Universal Health Care Reform in the United States

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17th August 2009, 01:49
Tomi

Quote:

Originally Posted by Mark in Oshawa

The problem is some generics just aren't as good. My wife takes losec for her acid reflux. The generic that the doctors keep trying to make her accept doesn't seem to work as well as the original Losec. The pharmaceutical industry is the biggest profitteering crooks in the whole medical system, and their manipulation of formulas for various drugs and the generic market is riddled with issues....

For the most part generics do the job, but there are issues....

That is true offcourse, but there is normally several different manufacturers of the generic medicines, maybe its worth to try some other brand, if it does not work, then its offcourse better to stick to the one that works.
Agree about the pharmaceutical industry 100%, also the way they advertise new medicines is a bit questionable, take for instance this Tamiflu, now it does not seem to be so good as told.
17th August 2009, 02:16
Mark in Oshawa

Quote:

Originally Posted by Tomi

That is true offcourse, but there is normally several different manufacturers of the generic medicines, maybe its worth to try some other brand, if it does not work, then its offcourse better to stick to the one that works.
Agree about the pharmaceutical industry 100%, also the way they advertise new medicines is a bit questionable, take for instance this Tamiflu, now it does not seem to be so good as told.

To be fair in the case of Tamiflu, a one size fits all antiviral drug is pretty hard to develop that will be a knockout punch. Nature and virus mutation being what they are, I suspect Tamiflu will help but isnt a panacea.
17th August 2009, 02:35
Alexamateo

Quote:

Originally Posted by GridGirl

.......To be honest I know nothing of the US medical system apart from that you need to get health insurance. What exactly do you get if you have full health insurance and roughly how much does it cost? Is it similar to car insurance where you make a claim your premium goes up and if for example you got cancer one year your health insurance would go up the next?...............

I'll give some recent personal history. I recently went the self-employed route and was very apprehensive about it, fearing the worst when it came to buying my own insurance. I was very pleasantly surprised to get complete family insurance for $3504 a year. This covers all medical/dental/vision with $25 office visit co-pays. There is a $1500 per member deductable, before co-insurance kicks in at a standard 80% coverage up to calendar year out-of-pocket maximum of $7500 per individual and $15,000 per family. I keep a six-month emergency fund of $18,000 so the deductibles etc are no problem for me.

To put it in perspective, At my previous employer, I had "great" insurance. My co-pay was $0, all deductibles were covered by a employer provided HRA (Health reimbursement account) The only thing I ever paid in the three years we had this plan were prescriptions, and I would recieve a check payable to me for the exact same amount three weeks later, and that was only at first, later we just picked up the prescriptions and we didn't owe a dime.

But, for this great insurance, $6000 was taken out of my paycheck over the course of a year. Using last year as a barometer, I can expect to pay out an additional $1500 this year in co-pays, deductables etc, so In a standard year with no major problems I'll actually be $1000 to the good over my previous insurance.

I was also apprehensive about dreaded pre-existing conditions. My 5 year old daughter was born with a congenital heart defect (coarctation of the aorta) and had heart surgery at 4 days old. Now, as one nurse put it, "it's a plumbing problem", and repairable, there is a chance she will have to have heart surgery again at age 15-18. They did ask for all of her records (she has an Echo done every year) , but they didn't attach any riders related to her. They won't however provide any psychological/behavioral coverage for my wife for seven years. :confused: My wife's doctor gave her a Zoloft prescription to help her deal with toddlers, but that's it as far as anything psychological. I told my wife she can't go crazy for at least 7 years :p : The only other conditions are a six month waiting period for dental and vision coverage, and a nine month waiting period for maternity benefits. In other words, you can't already be pregnant and sign up for insurance. I think those conditions are reasonable.

No, health insurance is not like car insurance, a claim alone won't raise premiums, although if I or someone in my family were do develop a chronic condition such as diabetes, the premiums would go up.

Another way it's not like car insurance is that it's not really treated like insurance, i. e. only used in catostrophic situations. I don't expect to go to the mechanic and pay the same $25 co-pay regardless of whether they are changing the oil, or overhauling the transmission. In someways there is an extreme disconnect with costs associated in medical care.

Something else I don't like is this: You get a bill for an office visit, and it says $109. Then the insurance pays $65 and the remaining $44 is automatically discounted. This is done because one insurance company pays $65 for a visit or procedure, another pays $75, or even $85, so they charge high to make sure they maximize their revenue. This hurts those without insurance because many times they refuse to negotiate with you and give you the discounted price even though you are paying cash today and there is no paperwork to file :angryfire . Did I mention this has happened to me? ;)

A couple of other thoughts on health care reform:

Any reform bill that does not include tort reform is incomplete on it's face.

There's a problem because there's five different versions of the bill and nobody know's what's in it and the populace in general doesn't really trust the government because of an annoying tendency to insert items for favored groups (like trial lawyer lobbyists), not debate them and then ram the deals through. Nothing this important should be treated that way.

