United Healthcare is quitting ACA policies

[Moxie]

Harrumph. We can't afford DH's work insurance so we purchase through the marketplace but every year there are fewer and fewer choices. UH says they are losing money on ACA plans. Healthcare is a constant headache.

[rwilk]

Ugh.  That's really annoying.

 

Pre-ACA, we were much worse off though.  We didn't have access to COBRA for complicated reasons, and had to try to get insurance on the open market.  DH and I got denied by everyone, for such things as "prior narcotics use" (me after a surgery---30 pills total prescribed), "asthma" (him, exercise induced, never requiring hospitalization).  It was terrifying. 

 

At some point, more fixes will be needed for health care.  But for nw, the fact that SOMEONE has to cover us, and that we can't be denied for silly preexisting conditions, has been life changing.

[umsami]

United Healthcare made billions in 2015.    They thought they'd make even more because of ACA, but haven't.  This is why for-profit healthcare is a bad model.  

 

• Revenues Grew 20% Year-Over-Year to More Than $157 Billion
• Operating Earnings Reached $11 Billion
• Cash Flows From Operations Exceeded $9.7 Billion
• Full Year Adjusted Net Earnings Were $6.45 Per Share

 

[Guest]

Don't google how much their CEO makes. You'll lose all sympathy for them.

[Guest]

 

United Healthcare made billions in 2015. They thought they'd make even more because of ACA, but haven't. This is why for-profit healthcare is a bad model.

 

• Revenues Grew 20% Year-Over-Year to More Than $157 Billion
• Operating Earnings Reached $11 Billion
• Cash Flows From Operations Exceeded $9.7 Billion
• Full Year Adjusted Net Earnings Were $6.45 Per Share

Yeah, but there is a reason wealthy from other countries come here. Our healthcare is better than that in state run countries. It just is. The innovation is here and part of what is driving it is for profit industry. As someone with health insurance, I don't like paying what I'm paying. But from a shareholder's view, they're doing their job. I know that's not a popular stance but they ARE a for profit company and their first duty is to the shareholders. I don't know what the answer is for healthcare but ACA definitely wasn't the magic bullet.

[umsami]

Yeah, but there is a reason wealthy from other countries come here. Our healthcare is better than that in state run countries. It just is. The innovation is here and part of what is driving it is for profit industry. As someone with health insurance, I don't like paying what I'm paying. But from a shareholder's view, they're doing their job. I know that's not a popular stance but they ARE a for profit company and their first duty is to the shareholders. I don't know what the answer is for healthcare but ACA definitely wasn't the magic bullet.

 

The US is great for those who are wealthy and can cash pay, definitely. In terms of the wealthy, they no longer exclusively come here.  Germany is a popular destination.  The UK is as well.   US outposts in the Middle East as well.   But in terms of providing health care for their entire population or general healthcare outcomes, we are ranked worst in the developed world. Other countries do it better, cheaper.  Even medical students don't graduate with the level of debt our students have.  Malpractice is different, too.  One major difference is that their health plans negotiate with drug manufacturers, whereas Medicare and Medicaid cannot.  

 

http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/

 

 

[Guest]

The US is great for those who are wealthy and can cash pay, definitely. In terms of the wealthy, they no longer exclusively come here. Germany is a popular destination. The UK is as well. US outposts in the Middle East as well. But in terms of providing health care for their entire population or general healthcare outcomes, we are ranked worst in the developed world. Other countries do it better, cheaper. Even medical students don't graduate with the level of debt our students have. Malpractice is different, too. One major difference is that their health plans negotiate with drug manufacturers, whereas Medicare and Medicaid cannot.

 

http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/

I'm curious to see what happens in coming years. Being a doctor is no longer a profitable enterprise unless you are a surgeon or OBGYN in most cases. The salaries won't justify the schooling cost before long. Something has to give- I'm just not sure what will first. Edited June 24, 2016 by texasmom33

[lovinmyboys]

Here is a total thread derail, but us healthcare is so overpriced. I don't even get it. My ds4 broke his arm recently and we just got the bill from the surgeon-$1530. It was pretty much a no complication break (it was buckling a little so it needed reduction). The surgeon was with us for maybe 5-10 minutes and it definitely wasn't a surgery. The bill wasn't even for the hospital visit or X Ray. We have really good insurance and it pays 100% for accidental injuries, but no wonder insurance is so expensive. The insurance paid over $1300 for that. I know we pay for the surgeon's knowledge, but $1500 for a run of the mill broken arm still seems ridiculous.

