I'm speechless. I can't imagine this: British treatment of premature birth

[Renee in NC]

That is just it in that if we all pooled our 8% together for universal single payer health care, then I bet everyone's health care costs would be cheaper;) I am for universal health care since I think it is the most cost effective solution IMHO. It is the profit factor in private health insurance that drives high premiums and bare bones coverage. Why are we letting a middle man who only wants to pay fat salaries and make large profits between us and our doctors?

 

My 2 cents:)

 

I can see the problem that people have with this. My dh makes slightly above minimum wage and I would gladly pay 8% into a single payer system. However, once you got over a certain income limit, it would no longer be fair to other people. Currently, social security has a cap - you only pay the 6.2% SS part up to a certain income level and then no more (Medicare tax goes on forever, I believe.)

[NoPlaceLikeHome]

I can see the problem that people have with this. My dh makes slightly above minimum wage and I would gladly pay 8% into a single payer system. However, once you got over a certain income limit, it would no longer be fair to other people. Currently, social security has a cap - you only pay the 6.2% SS part up to a certain income level and then no more (Medicare tax goes on forever, I believe.)

 

This is true, but I was only using Jenn C's number as an example. I am not sure what numbers would be necessary but I believe it would be significantly cheaper than at present. IMHO I believe that the fees should be graduated based on income as income taxes are currently done, but that is only one idea:).

[Haiku]

They are a business.

 

And that is why I think that they are the wrong entity to manage health care. Way back on the first page of this thread, someone stated that universal health care is all about saving money. I think it has been adequately demonstrated that corporate health insurance is all about saving money and, for that reason, people will always be left out. In my moral universe, chalking that up to "life's just hard" is unacceptable.

 

I simply refuse to believe that private health insurance will ever work without government regulation to ensure that everyone can get it, and everyone arguing against universal care also seems to argue against government regulating corporate health insurance companies.

 

Tara

[JennC]

That is just it in that if we all pooled our 8% together for universal single payer health care, then I bet everyone's health care costs would be cheaper

 

I don't think so. And this proposed 8% wouldn't raise enough to pay for the actual cost, so taxes WILL eventually have to go up to pay for it. And it is those making over 100,000/year who pay the taxes. The top 10 percent of wage-earners pay 90% of taxes. How arrogant to say that the wealthy should provide for the non-wealthy - and I'm thinking of the people at 300% of the poverty rate who qualify for free healthcare now.

I for one, do not equate paying more taxes with being patriotic, a la Joe Biden.

 

Every one's health care costs (cost, not the amount they pay, which will "magically" go to zero) will actually be the same or more, because people with no co-pay will not be as judicious in their use of hospitals for illnesses vs. preventive care. If you don't believe me, go hang out at a housing project for a while - I used to live in one, so I know first hand that this happens.

 

The people whose health insurance costs will go down are those with high premiums due to extreme health needs or high health care use. Everyone else's health insurance costs will go up - including healthy people who have insurance, want to keep their insurance or would forgo insurance (as the healthy 20-somethings who elect to not have insurance). This is just common sense. Now these people will have to be paying for their own insurance as well as those who will be paying less than the cost of their own insurance.

 

The COST will not go down, it will just be different people paying for it.

[cathmom]

I am so frustrated right now that I want to scream at the computer. I am so tired of the idea that if people would just man up and take responsibility for themselves, their health care woes would go away. I am so tired of the idea that if people don't have insurance, or have ridiculously expensive insurance, it must be their fault. I am so tired of the attitude that "I'm happy with what I have and I couldn't be bothered by your troubles." I just want to scream. I wish people would open their eyes and stop believing some fiction about what's going on with health care in America.

 

Tara

 

I'm about there as well. I actually polled my FB friends because politicians keep saying most Americans are happy with their health care. Less than 10 people answered, but most said they were. However, the way they phrased their comments sounded to me like they were saying, "We know it could be much, much worse, so yes, we're happy with it."

 

My dh and I have insurance. We pay for a private plan. They only reason this private plan is affordable is because I have had it since graduating from my master's program. I converted my student insurance to this plan. At times, I wanted to cancel it when money was tight, but dh would never allow it. When he was in college, he saw a man get hit by a car. The man was lying there in the street, with probably at least one broken leg and other injuries, and all he could say was, "I *just* cancelled my insurance because I couldn't afford it! How am I going to pay for this? What am I going to do???" AS HE WAS LYING THERE IN THE STREET!

 

That was over 15 years ago. I know things aren't any better today.

 

For a while, my dh worked for a state hospital. The coverage they offered was so bad! He was on it for free. To cover the rest of our family would have been 25% of take home pay! Even though he technically had insurance, we couldn't afford for him to go to the dr. When he left that job, we put him back on my private plan. Now, I won't let him take the insurance through work because if he loses his job, he may not be able to get back on the plan. So we have decent insurance, but if either of us had a serious illness, we would be in trouble.

 

There's just no need for this! It's just my personal belief that a civilized country wouldn't let its citizens live like this. But do I have faith that Congress can do anything? No, because they get their campaign money from the insurance companies and the pharmaceutical companies and not from us. Poor people don't make campaign contributions. Just look at the so-called credit card reform.

 

Sorry for the rant.

[Mrs Mungo]

Every one's health care costs (cost, not the amount they pay, which will "magically" go to zero) will actually be the same or more, because people with no co-pay will not be as judicious in their use of hospitals for illnesses vs. preventive care. If you don't believe me, go hang out at a housing project for a while - I used to live in one, so I know first hand that this happens.

 

You can't lump *everyone* with government insurance in with those who are living well below the poverty line. People living below the poverty line have all sorts of factors working against them: inadequate nutrition (*nutrition*, not *food*), poor living environments, having to send sick kids to school because they don't have sitters, not being able to take kids to the doctor because they can't afford to take off work during the week.

 

You are also forgetting that suddenly hospitals would be getting paid for treating a lot of people that they currently don't get paid to treat. If people had access to preventative care, many would use it. If they had access to "urgent care" clinics where you sign in, see a PA for something simplistic and go, many people would use it. If they had the ability to access care *other than* using an ER, many people would. This would help unclog the ERs, which are expensive to run. Some of this would balance out.

[LisaNY]

I find it hard to believe that no one tried to provide emotional support for the mother in this case.doctor's believed that

 

Why do you find that hard to believe?

