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Health Care in Retirement
Old 02-03-2010, 06:43 AM   #1
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Health Care in Retirement

I am getting very disappointed with this countries Darwinian approach to health care. The fact I cannot get care in this country with a pre-existing condition (ICD) that allows me to enjoy near perfect health and average visits to the doctor of 2 times annually, really gets up my nose!

I am fortunate I am a UK and Canadian Citizen as well as US. So when we completely screw the system up over here and make it totally not affordable for the average American, both my self and my wife can move to Canada and make our main residence there.

The fact one of us HAS to work just to get sub standard health Insurance is deplorable. I will be buggered if I an going to risk our hard earned nest egg to fund one of the most greedy and corrupt health care systems on the planet. (Of course there are honest folk everywhere and this is not a dig at hardworking health care professionals). It IS a dig on the money grabbing insurance companies. Health Care should be NON PROFIT!!! Period!

We both maintain our eligibility for Canadian health Care coverage at a minimum cost. I am sick of listening to lobbyist controlled opinionated pundits and completely incompetent talk show hosts on how the US health care system is far superior to the Canadian one.

Try talking to someone that has used all of them.

Personally I have had surgery in the UK , Canada and the USA in my life and all things being equal I would select the following for my family and loved ones:

1) I would Toss the UK one where the Sun does not shine!
2) The US Care is good (If you can afford it) But do not get a Heart Attack!

3) I would select the Canadian system HANDS down over all of these.

Unless we can do something about this, myself and my family will simply spend wonderful summers (153 days) in Sunny Southern Ontario and return to Florida in the Winter.

Does anyone else feel like I do about this that has ACTUALLY had experience [MODERATOR EDIT]?

SWR
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Old 02-03-2010, 06:52 AM   #2
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Originally Posted by ShokWaveRider View Post
2) The US Care is good (If you can afford it) But do not get a Heart Attack!

Unless we can do something about this, myself and my family will simply spend wonderful summers (153 days) in Sunny Southern Ontario and return to Florida in the Winter.
I don't understand what you are trying to say. Seems to be that if you are wealthy enough to split your residence in two countries, you may have enough assets/income to afford the US health care system (which you say is good)?

Just wondering...

BTW, I'm retired (worked for a U.S. company, owned by a Euro firm - located in Sweden), have retirement pre-Medicare health insurance for both me and my DW (co-pay, less than $500/mo) and am quite satisified with our coverage.

Many tout the Swedes as having a good life (due to all their social programs), but it comes at a heavy tax (maximum is slightly more than 60%, depending on income).

I'm happy with my current non-socialist system (in all areas of my life). Hope it dosen't get radically screwed up before I'm gone...

And before you bring up SS and Medicare as "social programs", remember where they are heading in the future...
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Old 02-03-2010, 08:32 AM   #3
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Hey, SWR, nice to see you stop by! Sorry I have nothing to add to your rant.

Rescume, people are generally happy with their system unless it doesn't work for them or their loved ones. Self insuring? You better have an extra million or two set aside. And there are plenty of people not well served by our system. Some think that it is radically screwed up now. Me for one.
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Old 02-03-2010, 09:12 AM   #4
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Originally Posted by ShokWaveRider View Post
I am getting very disappointed with this countries Darwinian approach to health care. The fact I cannot get care in this country with a pre-existing condition (ICD) that allows me to enjoy near perfect health and average visits to the doctor of 2 times annually, really gets up my nose!
Let's look at two sides to this issue. First, before I retired, I had lots of pre-existing conditions (high blood pressure, hyperthyroid, history of alcoholism, etc. and had no trouble keeping health insurance - provided I was careful about how I obtained health insurance. If I moved to a different job, I had to wait until the annual "open-enrollment" period - when anybody in the company can join regardless of ICD.

When I worked for myself, I had a couple of employees, and could always get group health coverage, with the same open enrollment period. Later in life, I could get "major medical coverage", which meant I had a $5000 deductible. The few times I got sick, I could afford to pay for the doctor from my own pocket. Never a problem with ICD with major medical coverage either.

