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May 31, 2009 at 7:48 pm #668309
JoBParticipantcatlbob…
i looked at going back on medicare since they raise my part B rates by 10% every year i don’t carry it… and i figured i would need a HMO supplement and then a full coverage supplement after that.
when we crunched the numbers it wasn’t feasible… although the 2 grand plus out of pocket we are facing this year on medical alone because i need to be reassessed.. too many nasty health conditions are masked by my symptoms… might make me change my mind.
TheHouse…
let’s see.. you would rather insurance payed for a series of operations and/or opiate medications that will disable anyone who works with their hands or drives for a living than massage therapy that returns someone to work.
yeah…. again.. not so cost effective for either the American taxpayer or insurance consumers.
May 31, 2009 at 7:58 pm #668310
JanSParticipantI’m going out on a limb here…but it’s just as relevant as the OJ, health club membership thing. I will venture that THe House still thinks we call ourselves “masseuse” and “masseur”and that we’re still called a “massage parlor”…just sayin’ – lol…
May 31, 2009 at 8:26 pm #668311
c@lbobMemberJoB
I think that, if the “pool” included 300 million citizens, your situation would be better under a single payer system.
May 31, 2009 at 9:01 pm #668312
JoBParticipantcatlbob..
i am all for a single payer system… the only option not currently on the table.
i think everyone would be better off with 300 million citizens in the pool and no exclusions for prior conditions.
i think preventative health care would become a priority.. as would streamlining and pooling of medical assets…
i think i would get an exercise stress test on an old fashioned treadmill with my doctor beside me wielding a stethoscope.. because there would be no incentive to make me use more sophisticated equipment unless something was discovered during the stress test that required more testing.
i think i would get a breath test from the hand held apparatus that the asthma clinic uses instead of sitting in an expensive booth being monitored by an expensive technician for the same reason.
And i think i would still need supplemental insurance for the things that my single payer system decided not to cover because they are not yet “proven” treatments or because they are not considered cost effective.
I pay an additional $300 a year for meds because i can’t tolerate the binders used in most generics… and under the current medicare drug system that would have increased to nearly a thousand.
I think there is still room for supplemental insurance in a single payer system… and for some of us it would definately be cost effective.
What my insurance company pays towards my medications now wouldn’t cover the cost of one emergency room visit..
May 31, 2009 at 9:58 pm #668313
c@lbobMemberThings don’t get put on the table by acquiescing to them being left off of it. If you want anchovies on that pizza, you gotta insist.
I all for people paying for supplemental insurance, or with cash, for that matter. Just don’t let it be de rigeur.
May 31, 2009 at 10:15 pm #668314
JoBParticipantcatlbob…
i would have made an invitation to the table for single payer insurance a condition of my support for an Obama predidency.
It’s too bad Move-on was so busy listening to the Hillary haters and jumping on a what they thought was a bandwagon that they didn’t ask for anything…
the single payer voice is the only voice that was not present during negotiations.. and as a result we are getting health care reform lite… little reform but better rhetoric.
asking would have been very good advice….
do you think move-on learned anything? If they did, it is probably too late for nearly another decade…
meanwhile… we get to listen to TheHouse :(
June 1, 2009 at 1:51 am #668315
Lucile 2MemberOf course I’m lucky!!!
JanS; I have no idea who should run it. I don’t trust the government and I don’t think business is doing such a good job either. I really don’t have any answers, because there is no middle ground. I supposed some may argue we have a middle ground right now, some people are “covered” (I say that lightly) by the government with Medicaid and some are covered privately. It is kind of a hodge podge at the moment, isn’t it.
Again, I don’t have the answers, I am weary of letting government run it, however, due to their poor track record (IMO) handling taxpayer dollars and the Social Security program.
June 1, 2009 at 1:56 am #668316
Lucile 2MemberIs there something wrong with domestic partnership, JoB? I think there is a bigger problem with my cousin and her boyfriend working the system, pretending not to live together and get Medicaid for their babies. Maybe we should crack down on the offenders (I realize they aren’t all offenders, I grew up at the poverty line, I get it), and see how much we can save to start with. I hope they decide to do that with the WA system before they do anything else!
