Health Care Bill and Your Personal Experiences

[TromboneAl]

I wonder how one's support of the health care reforms that are being discussed are influenced by personal experience.

By "Support the Reform" I mean support the kind of reforms that are currently being discussed in congress.

With "Had Problems" I m referring to things like problems getting health insurance, being denied coverage, being denied payment for a procedure, or having to spend huge amounts for insurance.

[Gone4Good]

I'll support reform as soon as they have a proposal that seriously addresses the cost issue. Otherwise we're just making more promises we can't keep.

[JOHNNIE36]

I'm concerned about one thing for us. I'm hearing that if you are happy with the plan you have you can keep it. I also hear that if the plan makes any kind of changes to cost or coverage, that it is thrown out as not being the same plan and you can't keep it. This would scare me. Health plans make changes all the time and it sounds like Obama is going to use my concern as mentioned above to disallow my current plan. If United Medicare Advantage makes any kind of change I'll be out of luck and will have to go with whatever the g'ment dictates.

[youbet]

Quote:

Originally Posted by JOHNNIE36 will have to go with whatever the g'ment dictates.

What's the problem? The govt knows what is best for you!

[samclem]

Quote:

Originally Posted by TromboneAl I wonder how one's support of the health care reforms that are being discussed are influenced by personal experience.

Observations: Can we reliably infer causation ("are influenced by") between the two things being measured?

While I wouldn't be surprised if those who have problems with the present system are more in favor of changing it radically, I'd guess that other factors may also be at work.

[Martha]

I support reform and I personally have had good experiences with health care delivery. I am not thrilled at how much we pay for the risk pool, but at least we have insurance and the pool's insurance is good.

However, my views are substantially effected by personally knowing a number of people who didn't have insurance and had significant problems as a result. Unable to by medications. Unable to pay for hospital bills. Not getting proper treatment for chronic illness. I know others who stuck around work far longer than they should have to keep the health insurance. Etc.

EDIT: On reflection, I do have one problem. I can't move to another state.

[ERD50]

Quote:

Originally Posted by Martha However, my views are substantially effected by personally knowing a number of people who didn't have insurance and had significant problems as a result..... Etc.

This is exactly why I feel it is so important that reform be sustainable. We want those same protections for people in the future. If we can't pay for it now, we not only won't have the money to continue, we will need to cut back at some time. We might run into a "pendulum swing" and end up worse than we are today. I want the best for people today and tomorrow.

It's disingenuous to just say that "we will find a way to pay for it". That hasn't worked for SS or Medicare. This is a democracy, and if the majority want health care reform, then the majority ought to be made aware of the costs and the majority should be willing to pay their share.

-ERD50

[Life_is_Good]

Every year my premiums go up (thx Blue Cross/Blue Shield) and every year both my wife and I have at least one disagreement with insurance referencing an unpaid procedure.

Now... to be fair... sometimes the Dr office incorrectly codes the invoice to insurance who then denies payment. But every single year? The process is flawed! It's red tape frustration to the max!

[Coach]

I support reform and have not had problems. But I would not have retired four months ago if my employer did not allow retirees to continue in their group plan.

Coach

[Martha]

Hey Coach, congratulations on your retirement!

[youbet]

Quote:

Originally Posted by ERD50 if the majority want health care reform, then the majority ought to be made aware of the costs and the majority should be willing to pay their share. -ERD50

And pay their share real time....... not leave a mountain of debt for the next generation.

[youbet]

Quote:

Originally Posted by Life_is_Good Every year my premiums go up (thx Blue Cross/Blue Shield) and every year both my wife and I have at least one disagreement with insurance referencing an unpaid procedure. Now... to be fair... sometimes the Dr office incorrectly codes the invoice to insurance who then denies payment. But every single year? The process is flawed! It's red tape frustration to the max!

Not to worry. Under the govt plan you'll receive free insurance and all procedures will be covered in full.

[DallasGuy]

I support reform. I had ONE illness in my life over 15 years ago...a ONE time occurance of a bleeding ulcer, yet still get denied coverage when I apply for individual health insurance. This is ridiculous. If congress changes just one law it should be to eliminate pre-existing conditions. That one change would give people access to health insurance easier and would allow them to switch insurance plans easier when the premiums are raised beyond what one would consider a reasonable increase. Hopefully that would force insurance companies to price the premiums more competively since people would probably switch to another plan if the premiums are too high compared to other similar plans. Fortunately at this point it looks like both Republicans and Democrats support eliminating the pre-existing conditions for health insurance plans so if any plan passes, this will probably be included.

