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[P]
Does medical insurance have to be heartless?

By Quixotic Raindrop in Op-Ed
Sat May 15, 2004 at 03:19:07 AM EST
Tags: Help! (Ask Kuro5hin) (all tags)
Help! (Ask Kuro5hin)

A friend of mine has been fighting chronic illness for years, a service-related disability (US Marine Corps), and has recently (finally) been able to get some relief ... and, naturally, insurance won't cover the costs. The Veterans Administration has been involved from the beginning, but has so far proven to be incapable of helping (drug pushing, mainly), and now she's stuck with thousands of dollars of bills for necessary medical treatment that insurance won't pay for. Oh, she works as a software engineer for one of the largest companies in the USA (and the world), and they treat her like she's a malingerer for having chronic illnesses.

Where should she go for help and advice that will do as little as possible to make the financial issue any worse? How is it that a pretty well-funded system like the VA can fail so miserably at one of its primary responsibilities (care of veterans who suffer service-related disabilities)? Is there any compassion left in the US? Or have we all gone the way of the Almighty Dollar?


Personally, I have had less-than-stellar thoughts about both the insurance and medical fields for a while ... as probably many other people have, too. But is it right to let a person who has insurance, and should be covered by both insurance and the VA languish into bankruptcy just because insurance agencies are more concerned with money than people? Or because the VA doesn't feel like helping? Both of us are literally at our wit's end as a result of this ordeal, and have run out of both ideas and patience with the "system."

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Does medical insurance have to be heartless? | 171 comments (157 topical, 14 editorial, 4 hidden)
Lawsuits (2.55 / 9) (#1)
by Mr.Surly on Wed May 12, 2004 at 02:34:50 PM EST

  1. People like to sue, justified or not.  Tort signal-to-noise is poor.
  2. Lawsuits make malpractice insurance ridiculously expensive
  3. Pharmaceutical companies charge big bucks for newer medications (albeit, to cover research costs)
  4. Medical care is ridiculously expensive because of  1, 2, and 3.
Result: a 45 minutes procedure costs $7500.  No special equipment, drugs, or personnel.

Okay, but ... (none / 3) (#3)
by Quixotic Raindrop on Wed May 12, 2004 at 02:48:03 PM EST

I understand #1, but #2 should follow only from successful lawsuits (or, fighting suits with-merit that are unsuccessful). Court costs should be next-to-nothing for trivial suits, which should be identified early and eliminated ... there is no need for a lawsuit with little or no merit to cost more than a few hundred dollars, which should already be accounted for by malpractice insurance underwriters and companies. It seems implicit that if there are lots of suits, and that they happen at the drop of a hat, then either they deserve to be filed, or many of them are trivial.

The question isn't about expense, though. It's about 1) medically necessary procedures not being covered (the insurance won't cover the surgery she needed for the endometriosis, for example) because the insurance company can't be bothered to pay for it, and 2) the utter failure of the VA in its primary role: caring for veterans with service-connected disabilities.

[ Parent ]
The question isn't about expense ... (none / 2) (#11)
by Mr.Surly on Wed May 12, 2004 at 04:51:06 PM EST

... expense was the answer to the question.

Not knowing the particulars of your friend's medical insurance, you make it sound as if it's covered, but insurance "just isn't paying."  Is that the case?


[ Parent ]

Here's the problem (2.83 / 6) (#27)
by CaptainSuperBoy on Wed May 12, 2004 at 08:55:43 PM EST

The insurance companies settle lawsuits all the time. This makes it attractive to sue: "Who knows, you'll probably get a settlement!" The result is premiums continue to rise as patients play the lawsuit lottery.

--
jimmysquid.com - I take pictures.
[ Parent ]
Different view (2.50 / 4) (#38)
by dhk on Thu May 13, 2004 at 11:33:33 AM EST

It might be helpful to catch a glimpse of the health care system of another country: I am working in a german hospital and have quite a good grasp of how everything is organized here. Of course, the german system is far from optimal, costs are sky high, efficency is much lower, but: The American practice of nearly obligatory sueing after hospital treatment and the large sums granted after success in these trials are laughed at constantly in Europe. So: People may like to sue, but lowering the sums in these trials by an order of magnitude would help a lot.

Pharmaceutical companies charge big bucks for newer medications Sure, but there can be regulations (the state in Germany, HMOs in the USA) to use alternative and cheaper medications.
- please forgive my bad english, I'm not a native speaker
[ Parent ]
High tort recovery. (2.80 / 5) (#65)
by edg176 on Fri May 14, 2004 at 04:42:43 AM EST

Europeans may laugh at the the "large sums" returned by juries in tort cases, but there are sound reasons behind quite a few jury awards.  For one thing, unlike Europe every year we have a smaller and smaller welfare state.  That means that if someone is significantly disabled by physician error and cannot work, they will have several serious problems.  First, they will have a problem simply paying normal bills.  Second, if the problem creates other medical conditions, the victim can look forward to years of high medical bills.  If you don't believe me, you can take a look at some of the publications that index personal injury jury awards.  Westlaw and Lexis both publish those guides.  

Thus, those supposedly sky high verdicts are in reality money that will have to be a person's sole means of support.  Drastically slashing the tort system will only screw over those people.  

[ Parent ]

Yes. (2.78 / 14) (#2)
by J'raxis on Wed May 12, 2004 at 02:47:03 PM EST

Of course they are going to be heartless. The entire concept of insurance is basically “pay me money so I can pay you less in the future, and I’ll try my damnedest to weasel out of paying you anything at all.” Insurance is probably one of the most avaricious and greed-centric industries other than, say, banking. What do you expect from them?

Yes, all business is about profit maximization, making money above all else, and so on. But at least most businesses provide a product or service that turns out to be somewhat useful. Insurance is about making money off of money. What could you possibly expect other than pure, unadulterated greed?

— J’raxis

[ J’raxis·Com | Liberty in your lifetime ]

Does it have to be that way though? (2.25 / 4) (#5)
by Quixotic Raindrop on Wed May 12, 2004 at 02:54:29 PM EST

While I agree that insurance is one of the biggest scams in capitalism, they do offer a service: coverage. There is an explicit promise to pay when covered events happen. Shifting the definition of "covered" in order to avoid covering something that seems blatantly obvious is, I agree, a side effect of rampant capitalism ... but I don't think that it has to be that way. Not in the least, in fact. Insurance can be both compassionate and profitable: many insurance companies make money hand over fist on the vast majority of their customers, who never file a claim. It is the part about actually following through on the coverage part that infuriates us.

[ Parent ]
Not possible with a profit motive (none / 2) (#55)
by ShadowNode on Thu May 13, 2004 at 09:25:17 PM EST

The only way that could come about would be through some sort of credit union for insurance.

[ Parent ]
The credit union model (none / 1) (#85)
by losthalo on Fri May 14, 2004 at 09:02:19 PM EST

needs to be applied to a lot more areas, IMO.

[ Parent ]
Some life insurers do this (none / 3) (#120)
by NoBeardPete on Mon May 17, 2004 at 02:37:27 PM EST

There are mutually owned life insurance companies. Basically, people that hold policies are the owners. This sounds like a swell idea to me.

In practice, though, it runs into some problems. When the cooperative is short on cash, they can't issue new shares the way a normal company can, so it's hard for them to fix the situation. When they are flush with cash, they face pressure from the policy-holders, who get overly excited, and want to see the organization privitized so that people can cash out. It's workable - some mutually owned life insurance funds have been around for a while. But it's tough going.


Arrr, it be the infamous pirate, No Beard Pete!
[ Parent ]

... which exists. (none / 2) (#145)
by vectro on Wed May 19, 2004 at 10:24:30 AM EST

Kaiser Permenante and many Blue Cross / Blue Shield affiliates are non-profit organisations that attempt to solve exactly the issues addressed above.

I'm a subscriber of a Blue Shield of California (a not-for-profit corporation), and I'm reasonably satisfied with their coverage. I had a $5000 issue, and while they delayed payment by misprocessing the claim, they admitted the mistake when I called them on it. The only time they unreasonably refused to pay was on a $6 charge, which the provder wrote off.

“The problem with that definition is just that it's bullshit.” -- localroger
[ Parent ]

yes. (none / 1) (#118)
by ekj on Mon May 17, 2004 at 05:56:14 AM EST

I'm sorry, but yes, it has to be that way, aslong as it's a competitive market motivated by profit.

Assume there's two insurers, one is "heartless" and costs $X a month. The other is "nicer" but costs 1.5* $X

In theory, people could go for the second one. In practice they won't. People don't know which one is heartless and which one is nice before they've had to be in the position of trying to extract (large amounts of) money from it.

That happens to relatively few of us. At the same time, the heartless corp will pay out less, which not only makes them cheaper, but also gives them more money for marketing. The end-result is the good old US of A.

One of the most expensive medical systems in the world, but still incapable of offering humane treatment to the entirety of the population.

In comparison to countries in Scandinavia for example, the US pays more pro capita but still comes out with lower life-expectancy, higher child-mortality, less doctors, fewer hospital-beds, etc etc etc.

In Scandinavia health-care is paid for by the state and available to all. I don't quite see the argument against this, especially when it ends up being cheaper and better than letting the "free market" sort it out. It seems to me, to many Americans "free market" is like a religious slogan - to be applied even where it is demonstrably inferior to other arrangements.

[ Parent ]

I'm sorry, but that sounds ridiculous. (2.83 / 6) (#50)
by skyknight on Thu May 13, 2004 at 08:15:11 PM EST

Insurance does provide a service: you get to exchange the risk of a large one time payment for guaranteed small and recurrent fixed expense. If this were not a worthwhile service, then why would people buy so much of it? Yes, there are greedy people in the insurance business, as there are in any profession, but you're not bothering to think about the realities. With insurance you have to be extremely defensive about making payouts or the company will be run into the ground, and there won't be coverage for anyone, legitimate or otherwise.

It's not much fun at the top. I envy the common people, their hearty meals and Bruce Springsteen and voting. --SIGNOR SPAGHETTI
[ Parent ]
What you've just described (3.00 / 6) (#62)
by NoBeardPete on Fri May 14, 2004 at 01:36:32 AM EST

Is how insurance normally works. Life insurance, car insurance, homeowner's insurance - these are all types of insurance that people expect not to collect on more than once in a great many years. These insurance policies cover rare and exceptional circumstances.

Health insurance is a totally different beast. Most people with health insurace totally expect it to cover routine, forseeable stuff, like physicals, basic check-ups, flu shots, etc. It's as though you bought a car insurance policy which partially subsidizes your gas and oil changes. All of the sudden, buying gas becomes a much bigger ordeal, with paperwork, and proof of need.

We're in this situation because of the US tax code. This type of comprehensive health insurance is a way for companies to transfer money to their employees without being taxes. If we'd rationalize the tax code, health insurance would probably move to covering rare, unforseeable circumstances. Companies could then give their employees extra cash, with which they could pay for the routine stuff out of pocket. I bet health care would end up making a lot more sense and being better overall as a result.


