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sasvermont
06-28-2012, 04:48 PM
I suppose we could discuss this like adults.

I, for one, am happy to have access to health insurance and happy for anyone benefiting from coverage. I can't imagine not wanting coverage.

I know some folks are livid about having to have coverage or be taxed if they don't. Lots of loopholes, as I understand it. Aren't there always?

Anyone? Or is this just too upsetting.

Karen
06-28-2012, 05:11 PM
I do not know enough of the matter to generalize, although that does not seem to stop most TV commentators. It will be interesting to see how it plays out, particularly as, in Massachusetts, we have had the individual mandate for a while. I do not think it is either the end of civilization as we know it, or the answer to cure all ills, which is why I guess I'll never be a network anchor!

pomtzu
06-28-2012, 05:18 PM
I for one, don't understand how this land of the free, can force people to purchase healthcare, or be taxed. :mad: I suppose that there are many pros and cons to this plan, but I really can't comment, since I haven't read the proposal. A couple of pros tho: you cannot be denied coverage because of a pre-existing condition, and that there is no limit on lifetime benefits.
My insurance is in place, I don't have to worry about getting any different coverage, since I have Medicare and a supplemental plan, tho I don't know at this point what changes will be made to Medicare and if it will effect my supplemental plan as well.

kaycountrygal
06-28-2012, 05:33 PM
I am dubious re Obamacare. If I had my "druthers", I'd rather not have it... but I won't go bonkers about Supreme Court's ruling. I also do not know how it will affect my Medicare and supplemental. I think -not positive - that those of us on Medicare will eventually have less coverage; I might be wrong.

snakemama
06-28-2012, 05:40 PM
Since my husband needs coverage BADLY and we can't get it due to a pre-existing condition...I'm happy. We've called over 40 places trying to get help so that my hubby can get back on his meds...which run around $1300/month without insurance...and no luck.

momoffuzzyfaces
06-28-2012, 05:57 PM
One thing that concerns me is where do the illegals fit into all of this? All Americans will have to have insurance or pay a fine, so will we be still covering the illegals health care too? I am not against immagration as long as it's legal. We can't trust the US government to even control that. How can we trust them with our health coverage?

Frankly, it frighens me. :love:

sasvermont
06-28-2012, 06:24 PM
I have not a clue about illegal immigrants and how their health coverage claims get handled. Do they pay taxes? How can they if they don't have a ss#? or do they.

I know a few people who don't have insurance coverage because they just don't want any, believe it or not. They will have to pay a penalty for no coverage I just don't know how much that will be.

Having been a healthy younger person and now a "falling apart older person" I don't know what I would do without insurance. Hospital stays and proceedures are so expensive that without the coverage, I would be in the poorhouse.

Vermont has just begun the process of establishing an insurance exchange and has, as I mentioned in an ealier post, has great coverage for folks who don't make much money, income wise. They really look after the people living here. They also have Medicaid etc., but in general, Vermont government treats it's residents nicely. I think I will stay here.

I get it that people don't like to be TOLD what to do. Heck, you need to have car insurance to drive a car. You need a license to drive, too. Surprisingly enough, many people don't have either and get caught from time to time. Shame on them. I don't see why people would get worked into a lather about having to have health insurance coverage.

We shall see how this all falls out. November will be interesting.

Freedom
06-28-2012, 06:39 PM
I am not against immagration as long as it's legal.

Glad you said that. My Mum was born and raised in London during WW II. She lived here 42 years, always had a green card. For that generation of English, it was hard for them to even consider changing citizenship. Many did, but not as many as may have had they not lived through the Blitz. It always surprises me how many people don't distinguish; and since we grew up with it (my brother and I), it was normal for us.

Anyway, having pre existing condition and having stopped work (well, the company disappeared in a take over and we were all let go) about 14 years back, I've been on a self pay plan for years now. I don't dare let it lapse, I'd be in a huge mess. Now paying over $700 PER MONTH, I am in favor of a change that covers pre existing conditions. This doesn't mean I think Obamacare is perfect; but then, no law is. There are so many aspects to nation wide coverage.

snakemama
06-28-2012, 06:44 PM
This doesn't mean I think Obamacare is perfect; but then, no law is. There are so many aspects to nation wide coverage.

This. I keep thinking today, when I see the conflict popping up all over....don't let the perfect get in the way of the good.

RICHARD
06-28-2012, 06:54 PM
Again,

Hospitals can charge what they want for services rendered.

Medicine and implant companies can do the same

Insurance companies - no one talks about malpractice insurance - are out to make a buck or 10 billion.

-----------------------

"O" care is a joke.

The government needs to step in and

Limit what charges can be billed to a patient.

Again, I worked for a HMO for 30 years and if the prices that were charged when I stopped working are even 5% higher
some people are making a crapload of money.

---------------------

If you go for a hospital stay - heaven forbid - ask for an itemized bill and check to see what item/treatment you received and what you did not get.

Find out what a Diagnosis Related Group is and what the limits are for a stay for a specific illness.

To make billing easier, the hospital no longer went thru a chart to see what a patient used - either in treatments or supplies.

They use a computer program that compiles what is used in an operation or stay.

Every time a patient stays they use a template for what is used during an average stay. If you use more of the facilities/supplies, they enter that into a database.

So, that raises the average costing per stay, per patient.

That number increases the cost according to the template.

------------

That average stay cost is used to universally charge the insurance or bill the government.

So, if you go in for a headache and stay overnight?

They pull up the costs for that diagnosis and charge at whatever the template says.

It does not matter if you get one aspirin and are sent home or five aspirins, a CAT scan and a blood tests for that stay.

----------------

Another billing rule is in a DRG is that a physician can only treat you for so many days for that illness and be reimbursed. Otherwise the hospital eats the extra costs.

The physician has to sign an attestation when the stay is complete - that means that he states the illness and treatment days are correct. Otherwise he can be taken to court and fined.

----------------


I won't go into the cost of implants - pacemakers, sutures, ortho kits and stuff like that.


Healthcare costs can be reigned in by controling the cost of inventing, formulating and manufacturing med supplies.

Also, the costs involved in bring and defending against malpractice suits are crippling the people that medicine should be saving.

Edwina's Secretary
06-28-2012, 08:02 PM
This. I keep thinking today, when I see the conflict popping up all over....don't let the perfect get in the way of the good.

Well said! I am proud to think this nation will begin movement toward joining the rest of the western world in seeing healthcare as something you should not have to be rich to have.

Karen
06-28-2012, 08:42 PM
Immigration needs to be reformed. That is a separate issue than health care, although of course they overlap.

Right now, anyone who shows up in an Emergency Room with no insurance gets treated anyway, as it should be, but the costs get swallowed by the rest of us with insurance. It doesn't matter WHY the person has no insurance - whether they are here illegally, too poor to get insurance, unemployed and coverage ran out, just didn't buy insurance - it's all lumped into one category. If the law works the way it should, everyone here legally should have some sot of insurance coverage, as there will be subsidies for extremely low income people, etc. But having insurance will hopefully mean they will go to the doctor for preventative care, and not end up in the Emergency Room at all. A minor asthma attack, for example, is far cheaper to handle with medication at home when necessary, than waiting until it has escalated into a life-threatening condition requiring immediate treatment and days of hospitalization. That's one example I can speak to from personal experience, as a lifelong asthmatic.

Don't ask me about any other medical conditions, that's the one I know.

sasvermont
06-29-2012, 12:10 AM
I don't think hospitals should be for profit. They pay their presidents bundles of money, just like the other big corporations, sports players, tv personalities, and I could go on. How much money can these people possibly be worth. How much harder and better do they work than a teacher working with Autisic children, for example. It is all about money. Money, money, money. Hospitals are all about money now, not just about saving and treating people.

This whole world is going to hell in a handbasket. I need to go to bed. I am getting goofy.

Money, money, money.

RICHARD
06-29-2012, 05:42 AM
So, Riddle me this?

Basically, if a family of four that takes in, let's say 20K a year (THIS IS THEORETICAL) cannot afford MI, because they have to....

Pay rent,
Eat,
Cloth themselves
Pay for transportation and whatever basic living expenses they incur, MUST FACE A PENALTY LEVIED BY THE IRS and probably will have their tax returns docked or be subject to whatever kind of collection method the gov't. may choose to enforce?

Nice.

The people that Obama puts to work processing and going about setting up the system to catch the scofflaws who either won't or cannot afford MI will lower the unemployment rate and create a whole new office/system to complicate an already over-porked federal system.

-----------------------

By putting people into a hole - penalizing them for not being able to afford insurance -will make them less likely to be able to afford insurance in the future.

How the eff does that make sense?

Oh, wait.

If the prez says so, it must be good for everybody.:confused::eek:

sasvermont
06-29-2012, 07:42 AM
It's my undersranding that if your income is low, you will get a subsidy (much like I do right now in VT) from either your state of Federal government so that you can have insurance at a low, low cost. Does that make sense Richard. Low income = low payment.

I think a lot is going to be what your state decides to do and how much the Federal government will fund each state. Very confusing.

smokey the elder
06-29-2012, 08:05 AM
*tiptoes in* I read an opinion piece that the "penalty" is truly a tax, and listed as such in the actual Act. The opponents of "Obamacare" used the Commerce Clause. The Justices actually read the Act and recognized that the "penalty" was in fact a tax. Apparently (this is all according to the opinion piece), a number of attorneys filed an "amicus" (friend of the court) brief that suggested that since it was a tax, it was a straightforward case. However. Mr. President sort of shot himself in the foot by insisting that it was not a tax.

There's a lot to like about the ACA. But it has to be paid for somehow.

Full text of the opinion piece is here. http://www.cnn.com/2012/06/28/opinion/balkin-health-care/index.html?hpt=hp_c2

RICHARD
06-29-2012, 08:43 AM
I understand that there is a clause for low income purchases of coverage.

But, when you don't have the money to purchase that coverage?

I have had WONDERFUL HCC and I have been in a situation where I did not (I owe my life to the FINE doctors at the University of Louisville - I don't advocate almost dying to get good treatment.)

------------

I don't mean to make this sound dramatic.....

Most of us have never had to worry about pinching pennies to afford (Fill in the blank).

There is a car commercial where the spokesperson shows a gal who bought a new car and her insurance is affordable, so she doesn't have to eat "ramen noodles" every day.

There have been a few times where I had to make do with a few days of eating rice - not fun but it makes you really appreciate what you do and do not have.

--------------

When you have a light bill, gas, water, car insurance, mortgage, HOA fees and what else - where, if you do not have a job with bennies, are you going to cut to be able to afford coverage?

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I am not often "gobsmacked" or at a loss for words, but when I am, it's because of some thing I see in nature, in the sky or some other silly thing or event.

I drove thru Springfield MO and got lost trying to find my room for that night.

One of the reasons?

I turned onto a street and thought I was next to an airport - there were so many parking structures and signs I literally drove back and forth for about 40 minutes - why?

There wasn't an airplane in sight, but the street was literally filthy with hospitals and clinics.

