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Old 07-26-2007, 11:40 AM   #21
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Ok, you've convinced me to take you off my ignore list. Four billion people in the united states yesterday, today changing our health care strategy to a better version converts us to a communist dictatorship run 3rd world country with good cigars.
The thing that I found shocking about Sicko was the number of people who had an HMO and were still dying because some insurance company claims clerk decided to deny them care.

Like the person with a brain tumor (now deceased) who was denied because "it must have been a pre-existing condition"!

I would never trust my health to an insurance company claims clerk.
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Old 07-26-2007, 12:07 PM   #22
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...a communist dictatorship run 3rd world country with good cigars.
Hey, don't knock Cuba, there's 2 billion of them down there. And anyone who chomps on a cigar while driving a '56 Chevy is OK with me.
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Old 07-26-2007, 02:05 PM   #23
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Yes, then we can be just like Cuba.
Really?

I guess you are of the I GOT MINE. Sorry the american health insurance system is going down the tubes. When a doctor cannot make a decision on treating a patient because he must call an insurance company something is wrong.

But many here are so blinded by capitalism that god forbid we treat each other as equals when it comes to getting health care. I don't care if you are a bazillionaire or a poor homeless person you both should be treated equally in the health care system. That means treated as equals. I have a feeling that is not so popular here on the forum.
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Old 07-26-2007, 06:04 PM   #24
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The thing that I found shocking about Sicko was the number of people who had an HMO and were still dying because some insurance company claims clerk decided to deny them care.

Like the person with a brain tumor (now deceased) who was denied because "it must have been a pre-existing condition"!

I would never trust my health to an insurance company claims clerk.
Just out of curiosity, I wonder if the family tried to appeal the decision. If that really happened without the "clerk" using actual medical records to base his/her decision off of, then it is a travesty. However, in my experience, if a claim like that were denied, the first thing I would do as the client's broker is expedite copies of medical records to the insurance carrier and walk them through the system to upper management to "prove" that the condition was not pre-existing. If that doesn't resolve the problem within a day or so, I would go straight to the division of insurance to file an appeal. In the case of a very serious health condition and an access to care problem, I can usually get a final decision within a very short period in time. (probably less than a day or two.). The division of insurance has the final say. If they tell the insurance company to pay the claim, the insurance company must pay. The division uses an un-biased third party examiner consisting of a staff of physicians to make the final decision.

I hope that most people know they don't have to take some "clerk's" cockamamee decision as the final answer. Always appeal to the division of insurance immediately if you are not getting results. The division of insurance is a department of consumer advocacy. They are generally "on your side" until the unbiased third party team of physicians makes their final decision. Call a broker for help if you don't know what to do!
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Old 07-26-2007, 06:14 PM   #25
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Really?

I guess you are of the I GOT MINE.
Not really....I was more or less being sarcastic here. It really irritates me that Michael Moore glamorizes the Cuban Medical system when, in fact, Cuban doctors are all but being held hostage by their system and paid barely enough to survive for all they do. It's no wonder many Cuban doctors are now trying to defect to America. Is that what Michael Moore wants to do to American healthcare providers? It's one thing to show one side of the story, but what about the other side? He has a real talent for leaving out the negative consequences of the single-payor system. The average American doesn't dig into detailed information...if you show them only the negatives, that's the picture left in their minds. For every negative story, I've got a great positive one. As an average American voter, I like to know both sides of the story. Why can't we see both sides? Why won't the media give any attention to the other side of the story? Let's see the negatives on BOTH sides of the fence.
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Old 07-26-2007, 07:39 PM   #26
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Hey, don't knock Cuba, there's 2 billion of them down there.


Good thing we didnt invade 40 years ago.

Hey, between the US and Cuba, we out populate China!
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Old 07-26-2007, 11:55 PM   #27
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I hope that most people know they don't have to take some "clerk's" cockamamee decision as the final answer. Always appeal to the division of insurance immediately if you are not getting results. The division of insurance is a department of consumer advocacy. They are generally "on your side" until the unbiased third party team of physicians makes their final decision. Call a broker for help if you don't know what to do!
If it's that simple, why were several lawsuits filed against Blue Cross when they retroactively canceled policies when large claims were filed? You would think that these people would just file an appeal and it'd all be fixed in a day or two. What do you know that they didn't? :confused:


But I guess they didn't do too badly in the end...