 

ETA: I see the insurance company made billions in profits. I guess $1500 broken arms mY not be hurting them that much

Edited June 24, 2016 by lovinmyboys

[Mom-ninja.]

 Our healthcare is better than that in state run countries. It just is. 

Except it isn't. 

[Guest]

Except it isn't.

I disagree. We are leading edge technology, particularly on genomics and cancer research. We have the funding AND the access. You don't end up on a six month waiting list here for cancer surgery. You do in state run systems. Ask people in Canada how long they have to wait to get into a specialist in many instances and how far out their surgeries are booked.

[Guest]

We can do better!! My crappy insurance costs more than my mortgage and Lord knows what it will cost next year. There must be a better way.

Edited June 24, 2016 by Moxie

[momof4inco]

Here in Colorado, we will be voting on universal health care for our state in November. I have two kids with medical issues, I am the first person to say I want to get rid of our big medical bills. But at what cost? My son can get into any specialist within a few months. That's much quicker than other countries with universal healthcare. Our insurance company approves everything we have ever wanted to do for him. Will someone decide he doesn't really need that test or procedure? Will the quality of care go down?

 

We are worried enough about universal health care that we are thinking about moving out of the state if it passes. 

[Audrey]

I disagree. We are leading edge technology, particularly on genomics and cancer research. We have the funding AND the access. You don't end up on a six month waiting list here for cancer surgery. You do in state run systems. Ask people in Canada how long they have to wait to get into a specialist in many instances and how far out their surgeries are booked.

 

 

Less than a week to see a specialist to remove a bad mole, and I'm way out in the boonies, too.  MIL had surgery for colon cancer the day after diagnosis.  Dh saw an ortho for his torn knee within a couple of days and had surgery schedule the following week. 

 

You're just not the top dog country for medical services that you seem to think you are.  Even your own researchers say the same.  http://www.urban.org/sites/default/files/alfresco/publication-pdfs/411947-How-Does-the-Quality-of-U-S-Health-Care-Compare-Internationally-.PDF

[Audrey]

Here in Colorado, we will be voting on universal health care for our state in November. I have two kids with medical issues, I am the first person to say I want to get rid of our big medical bills. But at what cost? My son can get into any specialist within a few months. That's much quicker than other countries with universal healthcare. Our insurance company approves everything we have ever wanted to do for him. Will someone decide he doesn't really need that test or procedure? Will the quality of care go down?

 

We are worried enough about universal health care that we are thinking about moving out of the state if it passes. 

 

 

It takes you MONTHS to see a specialist?   What kind of specialist?    Is it for something very rare for which there are extremely few specialists in that area?  

[FairProspects]

We can do better!! My crappy insurance costs more than my mortgage and Lord knows what it will cost next year. There must be a better way.

 

Yes. This, I'm not sure those who have employer sponsored health care get how bad it is. The plans on the exchange are *horrible*. Crazy expensive for terrible coverage. We were SO much better off before the ACA and there is just no end to the insanity in sight,

[Guest]

Yes. This, I'm not sure those who have employer sponsored health care get how bad it is. The plans on the exchange are *horrible*. Crazy expensive for terrible coverage. We were SO much better off before the ACA and there is just no end to the insanity in sight,

I'm not saying that at all!! The ACA got rid of pre-existing conditions so we now CAN buy an outside policy. Before the ACA, we were stuck with whatever plan DH's work offered. Great plan but $2k a month!! Insane!! At least with my crappy ACA policy, I'm saving $1k/month.

[FairProspects]

I'm not saying that at all!! The ACA got rid of pre-existing conditions so we now CAN buy an outside policy. Before the ACA, we were stuck with whatever plan DH's work offered. Great plan but $2k a month!! Insane!! At least with my crappy ACA policy, I'm saving $1k/month.

 

Ah. We are *far* worse off after the ACA, but we are self-employed, so no employer option. I think our premiums tripled for much worse coverage. We are younger though and as a result, lucky to be on the healthier side, so it was a raw deal for us. I hated the pre-existing conditions issue, but there has to be a better way. The current system is not sustainable at all.

[Katy]

I'm curious to see what happens in coming years. Being a doctor is no longer a profitable enterprise unless you are a surgeon or OBGYN in most cases. The salaries won't justify the schooling cost before long. Something has to give- I'm just not sure what will first.

 

Unless someone decides to open more medical schools and make them cheap, MD's will only go into specialties, and routine issues will get handled by walk in clinics staffed by nurse practitioners, physician assistants, and pharmacists.