Arrr, it be the infamous pirate, No Beard Pete!
[ Parent ]

Health care, taxes, and the FairTax (none / 2) (#88)
by J'raxis on Fri May 14, 2004 at 10:34:59 PM EST

Yes, and the ubiquity of health care insurance is what drives heath care costs up. Since so many people have health insurance through their employers, this allows the insurance companies to negotiate (read: coerce) lower payments for health care, which in turn means the uninsured have to make up the hospitals’ costs.

If you’re looking for tax reform, check out the FairTax bill. It’s more than just rationalizing the current system—the FairTax is a complete repeal of the income tax, replacing it with a 23% sales tax, which would, in part, complete obviate any of these kind of schenanigans employers play with payroll taxes.

— J’raxis

[ J’raxis·Com | Liberty in your lifetime ]
[ Parent ]

As much as I'd like that kind of system... (none / 3) (#89)
by skyknight on Sat May 15, 2004 at 08:16:57 AM EST

it will probably never happen. The problem with the tax code is that those in power don't want it to change, and they are the ones who have clout to keep the current system in place. Furthermore, the little guy in the present system is under the impression that he is sticking it to the rich, not realizing that the income tax code is a rich man's lawyer's playground.

It's not much fun at the top. I envy the common people, their hearty meals and Bruce Springsteen and voting. --SIGNOR SPAGHETTI
[ Parent ]
"Sticking it to the rich" (none / 0) (#157)
by J'raxis on Fri May 21, 2004 at 08:36:47 AM EST

Curiously, some of Bush’s thugs, such as Tom DeLay, actually support the FairTax.
Furthermore, the little guy in the present system is under the impression that he is sticking it to the rich …
Yeah, this is a major obstacle to the FairTax. The FairTax attempts to be progressive by having an already-built-in rebate system for tax-free spending up to the poverty line. But for some people, that’s not enough—they think the tax system shouldn’t just let the poor off easy, but it should also actually be designed to rob the rich of more money than it robs everyone else.

Can you point me to some concrete examples of how our tax system doesn’t even accomplish this in the first place? I know that there are dozens of loopholes that corporations exploit, but is there more to it than that? I usually try to counter the argument by just explaining that the tax system is solely for government revenue collection, not wealth redistribution, social engineering, or (what IMO boils down to) petty vindictiveness, but that often proves to be an insufficient argument.

— J’raxis

[ J’raxis·Com | Liberty in your lifetime ]
[ Parent ]

Well... (none / 2) (#161)
by skyknight on Sat May 22, 2004 at 08:36:10 AM EST

Can you point me to some concrete examples of how our tax system doesn't even accomplish this in the first place?

Most of what I would deem as abuse involves chicanery about "expenses" to reduce tax liability. A good concrete example that comes to mind is something of recent times, the "Hummer Deduction". There are myriad such loop holes, and if you can afford a good accountant then you can exploit them. What it boils down to is that the income tax code, weighing in at a whopping 7.5 million words, is completely unnavigable by the run of the mill tax payer. The consequence is that the middle class bears a disproportionately large tax burden. If there is to be any kind of justice, a tax code needs to be developed that can be fit on a few pages.

I usually try to counter the argument by just explaining that the tax system is solely for government revenue collection, not wealth redistribution, social engineering, or (what IMO boils down to) petty vindictiveness, but that often proves to be an insufficient argument.

Unfortunately, that is a completely useless mode of argumentation. While I agree with you that that is what taxation should be, other people are going to have different assumptions. If you want to get anywhere with such people, you have to reveal to them that their strategies are self-injurious. It does not suffice to say "your assumptions are wrong". You must attack them with something along the lines of "you assume these things, these things logically entail the following outcome, and this outcome is unfavorable to you because of X, Y and Z". That is the only way for affecting someone's opinion. The more concrete of a numerical and logical analysis that you can perform, the better your chances for swaying them.



It's not much fun at the top. I envy the common people, their hearty meals and Bruce Springsteen and voting. --SIGNOR SPAGHETTI
[ Parent ]
Tax code enables home ownership (none / 0) (#115)
by cdguru on Mon May 17, 2004 at 12:15:49 AM EST

Most people don't realize that outside the US ownership of their home isn't anywhere near as common as it is in the US. How many people in Netherlands or Sweden own a house in their 20s?

The problem with the tax code in the US is that it essentially enables home ownership. Nobody is going to touch that. This happens because the interest you pay on a home mortgage is 100% deductable. Since about 99% of what you are paying for the first few years on a 30 year mortgage is interest, this meas your effective cost for owning a home is around 10% of what you are paying out. Even if you are paying twice as much on a mortgage than rent, you end up paying 20% of what you were paying in rent.

Because of this, there are vast retail stores that cater to home maintenance, home decorating and stuff like that. Basically stuff that you wouldn't do if you were renting but do if you own the property. Change the tax code and those businesses close up. This would be a huge change in the economy, one that would change a lot of things you wouldn't even think are connected. It will never change, at least not in our lifetimes.

[ Parent ]

How do you figure the math? (none / 0) (#121)
by NoBeardPete on Mon May 17, 2004 at 02:47:49 PM EST

When you pay X$ for a tax deductable purchase, it doesn't reduce your tax bill by $X. It reduces the amount of money on which you pay tax by $X.

Suppose I'm in a tax bracket where I pay %20. I get a mortgage for a house, and pay $1000 per month. For the sake of this exercise, we'll say that's all interest to start with. I deduct $1000 from my taxable income, which means I pay $200 less in taxes. So I'm out just as much money as if I was renting the place for $800 a month.

This does favor home ownership over renting, but not to nearly the extent you're suggesting.


Arrr, it be the infamous pirate, No Beard Pete!
[ Parent ]

And all of this... (none / 0) (#158)
by J'raxis on Fri May 21, 2004 at 08:47:19 AM EST

And all of this convoluted gobbledygook about deductions and exemptions explains exactly what’s wrong with our current income tax system.

A similar situtation came up recently in a local issue for me, with regards to the MBTA, Boston’s transit authority. They’re talking about letting people deduct up to $700 worth of commuter expenses per year from their state taxes. People are commenting that a $700 savings would be great. First, this is clearly wrong, for the same reasons outlined here—with MA tax rates, you would merely be saving something like 5% or 10% of $700. Secondly, it would be a lot more direct, simple, and honest, for the state to just increase tax revenues flowing into the MBTA, and get the MBTA to decrease fares accordingly.

— J’raxis

[ J’raxis·Com | Liberty in your lifetime ]
[ Parent ]

[OT rant but I feel it has to be said] (none / 0) (#159)
by J'raxis on Fri May 21, 2004 at 08:55:42 AM EST

How many people in the US actually own their own homes anyway? I mean really own it, without making mortgage payments. Anyone laboring under the illusion that spending thirty years making monthly payments to a bank is equivalent to home ownership, and not to mere rental, is laboring under a delusion of the grossest proportions.

You pay a mortgage and think you own your home? Stop paying it and see how fast you get booted off of “your” property. Same as not paying your landlord his monthly rent. Eventually, you get to actually own your home, but with a mortgage, it’s more like a thirty-year lease.

Home ownership in the US, for the vast majority of people under 60, is a delusion. Taking into account how beneficial this illusion is to the current tax régime, the paranoid side of me wants to say that it’s an intentionally-engineered delusion.

— J’raxis

[ J’raxis·Com | Liberty in your lifetime ]
[ Parent ]

It is my understanding... (none / 0) (#90)
by skyknight on Sat May 15, 2004 at 08:21:06 AM EST

that we've been in this mucked up situation more or less since WWII. If my memory serves me, there was wage fixing occurring during that time period. As a mechanism by which to differentiate themselves to prospective employees, companies offered various benefit programs, the benefits of which were not counted as income and thus not regulated.

It's not much fun at the top. I envy the common people, their hearty meals and Bruce Springsteen and voting. --SIGNOR SPAGHETTI
[ Parent ]
We have HSAs now (none / 1) (#92)
by Shajenko on Sat May 15, 2004 at 02:38:04 PM EST

Health Savings Accounts essentially allow you to deduct your health care costs from your taxable income. And your money doesn't just go away when Jan. 1 comes around, like it did with those awful Flexible Savings Accounts.

[ Parent ]
No, no. (none / 1) (#146)
by vectro on Wed May 19, 2004 at 10:35:51 AM EST

You can already deduct all medical expenses from your income -- including insurance premiums -- though you have to itemize. See line 1 of 2003 form 1040, schedule A.

An HSA is an investment account that lets you save for future medical expenses (actually to pay the deductible on a high-deductible health plan), whereby the interest on the investment is tax-free. It's just like an IRA except you can take money out to pay medical expenses. And you don't have to itemize to get the HSA deduction.

More information on HSAs is available from the IRS.

“The problem with that definition is just that it's bullshit.” -- localroger
[ Parent ]

See a lawyer (2.66 / 6) (#10)
by Atomic Eco on Wed May 12, 2004 at 04:03:38 PM EST

You should try to find a lawyer (with expertise in the field) who will evaluate your case against the insurance company. Perhaps the VA can help you with this, at least so far as to get the evaluation.

If you have a strong case, lawyers will be interested, and you have a better chance of safeguarding against high legal bills (they might even work on contingency).

Finland.. where polar bears roam the streets.

After you have seen the lawyer... (1.33 / 6) (#12)
by undermyne on Wed May 12, 2004 at 04:55:37 PM EST

kill him and everyone in his office. Lawyers are the reason the medical system is totally fucked.

"You're an asshole. You are the greatest troll on this site." Some nullo

[ Parent ]
A heart? Business? (1.06 / 16) (#13)
by megid on Wed May 12, 2004 at 05:11:02 PM EST

Wake up, dreamer. Or in other terms: Get a fucking understanding of the basic processes of capitalist life, moron.

Not to insult you too much, but your question was just too stupid.

--
"think first, write second, speak third."

Wow... (none / 1) (#164)
by DDS3 on Sun May 23, 2004 at 03:32:22 AM EST

....another example of a troll trolling.  What are the odds.

[ Parent ]
Where she should go for help... (2.61 / 13) (#14)
by tap dancing lenin puppet on Wed May 12, 2004 at 05:13:16 PM EST

Where should she go for help and advice that will do as little as possible to make the financial issue any worse?

Canada.

The Next Question Is.... (none / 0) (#98)
by spectra72 on Sat May 15, 2004 at 09:46:38 PM EST

How hard is it to move Canada with a pre-existing medical condition like this? I mean, I seriously doubt you could just drive across the border and expect a chronic condition to be magically treated. The entire poor population of the US AND Mexico would be beating down their doors right now if that were true.

Seriously, I'd like to know. Would she have to become a citizen? How hard is it to do that? Contrary to popular belief, the US isn't the only country with immigration policies.

