Behold: Our Health Care system - current

[glassgowkiss]

Two cases involving my co-workers

 

CASE #1

 

Middle age mother experiencing some declining health symptoms headaches, eyesight etc,

 

Diagnosis: high blood pressure (Hypertension)

 

Insurance claim status: DENIED - preexisting condition even though she has no medical history of such.

 

Prognosis: Not good, she has kids and can't afford the meds out of pocket. Makes "too much" to qualify for any assistance. She can't afford a lawyer to sue "her" "insurance" company.

 

 

CASE #2

 

Middle age single male (part time climbing partner) experiencing significant knee pain causing some impairment.

 

Diagnosis: torn cartilage (meniscus tear)

 

Insurance claim status: DENIED - clause in "fine print" excludes this type of surgery or caps reimbursement at "$1,000" for out patient procedure.

 

Prognosis: Not good. Pay for it yourself or let it limit your activity and contribute to overall health decline.

 

These are 2 true cases from my co-workers. They pay $110-$140 every month for "health insurance" with a rather high copay that basically does nothing for them but does provide good returns for share holders and ceo's.

 

Life in modern 'merica, gotta love it.

 

You're either 1.) Not disclosing all appropriate details

2.) Aren't being completely truthful 3.) Aren't being told the full story by said coworkers

not the truth is we see it daily. you just choose to ignore the facts of life. sorry, but your response is just plain stupid (like most rest of them).

[Bug]

and married to two.

 

Jesus....how many times have you been married?

Who's counting.

 

Twice.

[mattp]

... complete baloney ...

can you explain what the cost of malpractice insurance is, and what part that plays in the overall economy?

 

I doubt he'll respond. It has been well established that the Republican hype about malpractice lawsuits being the root cause of all that is wrong or even much of what is wrong with our medical system is overbloated hype and pandering to folks who are not interested in facts, figures, or real discussion.

[mattp]

To be fair, I should note that KK has good company trotting out the malpractice claims issue. Factcheck, cited on the prior page, was reporting on similar claims made by our esteemed president Bush the Lesser when arguing for liability caps.

 

both the General Accounting Office and the Congressional Budget Office criticize the 1996 study the Bush administration uses as their main support. These nonpartisan agencies suggest savings – if any – would be relatively small.

 

...

 

“In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency, ” the CBO said.

[pc313]

It is standard procedure for insurance companies to deniy valid claims. They know that many people will never try to go beyond that initial rejection.

In 32 years dealing with insurance companies I still recieve

mail from my doctor's that say "THIS IS A BILL" your claim

has been denied, to witch I call and tell them to send it to

my insurance co. for I have full coverage,and 2-3 weeks later

I recieve a payed in full letter!! AND THE GAME GOSE ON!!!!!!

[Bug]

Told ya so.

[mattp]

I'm curious to hear how folks think the problems with denial of claims or cancellation of coverage, or for that matter the medical malpractice situation would play out with a move toward universal coverage. I think it is self-evident that the coverage issues would be aided and I see potential for improvement in the malpractice area but can anybody credibly argue that they'd likley get worse? I'd like to hear it.

[pc313]

I'm curious to hear how folks think the problems with denial of claims or the medical malpractice situation would play out with a move toward universal coverage.

Hell the govement denies claims all the time,I don't see universal coverage changing much,

other than getting everyone signed up under one insurance program who is not already insured,even then your going to pay some thing. NO FREE RIDES

Edited August 26, 2008 by pc313

[KaskadskyjKozak]

... complete baloney ...

can you explain what the cost of malpractice insurance is, and what part that plays in the overall economy?

 

I doubt he'll respond. It has been well established that the Republican hype about malpractice lawsuits being the root cause of all that is wrong or even much of what is wrong with our medical system is overbloated hype and pandering to folks who are not interested in facts, figures, or real discussion.

 

I never said that. I cited it as ONE factor, albeit a significant one in the higher costs of medical care. And it's not just malpractice insurance or lawsuits (settlements). The FEAR of lawsuit drives health care providers to go way overboard in providing extra services and care - often unneeded to AVOID lawsuits. Keep the machine plugged in, pump in those expensive drugs - you would not want to be sued, after all. Never mind that Uncle John was an obese fuck whose arteries were clogged by a few thousand pounds of ingested lard over his lifetime, if he dies, it's the doctor's fault, damn it! Speaking of which, unhealthy people raise our costs, as do an aging population - a less and less healthy, aging population. Then there's the freeloaders who don't buy insurance, and suck off the teat of big government, visit emergency rooms, call the ambulance because they're "lonely", excessively use an overburdened system. I know people who work in the health care industry and hear all the stories.