I am used to seeing huge medical campuses, but this was like freaking Disneyland.

--------------

That got me to wonder where the money came from to build all these 'facilities'.....I think I figured it out.

The news/BS programs will set the tone for the election in November.

They have me scared.

I try to think about what will happen, with either candidate in office and I don't like it.

The biggest problem - and I'll scream it from the rooftops every chance I get - is there needs to be, not a health insurance overhaul, but an overhaul in the way treatment is developed, given and the ramifications of treatment that goes badly.

---------------

The last thing that limits the effectiveness of ANY TREATMENTS is the mindset of all the people who watch HOUSE or any other show about medicine.

We are a mindless group of people that think George Clooney will come and take our temperature, look in our eye or check our prostate.

He'll wink, write out a prescription and after the next commercial we'll be back in the office thanking him because he cured us.

Our mindset is that we don't need to do the preventive crap.

One hour, with commercial breaks, will get us back on track.

-----------

Hey, do me a favor, watch TV for one night and count all the commericals from lawyers who are looking for people
to joint a class action suit.

My favorite is the firm with the phone number that spells out "B-A-D-D-R-U-G"

Nice.:rolleyes:

Randi
06-29-2012, 08:52 AM
I don't know a whole lot about US healthcare, but what SAS and ES say, I agree with. In Denmark, healthcare is payed for over the tax, except going to the dentist. Just like anyone can use the road for free, or the library, anyone can get sick and in need of treatment at a hospital and that should be free - not just for rich people!

momcat
06-29-2012, 08:57 AM
I was 19 when my grandmother took me with her to Scotland, she was born there and went back to visit. While we were in Dundee, Grandma got sick. With my family half a world away I was scared out of my mind. The owner of the hotel we stayed in told me not to worry, he would get help. About an hour later there was a knock at our door, it was the doctor. She gave my grandmother a complete examination, determined the problem, and gave her medication. The doctor came every day to do another examination, give medication, and would sit with us for a while. On her day off, the doctor took me sight-seeing around the city. When Grandma was medically cleared to continue our trip, she asked the doctor about her fee; doctor said there is no fee; Grandma said "But I'm not a British subject"; the doctor said "It doesn't matter, that's how it is here."

All through the debates about "Obamacare" I couldn't help but think about our experience in Dundee. As for the ACA, I don't know how I feel about it. Required coverage for pre-existing conditions is a huge plus and it's something I'll be dealing with soon. Another positive is that kids are covered even with pre-existing conditions. Anything that helps seniors get to their doctors and stay on their prescriptions can only be a good thing. There are some very good provisions but one has got to be changed, this electronic medical records nonsense. This is priveledged information and emr is a direct and blatant violation of the Privacy Act and HIPPA. Let us decide if we want our records mistreated like this, DON"T SHOVE IT DOWN OUR THROATS!

I was surprised at the Supreme Court's decision on the ACA. Maybe now those in charge will start working out the bugs and refine all of the provisions so it will work effectively for everyone.

pomtzu
06-29-2012, 08:58 AM
So Joe Blow, who must now buy a policy because Uncle Sam says so, and he complies just to avoid being taxed -(which I heard is somewhere around $600+ per adult) - buys it even tho he doesn't want to buy it. He buys the cheapest coverage available, which of course probably has big co-pays and deductibles. Is he now going to run to his doctor since he has insurance, rather than use the ER instead? I doubt it - not when he can go to the ER and never have to pay, and the hospital is still stuck for what his paltry insurance doesn't pay. But of course, John Q Public will get stuck with his bill in the end, just as it always has - in the form of higher insurance premiums and medical costs in general. So what has been gained by Obama's plan??? - not much when you consider this scenario, anyway.

Any thoughts??? Maybe I'm just being dense.

I'm so glad I already have insurance!!!!!

RICHARD
06-29-2012, 10:21 AM
I was 19 when my grandmother took me with her to Scotland, she was born there and went back to visit. While we were in Dundee, Grandma got sick. With my family half a world away I was scared out of my mind. The owner of the hotel we stayed in told me not to worry, he would get help. About an hour later there was a knock at our door, it was the doctor. She gave my grandmother a complete examination, determined the problem, and gave her medication. The doctor came every day to do another examination, give medication, and would sit with us for a while. On her day off, the doctor took me sight-seeing around the city. When Grandma was medically cleared to continue our trip, she asked the doctor about her fee; doctor said there is no fee; Grandma said "But I'm not a British subject"; the doctor said "It doesn't matter, that's how it is here."

All through the debates about "Obamacare" I couldn't help but think about our experience in Dundee. As for the ACA, I don't know how I feel about it. Required coverage for pre-existing conditions is a huge plus and it's something I'll be dealing with soon. Another positive is that kids are covered even with pre-existing conditions. Anything that helps seniors get to their doctors and stay on their prescriptions can only be a good thing. There are some very good provisions but one has got to be changed, this electronic medical records nonsense. This is priveledged information and emr is a direct and blatant violation of the Privacy Act and HIPPA. Let us decide if we want our records mistreated like this, DON"T SHOVE IT DOWN OUR THROATS!

I was surprised at the Supreme Court's decision on the ACA. Maybe now those in charge will start working out the bugs and refine all of the provisions so it will work effectively for everyone.

I worked in a records dept for 13 years and while EMRs to have an up side?

The one that makes me laugh are the 'electric signature' options.

When a doc gets lazy and gives his nurse his password to help him get caught up on his paperwork?

What about hackers or when the system gets compromised?

That is another moneymaker for the companies that lobby in D.C.

------------------------------


Pom,

You are absolutely correct.

As long as there are no sweeping changes to the HC system, people are going to get screwed.

Karen
06-29-2012, 10:46 AM
So Joe Blow, who must now buy a policy because Uncle Sam says so, and he complies just to avoid being taxed -(which I heard is somewhere around $600+ per adult) - buys it even tho he doesn't want to buy it. He buys the cheapest coverage available, which of course probably has big co-pays and deductibles. Is he now going to run to his doctor since he has insurance, rather than use the ER instead? I doubt it - not when he can go to the ER and never have to pay, and the hospital is still stuck for what his paltry insurance doesn't pay. But of course, John Q Public will get stuck with his bill in the end, just as it always has - in the form of higher insurance premiums and medical costs in general. So what has been gained by Obama's plan??? - not much when you consider this scenario, anyway.

Any thoughts??? Maybe I'm just being dense.

I'm so glad I already have insurance!!!!!

From what I understand - which I emphasize is very little, as I have not read the bill, preventive care is usually covered without a co-pay. So why wouldn't he go to the doctor? The $600 figure, by the way, is not accurate, it's a sliding scale, depending on income up to a certain level.

pomtzu
06-29-2012, 11:12 AM
From what I understand - which I emphasize is very little, as I have not read the bill, preventive care is usually covered without a co-pay. So why wouldn't he go to the doctor? The $600 figure, by the way, is not accurate, it's a sliding scale, depending on income up to a certain level.

I'm just saying what I have read/heard so far, and you know what is said about that. Only believe half of what you see, and nothing of what you hear. And there is much more to go to a doctor for, other than preventive medicine. If every doctor visit was preventive, then no one would ever have to pay their doctor anything. And even if there is no co-pay, the deductible will kill you until that's been met.

Catty1
06-29-2012, 11:55 AM
In Canada public health is paid for through our taxes. I think there are still one or two provinces that charge an additional health care premium, which people under a certain income don't have to pay.

Just so I understand the new US health care - does that mean one still has to pay for government coverage? When we had premiums in Alberta I think the max for a family was under $200 monthly, but don't quote me on that.

cassiesmom
06-29-2012, 12:31 PM
The SCOTUS determined that the federal government couldn't require the states to expand Medicaid to help cover more people. I've read in the paper that with Illinois Medicaid, the system is so prone to fraud and abuse that large amounts of money are being lost that could be spent providing care. So in my mind, we're back to the same problem which is many, many uninsured and under-insured people.

momoffuzzyfaces
06-29-2012, 12:38 PM
One thing they really need to do is monitor the hospitals. I had to go in for an overnight procedure in 1999. I took my medicines with me like they told me to do. Then the stinkers gave me my own medicine and CHARGED ME FOR IT!!! (I had counted my pills and knew exactly how many I had) I called them out about it and they did finally take that charge off the bill. Still they wouldn't take the 10 dollars for a box of tissues I never touched off though. :eek:

pomtzu
06-29-2012, 12:41 PM
Just so I understand the new US health care - does that mean one still has to pay for government coverage? .

You bet. I'm over 65 and on government Medicare, and I'll continue to have to pay that. My concern is that Medicare will reduce what they now cover, which is far from everything now anyway, and most of what's paid, is only paid at 80% of the cost. That's where private supplemental insurance comes in - to help out with that other 20%. My supplemental policy is a high option one (you can get lesser coverage), and they pay everything that Medicare doesn't. Between the 2 insurances, I have never paid so much as one cent to any doctor, hospital, lab, etc, since I have had it. I do pay for any occasional prescriptions that I might need tho, since I don't carry that coverage, but I take nothing on a regular basis.

Cataholic
06-29-2012, 12:51 PM
Snakemama said it best, "don't let perfect get in the way of good".

Something has to be done to fix this healthcare mess. Perhaps by making the entire nation involved in it- willingly or not- we, as the populus, can bring the health insurance companies back into conformity. Healthcare belongs in the hands of the doctors/nurses/healthcare providers. Not the people with NO medical training, who get to decide that open heart surgery = 2.43 days, and 10 minutes is enough for a pediatric newborn visit. Health insurance (actually, ALL insurance) companies continue to return high profits, doing less with less. Right now, the population most greatly affected by no insurance (our lower income'd and seniors) have NO voice. They don't have insurance, they can't complain, switch insurance companies, make a difference, etc.

I pay $257 a month for family coverage, preventatives are 'free', and I have a $5000.00 deductible. Thank God I am healthy, and pray that J remains so, too. There has to be something 'better' than that. One trip to the ER would set me back tremendously. This isn't really a good plan. To get something more in line with reasonable, I would pay over $750 a month. I can't swing that. While I recognize the need for health insurance, I can't afford health insurance. What I have is a catastrophic type of coverage. $5000 deductible. :eek:

We all have to do things we don't like: pay taxes on schools we don't use, property tax when services aren't that great. Heck, I pay a 'stadium tax' to subsidize the sports arena here, and I have never seen a game! Car insurance, I pay it. Go to another state and I pay their sales tax. The list goes on. I have to wear a seat belt, my child needs to be properly restrained, too. My dog has to have a county tag, and sometimes I have to pay tolls on roads that I know have been paid off for eons! Not sure why THIS is such a sore spot with people.

Basic health care, to me, is a necessity. Not a luxury. Anyone going without has an effect on the entire system. While this might not be perfect, it is a good start.

sasvermont
06-29-2012, 01:32 PM
That is another sore subject and should be considered health insurance coverage. How can teeth, gums etc. not be related to one's health. Dentists in VT charge horribly high prices and live expensive existances as well. I don't mind people making money, but why SO much? Greed! And stupid consumers.