[kalanamak]

 

2.) We have come to a point where we have the ability to cure many things, but at a great cost (a true cost, too, not just an inflated cost.) We haven't had the conversation in this country about how to balance those two things. Do we continue to cure everything, no matter what the cost? Who pays for that? Medical advances keep coming, how we are going to decide when the cost is too high?

 

A-Yup, and how we deal with our limits is either going to elevate our country or degrade it. I recall a story I heard in a lecture, about the first few doses of penicillin. The urine of the recipient was collected and it was recycled. Each day, a public health czar of the city decided who would get the doses. It had to be someone who would die without it, live with it, and had a compelling reason to live (prime of life, dependents, a child, etc). I would rather that, and all the room that has for error, than the biggest bully, with the biggest stick or strongest union or largest cash advance to whichever politician decide this.

What is "fair", who will decide is "fair" and how we will convince everyone else to go along with it (by being "fair" in the administration of it) is going to be crucial, and, honestly, articles about one horrible situation harm this process, rather than help it, IMnotatallH opinion.

I would *love* to introduce medical ethics into high school. If health care is going to absorb such a chunk of our budget, it should get some attention. (Said sternly, but without a bit of ire.)

[LisaNY]

:iagree::iagree::iagree:

 

Frankly I am more concerned about private health care insurance companies being between me and my doctor than the government. I believe that private health insurance companies are strictly motivated by the bottom line and fat paychecks, including the so-called non-profit ones.

 

Question for you - what will motivate the government to provide the best health care possible?

[LisaKinVA]

This is an emotionally-charged issue, from so many standpoints. I really feel for those who are living health care nightmares (as someone who already has spent $30k on fixing an issue, and still has another $15k to go, that no insurance company will cover).

 

The cost of care is complex. I've heard that we pay 2-3x what other countries pay for the same drugs, because socialized countries have some sort of cost controls which then forces those of us here in the US to pay more (Sen. Warner said something to this effect). People using ER's for things that aren't emergencies, the fact that that hospitals try to pay off equipment in TWELVE months instead of amortizing the costs over the half-life of the machine (and the cost of a scan doesn't "go down" after the machine is paid for either), an "over-reliance" on doctors by the general public (I don't feel good -- go to the doctor and you have a cold, or flu, which in most cases the doctor can't do anything about), the practice of "defensive" medicine which has driven the costs of OB care through the roof, and driven C-section rates up too. Treating pregnancy like a disease.

 

There is no "magic bullet" -- but I am left here wondering why the health care industry has to have all of these different pools in today's society. Why can't they base it on standard tables of the U.S. as a whole, or regions, like car insurance?

 

Why can't the insurance company work from the same coding for service, a standardized claims form, etc. -- so that it wouldn't take so much time to file and report? Whenever I have a problem with something routine that's "not" covered, it's almost always due to a coding issue.

 

I also think the way the "safety net" has been designed is pretty much worthless. In some cases it FORCES families not to work, because they can't afford needed care. There should be a scale to help people out and take more responsibility as they are...not simply cut people off entirely. Of course in a perfect world there would be a private, charitable organization that would do stuff like this...

 

Most of the "fixes" that are in this bill do nothing to actually reduce costs, but simply change who is paying for them.

 

I'm going to stop here... because all I'm going to do next is a rant on fairness.

[Janet in WA]

Those of us who live near the US border with Canada have another experience: A booming medical community supported by Canadians who surge across the border to access healthcare that either isn't available to them in Canada or for which the wait is staggeringly long.

[Lovedtodeath]

You can't lump *everyone* with government insurance in with those who are living well below the poverty line. People living below the poverty line have all sorts of factors working against them: inadequate nutrition (*nutrition*, not *food*), poor living environments, having to send sick kids to school because they don't have sitters, not being able to take kids to the doctor because they can't afford to take off work during the week.

 

You are also forgetting that suddenly hospitals would be getting paid for treating a lot of people that they currently don't get paid to treat. If people had access to preventative care, many would use it. If they had access to "urgent care" clinics where you sign in, see a PA for something simplistic and go, many people would use it. If they had the ability to access care *other than* using an ER, many people would. This would help unclog the ERs, which are expensive to run. Some of this would balance out.

Good points.

[Haiku]

forgo insurance (as the healthy 20-somethings who elect to not have insurance).

 

I see it kinda like car insurance. We aren't forced to have car insurance solely for our protection; it's also for the protection of others in the case of an accident. If I am uninsured and get in a terrible accident, the chance of me having enough money to compensate the other driver is very small (however, in our state, if you show proof of "enough" money, and I don't know the amount that qualifies as "enough," in reserve, you don't have to buy insurance), so insurance protects the other driver.

 

If people are so against having to pay for another person's health care/insurance, but they think it's fine for people to be uninsured, then what do we do when the person who is "young and healthy" and chose to forgo insurance gets cancer or wraps their car around a telephone pole? Do we tell those people, "Sorry, since you didn't buy insurance, we won't treat you"? Or do we treat them anyway and let everyone else shoulder the cost?

 

It seems to me like one of those situations where you can't have it both ways.

 

Tara

[mysticamethyst]

I have not read all 7 pages of responses and will probably mess mine up as I go. First, I am very sorry for the mother that is the worst experience that any parent should have to go through. However, the article doesn't go into what complications the baby had, which at 20 weeks would likely be many. What kind of life would that have been? How many sugeries would have followed, how many different procedures would have been preformed on this wee little spirit. Nothing about that sounds humane. Then you have the cost factor, all of the measures to sustain life are expensive and money doesn't just appear out of thin air, do I like that no, but it is reality. Then you also have to consider the emotions of the parents and how hard that would be on them, their relationship and soforth. I have friends that have a 2 year old and yes she did survive, but she has had 15 surgeries, cannot walk, talk, eat, drink, speak, nothing and she never will; she is just there. This is incredibly hard for my friend and her husband. At some point the inevitible will happen anyway as sad as that is.

 

I am happy for all of you that have relatives and your own children that have come from a rough start and are perfectly fine, but that is not the norm for premies, esspecially born from 20 weeks on.

 

Final thought, yes I have lost two children at the 19 week mark, does it hurt, oh my yes, does that mean they should have been saved, not really. :grouphug:

[astrid]

Link to the section of the healthcare bill that mandates that qualified plans pay for abortion please? I do not believe any of the proposals say this.

