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Old 06-26-2007, 11:25 AM   #1
angel659
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Health Care In The USA?

Hi

I hope this will not cause any conflicts on here regarding health care. I just would like to know from a brit point of view of what the Americans actually think about thier medical care.

We have the NHS over here, which we pay a certain percentage of our monthly salary to the national health scheme called this enables us to receive medical care. However if you were unemployed on benefits you would still get medical care. We do have silly waiting times over here, some hospitals are run down but generally I feel the NHS works if there were a couple of tweeks made. Considering it was the world war that made us think about the NHS I have more respect for it.

Anyway, from your perspective. I take it there is no mediaid everyone has private healthcare insurance. From what I have read from Michael Moore the scheme is actually fixed and currupted. Some people have been refused medical treatment for the most silly reason, so they do not have to pay and its a whole making money sheme rather than treating people. This is what has put my dh off living in the USA. WE were originally looking at FL or LA. Bruce read on Michael Moore that a young child past away, because her insurance company would not pay the hospital for necessary treatment. Just because she was in the wrong hospital. In our country if you are not in your local hospital that hospital claims the money back from the authortity that is funding your hospital.

Dont get me wrong our NHS system is not the best it has many flaws, but since I work within the NHS I see both good and bad. I dont moan about what the NHS provides. I feel we are incredibly lucky.

Please share your experiences, views and I really hope I have not caused any debate. It was more to show my dh its not as bad as he has heard about or that he is right and I am wrong.

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Old 06-26-2007, 11:31 AM   #2
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We have Medicaid. Unfortunately, many people who SHOULD qualify don't and many people who shouldn't be able to take advantage of the benefit get it handed to them.

I've always had great insurance, so I've never been on Medicaid. But, my cousin is on it. She is offered great insurance through her job for $10./week, but decided that she didn't want to pay that and stayed on the Medicaid. My best friend got pregnant without insurance and signed up for Medicaid. She paid about $80./month for it and it covered all of her obstetrical and her DS's first year of visits.

So, we have it. But, people fall through the cracks because they don't "qualify". I wouldn't want to be on Medicaid because I love my insurance. On the other hand, it ticks me off that so many hard working people with no real access to insurance get cut off while people like my cousin are allowed to reap the benefits of it even though they have access to great insurance.
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Old 06-26-2007, 11:41 AM   #3
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I think that our health care system has major flaws. And, yes, I have personal experiences to back it up.

My DS (11) is disabled and has several medical things going on. It's a long long list of things, but let me just get into a few:

1. DS is orthopedically impaired, and required leg braces. He had always been approved for these devices, but of course, they must be redone as they grow. DS sees the orthopedist after he turns 9, and they deny the AFOs. WHY???? Because apparently they only approve them for children through age 8...because I guess according to them, they children no longer require assistance after the age of 8.

2. DS has been in speech, OT, and PT since birth. They denied him for a new round of private therapy based on the fact that his condition is congenital, stating that "therapy would be of no benefit." Lesson learned??? Apparently, if you are born the way you are, you deserve no help.

3. DS is having growth problems. They are sending us to a major children's hospital for a round of testing in order to get to the cause and put him on treatment. We were supposed to be there as of yesterday, but are having to appeal insurance's denial of treatment, because "the condition is congenital and therefore treatment is not beneficial at this time." We have no idea why the growth problems are happening, and they may or may not have anything to do with his other issues. But, we can't know that until they do the testing. Lesson learned??? Again, don't be born the way you are because then you don't deserve medical treatment.




IMO---it's ridiculous. I pay hundreds of dollars a month for good health care only to have this crap happen all the time. this is just a few examples...I could go on...you tell me...is this wrong or right???
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Old 06-26-2007, 11:42 AM   #4
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We have private insurance. We work and pay for it. One of our biggest concerns in my dh remaining on the job as cop is his access to good insurance until we are both gone. This is a choice we make. I am happy with my level of care and have needed very expensive treatments and testing several times and it has never been a problem.

IE - a pediatric cardiologist specializing in fetal medicine was called in to give my then 23-week-along daughter an echocardiogram while in the womb after another perinatologist saw the need to have something checked. The 1 hour fetal echo cost well over $1000 and the doctor who sent me to the specialist charged $700 for the 2 minute diagnosis he provided after one of his radiologists provided an hour long sonogram at the cost of $500. This was all out of network and 100% covered. If the echo had shown a problem, the surgery and treatments my daughter would have needed would have been 100% covered, as well.
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Old 06-26-2007, 11:52 AM   #5
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I agree with you angel about our NHS, as much as i think it could be alot better, i couldnt imagine living without it. I think in the uk it really is a postcode lottery, if you live in one county services are completley different to maybe 5 minutes down the road and i think hospitals have alot to answer for and now alot of dentists have gone private. Saying that though....i like that i can just make a doctors appointment and just turn up without paying or if i needed to phone an ambluance without worry how im going to pay for it.

