Health Care In The USA?

[mickeyfan2]

Originally Posted by chris1gill

Michael Moore is correct. How can a hospital be FOR PROFIT? Better question, WHY should a hospital be FOR PROFIT? It's flat wrong. I have health insurance, and you know it is the BIGGEST PAIN IN MY you know what! The problem is I have a chronic progressive illness, which means I take away from their bottom line.... I am forever AND EVER going through circles trying to get my procedures and visits covered. I don't know how I manage it at times, at times I give up and just pay even though I know it's a covered benefit. I cannot spend all my time and more importantly, energy fighting the insurance companies... and don't even start on our prescription plan, that is even more a mess... we have to mail order all our medications, then they always have questions, or give you one refill, so every 3-4 months you're starting the process for X number of drugs all over again, new prescriptions, new forms, new everything.... our plan only covers one visit to a pharmacy per year....

Health insurance in this country is only for the healthy..... and if all you've ever been is healthy, you have absolutely no idea...

The hospital that I had my surgery at is for profit and the care it top notch. The profit goes to the country that the hospital is in. I am 100% for this.

[Chicago526]

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.

[DISUNC]

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.

[Chattyaholic]

Health insurance, and medical charges, are ridiculous.

My DH and I don't have employer paid health insurance, we pay our own which is about $450 per month just for basic coverage (high deductible, 80/20 after the deductible is met, no physican office coverage, etc.). It goes up every year, usually at least a couple hundred dollar increase.

We have no co-pay at the doctor's office, we pay the entire bill ourselves.

It's too expensive to go to the doctor so we rarely do. DH went for a physical a couple of months ago, and it was $190 (they tacked on a "new patient charge" simply because he had not been there in a few years, even though he has been a patient there OVER THIRTY YEARS!!!).

I'm supposed to have the pressure in my eyes checked every 4 months, but only go once a year because for the 2-minute procedure the opthalmologist charges $150. It was $90 the year before that, and I thought that was high, last time $150. I haven't gone yet this year, it'll probably be over $200.

How they can get away with charging such riduclously high amounts is beyond me.

And it's getting to where employers are paying less and less for their employee's health coverage, and with the way the costs keep rising I wonder how many more years anyone will have employee paid coverage. If it comes to that, there will be a LOT MORE who don't have insurance.

I remember when I was in the hospital 4 nights with pulmonary embolism it was over $8,000. I didn't have surgery, just an IV heparin drip and blood draws every 6 hours. Ridiculous.

[DISUNC]

Originally Posted by DznyLvr2005

meawhile I had to have surgery and the anesthesia wasn't covered.. BUT I DIDNT KNOW THIS UNTIL AFTER!!!

Anesthsia was NEVER covered by many Health Insurers!
Nor is Blood! Only if you donate blood, can you recieve "Free" blood if needed!

[mrsltg]

Originally Posted by DISUNC

Nor is Blood! Only if you donate blood, can you recieve "Free" blood if needed!

Sorry, if you are over 17 and meet the giving standards, fair enough!!! The saying "Pay it Forward" fits perfectly here.

[mickeyfan2]

Originally Posted by DISUNC

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.

[mrsltg]

Originally Posted by DISUNC

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?

[freckles and boo]

Originally Posted by mrsltg

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.

[agentpleakley]

I'm joining those that advise you that taking Michael Moore as an authority on any subject is ill-advised. If he hates it here so much -- leave. Sorry -- OT.

While our system is not perfect -- I imagine that federal healthcare plan was put into place -- ALOT of people would be screaming because of increased taxes. In any situation -- the current v. national system ... it's the middle class that is going to lose. The rich can afford it, the poor get it for free.

A doctor at a local hospital just moved here from Canada. He commented on the health care being better in the US.

[mrsltg]

Originally Posted by freckles and boo

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.

I think you must be confusing me with another poster. I never said I was paying 100% of my premiums?

[freckles and boo]

Originally Posted by mrsltg

I think you must be confusing me with another poster. I never said I was paying 100% of my premiums?

Oops. I am sorry!!! Nevermind....

[PlutoLuvr]

I'd heard about this "health care crisis" on the news quite a bit, but it never really sunk in until about six months ago.

DH & I are 35, very healthy, neither of us ever hospitalized or sedated. I've been self-employed since I graduated from college, so any kind of doctor visits were always a self-pay. Until last spring, DH always worked for very small employers where any kind of insurance election would have eaten up most of his paycheck. We just made do.

DH got kick-butt insurance last spring with a new employer. Both of us covered, everything covered, wowee! I go to a new gyno, one I'd been wanting to try out for a while but is expensive. He does the trans******l ultrasounds right there in his office (I wanted an IUD and had a good doctor will require this first). Boom. I find out I have ovarian cysts. We take the "watch and monitor" stance. We watch over the next nine months and eventually they ended up dissolving on their own, thank goodness.

DH gets laid off from this employer and has to go back to the smaller place. We can't afford the insurance offered through his work, COBRA is astronomical (it's more than our mortgage!), so I try to take out an individual policy for us. Figured I can write the premiums off through my own small business.

I'm friggin uninsurable now. No one will touch me. 35 years old, one "thing" that came up on one office visit since I was a teenager has made me uninsurable. We have one last hope with a high deductible insurance plan and a health savings account, but the last two insurance brokers I've spoken with have said, Don't hold your breath. Insurance companies don't have to insure you like they do others (individual vs. group plans). Even if you were able to find someone to insure you, don't be surprised if your claims are denied or if you're cancelled as soon as you make a claim.

I was prepared to spend $404 per month on a BCBS individual policy. We simply can't afford the $909 COBRA was going to cost, nor the $812 that will be deducted from DH's paycheck every month. I guess I'm just going to put that $404 per month into a savings account to pay for our medical care.

What I find really sad is the insurance "crisis" is in effect drowning out the dream of an awful lot of Americans: And that is to be a business owner. For the first time in my life, I'm considering leaving my own business I've worked so hard for to work for some huge company, probably in a cubicle, be micromanaged and, yes, have decent health care.

People say with awe to me all the time, "Oh, you're so lucky you're self-employed, to have your own business." You should see the looks change when I tell them the small business owner/self-employed individual can't get health care like those who work for big companies can.

We're at a loss

[mkycrzy1971]

Originally Posted by AllyandJack

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!!!

[mkycrzy1971]

Originally Posted by freckles and boo

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.

Not all...it depends on your particular plan. I have an HMO and my primary physician does not have to approve care through a specialist....nor give me a referral...however, I DO have to go to a specialist on the preferred provider list which is sometimes frustrating.