NationStates Jolt Archive

I go to a doctor, hospital if needed. Like, what else?
Edit: MUAHAHAHAHA, this is MYYYY thread now!!!
(What's with the odd timewarp?)

I was reading a book and I wondered about how people on NSG access/pay for health care. I'm adding a poll but please answer in thread how you access health care and what you like or don't like about it. Does the way in which your healthcare is funded/paid for affect your decisions about when to go to the doctor/etc.?


This is not my homework

I'm not really quite sure what you mean by "access health care"?

*refuses to wait for poll*

I'm not really quite sure what you mean by "access health care"?

I go to a doctor, hospital if needed. Like, what else?

Both of those.

I have a local practice for family health care (physicals, when any of us get a cold, etc). Covered by insurance, 10 dollar copay.

I can go to any specialist without a referral. 10 dollar copay.

I can go to any emergency room in an emergency. No deductible, no copay.

I have really good dental coverage (it usually sucks in the US). Don't pay for regular cleanings, and any work is covered 80%.

I have vision coverage (two pairs of glasses per year or contact lenses for a year, plus visits to fit these).

I also get half a million in life insurance from my job.

Sorry for the unclear OP, the poll should help, and I'll reword as soon as I figure out how.

Got brainfog today.

Nah, we were just being obnoxiously impatient. ;)

Sorry for the unclear OP, the poll should help, and I'll reword as soon as I figure out how.

Got brainfog today.

Bah, and I promptly sorta voted wrong. Doin it rong!

It's not... really by the government. I mean, it's paid for with money very concretely taken out of your paycheck every month. So it's not like the government magically pays for everything. But, well, that's obvious, I guess. So yeah, it's the first option anyway. Except not really, because your employer also has to pay a good bit of money towards your health coverage. But for unemployed people, the government pays for health care.

Now I have brainfog, too. Hrmph.

I split the cost of my health insurance down the middle with my boss...So really, I get it through my work, but pay as well...I'm glad to do it, and I'm glad I have it, but I'm most glad that I haven't had to use it, so I don't even know how sucky it is yet ;)

I think Smunk means how do you recieve your health insurance if you have it...be it through government programs, employment benefits, self-purchace, etc.


I actually just got COBRA'd by my parents untill I have employment. Since I graduated, I can't be claimed as a dependent, but the earliest I can start my full time job (assuming I can get one :( ) is September. In the mean time, I legally have to have health insurance (MA state law, not to mention, it is generally a bad idea not to have it), so my parents pay extra for me to retain their employer-provided benefits.

I'm in the military, and in my country military employees and their families get 100% health coverage, in addition to other nifty things like having college paid for, so on and so forth.

I'm, for lack of a better term, an 'independent contractor' and have no access to a company health plan (I don't work for the same company that often) and don't make money predictably or enough to pay for health insurance. My money is hand to mouth, no savings. I just hope I don't need it.

I split the cost of my health insurance down the middle with my boss...So really, I get it through my work, but pay as well...I'm glad to do it, and I'm glad I have it, but I'm most glad that I haven't had to use it, so I don't even know how sucky it is yet ;)
Employer option.

Bah, and I promptly sorta voted wrong. Doin it rong!

It's not... really by the government. I mean, it's paid for with money very concretely taken out of your paycheck every month. So it's not like the government magically pays for everything. But, well, that's obvious, I guess. So yeah, it's the first option anyway. Except not really, because your employer also has to pay a good bit of money towards your health coverage. But for unemployed people, the government pays for health care.

Now I have brainfog, too. Hrmph.
You voted correctly, as per my intention of that poll option.
I'm in the military, and in my country military employees and their families get 100% health coverage, in addition to other nifty things like having college paid for, so on and so forth.
Yeah, I missed that one, sorry. Military insurance is huge here too because we have an airbase.

I was reading a book and I wondered about how people on NSG access/pay for health care. I'm adding a poll but please answer in thread how you access health care and what you like or don't like about it. Does the way in which your healthcare is funded/paid for affect your decisions about when to go to the doctor/etc.?


This is my homework

:D

I get healthcare when I can afford it.

I've been to a doctor a few times in the last year, paying money I can't afford (although they are very nice at the clinic and don't really charge me as much as they're supposed to) to find out that there's nothing that can be done for me unless I had a whole boatload of money.

I pay for it out of pocket.


Health savings accounts are the way to go.

