Bush's Health Plan--merged threads

[lets-retire]

But I strongly suspect that universal care of some sort will be happening in the next 10 to 20 years.

At last something we both can agree on.

 

[figner]

lets-retire, thanks for clarifying. Best wishes to you and your wife in dealing with the health challenges.

 

[Zoocat]

I agree that many, if not most, of our society's health problems in midlife are due to lifestyle. But I have to take this opportunity to point out that some of us old babes who are overweight live a very healthy lifestyle (regular exercise and healthy diet) and are still overweight. Some of us just can't seem to live on a minimum calorie diet long enough to lose weight.

And a few of us became overweight in the first place because we took a prescription drug and our doctor knew nothing about the weight gain side effects. In my case it was Zoloft. Twenty five pound weight gain in eight months. A similar side effect is occuring today with some folks who take statins and beta blockers.

 

[donheff]

You seem to be missing the basic impediments to shopping around. Do you really think that the average consumer has any clue even what all of the necessary procedures might be during a hospital stay? Its not exactly a help to get bills that have a person or firm's name on them you have never heard of and the description is a code. How on earth could anyone but the provider or maybe the insurer sort that out?

But hey, I give up. You want to live in a Milton Friedman fantasy world, be my guest. But I strongly suspect that universal care of some sort will be happening in the next 10 to 20 years.

I just caught up on this thread at an opportune time. I have been fighting BC/BS over how much of $40K in surgery costs for my daughter's jaw surgery I am responsible for (so far, I am out about $16K). It has been a NIGHTMARE!!!!! I do not want to go to medical school to figure out WTF procedures they are billing me for. And I don't want to go to supply school to figure out WTF the hospital is wasting my money on.

 

[Beststash]

But I strongly suspect that universal care of some sort will be happening in the next 10 to 20 years.

I certainly hope it doesn't take that long!! I will stick my neck out and say that the next administration will pass universal healthcare for all (single payer plan) in the next 3-5 years.
All of this rhetoric about HSA's and private insurance does nothing about the insurance companies denial of anyone that has a healthcare issue - and the Bush plan is DOA.

Peace

 

[Jarhead*]

Please. If you are going to be an absurdist ******* at least take it easy with the personal insults.

Dory, your checks on the way. This kind of entertainment is worth twice the price.

 

[Nords]

Brewer--Someone as financially savvy as you should be able to recognize that spending money for some unknown treatment isn't exactly the smartest thing to do. At least review the bills to see what was charged and if there are errors. Only you or your wife can say if a treatment was provided, your insurer does not know. Something that might not be unusual for your wife's treatment might not have been needed in her case, but was accidentally put on the bill.

C'mon, guys, lighten up. No fair poking each other with sharp sticks until a moderator has to salvage what little civility can be gained from finger-pointing and "He started it!!"

Surely we've all spent a day or two in a hospital learning about prolonged sleep deprivation, perhaps with a spouse nearby screaming her lungs out or with a deathgrip on one of our extremities, having some admin weenie caring hospital staff explaining a procedure or a bill to us when we just want to get on with it. Or better yet, after we've escaped with our family to experience the chaos of more prolonged sleep deprivation, late-night feedings, & diaper changes, we've had to figure out a cryptic "explanation of benefits". It reads like something out of "1984".

I think we'd all quickly agree that the process of comparing costs & choosing health insurance, or any insurance, would be greatly simplified if it weren't so obfuscated by those who have nothing to gain by clarifying it.

You know, like dealing with the IRS. Or car salesmen. Or traffic tickets.

I sat down a couple weeks ago to review our personal property insurance. I'm still waiting for "my" company to do what I asked them to do and to explain how I'm protected. Or not.

 

[Tadpole]

So you basically just paid bills and you had no idea what you were paying for? How can you give such good investment advice, yet handle money so foolishly. My wife has had extensive medical care, but I can still tell you exactly what each bill I received was for.

To get back closer to topic the difference is you were paying AFTER the care was provided. MKLD asked for the price beforehand. Recently when my wife changed jobs and we were unsure if we were going to use COBRA I did the same thing. It's amazing what kind of information you can receive if you just ask. Things like basic price will flow freely.