 

:lurk5:

[astrid]

I'm Canadian.

 

I've read every.single.page. of the 26 page long thread. I'd like to address some things that have been accused of a national health care system.

 

 

 

THANK YOU. I recently spent 10 days in Canada (NS, PEI, NB) with cousins who were appalled that this is even a debate. As my crusty old second cousin said, "Heck, the graveyards in Canada are not overflowing!"

 

astrid

[mommyrooch]

THANK YOU. I recently spent 10 days in Canada (NS, PEI, NB) with cousins who were appalled that this is even a debate. As my crusty old second cousin said, "Heck, the graveyards in Canada are not overflowing!"

 

astrid

 

I think that I would get along with your second cousin. ;) This is certainly one way of putting things in perspective. :D

[astrid]

Yes, he's quite a character!

 

We enjoyed our visit very much. Halifax is an AMAZING city!

 

astrid

[angela in ohio]

Link to the section of the healthcare bill that mandates that qualified plans pay for abortion please? I do not believe any of the proposals say this.

 

Here is an analysis at Factcheck.org, which can hardly be accused of conservative views. ;) It has links to the bill and various amendments, as well as quotes from President Obama.

[mommyrooch]

Yes, he's quite a character!

 

We enjoyed our visit very much. Halifax is an AMAZING city!

 

astrid

 

I have always wanted to visit Canada. I think that most Canadians are more on par with what I believe in. I believe in a country helping it's citizens. Most Canadians that I have talked to are like you cousin. They are appalled that this is even an issue. Most of them can't imagine NOT helping their fellow citizens and they are willing to pay into the system to accomplish that.

 

Despite it's flaws I am convinced that Canada's healthcare system puts America's to shame. If I could get my entire family to move up there I believe that I would relocate in a heartbeat. My family is the ONLY thing keeping here. It certainly isn't because of my pride in my country. I for the most part lost that a long time ago. This saddens me because I believe that America does have some wonderful qualities. It has the potential of being so much more and so much better. We just can't seem to come together to make the changes that are so desperately needed and I'm afraid that we never will. :crying:

 

I am going to put Halifax on the top of my list if I ever get up that way. Thanks for the tip. ;)

[astrid]

you know, I could have WRITTEN your post! My mom has family in the maritime provinces, and we are really, seriously thinking about moving there, for all the reasons you articulate and more. I haven't been to Halifax in years, and dh had never been, but we really could see ourselves living there.

 

I strongly encourage you to check it out! pm me if you'd like!

 

astrid

[JennC]

I see it kinda like car insurance. We aren't forced to have car insurance solely for our protection; it's also for the protection of others in the case of an accident. If I am uninsured and get in a terrible accident, the chance of me having enough money to compensate the other driver is very small (however, in our state, if you show proof of "enough" money, and I don't know the amount that qualifies as "enough," in reserve, you don't have to buy insurance), so insurance protects the other driver.

 

If people are so against having to pay for another person's health care/insurance, but they think it's fine for people to be uninsured, then what do we do when the person who is "young and healthy" and chose to forgo insurance gets cancer or wraps their car around a telephone pole? Do we tell those people, "Sorry, since you didn't buy insurance, we won't treat you"? Or do we treat them anyway and let everyone else shoulder the cost?

 

It seems to me like one of those situations where you can't have it both ways.

 

Tara

 

I see your point, Tara, really I do. But yes, I believe that if Joe Six Pack should have the right to decide for himself if he wants to spend his money on snowmobiles, new cars and a big house. If he does not have health insurance, by his choice, then when the big bills come in, he should pay them. Maybe it means selling said luxuries, and making payments, and perhaps going bankrupt and then even having to make hard decisions about what care he can afford.

You see, in my view, the difference is automobile liability insurance is to cover someone else. That is closer to the equivalent to what universal health insurance is - everyone must pay to protect someone else.

If Joe Sixpack (I'm actually referring to his abs, not his alcohol use :D) chooses not to protect himself, that is now HIS problem.

 

What I don't understand is this: Why do people not have a problem with handing over such a huge control to the state? We choose to educate our children outside of the state system for a reason. The state system is failing. Medicare/Medicaid is a broken system. Look at what the state system did to the mortgage industry. (You must give a loan to anyone, because home ownership is a right.) Responsibility goes out the window and the nanny state "must take over."

 

I know I have stated before, but will reiterate because I feel I have been mischaracterized. I do think it is a good thing to take steps to help people who have the impossible choice, as you do, regarding your health insurance. (like CHIP) This is what the co-op idea is about, I believe. Also, allowing for insurance companies to design plans around their customers needs/wants. I do not want an insurance plan that covers birth control, abortion, well-baby checks, sports physicals, teeth cleanings, eye exams, etc. I consider these maintenance items to be more affordable than the premium in the first place. And if there was a large group of people who got togher with the same idea, our insurance would be cheaper, because it would not pay for those things.

However, many state governments require insurance companies to cover a long list of procedures (including ones I would rather not have covered) decided on by legislators - not customers. The insurance companies must comply in order to do business in that state. This is one main reason that insurance premiums are so high. If the government would quit regulating the InsCo to death, they could better meet the needs of their customers.

As well, then an ins.co could have a larger pool for each group because they could take customers from all 50 states to make up their pools. Group A "wants only catastrophic care" could include more people - cost goes down. Group B "wants the cadilac plan" could include more people - cost goes down.

It is basic economics, but our federal government has been failing basic economics for years now. For what it's worth, I am a republican in general, but I have never been so angry at a politician as I was at Bush for signing that darn 1st TARP plan. And I think that Clinton's Welfare Reform was one of the best things to happen during his administration (ok, its the only legislation I can remember ;))

 

Just thought I'd throw in that I am not in love with insurance companies. But insurance companies employ a lot of people. What government plan are we going to have to come up with when bluecross, healthOne, Kaiser, etc. have to start laying everyone off, because they are going out of business?

 

One size fits all, does not fit anyone.

 

random thought: We we soon see life insurance be mandatory as well, since we are all going to die? Maybe the state will start to provide this so that Martha doesn't have to foot the bill for a funeral.

[Lovedtodeath]

Great post Jennifer.

[NoPlaceLikeHome]

Why do you find that hard to believe?