I currently get health insurance through my husband's job. Should I just take the job option?

None of the poll options suit me well, but I chose the "I get my health coverage through my government, it's for everyone" since that's the basic coverage. I additionally have a private health and dental insurance in order to bypass this system should the need arise.

Yes, I have embraced my socially mobile bourgeoisie quite easily, thankyouverymuch.

I get my healthcare through the free National Health Service, and through my wife, who is a nurse in the aforementioned health service.

I currently get health insurance through my husband's job. Should I just take the job option?

Yes, as well as students whose parent's employers cover your insurance either partial or whole.

I have an HSA through my husband's employer and we pay for high deductable insurance. It's cheaper out of pocket that way and his employer is always running programs where they will put money in your HSA if you do things. Most recently they put in $175 because my husband promised to eat breakfast every day. We hit our deductible normally within the first 3 months of the year and after that everything is covered 100% except some surgeries and a few types of specialists that are covered at 90%

I'm British though I'd say I qualify for health care under a few other things (not that I can be arsed)

I additionally have a private health and dental insurance in order to bypass this system should the need arise.

but your a student :confused:

through my wife, who is a nurse in the aforementioned health service.

practicing medicine in the bedroom?

but your a student :confused:


He just graduated

I get my healthcare from the NHS which is currently providing excellent care for my mother who is having open heart surgery in the near future and for my father who has a catalogue of ailments and is getting a pacemaker next week. Although it suffers from abuse, misuse and human error I am hugely glad it exists and works well most of the time. My family have been good customers over the years and have little cause for complaint.

I'm for free health care, worldwide!

As populations grow, the chance of plague like outbreaks increase. I don't want to see everything go to hell just because one guy, with no health care, does a typhoid Mary by never seeing a Dr. because he can't afford it!

I have to pay about 10k a year to cover myself and the family. I am self employed. Even paying this much I think nationalized health care in the US will bankrupt the country.

I've been to a doctor a few times in the last year, paying money I can't afford (although they are very nice at the clinic and don't really charge me as much as they're supposed to) to find out that there's nothing that can be done for me unless I had a whole boatload of money.

Cash is always cheaper. Another note is that they make up for it by overcharging the private insurance folks. Same way they make up the difference in Medicare payments.

Although [the NHS] suffers from abuse, misuse and human error I am hugely glad it exists and works well most of the time.
And that, ladies and gentlemen, is that.

I hope none of you in the NHS nations do not really think it is free. It is paid for by it's citizens in one form or another.

I hope none of you in the NHS nations do not really think it is free. It is paid for by it's citizens in one form or another.
No, of course we are not aware of taxes.

We all think the NHS is conjured up from pixie dust.

the NHS is the best, healthcare is a fundemental right, charging people for healthcare is abhorent.

I get my health care from the Japanese government which offers various programs depending upon employment status, age and income. Since I currently work for a private ALT company with part time status (Ha!), I have to pay about $10 a month for the service. In exchange, the Japanese government covers 70% of my bill as long as I am sick. It also caps the cost of various drugs and procedures so it's a lot cheaper for me to go see a doctor if I need to. So, yes, I do see the doctor more in Japan than when I was back in the US.

As for the system itself, I have very few complaints and a lot of good things to say about it. Really wish that America would get something like the Japanese system.

I am covered through my parent's plan for another year or so, I think.

After that who knows?

I probably won't get any health insurance.

I haven't been to a doctor in a long ass time as it is. I'm healthy, so I'm not going to go. I've weathered out the few illnesses I've had in the past couple of years without going to a doctor, so I probably won't start anytime soon.

Now, maybe I'll set up an emergency health care savings account or something, but then again, maybe I won't.

All I know is that I don't plan on going to the doctor anytime soon.

i love the NHS, and i go to the doctor as and when i need to.

i'd agree that healthcare is a right in modern society. so woo NHS!! :)

I hope none of you in the NHS nations do not really think it is free. It is paid for by it's citizens in one form or another.


I noticed paying tax and national insurance but I never knew what it was for... :rolleyes:

My dad has to get (i.e. buy) health insurance through work, so I'm covered for some things through that. However, most stuff I have goes through the NHS. Thank god for state monopolies.:)

I am covered through my parent's plan for another year or so, I think.

After that who knows?

I probably won't get any health insurance.