June 1, 2009 at 3:36 am #668317
JanSParticipantquestion, Lucile…do they get Medicaid for themselves? If they are pretending to not live together, what other address does one use?
It’s sad that they feel they have to work the system like that…sometimes people get desperate when it comes to their kids. I’m not making an excuse for them…just wonder about their circumstances that make them do what they do.
I think it’s commendable that domestic partners are now considered to be added to insurance. Maybe I should find me one of those ;-)
June 1, 2009 at 4:37 am #668318
Lucile 2MemberMy domestic partner is pretty rad, what can I say? :)
I am not sure what address her boyfriend uses, to be honest, but I think it is his moms. She wanted kids really bad, so she purposely had two (very planned). I am not sure she gets Medicaid for herself, but since she is 25, I am pretty sure she is off of her mom’s, and her mother is also her employer, for a small business (5 people). I think she may be on Medicaid, but cannot confirm, and frankly not sure if I want to know. She has never heard the word “no”, maybe that has something to do with it. She grew up a millionaire child, and her dad was busted for tax evasion, so the money is gone. Isn’t that kind of ironic? It’s such a weird situation!
June 1, 2009 at 5:31 am #668319
HMC RichParticipantThe House has made his points. There is validity in what he says. Many others have very valid points. (I feel like frakkin’ McCain – I think I will be sick … fortunately I have an HMO).
The problem concerning the future is one that JoB stated. Single payer system is not on the table. The new (gag) administration and bureaucrats are already putting aside money (which they don’t have enough for everyone) for essentially government sponsored healthcare. They are helping to fund SCHIP on the back of smokers. Doesn’t government give us clarity?
Now, I think a connected database concerning health is a good idea but because the government will eventually be in charge, I suspect it will not operate as expected (like usual). Maybe I will be wrong. Not likely.
It is up to us to change it somehow.
Are there any other medical or insurance professionals on this blog who would like to chime in?
June 1, 2009 at 5:42 am #668320
charlabobParticipantI’m not a medical or insurance professional but I play one on television. Seriously, I have three physicians (two specialists and one GP) and all three support the single-payer plan. I did not select them for that reason–I selected them for their reputation as tops in their field.
I was an insurance professional (supervisor of claims) when I was 20 (just out of college.) I was promoted because, as an individual contributor, I was really good at coming up with reasons to deny claims. I was 20 and I didn’t know any better and it was absolutely ridiculous that I should even be allowed to evaluate claims, never mind deny them. Now, at the age of <um, more than 20> I know better.
June 1, 2009 at 6:05 am #668321
JoBParticipantcharlabob…
another thing we have in common.. our stint at medical insurance claims:)
but i was fired for approving too many :( maybe my advanced age at the time had something to do with that.. i was 25:)
Lucile2..
i have nothing against domestic partnerships… nor do i have anything against being married and getting access to health insurance that way… I think any of us lucky enough to have good insurance no matter how we got it are lucky indeed.
HMCRich..
i wouldn’t be so quick to condemn this administration for it’s attempts to solve the health care problem while the pharmacy companies have taxpayers by the throat for the medicare pharmacy option. There is plenty of blame to go around:(
****
i don’t know how to fix this system… though i think single payer makes more sense than anything else…
i do know that saying nothing is wrong with it is not the answer…
and that our current solution is far too expensive for us all.
And.. i think it is mean to make fun of or write people off because they can’t get or can’t afford medical insurance.
Hard times and hard choices don’t disappear just because you aren’t the one having to make them right now.
June 4, 2009 at 9:37 pm #668322
alki_2008ParticipantSure, it may cost more to treat emergency conditions than if those folks had preventative care before they got sick enough to become “emergencies’…but then there’s the “you can lead a horse to water, but you can’t make him drink” argument. There are plenty of people in our current system that already have access to preventative care and don’t use it, so there are no guarantees that providing preventative care to everyone through some “healthcare for all” system will reduce the number of people that show up as “emergencies”. Some people don’t want to go to doctors, whether it’s affordable or not. “Access” doesn’t equal “Use”.
And then there’s the issue of unhealthy behavior. I fully believe that those that take care of their health by not smoking, not drinking excessively, exercising, eating proper foods, etc should NOT pay as much for health insurance as those that live an unhealthy lifestyle.