[ Parent ]

She wouldn't have to be a citizen. (none / 1) (#117)
by ghjm on Mon May 17, 2004 at 05:08:23 AM EST

She would just have to be a permanent resident, the same as in the US. In fact the US even calls the status "Lawful Permanent Resident" now. When I first came here I was a "Resident Alien" for many years. I much prefer the term "Permanent Resident," which is what Canada has always called it (at least since they switched from "Landed Immigrant" several years ago.)

If she has a degree and a solid middle class background (e.g. a few dollars or a job offer, and a non-trivial resume), then she can probably qualify for Canadian immigration as a skilled worker. You can see the requirements on their Web site; it's a point system and you have to come up with (currently) 67 points to qualify. If she doesn't qualify as a skilled worker, then she probably has to have family already in Canada, or a credible argument that she's a refugee, or some other claim to sponsorship.

Once you've lived in Canada as a permanent resident for a number of years (I forget if it's three years or five), you can pursue citizenship. This is essentially identical to the U.S., except that Canada is somewhat more forgiving about the idea of dual citizenship - you don't have to renounce all previous foreign allegiances, the way you do in the US.

If she gets her permanent resident status (which may take a good long time - just like in the US, the immigration department is hopelessly backed up and the paperwork could take 12 to 18 months to come through), then she'll be covered by the provincial plan of wherever she decides to move to. In most provinces, coverage begins 30 days after you become a resident of the province. She'll need to buy temporary coverage, or remain covered under the travel provisions of her existing American plan, for those first 30 days.

There are no medical exams or questions about pre-existing conditions or anything like that. Once she's covered, that's it, she's covered, just like any other Canadian (or permanent resident). If you moved to Canada in the full knowledge that you would probably die within six months without a complex, multi-million-dollar arterial bypass operation, and on the 31st day you were to visit a Canadian doctor and tell him exactly what you've done, he might not be your best friend, but he would have no choice but to schedule the operation. (And you can be confident that it would be performed very competently, though not necessarily very soon.)

-Graham

[ Parent ]

Thanks! (none / 0) (#160)
by spectra72 on Fri May 21, 2004 at 12:50:03 PM EST

Very informative.

[ Parent ]
Vote Democrat (1.90 / 11) (#15)
by imrdkl on Wed May 12, 2004 at 05:24:09 PM EST

You've got to start somewhere.

Nope (none / 3) (#16)
by Cro Magnon on Wed May 12, 2004 at 05:42:22 PM EST

It was just as crappy under the Dems.
Information wants to be beer.
[ Parent ]
You may have a point (none / 1) (#17)
by imrdkl on Wed May 12, 2004 at 05:51:27 PM EST

I nearly forgot about the drug cards for seniors.

[ Parent ]
America (2.85 / 7) (#31)
by reklaw on Wed May 12, 2004 at 10:27:25 PM EST

Where your political choice is between right-wingers or rabid right-wingers.
-
[ Parent ]
Short answer, yes (2.81 / 11) (#18)
by nkyad on Wed May 12, 2004 at 06:30:17 PM EST

But never brainless, mind you, never brainless. You are under the wrong impression that the medical insurance industry is part of the healing business. It is not. They are in the money business, with a twist: the less they serve, the richer they get.

Don't believe in anything you can't see, smell, touch or at the very least infer from a good particle accelerator run


a thought (none / 2) (#30)
by reklaw on Wed May 12, 2004 at 10:26:26 PM EST

If you just saved up all the money that you pay into health insurance, and used it to pay for your own healthcare when needed, surely you'd come out ahead like 99% of the time? Otherwise the insurance companies wouldn't be making such large profits...
-
[ Parent ]
The remaining 1% will break you (none / 3) (#35)
by nkyad on Thu May 13, 2004 at 10:56:51 AM EST

An average middle-class family (say a couple plus one or two children) could certainly provide for its normal medical needs without resorting to insurance. But this scenary breaks at the moment Dad has a heart attack and lands in the surgical table - surgery plus intensive care time are well beyond the lone private citizen means. Actually, surgical procedures (plus surrounding hospitalar care needs) and advanced treatments are probably a major component of insurance final price: you pay for the thousands of Joes and Janes surgeries in exchange for them paying yours when you need it.

Don't believe in anything you can't see, smell, touch or at the very least infer from a good particle accelerator run


[ Parent ]
Even surgery is affordable (none / 1) (#143)
by vectro on Wed May 19, 2004 at 10:07:42 AM EST

An average middle-class family could certainly afford to invest $500/yr in medical savings -- less than a cheap insurance plan -- and be able to afford a few surgeries. You can have a basic surgical operation -- say, a laraparascopic cholecystectomy (the most common) -- for around $5000.

The real problems are twofold: One, realistically people have difficulty saving for such exigencies, just as people generally don't save enough for retirement. Secondly, there do in fact exist diseases that cost a lot -- a denerative disease that puts you in the hospital for a year, for example.

In addition to all of this, there are political and economic forces at work that make healthcare cheaper to the insured. The most prominant instance of this is "discounted" prices for insured patients: Insurers negotiate with providers to get discounts for their customers. For example, I am a Blue Shield of California individual plan member. Blue Shield will pay 70% if I go to a "preferred" provider, but only 50% if I go to some random doctor they don't know. Furthermore, if I go to the "preferred" provider, the provider will write off 30-50% of the bill in exchange for receiving the extra business that goes to "preferred" providers. In summary, if I go have my wisdom teeth removed by a certain surgeon (one that accepts Blue Shield), I'll pay $500 and Blue Shield pays $500. If my uninsured friend has exactly the same operation, he'll pay $1500.

What this all amounts to is in fact a cartel of sorts, though it's perfectly legal, because it's a buyer's cartel -- not a seller's cartel. You can pose a coherent argument that it benefits insured patients without affecting the uninsured.

“The problem with that definition is just that it's bullshit.” -- localroger
[ Parent ]

Insurance companies reinvest your premium (3.00 / 7) (#37)
by decaf_dude on Thu May 13, 2004 at 11:12:48 AM EST

Their source of income from premiums, while significant, is just one part; most (I believe) comes from reinvestment of that money with greater returns than the potential payments they make. However, in times of great investment losses (like the last few years), they simply up your premiums to cover the investment losses their investors made. Neat, eh?

Insurance business, just like a casino, can't lose. When you analyse their modus operandi you realize they're actually like Mafia, but with full legal system protection: they charge you protection money whether or not you want to be protected (e.g. car or house insurance), and they get to increase the racket^Wpremium amounts whenever they want. You as a consumer^Wcitizen can either pay up or reject such luxuries as mobility or shelter.

And that's how things are in Canada, I can only imagine it being actually worse in our capitalist neighbour to the south.

--
http://slashdot.org/comments.pl?sid=89158&cid=7713039


[ Parent ]
You're confused (none / 0) (#144)
by vectro on Wed May 19, 2004 at 10:13:51 AM EST

Or else I am.

Life, fire, flood, and some other kinds of insurance do invest premiums. This is because the nature of the insurance is such that claims will come in big waves -- hence it is necessary to have investments in preparation for these claims. These reserves are required by law.

Health insurance is different by nature -- there's no reason to think that everyone is going to need a heart transplant all at the same time. In fact, if that actually happened, we'd have a serious problem because the medical infrastructure for such a situation doesn't exist. Since there's no need to prepare financially for such a situation, health insurers don't need to save.

Theoretically speaking, the equation "premiums - claims - expenses = profit" should be true every month for every acturarial group for a health insurer. In fact it's not, but only because claims take time to process, and possible due to seasonal variation in claims.

Note that all of this assumes an acturarial system that allows premiums to vary over time. If not, then it would be possible for healthcare costs to rise while premiums stayed the same -- a disaster that insurance companies would have to be prepared for. Unsurprisingly, such contracts are extremely rare.

“The problem with that definition is just that it's bullshit.” -- localroger
[ Parent ]

No (none / 1) (#108)
by nicebear on Sun May 16, 2004 at 03:22:09 PM EST

This is true for people buying their own insurance, but most insurance is heavily subsidised by employers. Most employers won't simply give poeple extra cash instead, because they get tax breaks on providing insurance and because having more people in their insurance plan means they are able to negotiate better rates with an insurance company. Some also believe that providing insurance keeps employees healthy and so less likeley to take sick leave.


[ Parent ]
Try Ayurveda (none / 0) (#152)
by Steeltoe on Wed May 19, 2004 at 01:34:00 PM EST

It's infinitely cheaper to live a healthy life than to "repair" diseases that arises from a bad lifestyle. Ayurveda is ancient knowledge about life  that takes the whole human into account. The key ingredient involves doing what is right for your body. In prevention eastern medicine is more effective than western, although western excells in acute situations.

It could be interesting to follow a medical insurance where all the members followed the ayurvedic knowledge and did yoga, meditation etc. to strengthen their bodies.

Explore the Art of Living

[ Parent ]

My mother works in chronic illness (1.60 / 10) (#19)
by Verbophobe on Wed May 12, 2004 at 06:30:44 PM EST

And most of her clients are chronically ill because they no longer want to work.  Granted, some are genuinely ill, but they're a minority (I'd say 20%) of the patients she sees.

So, you know.  YMMV.

Proud member of the Canadian Broadcorping Castration

Indeed (none / 2) (#24)
by dn on Wed May 12, 2004 at 07:53:30 PM EST

Having been in the 20%, it sucks. It's incredibly disheartening for the doctors to give up and call you a hypochondriac when you are really sick.

    I ♥
TOXIC
WASTE

[ Parent ]

Don't all hypochondriac say that? (2.00 / 4) (#39)
by siberian on Thu May 13, 2004 at 11:49:39 AM EST



[ Parent ]
I know you're just trolling, but... (none / 1) (#45)
by coderlemming on Thu May 13, 2004 at 05:31:32 PM EST

I'm dealing with this right now.  The concept of hypochondria floating around in the background (or sometimes foreground) of a doctor's mind really puts a patient in a difficult position.  It gets worse if the patient has a difficult-to-diagnose condition.  Rather than digging deeply for the root cause of the problem, the doctor can just brush it off as hypochondria and leave the patient stranded.  The more the patient tries to push the doctor, the more the doctor becomes sure in his conclusion that it's just hypochondria.  That leaves the patient in a very uncomfortable and intractable situation.  In my case, I've got pretty much no choice but to switch doctors.


--
Go be impersonally used as an organic semen collector!  (porkchop_d_clown)
[ Parent ]
Ha ha (none / 1) (#54)
by dn on Thu May 13, 2004 at 08:48:41 PM EST

I finally found a specialist who thought "well no wonder you feel so bad" and recommended a minor surgery. So far there's been a big improvement.

To be fair, my family doctor didn't give up or kick me out. He just couldn't come up with an answer for a really odd collection of seemingly-unrelated symptoms. That happens.