I haven't been to a doctor in a long ass time as it is. I'm healthy, so I'm not going to go. I've weathered out the few illnesses I've had in the past couple of years without going to a doctor, so I probably won't start anytime soon.

Now, maybe I'll set up an emergency health care savings account or something, but then again, maybe I won't.

All I know is that I don't plan on going to the doctor anytime soon.
So what happens if you fall off a ladder and break your leg, or a headache turns out to be meningitis? If you chose not to get insurance, how is your care paid for?

but your a student :confused:

Actually, as of last week I am no longer a student, as of this week I am unemployed (although I like to think of it as a vacation), and as of next week I am a temporary GP for six months.

In any case, I was a student, yes. Why would that have precluded me from having a private dental & health insurance?

I hope none of you in the NHS nations do not really think it is free.

Uh... what?

Actually, as of last week I am no longer a student, as of this week I am unemployed (although I like to think of it as a vacation), and as of next week I am a temporary GP for six months.

I think I could sort you out a job at a bar, don't worry there is no shame in it :p

In any case, I was a student, yes. Why would that have precluded me from having a private dental & health insurance?

student = poor/debt

I think I could sort you out a job at a bar, don't worry there is no shame in it :p

There is never any shame in honest work.

student = poor/debt

Yes, but poor != destitute. The monthly fees are not that high, seeing as I am healthy and young.

Hmm. it's a bit of both for me, Government pays it, and it's for everyone. but I also pay my own health insurance too for top-up covering things the govt considers non-essentials.

all emergency and trauma sorts of things are govt funded, but electives aren't. Also the govt system is just to get us back on our feet and back to being tax payers, a lot of comforting fluff is not covered, hence the private insurance top-up to provide more than the basics.

I hope none of you in the NHS nations do not really think it is free. It is paid for by it's citizens in one form or another.

No, of course we are not aware of taxes.

We all think the NHS is conjured up from pixie dust.

:D

In all seriousness, I would much rather pay for health care through taxes than having to try and find the sums of money required at once.

Just coming on this forum you see people asking for medical advice, and when you say "why don't you just go to the doctor?" they reply "I don't want to have to pay for that". To me, and probably most people with free at the point of entry health care, that is a bizarre situation to be in.

I am a big fan of the NHS in Britain; though having worked for it I know how badly managed it can be. However it is something like the sixth largest employer in the world, hard to imagine an organisation like that working at all when scaled up for the US population.

My healthcare is entirely free, but it doesn't all come from one source. GP and hospital stuff is funded by the NHS and is universal to all. Eye stuff and dentistry is funded by the NHS due to me being on a low income (normally you have to pay yourself). Prescriptions are entirely bizarre again. The first £5 is paid by the NHS because of low income and the rest is paid by the universal part of the NHS.

It's all a bit screwy. Especially as last year they refused to give me the low income healthcare despite my financial situation not having changed since last year...


I don't normally go to the doctors. I always seem to think that whatever my problem is I don't think it's serious enough.

The good ol' NHS for me. I've not generally needed it, but I did have some nerve problems from an injury a few years ago and it was very gratifying to be able to go see my GP and then a neurology specialist (for an fMRI) about it. It turned out just to be nerve bruising, but if it had of been MS I may have otherwise ended up waiting years before it was picked up.

I'm also still on my parents medical insurance (for one more year) in Belgium, which is a slightly different system of universal healthcare. Everyone has medical insurance either through the government (paid for by taxes or free if unemployed), and medical costs are always partially or fully reimbursed (income and urgency/necessity dependant). I believe they have a similar system in France and may be a better system of universal healthcare for the US than an NHS model.

I am a big fan of the NHS in Britain; though having worked for it I know how badly managed it can be. However it is something like the sixth largest employer in the world, hard to imagine an organisation like that working at all when scaled up for the US population.
They could just have 50 State Health Services rather than one National Health Service to break it up a bit.

Veteran covered by veterans affairs.

British, so I pay my tax and national insurance for my free healthcare.:)

I am a big fan of the NHS in Britain; though having worked for it I know how badly managed it can be. However it is something like the sixth largest employer in the world, hard to imagine an organisation like that working at all when scaled up for the US population.

ah that's easy, you make everyone doctors by the time they're 20 and before you know it the US becomes one great big giant hospital service.:)

Long live the NHS. :D

I live in the US. I get my heath coverage through our state government -- for employees of the state, their families and eligible dependents. It's great coverage; far better than what I'd get from the state if I were poor. That never seemed right to me. It's also more comprehensive and far, far, far less costly than the coverage I'd get though my own non-profit employer, so I appreciate the option of being covered under it.