"Plaintiffs in the case claimed they had been left to pay crippling hospital bills -- some in excess of 100,000 dollars -- after Blue Cross had retrospectively cancelled medical coverage. Lawyer William Shernoff, who represents many of the plaintiffs, said his clients would not have to worry about paying medical bills ever again. "Every one of our clients is pleased," Shernoff was quoted as saying."
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Old 07-27-2007, 12:38 AM   #28
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...

But I guess they didn't do too badly in the end...

"Plaintiffs in the case claimed they had been left to pay crippling hospital bills -- some in excess of 100,000 dollars -- after Blue Cross had retrospectively cancelled medical coverage. Lawyer William Shernoff, who represents many of the plaintiffs, said his clients would not have to worry about paying medical bills ever again. "Every one of our clients is pleased," Shernoff was quoted as saying."
Yes, but can you imagine the stress and grief those patients and their families suffered while the courts sorted this out?? No doubt Shernoff's fee was added to the cost of doing business and passed along to the insured.
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Old 07-27-2007, 06:24 AM   #29
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Not really....I was more or less being sarcastic here. It really irritates me that Michael Moore glamorizes the Cuban Medical system when, in fact, Cuban doctors are all but being held hostage by their system and paid barely enough to survive for all they do. It's no wonder many Cuban doctors are now trying to defect to America. Is that what Michael Moore wants to do to American healthcare providers? It's one thing to show one side of the story, but what about the other side? He has a real talent for leaving out the negative consequences of the single-payor system. The average American doesn't dig into detailed information...if you show them only the negatives, that's the picture left in their minds. For every negative story, I've got a great positive one. As an average American voter, I like to know both sides of the story. Why can't we see both sides? Why won't the media give any attention to the other side of the story? Let's see the negatives on BOTH sides of the fence.

Both sides to the story? Ok 45 million here in america without insurance. I HAVE supposedly great insurance and just this past month had to deal with idiotic BS from the insurance company on a procedure that MY physician did!!

Please the american for profit system when it comes to health care is screwed up. Cuba yes its a communist mess. However they treated the people from 9/11 that were brought there, stunt maybe BUT if we took those people to an american physician at an american hospital they would not have been seen without that insurance card! Or sent to the way back of the line as uninsured american and we will see you when and if there is time so long as you are not in an immediate crisis.
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Old 07-27-2007, 09:32 AM   #30
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Both sides to the story? Ok 45 million here in america without insurance. I HAVE supposedly great insurance and just this past month had to deal with idiotic BS from the insurance company on a procedure that MY physician did!!

Please the american for profit system when it comes to health care is screwed up. Cuba yes its a communist mess. However they treated the people from 9/11 that were brought there, stunt maybe BUT if we took those people to an american physician at an american hospital they would not have been seen without that insurance card! Or sent to the way back of the line as uninsured american and we will see you when and if there is time so long as you are not in an immediate crisis.
Newguy - I am sincere when I say that I agree there is no doubt problems in BOTH systems. I am also sincere when I say that I truly believe a single payor system eventually winds up alienating a larger quantity of people when it comes to complicated medical problems. Y'all can bawk at me all you want on that point, but it's what I truly believe.

Yes, I am sure that single payor systems work wonderfully for routine, acute and relatively minor health problems. Fortunately, that kind of care will satisfy probably 80% or more of any population, and that's why single-payor systems are so well liked, because for the majority of minor health problems and even for acute care, they work great!

My concern is more for that 20% of the population that needs more than just routine care. IMO, that's when healthcare really matters. Granted, I am sure that the USA does alientate SOME of that 20%, but what happens to that 20% in a single-payor system? HOW MANY of them are trapped on a waiting list, worrying needlessly about a suspicious mass while waiting for an MRI or possibly dying while waiting for diagnostic tests? How many? I don't know. The numbers aren't published ANYWHERE! My feeling is that it's more than in the USA.