I can see many ways the government can (and should) regulate the health care industry.
  • Tort reform is one, electronic records and standard, computerized insurance forms is another.
  • Full-disclosure and uniform pricing for all procedures prior to performing services is necessary.
  • Standard health insurance plans (like standard automobile insurance plans is necessary to allow people to shop and compare.
  • Allow nurses (at neighborhood clinics) to preform routine care and prescribe medication - no need to waste a doctor's time on the simple stuff.
  • Different standards of care with age - I am 64 and my right leg need has a old football injury, my ankle a history of sprains from skiing.. If I break my leg, I sure don't need to be all the fancy medical care of a 25-year-old. Patch me up and allow me to walk - my body is getting old.
  • Don't ignore Darwin. No one lives forever. When I am 80 years old, I don't want or need an operation that will keep me alive for another 5 years. Let me die in peace.
This list and much more can be implemented with government regulations. I don't need or want a governmental bureaucrat as middle man. Government run health care takes in tax dollars and spits out some form of health care. We all know the hidden costs of these government programs are enormous because they are not transparent nor driven by competition.

Okay, you want health care - fair enough. But now is the time we must determine the BEST WAY to provide that health care. The answer is not "give it to the government".
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Old 02-03-2010, 10:53 AM   #5
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Firstly I should say I am a fan of Canadian Health Care.

The Myth about high taxes has been blown IMHO grossly our of proportion. When I lived in Canada I did research on the cost (to me) for Health Care. It worked out out at about $300 per month for me and my wife for the basic coverage. (NO DEDUCTABLES) This did NOT include drugs unless you were in hospital.

I currently pay $450 for a catastrophic plan with mega deductibles and my wife pats $350 to her work again with silly deductibles.

It cost and extra $125 per person for Added coverage to cover drugs and private hospital rooms.

Yes the taxes in Canada are higher than the US, but NOT all Taxes go to Health Care, even though opponents will lead you to believe otherwise. Drugs are cheaper in Canada also.

The care is good and I never experienced any more waiting times than I do here in the US.

The ONLY thing I noticed is that I did not get a bill for anything I had done and never had a CoPay or Deductible.

No phone calls were ever made when I went into an emergency room and the government NEVER made a decision on what care I received, the attending doctor did. Immediately! Not after a call to an insurance company.

The Canadian system works, If the US modeled the plan after it, we could do a lot worse.

We love to spend years and years, re-inventing the wheel and convincing the populous that each other's plans are garbage. Meanwhile millions of people loose their retirement nest eggs and loose what little insurance they have, or simply get dropped.

It is not right, and it does not work for everyone. It should!

Yes I guess this is my rant. But I (unlike a lot of talking heads) have experienced all of the options of the systems that I mentioned.

SWR
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Old 02-03-2010, 12:32 PM   #6
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ShokWaveRider,


Couldn't agree with you more. Not familiar with the UK system, but have good friends in Ontario, and one is a (severe) cancer survivor – could never get coverage here in the U.S. That person is in his 60's (under 65), and works because he loves to, and not because he has to. He is well off, but wouldn't be if he was a U.S. Citizen with the same medical history. Not just complaining here – will offer constructive criticism:


The biggest problem with the U.S. health care system is its roots. We have allowed government to delegate health care responsibility to (big) business – big mistake.


The health care “insurance” industry should be a regulated, but competitive private industry, where everyone obtains individual/family insurance coverage. You should be required to buy it for life. You do this with your car, home and life insurance, or suffer the consequences. Where you work (the size of the company/group, the average ages of the employees) should never be used to determine health care pricing as it does now. Bottom line – where you work should not be responsible for your individual/family's health-care. If this were implemented – you would be able to buy (competitively) any health insurance coverage that you wish for you/your family. The health care insurance industry should be free to provide varying levels of coverage that one may purchase, at levels that are fairly priced – but only for individual/family purchase. You would be free to purchase whatever level desired. This should apply to “all” U.S. Citizens! As for the rest of the health industry – current health industry insurance and government health programs pretty much have a way of self regulating outrageous costs now.


