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California Universal Health Care Bill Passes

California 2006 Health Care Financial Ruin Democrats

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#21 Godeskian

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Posted 06 September 2006 - 02:38 PM

View PostRhea, on Sep 6 2006, 07:02 PM, said:

The difference, which Delvo apparently doesn't get,  is that at least with something like the NHS *everybody* would be covered, which would mean the elderly and poor would suffer less. There are millions upon millions of people in this country with NO health coverage at all. That's what universal health care would change.

Unfortunately while everyone is 'covered' it's in many cases nothing more than a nice platitude. Someone I know has been waiting over five years, half a decade, for a simple piece of surgery that really doesn't qualify as elective, because she has NHS cover rather than private.

It makes virtually no difference if she has NHS or no cover.

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#22 Kimmer

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Posted 06 September 2006 - 02:55 PM

View PostNonny, on Sep 5 2006, 05:19 PM, said:

Nonny, thanks for the link and the info.

I usually read the SactoBee online, but I can't get it load for me cuz I forgot my password and don't have the email acct it's with. :-/

#23 Ilphi

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Posted 07 September 2006 - 06:52 AM

The efficiency of the NHS is just wierdly random.

Every single time I've been treated there - for a broken ankle from Judo, broken kneecap from playing Manhunt, cut arm from playing Polo, aside from a few hours too many waiting in the emergency room, I've been given outstanding care and attention and fully healed all for free. My visits to my GP are likewise free, and until last year I didn't even pay for prescription drugs.

Yet too there are simply terrible stories floating around about the waits and such forth.

I do have to admit that my dental care though is private, simply because its hard to find a NHS dentist nearby.
Yea, ere my hot youth pass, I speak to my people and say:
Ye shall be foolish as I; ye shall scatter, not save;
Ye shall venture your all, lest ye lose what is more than all;
Ye shall call for a miracle, taking Christ at His word.
And for this I will answer, O people, answer here and hereafter,
The Fool - Padraic Pearse

#24 Palisades

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Posted 07 September 2006 - 07:51 AM

View PostIlphi, on Sep 7 2006, 05:52 AM, said:

The efficiency of the NHS is just wierdly random.

Every single time I've been treated there - for a broken ankle from Judo, broken kneecap from playing Manhunt, cut arm from playing Polo, aside from a few hours too many waiting in the emergency room, I've been given outstanding care and attention and fully healed all for free. My visits to my GP are likewise free,
One thing that might explain it is that you're talking about emergency treatment and seeing your GP. Godeskian and Talkie Toaster were talking about non-emergency procedures requiring a specialist.


Rhea said:

The difference, which Delvo apparently doesn't get, is that at least with something like the NHS *everybody* would be covered, which would mean the elderly and poor would suffer less.
In the U.S. the elderly and poor are covered by Medicare and Medicaid respectively.
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"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

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#25 Godeskian

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Posted 07 September 2006 - 07:59 AM

View PostSolar Wind, on Sep 7 2006, 01:51 PM, said:

One thing that might explain it is that you're talking about emergency treatment and seeing your GP. Godeskian and Talkie Toaster were talking about non-emergency procedures requiring a specialist.

That may well be the differentiating factor. I've never had a problem with the emergency treatments I've had to have, either in the UK, Holland or for that matter the US. When I got an ear infection while on vacation in Florida, the folks at Mt. Sinai were incredibly helpfull and professional.

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In the U.S. the elderly and poor are covered by Medicare and Medicaid respectively.

I still think that private health insurance is possibly the most important thing anyone can do if they can afford it. Right infront of private dental care.

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#26 Ilphi

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Posted 07 September 2006 - 08:31 AM

View PostSolar Wind, on Sep 7 2006, 01:51 PM, said:

View PostIlphi, on Sep 7 2006, 05:52 AM, said:

The efficiency of the NHS is just wierdly random.