[momof4inco]

It takes you MONTHS to see a specialist?   What kind of specialist?    Is it for something very rare for which there are extremely few specialists in that area?  

 

The longest wait is for an epileptologist who specializes in my son's rare type of epilepsy. He can book out 6-9 months for new patients. We can usually get in within a few months as established patients. We had to wait 6 months on a wait list for a neuropsych eval, then our appointment was several months after that. The neurogeneticist is usually booked 3-6 months out.

 

Most of his other specialists are within a couple months (cardio, gastro, urology). None of his conditions are life threatening at this time, I'm hoping that people with more serious conditions get in quicker!

[TechWife]

This is quite possibly the first step towards a single payer system. It will continue to be a bloody battle which will last for many more years to come and likely none of us will be entirely pleased with the result.

 

For all of you who think you can see a specialist quickly in the US: That is not true nationwide. Try to find a psychiatrist in many areas and you will be in for a big surprise. Don't even think about easy access to a psychiatric hospital for inpatient care - the beds simply aren't there. In some areas, the general practitioner is the only MD with hospital privileges. If you have a heart attack, you end up waiting at the local hospital for an ambulance to arrive from a city an hour or more away so that you can transfer to a cardiology unit. Maybe, just maybe, a cardiologist will come through your small town and see patients once a month. That's fine if you're stable, but if you're newly diagnosed, you're going to need to make many road trips to see a specialist.

 

My family has received excellent health are here, largely due to he fact that we live near many research hospitals. But, I by no means think that everyone has access to this level of care. In fact, it likely never occurred to my husband's parents that this level of care we receive even existed. The first time my MIL saw a cardiologist was when she needed bypass surgery. He estimated that she had previously had around ten heart attacks and over 50% of her heart muscle was "dead." She died at the age of 63.

 

Access to healthcare is inconsistent.

[ChocolateReignRemix]

Yeah, but there is a reason wealthy from other countries come here. Our healthcare is better than that in state run countries. It just is. The innovation is here and part of what is driving it is for profit industry. As someone with health insurance, I don't like paying what I'm paying. But from a shareholder's view, they're doing their job. I know that's not a popular stance but they ARE a for profit company and their first duty is to the shareholders. I don't know what the answer is for healthcare but ACA definitely wasn't the magic bullet.

 

Actually, it really isn't better.  Our overall health outcomes are worse even though we pay significantly more per capita.  And if you believe there isn't a high level of innovation and research in other countries, then you are listening to propaganda over substance.

 

I do agree that our health insurance companies are representing their shareholders.  THAT is the problem.  Using a for profit model (often attached for employment which adds another party in the mix for no good reason) to distribute a good with a highly inelastic demand curve has been a failure

[Audrey]

The longest wait is for an epileptologist who specializes in my son's rare type of epilepsy. He can book out 6-9 months for new patients. We can usually get in within a few months as established patients. We had to wait 6 months on a wait list for a neuropsych eval, then our appointment was several months after that. The neurogeneticist is usually booked 3-6 months out.

 

Most of his other specialists are within a couple months (cardio, gastro, urology). None of his conditions are life threatening at this time, I'm hoping that people with more serious conditions get in quicker!

 

 

That still seems rather long to me and IME.

[ChocolateReignRemix]

This is quite possibly the first step towards a single payer system. It will continue to be a bloody battle which will last for many more years to come and likely none of us will be entirely pleased with the result.

 

For all of you who think you can see a specialist quickly in the US: That is not true nationwide. Try to find a psychiatrist in many areas and you will be in for a big surprise. Don't even think about easy access to a psychiatric hospital for inpatient care - the beds simply aren't there. In some areas, the general practitioner is the only MD with hospital privileges. If you have a heart attack, you end up waiting at the local hospital for an ambulance to arrive from a city an hour or more away so that you can transfer to a cardiology unit. Maybe, just maybe, a cardiologist will come through your small town and see patients once a month. That's fine if you're stable, but if you're newly diagnosed, you're going to need to make many road trips to see a specialist.

 

My family has received excellent health are here, largely due to he fact that we live near many research hospitals. But, I by no means think that everyone has access to this level of care. In fact, it likely never occurred to my husband's parents that this level of care we receive even existed. The first time my MIL saw a cardiologist was when she needed bypass surgery. He estimated that she had previously had around ten heart attacks and over 50% of her heart muscle was "dead." She died at the age of 63.