    I ♥
TOXIC
WASTE

[ Parent ]

Yes (2.25 / 4) (#26)
by CaptainSuperBoy on Wed May 12, 2004 at 08:53:10 PM EST

Hypochondriacs do everyone a disservice. They receive unnecessary medical care for free, and they make doctors skeptical when someone actually has a hard-to-diagnose problem. There's no way to tell if this woman is for real, but it's true that some people aren't. People with "chronic conditions" also make unrealistic demands on their workplace, like asking people not to use cell phones. I'm not kidding, there's a sign in one of the administrative offices at UMass asking people to turn off their cell phones because of the radiation.

--
jimmysquid.com - I take pictures.
[ Parent ]
Hypochondriac != malingerer (nt) (none / 0) (#67)
by spasticfraggle on Fri May 14, 2004 at 07:03:30 AM EST



--
I'm the straw that broke the camel's back!
[ Parent ]
The best solution... (2.52 / 17) (#20)
by gordonjcp on Wed May 12, 2004 at 07:15:14 PM EST

... is to live in civilised country where healthcare is provided by the state. That way your hard-earned money is not going to pay for a health-insurance company director's new Jaguar or holiday house in the south of France. Granted, it's probably going on hanging baskets of nasturtiums outside an old folk's home somewhere, but that's kind of not the point

America needs to get its hospitals out of the Dark Ages.

Give a man a fish, and he'll eat for a day. Teach a man to fish, and he'll bore you rigid with fishing stories for the rest of your life.


indeed (2.30 / 10) (#29)
by reklaw on Wed May 12, 2004 at 10:24:29 PM EST

I am amazed at the sham that seems to pass for healthcare in the US. Private health insurance? Hospitals that send you bills for emergency operations?

Most people are just forced to take a job that offers health insurance. What would be so bad about just doing it with tax? (on a voucher system, perhaps, so that people don't get upset about "big government", the "nanny state" and such).
-
[ Parent ]

Yeah, the US... (none / 2) (#43)
by spasticfraggle on Thu May 13, 2004 at 03:17:48 PM EST

Don't have an accident in Sweden either. You'll get a bill for emergency treatment and the ambulance.

Not the full cost though.

--
I'm the straw that broke the camel's back!
[ Parent ]

In the UK, Mountain Rescue costs you... (none / 2) (#81)
by gordonjcp on Fri May 14, 2004 at 04:12:22 PM EST

... but only if you have demonstrably been a total fuckmonkey and gotten yourself into trouble by bein g ill-prepared or just plain stupid. It happens a lot up here in Scotland, because we have the highest mountains in the UK so we get lots of climbers, and we have the most changeable weather. It can be clear skys all the way at 8am, pissing down with the cloudbase round about your shins at 11am, sunny again at lunchtime and by 5pm there's 6 inches of snow. Then by 9pm the 110mph gales have blown all the snow away.

Give a man a fish, and he'll eat for a day. Teach a man to fish, and he'll bore you rigid with fishing stories for the rest of your life.


[ Parent ]
Billed for services? SHOCKING! (1.80 / 5) (#69)
by duffbeer703 on Fri May 14, 2004 at 08:57:31 AM EST

I am amazed that supermarkets charge for basic food staples.... the state should pay!

Nobody's forced to do anything. Some even choose to go without insurance to keep the money. When I was an independent, I paid $350/mo for all-encompassing  family health and dental coverage that was good anywhere in the US.

People bitch about the costs, but have no problem paying $9/day for coffee or $2/bottle for water...

I rather pay for healthcare than pay confiscatory Euro income and VAT taxes.

[ Parent ]

My country has free healthcare. (3.00 / 6) (#75)
by Torka on Fri May 14, 2004 at 10:55:27 AM EST

And a comprehensive social services system that ensures no one who doesn't want to be is homeless and everyone can afford to eat.

Our median income tax rate: 33%

US median income tax rate: 30%

Curse our confiscatory taxes!

But I'm being unfair. Not bombing the shit out of a country of little brown people every 10 fucking years is quite a money saver for a government that wants cash for the little extras like providing food, shelter and medicine for all its citizens.

(See below for generic straw-grasping reply claiming that I probably have to wait decades for life-saving surgery and all our doctors use leeches)

[ Parent ]

Which country? (none / 1) (#77)
by alby on Fri May 14, 2004 at 11:36:10 AM EST

If I want to accuse you of having to wait decades for surgery and your doctors of using leeches I'd have to know which country you were in first!

--
Alby
[ Parent ]

New Zealand <nt> (none / 3) (#78)
by Torka on Fri May 14, 2004 at 11:40:08 AM EST

nt

[ Parent ]
CHRIST! NEW ZEALAND! (2.83 / 6) (#82)
by alby on Fri May 14, 2004 at 06:13:58 PM EST

Everyone knows in New Zealand you have to wait fucking ages for surgery! Ten years for a hip replacement! Plus afterwards they'll probably use leeches to control the bleeding!!!

Erm... ror? roffle? I think... Christ, I'll never make a decent troll.

--
Alby
[ Parent ]

No, alby (none / 0) (#166)
by grouse on Sun May 23, 2004 at 08:12:08 PM EST

it's Christchurch, New Zealand. Get it right.

You sad bastard!

"Grouse please don't take this the wrong way... To be quite frank, you are throwing my inner Chi out of its harmonious balance with nature." -- Tex Bigballs
[ Parent ]

No such thing as a "Free" lunch (none / 1) (#79)
by duffbeer703 on Fri May 14, 2004 at 01:44:05 PM EST

You forgot about your 12.5% VAT...

You also live in a nation that is the size of New York with a population of 4 million. A nation whose social services system is likely smaller than a single human service agency in New York City in terms of size, budget and constituents.

[ Parent ]

Only women and the weak need (1.00 / 26) (#22)
by Hide The Hamster on Wed May 12, 2004 at 07:31:40 PM EST

health insurance. You're a fucking weaking and deserve to die if you believe that health insurance/universal health care are necessary.


Free spirits are a liability.

August 8, 2004: "it certainly is" and I had engaged in a homosexual tryst.

I'd be interested to see more info. (2.83 / 18) (#23)
by bucephalus on Wed May 12, 2004 at 07:40:37 PM EST

Disclaimer: I know a bit more about this kind of stuff than most people because I work for a company which does health-insurance administration. My main focus is customer service: my job, basically, is to solve people's problems. Believe it or not, that's what I do -- I'm actually not an evil heartless money-grubbing bastard. Now with that said, several items jump out at me when reading this story:

For one thing, your friend says that she just suddenly left the VA system and ran to the Mayo Clinic. Then she complains because nobody will help her force her employer's group health plan to pay for it. Er. Huh? I see no mention in here of her trying to go through her employer's plan until after she went to Mayo, which is odd... if the VA was so horrible, and she had another plan covering her, why didn't she try that first?

For another, there's a lot of information missing here. Why are her claims being denied? Somebody at the insurance company doesn't just wave a magic wand and say "we won't pay." They have to make a determination based on the provisions of her plan, and furnish her with a reason for the denial. Usually that comes in the form of an Explanation of Benefits (EOB).

For another, there's no mention of what steps she's taken so far with the insurance company to try to resolve this. Hint: that's why the customer service people are there! And of course, this is an immediate answer to your main question -- where should she go? To her insurance's customer service department. They are her first and best option for help.

I notice there's no mention of any of the provisions of her plan, either -- in your comments, you make statements asserting that the insurance company keeps changing the definition of "covered." That's just not how it works -- there is a written document which she has access to (and she doesn't have to jump through hoops for it, either -- all she has to do is ask for a copy) and which spells out, in mind-numbing detail, how her coverage works and what, exactly, is and is not covered. Usually it's called the "Benefit Book", "Plan Document" or "Summary Plan Description." She needs to get a copy and read it, if she hasn't already. I know it's the most boring thing in the history of the world (really, I know... I've read enough of them myself), but it's the authoritative and, more importantly, usually binding source of information on her coverage. Knowledge is power.

And that's it for now. I'm going to ignore the flamebait (hint: throwing around the kind of statements you're using might antagonize the very people who could help her the most -- I work in customer service and I'm used to having every obscenity in the book lobbed at me, but others might not have the same tolerance) and wish your friend luck with her situation. Tell her from me that the more information she can gather about her situation, the better off she'll be.



I got denied by a health insurance co once (1.00 / 6) (#40)
by phred on Thu May 13, 2004 at 01:43:32 PM EST

I asked them why they denied my claim, they told me that they were having an off year and had to make the stockholders happy. While I was a bit peaved here, they told me they were only going to do this until ten thousand folks died needlessly, and then were going to start paying claims again.

[ Parent ]
Tell your friend to move to Canada. (1.50 / 6) (#25)
by kitten on Wed May 12, 2004 at 08:43:05 PM EST

They don't seem to have these kinds of problems. If you need medical treatment in Canada, you get it.
mirrorshades radio - darkwave, synthpop, industrial, futurepop.
Although... (2.66 / 6) (#28)
by tap dancing lenin puppet on Wed May 12, 2004 at 10:02:14 PM EST

Occasionally, you have to wait 6 months to a year.

I say this as a Canadian, not a conservative ideologue.

Of course, if our leaders pumped adequate funds into the system, and reeled in the unions, and made up their minds where they want funds to be directed (public system, private delivery; public system, public delivery; private system, private delivery), instead of flopping back and forth every few terms, this probably wouldn't be an issue.

(Example: in the 80's, the NDP (socialist-lite) decided that homecare should be public... so we bought out all private homecare businesses.  Then the PC (conservatives) were elected, and they slowly moved out of homecare, and allowed businesses back in, now the Liberals are elected, and they're considering moving homecare back to the public system... this is provincially, of course).

It's wonderful.  Meanwhile, we're tugged back and forth like a raggity, sick Stretch Armstrong.

[ Parent ]

shortly after I moved to the USA, (none / 2) (#48)
by Battle Troll on Thu May 13, 2004 at 08:04:35 PM EST

I needed an MRI. I went and paid $600 and had it done the same week. In Canada, I was triaged to 6 months even though I was having crippling pain (it was bad enough that the hospital decided to shoot me up with Dilaudid when I came in.) At the time, a private MRI was virtually unobtainable in Canada.

Fuckin' Yanks. I hate Bush. This is just another example of how the fucking Yanks are all a bunch of capitalist assholes.
--
Skarphedinn was carrying the axe with which he had killed Thrainn Sigfusson and which he called 'Battle Troll.'
Njal's Saga, ca 1280 AD
[ Parent ]

grammar (none / 1) (#49)
by Battle Troll on Thu May 13, 2004 at 08:05:18 PM EST

Rather than 'I was triaged', 'I had been triaged before I moved.'
--
Skarphedinn was carrying the axe with which he had killed Thrainn Sigfusson and which he called 'Battle Troll.'
Njal's Saga, ca 1280 AD
[ Parent ]
MRI's and healthcare. (none / 2) (#53)
by tap dancing lenin puppet on Thu May 13, 2004 at 08:45:18 PM EST

I needed an MRI. I went and paid $600 and had it done the same week. In Canada, I was triaged to 6 months even though I was having crippling pain (it was bad enough that the hospital decided to shoot me up with Dilaudid when I came in.) At the time, a private MRI was virtually unobtainable in Canada.

