how I hate insurance

[DopeyDame]

Yes, we do pay more for health care than anyone else. But we also expect more, and faster access. And we expect to see a Doctor, not a Physician Assistant, or Nurse Practioner. My neighbor had knee replacement surgery and had to wait 3 weeks. My Uncle in Canada had to wait 11 months. When I get sick, I go see my Doctor. When my family in Canada gets sick, they go to the local drug store and the Pharmacist treats them.
Our healthcare premiums cost just under 5% of our gross income. Our combined state and federal income tax rate is 27%, so combined that is 32%. Far less than the base tax rate in Norway. So they pay for their care likely at a higher rate than us.

Why in the world do you expect to see a doctor, and not a PA or NP? I looooove the NPs at my practice office, and they are more than capable of handling the vast majority of things that a general office sees. And when they aren't, they've already laid the ground work for the doctor so he can get to the more complicated stuff more efficiently. NPs and PAs are important and beneficial members of the health system. I can't imagine why you wouldn't want them!
And your family may go to your doctor when you get sick, but tons of people in the US go to Target or their local drugstore and have a PA or NP (not a pharmacist... in the US or Canada) diagnose and treat them.

 

[FlightlessDuck]

At my work, a family of four's insurance is not 4x the cost of one person. In fact, they don't count how many children, it's the same price.

Self.
Self/spouse
Self/children
Self/spouse/children

 

[tvguy]

Why in the world do you expect to see a doctor, and not a PA or NP? I looooove the NPs at my practice office, and they are more than capable of handling the vast majority of things that a general office sees. And when they aren't, they've already laid the ground work for the doctor so he can get to the more complicated stuff more efficiently. NPs and PAs are important and beneficial members of the health system. I can't imagine why you wouldn't want them!
And your family may go to your doctor when you get sick, but tons of people in the US go to Target or their local drugstore and have a PA or NP (not a pharmacist... in the US or Canada) diagnose and treat them.

That was not me, that was BCDisneyFanatic that said they only see a Doctor "
See Reply # 33

 

[disneymom3]

I don’t see a problem with pharmacists writing prescriptions for routine ailments. They know the medications better than the drs a lot of times. I have had three instances of a pharmacist catching a medication one of us could not take because of various issues that a dr had prescribed. In one case it literally saved my daughter’s life.

 

[DopeyDame]

That was not me, that was BCDisneyFanatic that said they only see a Doctor "
See Reply # 33

Huh? I replied to your post #14 (and quoted it) where you said " But we also expect more, and faster access. And we expect to see a Doctor, not a Physician Assistant, or Nurse Practioner. " That was well before post #33.

I'm wondering why you expect to see a doctor, not a PA or NP.

 

[tvguy]

Huh? I replied to your post #14 (and quoted it) where you said " But we also expect more, and faster access. And we expect to see a Doctor, not a Physician Assistant, or Nurse Practioner. " That was well before post #33.

I'm wondering why you expect to see a doctor, not a PA or NP.

I'm in the U.S. and that is how it works with my primary care physician. If I go to my Doctor, I always see my Doctor. The post I mentioned is from a Canadian who says in BC they see a Doctor at the Pharmacy.

 

[RamblingMad]

I'm in the U.S. and that is how it works with my primary care physician. If I go to my Doctor, I always see my Doctor. The post I mentioned is from a Canadian who says in BC they see a Doctor at the Pharmacy.

If I try really hard, I can Google and find articles that will convince you that the world is flat and that the MMR vaccination causes autism.

If I was running healthcare, I’d sure want to convince a bunch of people how terrible public healthcare is so that I can keep the money rolling in.

 

[mnrose]

If I try really hard, I can Google and find articles that will convince you that the world is flat and that the MMR vaccination causes autism.

If I was running healthcare, I’d sure want to convince a bunch of people how terrible public healthcare is so that I can keep the money rolling in.

