Americans want universal health coverage

[free4now]

The good part is they do 60 day supplies for the same co-pay as a 30 day supply at a regular pharmacy for letting them cut out the middleman and his profit.

I hate to say it, but I've had a bad experience with mail order prescriptions as well. I use a prescription shampoo. It only comes in one size bottle, which is considered a 30 day supply. I tried ordering a 90 day supply through my insurance company's mail order provider. They took the order, took my $20 copay, and sent me just a single bottle instead of three. Figuring out what happenned took lots of followup, but eventually I got someone who said that it was because my prescription was only written for a 30 day supply (with lots of refills). I asked them "is there any way I can confirm ahead of time that I'll get a 90 day supply when I order and pay for a 90 day supply?" Their answer: No. "Can you refund my money since you didn't send me the 90 day supply I ordered?" No... prescriptions are nonrefundable.

Next time I had my doctor explicitly write a 90 day prescription. Sent it in, and got another single bottle (30 day supply) for the $20 copay. I didn't bother following up that second time, I'm assuming they must just have some rule they can't send more than one bottle per order.

I considered reversing the charges with my credit card company, but decided it wasn't worth getting into a war with my health provider.

I went into the local pharmacy and found that I only pay $5 copay for a single bottle. So even if I had gotten the full mail order supply it still would have been more expensive.


The problem with privatized healthcare is that it's nearly impossible for the customer to shop around for the best deal. Unlike all other industries, healthcare providers charge you however much they see fit, for whatever they see fit, without much if any veto rights on the part of the consumer. Add onto that the insurance companies financial motivation to not provide what you pay for, and it's just bad new for the little guy. The only way to win is not to play the game.

 

[uncledrz]

I conducted my own study, and found that cruising boaters wanted free beer.

dory, your subset is too small. I conducted the same study last Friday night and the findings apply to the general population as well . I order to verify the findings, I've decided to continue my study tonight

On the universal health care, we are not, IMHO, ready for it at this time, even though it may be needed on many fronts, the cost is beyond our capabilities. A more uniform system should be possible, but I don't think we can get there with the leadership we now have.

 

[ladelfina]

It appears that the pharmacies - at least our local ones - are severely limiting quantities of meds they are holding in inventory to cut costs, preferring to "almost just in time" inventory filling that takes a couple of days.

(laugh) WalMart & Costco are just getting up to speed with "almost just in time" inventory?

That's exactly how every little mom 'n' pop pharmacy (that I've been to) does it in Italy. If you stop by in the morning and they don't have something, they place an order with some local distributor and will have it for you later, quite often the same day.

Instead of appointments, the public health physician in our town has posted office hours one or two afternoons a week (I remember my dad in the US worked in this old-fashioned way). The doc is in neighboring towns (like 5-10 miles away) on the remaining days so if you needed to, you could go a bit out of your way on an 'off' day. It's just walk-in and first-come, first-served. (except for emergencies - we all waited patiently when someone came in with something in his eye that needed removing right away - both he and the doctor asked very politely if we didn't mind...). It takes however long it takes. I have the doc's home phone and cell phone numbers so if something really serious happened I could always call him. Hey, wait, that's almost like "Concierge" medicine. 

I haven't had any real health issues so far, but aside from the open wards in some hospitals and having to bring your own towels, soap and TP, the technical quality of care seems very good, from relatives' experiences. You do have to wait longer for elective procedures than in the private system, but the length depends on where you are and what you need done. You may be called in earlier than necessary and then have to wait. In their system the gov't. pays the hospitals by the day, so if there's an open bed they stick you in there as kind of a "squatter" so no one else grabs it until they're ready for your procedure some days down the line. My DH went in for lithotripsy (ultrasound bombardment of kidney stones) and was in-patient for 5 days: 3 before and 2 after! That's not perfect, either, but in the US, they would probably do it drive-through to "cut costs", whereas here they wanted to keep an eye on him to make sure there was no bleeding or other complications. One downside is that once a bed opens up, they can give you very little notice, calling you at 5pm and telling you to show up at 7am the next day or lose your 'place in line.' Doesn't seem to be a big deal as everyone just adapts and 'goes with the flow'.

the cost is beyond our capabilities.

Untrue.

The US spends double (1/2 privately and 1/2 publicly funded) what other OECD countries spend per capita on health care, and many of these places do better than the US according to indicators like infant mortality, longevity and so forth.

We ALREADY spend public $ per capita equal to what they are spending in Switzerland or Japan.
Then we pay that much more again.
Then we look around and see that we are only covering 80% of the population, while they cover everybody.

 

[cute fuzzy bunny]

I seem to recall you had a few (probably exaggerated ) horror stories about e-mail customer service, too.

