Page 6 of 9 FirstFirst 123456789 LastLast
Results 76 to 90 of 123

Thread: Do we dare discuss the Supreme Court decision re: Healthcare

  1. #76
    Join Date
    Aug 2008
    Location
    Los Angeles, Ca
    Posts
    4,045
    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!
    Proud to be a crazy cat lady!

  2. #77
    250/month?

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



    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.
    The one eyed man in the kingdom of the blind wasn't king, he was stoned for seeing light.

  3. #78
    Join Date
    Apr 2001
    Location
    indianapolis,indiana usa
    Posts
    22,765
    Quote Originally Posted by Lady's Human View Post
    250/month?

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



    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.
    I've Been Boo'd

    I've been Frosted






    Men, it has been well said, think in herds. It will be seen that they go mad in herds, while they only recover their senses slowly, and one by one."
    Charles Mackay, Scottish journalist, circa 1841

  4. Quote Originally Posted by Karen View Post
    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!)

  5. #80
    Quote Originally Posted by Edwina's Secretary View Post
    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.)
    The one eyed man in the kingdom of the blind wasn't king, he was stoned for seeing light.

  6. #81
    Join Date
    Oct 2005
    Location
    Illinois, USA
    Posts
    24,254
    Quote Originally Posted by Edwina's Secretary View Post
    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.

    Quote Originally Posted by Lady's Human View Post
    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!.
    Last edited by cassiesmom; 07-11-2012 at 11:33 AM. Reason: Because this is a hot-button issue for me!
    Yikes! I've been Boo'd ... right off of the stage!
    Aaahh, I have been defrosted! Thank you, Bonny and Asiel!
    Brrrr, I've been Frosted! Thank you, Asiel and Pomtzu!


    "That's the power of kittens (and puppies too, of course): They can reduce us to quivering masses of Jell-O in about two seconds flat and make us like it. Good thing they don't have opposable thumbs or they'd surely have taken over the world by now." -- Paul Lukas

    Cassie's Catster page: http://www.catster.com/cats/448678

  7. #82
    Join Date
    Sep 2005
    Location
    St. Louis, Missouri
    Posts
    5,302
    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.
    facebook

  8. #83
    Join Date
    Aug 2004
    Location
    Alberta, Canada
    Posts
    20,283
    Jessika, that is abominable! I don't know who she would write to - but notifying the media is a good start!
    "Instead of wondering when your next vacation is, maybe you should set up a life that you don't need to escape from." -- Seth Godin

  9. #84
    Quote Originally Posted by cassiesmom View Post


    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.
    The one eyed man in the kingdom of the blind wasn't king, he was stoned for seeing light.

  10. Quote Originally Posted by Lady's Human View Post
    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!

  11. #86
    Join Date
    Sep 2002
    Location
    Kentucky, LAND OF THE EASILY AMUSED
    Posts
    24,614
    The secret of life is nothing at all
    -faith hill

    Mr. Show?

    No humans were hurt during the posting of this message.

  12. #87
    Join Date
    Sep 2007
    Location
    Delaware, USA - The First State/Diamond State - home of The Blue Hens
    Posts
    8,721
    Quote Originally Posted by RICHARD View Post
    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.
    I've Been Boo'd
    Thanks, Barry
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    My little dogs - two heartbeats at my feet.
    by Edith Wharton & Me
    Sparky the Fuzzbutt - PT's DOTD 8/3/2010
    RIP 2/28/1999~10/9/2012
    Myndi the Fuzzbutt - Mom's DOTD - Everyday
    RIP 1/24/1996~8/9/2013
    Ellie - Mom to the Fuzzbuttz

    To everything there is a season, and a time to every purpose under the heaven.
    Ecclesiastes 3:1
    The clock of life is wound but once and no man has the power
    To know just when the hands will stop - on what day, or what hour.
    Now is the only time you have, so live it with a will -
    Don't wait until tomorrow - the hands may then be still.
    ~~~~true author unknown~~~~

  13. #88
    Join Date
    Jun 2000
    Location
    Waltham, MA, USA
    Posts
    35,292
    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.
    I've Been Frosted

  14. #89
    Join Date
    Sep 2002
    Location
    Cincinnati, Ohio USA
    Posts
    11,421
    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.

  15. #90
    Join Date
    Sep 2002
    Location
    Kentucky, LAND OF THE EASILY AMUSED
    Posts
    24,614
    "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.
    The secret of life is nothing at all
    -faith hill

    Mr. Show?

    No humans were hurt during the posting of this message.

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Copyright © 2001-2013 Pet of the Day.com