Every single time I've been treated there - for a broken ankle from Judo, broken kneecap from playing Manhunt, cut arm from playing Polo, aside from a few hours too many waiting in the emergency room, I've been given outstanding care and attention and fully healed all for free. My visits to my GP are likewise free,
One thing that might explain it is that you're talking about emergency treatment and seeing your GP. Godeskian and Talkie Toaster were talking about non-emergency procedures requiring a specialist.

Ah, you could be onto something. How does the insurance-etc system work in the US when it comes to emergency care? I understand there are state-to-state differences, but broadly...
Yea, ere my hot youth pass, I speak to my people and say:
Ye shall be foolish as I; ye shall scatter, not save;
Ye shall venture your all, lest ye lose what is more than all;
Ye shall call for a miracle, taking Christ at His word.
And for this I will answer, O people, answer here and hereafter,
The Fool - Padraic Pearse

#27 Palisades

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Posted 07 September 2006 - 09:02 AM

^ What sort of information are you looking for?

Edited by Solar Wind, 07 September 2006 - 09:03 AM.

"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

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#28 Ilphi

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Posted 07 September 2006 - 09:11 AM

Well, if say I (as a hypothetical American citizen, not talking as a British citizen visiting) say break my leg climbing, cut open my arm, that sort of thing, and get taken into hospital, obviously I'm treated, how does the bill work? Does the US State provide emergency health care for free, if you have any kind of insurance through your company or something presumebly even the cheapest package includes emergency health, does that pay?
Yea, ere my hot youth pass, I speak to my people and say:
Ye shall be foolish as I; ye shall scatter, not save;
Ye shall venture your all, lest ye lose what is more than all;
Ye shall call for a miracle, taking Christ at His word.
And for this I will answer, O people, answer here and hereafter,
The Fool - Padraic Pearse

#29 Palisades

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Posted 07 September 2006 - 10:01 AM

View PostIlphi, on Sep 7 2006, 08:11 AM, said:

Well, if say I (as a hypothetical American citizen, not talking as a British citizen visiting) say break my leg climbing, cut open my arm, that sort of thing, and get taken into hospital, obviously I'm treated, how does the bill work? Does the US State provide emergency health care for free, if you have any kind of insurance through your company or something presumebly even the cheapest package includes emergency health, does that pay?
The U.S. government does not run the hospitals or doctors' offices. Health care in the U.S. is provided entirely by private practitioners -- with the exception of military hospitals and military health care practitioners and their counterparts for Veterans.

If an American citizen with private health insurance broke his leg and went to a (non-military) hospital, the portion of the bill covered by the private health insurance would be sent to the insurance company and the remainder would be sent to the patient's mailing address. Even the cheapest health insurance package would cover mending a broken bone once the deductible is met. My health insurance pays for 90% of the costs for emergency medical care once the $250 calendar-year deductible is met. (In the off chance I went to a hospital that did not have a preferred-provider agreement with my health insurance company, the insurance company would only pay 75% of the costs after the $250 deductible is met.) [Edit: My portion of the cost for covered medical expenses is limited to $6000 in a year after which my insurance company would pay 100% of additional covered expenses for that year.]

Each paycheck my portion of the health insurance premium is deducted from my gross pay. My portion works out to about $30/week, and my employer pays the rest of my health insurance premium. Paying the premium purchases coverage by the health insurance. I pay the premium regardless of whether I ever go to see a doctor, dentist, or other health care professional.

People who are self-employed or work for a company that doesn't provide health insurance benefits can opt to purchase health insurance on their own. Some opt for catastrophic or high-deductible health insurance. Another option is Health Savings Accounts. HSAs aren't health insurance per say; rather, they're a way to save money for medical care without it being taxed.

Medicare works similarly to my private health insurance although the red tape involved is causing some providers not to accept it. Medicare is run by the federal government and paid for via a payroll tax, a rapidly diminishing trust fund, and government accounting witchcraft. A person has to be 65 or older to qualify for health insurance through Medicare.