Exactly, and maybe if our government (both federal and provincial) would make up their mind and do one of the following, the level of care would actually be acceptable.

A- Contribute enough money to the public health system to buy the adequate number of machines, and remove some funding from private delivery of public services.  Commit to this for 40 years.  Rinse, repeat.

B- Commit to a private sector system, and just hand tax cheques back to all Canadians.  Commit to this for 40 years.  Rinse, repeat.

C- Which is not an viable option, but is most likely to happen, is that political ping pong will continue to be played with our health, with drastic shifts every four years.  Commit to this for 40 years, open the borders so we can head south to get the operations we need.  Don't worry, we'll bring you our cheap perscription drugs.

That's the great part about Communism, at least once a plan is arrived upon, it's usually stuck to (even though it often sucks, which is the bad part).

[ Parent ]

$600 or 6 Months? That's Ludicrous! (none / 1) (#128)
by D Jade on Mon May 17, 2004 at 10:42:24 PM EST

An MRI in Melbourne, AU costs me nothing and it's done on the same day! How could anyone justifiy $600 for a scan that takes virtually no time or effort to perform? Even factoring the post analysis in, this seems outrageous.

Thank god I live here and not over there!



You're a shitty troll, so stop pretending you have more of a life than a cool dude -- HollyHopDrive
[ Parent ]
heh (none / 0) (#131)
by Battle Troll on Tue May 18, 2004 at 11:21:53 AM EST

An MRI in Melbourne, AU costs me nothing and it's done on the same day!

It costs someone something, just not you.

How could anyone justifiy $600 for a scan that takes virtually no time or effort to perform?

Because of the immense capital cost of the equipment, which must be recouped somehow; in a for-profit system by billing clients, in a socialized system by balancing the capital costs against the cost of maintaining you without that scan (which are likely to be non-negligible.) In the socialized system, they bill every member society via taxes.

An analogy. How can doctors charge $100 for seeing you for 15 minutes? I mean, I could see you for 15 minutes for a lot less than that, right? But doctors need to recoup their training costs and to earn a wage capable of attracting people to a difficult, expensive job requiring 15 years of post-secondary education.
--
Skarphedinn was carrying the axe with which he had killed Thrainn Sigfusson and which he called 'Battle Troll.'
Njal's Saga, ca 1280 AD
[ Parent ]

It costs everybody... (none / 1) (#136)
by D Jade on Tue May 18, 2004 at 08:08:18 PM EST

How can doctors charge $100 for seeing you for 15 minutes? ... But doctors need to recoup their training costs and to earn a wage capable of attracting people to a difficult, expensive job requiring 15 years of post-secondary education.

True. I have no idea how much a medical degree would cost an individual in The US (or anywhere else for that matter). But over here, it would cost the student only $45-50K for the entire seven years. They would not have to pay that money back until they were in the workforce and would pay it back through their taxes (IE: they are taxed an extra 3% until their debt is settled).

The fees are also subsidised by the government which pays approximately half of the school fee. Sure, we have to pay higher taxes. But, like I said, the quality of life over here is much better for all (social issues aside).



You're a shitty troll, so stop pretending you have more of a life than a cool dude -- HollyHopDrive
[ Parent ]
don't get complacent, that can change very fast (none / 1) (#148)
by Battle Troll on Wed May 19, 2004 at 12:02:43 PM EST

I have no idea how much a medical degree would cost an individual in The US (or anywhere else for that matter). But over here, it would cost the student only $45-50K for the entire seven years.

That's the way it used to be in Canada. Now, it's more realistic to say $100-150K, especially figuring in cost-of-living. (In Canada, you have to have at least three years of undergrad to be accepted to med school, and a complete four-year degree is by far the most common; 4 years undergrad + 4 years med school + 3-5 years specializing adds up fast if you're not living at home.) I know that U Toronto med costs $10K/year today.

The problem is that advances in technology don't make labour-intensive jobs like medicine, teaching, daycare, music, or the law much more efficient. Doctors are more productive today than in 1960, but their increases in productivity haven't kept pace, and never could have, with the increases in efficiency in manufacturing, construction, and resource extraction. Therefore, the time costs of labour-intensive but necessary jobs are very high in comparison to the price of manufactured goods.

For instance, I bill $100/hr as a freelance musician; as I'm still in school, I have no tax liability, and I can earn enough in a couple of gigs to buy a complex manufactured good, such as computer or an air-conditioner or something. On the other hand, I have to work ca. 6.5 hours a week at that kind of fee just to keep my tuition current, and when you add rent (which keeps pace with wages,) food, utilities, and gas, I'm not exactly getting rich.

Anyway, we're getting wildly off-topic. Radiologists' time is extremely expensive because only about 0.01% of the population graduates from medical school each year (source, an article on medical recruitment publishes on a Gov't of Canada website,) and out of those, obviously only a small fraction specialize in radiology. If you assume a working life of 40 years for a radiologist, and that 1/10 of graduating doctors specialize in radiology (which is probably an order of magnitude too high,) then 0.04% is the replacement-rate-adjusted proportion of radiologists to general population. Of these, assume that 1/2 are in the business of reading MRI charts, and you get 0.02% of the general population able to read an MRI.

Setting aside the matter of recouping the capital cost of the MRI machine itself, it's clear that such a specialized, difficult skill would be extremely expensive, much as it would be expensive to buy artisanal handmade furniture instead of Ikea chairs, or free-range chickens instead of factory-farmed broilers.

But, like I said, the quality of life over here is much better for all (social issues aside).

As it happens, I live on the south shore of Lake Ontario, and I have mixed feelings. I agree that a basic level of universal coverage would improve the situation in the USA. On the other hand, I obtained treatment here that I could never get in Canada and am back to being a productive citizen instead of a drain on society. I can't condone that 40 million Americans are totally uninsured, or that insurance rates in the USA are so horribly high for families; on the other hand, I can't condemn the Americans because they did more for me personally than my own country did.
--
Skarphedinn was carrying the axe with which he had killed Thrainn Sigfusson and which he called 'Battle Troll.'
Njal's Saga, ca 1280 AD
[ Parent ]

They have exactly these problems (2.00 / 4) (#41)
by antipasto on Thu May 13, 2004 at 02:59:34 PM EST

Health care is free to all......... so long as you don't need a specialist... Then you have to wait! Those that had sense moved to the US to get $$$$$$ instead of the Can. gov wage.

[ Parent ]
In Soviet UKia (2.50 / 4) (#32)
by Bjorniac on Wed May 12, 2004 at 10:41:50 PM EST

healthcare system pays for YOU. Perhaps a move to a country with a national health service might be a good idea. OK, it's never going to be fantastic, but it is free (well, paid for by taxation of other people...).
Freedom for RMG! Join the Jihad...
Reenactment of our advice (2.86 / 51) (#33)
by K5 ASCII reenactment players on Thu May 13, 2004 at 10:05:05 AM EST

oil    ________                       __/
wells / DRAGONS\                     / _  COMMIE
  \ _-----------_                   / / \ VIKINGS
   /A|  SOVIET    \                /_/ _/.........
   |A|CANUCKISTAN  \           _    __/
    \|     A       /           \|   |
      \.../|\.....|    Merlin->|x\  \  COMMIES_
       |   |      \            /_/  |    _   / \
       |  LAND OF  |               /    / \  \  \
        \THE FREE _/              |    /   | \   |
        |        |                \___/    /_/  /........
         \...... \                _______      /
          |TACO/\_|              /       \____/     OIL!
          \BELL/                |             :   
       ____\ |_______           | ATHLETES    :
      /POOL CLEANERS \           \            :


that's really cool yo (nt) (1.20 / 5) (#51)
by circletimessquare on Thu May 13, 2004 at 08:18:55 PM EST



The tigers of wrath are wiser than the horses of instruction.

[ Parent ]
My hernia. (none / 0) (#76)
by alby on Fri May 14, 2004 at 11:33:18 AM EST

So what if it took me nine months to get my hernia removed? It never cost me a penny. (1600 if I went private, I checked.)

[ Parent ]
damn (none / 1) (#104)
by emmons on Sun May 16, 2004 at 04:50:03 AM EST

£1600? That's cheap! Sure you're not missing a 0?

Oh, I know why. In the US, that much would just be enough to cover the share of the anesthesiologist's pay for his time that would go to pay for medical liability insurance.

---
In the beginning the universe was created. This has made a lot of people angry and been widely regarded as a bad move.
-Douglas Adams

[ Parent ]

Only in America (n/t) (2.14 / 7) (#46)
by I Hate Yanks on Thu May 13, 2004 at 06:06:54 PM EST


Reasons to hate Americans (No. 812): Circletimessquare lives there.

It's not what insurance does (2.71 / 7) (#47)
by Blarney on Thu May 13, 2004 at 06:43:39 PM EST

Health insurance is only partially insurance. The major part of their business is not assuming the risk of large medical bills for people - what traditional insurance does - but rather involves using bargaining power to obtain a reasonable price for medical services in a price-discriminatory market. While an insurance company could, in theory, simply cover medical expenses the way that a fire insurance company covers homes, it would not be competitive because doctors generally charge individuals an order of magnitude more for medical services than they charge to bargaining organizations such as HMO's or PPO's.

It is a necessity for the modern health insurance company to be able to prevent people from getting health care - it is the only way that they can gain the bargaining power to obtain large discounts on otherwise extortionate medical bills.

"Health insurance" is really a collective bargaining plan in practice, and is not insurance at all. My theories are spelled out in more detail in my old K5 article here.

Spot on (none / 1) (#72)
by Atomic Eco on Fri May 14, 2004 at 09:36:03 AM EST

And this is the reason why you should always go through your insurance company for your treatment. They abhor people who try to get money back from them after purchasing the treatment on their own, since they will not have had the opportunity to use their bargaining power.

Insurance companies don't want to pay, and definitely not the rates that private persons can get.