Someone mentioned that if we do enroll millions of new health insurance folks, we will have a long wait for a Dr. appt. So? I am sure an emergency would be just that. I should think the Dr.s would be thrilled to have more people to carve on or stick. And paying ones to boot!

I, too, think we will see this insurance tax evolve and hopefully be fair, available to all humans and cheap! :eek:

Catty1
06-29-2012, 02:04 PM
If the USA gets dental insurance you'll be way ahead of Canada! :(

smokey the elder
06-29-2012, 02:04 PM
In an ideal world, preventative care catches conditions before they cost six figures to treat and send one into bankruptcy. In the real world, a lot of people cannot afford this.

In an ideal world, doctors prescribe appropriate tests. In the real world, our litigious society almost forces MDs to prescribe the kitchen sink.

In an ideal world, Republicans and Democrats would have crafted the ACA together. In the real world, this didn't happen.

I can't help but think about the kerfuffle over Medicare Part D, aka Prescription Drug Coverage. The world was going to end then, according to certain pundits. As far as I can tell, it's still here.

Bottom line: let's give the ACA a chance to work before chucking it out.

pomtzu
06-29-2012, 02:11 PM
Me thinks this will be a very long thread.................:p

Cataholic
06-29-2012, 02:25 PM
In an ideal world, doctors prescribe appropriate tests. In the real world, our litigious society almost forces MDs to prescribe the kitchen sink.

Do you really believe that health care has gone to hell in a hand basket because of too many tests? How about the argument that doctors aren't allowed to practice medicine because of what the insurance company mandates?

To really get a good understanding of the "malpractice crisis", read this article.

http://www.rwjf.org/pr/synthesis/reports_and_briefs/pdf/no8_primer.pdf

Cataholic
06-29-2012, 02:27 PM
Me thinks this will be a very long thread.................:p

Someone on FB posted this picture of a guy with a microphone and the caption was, "Brace yourselves. Everyone on FB is about to become a constitutional scholar!"

Very funny. :)

pomtzu
06-29-2012, 02:32 PM
Do you really believe that health care has gone to hell in a hand basket because of too many tests?

Funny you should say that. There are many things I don't bring up with my PCP that maybe I should. Why??? - test-test-test - that's how he is. I have enough trouble without finding more that I wasn't expecting. :eek:

Grace
06-29-2012, 02:35 PM
Someone on FB posted this picture of a guy with a microphone and the caption was, "Brace yourselves. Everyone on FB is about to become a constitutional scholar!"

Very funny. :)

Here he is -
https://sphotos.xx.fbcdn.net/hphotos-ash3/523804_486466604712105_1558774557_n.jpg

Cataholic
06-29-2012, 02:39 PM
Thanks, Grace! I can't figure out how to post things on here...STILL!!

Lady's Human
06-29-2012, 02:55 PM
Do you really believe that health care has gone to hell in a hand basket because of too many tests? How about the argument that doctors aren't allowed to practice medicine because of what the insurance company mandates?


The problem is BOTH!

I had bloodwork done. The list of tests was rather long, and I asked the doc about it.

They are required to run tests for things they don't think are problems, because the group and the insurance company has given them basically a list of "if you test for this you have to test for this too" as a CYA.

What the doc wanted to test me for pinpointed the issue rather quickly. The rest were just additional cost for all.

Lady's Human
06-29-2012, 03:03 PM
My opinion on the whole medical system is that SOMETHING needs to be done, as it is unsustainable the way it currently stands.

What the something is, though, I'm not sure, besides the nagging feeling that this ain't it. I asked a Union rep well before the case was decided what this does to certain sections of our contract, as the contract defies part of the law. The response was "Oh, we didn't think about that". The law as it stands basically trashes one section of our CBA.

There are a myriad of issues with the current system, like treating emergency rooms as primary care offices, the billling and claims systems are a damned farce, the shell games in relation to contracting (doc A works out of hosp A, but isn't working for them, but a contract company, therefore all docs under the YZ name are PPOs for ABC ins. Co. is an expensive lie.....), and treating hospitals as nonprofits when they are very, very much for profit entities, regardless of the official status of the organization.

The biggest problem with the affordable health care act? Ask 3 different experts on the impact of the law, and get 3 different answers. To me that spells trouble, as it means no one knows what the real impact is going to be. That they passed such a broad piece of legislation without being able to quantify the effects is disturbing.

Lady's Human
06-29-2012, 03:19 PM
Here he is -
https://sphotos.xx.fbcdn.net/hphotos-ash3/523804_486466604712105_1558774557_n.jpg

It's the hilt of a sword, not a microphone.

In addition, this is exactly the kind of derisive crap that makes peaceful discussions of politics impossible.

Disagreement isn't enough, you have to deride those who disagree with you and score "points" to win the argument.

Cataholic
06-29-2012, 03:32 PM
It's the hilt of a sword, not a microphone.

In addition, this is exactly the kind of derisive crap that makes peaceful discussions of politics impossible.

Disagreement isn't enough, you have to deride those who disagree with you and score "points" to win the argument.

Say what? You surely cannot be directing that towards me! I simply thought it was funny. Very funny. I wasn't deriding anyone. Sheesh.

And, ever since my eye injury, frankly, I don't see things that well, especially when I am looking at them on my phone, which was where I originally saw it. Sorry.

RICHARD
06-29-2012, 03:36 PM
Again,

The HMO I worked for passed a 'secret memo' around saying that the providers were to curtail any 'unneeded tests'.

A friend took his son in to see about the kid's injured arm.

An ace bandage and a few hours later he went BACK TO THE ER and told the doc to x-ray the arm.

A broken arm, cast and six weeks fixed it.

-----------------------------

Forget the 'constitutional scholar' horse puckey.

Talk, no listen, to the people who see it from the inside....

Ask a med salesman about selling product to a hospital.

Go online and look at the costs for Zimmer, Synthes, Baxter products and what pills/meds cost.

(Don't forget to cost what the product cost to make, the testing and how many times it took to get it right-I don't begrudge the companies those costs, but when something goes wrong?)


MOFF,

the ten bucks charge was for toilet paper.:eek:

Grace
06-29-2012, 03:53 PM
Say what? You surely cannot be directing that towards me! I simply thought it was funny. Very funny. I wasn't deriding anyone. Sheesh.

And, ever since my eye injury, frankly, I don't see things that well, especially when I am looking at them on my phone, which was where I originally saw it. Sorry.

I agree with you - I thought it was very funny, which is why I posted it on my FB page.

phesina
06-29-2012, 03:55 PM
It's the hilt of a sword, not a microphone.

In addition, this is exactly the kind of derisive crap that makes peaceful discussions of politics impossible.

Disagreement isn't enough, you have to deride those who disagree with you and score "points" to win the argument.

Speaking of peaceful discussion:

"Former (Michigan) GOP Spokesman: 'Is Armed Rebellion Now Justified?' - http://www.michigancapitolconfidential.com/17151

Grace
06-29-2012, 04:49 PM
Speaking of peaceful discussion:

"Former (Michigan) GOP Spokesman: 'Is Armed Rebellion Now Justified?' - http://www.michigancapitolconfidential.com/17151

The GOP in the State of Michigan is disgusting. From acting like petulant, pre-teens while banning two female Representatives from speaking on the floor - to this jerk with his "armed rebellion" comments. I'm ashamed to say I live here :(

Jessika
06-30-2012, 07:40 AM
I was very much opposed to it until I read a break-down of it. There are still a LOT of rumors and myths floating around about what is included in the bill that just aren't true.

I will say, though, that I am still NOT happy about being "penalized" for making a CHOICE to not purchase insurance. They say this is to prevent people from getting coverage on an "as-needed" basis, and hopefully promoting more wellness care so that emergency trips are avoided or lessened. I do understand that, but we live in America, we are the "land of the free", yet we aren't allowed to make a choice to have insurance or not or we get "penalized". Oh, sorry, they call it a "tax" so it's deemed "constitutional". :rolleyes:

BUT, I do encourage every one of you to visit this link and read the break-down of points. He even goes through and debunks some myths that are floating around, some of which I've even read in this thread.

http://www.reddit.com/tb/vbkfm

momoffuzzyfaces
06-30-2012, 01:39 PM
Now that the government controls our health insurance, it's only a hop, skip and jump until they control what we are allowed to eat. After all that is health related, right? and our bedtimes too. We must get the proper amout of sleep each night to stay healthy. :love:

Karen
06-30-2012, 02:54 PM
Now that the government controls our health insurance, it's only a hop, skip and jump until they control what we are allowed to eat. After all that is health related, right? and our bedtimes too. We must get the proper amout of sleep each night to stay healthy. :love:

I don't think you need to worry about any of that. After all, most countries have universal healthcare in the developed world, and none of them regulate bed time, and what folks eat!

Edwina's Secretary
06-30-2012, 05:37 PM
I was very much opposed to it until I read a break-down of it.
BUT, I do encourage every one of you to visit this link and read the break-down of points. He even goes through and debunks some myths that are floating around, some of which I've even read in this thread.

http://www.reddit.com/tb/vbkfm

Thank you for sharing this link. One thing I find is that most people who object to it have no idea what is REALLY contained in the bill. I hope many others read it.

Catty1
06-30-2012, 06:04 PM
I've gone on too little sleep here often in my life and I ain't done time yet! :D

FeatheredMonkey
07-01-2012, 09:20 AM
I can't seem to remember a program that the government has had it's hands in that was efficient, stayed within budget and was not riddled with extreme excesses or just downright fraud. I really don't foresee this program turning out any different.

I agree that there is a segment of our society that needs health care and can not afford it. In Arizona the program is called AHCCCS. Government run and paid for with tax money taken from working people and it is, like most government programs, extremely inefficient but it gives the needy healthcare.

I think this is just another step to make people more dependent on the government. The more dependent a person is on the government, the more control the government has over that person.

The government is currently spending millions advertising food stamps. Get more people on food stamps, they are more dependent on the government.

The list goes on and on.

RICHARD
07-01-2012, 10:15 AM
I've gone on too little sleep here often in my life and I ain't done time yet! :D

It all depends on what you do while awake!:)

--------------------------

At the risk of ticking everyone here off?

Most of have been on the edge of not being able to 'make it' in the world.

Some of us have been blessed with non-stop HCI or some kind of plan to fall back on.

My mom told me the story, with tears in her eyes, about the woman in from of her at the pharmacy.

The woman needed her prescription and was trying to 'barter' a deal with the person on the other side of the counter.

Paraphrasing here - "I don't have enough money to pay for my pills, can I have buy enough to to take until I get more money?"

It doesn't matter when you do not have money. A point that is seem to be lost on the masses.

---------------------------

Low cost HCI doesn't mean anything when you do not have the money to pay for it, period.

Monthly payments, co-pays and deductibles are pretty scary when you are living 'comfortably'.

Just do not fall, twist, break or get ill.

-------------------------

Basic HC in other countries is just that, basic.

