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Old 06-26-2007, 11:46 PM   #76
binny
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Minnie, I am not arguing with you, as I said I know there 2 sides to this story. I do know that MY life was put in jeapordy when I gave birth to ds. I know that MY FIL had to wait an obscene amount of time to see an oncologist. MY SIL had issues getting approval for a surgery that she desperately needed. What would be a 1 month wait time here was 2 years there ( I know this because I looked into it for her). So it does happen. Dh, who is Canadian as well and spent his whole life there, is happier with our insurance now than he was when we were there.

Lets face it no system is foolproof. Ours needs an overhaul I totally agree with that but, like others, I dont want the Govt in charge of it.
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Old 06-27-2007, 07:01 AM   #77
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Originally Posted by LukenDC View Post
I am very pleased with the health insurance that I receive from work. I have a choice between two insurance companies and I selected Kaiser Permanente. I contribute $20 out of each bi-weekly paycheck and my employer pays the rest of the monthly premiums. When I see the doctor, I pay $15 per visit and usually $8 per prescription. Lab work and x-rays are free. I have a primary care physician and I find that he is accessible. If I have a urgent, but simple, matter such as a sore throat, I can usually see the doctor or a nurse practitioner the day I call for an appointment.

Contrary to popular belief abroad, Americans do have a public welfare system that includes health care. Senior citizens are eligible for Medicare (paid for throughout one's working life with payroll taxes) and the poor can receive Medicaid. State and county governments may offer additional health care for low income people. There are also many charity clinics offering general care or care to targeted populations (immigrants, gay/lesbian, women, children, miners, etc.).

The US also has a system of public hospitals that accept the uninsured. In part this is why Americans' health insurance premiums are so high. Insured Americans pay for the uninsured via high monthly premiums.

Being uninsured in the US is frustrating and inconvenient, but not hopeless. The uninsured need to be resourceful and that can be difficult when one is ill. However, there are people---social workers, charity workers---who are willing to assist the uninsured.
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Old 06-27-2007, 07:45 AM   #78
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Originally Posted by damo View Post
I live here and don't know one person who doesn't like it or has had substandard care. Like I have said many times before my mother had cataract surgery in two weeks, mother in law had heart valve replacement within three weeks, father had skin cancer removed within two weeks, child next door was picked up by ambulance in the middle of the night when her blood tests taken that day came up that leukemia was suspected. Anyone I know with cancer have been treated promptly.

Nobody tells me what doctors I can and can't see. I can always see a doctor the same day I call. There are no billing surprises.

I wouldn't trade our Canadian system for anything. Sure, there will be issues where there is a doctor shortage but from many, many stories I read here on the Dis, waiting is a big issue in the US system as well.

We had discussed this topic to death here and it always comes up the same way. Canadians are overwhelmingly happy with their system but the Americans think it is not as good as theirs.

There was a poll done a while back on the Canadian board when a discussion was going on here about Universal Healthcare. Only 2% of the people responded that they would like a system similar the US.
I have never had to wait more than 1-2 days to receive health care...some Americans expect miracles or to be seen right NOW...they do not like to wait...that , my dear, is the problem.

I am glad that most of those in Canada like their National Healthcare plan, if it works for you, then it is great....however, I happen to like the fact that I can control my own destiny with my health plan...I even have about 5 choices of different types of health plans...if the govt controls it...I will not have these luxuries/choices NOR control my own destiny....the govt already tells me I have to pay 1/3 of my income to them....for what??? Our roads that are badly in need of repaving, to provide healthcare to those that do not WANT to work (my age and very capable) and illegal immigrants and their 20 children, So govt officials can take their golf "meetings", etc.??

Once American govt sticks their nose in your business, you NEVER get it out...I keep my nose clean and have healthcare of my own....because I work. Don't let some fool you...it is available...yes, they may have to give up their smokes, alcohol and even...dare I say it, find a job... but they do have it available if they would just take some initiative. NO, I am not saying that this applies to EVERYONE....there are some that truly are in a bad position or not able to work...there is medicare and medicaid for those (with all of it's faults...just like national healthcare would have). 2% or 50%...I think alot of Americans simply demand too much...they are spoiled.
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Old 06-27-2007, 08:05 AM   #79
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Originally Posted by mkycrzy1971 View Post
I have never had to wait more than 1-2 days to receive health care...some Americans expect miracles or to be seen right NOW...they do not like to wait...that , my dear, is the problem.