Because of my moms company we do get private health care but you only use the private health care for certain things, like if you need to see a specialist or have an operation. So really even our private health care will never fully take over because the nhs will always be there.
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Old 06-26-2007, 12:01 PM   #6
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I am very blessed to have good insurance from
my husbands LIRR benefits.....

However.....this country's healthcare system needs an overhaul....

The drug companies need to be totally reined in....

It is criminal that I could buy american made drugs.....
through canada for cheaper

There is a lot of corruption....I don't know the answer for
that.....
I think some type of national health care is coming in this
country....

There was a case of a 911 call from the EMERGENCY ROOM
OF a woman vomiting blood.....noone would help her.....
SHE WAS IN THE EMERGENCY ROOM.....AND DIED THERE....
OTHER PEOPLE WERE CALLING FROM THERE....911 SAID THEY COULD
DO NOTHING.....CAUSE SHE WAS IN A HOSPITAL

The doctors are not making more money....
ONLY THE INSURANCE COMPANIES....

Maybe Hillary will unveil her "national health plan" one day
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Old 06-26-2007, 12:15 PM   #7
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Although the system is broken and needs to be fixed I would take Michael Moore with a grain of salt.
There is healthcare for the elderly and poor (Medicaid and Medicare) but the "working poor" may not qualify -but still not be able to afford healthcare.
Drug prices are also through the roof.

Also here in the states we are used to a high quality of health care. We spend more money in the last days of life than any other country. So that makes health care costs rise and in turn makes insurance more expensive.

If you do have insurance you can usually get relatively good care.

It is a multi faceted problem without crystal clear answers. I would hope however that you would not judge in entire system by Michael Moore.
I am sure that we have some notions of nationalized health care that may not be correct as well.
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Old 06-26-2007, 01:08 PM   #8
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Well, I think that when our system works, it really works. You can get some of the best care in the world here. But when it doesn't work, it's horrible.

DH and I both have health care paid for through our employer (well, most of it anyway). It's very good coverage and we're lucky to have it. But, DH is type 2 diabetic and on insulin. If we ever lost our coverage from work (for whatever reason), DH is all but uninsurable. It is my greatest fear, that we will lose our insurance and we will have to go bankrupt to keep him alive.

I know a lot of people here fear UHC, and to be honest I'm not too nuts about the idea myself, the government has a way of screwing stuff up. But, having a cronic, expensive, and life-thretening illness in my family is opening my eyes to the fact that we can't keep going the way we are going. There has to be a solution that coveres everyone, keeps costs as low as resonably possible, and still gives good and timely care.
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Old 06-26-2007, 01:24 PM   #9
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Health care in the USA is for the following only.

If one is wealthy!

If one has a job the Company offers Health Insurance at a reduced rate (and even this has a multitude of problems)

If one is Dirt Poor!

In some States all children are covered.

Everybody else...Tuff LUCK!

The side effects of this is a cog in the USA wheel. Way too many people not getting the proper health care. No type of preventative maintenence. People who can retire due to financial stability, and open job opportuniies...DONT retire due to the "what if I get terribly sick", the costs are outrageous.

Many people take jobs JUST for health benefits. For instance a Husband may have a good paying job, but NO benefits. His wife will take a low paying job just for Health benefits.
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Old 06-26-2007, 01:34 PM   #10
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Quote:
Originally Posted by DISUNC View Post
Health care in the USA is for the following only.

If one is wealthy!

If one has a job the Company offers Health Insurance at a reduced rate (and even this has a multitude of problems)

If one is Dirt Poor!

In some States all children are covered.

Everybody else...Tuff LUCK!

The side effects of this is a cog in the USA wheel. Way too many people not getting the proper health care. No type of preventative maintenence. People who can retire due to financial stability, and open job opportuniies...DONT retire due to the "what if I get terribly sick", the costs are outrageous.

Many people take jobs JUST for health benefits. For instance a Husband may have a good paying job, but NO benefits. His wife will take a low paying job just for Health benefits.
Not true.

I am not wealthy, dirt poor or have an employer who pays my premiums. I pay 100% of my premiums and I pay all of my own RXs each month too. I just budget for it as our health is a must have. We could go without coverage and have nicer cars etc. but we chose not to.