Finland.. where polar bears roam the streets.
[ Parent ]

someone wiser than me said it better: (2.00 / 6) (#52)
by circletimessquare on Thu May 13, 2004 at 08:34:03 PM EST

"canada is a good place to have cancer, the us is a better place to have a heart attack"

proof:

http://www.globeandmail.com/servlet/ArticleNews/TPStory/LAC/20040505/HHEALTH05/T PHealth/

the problem with socialized medicine is that it isn't good for sudden emergencies which require heroic expense and effort, simply because that's so expensive

the problem with the us model is simple: if you're poor, well then fuck off and die

but no matter what system you live under, you will have a problem with healthcare and always, no matter what, you will be unhappy with it

why?

you will never be happy with health care, in any country, under any system, period, because WE ALL DIE

the technology for healthcare is always improving, such as with miracle drugs, but it takes billions to make miracle drugs (and i'm not talking about the fecking annoying, stupid advertising folks)

someone, SOMEONE has to pay for that

i'm not excusing the us system, i'm not excusing socialized medicine, and i agree that the vast majority of health conditions are treatable and manageable and there is no excuse why it should be otherwise

i'm simply saying: there will always be someone, somewhere, who with $500,000 more, can live 5 more days

if you triage the gradual decay of human health out, especially with increasingly aging populations int he developed world, what you get is a moving target that only grows into exceptionally huge amounts of money

no one likes to talk about the fact that it costs money, but it does, and someone has to pay for it

given enough money, we could all live to our maximum, but none of us have enough money put all together to do so

so we will always be unhappy with healthcare, simply because it lies at the intersection of mortality and money

we like to think of human life as sacred, and thinking of it in terms of dollar bills is revolting to us

but that, unfortunately, is the way it is

we all die, and hating healthcar eis just a way for us to hate our own mortality, and think we can put blame for it into some nameless, faceless, uncaring bureaucracy

that nameless, faceless, uncaring bureaucracy is in many ways just an agent of death itself, managing it the best it can (ideally, i know the situation can be improved in real life, i'm talking in generalities here) with the money it has

The tigers of wrath are wiser than the horses of instruction.

Good post, except for one thing... (2.33 / 6) (#56)
by Shajenko on Thu May 13, 2004 at 10:02:02 PM EST

...in the US, we pay more to the health care system and get less out of it than, for instance, the UK. A number of reasons are attributed to this, such as refusing care to people until they are in critical condition, when treating them earlier would have both cost less and given them a better quality of life.

So yes, you can't pay infinite money into the system to keep people alive forever. But we'd like to get our money's worth, at least.

[ Parent ]
The real problem with socialized medicine (2.75 / 4) (#73)
by JohnnyCannuk on Fri May 14, 2004 at 10:32:57 AM EST

is that there isn't enough of it. We have (had) a great system up here that worked great even for emergencies. But then a slash and burn Conservative government at the Federal level came to power and cut the funding, trying to discredit the system so that their friends in the Insurance industry could get a peice of the pie. Then we got a right of centre Liberal party in power and they continued the trend. Then a few provinces, namely Ontario and Alberta, got far right, darn near reactionary governments that slashed it even further. This caused long waits for MRI and ER visits. Then these guys say "Look socialized medical care doesn't work, we need to fix it by privatizing it". Well no shit it doesn't work - they broke it. And it will be them and their cronies that make money off of any privatized healthcare system. The old "self-fufilling prophesy".

Our Canadian system worked fine, was very efficient and gave good service until the mid-80's when the conservatives attacked it. Socialized medicine works fine when supported by the government(s) that are supposed to supoport it. But like anything, if it is sabbotoged and undermined by those who are supposed to support it, why it just might not work as well as expected.

I tell ya, even under attack, my Dad did just fine when he had a heart attack here. At least we didn't go broke paying for it. And my payroll taxes to support the system are nowhere near what my sister and her family pay for their coverage ($300 to $500 USD per month for a family of 4 in Arkansas). And both she and her husband are nurses. You'd think in a privatized healthcare system, they would at least get an employee discount.

Government run health care can keep cost sane because they have to deliver service (which is why our system up here, depsite the billions gutted from it still works pretty well) and companies want cost to rise because that's how they make their money (which is why my sister and her husband pay more per month for their health coverage alone than I do for ALL my taxes and insurance combined).


We have just religion enough to make us hate, but not enough to make us love one another - Jonathan Swift
[ Parent ]

Its how you die really (none / 2) (#83)
by GenerationY on Fri May 14, 2004 at 06:23:20 PM EST

Will Self (unblinking journalist and novelist, both literally and figuratively) was talking about this on the tv tonight. He was of the opinion that 90% of expenditure on health care is consumed in the final 6 weeks. Basically, what you want is drugs. Heavy, heavy drugs. So when we elect governments on their health policy, really we elect them on their death policy. Seemed an interesting idea really and not so divergent from what you were saying.

To digress a bit, I pay a bloody fortune for 'socialised' health care. Its not like any of us think its "free". Its brought firmly home to me every damn month that "someone" (ie. me) is paying for it. We talk about it all the time. That said, what you might like to consider is what we pay for private health care.  Relatively, its very, very cheap (this is partially because British courts do not go in for punitive damages; you may be found criminally liable, you may pay compensation, but you won't be hit for 20 million to teach you to be a good person in future).

So really, if you are poor socialised medicine is good. And if you are sufficiently rich, its a pretty good deal as well (tax+cheap private=US expensive private). Just the middle class that get squeezed sadly. I recently considered taking private care to hurry up something I was waiting for on the NHS. Right there in the doctor's office, he started to cut his prices until I'd say yes. He knew I could just wait instead. Bizarre how 'socialism' caused such classic competitive pricing.

[ Parent ]

Healthy market at work (none / 3) (#91)
by pyro9 on Sat May 15, 2004 at 12:13:27 PM EST

What you saw was a healthy market at work.

The fatal flaw of capitalist theory is that it assumes that the buyer has the option to decline if prices are too high. That works great for movies and such, but fails miserably for employment and health care (in the absense of adequate social programs).

In your case, the market worked much better since you truly had the option to simply decline his services if the price wasn't right.


The future isn't what it used to be
[ Parent ]
Unfortunately (none / 0) (#103)
by emmons on Sun May 16, 2004 at 04:40:30 AM EST

It doesn't work so well if you have a heart attack.

---
In the beginning the universe was created. This has made a lot of people angry and been widely regarded as a bad move.
-Douglas Adams

[ Parent ]
Well all I can say is (none / 0) (#116)
by GenerationY on Mon May 17, 2004 at 12:24:39 AM EST

that I have no complaints about how my dad was treated on the NHS when he had his heart attack. They did the job and did it well (for which I will always be grateful). My experiences of casualty ("ER" presumably) have been like many people's; long waits. But my limited experience of the NHS's performance in very actute situations is that they provide an exemplary service and I don't see how it could be improved either.

[ Parent ]
Pharmaceuticals (none / 2) (#99)
by iwnbap on Sun May 16, 2004 at 01:38:01 AM EST


the technology for healthcare is always improving, such as with miracle drugs, but it takes billions to make miracle drugs (and i'm not talking about the fecking annoying, stupid advertising folks)

someone, SOMEONE has to pay for that

Indeed thay do, but there is a way to ameliorate this; socialize the the purchasing of medications. In Australia, all medication is government subsidized by the Pharmaceutical Benefits Scheme.  All common medications are available to patients at a (subsidised) flat rate, approximately $30 for a course (any course) of medication.  Medications prescribed through hospitals are effecively free.

Purchasing is done by a combination of tender processes and direct negotiation with suppliers - and surprisingly perhaps the bureaucrats are effective at negotiating good prices. Mass market advertising is forbidden. Any drug not on the PBS can be bought by consumers (with prescription) at market price. All in all the system works very well, with a total cost of about 5 billion, which works out to about $250 per person per year.

So perhaps the answer is a bit of socialism?

[ Parent ]

Sure (none / 1) (#102)
by emmons on Sun May 16, 2004 at 04:36:57 AM EST

If you never want a new drug to be developed again, ever. For every country that negotiates lower than market rates for drugs, the market rate goes up that much. The money has to come from somewhere.

People wonder why drungs cost so much in the US... it's because the US is becoming the only place that drug companies can recover research and development costs. The same goes with medical equipment.

---
In the beginning the universe was created. This has made a lot of people angry and been widely regarded as a bad move.
-Douglas Adams

[ Parent ]

Perhaps instead (none / 2) (#106)
by iwnbap on Sun May 16, 2004 at 11:17:19 AM EST

If you never want a drug to receive mass-market advertising, ever.  I'm sure a huge amont of the saving is the heavy restictions on advertising, which are costs not passed on to consumers.  The pharmas are still selling their drugs in Australia, drugs are available roughly contemporaneously with the US, no-one's forcing them to sell, so presumably they're still making a profit and recouping their development costs.  And there's a healthy level of local R&D going on as well.

[ Parent ]
Market prices still stand for PBS. (none / 1) (#127)
by D Jade on Mon May 17, 2004 at 08:30:43 PM EST

For every country that negotiates lower than market rates for drugs, the market rate goes up that much. The money has to come from somewhere.

We don't negotiate lower than market rates for drugs mate. The PBS is a government subsidy.

The drugs still sell at the "Market Price" so the drug companies still make their all-important profits. At the same time, the consumer can actually afford the treatment they require because every taxpayer bares the cost of medication.

Also for people on low incomes, they are further subsidised by use of their healthcare cards. So they only pay around $5 for their meds.

Maybe you don't agree with the idea because it appears to be a socialist scheme. But it increases productivity because the poor spend less time being sick and more time making me money.

It's also good for drug companies because (proportianately) we buy more drugs.

Personally, I'd rather enjoy the quality of life we have in this country by sharing the cost of our sick than live in a society of inequity such as the US.



You're a shitty troll, so stop pretending you have more of a life than a cool dude -- HollyHopDrive
[ Parent ]
awesome (none / 0) (#129)
by emmons on Tue May 18, 2004 at 12:34:53 AM EST

If that's the case, then that's great. The previous post had said they negotiated them lower (as do Canada and most European countries), which hurts the US since we end up paying the difference- that type of thing obviously gets me going.

If your system works well, I'm not opposed to it at all. I'm just opposed to most of the subsidized health care systems proposed in this country because I have yet to see one that I think will work, be at least somewhat efficient and not bankrupt the country. If the politicians here figure out something sensible that doesn't
kill medical research, I'll be all for it.

---
In the beginning the universe was created. This has made a lot of people angry and been widely regarded as a bad move.
-Douglas Adams

[ Parent ]

It is pretty sweet (none / 0) (#138)
by D Jade on Tue May 18, 2004 at 09:55:20 PM EST

There are some drugs where lowered prices have been negotiated. But usually, these drugs are things which will be widely used like vaccinations.

The only problem now is that our (Not-So) Liberal government is trying to scrap the PBS along with our current Higher Education Contribution Scheme (HECS) which is our most successful socialist program.

What annoys me most about this discussion is that USians seem to prefer lower taxes as opposed to an equal and fair system. Yet at the same time, believe themselves to be patriotic. I mean, I don't really understand the country's ideology. But to me it would seem more patriotic to contribute to the overall well-being of your country via taxes (or some other means) than to pledge allegiance to a flag...

But like I said, I don't understand the USian mind...



You're a shitty troll, so stop pretending you have more of a life than a cool dude -- HollyHopDrive
[ Parent ]
cold war mentality, etc. (none / 1) (#141)
by emmons on Wed May 19, 2004 at 02:38:07 AM EST

We're complicated, but I'll take a shot. I'm going to write all of this in broad generalities because nobody is the same, but this is how it averages out.

