Health insurance rant.

[SilverPhoenix]

I'm not saying Canada has it perfect or anything close to it (obviously not, though from what I've heard in general it seems at least somewhat better than our current system), just saying it saddens me that health care is such an issue. I wish there was a solution that was effective and simple. I remember as a young child I just assumed that everybody got health care whenever they needed it and that it was simple to afford. Growing up and discovering how complex and expensive the medical system is in the US has been very disheartening. Even my mother, who is a nurse, gets depressed about it. I will get medical insurance when I'm not longer on my parents' plan because I do recognize how important it is and after all the ER visits I had a few years back (at least ten of them) I know I'd need to have insurance, but it really does seem like a big rip-off. Here people are paying ridiculous amounts of money monthly for medical insurance (and many of these people can barely afford it), and the CEOs are raking in billions of dollars, and then the insurance companies fight tooth and claw to not pay for the costs that the insured people are paying them to cover. It's BS! I feel like there's got to be a better way for this all to work, even if I don't know what that way is yet.

 

[MoSo]

Quote:
There are two programs in Oregon - you might look at the OMIP

http://www.omip.state.or.us/

which insures people who have been turned down elsewhere for insurance, or who are considered "high risk." My neighbor was laid off from work about 2 years ago and his COBRA ran out. His new job doesn't a) pay very well or b) offer any insurance and his wife has a complicated eye issue that requires multiple surgeries. They'd been turned down for private insurance but were eligible for OMIP.

 

[b.hromada]

Sounds to me like what all the health insurance companies are doing!

My hubby dropped ours this year, because he didn't have enough money in his paycheck to live off of. I was furious with him, and we had a nice argument about it too.

Back in March, guess what, he ended up in the hospital for 2 days! Yeah, now he says he wishes he'd never dropped it, that it was a lesson learned. Its just gotten so out of control, people can't even afford it any more. Although, hubby says he will certainly get it back come January! It makes you so scared to think of what could happen when you don't have it! Best of luck to you, I know its difficult to come up with all that money, and THEN, the out of pocket charges for things!

 

[Quillgirl]

Just for the record, our insurance has paid exactly what it should have paid, when it was supposed to pay it. No argument that some insurers are shady and try their best to deny claims or wear down a claimant until they go away. Other times people simply don't understand their contracts (they are not easy to understand) and are surprised when they are not covered for something that was not in the contract. And other times a claim is denied because someone in billing did not code something correctly. Example: my husband's GI procedure was denied because it was miscoded as a hysterectomy! Duh. I caught it, called and had the dr's office resubmit the claim with the corrected code and it was processed. A huge problem is that health insurance contracts are hard to read and understand for most people. They don't know how to compare them, catch the loopholes, or how to negotiate the claims process. This has nothing to do with smarts, or education. These are complicated legal documents.

On top of everything, medicine becomes ever more expensive when it is easy and lucrative to sue providers whether there is a valid claim or not. (Please do not tell me every claim is valid. I can tell you so many stories of people not taking responsibility for their own actions and blaming the nurse, doctor, hospital, ambulance driver for the outcome...) When a physician must pay $30,000 a year (on average) out of pocket for malpractice insurance in order to work (it is mandatory if you want hospital privileges) and can potentially be put out of business with a single claim, even one that is frivolous, there is a problem. That expense and risk will be passed to patients and their insurance companies.

 

[Organics North]

Quote:
I agree with you Quilgirl. It is just not safe to be with out any coverage. One needs to change their mindset and be willing to pay for the normal under a couple thousand dollar stuff.....HOWEVER one major event without coverage and you will be bankrupt!
We have a health savings account. My spouse and kids were able to buy a private plan. I was not. I needed to go to the state to buy a plan with other high risk folks. (You know people who might have a hangnail or something...

)

Again our system in the US is so broken! BUT, everyone should at least buy catastrophic coverage until we as a country can get off our butts and make some meaningful changes to the system.

________________________________

If the Canadian plan is so terrible as some of the propoganda being spread around the USA would suggest. I wonder why the average Canadian life span is 80.7 years and in the USA it is only 78.1 years??????????????????????????
Oh yes the per capita expense in Canada is $3,895 verses the USA a WHOPPING $7,290!!!!!!!

Hmmm Live longer for half the cost.... Just terrible.

Read up on wiki for starters:
http://en.wikipedia.org/wiki/Health_care_in_Canada

ON

 

[BlackBart]

Quote:
Believe me it is not perfect. Nothing is perfect when it comes to that volume of money going out per year.
Don't believe too much of what you read or hear. You have to live it to fully understand it. Most Canadians are very grateful for our Medical system.
The system is based on triage with some cracks. As with any huge cash expense, corners will be cut and those funds will be diverted. There has been talk of scrapping the whole thing or making it two tiered, so far that has been met with huge opposition.

I wonder which is worse, the government running the Health Care or big business (Insurance companies)?

