Anyone ElseTerrified about Repeal of ACA Bill
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VR, a lot of people don't have one thousand for a hip replacement. You, like me, are among the lucky ones who do. Btw, I've had two hip replacements and didn't pay anything under our BC/BS insurance. Anyway, low income people would definitely be better off waiting 6 months for a hip replacement, than not getting one at all.
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voraciousreader, the same thing happened to us in reference to our health ins. under ACA. That's enough for me to be against it and I'm also just cantankerous enough to get upset when the govt tells me I have to buy a product under penalty if I don't. That's another matter though and I think the penalty has been removed now. The main thing is the huge increase in costs and the reduction in coverage and the insurance company getting the power to choose my doctor and then overrule my doctor's choices as to tests and some prescriptions. For example, last year my husband's cardiologist prescribed a med for his heart rhythm immediately following a heart procedure. The insurance co said no. Guess what they "approved" in it's place? Ibuprofen!! OMG. No thanks, ACA. I am also not against everyone having health insurance but I wonder how it would be paid and I don't think politicians will ever get it right. I'm interested to read this thread and send only best wishes to all regardless of our various views on this subject.
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Pup... I went to urgent care because I was deathly ill from pain medication. I could not survive on high does of pain medication. I am sure most people would want surgery in a timely fashion and pay as little as possible. There is no perfect world. But the downside of Universal healthcare is too steep of a hill to tumble down when you consider all that is at stake....
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VR, people's lives are at stake. My DH and I are perfectly fine with paying higher taxes to guarantee health care for all. My guess is that people would pay less in taxes than what most of us currently pay for insurance. Not trying to get into a fight here, we just have different opinions.
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It oftens takes me about three to six months to get in to see a specialist with my current health care provider, and I have a PPO. When I had an HMO, my PCP would often be double booked three weeks out. I think many Americans, even before the ACA, experienced wait times that do not differ significantly than the wait times many Canadians experience. There seems to be a lot of variation in wait times in both the U.S. and Canada.
However it is my understanding that in both Canada, and some other countries with universal health care, people still have the option of private insurance or paying out of pocket, and I've learned that in many instances, when many of my European friends say they cannot get a particular medication in their country, or see a particular doctor, what they mean is they can't do so unless they pay out of pocket, and in many of these instances, the out of pocket expense has turned out to be not beyond their means, but they object on ideological grounds. But in any case, the fee is usually less than I pay out of pocket, and with health insurance here in the U.S.
For a disorder I have, it's a 4 to 6 month wait to see the specialist, and on top of my $600+ premium I pay a $45 co pay, a few hundred ofvthe $600 bill, my medication was $60 and then I had to pay another $30 to have it repackaged in to smaller capsules at a compounding pharmacy.
My friend in Europe waits three weeks, has no premium or out of pocket expense, finds out the medication is not on the list of covered medications for her country, and spends another three weeks lamenting about this fact before she forks over $30 out of pocket for it.
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pup...lives at stake.....fearmongering, emotions and nobleness does not lend legitimacy to such a complex issue. Let’s be clear, many struggle to pay taxes, make a living, and pay for healthcare...and the biggest struggle for all is .... TRYING to maintaining good health as we age....
Also...for all you sisters comparing European countries with ours....remember we have hundreds more millions citizens than most countries and close to an additional 30-40 more million illegals who we must care for. So be careful with your comparisons....
And remember what I said earlier....do you want the government’s policies guiding your treatments? If so, then most 40-50 year old women who are at average risk of breast cancer would more likely not qualify for mammograms and once they hit 50, they would only get mammograms every other year because that’s what the American guidelines call for. That recommendation also holds true for Canada and Europe.....soooooo...be careful for what you wish for.....
https://en.m.wikipedia.org/wiki/United_States_Preventive_Services_Task_Force
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Amazingly, the US spends significantly more on health care than 10 other index high income countries and is ranked 11th or last in quality. Those other 10 countries have universal health care. We in the US have pharmaceutical and insurance companies lobbying congress to keep prices high. Our approximately 12 mil undocumented aliens work and pay taxes but are not eligible for sponsored health care; but also cannot be thrown out of the ER for an emergency for which Medicaid pays.
https://www.iflscience.com/health-and-medicine/whe...
https://www.newsweek.com/united-states-health-care...