I think the wait time varies between cities. Certainly, if I am sick with a sore throat or viral illness, I can see my GP within 1-2 days.

Seeing a specialist is another matter.

Two years ago, I had a very suspicious mammogram/ultrasound. So suspicious that the mammographer told me that if I didn't have a surgeon, I needed to get one right away and "TODAY would not be too soon" to see one. Fortunately, I was an established patient at a breast surgeon. The mammographer even called the surgeon. I was not seen for 3 weeks. This is typical in my area for a surgeon. I then had to wait another several weeks for surgery.

Now we move on to dermatology. My mom had a suspicious mole on her leg. Took her exactly 6 weeks to be seen by a dermatologist (she was a new patient).

Same story with the gastroenterologist I go to--long wait times just to be seen. Maybe there is a shortage of doctors here.

But I suppose it is better than waiting 6 months? I just don't see where the quick turnarounds are anymore. I have dealt with health problems for many, many years and things have changed. Twelve years ago when I was diagnosed with thyroid cancer, the time between finding the nodule on my thyroid and having the surgery was 3 weeks. This was starting with a GP, having a huge diagnostic workup, getting into a surgeon, and having it removed. Now that was quick. I think these days the same process would take at least 2 months.
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Old 06-27-2007, 08:06 AM   #80
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I think there are probably pros and cons to both sides of the border. As with anything we do need to focus on the cons and see what we can do to fix.

I agree with some of the above posters that there are many resources out there for people and maybe the way to remedy these things is to have them more marketed so that those who are struggling can get help. (that commercial with Montel Williams and the bus for Rxs comes to mind)

But I also think they is a warped sense of entitlement in the US. We are entitiled to healthcare?????? Our parents and grandparents paid for their healthcare like any other bill. If they were unemployed they went and found another job, doing whatever it took. Many Americans expect a handout instead of providing for themselves ( and I am no talking about those who truly need our assitance, I want us and our govt to be there for them). I think people freak out about healthcare costs and dont want to pay but they think other things are necessities. I mean electricty is a necessity in this day and age, you use it you pay your bill, if you dont you are sent to collections this is your debt, if you are unable to pay there are programs out there to help you, you need to inquire about them, the electric company is not going to seek you out, unless you let them know they are going to assume you are able to pay, same with hospitals.

Insurance coverage is a "benefit" and I know many want it changed to an entitlement. We have many entitlement programs that are very much in need of overhaul (SS, Unemployment, food stamps) because of the abuses out there.

I am just very concerend about our govt taking this over and creating a beauracratic nightmare.
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Old 06-27-2007, 08:16 AM   #81
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Im sorry but there are plenty of people who say that their systems dont work. I can name 2 of my doctors that moved here from Canada because the system didnt work.


There are people who disagree and this is OK.

I have noticed the OP hasnt come back though.....
I think the OP is enjoying the debate. Im sure she didnt expect such an excellent response with some very interesting and contrasting opinions.

Here in the UK we pay approx 11% of salary, or 9.4% if your in a company pension scheme. Not sure how that compares to the average cost of healthcare plans, but it would be intersting to know. It doesnt just cover health care, but also our government pension scheme and some ofther benefits costs.

I certainly have had bad experiences in our NHS with my father being bumped from pillar to post without a proper diagnosis. I also am married to the OP who works as a nurse in our local hospital and hear all the time of all the efforts that some of the NHS staff make on a daily basis, even when the media reports nothing but bad things about the system. So I like to think I have a balanced view on our NHS and its certainly hard to fault generally.

I dont have to worry about what cover we have, or how expensive it is (apart from the pay deduction), I dont have to worry about paying to see a doctor, and am usually seen within 48hrs, the medication costs are low at around £6.85 per item on a prescription. All the kids prescriptions/eyetests/dental appts are all covered too. There are plenty of downsides too, but one of the best things is that its something left to worry about. We can also choose to pay into a health plan too, if we like, to get faster treatment in private hospitals, but most of the time for anything serious it just gets treated by the NHS.

Our system however is far from perfect though, and im certainly sure that in some areas the US system can be much better.

Like one post said earlier, when the system works, it works very, very well and the care can be exemplery but when the system doesnt work, it can be terrible.

The other thing that im curious about, a lot of posters reffered to the fact that they are extremely fortunate to be covered by their employer by the health care plans they have? I certainly wouldnt want to be convinced to stay in a job that I didnt enjoy because I couldnt afford to leave the care plan that went with it.