 

Access to healthcare is inconsistent.

 

You and your pesky facts.

 

[TechWife]

You and your pesky facts.

 

Yeah, sometimes my facts do get in the way off being able to live out my life in fantasyland! Sadly, since I've been volunteering at a hospital since last fall, I learn more and more about he inequities in our system. I'm thankful I work in a hospital that treats all patients equally, has four critical care ambulances, two neonate ambulances that can transport both baby and mom and one critical care helicopter. They are always busy driving all over our state and into some of thr surrounding states as well.

[Audrey]

This is quite possibly the first step towards a single payer system. It will continue to be a bloody battle which will last for many more years to come and likely none of us will be entirely pleased with the result.

 

For all of you who think you can see a specialist quickly in the US: That is not true nationwide. Try to find a psychiatrist in many areas and you will be in for a big surprise. Don't even think about easy access to a psychiatric hospital for inpatient care - the beds simply aren't there. In some areas, the general practitioner is the only MD with hospital privileges. If you have a heart attack, you end up waiting at the local hospital for an ambulance to arrive from a city an hour or more away so that you can transfer to a cardiology unit. Maybe, just maybe, a cardiologist will come through your small town and see patients once a month. That's fine if you're stable, but if you're newly diagnosed, you're going to need to make many road trips to see a specialist.

 

My family has received excellent health are here, largely due to he fact that we live near many research hospitals. But, I by no means think that everyone has access to this level of care. In fact, it likely never occurred to my husband's parents that this level of care we receive even existed. The first time my MIL saw a cardiologist was when she needed bypass surgery. He estimated that she had previously had around ten heart attacks and over 50% of her heart muscle was "dead." She died at the age of 63.

 

Access to healthcare is inconsistent.

 

 

Mental health care services could be better here, too.  

 

I think some people seem to think that Canadians want to sell the US on national healthcare, but we don't.  Largely speaking, we aren't at all concerned with how you choose to run your health care.  At most it perplexes us.  The exception may be the snowbirds who encounter a bit of a shock the first time they need healthcare while down south.  

 

It also seems to me that those same "some people" feel that Canadians think their health care system is perfect, but we don't.  Most of us think it's pretty good, but it could always be improved.  I think most Canadians feel that way about the country in general -- pretty good, but always room for improvement. 

Edited June 24, 2016 by Audrey

[Joker]

We have an awesome family doctor. We actually have his cell number and have been in contact with him after hours and on weekends when a dd is really sick (like a recent case of cellulitis). We can also get in on the same day when sick.

 

Specialists are different and especially those in mental health. Oldest had to be hospitalized to get the attention she needed. We now have one who won't listen to us, to dd, or the psychologist. We're almost back to square one and having to go on a list to wait months for someone who will treat her as she needs. We can allow the pediatrician to do so but it's such a gamble. Something needs to change.

Edited June 24, 2016 by Joker

[momof4inco]

That still seems rather long to me and IME.

 

That's our reality here. The hospital here is considered a top children's hospital. They built a new hospital quite a while ago, and they outgrew it almost immediately. We've seen it go from a half empty parking garage to hardly being able to find a parking space in a span of 6 years.

[cjzimmer1]

This is quite possibly the first step towards a single payer system. It will continue to be a bloody battle which will last for many more years to come and likely none of us will be entirely pleased with the result.

 

For all of you who think you can see a specialist quickly in the US: That is not true nationwide. Try to find a psychiatrist in many areas and you will be in for a big surprise. Don't even think about easy access to a psychiatric hospital for inpatient care - the beds simply aren't there. In some areas, the general practitioner is the only MD with hospital privileges. If you have a heart attack, you end up waiting at the local hospital for an ambulance to arrive from a city an hour or more away so that you can transfer to a cardiology unit. Maybe, just maybe, a cardiologist will come through your small town and see patients once a month. That's fine if you're stable, but if you're newly diagnosed, you're going to need to make many road trips to see a specialist.

 

My family has received excellent health are here, largely due to he fact that we live near many research hospitals. But, I by no means think that everyone has access to this level of care. In fact, it likely never occurred to my husband's parents that this level of care we receive even existed. The first time my MIL saw a cardiologist was when she needed bypass surgery. He estimated that she had previously had around ten heart attacks and over 50% of her heart muscle was "dead." She died at the age of 63.

 

Access to healthcare is inconsistent.