A preventive medicine task force recommended biennial mammograms for some women, a move that every cancer society refuted and which the ACA, insurance companies and most doctors disregard. As it was only a recommendation... My own doctor said all his ladies ages 40-forever get annuals and insurance pays it.
https://www.factcheck.org/2013/10/aca-doesnt-restr...
It seems only fair that we have the same healthcare benefits as those representing us in congress. If we did, we'd all have some mighty fine insurance!
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murph....American organizations refuted those recommendations. However, those recommendations are followed in those other European countries and Canada. Mind you, we have the same breast cancer mortality rates as those countries. In fact, the money that is now used for that unnecessary screening could be used for cancer research. But that will never happen because no politician and few clinicians will be brave enough to suggest it. And, I will also say that much of the population based screening that does take place does not save as many lives as we were led to believe. I will say it again...most of the population based screening that is done does not save as many lives as we told to believe. Population based colon screening saves many more lives than population based breast cancer screening. Diagnostic breast cancer screening saves many more lives than population based breast cancer screening. Radiologist daniel kopans will disagree. But more and more studies are showing that population based breast cancer screening has not saved as many lives as previously believed....and, with better treatments, thanks to research, we are seeing better mortality rates. Sadly, the one group that needs our attention are women under 40. Their breast cancers tend to be most aggressive and mammography isn’t effective in finding their breast cancers unless it is diagnostic and not population based.
So....with all the wasted dollars on screening, don’t you think we owe it to ourselves to base our decisions on FACTS and not EMOTIONS? There are a few brave doctors who speak out, but they are not being heard loud enough! We deserve better screening methods. On the horizon is genetic testing that will tell us who is at increased risk so that they will get more and perhaps better imaging and other modalities of screening.
Our lives ARE at stake. Our country spends a lot of money on healthcare....but the question that deserves an answer is ...who is in charge of the narrative and are we getting the right story so we can make more informed decisions about our healthcae?
And 12 million illegals? No one knows the correct number. I have heard as high as 35 million. And if you can’t gauge the correct number, how do you know how much they are paying in taxes.....and, how much are they sending abroad that isn’t getting taxed? And, how much are we the taxpayers spending for their healthcare? Murphy....if you have exact numbers, I can share with you the phone number of the Internal Revenue Service because they would love to know who those “undocumented” people are....And then we can have a real discussion about how to address their healthcare expenses....
I am not trying to be snarky. But if it is one thing that I have learned from my cancer journey is that the more I have learned, the less I know, and, there will always be more to learn..
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Breast cancer screening
https://www.sciencedaily.com/releases/2018/09/180912133536.htm
http://www.hkmj.org/abstracts/v24n2/166.htm
And the number of illegals:
http://www.cairco.org/issues/how-many-illegal-aliens-reside-united-states
And most recent study from Stanford/ MIT
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201193
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I have had Medicaid, an HMO and a PPO and I don’t see a difference between my treatment being guided by a corporation and my treatment being guided by the government in terms of gate keeping. The HMO was actually worse than the Medicaid because, aside from the fact I paid for it in a conventional sense, they often denied my requests to go outside of my PCP and were very opaque. I really never knew if I would get the care I needed or not until the doctor requested authorization, if the doctor even bothered to do so. Medicaid was much more predictable and transparent. My PPO is somewhere in between, but in all of these instances, my healthcare is ultimately policy driven, rather than completely personalized to what is best for me, and if I want a treatment that my insurance company, whether it be an HMO, PPO, or the government won’t pay for, I have to pay out of pocket.
I was aware that the U.S. and Canada have similar breast cancer mortality rates. But if, in Canada, women under 50 cannot get screening mammograms, with roughly equal mortality rates, then either women in Canada are being diagnosed at more advanced stages and Canada does a better job at keeping women with breast cancer alive, or screening mammograms in women under 50 are not detecting breast cancers....or rather, maybe the radiologists who read them aren’t.
Or maybe breast cancer is a qualifying condition for medicare after a person exhausts their resources. I’m not really sure but I know that people suffer with treatable, debilitating health problems or die due to lack of health care in the U.S. more than in any other first world country with universal health care.