I think politicians have misinterpreted people's complaints about insurance companies as a call to action. When it comes to change, there's the devil you know and the devil you don't. We may complain and hate certain things about our health insurance, but when push comes to shove, it is preferable to the alternative for many.
17th August 2009, 04:01
Mark in Oshawa

Quote:

Originally Posted by Alexamateo

I'll give some recent personal history. I recently went the self-employed route and was very apprehensive about it, fearing the worst when it came to buying my own insurance. I was very pleasantly surprised to get complete family insurance for $3504 a year. This covers all medical/dental/vision with $25 office visit co-pays. There is a $1500 per member deductable, before co-insurance kicks in at a standard 80% coverage up to calendar year out-of-pocket maximum of $7500 per individual and $15,000 per family. I keep a six-month emergency fund of $18,000 so the deductibles etc are no problem for me.

To put it in perspective, At my previous employer, I had "great" insurance. My co-pay was $0, all deductibles were covered by a employer provided HRA (Health reimbursement account) The only thing I ever paid in the three years we had this plan were prescriptions, and I would recieve a check payable to me for the exact same amount three weeks later, and that was only at first, later we just picked up the prescriptions and we didn't owe a dime.

But, for this great insurance, $6000 was taken out of my paycheck over the course of a year. Using last year as a barometer, I can expect to pay out an additional $1500 this year in co-pays, deductables etc, so In a standard year with no major problems I'll actually be $1000 to the good over my previous insurance.

I was also apprehensive about dreaded pre-existing conditions. My 5 year old daughter was born with a congenital heart defect (coarctation of the aorta) and had heart surgery at 4 days old. Now, as one nurse put it, "it's a plumbing problem", and repairable, there is a chance she will have to have heart surgery again at age 15-18. They did ask for all of her records (she has an Echo done every year) , but they didn't attach any riders related to her. They won't however provide any psychological/behavioral coverage for my wife for seven years. :confused: My wife's doctor gave her a Zoloft prescription to help her deal with toddlers, but that's it as far as anything psychological. I told my wife she can't go crazy for at least 7 years :p : The only other conditions are a six month waiting period for dental and vision coverage, and a nine month waiting period for maternity benefits. In other words, you can't already be pregnant and sign up for insurance. I think those conditions are reasonable.

No, health insurance is not like car insurance, a claim alone won't raise premiums, although if I or someone in my family were do develop a chronic condition such as diabetes, the premiums would go up.

Another way it's not like car insurance is that it's not really treated like insurance, i. e. only used in catostrophic situations. I don't expect to go to the mechanic and pay the same $25 co-pay regardless of whether they are changing the oil, or overhauling the transmission. In someways there is an extreme disconnect with costs associated in medical care.

Something else I don't like is this: You get a bill for an office visit, and it says $109. Then the insurance pays $65 and the remaining $44 is automatically discounted. This is done because one insurance company pays $65 for a visit or procedure, another pays $75, or even $85, so they charge high to make sure they maximize their revenue. This hurts those without insurance because many times they refuse to negotiate with you and give you the discounted price even though you are paying cash today and there is no paperwork to file :angryfire . Did I mention this has happened to me? ;)

A couple of other thoughts on health care reform:

Any reform bill that does not include tort reform is incomplete on it's face.

There's a problem because there's five different versions of the bill and nobody know's what's in it and the populace in general doesn't really trust the government because of an annoying tendency to insert items for favored groups (like trial lawyer lobbyists), not debate them and then ram the deals through. Nothing this important should be treated that way.

I think politicians have misinterpreted people's complaints about insurance companies as a call to action. When it comes to change, there's the devil you know and the devil you don't. We may complain and hate certain things about our health insurance, but when push comes to shove, it is preferable to the alternative for many.

Question, do you think if you had a gov't system you would pay MORE in taxes than you do in insurance? Second, would you accept a gov't plan if it was a simple bill with easy to understand objectives? Tort Reform isn't in the new bills anywhere and THAT is the biggest anchor on the medical system....
17th August 2009, 04:37
Alexamateo

Quote:

Originally Posted by Mark in Oshawa

Question, do you think if you had a gov't system you would pay MORE in taxes than you do in insurance? Second, would you accept a gov't plan if it was a simple bill with easy to understand objectives? Tort Reform isn't in the new bills anywhere and THAT is the biggest anchor on the medical system....

For me personally, yes, I would probably pay more in taxes than premiums. I went out on my own March 1, and at the risk of sounding immodest, I have met spectacular success and am moving into higher tax brackets (and during a recession to boot).