Ummm, let me see now....
A set of carlights were suddenly in her face and GOD froze time. Now God says to her, Tadpole, you are fixing to have you leg crushed to smitherines but I have brought you a cell phone. Get on that mother and call around and price the cost of your transportation to a hospital. Way I see it, you have CHOICES. A helicopter can take you anywhere in a 50 mile radius. Maybe Phili, maybe Baltimore; how about DC? Or we have an emergency vehicle that can take you to the local hospital. There are three of those within an hour's drive; call and get their prices. Of course, we can just call a cab but you might bleed to death before you get there; but, it is cheaper. Then there was a crash and God came to Tadpole's room and said "naughty Tadpole, you passed out before you chose your doctor and whether you wanted that leg patched up or not; you know the cab driver could have just left it in the car; that would have been cheaper. That doctor you didn't shop for, between you and me, he's good but you don't need nothin' good, you need something cheap and adequate. And, talk to that husband of yours, he hasn't shopped around at all to find you a cheaper place to go than this hospital. Seems to want them to get you breathing right first; what a waste of money. Tadpole, you are a worthless excuse for a human being with all this lack of preplanning your health care cost."

Now which is ultimately cheaper for society. A Tadpole that is patched up good enough to work even if she can't walk or a Tadpole that can't take care of herself at all?

 

[Beststash]

I sat down a couple weeks ago to review our personal property insurance. I'm still waiting for "my" company to do what I asked them to do and to explain how I'm protected. Or not.

After living in this property for about 20 years - "my" insurance company sent me a cancellation notice of my policy (which expires in March 07) and renewal of a "choice" plan. They had all of the paperwork completed and just wanted a signature. I view this as simply a move to get more denerio. I don't want to disrupt this thread - how about a new topic??

 

[mykidslovedogs]

We're not talking about shopping around in an emergency situation. Obviously, that's rediculous! There are thousands of $$ to be saved in making people more aware of their healthcare costs. I recently read an article that some huge% of all trips to the doctor for a sore throat ended up being a virus (not strep) that was not really treatable other than waiting it out and maybe taking some pain medication. Yet, for 1/2 of the cases, doctors still prescribed antibiotics at the parent's request (probably, cuz they didn't want to be sued!) This is HUGE waste of money, not to mention the fact that overprescribing of antibiotics leads to resistance, which leads to the need for more expensive antibiotics. If people didn't have such low copays, they'd wait 3 or 4 days before running to the doctor, instead of rushing in on the first day of the fever.

There are thousands of dollars to be saved in increasing people's awareness of searching for generic alternatives to brand name drugs. This is obviously not going to work for every person, but for a huge majority of people, there are plenty of generics that can be used in place of brand name drugs. When people only have to pay a small copay for a brand name drug, there is no incentive to look for generic alternatives.

There are thousands of dollars to be saved on simple lab and x-ray tests. Often times the cost of an x-ray or an ultra-sound in a physician's office is quite a bit less expensive than going to an outpatient lab. But again, when people only have to pay a copay, why check to see if there is a better price out there?

What about unnecessary tests? When people have a copay plan, they just do whatever the Dr. says. But, when the patient has to be responsible for using their savings to pay for a test, they will sometimes be more motivated to question the doctor about what the tests are for and why they are necessary. Besides, I think it's good for people to ask questions and understand more about their health.

I've had some pretty arrogant physicians who weren't willing to go into the details with me (guess they weren't used to being questioned by their patient). Guess what? I found another doctor with better bedside manner. Hey, if I'm going to pay for the office visit, I want the service I deserve. I once had a doctor who's billing dept refused to help me out with a claim problem. Guess what? I found another doctor with a friendlier service staff, and what do you know?....I didn't have the same kind of problem the second time around. They billed the insurance company properly as promised and the claim for the preventive service was paid at 100% NOT subject to deductible, just as my insurance contract promised. People with low copay plans are not motivated to hold doctors accountable for their services (other than through law suits after the fact). There are literally thousands of dollars to be saved in this area.

 

[Caroline]

Just listened to "The News Hour." Woman being interviewed said that by White House estimates, this plan would cover an additional 3 million our of the 47 million currently without healthcare.

I admit that I didn't listen to Bush's entire address -- but is this ALL there is

 

[brewer12345]

Just listened to "The News Hour." Woman being interviewed said that by White House estimates, this plan would cover an additional 3 million our of the 47 million currently without healthcare.

I admit that I didn't listen to Bush's entire address -- but is this ALL there is

You're surprised? This proposal is all about rearranging the dechairs on the hospital ship Titanic. The administration isn't interested in citizens unless they make (minimum) $100k.