I think a lot of the resistance to universal health care in the U.S. has it’s roots in McCarthyism and ideologies that stress self sufficiency, combined with not unreasonable fear of change.
I think if universal health care had been implemented in the U.S. around the same time it was in the U.K., and most Americans had grown up with it, people from both sides of the political spectrum would see it no less of a fundamental part of our society than those in countries that have it today do. Maybe there is some alternate universe out there where we have universal health care but not tax payer funded compulsory education, and it’s compulsory education that is the hot topic that has people at odds for many of the same reasons that universal health care does.
Anyway no offense intended to anyone but I think the issue of illegal immigrants with respect to universal health care is a red herring because access to it would have to be by authorization of the government, and most governments in countries with universal health care restrict access to citizens and legal residents. There is no reason that ours can’t do the same. My brother had to pay out of pocket to get treated for a sinus infection in France. It cost him $25.
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w....the argument with respect to screening mammography for women between 40 and 50 stems from the number crunchers who say mammography has difficulty spotting breast cancer in that cohort because their breasts are denser. If you would like to read more in simplier terms, a great place to start is reading American Cancer Society’ Chief Medical Director, Odis Brawley, MD’s book, How We Do Harm. I have a profound respect for him because when the American Cancer Society decided to to update their recommendation, the proverbial you know what hit the fan. So, their current recommendation is slightly more conservative than the rest of the usual American Organizations....they tried to take a higher ground and recommend screening mammos at 45 based on risk....so, I pretty much stand by my statements about the American recommendations....they are less grounded in science than other European countries and Canada
There are so many reasons why we have not adopted a more socialized way of offering medicine in America. Separating the delivery and expense of healthcare with conducting capitalism is the root of the so called “problem.” I will not debate that issue here because there is no middle ground. You will have liberals lining up saying it is our ethical responsibility to take care of all of our citizens and undocumented people regardless of cost and conservatives will say that thwarting capitalism will destroy the rest of the globe because US businesses are the backbone of medical innovation and discoveries....
And I just want to put out here the fact that I am a literacy volunteer. Our state funded organization, backed by donations, serves documented and undocumented people. When people show up at our doorstep, we make no distinction nor do we ask a person their status. Not only do I work with people for whom English is a second language, I also advocate for reasonable accomodations to make everyday instructions more understandable for them.
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@ Voraciousreader
I am not sure where you got your number of illegal immigrants living in the US from but it is greatly overstated: we have around 11 million per the Department of Homeland Security assessment, not 30-40 million as you stated above : Illegal Immigration Statistics
Another quick comment: you can't compare the efficiency of colonoscopies and screening mammograms. Margin of errors are different (due to technology limitations) and the underlying diseases are different too: removing a polyp even cancerous results in fewer recurrences than removing BC, even early stage. One can look at it from a different angle too: colonoscopy cost vs screening mammo cost. Big difference, and even if screening mammos save fewer lives than we would like them to I bet the efficiency of this low cost procedure is pretty high (if measured by $$ spent per person or similar.)
Just thinking aloud...
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voraciousreader:
The radiologist failed to spot my own cancer on the mammogram the first time it was imaged when I was 36. I really needed an MRI or to have the lump biopsied.
I think it's great that you are a literacy volunteer. I have often thought about volunteering at an adult literacy program but I'm not sure I would be very good at teaching someone who struggles with reading to read as learning to read was very easy for me and I am not sure that I would be able to approach the subject from the perspective of someone who struggles with it unless they were illiterate due to merely having had a poor education.
I used to tutor mathematics though. I struggled with arithmetic in elementary school so I understand the obstacles that many people who struggle with mathematics have.
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muska....look at the most recent Stanford/ MIT study. Documenting the undocumented is difficult to do. Think about it.....
Colonoscopy is a very effective screening program because it identifies and rids the body of masses that could become cancerous.
If you read about the population based breast cancer screening program, you will see where there is controversy.
While the link below is old, it gives a very good outline of the controversies...
http://journals.sagepub.com/doi/pdf/10.1177/1534735410384859
W....my mammogram missed my lump. A sonogram showed it for three years before it was biopsied. It was mistaken for a cyst. My type of cancer, mucinous, is often mistaken for cysts and often don't appear onmammograms....
