# Obamacare and Crohn's Disease



## seebee (Jun 28, 2012)

Now that the president's health reform was declared constitutional by the Supreme Court what does it mean for someone with a disease like Crohn's? Do you think it's to our advantage?
I was just wondering since I was never pro Obamacare to begin with.


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## Slim Johnson (Jun 28, 2012)

It is absolutely beneficial for us. Maybe instead of calling it "Obamacare", you could call it the Affordable Care Act (which is it's proper name).

Why are you against it? I am curious. Have you any idea what the bill does? OR was it because of Fox news? Or another reason altogether?

It's disheartening that so many people are against legislation that would directly benefit them. Truly a shame, and an accurate representation of America in it's present form.


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## EthanPSU (Jun 28, 2012)

Couldn't of said it better Slim. This bill will make our medication so much cheaper in the future, you should be 100% for this bill being a Crohn's sufferer


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## Keepingfaith (Jun 28, 2012)

I'm pretty excited about it! It means I can't be denied insurance(or be 'easily' denied) because of my pre-existing medical condition. I can also stay on my parents insurance plan for much longer. God knows, even with a job, at 18 that there is no way I'd be able to pay for all these medications out of pocket.

  It is very sad so many people are bashing it. I think it is because they believe everything they hear on the news & they don't realize that, at any time, they themselves can be DX with a disabling illness with no cure, like Crohn's Disease.


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## seebee (Jun 28, 2012)

I didn't like the idea of it but that was before I was diagnosed so now your job guys and gals is to convince me of it's benefits!


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## DustyKat (Jun 28, 2012)

This just makes me realise how easy it is to take something for granted (universal healthcare) as I have never known any different. 

Good luck guys, I hope the reforms continue. 

Dusty.


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## Slim Johnson (Jun 28, 2012)

Read the bill.

http://www.healthcare.gov/law/full/


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## Slim Johnson (Jun 28, 2012)

DustyKat said:


> This just makes me realise how easy it is to take something for granted (universal healthcare) as I have never known any different.
> 
> Good luck guys, I hope the reforms continue.
> 
> Dusty.


You suck!!:stinks:



Not really.


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## seebee (Jun 28, 2012)

Slim Johnson said:


> Read the bill.
> 
> http://www.healthcare.gov/law/full/


Thanks for the link. I'll definitely read up on it over the weekend.


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## nogutsnoglory (Jun 28, 2012)

I'm thrilled because more people will be covered and rates will go down. We will be protected against discrimination based on our pre-existing condition. 

How does this lower medicine costs though?


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## EthanPSU (Jun 28, 2012)

seebee said:


> Thanks for the link. I'll definitely read up on it over the weekend.


Too bad everyone in the US can't / won't do this. They will spend there day just watching fox news.


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## Slim Johnson (Jun 28, 2012)

nogutsnoglory said:


> How does this lower medicine costs though?


With Medicare, when a person falls in the "doughnut hole", it provides for 50% discounts on brand name medication, until the catastrophic coverage kicks in.

It also allows for preventative care to be covered (which was previously not covered) which would include vaccinations, and cancer screenings.

Also, my last colonoscopy was free, thanks to the Affordable Care Act. It's considered a preventative screening.


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## seebee (Jun 28, 2012)

Slim Johnson said:


> With Medicare, when a person falls in the "doughnut hole", it provides for 50% discounts on brand name medication, until the catastrophic coverage kicks in.
> 
> It also allows for preventative care to be covered (which was previously not covered) which would include vaccinations, and cancer screenings.
> 
> Also, my last colonoscopy was free, thanks to the Affordable Care Act. It's considered a preventative screening.


Does this only apply to Medicare or private insurances as well?


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## Manzyb (Jun 28, 2012)

EthanPSU said:


> Too bad everyone in the US can't / won't do this. They will spend there day just watching fox news.


I prefer to get my news from John Stewart!

:ylol:


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## Slim Johnson (Jun 28, 2012)

The preventative care applies to private insurance, as well as Medicare. 

Medicare will also compensate entirely for some preventative screenings.

Presently I have both private insurance, and Medicare. Thanks to both coverages, and the ACA, my surgery cost me ~1300$; down from >57,000$.


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## DustyKat (Jun 28, 2012)

I would like to give an example of Matt's journey so you can all compare. Bear in mind that nothing is for free, we pay for this system through our taxes and it does differ from country to country. Not every aspect of our system is free and Matt likely received some of his out of hospital care for free because of his age. Having said that if you do have to pay out of pocket a certain amount will be refunded to you via Medicare: 

All of Matt's bloods tests from November 2010 and ongoing - free. 

Medicatons are $34.00 per script or less. 

Hospital admission December 2010 for eight days which included CT scans, IV's, meds, blood, faecal tests, daily doctors visits, etc - free.

Hospital admission January 2011 for 3 and half weeks which included all of the above plus insertion of a drain - free. 

Between discharge and surgery in April all dressing supplies for drain were provided free. 

Weekly GP visits and bloods free. 

Progress scans free. 

Cost to fly to Sydney and back 3 times, including accommodation, was subsidised. 

Visits to two specialists were subsidised. 

Admission to hospital in April for eight days for an ileocaecal resection - free. 

In a nutshell, if you go to a public hospital as a public patient, which is still the main system here, you do not pay anything. Outside of hospital most blood tests are free, PBS scripts are $34.00 full price if you don't have a concession/pension card but not all meds cost that, many GP's bulk bill so that is free, specialists usually don't bulk bill so you have to pay and then claim a certain amount of money back from Medicare, imaging done outside of a hospital will usually need to be paid for and you claim back a certain amount from Medicare. 
You still have the option of private health insurance and can go the private route if you wish. This system would be similar to what you have. 

Sorry Slim...


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## Manzyb (Jun 28, 2012)

I am happy about this.  

I like the idea that one day I cannot be discriminated against, because I have a pre-existing condition.

Do I think its right to force people to buy insurance?  I don't think its wrong.  In the long run, we end up paying for those who don't have insurance.  If someone gets into a serious car accident and/or had some type of trauma, if they don't have health insurance, we don't just let them die and not treat them.  Instead, EVERYONE ends up paying for it in the long run.  It runs medical care prices, drugs, procedures, everything up.    

That is part of the reason why it will help drive prices down in the long run nogutsnoglory.  At least... that's what I gather!  I could be completely wrong.


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## Manzyb (Jun 28, 2012)

Thanks for explaining that some, Dusty.

I knew a little bit about then NHS, but not much.  I don't see what would be so terribly wrong with having something similar to that?


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## Slim Johnson (Jun 28, 2012)

Kat, you throw that word "free" around so loosely!

I thought the price I came away with was pretty good. My son broke his arm last April, and the bill just for the ER was 800$ _after_ insurance. His bill didn't include a week stay in the hospital either..oo:

Several years ago, I had a trip to the ER to stitch up a gash on my head. The bill after insurance was over 1200$! I was beyond shocked.

The ACA is a big step in bringing some sense into American health care.


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## DustyKat (Jun 28, 2012)

> Kat, you throw that word "free" around so loosely!


I refuse to count how many times I used it in that post! :lol:


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## nogutsnoglory (Jun 28, 2012)

Slim Johnson said:


> With Medicare, when a person falls in the "doughnut hole", it provides for 50% discounts on brand name medication, until the catastrophic coverage kicks in.
> 
> It also allows for preventative care to be covered (which was previously not covered) which would include vaccinations, and cancer screenings.
> 
> Also, my last colonoscopy was free, thanks to the Affordable Care Act. It's considered a preventative screening.


My colonoscopy wasn't covered through private insurance.


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## RFarmer (Jun 28, 2012)

EthanPSU said:


> Too bad everyone in the US can't / won't do this. They will spend there day just watching fox news.


Don't even get me started on Faux news. 


I'm not sure how this bill works. Does it mean you have to have insurance? Seems no good for poor people. I mean, where I come from, all our medical expenses are paid. But our prescriptions are not. 

But I would like to take this opportunity to express my firm love for Obama. Why? Because the Reps call him too liberal, and the democrats call him too conservative. He supports gay marriage, quite much against the right, but isn't bowing down to half-year lefties. Meaning, he opposes the crazies in the Republican side, AND the crazies in the Democrat side. MEANING, he isn't working for one side or the other. MEANING, he does what he thinks is right. He works for people, not bipartisanship. He is handsome. He is God. I love barack obama.


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## realtormatt (Jun 28, 2012)

You can thank both Mitt Romney and the GOP from 1993 for today Obamacare.  This is exactly what the GOP proposed in the early 1990's to combat the Hilary Clinton healthcare reform.  It is also pretty similar to what Mitt Romney passed in Mass when he was governor.  In fact Obama's team consulted in Romney's team who created it.  Its a shame that the GOP now is fighting what they wanted 20 years ago just because it was proposed by Obama.

If you watch either Fox News (The right) or CNN (The Left) and believe what you are being told you are sadly misinformed.  

Disclaimer, I am neither a democrat or republican and a small business owner.  I vote based on the prior voting records of the candidates on the bills that are important to me.


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## EthanPSU (Jun 28, 2012)

RFarmer said:


> Don't even get me started on Faux news.
> 
> 
> I'm not sure how this bill works. Does it mean you have to have insurance? Seems no good for poor people. I mean, where I come from, all our medical expenses are paid. But our prescriptions are not.
> ...


Well good because you will most positively be seeing him for 4 more years.


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## RFarmer (Jun 28, 2012)

EthanPSU said:


> Well good because you will most positively be seeing him for 4 more years.


Much better than Dick Rantorum or that political hooker. Both of them are so smarmy. 

I think most who like Rick are right extremists,  and most people who like that other dude (who's name escapes me) think he's gonna save america's economy because he has lots of money. 

I don't know much about politics. But Obama's opponents are just silly candidates. Also, I rigged the elections in his favor.


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## tots (Jun 28, 2012)

I am not sure why I should vote for or be forced into something the President and congress will not take part in. Have you ever wondered why, even after they leave office they no longer need private health care or Medicare? How about the rich in other countries that come to us for medical care? Also- I could be wrong- but after reading the posts from
the UK etc... They wait FOREVER for care no matter their symptoms. And if your older then sometimes you end up to old to treat. The best person to ask is your Dr and no matter the political party not one of my Drs think this plan is good.

Please correct me if I have misunderstood any of the "facts" I have mentioned. I really wont mind.

Lauren


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## Supreme_2 (Jun 28, 2012)

Sure hope the insurance premiums change for the better.  To insure me, my husband and 2 children equals $1500.00 per month.  Totally sucks!  More than my house note.


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## bumble_bee (Jun 28, 2012)

I gotta say my experience is the same as DustyKat. I can't even imagine having to pay a bill for whatever I had done in regard to my health...being sick is stressful enough without having to worry about how I'm going to pay for it when alls said and done! We too have universal healthcare here, nobody has to pay for things like doctors visits, hospital stays, blood work, scans etc but we do have to pay for drug prescriptions. Usually you have what we call 'extended health insurance' through your employer and this usually covers a good portion of prescription costs. Either your employer fully covers the premium or you each pay a portion. After that, we have something called Pharmacare which is basically the government. This helps cover the cost of prescriptions once a predetermined deductible has been met in prescription costs. The deductible is based on your previous years tax returns so those that make more have a higher deductible to reach before Pharmacare kicks in. Once it starts though, you pay very little, if any out of your own pocket. As was previously mentioned, none of this is really 'free', we pay for it in our taxes but its all I've ever known and can't imagine things any different! I think the amount paid in taxes is less than the amount you'd pay for each hospital stay, doctors visit and set of tests...especially for those of us with ongoing medical needs.


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## Beach (Jun 28, 2012)

Obamacare has some good points and equally bad points.  A concern is not reining in costs.  It does little in this area - there isn't tort reform, special interests have made sure their programs are included in coverage, little incentive for patients to save costs, etc.  As a nation that is already high in debt, and watching many European countries struggle to find lenders to continue financing their way to life, one would think cost containment would be a greater consideration than it has been.   

And even though the mention of leaving kids onto their parents insurance till the age of 26 was given, in the end it will be youth paying higher costs for Obamacare.  More reforms will be needed if we are to afford the new healthcare law.  Overall, the baby boom generation had few kids.  Not enough money has been paid into the entitlement programs, and there are now fewer workers to support those retired. 

Along those lines, recall this article by a concerned professor, Walter Russell Mead, on Obamacare.  

"War on the Young: Healthcare Edition"

http://blogs.the-american-interest.com/wrm/2011/12/15/war-on-the-young-healthcare-edition/

snippet from his article:

...In itself, this isn’t a bad thing.  Young people in the first years after college move from job to job and many can’t get or afford good insurance.  Via Meadia congratulates the newly insured and in itself, this is one of the pieces of the health care bill we liked.
But there’s a catch.  As more pieces of the bill come online, the health care law turns into yet another example of middle aged America’s war against the young.  The individual mandate will force millions of struggling young people to pay higher than necessary premiums in order to subsidize insurance for old geezers like me.
This would be OK, I suppose, if today’s young people would get the same service in turn — but they won’t.  The costs of health care are rising so rapidly, and the government is so stretched, that when today’s struggling research assistants and interns grow into respectable pundits, the health insurance they get will cost more and do less than the insurance they helped my generation to afford.  Thanks, kids, for the cash...

&



> ...Anyway, it’s a shame that we can’t reform health care in this country without sticking it to the young.  Lately, some of them seem to be noticing.  Even as more young people enjoy the benefits of extending the parental insurance protection, support for President Obama and the Democrats continues to fall among young adult voters.  If the millennial generation ever figures out the intergenerational scamming at the heart of what’s left of the blue social model, American politics will change, fast.


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## bumble_bee (Jun 28, 2012)

There's always issues about how long you wait, I know this is a big complaint in Canada but I've experienced both sides of this coin. There have been instances where you wait all day but I've only seen this if you have something like a broken ankle or something that although needs tending to, isn't going to do you much harm to sit and wait a bit. I've been to the ER many times in pain and needing scans of some sort or another and have been out within hours too. I really believe that our system is based on need and if you're in a lot of pain or something is life threatening, you get in quickly and are dealt with promptly. The long waits, in my experience, are only when its something less serious


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## PsychoJane (Jun 28, 2012)

I'm really not a pro in finance or economy or anything that could be close to be related to that but I am gonna make a guess here. It is sure that the system is quite different and probably it won't even have the same consequence. 

Here in Quebec, one of your Northern neighbors, we are often hearing the population complaining about "L'exode des cerveaux"(Brain migration?) which is stands for the migration of scientists, researchers, professional that move abroad in search of better payments/conditions. Even though it is a bit overrated (it seems that some believe everyone is leaving which really is not the case), it is still a phenomenon that happens, because the wages for health professional(and other fields) are higher in the states than they are here (public system oblige). I don't know if there will be any consequences on this aspect on the long run? If so, I doubt that health professionals will be the first to stand for the ACA. I might totally be wrong though, I'm only wondering about that point.

In term of waiting forever, I think it is true that you are prone to wait longer with Universal Health Care but, usually, the waiting time depends of the condition. I know you can wait pretty much forever for benign things, like if you have basic problem like common wart and want to see a dermatologist you can wait up to a year, maybe even two.  If your blood tests are a total wreck, you will be seen promptly, etc etc. I know for a fact that I have never waited abusive amount of time. For instance, my surgery this year really was not an emergency. My quality of life really was impacted but I was not endangered by my condition. The surgery was requested end of march and performed beginning of may. It is sure that UHC can have downside, especially for non-urgent conditions (I think the worst here are those related to orthopedic surgery), but at the same time, is it normal to be letting some people without the resources to receive health assistance?


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## EthanPSU (Jun 28, 2012)

PsychoJane said:


> I'm really not a pro in finance or economy or anything that could be close to be related to that but I am gonna make a guess here. It is sure that the system is quite different and probably it won't even have the same consequence.
> 
> Here in Quebec, one of your Northern neighbors, we are often hearing the population complaining about "L'exode des cerveaux"(Brain migration?) which is stands for the migration of scientists, researchers, professional that move abroad in search of better payments/conditions. Even though it is a bit overrated (it seems that some believe everyone is leaving which really is not the case), it is still a phenomenon that happens, because the wages for health professional(and other fields) are higher in the states than they are here (public system oblige). I don't know if there will be any consequences on this aspect on the long run? If so, I doubt that health professionals will be the first to stand for the ACA. I might totally be wrong though, I'm only wondering about that point.


See thats a great point, I have never heard of that term or definition, most likely because I live in the states, but seeing it from that view point is kind of like a "what if" scenario. But I don't think it would affect the states because if you think of it, most on the "brain migration" are moving to the states, and even if the states change it's policy, they are bound to stay due to hardly anywhere else in the world paying more for their services.

But this community is great because we have people from everywhere and you learn something new every day, now I know what "Brain Migration" is.


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## Gculk (Jun 28, 2012)

I think it's goodish.  It's as good as you're going to get down there.

Look.  Your current system is utterly unsustainable.  It eats away 17% of your GDP.  Compare with every other system with comparable results, and you see how much waste is ongoing.  That's literally about 2 in every 10 people are working in healthcare services in some manner.  Compare to other developed countries which average about 1 in 10.

You don't have to buy insurance.  You still have the option not to, but don't you bullshit saying that you'll just pay out of pocket.  How about if you die on the table?  There's a tab that the taxman is picking up.  That is why you pay a penalty if you don't buy insurance, and it's perfectly reasonable.

Is the bill perfect?  No, it has some issues.  But imagine you were from a poor family, had to choose between health insurance, or going to university.  Lets say you chose university, and happened to lose the genetic lottery.  Then you get caught in the welfare trap that is medicaid, where you can't work without losing medicaid, and are then not valid for private insurance because of pre-existing conditions.  A society where this is a possibility does not deserve to be called first world.

And about it being hard on poor?  Well no, people who can't afford health insurance don't have to pay the penalty.

I think the US just needs to learn that they are clinging to dogma, the dogma of free markets solve anything and everything.  It's blind, and ignores the fact that the 'father' of the free market used a sentence to describe the invisible hand of the free market.  He used books to describe how a totally free market would turn into groups of cartels jockeying for position to infuence government decisions.

Basically he warned that if not properly restrained, capitalism would create the United States of America, 2012.

Enjoy,
Nathan


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## DustyKat (Jun 28, 2012)

Is there waiting in ER departments? Yes but I would hazard not much different to the US if what I read on here is anything to go by. I have had 4 ER visits with my kids and never had to wait longer than 10 minutes. With specialists I have always been able to make an appointment with a time frame that suits me. When it was urgent the GP rang late on a Friday afternoon and Matt had a consult the following Tuesday, scopes Wednesday, CTE Thursday and final consult Friday. 

There will always be wonderful stories and horrendous ones with most people fitting somewhere in-between. At the end of the day those that can afford it have a choice, private health insurance and private hospitals, but if you can't or choose not to you will receive appropriate health care no matter what age. As I said care does vary from country to country and we do not have the NHS we have Medicare.

I don't know about the rich going to the US for care. Where are they coming from? 

What really interests me is the amount of GDP spent on healthcare. What do they say in the US about this aspect of things? Why is it as high as it is? This is only one article and I chose this one as I was looking for more recent data...

http://www.kff.org/insurance/snapshot/oecd042111.cfm

...I would really appreciate anyone's thoughts on this. 

Dusty.


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## EthanPSU (Jun 28, 2012)

DustyKat said:


> Is there waiting in ER departments? Yes but I would hazard not much different to the US if what I read on here is anything to go by.


Hah, I broke my arm last year and it was CLEARLY broken, and I waited about 30min in the ER before they had me processed.....In the US


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## Gculk (Jun 29, 2012)

Yeah, a broken arm won't kill ya.  Might hurt like hell, but as long as the circulation is not impaired, you'll be ok.

Believe me, they had no issue knowing the arm was broken, but I'm sure the fellow that got in before you that it turned out was having a heart attack was absolutely chipper that you had to wait a bit extra.

:ylol:

Dusty: As for how much healthcare costs down there, I have a few inklings.  I am going to see over the next couple of years if I can get a research grant on it because I'd like to see the levels of equipment they have.  I figure that the for-profit nature means that competing hospitals end up with a great deal of redundancy.  Basically what I mean is that, because Drs Joe and Bob only have enough patients between them in Canada for one MRI machine to run full time, they buy one.  But in the states, since they themselves charge for each of their patients they send to their MRI, both buy an MRI machine, effectively doubling the end cost of providing MRI service.


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## tots (Jun 29, 2012)

30 min for an arm is really not much of a wait. Not to say its not
A significant injury.  But if you look at older posts you will see
long (I mean months) for appts to see a specialist or months for
a colonoscopy for a person in unbearable pain.  Weight loss, bleeding
Etc....  Why does the president come out and say he will put himself and 
His family on this plan?


