cyclezealot

Better read the small print first. Many, many policy holders learn the hard way what coverages they don't have.Those alone can bring on bankruptcy. We are lucky in that we've been given a visa that allows us to buy into the French national plan, while in the EU.. No deductibles. 3 euros for Dr visits, and medications. No worries about what is not covered. You'll find Doctors will even force you to sign a statement should you demand to go home early from Hospital stays; because you have refused his/her recommended treatment. ( Some don't want to be in a hospital for a prescribed stay.?) The cost for all this. 160 euros a month for two.. Depending upon income. what. about 1/10 th US costs for undetermined coverages. .. Should you have needed hospitalization. You need come to the EU. We discovered a whole week in the hospital along with surgeon's fees was only 1600 dollars. Maybe less than the cost of your deductible.?.. Your trip to the EU, even without insurance might prevent you from going bankrupt. Bring your bike.

Retro Grouch 

Please don't take this wrong because I certainly don't intend it that way. There are actually 2, quite different, different concepts of health care financing.

Ultimately, somebody is paying for every health care procedure, doctor visit, etc. The American, stand on your own two feet model, is that everybody should pay for their own. That's what a pure insurance program is. Everybody ultimately pays into a pool that pays their health care costs plus an administration fee. The folks who have big health care hits and can't pay their own are actually covered by people whose health care costs are more modest. That model works well for shipwrecks and auto insurance where claims are rare but relatively large and unaffordable. Not so good for frequent claims because, besides the actual claim cost, there is also the administrative fee that has to be paid.

The second concept is that health care is so important that a benevolent government should assure it's availablity for all residents. Crazy as this may sound to many in the United States, we actually do that in other areas. In the early days of the Republic, fire insurance companies financed their own fire fighters. If your burning house didn't have a cast iron "Fire Mark" sign showing that you were an insurance member, the fire fighters might show up but not attempt to save your house. I'm glad that we got away from that but I wonder how the arguments for and against sounded at that time.

Most of the developed world, minus the US, follows the second model. I think that's because the first model is too mean spirited for words. People who have serious chronic health problems are simply unprofitable for any insurance company to insure so, whenever it's legal, they are excluded by the underwriters. Heart disease, the most common way to die, can run up a hundred thousand dollers in ER and CCU charges in a flash. Even if you have insurance that pays 80%, your share comes to $20,000 plus, of course, the 40% insurance administration fee that's buried in there somewhere. Is it any wonder that health care costs are a major cause of personal bankruptcies. Guess who pays for the hospital services (plus administration costs) when patients default? We all do anyway. I wonder how much, if any money, we're actually saveing.

It hurts us in the global economy too. Manufacturers in the United States have to compete with factories in other countries that don't have to finance their worker's health costs. In effect, those factories are comparatively subsidized by the other governments. Our manufacturers aren't doing so well these days and it's hurting our overall economy.

I've come to the conslusion that a single payer system that covers everybody is the only one that makes sense today. It looks to me like the best solution to this mess is to reduce overall health care costs. The quickest, most efficient way to do that is to work to minimize the administrative burden. That's the seldom mentioned benefit of a single payer program.

DnvrFox

All you wonderfully healthy people who are so proud of your life's decisions just need to take one fall on ice andor be in a car wreck and break your neck at C-4, C-5 and become paralyzed from the shoulder's down.

Then all your pride and smugness and how great you are will absolutely vaporize as you face the prospect of months on so-called "rehab," $18,000 wheelchairs, providing aides the rest of your life, etc., etc.

Or, see that brown spot on your skin? That's melanoma. You are going to die soon without some pretty good treatment. Which among you will volunteer to die first?

Do you have any clue at all what melanoma treatment costs?

"Pride goeth before a fall."

You make me sick!

Retro Grouch 

"Fire Department. What do I need a fire department for? I've never had to call the fire department."

John E

Spot-on, Denver.

Bad things sometimes do happen to good people, and that is why all of us need at least some sort of high-deductible catastrophic medical insurance. The flip side is that I resent paying for expensive, extensive, extended health care for folks who have abused their bodies for decades and are now reaping the rewards of diabetes and heart disease, and I question the wisdom of throwing tons of resources at prolonging the dying process instead of prolonging and improving quality of life.