Medicare is something where everyone that works pays the same percentage, irrespective of the “healthy-ness” of their lifestyle…but I’m fine with that, since it would be almost impossible for the “system” to adjust people’s Medicare deductions based on lifestyle. I look at Medicare deductions like this: much of what it covers is geriatric issues, so everyone’s at the same ‘risk’, and those that led unhealthy lifestyles will either die before reaching the age where Medicare kicks in or else won’t live that long and so won’t use a huge ton of Medicare resources.
Is it really better to advocate for a system that’s flawed just because it’s different from what we have now, rather than trying to get a system that’s actually “better” onto the table?
FYI – I’m not going to go into details, but I personally HAVE been denied the ‘regular-rate’ insurance and had the major-state-sponsored catastrophic-only insurance as my only option before (not in WA). Yes, it was expensive…but I paid it and didn’t pay for a lot of other things that would’ve been nice to have (ie, cable tv, eating out, espressos, etc). Later, in WA and with the same history, I was not denied coverage by any of the insurance companies I applied to. I pay for private insurance, even though I could get employer-subsidized health insurance that would cost me less…but I want more choice in what insurance plan I have, so I get what I pay for. I still pay more in premiums than I use in treatment or doctor visits.
June 5, 2009 at 3:39 am #668323
KevinParticipantI would highly suggest the following as “required viewing” regardless of your thoughts on this issue.
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“Sick Around the World”
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http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
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“Sicko” with Michael Moore
available for rent on NetFlix
http://www.netflix.com/Movie/Sicko/70068652
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June 5, 2009 at 3:42 am #668324
JoBParticipantfor a diabetic.. insulin is preventative care…
June 5, 2009 at 4:10 am #668325
KevinParticipantThat is putting it mildly JoB! Several years ago when we had so-so insurance, my wife was paying $700 per month for insulin. Currently with good insurance, she has a $25 co-pay.
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In contrast to that, we have a diabetic cat and his insulin runs around $25 per month paying full price, as he does not have health insurance.
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There can’t be that big a difference between people insulin and cat insulin :)
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June 5, 2009 at 8:28 am #668326
alki_2008ParticipantKevin, is there a difference in the amount of insulin used? Cats are pretty small compared to people, so just wondering if your cat goes through a bottle of insulin as fast as your wife? This is not a snarky question, just genuinely asking.
JoB, is insulin really considered “preventative”? Sure, it prevents someone from going into diabetic shock – but it doesn’t prevent someone from being diabetic. Personally, I would consider insulin a ‘treatment’ for diabetes. To me, “preventative care” entails things like nutrition counseling for people that are “pre-diabetic” – but still, some illnesses can’t really be prevented as easily as other illnesses (ie, type I vs type II diabetes)…so access to preventative care doesn’t change much for those folks.
June 5, 2009 at 3:26 pm #668327
JoBParticipantAlki_2008…
i too consider insulin a treatment… as are many other drugs used to manage chronic illness.
However, when it comes to the medical care available to those without insurance… a diabetic has to crash and come into the hospital through the emergency room.. where the docs generally give them free samples…
if they have a home.. an address.. they may get hooked up with one of the indigent programs that pharmaceutical companies provide… if the admitting doc is willing to fudge paperwork for them… i think the caveat is that you have to be under a doctor’s care…
otherwise… they use the samples till they crash and end up back in the emergency room.
Unfortunately we are footing the bill for treating chronic illness in the most expensive way possible because the hospitals pass the cost on to consumers and the insurance industry… and they pass the cost on to us.
Some states have programs that step in if patients qualify… but not all. Our state just cut that program to the bone.
There are documented cases of patients dieing from manageable illnesses like lupus and cancer because although hospitals were required to give expensive heroic care to save their lives in crisis… there was no program they qualified for to receive medication in a timely manner.
I wish these were isolated instances.. but i am in touch with many in the chronic illness community who have lost jobs and therefore insurance due to illness… and i have lost friends to conditions that could have been managed had they had access to the kind of care i get… the kind of care they had until they ran out of money.
oh.. pet meds… same meds.. generally cheaper for pets… one of our dogs and i were on the same anti-inflammatory for a while. Hers was more than half the retail cost of mine. same pills…
June 5, 2009 at 3:34 pm #668328
CMParticipantThat’s because dogs can’t sue.