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## Clash (Jun 29, 2012)

I have a question. I have read several threads where the poster was stating they were on Remicade but would have to come off soon because the country they lived in only provided it for a year, at that time tests were done to determine if remission had been reached and if so they had to stop the Remicade. Does anyone remember these threads? That really bothered me as Remi is working great for my son and the thought of him not having the med because it worked well enough to put him remission staggered my mind. I do believe one of the posters even said it was due to cost saving measures or cost effectiveness. Was this a product of single payer healthcare system or universal healthcare or something else?


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## Skycruiser (Jun 29, 2012)

Deleted.


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## StarGirrrrl (Jun 29, 2012)

tots said:


> I am not sure why I should vote for or be forced into something the President and congress will not take part in. Have you ever wondered why, even after they leave office they no longer need private health care or Medicare? How about the rich in other countries that come to us for medical care? Also- I could be wrong- but after reading the posts from
> the UK etc... They wait FOREVER for care no matter their symptoms. And if your older then sometimes you end up to old to treat. The best person to ask is your Dr and no matter the political party not one of my Drs think this plan is good.
> 
> Please correct me if I have misunderstood any of the "facts" I have mentioned. I really wont mind.
> ...



I am in the UK and you are quite right in what you say.

However, no medical system as I see it is perfect. You'd need to decide which lesser evil you'd rather have- that in the US today or the new proposal.

I've lived in the US too and personally I think anything would be better than what you have now.

Out of interest do you know on what grounds your Drs disagree with the plans?


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## Slim Johnson (Jun 29, 2012)

Gculk said:


> I think it's goodish.  It's as good as you're going to get down there.
> 
> Look.  Your current system is utterly unsustainable.  It eats away 17% of your GDP.  Compare with every other system with comparable results, and you see how much waste is ongoing.  That's literally about 2 in every 10 people are working in healthcare services in some manner.  Compare to other developed countries which average about 1 in 10.
> 
> ...


This is a well thought out statement. People here are so convinced by the rhetoric, they are begging to have laws that benefit them DIRECTLY, changed to benefit an industry. Why is healthcare so expensive here? Because of the "free market".

 Why is it that insurance companies get FAT discounts on healthcare charges; yet if we pay out of pocket for the SAME care, we get no discount? My surgery cost over 50K$, just for the hospital services! The insurance company received a discount of OVER 15K$! I have now idea how much Medicare was able to write off. How can we as Americans deem this sort of pandering acceptable?

Sarah Palin was bellowing about "death panels" denying care to people who need it, if "big gubmin't" took over healthcare. Ironic that PRIVATE insurance companies have well paid staff, who's sole purpose is to DENY YOU coverage? Death panel?? Really? Medicare has yet to deny me care, or ask me to provide proof that my condition isn't preexisting, or work related; prior to a procedure. My Private insurance on the other hand...

And what is this nonsense about Babyboomers not having many children? You really believe that nonsense? I am a child of a Babyboomer, and the population has DOUBLED in the last 30 years.. The idea that there are fewer people paying into "entitlements" (they aren't entitlements if you pay for them..) is pure BS. There are more people working, and paying taxes now, than there were even ten years ago. If I am wrong, then show me in factual form, just one year that the United States population hasn't grown in the last 50 years. 

I still don't get how people in this country can be so against something that benefits them directly. So what if we have to pay more in tax? I would rather pay 10% more in tax, than be denied care, or hear that someone I know died because they couldn't get treatment for an illness. Better yet, cut military/defense spending by 20% and apply the difference to healthcare, and education?

Oh wait.. that's SOCIALISM!


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## RFarmer (Jun 29, 2012)

Slim Johnson said:


> I still don't get how people in this country can be so against something that benefits them directly. So what if we have to pay more in tax? I would rather pay 10% more in tax, than be denied care, or hear that someone I know died because they couldn't get treatment for an illness. Better yet, cut military/defense spending by 20% and apply the difference to healthcare, and education?
> 
> Oh wait.. that's SOCIALISM!


tl;dr you've got a lot of dumb people who use either being religious or being a military child as an excuse to say dumb, ignorant things. They don't think.

long version.

I can answer that... America is a silly place. Full of right wing crazies, hicks, and ignorant hateful parents who live vicariously through their children. Anything that smells of equality, anything non-capitalistic, anything that brings poor closer to rich, anything that smells of "commi-nism", or ANY of the other 20+ million things that many American's hate just because they're told to, is a terrible idea, and is going to bring down the apocalypse. 

I suspect a lot of right wing crazies also don't like access to medicine because it means we don't have to rely on praying solely :/ I read an article somewhere, sometime about how the right wing wanted to ban abortion clinics, which would only be able to keep poor/raped/unfit women from aborting their babies. The article went on to explain how the far right does this because it can't control the rich, it can't control people's values, and it can't control the progression of time, so it tries to control the poor.

OF course, I'm not saying every christian in America is bad. I live in Canada now. They don't really have an anti-gay, muslim hating, kill abortion doctors far right. It's more fiscally conservative than socially. And even the far right here is often shocked by the far right in the US, and how many statements it makes out of ignorance.


I like how this thread is full of opinions. Unfortunately, I don't like reading them  Anyone got a good non-partisan explanation of good and bad sides of healthcare reform? With bullet points?


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## Beach (Jun 29, 2012)

The mention about baby boomers and few kids comes from the declining birthrate seen in America and the west for that matter.  It is frequently mentioned in the news.  It's one of the bigger problems we face.  At one time I believe it was 12 workers supported one person in retirement receiving government benefits.  Some have speculated that it could eventually be down to 2 workers for every retired citizen in the future.  It is why Social Security and Medicare are often mentioned as needing reform in order to make them affordable.     

For some information on the topic I recall this.  

"Europe’s Greying a Disaster for Growth"

http://blogs.the-american-interest.com/wrm/2012/04/02/europes-greying-a-disaster-for-growth/



> The slowly expanding sovereign-debt crisis and Europe’s halfhearted attempts to deal with it have dominated reporting about Europe for the past few years, but the Continent has a graver and even more intractable problem. Megan McArdle points out at The Atlantic that even if Europe manages to get its finances under control its demographics threaten to further cripple its economy:
> Unfortunately, growth (or at least the sustainable variety) is typically a long time in the baking, and dependent on two main ingredients: more workers and higher worker productivity. And much of Europe is short on the former. That has big implications for Europe’s future. [...]
> Italy’s fertility rate has actually been inching up from its 1995 low of 1.19 children for every woman, but it is still only about 1.4—well below the number needed to replenish its population (2.1). As a result, even with some immigration, Italy’s population growth has been very slow. It will soon stall, and eventually go into reverse. And then, one by one, the rest of Europe’s nations will follow. Not one country on the Continent has a fertility rate high enough to replace its current population. Heavy debt and a shrinking population are a very bad combination.
> This nails it. Generous welfare programs, early retirement, low birthrates, and crippling debt are the most serious problems facing the developed world at the moment. As with the debt crisis, it doesn’t appear that Europe has developed any credible plan to deal with the most serious long-term issue it faces.


& from the Washington Post 

"There Are No Winners In The War Against The Young"

http://blogs.the-american-interest....ung-is-real-and-the-young-are-already-losing/

excerpt from the article:



> That’s the reality, writes Matt Miller in the Washington Post:
> You [younger Americans] are in big trouble. You don’t even know it. You’re busy trying to get a degree, land a job, start a family, save for a home. You don’t follow the news. But trust me—you’ve been taken for a ride by your elders. . . .
> The job market for young people is a disaster, the toll of a burst financial and housing bubble that both parties let fester. The crisis has reached the point where years of unpaid labor (in the form of internships) have become a way of life for millions of Americans in their 20s.
> Our K-12 schools have slid from the best in the world to mediocre under both Republican and Democratic presidents and governors. That’s largely because for decades we’ve embraced a bipartisan policy of recruiting middling students to become teachers.
> ...


As for the high cost of our medical services, I suppose new technology and more services drive costs up.  That is mentioned from what I've read.  Some view more access to medical care as a plus, and as mentioned here others a negative.  Not sure if we will see a large role with central planning in the near future telling hospitals what services they can offer and not.  Possibly that will come.  Do remember this mention about new panels limiting services to different medical tests.  

"Are Death Panels Making A Comeback?"

http://blogs.the-american-interest.com/wrm/2012/04/22/are-death-panels-making-a-comeback/

snippet:



> ...According to the Times, many of these additional routine procedures are ordered by doctors because they fear malpractice lawsuits. The more tests they run, the better protected they are. They are also ordered because, well, they pay, and doctors and hospitals are, on the whole, fond of money.
> Some estimates cited in the Times piece suggest that unnecessary treatment accounts for one third of total medical spending in the country. Obamacare advocates sometimes played that down in the debate over the law before it was passed. Any talk about cutting back on “unnecessary” procedures was sure to spook the voters; as fast as you can say “death panel” voters worry when health care reformers talk about those horrible bitter clingers out there in the boonies using “too much” health care to prolong their worthless Snuggie wrapped, polyester-clad existences for a few more miserable months of watching Fox News and American Idol.
> Physician greed and patient insensitivity to cost (if insurance is paying, why not have just one more little test to make sure?) are definitely part of the mess. But every doctor I’ve ever talked to — and the Mead family has been producing physicians in every generation back to great-grandfather Mead who graduated from medical school in the late 1800s — says that malpractice fears play a huge role in driving doctors and hospitals to play defensive medicine...


The other mentions are our litigious society.  We tend to sue each other a great deal.  That causes physicians to practice defensive medicine, meaning more tests are ordered than necessary in order to cover their ass in trying to prevent a law suite.  As mentioned above, some view defensive medicine as attributing 1/3 of the cost to our medical system.     

Another problem with high costs comes from our 3rd payer system.  Insurance or government programs will pay high fees to hospitals, with our requiring patients to shop around.  

Overall though, most medical costs are incurred during the last year or 2 of life, when a person is in what doctors some times referred to as "the death spiral."  Obviously, hard to pull the plug on granny.  But at the same time, I'm guessing these costs will come under greater scrutiny in the future.  

Going off topic, but on my mind as I have/had a relative that worked for his city as a paramedic, with generous salary and benefits.  He was able to retire at a young age recently.  There was the lovely news that pensions funds the US have been underfunded to possibly the tune of 6 trillion dollars.  Along with all the other debt not sure how we will pay for that.  I guess I wouldn't want to be a government worker looking to rely upon pensions.  Fun stuff.     

"Time to Occupy State Pensions?"

http://blogs.the-american-interest.com/wrm/2012/06/25/time-to-occupy-the-pension-funds/


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## Staceyscarlete (Jun 29, 2012)

How are Americans so blind to realize how unfortunate it is to be caught in a position when you need to choose between paying for a cancer treatment and a mortgage. And that you live in a first world country and accept this is beyond me.   I'm a Canadian and I've never had to face this problem.  I will give you a picture of what my experience has been for the last 7 years.  
I had a severe kidney infection while pregnant with my first child.  Stayed in a private room at a hospital for one week came home and had a nurse come to my house everyday for 6weeks to give me antibiotics.  
Both my children were delivered at the hospital regular births, two night stays at the hospital for each.  Option of a nurse to come to your home twice to help you with any issues.  Saw my obgyn regularly and had appointments and all gestational tests run for each. 

My husband had open heart surgery.  Saw three different cardiologists and had a hole in his heart and leaking valve repair.  He spent 7 days in the hospital in a private room one of the best in Toronto.  He has yearly testing done.
My husband has a predisposed condition that causes hearing loss.  He had surgery to have this repaired and has yearly testing done on his ears.
I have crohns disease.  I have had three colonoscopies and see my specialist regularly in fact he calls me weekly when I am flaring.  
I have peripheral neuropathy I have seen three neurologists and had multiple tests all within a reasonable times frame- EMG, CT scans, MRIs 

Everything I mentioned above was at no added cost to me outside of my regular taxes.  I do not have any insurance at all and though I pay for my meds I have researched and found that most of them are nearly twice the cost in the US.  All tests and operations were done by some of the best doctors here in Toronto and all appointments, tests and follow-ups were done within a reasonable time frame.  
That is a first world health care system.

The only reason rich people will go to the states is because the doctors in America are privatly paid.  Which means you have some of the best in the world since you can intice them with higher pay and that if you offer the right amount you can get pushed to the front of the line no matter the level of your problem.  I can't see how that is fair.  In Canada doctors see you on a triage basis determining who needs care first.


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## randy.stand (Jun 30, 2012)

10 mins wait in A&E? Blimey,lucky if your saw in 3 hours in UK.

There are a lot of positives about our NHS though. It's the main pull for political party votes at general elections. One of the UK's gems, that I think everyone would hate to see go, despite how much we moan.


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## Slim Johnson (Jul 2, 2012)

Beach said:


> The mention about baby boomers and few kids comes from the declining birthrate seen in America and the west for that matter.  It is frequently mentioned in the news.  It's one of the bigger problems we face.  At one time I believe it was 12 workers supported one person in retirement receiving government benefits.  Some have speculated that it could eventually be down to 2 workers for every retired citizen in the future.  It is why Social Security and Medicare are often mentioned as needing reform in order to make them affordable.


While I can see you put some time into your response, it does not prove a decline in the US population...

Here is a table showing the US population GROWTH over the last 30 years.

Now turn off Fox, and do some real research.


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## Beach (Jul 2, 2012)

Slim Johnson said:


> While I can see you put some time into your response, it does not prove a decline in the US population...
> 
> Here is a table showing the US population GROWTH over the last 30 years.
> 
> Now turn off Fox, and do some real research.


Thanks Slim, I did post a good deal of information above about my concerns, largely with the cost and also with the declining birth rate which makes for higher debt loads for todays youth.  Thanks too for the link to population numbers.  I think though we are missing each other on this topic.  

As was mentioned above, particularly with the Atlantic article piece, The Greying of Europe, the birth rate in America has slowed or another way to put it declined from what it was in the past.  In Europe some even say the population there is shrinking with a birth rate of only 1.7 kids (not all kids have children, pass away early), but here in the good old US of A we are staying about even it is though with 2 kids born per family.  Think of it this way in personal terms.  The baby boom generation family would have had 3 to 4 brothers and sisters, along with two parents.  As the parents aged, and entered retirement, there 3 to 4 kids able to support them, not only personally with help, but also with providing tax money into the government run health care system along with Social Security.  

Things changed during the baby boom generation.  They where able to plan their family sizes, and as a result had fewer children.  That means as the large baby boom generation continues to head into retirement there are 1 to 2 kids supporting those in retirement.  We have the additional problem in that medical costs have exploded upwards over the last few decades!  And people are living longer after retirement, around 15 years now.  That results in todays retires having not paid nearly enough money into the entitlement programs that we currently have.  I believe only around 1/3 has been paid into the programs, if I recall correctly.  The rest will have to be raised elsewhere.  

As mentioned in an earlier post, I had concerns with Obamacare costing a good deal of money.  Over the weekend economist Lawrence Kudlow had a mention on this.  He wrote about how the original projection of the new Affordable Health Care act has been revised upward, significantly already.  Originally the new health care law was said to cost 900 billion over the first 10 years.  Now the CBO predicts it will cost us 1.8 trillion for the first 10 years!  That's double the original cost!  And to be honest, with the way Washington works, I wouldn't be surprised if costs end up being 2 to 3 times that amount.  As typically happens, rosy numbers are originally predicted out of government that rarely come true.      

Here is Lawrence Kudlow's article.  Don't worry, it's safe for you to read, Lawrence works at CNBC.  

"A Game-Changer For Romney"

http://news.investors.com/article/616672/201206291741/a-game-changer-for-romney.htm

I was pleased to read that some measures are being made to rein in court costs.  I know other measures have been taken in other states perviously.   Being that defensive medicine is one of the leading reasons why American health care is to expensive, this newest idea from New Hampshire could help.  

"Jackpot Justice Takes a Hit"

http://www.commentarymagazine.com/2012/06/29/jackpot-justice-takes-a-hit-medical-malpractice/

Trial lawyers will not be happy with this idea, but it looks good from what I can tell.  People harmed will be compensated, and defendants have a reason to settle with out racking up enormous legal fees.  

Off topic but that is one area also that I wouldn't want to be in, or studying to become, an attorney.  Seems that automation is going to be putting a good deal of pressure onto the lawyer profession.  There won't be as many jobs as their used to be, and of those remaining will pay less.  

Overall as blue collar jobs came under pressure from automation over the last few decades, white collar jobs are now feeling the pinch from computers.  

"Student Loan Program Pumps Legal Ed Bubble: For Now"

http://blogs.the-american-interest....t-loan-program-pumps-legal-ed-bubble-for-now/


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## lizzy (Jul 3, 2012)

Personally (you might all hate me for saying this) but I find it shocking that people are even questioning Obamacare! Who wants to live in a country where people are sick and can't afford to get treatment? Illness is 9/10 something you cannot help, you didnt cause, surely its about giving everyone a level playing field, being kind to your fellow man.

I am also shocked at some peoples incredibly cynical view on the NHS! What about children, babies, people with chronic and deblitiating illnesses treatment so they can live and have dignity - is bad? 
Another upside of the NHS is that the government has more of a responibility to stop business causing people harm. McDonalds making people fat, drugs ruining peoples lives for generations, smoking! Smoking has been something the government has really cracked down on and its worked. Less people smoke=less people using NHS. 

Well its nothing to do with me as I don't live in America but I hope you dont mind me having my "2 cents".


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## Slim Johnson (Jul 5, 2012)

Thanks for the reply Beach. 

While our population may not be growing as fast as it was thirty years ago, it is still increasing exponentially, meaning more people are inherently paying into the system (I still cringe at the misnomer: entitlements).

I live in Utah, and as a state, people here generally have large families. My grandfather in particular, had over 60 children, between 5 wives. My parents had three kids together, while my Dad had a 4th with another woman, after my parents divorced. I have two kids of my own, and I also have 2 stepchildren. So I still don't see any population decline here. What is going on in Europe has no relevance in what's going on here. Although I think the US as a country could learn from our friends across the pond.

I also don't believe the projections being made about the Affordable Care Act, with regard to the cost. We will be saving boatloads of money by providing preventative care. We will also be reducing the cost of care by catching disease earlier, than we would if we were to stay on the current agenda.

Because of the Affordable Care Act, my cancer screenings, bone density scans, and other preventative procedures are covered 100% by Medicare. This means that I will have more money in hand to feed my children healthy meals, more money to pay my bills, and more money to put toward medical care that isn't fully compensated my Medicare. That alone is a terrific benefit! 

I couldn't care less about the impact on Gub'mint spending, because I already don't agree with many of the things our Gub'mint spends our tax dollars on. For example: Military Nascar teams, overseas wars, military occupations, WMD's, TARP, challenges to constitutional law, challenges to gay marriage.. ad nauseum. 

Naturally, we are going to be inundated with naysayers claiming that it is going to cripple the economy. These are the same people who are profiting on our suffering. Our politicians are included. I don't see any other first world country going broke due to healthcare. We are the ONLY first world country on the planet that doesn't offer universal healthcare. WHY? My best guess was just stated.


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## Ihurt (Jul 6, 2012)

The reason we do not have universal health care is because of the AMA(American medical association) here in the states. If the health care system was regulated by the government, the hospitals would not be allowed to charge these exuberent amounts of money for tests and visits etc... The health insurance we have now has a $2,500 deductible for each family member! That is crazy. I even called the insurance company myself to ask why the rates and deductibles are so high. I was told it is because the hospitals and doctors are charging ridiculous amounts of money for things. IN example: for a half an hour doctors visit one of my doctors charged my insurannce $430. When my son had an MRI of his knee they charged $4000. I mean come on, this is outrageous!

We need this change. The Obamacare is a small step in the right direction, but it will be a long time I am afraid before things really start to look up. Oh, and here in the states when you go to the emergency room, you can sometimes wait over 10 hours!! This has happened to me before and in one of the best hospitals in Chicago! In any event, I believe that health care should be FREE for all everywhere!


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## Beach (Jul 6, 2012)

Well I wish medical treatment was free!  That would be nice.  That is the problem, workers in healthcare do not work for free.  Doctors, nurses, administrators, etc all want to be paid.  We pay for our healthcare one way or another, directly or with third person as our current system is set up.  We also will continue buying insurance.  As is, government already covers around 50% of medical expenses in our country.  Since Medicare and Medicaid came along medical expenses have exploded upwards in our country, not downwards.  We already knew that the two government programs medical programs where going bust and needed adjusting.  To suggest the new health care system is going to magically control costs would be to deny economic reality.  Even the CBO has said so.  

Last I checked the AMA was in favor of Obamacare, but already wanting to made adjustments.  Drug companies like it also.  They helped promote the law.  From what I gather all the special interest groups like the new Healthcare law.  They want a piece of the pie, to be included in what must be covered and how medicine is practiced in America.  

