Health Insurance help needed

[djv]

M J do you do all your doctering at one clinic and hospital. If so they may have a plan you can join. It may be better it may not. They also may have a plan such as DTB talks about. I know here in Wisconsin some hospital are teamimg up to offer such things. Of course it means that is wear you go to. But if on vacaton and not home. A emergency comes up they have rules for that.
What the heck I would check-em all out.

 

[He Hate Me]

Forget health insurance,just eat correct and exercise for preventive medicine,dont eat high risk foods like meat and avoid processed sugar and stretch out every morning.

 

[Skinar]

I'm unhappy to see that almost all of you ignorant f**ks have completely missed the target here. The Doc from Canada has the answer. It's time for folks in the USA to get realistic about healthcare costs. I'm no Hillary Clinton fan, but they were on the rigth track when they tried to nationalize (socialize) healthcare. The great state of Kentucky instituted some health insurance reforms, like transportability, limitations on pre-existing condition clauses, etc, which ended up running all but 3 healthcare providers out of the state. WHY? Because they had other state to run to and hide.

Now, I realize I will get flamed big-time by the Bill and Hillary haters, the conservatives, the friends of the insurance industry, and who knows what else, but I don't give a big rat's ass at this point. My insurance costs have TRIPLED in the last 3 years. The Canadians that I know happen to LIKE their single payer system, including the Canadian one doctor that I know personally. He doesn't have to spend nearly as much on staff to handle the damn insurance billing as he would in the United States.

Everyone in the USA receives healthcare. WE ALL pay for those services either through premiums or taxes. 96% of all Medicare dollars go to providers. 70% of insurance premiums go to providers, the remainder goes into the pockets of agents, and insurance executives. Since we all pay these costs anyway, and it has become a necessity of life, not an extravagance, should we not pay these fees in the most efficient way possible?

FLAME ON !!!!!!!!!!!!!!!!!!!!!!!!!!

Skinar

 

[ozball]

Skinar,

there are different strengths to both systems. The canadian system is definitely more efficient in terms of dollars spent being fully utilised in direct care, but this comes at a cost for patient convenience, particularly in high tech specialties.

Our rural clinic of six docs has two back office staff who deal with billing, letter typing, and personel management. The equivalent US clinic would likely have a billing clerk per doctor to deal with different insurance companies and paperwork. My annual bad debts are somewhere below 2%. In your system a large percentage of dollars that you, the consumer spend, go into the middlemen, insurers, agents, etc, as you describe. Single payer systems definitely streamline some of this waste.

Additionally, the US system has massive duplication and excess capacity, whereas the Canadian system has excess demand with respect to capacity, particularly in regards to medical technology. This leads to very short waits for you guys when you need, for example an MRI scan, or elective surgery. Up here, the wait for an MRI scan can be months. Despite this, truly urgent things still get done quickly, and the main price we pay in the Canadian system for universal access is the inconvenience of waiting for elective tests and procedures. My feeling is that the wait list issue has been overplayed in the media, perhaps used as a bogieman by your insurance industry that fears "socialized medicine".

A system where increasingly health care benefits are not provided by employers (more casual and part time workers, and the self employed) and larger percentages of the population don't have medical coverage does not seem to be a situation that can continue forever.

For those who are adequately insured, the US system provides, at least as far as I can see, very rapid access to the most advanced health care services that exist, but at a higher cost than other systems. The Achilles heel of your system is the underclass of uninsured and those in the middle class who are finding insurance too expensive to maintain. In a universal system, the cost for all drops across the board.

This shouldn't be about Democrat vs Republican, and I hope doesn't degenerate into a political flame war. The question that needs answering is how to get our webmaster affordable health insurance for himself and his family, so he can keep this incredible website going

We may have to change the whole system to get this to happen. Suggestions welcome.

Cheers

ozball

 

[DOGS THAT BARK]

Skinar You are correct about Ky rates and our Health Care Reform.You can get same coverage for 30% less accross state line.
You may be surprised to know that the insurance industry fought our health care reform tooth and nail from onset.After our great Governor would not compromise,most carriers left Ky rather than conform to the reforms guidelines knowing it was a losing proposition, which lead to less competition and we all know the rest of the story.One point you may not be aware of is where all these changes that went into our health care reform came from.I'll just say they were voted out on a national level,and not that they weren't great ideas from a benefit standpoint, they just wouldn't float from an economical standpoint as we found out.Several changes have been made since its inception but I will give you two that caused most insurers to leave.

Same rates regardless of health:
They could wheel someone out of hospital and if they could sign an application they had insurance with ,I believe a 60 day waiting period initially,at same cost of one in perfect health.
(Effect) Why carry insurance prior to getting sick.You now have all sick people in risk pool and few healthy to offset claim ratio.

#2 Unlimited benefits on aids.
Insurance carriers in all other states as far as I know have limits on exposer to aids risk because of costly nature of illness.Under our intial plan all you had to do is be a Ky resident for 60 days and you had unlimited benefits.So where do these people move to that have exhausted benefits in other states?

Both these have since been repealed and a few carriers are coming back.I don't have the answer to what needs to be done and not sure there is an answer.I have heard pros and cons on national healthcare and while I have yet to see anything run by the government be cost efficient I am at same point as Skinar that something has to be done.
Oz: Appreciate your thoughts on the subject. Quite interesting.

 

[Skinar]

Thanks Oz for your post. I fall in the no-man's land of being self-employed, although my wife teaches and we are able to get insurance through the state. Still, those rates have nearly tripled in the last few years. I looked into getting insurance on the open market and found the lowest premiums available were on the order of $750/month. DTB, you are on target about things here in KY, I have an insurance agent who is a good personal friend, and the reforms cost him ALL of his health insurance business, he only does P&C now.

The commonly accepted wisdom is that the government can't run anything efficiently. If so, why do we continue to let them run our military? BTW, those $5K hammers and $3K toilet seats paid for all those non-reported skunk-works projects like the stealth fighter and B-2 bomber. Is there ANYONE in MJ's who cannot tell a horror story about their dealings with an insurance company? Would you consider the current state of health insurance companies and their claims denial process efficient? I think it's plenty efficient for the stockholders, executives, and agents, but that's as far as it goes.

At this point MJ, you are screwed and there is not a f**king thing you can do about it except pay the man, do without, or move to Canada.

Skinar

 

[Neemer]

Jack...

AWP for #60 Altace tablets is around $75 bucks. For #30 Aciphex is about $113.97. Remember, that's average wholesale price and not cost. Cost would be about 15-20% less that AWP... Hell, just go get 'em across the border; they are about half of cost...

 

[djv]

Skinar Very nice of you to call us ignorant fu**s. I thought you were close to 50. Those remarks make you sound like 16. Im happy you have your point of view. However other folks have there view. That does not mean there ignorant anything.

 

[Neemer]

Skin...

Your friend did the wise thing. I believe that in the state of Kentucky now, insurance agents get a measly $25 bones to write a group health insurance policy. Not worth the time or effort....

 

[Skinar]

djv,

Sorry about the stupid remark. I am about 50 and at the time of writing, had about that many beers

. I still believe in what I'm saying about the health insurance problem, but I was way off base earlier.

A buddy said recently that after a big day on the golf course and many beers, he comes home the genius of all time. The next morning he's the same old dumbass

. I thought he was talking about me when he said it.

Skinar

 

[djv]