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July 1, 2009 at 6:39 pm #668359
HMC RichParticipantWill the Patricians who are going to try and pass this government option be willing to give up their insurance and join the government option?
It seems to me that the members of the House and Senate ought to have the same healthcare as the rest of the citizens they are supposed to be representing.
Jamminj, I don’t know. If they are undercut by the government maybe they feel they won’t make enough profit. Employers just might dump insurance for their employees since the government would pick them up, which may in turn drop the number of policies being paid into each month. I don’t know. Somebody tell me too.
July 1, 2009 at 6:46 pm #668360
JanSParticipantOh, if we were only so lucky to have the insurance that the Congress has. I think that at some point they need to be like the rest of us regarding that. Theirs is a job just like any other job, right? So, give them options once a year, have their employer pay part, have them pay the rest…but then, that’s never gonna happen, is it?
July 1, 2009 at 6:51 pm #668361
JoBParticipantHMCRiich…
in a perfect world, the public option would be the one members of the house and senate are now enjoying.
of course, we don’t give that to the old folks.. but…
even making a program like medicare available at a reasonable cost would be a big step…
and yes.. if i qualified i would drop my insurance to join.
“If they are undercut by the government maybe they feel they won’t make enough profit.”
Are you aware that those who have to seek insurance outside their employers are paying a much higher premium whether they have pre-existing conditions or not… and for much less insurance coverage?
Are you aware that those with pre-existing conditions often can’t get medical insurance at all.. at any price?
Are you aware that your insurance can be cancelled retroactively if the insurance company suspects your condition could have been pre-existing.. even if you have never received a diagnosis or medical treatment for that condition?
Are you aware that small businesses pay a much higher premium for each employee than larger businesses.. regardless of pre-existing health conditions of their employees?
“Employers just might dump insurance for their employees since the government would pick them up, which may in turn drop the number of policies being paid into each month.”
Not likely.
Are you aware that businesses above a certain size are mandated by law to provide health care policies for their full time employees?
Maybe.. just maybe.. insurance companies would have to offer decent policies at a reasonable profit to compete with a government sponsored option.
lions and tigers and bears.. oh my
July 1, 2009 at 6:56 pm #668362
HMC RichParticipantMaybe I am not awake yet.
July 1, 2009 at 7:12 pm #668363
HMC RichParticipantJoB, you misunderstood me. What I said was conjecture. I don’t know. I actually did know some of your points. More information needed from more sources. I was not arguing on this one.
July 12, 2009 at 10:28 pm #668364
bluebirdMemberWendell Potter, former Head of Corporate Communications at CIGNA (which provides health insurance to nearly 70 percent of the Fortune 100 companies) admits that, in fact, “Sicko” “hit the nail on the head” and told the real truth about how much better people in other countries have it when it comes to their health care.
July 13, 2009 at 4:20 pm #668365
JoBParticipantbluebird…
thanks for posting this..
i encourage everyone to read some of the comments too.
i think it’s time that Single Payer Option became a public chant.
I am not naive enough to believe we will get it.. but i believe it’s a much better place to start negotiating than the compromises already on the table.
remember when we were sold the idea that mandatory auto insurance would bring our premiums down? not so much :(
July 13, 2009 at 6:08 pm #668366
JoBParticipantI just spent the last hour trying to access info on insurance claims for the services provided to me by the medical insurance we pay for every month through my husband’s employer… so i would know how much of the bills that have been sent to me should in fact be paid.
I overpaid one by a couple of hundred plus last week and it will be months before that is repaid to us by the clinic i no longer attend… they will be glad to credit our account so i can use the money.. but require a request from my husband with full documentation to initiate a refund for the bill i paid over the phone with my credit card.
it turns out i can’t really access the website to get information or get tech support to get onto the website or even request a refund from the clinic that was overpaid.. because i don’t own an insurance policy.. my husband does.
the same entities that would be after me in a heartbeat for the bills since this is a community property state.. require a power of attorney signed to them within the last 6 months authorizing me to handle the account before they will talk with me… unless of course i am paying the full amount (before insurance adjustments) over the phone by credit card… which will have to be mine… even though they misfiled the original claim.