"The AMA, A Key Backer Of Obamacare, Looks Into Reboot"

http://www.forbes.com/sites/bruceja...-a-key-backer-of-obamacare-looks-into-reboot/ 

I thought this was a nice quote about the problem:

"Obamacare Killing Affordable Student Insurance"

http://blogs.the-american-interest....amacare-killing-affordable-student-insurance/

excerpt:



> ...One of the problems with the American health care system is the ability of lobbies to persuade Congress and state legislators to mandate coverage for their own pet causes or diseases. Chiropractors, acupuncturists, psychologists, drug companies: everyone wants to be included in mandatory coverage.
> Unfortunately, every year special interests will find ways to hook new mandates onto the insurance requirements, and every year the cost of coverage will inexorably rise.
> At one level there is nothing wrong with this; the more coverage for consumers, the better. But there’s the question of cost. If all insurance plans have to be gold-plated, full-service — and pre-existing conditions have to be covered — then health insurance is going to be unaffordable for many and perhaps most people. Young people in particular need low cost options; their incomes are low and their health risks are less so for some students choosing a cheap plan with limited coverage makes sense.
> Students probably won’t be the only ones to face nasty surprises from the new system as time goes on. Although Obamacare was passed more than three years ago now, most of its provisions still have not taken effect. The public is slowly becoming aware of “minor” provisions hidden deep within the 2,700 page bill that are turning out to have a major impact on their lives. In many cases, people haven’t liked what they’ve seen; contrary to the predictions of supporters, public support for the bill has actually dropped in the years since its passage.


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## RFarmer (Jul 7, 2012)

Has anyone mentioned the US' defense budget? 

I mean, I'm not going to say that the US military is either Saint or Satan (and none of you do either, so let's not argue about it), because I just don't know... but it gets A LOT of money. Why is so much money being spent on military stuff, when you've still got such big problems in your own country.

(this actually makes me kinda think that the US military is on the more evil side of things, and had some scheme which was more important than it's people.)



EDIT: WHY DOES : o PUT TOGETHER GIVE THIS FACE  INSTEAD OF THIS FACE :blush:


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## RFarmer (Jul 7, 2012)

Slim Johnson said:


> I live in Utah, and as a state, people here generally have large families. My grandfather in particular, had over 60 children, between 5 wives.



Holy. 

Guess I know who to blame for overpopulation! :rof:


----------



## David (Jul 7, 2012)

I of course want everyone to have access to healthcare; it breaks my heart when people here can't get the care they deserve.  However, we're putting an awful lot of trust in companies that have violated our trust time and time again.  As far as I know (correct me if I am wrong), there are no caps in this bill for cost increases.  Year after year my monthly insurance dues go up.  I can't afford to pay more per month so I instead have to opt for less and less coverage.  I'm now at a $7,000 deductible.  Next year it might be a $10,000 deductible.  A few years after that, a $15,000 deductible.  I've been foregoing care because I can't afford it yet I have insurance.  This, in part, is why insurance companies have had such record breaking profits the last few years.  And with this bill, I'm forced to get insurance so the insurance companies have little reason to try and be competitive and entice me with great deals.  In fact, since I have a preexisting condition, I'm sure they'll try to piss me off enough that I go to someone else and we all start playing insurance company roulette.  

I'm glad everyone is "covered" but that doesn't mean healthcare is affordable.  My guess is healthcare is only going to get less and less affordable but the insurance companies will continue to make more and more money since everyone is paying in.  "Ok insurance companies, we'll give you more money than ever and you have to cover everyone you're going to be nice now, right?"

They sure are good at chess.  I don't want to play anymore because the game is rigged.  I was going to stop playing because my deductible got to the point that it's cheaper for me to just save the monthly dues, pay cash to my doctor who gives me a break as they love not having to deal with the insurance companies, and hope nothing too bad happens.  A lot of people were starting to do this and this was the chink in the armor of the insurance companies.  Now, I'm forced to play and the game just became much more complex and that weak spot in their armor is no more.

How bad does it have to get before Americans realize just how much we're being screwed?


----------



## Beach (Jul 7, 2012)

It's not so much the insurance firms fault for the higher costs - even though I don't have much trust in them either.  As the NYT's rticle mentions about the insurance firms, they appear to be ramping up insurance costs in order to meet coverage requirements for the new health care law.  My insurance costs rose also, around 30% last year or maybe it was two years ago.  The cost increase was not pleasant to see.  

From what I understand, the new health care law is pretty much designed to remove the private insurance firms out of health care.  It will take time but likely we will have single payer insurance eventually.  Costs will not decrease though.  Obamacare requires plans, private, or through the state exchanges, to offer more medical services.  And with more services comes higher costs.  Every special interest group feels they need to be included in our medical insurance coverage essentially.      

Here is a mention on how the system works:

http://online.wsj.com/article/SB10001424052702303506404577444410947791758.html



> ...Starting in 2014, people will have new options to buy insurance through exchanges or enroll in the Medicaid program.
> 
> Most people will also be required to carry a set level of insurance or pay a penalty. That provision is at the heart of the constitutional challenge to the law, which the Supreme Court is set to rule on by the end of June.
> 
> ...


Also thought this a nice article on partially why America has high medical costs.  We pay a good deal more than we need.  This is why it is unlikely that we will see lower costs any time soon.    

"What we can learn from Singapore's health-care model"

http://www.washingtonpost.com/wp-dyn/content/article/2010/03/03/AR2010030301396.html

snippet from the article:



> ...We obviously can't transplant Singapore's approach wholesale to the United States. But the reason we can't emulate even some of Singapore's success has to do with that iron law of health-care politics: Every dollar of health-care "waste" is somebody's dollar of income. As a stable advanced democracy, we're so overrun by groups with stakes in today's waste that real efficiency gains are perennially blocked.
> 
> Any hope for something better starts with tallying the price of today's paralysis. Think about that $2 trillion the next time you see states, citing budget woes, shut the door to college on tens of thousands of poor American students. Or when the next firm moves jobs overseas because health costs here are soaring. Or when the next bridge collapses. Thanks, Medical Industrial Complex!
> 
> We return now to our regularly scheduled political battle, which (no matter the outcome, according to some projections) will leave health costs headed to more than 20 percent of GDP by 2019.


Another article I liked from Gerri Willis.  

"What Obamacare Will Mean for You"

http://www.foxbusiness.com/on-air/willis-report/blog/2012/06/29/what-obamacare-will-mean-you


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## David (Jul 7, 2012)

Beach said:


> From what I understand, the new health care law is pretty much designed to remove the private insurance firms out of health care.  It will take time but likely we will have single payer insurance eventually.


If this was the case, insurance companies stock values would have tanked with the supreme court decision.  They've been down a little, but nothing that would suggest that institutional investors are worried about their long term outlook.


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## kiny (Jul 7, 2012)

As a non US person I think this is great. The cost of Crohn will now weigh more on the government, which will lead to cheaper and hopefully safer medication, if anything it will increase funding for crohn.


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## David (Jul 7, 2012)

kiny said:


> As a non US person I think this is great. The cost of Crohn will now weigh more on the government, which will lead to cheaper and hopefully safer medication, if anything it will increase funding for crohn.


Can you provide an example in history where the same basic thing has happened (in the USA)?


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## kiny (Jul 7, 2012)

David said:


> Can you provide an example in history where the same basic thing has happened?


No I can't, the US has been pretty much an exception to the rule in the West.

Is the government now responsible to cover a bigger part of the cost of crohn to society or is the change not that big than I assume?


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## David (Jul 7, 2012)

The problem is that the only way costs will come down when the government is involved and there are private, for profit companies between the consumer and government, is for there to be price controls.  And that isn't going to happen because our government is no longer for the people, by the people, it's for the corporations, by the corporations at the expense of the taxpayer.


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## Beach (Jul 7, 2012)

David said:


> If this was the case, insurance companies stock values would have tanked with the supreme court decision.  They've been down a little, but nothing that would suggest that institutional investors are worried about their long term outlook.


That's a good point.  Will be interesting to see how this plays out.  

Here is the argument for why single payer might come about from the ObamaCare decision.    

"ObamaCare decision may hasten the arrival of a single payer system"

http://www.foxnews.com/opinion/2012/06/28/obamacare-decision-may-hasten-arrival-single-payer-system/


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## kiny (Jul 7, 2012)

Yes, well, the influence of corporations is starting to worry me sometimes, well it's starting to worry me a lot. I dread landing on news sites when studying medications that talk about profits and stock prices instead of having good intentions. I dread the relationship between doctors and big pharma, don't know what to think about insurance companies. The government should step in and try to direct the money and research so that it benefits the people instead of the companies.


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## Mark74 (Jul 7, 2012)

I work with a doctor and he is worried what benefits the insurance companies are going to stop covering to cut cost.  I am worried they will not cover the biological drugs or will make an outrages copay.  Speaking for those of us on these drugs I don't think anything would work after these.
There are a lot of good things about the aca but nothing to stop the insurance companies from cutting benefits also they can charge is four times what a well person is.
I think they moved to fast, didn't consult those effected.  You thought it was hard getting a specialist appointment now just wait.


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## Beach (Jul 7, 2012)

kiny said:


> As a non US person I think this is great. The cost of Crohn will now weigh more on the government, which will lead to cheaper and hopefully safer medication, if anything it will increase funding for crohn.


Well, that would be nice, but I don't have hopes for that.  I recall the last budget President Obama submitted cut funding for IBD research.  No one voted for the President's budget, his party or the opposition though, so for what it is worth...  

"Ibd funding to be cut"

http://www.crohnsforum.com/showthread.php?t=33876&highlight=obama


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## kiny (Jul 7, 2012)

That sucks beach, I heard that there was an "IBD day" introduced under Obama, so I thought he was on our side so to speak. I am really really crossing my fingers that research goes to something that is safe and sustainable for all, or hell, a cure why not, I think it's about time.


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## Beach (Jul 7, 2012)

Not a day, but a week!  Very small detail, but the Crohn's week was a resolution passed by the Senate.  Recall this reporter that has Crohn's giving a report on the resolution that occurs in December.  

"Senate Supports Crohn's and Colitis Awareness"

http://video.foxnews.com/v/1306741643001/senate-supports-crohns-and-colitis-awareness/

Oh, to many link posts in a night.  I think my limit is up.  Time to go read.


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## cal1 (Jul 8, 2012)

seebee said:


> Thanks for the link. I'll definitely read up on it over the weekend.


Gee, it is only 1,990 pages of legalese. Apparently Slim Johnson has read it cover to cover and understands it fully.  That is way more than most all members of congress have done.  After all, like Nancy Pelosi said: "if you want to know what is in the bill, you have to pass it first."  Sound reasoning to pass a bill if you ask me.


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## Slim Johnson (Jul 9, 2012)

cal1 said:


> Gee, it is only 1,990 pages of legalese. Apparently Slim Johnson has read it cover to cover and understands it fully.  That is way more than most all members of congress have done.  After all, like Nancy Pelosi said: "if you want to know what is in the bill, you have to pass it first."  Sound reasoning to pass a bill if you ask me.


I don't think any of Congress read the bills they pass. They leave it to their staff. And where do you get the idea that I have read the bill cover to cover, and understand it fully?? Did I make that statement somewhere?


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## cal1 (Jul 9, 2012)

Slim Johnson said:


> I don't think any of Congress read the bills they pass. They leave it to their staff. And where do you get the idea that I have read the bill cover to cover, and understand it fully?? Did I make that statement somewhere?


You seem to speak about it with authority and rail against anyone who does not agree with your position on it. Below is an example:

_It is absolutely beneficial for us. Maybe instead of calling it "Obamacare", you could call it the Affordable Care Act (which is it's proper name).

Why are you against it? I am curious. Have you any idea what the bill does? OR was it because of Fox news? Or another reason altogether?

It's disheartening that so many people are against legislation that would directly benefit them. Truly a shame, and an accurate representation of America in it's present form. _

If you have not read it, how can you make such statements?


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## tots (Jul 9, 2012)

Getting something for "free" is always great right?  
This is far from free and will be very restrictive on what
your Dr can do.  

How many people really like their HMO?


Lauren


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## Slim Johnson (Jul 9, 2012)

cal1 said:


> You seem to speak about it with authority and rail against anyone who does not agree with your position on it. Below is an example:
> 
> _It is absolutely beneficial for us. Maybe instead of calling it "Obamacare", you could call it the Affordable Care Act (which is it's proper name).
> 
> ...


I have read parts of the bill, while not reading it all. 

I see nothing wrong with the above statement. Asking people to make educated decisions? What's wrong with that? Asking people not to believe what they see on TV? I see nothing wrong with critical thinking, maybe you do, and maybe that's why you are flaming me? 

Railed against someone?? LOL. Really? Put on your big boy pants please.

Perhaps you should be more specific with what your issue is.. Rather than clutching at straws.:ysmile:


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## DougUte (Aug 7, 2012)

nogutsnoglory said:


> My colonoscopy wasn't covered through private insurance.


That is probably because there is a grandfather clause for insurance plans that existed before the AFA became law. As long as they do not change their plans they can operate as always. But if they change their plans almost in any way at all they lose their exemption and fall under the AFA. I don't remember the criteria insurance plans have to follow to stay grandfathered, but it is so strict that none of them will be able to for long, especially since they can't significantly raise rates.


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## jvc7477 (Aug 8, 2012)

I think what most people are afraid of about this bill is  How will the government pay for it


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## Naturelover (Aug 8, 2012)

I have been in PT for approx. 19 months. Not 19 months straight, but in the last two years. What I have witnessed is that the folks on Medicare are being denied appropriate services. They are only allowed so many visits per illness or situation and most of the time, the visits are not enough. I have watched the personnel, including the OT & PT grimace in anguish as their hands are tied. They have been as creative as they can to meet their patients needs, but their hands are tied. 

The majority of people in health care are in the field because they really do enjoy helping others.

Doctors have to either close up shop or merge with large hospitals in order to meet the dead lines and guidelines for automated medical records. Many doctors’ offices are currently in a shamble because of this. No one was prepared to "hurry up and automate records".

Doctors are leaving the medical field because they cannot afford to meet the new automated guidelines. They do not have the means to purchase all the necessary computers etc. Has anyone noticed that it is rare now to locate a doctor who runs his/her own office without having a slew of other doctors merged in with them?

Are you aware that if you need surgery or have an emergency that there will be government appointed personnel that are not health professionals making the decision as to what care you will be allowed to receive and what care you will be denied? They will be looking at you as a dollar sign not as a human being in need of medical care. What that means is this. If you arrive at the hospital and you need life saving surgery, you will have to wait for hospital personnel to contact a govt official to get approval for the surgery. If the govt personnel is on a coffee break for the remainder of the day, you're screwed. Plane and simple as that. You won't care about the health care system because you will be 12 ft under. Dead as a doornail.

Are you also aware that since most doctors’ offices have had to merge with hospitals, they now have to follow the hospitals rules not their rules. Your doctor will no longer be allowed to refer you to the doctor they think would be best for your situation, but the doctor that is affiliated with that hospital.

Has anyone noticed the increase in wait time just to get an appointment to see a doctor? As my PCP put it, she is always running behind because it takes so long for a patient to get an appointment for a simple matter that by the time they see her, they now have shortness of breath, chest pains and the list goes on. Now the doc who has the patient scheduled for a fifteen minute slot has to spend 45 minutes to an hour or more with one patient while everyone in the waiting room gets to sit around twiddling their thumbs for an hour or more. 

Have you noticed how rushed doctors are now? It is almost impossible for them to give the quality of care they want to, and they do want to give quality care, because of time constraints. According to the new health care law, when you see a doc, the doc is supposed to input your visits into the computer right then and there. OK, now your doc has just become a secretary. Where is the time for your doc to give you the undivided attention you so desperately need and deserve? Do you see why docs are leaving the field? They signed up to be docs, not secretaries. They signed up to help patients and now their hands are being tied.

Are you aware that your primary care physician or general practitioner is rated at the bottom of the pay scale? Your PCP or GP is required to do the most work with the least pay.

Have you noticed that same day sick visits are becoming obsolete? Docs can no longer afford to leave same day sick visit time slots open. Those slots are now filled to overflowing. Docs are double and triple booked these days.

Your primary care doctor is expected to manage all your care. That includes co-ordinating your care with other specialist and talking on the phone with them. Oops! Where are they going to get the time to spend taking care of you when they are already double and tripled booked and have to be on the telephone? It is the rare office that budgets time slots for their docs to return calls. I've seen my PCP's stack of files to return calls to patients or other docs. I also know for a fact that even if she is scheduled to leave the office at 5pm, she often can't because of being double and tripled booked and trying to return only a small fraction of the mountain of phone calls. She has called me just before 10 pm because she knew it was an urgent situation. She does not get paid any extra for the five hours she had to stay at work to attempt to give quality care to patients. Her office is not the exception. Most docs office's are now being run this way.

Let's say you are considered a complicated medical patient. (Hmmm. Crohn's patients are complicated patients.) The office manager is in charge of making sure the most number of patients are seen that day. Your doc is out of the office and you need to be seen. The following really did happen to me. The office manager will tell you that you cannot have an appointment until the doctor gets back. Your care is too complicated and it would be unfair for another doc to attempt to get to know what your health care needs are. You can go to the ER if you need to be seen, but you are not getting an appointment in this office until your doctor gets back. But oh wait! Your doctor is double and tripled booked so there are no appoints with her till next month. What the He&*!!!!! You are now becoming very stressed out and that makes your health situation worse. So much for trying to watch those health care dollars. The cost to go to the ER is waaaaay more than the cost to visit your local PCP. I had to call my health insurance company to see if they would cover the ER visit. After explaining the situation to my health insurance co., they said it sounded like I was being forced to go to the ER and that I really didn't have any other choice. Four stressful days later, condition deteriorating, I finally relented and went to the ER. I was fortunate my health insurance co. covered the ER visit. I know of other patients in the same boat and their health insurance co. did not cover their ER visit.

Since I have been very involved with the health care system since my children were born, I have watched the level of care as well as the quality of care decline. The quantity of available care has also declined. Now toss in the govt to run the health care and what do we have? A horrific mess! The govt can't even properly run Medicare, how do Americans think the govt can or will run national health care? The special interest groups will rule the roost on that one. Dollars will speak. Not common sense.

I urge each and every one of you to read the health care bill for yourself. Don't rely on the news media or politicians to tell you what's in it. You will NOT get the true picture. The majority of the health care bill will hurt the majority of Americans.

Enough of my ranting and raving for now. Blessings, NL


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## GutlessWonder86 (Aug 12, 2012)

My primary MD is extremely busy and that's why I have a list of questions when I go in so everything is answered. Also, I always bring an updated list of my new medications that other MDs put me on as well as any important inpatient hospitalizations. I do this for all of my doctors so everyone is on the same page. They truly appreciate what I do for them and in return, I get the care I need even in emergencies because they have everything.

Oh, when I did the medicaid billing for the hospital and clinic, it was a joke how much the state govt. reimbursed for welfare patients. Once this new health law goes into effect, the payments will NOT be the same as medicaids. It will be much lower, thus, many doctors will either retire early or just accept private pay or private insurance only and tell those with the new govt. coverage to find a clinic that accepts them. 

Doctors do have a choice at least which insurance companies they want to deal with BUT if the reimbursements aren't reasonable enough where they can meet payroll, pay for rent, new medical equipment, etc. they can even send out letters to their current patients and tell them to go elsewhere or refer them to someone who does accept their insurance. My hematologist now refers her iron infusion patients to another facility because the insurances have been reimbursing at an extremely low rate and they were losing money so now we go to another hospital's clinic for that.  I have a feeling this is what is going to happen in the long run. 

I talked to all of my MDs and they reassured me that since I'm one of the few that are compliant, they won't drop me as a patient once my husband's company picks up the gov't insurance because they already told their employees that they will pay the fine. So much for us being able to keep our own doctors.(BO's LIE #1)  (I'm lucky I can keep mine). Some of his coworkers have been told that they'll have to look elsewhere when the time comes as their physicians are not accepting the government payments as it's like a slap in the face for all of the hard work they've done to help others.

BUT if you are rich like those in government, you can afford a luxury health care plan that's goes above and beyond for their patients.  must be nice.

i don't think it's fair to force people to take an insurance plan if they just can't afford it by penalizing them  with a huge fine or throwing them in jail. Whatever happened to freedom of choice??  If they can't afford it, then what...fine them and then they'll be out of a home because they didn't choose a health care plan and now, the funds they did have went to paying a penalty?  

Why not make the insurance industry accountable where they offer very affordable plans where it won't cost a family (say of 4)) their living space or a car that's needed to go to work?

The insurance companies should be held accountable and threatened, not hard working people or people trying to make ends meet where they can't afford expensive coverage.  Health insurance should be for everyone and not just the very rich.


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## Gculk (Aug 13, 2012)

GutlessWonder86 said:


> Why not make the insurance industry accountable where they offer very affordable plans where it won't cost a family (say of 4)) their living space or a car that's needed to go to work?


Because stubbing your toe would go over the coverage provided by such a plan.

Health care is expensive.  Too expensive for a REASONABLE family to easily afford, year in year out without gaps.

The only way that the 'insurance industry' can offer plans like that is if they were to, say, charge as a portion of income.  Like in a single payer system.