John E

My mother died of MS-related complications at age 66. Since her mother and both grandmothers lived well into their 90s, her father to 88, and one of her grandfathers to 86 (when he was run over by a truck while walking to work), I figure MS shortened her life by about 30 years. Her mother-in-law, a Christian Scientist, repeatedly told her, "You can choose not to be sick," whereas her mother, a registered nurse, countered, "I have seen too many germs under the microscope not to be believe in them." My father had to fight continuously with his MacDonnell-Douglas [Boeing] group insurance provider to keep her covered.

We have also recently lost Sheldon Brown, one of the heroes of vintage bicycling, to MS, at the tender age of 63.

The theoretical purpose of insurance is, of course, to spread risk, but as long as insurance companies cherry-pick the healthiest individuals, I am not sure how we get there.

DnvrFox

The lack of good health habits is a societal problem far beyond the discussion of health insurance. When we have a society where folks are constantly bombarded by "super-size" and sugar-filled non-nutritious drinks and snacks are fed to and sold to kids in school, and where - and I have seen this in my own town - folks get in their cars to travel 3 houses down to another house to visit other folks, etc., etc., where folks opt to NOT stop smoking, etc., there simply is NOT an environment of healthfulness.

And. of course, I totally agree that prevention and good health education and habits need to be instilled at an early age.

Personally, I think that the "McDonald's" syndrome - the whole fast-food bit - has cost this nation billions in additional health care costs, and we are just starting to see those costs escalate even higher.

But, again, I believe this is a societal problem separate from the issue of health care coverage.

cyclezealot

Maybe a question to ask ourselves . When we loose our jobs. Maybe the insurance costs our employers have to bear, is a part of the reason we lost our job.

tulip

I'm all for living in the EU, but it's so darned hard to get a job over there! Believe me, I've tried. As I get older and my health insurance premiums rise, I can see a scenario in which I will move there eventually.

cyclezealot

.. Tulip. I meant maybe a medical vacation just might save an American from becoming homeless. Even without insurance. You'll of course have to pay out of pocket costs. But, that will be like 1/10 of US costs. Critics here say the system is so expensive , because its universal. If so, how come we find medical services here so cheap.?. Found out yesterday , why we feel doctor's appointments are so thorough.. By law, doctors must spend 20 minutes with a patient. They must give you what you pay for. GP's fees are limited to 22 euros for an office visit. The SAMU doctor will make a house call , for the uninsured , ( if necessary !) for 45 euros. Of course, for those on the national plan. 3 euros. A House call.!. I understand if you have a retirement visa, you'll eventually qualify for the national plan. Retirement visas are not impossible to receive, with persistence. You must prove financial independence.

Rober

I am just amazed at some of the responses to this topic. I work with people daily who have been cherry-picked out of private insurance pools for chronic health problems, or have had certain medical conditions excluded from coverage because of "existing condition" clauses in group plans. Unbelievably, some honestly admit to chronic mental health problems on insurance applications and are excluded from anything even remotely statistically related to those problems, even though HIPAA confidentially protections prevent insurance companies from finding out that any mental health treatment was ever applied to the patient.
What shocks me here is the cold-hearted, socially negligent, and even selfish attitudes of some who seem to want to scape-goat the poor as the "cause" of corporate greed and parasitic profit taking, or hold themselves sanctimoniously superior to others because they are (for the moment) in good health. Believe me, a heart attack, a cancer, a serious injury, or even a broken bone is a quick trip to poverty for all but the most wealthy individuals in our country - especially for those over 50.
Equal distribution of the risks and costs of health care in our country is the only fix for our abysmally bad heath care "system." Now, I'm also much in favor of a "fat tax," but I agree - that's another topic entirely.

cyclezealot

Rober. I once read a news story. On Yahoo maybe. Because of strict bankruptcy laws in Utah. Once, a patient had a brain operation.. Because of Utah law, doctors feared the patient would not repay the bill. So, they did not return skull fragments, until the patient had the ability to pay.. So, until they had the cash , sorry- no skull.. had to wear a helmet. Don't know how it was resolved. Utah has one of the highest bankruptcy rates in the US. Most caused by medical expenses. Not joke.


