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mharvey90

mharvey90

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Jun 27, 2009
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So, being an American, I know everybody has different opinions on how health care should be reformed, blah blah blah. But we all have a lifelong disease that requires costly treatment. I'm 19 years old, my father is disabled, and when my stepdad got a new job last year I couldn't get on his health insurance because it only covered me until I was 19. So I had to go on my University's health insurance plan, which is of course geared towards students who get the occasional cold or flu, and nothing else. So, in a matter of 6 months, I have racked up thousands upon thousands upon thousand of dollars in medical bills that my insurance company will not pay for!!!! I have sat on my couch sick as hell for weeks and weeks waiting for a possible approval for treatment from my insurance company!! Right now I need to see a surgeon and can't because he doesn't accept my insurance! So my condition is getting progressively worse (I just posted in the support forum about this). Luckily my mom just got a new job that offers health insurance that will cover me til i'm 26, but that won't kick in until January...so I am impatiently waiting. So I would be super interested to hear a)American's horror stories with health insurance and Crohn's, b)American's who have good insurance and have been lucky enough not to have any problems affording treatment, and c) people from Europe, or other parts of the world in countries with national health insurance, and what you think about the system, and how it has helped you/harmed you in treating Crohn's. Thanks!
 
hi... somewhere in a recent thread, one of our members posted some advice on how to get Crohn's medication at a reduced cost.. i honestly can't remember which thread or member it was, but hopefully they'll see this post of yours and help out.

i'm in the UK, and although our NHS is struggling, and is the cause for many complaints like very long waiting lists, waiting times, understaffed, bed shortages, and general cutbacks across the board, i wouldn't be without it. literally the NHS has saved my life, and it is always there for us, no matter what our financial situation is. prescription drugs are paid for personally, but there are many conditions and circumstances whereby people have exemption certificates and don't pay prescription charges.

if i added up the actual cost of all the treatment i've had in my lifetime, plus the medications/other supplies, i really don't think i would be alive now as there's no way i could have funded it all.
 
I wish you the best of luck. Im in Canada and it took me 5 months to get approval for my Remicade, but luckily thats my only battle I've had health care wise!
 
It sounds so awful! I saw that movie 'Sicko' with Michael Moore about the US health system and was completely stunned by it.

I am glad I live in NZ and we have public health. It's not without it's issues but at least I can get treated. Sometimes one has to be pushy/assertive but at least I don't have to worry about the bills. I was in hospital for ten days back in July - I'd hate to think what that would have cost! I suppose if I was in the US with no insurance I would have had to discharge myself and suffer.

My sister in law comes from the US (Washington) and her Dad is really ill at the moment. He has insurance for noe because he has still been struggling to work (at 70 years old with multiple health problems). He and his wife have decent jobs and are by no means poor, but my sis was saying that if he stops work he will not have insurance subsidised by his employer anymore and on retirement couldn't pay the premiums. So wrong that an old sick person should not get treated when they've paid insurance all their lives!

Thank goodness for public health.
 
People over 65 do get Medicare here in the US...I have been paying into it since I started working.It's sort of like government health insurance... I wonder why he's not on that Shaza??
 
imisspopcorn said:
People over 65 do get Medicare here in the US...I have been paying into it since I started working.It's sort of like government health insurance... I wonder why he's not on that Shaza??
Click to expand...

Who knows? It was only a brief chat we had. He's an educated man, works as a teacher i think and his wife is a psychologist so I'd have thought they'de be on to it!! maybe I got it wrong. I must ask because he's really unwell in the hospital at the moment and even when he improves he shouldn;t be working!
 
Well I totally support reform to a system like NHS. But I don't see that happening here any time soon unfortunately. I know that people say that some problems with NHS is long waiting times, no beds at the hospitals, etc. But there are the same problems here! I've waited very long periods of time to be approved for my Remicade and Humira. Also, when I had to go to the Emergency room back in March, I waited 7 HOURS to even be placed into a bed!!!!!!!!!! Meanwhile I was bawling my eyes out in the waiting room that entire time, running back and forth to the bathroom, vomiting and having uncontrollable diarrhea! And this was on a weekday morning, so it wasn't even like it was a Friday night when ER's get super busy! Soooooooooo frustrating!!!!!!!!!!!
 
I was in ur case where I didn't have insurance at all.. Trying to ATLEAST get it from school.

I am on disability now so I am covered but before i was able to get HUMIRA and REMICADE for free.

I would give the company's a call and explain to them your situation.

