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NancyAndFriends Posts: 1,153

Thought I would pass on this 'thought provoking' message.   bear_whistle




American Health Care

Two patients limp into two different American Medical clinics with the same
complaint.
Both have trouble walking and appear
to require a hip replacement.

The first patient is examined within the hour, is x-rayed the same day and
has a time booked for surgery the following week.

The second sees the family doctor after waiting a week for an appointment,
then waits eighteen weeks to see a specialist, then gets an x-ray, which isn
t reviewed for another month and finally has his surgery scheduled for 6
months from then.

Why the different treatment for the two patients?

The first is a Golden Retriever.....

The second is a Senior Citizen.

DebbieD Posts: 3,540

Ouch!!!  But sadly, so very, very true.....

Daphne Back Road Bears
Laconia, NH USA
Posts: 6,568

If it wasn't for insurance companies................and the number of humans vs. dogs in need of medical care................and.... and.... yet WE should be receiving the prompt and often personalized service and care that our beloved pets do. It certainly is fair!

thumperantiques Newcastle, Ontario
Posts: 5,643

Wow, that surprises me - in Canada, the waiting times are ridiculous and we have national health care.  I thought the wait times in the U.S. were shorter.   We're a border community and people from this area are traveling to N.Y. state to get MRI's and other tests that take too long here.  That's an eye opener.

                                                      hugs,

                                                      Brenda

Dilu Posts: 8,574

From the time it was agreed I had to have a new knee to the surgery was 3 weeks.  I barely had time to clean and stock the freezer.....


I had the date and the doc and all the pre-op stuff done but still didn't have insurance approval until I called and cried and complained that they promised me they would believe their doctors esepcially since it is the self same doctors who OWN this insurance company and I am stressed enough and only 3 days to surgery and how dare they make me wait over the weekend yda yada yada.....with a hint of maybe I should have gone with Healthnet instead of you......yada.....

[size=20]and within an hour......what do you know![/size]


so I can't complain toooooo much


and the hysto?  Well that was less than 2 weeks-but thats only because the doctor was worried I'd end up bleeding to death if he didn't get me in.....sheesh.....



But health care is frightening.  It is a BIG BUSINESS and the bottom line is always more important than the health and safety of the patient.


Been this way since the 80's when they introduced managed care and DRGs and started shortening hospital stays as much as greedily possible.


So.....

If someone does get a long wait for a new hip they are seeing the wrong doctor or they are not being proactive-


no it doesn't take 6 months but it can take a month maybe 2 dependingon the severity of the situation


And I know I have said this many times, and you all are tired of hearing it, but for you newbies here

[size=20]YOU MUST DO YOUR RESEARCH AND BE PROACTIVE[/size]

CUZ


Nobody cares more about your health than you do

learn as much as you can before you go in and you'll be surprised how differently you will get treated by your doctors and other health care individuals!



bear_grin

Daphne Back Road Bears
Laconia, NH USA
Posts: 6,568

Brenda - I find the original post with a 6 month wait to be a little exaggerated. If we were in the UK under socialized medicine I could understand. A friend of mine in Wales had to wait almost a year to have carpal tunnel surgery and couldn't work in the mean time. This same friend has had to wait over two years to get started on an insulin pump! I had my tendon release surgery within a week and a half from diagnosis and waited 3 months to get an insulin pump because training and blood work etc. had to be done first. If a patient in is dire need of surgery I can't see this country putting it off 6 months.

It is indeed true that vetrinary medicine practice and care CAN be much quicker and efficinet than it is for humans. But not to the point of human neglect or risking one's life. And the circumstances are all very different.

I'll still take the US health care system over any other well-known country. Though I'd love it if we could use some of Sweden's medicine and techniques here in the States. The rules governing medicines and procedures here in the states are ridiculous at times!

Dilu Posts: 8,574

It all depends on who gave how much money to which adminstration/congressman/senator.......