I find it hard to believe because I am a nurse and I went into nursing because I do care and I did provide emotional support as a nurse. I believe that many, not all, nurses, doctors, social workers go into their professions because they care:)

 

P.S. I also think she must have encountered multiple health care providers as would be the case in any hospital as well which is also why I find it hard to believe that not one person offered emotional support. Perhaps it was offered and she she did not see it that way:(

Edited September 15, 2009 by priscilla

[NoPlaceLikeHome]

Question for you - what will motivate the government to provide the best health care possible?

 

As it stands IMHO there are many happy customers of medicare and I see that as an example. Sure Medicare could use some reforms like stopping the big hand out to pharma and instead set more reasonable prices for drugs as they do in Canada:)

Edited September 15, 2009 by priscilla
spelling

[mommyrooch]

Link to the section of the healthcare bill that mandates that qualified plans pay for abortion please? I do not believe any of the proposals say this.

 

It doesn't say that. The way the plan is worded is that reproductive services would be covered. There are a LOT of things that could fall under reproductive services. It is argued by many that because the plan states that it will cover reproductive services then it stands to reason that abortion will be covered. :confused: This seems like a pretty big assumptious leap to me. I have yet to read where it "specifically" states that abortions will be covered. People saw the words reproductive services and ran with them.

 

I have a question for those of you that use abortion as one of your primary arguments against government ran healthcare. Have you called your current insurance companies to find out if they ever cover reproductive services?

 

I currently have BCBS right now and my plan DOES cover reproductive services. So, according to this line of thinking it would be a reasonable argument to say that private insurance companies "must be" covering abortions since they cover reproductive services. Right? After all, this is what we are saying the government plan is doing. Since they are covering reproductive services then they "must be" covering abortions. Am I right?

 

On the other hand, if these "private" companies cover reproductive services but do not specifically cover abortions then it stands to reason that just because the government option covers reproductive services then that doesn't necessarily mean that it will include abortions in that coverage. Right?

 

I'm just trying to wrap my mind around how it is okay for "private" companies to cover abortions and that be acceptable but if the government offers the same coverage it is completely unacceptable.

 

On the other hand, (I'm running out of hands. :tongue_smilie:) I'm trying to wrap my mind around how just because the government plan is offering coverage for reporductive services this automatically equates to abortion coverage. :confused: There are a LOT of things that could fall under the classification of reproductive services. Just because the government plan would cover reproductive services does NOT mean that it would include abortions in that coverage. It also does not mean that Obama lied. This plan may have an exclusion to that coverage. We don't know that. Where does it "specifically" say (without assumption) that abortions will be federally funded?

 

Either way, it seems really hypocritical to me that private insurance companies can choose whether or not they want to cover abortions yet if the government makes that same choice it is terrible.

 

I would wager that many of the plans that Americans already have cover abortion costs to some extent. They might do it claiming it is only covered if it is "medically necessary" but isn't abortion still abortion to many, no matter what the reason?

 

Check your current policies if you are opposed to this part of the government plan and see if THEY EVER cover abortions. If they cover abortions in any way under any circumstances and you are choosing to do business with them then you rightfully cannot use this argument against the government plan. After all, we don't even KNOW for sure if the government plan is going to cover it.

 

There are a lot of people making a lot of speculations without proven facts. Just because the plan states that it will cover reproductive services does not prove that abortions will fall under that.

 

I'm still waiting to see documented proof that specifically states that abortions will be covered under the federal plan.

[JennC]

 

I'm still waiting to see documented proof that specifically states that abortions will be covered under the federal plan.

 

 

I'm curious about this, too. That is why I originally asked the question. BTW my health ins co is mandated by state law to cover "reproductive services" and yes this is euphemism here for abortion on demand. I don't like it. I wish Health insurance companies were not forced to cover procedures that their customers do not wish to pay for, or would not use. And that is not just abortions.

[LisaNY]

As it stands IMHO there are many happy customers of medicare and I see that as an example. Sure Medicaid could use some reforms like stopping the big hand out to pharma and instead set more reasonable prices for drugs as they do in Canada:)

 

Yes, but my question is, what is going to motivate the gov't to continue in this way when the system gets flooded with millions more? How will things "pan out" then?

[mommyrooch]

I'm curious about this, too. That is why I originally asked the question. BTW my health ins co is mandated by state law to cover "reproductive services" and yes this is euphemism here for abortion on demand. I don't like it. I wish Health insurance companies were not forced to cover procedures that their customers do not wish to pay for, or would not use. And that is not just abortions.

 

On the other side of the coin I wish that their customers could choose to get and pay for coverage on procedures and treatments that are not covered in the plan.

 

For example, my daughter right now is needing vision therapy for her eyes. My insurance company (BCBS) will not cover it. I pay them

thousands of dollars a year in premiums for coverage only to be told they will not cover her treatment even though it has been deemed "medically necessary." by her doctors. I can not get ANYTHING done without first getting the "approval" of my insurance company. What's worse is that often times they don't approve of treatment. Just as in the case of my daughter.

 

That is frustrating and it angers me. This is what upsets me when I hear the argument that people don't want government coming between them and their doctors. They say that they don't want government making their medical decisions but do these same people not realize that this is already happening everyday? :confused: My company is doing it to my family right now!

 

Insurance companies are already coming between us and our doctors EVERY SINGLE DAY! My daughters pediatrician and her Optometrist both "medically" agree that my daughter needs this therapy but my insurance is allowed to pick and choose what they will cover despite what her doctors are recommending. How is that not coming between a doctor and their patient?

 

My daughters therapy is going to cost approx. $3,000 and my insurance company has denied coverage. They are being allowed to pick and choose what they will or will not cover even if it goes against what our physician is recommending. :cursing: :banghead:. Since when do insurance companies know more about a patients care than that patients own doctor?:confused:

 

How is private insurance companies being able to choose what they will or will not cover any different than the government choosing what they will or will not cover? At least with a government plan I wouldn't be paying thousands of dollars for coverage just to be told that I wasn't covered anyway. Under the current system we pay thousands of dollars for a service only to be denied that service. How is this system any better? I just don't see it. :001_huh:

[cathmom]

On the other side of the coin I wish that their customers could choose to get and pay for coverage on procedures and treatments that are not covered in the plan.