In British Columbia your monthly fees would be $56 per person if the company you work for doesn't have a plan. If you make a poverty wage then Medical coverage is free (and some Dental and education). If your a immigrant then Medical coverage is free up to a certain time line. If you know how to work the system then you are made in the shade, indefinitely.

Nobody is turned away from a Medical facility or denied medical help.
Almost everything is free. I will not say everything is free but 98% is paid for. Cosmetic face lifts, you pay

I am sure there are lawsuits but we never hear of them.
The Doctors and Nurses are hired by and paid by the Government.

Most of my neighbors are Americans and they receive BC Medical. Some of them waited until they got the Medical coverage approval to get their needed operations done here. A couple have told me when they travel to the States and if they get sick, they want to be driven to the border and dumped at the first Canadian Hospital. I asked why? Because they told me going to a US Hospital would make them bankrupt. They like our cheap Meds too.
I don't know if I should believe them or not.

My sister-in-law worked in the USA Medical system for years. She too would get dis-heartened but really liked the money she made and the opportunity to make more. She said the health industry is a business there. I don't know if that is true or not.

I don't know how the US Medical system will end up working but I think everybody has the right to medical help without going broke or having money as a deciding factor whether you get treated or not.

From what I have been told by relatives the German Health-care system seems to work pretty good and most people are happy with it. But again it isn't perfect either.

 

[ChikeeMomma]

Self employed here. So we buy our own health insurance, too. It's a pain! The hospitals and doctors offices sometimes have bogus charges (sometimes an accident and sometimes they can get away with it). So I have learned to carefully look over bills and explanation of benefits, thoroughly! And, of course, our premium is always going up even though we don't use it often.

 

[Sonoran Silkies]

Our insurance is good. Really good. Our costs have gone consistenly down over the last several years as the company has narrowed down the plans it offers, leaving only the one we have had for years. Mind you, it is not cheap, but it costs us probably a third less than what it cost five years ago. The reason they have narrowed the plans down? Because the cost of administering multiple plans is too high; because HMOs ended up costing more rather than less than convention insurance.

Really, whose responsibility is it to pay for the cost of becoming ill? EVERYONE gets sick or injured sooner or later. Or repeatedly.

When I was a kid, medical insurance covered only the BIG expenses such as serious conditions that required surgery or hospitalization. Now we expect it to cover everything. We did not live is a sue-happy culture who expect that bad things never happen to good people.

Probably the only part of our insurance that could be improved is the cost of prescriptions. I picked up two today that cast me $66. Without insurance they would have cost an additional $250. They were out of the 3rd med I need--it will cost me another $75; $350+ if I didn't have insurance.

 

[redhen]

What scares me the most is that we'll lose our health care "freedom"...
Right now i have so many choices ... i dont have to settle for care that i'm not happy with.
From what i know of Canadas health care...they do NOT have the health care freedom that we have here in the states...
No matter what they say..they do NOT.
And... their health care isnt ALL free.. the people i talk to from Canada tell me how much they have to pay and how FAR they have to travel to find a clinic that has a doctor that treats their specific problem (literally HOURS..) And the prices they quoted were HIGHER then what we pay here in the states for some things!!!!!!!!!!!!!!!!!!!!
I do NOT want to end up like them.... it truly scares the crud out of me..
Also..i think that the Canadians that say how great their health care is have never had health care freedom like we have here... they really dont know any different. They dont really know what they are missing...
Also..i know that MANY Canadians come here for health care..(WHY IS THAT?? Think about it people!!!!!!..).what will WE do when that happens to us? Where will WE be able to go?? We surely wont be able to go to Canada to get the care that we need or want! They have enough of their own health care problems...

This is really stressing me out... i DO NOT want to lose my health care freedom!!!!!

 

[Crusty McPottydoodle]

Quote:
Actually, our system works on a triage system. The more serious your condition, the farther up the list you go. We do not have case workers. The attending doctor decides how serious the situation is and how fast one needs to be seen. I scratched my cornea a couple of weeks ago and had a bad reaction to the antibiotic drops and had serious vision imparement. I was in the ER 3 times in 3 days. My longest visit from start to finish was 2 hours. My last visit was at 4pm on a Monday. The ER doc decided I needed to see an eye specialist. Under non-emergency circumstances, the waitlist is weeks long. I was in to see her at 8am the next morning - again at no charge to me.

My friend had a suspicious mole on her leg. She was in to see the specialist the next day. It was cancerous and within a week it was removed.

In my province we pay monthly for healthcare based on income.

For those who do not qualify for premium assistance (which ranges from 20% to 100% subsidy) the monthly rates are:

$57 for one person
$102 for a family of two
$114 for a family of three or more



Yes, impatient people pay to go to the US to jump the queue. While yes, a lot of these are waiting for treatment for conditions that affect quality of life, they are not conditions that are life threatening.

Yes, I suppose our taxes are higher than those in the US, but I wouldn't be surprised if the extra we pay in taxes would still work out to be much less than the average person in the US pays in healthcare costs.

There seems to be a lot of misinformation about the Canadian healthcare system and how it works.