I'd like to make a prediction. I do believe that America will soon have a single-payor system. Michael Moore and the media have already done a pretty good job of seasoning the American public to vote for it. It will work GREAT for about 10-15 years, and everyone will LOVE it. Then, in about 15 years or so, our elderly population (which will be a lot bigger by then and include many of the people on this board) and AARP will be lobbying, whining and complaining about wait times for specialized care (particularly eyecare, cancer care, and orthopedic care). They'll aslo spend a lot of time whining and complaing about limits on prescription drug coverage - because the Part D plan will go bankrupt or close to it. Doctors will start opening up private clinics that will not serve the general public, because the Medicare system will not pay them enough to make their careers worthwhile. In addition to extra taxes, the people who can afford it will be lining up to buy private, catastrophic health insurance and drug cards. The people who can't afford it will be left waiting.
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Old 07-27-2007, 09:59 AM   #31
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For those who want to understand the Canadian system better, here is a story from one of the Washington rags:

The best solution: questions and answers on the Canadian health care system Washington Monthly - Find Articles
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Old 07-27-2007, 11:23 AM   #32
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Yes, I am sure that single payor systems work wonderfully for routine, acute and relatively minor health problems. Fortunately, that kind of care will satisfy probably 80% or more of any population, and that's why single-payor systems are so well liked, because for the majority of minor health problems and even for acute care, they work great!

My concern is more for that 20% of the population that needs more than just routine care. IMO, that's when healthcare really matters.
It's nice that you have these strong unfounded beliefs. Hospitals in Canada get paid by the insurance company just like on the US. If there is demand for more capacity, they build it because there is additional demand. Many hospitals aspire to become major referral centers.

More important, the doctors decide what the patients need. Not the claims clerk! And they are assured of getting paid without any hassle. They don't need extra staff to collect data for billing and for collections.

It has been estimated in Sicko that 30-35% of medical costs are soaked up in such administrative overhead and it is the most rapidly growing component of health care.

How about the people that get sick in the US and then get their insurance cancelled? By the time they finish their escalations, they might be dead.

Please spare us your predictions. Predictions are easy. Determining what the future will hold, now that's hard.
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Old 07-27-2007, 11:28 AM   #33
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For those who want to understand the Canadian system better, here is a story from one of the Washington rags:

The best solution: questions and answers on the Canadian health care system Washington Monthly - Find Articles
I noticed a few things in the article needing clarification:
1) Ambulances are not covered by the system but by private insurance.
2) Drugs, when covered by the province are subject to a means test. My meager pension is enough to make me pay 100% of their costs.
3) Coverage outside the home province is fine, but, because it will only pay up to its published rates, extra insurance is needed when traveling to the US. For sunbirds this can be very expensive and is subject to exclusion for pre-existing conditions. What most provide is emergency stabilization when practical and then transportation home. When a friend's father had a heart attack in Florida, he was whisked home but his wife who doesn't drive, was left in Florida with their car. Her son flew down and drove her home. This tends to keep poorer retirees closer to home as they get older.
4) Teeth and corrective eye costs (except cataracts) are not covered.
5) Things like personal wheelchairs are not covered.
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Old 07-27-2007, 11:41 AM   #34
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It's nice that you have these strong unfounded beliefs.
Well, my beliefs are not completely unfounded. Did you watch any of the videos or read any of the testimonials from some of my earlier posts?
On The Fence Films :: Movies

and what about these stories? Are they completely false?

SOCIALIZED MEDICINE
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Old 07-27-2007, 11:47 AM   #35
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Well, my beliefs are not completely unfounded. Did you watch any of the videos or read any of the testimonials from some of my earlier posts?
On The Fence Films :: Movies


Holy cow, you're not doing yourself any favors with this "source". These guys are about as far out there as you can get without putting on a tin foil hat and waiting for the aliens to land. All of which will look exactly like Hitler.

This stuff is really good though...keep it coming. You cant pay for entertainment this good.
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Old 07-27-2007, 12:03 PM   #36
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[/url]

Holy cow, you're not doing yourself any favors with this "source". These guys are about as far out there as you can get without putting on a tin foil hat and waiting for the aliens to land. All of which will look exactly like Hitler.

This stuff is really good though...keep it coming. You cant pay for entertainment this good.
Let me guess....you didn't watch any of the videos.
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Old 07-27-2007, 12:07 PM   #37
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Didnt need to. I know what to expect from a bunch of whackos who publish a bunch of movies telling me why the government is evil, out to get me, and are zapping our brains with z-rays from planet 12.