I haven't a clue how Medicaid works, but if you want to try to sort through it, you can Google it. I think Medicaid is run and funded by the individual states.

Federal law requires hospitals to provide emergency medical care to people who are uninsured, even if they can't afford to pay the bill. Someone who is uninsured but can pay the bill would just pay the bill when it's sent to him. If the person can't pay the bill, depending on the situation, the hospital or government might absorb the cost for the emergency medical care if the person can demonstrate extreme financial hardship. Otherwise, the person would have to negotiate a payment schedule with the hospital, or the hospital might eventually turn the bill over to a collection agency.

Edited by Solar Wind, 07 September 2006 - 04:53 PM.

"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

FKA:
TWP / An Affirming Flame / Solar Wind / Palisade

#30 Cardie

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Posted 07 September 2006 - 10:32 AM

The people in most desperate straits under the US system are people just above the Medicaid cut-off poverty line, who work--sometimes several jobs--but don't qualify for benefits at any of them.  Many employers of hourly employees won't given them enough hours to become full-time and qualify for benefits, because health insurance is so expensive for them to fund, especially small businesses.  One of our problems with getting people off welfare ("the dole") was that if they got jobs that put them over the maximum allowable Medicaid wage, they wouldn't be covered at all.

I think you could go single-payer in the US, for catastrophic, emergency, and basic healthcare, save on admin. costs due to simplification and consolidation, fund it with fees assessed to businesses on a per employee basis--which would still end up less than what the employers dole out now for private health insurance.  The unemployed and retirees over 65 would continue to be covered as they are now.  People who can afford supplementary private insurance could purchase it, as in the UK.

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#31 Rhea

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Posted 07 September 2006 - 10:35 AM

^Or, if you're lucky, like me, your employer pays 100% of the cost of your insurance - and with the exception of a small co-pay for doctor visits and prescriptions, I pay nothing.

However, I have an HMO, which can be a real pain in the butt. There are local administrative organizations (called IPA's) which act as a buffer between patients and doctors/specialists/therapists and this type of health insurance company, and they can sometimes be the source of the problems themselves!!

For instance, I had back surgery for the second time in two years this summer and when it came time to start physical therapy, it turned out the IPA (the local administrative organization) had decided to go into the physical therapy business themselves (any lawyer can immediately spot the conflict when an organization that gives out contracts to physical therapists suddenly deciding to offer themselves as the only  physical therapy game in town).

They hurt me pretty badly - it's a mill where, if you've had lumbar surgery, no matter your age or condition or what KIND of lumbar surgery, you follow a 4-week PT regimen and you're out.  :eek:  They damaged me badly enough that I ended up flat on my back for two weeks with a muscle spasm in my back, and now the surgeon and I are doing the paperwork to bypass them.

Another way for a person to qualify for Medicare is if they are permanently disabled (omitted from Solar Wind's excellent post above).

The federal law that requires hospitals to provide emergency care to everyone can work against them. We have a huge immigrant population in my state, both legal and illegal, and because the immigrants have been using hospital emergency rooms not as emergency rooms but as health clinics and never paying, a number of hospitals in my state have actually had to close!!!!

Obviously, universal health care would solve some of the more serious problems, like the hospital closures mentioned above.

And I live in California, where this bill passed.

Edited by Rhea, 07 September 2006 - 10:39 AM.

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#32 Palisades

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Posted 07 September 2006 - 10:47 AM

View PostCardie, on Sep 7 2006, 09:32 AM, said:

I think you could go single-payer in the US, for catastrophic, emergency, and basic healthcare, save on admin. costs due to simplification and consolidation, fund it with fees assessed to businesses on a per employee basis--which would still end up less than what the employers dole out now for private health insurance.  The unemployed and retirees over 65 would continue to be covered as they are now.  People who can afford supplementary private insurance could purchase it, as in the UK.