I am not entitled to the adjusted claim information or even confirmation that they have billed the insurance company and received the adjusted claim notice even when i have a copy of the notice in hand and can verify their clinic billing code… because i am not the insured…
oh.. and by the way.. every bill states that they will be turning this over to collection if they are not paid by return mail…
ain’t this fun?
And you wonder why a single payer system in which every person owned their own health insurance policy and could deal with their insurance company and their medical providers on their own behalf might be a good thing….
we have spent enough that my insurance company will now pay a large percentage of every bill they approve… but i somehow can’t get a list of what they approve and their denials don’t make much sense… and i will have to fight them if i can..
oh wait.. i can’t fight them.. hubby will have to take time off work to fight them since i am not the insured.
why does anyone wonder why a simple system that spells out what is and is not covered and allows the person receiving the benefits to advocate on their own behalf would be a good idea?
my husband’s privacy is so protected that i can’t access my own information.
not so cool.
A single payer system is the only system that will put us back in control of our own health care, guarantee us access to our own medical records, guarantee us access to our own medical insurance claims and the central databank that contains our own complete medical history and will give us full disclosure of benefits so we can make informed decisions about the need for supplemental insurance.
So why isn’t everyone calling their congressional representatives every day to tell them they will settle for nothing less?
July 14, 2009 at 7:35 pm #668367
lizruMemberHere’s some numbers, folks. 60% of bankruptcies in Washington state and the U.S. have health care bills as a major component. Do we really think it’s OK for American’s to have to go into bankruptcy to pay for health care?
Also, the number is closer to 30 cents on every healthcare dollar. That’s the money you’re paying for administrative overhead when you’re working with insurance companies. Medicare in comparison is closer to 3%. That’s why people think a government managed option would be better than the insurance companies and keep them honest.
July 14, 2009 at 10:08 pm #668368
JoBParticipantTonya 42…
that deductible that i thought was too high for me to meet this year unless i got really sick..
It is astounding how quickly the medical bills piled up for nothing more than some routine tests… it took me less than 2 months.
Good thing we have pretty full coverage after the deductible.
I can understand why so many people end up in bankruptcy over illness.. mine isn’t even critical.
July 17, 2009 at 12:46 am #668369
Sky2625MemberThe anecdotal insuance nightmares quite clearly illustrate that a vast majority of posters here are not satisfied with the status quo.
All through my reading of this thread, I kept asking, how can we re-boot health insurance so that these problems are addressed and people are satisfied with it (including free-marketers like myself)?
JoB’s #83 post (second-to-last paragraph) is what I have been waiting for. Though I oppose single-payer (for governmental malfeasance reasons), JoB clearly detailed what insurance ought to look like, or at least what the insurance-customer interface ought to look like.
I like those reforms, JoB. You’d say single-payer would do it, I’d say reform legislation is all that we need to get there. But that’s not the point I’m going for here.
The point is, now that we’ve conveyed our desire for something different, let’s talk about what different looks like. What should health insurance do? How do you want it to work for you? What do we, as citizens, have to do to get the industry to work that way?
July 17, 2009 at 1:09 am #668370
JoBParticipantsky2625…
the public option now being bandied in congress wouldn’t solve the problems of dependents who do not own their medical insurance policies because to qualify for those policies you can’t be eligible for another policy.. and i and every dependent currently covered are eligible through the primary’s workplace.
Nor would it necessarily lower insurance costs for those who are employed because only those who are not eligible for insurance through the workplace or through medicare or medicaid would be eligible for the public option.
oh.. and buried in that bill is mandantory health insurance for all.. so if you are eligible for insurance through your workplace.. you would have to purchase at least the cheapest policy available.