It means I have very low copays for office visits or prescriptions, a wide range of providers that I have nearly full choice from, and generally speaking, don't have to think much about the financial disaster that some health conditions cause others. (Each of my pregnancies, from prenatal care through delivery cost $10 for the initial office visit. All labs/radiology/hospitalizations were covered in full.) We get sick or injured, we go, and think nothing of it. Fortunately, we're generally healthy, so it hasn't been a major concern. Seems only right that everyone has access to a similar high quality of care.

In Alberta, we are still one of only two provinces in Canada that require you to pay health care premiums. If you're low income, you can get a subsidy and pay nothing. For a family of four, this 'premium' is $88 a month. The premium will be eliminated as of Jan. 1, 2009.

Other than that, I pay zilch. The only out-of-pocket expenses are medications if necessary. Now THAT can get expensive if you don't have employer benefits. Through my former union, we paid a $5 flat dispensing fee, and they covered the rest of the cost of the medication. Right now, we have no such benefits, but are lucky to not really need medications. Still, we are lucky in that Canada encourages the growth of generics, meaning even when you have to pay out of pocket, you can usually get a cheaper generic drug so you don't break the bank.

I honestly don't understand how anyone would possibly want to live in a system that doesn't offer you at least this.

All I know is that I don't plan on going to the doctor anytime soon.

No one plans for this. Unless you're one of those hypochondriacs or desperate attention seekers.

I have rarely needed health care intervention...but rarely is not never. Two pregnancies, a car accident when I was younger and the odd illness that needed medication. Certainly not excessive...yet had I been required to pay for even that care, I doubt I could have done so.

In Alberta, we are still one of only two provinces in Canada that require you to pay health care premiums. If you're low income, you can get a subsidy and pay nothing. For a family of four, this 'premium' is $88 a month. The premium will be eliminated as of Jan. 1, 2009.

Other than that, I pay zilch. The only out-of-pocket expenses are medications if necessary. Now THAT can get expensive if you don't have employer benefits. Through my former union, we paid a $5 flat dispensing fee, and they covered the rest of the cost of the medication. Right now, we have no such benefits, but are lucky to not really need medications. Still, we are lucky in that Canada encourages the growth of generics, meaning even when you have to pay out of pocket, you can usually get a cheaper generic drug so you don't break the bank.

I honestly don't understand how anyone would possibly want to live in a system that doesn't offer you at least this.

I'm fine with my system. I am fully covered on prescriptions (10 dollar fee per prescription). See my previous post for my great coverage.

I've seen how bad it can be in America without health care coverage, and I've seen what happens in Canada when they don't have the specialist you need to survive (they tell you to fuck off and die). And the accounting system at the UK NHS can only be described as fanciful - it's apparent to me that it's far more expensive than the books are showing.

Everyone should have health care. I believe the best way is to mandate that employers buy it for you. For those who are unemployed, the state can pick up the rest (Medicaid and Medicare in the US already exists for the elderly who are uninsurable and the indigent).

The real gap in the US is the "working poor". I think that employers at all levels should be required to purchase the same coverage level I have.

I hope none of you in the NHS nations do not really think it is free. It is paid for by it's citizens in one form or another.

As are roads.
And elementary/secondary education.
And public buildings.
And the sewage system.
And the water treatment systems.
And the wages of government employees.
And the costs of maintaining even a tiny military.
And the postal service.
And the cost of maintaining national and provincial parks.

We're not fucking stupid. We pay into a general pot, and money comes out of that pot to fund any amount of works in the public interest. Those of us living in countries with an NHS are well aware of how taxation works. I don't begrudge my taxes going into road construction even when I will never utilise that particular road...why on earth would I begrudge such a basic thing as health care to any human being within our reach? A country full of sick people who cannot access health-care benefits no one. Just like a country full of shitty roads you can't drive on without losing an axle benefits no one.

I'm fine with my system. I am fully covered on prescriptions (10 dollar fee per prescription). See my previous post for my great coverage.

I've seen how bad it can be in America without health care coverage, and I've seen what happens in Canada when they don't have the specialist you need to survive (they tell you to fuck off and die). And the accounting system at the UK NHS can only be described as fanciful - it's apparent to me that it's far more expensive than the books are showing. Um...doesn't the US government pay more per capita for the maintenance of the health care system than any other country in the world?