Email is worse than calling. Half the customer service emails I send are responded to that I have to call their 800#. Apparently the email people have figured out how to significantly reduce their work load. The only decent customer service I've gotten in the last couple of years has been from Leapfrog and from Canon, both of which responded admirably. Everyone else fell somewhere between 'inadequate' and 'useless'.

For someone who seems to have a pitch-perfect memory of every subpar experience from the last twenty years, do you have any personal experience with organizing a customer service department, or a nifty approach that would resolve their big problems? Or do you have a dismissive one-liner that chalks it up to cheap, stupid, immoral companies and brain-dead corporate culture?

Now theres a nice constructive comment and question.

I provided customer service to hundreds of customers in my 20's when I was doing a couple of startups. I said what I was going to do, and then I did it. If I couldnt do what I said I would do, when I said I'd do it, I called or visited the customer and explained why, and made it up to them.

Later when I ran about 1/3 of the IT shop of a fortune 500 company, servicing approximately 110,000 users, hundreds of satellite offices, hundreds more of our customers with thousands of employees each, etc...I used the same formula to fairly good success.

Its not rocket science.

If I buy something and someone tells me its to be delivered on a certain day, either deliver it or call me and tell me what screwup happened and then make it up to me.

If I call your tech support for a product, I expect to get someone that is knowledgeable enough in the product to identify problems and solve them, or replace the product.

The formula I now receive ~95%+ of the time is to tell me what I want to hear to buy the product and then deliver it when you feel like it, if at all, and often not when the seller says they will, without any communications as to breakdowns in the process.

If and when the product develops a problem, wait 2 days to reply to my email that they cant resolve my problem in email. I then call to hear that they, like every other company on earth, are now experiencing an unusually high call volume! 20 minutes later, I get a guy in another country who cannot understand what my problem is or what I'm even saying, and knows very little about the product, but will read me a script of things to do that have nothing to do with my problem.

I realize that it costs time and money to communicate with your customer effectively. Whats galling is to watch companies pull up short on meeting their committments, fail to communicate at all, lose customers, then spend billions on incentives to get new customers on board.

I guess rolling this back to the original topic, what we can probably expect from universal health care is what we used to get from the old 'ma bell'. Satisfactory, relatively reliable service at a high cost with tons of bureaucracy and an "I dont give a crap about you" attitude. Hell, Lilly Tomlin is still around to do ads for them...

 

[AFloat]

I conducted my own study, and found that cruising boaters wanted free beer.

I'd vote for that but I'd rather have universal health care.

We get our perscriptions via a Canadian mail order co. with no problems and at half the US price.

 

[Martha]

I guess rolling this back to the original topic, what we can probably expect from universal health care is what we used to get from the old 'ma bell'.  Satisfactory, relatively reliable service at a high cost with tons of bureaucracy and an "I dont give a crap about you" attitude.  Hell, Lilly Tomlin is still around to do ads for them...

Pretty much the same as we get from insurance companies.

 

[Rich_by_the_Bay]

Pretty much the same as we get from insurance companies.

Nicely summarized.

At least Universal will be, well, universal.

 

[Cool Dood]

Now theres a nice constructive comment and question.

Maybe you were already taking this into account, but I didn't mean my comments or questions in a snarky way, although I realized afterward that they could come across that way. I guess I should really take longer and work on that clarity of expression thing.

If and when the product develops a problem, wait 2 days to reply to my email that they cant resolve my problem in email. I then call to hear that they, like every other company on earth, are now experiencing an unusually high call volume! 20 minutes later, I get a guy in another country who cannot understand what my problem is or what I'm even saying, and knows very little about the product, but will read me a script of things to do that have nothing to do with my problem.

Christ almighty, the f'in day after I write that post, I have an urgent customer service need for like the first time in five years, and there's no response to e-mails or "live-chat," and when I call they're "experiencing a heavy call volume," even though the phone rang like ten times and I'm sure there's no one else who's calling now!!!!

I f'in give up....

This is insane, and I guess... I guess.... ok, gimme a break, and while you're at it pass me a tissue, this is hard to say.... I guess you were right!


(ah, I did get a bit of relief... I just got the e-mail response while previewing this message, and it hasn't been all that long. You can still have the point, although I don't feel all that hard done by in this particular circumstance.)

 

[cute fuzzy bunny]

Welcome to my world.

My wife has an alternative solution to the customer service problem: stop buying things!

As far as the universal health care, it does solve two problems for my wife and I: escalating costs for an ER and the problem of getting her health care when she decides she's had enough of working, since she has a preexisting condition that no insurer would accept.