If the government paid for 100% of health care in the U.S., more people would seek health care. Consequently, we would need even more doctors and health care professionals, and as it is, we have a declining ratio of medical students to population. To attract the necessary number of doctors and health care professionals, their salaries would have to increase. The alternative is a huge increase in wait times.

Edited by Solar Wind, 07 September 2006 - 12:00 PM.

"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

FKA:
TWP / An Affirming Flame / Solar Wind / Palisade

#33 Shalamar

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Posted 07 September 2006 - 11:29 AM

I live in Texas. I have what is called county health care HCHD- as the job I had was not providing me benefits - someone enrolled in HCHD pays a sliding scale based on their income - I also had it two years ago when I had cancer surgery. I had some income so I payed a modest amount at that time.

I have been out of a job since the first of the year when I went into the hospital for two weeks with pneumonia. Had multiple CAT scans, Two MRI's, and Three EUS's ( all major testing/ diagnostic proceedures ) With no job I paid nothing. Since then I have fallen, resulting in compression fractures of my lower spine ( more MRIs ), been diagonosed with DVTs (Ultrasound and more CAT scanns) and been hospitalized for a week in May.  and just last week admitted again for another week when I had internal bleeding ( at least it wasn't the heart attack they thought it was )

For all of this including the twice that I ended up in the hospital by going througth the emergency room I have not paid a penny.

My medications are $5 to fill and refiLl, including a three week stint  on Lovramax - an injectable medication that if prescribed without me being HCHD would be $599 per one weeks worth of medication - ( and that $599 is checking at the biggest pharmacy discounter in the city )

My twice a week clinic appointments cost me nothing as well.

However there is a down side of this- you don't pay in money, you pay in time.

The time I went to the ER with pneumonia, they took me into the treatment area immediately- my vitals were rocky - and they began treatment right away but it was over fifteen hours before they found a bed for me.

I was lucky last week I had to be in the treatment area only ten hours.

When I went in for the compression fractures ( Feb 2nd ), I sat in the waiting room from nine in the moring till after midnight before even being taken into the treatment area - and when I finally saw a doctor he saw me for all of maybe ten minutes and determined that I'd "just injured my back muscles" - it was the middle of March before they made the proper diagnosis and got me on pain medication.

It is the weekly clinics where you pay the worst- my doctor may spend twenty minutes with me but I have in general waited 3 hours to see him, and to get my appointment for next week and any perscriptions filled, I wll wait an average of two more hours. One visit takes up half a day. And thats for what I call the "fast" clinic.

A first appointment with a your assigned main physician may take four to six months to set up. I haven't been able to get into the eye clinic even with a referal becasue they are booked up past the six month limit.

To do a non ER walk -in each general medicine clinic is limited it to the first 10 walk ins. The time I had to do a walk in at my local clinic I got there at 5 am to wait in line for a 7 am door opening - I made it as #9 of the first ten.  The doctor saw me at 1 pm ish and getting my meds took me until ten minutes before they closed at 7 pm

The lines are long, the health care staff small and over worked- but going at it valiantly- they have all been professional, kind, friendly and thoughtful.

So we pay in time.

However I'd give anything to have my private health insurance back.

Edited by Shalamar, 07 September 2006 - 11:33 AM.

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#34 Nonny

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Posted 07 September 2006 - 01:45 PM

View PostSolar Wind, on Sep 7 2006, 05:51 AM, said:

In the U.S. the elderly and poor are covered by Medicare and Medicaid respectively.
Well, that certainly depends on what you mean by "covered."  

View PostSolar Wind, on Sep 7 2006, 08:01 AM, said:

I haven't a clue how Medicaid works, but if you want to try to sort through it, you can Google it. I think Medicaid is run and funded by the individual states.
If you're very, very lucky, you'll never have to know.  