Here's the thing, you get what you pay for, or in the case of private industry, you get what you pay for, minus the company's profits. With the number of people looking for health insurance being relatively stable, and the net migration to/from a given company being low, how on earth can insurance companies hope to offer revenue growth except by cutting costs or raising rates?

On the same side, how can price controls be brought in without being said to take away corporate accountability to shareholders?

There is NO ethical way to resolve this conflict.  It's a goddamn hard choice that has to be made, and a goddamn hard DEBATE that has to be had.  Not a war of words, nor a clever advertisement about how Government intervention is inherently evil, nor one about how the insurance companies are evil.  It needs to be an intelligent, informed conversation.

I hate seeing the crap about 'oh there'll be government 'DEATH PANELS!''  Private insurance companies have a direct stake in seeing their costliest clients becoming non-clients.  Read through this forum, or any other and see how people have to take days off to fight their way through private insurance red tape.

Sure there will be cost measures in single payer, obviously, but to put it in perspective, I have NEVER heard of someone being denied treatment due to cost.  It may take a while for 'new' treatments to be approved, and at times there will be standards that aren't perfect such as biologics being approved for one year in many single payer systems, but it takes willful ignorance to state that the same things would not happen in private insurance.

Another book for you all

Nathan


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## Ckt (Aug 13, 2012)

Oh my!politics politics!!tut tut well..one thing I want to set straight..the prEsident and congress do have great health insurance..I have the very same one because it is a part of the federal government system!!i worked for Indian health service out west as a nurse so I certainly am not rich. I havent been se to work in ten years because of crohns, surgeries,etc.. The big dudes and dudettes in high levels of the fed govt get the same choices on that that I did,the housekeepers in the hospital are given,the curators for the smithsonian..so,yes,their salaries are huge up on the hill but not the benefits via the govt system..they're just good in general..
I WANT everyone to have health care coverage! If that means I pay more taxes,on a very limited budget..bring it on!!


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## rkoll327 (Aug 13, 2012)

Politics aside, I think the ACA is definitely a wonderful thing. The pre-existing condition part is HUGE for anyone with Crohn's. I also think that the tax credit for small business owners is great (my father owns his own independent pharmacy, a dying breed!). Clearly the healthcare situation we have right now isn't working, I am all for a change and while the plan may not be foolproof right now it's a step in the right direction!


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## LaurinaED (Nov 7, 2012)

In the last few months my insurance has doubled covers almost nothing and I have been refused my humira by my insurance company because of changes in healthcare! I have private insurance through blue cross blue shield and never had a problem before the healthcare "reform" started. Can anyone explain to me why if things are suppose to get better for us because I'm not sure how much longer I will be able to deal without humira or remicade! My medical bills from march til now are already about 6,000 I owe AFTER what my insurance paid!


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## tots (Nov 7, 2012)

Because you can't get something for nothing.  
Someone will have to pay for this coverage- and 
less will be covered.  There will be people who 
have no medical knowledge making your medical 
decisions.  I used to work for an HMO.   It's not
pretty



Lauren


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## Ihurt (Nov 8, 2012)

It is a complete joke!!!! I blame the Big Pharmacies! First off, they should NOT be charging the ridiculous amounts for medications!! That is highway robbery! I heard that some of the biologic meds can cost up to like $6000 for one infusion! That is disgusting in my opinion! Health care reform in my personal opinion would be FREE healthcare for all people! But of course that is not going to happen in the good ol greedy united states!


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## Ckt (Nov 8, 2012)

Ihurt..hey girl! I completely agree..big pharm rules the world of medical care. It's disgusting!and the biologics are that expensive without health insurance. I couldn't do it if I didn't have the insurance I have. Snd humira is $4000 a dose..I take it once a week so that's $16,000 a month without coverage! There's no way in hell anyone could sfford that! And he's, they have programs to assist those who can't afford it..or they help with copays. I just feel they have this monopoly on health care and wonder how much they affect laws on the hill. I question,too, the under utilization of medical marijuana. You know it has to be controlled by big pharm..here's a very cheap and by many accounts, effective treatment but its seen as evil!i can't use it because its illegal where I live but I've read many here who use it and do so well!
Also..low dose naltrexone..a very inexpensive treatment that I had never heard of until I came to this forum. I did discuss it with my gi doctor and she's open to it! I just feel they really have too much power! We do need universal health care in the USA..


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## CLynn (Nov 8, 2012)

As was said previously, it has it's good and bad points. But one thing I will never agree with is that under Obamacare, at some points, THEY decide if you are allowed to treat certain diseases based on things like your age. For instance, if at 70 you are diagnosed with cancer, they will NOT cover treatment for you, you would have to pay for it on your own should you choose to treat.


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## Hobbes650 (Nov 8, 2012)

Late to the party, but I wanted to mention some points about why US healthcare costs are so high- these were not addressed with the ACA.

1) Lawyers.  If you get sick and die in the US, your family would not have any trouble finding a lawywer who would sue the doctor's butt for malpractice.  Whether or not the case wins is besides the point, all these lawsuits make costs go up, and it's a problem with the US legal system, not just healthcare

2) Price Controls.  Every gov't system relies on price controls and other gov't mandates dictating what services are provided and how much.  Instead, more choice should be available to the patient.  Insurance companies cannot even sell their health plans across state lines.  Imagine if the isurance companies could sell their policies across state lines, like auto insurance.  My car insurance is not specific to my state and health insurance should be similar.  Whenever prices are dictated, shortages result and lots of abuse to the system occurs.  The shortages we have now are because some things are so expensive, and the ACA expands the very cause of this problem.  Look at your hospital bill more closely and ask yourelves, is it really fair that the tyelonol they gave me costs $20 (or some similar amount)?  My last CT scan cost $11,000 as listed on the hospital bill.  Why?  When Plasma TV's came out, they cost about that price and then the price dropped like a stone over the next few years.  Not so in healthcare.  In short,the who point of ACA was to give coverage to people who did not have coverage- it had NOTHING to do with being more "affordable".  That's just laughable.


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## CrohnsChicago (Nov 8, 2012)

I heard hospitals only pay around one third of what we wind up actually paying for the medications, diagnostic machines and supplies they use to treat us. And they just mark up terribly when it comes time to give us the bill for service. They are aggressive price-setters taking advantage of the poor and uninsured.:yfrown:


http://am.blogs.cnn.com/2010/04/27/prescription-for-waste-outraged-by-hospital-fees/?iref=allsearch/




Hobbes650 said:


> 2) Price Controls.  Every gov't system relies on price controls and other gov't mandates dictating what services are provided and how much.  Instead, more choice should be available to the patient.  Insurance companies cannot even sell their health plans across state lines.  Imagine if the isurance companies could sell their policies across state lines, like auto insurance.  My car insurance is not specific to my state and health insurance should be similar.  Whenever prices are dictated, shortages result and lots of abuse to the system occurs.  The shortages we have now are because some things are so expensive, and the ACA expands the very cause of this problem.  Look at your hospital bill more closely and ask yourelves, is it really fair that the tyelonol they gave me costs $20 (or some similar amount)?  My last CT scan cost $11,000 as listed on the hospital bill.  Why?  When Plasma TV's came out, they cost about that price and then the price dropped like a stone over the next few years.  Not so in healthcare.  In short,the who point of ACA was to give coverage to people who did not have coverage- it had NOTHING to do with being more "affordable".  That's just laughable.


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## Hobbes650 (Nov 8, 2012)

One does not "take advantage" of poor and uninsured.  If you don't have any money to begin with, you can't be taken advantage of.  Rather, It's abusing the system.  Point is the same- costs are too high so services get cut and that hurts the poor and uninsured the most.  To really help the poor and unsinsured the focus should be on reducing healthcare costs.  A separate system for poor and uninsured should certainly be available, but that's not what the ACA is about.


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## CLynn (Nov 8, 2012)

Hospitals also are very often guilty of billing for things not given or done, everyone should go over the bills with a fine tooth comb. And pharmacuetical companies have too much power to set ridiculous prices and keep generics off the market.


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## newlymarriedtocrohns (Nov 8, 2012)

CLynn said:


> As was said previously, it has it's good and bad points. But one thing I will never agree with is that under Obamacare, at some points, THEY decide if you are allowed to treat certain diseases based on things like your age. For instance, if at 70 you are diagnosed with cancer, they will NOT cover treatment for you, you would have to pay for it on your own should you choose to treat.


Hi CLynn, would you mind sharing a source for this? Are you referring to the infamous "death panels", where allegedly people without medical experience would make life/death decisions about the patient's treatment? 

In my research, the Payment Advisory Board has no authority to make decisions about treatment methods or to deny individual people treatment. The board is made up of medical consultants to cut financial overhead and administrative costs within the hospital. According to Factcheck.org, the ACA, page 490, states that the board won't be able to make any recommendation to ration health care. Politifact.com gave this claim a "pants on fire" false claim, also reaffirming that "...there is no panel in any version of the health care bills in Congress that judges a person's "level of productivity in society" to determine whether they are "worthy" of health care."

If you're referring to something else or a new policy that would deny coverage, would you mind sharing? If ACA works the way it's been described to me, then the freedom for my hubby to never be denied coverage for treatment is my favorite part. If that's not true, I'd like to know. Thank you!


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## CLynn (Nov 8, 2012)

Newly, while I haven't researched it long and hard, I found a few sites about it. The one I post in this reply is the by far the most official seeming one, and although it does not outrightly say it's true, it also does not say it isn't, just mixes up the thought with other aspects related to senior health care. Believe me, having had Crohn's since my 20's, I too want insurance companies to not be able to deny for pre-existing conditions. And while I think that national plan CAN be a good thing, at my age, even this eternal optimist realizes that rarely are things what they are first made out to be, in total, if that makes sense, so I don't trust easily, especially our government, lol! 

http://ourfuture.org/healthcare/healthreformfactcheck


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## CLynn (Nov 8, 2012)

I did read on after I pasted that link and found this....

PART D: WSJ: Comparative effectiveness research...is generally code for limiting care based on the patient’s age. The cost of a treatment is divided by the number of years (called QALYs, or quality-adjusted life years) that the patient is likely to benefit. In Britain, the formula leads to denying treatments for older patients who have fewer years to benefit from care than younger patients. Rep. Paul Ryan (R-Wisc), Sen. Tom Coburn (R-Okla), Rep. Ginny Brown-Waite (R-Fla.), Rep. Paul Broun (R-Ga.) have all made a similar argument, see here. 

TRUTH: Comparative effectiveness research in reality is not an attempt to implement QALYs used by countries such as Britain and Canada. Rather, as columnist Paul Krugman stated in his column July 24, "the Obama administration and Congressional Democrats have also been emphasizing the importance of “comparative effectiveness research” — seeing which medical procedures actually work." Even conservative columnist David Brooks commended comparative effectiveness research as one of the ideas that "sounds good" in his column from the same day. Below is an explanation from the legislation's text of what comparative effectiveness research is, and its roll in fixing the nation's health care problems


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## DustyKat (Nov 8, 2012)

It is a shame that the term 'Death Panel' was ever coined by Sarah Palin. It has created fear and scaremongering and stifled discussion on advanced care planing in the US. Is there nothing more humane than a person having the right to decide how they choose to spend their last months/days? 

I work in palliative care and the distress I see so frequently by family members because they hadn't discussed 'things (wishes)' with Mum or Dad or another family member is heartbreaking. We have a system in place here for people to discuss Advanced Care Planning (A Living Will) with their GP but unfortunately is under utilised. These type of legal documents not only provide peace of mind for the patient, knowing that their wishes will be respected, but they also provide it for the family in what can be a time of great sorrow and distress. 

There are aspects of healthcare here (Australia) that require government approval e.g. biologics (due to their cost). However, by and large, the healthcare of an individual is between the doctor and their patient. I find it surprising and confusing that members of this community are denied medication and tests by an insurance company that my GP writes a script or a referral for and I pop along to the pharmacy or the radiology centre and have the script filled or the test performed. Government isn't remotely interested in the day to day interactions of doctors and their patients. 

That's my two cents worth! :lol: 

Dusty. xxx


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## Ihurt (Nov 8, 2012)

Oh yeah, I had procedures done and when I got my bill they charged for every single thing down to the little protective  sleeve they put the thermometer in, I swear. Also, anyone who is the room with you while you are having the procedure, you will get a seperate bill from that person. I had a very low dose of pain med( 1 shot of fentyl) after my procedure. They charged me $450 for it!!! 

Also, yes, insurance companies will charge you up the butt for preexsisting conditions. My son has asthma. Well back when I was working the company was in the middle of getting a new insurance company.. Well that left us without insurance for like a couple months. I tried to get insurance for my son for those 2 months since he has asthma and I did not want him without health insurance for that long. Oh I never got denied, but almost every insurance company wanted to charge me like $1000 to $1600 a month!!! That was because he had a per-exsisting condition. Unreal! 

I think it is just sad that they can get away with treating people this way. They say they cannot afford free healthcare in the US!! I say Bullshit! If they can have free healthcare in some of the poorest countries( like cuba), then there is NO excuse here!!!! Greed is all it is about here!


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## Hobbes650 (Nov 12, 2012)

Ihurt said:


> Oh yeah, I had procedures done and when I got my bill they charged for every single thing down to the little protective  sleeve they put the thermometer in, I swear. Also, anyone who is the room with you while you are having the procedure, you will get a seperate bill from that person. I had a very low dose of pain med( 1 shot of fentyl) after my procedure. They charged me $450 for it!!!
> 
> Also, yes, insurance companies will charge you up the butt for preexsisting conditions. My son has asthma. Well back when I was working the company was in the middle of getting a new insurance company.. Well that left us without insurance for like a couple months. I tried to get insurance for my son for those 2 months since he has asthma and I did not want him without health insurance for that long. Oh I never got denied, but almost every insurance company wanted to charge me like $1000 to $1600 a month!!! That was because he had a per-exsisting condition. Unreal!
> 
> I think it is just sad that they can get away with treating people this way. They say they cannot afford free healthcare in the US!! I say Bullshit! If they can have free healthcare in some of the poorest countries( like cuba), then there is NO excuse here!!!! Greed is all it is about here!



Wow.  What flavor is that koolaid?  Seriously need to get over this greedy docotor, insuranace co, hospital, concept.  You need to see how much Hospitals have to pay for the stuff they provide before making comments like this.  If I come over to your house and offer you a product and service that you really, really want and I say it won't cost you one penny, what will your reaction be?  You'll slam he door in my face, as you should.  Please remember that next time someone offers you free stuff.


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## Ihurt (Nov 12, 2012)

Not exactly sure where you are coming from with your comment. First off, I was never offered anything for free nor did I expect it. 

what I was getting at is, as in some other countries, the people that live there pay taxes to the government which in turn pays for their health care. This way it is regulated and greedy hospitals and insurance companies are not allowed to rob you blind!!! 

I am sorry, but there is no way in hell that ANY hospital should charge $450 for one shot of a pain med!! That is outrageous. There is no way in hell they had to pay that amount to get this drug. It is disgraceful. I also just had an MRE of the small bowel. The final charge was $6,190!! Here you pay about the same for a colonoscopy as well!! This is not right. Like I said before, it is like being robbed without a gun! My close friend lost her home because of HUGE outrageous medical bills. Sad thing is that this is happening to a lot of people here in the US when it should not be!















Hobbes650 said:


> Wow.  What flavor is that koolaid?  Seriously need to get over this greedy docotor, insuranace co, hospital, concept.  You need to see how much Hospitals have to pay for the stuff they provide before making comments like this.  If I come over to your house and offer you a product and service that you really, really want and I say it won't cost you one penny, what will your reaction be?  You'll slam he door in my face, as you should.  Please remember that next time someone offers you free stuff.


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## Hobbes650 (Nov 12, 2012)

Ihurt said:


> Not exactly sure where you are coming from with your comment. First off, I was never offered anything for free nor did I expect it.
> 
> what I was getting at is, as in some other countries, the people that live there pay taxes to the government which in turn pays for their health care. This way it is regulated and greedy hospitals and insurance companies are not allowed to rob you blind!!!
> 
> I am sorry, but there is no way in hell that ANY hospital should charge $450 for one shot of a pain med!! That is outrageous. There is no way in hell they had to pay that amount to get this drug. It is disgraceful. I also just had an MRE of the small bowel. The final charge was $6,190!! Here you pay about the same for a colonoscopy as well!! This is not right. Like I said before, it is like being robbed without a gun! My close friend lost her home because of HUGE outrageous medical bills. Sad thing is that this is happening to a lot of people here in the US when it should not be!




I agree 100% that the cost is completely outrageous.  My last CT scan cost $11,000.  Room and board cost me $1000 per day (my insurance only covers up to $350 per day).  But I don't see the costs on the other side, and finding that part out is next to impossible in the US system.  Fixing the cost issue is the most important thing we can do in the US, but currently we have our blinders on.  The ACA is a expansion of the blinders and the cost is only getting worse.  No rational person would expand gov't run healthcare under the current system, without first addressing the main reasons for the already high costs.  That's the discussion that should be happening.


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## DustyKat (Nov 12, 2012)

$11,000 for a CT?! :yfaint: 

As you say, the cost is outrageous.  I hear what you say about not knowing the costs on the other side but if I go to a radiology centre here (these are privately run businesses) and pay up front for a CT scan the cost is about $400. The difference is mind blowing and I thought I was doing it tough if I had to pay $400. 

Dusty.


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## Hobbes650 (Nov 12, 2012)

DustyKat said:


> $11,000 for a CT?! :yfaint:
> 
> As you say, the cost is outrageous.  I hear what you say about not knowing the costs on the other side but if I go to a radiology centre here (these are privately run businesses) and pay up front for a CT scan the cost is about $400. The difference is mind blowing and I thought I was doing it tough if I had to pay $400.
> 
> Dusty.



I don't have the bill anymore, but that $11K could have been for when my doctor put the scope inside my ileum to look. I remember being shocked byut the scope cost and the CT cost.  Either way, completely outrageous.  At the time, I was hospitalized for a small bowel obstruction.  The CT test and the scope were done after the other tests could not rule out Crohn's.  The 7 days of care billed to my insurance was over $40,000, and I did not have any surgery.  Now, when I go to ballgame I expect to pay higher prices for a beer.  But when prices got crazy, like $7 for a lousy bottle of Coors, I choose to drink beforehand.  Unfortunately when I go to the hospital, I can't do that.  :biggrin:


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## Hobbes650 (Nov 12, 2012)

Hobbes650 said:


> I don't have the bill, but that $11K could have been for when my doctor put the scope inside my ileum to look.  Either way, completely outrageous.  At the time, I was hospitalized for a small bowel obstruction.  The CT test and the scope were done after the other tests could not rule out Crohn's.  The 7 days of care billed to my insurance was over $40,000, and I did not have any surgery.  Now, when I go to ballgame I expect to pay higher prices for a beer.  But when prices got crazy, like $7 for a lousy bottle of Coors, I choose to drink beforehand.  Unfortunately when I go to the hospital, I can't do that.  :biggrin:


Any yes, you hit the nail on the head- there need to be other resources available for healthcare services in the US.  But with the passage of ACA, these smaller kind of healthcare centers will be decreasing in numbers, forcing people to go to hospitals for all kinds of services.  Doctors too, will be moving from private practice to become hospital employees because it will be too expensive otherwise.  Not exactly how you bring costs down.


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## Ihurt (Nov 12, 2012)

I have to blame a lot of stuff on the hospitals. Here is the thing; if you walk in a hospital and say you are paying cash for lets say a CT scan. well you will likely be charged like $3000 or something like that. But when you have insurance, they will charge your insurnace company like over $8000. They do this to milk the insurance companies. I remember when my son was little I was paying cash for him to see his pediatrician. They charged me like $69 per visit. When I finally got insurnace that they accepted, I got my insurnace statement and noticed that they charged the insurance like $290.  WTH!! That makes NO sense. They are scamming the insurance companies. This in turn is why I have a $2,500 deductible no doubt!!! The hospitals/doctors rip off the insurance companies and then the insurance companies stick it to us! It is so corrupt is stinks. 

Oh, another thing here that I learned is that if you go to a facility that just does MRI's like the Open MRI establishments, you will pay WAY less for an MRI than you will if you have it done in the hospital. Unfortunately they did not offer MRE's at the Open MRI facility. Also, when I go to the open MRI facility, I only have to pay my $25 copay! If I do it in the hospital, it gets added to my deductible and I pay in the thousands! 

Something does need to be done, but not sure what can be done. I mean there is so much corruptness and greed that I just do not see them changing anytime soon.


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## Hobbes650 (Nov 12, 2012)

Maybe.  Corruptness definitely.  Not sure how you can call it greed when poor people are getting charged the same outrageous price as the wealthy- truly greedy people are smart enough to charge wealthy people more.  But those in gov't will certainly tell you they need to protect you from greedy doctors and hospitals, that's a given.  I'd also like to be protected from a greedy and corrupt gov't that wants to create more gov't jobs and higher gov't paychecks and pensions at the cost of the sick.  The same common sense approach that's used in auto insurance could be applied to healthcare.  Auto insurance is certainly not a perfect solution, but does offer some solutions that work to keep costs down.  And then there's the other problem.   Don't get me started on the lawyers and the cost of malpractice insurance.