 

Anyways, I'm sick of your bullshit, MattP. Time for you to go on ignore for a while - you're a waste of time.

 

[KaskadskyjKozak]

I'm curious to hear how folks think the problems with denial of claims or the medical malpractice situation would play out with a move toward universal coverage.

Hell the govement denies claims all the time,I don't see universal coverage changing much,

other than getting everyone signed up under one insurance program who is not already insured,even then your going to pay some thing. NO FREE RIDES

 

The government will have to cut costs just like insurance companies. They'll do it by denying services, by making it difficult to get treatment (longer wait times), by providing second rate drugs, care, machines, facilities. The quality will go down, costs will go up. Those of us who bear the brunt of the costs will pay EVEN MORE. Those who get a free ride as it is will continue to do so, and be joined by more like them. The rich will get the best care $$$ can buy - as always, and only pay a little more for it.

 

[Mal_Con]

One thing insurance companies do now that would be entirely eliminated is that they get kickbacks to push drugs from those companies to the extent of making you go through all sort of hoops to continue your prescription which is already working in an effort to switch you to something with more side effects.

[pc313]

 

 

The government will have to cut costs just like insurance companies. They'll do it by denying services, by making it difficult to get treatment (longer wait times), by providing second rate drugs, care, machines, facilities. The quality will go down, costs will go up. Those of us who bear the brunt of the costs will pay EVEN MORE. Those who get a free ride as it is will continue to do so, and be joined by more like them. The rich will get the best care $$$ can buy - as always, and only pay a little more for it.

 

The goverment has been cutting coverage,and raising permiums on Medicare,Medacaid, and VA! Leaving the state's to pick up more of the cost,and the states pass it on to us. So were going to get fucked anyway you look at it!!

[prole]

None of you people are going to give a shit about health-care when you're standing in line to pay $10 for a gallon of water.

[pc313]

THANK GOD FOR MY MY FRIST NEED WATER FILTER! And the fact I

live on a river,but I get your point! $1.00 a gal. at Safeway

[KaskadskyjKozak]

One thing insurance companies do now that would be entirely eliminated is that they get kickbacks to push drugs from those companies to the extent of making you go through all sort of hoops to continue your prescription which is already working in an effort to switch you to something with more side effects.

 

I'm not sure I buy this... but, yes, if you are sick and old, doctors try to give you a whole slew of drugs. But is that all about pushing drugs for profit as much as it's how we approach medicine and treatment in this country?

[blurpy]

... complete baloney ...

can you explain what the cost of malpractice insurance is, and what part that plays in the overall economy?

 

I doubt he'll respond. It has been well established that the Republican hype about malpractice lawsuits being the root cause of all that is wrong or even much of what is wrong with our medical system is overbloated hype and pandering to folks who are not interested in facts, figures, or real discussion.

 

I never said that. I cited it as ONE factor, albeit a significant one in the higher costs of medical care. And it's not just malpractice insurance or lawsuits (settlements). The FEAR of lawsuit drives health care providers to go way overboard in providing extra services and care - often unneeded to AVOID lawsuits. Keep the machine plugged in, pump in those expensive drugs - you would not want to be sued, after all. Never mind that Uncle John was an obese fuck whose arteries were clogged by a few thousand pounds of ingested lard over his lifetime, if he dies, it's the doctor's fault, damn it! Speaking of which, unhealthy people raise our costs, as do an aging population - a less and less healthy, aging population. Then there's the freeloaders who don't buy insurance, and suck off the teat of big government, visit emergency rooms, call the ambulance because they're "lonely", excessively use an overburdened system. I know people who work in the health care industry and hear all the stories.

 

Anyways, I'm sick of your bullshit, MattP. Time for you to go on ignore for a while - you're a waste of time.

 

All right then, so malpractice (or the fear of a suit) is a significant factor. How significant? You should be able to express that in terms of the percentage of dollars spent on healthcare, or a percentage of GDP or somesuch. Perhaps you have some evidence the GAO or the CBO didn't have? That was 2004, so perhaps new evidence has come to light.

 

These other items you cite may well be factors too - unhealthy population, uninsured 'freeloaders', aging people. Can you establish just how common and significant they are, and how much of a drain they represent?

