wathe
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Posts posted by wathe
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Generally replying to all:
Things like time off for care givers and home renos and special cars wouldn't generally be paid for by health insurance here either (although sometimes they can be) . But I got the sense from the gofundme page that ICU bills and other direct medical expenses were "staggering" in this case, and that prompted my question.
US health insurance is way more complicated than I realized, with huge gaps in coverage apparently.
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4 minutes ago, Laura Corin said:
There are a couple of sets of data here:
https://en.wikipedia.org/wiki/List_of_countries_by_average_wage
Interesting.
I suspect our wage range is narrower, though - low wage earners a better paid, high wage earners less. I don't have a any data to back that up, it's just a general impression
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6 minutes ago, Laura Corin said:
I don't know how Canadian salaries compare to US ones, but I've always assumed that many UK salaries can be lower because the individual post-tax liability for health care expenses is so small.
No Idea. From what I read on this board, it would seem that teachers are much better paid here. I get the sense that quality of life, and what's affordable and what isn't for most people is similar (other than health-care, obviously!)
Quality of life might not have been the best word choice. I mean general affordability of life-style.
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1 hour ago, Katy said:
It isn't up to the White House. All federal employees (except congress, senate, and the VP & president themselves) have the same federal health care options. The strange thing is that federal government health plans are generally much better than what is available to the rest of the country.
They may be mixing up deductible and OOP max.
Federal employees here have really, really great supplementary insurance as part of their benefits package. I don't know why I assumed the US would be similar. Clearly I have no idea!
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This has all been very eye-opening. Thanks again, everyone.
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11 minutes ago, Frances said:
I’m not sure any insurance here would pay for everything for a hospitalization. I’ve never heard of a health insurance plan here that doesn’t have deductibles and copays. Plus, there’s always the risk that not all doctors caring for you are even part of your health insurance plan. Out of network costs can add up very quickly. I have excellent employer provided insurance for which I pay very little, but I would guess that in a situation like his I would still hit my yearly out of pocket maximum both this year and likely next year as well. We’ve been fortunate to never even come close to it, but I think it is about $5k for our family in network and about triple that for out of network.
As for the White House looking after its own, I would assume he is a federal employee and would have the same insurance options as most other federal employees. Unless some people at the White House wanted to personally pay for his out of pocket health expenses, I don’t think there is a way around having insurance with deductibles and copays. At least he probably doesn’t pay very much for the insurance, as I’m guessing most of it is paid for by his employer, the federal government. Some people here pay thousands of dollars each month for insurance here and still have high out of pocket expenses.
Another concept that's different. No "networks". Or, the whole province is my network, I guess. It all sounds very complicated. And stressful!
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Thanks all. It still seems weird to me that the White House wouldn't look after its own people. I clearly have a poor understanding of American health insurance.
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I didn't realize that government employee health insurance would only pay for part of hospitalization expenses - I assumed it would pay for all. Thanks for setting me straight.
Here, hospitalization is paid for 100% by the state for everyone*. The only things I would pay for out-of-pocket would be "upgrades" - parking, in-room entertainment unit/TV, upgrade to private room etc. Doctor's fees are also paid for by the state 100%, including outpatient/office doctor's bills (except some very few things deemed not medically necessary, like cosmetic surgery, are billed privately). I would never even get a bill.
We don't have universal pharmacare in my province (out of hospital) or allied health (physio, dental). Plans for those expenses are often provided by employers, or paid out of pocket. They are paid for by the state for over age 65, children under 25 without private insurance, those on disability and on social assistance.
*Canadians who've lived in-province for at least 3 months
ETA - I do pay an awful lot in taxes, though.
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10 minutes ago, BusyMom5 said:
I have no idea what type of insurance he has, but anyone can have a GoFundMe. There will be a deductible- maybe low, maybe high. Possibly a co-pay until a maximum out of pocket amount. It could also be for non-medical expenses, loss of work, a spouse's time off, ect. I would assume that he has good insurance as a federal employee, and that its just a way to show support and for other non-medical expenses.