 

For example, my daughter right now is needing vision therapy for her eyes. My insurance company (BCBS) will not cover it. I pay them

thousands of dollars a year in premiums for coverage only to be told they will not cover her treatment even though it has been deemed "medically necessary." by her doctors. I can not get ANYTHING done without first getting the "approval" of my insurance company. What's worse is that often times they don't approve of treatment. Just as in the case of my daughter.

 

That is frustrating and it angers me. This is what upsets me when I hear the argument that people don't want government coming between them and their doctors. They say that they don't want government making their medical decisions but do these same people not realize that this is already happening everyday? :confused: My company is doing it to my family right now!

 

Insurance companies are already coming between us and our doctors EVERY SINGLE DAY! My daughters pediatrician and her Optometrist both "medically" agree that my daughter needs this therapy but my insurance is allowed to pick and choose what they will cover despite what her doctors are recommending. How is that not coming between a doctor and their patient?

 

My daughters therapy is going to cost approx. $3,000 and my insurance company has denied coverage. They are being allowed to pick and choose what they will or will not cover even if it goes against what our physician is recommending. :cursing: :banghead:. Since when do insurance companies know more about a patients care than that patients own doctor?:confused:

 

How is private insurance companies being able to choose what they will or will not cover any different than the government choosing what they will or will not cover? At least with a government plan I wouldn't be paying thousands of dollars for coverage just to be told that I wasn't covered anyway. Under the current system we pay thousands of dollars for a service only to be denied that service. How is this system any better? I just don't see it. :001_huh:

 

Exactly!

[lionfamily1999]

I'm curious about this, too. That is why I originally asked the question. BTW my health ins co is mandated by state law to cover "reproductive services" and yes this is euphemism here for abortion on demand. I don't like it. I wish Health insurance companies were not forced to cover procedures that their customers do not wish to pay for, or would not use. And that is not just abortions.

"The president said “no federal dollars will be used to fund abortions.†But the House bill would permit a “public option†to cover all abortions, and would also permit federal subsidies to be used to purchase private insurance that covers all abortions, a point that raises objections from anti-abortion groups. That’s true despite a technical ban on use of taxpayer dollars to pay for abortion coverage."

 

From factcheck.org (http://factcheck.org/2009/09/obamas-health-care-speech/) this is where they critiqued his speech (you lie).

[JennC]

On the other side of the coin I wish that their customers could choose to get and pay for coverage on procedures and treatments that are not covered in the plan.

Insurance companies are already coming between us and our doctors EVERY SINGLE DAY! My daughters pediatrician and her Optometrist both "medically" agree that my daughter needs this therapy but my insurance is allowed to pick and choose what they will cover despite what her doctors are recommending. How is that not coming between a doctor and their patient? The insurance company is a private business. It sounds like you are extremely frustrated. I can see why. But it is the right of a private business to conduct their business in their own way. If you are buying individual insurance, you shop around and pick your plan (I remember your problem with that, I just mean that IF you do buy your own, you shop around.) If you are covered under an employee plan you are always allowed to opt out. There is no law saying you must buy their product. They provide a service, which sounds to be very un-useful to you. But this does not mean they are doing anything "wrong" You don't like it and you don't have to buy it. I understand it would be better for you if it met your needs, but think of this. If you go to Ruth's Chris steak house, you cannot protest if they won't sell you a $10 sirloin. Yes, these exist and yes, it would seem to you like an easy request. But they sell $50 steaks. Only the best, blah, blah, blah. It is out of my price range, but I don't have the right to make them sell a product just because it would benefit me. That said, I will restate my opinion that I believe it is reasonable to help people in the "high-risk, uninsurable category" to purchase some type of affordable health care for their family. I am really not an ogre. (nothing against ogres :D)

 

Since when do insurance companies know more about a patients care than that patients own doctor? I would say Ins Cos don't necessary know anything about their customers or their recommended health care. They know how much it costs and if on a large scale they can afford to provide that service for 'everyone' (because if they provide it, it will raise their cost)

 

How is private insurance companies being able to choose what they will or will not cover any different than the government choosing what they will or will not cover? Because the government is not paying for it, the insurance company is. And the customers' rates are adjusted yearly based on the actual cost to the insurance company for the covered care. Less coverage = lower premium price.

 

It is impossible to read you posts about your daughter and son and not have compassion for your personal grief from the medical conditions in your family, and the trials that come from dealing with them. A hug to you, and possibly a glass of wine, It has health benefits, I've heard. :001_smile:

[mommyrooch]

It is impossible to read you posts about your daughter and son and not have compassion for your personal grief from the medical conditions in your family, and the trials that come from dealing with them. A hug to you, and possibly a glass of wine, It has health benefits, I've heard. :001_smile:

 

Jennifer, Thanks for the kind words. I really do appreciate it.

 

I understand where you are coming from. I really do. I just don't "agree" with the way you view things.

 

You support the way current insurance issues are handled because insurance companies are a "business" and therefore have every right to be run as one. I do not agree with this. It's as simple as that. I do not even remotely compare my families healthcare coverage (or lack thereof) to that of ordering a steak at a steakhouse. This is where the fundamental difference in our opinions lie.

 

You see healthcare as any other business. Insurance companies to you are organizations simply providing services.

 

I see healthcare as a basic human right. Insurance companies to me are resources that "should" be accessible to humans when they are faced with medical problems. Regardless of the profit margins, regardless of a persons financial status, regardless of whether a person "planned" properly for the unexpected etc. If a person is sick and needs medical care that person should be able to obtain healthcare. Period. Final.

 

Let me explain it this way. I kind of compare healthcare to air and water. Imagine if all of a sudden air and water were not free and "businesses" stepped in and started picking and choosing whom they would provide it to and whom they wouldn't. Since air and water are needed for "life" then "I" morally believe that they should be available to EVERYONE. I put healthcare into the same category.

 

See the difference of our opinions? Until we can agree on this basic fundamental issue we will never be able to view the bigger issues the same way.

 

Also, note in my post where I said that it would be nice if insurance companies would allow it's customers to pay for certain coverage and therefore get access to that. In the example of my daughters vision therapy I am not even getting the choice to pay for coverage for it. They just flat out won't cover it even if I am willing to pay. Even if looking at it from a "business" perspective this is just bad business.

 

And you can't use the excuse that they won't cover it because they view it as a financial risk. They cover things that cost way more than $3000 so they are paying a lot more money on other things.

