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Mar 11, 2013

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Peggy Hickle

Having been uninsured for the last ten years - and periodically before that, I can tell you, it's pretty scary out there. I have found that doctors are pretty good at discounting fees because they actually have to look you in the eye. Hospitals are another story -- if you even get that far. Many of us in the subculture of the uninsured have simply stopped going to the doctor for fear that something unaffordable will be discovered or that we will have something recorded on our "permanent record" that will then become a pre-existing condition should we ever be able to afford health insurance.

Hartzman

"The state Medicaid program, which provides health coverage to the state’s poorest women and children, held over $132 million in bills it owed the federal government from last year;

this means the state General Fund needs to find up to $262 million by June 30 to cover Medicaid."

bizjournals .com
.
.
How much of the $262 million is going to come from local municipalities?

justcorbly

My experiences during the lengthy illnesses of both my parents ten years ago convinced me that no one in the mix polices or monitors the billing practices of anyone. Hospitals passed along charges from third-parties who, from a patient's point of view, were just hospital staffers. So, I'd ask the hospital, "What's this charge for?" They'd say, "It's not our charge. It's an independent contractor's charge." Typically, the contractor's answer was, "That's the charge we negotiated with the hospital. Talk to them."

The insurance companies were simply untruthful and abusive, often making decisions and altering treatment in direct opposition to the physicians' advice. Since the hospital wanted its money, the insurance company always won. (When doctors went head and did what they thought best, regardless of what the insurance company would cover, they found the insurance company had called the hospital to check on them.)

formerly gt

We've taken a bad system and made it worse. Every effort govt has made to provide "healthcare security" has only exacerbated the problem. business has done an equally poor job.

if we want the best care at the cheapest price, we need to dump the current system and redesign it. we need to uncouple HC from employment. we need to create incentives for people to shop for the best price/service. we need to protect people from catastrophic events. we need to inject competition. we need to create incentives for providers, especially hospitals, to be more efficient and customer friendly.

if we want to provide hc as a right, then let's do it. let's create govt hc. and let's make sure that it is properly regulated.

but we need to accept the fact that choices will be made, 85 year-olds may not have access to all the treatments that extend their lives because it's too expensive. a newborn with a costly defect may not be treated. and, if we cannot afford private treatment, we will live and die by these decisions.

we need to accept the fact that sharing the costs will give others/govt more control over how we live our lives. undesirable behaviors may be outlawed on the basis they are unhealthy.

we need to accept that politics, not science or a trusted physician's opinion may determine how some diseases or conditions are treated medically.

finally let's accept the fact that we will create two distinct classes for health coverage. the 1% will still be able to afford private hc, while the rest of us will get by on govt hc. our hospitals will look even more like the post office or a VA hospital than they do today.

we will not have hc equality. not everyone will have access to the mayo clinic, md anderson, duke or even chapel hill. and it may not cost us any less or provide any better outcomes than the current system or a different one.

(a side note about shopping around, when our cat needed to have it's leg amputated we found a vet to do it locally. It was $900 less than our vet in Greensboro wanted. three years later the cat is fine.

We also use one vet for vaccinations and another to treat illnesses and injury.)

Roch

"but we need to accept the fact that choices will be made, 85 year-olds may not have access to all the treatments that extend their lives because it's too expensive. a newborn with a costly defect may not be treated. and, if we cannot afford private treatment, we will live and die by these decisions. "

Hellllllo, McFly!

formerly gt

you doubt this?

David Wharton

Roch: it's called the Liverpool Care Pathway.

Roch

"you doubt this?"

Doubt it? No, seen it for decades. You are describing the state of health insurance well before "government health care."

polifrog
You are describing the state of health insurance well before "government health care."
Now, there's a myth.
Roch

David, while I find the Daily Mail an unimpeachable source, I think the most interesting story there now is: "Eight-year-old boy marries 61-year-old woman after 'dead ancestors told him to tie the knot'" followed closely by "What is wrong with Zooey Deschanel's eyelid?"

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