Literacy volunteer...all I will say is that it has eniched my life more than my students will ever know. I have learned so much from all of them. What they all share is boundless joy in reading and THINKING. They are the most motivated people I have ever known. They have even taught me to think more clearly. Recently, I read an article about aging and the mind. It went on to mention how becoming a literacy volunteer might improve memory over time. I do feel from my years of being challenged by this select group of people that it is helping my memory....I will let you know in another 30 years when I hopefully reach my mid 90s!
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I am so discouraged. I was just shopping for a policy and anticipate making $5000 more than last year. I was horrified to see the rates and don't know if everything has gone up or if that 5 grand threw me into a different bracket, but that pay increase is eaten up by increase in my co-pays, deductibles and my max out of pocket is exorbitant. I am getting now where and in truth I was better off on Medicaid and public assistance. So I will have insurance but won't be able to afford to use it. I am so upset.
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Not Broken - that stinks. Health care has now become a luxury and a necessity.
Our deductible is $5k too. We met that in 2 months after I was DX so by the time I had radiation some months later we were covered at 100%. Thank God for that because we couldn't have afforded it.
How reprehensible is that we have this insidious disease and have to go bankrupt to keep it at bay. There's something seriously wrong with that.
There was an article in our local paper about a 30 something year old who had metastatic BC from the onset. She got involved in a new treatment that costs $17k a month for meds and insurance won't pay for it. OMG what is she supposed to do? She has a young daughter.
I wish the focus for BC was how to flipping pay for the treatments and meds. Stage IV ladies have posted they have emptied their bank accounts and eaten up their savings just to afford them.
Diane
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edwards, good healthcare has DEFINATELY become a luxury. I know I am due for an MRI to rule out possible, though unlikely adrenal cancer, plus testing for another problem. I would hate to spend thousands of dollars that I don't have only to find out false alarm and all is well, and yet what if I don't do the testing and this is a serious problem that should have been addressed? The silver plans on the ACA are more like catastrophic but the gold plan's premiums are so high that it all evens out and neither is a viable solution. I am not sure how to proceed but gotta say I am stressing. At least under Medicare our preexisting conditions won't be an issue but I have to wonder if Medicare is all I hoped it would be. I suspect the rates of Medicare and the cost of supplemental gets expensive and then the deductable and other expenses, and clearly that program is being challenged and cuts are coming.
Years ago when I had a Cadillac plan I did not need it and was young and healthy, yet every time we got a wage increase all or most of it went into the healthcare program. There are no easy solutions here but something has to be done. I worry about the generations going forward with this system that continues to crumble. Let us just pray for good health going forward. Best wishes.
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You are in a almost no win predicament. If you don’t you may wish you had and if you do and it’s all clear which is good you will have invested $ you could use elsewhere.
I have Medicare as a secondary because my husband has BC/BS coverage. I do know people who have Medicare and that includes my sister and BIL. They have a supplement. You definitely need one with Medicare since they don’t pay 100%. I’m not sure how much they pay for that but whatever it is helps with the skyrocketing health costs.
I wish you luck.
Diane
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Oct 30, 2018 11:51AM pupmom wrote:
VR, people's lives are at stake. My DH and I are perfectly fine with paying higher taxes to guarantee health care for all. My guess is that people would pay less in taxes than what most of us currently pay for insurance. Not trying to get into a fight here, we just have different opinions.
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Icietla writes in agreement with pupmom:
https://www.youtube.com/watch?v=iPDl9yKSnDE
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icietla,
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people’s lives are at stake amd that’s why we need better healthcare for those in the individual marketplace...and for EVERYONE else!
Dr. Brawley’s book, How WE do Harm, is predicated on the assumption that the problem with providing healthcare is multifaceted....
“How We Do Harm exposes the underbelly of healthcare today—the overtreatment of the rich, the under treatment of the poor, the financial conflicts of interest that determine the care that physicians' provide, insurance companies that don't demand the best (or even the least expensive) care, and pharmaceutical companies concerned with selling drugs, regardless of whether they improve health or do harm.“
https://books.google.com/books/about/How_We_Do_Harm.html?id=mvUtwZlU6ksC&source=kp_book_description
Rather than approach this complex problem from an emotional level....perhaps it is time to understand the problems from a logical position and then, and only then, we can we come up with a rational solution.