Go to Mexico and trip into the "clinica" and check out the care.

Look carefully at what they have to offer and pray to god you don't get sick.

A 'curandera/o' might be able to give you and herb or poultice that may make you well.

Forget an X-ray, CAT, MRI. A blood test just might be "it's red and runs"

-----------------------------

Tax, schmax.

You can't afford to pay for anything, now BO and the SC morons, want to make it so you cannot afford more things.

In Cah-lee-fuh-nee-ah, they were ways that the Tax Board and the State Gov't. found ways to take money from you.

If you do not register a vehicle on time, they will garnish your wages or take the money out of your tax return.

If you don't pay child support, they will hit you there also (Kids do need to be taken care of, but that is another topic)

So, what happens when you do not or cannot afford to pay for HCI?

You are 'penalized' for your inability to comply. Heaven forbid you wait until your tax return to get HCI and find out that your money is taken to pay that penalty.

----------------------

The people who put this HCI law together do not know what it's like to struggle to pay your bills, put food on the table and keep a roof over your head.

If you have HCI don't worry about it, you're cool.

Don't pay attention to the people who are in ratty pajamas or look unkempt when you go to the ER or Drs' office.
Sit far away from them and don't make eye contact either. You'll feel better knowing you don't have the problems that they do.:o:(

RICHARD
07-01-2012, 11:09 AM
I just saw a bit of an interview between Nancy Pelosi and David Gregory (NBC).

"It's not a tax, it's a penalty. It a penalty for the people who are freeriders...


------------------------------

IF YOU CANNOT AFFORD TO PAY FOR HCI, YOU ARE NOT CHOOSING NOT TO PAY FOR IT.

YOU CANNOT AFFORD IT.

And even if they have 'Low Cost' programs that you still CAN'T afford, what happens then?

------------------

I always thought that politicians were effing stupid.

Kinda sad to know I am right.

Edwina's Secretary
07-01-2012, 12:40 PM
There are reasons people do not buy medical insurance. Some do not buy it because they figure they are young and do not need it. There are people who prefer to spend there money elsewhere knowing they can always go to the emergency room if it really matters. Some cannot afford what it costs today (well over $1,000 a month for family coverage) but would love to be able to buy it if it was less expensive.

I would like to see universal healthcare coverage as most of the western world has. But that would be too much of a shock to the system for this country. Something is better than nothing.

The purpose of the act - and the link Jessika posted http://www.reddit.com/tb/vbkfm is a really good summary - it to make healthcare affordable.

This
IF YOU CANNOT AFFORD TO PAY FOR HCI, YOU ARE NOT CHOOSING NOT TO PAY FOR IT.

YOU CANNOT AFFORD IT.
is simply not true. There are people who choose not to pay for it.

The other day an employee asked me if he could add his wife to his insurance because she is pregnant. I told him that is like buying car insurance after you have an accident.

And this
And even if they have 'Low Cost' programs that you still CAN'T afford, what happens then? is the whole point. Making healthcare affordable. Tort reform will not make these people any more able to afford insurance.

But, as some continue to post without reading what the ACA really says:

No, there would not be coverage for illegal immigrants

It will - over time - get rid of pre-existing condition exclusions

It has provisions designed to decrease the cost of medicines

It will - over time - eliminate life time maximums

It will - over time - require insurance to cover preventative care

Beginning in 2014 if you can afford it you will be required to either have insurance coverage or pay a tax or mandate or whatever you want to call it. Of about $600 a year. If you choose not to have insurance. Again if you can afford it. There are provisions in the plan for those who cannot afford it.

There are no "death panels" any where in the bill.

Now which one of those things takes away your freedom? Which one of those things is so oppressive? Which one of those things represents the government intruding in the doctor/patient relationship? (That is still left to the insurance companies and their profit motives!:rolleyes:)

Cataholic
07-01-2012, 12:49 PM
I was very much opposed to it until I read a break-down of it. There are still a LOT of rumors and myths floating around about what is included in the bill that just arent true.

BUT, I do encourage every one of you to visit this link and read the break-down of points. He even goes through and debunks some myths that are floating around, some of which I've even read in this thread.

http://www.reddit.com/tb/vbkfm


Thank you for posting this. Great, easy to read information.

momoffuzzyfaces
07-01-2012, 01:39 PM
No, there would not be coverage for illegal immigrants


There are no "death panels" any where in the bill.



Well, since lots of illegals already get free care, it would make sense that they don't mention covering it.
Who wants to turn someone who is sick away just because they broke a law by being here illegaly? No one!

As for 'death panels', please don't give them any ideas!!! I look for them to sneak them in when no one is looking.

Edwina's Secretary
07-01-2012, 03:11 PM
Well, since lots of illegals already get free care, it would make sense that they don't mention covering it.
Who wants to turn someone who is sick away just because they broke a law by being here illegaly? No one!

As for 'death panels', please don't give them any ideas!!! I look for them to sneak them in when no one is looking.

The only one talking about death panels is Sarah Palin - and thankfully she is yesterday's news.

When do you think "no one is looking"?

Who is "them"?

What is it in the bill - not the stuff that people make up - but what is really in the bill - that you don't like?

lizbud
07-01-2012, 06:29 PM
I was very much opposed to it until I read a break-down of it. There are still a LOT of rumors and myths floating around about what is included in the bill that just aren't true.

I will say, though, that I am still NOT happy about being "penalized" for making a CHOICE to not purchase insurance. They say this is to prevent people from getting coverage on an "as-needed" basis, and hopefully promoting more wellness care so that emergency trips are avoided or lessened. I do understand that, but we live in America, we are the "land of the free", yet we aren't allowed to make a choice to have insurance or not or we get "penalized". Oh, sorry, they call it a "tax" so it's deemed "constitutional". :rolleyes:

BUT, I do encourage every one of you to visit this link and read the break-down of points. He even goes through and debunks some myths that are floating around, some of which I've even read in this thread.

http://www.reddit.com/tb/vbkfm


Thanks for this info.It explains a lot.:)

Jessika
07-01-2012, 07:10 PM
I'm glad that link has helped you guys. I know it helped explain it to me a lot!

RICHARD
07-01-2012, 10:07 PM
Make mine a sugar free Kool-Aid.

----------------

Affordable HCI?

When you do not have the money to pay for insurance, it's not that you do not choose to buy it, It's you cannot afford it.

I guess it's too hard to imagine that when you never have had to worry about it. I heard the same crap on all the sunday news shows and how my life is going to improve because some arseholes voted to penalize people for being poor.


--------------

Universal healthcare is the stupidest thing on the planet.

Case in point?

Go buy some accessory/aftermarket part for your car that says "UNIVERSAL FIT" or "FITS ALL MODELS" on it.

You are going to get a part that might fit your car.

It's more or less a sub standard fit, finish, and material.

I'd love to trust my health or loved ones to a 'close enough' style of medicine.


--------------------------

As with anything on the planet, I'll believe it when I see that it's great for everyone.

This bill is Horse Crap and to think that the prices of meds and implants will go down is pretty entertaining.

Please,

Cross you legs and don't let anyone blow smoke up your heinie. It's not good for you and you may not be covered by your insurance company.

Karen
07-01-2012, 11:03 PM
Richard, did you read the page Jessika posted?

RICHARD
07-02-2012, 05:59 AM
Richard, did you read the page Jessika posted?

No, I didn't.

I tend to be a pretty cynical person and of the mind that i'll see things and then I believe.

And even then?

------------------------

Went back to read the page and still have my doubts.

One thing that amused me was the idea that the bigger market a manufacturer has of a market the more they will be taxed in order to drive the costs down?

So, If you are ABC corp and you have 75% of a market, let's say ear widgets, and now you must pay a larger tax what is to keep you from spinning off or breaking up your company into divisions?

Are you going to pay more taxes to keep up you margins and what about the stockholders? Where does their profits go and what does that do to the prices of the ear widgets?

Do you scale back production and lay off more people in order to lower your percentage of the market?

I don't do any of the biz shows/networks and could not run a company to save my life but, I do see problems with that part of the program. It's common sense to me.

If you threaten to tax a company more because they control a larger market share that only means trouble.

That is the point where CEOs get creative with the bottom line and the phrase 'creative marketing' comes into play.

----------------------------------

54076


Why, I feel less irritated already!

momoffuzzyfaces
07-02-2012, 09:24 AM
The thing that really bothers me is that they (the government) have made a royal mess of every program they control: Social Security, a mess; Medicare, a mess: Medicade, a mess; Welfare, a mess; food stamps, a mess, etc. Why on earth should we believe this new program will be any different when they can't even make those work? :eek::love:

Or maybe they plan on combining all those messes into this new Health care program for one gigantic ginormous mess? :love:

Lady's Human
07-02-2012, 09:58 AM
The thing that really bothers me is that they (the government) have made a royal mess of every program they control: Social Security, a mess; Medicare, a mess: Medicade, a mess; Welfare, a mess; food stamps, a mess, etc. Why on earth should we believe this new program will be any different when they can't even make those work? :eek::love:

Or maybe they plan on combining all those messes into this new Health care program for one gigantic ginormous mess? :love:

And the current system is wonderful how?

It can't stay as is, billing is a labyrinthine mess. SOMETHING has to change. I don't see this as a cure all, but it may start a serious discussion, rather than a discussion with the various sides trying to score points for the PR Grist mill.

Lady's Human
07-02-2012, 10:27 AM
BTW, as a political aside.....

Anyone who thinks Gov. Romney is going to repeal ACA needs to look at the man's history as governor.

First, this bill is largely based on the plan he enacted in Massachusetts.

Second, this is a man with no convictions whatsoever.

He was for health care reform, but now he's against something he fought for in MA?

He enthusiastically signed the Massachusetts Assault Weapons Ban, but now goes to the NRA convention as the keynote and speaks on second amendment rights?

His only conviction is that he belongs in the Oval office. Beyond that, the man has NO core beliefs.

RICHARD
07-02-2012, 11:47 AM
BTW, as a political aside.....

Anyone who thinks Gov. Romney is going to repeal ACA needs to look at the man's history as governor.

First, this bill is largely based on the plan he enacted in Massachusetts.

Second, this is a man with no convictions whatsoever.

He was for health care reform, but now he's against something he fought for in MA?

He enthusiastically signed the Massachusetts Assault Weapons Ban, but now goes to the NRA convention as the keynote and speaks on second amendment rights?

His only conviction is that he belongs in the Oval office. Beyond that, the man has NO core beliefs.

Mexico has a new president.

I may move down there.;)

-----------------------

I spoke to a friend (Yes I have friends) that works at a large hospital, It rhymes with Best Wirginia and she's not really enthused about the new act.

(Do they call it an act because it has a certain pretend factor associated to it?)

I am all for EVERYONE HAVING insurance, but what bothers me is the cost to everyone.

If you drive a Cadillac and you buy the cheapest insurance to drive it around?

Great. But if you need to take it in for service and your insurance company says you have to go to a Yugo dealership to have the work done?