The public option currently being bandied is definately not a single payer system.
the biggest problem with health care insurance reform is that the people paying the lobbyists to influence the legislation have every reason to fight reform… to give us the appearance of reform with no real substance…
except maybe mandatory health insurance which guarantees the insurance company more customers…
i don’t remember where the quote came from.. and i am only able to paraphrase it at best… but.. the problem with health care reform from the vantage point of the health care and health insurance industry is that everything we are calling wasteful spending is a profit generator for someone…
including the myriad of health insurance industry codes, billing systems and coverage restrictions.
July 19, 2009 at 3:35 am #668371
alki_2008ParticipantDoes the proposed public health insurance option have any requirements for the covered person’s behavior? I mean, will taxpayers have to subsidize the ailments of smokers that CHOOSE to endanger their health by smoking…not to mention that a pack-a-day smoker would probably be able to buy private insurance if they weren’t spending hundreds of dollars each month on cigarettes.
It seems the topics of government-provided health CARE and health INSURANCE are often mingled. Wasn’t the “Sicko” movie about governmen health CARE, not about INSURANCE? Potter was a health insurance executive. Those that are hailing him now for being such an advocate would have been villifying him a few years ago because he was part of the ‘greedy insurance industry’. My, how quickly things change.
I read some of the comments from that Raw Story article, and there were a lot of comments about how people in countries with public health care can GET health care…but there’s no mention of the quality of that care. Not to say that US doctors are always the best, but to generalize and equate available care with quality care seems erroneous.
Tonya42 – thanks for your posts. Glad to see comments from the provider perspective.
JoB – I’m sorry, but it’s really hard to extrapolate your circumstances to the entire population as a whole. If you’re missing something in coverage because your husband missed a deadline, than is that the insurance company’s fault? If you overpaid, while plenty of other people don’t, then does that mean the system is broken? If your blood sugar is high, then should you be eating FullTilt’s ice cream?
Are you aware that those with pre-existing conditions often can’t get medical insurance at all.. at any price?
I know 5+ people (including myself) with pre-existing conditions that CAN and DID get great insurance, and at standard prices.
Are you aware that your insurance can be cancelled retroactively if the insurance company suspects your condition could have been pre-existing.. even if you have never received a diagnosis or medical treatment for that condition?
I know 3+ people that recently had major expenses due to conditions that probably did exist before they got their insurance policies, and the insurance companies did NOT drop them and actually covered their medical costs (an organ transplant in one of those cases).
Plenty of people I know don’t have trouble getting copies of their medical records. Just because you have problems, doesn’t mean that every one does.
I guess all of these folks are atypical though, since they’re not you.
July 19, 2009 at 1:46 pm #668372
JoBParticipantAlki_2008…
I’m glad that you know some people who had good outcomes with their insurance companies… and some people who had no trouble getting their health records. I love hearing stories with good outcomes.
But, wouldn’t it be better if everyone had the legal right to a good outcome?
If we are going to blame people for their illness.. let’s blame runners for foot, knee and hip injuries because running on hard surfaces is clearly high risk behavior for impact injuries … and tennis players for elbow and shoulder injuries because hitting a tennis ball repeatedly is clearly high risk behavior for tennis elbow and shoulder injuries… and people who use their keyboard for long periods of time because typing is clearly high risk behavior for carpal tunnel syndrome.. and anyone who suffers an accident during sports activities because that is clearly high risk behavior and anyone who is injured while driving their car because that is clearly high risk behavior too….
Heck.. that’s barely getting started.. we could deny coverage for exposure to toxins and carcinogens and any number of other known health risks…
and how about people who have a family history of genetically inclined disorders.. they could be denied for not arranging their lives so that they mitigated for their genetic tendencies…
and that’s just the short list:)
this blame business is a slippery slope…
if we are going to go there .. let’s suspend heroic measures for anyone diagnosed as terminal… it would save tons of money and heroic health care won’t much affect their final outcome…
Of course, if we did that, i wouldn’t be here now.. I was given my first terminal diagnosis at a pretty young age and survived that one and more… but let’s not get sentimental.
Thanks for being concerned with my health… but my doc and I have that under control.