We all deserve better....
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btw....Dr. Brawley’s book begins with a patient who enters a public hospital with her breast in a paper bag. He was ANGRY and wondered how, in an industrialized, RICH,country, this could ever happen!
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"My guess is that people would pay less in taxes than what most of us currently pay for insurance."
Yes, true for some people, but...
...What about the 56% of the population who get their coverage through their employer? These people aren't paying out-of-pocket for health insurance. However with 'medicare for all', they will lose their current gold-plated employer healthcare plans, and see a significant tax increase to cover the cost of government healthcare. Will they see an equivalent wage increase from their employers, who will no longer be providing healthcare coverage? Sure they will. 🙄
...What about the 47% of the population who currently pay no income tax? Yes, most do pay payroll tax, but how much of a payroll tax deduction can they tolerate? Would it be enough to cover even a fraction of the cost of healthcare? Not a chance.
I'm Canadian. I support universal healthcare. I wish the U.S. had universal healthcare.
But here's the dirty secret. Canada - and probably many other countries with universal healthcare - doesn't have enough money to provide the care necessary to the increasing and aging population. So the government is cutting back on what they pay for.
When I was diagnosed with breast cancer 13 years ago, my care was exceptional. My screenings for the first few years that followed were excellent. But over the years, I've seen the level of care degrade. Tests that used to be readily available and automatically ordered, suddenly aren't (breast MRIs, for example). Why is that? Government guidelines for various tests and procedures have been tightened up, and while doctors have always had the discretion to prescribe whatever tests and treatments they felt were best, now in certain cases doctors are being measured on and penalized for the number of exceptions they make. So naturally they are choosing to make fewer exceptions.
Here in Ontario, my universal healthcare doesn't include dental care, doesn't include vision care, doesn't include drug coverage except for drugs administered in hospital (and then, only those drugs that are listed in the formulary, which is just a subset of all the drugs that have been approved by Health Canada and doesn't include most recently approved drugs). And it's getting more difficult to get access to tests and procedures that are covered. (Note that coverage is broader for children and seniors.)
Canada has had universal healthcare for 50 years. Every baby boomer has been paying into the system through their taxes for their entire working lives; I've been paying higher taxes than the average American for 40+ years. Most of us barely used the healthcare system for the first 30 to 40 years that we were paying in. And yet despite this, despite all the years the government has collected taxes for this program, despite the fact that our healthcare costs are tightly managed and are significantly lower than the costs in the U.S., despite the fact that there is so much that isn't covered, there still is not enough money. As a result, we are seeing cutbacks and degradation in care. I am still grateful that I live in Canada and have healthcare coverage, but I am worried about what the future holds.
Given what's happening in Canada, I don't see how in the world the U.S. will be able to provide full healthcare coverage to all citizens, 'medicare for all', if the government just starts to collect money into the pot now. If the math doesn't work for Canada after collecting taxes for 50 years, how can it work for the U.S. collecting taxes for 1 year? How can it work when you won't be able to collect nearly enough taxes from a large portion of your population? How do you make it acceptable to take away gold-plated employer plans from over 1/2 of the population, to move these individuals to the government program? How do you dismantle the massive insurance industry?
As an outside observer, I'd say that there has been too much focus and too much arguing about what works in other countries, without considering the very different situation the U.S. is in today vs. those countries when they started their programs decades ago. The fact that universal healthcare is moderately successful in Canada (or pick any other country in the world), doesn't mean that the U.S. can drop the same system into the U.S. today and it will be successful. The fact that countries with universal healthcare spend so much less per capita than the U.S. doesn't mean that costs will drop to similar levels in the U.S. with the implementation of universal health care. The healthcare infrastructure in the U.S. today is nothing like what these other countries have built up over 40 or 50 years. If the U.S. had implemented universal health care in 1968, as Canada did, it might be working great today. If the U.S. had adopted universal health care in 1993, when HillaryCare was proposed, even then it would have been difficult to implement, but after a bit of pain, you might have a viable program today. But how do you start from scratch today and suddenly and instantaneously cover everyone for everything? The math doesn't work. Catastrophic coverage only, with a modest tax increase? That might work, but it wouldn't eliminate the need for insurance, so I doubt that would be acceptable.