VERY SERIOUS because I bet a lot on here can vouge for this.
 
There are patient assistance programs for drugs that do not have a generic equivalent. Call: 1888-4 ppa now. If you earn less than $27k Remicade is available for a minimum. Pentassa is available for people making less than $20k. Also call the drug companies . We got it good here in the USA but you have got to jump through the hoops. Good luck
 
Sometimes those hoops are not only far too high, too great in number, but are also lit on fire and being held by people who don't give a damn.

My 2 cents. :)
 
My insurance has covered a lot, but the bills still kill me. To have a colonoscopy & endoscopy done, it costs over $10,000 cash! With insurance it's still almost 1 grand for the hospital, gi, anesthesiologist and biopsy. I'm having my third endo done this year in three weeks and hopefully I will have reached my $2500 max and insurance will cover it fully. Next year I signed up for the insurance at my job that is more comprehensive so hopefully I will be able to keep some money in the bank. The premiums are higher, but the copays and co-insurance are lower and more predictable.

The worst is prescriptions. Every 30 days I have to refill, and my insurance absolutely hates Nexium so I have to pay $50 for it..... $30 for "preferred" brand names like pentasa and entocort, and $5 for generics.

I find it funny that my insurance will fully cover colonscopies for preventiveness purposes when you're over 50. If you're 19 with crohns, good luck with that........
 
^^^ I find that appalling too, as I have a confirmed problem, and it is not of a speculative nature that I *might* have an issue based on age or statistics. It's here, it's now, and it's ripping my insides up. Sure it's not "preventative" in the light of diagnostic exploration for a risk group, but having an existing, concrete issue earlier in life is of crucial importance, how can you argue otherwise? It's disgusting. Nice going Senate, btw, on putting another step in the right direction tonight. :)

I just found out by confirming and enrolling my benefits through work for 2010 the other day that my insurance will only get worse next year as far as coverage, even though it's the same version, the best they have for someone with something chronic like us. Everything I cover/pay for went up, in 3 areas: Out of pocket maximum, deductibles and my premiums, and that's universal, it's not just for me. It's like they feel the heat of the oncoming fireball that is reform. W*nkers. :mad2:
 
Actually yes, I've always thought "Max out of pocket" was a misnomer as the fine print is that it doesn't include meds or copays or a deductible. Those copays alone have to reach a grand to $1,500 at least, separate.

My meds have a separate max and it's supposed to be $2000 after a deductible.

When I got this disease I guess you could say I had expensive taste.

The only good thing is that if I'm in network, I have no lifetime max coverage, otherwise out of network it's $2 million max. Good to know I won't bleed out one day because they've got my back there, huh? / sarcasm
 
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well here are my two cents. The health care here in Canada has it's ups and downs. I've had both my colonscopies covered, and have never had to pay to see either of my specialists. (Gastro, and Rheumo)
The prescriptions i've been given however are another story. I am lucky enough to have a quality medical insurance program through work that takes care of that, (covered my humira $1300 for two months supply),but for some people i know without work place insurance, prescripts are pricey. Not $10,000 for a colonoscopie pricey but still pricey.
My 74yr old mother has to pay out of pocket for her meds, cause she makes too much on old age pension and widows pension, to have it covered by medicare.
And her being a diabetic it can cost her upto $600/mnth. Not easy on a pension. But i guess she's lucky cause she can still get specialized treatment at no out of pocket (nothing is for free iknow). She's getting lazer treatment done on her eyes now to blast blood vessels that have swollen. So that is a good thing.
But we do have long waits, and some have argued sub standard care. Not Dr's, or nurses. Just the way they're allowed to treat us i guess. Because most are being head hunted by cities in the States for their expertise.
 
Ugh, on my student health insurance plan through my university, my prescription benefit max was $600 a year!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I went over that with 2 months worth of Pentasa. I didn't find this out until I tried to get remicade, which I was paying in full (for 4 infusions) until I finally had to stop because of an allergic reaction. Not only did I have a $600 max on presciptions, but also some ridiculously low max on x-ray and lab work, so between remicade, prescriptions, blood work, ct scans, etc, I am thousands upon thousands of dollars in debt JUST in medical bills! and I'm only 19 years old!!! It makes me feel a lot better though to know that other people are going through this as well. As if having crohn's isn't bad enough....I really really cannot imagine what cancer and HIV patients deal with. People with diseases like that have no choice but to die without adequate treatment, unless they are rich. :(
 
here's something i just read on facebook from a friend of mine who moved to Tennessee. He's a Doctor who had a been swayed to move down south.
(more money more money)
He was telling me about a patient he say the other day who suffered his first ever seizure. And is now crosseyed.but with no insurance he cannot see a neurologist and if he were to get insurance it woud not help because it would be considered pre-existing so he remains crosseyed.
pretty sad.
 