It really does

Daphne Back Road Bears
Laconia, NH USA
Posts: 6,568

Sad how politics effect our healthcare.
OK, politics effect EVERYTHING!
And we live in a FREE country??  :crackup:  :crackup:  :crackup:  :doh:  :doh:  :doh:

Dilu Posts: 8,574

You said it Daphne....it is sad.....


Still and all, like you said earlier, I prefer our health care to what i saw in Germany and Italy and Switzerland.....

And what our friends tell us from New Zealand or Oz or Canada or England.....



[size=20]sigh[/size]



It breaks my heart that EVERYONE doesn't have quality health care at a price they can live with.....



Especially when you consider how much money congress wastes on a daily basis.....

kathytaylor Ruby Mountain Bears
Northern Nevada, USA
Posts: 1,467

As a medical insurance biller, I can tell you what the difference is in Healthcare, for most of us with pets, we don't have insurance for our pets, we pay cash for thir care. Vets don't have to jump through the hoops and obstacles that MD's do. I spend 75 % of my time on the phone with insurance companies getting them to approve surgery for patients so it will be paid for. If we paid for our own healthcare, we would decide when it got done, and how and who did the surgery. Often times people are limited to their In Network providers. The Wait can be Months. I work for the Only Urologist for 250 miles area, I tell you he is a busy man. And since there is only one of him the wait unless it is emergency is over 8 weeks. He is a good Dr and will not turn away patients without insurance or money. He can't see them suffering.
Most Dr. are unfortunately at the mercy of Insurance Companies and most of them are crooked. People pay for Insurance, then the insurance refuses to pay for their health care needs.

rkr4cds Creative Design Studio (RKR4CDS)
suburban Chicago
Posts: 2,044

I can't speak more highly of BC/BS. Both of my major surgeries were scheduled and accomplished with 3 weeks, TAH ( Total Abdom Hyster.)  and knee replacement. And that wait was only to get all of the testing for heart, blood drawn, etc finished in time for the Dr's next available surgical date.
If it were crisis care they would have been done 'alnost' immediately.

I've never had a bladder infection in my life, with the exception of the TWO that I developed, botyh times in the week prior to the surgical dates, 15 years apart. Weird.

I'm so enthused about my new knee that I've already scheduled the other for 16 Oct. (I'm a b_ _ _ _  in the summer humidity; I don't need to complicate my life!!)

What would you guess is going to visit me the week before? LOL

Bobbie

Judi Luxembears
Luxemburg, Wisconsin
Posts: 7,379
rkr4cds wrote:

I can't speak more highly of BC/BS.

Well on the other side, I can't speak LOW enough of BCBS.  They were charging me personally $1,444.00 dollars PER MONTH for health care insurance .  This was just for me, not the rest of my family.  Our agent, who was also a friend, came right out and said that BCBS is trying to price us out.  Well, they did.  I am a very heathly person (unitl a month ago) and rarely got sick...BUT because I have diabetes...I am discriminated against .  NO insurance company will give coverage to a diabetic, no matter how hard I stick to my health management regimine.    Diabetic medications and test strips cn cost out of pocket over $300 per month...just to stay alive.

Health insurance companies have no problem taking your money but don't want anyone who might make a claim.  It's not like I am a smoker with lung cancer...I did not do anything to cause my diabetes but am treated like *#!T by insurance companies.

The ONLY way I can get any coverage at all is through HIRSP, Health Insurance Risk Sharing Plan, a government program for those who are deinied by every other health inurance company.   :pray:  :pray:  :pray: Thank goodness for HIRSP..now I only pay $400 per month.

This whole subject gets me riled up. bear_angry

psichick78 Flying Fur Studios
Calgary, Alberta, Canada
Posts: 3,073

Oh boy, I have to admit, the wait here can be pretty long, but I'm very happy to live in CANADA

I can't even imagine paying more than $30 a month for unlimited health care. But yes, we have crazy long wait times here. All the doctors go to the US because there is more money there.

Judi, how they can expect someone to pay those amounts?