You wouldn't even have to try that hard. People are so afraid of "socialism" (and that's NOT what a single payer system is anyway) that they keep on accepting our ridiculous system of health care that allows some people to get enormously wealthy off the misfortune of others. Health care should not be a privilege reserved only for the wealthy and we are quickly getting to that point in the US.

 

[dez1978]

Well, for any of the insurance plans I am familiar with, there is a base rate that covers one person, and then for a small amount a family member is added. So if you are the only one insured now, you would pay the base rate, not half of what you paid together.

it does stink though

through my work, coverage for just myself is like $65/month. Adding my kids is 100 more. Its the spouse thats expensive. DH costs me as much as the other 3 of us combined.

 

[RamblingMad]

through my work, coverage for just myself is like $65/month. Adding my kids is 100 more. Its the spouse thats expensive. DH costs me as much as the other 3 of us combined.

It’s the penalty for getting married.

 

[dez1978]

It’s the penalty for getting married.

lol, just one of many

 

[RamblingMad]

lol, just one of many

Taxes are higher too.

For all the family friendly talk from our elected officials, you’d think there would be less penalties.

 

[tvguy]

If I try really hard, I can Google and find articles that will convince you that the world is flat and that the MMR vaccination causes autism.

If I was running healthcare, I’d sure want to convince a bunch of people how terrible public healthcare is so that I can keep the money rolling in.

Okay?

 

[michellev]

I live in Ontario and I think I can explain how/when we use different levels of care. Maybe this will clear up some misconceptions.

1. I see my Doctor for non emergency issues. This is where I go for my annual physical. It is where I made an appointment when I was having acid reflux issues and wanted help. For a physical you generally make your appointment a few months ahead, but for regular appointments I can get it in a day or two.

2. I go to the walk-in clinic (this is not to be confused with the pharmacist!) for issues which are fairly emergent but not true emergencies. An example may be that your child develops an ear ache around dinner time and you want it looked at that evening. Walk-in clinics are generally open pretty late. You see a Doctor, just not your personal physician. Where I live there are a ton of walk-in clinics which means I don't wait more than 20 minutes to see a doctor.

3. I am fairly confident that in Canada pharmacists are exactly the same as in the US (I have used them in both countries). I get my prescriptions filled, flu shot, consult about prescriptions. They are in no way a substitute for your Doctor.

4. I have never seen a nurse practitioner, but maybe in other areas of the country this happens.

 

[mjkacmom]

I live in Ontario and I think I can explain how/when we use different levels of care. Maybe this will clear up some misconceptions.

1. I see my Doctor for non emergency issues. This is where I go for my annual physical. It is where I made an appointment when I was having acid reflux issues and wanted help. For a physical you generally make your appointment a few months ahead, but for regular appointments I can get it in a day or two.

2. I go to the walk-in clinic (this is not to be confused with the pharmacist!) for issues which are fairly emergent but not true emergencies. An example may be that your child develops an ear ache around dinner time and you want it looked at that evening. Walk-in clinics are generally open pretty late. You see a Doctor, just not your personal physician. Where I live there are a ton of walk-in clinics which means I don't wait more than 20 minutes to see a doctor.

3. I am fairly confident that in Canada pharmacists are exactly the same as in the US (I have used them in both countries). I get my perscriptions filled, flu shot, consult about prescriptions. There are in no way a substitute for your Doctor.

4. I have never seen a nurse practitioner, but maybe in other areas of the country this happens.

This is exactly how it works where I live in the US, except some offices have PA’s and it’s faster to get in to see them.

 

[maddiel]

I live in Ontario and I think I can explain how/when we use different levels of care. Maybe this will clear up some misconceptions.

1. I see my Doctor for non emergency issues. This is where I go for my annual physical. It is where I made an appointment when I was having acid reflux issues and wanted help. For a physical you generally make your appointment a few months ahead, but for regular appointments I can get it in a day or two.