To level the playing field – every U.S. Citizen should pay a portion of their health insurance premium towards a national health care pool. God forbid – should you be unfortunate to be handed a life-long sentence (no matter how long that life is) of disease/illness (cancer, diabetes, etc.) as determined by a national standard, that “specific” portion of your medical coverage would be covered by the national health-care pool. Many states already have this type of health-care coverage for those that are currently unable to obtain insurance coverage. This would in effect “level the playing field” for the insurance industry's coverages for everyone. Just because you're old, doesn't mean that you should not have to buy individual coverage. Life-threatening diseases associated with the elderly would be covered under the health-care pool, and normal health issues covered by your individual insurance coverages.


Those that cannot afford coverage, would be placed under existing government programs already in place. Let's face it – there is no such thing as free medical coverage – except for the uninsured. If you don't control costs by forcing the uninsured into the system, they will continue to show up in hospitals for expensive medical coverage at costs approaching ten times non-emergency coverage. You can't throw them out, and they don't usually have the means to pay. If they're in the U.S. illegally – treat them and deport them. Social Security and Medical coverage cards should be verified/mandatory for U.S. Employment.


Every business (big or small) should compete for employees on an equal basis – pay. Union collective bargaining should be limited to work/pay related issues. Even retirement should be an individual's required responsibility, and not connected to where one works. Financial institutions are well equipped to handle this now – you currently do it through where you work. You should learn financial responsibility in high school as a requirement to graduate – no excuses. The U.S. Seems to have forgotten that small business is what made America (and Americans) rich! Just ask Bill Gates. The book “The Millionaire Next Door” clearly points this fact out. I'll get off the soap box now.....
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Old 02-03-2010, 12:42 PM   #7
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SWR!
Greetings...I couldn't agree with you more. Anthem Blue Cross just increased our (2 of us) premiums by over $400 per month. We can pay, but I hate giving that company our hard-earned money: to an insurance cartel indeed....

We do have managed care in the US - managed by insurance companies and lobbyists. Two of my friends went through a real nightmare; here is their story. They did not have insurance because of the cost. He accidently cut off two fingers with a saw. The hospital said "this" finger would cost $12,000 to re-attach, and "the other" finger would cost $25,000 to re-attach. He had to choose which finger to re-attach, because they couldn't afford both!

I would like to see a single payer system. I remember that we are the government. We need a functional health delivery system. I receive no joy seeing people around me losing their homes and nest eggs because of a personal health catastrophe. And no, I don't think it would be like the DMV - as the pundits would have me believe.

The way things are, it seems that we are headed toward a situation resembling those I have seen in countries such as Brazil or Argentina - where there is a vast disparity between the "haves" and "have nots." I do not look forward to the social instability that goes with this scenario.

I like Canada; it reminds me of the US about 30 years ago, when everything felt easy-going [MODERATOR EDIT].

Best of Luck with your situation!
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Old 02-03-2010, 12:53 PM   #8
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One other addition that should be mentioned is that when you reach 65 in Canada (I have 2 siblings in this situation), you Pay $100 per year and EVERYTHING is covered. Drugs, The lot!

No programs that are specifically designed to take absolute advantage of old folk, Part D C B A whatever the hell they are.

When you reach 65 you should not have to worry about Health Care!

If it were I, I would simply Fire (No pun intended) ALL the insurance companies as I really believe they are the root cause of the problems.

We DO NOT NEED Health Insurnce at all in this country. We need HEALTH CARE!

SWR
The sooner we start focusing on Health Care REform and NOT Insurance Reform. The better.

SWR
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Old 02-03-2010, 01:48 PM   #9
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One other addition that should be mentioned is that when you reach 65 in Canada (I have 2 siblings in this situation), you Pay $100 per year and EVERYTHING is covered. Drugs, The lot!

No programs that are specifically designed to take absolute advantage of old folk, Part D C B A whatever the hell they are.

When you reach 65 you should not have to worry about Health Care!

If it were I, I would simply Fire (No pun intended) ALL the insurance companies as I really believe they are the root cause of the problems.

We DO NOT NEED Health Insurnce at all in this country. We need HEALTH CARE!

SWR
The sooner we start focusing on Health Care REform and NOT Insurance Reform. The better.

