The good old USA and medical costs

[cute fuzzy bunny]

Quote:

Originally Posted by JohnP I'd start by looking at the costs of the forms processing between the Dr's offices and the insurance companies for a real eye-opener, as highlighted by CFB earlier.

You're getting there.

Look at my current travesty at getting Blue Cross to pay for Lunesta.

First the doc wrote the prescription. Pharmacy says its not on BC's approved list, so I have to pay for it or get the doctors office to do a 'pre-approve' with the insurance co. Pharmacy says it'll probably take a week due to the upcoming christmas holiday. Six weeks later after three phone calls and a stop into the doctors office, they confirm that I have to try two approved meds before BC will take the pre-approve. She says its taken 6 weeks because every time she called BC, they put her on hold for half an hour or hung up on her while she was on hold. This is all quite interesting, because I have long term insomnia that has resisted every other treatment, and there is only one prescription drug approved for long term insomnia...lunesta. So I can certainly TRY two other meds, but none of the approved ones are effective for more than 10-14 days. Someone explain that logic, please?

So my first drug is temazapan aka halcion aka restoril. Banned in almost every other country outside the US (where the manufacturer resides, btw) because its been linked to aggressive behavior and people killing their families and whatnot. Sorry about those posts a few weeks back, by the way. That actually works but I cant remember anything the next day and have trouble picking things up and hanging on to them, and as described in 10 days it just stops working. In fact, I couldnt sleep at all for 2 days due to rebound effect.

So they give me ambien. Another three stooges situation. Turns out Ambien isnt on the approved list either, but the doctor (who apparently didnt know or check) prescribed it to me anyhow and the pharmacy filled it and sold it to me with the BC co pay amount. So the doctor prescribed me an unapproved drug as part of the approved drug cycle, the pharmacy either didnt check with BC before prescribing or BC gave approval in error. So two or all three entities involved made a mistake. Who wants to bet that somewhere along the line I get a bill for $70 (the diff between the co-pay and the drug cost) from someone who got left holding the bag and that becomes MY problem?

Ambien gives me a perfect 8 hours, after which I am as lazy as I can ever imagine being, which is good because if I could summon up any motivation, I'd want to throw myself off a bridge. Deep, severe depression. I take it for three days and then tell the doctor I cant take another one. Actually my wife told me to call the doctor and tell him I wasnt taking another one.

At this point they're not sure if taking one approved and one unapproved drug constitutes fulfilling the two drug cycle requirement, or if I need to take a third that IS approved. I now have $200 worth of drugs BC has paid for that I am going to throw out. Further, when I mention that the 2mg Lunesta the doctor originally prescribed and I paid for out of my own pocket might need to be bumped to the 3mg dosage, the doctors admin thinks we would need to start the whole process over again with two more drugs and all new paperwork. That was about 2 weeks ago. I havent heard anything from them since.

So figure for yourself how many people, how much time, how many forms faxed, phone calls made, etc just to get me approved for the only prescription drug available that is effective for me and approved for the use I need to put it to.

I'd almost be happier if they just said right out of the chute "We dont cover new expensive drugs like this". But the allure of the insurance company actually paying for my $1200 a year prescription meds and my growing fascination with this incredibly inefficient bureaucracy keep me hanging in there. By the way, there is nothing obvious to me in the blue cross marketing crap you get when buying a policy that says they get to pick and choose your prescription drugs, to the extent of asking you to try cheaper older crud that has side effects and isnt even appropriate for your situation or condition.

By the way, guess which industry uses the most paper every year? The medical business, with most of it going between them and insurance companies. You should see the healthcare breakdowns for costs...paper actually makes a significant piece of the pie.

Huge bureauracy. Tons of forms. On hold for a half hour. Procedures that make no sense at all. People eating, drinking and smoking too much, or not wearing seat belts or helmets but expecting the insurance company to rivet them back together again when they crash, people who cant let a loved one go, doctors who wont throw in the towel when its a lost cause, doctors who take it personal when someone dies and will do everything to prevent that, unnecessary tests, lack of worthwhile preventative care.