Understood - but the gofundme specifically states "staggering medical bills", and that's the bit that's left me wondering.
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I'll add that I know that a lot of Americans are uninsured or under-insured. But a White House director? It feels like it doesn't add up and that I'm missing something.
My Canadian family members who work for government have kick-a$$ supplementary insurance plans through their employment (in addition to their publicly funded universal healthcare insurance).
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American boardies, please help me make sense of this - it has left me scratching my head. Reported in NYT today (excerpt), "Crede Bailey, the director of the White House security office who was hospitalized for months with the coronavirus, had his foot and the lower part of one of his legs amputated as he battled the infection, a friend of his wrote on a GoFundMe page dedicated to his medical bills."
I know that health insurance is often linked to employment in the US. But does this case make any sense? Why would a director of the White House security office need a gofundme to pay for medical expenses? Surely a White House security office director should have insurance through his employer? Am I missing something here?
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Boardgamegeek suggests 5+. I find that suggested ages on games tend to skew older than necessary - we pretty much ignore them. (Maybe it's a kind of aspirational marketing to make younger kids feel more grown up?)
If you are worried, watch a review to get a better idea if it will be a good fit.
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It'll be fine for the 6 year-old.
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3 minutes ago, kand said:
I didn’t know this—that Hep B was not much risk to an adult and most adults clear it from their system without negative effect. If that’s the case, why is it one of the vaccines required for health care providers? Is that so they don’t pass it to a young patient, rather than to protect the health care provider from their patients? Or is it to protect those people who won’t be among those who clear it without issue? I had to have it college due to being in a health field, and I assumed it was to protect me.
It's primarily to protect the HCW. It also protects patients. Most adults do clear it. But even if a small percentage don't clear it, it's still a lot of cases that would otherwise have been almost completely preventable with vaccine. She quotes that 95% of those exposed do not develop an infection. That means 5% do, and that's actually quite high (the risk of developing an HIV infection from a known positive medical needle-stick exposure is roughly 0.3%, by comparison, (without post-exposure prophylaxis)). The other issue with Hep B is that up to 50% of those who do go on to develop chronic Hep B don't have a history of acute hepatitis - they didn't know they had it.
The numbers I've seen suggest that for acute hepatitis B, 70% of those infected are sub-clinical, and 30% develop icteric hepatitis (jaundice). No, thanks - I'll take the shot.
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Our old dog used to drop the treat ball down the stairs to get the treats out without having to work for them. He was a smartie.
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Whether or not universal Hep B vaccination in infancy makes sense depends on whether one is looking at immunization from an individual protection point of view, or a public health point of view.
Hep B immunization in infancy probably won't make much difference for a low risk baby in a low risk family (both parents negative, well educated, stable family life - plus all the usual other social determinants of health), but can make a huge difference for higher risk babies. Universal, routine immunization ensures that the highest proportion possible of higher risk babies are protected - as the highest risk families tend to be the ones that fall through the cracks, and universal programs shrink the cracks, so to speak.
Both PP's are right, in that Hep B is transmitted by blood and bodily fluids, and can survive outside the body for days. But it's also true that most Hep B is spread by sexual contact (bodily fluid exchange) and needle sharing (blood). But, if mother is infected, mother to child transmission rate is really high (90%), and father to child is also relatively high (as high as 65%). Whether or not universal infant hep B immunization make sense from a public health point of view depends on the prevalence in the population, I think. Most mothers are diligent with prenatal care, but a significant number aren't, and those at highest risk of Hep B are among those that are less likely get high quality prenatal and antenatal care. I don't think that there is any question that universal Hep B immunization in infancy prevents childhood Hep B at population level. The calculus is how many cases, at what cost.