SWR

I see that you don't agree with my ramblings - so be it. The U.S. will never adopt Canada's health care policies given the current environment. FYI - health care (insurance) is health care (insurance) - no matter what form it takes - even in Canada. You do have health care insurance in Canada.
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Old 02-03-2010, 01:55 PM   #10
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I see that you don't agree with my ramblings - so be it. The U.S. will never adopt Canada's health care policies given the current environment. FYI - health care (insurance) is health care (insurance) - no matter what form it takes - even in Canada. You do have health care insurance in Canada.
No No, I do agree with your observations (Ramblings). I just think it is not right to focus on insurance.

In Canada we ONLY have to buy Supplimental insurance as a consumer for over what the government provides. That is the $125 per person I mention, In some cases this pays Doctors and institutions.

Doctors are payed (for the most part) By Government not insrance companies.

Again, I am an advocate of socialized BASIC medicine. Based on personal experiences and not hersay.

SWR
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Old 02-03-2010, 02:05 PM   #11
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Yes, but besides your supplemental (insurance) medical costs you pay out of pocket - the Canadian Govt. pays the balance of your incurred medical (insurance) costs to private health care/medical providers - out of the taxes paid by all Canadians. As I mentioned in my ramblings: " Let's face it – there is no such thing as free medical coverage – except for the uninsured". All Canadians pay (through their taxes) for health care (insurance).
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Old 02-03-2010, 04:02 PM   #12
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All Canadians pay (through their taxes) for health care (insurance).
I perfectly understand that fact. I mention it above in one of my rants. What I am saying is I Pay a LOT more in the USA for a lot less LESS coverage. Remember I talk from experience. I prefer living in the US, so I put up with it. My choice entirely.

I had a procedure in Canada and it cost me NO OUT OF POCKET extras at all. I had the same exact procedure in the US, It cost me $10k + out of pocket. The only difference is I had a private room in the US versus a shared room, which was actually by luck not planning. It was not worth 10k for 4 days. If I did not have insurance and I had money to take, it would have cost $120k + OUT OF POCKET, I have a mountain of paper to prove it. In Canada NADA! (Taxes excluded). AND I was not bombarded with dead trees for years after the procedure. That alone along with all the phone calls sorting out the errors is worth it alone.

This was my case, I am sure there are a lot of examples for and against in both scenarios. What I am saying, ALL things Considered IMHO (based on experience), the system in Canada is better Overall.

IMHO Americans are VERY ill informed about this subject. INTENTIONALLY of course I am sure. This coupled with the fact that the majority of us listen to more hearsay than fact, based on how rich the purveyor of such info is.

For some reason in this country, the more money you have the more convincing you can be. We listed to outright lies every day. It is called false advertising. Perfectly legal here, or at least that is what it seems to me.

Remember not all one pays in Canada is allocated for Health Care, I did a calculation a few years ago and it was about 40% less than we pay as a couple in the USA. But we did not have any deductibles or copays ans the services is very similar.

SWR

I know there is no free lunch.
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Old 02-03-2010, 05:45 PM   #13
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This is the current problem in the U.S. - Health care insurance is the only type of insurance that one is "expected" to actually use. None of us ever wants to file a claim against our car, house, or life insurance. That would mean your car was wrecked, your house was damaged, or you died...

Health insurance in this country needs to be divided into two distinct coverage categories. The one you "are expected" file against, and the one you hope to "never" file against. I divided them in my first ramblings: the National health care insurance pool was to address those areas of health care that are categorized as life altering (live with, or potentially terminal). The other category was for normal health care concerns.
The normal coverage area is for everything in life that sneaks up on you, but you are expected to recover from quickly (colds, flu, broken bones, etc.)

The national coverage area is for things that sneak up on you and you will never completely recover from (diabetes, cancer, ICDs, etc). Not meaning to single you out, but an implanted defibrillator (if I'm correct) is one of those that fits this category.

The health care insurance industry "does not" separate these categories and is expected to cover all ailments. This is where they individually get you. Any indication that you could easily slip into the "won't recover completely" scenario - and your insurance is jacked up or canceled. They use anything in your current health status to clip you accordingly. Take this unfair leverage away for them, and they're left with (competitively) selling you health care insurance for just normal coverage. Creating the national pool of health care coverage accomplishes that goal. If you should get unlucky and manage to pick up something that places you in the national pool for specific coverage of an illness - they suffer no losses (they are your greatest advocate for assisting you with getting that national coverage). They would handle the entire process (treatment, billings, etc.) as if you were their customer and the treatment was normal business....