2. I go to the walk-in clinic (this is not to be confused with the pharmacist!) for issues which are fairly emergent but not true emergencies. An example may be that your child develops an ear ache around dinner time and you want it looked at that evening. Walk-in clinics are generally open pretty late. You see a Doctor, just not your personal physician. Where I live there are a ton of walk-in clinics which means I don't wait more than 20 minutes to see a doctor.

3. I am fairly confident that in Canada pharmacists are exactly the same as in the US (I have used them in both countries). I get my perscriptions filled, flu shot, consult about prescriptions. There are in no way a substitute for your Doctor.

4. I have never seen a nurse practitioner, but maybe in other areas of the country this happens.

I'm in Nova Scotia. It works much the same here as there in regard to doctor visits and walk in clinics. Pharmacists here can assess and prescribe for minor ailments. Nurse practitioners work within medical practices and have limited prescription powers as well. They both act as forms of triage to some extent. My family doctor is sole practitioner who doesn't practice with a nurse practitioner, but I have family members who see one occasionally as part of their doctor's practice. I haven't had a pharmacist prescribe anything for anyone in my family (but I should really go to one and get my flu shot soon!)

M.

 

[Southernmiss]

I live in Ontario and I think I can explain how/when we use different levels of care. Maybe this will clear up some misconceptions.

1. I see my Doctor for non emergency issues. This is where I go for my annual physical. It is where I made an appointment when I was having acid reflux issues and wanted help. For a physical you generally make your appointment a few months ahead, but for regular appointments I can get it in a day or two.

2. I go to the walk-in clinic (this is not to be confused with the pharmacist!) for issues which are fairly emergent but not true emergencies. An example may be that your child develops an ear ache around dinner time and you want it looked at that evening. Walk-in clinics are generally open pretty late. You see a Doctor, just not your personal physician. Where I live there are a ton of walk-in clinics which means I don't wait more than 20 minutes to see a doctor.

3. I am fairly confident that in Canada pharmacists are exactly the same as in the US (I have used them in both countries). I get my perscriptions filled, flu shot, consult about prescriptions. There are in no way a substitute for your Doctor.

4. I have never seen a nurse practitioner, but maybe in other areas of the country this happens.

Yep. South USA, too.

I've seen my the NP in my gyno's office. No different than seeing the doc in care or questions asked. I asked for her for 2 yearly checkups. This year, I figured I needed to touch base with him just to be sure he was stil okay managing a thyroid prescription in a special way that I request.

Probably won't see him again next year, unless an issue creeps up.

I have 2 NP sisters in law who are highly intelligent, completed a lot of school, and who work their tails off doing the jobs the docs don't want to do. One makes regular all day hospital rounds on weekends. She can write prescriptions.

There's a shortage of specialist docs, why not use PA or NP to keep the docs available for more complex issues.

 

[ReneeA]

I have a huge issue with insurance companies in this country. Even when you think you have coverage, you don't. I work for a specialty hospital as a liaison - I'm a RN, go into the ICUs and work with physicians and case managers to identify patients that require our level of care like: patients that haven't been able to be weaned from the vent (we have a 70% vent wean rate when hospitals couldn't), patients with wound vacs, long term IV antibiotics, cardiac arrhythmias, complications from surgeries, etc. Many, many patients that have failed skilled nursing facilities because they are way too complicated and need RN and MD care daily. Insurance companies deny our level of care all the time because they don't want to pay for it, even though patients are *entitled* to it under their policies. Some instances of recent denials:

A 41 year old female got the flu last year, developed sepsis, pneumonia and couldn't come off the vent. Had previously been a working woman with a "good" insurance policy through her job. Denied because there are nursing homes in our area that take vents. Problem is that they do no weaning, because they get paid more for vented patients. Therefore, that insurance company doomed that young woman to living on a vent in a horrid nursing home until she dies.

Or how about the 66 year old, recently retired man who has a managed Medicare policy? Had a wound that wouldn't heal, developed sepsis, needs a wound vac and 6 weeks of IV antibiotics. Needs to see a wound care specialist, infectious disease doc and an attending daily because of how sick he's been. Denied - even though he has criteria as outlined by Medicare guidelines. My docs have started fighting denials by using g the terminology "you are denying this patient their rights under Medicare." That works occasionally because they don't want to be turned in for not following guidelines.