 

[Brat]

Who knows how this will shake out, but at least Bush has started the conversation.

Frankly I would like to see 'community rating' for health insurance, that way those with pre-existing conditions could purchase a policy. What does concern me is that folks who know they will be needing a lot of services will concentrate in certain policies. As crazy as it seemed to many this is exactly what the 'donut hole' in the Medicare drug program was designed to address.

I would like to see a program that focuses on prevention, perhaps encouraging clinics such as those in some pharmacies staffed by Nurse Practitioners. Not full service shops, a place where conditions could be triaged(sp) and treatment started for uncomplicated problems. If the situation is likely to need an x-ray or immediate lab work then go to the more expensive Physician staffed clinic.

The first group to be covered should be all expectant mothers, children and students.

 

[Rich_by_the_Bay]

I would like to see a program that focuses on prevention, perhaps encouraging clinics such as those in some pharmacies staffed by Nurse Practitioners. Not full service shops, a place where conditions could be triaged(sp) and treatment started for uncomplicated problems. If the situation is likely to need an x-ray or immediate lab work then go to the more expensive Physician staffed clinic.

That's what some HMOs do. Seems to work ok, though a lot of patients insist on seeing "the doctor." It appears that a cold which will go away by itself does better when an MD does nothing that when a NP does nothing, at least in the eyes of some patients.

I love doing primary care, but this type of thing was a frustration. Now I am at the other end of the severity spectrum. I still work with NPs but their role is different and we are all part of a team caring for the desperately ill. I like it and I think and hope the patients get good care as a result.

 

[larry]

I've had some pretty arrogant physicians who weren't willing to go into the details with me (guess they weren't used to being questioned by their patient). Guess what? I found another doctor with better bedside manner. Hey, if I'm going to pay for the office visit, I want the service I deserve. I once had a doctor who's billing dept refused to help me out with a claim problem. Guess what? I found another doctor with a friendlier service staff, and what do you know?....I didn't have the same kind of problem the second time around. They billed the insurance company properly as promised and the claim for the preventive service was paid at 100% NOT subject to deductible, just as my insurance contract promised. People with low copay plans are not motivated to hold doctors accountable for their services (other than through law suits after the fact). There are literally thousands of dollars to be saved in this area.

MIL has had symptoms of heart attack and had tests run (which at this point don't show anything) so she met with doctor to discuss checking for blockage.

DW went along for the visit and was asking the Dr. LOTS of questions and when the talk turned to balloon or stent DW asked how many the guy had done and his reply was, "I just started last week". DW was not amused as she assumed he was much more practiced than that. His attitude really turned her off.

So it's off to another town in western Kansas to find a different Dr. as this is probably something that shouldn't be performed soley based on price.

 

[mykidslovedogs]

So it's off to another town in western Kansas to find a different Dr. as this is probably something that shouldn't be performed soley based on price.

You bet! And getting involved and asking questions (whether she is on a copay plan or a high deductible plan) could save you and the insurance company from expensive problems created by malpractice (as well as the time and energy of a law suit after the fact!) Good for you for doing the research! It will be well worth your time and your MILs health! I have a lot of respect for you for doing what you are doing. Many people would just do what they are told and not ask questions, especially if they were receiving "free" care.

In a nationalized program, we might eventually not have the luxury to shop for the best (because the best of the best might be few and far between due to mediocre government salaries created by price controls.)...I sure would hate to be "stuck" with the guy who hardly has any experience....

 

[larry]

MIL is under Medicare and AARP as far as ins. goes.

As to asking questions, part of the problem is that if he (we'll call him Dr. Wiseacre)performed the procedure and she had any problems she would have to be airlifted 200 miles away and that should be a major factor also. The second opinion takes this into account.

Rural America healthcare at its best!

 

[mykidslovedogs]

MIL is under Medicare and AARP as far as ins. goes.

As to asking questions, part of the problem is that if he (we'll call him Dr. Wiseacre)performed the procedure and she had any problems she would have to be airlifted 200 miles away and that should be a major factor also. The second opinion takes this into account.

Rural America healthcare at its best!

I'm sorry to hear about your dilemma. It's unfortunate that she doesn't have more options under Medicare.

