the need to have a tax-funded, public system.  To me, they're common-sense changes to our healthcare system as it is...err.. was that would dramatically reduce premiums for insurance and costs of medical-related services, devices, etc..

Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

ppearl214

  • Administrator
  • Hero Member
  • *****
  • Posts: 7449
  • ANA Forum Policewoman - PBW Cursed Cruise Director
Re: the new health bill?
« Reply #329 on: April 29, 2010, 05:52:26 am »
Isn't hijacking a crime?  

depends on which forum and if the Moderator whips come out!  ;D

BTW, working on a new prescription of Imitrex 100mg... day 6 of migraine.

Pooter, your comment of "...Personally, I think you can have your cake and eat it too.  Meaning, I think you can reduce the costs AND have a "for profit" system. ".....these are the details I want to see..... Although Massachusetts has much (but not all) of this in place already, this am's news is now noting that region's largest healthcare org (Partners Healthcare -- they handle many of the major hospitals here, including Mass General Hosp, which we know many AN'ers have their AN surgeries at MGH/MEEI) is now being federally and state investigated for (I hope I get this right....) "anti-trust" and raising rates... and they have responded by noting their "competition" in a major medical market (link to this morning's news:  http://www.boston.com/business/healthcare/articles/2010/04/29/justice_department_launches_antitrust_review_of_partners_healthcare/) ... thus, shooting for the "for profit" at the expense of the insurance industries and me.......



*sits back with ice pack, Rx, diet cinnamon rice cakes .......*
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"