Sad Story

[Bestwifeever]

Kat, as I said, I am so sorry about your friend. I think the person who mentioned she had been depressed got that idea from the link you provided:

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Sad stories quickly spread. A writer, artist and longtimereviewer for such esteemed publications as Publishers Weekly, Melissa had been depressed over finances and the death of her sister years before. Most recently, her beloved dog, Daisy, had been sick and she had strained herself lifting her. It had been a bleak winter of worries and frustrations and fear.

I remember 25 to 30 years ago that affordable health insurance was readily available through associations, guilds, etc., for people in the creative arts to join. That model seems to be gone for the most part--I just checked the Chicago groups I know about and it's no longer offered. But that still was a group policy, so even that wasn't the solution to affordable health insurance for all.

[snodog]

So sorry to hear about your loss. Maybe this will draw attention for change so that healthcare will be a right in the US someday.

[Bestwifeever]

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Originally Posted by Purron ...Since this topic keeps coming up in different threads, I think there is a strong desire to talk about health care - an issue which certainly pertains to early retirement. It would be great if we could find a way to talk about this issue without the thread getting closed.

Any thread is likely to be closed when discussion deteriorates into partisan political commentary and sniping.

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Speaking of closed threads, I see RonBoyd's is now closed. I don't understand why. I would have been unhappy if I had been away from my computer for a day and didn't even get a chance to say something to him before the conversation was ended.

As admin JanetH suggests (after she explained the rationale behind closing that thread), people can PM RonBoyd with comments if they wish.

[Texas Proud]

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Originally Posted by Silver ERD50....I do not agree with your statement above at all. In many cases, individual health insurance is NOT available at an affordable cost. Some people make a huge effort to try and get health coverage under our "messed up system" only to be turned away time and time again. This is because they cannot afford the cost for catasrophic coverage plus paying 100% of their healthcare costs because the deductable is so high. Sometimes it comes down to a choice......buy healthcare insurance and be homeless, or have a home and hope for the best. Perhaps you don't live in the United States so don't understand our current healthcare system. It isn't an emotional issue....and it's not personal. It's just business. Healthcare if is simply a product just like toothpaste or printer paper. If you can buy it, you can get it.

I think the point is that people throw around a number of between 30 and 50 million without insurance... but when that number was actually put to scrutiny it was not as 'bad' as it looked.. a lot of people could afford insurance, some could get help from the gvmt (medicaid)...

The point is we do not know why she did not have insurance... and we will not be able to find out either.... and as mentioned before, we do not know if the outcome of this story would have changed if she had insurance...

[ERD50]

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Originally Posted by Silver "Many of those people choose to be uninsured (it's available, and at reasonable prices, yet they don't pursue it), some don't take the extra effort that is required under our messed up system to get coverage". ERD50 ERD50....I do not agree with your statement above at all. In many cases, individual health insurance is NOT available at an affordable cost. Some people make a huge effort to try and get health coverage under our "messed up system" only to be turned away time and time again. ....

I don't think we really disagree, we just need to look at my words more closely - I said "many" choose, I didn't say "most" because I don't know if that is true. And I agree with you - our messed up system makes it difficult (often impossible in practical terms) for many people to get insurance. It is one of the reasons we need reforms.

But I take exception with broad numbers like "50 million". I don't know what the real numbers are for people who are effectively "shut out" of the system, I imagine a search would come up with some questionable number that might at least give us a rough range. But I absolutely do know people who could have bought cheap policies and didn't, I absolutely do know people who could make more of an effort to hold a job that does provide coverage, etc. And if I know some of those people, I'm guessing it isn't an insignificant number overall.

-ERD50

[FIRE'd@51]

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Originally Posted by obgyn65 This story, plus the many cases I know of, are the main reason why I am a huge supporter of Obamacare.

Just curious. Exactly how did Obamacare help in this case?

[Major Tom]

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Originally Posted by FIRE'd@51 Just curious. Exactly how did Obamacare help in this case?

It didn't. That was his point. Obamacare doesn't kick in until 2014.

[FIRE'd@51]

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Originally Posted by Major Tom It didn't. That was his point. Obamacare doesn't kick in until 2014.

Oh, that's great. Help is on the way in three years. Wonderful. What about all the people who need help now or they will probably be dead by 2014?

[obgyn65]

Hi ERD50 - The last time I debated with you on this topic, the thread was closed as deemed "too political". This time I will stay away from this thread.

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Originally Posted by ERD50 But I also think it is over-reaching to say that 50 million (or whatever number) are uninsured through no fault of their own.

[Katsmeow]

FWIW, the author of the article is a novelist who was a friend of Melissa's. I also think we do know why she didn't have health insurance. It was money. I think the facts if looked at reasonably indicate that she thought it was a non-life threatening injury from picking up her dog. She had in the past called a doctor and asked for a prescription to try to avoid the cost of the visit.