 

[Helena]

I've read all comments here and all I can add is this -- if the excellent minds on this Forum cannot figure it out in 5 pages of discussion...

...then I'm against it on the grounds that anything this unclear must necessarily include something they're trying to sneak by us.

The devil's in the details


Did you catch this ?


" Initially, only 20 percent of those who are covered through work will see a tax increase, according to White House estimates. But that number will go up over time, because while the deduction cap would be indexed to inflation, health care costs rise much more quickly. Hence, your plan costs could exceed the deduction cap within a few years of the cap's implementation, depending on your circumstance.

Ten years after the proposal is in effect, 40 percent of plans will exceed the standard deduction, according to a preliminary analysis of the proposal by the Tax Policy Center. "

http://money.cnn.com/2007/01/23/pf/taxes/health_proposal_effect/?postversion=2007012321

 

[Helena]

I just caught up on this thread at an opportune time. I have been fighting BC/BS over how much of $40K in surgery costs for my daughter's jaw surgery I am responsible for (so far, I am out about $16K). It has been a NIGHTMARE!!!!! I do not want to go to medical school to figure out WTF procedures they are billing me for. And I don't want to go to supply school to figure out WTF the hospital is wasting my money on.

$16,000 is quite a large out of pocket. Most BCBS policies have
a maximum out of pocket, then go to 100%... unless you have
been serviced by a non-contracting provider who is balance
billing you over what BCBS allows... or, unless the service is
not covered by the contract.

 

[mykidslovedogs]

" Initially, only 20 percent of those who are covered through work will see a tax increase, according to White House estimates. But that number will go up over time, because while the deduction cap would be indexed to inflation, health care costs rise much more quickly. Hence, your plan costs could exceed the deduction cap within a few years of the cap's implementation, depending on your circumstance.

Ten years after the proposal is in effect, 40 percent of plans will exceed the standard deduction, according to a preliminary analysis of the proposal by the Tax Policy Center. "

http://money.cnn.com/2007/01/23/pf/taxes/health_proposal_effect/?postversion=2007012321

I wonder if anyone has considered the possibility that the inflation rate might slow once people become more in tune with the cost of their care - thereby leading to lower demand for brand name drugs and wasted and unnecessary services

 

[sgeeeee]

. . . It appears that a cold which will go away by itself does better when an MD does nothing that when a NP does nothing, at least in the eyes of some patients. . .

I would be willing to do nothing for patients at half the cost of either the MD or the NP. Next time one of you has a cold, send me any amount of money you see fit and I promise to do nothing.

 

[Helena]

I wonder if anyone has considered the possibility that the inflation rate might slow once people become more in tune with the cost of their care - thereby leading to lower demand for brand name drugs and wasted and unnecessary services

You want to bet the farm on that ?

 

[brewer12345]

Frankly I would like to see 'community rating' for health insurance, that way those with pre-existing conditions could purchase a policy.

We have this in the individual health market in NJ. Its not a panacea. Everyone can get access to insurance with very few restrictions allowed related to one's health status, which is good. The downside is that a lot of insurers won't play in the state's market, so there isn't much competition. As a result, there isn't a lot of choice on the structure of the policy and the companies to buy it from. Insurance is also very expensive. I suspect that most of this is due to the fact that everything is expensive in "God's Country" (NJ), but it is no doubt exacerbated by the lack of competition.

I suppose I am happier knowing that I can always buy a policy here no matter what happens to me. But the price is pretty hefty and clearly knoks a lot of people out of the market. Its just not clear that it would be much better with more competition.

 

[lets-retire]

Brewer--That is why I believe universal coverage by private insurance won't work. Even if the government splits the contract up into regions to allow for some competition there will not be enough to keep the prices low similar to the gas industry. If they go with one company there will be no competition for the contracts. I think this will result in one of three things. 1) the government pays whatever the companies want, resulting in an expensive and probably inferior system. 2) The government dictates the price to the companies, resulting in an inferior system. Or 3) the government taking it over, also resulting in an inferior system.

I know it's been stated, but I can't recall the thread, but maybe if there was some way to increase the number of doctors. Maybe increasing the number of medical schools. This has to taken into consideration. Failure to do so will result in an increase in demand without any appreciable increase in supply, resulting in price increases or severe rationing. Now we have rationing based on ability to pay, so they say, but if the number of health care providers is not addressed rationing will be based on the availability of service not pay. Either way there will be rationing.