And yeah, somewhere in there a few percentage points of uninsured people, immigrants, and legal costs.

[cute fuzzy bunny]

Quote:

Originally Posted by Honkie • Twenty percent of Americans think the sun orbits the Earth. Seventeen percent believe the Earth revolves around the sun once a day (The Week, Jan. 7, 2005).

Indeed, along with these gems that were uncovered as part of a 2002 national geographic survey and several other scholastic grops surveying US citizens 18-24 years of age:

Percentage of U.S. citizens ages 18–24 in 2002 (post-9/11) who couldn’t find Afghanistan on a map: 83%

Percentage who couldn’t identify Israel: 85%

Percentage who could correctly place the 2001 Survivor TV series island in the South Pacific: 86%

Percentage who couldn’t find the U.K.: 69%

Percentage who couldn’t find France: 65%

Percentage who couldn’t find Japan: 58%

Percentage who couldn’t find the Pacific Ocean: 29%

Percentage who couldn’t find the U.S.: 11%

Rank of U.S. respondents compared with those of the other 8 countries polled: second to last

Rank of U.S. respondents in estimating the population of the U.S.: last

Percentage of high school seniors who thought that Italy, Germany, or Japan was a U.S. ally in World War II: over 50%

Percentage of high school seniors who thought the Gulf of Tonkin agreement ended the Korean War: 43%

Percentage of 17-year-olds who correctly placed the Civil War in the period 1850–1900: 33%

Percentage who thought the Civil War happened in the 18th century: more than 25%

Percentage who correctly identified Abraham Lincoln as the author of the Emancipation Proclamation: 66%

Percentage who said Lincoln wrote the Bill of Rights: 14%

Percentage who said Lincoln wrote the Missouri Compromise: 10%

Percentage who said Lincoln wrote abolitionist novel Uncle Tom’s Cabin: 9%

Percentage of college seniors at the 55 top colleges in the country who knew that the phrase “Government of the people, by the people, for the people” comes from Lincoln’s Gettysburg Address: 22%

Percentage who could identify James Madison as the “Father of the Constitution”: 23%

Percentage who could identify and correctly place in time the Reconstruction: 29%

Percentage who knew George Washington was the American general at the Battle of Yorktown: 33%

Percentage who were familiar with the name “Snoop Doggy Dogg” and could identify him as a rapper: 98%

Percentage who knew Beavis and Butt-head are cartoon characters: 99%

Percentage of Ivy League students who didn’t know the name of the U.S. Speaker of the House: 44%

Percentage who couldn’t identify the chairman of the Federal Reserve Board: 35%

Percentage who didn’t know how many U.S. Supreme Court justices there are: 23%

[F-One]

So the US is #1 in TV watching of entertainment or whatever one calls it

Ever noticed the insurance negotiated price for various medical expenses - I've had bills of over $400, insurance "negotiated" it to under $100 of which I paid less than $15. And I know it's not just paying for those without insurance

[farmerEd]

OT: Insomnia

Have you ever tried good old "Benadryl"? Its something my doctor recommended to keep me from itching (I get very dry skin in the winter), but is also for colds...I don't use it for the itching or the colds, but one pill knocks me down for 8 hours every time...and they cost about $5 for 50-100 pills, over-the-counter. Its worth a try....works like a charm, and ocne you get used to it not very groggy in the AM and no other side effects that I am aware of.

[yakers]

Quote:

Originally Posted by wildcat Get Out - You are really leaving out a huge part of the equation and no pun inteneded - obese/overweight Americans. We, by nature, will point our finger at anything but ourselves - the doctors, the lawyers, the government, the drug companies, the HMOs, yada yada - it all adds up. But when you have a country with a lot of overweight/obese people (an "epidemic" according to the media ), you have high health care costs. Your equation looks like you are leaving out quite a bit but it is just your opinion. Bingo Honkie.

I'm going to set up a weight poll on this under "Other Topics", since it is anonymous maybe people will actually post.