Very sad. And it's even sadder that there are conglomerates and entities that push for that to continue as the status quo.
 
Speaking from a Canadian point of view I'm pretty happy with our health care system, as said previously it has it's good points and bad points.

In BC everyone has to pay a Medical Service's Plan premium, for a family of 3 or more it is $108 / month. We have never had to pay this as either the company I have worked for or my husband's company has always paid this. We pay 20% of prescription costs (with this company), we also have almost 100% of our dental covered and $250 for visioncare every 2 years, eye exams are free, chiropractor and naturopath are free up to $500 / year each.
If you do not pay your MSP premium you can still get care at Emergency at the hospital, and I'm sorry to say there is a specific ethnic group out west here that really takes advantage of this and uses the ER as their Dr's office, this clogs the hospital up for everyone else - but isn't that always the way it is??

I have always been able to get my kids into the Dr within the same day or next day. If I prefer I can go to a walk in clinic and wait to see the "Dr. of the day". Emergency room visits tend to be a wait except for at Children's hospital (about an hour away).
Colonoscopy and Endoscopy took 4 months to get done, but I later found out that they had lost my son's chart and once we got the Ped Dr on board we were in within a week. MRI was going to take up to a year, we wanted to find out what was going on with abscesses and fistulas and went private - paid for it ourselves $750. We get this amount taken off of our taxes at year end. We also decided to try some hyperbaric treatment, Dr. would not prescribe so we paid for this ourselves at a private clinic, I think it worked out to $105/75 minutes. We can claim this on our taxes as well.
If my son's fistulas do not heal I already have a colo rectal surgeon that I want to consult with - I will ask the GI (with whom I have an appt with in Feb) to refer us to - all of these appointments will be covered - I pay nothing.
If we decide to go with surgery - this too will not cost anything, I have no idea how long the wait time will be though. What I am hoping for is to get a referral in Feb, do the consult and schedule surgery for summer (when he is not in school).
I believe our Dr.'s here are influenced by "Big Pharma" as much as anywhere else, but overall I feel it could be much worse. I consider us lucky to live an hour away from the largest Western Canadian city that has a lot of very skilled professionals. If we lived up North somewhere I don't know what our level of care would be.
I am sorry to hear of all the people who suffer on here, and feel that there is nowhere to turn because they cannot get medical insurance and do not have the $$ to fund their treatment - that is not right.
 
Healthcare really sucks.
Luckily I was able to get on the state insurance. It was a fight and a big hassle but I got it in the end. My insurance didn't cover one er visit because I applied and they denied it because they never contacted me for an appointment (they are supposed to send a letter). Calling never works because it's a 2-3 hour hold time and it disconnects at a certain time. Fortunately, the hospital said that if I am on the state insurance I qualify for financial assistance through the hospital! I just signed a form and its taken care of. And this was all after their lawyers were calling me harrassing me for the thousands of dollars I owe them and can't pay.
Oh well.

Is there any sort of thing like that in your state? I live in Arizona and ours is called AHCCCS
 
Here in the UK I have had good and bad experiences on the NHS, but much more good than bad. I can see a doctor whenever I want who will refer me to a hospital consultant specialist if needed. I might have to wait a few weeks for this or even months if it is non urgent (like a joint swelling). Any medications I need cost me about £7.30 (not sure of the exact amount) irrispective of their actual cost or I can pre-pay about £100 per year and not pay anything else. There are exemptions for kids, students, pregnant and new mothers, elderly people and those on certain benefits. If I have an emergency I can call an ambulance or an out of hours doctor or go to A&E and be seen within a couple of hours. I will receive no bill for any of this.

If I need treatment for an ingrown toe-nail or cancer I still don't have to pay anything.

A very small part of my salary goes towards the cost and if I am unable to work and contribute the system I still get treated without cost.

The NHS does have it's shortcomings but it is a wonderful system and it is fantastic not to have the added worries of costs at a stressful time like being ill.

I hope the new reforms work well in the US so that the people who really can't afford to pay for it will receive the treatment they need.