What happens to an  American if you  get really sick with cancer, break a bone or need a trip to the emergency room, and you have no insurance or money?????????

Dilu Posts: 8,574

BOBBIE said:

What would you guess is going to visit me the week before?

Bobbikins, and idea:  About 2 weeks before surgery in October start drinking Cranberry juice.  It can be one of the mixed juices you can add 7UP whatever. Just make sure it has cranberry in it 

Cranberry juice will bring down the PH in your urinary tract system.  Lower Ph=higher acidic lever, which, believe it or not, is what you want.  A healthy bladder system is about Ph 5.

Be sure to let us know before you go in so we can root you on!

How on earth you can think of doing it again is beyond me, but I am only 6 weeks out from my new knee replacement and so I am still dealing with pain and swelling and poor sleep and stuff and bother!



HEATHER said

What happens to an  American if you  get really sick with cancer, break a bone or need a trip to the emergency room, and you have no insurance or money?????????

It is a huge problem Heather.

Hospitals are closing right and left, because they are unable to stay afloat.  By law they have to see you if you show up at an ER.  It used to be just the border states that had problems, California, Arizona, New Mexico, Texas, because so many from south of the border would come across for health care.  They couldn't pay for it and don't pay for it and the hospitals swallow the costs.

Now it is across the states.  So many US citizens are uninsured and use the ER for primary care.  In other words, go to the ER for a cold or hang nail or , my favorite, CAT SCRATCH FEVER.

Truly medicine is in a crises in the states, and it will come to a head in the next 5-10 years. 

Insurance is out of the cost range for most US families.  Many big corporations who used to have health care coverage for employees are dropping it because their costs have become so outrageous.

More and more states are dropping their low income insurance that they used to have for the poorer families because more and more the "middle" class families are using it.

So:

insurance costs are sky high
no one can afford it anymore
there are more uninsurred sick people using ERs
the hospitals are closing because no one is paying for the care
Obstetricians are changing their specialties because they can't afford the mal practise insurance
Other doctors are going back to school and becoming lawyers
ambulance chasing lawyers are making multimillions and then running for vice president
Law suits are raising the costs to the insurance companies


it is truly a viscious circle, and the people suffering are the truly needy-the ones who have debilitating illnesses that have been priced out of the insurance coverage needed to help keep themhealthy and well.

Judi was most definetly not exaggerating when she quoted her insurance costs-you need to know that, and for alot of people that cost would have been per quarter, (every three months)


This is one of the reasons we HAVE to be proactive and really understand how to stay healthy.....we may have insurrance today and a week from now discover nothing is covered anymore.

bear_cry

Dilu Posts: 8,574

I forgot to say that Doctors who used to  make beaucoup bucks for being doctors are having their lifestyles changed and aren't making the money they used to.

They are being absorbed into huge corporations that pay them salaries, and if they try to go it alone they can't get the patients who have insurrance because those people have to stay with the doctors approved by the insurrance companies- what that means is that in exchange for agreeing to see the patients those doctors agree to take less from the insurrance companies



seeing a pattern here?


Health Insurrance companies had a banner year last year as far as money in to ratio money out.  Check it out on Forbes or some other money oriented web site.....


so while we are sick and struggeling the Blue Crosses, Pasific Cares and Healthnet CEOs are getting multimillion dollar bonuses.....  bear_angry

Aleta - The Silly Bear The Silly Bear
Portland, Oregon
Posts: 3,119
Website

My husband and I are both self-employed.  On a wing and a prayer we have gone uninsured throughout our 25 years of marriage.  Knock wood, we have always been able to pay for whatever health care we've needed out of pocket.  Sad, but true, the out of pocket expenses every year were thousands less than we would have paid to be insured. 

What I would like to know is this:  Why is it, those with insurance are given a discount on services while those of us who pay cash pay the highest cost for the same services?  This is the practice they used in the medical office I went to when we lived in the Seattle area.  I don't know if this is the same in other areas as well.