I'm not sure why talking about 'it's more expensive than the books are showing' makes any difference considering that.

Everyone should have health care. I believe the best way is to mandate that employers buy it for you. For those who are unemployed, the state can pick up the rest (Medicaid and Medicare in the US already exists for the elderly who are uninsurable and the indigent).

The real gap in the US is the "working poor". I think that employers at all levels should be required to purchase the same coverage level I have. Well, I can't really argue with that...however it gets done, ensuring that everyone has coverage seems common sense.

Um...doesn't the US government pay more per capita for the maintenance of the health care system than any other country in the world?


Other than Medicaid and Medicare, the Federal government doesn't pay anything for the maintenance of the "health care system". Not one cent.

It pays less for medical research than the pharmaceutical companies.

State and local governments may run public hospitals, but they are usually quasi-governmental concerns.

Medicaid and Medicare are out-of-control government systems, and they spend and waste tremendous amounts of money. I remember getting a detailed examination of the NHS accounting system when I was there to help write software for it. It is farcical to assume that any of the numbers you're getting out of any of those systems reflect the real costs.

States usually get stuck with the bill for people who aren't covered who appear at emergency rooms for treatment - a lot of poor people don't bother to fill out the forms for Federal aid. There's a land office business for the Federal support for the elderly - whole industries have sprung up around things like electric scooters.

Say you're 66 years old, on Medicare. Call the Scooter Store, and they'll have a doctor write you a prescription for the scooter they sell. You get the scooter for free (even if you don't need one), and the doctor has never seen you. They charge the government 5,000 dollars for a scooter.

See?

And if I oppose this sort of thing, I'm voting against helping the elderly with their mobility...

I chose the "Government for low income" option, but that's only partly true. I have Medicare because I'm disabled, regardless of my income. Then I have Medicaid, which is for low income, as a secondary insurance. It covers the 20% that Medicare doesn't cover.

As are roads...
A country full of sick people who cannot access health-care benefits no one. Just like a country full of shitty roads you can't drive on without losing an axle benefits no one.
Neither of which exist in any modern country. Oh, that was hyperbole... Sorry.

What is needed is a common-sense approach to health care and how to provide it.
1. Allow/require health care plan providers to offer plans that don't have any of the over 1900 specific-coverage mandates that they now have to deal with.

2. Encourage individual participation in the process by allowing the same tax deductions as a business is allowed to take for the purchase of a health care plan.

3. Quit thinking of health care plans as insurance.

4. Allow/require a grace period for those with "uninsurable" conditions to sign up.

There are probably a few more steps that can be taken. None of which should ever require government mandated universal health care coverage. One should always be free to decline coverage -- with the knowledge and warning that they may become uninsurable in the future.

Other than Medicaid and Medicare, the Federal government doesn't pay anything for the maintenance of the "health care system". Not one cent.
Ah, I see, the figures refer to per capita spending by citizens, not government, my bad. Nonetheless, a study (http://www.sciencedaily.com/releases/2005/07/050712140821.htm) put out by the John Hopkins Bloomberg School of Public Health reasserts once again that you yanks pay more for your health care system than any other country in the world at $5,267 per capita on health care. Most other OCED countries are only spending $2,193.

What is going so wrong with your 'private' and 'efficient' system? What boggles my mind even more is some of the idiots in my country who actually want to emulate such an expensive, and problematic system. The study says that we can't blame surgery wait times, or malpractice suits for the ridiculous price you guys are paying for your health care.

Even if some governments are cooking the books, it still seems that the publicly funded health care is miles ahead in terms of cost efficiency.

Neither of which exist in any modern country. Oh, that was hyperbole... Sorry.

What is needed is a common-sense approach to health care and how to provide it.
1. Allow/require health care plan providers to offer plans that don't have any of the over 1900 specific-coverage mandates that they now have to deal with.
You'll have to explain that a bit, puleez.

2. Encourage individual participation in the process by allowing the same tax deductions as a business is allowed to take for the purchase of a health care plan. Oooh, now that I like. Except wait...tax deductions aren't 'free' either! OMG! You don't understand how taxes weeeerk! :p

We have some tax deductions here for medications (which isn't covered under the health care plan), but you have to spend an incredible amount per year to even qualify. That sucks ass.