..
In January, University of Utah hospital surgeons removed half the skull of Briana Lane, age 22 and unemployed, in order to save her life after an auto accident, but because putting the skull back in place was not quite an emergency, it was delayed by negotiations over cost. The skull remained in a freezer for three months, with Lane battling serious pain (and wearing a plastic helmet for protection, feeling her brain "shifting" on her) while the hospital negotiated with the state Medicaid office, which pays only for long-term "disabilities." Her skull was finally reattached on April 30. [Salt Lake Tribune-AP, 5-11-04]

https://www.abovetopsecret.com/forum/thread56834/pg1

howsteepisit

Great discussion all. My take on health insurance has totally reversed since I got married. My wife has bi-polar illness, and as a result of some of the medications ( at least partly, a know side effect) gained 100 pounds and will quite possible develop diabetes. She is uninsurable. I have had a long term diagnosis of major depression for which I was treated for years, turns out it was a thyroid problem, but until time passes far enough for some insurers I am uninsurable. I fortunately have insurance through my work. But I question why my employer should have to take on and pay for a "high risk" individual like myself. BTW in a year I have had 0 claims, but I am high risk.

All that being said, I also see that we have a social view that money should be no object in saving of a life. In the modern world I just do not think that's a realistic view, but if pressed to put a cap on how much we should spend to save an individual I sure cannot say. Given the high health care costs, and profit pressures on private insurers the only solution I see is a single payer system, that is government run. That or the is a huge pile of us that are just going to die younger than needed and have a poor quality of life because we are excluded from being able to insure ourselves either due to financial reasons, or health conditions, or poor personal choices. And its not possible to separate all of those, not all smoker die young, not all health food fanatics avoid cancer and heart disease.

Its a absolute mess.

ONe last thought that I think really drives peoples opinions on this - Do you believe heath care is a basic human right?

overthehillmedi

If the money converter that I just used is to be believed then E160 = US$205 = CDN$250,therefore,cyclezealots E160 would pay for over a years worth of premiums of my company subsidized retirement medical plans premiums. Even if I was paying the full pull,it would cover more than four and a half months worth of coverage.I hate to think what Bob Nichols US$1300 Blue Cross/Blue Shield premiums would cover.Enjoying my Universal medical plan all the more now.

Rober

[QUOTE=cyclezealot;8285762]Rober. I once read a news story. On Yahoo maybe. Because of strict bankruptcy laws in Utah. Once, a patient had a brain operation.. Because of Utah law, doctors feared the patient would not repay the bill. So, they did not return skull fragments, until the patient had the ability to pay.. So, until they had the cash , sorry- no skull.. had to wear a helmet. Don't know how it was resolved. Utah has one of the highest bankruptcy rates in the US. Most caused by medical expenses. Not joke.

I haven't heard of this, but it doesn't surprise me. Utah legislators like to scape-goat poor people too, and seem to think punishing people for being poor is justified. This is one of the brightest red states, after all. The high bankruptcy rate here is probably a factor of many socially ingrained behaviors, with over-population prominent among them. Families with 6, 8, and 10 children are common, and each child eventually creates another high-density family with all the expected purchases and debts. This practice is unsustainable and most often contributes to the cycle of poverty from which bankruptcies emerge. Image just two children in a family of 8 having chronic medical problems? This situation, coupled with one of the nation's lowest college graduation rates, essentially guarantees poverty and public resource dependence. Imagine also trying to sustain a family of 8 or 10 on two X-Mart level income and benefit plans? The whole thing is sad, mostly because it is so preventable.

(Edit - afterthought) People in Utah are also known for extreme deference to authority of all kinds. Doctors are seen as authority figures here, with high social status. Doctors will frequently "force-qualify" (use their social influence, authority, and "pull" in the welfare system) a patient who is living in poverty for Medicaid benefits in order that their medical bills be paid by the public at large. Hospitals and doctors are eventually willing to take Medicaid re-embursment rates as a "better than nothing" solution. But, of course, that is also a back door way of forcing the taxpayers to subsidize their losses. I wish the Canadians on this board would come down here on a mercy mission and show us how it is done! But, then again, we've done nothing but criticize Canadians out of envy for their genuinely fair and practical healthcare system.