It's not given routinely until age 12 in my province, unless there are risk factors, and there is controversy about that. Other provinces provide it universally it in infancy. We had our kids immunized against hep B as young children (and paid for it out of pocket) because we planned to travel - we did both hep A and B at the same time.
Edited - to add missing words in fist sentence - makes more sense now!
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22 minutes ago, Carol in Cal. said:
I encourage you to read “And The Ladies Of The Club”. It’s a fantastic historical novel, and among other things it describes some of these illnesses that were almost eradicated by vaccines. I found it to provide helpful information in making up my mind, when Mothering Magazine and other local sources were very anti vax.
This post made me want to comment further on "Your Child's Best Shot". It's chock a block full of info, including the historical burden of each disease covered. Those sections were eye-opening for me.
It also covers the current incidence of each disease, pathophysiology, how the vaccine is made (and what it's made from) and how it's tested, how it's given, its efficacy, and risks (including the very rare ones, with numerical data). It's really a very thorough treatment of the topic, with lots of data. I love data - very helpful for decision making.
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The Canadian Pediatric Society has oodles of immunization information. Their book, "Your Child's Best Shot", is particularly good.
I agree with pp that CDC advice is standard of care in the USA.
If by "moderate", you mean alternative to standard of care, then I disagree about your use of the term moderate.
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7 hours ago, kristin0713 said:
Umm, where do you live that there are pythons?
4 hours ago, Bambam said:I'm wondering if the python was a pet too?
I'm quite sure Bookbard is in Australia. I think wild diamond pythons are common where she is.
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8 minutes ago, Corraleno said:
I think there is also an assumption that prioritizing "essential workers" will benefit the economy more than keeping a bunch of elderly and/or unhealthy people alive. Vaccinating the 1.4 million nursing home residents in the first group should cause a significant drop in the death rate, which will encourage people to feel like the pandemic is almost over and go back to life as usual. So the next priority is protecting the supply chain by vaccinating meat processors and delivery drivers and grocery workers, etc., while the 50 million people 65 and older just isolate at home and wait their turn. That's my somewhat cynical take on it anyway.
I think you are probably right.
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1 hour ago, vonfirmath said:
We got a game called Concept we really enjoy playing.
We split up into two teams -- but honestly its just fun trying to figure out how to get the concept across and trying to guess the concept being illustrated.
We really like that one too. We don't bother with points or winning. I agree that just trying to figure out how to get the concept across is really fun.
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38 minutes ago, Corraleno said:
Plague is also transmitted directly from person to person.
That's really rare though (to the point that human to human transmission by aerosols remains controversial), and low pandemic potential - primary pneumonic plague ((plague acquired by inhaling aerosols from an infected animal or human) victims get sick fast, and die fast. Plague is almost always spread by fleas, and most pneumonic plague cases are secondary (spread to the lungs inside one's own body after being bitten by and infected flea).
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On 12/10/2020 at 2:16 PM, rebcoola said:
Our newest game that we are giving everyone is Poetry for neanderthals. A guessing game where you can't use any words with more than one syllable or you get bonked on the head with an inflatable club.
My kids will love this. Thanks!
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US healthcare/insurance question
in The Chat Board
Posted
Wait times can be a problem here (usually for more chronic issues), and referrals are needed for specialists (there is gatekeeping). There is definitely griping about that. For example, you would wait a long time for an MRI of your shoulder for rotator cuff problem, or for back pain without neurological deficit. But, once you access the service, (MRI, specialist etc), it costs nothing out of pocket. Cataract surgery, joint replacement surgery - those all have long waits.
Truly acute issues get handled quickly. If you get emergency sick (appendix, ruptured aneurysm, trauma), you get very well cared for immediately, at no cost OOP.
If you get very sick sub-acutely (say, cancer) you get care, in a timely fashion, no cost OOP.
Semi-acute but not very sick (say grumbling gallbladder, but not acute cholecystitis) do tend to wait.
Preventive and primary care are also no cost OOP, and access is very good for most people (there are provider shortages in some more rural and remote communities).