Please dont think I am critisising the system you have, im just curious about it and am very interested in all of your opinions. I know Michael Moore's films tend to be like propoganda, but he sometimes raises some excellent questions that seem to go un-answered.

So, for a family of 5, if all in general good health, how much would I expect to pay in premiums to a decent health care plan?
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Old 06-27-2007, 08:23 AM   #82
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The other thing that im curious about, a lot of posters reffered to the fact that they are extremely fortunate to be covered by their employer by the health care plans they have? I certainly wouldnt want to be convinced to stay in a job that I didnt enjoy because I couldnt afford to leave the care plan that went with it.
Many people don't make career moves that would be more satisfying EXACTLY for this reason. Having access to a decent health plan is part of your consideration in taking jobs, leaving jobs, etc.
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Old 06-27-2007, 08:26 AM   #83
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Originally Posted by mkycrzy1971 View Post
I have never had to wait more than 1-2 days to receive health care...some Americans expect miracles or to be seen right NOW...they do not like to wait...that , my dear, is the problem.

I am glad that most of those in Canada like their National Healthcare plan, if it works for you, then it is great....however, I happen to like the fact that I can control my own destiny with my health plan...I even have about 5 choices of different types of health plans...if the govt controls it...I will not have these luxuries/choices NOR control my own destiny....the govt already tells me I have to pay 1/3 of my income to them....for what??? Our roads that are badly in need of repaving, to provide healthcare to those that do not WANT to work (my age and very capable) and illegal immigrants and their 20 children, So govt officials can take their golf "meetings", etc.??

Once American govt sticks their nose in your business, you NEVER get it out...I keep my nose clean and have healthcare of my own....because I work. Don't let some fool you...it is available...yes, they may have to give up their smokes, alcohol and even...dare I say it, find a job... but they do have it available if they would just take some initiative. NO, I am not saying that this applies to EVERYONE....there are some that truly are in a bad position or not able to work...there is medicare and medicaid for those (with all of it's faults...just like national healthcare would have). 2% or 50%...I think alot of Americans simply demand too much...they are spoiled.
I work, too, and health insurance isn't available. I'm self-employed. I work in a town with about 75 other self-employed court reporters (we're all independent to remain "neutral") and none of us can secure an individual policy.

My mother owns a process service company. She is self-employed with two people who work for her. She cannot get insurance, either.

There is a loophole. I'm quickly learning about this. Government has stuck its nose in group coverage with HIPAA and has helped millions of Americans. That means your insurance company has to pay your claims and can't exclude, say, your upper respiratory system because of a cold you had four years ago as long as you stay in some sort of group coverage.

Folks who are self-employed really have no protection and no recourse. Seriously. I applied for a policy in March with BCBS. I'm appealing the rejection for the third time now! I'm 35, in good health, have never even been hospitalized or sedated, and, under the current laws, it's doubtful I will ever be able to obtain an individual policy with anyone because of this rejection. Even if I did, the law is not on my side. As soon as I make a claim, it will most likely be denied and I will be cancelled shortly thereafter. The CAN and DO reject individual policies, as one broker told me, to even out the risk they legally have to take with group policies.

So it seems those with group policies are taken care of thanks to government intervention in 1996. Those who are poor are taken care of. What about the self-employed? How's about something similar to HIPAA for us? I'm not looking for a handout, and neither are the self-employed people I know. We just want the same protections that those in group coverage get, which came about because insurance was getting a little bit too greedy and, unfortunately, the government had to step in and impose some laws to protect Americans.
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Old 06-27-2007, 08:31 AM   #84
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Originally Posted by PlutoLuvr View Post
I work, too, and health insurance isn't available. I'm self-employed. I work in a town with about 75 other self-employed court reporters (we're all independent to remain "neutral") and none of us can secure an individual policy.

My mother owns a process service company. She is self-employed with two people who work for her. She cannot get insurance, either.

There is a loophole. I'm quickly learning about this. Government has stuck its nose in group coverage with HIPAA and has helped millions of Americans. That means your insurance company has to pay your claims and can't exclude, say, your upper respiratory system because of a cold you had four years ago as long as you stay in some sort of group coverage.

Folks who are self-employed really have no protection and no recourse. Seriously. I applied for a policy in March with BCBS. I'm appealing the rejection for the third time now! I'm 35, in good health, have never even been hospitalized or sedated, and, under the current laws, it's doubtful I will ever be able to obtain an individual policy with anyone because of this rejection. Even if I did, the law is not on my side. As soon as I make a claim, it will most likely be denied and I will be cancelled shortly thereafter. The CAN and DO reject individual policies, as one broker told me, to even out the risk they legally have to take with group policies.