Retro Grouch 

Sometimes they don't.

I used to be a safety consultant for an insurance company. As such I have interviewed hundreds of company personnel managers. Many admitted to trying to determine family and personal health situations with the aim of excluding prospects who they fear will run up their group health costs. They are prohibited by law from asking directly, but they can use any information that they acquire.

In other words, finding your next job may be more difficult.

bjjoondo 

Due having chronic Reiter's Syndrome, Bladder/Bowel problems, etc. I quite working as it was costing me $1000's of dollars a year in doctor vist's (4 or more specialist) and meds that had more side effects than you can imagine. I suffer quite a bit with a lot of pain and problems that can make life hell at times but I'm still better off in the long run. Yes, I would like to be able to see a doctor but simplely we can't afford it. When I did have insurance back 10 years ago, it was semi-affordable thru my wifes work but after a forced switch in insurance companies and since she only makes $25,000 a year, there's NO WAY we can afford the "$700.00 a month" that her current health insurance carrier want's to insure ME!!

I could work at a min. physcial job 4 hrs. a day MAX, that's as much as I can stand BUT there's no company that will insure a part-time worker, that I've looked into so I just take too many OTC pain meds and keep on struggling. I'm all for Socialized Meds, at least I could see a doctor, I don't care if he/she is not the top of their class at John Hopkins University!!

austropithicus

My point is that the prices have reached the point of diminishing returns. It's not worth it. You are better off saving that money for the day you do get sick.

Sorry to hear about your bad luck. Actually, I'm for universal care like the Canada and Europe. I've become cold hearted because the current system exists to create profit and does little to prevent illness. I don't like the current system and that's why I don't participate. Good luck to you.

100 years ago people died when these things happen. We can't all expect to live to be 85. Assisted suicide should be legalized. HTFU.

It's a right only if we make it one, just like all other rights. I think it should be but there needs to be limits. It's hard to argue that everyone is entitled to millions of dollars of life support. Someone has to pay.

Digital Gee

Whoa.

austropithicus

Don't you agree? I'm trying to be practical.

Rober

An Ethical Suicide Parlor would be cheaper to run than a trauma-rated, full-service hospital I guess. We wouldn't need as many medical schools either. Wow. What an idea.

Monoborracho

Austro...good to see you over in the old guys forums.

Gym memberships and organic foods aside, you will still be subject to the laws of probability that go with aging bodies. A bike accident, a torn-up knee, a child who is hurt in an accident, your wife having cancer...YOU having some life threatening disease. I don't know what your marital and family situation is, but at some point you won't want to bet your life savings, provided you have some, against a huge medical bill.

Retro Grouch 

Actually, that's a good point. Insurance companies don't generate wealth so every dollar they pay out in claims has to come from policyholders plus, of course, their 40% administration cost.

One way that insurance can help, however, is negotiating lower prices with providers - the PPO network. Back when most doctors were individual practices an individual could usually negotiate a lower price by simply offering to write a check on the spot. Today almost all doctors are part of some mega healthcare organization that doesn't negotiate with individuals.

The bottom line is, however you pay for it, Americans pay roughly double for health care as western Europeans. For that we get about the 25th best health care results. That's pityful! And don't blame malpractice claims either. First of all, the total amount paid out in malpractice claims is no where near enough to cover the difference in cost between the US and western Europe. Secondly, if we could improve our medical results to - say - fifteenth best, maybe the number of malpractice claims would go down.

If we were paying twice the price for crude oil you can bet our politicians would be finding a way to fix it.

Monoborracho

Okay all you regulars, let's just settle down. This topic is sucking in all the youngsters from over in the P&R forum. And they're not like us. They still know it all.

austropithicus

Aha, maybe that's why I am so flippant. I have no savings so I have nothing to lose.