As far as the second, I don't know, I just think it's not the role of government to provide us with healthcare. Provide the laws and framework within which it exists, yes, but to actually pay for it, no.
17th August 2009, 04:41
Alexamateo

Actually the best situation is to probably be a Canadian living near the US border. A nice government provided system at low cost to the consumer, and the US, just a short drive away should a little more be desired ;) :p : :D
17th August 2009, 05:45
Mark in Oshawa

Quote:

Originally Posted by Alexamateo

Actually the best situation is to probably be a Canadian living near the US border. A nice government provided system at low cost to the consumer, and the US, just a short drive away should a little more be desired ;) :p : :D

ummmm That would be me if I had the money to swing it.. :)
17th August 2009, 06:11
Tomi

Its common known that every day buss loads of us people goes to canada and buy their medicine from there, it was a program in tv here about it not so long time ago.
17th August 2009, 06:31
janvanvurpa

Quote:

Originally Posted by Mark in Oshawa

Jan...I would be insulted if it was anyone else but you, but you never seem to accept someone just might have an opinion you don't like. So in short, bite me...

One of my best friends from my timing and scoring days lives in Scottsville NY and he and I have always talked on and off about the differences in coverage. I do know also many Canadians drive to Buffalo (and PAY CASH)for MRI scans and other routine tests they have to WAIT for in Canada. When people are willing to drive and PAY for a routine "Free" test, doesn't that tell you something?
Since when did you become an expert on the Canadian Healthcare system? I have an OHIP card in my wallet and KNOW the pluses and minuses of my healthcare system.

It is funny, you have no problem spreading your opinion and passing it off as fact but you get offended when you see someone else doing it. My opinions on what is going on in the US may be ancedotal but my opinion on what is going on with our system I can back up. Read any Toronto paper talking about healthcare over a year and the talk of wait times for procedures is often....

******** you write FLAT statements which very often are complete boolock and then when you're caslled out for writing your NARROW opinion with no qualifiers ie "There's no waiting", then you whine piteously that it's merely your opinion and I can't accept anybody else's opinions
Bullsheet,
I can't stand people writing OPINION as FACTS.

You can have your voluminous and verbose opinions but OCCASIONALLY ADD A "In my opinion" or "It seems to me" or "Somebody I was talking to said, but I HAVE NO PERSONAL EXPERIENCE....".

And I don't doubt you keep abreast of Canajian Health care developments, but don't write crap about this *****up system here when your experience is SO MASSIVELY LIMITED to anecdotal contacts with a few people.

Your ranting about me "since when did I become an expert on the Canadian system?" is flat bizarre, I never claimed to be an expert any ANY, although I did say I have been treated for motorsport related serious injuries in a number of different countries over several decades.
That's limited experience but my 30 year informal poll shows most people have NEVER been treated for injuries, had an operation, or been hospitalised.
So I guess i have a LOT MORE actual experience than average TO BASE AN OPINION ON.

That's the real rub: opinions are one thing but are they based on actual personal experience, or second, third, 15th hand re-telling?
Informed opinions or just talk.

Or opinion with no qualifying phrases presented indistinguishable from a "fact'.
17th August 2009, 07:14
Mark in Oshawa

Quote:

Originally Posted by janvanvurpa

********, you write FLAT statements which very often are complete boolock and then when you're caslled out for writing your NARROW opinion with no qualifiers ie "There's no waiting", then you whine piteously that it's merely your opinion and I can't accept anybody else's opinions
Bullsheet,
I can't stand people writing OPINION as FACTS.

You can have your voluminous and verbose opinions but OCCASIONALLY ADD A "In my opinion" or "It seems to me" or "Somebody I was talking to said, but I HAVE NO PERSONAL EXPERIENCE....".

And I don't doubt you keep abreast of Canajian Health care developments, but don't write crap about this ***** up system here when your experience is SO MASSIVELY LIMITED to anecdotal contacts with a few people.

Your ranting about me "since when did I become an expert on the Canadian system?" is flat bizarre, I never claimed to be an expert any ANY, although I did say I have been treated for motorsport related serious injuries in a number of different countries over several decades.
That's limited experience but my 30 year informal poll shows most people have NEVER been treated for injuries, had an operation, or been hospitalised.
So I guess i have a LOT MORE actual experience than average TO BASE AN OPINION ON.

That's the real rub: opinions are one thing but are they based on actual personal experience, or second, third, 15th hand re-telling?
Informed opinions or just talk.

Or opinion with no qualifying phrases presented indistinguishable from a "fact'.

I just do what you do John...except you have a hate on for me while I find your complaints a little hypocritical. You make assumptions about the Canadian system based on what I cant discern, while I have many friends in the US who have told me their experiences and opinions. Some want a Canadian style system, some don't. My point in this whole thread is maybe those against what Obama is proposing may have a pretty good reason to not like this particular version of socialized medicine. You I know seem to think the US is overeacting and is going to hell in a handbasket if they don't accept the Obama plan or not....I find I haven't found your clear opinion on much of anything except a dislike of my thoughts.

Actually...not sure what your EXACT thoughts are. As for calling me a post whore, thanks...its a hobby. When Ia m gone for 5 or 6 days you can post away and spew YOUR opinion and I am not going to complain. I used to find you annoying, now I find you just amusing....

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