 

While I totally agree that access to healthcare is inconsistent, I don't see how ACA is going to solve that. At least for people living in small communities.  There will still not be a level 1 trauma unit in the middle of nowhere, the research hospitals are still going to be located in the heavily populated areas etc.  Yes more people have insurance and thus can access basic care but I'm not sure it will have any impact on how far to travel or how quickly those who live in rural areas will get that care.

[kewb]

I am thankful for Aca. Without it my do is uninsurable.

 

That said, since Aca started there are only 3 viable choices for insurance in my state. There was another company that popped up last year but they were a start up and with dh's medical stuff I wanted tried and true.

 

Not sure what the right answer is but I never thought healthcare should be a for profit industry.

[SemiSweet]

American exceptionalism is a weird thing. We are military, we have had various medical issues throuout the years and never paid one red cent, other than getting a couple prescriptions at civilian pharmacies. The quality of our care has almost always been top notch, with rare exceptions, and I used to work in the medical field before I joined the Air Force, I'm pretty familiar with the US model.

 

But you will hear all these military members complaining about healthcare and how the Feds suck at running anything, even as they are using those federal benefits. You hear people talking about American innovation even as they are show actual facts about health outcomes in the developed world. I will never understand how a person chooses the most socialist type of lifestyle available in the US, then decries socialism.

 

Seriously, Medicare is one of the most successful programs to ever exist here. It's efficient, not perfect, but still a great program, and expanding it to cover every American would solve the problem, the wheel does not need to be reinvented here. But we've just always done it this way and there are a lot of lobbyists, so to heck with the people, let them go bankrupt over medical bills. Sigh. Off my soap box, I'm irritated.

[lovinmyboys]

American exceptionalism is a weird thing. We are military, we have had various medical issues throuout the years and never paid one red cent, other than getting a couple prescriptions at civilian pharmacies. The quality of our care has almost always been top notch, with rare exceptions, and I used to work in the medical field before I joined the Air Force, I'm pretty familiar with the US model.

 

But you will hear all these military members complaining about healthcare and how the Feds suck at running anything, even as they are using those federal benefits. You hear people talking about American innovation even as they are show actual facts about health outcomes in the developed world. I will never understand how a person chooses the most socialist type of lifestyle available in the US, then decries socialism.

 

Seriously, Medicare is one of the most successful programs to ever exist here. It's efficient, not perfect, but still a great program, and expanding it to cover every American would solve the problem, the wheel does not need to be reinvented here. But we've just always done it this way and there are a lot of lobbyists, so to heck with the people, let them go bankrupt over medical bills. Sigh. Off my soap box, I'm irritated.

My Dh is an army reservist so in the 13 yrs we have been married, we have had tricare for over 4 years off and on. I think like anything it has good and bad things. We have lived in some places where I couldn't find any provider who was accepting new patients with tricare. I found a pediatrician that took it and I asked about it and they said the way tricare reimburses they are lucky to break even on most types of care. Having insurance no one accepts isn't all that helpful.

 

I also once had to take my ds to an army hospital ER and I was very unhappy with his treatment. I have only been to an ER two other times, but the treatment at those was so much better. That one experience may not be a good reflection of military care, but it definitely colored my perception.

 

This last time Dh was deployed, we opted to keep our civilian insurance and have tricare as secondary because tricare honestly has not been great for us. I realize that we are lucky to have good civilian coverage and I am sure it influences how I feel about tricare. If we were paying $1500 a month for crappy insurance, free tricare would look a lot better.

[SemiSweet]

My Dh is an army reservist so in the 13 yrs we have been married, we have had tricare for over 4 years off and on. I think like anything it has good and bad things. We have lived in some places where I couldn't find any provider who was accepting new patients with tricare. I found a pediatrician that took it and I asked about it and they said the way tricare reimburses they are lucky to break even on most types of care. Having insurance no one accepts isn't all that helpful.

 

I also once had to take my ds to an army hospital ER and I was very unhappy with his treatment. I have only been to an ER two other times, but the treatment at those was so much better. That one experience may not be a good reflection of military care, but it definitely colored my perception.

 

This last time Dh was deployed, we opted to keep our civilian insurance and have tricare as secondary because tricare honestly has not been great for us. I realize that we are lucky to have good civilian coverage and I am sure it influences how I feel about tricare. If we were paying $1500 a month for crappy insurance, free tricare would look a lot better.

Our ER experiences have been among the ones that were less awesome, but we've always lived in places that either had a military hospital or had no issue finding providers that accepted Tricare. I can definitely see where that would be irritating. I've had both civilian and military coverage and have had to fight way more with the civilian companies for coverage, and of course had to pay much more out of pocket.