A lot of the flag-waving is left over from the cold war mentality that communism (and hence socialism) == unAmerican and evil, though the roots of some of that go back much farther.

Though the following has changed/lessened somewhat since the start of the modern liberal movement in the 60s, they still hold true in large part:

We generally don't trust the government to spend money efficiently. Hell, we tend to not trust government much at all- a legacy of the revolutionary war, really. So, we usually value freedom from government control above most else, even when it could be argued as irrational to do so (eg gun laws). We also hold the ideal that anyone who works hard enough has the opportunity to make a decent living and therefore does not need government assistance for healthcare, etc.. To many it is an attack on that ideal or even an insult to categorize individuals as poor and in need of assistance (even if that status isn't likely to change). The belief is that anyone can do well if they want to. It's the land of opportunity, after all.

A lot of Americans don't like the idea of social welfare programs on principle, even if we recognize the benefits. Social welfare programs are sometimes considered unAmerican because American is defined as success through personal initiative and responsibilty. Welfare is neither.

Our private sector is obviously very good at being efficient, in large part due to the agility that comes with a lack of regulation or other government involvement. We like it that way. A lot of people equate taxes to dreaded government involvement and control in the economy or personal life- things we usually distrust and regard as an attack on freedom. We like to let the market works its magic as much on its own as possible.

High taxes, regardless of necessity or merit, are opposed by many on principle.

Overall, our system works wonderfully at producing neato technology and driving productivity. So, a lot of people oppose change not only on principle, but also out of fear of breaking what we know to work well.

All of those things combined make us pretty well oppsed to any major changes in the status quo, regardless of how well they might be said to work.

Sometimes, however, we're in a good mood and think that paying higher taxes to pay for <whatever> wouldn't be so bad, but then we can't get over our mistrust of government to handle it well. Occasionally we think that we can trust the government to do something fairly well, but we're not in the mood to raise taxes- especially since we don't think that the government is doing well with some of its other stuff. So in order to pay for our new fangled thing we demand that the government make itself more efficient by cutting that other stuff. Very, very rarely are we both in a good enough mood to raise taxes and have enough trust in the government that it can do something well. Usually that's about the time a recession or scandal of some sort rolls around.

---
In the beginning the universe was created. This has made a lot of people angry and been widely regarded as a bad move.
-Douglas Adams

[ Parent ]

Tell your friend. (none / 2) (#57)
by SIGNOR SPAGHETTI on Thu May 13, 2004 at 10:35:00 PM EST

To move to Iraq.

--
Stop dreaming and finish your spaghetti.

Oh bother. (none / 1) (#58)
by SIGNOR SPAGHETTI on Thu May 13, 2004 at 10:50:01 PM EST

WASHINGTON -- Fresh from a two-day weekend visit to Iraq, the Bush administration's top health-care official defended the $950 million that will be spent to help Iraq establish universal health care.

Congressional Democrats have criticized the administration for helping Iraq to establish universal health care without doing the same for U.S. citizens.

Health and Human Services Secretary Tommy Thompson said yesterday there are major differences between the two countries that defy simple comparisons.

"Even if you don't have health insurance," said Thompson, who toured medical facilities in the Iraqi cities of Baghdad and Tikrit on Saturday and Sunday, "you are still taken care of in America. That certainly could be defined as universal coverage. Every American's health care is far superior to what the health care is in Iraq."

Sen. Edward Kennedy of Massachusetts, ranking Democrat on the Senate Health, Education, Labor and Pensions Committee, responded yesterday, saying the U.S. system doesn't sufficiently meet the needs of 44 million uninsured Americans.


--
Stop dreaming and finish your spaghetti.
[ Parent ]

GWBush said that too (none / 1) (#59)
by Blarney on Fri May 14, 2004 at 12:10:05 AM EST

I can't remember exactly when or where, but he did state that we do, in fact, have universal medical coverage in America. All sick people need to do, in his view, is go around begging until they get treated.

Of course, they'll end up owing a lifetimes income or more, but that's reasonable. As a medieval poet wrote once, "Why should a villein be allowed to eat beef?"

[ Parent ]

Tell her where to go! (none / 3) (#60)
by mcgrew on Fri May 14, 2004 at 12:43:55 AM EST

Anywhere but the US. We have the 5th best health care in the world, and we pay more for it than anyone. Every other non-third world country has universal health care.

Your friend is lucky - lack of insurance killed my best friend ten years ago. Our way of paying for medical care is just God damned evil.

"The entire neocon movement is dedicated to revoking mcgrew's posting priviliges. This is why we went to war with Iraq." -LilDebbie

Keep in mind (1.60 / 5) (#101)
by emmons on Sun May 16, 2004 at 04:23:17 AM EST

We're the only ones in the world that pay for medical research.

---
In the beginning the universe was created. This has made a lot of people angry and been widely regarded as a bad move.
-Douglas Adams

[ Parent ]
did you write that withut smirking? (none / 0) (#124)
by DominantParadigm on Mon May 17, 2004 at 08:07:18 PM EST

ehn tea

Caller:So you're advocating bombing innocent children? Howard Stern:Yes, of course!


[ Parent ]
That's the point: (none / 0) (#142)
by bob6 on Wed May 19, 2004 at 05:23:28 AM EST

Why do you pay for medical research and then have to pay again in order to use it?

BTW, no, you aren't.

Cheers.
[ Parent ]
um... (none / 0) (#150)
by Run4YourLives on Wed May 19, 2004 at 12:38:39 PM EST

care to prove that?

It's slightly Japanese, but without all of that fanatical devotion to the workplace. - CheeseburgerBrown
[ Parent ]
The original poster was exaggerating (none / 0) (#167)
by grouse on Sun May 23, 2004 at 08:38:42 PM EST

although this OECD report shows that the 2000 U.S. health R&D was 76 percent of the OECD total (calculated from the annexes). The U.S. also contributed a portion of its GDP more than twice the nearest competitor (the UK).

You sad bastard!

"Grouse please don't take this the wrong way... To be quite frank, you are throwing my inner Chi out of its harmonious balance with nature." -- Tex Bigballs
[ Parent ]

No, not really (none / 0) (#155)
by gethane on Thu May 20, 2004 at 08:18:00 AM EST

http://www.pbs.org/wgbh/pages/frontline/shows/other/interviews/angell.html

Well, its certainly not true in the case of the pharmaceutical companies anyway.

[ Parent ]

-1, not exactly earth shattering. (2.00 / 7) (#63)
by HardwareLust on Fri May 14, 2004 at 01:37:07 AM EST

You're probably the last person on earth that's figured out that the dollar wins out over everything in the U.S..

America is a truly fucked-up place to be sick if you are not rich.  Pretty soon, it's just going to be a fucked-up place to be, period.

I'm so tired of having this discussion, I'm not even going to bother anymore, so it's -1 from me.  



If you disagree, POST, don't moderate!

personally... (1.00 / 11) (#68)
by dimaq on Fri May 14, 2004 at 07:56:50 AM EST

I think anyone who willingly joins any army or fails to put up a fight against draft deserves the most pathetic remainder of their life imaginable anyway.

other than that, perhaps the subject in question should live in another country.

and oh yeah, anyone slaving for a large company is rather stupid too.

big and heartless (2.25 / 4) (#70)
by karb on Fri May 14, 2004 at 09:16:23 AM EST

I don't know about the rest of you, but my big and heartless HMO is actually a non-profit.

No doubt you've heard many stories about how my HMO, unburdened by responsibility to shareholders, outshines all others in commitment to patients.

Or not.

It's unfortunate when the money isn't really available to help someone with a crippling (and expensive to treat) illness. Unfortunately, the 'free' money has to come from somewhere, and in any healthcare system (even a single-payer) it likely comes at the expense of someone else's healthcare.

Now, that's my opinion on the insurance company. There's no excuse for the VA debacle. They need to be cleaned out if they're incompetent. And the VA doesn't seem to get enough funding, despite the fact that it's hard to think of any non-politician group that wouldn't favor increased funding. That should be fixed.

This is kind of a non-sequitor, but I always marvel that our healthcare is prohibitively expensive despite many of our doctors hailing from overseas. We technically have a glut. But even _with_ my insurance I still pay $20 for a six minute doctor's visit that was perhaps planned a few weeks in advance.
--
Who is the geek who would risk his neck for his brother geek?

Big, Heartless, and for-profit (3.00 / 5) (#74)
by dmarcov on Fri May 14, 2004 at 10:37:00 AM EST

What is interesting, and the part they gloss over, is that it is only the hospitals that are not-for-profit. The doctors (and the clinics they work in) actually are a seperate organization called "The Permanente Medical Group". They are for-profit, and contract with the not-for-profit hospitals to provide services.

The Permenente group is generally rather profitable, and since it is (as I recall) owned by the doctors, they (the doctors) tend to do pretty well by taking in the money from members (patients), and then paying for hospital services for a lower cost (than an HMO/PPO/Insurance company that has to pay "retail" for hospital services) to the non-profit hospital company.

It's a rather clever set up, I think.

[ Parent ]

Why didn't you mention the condition? (1.50 / 6) (#71)
by duffbeer703 on Fri May 14, 2004 at 09:19:09 AM EST

<blockquote>In January 1996 I left for bootcamp in Paris Island South Carolina. I had 13 weeks of basic training, and I loved every bit of it. To this day I still think it was a HUGE turning point in my life, where I found something i loved and wanted to be part of for life. Fast forwarding to the year 2004. I have been fighting Chronic Daily migraines, endometriosis and depression for about 6 years.</blockquote>

Your friend as a variety of conditions that often pop up when people are depressed or going through extreme stress -- medicine doesn't have any magic bullets to psychosomatic conditions.

I don't intend to be harsh, but I would be willling to bet that the attention your friend received from the Mayo doctors has more to do with her improvement than any surgery. The disjointed & rambling nature of her writing attests to that.

You should recommend that she seek out therapy and drugs for her depression... you'll probally be amazed by the improvements in her other conditions.

Why? (none / 1) (#80)
by GenerationY on Fri May 14, 2004 at 02:49:48 PM EST

I'm guessing because he didn't fancy having random people attempting unqualified diagnoses of his friend. Do you know what endometriosis is? I think you are missing the point somewhat.

[ Parent ]
Wow dude, you're psychic (2.50 / 4) (#84)
by Blarney on Fri May 14, 2004 at 07:13:36 PM EST

It seems strange for you to be recommending a medical plan for this person, as whether or not you are an actual medical doctor, osteopath, chiropracter, nurse, pharmacist, or other qualified authority there still exists the rather important difficulty that you have never seen this woman in your life, let alone examined her with the attention to detail that is part of competant medicine.

Obviously you must have psychic powers that enable you to decide what medical care is best for this woman - powers which trump such outdated Enlightenment dogmas of experimental observation and scientific treatment that persistently drag down our efforts to craft a better America.

You're not alone in having these powers - most health insurers and drug enforcement agents have them as well. They also, like you, know what treatment is best for someone that they've never seen.