And I mentioned Hitler, which means this thread is legally ended.
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Old 07-27-2007, 12:33 PM   #38
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And I mentioned Hitler, which means this thread is legally ended.
On the one hand, I have to say 'Thank God'

On the other hand, I have to point out that it's generally not an accepted use of Goodwin's Law to intentionally use it to stop a conversation, especially if you make the statement and then immediately invoke Goodwin's Law on yourself.

So, to get us all out of this sticky situation, I'd like to officially call Goodwin's Law on CFB. Thread adjourned.
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Old 07-27-2007, 12:39 PM   #39
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Well, my beliefs are not completely unfounded. Did you watch any of the videos or read any of the testimonials from some of my earlier posts?
On The Fence Films :: Movies

and what about these stories? Are they completely false?

SOCIALIZED MEDICINE
Anecdotes do not make a story. They might create some entertaining passtimes but are a really lousy way to decide public policy, especially for life and death decisions. For example, Marie Therese wrote:
News Hounds: Quick, Pass the Viagra! Hannity's Overhyped Hit Job on "Sicko" Falls Flat!

Quote:
In his "documentary" Browning only highlights three cases. There are 76 videos on YouTube right now, outlining medical insurance horror stories in the United States.
...
Here are a few of my own observations about the so-called "best health care system in the world:"
1. College student son of a friend suffered three strokes as a child of 3 months. He is moderately physically impaired. When he graduates in two years, there are many companies that will not hire him because he is a health risk. Cannot buy health insurance under the current system. Uninsurable.
2. 16 year old son of a good friend, diagnosed with a benign tumor on his spine. Tumor removed successfully. Tests reveal benign brain tumor, which must be monitored regularly by doctor. Now, at 20 years old, he is uninsurable.
3. Acquaintance in mid-50s, worth $2.5 million in property and trust funds. Anemic and overweight. Cannot find any company that will insure her, even though she's willing to pay for it. Uninsurable even though able to pay high premiums.
4. Adult piano student of mine fifteen years ago. Her mother and her two sisters lived into their nineties. All three women owned homes that were to be left to my student's two children as the only heirs. All three women needed long-term care. My student could not get Medicaid to pay until she had sold all three homes and used up the proceeds, thereby depriving her children of their inheritance.
5. I'm 59 years old. My health insurance premium is over $500.00 a month and does not cover my prescription eyeglasses. It covers 10% of basic dental. In three years I will not be able to afford the premium. Have received a letter recently telling me that if I'm late again with my payment, they reserve the right to cancel my coverage. I have paid tens of thousands of dollars to this insurance company for 32 years.
6. The HIPAA portability provisions do not extend to self-employed individuals. This means that I do not have the ability to move to a more affordable state unless I am willing to take the chance and live without health insurance since there is no portability guarantee.
There are millions of other Americans just like me out there, each with just as many or more "horror" stories.
Don't miss the audio clip of Thom Hartman Show, Air America, July 5, 2007 on this site. And BTW, Stuart Browning does not need to worry about his coverage anymore, because Embarcadero Technologies, Inc. is looking after him: Sample Contracts - Separation Agreement and General Release - Embarcadero Technologies Inc. and Stuart Browning - Competitive Intelligence for Investors
Quote:
2. The Company further agrees to provide Browning with full
participation in the Company's health, disability and life insurance benefit
programs, at the Company's expense, during the Severance Period. At the
conclusion of the Severance Period, Browning will be eligible for continued
coverage in the aforementioned benefit plans to the fullest extent provided by applicable law
BTW I am hard on you because you claim to know about the Canadian system. I am Canadian. I use the system. So do all my relatives and friends. Who are you going to believe? Stuart Browning or me?

Will you be able to get another job?
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Old 07-27-2007, 12:45 PM   #40
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On the one hand, I have to say 'Thank God'

On the other hand, I have to point out that it's generally not an accepted use of Goodwin's Law to intentionally use it to stop a conversation, especially if you make the statement and then immediately invoke Goodwin's Law on yourself.

So, to get us all out of this sticky situation, I'd like to officially call Goodwin's Law on CFB. Thread adjourned.
I break all kinds of rules. You can always count on me.
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