 

Their reason for not covering vision therapy is that "they" do not think that it is "medically necessary" When we found out that my dd's therapy wouldn't be covered we filed a petition to try to get the therapy approved. When they sent me my ever so wondeful letter of denial the reason stated for the denial was that they did not deem the therapy to be "medically necessary"

 

This is where I have a HUGE problem. It HAS been deemed medically necessary by both of her doctors but "they" (meaning BCBS) apparantly know much more about it then the specialists themselves. Heck, I even said that I would be willing to pay extra for the coverage but I'm not even being given that chance. This makes absolutely no sense to me even from a "business" and financial viewpoint. My daughter's vision therapy is much less risky and costly than say, open heart surgery.

 

Anyway, we could go on and on all day but like I said, until we can agree on the role that insurance companies should play in healthcare then we will never agree on all of the other issues surrounding it.

 

You see healthcare as any other "business." I see it as a basic human "right." We shall never agree on this key point therefore we shall never agree on how it should be handled. ;)

 

Thanks again for your kind words. I really do appreciate them. :grouphug:

[LMA]

Jennifer, Thanks for the kind words. I really do appreciate it.

 

I understand where you are coming from. I really do. I just don't "agree" with the way you view things.

 

You support the way current insurance issues are handled because insurance companies are a "business" and therefore have every right to be run as one. I do not agree with this. It's as simple as that. I do not even remotely compare my families healthcare coverage (or lack thereof) to that of ordering a steak at a steakhouse. This is where the fundamental difference in our opinions lie.

 

You see healthcare as any other business. Insurance companies to you are organizations simply providing services.

 

I see healthcare as a basic human right. Insurance companies to me are resources that "should" be accessible to humans when they are faced with medical problems. Regardless of the profit margins, regardless of a persons financial status, regardless of whether a person "planned" properly for the unexpected etc. If a person is sick and needs medical care that person should be able to obtain healthcare. Period. Final.

 

Let me explain it this way. I kind of compare healthcare to air and water. Imagine if all of a sudden air and water were not free and "businesses" stepped in and started picking and choosing whom they would provide it to and whom they wouldn't. Since air and water are needed for "life" then "I" morally believe that they should be available to EVERYONE. I put healthcare into the same category.

 

See the difference of our opinions? Until we can agree on this basic fundamental issue we will never be able to view the bigger issues the same way.

 

Also, note in my post where I said that it would be nice if insurance companies would allow it's customers to pay for certain coverage and therefore get access to that. In the example of my daughters vision therapy I am not even getting the choice to pay for coverage for it. They just flat out won't cover it even if I am willing to pay. Even if looking at it from a "business" perspective this is just bad business.

 

And you can't use the excuse that they won't cover it because they view it as a financial risk. They cover things that cost way more than $3000 so they are paying a lot more money on other things.

 

Their reason for not covering vision therapy is that "they" do not think that it is "medically necessary" When we found out that my dd's therapy wouldn't be covered we filed a petition to try to get the therapy approved. When they sent me my ever so wondeful letter of denial the reason stated for the denial was that they did not deem the therapy to be "medically necessary"

 

This is where I have a HUGE problem. It HAS been deemed medically necessary by both of her doctors but "they" (meaning BCBS) apparantly know much more about it then the specialists themselves. Heck, I even said that I would be willing to pay extra for the coverage but I'm not even being given that chance. This makes absolutely no sense to me even from a "business" and financial viewpoint. My daughter's vision therapy is much less risky and costly than say, open heart surgery.

 

Anyway, we could go on and on all day but like I said, until we can agree on the role that insurance companies should play in healthcare then we will never agree on all of the other issues surrounding it.

 

You see healthcare as any other "business." I see it as a basic human "right." We shall never agree on this key point therefore we shall never agree on how it should be handled. ;)

 

Thanks again for your kind words. I really do appreciate them. :grouphug:

 

Some questions: I feel like you are assuming that the govt. will pay for whatever treatment you want. Do you think that a govt. system will pay for your daughter's VT? Do you think that the govt. will cover ever possible medical procedure? Working with Medicare with my mother, most stuff is not covered. My mother pays Medicare premiums out of her Social Security, has to have a Medigap policy to cover the difference between what Medicare paid for the claim and what the doctor covers. She has to pay a Medicare D plan also. The monthly for the Medigap and the Medicare D is $500 a month, which is alot. Her Medicare premiums come out of SS. These are not cheap. Plus there are still copays for the medication which are not cheap. Her Lipitor copay was $99 last month and she wasn't in the doughnut hole yet. Once you fall in the Doughnut hole for meds (after $2500 roughly), you must pay out of pocket for the next $1200 or so. If you want something that Medicare or your gap policy won't pay for, then you must pay out of pocket. There is not additional coverage that is optional.

 

There are lifetime and yearly limits on hospitalization. Doctor's treatment plans are based on what Medicare pays. If she needs a test that Medicare won't pay for, the doctor chooses another test that Medicare will pay for even if it is not the proper test. Medicare patients have to do 3-month well visits with the primary doctor(because Medicare will pay for a well visit every three months or many doctors will not treat them when they are sick. You have to go to a yearly well visit with every specialist or they may not treat you when they need it. On this board, many people don't like to do well visits with their pediatricians. Well, with a govt. plan, you will be forced to. This will be a consequence of the govt. system.

 

The Medicare system gives us an idea of how a govt. system will work. It isn't a great system and many people's care falls through the crack. There is a lot of fraud. They had to put a per day test limit because doctors were ordering 6 tests at once.

 

Louise

[JennC]

Jennifer, Thanks for the kind words. I really do appreciate it.

 

I understand where you are coming from. I really do. I just don't "agree" with the way you view things.

Have a great weekend. We leaving today for a family trip - dh's parents are having their 50th - 750 miles in the car each way. :auto:

[Joker]

On the other side of the coin I wish that their customers could choose to get and pay for coverage on procedures and treatments that are not covered in the plan.

 

For example, my daughter right now is needing vision therapy for her eyes. My insurance company (BCBS) will not cover it. I pay them

thousands of dollars a year in premiums for coverage only to be told they will not cover her treatment even though it has been deemed "medically necessary." by her doctors. I can not get ANYTHING done without first getting the "approval" of my insurance company. What's worse is that often times they don't approve of treatment. Just as in the case of my daughter.