[ktgrok]

I disagree. We are leading edge technology, particularly on genomics and cancer research. We have the funding AND the access. You don't end up on a six month waiting list here for cancer surgery. You do in state run systems. Ask people in Canada how long they have to wait to get into a specialist in many instances and how far out their surgeries are booked.

 

 

Do you understand why they have a waiting list and you don't? Because here many of the people that would get cancer treatment or surgery THERE, can't afford it here, so you have less of a line. Because a bunch of the people that need treatment can't afford to get it. 

 

How can anyone feel good about having a shorter time to treatment because other people are going without???

[NoPlaceLikeHome]

I disagree. We are leading edge technology, particularly on genomics and cancer research. We have the funding AND the access. You don't end up on a six month waiting list here for cancer surgery. You do in state run systems. Ask people in Canada how long they have to wait to get into a specialist in many instances and how far out their surgeries are booked.

This is simply not true. Additionally try get cancer treatment here in the US if you have no insurance or money to pay hundreds of thousands of dollars. My mom was told no chemo unless she could pay her bill despite having insurance (which we were grateful for since my parents went without insurance for 3 years and certainly could not afford to pay for health care out of pocket).

 

http://www.nytimes.com/2014/07/06/sunday-review/long-waits-for-doctors-appointments-have-become-the-norm.html

 

This article debunks what you have said:

 

http://www.pnhp.org/news/2012/june/5-myths-about-canada%E2%80%99s-health-care-system

[Bluegoat]

I disagree. We are leading edge technology, particularly on genomics and cancer research. We have the funding AND the access. You don't end up on a six month waiting list here for cancer surgery. You do in state run systems. Ask people in Canada how long they have to wait to get into a specialist in many instances and how far out their surgeries are booked.

 

Well, it is easy to have a shorter list when many people simply can't get on it at all, isn't it?  (Though there are many things that affect wait times.)

 

 

 

But - this is actually just pretty inaccurate in terms of saying the US is better than universal insurance.  There are many universal medical care systems, pretty much every western country but the US has them.

 

The UK, and Canada, tend to have, on average, longer wait times than the US.

 

Every other example is about the same or better than the US on wait times.

[NoPlaceLikeHome]

I am thankful for Aca. Without it my do is uninsurable.

 

That said, since Aca started there are only 3 viable choices for insurance in my state. There was another company that popped up last year but they were a start up and with dh's medical stuff I wanted tried and true.

 

Not sure what the right answer is but I never thought healthcare should be a for profit industry.

Well you can thank those who fought healthcare reform for your crappy choices IMHO. These same people also fought offering a public health insurance option for all marketplaces since for profit insurance companies did not want competition.

[NoPlaceLikeHome]

Well, it is easy to have a shorter list when many people simply can't get on it at all, isn't it?  (Though there are many things that affect wait times.)

 

 

 

But - this is actually just pretty inaccurate in terms of saying the US is better than universal insurance.  There are many universal medical care systems, pretty much every western country but the US has them.

 

The UK, and Canada, tend to have, on average, longer wait times than the US.

 

Every other example is about the same or better than the US on wait times.

I think it is important to point out that wait times are longer for elective surgeries and this is a function of the country choosing to spend less money on healthcare. Actually as a nurse, I see no problem with longer wait times for elective procedures since sometimes the procedure may be worse than doing no procedure as in the case oftentimes with back surgery for example.

[Bluegoat]

My Dh is an army reservist so in the 13 yrs we have been married, we have had tricare for over 4 years off and on. I think like anything it has good and bad things. We have lived in some places where I couldn't find any provider who was accepting new patients with tricare. I found a pediatrician that took it and I asked about it and they said the way tricare reimburses they are lucky to break even on most types of care. Having insurance no one accepts isn't all that helpful.

 

I also once had to take my ds to an army hospital ER and I was very unhappy with his treatment. I have only been to an ER two other times, but the treatment at those was so much better. That one experience may not be a good reflection of military care, but it definitely colored my perception.

 

This last time Dh was deployed, we opted to keep our civilian insurance and have tricare as secondary because tricare honestly has not been great for us. I realize that we are lucky to have good civilian coverage and I am sure it influences how I feel about tricare. If we were paying $1500 a month for crappy insurance, free tricare would look a lot better.

 

If I'm understanding it correctly though, aren't these the kinds of issues would be the ones that would go away if everyone was covered under the same insurer?