--------------------------

I had an accident on my motorcycle and the insurance company was adamant that I take it to the dealership where I purchased it.

I had to take my rice grinder to a Harley Davidson mechanic (The dealership was sold to an H-D group) and while they did a good job of fixing it?

When I showed up at the door, these guys didn't want to even touch the bike because it was Japanese. They also jacked up the price of the parts and labor.

The fix was more than the bike was worth.

-------------------------

Everyone should be able to go to the doctor and 'be fixed'.

The same people who really want this law/act/initiative enforced are the people who have insurance.

They are also the people who do not want to be tracked by their shopping cards, emails or the government.

Yet, it's OK for the government to tell others they must buy insurance and they will tell you what plans they will subsidise so you can be in accord with the law?

------------------------

Go check out what the prices are just to see a doc, then go to another and another.

Yugos, Volkswagons and Mercedes prices are what you are going to see.

Instead of setting guidlines against gouging the system and setting prices for basic services?

We get a totally screwed up law put into effect that people are already trying how to figure out how to scam it.

Look at Medicare fraud.

The FBI broke up a So Cal gang that scammed 100 MILLION dollars from the FED/MEDICARE system.

100 million is a drop in the bucket compared to the yearly amounts spent for healthcare.

But think of the lives that could be impacted by that amount of money.


-----------------------

Look past the "Affordable Health Care Insurance".

Why not "Affordable Health Care" or "Health Care Cost Initiative"?

You can get all the insurance, affordable insurance you want.

That does not guarantee you will get good care.

HC guarantees you will be seen or have access to a physician.

It does not mean he/she will be able or willing to give you the best possible care. Access to costly tests/exams are going to determine exactly how you are treated.

----------------------

It going to be a giant party where the word is going to be "Free Liquor".

People will flock and when they come inside they'll see that some people will get beer, the good stuff will be served in the back, where not all of us are welcome.

------------------------

The MIttster probably isn't the best bet for running the US, I'd much rather have someone with the idea or would try to reform the system first and not to try and push everyone into an elevator car that has strict load and occupancy limits.

It ain't going to work.

momoffuzzyfaces
07-02-2012, 11:53 AM
And the current system is wonderful how?

It can't stay as is, billing is a labyrinthine mess. SOMETHING has to change. I don't see this as a cure all, but it may start a serious discussion, rather than a discussion with the various sides trying to score points for the PR Grist mill.

Never said it was wonderful, quite the opposite. They are going to take something already a mess and make it worse. :love:

smokey the elder
07-02-2012, 12:25 PM
I don't know if this is directly related to the ongoing debate, but one big problem with medical care is: try getting a quote for something you want done. Say, a knee replacement. GOOD LUCK! Every other product or service I can think of has the prices transparent. I reckon if people knew what they were paying, they could decide if they are getting what they pay for. If someone wants to buy a Kia and sees a Cadillac price, they know right away something's not OK. No such "common lore" exists, AFAIK, in health care prices.

Edwina's Secretary
07-02-2012, 03:20 PM
The thing that really bothers me is that they (the government) have made a royal mess of every program they control: Social Security, a mess; Medicare, a mess: Medicade, a mess; Welfare, a mess; food stamps, a mess, etc. Why on earth should we believe this new program will be any different when they can't even make those work? :eek::love:

I get really tired of the old canard - of course there are things that the government controls that are done well! I could start with the interstate highway system - or the space program (remember landing on the moon) or the fact that I can drink milk and not wonder if it is water with chalk in it - or buy a prescription and not wonder if the drug will kill me. You can thank the Food and Drug Administration. Remember all those banks that have failed? Without the FDIC all the people who had money in those banks would have been wiped out - as they were back in the 1920's and 1930s. How safe is your drinking water - how clean is the air you breath?

As if the current system - insurance companies - is doing a great job. Insurance companies exist to make profits - and they do that by NOT paying claims. They are extremely intrusive in the doctor-patient relationship - telling doctors how they must treat patients (and with profits the driver!)

And what makes me laugh is people who admit they don't know what they are talking about and talk about it anyway.

The hospitals here in California have come out very strongly in favor of the act. We...well those of us who either have insurance or pay taxes that is...are already paying for the uninsured.

momoffuzzyfaces
07-02-2012, 04:20 PM
I get really tired of the old canard - of course there are things that the government controls that are done well! I could start with the interstate highway system - or the space program (remember landing on the moon) or the fact that I can drink milk and not wonder if it is water with chalk in it - or buy a prescription and not wonder if the drug will kill me. You can thank the Food and Drug Administration. Remember all those banks that have failed? Without the FDIC all the people who had money in those banks would have been wiped out - as they were back in the 1920's and 1930s. How safe is your drinking water - how clean is the air you breath?

As if the current system - insurance companies - is doing a great job. Insurance companies exist to make profits - and they do that by NOT paying claims. They are extremely intrusive in the doctor-patient relationship - telling doctors how they must treat patients (and with profits the driver!)

And what makes me laugh is people who admit they don't know what they are talking about and talk about it anyway.

The hospitals here in California have come out very strongly in favor of the act. We...well those of us who either have insurance or pay taxes that is...are already paying for the uninsured.

Well, you are certainly entitled to your opinion and I respect it even if I don't agree with it. Only time will tell what this new bill will prove to be. :love:

smokey the elder
07-03-2012, 11:00 AM
The whole thing is really a big unknown and it'll take time to see how the law actually plays out.

Cataholic
07-03-2012, 11:28 AM
I don't know if this is directly related to the ongoing debate, but one big problem with medical care is: try getting a quote for something you want done. Say, a knee replacement. GOOD LUCK! Every other product or service I can think of has the prices transparent. I reckon if people knew what they were paying, they could decide if they are getting what they pay for. If someone wants to buy a Kia and sees a Cadillac price, they know right away something's not OK. No such "common lore" exists, AFAIK, in health care prices.

I went to the doctor last week. As I was leaving, I asked for a bill (I have a big deductible, I know I have to pay for the visit). Again, I heard, "we don't know what the charge will be...it depends on your insurance". LOL. It shouldn't! The charge should be what the charge should be. A doctor's ten minutes in the exam room with the patient.

Randi
07-03-2012, 12:07 PM
I went to the doctor last week. As I was leaving, I asked for a bill (I have a big deductible, I know I have to pay for the visit). Again, I heard, "we don't know what the charge will be...it depends on your insurance". LOL. It shouldn't! The charge should be what the charge should be. A doctor's ten minutes in the exam room with the patient.
Of course the charge should be what the charge will be, not what they can "get out of it"! Anything else sounds like a banana republic.

RICHARD
07-05-2012, 11:30 AM
Ind. woman accused of embezzling $300K from pet insurance firm
THE ASSOCIATED PRESS
First Posted: July 04, 2012 - 4:01 am
Last Updated: July 04, 2012



JEFFERSONVILLE, Ind. — A southern Indiana woman faces dozens of forgery and theft charges alleging that she embezzled more than $300,000 from a pet insurance company.

Christina Heaven of Jeffersonville has been charged with 59 forgery and theft counts accusing her of embezzlement from PetFirst Healthcare. Her trial is scheduled for November.

The Courier-Journal of Louisville, Ky., reports (http://cjky.it/O25Yra ) the 35-year-old Heaven was an administrative worker at the Jeffersonville company. She's accused of using her boss's social security number to open a secret checking account in the PetFirst name with a credit card account in 2010.

Heaven allegedly deposited checks from PetFirst customers totaling $314,723 into that checking account and then withdrew $293,703.


Brandon Smith, one of Heaven's attorneys, urged the public "not to rush to judgment before the evidence is available."


___

This would NEVER happen to a human insurance company.....

Karen
07-05-2012, 06:16 PM
I went to the doctor last week. As I was leaving, I asked for a bill (I have a big deductible, I know I have to pay for the visit). Again, I heard, "we don't know what the charge will be...it depends on your insurance". LOL. It shouldn't! The charge should be what the charge should be. A doctor's ten minutes in the exam room with the patient.

Unless you have some really obscure plan, the person who handles the billing ought to be able to tell you that right away, or with a quick search on his or her computer! Sheesh!

Just today, I was on the phone with an insurance company. In May, as you know, I ended up having my gall bladder removed. Good riddance. But part of that was, my primary care's office suggested I go to a nearby Urgent Care place, as they didn't have anyone who could see me that afternoon. So I dutifully looked up where it was, went there, and briefly saw a doctor, who told me they didn't have any ultrasound available there, so it was most likely my gall bladder, but I would go to the Emergency Room at the hospital. They had taken all my information, and said they'd call, and let them know to expect me. Before I left, I said, "Now, before I leave, don't I owe you a co-pay?" I was in pain, yes, but still had the presence of mind to inquire. "Na," I was told, as we couldn't really do anything for you, so go on ahead, you don't owe anything." I asked if they were sure, they said yes, and onward I went.

This week, more than a month later, I got a bill for $15. That's my copay, I KNOW that amount. I had no problem paying it, just would have preferred to get it over with while I was there the first time! Instead, they had to wait, generate paperwork, bill my insurance company for the whole amount, figure out there was $15 the insurance didn't pay, and send me a bill for that. And have someone available to answer the phone when I called to ask, "What the heck?" Talk about a waste of everyone's time and money!

katladyd
07-09-2012, 01:13 AM
Here in California, they have pretty much told me that on my income of between 10k-15k, I will be FORCED to by into Obamacare at the nifty sum of $250 per month. Oh yes, we will get a subsidy, we will get a tax break, big f***ing deal! I will still HAVE to pay $250 per month or be penalized. I have elderly relative on Medicaid and they have been warned that their coverage will be severely cut. Nice. Illegals, on the other hand, will still get full coverage. Again, nice. I do like the idea of insurance companies not being able to say "no" to pre-existing conditions, that's good. Where am I and millions like me going to get the money to pay for this?
Who the H*ll knows. I do know that our president doesn't really care how much I won't eat or if I have to live in my car, but he DOES care whether or not I buy this infernal insurance. Tell ya what, I'M NOT BUYING IT! LET THEM ARREST ME! I WON'T BACK DOWN OR STARVE!

Lady's Human
07-09-2012, 03:34 AM
250/month?

Don't know where you're getting that figure:

http://upload.wikimedia.org/wikipedia/en/3/31/PPACA_Premium_CRS.jpg

In addition, the "severe cuts" to medicaid shouldn't affect an elderly person, as 1) an elderly isn't under Medcaid, rather, they are under Medicare, and 2) while there are budgetary cuts made under the law to Medicare, there is an increase to fraud fighting efforts, which might see some budgetary relief.

The only "coverage" illegal aliens recieve is emergency room care, which is afforded to anyone. They're illegal, thus they have no legal status, so how could they be legally covered?

While I don't think the law is a panacea by any stretch of the imagination, the outright lies told about it by oppponents are getting tiresome. It's easy to find the information to counter the propoganda.

lizbud
07-09-2012, 10:44 AM
250/month?