 

That is frustrating and it angers me. This is what upsets me when I hear the argument that people don't want government coming between them and their doctors. They say that they don't want government making their medical decisions but do these same people not realize that this is already happening everyday? :confused: My company is doing it to my family right now!

 

Insurance companies are already coming between us and our doctors EVERY SINGLE DAY! My daughters pediatrician and her Optometrist both "medically" agree that my daughter needs this therapy but my insurance is allowed to pick and choose what they will cover despite what her doctors are recommending. How is that not coming between a doctor and their patient?

 

My daughters therapy is going to cost approx. $3,000 and my insurance company has denied coverage. They are being allowed to pick and choose what they will or will not cover even if it goes against what our physician is recommending. :cursing: :banghead:. Since when do insurance companies know more about a patients care than that patients own doctor?:confused:

 

How is private insurance companies being able to choose what they will or will not cover any different than the government choosing what they will or will not cover? At least with a government plan I wouldn't be paying thousands of dollars for coverage just to be told that I wasn't covered anyway. Under the current system we pay thousands of dollars for a service only to be denied that service. How is this system any better? I just don't see it. :001_huh:

 

 

Off topic, but have you tried to get her vision therapy through an opthamologist? My dd needed vt and BCBS has paid for it through her pediatric opthamologist. I find I can get very little paid by BCBS if I go through an optometrist.

[Lovedtodeath]

 

This is where I have a HUGE problem. It HAS been deemed medically necessary by both of her doctors but "they" (meaning BCBS) apparantly know much more about it then the specialists themselves. Heck, I even said that I would be willing to pay extra for the coverage but I'm not even being given that chance. This makes absolutely no sense to me even from a "business" and financial viewpoint. My daughter's vision therapy is much less risky and costly than say, open heart surgery.

If you are willing to pay extra for coverage, then why don't you just pay for the therapy?:confused: I don't get it.

[PineFarmMom]

I'm still waiting to see documented proof that specifically states that abortions will be covered under the federal plan.

 

 

I'd like documented proof that specifically states that it will NOT!!! I'm not yet comforted by words out of the mouths of anyone. I want to see it in writing. If everything passes and that is part of what will be covered, I don't know exactly how we'll handle it because we just couldn't pay into something that knowingly murdered babies. :(

[Supertechmom]

I'd like documented proof that specifically states that it will NOT!!! I'm not yet comforted by words out of the mouths of anyone. I want to see it in writing. If everything passes and that is part of what will be covered, I don't know exactly how we'll handle it because we just couldn't pay into something that knowingly murdered babies. :(

 

Medicaid does pay for abortions. My friend's plan (they now offer medicaid under insurance "plans" run by insurance companies) specifically states that abortions are covered under it. Federal money doesn't pay for it just your state taxes. I don't know if every state allows it but if this conservative bible belt state does, then I would think most others do. To me this is splitting hairs. Federally we don't use our taxpayer money to provide for abortions. We just use our state taxes. You may all ready be supporting abortions and been doing so for years without even knowing it. You can google your state's medicaid program and find most of the plans, handbooks, and covered services online. Abortion is under family planning services beside brith control and sterilization.

 

 

To me this is the whole issue in a nutshell. They all are saying one thing, thinking this and little of it actually correlates to the reality we are all dealing with. I would like for them all to deal with the reality of what really takes place everyday and not the preconceived notion they have

[PineFarmMom]

Medicaid does pay for abortions. My friend's plan (they now offer medicaid under insurance "plans" run by insurance companies) specifically states that abortions are covered under it. Federal money doesn't pay for it just your state taxes. I don't know if every state allows it but if this conservative bible belt state does, then I would think most others do. To me this is splitting hairs. Federally we don't use our taxpayer money to provide for abortions. We just use our state taxes. You may all ready be supporting abortions and been doing so for years without even knowing it. You can google your state's medicaid program and find most of the plans, handbooks, and covered services online. Abortion is under family planning services beside brith control and sterilization.

 

 

 

 

Thanks for the information. I now feel ill. :( I will look into it. It's one thing, I suppose to have paid and not known but to go forward knowingly?? ACK!

[mommyrooch]

If you are willing to pay extra for coverage, then why don't you just pay for the therapy?:confused: I don't get it.

 

I AM paying for the therapy. Do you really think that I would let my daughter go without help if I had ANY way of helping her? Insurance coverage or not. I would give up my home if I had to for my kids. I would give up EVERYTHING if I had to for my kids. What an offensive question. :angry:

 

We are paying for the therapy. It is just monumentally insulting that we HAVE to pay out of our own pockets when we are paying expensive premiums for insurance that is not even insuring us. This is putting a financial strain on our family and it is not right. This is a fine example of how "wonderful" our current system is. Those people that do work hard and that able to provide insurance by paying for it themselves still cannot get coverage for something that is deemed "medically necessary" by the medical specialists involved. It's not like I want to get my daughter a facelift! :tongue_smilie:

 

It isn't about us paying for the therapy. We ARE doing that because we love our daughter and the good Lord has blessed us so that we can. As long is there is breath in me I will give EVERYTHING I have to help my children. This is about HAVING to pay for it when I already pay for insurance for my family and then can't get the help they need covered. Surely you can see the problem with that.

[mommyrooch]

I'd like documented proof that specifically states that it will NOT!!! I'm not yet comforted by words out of the mouths of anyone. I want to see it in writing. If everything passes and that is part of what will be covered, I don't know exactly how we'll handle it because we just couldn't pay into something that knowingly murdered babies. :(

 

Do you have insurance? If you do did you check with your insurance company to see if they "had it in writing" that they don't ever cover abortions?

 

Virtually every insurance company that is already in place funds abortions. I personally don't support this. However, it is hypocritical to deny a universal healthcare plan on this basis because we as a nation have ALREADY accepted this practice because we still buy into the current insurance plans that do this very thing.

 

If you are that strongly opposed to this then you should see about putting a stop to the insurance companies that are already operating in our country because they have been funding this for years. They are just as guilty of this horrible thing as the government would be if they covered it. And that is still a big if. We still don't know that they will.

[Mrs Mungo]

I think an emphatic statement that you will never cover abortions is a horrible policy.