Good luck America
 
I am lucky to have a job that provides me with good insurance. I pay out $2400 and and then everything after that is covered 100%. So usually that is my first Remicade of the year and then everything is free the rest of the year.

I also have a health savings fund, so I just plan to have the $2400 taken out of my checks tax free. 2010 it actually increases to $3000 though. Thank goodness for raises to cover the difference.

Outside of hassling with them to bill correctly I have been fairly lucky when it comes to insurance. My only real worry is reaching lifetime maximums, but I am fairly confident the federal government will get rid of those as part of a health care bill before I ever reach those limits.

I am content to be a cubicle jockey if it means having the benefits I have. It should be mentioned that I also work for a Dutch company, which may explain the ridiculous benefits we receive.
 
I get scared each month that I will not be able to come up with the money that I pay for the health insurance. I got approved for Medicare but that only covers 80% so people in US on Medicare have to find supplemental insurance to cover the other 20%. They still make you pay each month for the Medicare even if you pay for the supplemental insurance. I am now on Aetna. They have covered and approved everything so far. If I am not able to keep this I will go into more debt or not be allowed to get treated properly. The prescriptions are not covered that well though. With everything adding up each month from doctor visit copays, to prescription costs and the living expenses (I have to keep a roof over my head), I get afraid each month that I will not be able to pay out the extra money for the Aetna.
 
Had nothing but a good experience with the NHS. As much as I think I'd like to live in a different country for a while I cannot bear to leave this system. I certainly wouldn't move to any country without universal healthcare.

What I find frustrating is that so many of the people who oppose universal or 'socialized' medicine in the U.S are the same people who claim to be Christians. Whilst not a Christian myself I respect the philsophy behind its teachings and I'm sure Jesus would weep at the sight of all this avoidable suffering that occurs year on year in a supposedly civilized and developed country. It is a stain on an otherwise brilliant country.
 
My boyfriend always said that he wished he could give me his health insurance because he never needs it. I wish it could work that way.
 
mharvey90 said:
Medicare is good but of course only available to the eldery or disabled. From what I understand, our Medicare is similar to the NHS. You pay a certain amount into Medicare in each paycheck...depending on your wages, and then when you are retired you basically have completely free medical coverage. It makes me sick how so many people in this country are so afraid of or just despise a system like the NHS. These are people that are incredibly rich and don't have a problem paying extremely high premiums, co-pays, etc, and people who don't have real medical problems and have no idea what it's like to suffer when you can't afford treatment.
Click to expand...

I am on disability and was offered medicare. It is not completely free. I paid for it while I was working out of each paycheck and now that I am disabled I still am paying for it. I pay extra for supplemental insurance (because medicare no matter what age you are only covers 80%). I do not see that it is anything close to the NHS system from what people describe on here. I would be in debt beyond belief or just not be able to get the proper care that I need if I only had the medicare alone. I pay extra like mentioned above for extra insurance. I got lucky with Aetna. Some supplemental insurances would not take me because of being 29 or it was at a cost of 650 a month. Aetna supplemental insurance is a couple hundred extra a month ontop of still paying out of each check for medicare costs. It is a lot of money each month, but I know that I am able to get the treatments that I need and have the doctors of my choice. Even if I qualified for medicaid, there are quite a few doctors that do not accept it. I do believe there needs to be an adjustment to the medical system here in the U.S. so that more people can have some form of insurance, but I feel that in this country a NHS system would not work well. Dont be disgusted with me for saying this. I am not incredibly rich, I do have crohns and am having great difficulty health wise, and I do not enjoy paying all my co-pays. I dont think we need a system for free health care for everyone, that would just be a total disaster for everyone if they started that. Again I think that there just needs to be an adjustment so that people are not left without some form of health insurance.
 
Jenn why do you think an NHS type system wouldn't work well?

Personally I'm of the opinion that it is a matter of diginity for every citizen to recieve healthcare regardless of ability to pay and regardless of its costs. We're not overley taxed in Britain and we still manage to cover everyone.

Unfortunatley we live in an age of greed where the poorest have no voice within the democratic process.And in a world of 6.4 billion people - individuals are commodities whose individual humanity bareley registers. Thus, the moral immeadiecy of helping these people is diluted.
 
It might work well where you are but I think with our government there would be major problems if they were to start a system like the NHS here. It would not be the same as your system. I am not disagreeing with you that everyone should have some form of health insurance though. I feel that our system just needs some "adjustments" made so that may happen.
Possibly adjustments where more people qualify for our medicaid system which is a government program. As of now though it is very hard to qualify for that health insurance, and like I mentioned above there are a lot of doctors who do not accept that insurance.
 