Don't know where you're getting that figure:

http://upload.wikimedia.org/wikipedia/en/3/31/PPACA_Premium_CRS.jpg

In addition, the "severe cuts" to medicaid shouldn't affect an elderly person, as 1) an elderly isn't under Medcaid, rather, they are under Medicare, and 2) while there are budgetary cuts made under the law to Medicare, there is an increase to fraud fighting efforts, which might see some budgetary relief.

The only "coverage" illegal aliens recieve is emergency room care, which is afforded to anyone. They're illegal, thus they have no legal status, so how could they be legally covered?

While I don't think the law is a panacea by any stretch of the imagination, the outright lies told about it by oppponents are getting tiresome. It's easy to find the information to counter the propoganda.




Watch out LH. You keep posting like that and people are going to start thinking you know what you're talking about. ;)

Edwina's Secretary
07-10-2012, 09:43 PM
Unless you have some really obscure plan, the person who handles the billing ought to be able to tell you that right away, or with a quick search on his or her computer! Sheesh!

Not really Karen. Many insurance plans have doctor co-pays that are dependent on many factors. If you have met your deductible - and you could have a variety of doctors billing toward that deductible can make a difference in what you owe. Sadly, it is not at all unusual for a doctor's office to not be able to tell what the patient's co-pay is until they have processed the claim to the carrier and learned what the carrier is going to pay. Many plans vary what the co-pay will be based on the purpose of the visit as well.

Plans that have the same doctor co-pay regardless tend to be HMO type products.

Plans with variable co-pays are probably the most common these days as the insurance companies continue to look for ways to control costs and increase profits.

Don't blame the doctor's staff! It is just often not as easy as a quick computer search. I was in Kaiser HMO for a year and knew exactly what a doctor visit would cost. Now that I am back in a PPO (high deductible) I don't have a clue until the doctor files the claim and bills me.

(And if you wonder why I went back - I am tied to what the employer offers!)

Lady's Human
07-10-2012, 10:34 PM
Not really Karen. Many insurance plans have doctor co-pays that are dependent on many factors. If you have met your deductible - and you could have a variety of doctors billing toward that deductible can make a difference in what you owe. Sadly, it is not at all unusual for a doctor's office to not be able to tell what the patient's co-pay is until they have processed the claim to the carrier and learned what the carrier is going to pay. Many plans vary what the co-pay will be based on the purpose of the visit as well.

Plans that have the same doctor co-pay regardless tend to be HMO type products.

Plans with variable co-pays are probably the most common these days as the insurance companies continue to look for ways to control costs and increase profits.

Don't blame the doctor's staff! It is just often not as easy as a quick computer search. I was in Kaiser HMO for a year and knew exactly what a doctor visit would cost. Now that I am back in a PPO (high deductible) I don't have a clue until the doctor files the claim and bills me.

(And if you wonder why I went back - I am tied to what the employer offers!)

This in a nutshell, is a huge fault with the current system.

It's why people wind up in bankruptcy for medical bills, hard to plan when you have no earthly idea what your expenses are going to be beyond some very, very vague guidelines, further exacerbated by the contractor shell game. (Well, yes, all our staff are PPO for your insurance, however, Dr XYZ isn't part of our staff, he/she contracts with us through Dewy, Screwem and Howe, and therefore aren't part of our PPO group. hat do you mean you didn't realize what you were agreeing to while you were in excruciating pain? We have your signature, it's valid.)

cassiesmom
07-11-2012, 11:22 AM
Not really Karen. Many insurance plans have doctor co-pays that are dependent on many factors. If you have met your deductible - and you could have a variety of doctors billing toward that deductible can make a difference in what you owe. Sadly, it is not at all unusual for a doctor's office to not be able to tell what the patient's co-pay is until they have processed the claim to the carrier and learned what the carrier is going to pay. Many plans vary what the co-pay will be based on the purpose of the visit as well.

Plans that have the same doctor co-pay regardless tend to be HMO type products.

Plans with variable co-pays are probably the most common these days as the insurance companies continue to look for ways to control costs and increase profits.

Don't blame the doctor's staff! It is just often not as easy as a quick computer search. I was in Kaiser HMO for a year and knew exactly what a doctor visit would cost. Now that I am back in a PPO (high deductible) I don't have a clue until the doctor files the claim and bills me.

(And if you wonder why I went back - I am tied to what the employer offers!)

I learned something very interesting when I worked for a company that paid its own claims. The claims are generally paid in the order they arrive. So if a big bill gets to the carrier and you haven't met your deductible, they will apply it toward your deductible. Then the next one that comes in might be paid because you met the deductible with the previous huge one. It was a bugger for people who were reaching their policy maximum because the providers who got their claims in first got paid, and the ones who dragged their feet got denied because the member had met their policy maximum. I've also worked for two Fortune 500 health plans and I can say with certainty that it's a huge help if you are familiar with your plan - deductible, co-pay, out of pocket and all that stuff. Someone from the physician's office can call the 800 number but they frequently have to plow through a lengthy menu of phone prompts to get the information they need.

I had a high-deductible health plan for a little while. It was expensive but relatively easy to manage- I paid for everything and submitted claim forms. I think the Affordable Care Act is going to have more people confused and uncertain about their coverage and benefits for awhile until the payors and providers figure out what the laws require, and it all gets sorted out.


This in a nutshell, is a huge fault with the current system.

It's why people wind up in bankruptcy for medical bills, hard to plan when you have no earthly idea what your expenses are going to be beyond some very, very vague guidelines, further exacerbated by the contractor shell game. (Well, yes, all our staff are PPO for your insurance, however, Dr XYZ isn't part of our staff, he/she contracts with us through Dewy, Screwem and Howe, and therefore aren't part of our PPO group. hat do you mean you didn't realize what you were agreeing to while you were in excruciating pain? We have your signature, it's valid.)

This is how we used to coach patients to respond to the contractor shell game. Say to the provider: No no no no. That was emergency department care. Payable at in-network level under prudent layperson rule. I want Dr. XYZ's care to continue to be paid at the in-network level for continuity of care purposes. What do I have to do to make sure that's done? What else can you do to help me get that done?
Then call your insurance. If you contact the payor yourself they might send the claims back for reprocessing at the higher level. The squeaky wheel gets the oil, so squeak!.

Jessika
07-11-2012, 06:41 PM
On the subject of medical costs, a friend went to the ER with excruciating pain one night (involuntary moaning/screaming in pain type of pain). Their triage was so bad they made her sit in the waiting room while people with cuts, etc, go in before her. She ended up passing a kidney stone while sitting in the waiting room. They finally call her in (after all that was over), took some vitals, palpated her abdomen, and said "well looks like you've already passed it, if you experience it again come back, otherwise here's a prescription for some pain meds".

She got the bill a week or so later -- over $1000. OVER A THOUSAND DOLLARS to have her vitals taken and abdomen palpated after she passed the kidney stone IN THE WAITING ROOM.

THIS is wrong.

Catty1
07-11-2012, 07:04 PM
Jessika, that is abominable! I don't know who she would write to - but notifying the media is a good start!

Lady's Human
07-11-2012, 07:23 PM
This is how we used to coach patients to respond to the contractor shell game. Say to the provider: No no no no. That was emergency department care. Payable at in-network level under prudent layperson rule. I want Dr. XYZ's care to continue to be paid at the in-network level for continuity of care purposes. What do I have to do to make sure that's done? What else can you do to help me get that done?
Then call your insurance. If you contact the payor yourself they might send the claims back for reprocessing at the higher level. The squeaky wheel gets the oil, so squeak!.


I was shunted to a lawyer, and the bill sits. It's not enough for them to go to court to recover. Both the Ins. Co and the hospital have stonewalled. I refuse to pay, I actually invited them to take me to court to collect, and they have refused.

The contractor shell game is completely supported by state and federal law, so the consumer is screwed.

Edwina's Secretary
07-11-2012, 11:24 PM
This in a nutshell, is a huge fault with the current system.

It's why people wind up in bankruptcy for medical bills, hard to plan when you have no earthly idea what your expenses are going to be beyond some very, very vague guidelines, further exacerbated by the contractor shell game. (Well, yes, all our staff are PPO for your insurance, however, Dr XYZ isn't part of our staff, he/she contracts with us through Dewy, Screwem and Howe, and therefore aren't part of our PPO group. hat do you mean you didn't realize what you were agreeing to while you were in excruciating pain? We have your signature, it's valid.)

A perfect description of a very, very imperfect situation! With our policy the deductible (as with most policy) is a family deductible so I would need to keep track of what the insurance has paid for my husband, what has not been paid, what will not be paid, how much I have spent so far this year, divided by two taken to the fifth power and the square root of 3.

I sympathize with the doctors as well. How can they predict their revenue? How do they know if they are being paid correctly?

I cannot imagine how the system could get much more screwed up!

RICHARD
07-12-2012, 05:03 PM
http://shine.yahoo.com/parenting/parents-11-old-died-sepsis-hospital-sent-son-183800609.html


Healthcare!

pomtzu
07-12-2012, 05:34 PM
http://shine.yahoo.com/parenting/parents-11-old-died-sepsis-hospital-sent-son-183800609.html


Healthcare!

Pretty damn scary. I wonder if the parents had insurance, and if they didn't, that it made a difference in the "care" the boy received.

Karen
07-12-2012, 06:18 PM
A friend of mine, employed and with health insurance, was sent home from the emergency room after a fall in which he fractured vertebrae in his neck. He wasn't even given a brace. He has been in a wheelchair ever since getting taking back to a different hospital a few hours later. Yes, lawsuits were filed. Negligence happens, with or without health care insurance. He is still working on rehab and now can walk a few steps with a walker, but it has literally been years.

Cataholic
07-12-2012, 07:35 PM
Negligence happens, of course. Insurance has nothing to do with it. Karen, your friend's situation sounds like negligence. The link Richard provided just sounds ridiculous, beyond negligence- but of course there isn't (unless you consider gross negligence). And, according to some on here, these parents should just 'suck it up', as no amount of money will bring back their precious child. Not a position I agree with, from both a maternal and legal position.

This totally drives home my own personal crusade- doctors simply don't know everything. I read on here, and in the news, what people do and don't do because their doctor told them so, and I am stunned. It is like the patient has no brain function!!! They give some really bad advice. I, personally, would have created such a stink at the hospital that something further would have been done. I know my own child, I know my own body, and if something isn't right- something isn't right. Far better to spend MORE on TOO much care than walk away, because a doctor told me everything was ok.

Poor parents, and all the people that loved this little boy. A needless death.

RICHARD
07-12-2012, 09:10 PM
"Go to the ER..."

Sloppy medical practices kill more people that we will ever know.

--------------------

One common problem with people who must see a doc/phys/surgeon?

Ask questions.

Don't be a jerk and diagnose yourself based on an article, TV show or what happened to Uncle Chester in 1972.

----------------

Jackie Speier, a politician from CA was on the tube today saying that the Obamacare model touting 'Preventative Doc Visits' was a wonderful thing.

Ask a provider about their schedule. Then try to get people to go see a doc for a preventative checkup.