After reading what Judi posted about not being able to get insurance coverage because of her diabetes, I'm wondering if someone such as myself, with high blood pressure and having had cancer, can even get insurance coverage these days.  It is posts such as these that are very helpful in bringing ideas into the forefront what perhaps we've been neglect to think about. 

Warmest bear hugs,  :hug:
Aleta

Helena Bears-a-Bruin!
Macclesfield, UK
Posts: 1,291

Ohhh nooo, I feel a little rant coming on.... bear_grin These are just my views, formed from my own experience and not intended to upset anyone.... bear_flower ....

You can give me the socialized health care we have in the UK any time, over the insurance based system that has now crept into our dental care service. Really, the prices are ridiculous, and I'm yet to be convinced that the end result is any better.

Our healthcare system is by no means perfect - taxes are high to pay for it, waiting times are often overlong, and the service can vary a lot between areas - but everyone has the right to it no matter what their circumstances. I can make an appointment to see a GP on the same day I need to see him/her, and be referred to a hospital the same day if the doctor thinks it's necessary. I can walk into any accident and emergency department and be treated. I don't need to worry about insurance.

Having said all that, I do have private (insurance driven) dental care because in our area there's no choice. And I have on one occasion chosen to use a private medical service because the waiting time on the National Health Service was too long.... so as I said, nothing's perfect!

sarahjane Brisbane
Posts: 2,951

...BUT because I have diabetes...I am discriminated against .  NO insurance company will give coverage to a diabetic, no matter how hard I stick to my health management regimine.    Diabetic medications and test strips cn cost out of pocket over $300 per month...just to stay alive.

Judi I really feel for you and know what you mean about not being able to get insurance ... My sister was a diabetic and insurance over here refused to cover anything that may be related to her diabetes...which is just about everything you can suffer from (and if there is not a link they will find one!!!). It used to cost her a fortune to buy syringes etc too, but if she was a drug addict she would have qualified to get them free (how crazy is that!!!)

Also we find that with a large family insurance is unaffordable for us too...

Touch wood our family has been fit and healthy so far, but with the waiting times as long as they are over here I dread the idea that someone in my family may need the health services!!!

Helena Bears-a-Bruin!
Macclesfield, UK
Posts: 1,291
Judi wrote:

because I have diabetes...I am discriminated against .  NO insurance company will give coverage to a diabetic, no matter how hard I stick to my health management regimine.

I find this SO disturbing.

The first time I travelled to the States I work in a hotel to earn a little money, and met a lovely caring woman who worked in the laundry room there. She told me (after a few weeks of knowing her) that she had a breast lump, and it had been there for about a year. A year! I asked if she had been to see her doctor? She said no, because she didn't have insurance.....   bear_cry :mad:

It made me appreciate the system we have in the UK. Judi, I'm speechless  bear_noexpression .

Dilu Posts: 8,574

Aleta:


I pray you hit 65 before anything goes wrong, because you are right.  Were you to try and get coverage now you would have a very difficult and expensive time of it.  Once you hit Medicare age and sign up you are covered for everything, no matter your past history.


Your biggest problem will be choosing your secondary insurrance.  Most all seniors and disabled who are on Medicare also have a secondary-which then becomes your primary.  You sign over your medicare to the insurrance company.  Then they cover you and say yay or nay to your health care.  But there are much strickter rules governing them.


Yes you can go with just Medicare but it actually works out better for most retirees to go with a company


You are also right re: the 'discounts' given to various insurrance companies.  However you can try bargaining with your healthcare provider.  I have done it.  I have said I know that you get $xxxx per visit from Blue Cross or Healthnet.  I will pay you that and 10% more in cash for my visits.  I save you massive billing headaches, and youtreat a cash patron with the same respect you treat an insurrance comapny.

There are even some doctors in the larger cities who are no longer taking insurance.  They habve smaller overheads, no longer need billing experts and find the whole business of medicine a lot easier.