[ERD50]

Quote:

Originally Posted by youbet And pay their share real time....... not leave a mountain of debt for the next generation.

Yes, we are getting a sample of what the "we will pay for it later" attitude can bring - just look at California. They are making big cuts because "later" caught up with them.

I don't want to sound too negative though - let me reinforce that if they can do this for a reasonable price and spread the costs reasonably, I'm all for some of the reforms they are talking about. But I won't accept smoke and mirrors for costs, savings, and how to pay.

Looks like Obama is starting to hear that message - let's hope something good comes from it. I never would have thought that it would be the Dems themseleves providing the "gridlock" that we often need to avoid having Congress run roughshod over the public.

I am also wondering how many people read the poll carefully before voting? Are they voting in favor of "reform", or "THIS reform bill", which is what T-AL asked?

-ERD50

[crazy connie]

I believe we need to make changes and many are common sense things. The congresscritters have done an extremely poor job with what is being touted now. There are a lot of smaller cuts and modifications that can make a difference. Extreme rationing and denial of service to our elderly to provide coverage for people who are not legally here is not what I want to see.

So, it is not said that all I do is gripe and not offer solutions I propose the following items.

DME (durable medical eqpt) is not what my government needs to buy me when I am old or infirm. How many $4000 scooters have we already paid for? I can buy it or do without.

Generic meds is the limit that ins needs to cover.

City clinics for healthy children where they are seen by a nurse practioner for all routine health care. We can not afford Pediatricians time to discuss diaper rashes.

Required Parenting Education classes during pregnancy and the 1st 5 years to reduce un-necessary medical visits.

Co-pays that are realistic and force all consumers to evaluate the need in advance. Ridiculously low or income based fees encourage over consumption.

Correct our welfare system to require 40 hours work in order to recieve housing, food, healthcare and any other subsidies for all able bodied individuals. If you do not work then you do not get a free ride. We need to get people off the pity pot and take care of business. You don't need a degree to clean up litter or paint gov't buildings or mow grass in the parks.

For those who want education: A large tax credit only upon completion of a course of study with defered intrest student loans to finance it.

Why do we pay for glasses frames and see an opthamologist for routine glasses instead of an optician? In most cases only because our insurance covers it. Do we need society to pay for stylish frames or can't we get by with basic or self pay?

Can you add to this list?

[ziggy29]

Quote:

Originally Posted by crazy connie Generic meds is the limit that ins needs to cover.

Agreed in 99% of the cases. Someone wants the name brand, they pay for it. There are times when people react badly to the inert ingredients in a generic medication, and in those cases and ONLY those cases, an exception to use a name brand could be granted. Other than that, the same principle should apply as is the case with most health insurance today: you get a generic if it's available, and you pay any excess for name brands.

Quote:

City clinics for healthy children where they are seen by a nurse practioner for all routine health care. We can not afford Pediatricians time to discuss diaper rashes.

Sounds good but we already have a nursing shortage as it is, and relying more on RNs and NPs could exacerbate that. In principle, though, I like more reliance on NPs rather than full-blown MDs for a lot of relatively minor treatments.

Quote:

Correct our welfare system to require 40 hours work in order to recieve housing, food, healthcare and any other subsidies for all able bodied individuals. If you do not work then you do not get a free ride. We need to get people off the pity pot and take care of business. You don't need a degree to clean up litter or paint gov't buildings or mow grass in the parks.

Sounds good but it's not easy to "get a job" in this economy. I have no quarrel with the community service in lieu of a "real job" angle for allowing the unemployed to receive the goodies, but in terms of performing basic maintenance of public facilities as you mention, good luck getting it past public employees' unions.

[crazy connie]

Sounds good but we already have a nursing shortage as it is, and relying more on RNs and NPs could exacerbate that. In principle, though, I like more reliance on NPs rather than full-blown MDs for a lot of relatively minor treatments.

Subsidize the extra education for RN's, Paramedics and Military Medics to upgrade their education. The Dr shortage is also pretty severe and projected to get worse.