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## tots (Nov 12, 2012)

I understand people think our healthcare system is horrible. 
That other countries do a better job.  

Well, our system and level of care can't be that bad we have people coming to 
The US from those countries for medical care.  As for Cuba,  I will opt to
Keep my docs in the US.  When I have an emergency (such as 
bleeding) it dosent take me months to get scoped. 

Also. I have worked for Drs and Ins company's (HMOs). And those 
Drs get a bonus every month they have a low referral to specialist
rate.  So yes there are people who have never laid eyes on
you deciding if you can see a specialist.  It was heart breaking to 
see two young men with families die because they were not 
Referred to us soon enough or even given X-ray exams soon enough
They didn't fit the profile for the diseases they died from. It's true and 
it already happens here.  It's called an HMO. 


Lauren


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## squeaky (Nov 12, 2012)

I live in bc, canada. My medical expenses are so different than yours. I pay my medical $64 month to government and when I have surgeries/tests etc I don't pay anything. Only thing I pay for is medicine. $64 is for a single person.
It is mandatory to pay it, if you earn below a certain amount yearly you can pay less. When I was on unemployment I didn't have to pay for 8 months (as I had paid the full amount when I couldn't afford it, it was like back pay from medical) . then a lower premium, when back on my feet I paid the full amo


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## tots (Nov 12, 2012)

Squeaky-   How long do you have to wait for an appt or any 
tests?  I don't remember reading  here much about Canada. 
Mostly the US and UK.  


Lauren


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## squeaky (Nov 12, 2012)

you can wait for appts, I was in pain and wanted to see family dr, I could get in after 11 days... don't think so, went to medical walk in where family dr was at the next day, waited 2 hrs. Couldn't get in to specialist, called them first and couldn't get past receptionist, she told me to go to family dr. family dr had to refer me to GI specialist. So after finally seeing him I have an another appt for followup next june. If I have a flare up before then I have to go to my family dr first. 
 A friend has a mri scheduled for next jun.  We do have wait times.


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## squeaky (Nov 12, 2012)

From listening to the news there are lots of canadians who rather than wait here for tests etc, that they don't have to pay for would go to the states and pay for the procedure because they don't have to wait.


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## Ihurt (Nov 12, 2012)

Oh I agree with you there! The wealthy should be made to pay more in taxes! It is sick to think that they get to slip through loop holes and pay NO taxes while the mid class and poor have to pay!! That needs to change! I hope that they pass that bill where the ones making over $250K a year have to pay more! It's about time they do pay! 

Oh I know. I mean a lot of people are so sue happy today. I mean yes, there are proabably a lot of times when a surgeon or doctor deserves to be sued. I read in the newspaper about a lady who her 3 year old son died because of an overdose of medication given to him in the hospital. They should be sued for that! I mean there are way too many people lying in the cemetary today due to careless mistakes made by either doctors, surgeons or hospitals. But then you get the people who want to sue for every single thing. I know my gyne told me that her insurance was getting so high it was ridiculous. She said that gyne's have to have the biggest malpractice insurance. She said peopel will try to sue the OBGYN for anything that goes wrong, even if it had nothing to do with anything the gyne did or did not do... 

I know my son had a car accident not to long ago. A drunk driver cut him off. well the passenger in my sons car ended up having her femur broke in her leg. Well thankfully my son had good car insurance that covered everything since the guy who caused the accident did not even have insurnace at all! Well now my sons insurance company is now sueing the guy personally for all the money( hospital bills from the girl who broke her leg). Here is the kicker. The girls mother actually wanted to try and sue my son even though he was not at fault at all for the accident. The insurance company was nice though, they paid her mom some money and are just going after the guy who caused the whole mess.  

But yeah, back to your point, yes, I agree, the rich should have to pay more than the mid class and the poor in my opinion. 
















Hobbes650 said:


> Maybe.  Corruptness definitely.  Not sure how you can call it greed when poor people are getting charged the same outrageous price as the wealthy- truly greedy people are smart enough to charge wealthy people more.  But those in gov't will certainly tell you they need to protect you from greedy doctors and hospitals, that's a given.  I'd also like to be protected from a greedy and corrupt gov't that wants to create more gov't jobs and higher gov't paychecks and pensions at the cost of the sick.  The same common sense approach that's used in auto insurance could be applied to healthcare.  Auto insurance is certainly not a perfect solution, but does offer solutions that work to keep costs down.  And then there's the other problem.   Don't get me started on the lawyers and the cost of malpractice insurance.


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## seebee (Nov 12, 2012)

My question is how will things change come January?


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## CLynn (Nov 13, 2012)

Guess we will see then. Sort of scared to find out, though....


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## Naturelover (Nov 13, 2012)

http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

Here is 193 pages of fun reading for all regarding the Obama Health Care Act


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## Naturelover (Nov 13, 2012)

Below are links to the Obama Health Care Act. There are pdf files you can download and print, if you so choose, and read at your leisure.

http://www.healthcare.gov/law/full/

http://www.govtrack.us/congress/bills/111/hr3590/text

http://www.healthcare.gov/law/resources/authorities/patient-protection.pdf

http://www.healthcare.gov/law/resources/authorities/reconciliation-law.pdf


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## nogutsnoglory (Nov 14, 2012)

I thought Obamacare just changed how insurance companies can treat people. I'm being told there is going to be a government healthcare option. Is this going to be open to everyone? How much will it cost and who will be the providers?


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## Naturelover (Nov 15, 2012)

Nogutsnoglory,

   I posted links to the actual Obama Health Care Act. Go read them for youself so you don't get any biased comments on the matter. Don't rely on others to do your homework for you. Their answers may be wrong.


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## Hobbes650 (Nov 15, 2012)

CLynn said:


> Hospitals also are very often guilty of billing for things not given or done, everyone should go over the bills with a fine tooth comb. And pharmacuetical companies have too much power to set ridiculous prices and keep generics off the market.



Hi Cylnn, You probably don't want to go over your bills with a fine tooth comb since it could be quite stressfull.  If you do, you will discover charges that seem outragous.  Problem is, the bill is only one side of the the problem- we don't see what the corresponding costs are that the hospital has to pay for.  What's worse, is that under the ACA hospitals and doctors will be paid less in an effort to reduce healthcare costs- which is the dumbest idea yet.  Imagine if you were upset over how high your phone bill is.  Would cutting your paycheck bring your cost down?  Would paying your phone company less force them to charge you less?

The ACA is about nationalizing healthcare- one size fits all for everyone, completely paid for by the taxpayer and completely controlled by the gov't.  This is to correct all the inequality that occurs in healthcare.  If you believe that, great you will have no problem going forward.  But the reality is that the ACA will force many suppliers of healthcare (doctors, hospitals, clinics, etc) to go out of business becasue they will not be able to pay their expenses.  It's just too bad that the debate in the US is not honest- nobody who favors the ACA says it's about fairness.  Instead, proponets all promote how much more efficient the system will be, and how much less expensive it will be, and how much better off society will be.  Total bs.

I also just learned that you can make upt to $92,000 a year, have no dependents, and be eligible for Obamacare.  Yes that's right, you can make $92,000 and still be eligible for government welfare.  If there is one stat that proves this bill is not about making healthcare cheaper but rather controlling it it's this one.  What's next, an Affordable Housing Act where you can get a house paid for by the taxpayer as long as you make under $200,000 a year?  An Affordable Car Act? How about an Affordable Television Act?  I could certainly use a new plasma screen.


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## CLynn (Nov 21, 2012)

Hobbes, I would have to a xanax first, lol! Then check the bills over.


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## IAmTheWalrus (Nov 21, 2012)

Hobbes650 said:


> Hi Cylnn, You probably don't want to go over your bills with a fine tooth comb since it could be quite stressfull.  If you do, you will discover charges that seem outragous.  Problem is, the bill is only one side of the the problem- we don't see what the corresponding costs are that the hospital has to pay for.  What's worse, is that under the ACA hospitals and doctors will be paid less in an effort to reduce healthcare costs- which is the dumbest idea yet.  Imagine if you were upset over how high your phone bill is.  Would cutting your paycheck bring your cost down?  Would paying your phone company less force them to charge you less?
> 
> The ACA is about nationalizing healthcare- one size fits all for everyone, completely paid for by the taxpayer and completely controlled by the gov't.  This is to correct all the inequality that occurs in healthcare.  If you believe that, great you will have no problem going forward.  But the reality is that the ACA will force many suppliers of healthcare (doctors, hospitals, clinics, etc) to go out of business becasue they will not be able to pay their expenses.  It's just too bad that the debate in the US is not honest- nobody who favors the ACA says it's about fairness.  Instead, proponets all promote how much more efficient the system will be, and how much less expensive it will be, and how much better off society will be.  Total bs.
> 
> I also just learned that you can make upt to $92,000 a year, have no dependents, and be eligible for Obamacare.  Yes that's right, you can make $92,000 and still be eligible for government welfare.  If there is one stat that proves this bill is not about making healthcare cheaper but rather controlling it it's this one.  What's next, an Affordable Housing Act where you can get a house paid for by the taxpayer as long as you make under $200,000 a year?  An Affordable Car Act? How about an Affordable Television Act?  I could certainly use a new plasma screen.


Love how you're comparing someone's health, something, in most cases, they have no control over. It's someones life, not some material object like a car or TV. 

The American health care system is a shambles, thank God, as someone with Crohn's, I'm looked at as a patient in need as opposed to a giant check book like they do in the States.


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## Hobbes650 (Nov 21, 2012)

IAmTheWalrus said:


> Love how you're comparing someone's health, something, in most cases, they have no control over. It's someones life, not some material object like a car or TV.
> 
> The American health care system is a shambles, thank God, as someone with Crohn's, I'm looked at as a patient in need as opposed to a giant check book like they do in the States.



Hi Walrus, I cetainly do not suggest that peoples health be treated at the same way as material objects, that's abusrd.  The prices of the goods and sevices can cetainly be treated in a more similar fashion to bring prices down. A really good way to do that is to open the industry up, make it more competitive.  Lasik eye surgery is a great example of one item in health that has done this and prices dropped dramatically.  Sorry, I guess I should have used the lasik example to better illustrate the point iinstead of being a little absurd in order to illustrate the complete abusrdity of the situation now.  The one size fits all approach to most healthcare issues in the US is the wrong approach.  Having a unique and separate system for people who cannot afford healthcare is best, that's all.


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## Ihurt (Nov 21, 2012)

It's definitely all about the money here in the United States when it comes to health care, unfortunately! It all comes down to hospitals charging insurance companies outrageous amounts of money for tests.  Then the insurnace companies charge the people WAY too much just to have the insurance and crazy insane deductibles! The insurance companies even deny patients needed tests here. 

Last year my son had to have knee surgery due to a knee injury. His orthopedic surgeon wanted him to have an MRI of his knee right away to see the extent of the damage. Get this; the insurance company tells the doctors office that they do not think he needs an MRI yet, that he has to go to physical therapy first!!!! Ummm ok, I am no doctor but I think when a person injures their knee the last thing you would want to do is have them do excercises with it without seeing the extent of damage! Well, the stupid insurance company would not budge. So my son went to PT for like 2 sessions and finally told the Therapist that he could not do anymore excercises as it was causing him to much pain.  I finally called the insurance company back and told them about this. The lady at the insurance company told me that my son would have to at least go to 5 sessions of PT before they would cover an MRI. At that point I was getting really pissed. So I told the lady that fine he will go, but if he gets any worse due to you all forcing him to have PT in order for you all to ok his MRI, well you will be hearing from a lawyer! Well, finally we got the call back saying they would ok the MRI. 

But the whole point is is that the US health care system is a mess, that is for certain. To much greed and you cannot trust anyone any more. Being chronically ill for the last 9 years I can honestly say that the one thing I have learned is that the doctors and insurance companies best interest is not the patients best interest as sad as it is. It is all about the money! Sad but true!


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## CLynn (Nov 21, 2012)

It seems designed to help the insurance companies NOT have to pay out any more money than they want to. I have dealt with insurance since I got Crohn's while I was in college. Over time, I see that they pay less and less of what they used to. My husband is diabetic, type I, and this year when he ordered his insulin, the cost was applied to his deductible instead of just being paid at the normal prescription benefit prices. $700.00 is alot of money, we were livid, it's not like he can choose NOT to take the medicine, it's life and death. Never in all the years I have dealt with insurance have I seen them do this with prescriptions, apply them to the medical deductible.


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## M_Zalucki (May 11, 2013)

Okay I've read through a lot of these posts, some of you have made some very good points; here's how I see it.  First my background, I'm a 21 year old Crohn's patient, and currently a full-time student, born and raised in Massachusetts.  In January I was kicked off my parents health insurance by the state, which was a state-funded plan (Network Health).  I was subsequently denied coverage from every other state offered health plan; commonwealth care, Mass Health, etc...  I was forced to pay over $800 for a premium to get on my schools insurance and receive their coverage, which will expire come August, and I didn't actually get on it until February.  While the Affordable Care Act will lower the cost of my medications in the long run, it also reduces the ratio between how much the insurance companies can charge for young-old peoples premiums.  "Those provisions would drive premiums down for 55-year-olds but would drive them up for 25-year-olds—who are then implicitly subsidizing older adults. According to the Urban Institute, many young people could see their premiums double, whereas premiums for older adults could be cut in half" [1].  So while I will be spending less on my medications, I will be hit much harder regarding my health insurance premiums.  Possibly in the aggregate this will save me more money than it will cost, but from my preliminary estimates that is not the case, in fact far from it.  Also, while I cannot be denied for having a pre-existing condition, this was not a factor in me being denied all health coverage from the state earlier this year.  Also, disregarding pre-existing conditions does have downsides: "That concept [the 'guaranteed issue'] applied to fire insurance would require fire insurers to cover applicants who waited until their home caught on fire to call for coverage" [2]. It will also be harder to see your specialist once the Affordable Care Act is fully in place, "Access to care will become a huge issue as waiting times to see doctors and enter hospitals grows" [2].  To me, this is a scary notion; as many of you know Crohn's is unstable, flare-ups can come without notice, I for one do not want to have to wait months to see my specialist while I'm dropping weight at alarming rates and spending a third of my day in the bathroom!!!  More over, as the son of a second generation small business owner who has worked in my father's manufacturing company since the age of 8, I have already seen the effects of the ACA on small business taxes, and I've seen first hand the stresses this will put on our nation's business owners (who make up most of your employers by the way!).  Obamacare is going to force a lot of small businesses to cease paying for their employees health insurance, forcing more people onto government funded programs; guess who pays for that, my tax money. 

Overall, while there are some ways in which I will benefit from the Affordable Care Act, there are far more negatives.  From my initial analysis it will end up costing me more than it saves me, as well as making it harder to see my doctor; these are only several of the negative points that I have decided to present to you, and I would be more than happy to go into further detail.  Ask some Canadians how they feel about universal health care though, and you will hear pros and cons from everyone.  Stories of local government officials literally picking names from a hat to determine who would be allowed to see a doctor that month, yet other stories of universal health care making life easier.  Part of me thinks acceptance of this legislation involves a liberal mindset, and maybe that's why I have trouble in doing so...  _________________________________________________________________
References: (sorry it won't let me post the links)
[1] "ObamaCare: A Bad Deal for Young Adults" by Aaron Yelowitz, CATO Institute, November 5, 2009
[2] "Look Out Below, The Obamacare Crisis Is Coming" by Peter Ferrara, Forbes, April 7, 2013


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## amrycrohns (May 11, 2013)

There are a few positives in this bill they are few and far apart.  I am just at the point with tax's and premiums and everything else I see that I do not want to pay for other people's stuff.

How many people here have seen someone use one of them free food cards EBT or whatever they are called then see them in parking lot in 70,000 dollar vehicle.  This system will be abused like so many others.


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## seebee (May 11, 2013)

amrycrohns said:


> There are a few positives in this bill they are few and far apart.  I am just at the point with tax's and premiums and everything else I see that I do not want to pay for other people's stuff.
> 
> How many people here have seen someone use one of them free food cards EBT or whatever they are called then see them in parking lot in 70,000 dollar vehicle.  This system will be abused like so many others.


You are right. The system will benefit some but many others will use it to their advantage at the expense of others.


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## DougUte (May 12, 2013)

Didn't know that using beneficial aspects of the ACA means you are taking advantage of others. ACA has already cut my expenses by about $9000.00 per year, just by allowing employers to offer high deductible health plans. 

I am not a liberal by any means, but the fact is that most small employers in Utah have never offered health insurance to their employees. The ACA is not responsible for small employers not offering health insurance because of the cost. They were not offering it even before the ACA.


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## seebee (May 12, 2013)

If you are entitled to it, then use it but there will be those who will make themselves using various ways to make themselves entitled.


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## amrycrohns (May 13, 2013)

DougUte said:


> Didn't know that using beneficial aspects of the ACA means you are taking advantage of others. ACA has already cut my expenses by about $9000.00 per year, just by allowing employers to offer high deductible health plans.


My comment was geared more toward people living off of our system then people who work and earn a living.  SSD, welfare, food stamps, free medical and everything that can be abused is being abused.  Some people really need it and I don't mind that too much.  When you are having more kids to get more money or saying your baby's daddy lives somewhere else so you don't have to count thier income.  People work under the table pay no tax's and collect aid from the goverment and let's not forget the drug dealers making more money then most honest people and getting free aid.  

I am glad your medical costs went down, most people I know who pay a premium had significant increase's in premiums with in months of ACA being upheld.  My premiums only went up slightly nothing to lose sleep about since my entire family gets 100% everything no co pays.


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## DustyKat (May 13, 2013)

seebee said:


> If you are entitled to it, then use it but there will be those who will make themselves using various ways to make themselves entitled.


Perhaps that is the very reason to steer away from these ad hock measures. 

No matter what welfare/assistance etc is on offer you will always have those that abuse the system but does that mean we don't offer these basic services? 

Universal health care is paid through taxes and yes, there will be those that avoid paying taxes too. But you can earn a billion dollars or nothing and still access the same public hospital, the same doctor. Of course for those that choose to they can also opt for private health care which does allow greater choice. 

It is all about everyone having access to decent hospital care full stop, at no added cost to the consumer. 

I will be honest and say that knowing my children will never have the full burden of their health care is comfort indeed. I have paid my taxes from the time I left school and I can say i never received back what I put in as far as services are concerned. I spent nigh on 25 years or more subsiding the health care system through my taxes and didn't use it, well aside from the births of my children, but I am certainly seeing the benefits of it now with 2 children with Crohn's. Our time did come but even it didn't I wouldn't mind as I believe it to be a basic human right. 

Does the system have problems? Of course it does, just as any system does. Is it free? Of course not, we all pay for it through a levy via the tax system. I am just happy it is there.  

The health system in the US and rest of the developed countries took different paths and for the US it would never be as simple as adopt this or that system and all will be well. Your infrastructure is based on your system and that makes widespread change difficult. I just hope that a way forward is found that makes affordable healthcare a right, not a privilege, as there is nothing more heartbreaking than coming to the forum and reading that someone can't proceed with a given treatment and/or go to the ER because of the cost.  

Just my two cents worth, :wink: 

Dusty.


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## LindaS (May 14, 2013)

I am personally in favor of ACA.  I am also very fortunate that my husband's job provides excellent insurance, so while it pays less than other jobs he considered, we decided the health care was worth it.  But I hate the fact that he chose a job in part because of the health insurance.  A coworker would love to stay home with her kids (and they can afford it) but because she carries the health insurance in her family, she can't.  I wish they had gone farther and instituted universal health care.

After college, I had a soul-sucking job working for Empire Blue Cross and Blue Shield.  We called it the Evil Empire.  My entire job was to find ways to deny claims.  The idea was, if we denied claims, even ones that should be paid, a certain percentage would never question it and the company wouldn't have to pay.

I do not trust insurance companies.  I really wish the ACA didn't require them as middlemen paying for care.


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## mccindy (May 14, 2013)

The Affordable Care Act is a big step in the right direction.  The primary fix is the requirement to carry insurance. I know too many people who don't carry insurance because they don't want to pay for it - but then when there is a major medical disaster, they can't pay the high bills incurred.  When that happens, Medicare steps in and reimburses the facility and providers for the unpaid bills.  This is an enormous drain on the Medicare system, and it's why the ACA will help to stop the shortage in Medicare.  If billions are saved by not needing to pay unpaid hospital bills, Medicare has more funds available to cover the enrolees, as well as to close the prescription doughnut hole that often forced seniors to choose between medication and food.  Allowing children to stay on their parents' insurance is another huge part, because kids in college or just getting started in life who don't have insurance can have their credit damaged literally for life if a medical emergency happens and they can't pay for it.  Requiring more employers to offer the insurance also helps everyone, even those employers who feel like they are being ripped off.
The third and arguably best part of the ACA is the elimination of disqualification based on pre-existing conditions.  What a joke that has always been, that the business administration of some insurance company could dictate whether an enrolee's necessary medical care could be denied because they had the condition prior to starting with that particular company.  This was a senseless rule and I'm so glad to see it going by the wayside.