It's a nice model and wonderful way to believe that this will solve all the problems we have in providing a low cost service to the masses.

-------------------


Good physicians/surgeons/doctors are hard to find.

They put quite a bit of time into getting a sheepskin to take care of people.

This Obamacare BS ( I love how the media changed it into the ACA, after the SC voted it into reality )
is going to put a huge pox on the HC industry. It's going to chase away some of the best people we have practicing medicine.

Years ago there was a shortage of OB docs because of malpractice insurane/rates/suits.

I wonder how many docs will drop out when the gov't. becomes more and more involved in the HC industry.

The same people who didn't want Big Brother to interfere with their private lives are jumping with joy now that the gov't. is going into the HC biz.

I love it.

Edwina's Secretary
07-12-2012, 11:08 PM
Basic HC in other countries is just that, basic.

Go to Mexico and trip into the "clinica" and check out the care.

Look carefully at what they have to offer and pray to god you don't get sick.

A 'curandera/o' might be able to give you and herb or poultice that may make you well.

Forget an X-ray, CAT, MRI. A blood test just might be "it's red and runs"



Here's what I mean about people who do not know what they are talking about....

We know a couple. They are both doctors with Seguro Social - the Mexican health system. He is in general practice - at a clinica. She is a specialist at a hospital.

They are every bit as educated as a doctor in the US. In fact they attended a University in Guadalajara where a good number of US doctors go to study. I would (and have) trust them with my healthcare.

I would not think of insulting them by telling them they are considered to be practicing "folk medicine" that they are "shamans" - that they are unfamiliar with X-rays, CAR scans or MRIs. By someone who I suspect has never even seen a clinic in Mexico. Maybe even never have been to Mexico?

So...don't be a jerk and listen to people who enjoy saying the sky is falling - even if they have never seen the sky.

blue
07-13-2012, 12:16 AM
While working construction and now with computers/IT, I have met some pretty dang dumb doctors. Not 5 gallon bucket dumb, but not learning a thing they dont have to past getting the PHD or outside of their field. In the last year I met a doctor who was a year or two older then myself who had never, emphasis Never, used a computer until she started working at the facility 2 years ago. Thats 2010.

There are plenty of dumb people out their with high IQs. The smart Docs are the ones getting out of their practices and retiring.

caseysmom
07-13-2012, 01:32 AM
Here's what I mean about people who do not know what they are talking about....

We know a couple. They are both doctors with Seguro Social - the Mexican health system. He is in general practice - at a clinica. She is a specialist at a hospital.

They are every bit as educated as a doctor in the US. In fact they attended a University in Guadalajara where a good number of US doctors go to study. I would (and have) trust them with my healthcare.

I would not think of insulting them by telling them they are considered to be practicing "folk medicine" that they are "shamans" - that they are unfamiliar with X-rays, CAR scans or MRIs. By someone who I suspect has never even seen a clinic in Mexico. Maybe even never have been to Mexico?

So...don't be a jerk and listen to people who enjoy saying the sky is falling - even if they have never seen the sky.

I know a few ex pat's living in Mexico, they have had outstanding medical care for a ridiculously low cost.

RICHARD
07-13-2012, 10:32 AM
Here's what I mean about people who do not know what they are talking about....

We know a couple. They are both doctors with Seguro Social - the Mexican health system. He is in general practice - at a clinica. She is a specialist at a hospital.

They are every bit as educated as a doctor in the US. In fact they attended a University in Guadalajara where a good number of US doctors go to study. I would (and have) trust them with my healthcare.

I would not think of insulting them by telling them they are considered to be practicing "folk medicine" that they are "shamans" - that they are unfamiliar with X-rays, CAR scans or MRIs. By someone who I suspect has never even seen a clinic in Mexico. Maybe even never have been to Mexico?

So...don't be a jerk and listen to people who enjoy saying the sky is falling - even if they have never seen the sky.

I was going to let this one pass, but I find that you are at times very entertaining and insulting caustic.

You can never let a post of mine go without making it a point to counterpoint a comment that I make.
I try to keep things light, but that is kinda impossible when people who have no sense of humor take me to task.

Of course I have been to Mexico, of course I have been to the clinics and also been to 'curanderas, brujos and brujas'. The Expats who can afford to go to the doctors can and will.

(Just so you know, The Most Interesting Man in the World was my Infectious Disease doctor....You don't have a sense of humor, so I won't explain it to you.)

I have seen the best kind of care offered and been a patient on the receiving end of WORLD CLASS Pat care.

I did put in 30 years in the HC industry and I remember you asking ME for some advice as to how to look at or into a hospital bill.

I may not know all there is about medicine, but might know a bit more about how a hospital runs.

It runs on paper and on that paper is printed dead presidents.

------------------

The real danger of the Obamacare debacle are the people who won't bother to look up into the sky to see what is flying about. They are the dedicated brainwashed who believe the government is too involved with our lives, but go on and crow about how the government will reform an industry that's got it's head shoved so far up the politico's rear end they know exactly how many have prostate problems.

-------------------

The next time someone you know or even yourself runs into a problem with the 'system' do not complain about it.

Go back to watching "Scrubs" or "House" and figure out how they resolve a health care issue in 48 minutes.

And watch for the lawyer commercials or the ads that want you to go see a doc when your medication causes you anal leakage, dizziness, an erection that lasts more than 4 hours or tingling in the arms or legs.

That's all you need to know.


Yeb vas.

Edwina's Secretary
07-13-2012, 06:47 PM
I was going to let this one pass, but I find that you are at times very entertaining and insulting caustic.

You can never let a post of mine go without making it a point to counterpoint a comment that I make.
I try to keep things light, but that is kinda impossible when people who have no sense of humor take me to task.


There is nothing I like more than a challenge! So I counted. You have posted 13 times in this thread. I have posted seven times. Only two of those posts were in response to something you posted. I think "never" is a bit of hyperbole??


I did put in 30 years in the HC industry and I remember you asking ME for some advice as to how to look at or into a hospital bill.


Indeed, seven years ago I asked you about how to understand a hospital bill - while you were working in one. Come to think of it - around that same time you were a guest in my home.

The good old days eh?;);)

RICHARD
07-13-2012, 08:34 PM
While working construction and now with computers/IT, I have met some pretty dang dumb doctors. Not 5 gallon bucket dumb, but not learning a thing they dont have to past getting the PHD or outside of their field. In the last year I met a doctor who was a year or two older then myself who had never, emphasis Never, used a computer until she started working at the facility 2 years ago. Thats 2010.

There are plenty of dumb people out their with high IQs. The smart Docs are the ones getting out of their practices and retiring.

LOL, back in the early 80s the first comps came onto the scene and the docs then were the guys that had been practicing since the eary 70's. They hated the comps because they had to learn to type.

Watching a doc type gave me hours of pleasure.

-----------------------------------------

They was a wave of OB docs who were leaving that part of he OB/GYN scene because of the malpractice insurance rates and lawsuits.

I had to laugh at the 'preventative medicine' talk in the OCA.

So, sending people to have preventative checkups will make them healthier?

Yes, but now you are asking physicians to see more patients during the day?

Well, they can be seen by NPs and that will solve that problem, but what their schedule?

The OCA is going to choke the system with patients, sick and well, during a time when their is a shortage of physicians.

---------------------

Again, getting insurance does not guarantee you are going to give everyone the same kind of treatment.

For some reason, the people who think that this CA will solve the problems in the system are the same people who believed Nancy Pelosi, who didn't bother to read the 2k pages of the act, she took it on faith that the thing will work.

"I didn't read it, it's good."

Really?

----------------------

I sincerely do not know what I am talking about.

I'll leave the expert opinions to the people who know it all.

They are the really, really smart people.

RICHARD
08-15-2012, 02:07 PM
I love the fact that other countries have uni health.

Coverage for everyone!

http://www.dailymail.co.uk/news/article-2188226/Bionic-hands-Chinese-man-spends-years-building-new-arms-DIY-accident.html?ITO=1490

catlady1945
08-21-2012, 05:41 PM
I live in a country with Health Care --- guess where I stand on this subject? I love never having to worry about whether or not I can afford to see a doctor.

Karen
08-21-2012, 06:32 PM
No, as I have heard many, many varying opinions from Canadians on their "universal health care" system. Don't know where in the spectrum you fall. The complainers make the most noise ...

Edwina's Secretary
08-21-2012, 10:26 PM
I live in a country with Health Care --- guess where I stand on this subject? I love never having to worry about whether or not I can afford to see a doctor.

Amen! Maybe some day we will be as lucky in this country!

Lady's Human
08-30-2012, 09:52 AM
Just found out that my insurance (one of the "cadillac plans so loathed by all in the discussion, after all, I'm a federal worker (BTW, I wish I had half the benefits the lunatics accuse us of having)) will cover an allergist visit, but not the materials used. In other words, go for a cut, and we'll pay for the visit, but you're paying $300 for the band aid.

ladies and gentlemen, the system is broken and needs a reset.

Karen
08-30-2012, 11:48 AM
Just found out that my insurance (one of the "cadillac plans so loathed by all in the discussion, after all, I'm a federal worker (BTW, I wish I had half the benefits the lunatics accuse us of having)) will cover an allergist visit, but not the materials used. In other words, go for a cut, and we'll pay for the visit, but you're paying $300 for the band aid.

ladies and gentlemen, the system is broken and needs a reset.

That's just about the silliest one I have heard! Sheesh! Like you, the patient, has any control of what materials the doc is going to use, either!

RICHARD
08-30-2012, 12:47 PM
Just found out that my insurance (one of the "cadillac plans so loathed by all in the discussion, after all, I'm a federal worker (BTW, I wish I had half the benefits the lunatics accuse us of having)) will cover an allergist visit, but not the materials used. In other words, go for a cut, and we'll pay for the visit, but you're paying $300 for the band aid.

ladies and gentlemen, the system is broken and needs a reset.

But ObamaCare will remedy all that and more!

If you are one of the next 30 callers, we'll cover the next visit for free, just pay a co-pay and any materials, paste, labels and S&H.

----------------

Again, you are charged on an average, whether or not they use all the supplies the insurance is billed for.

But why are we going to take away THEIR cut of the pie?

Lady's Human
08-30-2012, 12:51 PM
But ObamaCare will remedy all that and more!

If you are one of the next 30 callers, we'll cover the next visit for free, just pay a co-pay and any materials, paste, labels and S&H.

----------------

Again, you are charged on an average, whether or not they use all the supplies the insurance is billed for.

But why are we going to take away THEIR cut of the pie?

Richard, an allergy test kit is routinely used en toto, especially on the initial visit. The issue is that the office visit is covered, but the supplies used in the covered office visit are part of the annual deductible, despite the insurance plan claiming to cover all testing.

Okay, it's an allergy test, so it's covered (the brochure says all testing is covered).

WRONG.......the test is covered......the materials aren't, in which case the
testing isn't covered (without the materials, there's no damned test, boys and girls).

Parse it however the hell you want to, but a lie is a lie.