We also need everyone to purchase individual/family health care insurance as they do now for auto/home/life. Allowing the health care insurance industry to group/customize coverages "of any size/type" via (big) businesses, culls the herd in their favor and leaves many out in the cold - having to negotiate in a totally unfair scenario (you know all too well what I'm talking about here). It also pushes (big) business to look unfavorably on older workers.....

Pull this off for everyone in the U.S. and the health care insurance industry will have to compete with other providers for your business on a level playing field. Policy costs would go down and health care costs would go down accordingly.

I have to correct myself on one area of health care that I threw in with the others - the drug companies need to be regulated as to rights. They currently are allowed to gouge in the U.S. on newly discovered drugs as a single source provider. This should end immediately! In all fairness they should be awarded royalties off any competing drug maker looking to produce the new discovery. If an improvement should be discovered (by a competitor) they should all share in royalties. Allowing drug companies to gouge is Un-American!
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Old 02-03-2010, 06:09 PM   #14
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I perfectly understand that fact. I mention it above in one of my rants. What I am saying is I Pay a LOT more in the USA for a lot less LESS coverage. Remember I talk from experience.
Anyone who has done any research knows that the health care cost per capita in the US is considerably higher than any other country, that's well documented. And there is no concrete proof that health care in the US is better (ie, worth it), if anything longevity and infant mortality stats suggest the US is well down the rankings. The US is the only remaining developed country that does not have universal and/or socialized health care for all it's citizens.

Lobbyists are a problem, but the mainstream population enables them because they don't resist - they could. The majority have health insurance through their employer, with the employer typically footing 80%+ and the employee 20% or less. What employees don't realize, is they pay the balance when they purchase goods and services - they only "see" the small contribution they have to make. So the mainstream population "grunts heavy and lifts light" when they talk about health care. They feel bad for those who don't have coverage, but they quietly don't want their current plan tampered with.

The information is all readily available. Let us know when you figure out how to get it to register with the mainstream population, until then you can expect the status quo.
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Old 02-03-2010, 06:14 PM   #15
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....IMHO Americans are VERY ill informed about this subject. INTENTIONALLY of course I am sure. This coupled with the fact that the majority of us listen to more hearsay than fact, based on how rich the purveyor of such info is.

For some reason in this country, the more money you have the more convincing you can be. We listed to outright lies every day. It is called false advertising. Perfectly legal here, or at least that is what it seems to me.

.....
With all due respect to your views, which I am not arguing for or against, it is very hard for me to read about how "Americans are intentionally very ill informed about this subject." (I hope you don't mean to insult Americans.)
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Old 02-03-2010, 07:38 PM   #16
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With all due respect to your views, which I am not arguing for or against, it is very hard for me to read about how "Americans are intentionally very ill informed about this subject." (I hope you don't mean to insult Americans.)
I didn't take it that way at all - I believe the reference was to imply that Americans get the best up to date information available (that money can buy).... Anyone regularly watching cable news channels can easily figure out who's paying for what.
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Old 02-03-2010, 07:48 PM   #17
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I didn't take it that way at all - I believe the reference was to imply that Americans get the best up to date information available (that money can buy).... Anyone regularly watching cable news channels can easily figure out who's paying for what.
Oh, now I see what you're explaining, thanks--my intial take on ShokWave's rant was that Americans are intentionally ill-informed (i.e., Americans choose to not be informed). I take all "news" with a huge grain of salt, personally.
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Old 02-04-2010, 06:34 AM   #18
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One other clarification I should make is about Insurance. When I had my second implant, by far the MOST stressful part of it was dealing with the insurance companies afterwards, the oppo itself was painless and well done, the care I received was good.