So it seems those with group policies are taken care of thanks to government intervention in 1996. Those who are poor are taken care of. What about the self-employed? How's about something similar to HIPAA for us? I'm not looking for a handout, and neither are the self-employed people I know. We just want the same protections that those in group coverage get, which came about because insurance was getting a little bit too greedy and, unfortunately, the government had to step in and impose some laws to protect Americans.
I find this interesting. I work for/manage a very small company of 10 employees. We only have two of our employees that require the healthcare that we offer.

We pay a fee to use a "broker" who goes out and finds us insurance. We have BC/BS and only insure two people. I wonder why it is so easy for us to purchase this but not you (or your mother)?
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Old 06-27-2007, 08:35 AM   #85
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Im sorry but there are plenty of people who say that their systems dont work. I can name 2 of my doctors that moved here from Canada because the system didnt work.


There are people who disagree and this is OK.

I have noticed the OP hasnt come back though.....
Sorry just catching up with the posts. There are so many and with work its been difficult to get on here. Night shifts and sleep.

Just back tracking to where I was I wanted to reply to you before I carried on. In case I forgot.
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Old 06-27-2007, 08:35 AM   #86
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Originally Posted by PlutoLuvr View Post
I work, too, and health insurance isn't available. I'm self-employed. I work in a town with about 75 other self-employed court reporters (we're all independent to remain "neutral") and none of us can secure an individual policy.

My mother owns a process service company. She is self-employed with two people who work for her. She cannot get insurance, either.

There is a loophole. I'm quickly learning about this. Government has stuck its nose in group coverage with HIPAA and has helped millions of Americans. That means your insurance company has to pay your claims and can't exclude, say, your upper respiratory system because of a cold you had four years ago as long as you stay in some sort of group coverage.

Folks who are self-employed really have no protection and no recourse. Seriously. I applied for a policy in March with BCBS. I'm appealing the rejection for the third time now! I'm 35, in good health, have never even been hospitalized or sedated, and, under the current laws, it's doubtful I will ever be able to obtain an individual policy with anyone because of this rejection. Even if I did, the law is not on my side. As soon as I make a claim, it will most likely be denied and I will be cancelled shortly thereafter. The CAN and DO reject individual policies, as one broker told me, to even out the risk they legally have to take with group policies.

So it seems those with group policies are taken care of thanks to government intervention in 1996. Those who are poor are taken care of. What about the self-employed? How's about something similar to HIPAA for us? I'm not looking for a handout, and neither are the self-employed people I know. We just want the same protections that those in group coverage get, which came about because insurance was getting a little bit too greedy and, unfortunately, the government had to step in and impose some laws to protect Americans.
DH and I are both self employed and we have insurance. We joined a non-group group type insurance. It is a private insurance for individuals to be grouped together. We have been paying our own premiums for the past 21 years.
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Old 06-27-2007, 09:01 AM   #87
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Originally Posted by PlutoLuvr View Post
I work, too, and health insurance isn't available. I'm self-employed. I work in a town with about 75 other self-employed court reporters (we're all independent to remain "neutral") and none of us can secure an individual policy.

My mother owns a process service company. She is self-employed with two people who work for her. She cannot get insurance, either.

There is a loophole. I'm quickly learning about this. Government has stuck its nose in group coverage with HIPAA and has helped millions of Americans. That means your insurance company has to pay your claims and can't exclude, say, your upper respiratory system because of a cold you had four years ago as long as you stay in some sort of group coverage.

Folks who are self-employed really have no protection and no recourse. Seriously. I applied for a policy in March with BCBS. I'm appealing the rejection for the third time now! I'm 35, in good health, have never even been hospitalized or sedated, and, under the current laws, it's doubtful I will ever be able to obtain an individual policy with anyone because of this rejection. Even if I did, the law is not on my side. As soon as I make a claim, it will most likely be denied and I will be cancelled shortly thereafter. The CAN and DO reject individual policies, as one broker told me, to even out the risk they legally have to take with group policies.

So it seems those with group policies are taken care of thanks to government intervention in 1996. Those who are poor are taken care of. What about the self-employed? How's about something similar to HIPAA for us? I'm not looking for a handout, and neither are the self-employed people I know. We just want the same protections that those in group coverage get, which came about because insurance was getting a little bit too greedy and, unfortunately, the government had to step in and impose some laws to protect Americans.
You can all form an organization and try to get a policy that way. A lot of professional organizations do this.