I am exceedingly healthy for a woman who has lived with the stress of an intractable pain disorder and had so many serious health issues. When you couple that with a strong family history of heart disease and diabetes… paying attention to my blood pressure and blood sugar at 60 isn’t exactly unexpected:(
I am definately not typical.. nor do i consider my experiences with access to health care typical.
I have had good health insurance when i really needed it and i have had incredible luck or i wouldn’t be here…
but if a woman like me who has had no choice but to become proficient dealing with the health care industry and health insurance and who has had the luck to be married to someone with a very good job and very good insurance when i needed it desperately still struggles… what do those who aren’t as lucky or as well educated do?
because i am very clear that i am one of the lucky ones when it comes to access to health care…
As for those health risks you mentioned, my doc is actually more concerned about the stress posting online has on my blood pressure than the occasional child’s scoop at Full Tilt…
He’s probably right… but i haven’t figured out how to enjoy life without exposing myself to risk somewhere …
have you?
July 20, 2009 at 1:51 am #668373
alki_2008ParticipantWow, JoB — Once again, you’re misinterpreting what I wrote. I didn’t say that EVERYONE should be blamed for their illnesses.
Being active (tennis, running, etc) has good health benefits (ie, cardiovascular, weight management). When it comes to smoking…what possible good health effect does someone get from smoking?
When it comes to genetic pre-dispositions, people don’t have any control over that…but people have control over whether to smoke and purposely inhale carcinogens.
Comparing smoking to all those other things you mentioned is apples-to-oranges.
Besides the health aspect…why should taxpayers subsidize health insurance for smokers that spend hundreds of dollars a month on cigarettes? IMHO, cigarettes are not a ‘necessary’ living expense (like rent, food, or education), so if they chooose to spend their month on cigarettes, then too bad for them.
Also, I didn’t say that smokers should be “denied” coverage. Instead, they should have to pay more than non-smokers, as with most private insurance plans. I posed a question about whether such things would be included in the public plan…but you leapt to the assumptions that I want to BLAME everyone and completely DENY smokers any health insurance coverage at all.
Once again, this is an extremely one-sided “exchange”.
July 20, 2009 at 2:13 am #668374
JanSParticipantI’ve thought about the effects of smoking often (I’m an ex-smoker, 27 years now). Considering the diseases that smoking can cause, I’m surprised that it’s still subsidized by the gov’t. – well, tobacco farmers. Is there another use for tobacco, besides smoking, chewing, dipping, etc? And…it’s addicting. I will disagree with any argument that says it isn’t. Ask a 40+ year smoker how hard it is to quit – they’ll tell you.And if the price was 10 bucks a pack, some would still buy. So..my question..can we expect smokers to pay more for the health insurance that they get if the gov’t. condones smoking – and another question… If a smoker never gets a disease that is “caused by smoking”…should they still pay more for their health insurance? I don’t have those answers, so I’m asking for general opinions.
For me, I hate smoking. I dislike being around smoke, I dislike when the smoke wafts into my apt. from the downstairs neighbor (non-smoking bldg. but they go out on their patio). I’m of the opinion that cigarettes in general shouldn’t exist if I was to be truthful, but that ain’t gonna happen. So…my questions are directed at everyone…
and the last question, I think is…should our gov’t. be subsidizing the tobacco industry, instead of taxing the hell out of ’em because the end product is so carcinogenic?
July 20, 2009 at 5:58 am #668375
JoBParticipantalki_2008..
it’s too easy to make one class of people scapegoats for their behavior… and blame them for their illness… or poverty… or…
I agree that there is no redeeming value to smoking… but then i am not a smoker.. so how would i know?
It’s too easy to exercise hindsight now and blame people for habits that were started when the health hazards weren’t as clear… and as Jan pointed out.. were heavily subsidized by our own government… especially if you don’t smoke or were able to quit.
I certainly know and love enough people who have tried more than once to quit… and i have seen the impact not smoking has had on cognition and weight… not to mention mood… impacts that hadn’t ended after years of being smoke free.
We still don’t understand the total effects of nicotine and other ingredients that were added to tobacco to increase it’s addictive qualities on the brain… and until we do we are unable to compensate for the brain chemistry imbalances caused by a lifetime of smoking.