 

I had a friend whose dh has testicular cancer when they were first married. They stored some of his sperm. Later, when he was in remission and they were ready to conceive they discovered that she also had health conditions that would make it difficult for her to conceive. So, they did in vitro. They really only had one shot at it. The doctors implanted embryos, 3 developed. A few months into her pregnancy one of the babies died. They needed to remove the dead baby in order to insure the survival of the other two. Because federal dollars cannot pay for an abortion they had to pay for that procedure out of pocket.

[mommyrooch]

Some questions: I feel like you are assuming that the govt. will pay for whatever treatment you want. Do you think that a govt. system will pay for your daughter's VT? Do you think that the govt. will cover ever possible medical procedure?

 

Very good questions.

 

In a word. No. I do not think that the government will pay for everything. I'd be pretty naive if I thought that. ;)

 

I do believe that a universal plan would cost the average American citizen a LOT less than they are currently having to pay now.

 

Under a universal plan I believe the average cost of healthcare would be substantially less per family than it is now so if and when certain things were denied a family would be better equipped to handle it because they wouldn't be paying as much for the coverage in the first place. It wouldn't hurt families as much as it is hurting them now.

 

It is the fact that I am paying THOUSANDS of dollars for coverage only to be denied the coverage. A very large portion of my husbands wages currently goes to premiums. At least under a universal plan the initial coverage costs (i.e. taxes to fund it) would be substantially lower annually so if my family had to pay out of pocket for something that was denied we wouldn't have already spent that much needed money on coverage that wasn't even there when we needed it. More money back in our pockets annually equates to a greater ability to pay for our care if we "have" to. Does this make sense?

 

It is the insult of paying so much for a service to be given so little in return. At least with a government plan if you were denied coverage you wouldn't have had to pay an arm and a leg for it. You might actually have a better chance of paying for those uncovered services out of pocket because you weren't already paying most of your money into a system that wouldn't even help you anyway.

[Janet in WA]

They needed to remove the dead baby in order to insure the survival of the other two. Because federal dollars cannot pay for an abortion they had to pay for that procedure out of pocket.

 

Delivery of a dead fetus is considered an abortion?

[mommyrooch]

I think an emphatic statement that you will never cover abortions is a horrible policy.

 

I had a friend whose dh has testicular cancer when they were first married. They stored some of his sperm. Later, when he was in remission and they were ready to conceive they discovered that she also had health conditions that would make it difficult for her to conceive. So, they did in vitro. They really only had one shot at it. The doctors implanted embryos, 3 developed. A few months into her pregnancy one of the babies died. They needed to remove the dead baby in order to insure the survival of the other two. Because federal dollars cannot pay for an abortion they had to pay for that procedure out of pocket.

 

I agree, in my opinion there is a time and a place for even abortions. What happened to your friend is a fine example of that. To me, for any plan to say that they will NEVER cover abortions is something that I don't agree with. I think that this should be approached on a case by case basis just as all healthcare decisions should be.

 

That however is a whole other hot topic. ;)

[Mrs Mungo]

Delivery of a dead fetus is considered an abortion?

 

It was, they could not perform it at the military treatment facility and the insurance would not pay for it.

[Haiku]

Today my husband and I decided to split the family into two insurance groups: he and my child with chronic health problems would stay on his employer-sponsored insurance, and I and the other two kids would buy our own private insurance.

 

I called the insurance broker to talk to him about affordable plans.

 

They won't cover us because my son has asthma.

 

Ok, jettison the son back to the employer-sponsored health insurance. Now it's just me and one child. Ok, let's get going. We go through this whole rigamorole to get us set up and ... guess what? (I bet you'll NEVER guess!)

 

They won't cover us because, nine years ago, I saw a doctor a few times about some migraines.

 

I haven't seen a doctor or taken medication for this in NINE YEARS.

 

I am dead serious. I am not joking. This really happened. We are truly stuck.

 

Tara

[Janet in WA]

 

It was, they could not perform it at the military treatment facility and the insurance would not pay for it.

I'll have to take your word for it because I'm no expert on the military's health care, but I find it hard to believe that the reason this procedure wasn't provided was because it was considered an abortion.

[Lovedtodeath]

I AM paying for the therapy. Do you really think that I would let my daughter go without help if I had ANY way of helping her? Insurance coverage or not. I would give up my home if I had to for my kids. I would give up EVERYTHING if I had to for my kids. What an offensive question. :angry:

Of course I knew that you are paying for her therapy. I was not assuming that you weren't. That was not the reason for the question. I am sorry it came across that way.

It isn't about us paying for the therapy. We ARE doing that because we love our daughter and the good Lord has blessed us so that we can. As long is there is breath in me I will give EVERYTHING I have to help my children. This is about HAVING to pay for it when I already pay for insurance for my family and then can't get the help they need covered. Surely you can see the problem with that.

Yes, I see the problem with that. What I fail to understand is your emphasis that you will pay the insurance company extra money for the coverage. It makes no sense that you would see that as acceptable, given that you are finding paying for it yourself unacceptable.

 

I'd like documented proof that specifically states that it will NOT!!! I'm not yet comforted by words out of the mouths of anyone. I want to see it in writing. If everything passes and that is part of what will be covered, I don't know exactly how we'll handle it because we just couldn't pay into something that knowingly murdered babies. :(

Your taxes support a great many barbaric things. War, torture, experimentation, the death penalty. They also support $120 haircuts for politicians. Yet we are still obligated to pay them. Do you think that Ceasar was not using tax money for a great many barbaric things? Yet everyone had to pay Caesar.

 

Today my husband and I decided to split the family into two insurance groups: he and my child with chronic health problems would stay on his employer-sponsored insurance, and I and the other two kids would buy our own private insurance.

 

I called the insurance broker to talk to him about affordable plans.

 

They won't cover us because my son has asthma.

 

Ok, jettison the son back to the employer-sponsored health insurance. Now it's just me and one child. Ok, let's get going. We go through this whole rigamorole to get us set up and ... guess what? (I bet you'll NEVER guess!)

 

They won't cover us because, nine years ago, I saw a doctor a few times about some migraines.

 

I haven't seen a doctor or taken medication for this in NINE YEARS.

 

I am dead serious. I am not joking. This really happened. We are truly stuck.

 

Tara

If it has been more than 5 years, you are under no obligation to tell them about it. I am sorry this happened to you. :( Usually, under any insurance plan the children make very little difference in the premiums. It was the case when we shopped around.