The U.S. needs a better health care system. You need to find a way to ensure that everyone is covered. I think most people on both sides of the political spectrum want that. The disagreement is in how it's done. The current system doesn't work for too many people and those people should not be criticized for saying so. 'Medicare for all' is a great campaign slogan but is unrealistic, at least in the short-term. It would be nice if rather than argue and name-call, the two sides would work together to figure this out. Start from scratch thinking. Unfortunately, no matter who the winners are on Tuesday, I can't see that happening.
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Beesie,
Great info...a very rational, thought out perspective. I think you and voraciousreader should get together and actually lay out a plan, then lobby the heck out of it to Congress. You both are so grounded, well-read and are critical thinkers I really think you could figure this mess out. ☺️
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Universal health care aside, the cost of health care in the U.S. is greatly and unnecessarily inflated.
Why should an ear exam cost close to $600?
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My DH has the gold plated health insurance coverage from his job. It’s BC/BS. While our deductible is high - $5k with the escalating costs for tests and meds it’s not far fetched that we can and have met that deductible in a few short months. Since my husband is an associate his monthly insurance payment is greatly reduced plus he has long term care, life insurance and accidental death coverage as well. The long term care will expire when he retires. We have supplemental coverage for life insurance and accidental death.
Even with all of this coverage we still had to buzz saw through our flex plan of $2500 yearly to cover out of pocket expenses. For instance BC/BS doesn’t cover surgeries for skin cancer something my husband has had to deal with multiple times. He framed houses when he was in college to pay for tuition. No one cautioned us about the effects of sun exposure back in the day. It cost us several thousand for his surgeries.
My BC treatment was costly like everyone else’s was.We reached our deductible just in time for my 33 radiation treatments. Thank goodness for that. I don’t know how we would have afforded it had it not been for insurance.
There are no easy answers to the health care crisis. I worry about my children and grandchildren and how they will be able to afford it.
Diane
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So many of you are very knowledgeable about this issue but as for me I can only speak about my personal experiences. I have found that when I paid cash for my meds it is cheaper than what my insurance had paid. My son does not have coverage and when he pays cash to our PCP he is charged less. My mother on Medicare is billed at complex level for a quick 5 minute visit and my son paying cash was billed by the same doctor as a simple visit and charged far less for more complicated issues. Those with insurance ultimately absorb much of the cost for those that do not have. And what about the very poor? Again our hospitals absorb these expenses never mind all the middle income who end up bankrupt and ultimately can't pay their bills. That too is passed on to those with insurance. Also our hospitals all have programs for those who income qualify and are uninsured or underinsured. So who pays for that? Guess.
I invest in pharmaceutical companies and because the other countries with universal healthcare won't pay the high cost of drugs they are discounted while the insurance companies here absorb the cost. That is a known fact. The system is very lopsided and again this country ends up paying for the research and development for the cost ultimately to be passed on to OUR healthcare system. I don't know if Medicare for all is the answer but can we at least make some small changes in the right direction? The system is imploding under the weight. Something needs to be done ASAP.
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Sorry if I sounded witchy but I am so very disgusted and worn out from the worry. Why can't this country take care of our own instead of worrying about the whole world? And I just can't help but believe that by cutting out the middle man that costs would go down. Ugh...OK, I am done with my whining. I just hope that those smarter than I can come up with some solutions. That is why we elect them to office. Get out and vote for whoever you believe can serve best.
Stay healthy my friends.
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NotBroken, I agree with everything you said, very articulately, btw. Election polls indicate that health care is the #1 concern of Americans. Hopefully, tomorrow will usher in something better than what we have now.
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NotBrokenJustBent:
My health care provider does not reduce rates for the uninsured. That is how I was billed almost $600 to have someone look in my ear. They forgot to run my insurance. This was not at my usual branch, which charges $300, but it was the same provider. The hospital in my area also does not take medicaid and does not get many low income individuals compared to the other hospitals in the area and is still pretty pricey.
I would like to imagine there was some particularly good reason for this...that it is humanitarian or out of some type of necessity...I am sure there is at some health care facilities, but I've looked in to it and at my facility it really just seems to be profit driven on the part of the administration, and while they pay their doctors and medical staff well, and do have nice facilities, what they do with the remainder of the money is a little dubious.
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