[cute fuzzy bunny]

Quote:

Originally Posted by farmerEd OT: Insomnia Have you ever tried good old "Benadryl"? Its something my doctor recommended to keep me from itching (I get very dry skin in the winter), but is also for colds...I don't use it for the itching or the colds, but one pill knocks me down for 8 hours every time...and they cost about $5 for 50-100 pills, over-the-counter. Its worth a try....works like a charm, and ocne you get used to it not very groggy in the AM and no other side effects that I am aware of.

Yep, most people dont know that the main ingredient in the sleep tablets they pay $8 for a package of 4 is the same as the main ingredient in benedryl. Bought the costco $3.50 for 400 tablets for many, many years. My standard was 2mg of melatonin and one benedryl, and a second one if I woke up. It seems to be pretty safe; my wife says benedryl is what they give most people in the hospital that are having trouble sleeping.

I found that after a few weeks to months the effectiveness of the benedryl slacks off and I have to stop taking it for a week or two. Never found anything else safe and OTC to use during the 'gap'. It definitely makes me groggy in the morning and a little sluggy all day though. It makes my dad climb the walls when he takes it...doesnt make him tired at all.

[Rustic23]

This thread seems to run back and forth as to what “The Government” should provide and if “The Government” provides health care the care will it be either better or worse than some other people living under another government that does not pay as much.

You can get data on both sides of this, and most of it means exactly what the person quoting them wants it to mean. Without an impartial study of the data most of what people are quoting is worthless! Example: Why has the cost of medical care risen? Lawyers, Paper work, greedy doctors, more third party payers? You can find data to support all or none of these, pick your poison pick you side and TYPE. In reality it won’t solve the problem.

Dose Canada’s socialized medicine work better than the pseudo capitalist US system? If you are the guy who can not afford the procedure in the US but would get it for free in Canada the answer is YES, if you are the parent of a child that dies while waiting for a transplant in Canada, NO.

As I posted in another reply, the government, in this country is us. Howard wrote once, ‘Shouldn’t health care be a right?’, my reply was why do people get off thinking they have a right to what I have worked hard to get?

[Nords]

You guys are really motivating me to call the doctor for the ol' annual exams...

[justin]

Quote:

Originally Posted by (Cute Fuzzy Bunny) Percentage of U.S. citizens ages 18–24 in 2002 (post-9/11) who couldn’t find Afghanistan on a map: 83% Percentage who couldn’t find the U.K.: 69% Percentage who couldn’t find France: 65% Percentage who couldn’t find Japan: 58%

Afghanistan, UK, France, Japan? Heck, I can't even find my wallet half the time, let alone countries I've never been to.

[Martha]

Quote:

Originally Posted by Rustic23 Dose Canada’s socialized medicine work better than the pseudo capitalist US system? If you are the guy who can not afford the procedure in the US but would get it for free in Canada the answer is YES, if you are the parent of a child that dies while waiting for a transplant in Canada, NO. As I posted in another reply, the government, in this country is us. Howard wrote once, ‘Shouldn’t health care be a right?’, my reply was why do people get off thinking they have a right to what I have worked hard to get?

You talk about basing decisions on facts. I agree. Do you have evidence to back up your claim that a child will wait longer for a transplant in Canada? I do not believe that to be the case.

I think each of my posts have been rather apolitical on this thread as I have just raised issues we need to think about. But to be political, What gives you the right to keep all the money you manage to suck away from your employer? So what do you want? No subsidized healthcare for anyone? Babies to die so you can drive a Beemer? We are a rich country. We can afford decent healthcare for our population. There. I'll stop being political now.

[ladelfina]

I'll repeat: the US is already spending public money per capita (to cover a few) equivalent to systems in Switzerland and Japan (that cover everybody).

Why can't those public dollars translate into basic care, catastrophic care, SOME kind of care, for everyone? We are all paying already. I paid taxes in, yet got not one dime of health care out.. had to pay for private insurance at $700/month. That's a figure many taxpayers cannot afford. So we have almost 20% of the population without insurance.. many without access to insurance.