[Laura Corin]

Yeah, but there is a reason wealthy from other countries come here. Our healthcare is better than that in state run countries. It just is. The innovation is here and part of what is driving it is for profit industry. As someone with health insurance, I don't like paying what I'm paying. But from a shareholder's view, they're doing their job. I know that's not a popular stance but they ARE a for profit company and their first duty is to the shareholders. I don't know what the answer is for healthcare but ACA definitely wasn't the magic bullet.

 

The UK is home to GlaxoSmithKline and AstraZeneca, respectively the world's fifth- and sixth-largest pharmaceutical companies measured by 2009 market share.^[4] Foreign companies with a major presence in the UK pharmaceutical industry include Pfizer, Novartis,^[5]Hoffmann–La Roche and Eisai. One in five of the world's biggest-selling prescription drugs were developed in the UK.^[6]

 

^{The UK is pretty much exactly one-fifth the size of the US in population terms.}

 

^{https://en.wikipedia.org/wiki/Pharmaceutical_industry_in_the_United_Kingdom}

 

[Splash]

My daughter would go without life saving medication in many other countries.  It is obscenely expensive and many countries have said no, Canada, Australia, India, some areas of England.  My daughter would be dead without this medication and there is no way we could afford to pay for it out of pocket, I couldn't earn enough in a year to pay for even two months worth.  It is a worrisome place to be right now.  My husband can only do the job he's in for a few more years (this provides us with excellent medical benefits) so we've been looking at what to do next.  I'm not sure what the answer is but I'm thinking universal healthcare isn't the answer either.

 

[MedicMom]

That still seems rather long to me and IME.

DS6 is on a 10 month waiting list for a neuropsych. we have good insurance too. Just takes forever.

[Bluegoat]

I think it is important to point out that wait times are longer for elective surgeries and this is a function of the country choosing to spend less money on healthcare. Actually as a nurse, I see no problem with longer wait times for elective procedures since sometimes the procedure may be worse than doing no procedure as in the case oftentimes with back surgery for example.

 

Yeah, it's a balance, isn't it, and it can be hard sometimes to get it quite right.  It's absolutly true that people in other places tend to go for some less aggressive tactics than doctors and patients in the US do, and I think maybe this is what some Americans find scary - it goes against their instincts.  But in reality, the health outcomes aren't worse, and as you say in many instances better.  Agression hasn't proven to be the most beneficial approach.

 

Plus, there are other things that affect wait times that have little to do with who runs the insurance.  A big country like Canada has some considerations that a geographically smaller one wouldn't, for example.

 

That being said, as a Canadian I'm not sure that we have the best run system in terms of things like wait times, there are lots of different approaches, and maybe something different would be better.  But I sure as heck would not want to move to something like the US system, now or before.

[Bluegoat]

We get medical tourism from the US here as well.  It happens all over, to where procedures happen to be most developed, or more reasonably priced.

[Laura Corin]

Here in Colorado, we will be voting on universal health care for our state in November. I have two kids with medical issues, I am the first person to say I want to get rid of our big medical bills. But at what cost? My son can get into any specialist within a few months. That's much quicker than other countries with universal healthcare. Our insurance company approves everything we have ever wanted to do for him. Will someone decide he doesn't really need that test or procedure? Will the quality of care go down?

 

We are worried enough about universal health care that we are thinking about moving out of the state if it passes. 

 

For reference: my 91 year old mother lives with me in Scotland, so I have a lot of experience of getting in to see specialists.  The longest wait has been a couple of months for something that was uncomfortable but not life-threatening.  A GP appointment for an urgent matter is same-day.  For a non-urgent matter with a named GP it could be a week or two.  It's fine.

[NoPlaceLikeHome]

My daughter would go without life saving medication in many other countries.  It is obscenely expensive and many countries have said no, Canada, Australia, India, some areas of England.  My daughter would be dead without this medication and there is no way we could afford to pay for it out of pocket, I couldn't earn enough in a year to pay for even two months worth.  It is a worrisome place to be right now.  My husband can only do the job he's in for a few more years (this provides us with excellent medical benefits) so we've been looking at what to do next.  I'm not sure what the answer is but I'm thinking universal healthcare isn't the answer either.

I am sorry about your daughter but is this indeed really the fact about other countries? I have read many articles about other countries offer drugs that we have not even approved yet. Or how in many countries drugs are often way less expensive than here. When I need particular meds I saved thousands of dollars by ordering from Britain at the time. 