Are there advantages to the British system?  You bet there are.  And if you are youngish and healthy it is a great system.  The drawbacks come in when you have chronic problems.  But there are serious probelms with the US way too.

Part of our problem is that they call it the free market place.  But it really isn't a free market place at all.

The insurance companies lobby congress, pay congress, gift congress, put it however you like, to get laws inacted in their favor.

were it a truly free market place this wouldn't happen and the fees we pay would be a lot less.

There is a reason why the laws protecting people on Medicare were enacted.....to make up for the laws that practically killed off the ability of seniors to get service. " Who wants to insure an old fart?  They are sick leave them alone and pretty soon you wont have to worry about them anymore"

Practically nothing in the US economy is a "free market" anymore.  Between the lobbiests and the lawyers we are becoming a 2 class society


The rich and the rest of us.

Nope, I am not ranting.  Just an old lady interjecting another view point from years of experience for everyone to put into the mix as the ponder the morass of medicine in the States


bear_wacko

Dilu Posts: 8,574

[size=20]Hiya Nanc[/size]

Bet you weren't expecting any of this when you posted your amusing story!



Don't take it personally-  it really was a cute story bear_grin


But on the other hand.....maybe it gives you US folks something to think about writing your congress/sentor folks about..... :crackup:

If anyone needs addresses let me know


bear_original

NancyAndFriends Posts: 1,153

:clap:  :clap: I am just getting back on after I posted this and I have found each and everyone of your posts very informative.
First let me say, that the email I received and posted here...I feel is probably an exageration...but was meant in all honesty, to show the nonsense and abuse that goes on for people, especially seniors as far as health care.

The few of you who know me well, know that situation my son went thru...and is still going thru, after his beloved wife passed away.  It is a real burden and I felt and still feel it was a horrible injustice.

With that said...my husband and I have always had insurance...until a little under a year ago.  Now at 61 and 63, we have absolutely no protection and believe me, it is something that I worry about on a daily basis.  We are very healthy people...not a problem at all except for my husbands high blood pressure (thank the Lord for His blessings) and as Dilu said, we are very proactive as far as taking care of ourselves.  The only problem we have is my husbands high blood pressure and a year ago (while still under insurance) he went to an Internist and had it checked.  They tried this and that and finally found a drug that has it perfect.  I found out that Aetna paid 37,000.00 to the Dr. and the lab, just to find out he had high blood pressure and what drug to use.  Can you imagine?  37,000.00?  The Dr. was only allowed legally to write him a pres. for 1 year.  He said just to come back and he would just re-new it...only he has left Harbin Clinic (no one will say where he went and I cannot find him) and the new Dr. (of course wants to do all the tests over again).  Now what?  With no insurance, we cannot afford 37,000.00 to get his medicine he needs.  I have absolutely no idea what we are going to do.  Perhaps a 'Doc in the Box'?  I don't know.
Judi, my heart goes out to you...we have friends that are just a little older than us and about 5 years ago, the Dr. who saw Denzel made a note on his medical history, that he had diabetic 'possibilities'...just posibilites.  He does not have nor has ever had diabetes and yet his insurance company got a hold of that and he is now paying 1700.00 a month for medical insurance on one little notation that his Dr. put on his record.  His wife Patty, doesn't have any medical because they cannot afford it for her also.  That is just criminal!  I'm sorry, but this country is in a crisis!
Dilu, you are just a wealth of information on this subject...did you see the article that Date Line did on the subject of insurance companies paying a different amount than the rest who are paying cash?  That was VERY hard to watch.

This was a hard thing for me to write because we have never found ourselves in a position such as this.  I can sypathize with you Aleta...we are in the same boat! 
It is very frightening...I guess if something drastic happens, my little 'friends' will cease because I will not burden my family with bills to pay for the rest of their lives...I have already seen that happen...as some of you know, what my situation is there and why I cannot afford to pay the high costs for insurance for myself.