I wasn't lucky enough.  Until the BVA rescued me with 100% p&t service-connection for my main disability, I had nothing but Medicaid (MediCal in California) and, trust me, it was hell, and not just dealing with the overworked, underpaid, overwhelmed, untrusting, mean as snakes social workers.  Most doctors and dentists, no matter how big their social consciousness, eventually bail from the program because they're getting hounded by the state too.  And watching patients suffer when they can help them with procedures the state won't allow grinds them down.  But there are also sadists among them who get a kick out of mistreating patients.  They get away with it because patient credibility is mighty low when you're poor, elderly, disabled or otherwise marginalized.  

Unlike most of my friends from the bad old days, I now have the best of care, but only because the VA granted me priority one status.   Whenever I do encounter someone bad in the VAMC, whether health care or support, I report it, all the way up to my congresswoman if necessary, and get that person off my health care team, but it doesn't happen so much anymore, and I'm happy with everyone else.  

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#35 Rhys

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Posted 07 September 2006 - 06:30 PM

I live in the province of Ontario, in Canada, where we have a tax-funded health care system (governed at the provincial level, not the federal level).  I also worked for several years for a company that does hospital computer systems, and have several family members in health care professions.  The Ontario system has its flaws, but I do prefer it to a completely private system, even though I'm generally pretty conservative, fiscally-speaking.

Hospitals in Ontario are still run as businesses - they're not technically owned by the government, but they are heavily government-funded, so there is a lot of government control.  e.g. The government can effectively force hospitals to merge their administrations, or close a hospital.

The Ontario health insurance (OHIP) does not cover all medical care.  It doesn't cover elective surgery, prescriptions, dental care, optometrists/eye glasses (used to cover check-ups, but not any more), and there are some other exclusions.  Private health insurance is available to cover most of these things.  Most companies offer this insurance to their employees.

The major benefit of this system are that no one has to worry that they're going to lose their house from a sudden, unexpected illness or injury.  I consider that a major plus.

There are several negatives, though - we do pay for it in taxes.  There are often long wait lists for surgeries, or lineups in emergency rooms, or bed shortages in hospitals.  Sometimes it's tough to compete for the health care professionals, against private hospitals that have more freedom in the wages they can offer.  A lot of people don't appreciate the cost of health care, and go to the emergency room for just anything.

There's a lot of talk, on and off, about allowing more private health care in the province (without getting rid of the public system) - mostly as an answer to the long waiting lists.  There's a lot of resistance to that, but I think there are benefits, as long as we can avoid a situation where all the good doctors go to the private system, leaving "left-overs" for the public system.

There are a few things I think would improve the system:
(1) When someone gets health care, give them the bill, even if they don't pay it.  Let them realize how much it costs, so they (maybe) think twice about coming in for a stubbed toe.

(2) Open up the private system, but require all health care professionals to spend a certain percentage of their time in the public system.  Let them take patients for cash half the time, but OHIP-funded ones the other half, so we can attract good doctors, but not prevent people from having access to them.

All said, though, I'd keep the current system rather than go fully private.

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#36 Themis

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Posted 07 September 2006 - 09:58 PM

I have employer-provided health care.  Our deductible was just raised to $1000.  Actually, I had met both my deductible and my out-of-pocket maximum earlier this year, but they redid the contract as of July 1 so now there's another $500 added to both.  What's more I loath my job and desperately want to quit, but I'm just over four years short of Medicare.  I think my job is the cause of the major depressive episode I've been going through for a few months, to the point where my internist wants me to see a shrink to work out my meds, but my she told me "You can't quit your job - you're uninsurable."  Even though my job is the main problem.

Isn't America wonderful??!!

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#37 Rhea

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Posted 07 September 2006 - 10:49 PM

View PostThemis, on Sep 7 2006, 07:58 PM, said:

I have employer-provided health care.  Our deductible was just raised to $1000.  Actually, I had met both my deductible and my out-of-pocket maximum earlier this year, but they redid the contract as of July 1 so now there's another $500 added to both.  What's more I loath my job and desperately want to quit, but I'm just over four years short of Medicare.  I think my job is the cause of the major depressive episode I've been going through for a few months, to the point where my internist wants me to see a shrink to work out my meds, but my she told me "You can't quit your job - you're uninsurable."  Even though my job is the main problem.