 

And, if true, don't they demonstrate that there is a problem in the healthcare arena that we as a society ought to address?

[akhalteke]

Fatties

[akhalteke]

Freeloaders

[blurpy]

Freeloaders

 

ok, now we're getting somewhere. the obesity epidemic across the country (illustrated in CA in this case) is burdensome to the healthcare system, and the uninsured (again, in one area, but probably can be extrapolated) are part of a trend that some suggest will overwhelm the healthcare system (at least in those areas) in a matter of years.

 

keep 'em coming....

[akhalteke]

Can't. I work for a living.

[KaskadskyjKozak]

 

And, if true, don't they demonstrate that there is a problem in the healthcare arena that we as a society ought to address?

 

Yes, the gov't needs to bus lardasses up to the Mt. Si trailhead every weekend, and force them up and down the hill with an R.Lee Ermey style "motivational speaker" on their heels.

[mattp]

Our anti-socialism friends get angry when I question whee they get their information and complain when I provide references to outside sources, whether web links or (gasp) a book that I admit I have not read. However, their arguments depend on a number of assertions that amount to fiction, and they have yet to provide any evidence to support these ideas. Consider these items:

 

Claim: government provided healthcare is inherently poor quality

Really? the Veterans’ Administration has been slammed for providing poor quality care in the past but all current studies I can find indicate it is known for excellent care and recent innovations in record-keeping. The President gets care at Bethesda Naval Hospital. The medicare system, once touted as socialism, is one of the most if not the most broadly subscribed healthcare insurance systems in the country. It is more efficient in terms of administrative cost and the claims process than any private insurance company. Even those who can afford any healthcare they want still use it.

 

Claim: it will cost all of us more if we have universal coverage

I already noted that the medicare system is more efficient than any private system. In trying to evaluate prospects for increased cost with universal coverage, I find few editorial comments and no numerical studies or estimates of potential increases in cost to consumers associated with current proposals when browsing the web searching “U.S. healthcare costs” “healthcare reform” and similar items. It may cost us more in the end but this is far from certain. What we DO know is that the US spends more per capita on healthcare than anybody, and we get less for it. We are the only civilized nation that doesn’t have universal healthcare of some sort.

 

[mattp]

KK and others frequently complain that the malpractice crisis is driving up medical costs. However, when you try to figure out just how much it may be contributing to our overall healthcare bill, it becomes clear that the amount it tiny. I can’t find good statistics on this, but I find several sites putting the cost of medical malpractice insurance and defensive medicine combed at 2% of the overall cost of healthcare.

 

malpractice costs represent 2% of medical spending

link

 

1-2% of total healthcare costs

here

 

Good summary of myths about malpractice

here

 

Even on webpages with scathing editorial about greedy trial lawyers I cannot find any claims that the actual cost of the medical malpractice is higher than these tiny percentages, for example example

 

I believe there are some problems with the malpractice system, and I've already acknowledged that the impact on certain specialties like obstetrics is huge, but the arguments from KK and others overstate the situation and ignore the fact that one of the problems is that there is a lot of malpractice. Four years ago, John Kerry said we should not have punitive damages in malpractice cases, we should impose measures to prevent unfounded malpractice lawsuits, and attorney's should be personally barred from bringing such cases through a three-stikes-your-out rule. These sound like sensible ideas to me. Railing against trial lawyers based on BS or suggesting that the existence of a malpractice crisis argues against broader healthcare coverage does not.

[blurpy]

 

And, if true, don't they demonstrate that there is a problem in the healthcare arena that we as a society ought to address?

 

Yes, the gov't needs to bus lardasses up to the Mt. Si trailhead every weekend, and force them up and down the hill with an R.Lee Ermey style "motivational speaker" on their heels.

 

all right smartypants, who is going to pay for the fuel, the drivers, the 'motivational speaker' and the wear and tear from hauling all those fat bums around? my tax dollars? are you kidding?

 

I've got you pegged, friend, you're a commie, pinko, socialist douchebag aren't you! I knew it all along. You Obamalama lover. You're just a sheep in wolf's clothing.

 

go sell your commie, pinko schemes somewhere else, buddy, like Cuba or something. Why don't you smoke Fidel's cigar while you're there.

[Stefan]

If America is so great, how come I get this 100% common answer from so many foreigners who I pose this question:

 

Q: Would you want the American health care system in your country?

 

A: No.