If you are not dependent upon tobacco it’s unlikely you understand the trade-off that all smokers make. I have met very few who still smoke because they think it’s a cool choice. it certainly isn’t an easy one these days.
there is no redeeming value to cocacola either but if you try to take mine away you will have a real fight on your hands. I am well aware of the downside of my own personal drug of choice.. but i am also aware that without it I am unable to function.
should i be censured or denied treatment because i drink coke?
High risk behavior is highly individual. If you have been paying attention to those who live to be 100+ and are still enjoying the process, you will find that many of them indulge in what society now calls high risk behavior.. including smoking and drinking… with no apparent health consequences.
My mother smoked 3+ packs of cigarettes a day… until prevented by the need for oxygen due to a collapsed lung caused by a huge cancerous tumor… not by anything related to smoking.
i pay the bill for her smoking.. with tobacco residue triggered asthma and moderate lung damage even though i have never smoked a single cigarette.
I have a brother whose high risk behavior will likely kill him… it certainly lands him in the emergency room with life threatening consequences far more often than is comfortable for his family..
He doesn’t smoke, he doesn’t do drugs, he only drinks socially.. and moderately at that. He works out… it pretty buff for a guy in his 50s and can out iron man most 20 year olds. He is the mid aged poster boy for physical fitness and mental health…
Yet in the last 10 years alone his medical bills have far exceeded not only mine but the combination of all other members of his extended family… 1 brother, 2 sisters, their spouses, 4 nephews, 3 nieces, their spouses and children and his wife and 3 kids… and some of us have some pretty significant medical challenges.
He indulges in high risk athletic activities… He has collapsed his lung twice in the past 5 years and still regularly outperforms his peers 30 years younger. Currently, he is attending a boot camp type program where physical excellence is a requirement.
he isn’t alone though.. in my family the athletes have logged more lifetime health-care dollars for injuries than the smokers… or the drinkers.. or the chronically ill.
risky behavior is risky behavior.. and no matter how you justify your favorite brand of risky behavior.. or how socially acceptable it is… we all pay higher insurance rates for it.
July 20, 2009 at 6:43 am #668376
alki_2008ParticipantThe addictive aspect of smoking does complicate the issue. Many health insurance companies cover cessation programs, and it’s hard to find anyone NOW that can argue they don’t know about the health risks. However, just because something is addictive doesn’t mean the government should encourage it. UNOS applies a lot more ‘standards’ then just smoking. They consider people’s behaviors in organ allocations…particular alcoholism in liver transplant cases. I don’t know what their policies are for other organs.
The increased premiums for smokers is based on a host of actuarial calculations, wherein smokers have a higher likelihood for many diseases (particular cancers…and not JUST lung cancer). I think there’s also an assumption by insurers that people who smoke are more likely to practice other unhealthy behaviors. To clarify…I am NOT saying that all smokers are unhealthy in general, so please don’t jump to that assumption. I am saying that insurers make such associations and factor that into risk assessments and premiums.
I don’t think that government subsidization of the tobacco industry means that we should condone smoking and subsidize smokers’ health insurance. If we absolve tobacco companies of the unhealthy effects of their products, then isn’t that comparable to absolving banks of their bad practices because the government bailed them out? To clarify, this does not mean that I agree with either industry…just making the comparison.
JoB-
i am also aware that without it I am unable to function.
Really? I feel the same way about coffee, which is odd because I only started drinking it 2 years ago. I actually think I functioned better in the years before I started drinking coffee. :( At least now I can limit myself to 16oz per day. However, with recent research indicating some actual health benefits of coffee…then I may increase my daily ration. ;)
I used to enjoy sodas too, drinking at least 1 per day…but now I’m down to 1 per week. Was tough at first, but so was every habit I’ve given up/cut down.
should i be censured or denied treatment because i drink coke?