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I don't think necessarily EVERYONE needs health insurance. But if someone is sick they should be treated and not have to worry about going into debt.
 
We personally have pretty good private insurance coverage, other than a few gripes I have with getting reimbursed for my LDN. I've come to the conclusion that I'll just pay the twenty-five bucks out of pocket for it and forget the paperwork.

A friend of ours is currently on dialysis waiting on a kidney transplant. She has excellent insurance. They cover eight thousand dollars a month for a drug she gets before her treatments to keep her blood pressure regulated. Her out of pocket for this drug is currently a thousand a month! She cannot get on disability and medicare because they say she doesn't have enough credit hours, she also cannot draw on her father's or husband's for some reason, not sure about that. She cannot get any state help because her husband makes more than thirty thousand a year, that is the limit for a household of four people! She can get some kind of assistance from the drug company but not until their next enrollment which is three months away.

I think a major problem with our healthcare system here is that employers also pay too little and make it outrageous for the employees to buy into private insurance. Any company making billions of dollars in profits should be required to pay all premiums for their employees. I personally know several people that worked for Walmart and Macy's and all of their children were on state funded insurance that ALL of us pay for. Any company that size should not be able to make those kinds of profits while their employees dependents are on welfare.
I'm not just bashing Walmart or Macy's here, I'm using it as an example of MANY companies that do the same thing.

At the moment, we pay nothing for our insurance, it is entirely coverred by my husbands employers. It is a benefit on top of his salary, not that he makes tons of money. We support five people on fifty or so thousand a year, which depending where you live, isn't much. We have chosen to pay out of pocket thousands upon thousands in the past few years for alternative treatment for my husband's lyme issues when conventional options that would have been paid for by insurance failed. This has kept him able to work to keep paying into a system that has to cover dependents on welfare for employees of huge companies making billions.

I also know people that will buy beer and cigarettes every day and then claim they can't afford the premium for their insurance through work so just opt not to have it! If they'd save all that money that will eventually cost them their life, and many unpaid medical bills, they could probably pay for the insurance.:ybatty:
Sometimes it's a priority thing and people put other things ahead of insurance thinking they don't really need it.

They should absolutely include more people on Medicaid that truly cannot afford to buy insurance.

Just a few more thoughts there to ponder.

Miss
 
Here are a few things I think they need to do away with or change feel free to add.
1. pre-exsiting condition
2. lifetime max
3. reasonable co-pays
4. perscription cost
This is what I can come with right of the top of my head but I recomend to anyone that is living in the US to write to your senator or congress man/woman. I am currently working on a letter to mine someone that is actually on our side.
 
I think the people that smoke and drink excessively should have a harder time getting insurance. I mean essentially they are creating their own risks towards diseases. WE KNOW in the medical community that smoking is the number one risk factor of almost every top disease diagnosed. Heart disease, stroke, lung disease, cancers, diabetes, chronic lower respiratory diseases...

We KNOW if you drink excessively for many years... YOU WILL get cirrhosis of the liver. These are not possible side effects... they are EFFECTS of drinking.

I don't get it.

It's like pouring gas on a fire.

/rant
 
i could rant on this issue for a million more posts...especially with the passing of the health care bill in the senate this morning... -.-
 
I live in the US and pay $400/month for a $7500 deductible policy with copay up to $10,000. It pays for half my Pentasa only after I reach my deductible. I would be willing to pay $800/month just to see the health insurance companies closed down. They are heartless weasels.

The Health Reform bill is now in the House. The Senate version sucks, but it's a lot better than what we have now. I hope it makes it.

BTW I am considering buying my mesalamine from online pharmacies in Canada. Following Consumer Reports' advice, I checked several of them using the PharmacyChecker site. There I found 500mg Pentasa for about 70 cents a piece. That's a great price compared to anything I have found in the States. If they are the real thing.
 
In Canada, health care isn't administered on a national level. It is a provincial (state) jurisdiction. Policy varies by region. Where I am it is a two-tiered system.

I have a good plan through my employer that pays all of my drug costs and will even provide me with a private hospital room should I require it. It does not bump me up the queue however, so I have to wait for specialist care on a by-need basis. Fair enough.

Hard to fathom what hoops some of you Americans have to jump through. Breaks my heart.
 
What is ironic though is that, while there is a presidential push to "Canadianize" the American system, the exact opposite is happening across the border.
 

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