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## mccindy (May 14, 2013)

amrycrohns, you already pay for everyone else's stuff.  that's how taxation works.  Currently you pay taxes in to the Medicare system, which pays out billions to hospitals to cover bills incurred by those who had no insurance.  When people are forced to carry insurance, they will not be able to ring up those huge unpaid bills and the Medicare system will save money.  There is no perfect system but I believe our President was right in introducing this program because something had to be done.  It's not fair that we all pay in to the tax system but only certain people can reap the benefits.  The middle class bears the brunt of those expenses.


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## LindaS (May 14, 2013)

One other thing I'd like to mention is that when my husband first graduated from law school, he worked as a bankruptcy attorney.  All but 3 or 4 of his cases involved either a death in the family, a divorce or a health crises.  He will tell you that the overwhelming majority are health crises.  These people would be so far in debt that bankruptcy was the only way to get out of it.  And most of them had insurance.  A good friend of mine lost her son to CF.  After a year that started with an infection that led to multiple ICU visits and months in the hospital, he died.  And then she and her husband had to declare bankruptcy because even though they had insurance, they had a half million dollars in medical debt.  She said that she eventually turned her phone off, because while in the ICU with her son, collection agencies would call.

No one should have to go through that.  Ever.


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## mccindy (May 14, 2013)

One more good thing about the ACA, which will apply to what you've said, Linda, is the insurance exchange.  Few industries are as confusing as the insurance industry.  The exchange will force all insurance companies to be listed in one place, with a clear description of enrollment costs, deductibles, out-of-pocket annual limits, and more.  Consumers will be able to choose an insurance that fits their spending limits.  Some companies require a higher participation cost but offer more coverage on hospital visits and testing.  This can make a procedure that costs thousands of dollars literally only cost a hundred or two.  More people should also receive finance education in high school though - most Americans live at or beyond their means and when unexpected bills come up, they don't have the reserve to pay for them as they should.


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## LindaS (May 14, 2013)

mccindy said:


> More people should also receive finance education in high school though - most Americans live at or beyond their means and when unexpected bills come up, they don't have the reserve to pay for them as they should.


While I agree with this statement, when a medical crises arises, and you or a family member is in the hospital for any length of time, unless you have a very large savings, it won't cover the costs as they are now.  My first bowel resection, in 1995, cost almost $70,000.  But my insurance back then picked up the entire tab.  With my second, in 2006, it was around $100k.  I can't imagine what they cost now.  No working person could afford that with savings.


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## mccindy (May 14, 2013)

Linda - that's what I mean, the reserve would be to cover the out-of-pocket portion of the bill after insurance picks up the main portion.  I didn't mean people should have enough reserve to cover procedures without any insurance.   That would be a nightmare and unattainable!


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## LindaS (May 14, 2013)

mccindy said:


> Linda - that's what I mean, the reserve would be to cover the out-of-pocket portion of the bill after insurance picks up the main portion.  I didn't mean people should have enough reserve to cover procedures without any insurance.   That would be a nightmare and unattainable!


Oh.  Even still, my friend had insurance, and the non-covered portion was so much that there was no way she could afford it.  She and her husband still had to declare bankruptcy.  And they lost their house, because they decided to pay bills so care would continue, instead of their mortgage (although I doubt they wanted to live there any more without their son).  Now, about 5 years later, they are finally getting back on their feet.  It is horrific enough to lose your child, but then to also have to declare bankruptcy is just insulting.

Hopefully, over the next few years, this legislation will get tweaked so that can't happen.


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## mccindy (May 14, 2013)

I certainly hope so.  How awful, to lose a child and then still have to go through all that financial difficulty as well.  I hope that the ACA is able to force insurance companies to do what they are actually supposed to do, pay for the medical bills that the premiums are meant to cover.  It's sad that the insurance industry has become such a money-hungry entity, fattening the pockets of executives to the detriment of the health of America.


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## LindaS (May 14, 2013)

Here's a transcript of Kerry's testimony in front of the senate, about her bankruptcy process.  I still think of how brave she was to testify about it.  She's a lot stronger than I think I would be.http://www.judiciary.senate.gov/hearings/testimony.cfm?id=e655f9e2809e5476862f735da151bfa1&wit_id=e655f9e2809e5476862f735da151bfa1-1-0


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## mccindy (May 14, 2013)

What an incredibly well-spoken woman.  To go through all that, share her story and do so well to share both the pain and humiliation she felt during that time.  She articulates well the very need our society has to protect the family during times of hardship - I know there are some who might say that one of the parents should have gone back to work to support them and prevent the financial losses, but imagine the mental and emotional toll on the parent who would have missed the end of the child's life.  I hope that her testimony made some difference.


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## nogutsnoglory (May 14, 2013)

I am a proponent of the ACA but surprisingly some of my doctors say its bad and they won't be reimbursed as much. These aren't conservatives either but NY liberal docs. Do they know something we don't know? Why would this bill effect their reimbursement?


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## DougUte (May 15, 2013)

I have heard that also. But I also know doctors that are all for it because patients are able to better afford care.


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## mccindy (May 15, 2013)

Docs will be affected because reimbursements are changing.  More careful screening needs to be done because if procedures are performed and then denied, payment won't be received.  Plus providers are being held much more accountable for care and that affects reimbursement also.  For example, if a patient contracts pneumonia more than 48 hours after being admitted to the hospital, it is a hospital-acquired pneumonia and the hospital and all providers are held responsible for that infection.  No reimbursement will be given for any care for the patient because it is considered the hospital's responsibility that the patient contracted pneumonia while in their care.


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## Amy2 (May 15, 2013)

I believe that every citizen in the world is born entitled to an education, a decent job, safe, modest housing, healthy food and good healthcare.  Obamacare is a tiny step in the right direction.

Our 19 year old has been able to stay on my husband's insuance because of Obamacare.  She earns a little over minimum wage and would not be able to afford decent insurance on her own.

The U.S. is a very wealthy country.  We can afford to treat our citizens decently.


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## amrycrohns (May 15, 2013)

Amy2 said:


> The U.S. is a very wealthy country.  We can afford to treat our citizens decently.


We are something like 17 trillion dollars in debt.  I have been to 3rd world countries and we live better then them.  But we also have a ton of etitlement programs that we can not afford and are living off of borrowed money.


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## mccindy (May 15, 2013)

The National Debt is something of a joke, to be honest.  We owe money in reparations to countries with whom we had a military conflict or war.  We owe money to countries with whom we trade goods.  If we spent less on defense and unnecessary research projects, and stopped the leakage that occurs with government spending, programs designed to help people could be properly funded and so could our educational system.  We could also make more money by increasing taxes on companies that choose to move facilities overseas and then ship their goods back into the U.S., and taxing corporations at a rate equal to what ordinary citizens pay.


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## Amy2 (May 15, 2013)

Our debt has been higher as a percentage of the GDP in the past.  We just need to start collecting taxes from the rich at a much higher rate (like we used to).  Eliminating spending for education that results in a continued decline in American competitiveness will not make the U.S. stronger. Any approach that results in significant declines in standards of living for average working Americans will result in a corresponding drop in tax receipts and actually make our debt worse.  It's time to spend on education and infrastructure, which will create jobs.  Of course we should raise minimum wage, too.


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## mccindy (May 15, 2013)

Unfortunately the GOP just voted to eliminate overtime pay, more detriment to the middle class and benefiting the rich.  Again.


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## amrycrohns (May 15, 2013)

We are getting off the subject of ACA a little now and getting into political views.  Which will vary from person to person.  I am middle class, me and my wife both come from being very poor.  We do very well for ourselves now a days after many years of sacrifice.  The ACA has not one benefit for me personally or my family.  It has however raised our premiums slightly as insurance companies prepare for ACA to go into full effect.  I am paying more tax's now then ever and see some of the other benefits afforded to me for being in the military being cut.  So in the end I am paying more and getting less.


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## Amy2 (May 15, 2013)

You're either middle class OR you do very well for yourselves, can't be both.  
People mean different things when they say middle class.  Some people who call themselves middle class make $40K, others make $200K.  Huge difference.  Once my husband passed the $100K mark, our lives got much easier, much less stressful and much more fun.  I never complain about the taxes we pay!  Also, when we were poor, it wasn't because we didn't work hard or sacrifice, we just had a run of bad luck, like many people do.  Don't you think health care should be a right?


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## Clash (May 15, 2013)

I agree amrycrohns, ACA will not benefit my son either. He is fixing to enter college but from my research it would benefit him more healthcare wise to encourage him to pick up minimum wage job rather than get and education and better himself. The premiums he'll have to pay at his projected salary will put the premiums too high to consider self sufficiency

Our insurance was established before 2010 so according to ACA they don't have to provide until he's 26. Our insurance will cover him until 26 as long as he is a full time student.

And above a poster said Medicare was overburdened because they had to pick up the unpaid bills of those that opted not to get insurance then had an a medical emergency. I don't follow that at all since there are guidelines to be picked up by Medicare and if you don't meet those guidelines Medicare is NOT going to puck up your unpaid hospital bill. If you do qualify the Medicare would pick it up regardless when you applied. Unpaid hospital bills(depending on the type of hospital) are written off and the cost passed down to tax payers and insured patients.


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## amrycrohns (May 15, 2013)

Amy2 said:


> You're either middle class OR you do very well for yourselves, can't be both.
> People mean different things when they say middle class.  Some people who call themselves middle class make $40K, others make $200K.  Huge difference.  Once my husband passed the $100K mark, our lives got much easier, much less stressful and much more fun.  I never complain about the taxes we pay!  Also, when we were poor, it wasn't because we didn't work hard or sacrifice, we just had a run of bad luck, like many people do.  Don't you think health care should be a right?


You can live very well in the middle class if you live with in you means.  We make about 100k, thats not including 100% medical for family and life insurance.  No healthcare shouldn't be a right, I don't mind it being provided to people who need it and can't get there own, its all the people that need it that are to lazy to work and live off goverment programs.


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## Beach (May 15, 2013)

I recall seeing a report the other day that I found interesting.  It found that young men will be paying much more for the new health care act.  

"Obamacare Kicks Young Men While They’re Down"

http://blogs.the-american-interest.com/wrm/2013/05/14/obamacare-kicks-young-men-while-theyre-down/



> Young men will be the biggest losers in the transition to Obamacare, according to a new report by the actuarial and consulting firm Milliman. The report estimates that males as a whole will see an 11 percent increase in insurance premiums, while females as a whole will see a nine percent decrease. Men under 40 will face insurance hikes of 18 to 31 percent; females under 40 will benefit from 13 to 19 percent decreases.
> 
> But here’s the real kicker: premiums for young men ages 25-36 could increase by more than 50 percent, and females 25-29 will face a 4 percent increase. In other words, if you’re young, you lose. If you’re a man, you lose. If you’re a young man, you really lose.
> 
> Recent news about Obamacare premium costs has tended to focus on whether the premiums will go up or down on average. What this data shows is that these broader national or state averages hide scarier changes in the group-by-group breakdowns. Young people are already the hardest hit by the recession and by the plethora of other entitlement programs that subsidize the boomers. Young men, in particular, are especially hurt by some of the country’s current economic shifts. Passing a law that forces them to shoulder an even greater economic burden and then spending tons of money to convince them to sign up for this raw deal is both cruel and irresponsible.


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## Amy2 (May 16, 2013)

amrycrohns said:


> You can live very well in the middle class if you live with in you means.  We make about 100k, thats not including 100% medical for family and life insurance.  No healthcare shouldn't be a right, I don't mind it being provided to people who need it and can't get there own, its all the people that need it that are to lazy to work and live off goverment programs.


You are already paying for the uninsured, after their problems get big enough that they head to the ER.  Do you want to live in a country where people are turned away in the ER?  If not, then it's better to pay for their preventative care, from a purely financial POV.

People in the US just aren't used to thinking of healthcare as a right, but we have lots of other rights, that cost others money.  If you leave your stove on and your house catches on fire, my tax dollars will help send a fire truck to your house.  Is a house more important than a body?  Or do you think only people who can afford to pay the firefighters should get to have their houses put out?


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## Amy2 (May 16, 2013)

Beach said:


> I recall seeing a report the other day that I found interesting.  It found that young men will be paying much more for the new health care act.
> 
> "Obamacare Kicks Young Men While They’re Down"
> 
> http://blogs.the-american-interest.com/wrm/2013/05/14/obamacare-kicks-young-men-while-theyre-down/


I have a young male relative who will have healthcare for the first time since he left his parent's house.  He works full time, but because he makes so little, it will essentially be paid for by other people.  There are plenty of young men in low paying jobs just like his.


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## rygon (May 16, 2013)

Gets me that Americans see owning guns as a right, yet sees healthcare as needed only for the people who can afford it... (bit of generalisation there I know  ) 

Percentage wise how many people do you really think play the benefits system now, I'm sure its pretty low compared to the people who really need it. 

I pay into our healthcare system by means of tax, and tell you the truth I'd rather be healthy and not get my money's worth


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## Beach (May 16, 2013)

The sad part about the new unpopular Obamacare is that something new could have been written, that could have helped people much better.  How the new generally works is that largest group that has been uninsured are young Americans.  They must now buy premium health insurance, buying items they don't really need.  This helps out older Americans, keeping health insurance costs down for them.  To not buy insurance is to leave one open to IRS penalties - which with the recent IRS bias scandal is a frightening thought.      

As can be imagined every health group in the country is lobbying to be included with the mandatory insurance coverage.  They are lobbying politicians, as to be left out can be hurtful for ones business.  The most powerful lady in the government overlooking health care was even recently playing into this.  Katheleen Sebelius mentioned that companies should volunteer money to help raise further awareness that young Americans need to buy health insurance.  I'm guessing plenty of companies and health groups will be helping the Health Secretary out, to be richly rewarded later.      

As for expanding the rat hole of Medicaid, which is what the AHA does, another report came out in the prestigious New England Journal of Medicine highlighting how poorly this program works to help improve the poors' health.  

Our old health care system wasn't all that great.  It's easy to see why the new AHA act isn't popular today.  

It's a political article, but on the Medicaid study.  

"More Trouble for ObamaCare"

http://www.commentarymagazine.com/2013/05/02/more-trouble-for-obamacare/

snippet from the article:



> In March 2011, Avik Roy wrote about something that constituted, in his opinion, “simply put, the greatest scandal in America. Bigger than Madoff, bigger than the Wall Street bailout, bigger even than the plight of the uninsured.” The scandal was a study demonstrating that “despite the fact that we will soon spend more than $500 billion a year on Medicaid, Medicaid beneficiaries, on average, fared worse than those with no insurance at all.” (Emphasis in the original.)
> 
> Indeed, Medicaid does not tend to fare well when tested. But yesterday’s news was among the worst that proponents of expanded Medicaid and its larger ObamaCare policy disaster could have received. The New England Journal of Medicine reported the results of a study conducted by major health-policy scholars–including ObamaCare advisor Jonathan Gruber–further showing that Medicaid is an expensive bust. The conclusion from the study authors:
> 
> ...


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## mccindy (May 16, 2013)

Clash and amry - you are both mistaken.  Clash first - it doesn't matter if the insurance was established prior to 2010, under ACA they do have to provide insurance for your son until he is 26.  The only area where time of establishment is critical at this point is for pre-existing conditions, and that stipulation goes away next year.  
amry - ACA does benefit you, and everyone else.  The Medicare program shoulders an enormous burden by reimbursing medical facilities for unpaid hospital bills literally in the billions, incurred by the uninsured.  If this were to continue unchecked, the Medicare program would fail within a matter of years.  However, under ACA, with millions more people insured and a push for wellness and prevention rather than treatment after the fact, Medicare will save billions of dollars each year and continue to remain a viable program.  
I know many people who are working at places where health care is not available.  Under ACA some of those employers will be forced to offer insurance, or pay a fine.  The employees will be forced to carry insurance, or pay a fine. I don't have a problem with that.  I don't mind my taxes going to a program that helps cover insurance for everyone, but I don't like them going to pay bills for people who aren't carrying insurance, don't go the doctor, and then incur enormous bills when they do get so sick they have to be emergently admitted to the hospital and treated. 

Also, read carefully when researching the ACA.  Premiums will increase for young men, but ONLY if they are picking up insurance directly from the exchange and not from their employer.  Part of the reason for this is that the risk pool is being expanded to include the elderly, and insurance companies cannot charge different premiums based on gender.   Previously women were charged more than men were, and now that is no longer the case - so the rise in men's premiums and the decrease in women's is a change to bring more equality to the cost.  
http://money.cnn.com/2013/05/14/news/economy/obamacare-premiums/index.html


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## Beach (May 16, 2013)

McCindy - I wish I held your enthusiasm that current prevention measures will save money.  It is an old saying that we hear.  Government has been involved in our medical system for over 60 years at this point, with each generation of politicians saying they will cut medical costs.  That hasn't exactly happened with our medical system though.  Medical costs have exploded upwards.  Some recent estimates put our medical wasteful spending at 800 billion and upwards - more than we spend on national defense.  

Sadly also there have been a number of articles of late showing the opposite when it comes to current prevention care options with the new health care law.  For example ~

"Think preventive medicine will save money? Think again"

http://www.reuters.com/article/2013/01/29/us-preventive-economics-idUSBRE90S05M20130129

As your CNN article points out, historically fewer men seek to see doctors.  As a result, due to a higher number of visits by females, costs have historically been higher for women.  Makes sense.  

And that is where one way a difference could be made with improving our medical system, and seeing less of our economy going toward the health care industry.  People need choices and incentives to stay healthy, and choose medical options that might be equal in care, but less in cost.  

One country, with a high life expectancy and Universal care is Singapore.  Their medical costs though are around half of what other countries pay for Universal care.  That is due to giving their citizens choices, and greater incentives to exercise and eat healthy.    

"What we can learn from Singapore's health-care model"

http://www.washingtonpost.com/wp-dyn/content/article/2010/03/03/AR2010030301396.html 

&

"In Praise of Discrimination in the Health Insurance Market"

http://reason.com/archives/2012/06/28/in-praise-of-discrimination-in-the-healt

From John Stossel's article:



> ...Above all, discrimination is what makes insurance work. An insurance regime where everyone pays the same amount is called "community rating." That sounds fair. No more cruel discrimination against the obese or people with cancer. But community rating is as destructive as ordering flood insurance companies to charge me nothing extra to insure my very vulnerable beach house, or ordering car insurance companies to charge Lindsay Lohan no more than they charge you. Such one-size-fits-all rules take away insurance companies' best tool: risk-based pricing. Risk-based pricing encourages us to take better care of ourselves.
> 
> Car insurance works because companies reward good drivers and charge the Lindsay Lohans more. If the state forces insurance companies to stop discriminating, that kills the business model.
> 
> ...


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## Clash (May 16, 2013)

> The Affordable Care Act requires plans and issuers that offer coverage to children on their parents’ plan to make the coverage available until the adult child reaches the age of 26. The issued regulations state that young adults are eligible for this coverage regardless of any, or a combination of any, of the following factors: financial dependency, residency with parent, student status, employment and marital status. This applies to all plans in the individual market and to employer plans created after the date of enactment (March 23, 2010). For employer plans that were in existence prior to the date of enactment, young adults can qualify for dependent coverage only if they are not eligible for an employment-based health insurance plan until 2014. Beginning in 2014, young adults can choose to stay on their parent’s health plan until age 26, even if they are eligible for their own employer-sponsored insurance plan. This law does not require that a plan or issuer offer dependent coverage but that if coverage is offered it must be extended to young adults up to age 26.


http://www.ncsl.org/issues-research/health/dependent-health-coverage-state-implementation.aspx

There are, at this time, caveats still in place for insurance policies established before 2010

And again medicare does NOT cover uninsured's unpaid bills, it only covers bills for those who qualify for medicare and it would pay those bills regardless of when they apply for medicare.

Lastly, saying that he will only have to go through the exchanges is making assumptions that employers will in fact be offering insurance at a less expensive rate. Insurance companies under the ACA are still for-profit companies, to compensate, premiums have already started going up through employers. Employers will only offer policies if it benefits them to do so, for some they will come out cheaper per employee to pay the fine.


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## Clash (May 16, 2013)

I found this interesting as well:


http://kff.org/infographic/the-requirement-to-buy-coverage-under-the-affordable-care-act/

and this:

http://101.communitycatalyst.org/aca_provisions/coverage_tiers

There is no argument that implementation of the ACA will affect how much we pay and how much we are covered. I have no problem with a healthcare fix but I at least expect to receive the same level of coverage for the same price that I have now and I would expect, regardless of ability to pay, everyone would get the same level of coverage.