Others chose not to pay for the better coverage from their employer, let the state cover their kids even if they could do it themselves, not get a job to get coverage just to name a few ways people are either without coverage or with poorer quality insurance. Not all without insurance are in this group.

My sister, who is a waitress, has health care with her restaurant chain.
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Old 06-26-2007, 01:35 PM   #11
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Quote:
Originally Posted by DISUNC View Post
Many people take jobs JUST for health benefits. For instance a Husband may have a good paying job, but NO benefits. His wife will take a low paying job just for Health benefits.
Why is this bad? People work for many different reasons. Should one only work for altruistic purposes? My husband works in a very dangerous profession. He has stayed in his job the last 7 years because his pension is incredible and we are entitled to life time insurance after retirement. This is a choice we are making. Is this not ok?
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Old 06-26-2007, 01:42 PM   #12
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Quote:
Originally Posted by mrsltg View Post
Why is this bad? People work for many different reasons. Should one only work for altruistic purposes? My husband works in a very dangerous profession. He has stayed in his job the last 7 years because his pension is incredible and we are entitled to life time insurance after retirement. This is a choice we are making. Is this not ok?
I am just curious - if you are paying 100% of your premiums is this with your own employer or your husband's? Will your husband's employer be paying the full premium after retirement if they aren't paying the full premium now? I am not sure I understand. No malice intended, I am sincerely curious.
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Old 06-26-2007, 03:16 PM   #13
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Quote:
Originally Posted by DISUNC View Post
Health care in the USA is for the following only.

If one is wealthy!

If one has a job the Company offers Health Insurance at a reduced rate (and even this has a multitude of problems)

If one is Dirt Poor!

In some States all children are covered.

Everybody else...Tuff LUCK!


The side effects of this is a cog in the USA wheel. Way too many people not getting the proper health care. No type of preventative maintenence. People who can retire due to financial stability, and open job opportuniies...DONT retire due to the "what if I get terribly sick", the costs are outrageous.

Many people take jobs JUST for health benefits. For instance a Husband may have a good paying job, but NO benefits. His wife will take a low paying job just for Health benefits.
Not true....I do not fit into ANY of these catagories. However, I do have healthcare....it is just a must when you have a family.
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Old 06-26-2007, 02:40 PM   #14
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Originally Posted by AllyandJack View Post
We have Medicaid. Unfortunately, many people who SHOULD qualify don't and many people who shouldn't be able to take advantage of the benefit get it handed to them.

I've always had great insurance, so I've never been on Medicaid. But, my cousin is on it. She is offered great insurance through her job for $10./week, but decided that she didn't want to pay that and stayed on the Medicaid. My best friend got pregnant without insurance and signed up for Medicaid. She paid about $80./month for it and it covered all of her obstetrical and her DS's first year of visits.

So, we have it. But, people fall through the cracks because they don't "qualify". I wouldn't want to be on Medicaid because I love my insurance. On the other hand, it ticks me off that so many hard working people with no real access to insurance get cut off while people like my cousin are allowed to reap the benefits of it even though they have access to great insurance.
AMEN!!!
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Old 06-26-2007, 11:41 AM   #15
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Health insurance in the US is often a benefit of employment. Employers pay all or (much more often) a portion of the insurance premium and the employees pay the rest. Larger employers with more employees usually have access to a wider range of plans. As an employee, you can choose to insure only yourself, yourself and your partner/spouse, or your entire family. More insurance costs more money. Most employers also offer at least two different types of plans. An HMO (Health Maintence Organization) is less expensive but your healthcare is managed by your primary care physician and all treatment must be approved by that physician. A PPO (Preferred Provider Option - I think) is more expensive but basically you can choose to see any doctor you select. A doctor within "the network" will cost less than a doctor outside the network, but you can make decisions without waiting for approval from your primary care doctor. There are still co-pays (I pay $15 per visit in my HMO) and PPOs often require you pay deductibles and co-pays. One of the biggest controversies in America is the idea of health insurance companies being for-profit entities, which can put the interest of the shareholders in front of the interests of the insured.

The self-employed or those without health benefits at their jobs can buy health insurance independently but it is very expensive. At the age of 65 Americans become eligible for Medicare. The disabled and the poor are eligible for Medicaid. These are two different programs administered through the government and I am only vaguely familiar with how they work. I have no doubt that someone on the boards can fill you in. Our state (Illinois) also has insurance available for low rates for families with uninsured children. There are many measures in place to fill the gaps, but there is no comprehensive approach here.
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