ETA: Info from the National Court Reporters Association http://ncraonline.org/AboutNCRA/Memb...ce/default.htm

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Old 06-27-2007, 09:01 AM   #88
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Believe me, I wish it were easier!

I'm tied up with an appeal of my application with BCBS (third rejection -- all based on incomplete medical records, which I keep getting myself from my doctors' offices). I was told by one broker that if BCBS doesn't "pick" us up, it's possible Aetna or Cigna would. Well, they won't because of this rejection.

BTW, I was rejected because BCBS said I never attended a return appointment with my gyno. I did and provided the office note showing I returned and everything was normal. Start appeal no. 1.

Six weeks later, I get my second rejection saying, once again, I did not return for my annual exam. ***? I call my doc's office, have him fax me the note for my annual and send it off to BCBS. Start appeal no. 2.

Just received my third rejection from BCBS -- mind you, this is just the APPLICATION! I'm not even trying to get them to pay a claim here -- saying I was supposed to have a biopsy that I didn't show up for. Hello! The biopsy was done on that annual exam y'all said I didn't show up for that I faxed you the note from. So now we're into appeal no. 3.

Two different brokers are now telling me I can kiss any hope of an individual policy goodbye. Maybe -- maybe -- I can hope to get a high-deductible catastrophic plan and supplement it with an HSA, but the laws for that change every year in FL, and right now the laws seriously favor the insurance companies. Both brokers have told me NOT to go that route until the new laws come out in August.

All of this from a cyst that my doctor saw when I went off hormonal BC after being on it for 20 + years. The cyst went away on its own.

Oh, and all these visits that BCBS said I never showed up for and hence are denying my application, guess who paid for them? You got it, BCBS. I was covered under my hubby's PPO with BCBS last year.
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Old 06-27-2007, 09:06 AM   #89
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Wow, so many responses. Thank you ever so much for giving me an insight in to the Americas health care. I agree Michael Moore maybe a little OTT, but there were some points he raised that rang alarm bells in dh and I ears.

It was the people who had insurance and was diagnosed with cancer. The insurance company would not pay because she was too young to get ovarian cancer This would not happen within the UK. People get treated for cancer from start to finish.

In the UK everything is available as Gillsfan explained we pay a certain fee out of our monthly wages to cover this. Regardless of employment they receive medical care and also illegal immigrants. I agree that people dont want to pay for medical care when people are unemployed or illegal immigrants. I am not sure what benefits american citizens can apply for. We have people who claim for unemployment benefit, single parent allowance etc illegally. People like this I dont like paying for.

My hospital is forever slated in the paper. Regarding MRSA or CD toxin etc. The problem is the hospital I work for has been outgrown with the local population. Our Govt insists that they build more homes in our area for the homeless or new buyers. They dont think about hospitals. They have closed two hospitals within a 35 mile radius, due to financial reasons. Which is silly. My hospital has bed crisis nearly everyday. We get through it. Our waiting times have improved immensly over the years, but in other areas it still remains the same. Poor fil still is poorly and has not been diagnosed. Instead of referring him to London to see a specialist they just pass him off with different medications. Now he has liver problems. I feel this is due to neglect.

Yes we have our flaws, but I am so pleased that if I walked into our A&E department we would not be turned away. I worry from my children perspective. I would hate it if I took my dd or ds to ER and I was refused, due to not proper cover or I was in the wrong hospital. The worst case scenario the insurance company said no for no real reason other than costs.

I can see that your country health care would be better if it worked well. I would be so petrified that I would be refused treatment or cover. I am still confused as to why people are unable to get insured?? Or insurance companies refuse, because of the most silly reason i.e too young to get ovarian cancer

How much would I expect to pay for a full cover health care scheme for a family of 5. Both dh and I have asthma and my dd has asthma. Other than that I cant recall any health reasons other than me being overweight.

Thanks again.
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Old 06-27-2007, 09:19 AM   #90
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How much would I expect to pay for a full cover health care scheme for a family of 5. Both dh and I have asthma and my dd has asthma. Other than that I cant recall any health reasons other than me being overweight.

Thanks again.
I work for a small company and we (the company) get probably the higher rates. We pay 75% of our employees coverage. For a family plan, this is about $145 per pay period or $3,770 per year. After that there are out of pocket expenses--each visit would require a $10 payment for a regular doctor and $20 for a specialist. There is also a cost (usually $10, $25, or $35) associated with each medication you might need.
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