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## mccindy (May 16, 2013)

Clash, Medicare does reimburse for uninsured bills.  I've worked in hospitals for years and I can promise you, that is exactly what happens.  Uninsured people choose not to seek medical attention for minor conditions because they don't want to incur the bills.  Then when they get very sick, they need to be seen emergently and usually admitted. The cost of this care when compared to the preventative care which would have happened had they been insured and sought out care is astronomically higher.  Those bills are unpaid because obviously an uninsured person cannot afford the tens of thousands of dollars in bills they've built up.  The Medicare system reimburses all participating facilities for those bills.  I've personally seen time and again someone who started with a minor infection admitted with full-blown pneumonia or sepsis and end up intubated, on a ventilator, in critical care.  The cost per day is $10,000 to $20,000 and they are usually in for two weeks to a month.  How can any logical person think that preventative care could ever cost more than treating an illness?  A doctor's office visit costs $150-$300.  A prescription, again anywhere from $50 to $200, average.  If people are educated to take care of themselves (dietary and nutrition, exercise, tobacco cessation and limited alcohol consumption), the cost of the health care system drops dramatically.  Honestly I think our entire country would be better off if the public school system had required courses in health and wellness, and physical fitness again became a focus.  The laziness of the everyman and the affordability of processed food with poor nutritional value is half of what is causing health care costs to rise.

And no, I don't have a problem with charging smokers and drinkers and those who choose not to exercise more for insurance.  But to charge women more than men?  Most of those costs should be shared.  Women's health care costs more than men primarily because of either pregnancy and women's health issues or pregnancy prevention.  And if you don't believe men should share that cost, then perhaps you don't believe men should have a say in their rights when it comes to their own children.  I believe both of those things.


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## Clash (May 16, 2013)

Mccindy, what you are saying doesn't make any sense. If you make below the income amount and meet other requirements you qualify for medicare, if you make above that amount you don't qualify for medicare. If you are uninsured and show up at the hospital with pneumonia and receive treatment you owe a bill, when they check and see that you qualify for medicare, then medicare picks up the bill. When they check and see that you don't qualify for medicare then the hospital writes it off and it is passed down to tax payers and through cost to the insured.

Having insurance doesn't make you any more likely to go to the doctor, there are many, many, many, insured patients and medicare patients that started with a minor infection and don't go to the doctor and end up at the hospital with pneumonia.

I have no idea where you get the opinion that I would think men should be charged more than women the increases that are headed down the pipeline will hit both men and women, the largest will be seen among the young adults.


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## Beach (May 16, 2013)

Looking after our children's welfare is very important for our nation.  Costs are generally thought to be higher for women because females live longer, and for many reasons are more comfortable making hospital visits.  

"Why Women Are More Expensive To Insure Than Men, Mostly because we actually go to the doctor, it turns out. Oh, and we die later."

http://www.buzzfeed.com/annanorth/why-women-are-more-expensive-to-insure-than-men


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## Clash (May 16, 2013)

As far as preventive care, as long as it is health preventive and not cost preventive then it is a great thing. But the United States Preventative Task Force has twice made reccomendations that are cost preventative but greatly opposed by the AMA, one being mammograms.

It would be great if on every corner there was a vegetable stand instead of a fast food restaurant. The best preventative care in that situation is the parent but you can't roll back time things are what they are today and didn't Clinton institute a health/nutrition class in school and demand that healthy food be served but when lobbyists came forward they labeled school pizza a vegetable.

I think you have alot of passion for what you believe in and I think that is awesome, it is part of what makes us indivual, our beliefs. But I've researched as well and although my son may benefit(if our ins didn't already stipulate it) from the "until 26 law" there will be many, many other things about the ACA that will affect him negatively. That is just my opinion, from my research, I do though respect your opinion and will end any further debate on my part.


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## Gculk (May 16, 2013)

Clash - Just for a bit of a mental exercise - you seem to be pro-free market healthcare.  So justify the belief of superiority of free market healthcare given the cost.  For reference, the US pays around 17% of GDP in healthcare costs, compared to between 7% and 10% for most other developed countries.  Lets assume that the results are equal (considering there is some evidence that the US has worse outcomes this is at least a reasonable, at most a generous assupption).  Doesn't this show that the free market healthcare is failing utterly?

For reference, I think the ACA is more of the same - there are benefits and drawbacks.  I think it gives some more surety, at the cost of higher rates for young private insurance buyers.


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## Clash (May 16, 2013)

> I think it gives some more surety, at the cost of higher rates for young private insurance buyers.


You are just repeating what I am saying. If you are going to replace a broken system I just perfer it not be replaced with another broken system.


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## Beach (May 16, 2013)

Sounds like you are holding class professor Gcluk.  :ybiggrin: I'm sure Clash will answer for him/her self, just wanted to offer that here in the US there was a recent show debating free market medicine verses the 3rd payer insurance and government run system we have here in the US, by and large.  Thought it was interesting viewing.    

"Free Market Medicine (Airs Sunday at 10PM ET on FNC)"



> Obamacare promises to cover the uninsured, and somehow... lower costs. How can it do both?
> Wyoming senator, and licensed orthopedic surgeon, John Barrasso, explains that Obamacare is incredibly complicated.
> Pediatrician Steve Auerbach says ObamaCare doesn't go far enough... and America needs more government control. He debates orthopedic surgeon Lee Hieb who says free market medicine would be much better.
> Congressman Ted Poe, R-Texas, shows me the government's gigantic book of medical codes. Medical code W6161XA means a patient has been bitten by a duck. But W6162XA means a patient has been STRUCK by a duck. Doctors must use these codes when billing insurance companies and Medicare. Next year, they will have to use a new code book that's 10 times bigger.
> ...



Read more: http://www.foxbusiness.com/on-air/s...edicine-airs-sunday-10pm-et-fnc#ixzz2TVLl2LOD


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## Gculk (May 17, 2013)

Beach:

Ok, so doctors that don't need the overhead of billing insurance (which obviously doesn't want to have to pay) offer more reasonable rates.  This is obvious.  The US spends ~200 BILLION a year on insurance administration.

Now the question is, what is the reasonable response?  Greater reliance on private healthcare which REQUIRES insurance for general critical illness (a decent hospital stay for someone with Crohn's could easily run $100k or more - do you expect the average family could afford that?).  I don't think so - but maybe someone could convince me that it was feasible.

I believe the preponderance of evidence says that public single-payer healthcare provides a better cross-sectional return than a private insurance program.  Perfect?  No - Wait times are often a bit excessive.  However, private clinics could alleviate this, which is one issue I take with Canada's healthecare system.  Further, in the event of major 'backup' of main public health facilities (say due to shutdown at a public hospital of an MRI machine, or simply unmet demand), then private channels could be rented in order to bridge the gap.

I didn't particularly like the bit - it was very fox newsy, ok, so that's the code for getting bit/hit by a duck.  Very funny and a good way at poking fun at bureaucrats, but at the end of the day what does it tell us?  That there is a specific way to bill an insurance company.  Do you think for a second that insurance companies want to be billed on an ad-hoc basis?

At the end of the day, at least in the US, the big argument is - is Health care a basic requirement, or an elective?  I think instead the argument should be what part of Healthcare is a basic requirement and which part is elective.  Lets assume you're outside one day, and a person decides to assault you.  You call a socialized 911, which responds with a socialized policeman, who drives on socialized (for the most part) roads.  So obviously some public safety is socialized.  However, as soon as that man is successful and hurts you, you go to the hospital, and you are given a bill.

This might be a bit of a contrived situation, and there are counter arguments to that situation.  But lets take a realistic look at private insurance.  The way that insurance premiums work is that people are grouped together in a set.  Lets say that for an insurer that serves 10,000 people, it is broken into 100 groups of 100.  I'm sure we can imagine that by pure chance, some of these groups will have more people come down with expensive illness than others.  This group, when renewing insurance in the next year, will have higher premiums due to the groups higher risk pool.  This is group re-underwriting.

Lets say there are 10 unhealthy people, and 90 healthy people, compared to an average groups 1 unhealthy and 99 healthy.  At the end of the year, many of these healthy people will be attracted to buy into, at a lower premium, a new group, either at another insurance company, or simply by changing plans with the current insurance company.  Therefore, at the end of the next year there are 10 unhealthy people, and only maybe 40 healthy people.  Premiums will have to go up again, and more healthy people will leave for better premiums in fresh groups.  It's called the death spiral.  In the end, the unhealthy, who can't buy in to new groups will have increasing premiums until they are simply unaffordable and they must either forgo health insurance, or be paying the cost of their illness anyways.

Even if group re-underwriting was made illegal this would happen.  Any insurance company that happened to have higher than average illness, and so costs, would have to increase its premiums.  This would lead to healthy clients moving to more affordable companies with a lower disease load, while the sick had to stay - they can't buy in at a new company due to their illness.

Sorry for the book - I just don't like the health care debate.  I think anyone with the right information can see it's all a big shell game.


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## Beach (May 17, 2013)

Gculk -  I think what is important today is to add or keep flexibility with our health care system.  You might think of health care in a similar way as changes going on in schools and Universities, with MOOCs, and now, with student debt levels reaches a crisis, with some promoting the idea of Stuff learned over Time served on campus for obtaining degrees.       

I think in theory it could be said that single payer national health care insurance, as Canada has, would cost less, and provide decent health care coverage here in the US.  

Then again that likely would not happen in America in my opinion.  One example often shown in the US where government largely has a monopoly that is performing poorly is with our government schooling.  Costs are high and quality is poor with our government run school system.  I believe we spend more than any other western nation per student for education, and yet our students tend to score poorly in testing.  

Many of the same arguments made with improving our schools are frequently made in health care.  Parents should be given a choice on where they can send their kids.  Kids should not be forced to attend failing schools.  Private schools cost less on average.  Yet as can be imagined, intrenched interests are not interested in seeing improvements.  Doing so costs jobs, and hurt some poorly performing districts.  Poorly performing schools though do not help kids and the nations future.

Overall, regardless of the system, change is coming with health care.  Technology and the internet is transforming how we perform medicine.  Additionally many doctors are moving away from the current insurance system.  For example ~

"The End of Health Insurance as We Know It?"

http://blogs.the-american-interest.com/wrm/2013/05/15/the-end-of-health-insurance-as-we-know-it/ 

& on changing health care

"Robots to Health Care Workers: Give Us Your Jobs, Please"

http://blogs.the-american-interest....health-care-workers-give-us-your-jobs-please/

& since I know of someone that moved to Central America recently, found this interesting - on the costs in particular, and the competition aspect.  It's somewhat similar to the Singapore health care article posted earlier.      

"Want Cheaper Health Care? Retire Abroad"

http://blogs.the-american-interest.com/wrm/2013/04/18/want-cheaper-health-care-retire-abroad/

&

Not to post to many articles about America's health care, but another problem with single payer health care in America can be seen with our VA Hospitals.  

"VA Hospital Scandal Points to Madness of Single-Payer Health Care"

http://blogs.the-american-interest....oints-to-madness-of-single-payer-health-care/



> Advocates of single-payer have long pointed to VA hospitals as examples of how a single-payer, government-run health care system can work in America. But this NYT story on a whistleblower’s letter complaining about a “pattern of problems” at one Mississippi VA hospital paints a much less appealing portrait of these institutions:
> The problems over the last six years include poor sterilization procedures, chronic understaffing of the primary care unit and missed diagnoses by the radiology department…
> The final whistle-blower, a retired ophthalmologist who was active in the physician’s union at the medical center, told the special counsel that a former radiologist at the hospital “regularly marked patients’ radiology images as ‘read’ when, in fact, he failed to properly review the images and at times failed to review them at all,” the special counsel’s letter to the White House says. In some cases, fatal diseases were not diagnosed, the letter says.
> One hospital, of course, can’t justify a sweeping indictment of a whole health care concept—except for the fact that, as the NYT says, this particular facility “had been considered one of the better medical centers in the department’s sprawling system of 150 hospitals.” If systematically poor treatment can persist unaddressed for six years at the top of the VA hospital system, what goes on at the bottom?
> ...


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## Gculk (May 18, 2013)

You know what?  For the United States I'd have to agree.  Your system is so top down and ass backwards that it would never work - your politicians are way too arrogant.

What you've said about schools is right on the money.  US lawmakers have failed in constantly increasing ineffective standardized tests.  Now US schools are teaching to the standardized tests, and all efforts for reform are attempts to get test scores up, such as No Child Left Behind. More standardized testing, and then if one school does poorly on standardized testing, sending children to schools where they've taught to the test better.

Your politicians - of all stripes - need to be humbled severely.  Your system has bills authored wholly by untrained lawmakers (No Child Left Behind was proposed by Bush, ex military, then Business training, and was authored by two lawyers and a business administrator).  I'm not going to only pick on the Republicans - Not one of the people who created Obamacare had any background in medicine either.  The closest that any ideas came to being from a medical professional was that some ideas were taken from Bob Dole to increase bipartisan support - and he worked as a clerk in a drug store once.

A better method would be to delegate more responsibility to the Departments.  Lawmakers should state goals.  These goals should be submitted to Departments to have trained professionals to provide a 'how' to the goal, and feedback on if it is a good goal.  Then these programs should be ratified.

Man I'm glad I'm Canadian.


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## Beach (May 18, 2013)

Yeah, a sad bit about No Child Left Behind has been the cheating scandals that have followed.  If student test scores are down, cheat to make them look better.  One example that made the nation news for awhile ~

"By Any Means Necessary"

http://isteve.blogspot.com/2011/07/by-any-means-necessary.html 

snippet from Steve Sailor's article:



> ...Investigation into APS cheating finds unethical behavior across every level
> 
> By Heather Vogell
> 
> ...


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## amrycrohns (May 18, 2013)

Amy2 said:


> You are already paying for the uninsured, after their problems get big enough that they head to the ER.  Do you want to live in a country where people are turned away in the ER?  If not, then it's better to pay for their preventative care, from a purely financial POV.
> 
> People in the US just aren't used to thinking of healthcare as a right, but we have lots of other rights, that cost others money.  If you leave your stove on and your house catches on fire, my tax dollars will help send a fire truck to your house.  Is a house more important than a body?  Or do you think only people who can afford to pay the firefighters should get to have their houses put out?



If you go to the ER without insurance you should get a bill, why should I get a bill?  No one should be able to sit in their house on their butt, and get free housing, free food, and free medical off of the dime of the working.

Non of the above things should be rights, these are all things worked for.  We have volunteer firefighters, we pay for our fire trucks via Bingo and 4 events we hold a year BBQ, 5k run and other activities we also donate to the fire company yearly as a community.  We still owe over 300,000.00 on our trucks, and we don't want you to pay for it.

The only people I don't mind helping out are the disabled and I mean the really disabled, not the people that fool the system with a back problem and carry around 80lb bags of concrete working under the table.

Why do so many people in the US feel entitled to everything?


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## Gculk (May 18, 2013)

amry:

Nobody likes the welfare cheats living in government housing, using government food, using government healthcare.  What's the solution?  

Credit check if you get hit by a car?  Do you lay in the bed bleeding out, surgeons on either side, with an accountant standing in front of you with an ipad in one hand running the credit check and a meter stick to smack any impetuous surgeon who starts operating before the verdict is in?

No, emergency care must be delivered previous to any financial consideration.  However, if we give emergency care previous to financial consideration, then  welfare cheats who simply won't work either way will be a strain on the system as they will, if left to their own devices, be dying of malnutrition and the elements - don't expect charity shelters to manage everything, they're hard up enough as is.  It is cheaper to offer maintenance welfare (housing and food) to the cheats than it is to offer them help only in the ER.

I hate welfare cheats as much as the next guy.  But for whatever reason, shelter or no, they simply refuse to work.  Instead of looking at welfare cheats as a problem in and of themselves, look for effective ways to get them off of welfare - education, and opportunity.

Before you feel particularly harshly about these people, remember that they aren't necessarily 'choosing' this lifestyle, by and large.  They may be essentially choosing it by not choosing to do something else, but stories like this:

http://www.goodnewsnetwork.org/insp...ollege-for-crime-filled-fla-neighborhood.html

Indicate to me that this style of abject poverty without physical disability is a societal problem, not a simple matter of choice.


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## Amy2 (May 18, 2013)

Societies decide what rights 'should' be, it's ever changing, not concrete.  I'd like to live in a society where everyone gets medical care, regardless of their ability to pay.  And that's how it is in most civilized countries.

Preventative care is the most humane and the most cost effective.

So, unless you want everyone who can't pay in the ER turned away, you should advocate for paying for preventative care.  Sending a bill to someone too poor to ever pay that bill is ridiculous.  So, what's it going to be; pay for preventative care or turn them away at the ER?

Do you honestly think people would put up with being turned away at the ER?  They arrive with a bleeding child and are simply told to go home.  "Sorry, Sonny, I guess you are going to die."  Desparate people do desparate things.

You sound like one of those bitter people, "No one gave me anything...I had to work for everything I have..."  Which isn't true (for anyone).  You made it because other people helped you make it.  They built the roads, schools, power lines, etc. that allowed you to do pretty much everything you have ever done.  And most people want to work, but many of the good jobs have vanished in recent decades and they aren't coming back.
That's certainly not the fault of the little guy who is now sitting on his couch because he collects more from uninsurance than he would from working full time at McDonalds.

The rich are really good at pitting the middle class against the poor, especially the lower middle class who work their butts off for so little.

We can collectively change where the bottom is.  Clean water, air, education, health care, housing, a decent job and healthy food sounds like a reasonable bottom to me.

There is a reason Norway is the happiest place on earth.


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## Gculk (May 28, 2013)

Maybe not directly related to Crohn's, but some good news about Obamacare for all you who think it'll pummel the young ones getting insurance:

http://www.forbes.com/sites/rickung...e-insurance-exchange-announces-premium-rates/


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## Beach (May 28, 2013)

I recall seeing that last week, and thinking truly that could be good news.  I hope it turns out better for Obamacare than many groups such as the CBO have been predicting.  

For another view on Obamacare costs coming in for California, Oregon and Washington, and services being offered.   

"Obamacare Victories Carry a Heavy Cost"

http://blogs.the-american-interest.com/wrm/2013/05/28/obamacare-victories-carry-a-heavy-cost/

&

"ObamaCare Health Insurance Exchanges Are A Downgrade"

http://news.investors.com/ibd-edito...860-obamacare-exchanges-hurt-medical-care.htm


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## Clash (May 28, 2013)

My family is having some issues and I was wondering if anyone else had run into this:

My father is retiring and moving full time to the home my mother and him share. He has commuted for years between their home and an apt where his business is located. Because of this he has used a GP in that area. He is now looking to transfer to a GP in the area he is moving to. My Mom has been with a doc in this area since 1993 and asked that his med records be sent to this doc. When she called her doc she was informed that the GP was not taking new patients. When she asked further she was told it was really that the GP didn't want to take Medicare patients, so no new patients at all. She was told Medicare pays the doc  little over two dollars for a standard blood test and it would serve the doc better to sstop taking patients, serve the ones he has and spend two days at a state funded facility on salary. She has contacted the other GP groups in town and received the same story...no new patients or limited New patients. One group has taken my Dad under consideration and will be contacting Mom to let her know if they will take him. She is now starting to contact other offices in nearby cities.

This is just the GP he also sees a cardiologist and we are afraid we will face the same situation. 

Anyone else faced this or have any advice on how to move forward? I hate that they may have to travel just to find a GP.


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## AinA (May 29, 2013)

Clash,

We had the same issue with my adult disabled daughter.  It was Medicaid for us, but the policies of all of the doctors we encountered were the same for Medicare.

The only place we could find to take here was a public health clinic.  It was absolutely miserable AND incompetent.  They used too small of a cuff and diagnosed her with hypertension!  When I brought up cuff size I was dismissed summarily.  Seriously?  They were clearly accustomed to compliant, medically ignorant patients.

The only thing Obamacare did positive was when they mandated medical coverage for adult children.  We snuck in to an excellent GP with that.  They allowed her because of our private insurance.  She is now aged out but she gets to stay and now she wants to move!  Sigh!  She does NOT get it due to her disability.  

Here's a kicker...  my daughter's on SSI because she's permanently disabled (intellectual delays) so she gets Medicaid.  We're forced to use any private insurance available.  Think about that for a minute....  Private insurance has premiums, deductibles and co-pays.  Private citizens are not allowed to bill Medicaid for services.  All of the GPs we encountered refused to bill Medicaid as her secondary so we, as parents of a 25 year old adult disabled child, were then obligated to her $500 deductible and all of her co-pays.  

Of course we paid it, but we pay thousands monthly in taxes and provide an enormous amount of support for our daughter, and will for the rest of our life and beyond.  My husband chose his career and employer for the health coverage exclusively.  We've made sacrifices in our life for him to be where he is to ensure we have high quality insurance because we saw the writing on the wall with my health.

If we slip into national health care, which IS the intention of the ACA, my coverage is going to suffer.  My current coverage flies me to my specialists every three months.  Is Obamacare going to cover that?  