How can anyone defend this state of affairs as rational?

[Martha]

Well I know I can't.

As HaHa said earlier, it goes back to that old "America, love it or leave it" attitude.

Also, people believe that even if our healthcare is more expensive, it is "better" than what you get in countries that provide some form of universal care.

If the USA is so great, what don't we demand the best of everything? Healthcare for all and darn it, make it the best healthcare in the world.

(This is political )

[renferme]

Our healthcare is so good, that old people are living too long !
Too long? yes, they end up in extremely expensive care facilities and use up their life savings living a very low quality of life.
My Dad is 89, living in an assisted care home, a nice place, but of course, they're draining him of his money. His mind is ok, but still not good enough to have understood and picked out a prescription drug plan on his own. My sister had to do that for him. He remembers very little, except what happened 30 years ago.
My Mother died in a nursing home; her last few years were spent just having the health care system keep her alive.
Is living a long time with a low quality of life good ?
That's why I think our health care system is too good and too expensive.

[sgeeeee]

Quote:

Originally Posted by Rustic23 . . .You can get data on both sides of this, and most of it means exactly what the person quoting them wants it to mean. . . .

That's not what I'm seeing. It seems to me that all the data is pointing to the fact that Americans pay more and get less and that the major contributor to cost is forms and filing costs. The arguments against these points seems to be entirely by anecdotal evidence at best. What data am I missing?

[maddythebeagle]

Quote:

I don't know where you got your facts...Rush Oxytocin Limbaugh says that people from other countries that offer SOCIALIZED healthcare ALL come here to the USA to get the best health care in the world..thats my story and I'm sticking to it...no matter what the facts are [/sarcasm]

I think there is some truth to foreigners coming here (a least the Mayo Clinic and some of the "destinations of last resort"). I have been treated at the Mayo for a relatively rare condition and there are several Canadian license plates in the parking lots and folks from other countries there). I really doubt there is many foreigners at the local HMO clinic though

[Zipper]

Rustic23, you're so full of sh*t!

That has to be one of the most assinine posts I've read at this site.

We have world class medical care in London ON and everywhere else in Canada.

Children dying. Give me a freakin' break!

[wildcat]

Rustic,

How do you work hard and earn the right to health care?

[farmerEd]

Quote:

Originally Posted by Rustic23 This thread seems to run back and forth as to what “The Government” should provide and if “The Government” provides health care the care will it be either better or worse than some other people living under another government that does not pay as much. You can get data on both sides of this, and most of it means exactly what the person quoting them wants it to mean. Without an impartial study of the data most of what people are quoting is worthless! Example: Why has the cost of medical care risen? Lawyers, Paper work, greedy doctors, more third party payers? You can find data to support all or none of these, pick your poison pick you side and TYPE. In reality it won’t solve the problem. Dose Canada’s socialized medicine work better than the pseudo capitalist US system? If you are the guy who can not afford the procedure in the US but would get it for free in Canada the answer is YES, if you are the parent of a child that dies while waiting for a transplant in Canada, NO.* * As I posted in another reply, the government, in this country is us. Howard wrote once, ‘Shouldn’t health care be a right?’, my reply was why do people get off thinking they have a right to what I have worked hard to get?

Let me guess, a Rush Limbaugh listener?

Tell me, are por people allowed to drive on the roads that "you worked so hard to pay for" are poor people entitiled to due process in a court of law? who do you think pays for that? Should the fire department respond to a house if the person is poor and pays little or no taxes? what about police or military protection...if Korea decides to invade a poor community, should the military bother to respond?

[getoutearly]

I'll have to be a bit more careful about my "slight" political leanings getting into the forum! It is interesting to see the different politics poking out from under the postings though. Hey, that's why they make more than one flavor of ice cream... a lot of good food for thought anyway... Can't say that I agree with all/most of it, but interesting none the less.

[cute fuzzy bunny]

I havent got the slightest interest in politics and honestly, I just see different perspectives from people with different viewpoints and information.

I did ask a few posts ago what brought you to your conclusions...