Sounds good but it's not easy to "get a job" in this economy. I have no quarrel with the community service in lieu of a "real job" angle for allowing the unemployed to receive the goodies, but in terms of performing basic maintenance of public facilities as you mention, good luck getting it past public employees' unions.[/quote]

Ceta was a program in the 70's and it could be revived to get skills to the unskilled. Subsidize wages partially for 6 to 12 month with small businesses. As far as the public employee unions, if they are not laid off they need to go suck their thumb when not working!

[Martha]

Quote:

Originally Posted by ERD50 I am also wondering how many people read the poll carefully before voting? Are they voting in favor of "reform", or "THIS reform bill", which is what T-AL asked? -ERD50

He asked about the "kind of reforms being discussed in Congress." Not a specific bill, which changes from day to day.

[Martha]

Quote:

Originally Posted by crazy connie DME (durable medical eqpt) is not what my government needs to buy me when I am old or infirm. How many $4000 scooters have we already paid for? I can buy it or do without.

If you can't walk, what do you do? I think that we need cheaper scooters. Medicare has to be able to negotiate costs for drugs and durable medical equipment.

Quote:

Generic meds is the limit that ins needs to cover.

Some drugs have no generic equivalents. Insulin for example. There are all branded. Specialty drugs as well, that can be very expensive. But yes, if there is a generic equivalent, take the brand name off the formulary.

Quote:

City clinics for healthy children where they are seen by a nurse practioner for all routine health care. We can not afford Pediatricians time to discuss diaper rashes. Required Parenting Education classes during pregnancy and the 1st 5 years to reduce un-necessary medical visits.

I know that there is a fair amount of intervention, at least in Minnesota and Wisconsin, with poor women and how to take care of their children. One program I recently learned about was early head start, which starts right after birth. A head start person makes visits, checks the babies to see how they are doing with development, and works with the parents to make suggestions on what they can do to help baby learn. WIC also is very good at teaching about nutrician. Early head start is not required for TANIF recipients. I think it should be.

Quote:

Co-pays that are realistic and force all consumers to evaluate the need in advance. Ridiculously low or income based fees encourage over consumption.

How does income based fees encourage over consumption? You run the risk of under consumption if a person has no ability to pay a copay. I have spent several years paying out of my own pocket copays for some street kids who need mental health medication. They are not covered by medicaid but through state programs get low cost drugs. But hey have no money to pay the small copay. Plus, they don't have good sense. If they have a small amount of money, such as through selling blood, they will use the money to buy cigarettes, which is more important to them then an antipsychotic drug with unpleasant side effects. But I do agree that skin in the game is important. But requiring too high of a deductible and copays sometimes results in people forgoing necessary care which ends up costing more in the long run. There have been some studies on this issue.

Quote:

Correct our welfare system to require 40 hours work in order to recieve housing, food, healthcare and any other subsidies for all able bodied individuals. If you do not work then you do not get a free ride. We need to get people off the pity pot and take care of business. You don't need a degree to clean up litter or paint gov't buildings or mow grass in the parks.

Already has happened. Able bodied people without kids don' get welfare. If you have kids you still have to go through work programs and find work in a certain amount of time. The bad thing is that able bodied people who can't find work are SOL. Also, there are a lot of borderline able bodied people. People with poor skills and maybe some mental health issues. We need more work programs, especially when our economy is in a recession.

Quote:

For those who want education: A large tax credit only upon completion of a course of study with deferred interest student loans to finance it.

Thank god for student loans! I am only financially independent today because of loans and grants for school. We do need to get a handle on the cost of higher ed, which like health care has far outpaced inflation. One thing I have seen with our local university is building, building and more buildings, because of the ability to finance through bonding, where regular operating costs cannot be financed that way. Maybe less building and more on teaching?

Quote:

Why do we pay for glasses frames and see an opthamologist for routine glasses instead of an optician? In most cases only because our insurance covers it. Do we need society to pay for stylish frames or can't we get by with basic or self pay?

I have never had insurance that covers eye care and at least for medicaid eye care is limited and you only get "welfare" frames.

Thanks for thinking about these things Connie. It is important.

[Martha]

Quote:

Originally Posted by crazy connie Ceta was a program in the 70's and it could be revived to get skills to the unskilled. Subsidize wages partially for 6 to 12 month with small businesses. As far as the public employee unions, if they are not laid off they need to go suck their thumb when not working!

A wonderful program. I got a job through CETA.