RICHARD
08-30-2012, 07:11 PM
Richard, an allergy test kit is routinely used en toto, especially on the initial visit. The issue is that the office visit is covered, but the supplies used in the covered office visit are part of the annual deductible, despite the insurance plan claiming to cover all testing.

Okay, it's an allergy test, so it's covered (the brochure says all testing is covered).

WRONG.......the test is covered......the materials aren't, in which case the
testing isn't covered (without the materials, there's no damned test, boys and girls).

Parse it however the hell you want to, but a lie is a lie.

Why are you yelling at me?;)

------------------

They get you coming and going.

They charge the insurance for the 'test'.

You figure that any and all materials would be covered....but that is the way they screw you.

---------------

Blame it on DRGS...

http://en.wikipedia.org/wiki/Diagnosis-related_group

---------------------

The prez thinks that by giving EVERYONE insurance, or forcing EVERYONE to buy insurance, it will solve all the problems.

It's like having a car that gets 7 miles to a gallon, giving it a wash and polish, then claiming it will get better gas mileage.

The whole system has to be reworked - and that isn't going to happen until they get take the bull by the horns -
And that's hard when you try to take the bull by the feces.

lizbud
08-31-2012, 09:42 AM
Richard, an allergy test kit is routinely used en toto, especially on the initial visit. The issue is that the office visit is covered, but the supplies used in the covered office visit are part of the annual deductible, despite the insurance plan claiming to cover all testing.

Okay, it's an allergy test, so it's covered (the brochure says all testing is covered).

WRONG.......the test is covered......the materials aren't, in which case the
testing isn't covered (without the materials, there's no damned test, boys and girls).

Parse it however the hell you want to, but a lie is a lie.


Same thing happened to me when I was referred to a allergist by my primary care doctor. The test itself was 600.00.
My Insurer refused to pay at first, saying it wasn't covered. Then they said the allergist wasn't part of the network and
he wasn't covered.

In the end my Insurer paid all of the bill when I reminded them that THEY were the ones who referred me to the specialist. (an error on their part)
I hate dealing with Insurance companies.

RICHARD
09-05-2012, 04:03 PM
Wha-wha-what?


Talk about out-of-pocket-costs?

http://news.yahoo.com/scorpion-sting-leaves-arizona-woman-huge-bill-225717487.html

Four more years!!!!!!! That should fix EVERYTHING wrong with HealthCare.

Lady's Human
09-05-2012, 04:50 PM
Gov. Romney is a complete tool.

The Republicans couldn't have chosen a worse candidate is it had been scripted as a bad political comedy.

ABout the only thing he "fixed" in Massachusetts was the state budget....sort of......he screwed every municipality in the state in the process and forced cities and towns to jack property taxes, but he "fixed" the state budget.

I've said it once, I'll say it again: The man is a used car salesman with a billion dollar bankroll.

RICHARD
09-05-2012, 05:01 PM
Gov. Romney is a complete tool.

The Republicans couldn't have chosen a worse candidate is it had been scripted as a bad political comedy.

ABout the only thing he "fixed" in Massachusetts was the state budget....sort of......he screwed every municipality in the state in the process and forced cities and towns to jack property taxes, but he "fixed" the state budget.

I've said it once, I'll say it again: The man is a used car salesman with a billion dollar bankroll.

I gotcha......I don't care for either, either.

But the lamest, moronic idea is that HC will be 'reformed' by stupid men who have no idea as to how it needs to be reformed.

I do not know everything about HC, but I know enough to say that the whole system is broken and promising reforms by putting "HC within everyone's reach" is just blowing smoke up everyone's rear.

Edwina's Secretary
09-05-2012, 05:17 PM
But the lamest, moronic idea is that HC will be 'reformed' by stupid men who have no idea as to how it needs to be reformed.



Perhaps then, instead of stupid men...some smart women ought to be in charge of fixing it.

Kidding aside "stupid men" is the sort of generalized ad hominem comment that stands in the way of getting things done.

mrspunkysmom
09-05-2012, 07:42 PM
I've said it once, I'll say it again: The man is a used car salesman with a billion dollar bankroll.

That's funny. That's exactly how he comes across to me. :D

RICHARD
09-05-2012, 08:06 PM
A used car salesman or a community organizer that is more community than organization.

I hope that people are ready for change.



Please re-elect President Dwayne Elizondo Mountain Dew Herbert Camacho.

RICHARD
09-05-2012, 08:21 PM
Si se puede, perro no tienen sesos acer el trabajo.

mrspunkysmom
09-05-2012, 08:36 PM
A used car salesman or a community organizer that is more community than organization.

I hope that people are ready for change.



Please re-elect President Dwayne Elizondo Mountain Dew Herbert Camacho.

I have to admit that if the legislature was populated with like-minded people that are interested in running the country, President Obama would be very effective. However, we have several agenda driven politicians on all sides that remind me of a Kipling quote.

RICHARD
09-05-2012, 09:33 PM
Gimme What You Got
-d. henley

Baby picks off your plate--yours looks better
And she throws hers on the floor
Here, in the home of the brave
And the land of the free
The first word that baby learns is more


So you're out there floating like a big, puffy cloud
With the pool and the charcoal
And the kids and the wife
Til the reruns of your dreams are interrupted
And you step out into life


And it's still gimme, gimme what you got
Gimme, gimme what you got
I said gimme, gimme what you got
(I want it, I want it)
Gimme, gimme what you got


Now it's take and take takeover, takeover
It's all take and never give
All these trumped up towers
They're just golden showers
Where are people supposed to live?

You can arm yourself, alarm yourself
But there's nowhere you can run
Cause a man with a briefcase
Can steal more money
Than any man with a gun


I said gimme, gimme what you got
Said gimme, gimme what you got
Gimme, gimme what you got
Gimme, gimme what you got


You got the price of admission--
You don't have to ask permission
To take somethin' from another man
You cross a lawyer with the godfather, baby
Make you an offer that you can't understand


From Main Street to Wall Street to Washington
From men to women to men
It's a nation of noses pressed up against the glass
They've seen it on the TV
And they want it pretty fast


You spend your whole life
Just pilin' it up there
You got stacks and stacks and stacks
Then, Gabriel comes and taps you on the shoulder
But you don't see no hearses with luggage racks


Gimme, gimme what you got
I said gimme, gimme what you got
I said gimme, gimme what you got
(I want it, I want it)
Gimme, gimme what you got

RICHARD
09-05-2012, 09:59 PM
I wonder what a Dem would have done?

http://news.yahoo.com/gop-freshman-andy-harris-saved-2-olds-life-195325127--abc-news-politics.html

Waited for Obama to sign the "Medicine by the Road Act"?


Healthcare for everyone at the roadside?

----------------------

Camacho/Not Sure 2012

Edwina's Secretary
09-05-2012, 10:43 PM
Si se puede, perro no tienen sesos acer el trabajo.

I am curious....who are you suggesting does not have the brains to do the work?

It reminds me of an saying...if you want to get something done...find the busiest person you know...

Working hard these days are we?

I am always amused (to quote) by people who are full of opinions about how stupid other people are...while failling to offer an evidence of intelligence themselves!

RICHARD
09-06-2012, 10:16 AM
Wheeeeeeee.......

Back when I was working the trend was moving towards hiring people with college degrees.

Hmm, hokay.........that should help the cause.

On two occasions people were hired to work with me that had degrees and no background in healthcare. It was frustrating because they asked questions and when they heard the truth or facts?

They chose to ignore the facts and move in their direction.

They were let go after less than a year.

-------------

I outlasted four bosses in 7 years (they were doing a job I had held for 10 years at another facility) -the job was salaried so they didn't feel the need to work to get the job done, my co-worker and I had to clean up the messes.

So, when I see a used car salesman and a community organizer try to come in and change a system THEY KNOW NOTHING ABOUT, its pretty effing scary.

Either one will hand it off to a subordinate -with god knows what agenda fuels them - say that THIS is the direction HC needs to go in...

You can bet your bottom dollar that some AH lobbyist will grease the wheels in order to get his company or products put into the system.

I am glad I am not a young person starting off in this day and age.

Our government -no matter who is in charge - has killed any idea as to what an American Dream is or should be.

HC is something that needs to be fixed NOW.

Revisit the thread in a few years - talk to some physician/surgeon/care giver and see what they think - you may be a little surprised.

RICHARD
09-06-2012, 04:05 PM
A story about how the US health care sys wastes 750 BILLION dollar a year.


http://news.yahoo.com/report-us-health-care-system-wastes-750b-140106406.html


I see the light at the end of the tunnel....






IT'S A TRAIN!!!!!!!!

RICHARD
09-07-2012, 09:38 AM
Here's an update about the woman who was charged 83,000 dollars for treatment of a scorpion bite..

She was charged 1,300 dollars for an ER visit.

She was charged 39,000 dollars for two doses of an anti-venom for scorpion bites called ANASCORP.

Her bill is being amended.

Apparently ANASCORP is manufactured in Mexico and sold there for .......

100 Dollars a dose.

Yes, let's give insurance to everyone and let the prices fall where they may?

RICHARD
09-07-2012, 01:31 PM
http://news.yahoo.com/spin-erectile-dysfunction-drugs-spider-toxin-171122079.html


Spider toxin as an ED med?

They just have to iron out the side-effects, like chasing Little Miss Muffett around her tuffet?

-----------------

In all seriousness,

This will be another drug that, if approved, that costs 48 cents to make and be prescribed at 700 dollars a pill.

Edwina's Secretary
09-07-2012, 06:50 PM
Wheeeeeeee.......

Back when I was working the trend was moving towards hiring people with college degrees.

Hmm, hokay.........that should help the cause.

On two occasions people were hired to work with me that had degrees and no background in healthcare. It was frustrating because they asked questions and when they heard the truth or facts?

They chose to ignore the facts and move in their direction.

They were let go after less than a year.

-------------

I outlasted four bosses in 7 years (they were doing a job I had held for 10 years at another facility) -the job was salaried so they didn't feel the need to work to get the job done, my co-worker and I had to clean up the messes.

So, when I see a used car salesman and a community organizer try to come in and change a system THEY KNOW NOTHING ABOUT, its pretty effing scary.

Either one will hand it off to a subordinate -with god knows what agenda fuels them - say that THIS is the direction HC needs to go in...

You can bet your bottom dollar that some AH lobbyist will grease the wheels in order to get his company or products put into the system.

I am glad I am not a young person starting off in this day and age.

Our government -no matter who is in charge - has killed any idea as to what an American Dream is or should be.

HC is something that needs to be fixed NOW.

Revisit the thread in a few years - talk to some physician/surgeon/care giver and see what they think - you may be a little surprised.

I am reminded of a bit from the musical Evita...she returns from a trip to Europe and complains..."they called me a wh**e, they actually called me a wh**e. The response..."That's okay, they still call me admiral even though I left the sea long ago!"

catlady1945
09-09-2012, 12:21 PM
"Brevity is the soul of wit"
William Shakespeare