[ Parent ]

endometriosis is not pscyhosomatic (none / 0) (#132)
by vmarks on Tue May 18, 2004 at 11:49:20 AM EST

Endometriosis is not psychosomatic, and is not connected to depression.

Migraines may or may not be connected to stress and depression, but endometriosis is unrelated, and the only treatment for it is surgery. I say treatment and not cure because the condition will come back over time after surgery.

Your suggestion that therapy for depression will improve endometriosis is akin to suggesting that a friendly chat will cause cancerous tumors to remove themselves. It is ludicrous.


[ Parent ]

Yes (none / 3) (#94)
by Big Sexxy Joe on Sat May 15, 2004 at 06:42:18 PM EST

The US has a philosophical commitment to laizee-faire capitalism.  Our principles are so strong that we are willing to have poor healthcare and a poor education system, neither of which will ever become adequate.

Interestingly enough, the US is also the nation that spends the most on healthcare.  Such is our strong commitment to our ideals.

I'm like Jesus, only better.
Democracy Now! - your daily, uncensored, corporate-free grassroots news hour

Lost adequacy (none / 0) (#140)
by Brandybuck on Wed May 19, 2004 at 12:29:11 AM EST

Our principles are so strong that we are willing to have poor healthcare and a poor education system, neither of which will ever become adequate.

While that may be true, don't blame laisse faire capitalism, free market, free enterprise, or any other demonized synonym. That's because the US used to have much higher literacy and cheaper healthcare.

Literacy among US citizens used to be 95%. It's plummeted drastically in the last sixty years. You also used to be able to afford healthcare out of your own pocket, at least if you were somewhere above the destitute line. Now days even the wealthy can't afford pay-as-you-go healthcare, and must resort to insurance.

Ever read Little House on the Prairie, or watched the television show? Maybe it portrays a dimly recalled childhood that wasn't so idyllic as it seemed. Maybe it only portrays a particularly select slice of Americana. But that schoolhouse wasn't a government school. And none of the farmers had health insurance. Of course it wasn't a perfect world, but when a tiny town of farmers had an affordable private school and personal physical, maybe we're not so high and mighty in our present century as we think we are.

It seems to me that in our effort to provide good education and healthcare to the poor, we've only managed to drag down the middle class. For the amount of money we're throwing at public education, we can more than afford an elite private school education for every child in America.

[ Parent ]

Different times... (none / 0) (#162)
by Rich0 on Sat May 22, 2004 at 03:44:13 PM EST

However, back then the only thing your doctor bill paid for was one doctor's time.  Maybe a little bit for his education and the tools he could fit in his bag.  Healthcare took place in your home, and you got a friend/relative to change your soiled sheets.  

Now when we're talking about healthcare these days we're talking about huge expenses.  Usually a team of doctors and nurses, a room in a hospital, laundry service for that room, food, etc.  Next factor in equipment - all kinds of fancy computerized equipment.  You have to pay the software developer who wrote the firmware for your heart monitor, and the tester who tested the living daylights out of it, and the box-checker who made sure all the paperwork met FDA guidelines.  Next factor in the drugs - those drugs cost a FORTUNE to develop - somebody has to pay for that.

On the other hand, these days unless you have a serious case of cancer or heart disease you're probably expected to leave the hospital alive.  Back in the day, you could die from gangrene if you stepped on a dirty nail.

And education consisted of reading, writing, and what would today be considered elementary school math.  Maybe a little algebra.  Oh, and history.  One teacher for everything.

You can't really make a direct comparison - unless you want the level of education we had back then, and the same life expectancy.

No question - things need to improve - but it isn't just as simple as a return to "old times..."

[ Parent ]

RRR (none / 0) (#163)
by Brandybuck on Sun May 23, 2004 at 12:45:20 AM EST

And education consisted of reading, writing, and what would today be considered elementary school math.  Maybe a little algebra.  Oh, and history.  One teacher for everything.

Of course it was so much easier in the past. There was less history to teach. Give me a break!

We CAN make a direct comparison, because reading has not changed. Writing has not changed. And elementary school math has not changed.

[ Parent ]

No one's reading this anymore (none / 0) (#171)
by BlackStripe on Sun May 30, 2004 at 01:20:02 AM EST

But I was catching up on old stories and saw your misplaced stat. According to the CIA, for what that's worth, US literacy is 97%. If it plummeted in the last 60 years (I couldn't find a chart over time) it seems to have gone right back up. I'm not a rah-rah American at all, but wanted to correct the numbers.

1
Isaac

Literacy:

definition: age 15 and over can read and write
female: 97% (1979 est.)
total population: 97%
male: 97%



[ Parent ]
Is VA neccessarily responsible? (none / 1) (#96)
by Bossk on Sat May 15, 2004 at 07:33:39 PM EST

Regarding ...

How is it that a pretty well-funded system like the VA can fail so miserably at one of its primary responsibilities (care of veterans who suffer service-related disabilities)?

And, in her description she states ...

I am service connected which means that the Veterans Administration has determined that my problems occured and were diagnosed in the military.

I'm not familiar with US military insurance laws, but would/should the VA be responsible for a illness that occurs while serving that has no causal link to service? I would imagine they offer lifetime medical insurance for being a veteran, so I'm assuming they do but it is insufficient.

It also sounds like you are implying that she also has corporate medical insurance. I wasn't aware you could possess two med insurances? It would seem like a justifiable illness to cover.

VA != insurance (none / 1) (#100)
by Quixotic Raindrop on Sun May 16, 2004 at 02:47:16 AM EST

The Veteran's Administration is not insurance; Congress has funded the VA and in particular its hospital system specifically for the care of veterans who suffer disabilities during, or caused by, their service in the United States Uniformed Services (IIRC), which includes the Army, Navy (and Marine Corps), Air Force, Coast Guard, and Public Health Services (USPHS). The VA is required by law to treat veterans of these services in a particular order, and top on the list is veterans who are 50% or more disabled due to a service-connected disability (see the section on Priority Groups, approx. two "page down" depending on your screen resolution).

The medical insurance she has is through her work. I suppose that, in theory, you could probably have as many health insurances as you could afford premiums for; I am not aware that it is illegal or contractually forbidden from being done. Cost is probably the prohibiting factor for carrying multiple health insurances for most people, as it would be for her.

[ Parent ]
Multiple policies (none / 3) (#109)
by dougmc on Sun May 16, 2004 at 03:27:23 PM EST

I suppose that, in theory, you could probably have as many health insurances as you could afford premiums for
I suppose that you're right. However, in practice I don't think it's such a good idea. If you ever do have a claim, especially a large claim, the various insurance companies will fight over who should be paying the claim, and during this period, nobody will be paying the claim, even though it's obviouly something that should be paid.

I've seen it happen with auto insurance (my mother's car was hit while being towed, and the three insurance companies involved (tow truck, my mother's and the person who hit it) quibbled about it for months) and have no reason to believe that health insurance would be any different.

[ Parent ]

My solution: Threaten to sue (none / 2) (#123)
by flimflam on Mon May 17, 2004 at 06:12:22 PM EST

My insurance provider (Aetna/US Healthcare at the time) refused to pay for my daughter's birth for the longest time. I had checked before hand that they would cover it (it was a home birth with a midwife) and they assured me that it would be no problem. About a year later I found out from the midwife that she was still trying to collect and could I call them. I spent the next year talking to various people who continued to claim that yes it should be covered, there must be some mistake, perhaps this was improperly claimed by the midwife etc. etc. etc. Finally I did what I should have done a long time ago and told them that this would be the last time I called and they would soon hear from my attorney. 3 days later (on my daughter's 2nd birthday, no less) a $6,000 check showed up in the [midwife's] mail. Coincidence?

You decide.


-- I am always optimistic, but frankly there is no hope. --Hosni Mubarek
At least in america we don't have strikes (none / 1) (#134)
by ProfessorBooty on Tue May 18, 2004 at 04:46:09 PM EST

http://story.news.yahoo.com/news?tmpl=story&cid=1845&ncid=737&e=1&am p;u=/cpress/20040430/ca_pr_on_na/b_c__health_strike

9 weeks a year vacation max? 36.5 hour work weeks?

Guess thats what happens when you get government and unions involved.

lol.... (none / 1) (#149)
by Run4YourLives on Wed May 19, 2004 at 12:37:22 PM EST

only in America is a 36.5 hour work week considered a small amount.

It's slightly Japanese, but without all of that fanatical devotion to the workplace. - CheeseburgerBrown
[ Parent ]
debt (none / 0) (#156)
by ProfessorBooty on Thu May 20, 2004 at 04:43:49 PM EST

how else do you expect americans to pay off their consumer debt?

how else do you expect us to support our social systems (which some european countries are having problems with).

[ Parent ]

Who is the customer? (3.00 / 4) (#139)
by Brandybuck on Tue May 18, 2004 at 10:13:49 PM EST

You've undoubtedly heard the saying "follow the money". It's a good rule of thumb to use for determining an organization's motivation. But I want to go one step further, and make it personal. "Follow the customer!"

How does this relate the medical insurance? Easy, you are not healthcare's customer. You are not the hospital's customer. You are not the physician's or nurse's customer. In most cases, you aren't even the insurance company's customer!

I had surgery last year. Sitting in the HMO hospital bed with nothing to do but watch Oprah and listen to the IV drip, I got to thinking. I wasn't a customer of any part of the system, even though ultimately I was paying for it all! The nurses treated me rudely, the hospital fed me inedible food, and the administrators made me fill out forms and sign agreements whilst I was doped up on morphine. The physician, for the ten minutes I say him during the week, was at least friendly. But that's part of physician training (Bedside Manner 101). No one gets treated this way in a hotel (or at least in a hotel with a future), but it's routine in hospitals. Unfortuantely, I wasn't the customer, I was merely the product...

I wasn't the customer of the HMO, my employer was. If your employer provides any sort of health insurance or benefit, you are NOT the customer, your employer is. They'll bend over backwards to please your employer, but they could care less about you.

This is where the US health industry made a wrong turn. It's why it's so expensive. It's not the lack of tax funded health care, or the high cost of medical technology, or worker's comp fraud, or anything like that. It all stems from a grand disconnect. The person paying for health care is a different person from the customer.

The insurance companies don't care how expensive health care is, because ultimately they're not the ones paying for it. They are unable to shop around. How do you know if Dr. Bob is cheaper or more expensive than Dr. Fred? You don't! And even if the ability exists to shop around insurance companies, odds are that it is your employer doing it, and not you. They have a completely different persective on the matter than you.

Dumping the whole thing onto the government's lap isn't going to solve the cost issue, only who pays for it. The only way to solve it is to get back to a user-pay system. If healthcare for the poor is a concern, provide tax funded healthcare vouchers. But get the customer back into the equation!

Does medical insurance have to be heartless? | 171 comments (157 topical, 14 editorial, 4 hidden)
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