We can speculate that even with health insurance she might have called for the prescription and not gone to the doctor. No one can know what would have happened. I think it is without doubt that she would have had more and better choices if she had insurance or if we had a somewhat different healthcare system (I still can't wrap my head around the fact that people without insurance paid more. I had gall bladder surgery a couple of years ago and what the insurer paid was a small fraction of the billed cost).

[FIRE'd@51]

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Originally Posted by Katsmeow (I still can't wrap my head around the fact that people without insurance paid more. I had gall bladder surgery a couple of years ago and what the insurer paid was a small fraction of the billed cost).

I struggled with this for many years, as well, and finally was able to justify it in my own mind as simply a benefit of paying into the system by purchasing the insurance (even a high deductible policy). Even if the policy never pays a dime, one still benefits from the negotiated rates.

[Nords]

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Originally Posted by Katsmeow I'm sure that if she had realized that her pains were heart attack symptoms she would have done that. I have no doubt that if she thought she was having a heart attack she would have gone to the ER.

I'm sorry, Katsmeow.

From my limited understanding of the subject, women's heart attack symptoms can be very confusing to diagnose.

Quote:

Originally Posted by Purron Speaking of closed threads, I see RonBoyd's is now closed. I don't understand why. I would have been unhappy if I had been away from my computer for a day and didn't even get a chance to say something to him before the conversation was ended.

Happened pretty fast, hunh? I was surprised to see it close so soon too, until I started reading it.

The whole point of throwing a temper tantrum and huffing off is to not have to listen to the other posters...

[Silver]

Quote:

Originally Posted by FIRE'd@51 I struggled with this for many years, as well, and finally was able to justify it in my own mind as simply a benefit of paying into the system by purchasing the insurance (even a high deductible policy). Even if the policy never pays a dime, one still benefits from the negotiated rates.

I'm sorry.....but the last statement is just not true. Whatever amount that is paid to a healthcare provider before the deductable is met is paid at the total billed rate. There is no negotiated rate or discount for any healthcare services when paid by the consumer, unless the healthcare provider has agreed to a "cash-pay discount" prior to the provision of services.

Unless you have some special arrangement (which if you do that's great....but very uncommon) American's pay into the healthcare insurance system, but still pay 100% charged rates prior to meeting any deductable, which may be several thousand dollars a year.

So....perhaps we pay only $1,000/month for a catasrophic policy, with a deductable of $7,000/year. The consumer pays $19,000 a year before dime number one is paid by the insurer.

I'm not seeing the benefit of negotiated rates here.

[FIRE'd@51]

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Originally Posted by Silver I'm sorry.....but the last statement is just not true. Whatever amount that is paid to a healthcare provider before the deductable is met is paid at the total billed rate. There is no negotiated rate or discount for any healthcare services when paid by the consumer, unless the healthcare provider has agreed to a "cash-pay discount" prior to the provision of services. Unless you have some special arrangement (which if you do that's great....but very uncommon) American's pay into the healthcare insurance system, but still pay 100% charged rates prior to meeting any deductable, which may be several thousand dollars a year. So....perhaps we pay only $1,000/month for a catasrophic policy, with a deductable of $7,000/year. The consumer pays $19,000 a year before dime number one is paid by the insurer. I'm not seeing the benefit of negotiated rates here.

Well. perhaps it has something to do with the PPO nature of our insurance policies, but both DW and I have benefited (with different insurance companies) within our network from the negotiated rate even though we hadn't satisfied the deductible. Of course, only the negotiated rate was applied to our deductible (not the billed rate). However, it even works out better than that because our hospital gives us a 25% "prompt pay" discount for paying our copay (after the hospital has filed the claim with the insurance company) within 15 days. So in actuality, we still end up with more $ credited to our deductible than we actually paid.

[ERD50]

Quote:

Originally Posted by Silver Quote: Originally Posted by FIRE'd@51 ... Even if the policy never pays a dime, one still benefits from the negotiated rates. I'm sorry.....but the last statement is just not true. Whatever amount that is paid to a healthcare provider before the deductable is met is paid at the total billed rate. There is no negotiated rate or discount for any healthcare services when paid by the consumer, unless the healthcare provider has agreed to a "cash-pay discount" prior to the provision of services. Unless you have some special arrangement (which if you do that's great....but very uncommon) ...

Quote:

Originally Posted by FIRE'd@51 Well. perhaps it has something to do with the PPO nature of our insurance policies, but both DW and I have benefited (with different insurance companies) within our network from the negotiated rate even though we hadn't satisfied the deductible. ...

Well, you made me look. I have ins from a mega-Corp, so I assume it is similar to others and I absolutely got the negotiated rates for the amounts that I paid out-of-pocket before I hit the deductible. Specifically, on one bill, I paid $122 out-of-pocket for $315 "charged", all of which was applied to the deductible which was not met at that time. The $122 was the "allowable charges" out of the $315.