I wish there was a way for a group of people to get together and form a 'company', so we could get insurance.
I thought Ebay had that...but I will tell you that as a Power Seller, I did receive a card that allowed me to get a 20 % discount on my new glasses and I greatly appreciated that.

My ranting and raving is all done...sorry it took so long but thanks for hanging in there with me.

hugs,
nanc..

rkr4cds Creative Design Studio (RKR4CDS)
suburban Chicago
Posts: 2,044

Hi Nancy & Judi,

I'd like to say that I'm too familiar with both sides of this - I was counting our BC/BSI blessings only on account of my DH's union (electical) but that can change at any time - there are only 2 guarantees in this life!!

Our oldest son & DIL are both disabled and have only Soc Sec & Medicare. Brian is 41; became diabetic at 11. After many health problems throughout his life he rec'd a double transplant about 7 years ago, pancreas and kidney. Dialysis and diabetes were gone overnight. But continuing BP probs and kidney function and other health things follow him. And he receives just $900 a month from Soc Sec to live on. (Having that garnished for child care has not been easy..)
I don't know what they pay in health care/ins.  So we live daily with waiting for the phone to ring, one more time....

did you see the article that Dateline did on the subject of insurance companies paying a different amount than the rest who are paying cash?  That was VERY hard to watch.

Nutzzz - I missed that one.
Brian's wife, our DIL, became disabled from a work injury to her back 10 years ago with the PO, just about the time she was also diagnosed with MS.

The point I'm getting to is that she had back surgery to 'restack' her back 2 years ago, the very same surgery & Dr that my DH had a year ago. Because we have insurance with PPO, they 'write off' between 1/2 - 2/3 of all of our health treatments (appts, surgeries, medications, etc) and then BC/BSI pays the major portion of what remains and we are billed a small amount to finish it off. 

But our DIL, w/only Medicare, had no write off through using an in-network Particpating Provider, was charged the full amount that Medicare allowed and was put on a payment budget, which is astronomical, in adittion to her monthly Medicare policy. This total surgery & rehab runs about $300,000. She will never have her debt paid off. The ppl who need it most (annually bringing in less than 12,000 on disability) pay full price and we who have ins get off almost scot-free. It just makes no sense.  End of rant.

Helena Bears-a-Bruin!
Macclesfield, UK
Posts: 1,291
Dilu wrote:

Are there advantages to the British system?  You bet there are.  And if you are youngish and healthy it is a great system.  The drawbacks come in when you have chronic problems.  But there are serious probelms with the US way too.

Dilu, my dad had a triple heart bypass and valve replacement only 3 years ago at the age of 75. All of this was done at the expense of our NHS system (which dad contributed to during his working life). So even the oldish and unhealthy can benefit too. Granted it's expensive in terms of taxes, and can sometimes seem unfair to those people who need little if any healthcare and still have to pay....but I would rather pay the tax, and I think most people here feel that way. When it does become a problem is when the money is mismanaged, and unfortunately that happens all too often :cry:.

Oh, and I blame the pharmaceutical companies too (and feel qualified to say that since I worked for one!!!).  But I won't get started on that....lol  bear_tongue

Acipenser Bine-Teddies
Stockholm
Posts: 862

Daphne - I thought the first was German and the second Swedish.  :crackup:

Dilu - I don't know why you had bad experiences with the German health care system. It is still much better than the Swedish one and the Swedish system appears to resemble the Bristish, with long waiting lists. All these systems are tax financed and cost a lot that way, but at least we get what we need (eventually) and people without a job get treated equally.
Swedes have made a habit of going to Germany for treatment, because its a lot faster, more efficient and you get a whole package, while in Sweden people are sent home as soon as possible, regardless of whether they have any help or not. Actually in Sweden, older people and those with chronic problems are taken care of much better than those who have an occasional problem. It takes time to get into the system, but once you are established, the system rolls on of its own accord.
Competing with Dilu on the coloring here  bear_tongue Oops, almost chose white text. Didn't know we have secret ink  :crackup:  :crackup:

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