Isn't America wonderful??!!

Themis

{{{{{{{{{{Themis}}}}}}}}}}} I've done a lot of jobs in my life I wasn't any too fond of. I know how stressful it is.

I had a choice of either HealthNet HMO or HealthNET PPO at work. I took the HMO, which has its down side, but I would have had to cough up a minimum of $2500 this year with the back surgery, which I didn't have to because I took the HMO. I just watch the bills go by. $160,000 just for the hospital costs, not counting any of the doctors' bills! :eek:  :eek2: Even though I don't have to pay anything, just watching numbers that big roll by makes me faint.  :o

My feeling is that if you had a system that gave everyone in the country the same coverage you might have to buck the system sometimes to get something you need, but at least people wouldn't be dying because they can't afford a doctor.

Edited by Rhea, 07 September 2006 - 10:52 PM.

The future is better than the past. Despite the crepehangers, romanticists, and anti-intellectuals, the world steadily grows better because the human mind, applying itself to environment, makes it better. With hands...with tools...with horse sense and science and engineering.
- Robert A. Heinlein

When I don’t understand, I have an unbearable itch to know why. - RAH


Everything is theoretically impossible, until it is done. One could write a history of science in reverse by assembling the solemn pronouncements of highest authority about what could not be done and could never happen.  - RAH

#38 Themis

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Posted 09 September 2006 - 06:05 PM

View PostRhea, on Sep 8 2006, 03:49 AM, said:

My feeling is that if you had a system that gave everyone in the country the same coverage you might have to buck the system sometimes to get something you need, but at least people wouldn't be dying because they can't afford a doctor.

Or they'd be able to go to a doctor before they needed the ER or before it became critical or even terminal.

Under any of the national health care systems, it seems that people with money can always find their way around the system, but the system is there for those without money.  The National Health in the UK took pretty good care of a friend's daughter who had Lupus.  She died last year, but it would probably have been a lot sooner without the NHS.

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#39 Lin731

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Posted 10 September 2006 - 12:39 PM

I have a friend still working where I used to work, the place that led to back surgery (and I think she's working on her own "zipper neck" as I type this). It's too physically demanding but she can't quit. Why? Because she has pre-existing medical conditions. If she changed jobs, she'd most likely be denied coverage by a new employer.

I recently started a new job (decided one scar on my neck was enough) so I quit and found another job. At the old job, I had supplimental health policies through AFLAC. Paid into them for 4 years and never drew a dime from them. I tried to get shortterm disability coverage from them at my new job, they declined because of my neck surgery. Apparently they only want to take your money and decline coverage if they think they might actually have to pay you something. Aint America grand? The problem with this mishmash private healthcare system is we're drowning in paperwork and a ton of pencil pushers to fill it all out. In some states you have as many as a 1000 different providers with their own forms, coding, coverages and policies. It's nuts. We, at the very least need standardised forms for ALL providers.
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#40 Spectacles

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Posted 10 September 2006 - 02:18 PM

I thought of this thread when I read this in today's paper:

http://www.post-gaze...3/719928-37.stm


Evidently, the new trend is for Americans to travel to other countries to have some medical procedures done because the cost of travel and medical care is less than what they'd have to pay out of pocket--even with insurance--to have the procedure done here.  :blink:

Edited by Spectacles, 10 September 2006 - 02:19 PM.

"Facts are stupid things." -Ronald Reagan at the 1988 Republican National Convention, attempting to quote John Adams, who said, "Facts are stubborn things"

"Although health care enrollment is actually going pretty well at this point, thousands and maybe millions of Americans have failed to sign up for coverage because they believe the false horror stories they keep hearing." -- Paul Krugman



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