88 year old man had open heart surgery, did well, but needs rehab because he lives home alone. My case manager submitted for authorization from his Managed Medicare policy for a skilled nursing facility to get him a couple weeks of rehab because a home health care RN popping in is not enough care. As the doctor charted everywhere, "it's a safety issue. This patient needs some rehab to get stronger and to have a safe discharge." Per the denial from insurance "Safety is not a covered benefit under his policy." The man fell and died at home less than a week later.

I could go on and on and on. The closer we get to the end of the insurance company's fiscal year, the more denials we see. They have to make budget so they can post their billions in profit and pay their upper management multiple millions, all the while denying patients the care they need and are entitled to.

 

[fla4fun]

through my work, coverage for just myself is like $65/month. Adding my kids is 100 more. Its the spouse thats expensive. DH costs me as much as the other 3 of us combined.

Is that $65 per month the full cost, or just your part? I understood the OP was paying OOP for coverage privately, not having a subsidized premium through a job. Perhaps I misunderstood? We are in open enrollment where I work right now, and they show us the full cost of the policies, and then the breakdown of what the company pays versus what we employees pay. The full cost for one is much higher than the additional cost for adding the spouse, no matter which plan we select, which is what I have seen in most non-subsidized plans. I had to buy insurance privately between jobs a few years back, and my premium was well over $1,000 per month, and I could have added a spouse for just under $300.

However, if you are only looking at the employee portion of the premiums, then you are correct that the portion the employee pays for just themselves is usually much less than what the portion is to add someone. My portion of the premium for just me is $34 per month, and it’s three times that to add family.

So the amount you actually pay depends on a lot of variables. I think it’s horrible.

 

[kimblebee]

Yes, we do pay more for health care than anyone else. But we also expect more, and faster access. And we expect to see a Doctor, not a Physician Assistant, or Nurse Practioner. My neighbor had knee replacement surgery and had to wait 3 weeks. My Uncle in Canada had to wait 11 months. When I get sick, I go see my Doctor. When my family in Canada gets sick, they go to the local drug store and the Pharmacist treats them.
Our healthcare premiums cost just under 5% of our gross income. Our combined state and federal income tax rate is 27%, so combined that is 32%. Far less than the base tax rate in Norway. So they pay for their care likely at a higher rate than us.

I wish your family would stop misinforming you. Either that, or they’re leaving parts out. I have six different doctors for one thing or another and I’ve never, like never, seen a pa, or an np.

Also, if I went to a pharmacy and asked for an rx they would laugh at me.

I'm in the U.S. and that is how it works with my primary care physician. If I go to my Doctor, I always see my Doctor. The post I mentioned is from a Canadian who says in BC they see a Doctor at the Pharmacy.

I’m in Canada, and when I want to see my dr, I see my dr. If it’s late and his office is closed, I can go to ANY walk in clinic, or, worst case scenario, ANY hospital without worrying if they’re in my network, or if I have to pay a co pay.

I don’t know (based on prices) what sort of situation you’d have to go through to owe hundreds of thousands of dollars (that you’re responsible for, not insurance paying for), but what’s your ballpark for this?

Four months in three different hospitals, a week in ICU hooked up to three different IV’s, two surgeries, six ambulance trips, too many doctors and specialists to list, six weeks of IV meds (times two), physical therapy, occupational therapy, three meals a day for 114 days, use of a hospital bed at home for two months, ongoing use of a wheelchair, and a toilet seat with arm rests to ease rising up afterwards.

Thats not even including all the incidentals like kleenex, and Tylenol, and painkillers, and rash cream and thermometers.

We haven’t seen one bill for any of this, and we won’t. You can’t understand the sense of relief that comes with that.

As a pp said, I have not met one Canadian who would EVER want to be subjected to your health care system. I used to feel superior, now I just feel true pity.