[TechWife]

While I totally agree that access to healthcare is inconsistent, I don't see how ACA is going to solve that. At least for people living in small communities.  There will still not be a level 1 trauma unit in the middle of nowhere, the research hospitals are still going to be located in the heavily populated areas etc.  Yes more people have insurance and thus can access basic care but I'm not sure it will have any impact on how far to travel or how quickly those who live in rural areas will get that care.

 

It's not and no one on this thread (or anyone else I've ever heard for that matter) has said it will.  ACA means "Affordable Care Act." Affordability is one part of the accessible health care. Another part is availability. Having insurance doesn't mean that someone can access basic care. It also doesn't mean that someone can access care that goes beyond the basic level. 

 

While I am blessed to be within 35 minutes or so of three such facilities, I am not speaking solely of Level 1 Trauma care hospitals. I am speaking of the availability of hospitals that can handle routine matters such as heart attacks, mental health crisis and compound fractures. Because the specialists aren't in the area, it simply isn't possible to get treatment locally. Transport to another hospital where specialists are available becomes a must. Many of these hospitals aren't trauma centers, they are simply hospitals where cardiologists, orthopedic surgeons and many other routine specialists have privileges and the hospital is equipped with appropriate monitored beds and up to date surgical suites. 

 

Additionally, routine care for complex situations is not available in rural areas. These folks also must travel and because there are fewer specialists to go around, they face long wait times for appointments. Endocrinology, psychiatry, nephrology are just some examples of specialties where routine monitoring by a specialist is needed, yet can be hard to access in a timely manner. 

 

My point is simply that those who think there is easy access to specialists in the US are sadly mistaken. It is not the case nationwide. We aren't in a position to site long wait times in other countries as a reason our medical system is superior, because those waits exist here as well. 

Edited June 24, 2016 by TechWife

[Bluegoat]

I am sorry about your daughter but is this indeed really the fact about other countries? I have read many articles about other countries offer drugs that we have not even approved yet. Or how in many countries drugs are often way less expensive than here. When I need particular meds I saved thousands of dollars by ordering from Britain at the time. 

 

The way it generally works is that to get a drug sold in a country like Canada, it needs to get on a list of approved drugs - this is beyond testing and safety which also has to happen of course.

 

It is almost exactally like the way an insurance company in the US decides to approve drugs.  The main difference is, it is an open decision, the boards that make the decisions have to be made up of certain public representatives (doctors, members of public, etc.) and so on. 

 

As far as that goes, I really don't see much difference, and insurer in the US could also refuse to cover an expensive drug.  We try and get the right decisions about such things, and sometimes there are disagreements and appeals, and then the policy may change.

 

What may be trickier in some cases is if a drug isn't approved, but you wanted to pay out of pocket, it could be difficult to get access.  OTOH there are also ways for people who need rare drugs to set up alternate arrangements.

[TechWife]

If I'm understanding it correctly though, aren't these the kinds of issues would be the ones that would go away if everyone was covered under the same insurer?

 

Quality of care issues would go away if everyone had the same insurance? No, there would still be good providers and crappy providers. 

[Bluegoat]

Quality of care issues would go away if everyone had the same insurance? No, there would still be good providers and crappy providers. 

 

Um, no, I meant that some providers refusing state insurance would go away if that was what everyone had.

[Wheres Toto]

The UK is home to GlaxoSmithKline and AstraZeneca, respectively the world's fifth- and sixth-largest pharmaceutical companies measured by 2009 market share.^[4] Foreign companies with a major presence in the UK pharmaceutical industry include Pfizer, Novartis,^[5]Hoffmann–La Roche and Eisai. One in five of the world's biggest-selling prescription drugs were developed in the UK.^[6]

 

^{The UK is pretty much exactly one-fifth the size of the US in population terms.}

 

^{https://en.wikipedia.org/wiki/Pharmaceutical_industry_in_the_United_Kingdom}

 

 

 

I think a lot of people in the US, unless they are in the pharma industry, don't realize that many of the biggest pharma companies are not US companies.  They definitely have a presence/regional offices here, but they are not US-based companies.

 

Among the top companies:

 

Pfizer is US

Hoffman-LaRoche (Roche) is Swiss

Novartis is Swiss

J&J is US

Sanofi is French

GSK is UK

AZ is UK

Abbott is US

Merck is German

Bayer is German

Novo Nordisk is Danish

Boehringer Ingelheim is German

Bristol Myers Squibb is US.