BUT, arguing for a YEAR and more with the insurance companies (we has double coverage) was a nightmare! What is covered what is not what was DENIED, In Plan out of plan, Blah Blah Blah, I had to write to my congressman, local health care folks in Tallahassee, you say it I did it, and I am not alone. I have a MOUNTAIN of paperwork on this to prove it. Finally we came to an agreement, I nearly had a heart attack figuratively speaking that is, and that was not my problem in the first place. This kind of stress only compounds the issue. They just do not get it! (Insurance companies)

When I said earlier that we do not need Health Insurance we need Health Care, I meant we need a Meaningful Health Care Plan. I know we have health care, and the service is for the most part very good.

Let us STOP pandering to everyone and their mother that waves votes and bucks at us, and think about the problem for a change. It is not hard to fix really, just look at Europe, Japan, and Canada. It works for them. It does not need to be perfect, just not let us go broke when something that is BEYOND our control happens. IMHO It is a human rights issue, or at least it should be.

SWR
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Old 02-04-2010, 09:02 AM   #19
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I think it is important to look at Canada's last 50 years of flirting with socialism. A whole lot of things were run by the government - the ferries are one thing that pops into my head. For a time the economy was in real trouble, with the Canadian dollar exchange rate almost 50% higher than the US dollar. In the last couple of decades, the government has done many things to control their spending and clamping down on excessive costs in all sectors of the government.

The Canadian government sets the rate of compensation to doctors. Although it is difficult to get exact numbers, the US physicians are paid between 50% and 100% higher than Canada. The cost of drugs are held down by the Canadian government bargaining a fix price with all manufactures. Plus, in Canada, physicians are under heavy pressure to use generic drugs - while in the US, the pharmaceutical companies put heavy sales pressure on doctors to use the latest (but not always the greatest) drugs.

Most importantly, the Canadian system has evolved over a long time. They have learned what works in their country and what does not.

For the US to suddenly switch to an entirely new health care system would certainly result in massive inefficiencies and endless headaches for the patients. There are many, many things the US can do right now to many of the problems we all know exist. In the future, periodically, the system can be revisited to continue to improve competition and reduce costs using capitalism coupled with governmental regulations.

The Sherman Anti-Trust Act was passed in 1890 to break up many monopolistic cartels - from oil to tobacco. There is no reason the same kind of legislation can't be passed today to break up the health insurance cartels, and clean up a ton of inefficiencies in a health care system that has become a political, money-hungry machine, rather than a program to maintain the health of the American people.
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Old 02-04-2010, 06:03 PM   #20
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Shokwaverider,

Couldn't find this thread anymore - linked to it from an email.

I went through a similar situation in 2005 when I became unexplainably ill. Hit me like a ton of bricks and no one could tell me what was wrong. Spent thousands with heart specialists, gastroenterologists, and finally surgeons. All they could find was gallstones, and they weren't bothering me, but was causing a stomach coating from bile back-up. No one was sure that this was what was causing the problems, but they recommended removal. This caused me to get worse, and have other issues. Went to other specialists (internal meds, and allergy), but to no avail.

I figured out by myself that a simple BP medication was the only constant string throughout the ordeal. Since I was taking two different BP meds at the time - I stopped taking the original one, and all of the symptoms cleared up. This ordeal went on for over 2 years. I had only been taking that BP med for a little over a year when this all started. I was normally a little high, but always told the doctor "no" for going on a BP maintenance drug. My a little high BP, used to be considered normal not that long ago....

I also had mountains of paper billing and numerous issues. A lot of claimed out of network was paid when I disputed it. A "year" after the surgery, I received a bill from an anesthesiologist for the surgery. Since I had already paid one I called the insurance company to complain. I was told that this anesthesiologist was "on-call" for the one administering for me, and that the billing was legitimate - they paid their portion and sent the rest to me to pay. One year later (and they have one year to file all claims), and this doctor wasn't even in the hospital.......

Talk about nitwittydom to the max here. Been fine for three years now.

A lot of frustration with the insurance company could have been eliminated if competition was leveled as I mentioned with my earlier ramblings. They wouldn't be so quick to upset me and fight where they knew they were wrong not to pay the bill (out of network, right). I could definitely see costs go down, too, from increased competition. It's not going to go to Canada style anytime soon, so we should push to correct what we can to eliminate what you and I went through with them. As for doctors - I'll let my story speak for itself....
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