 

[d]

Satisfactory, relatively reliable service at a high cost with tons of bureaucracy and an "I dont give a crap about you" attitude.

you have no doubt underestimated the latter two, and grossly overestimated the first two; with the insertion of "very" you've got the cost about right.

 

[cute fuzzy bunny]

Quite possible.

Whats the other alternative? Health care only for the healthy and wealthy?

 

[Rich_by_the_Bay]

Whats the other alternative? Health care only for the healthy and wealthy?

You forgot "employed."

 

[razztazz]

You forgot "employed."

C'mon. You know better than that. Employment is no gurantee of medical insurance. In fact the big push these days is to cut cut cut cut cut it away. What they want is for people to me made to work and also NOT get any medical insurance associated with it. Red da papers lately? And then if one should get too sick or injured to work..well there goes your insurance model.

 

[maddythebeagle]

You forgot "employed."

and retired government employees

 

[razztazz]

You forgot "employed."

and retired government employees

Yep.. My gov provided policy works fine. If "The System," starts giving me lip about a test I need, (I can tell they're squriming about what the insurance will allow or what they'll pay) I just pay for it myself. Go over everybody's head. Shoot holes in the Dr's misdiagnosis (every wrong and very expensive) at the same time. Everybody's a winner.

 

[d]

Whats the other alternative?

you suggest that i have a viable alternative to the current system; i don't -- nor have i seen a convincingly viable alternative put forth elsewhere. achieving what i suspect folks want is not likely possible, and attempts to reach such an unachievable result will end as you have suggested, subject to my modifications: "less than satisfactory, relatively unreliable service at a very high cost with tons near unimaginable levels of bureaucracy and an "I dont give a crap about  f**k you" attitude.

 

[Lakewood90712]

If Walmart sold medical insurance ,  started a chain of hospitals and medical offices, they could import doctors and rx. from china and undercut the competion. Cost would be so low that most anyone could afford it.

That would really piss-off the AMA and others, but they could prob. make it work if they wanted to.

I think Costco already offers insurance to customers.

Not the kind of hospital I'd go to , but maybe not such a nutty idea ?

 

[d]

they could import doctors

no doubt you've noticed that we've been importing MDs for many years now ...

 

[razztazz]

Whats the other alternative?
you suggest that i have a viable alternative to the current system; i don't -- nor have i seen a convincingly viable alternative put forth elsewhere. achieving what i suspect folks want is not likely possible, and attempts to reach such an unachievable result will end as you have suggested,

So much for the Big Pie Principle.

 

[d]

If Walmart ...

re Walmart clinics, see:
http://money.cnn.com/2006/03/31/news/companies/walmart_f500_fortune_041706/index.htm

 

[treypar]

I am ready to retire and have the funds but health care insurance is my major issue. I do not know how to solve this problem.

 

[Craig]

Yea, sign me up for this brilliant move ... can't wait to get health care like they have in Great Britain ... :

 

[razztazz]

Yea, sign me up for this brilliant move ... can't wait to get health care like they have in Great Britain ...

You're saying that the American medical machine is no better than England's? Or the American insurance industry is no better than England's? You're saying, if there were to be any Gov involvement, and there need not, that the US gov is and can be no better than England's?

The same people who constantly crow about how great the American "anything" is simultaneously find every component of it infinitely trashable. We simply can do not better... be no better.. manage no better.. produce no better than whatever their most deridabe straw man example is. But we're better than everybody. But all extant deficiencies are OK and must not be addressed or we'll be "Like Them"

(Unless I'm reading you wrong)

 

[astromeria]

If the gubmint provided catastrophic insurance, almost all Americans could afford to self-fund or buy inexpensive insurance for physicals, tests, and treatments. No doubt there would be a desire for gold-plated, wrap-around insurance as well, just as those who can affiord it now buy Medicare wrap-around policies. (Obviously the poor would need more complete assistance, as they do for food and housing.)

As a first <I mistyped that as frist>step, COBRA should be extended to 3 or 4 years (at cost plus 1%), and 60-year-olds and up should be able to buy into Medicare at cost.

 

[Rich_by_the_Bay]

If the gubmint provided catastrophic insurance, almost all Americans could afford to self-fund or buy inexpensive insurance for physicals, tests, and treatments. No doubt there would be a desire for gold-plated, wrap-around insurance as well, just as those who can affiord it now buy Medicare wrap-around policies. (Obviously the poor would need more complete assistance, as they do for food and housing.)

As a first <I mistyped that as frist>step, COBRA should be extended to 3 or 4 years (at cost plus 1%), and 60-year-olds and up should be able to buy into Medicare at cost.

Astro gets it right once again. Dead on.

Pretty sharp for someone from the slow country .