Limited tort is required before this issue can be resolved.
June 5, 2009 at 3:54 pm #668329
JoBParticipantCM..
do you think so?
i think it is because medication for humans is bound to the FDA review process and part of what the drug companies get in return is “return of costs for research and trials.. much of which is already govt funded… by being granted patents on the med.
they pass those costs on to American consumers.. while selling the same drug manufactured in the same plants to other countries for substantially less and to the veterinarian industry for less than that.
You are right that dogs can’t sue.. but their owners can.. and the those who take the drug and live in other countries can.
good gig for them… but we pay for it..
and don’t even get the kind of protection we are supposed to get from the FDA process since the drug companies are monitoring themselves in drug trials.
limited tort would increase drug company profits.. but there is no guarantee it would lower drug costs…
the only thing that lowers drug costs is when the patent wears off and the drug is available for generic. Even then, most companies repackage the drug with a different delivery system (caps vs geltabs) or bind it with an agent to increase effectiveness (for pain drugs that’s tylenol) and regain their patent.. without the expensive trials since the ingredients have already passed FDA approval.
like i said.. nice gig.
June 5, 2009 at 5:44 pm #668330
c@lbobMemberJune 5, 2009 at 5:50 pm #668331
c@lbobMemberJune 5, 2009
Dear Senator Murray,
In your remarks at the Healthcare for All rally on June 2, you said you would take back a strong message to congress that health care shouldn’t be a privilege for the few but a right for everyone. You also said the numbers at the rally sent the needed message to congress.
I’m glad you came, but fearful that the “message” you and your congressional colleagues are prone to perceive will seat the biggest problem in health care at the head of the table.
That problem is the insurance industry.
I will judge it a failure if the “solution” does not provide, at a minimum, a competitive public plan. I don’t want the law to provide a handicap to health insurers like the recent Washington state bill did. If private industry is as efficient and capable as the conventional wisdom says it is, it should be able to compete with an efficient and capable public plan.
That’s as good a chance as the health insurers should get. My preference is to cut them out of baseline health care entirely, with a universal single payer plan.
Sincerely,
Robert Shields
June 5, 2009 at 5:53 pm #668332
alki_2008ParticipantVeterinary drugs (except for a few exceptions) are basically off-label use…meaning that the medications are being used for purposes that they haven’t been tested/approved for. Obviously, that doesn’t mean it doesn’t work but it does protect the drug companies, since veterinary patients are using the drugs off-label.
In order for drugs to be specific to veterinary patients, then the drug companies would have to run through all the same trials for the exact same drug to have that drug approved for animals. They can’t just say that “xyz is FDA-approved for humans” so let’s start at stage 4 and get xyz FDA-approved for dogs, and then again for cats, and then again for horses. They have to start ALL OVER, at state 1 trials. The costs are just not feasible, unless pet owners want to spend 10x as much for their pets’ medications.
JoB – I was just trying to clarify what you meant by “preventative care”. Availability/access to “preventative care” vs “treatment” would make a big difference in the costs/effectiveness of health care reform policies.
And I’d hope that anyone taking insulin IS under a doctor’s care. The dosage a person requires can change over time, so regular evaluation is essential to ensure someone’s not under- or over-dosing.
June 5, 2009 at 6:07 pm #668333
c@lbobMemberJoB
Max Baucus met with Bernie Sanders and major single payer advocates this week, and Max now says that it was wrong of him to exclude Single Payer advocates from the debate.
He deflected the single payer issue to the President, and Obama said that the bill should include a public plan.
http://online.wsj.com/article/BT-CO-20090604-716947.html
So, that’s where that is what is being considered now.
A public plan is probably the best that single payer fans can aspire to this year. But, if it isn’t made still born by handicapping it for the benefit of insurance companies, I think it can have as good a outcome for citizens as single payer, it just expands the timeline.
So, as I said to Senator Murray, implement a public plan that has the same 2% overhead that Medicare has. Then let’s see if private industry chooses to compete.
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