I am on double doses of Enbrel for my Ankylosing Spondolitis, I know a man with the same disease on Medicaid in my state, and we have excellent medicaid coverage in Alaska, trust me I know this after moving my daughter to Washington and comparing coverage.  The state only allows him a shot every other week in spite of the fact his paralysis is progressing; that is a 1/4 of the dose I need to stay pain free.  Do you really believe a nationalized health care is going to adequately meet my very expensive medical requirements?  Pffft!


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## Jennifer (May 29, 2013)

Sounds like it would make more sense to take her off of private insurance so there wouldn't be a copay. I have Medicaid and everything is paid for 100% minus ER trips ($5 co-pay).


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## Clash (May 29, 2013)

AiaA, I have a couple of questions:



> We snuck in to an excellent GP with that. They allowed her because of our private insurance. She is now aged out but she gets to stay and now she wants to move! Sigh! She does NOT get it due to her disability.


Are you saying that your daughter aged out of the insurance stipulation created by Obamacare(meaning she is now older than 26) or that she has aged out of the doctor's practice?(as in it was a pediatric practice?)

I completely understand what you are saying AinA, I had the same experience when my kids were on our states version of CHIP/Medicaid while I was in college. I jumped at the chance for employment while still in school and budgeted everything to get them on the employer's private insurance! The difference in QOC was staggering!

Jennifer, it seems AinA is implying that you are forced to use private insurance if it is available to you.



> Here's a kicker... my daughter's on SSI because she's permanently disabled (intellectual delays) so she gets Medicaid. We're forced to use any private insurance available.


I believe my ex SIL was recently faced with the same dilema, son was on SSI/medicaid and now is eligible to be on his Mom's newly acquired health insurance due to the extention of age on adult children. Her pros and cons were the same as AinA's better quality of care but now paying co-pays, deductibles etc with the added financial burden of having a child that is and will be a dependent in their household for her life and beyond. The deductibles and co-pays should be done away with in 2014 though, as that is when the next step of Obamacare should go into effect.


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## Jennifer (May 29, 2013)

Clash said:


> Jennifer, it seems AinA is implying that you are forced to use private insurance if it is available to you.


If you're low income (receiving only SSI) and an adult there's no way you can afford private insurance so I'm failing to see how you could be forced to use it by Medicaid.


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## Clash (May 29, 2013)

The daughter has access to her parents private insurance since Obamacare enacted the age extention to 26. So now you can remain on your parents private insurance plan until you are 26 years old, I think the daughter she is referring to is 25 so she has another year of eligibility on her parents plan, unless I am reading it completely wrong.


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## Clash (May 29, 2013)

Also, I'm not sure but I think she is saying that medicaid would pick up what private insurance doesn't cover(not sure if that would include the deductibles/co-pay or just the coverage percentages the private insurance doesn't pay like 90/10, 80/20 etc.) but the doctors' offices she goes to doesn't file for the medicaid after filing private insurance for the primary since they will make more money with her paying what private doesn't pay.

I


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## Jennifer (May 29, 2013)

Ah, they're going to the wrong doctor offices then. Have to go somewhere that will actually bill Medicaid. They charge the private insurance first and use Medicaid as a secondary insurance. In the end you don't pay anything.


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## DougUte (May 29, 2013)

Jennifer said:


> Sounds like it would make more sense to take her off of private insurance so there wouldn't be a copay. I have Medicaid and everything is paid for 100% minus ER trips ($5 co-pay).


My wife is on Medicare (the federal program). If Medicaid works the same way Medicare does then there should be very little that needs to be paid for out of pocket. I have insurance through my work, which my wife is also covered by. My private insurance is primary. Medicare covers the stuff I would have to pay out of pocket - the deductibles and co-pays on everything except Prescriptions. (We don't qualify for Medicare D).


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## Clash (May 29, 2013)

Jennifer, yeah I think that is what she was saying, that she got her in with a great GP because of the private insurance but they won't file the medicaid as secondary.


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## Jennifer (May 29, 2013)

I'm sure there's a doctor just as good that you wont have to pay out of pocket for. There's an office here where I live that has multiple doctors working in it (Community Health Centers of the Central Coast here in California) and I've tried out almost every single one until I found one I liked. You don't have to stick with the same GP if there are others working in that same office. You are able to switch doctors until you find one that works for you.


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## AinA (May 29, 2013)

Arrgh! Lost my first post...

Jennifer, with Medicaid you are by law required to use any private insurance first so we had no choice. The only clinic that would double bill was the public health clinic that misdiagnosed her with hypertension by using a too small cuff. Plus the place was filthy and I've been to bush clinics in Alaska so my bar isn't that high. 

It could be in CA there is some type of law that stipulates they must bill public secondary?  Also, since she's disabled and gets Medicaid through SSI they do not restrict their coverage like normal Medicaid - meaning she could not select a specific provider from the state's list and in two years I was only able to talk one private provider into taking her in spite of her "open" card. They all refused without their name as the designated provider. 

The one office manager I managed to convince to take her stopped serving her after 2 mos in spite of being paid? Main office caught her. Total catch 22. Plus that clinic maintained separate appointment books! Medicaid patients, even for a sick call, had a very restricted number of appts.  She had bacterial pneumonia (her brother and father both had it) and the clinic initially made an appt that afternoon until they realized she was Medicaid, then it was end of day three days later!  I have zero faith in public health care. 

Doug, are you able to submit your own bills to Medicare?  I can't say why the private practitioner's in that area just absolutely refused to double bill. If she went to the hospital they did double bill (whew on that one... Broken ankle) and we did not have to cover the copay on that at all.

Clash, you're pretty much spot on. She was 25 when the policy came into effect. She's now 26 so she has since aged out.  She is still able to go to the clinic with the good GP because she is now considered an established patient.

At the time I was trying to find medical care for her, it became very apparent to me what was going on with seniors. It broke my heart because those seniors and that move from their home area or if their doctor retires, are completely left hanging high and dry!  Is it possible for your father to temporarily purchase a high deductible policy in order to get his foot in the door at the clinic your mother goes to?  Is it too late for him to take advantage of the COBRA policy from his former employer?


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## Clash (May 29, 2013)

AinA, I had a bad experience with state sponsored insurance for my kids as well. I think each persons experience with public health care is as individual as CD can be for each person.

At the time my kids were on state funded healthcare we didn't have the choices among pediatricians or GPs since most refused medicaid, now they just refuse new patients. The groups that did accept medicaid were such a step down in QOC. 

As far as my father, he was self-employed and has reamained on as a consultant while the sell of his business went through. Mom got a call from the office that stated they were taking limited patients, they were turned down again. 

So that was all of the groups in our area, Mom is going to start contacting groups in a nearby city tomorrow. Hopefully she can find some one to take him.

I'm wondering if a referral to a cardiologist from his present GP or cardiologist might help when we start the process for finding a new cardiologist?


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## purdueCrohns (May 29, 2013)

Obamacare is nothing but negative for Crohn's patients


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## DougUte (May 29, 2013)

AinA said:


> Doug, are you able to submit your own bills to Medicare?  I can't say why the private practitioner's in that area just absolutely refused to double bill. If she went to the hospital they did double bill (whew on that one... Broken ankle) and we did not have to cover the copay on that at all.
> 
> ?


We have never had the problem with a practitioner refusing to double bill.Some try to bill medicare as primary even though they are told otherwise, but a call to the Billing office has always fixed it. So I don't know if an individual can bill medicare.


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## purdueCrohns (May 29, 2013)

Ok, I stand corrected.  That 26 thing is good.


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## superzeeman (Jun 2, 2013)

All I know is that since Socialized medicine has been passed my insurance has gone up and up and now my company is thinking of dropping our care altogether, I may have a high deductible but have excellent script coverage and I cant lose that or I am in big trouble. And to top it off, they are cutting most people back to 28 hours so they wont have to have the insurance or the fines. This program was not well thought out at all and even the Dems are saying it is a train wreck waiting to happen. I would love this program to work but I am skeptical to say the least.


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## amrycrohns (Jun 2, 2013)

superzeeman said:


> All I know is that since Socialized medicine has been passed my insurance has gone up and up and now my company is thinking of dropping our care altogether, I may have a high deductible but have excellent script coverage and I cant lose that or I am in big trouble. And to top it off, they are cutting most people back to 28 hours so they wont have to have the insurance or the fines. This program was not well thought out at all and even the Dems are saying it is a train wreck waiting to happen. I would love this program to work but I am skeptical to say the least.


Sad to say this playing out across the country many of my family members are already suffering from ACA.  Just for instance my brothers insurance rates nearly doubled in past year, forcing his wife back to work so they can afford health insurance.  How I see this so far is the only people that are benefiting are the ones that already live off the government and it's at the cost to the working people.  Maybe some college students that can stay on their parents plans.  

2 of the specialist I see are going to cash only business in 2014, they claim that the overhead on paperwork does not justify them taking insurance in private practice.


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## Ice (Aug 21, 2014)

Normally, I avoid discussions on the healthcare system and insurance system in the United States, but I would like to share a story related to healthcare with everyone here because it's a type of story that nobody hears about or talks about when they talk about how the United States healthcare system works or doesn't work.

So.

I'm in my 30s.

For all of my life, I have had a genetic blood disorder that makes me chronically fatigued. Though the body adapts and adjusts on its own, it doesn't take away the fact that fatigue can become a chronic and life-invasive problem, iron overload can end up crippling organs like the pancreas and liver and heart over time, and that in times of sickness, blood transfusions may be needed... which in turn accelerates the body's need for chelation - to remove the excess iron before iron damage is accelerated as well.

Through my father, I had great health insurance and I - and my family - took 'good insurance' for granted... up until the time I went to university.

At the time, health insurance from parents only extended to students IF AND ONLY IF they were full time students... and not all health insurance policies did this. My father's policy did this... as a 'courtesy'.

At that time also, if you were a student, and you had parents, and unless you were working full time to the tune of being able to fully 100% support yourself, you were considered a dependent and any and all government-related applications took into account your family/the people who the government assumed would help to support you. 

This applied to FAFSA... and this also applied to things like government-subsidized/funded healthcare plans and systems.

Well, as life happens, I got hellishly sick, and ended up being withdrawn from school by my own university's medical clinic and I was also forced to quit my part-time job and move back home with family.

Desperately sick with mononucleosis while having a genetic blood disorder that already predisposed me towards extreme fatigue and blood-related issues including an enlarged spleen which only got dangerously worse with mono, I lost my health insurance.

No big deal, right? Just buy another policy.

WRONG.

Remember what I said about the pre-existing condition?  The genetic blood disorder?

It automatically made me ineligible to purchase ANY individual policies and because the GROUP insurance dropped me and not because my father lost his job or some such, I was ALSO ineligible for COBRA.

Before the ACA, you got your policy one of five ways:

1)  Through work.

2)  Through individual policies THAT REQUIRE PRE-SCREENING AND UNDERWRITING WHICH DENIES PEOPLE WITH PRE-EXISTING CONDITIONS THE RIGHT TO PURCHASE A POLICY.

3)  Through COBRA - IF you remembered to sign up for COBRA at the loss of your job AND it was limited to only a certain amount of time AND it cost 150% percent MORE than the premium once did at full price without company pay-in.

4)  And once THAT exhausted... you could get a HIPAA policy... which cost just as much and was more often than not a horrible 'catastrophic' policy.

5)  Through the government.

Oh! So then I should have gotten government-subsidized insurance, right?

ALSO WRONG.

My state had government-subsidized healthcare policies at the time that tied in with the federal government's, but because my family wasn't COMPLETELY IMPOVERISHED and because even though I had lost my job, lost my schooling, and was struggling with severe illness on top of a severe flareup of a pre-existing genetic condition, I WASN'T PREGNANT and so I didn't qualify.

Oh! Then disability!

AGAIN, WRONG.

Because I didn't have an 'automatic disability', I was put through the 'alternative' qualifying system and because I was in my early to mid-twenties and though I had worked part-time, I hadn't worked enough hours accumulated to qualify and my condition - though 'a struggle' wasn't 'so bad I needed disability'.

And so for a year and a half until I was able to return to school, I - along with my family who helped - was forced to foot 100% of any and all uninsured medical bills that piled up and that included hospital bills, ambulance bills, and diagnostics bills.

I liquidated any and all savings and went into medical debt by the thousands all in one shot.  I went bankrupt without going bankrupt and would live for the next several years on credit.

My bills that I couldn't pay totaled to over 20% of my parents' yearly income (the government thinks med bills ought not total to more than 10% of a year's wages - HA!) and my parents still had a minor who was dependent-dependent on them and mortage payments to pay.

And we weren't done.  Far from done.

Eventually, things improved enough for me to return to school and go back to work... but not enough to school fulltime and not enough to work fulltime and not enough to get on the company's policy which only extended insurance at the time to fulltimers, and during this time, my father's insurance policy changed... to include adult children who were students up until they are age 25.

My parents begged my father's HR department to reconsider my situation and eventually, I was put back on the policy regardless of my schooling status as I was deemed 'an adult child who has a disability' by my father's HR and benefits department.

So until I was 25, I had my father's insurance plan again and in the meanwhile, I struggled to finish school and struggled to hold down a job and.

After being so sick for so long, it was hell on earth to do either and a few years later, the GI problems started in the worst of ways like they are wont to do... and RIGHT as my 25th birthday passed and my insurance policy had dropped and RIGHT when I was out of town.

Because of the pre-existing blood disorder, I should have been hospitalized because I was vomiting and having explosive diarrhea that wouldn't quit while also being blown up with bloating like a bullfrog and in so much pain I was cold sweating and had a high fever that wouldn't go down... but I wasn't.

We were still paying off all the OTHER &%$#ing stupid medical bills from before that I refused to go to the ER.

If I were to go, I would be billed TENS of thousands, and even if I was already bankrupt (which I was, AND STILL IN DEBT from previous medical) and even if I was working part-time to help support myself (I WAS until that episode)... I would not (and did not, I tried) to qualify for aid of any sort and neither would my family.

So I didn't go and I sat in a hotel's bathtub of cold water with the shower running to keep my fever down and lunged for the toilet to either vomit or have diarrhea or both and I did this for 12 hours until finally, nothing else could possibly come up of substance and I was able to stand a drive back home.

Going back to the insurance issue, I was dropped owing to age, but since it wasn't like last time where I was 'faulted' for causing my policy to drop, my father was able to buy COBRA... at 150% the 100% premium cost.

Again, because my family wasn't destitute and because I lived with them, I was denied any kind of government-subsidized policies or programs and again, because of a pre-existing condition, I was denied access to any individual policies, and again, because I hadn't qualified in my working hours, I didn't qualify for disability.

COBRA was my one and only and very expensive option and I was on COBRA for 3 years - the maximum the policies allow - and after that, I went on a HIPAA plan... where I stayed until the ACA began.

During the COBRA years and beyond, I WENT BROKE, BROKE, AND MORE BROKE, lost jobs because of illness, forced myself to work again despite being sick because I needed to pay for my illness, and got sick, got sick, got sick.

My parents footed my insurance policy because it would otherwise cost me 50%+ of my year's wages and they refused to charge me rent even though I volunteered to pay a little... and I paid for everything else with what I could earn.

When the ACA came around, ONE OF THE MOST IMPORTANT THINGS IT DID THAT THE INSURANCE COMPANIES COULD HAVE DONE SOONER BUT NEVER DID BECAUSE THEY WOULD LOSE MONEY OTHERWISE was remove the %$#@ed pre-existing conditions clause that ended up blacklisting people who had pre-existing conditions from buying health insurance.

Don't blame the ACA.

Blame the fact that insurance companies were allowed to cherry pick and do underwriting and legally discriminate against people who have health disorders that they can't be faulted for.

Blame the fact that because of how insurance works and because of how a broken welfare system works, hospitals and doctors are allowed to and are sometimes forced to hyperinflate the costs of medical care.

There's this assumption that everyone was covered 'just fine' before the ACA went into effect and that's just wrong.

If you had fulltime work or was married to someone who could get a company policy, then you were covered.

If you were 100% HEALTHY or you LIED on the health screening, you could get cheap 'THIS IS ONLY FOR HEALTHY PEOPLE' insurance.

If you were pregnant, destitute, someone who had no ID or social security number because you were not of this country, you could get 'you deserve government aid' insurance and other financial aid.

But if you were a citizen, had a pre-existing condition, was trying to earn wages, was being helped by struggling parents of the disappearing middle class, and NOT pregnant, fat chance.

God, I can still remember the person who helped me at the local government office who joked about me being automatically approved for services if only I were pregnant.

With the ACA - and NO it is NOT perfect - for the first time in my ADULT LIFE, I could apply for individual insurance that didn't depend on my health status or my work status and YES, EVEN THOUGH IT IS NOT CHEAP, it's still CHEAPER than the alternative (COBRA, HIPAA) and better than NOT having anything at all (paying 100% out of pocket) and better than sitting in a hotel bathroom and bathtub in freezing cold water with a high fever while having diarrhea and vomiting and crippling pain.

Everyone's angry about the ACA but the reality of the situation is, I think most people never truly understood the cost of medical care and health insurance in the United States to BEGIN with.

Healthy people got away with paying $50 a month regardless of their socioeconomic status.

Desperately sick people who were denied individual policies and denied government-sponsored care because they weren't drop-dead destitute (or pregnant) but were constantly drowning in medical debt were paying 100-150+% that amount and I was -YOUNG- at the time.

How everyone else got their 'cheap' insurance was because the costs were being footed 100% by those who were sick and those whom the insurance companies could gouge money from... like myself and my parents.

The idea of aborting fetuses known to have debilitating genetic disorders is abhorrent, and yet the idea of spreading out the cost to help support - yes, HELP SUPPORT - the people who are sick through not fault of their own is just as abhorrent and just as abominable - enough to make people want to impeach a president and declare the ACA unconstitutional.

But hey, life's about luck, right, and according to my insurance carrier, privilege.

Being able to afford health insurance is a 'privilege', everyone, not a right.

Guess it must feel great to be born 100% healthy and to never worry about things like this.

Oh well; life moves on.


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## dave13 (Aug 21, 2014)

The affordable care act limits my working.With my aca insurance if I make above a certain amount I get bumped to a higher premium bracket.In other words,I can't get a part time job to supplement my full time job to help pay medical bills.I would get bumped to a bracket I can't afford because I'm trying to work hard and pull my weight.I'm being told I can't try to get ahead.I am penalized for working!

Obama care is deeply flawed.It's designed to keep us struggling financially and sick.Americas health care system is not designed to get us well.We are more profitable if we are sick.Can't bill us if we get well!!

I really feel Obama wants to perpetuate dependence on government.Working use to be perceived as a good thing.Now it is something someone else does so the unwilling can get a check.I didn't say unable,there are many who truly need assistance.I may be one of them soon.Generations have been raised to avoid work and feel entitled.

I would also like to get the health care I would be entitled to if I came here illegally.Obama seems to care less about Americans who work hard each day and more about an illegal coming here to exploit the system.Americas working poor supports this corrupt system,never getting ahead because we would be penalized if we tried.

I vote for people,not parties.America is screwed.

America and it's health care is like a chronie.It doesn't look sick,but if you really take a close look inside....


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## Ice (Aug 21, 2014)

ACA plus my state's combined policies regarding ACA said that if I made below a certain number in terms of income, I couldn't even qualify to -buy- insurance at all no matter how much I wanted to and was willing to fork over and that I would be forced - not even an option - to apply for the state-funded policies that were supposedly expanded to include more people.

Ironically, I got rejected and denied in both tiers because they were saying that I belonged in the other tier.  Tier 1 said Tier 0 and Tier 0 said Tier 1 and nobody agreed and the deadline passed without any agreement.

I ended up having to buy outside that particular system and bought into an individual policy that didn't have any relation to the government save for having to follow certain new regulations.

But I never would have been able to do that before - buy ANY insurance for myself outside of work - before ACA.

It IS a deeply flawed system and it needs an overhaul, but the older system was no better, either, in my honest opinion and the problems in the system have been longstanding.

Being totally and completely unable to buy health insurance (pre-existing could never buy into individual and if you lost your job or only worked part-time, you couldn't get insurance through work) in a country where health insurance is almost mandatory to make individual healthcare costs affordable is like punishing people for working which disqualifies them for things... except it's punishing people for pre-existing conditions instead.

I totally can see what you mean by being punished for working; I need to either work more or not work at all to fit into a 'bracket' that's entirely of the government's construction and since I don't fit, I get punished for it.

I struggle to make ends meet and dangit, I DO STILL WORK.

But you're right; it's as if I've been punished this entire time because I keep trying instead of completely giving up.


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## dave13 (Aug 21, 2014)

Ice said:


> I struggle to make ends meet and dangit, I DO STILL WORK.
> 
> But you're right; it's as if I've been punished this entire time because I keep trying instead of completely giving up.


This is exactly what I mean.We are punished for trying.We try to be productive and improve our quality of life.We watch someone who makes no effort and wallows in pity get a free ride.There only real affliction is ignorance and apathy.

Those people,and the politicians who enable them,screw over the ones who really need help.

Wow,I'm totally depressed now.I have to get ready for work.:rof:


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