-ERD50

[NW-Bound]

Sorry to hear about your friend, Katsmeow.

If Melissa were penniless, she would have received care and been alright. My state has an indigent health care system, and I am sure most (all?) states have something similar.

My mother told me the following story, back when she was spending a lot of time at a convalescent home with my late father who was recuperating there.

Another patient in the same ward was a homeless woman who was recovering from a heart attack after getting discharged from a hospital. Her homeless husband, who wandered the streets with her and who managed to get a 911 call that saved her life, hanged around during the day when he was not out looking for some day laborer's work to make a bit of money. He most often came back empty handed, not finding any work, and my mother once gave him a bit of money, like $20. At night, he found a place to sleep somewhere. After the woman recovered, they were turned back out into the streets. But the medical care she received was the same as any other patients, such as my late father who was on Medicare.

I just don't know what to make out of that, or to draw any conclusion. I don't know what the solution is, but people at the two ends of the wealth spectrum get covered, while people with few means are left out.

[Purron]

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Originally Posted by ERD50 have ins from a mega-Corp, so I assume it is similar to others and I absolutely got the negotiated rates for the amounts that I paid out-of-pocket before I hit the deductible. -ERD50

A great number of Americans who currently have decent health care coverage have it because they work/worked for a Mega Corp or a Federal/Local government agency and got bennies like negotiated rates and limited out-of-pocket expenses.

Questions: Is this really the American way? Why is access to good, affordable health insurance coverage tied to where you work? How many people are trapped in an unproductive job with a big corporation or the government because they can’t risk the loss of health insurance? How many brilliant people who may be thinking about starting the next big successful company in our country won't try it because they need guaranteed insurance coverage?

Many people right here on ER.org stuck with a job they hated with the government or a big company just long enough to get the retiree health benefits. Imagine if some of these brilliant people were free to move on to a job they loved instead of hanging on to a job they hated just because they needed the insurance coverage.

Seems to me this is not promoting productivity, small start up companies and the entrepreneurial spirit in America. If Bill Gates was working for the Department of *Whatever* and had a kid with a health problem, would he have risked chucking it all to start Microsoft?

[ERD50]

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Originally Posted by Purron A great number of Americans who currently have decent health care coverage have it because they work/worked for a Mega Corp or a Federal/Local government agency and got bennies like negotiated rates and limited out-of-pocket expenses. Questions: Is this really the American way? Why is access to health insurance tied to where you work? How many people are trapped in an unproductive job with a big corporation or the government because they can’t risk the loss of health insurance? How many brilliant people who may be thinking about starting the next big successful company in our country won't try it because they need guaranteed insurance coverage? Seems to me this is not promoting small start up companies and the entrepreneurial spirit in America. If Bill Gates was working for the Department of *Whatever* and had a kid with a health problem, would he have risked chucking it all to start Microsoft?

Excellent questions. I agree 100% that Health Insurance should not be tied to employment. Imagine if our car or homeowners insurance was tied to our employer. If we lost our job, wanted to change jobs, or start our own company, we would need to worry about how we would keep our car or our home insured. Crazy, right?

Why should Health Insurance be any different? I shouldn't. But the govt created this situation when they gave preferential tax treatment to Employee provided Health Insurance. Then companies used this to attract talent, as it was 'cheaper' than salary. So companies competed with 'better' policies, which means low/no deductibles, low/no co-pay, and all of that just moves the whole idea of what insurance is supposed to be about and raised prices for everyone.

One of the reasons I'm so skeptical of the govt providing the 'answers' to our HC problems, is that they are the cause of most of the problems we have today. Fool me once...

-ERD50

[Letj]

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Originally Posted by ERD50 I'll start at the end - It appears that this person chose to do what she loved, and that didn't come with coverage. Some of us chose to do things we really didn't 'love', in order to get/maintain that coverage. -ERD50

It detect quite a bit of derision in this comment. Why shouldn't she do what she loved while at the same time having healthcare? Why should working for a large corporation with cushy coverage be more valuable than her chosen vocation? This is essentially why universal healthcare is a must in every society so you don't have to choose a profession that you hate just for medical coverage. I would hate to live in a society where everyone chose the "right" and most "lucrative" career just to get health coverage. I like having artists, philosophers, accountants, scientists and yes even thinkers in society. God forbid if we all worked for big corporations and governments just to have great benefits.

[Westernskies]

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Originally Posted by ERD50 One of the reasons I'm so skeptical of the govt providing the 'answers' to our HC problems, is that they are the cause of most of the problems we have today. Fool me once...-ERD50

Oh, come on ERD50, how can you say that? Look at Freddie, Fannie, SS, Medicare, Cash for Clunkers, PBGC, USPS, and all the other successful federal programs. You really need to temper your "skepticism" with a bit of "federalism" and get onboard with with this HC issue, it'll be great. Really.