Again, I never said smokers should be DENIED treatment.
due to a collapsed lung caused by a huge cancerous tumor… not by anything related to smoking
Are you implying that only lung cancer is “caused by smoking”? All those additives in cigarettes are carcinogenic (ie, cancer-causing). Smoking increases the risks of all kinds of cancer, not just lung cancer. I’m not saying that her “cancerous tumor” was caused by smoking, but I also don’t see how anyone can say it wasn’t.
July 20, 2009 at 7:14 am #668377
JanSParticipantAlki-2008…as an aside question…and I agree, we should not absolve tobacco growersof the unhealthy aspects of their products..but…should they be subsidized by the gov’t. still? I have a real hard time with that one…subsidizng to keep the tobacco farms from going under, which, yes, saves their “livlihood”, but the end product is carcinogenic, and maybe they should be encouraged to grow something else? I realize that’s a simple way of looking at a complex problem. Again, as I said before, I don’t have the answers, and I think that those who do have the answers are afraid to give them, risking losing the support of those farmers.
Back in my smoking days, I lived in Winston-SAlem, NC, and remember the stench that came from the cigarette factory….hated it. And my cigarette of choice was Winstons – go figure. I’m so glad I quit. It didn’t save me from other health issues, but it did help with many things.
July 20, 2009 at 11:02 pm #668378
JoBParticipantit seems I can’t repeat a common saying about people who make assumptions without getting a post tagged for name-calling.. so i am resubmitting this post without that comment.
Pretty comical considering some of the comments directed at me by the recipient of this one that you can easily find on another thread…
but.. whatever… it gave me the chance to edit…
alki_2008…
My cocacola is medically prescribed:) yes really.. and at one time i even had a valid prescription on a prescription pad for it so i could take it with me into restricted areas.
i really can’t function without it.. that is.. i can’t get up and leave my house for an appointment.. drive myself and safely drive myself home without consuming cocacola in addition to my medications. Without the coke i collapse.
With the help of several docs i have tried substituting a wide variety of legal pharmaceutical stimulants and medications with stimulating side effects with varied degrees of success. Unfortunately all of them prevented sleep. Coke doesn’t.
It is the considered opinion of more than one physician that in my case the benefit of consuming cocacola (this specific soda) outweighs the possible harm. Without coke i am not only housebound, but bedbound… it really does impact my ABILITY to function.
but hey.. you probably know better… or was that just an excuse to take a another cheap personal shot?
as for the cost thing.. should i pay higher insurance rates because i drink coke?
I already pay higher insurance rates because of my diagnosis even though i don’t consume medical services at a high rate and i have out-survived the actuarial tables you cited as evidence for my illness….heck.. i have out-survived more than one medical diagnosis… but that’s probably irrelevant.
actuarial tables sound so important.. but they have no real bearing on any individual’s prognosis…
they are nothing more than a compilation of statistics that the insurance company uses to hedge their bet that you and i will pay more in than they have to pay out…
As for my mother. You know absolutely nothing about her or her illness… and in this case your assumptions really got the better of you.
it is far more likely that both my parent’s cancers had more to do with being exposed to the downwind effects of Hanford or to chemical leaching from the Umatilla chemical weapons storage or the chemicals sprayed on the wheat fields surrounding our homes than cigarettes.
They were both outdoors people and we were literally fed by the wildlife that existed in both of those areas.
In spite of smoking, mom was a 30+ year survivor of both breast and uterine cancer and the tumor which eventually collapsed her lung was generally thought by her physicians to be metastasized breast cancer that she had successfully fought off for over 25 years.
Mom and i have something in common… we both beat the odds on the actuarial tables by a healthy margin… in spite of our bad habits.
And yes, lest you should question the likely cause and effect of Hanford and Umatilla and the pesticides on the wheatfields on mom’s health… people who lived in the area i was brought up in and lived in the area during the “experiments” at Hanford.. have a much higher than normal incidence of prostate, breast and uterine cancer… not to mention other blood disorders and immune conditions… than normal.
You can look it up. It actually makes quite interesting reading.
the problem with making assumptions about other people’s lives is that you don’t have the basic information… so it’s pretty easy to come up with false conclusions.
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