3. Quit thinking of health care plans as insurance. Mmmm? Flesh this one out for me too, I'm interested...

4. Allow/require a grace period for those with "uninsurable" conditions to sign up. So they would still get coverage for those 'uninsurable conditions'? Why a grace period? Is this to deal with the unemployed who couldn't afford the fees?

There are probably a few more steps that can be taken. None of which should ever require government mandated universal health care coverage. One should always be free to decline coverage -- with the knowledge and warning that they may become uninsurable in the future.
But should anyone ever have the 'right' to decline coverage for their children, for example? What about those with mental illnesses who decline without full knowledge of the consequences? Under this plan, how would you be dealing with people on fixed incomes, or who are unable to work who could not afford a plan?

Ah, I see, the figures refer to per capita spending by citizens, not government, my bad. Nonetheless, a study (http://www.sciencedaily.com/releases/2005/07/050712140821.htm) put out by the John Hopkins Bloomberg School of Public Health reasserts once again that you yanks pay more for your health care system than any other country in the world at $5,267 per capita on health care. Most other OCED countries are only spending $2,193.

What is going so wrong with your 'private' and 'efficient' system? What boggles my mind even more is some of the idiots in my country who actually want to emulate such an expensive, and problematic system. The study says that we can't blame surgery wait times, or malpractice suits for the ridiculous price you guys are paying for your health care.

Even if some governments are cooking the books, it still seems that the publicly funded health care is miles ahead in terms of cost efficiency.

Here's a starter, and it's only one area.

I've written software for large insurance companies to examine billing data from people injured in car accidents. It used to be that if you're in an accident, the insurance company of the person at fault will pay the medical costs.

Well, since medical costs translate during lawsuits into "medical specials" which translate (by simply and unofficially multiplying by 3 to 5) into the "pain and suffering" award. So, you want to run up the medical specials with extra visits, extra unnecessary treatment, etc. Many orthos, physical therapists, and especially chiropractors will do this (most states consider chiropractors to be valid medical treatment, so you have to pay them).

In addition, software is available for these medical people to engage in multiple billing, unbundling and rebundling of treatment codes in order to get the most money billed, etc.

I was just writing software to identify when that software was being used.

Imagine a doctor billing from two offices, 180 miles apart, for a visit by the same patient on the same day.

Imagine a doctor treating a soft tissue injury with hot/cold packs (essentially a pack of warm or cold water) a whole year (soft tissue injuries resolve one way or the other within 6 to 12 weeks and hot/cold packs are no longer valid medical treatment at 1 year).

I found that one insurance company alone was spending nearly 1 billion on hot/cold packs in Florida - outside of the valid treatment window.

That's what's going on. People are actively gaming the private system (and gaming the public system).

Ah, I see, the figures refer to per capita spending by citizens, not government, my bad. Nonetheless, a study (http://www.sciencedaily.com/releases/2005/07/050712140821.htm) put out by the John Hopkins Bloomberg School of Public Health reasserts once again that you yanks pay more for your health care system than any other country in the world at $5,267 per capita on health care. Most other OCED countries are only spending $2,193.
From the NY Times:
http://graphics8.nytimes.com/images/2006/12/30/business/31view.L.jpg
Out of interest.

all emergency and trauma sorts of things are govt funded, but electives aren't.

Yeah, non-essentials like dentistry and psychological help. You know, cosmetic stuff. ;)

Here's a starter, and it's only one area.

I've written software for large insurance companies to examine billing data from people injured in car accidents. It used to be that if you're in an accident, the insurance company of the person at fault will pay the medical costs.

Well, since medical costs translate during lawsuits into "medical specials" which translate (by simply and unofficially multiplying by 3 to 5) into the "pain and suffering" award. So, you want to run up the medical specials with extra visits, extra unnecessary treatment, etc. Many orthos, physical therapists, and especially chiropractors will do this (most states consider chiropractors to be valid medical treatment, so you have to pay them).

In addition, software is available for these medical people to engage in multiple billing, unbundling and rebundling of treatment codes in order to get the most money billed, etc.

I was just writing software to identify when that software was being used.

Imagine a doctor billing from two offices, 180 miles apart, for a visit by the same patient on the same day.

Imagine a doctor treating a soft tissue injury with hot/cold packs (essentially a pack of warm or cold water) a whole year (soft tissue injuries resolve one way or the other within 6 to 12 weeks and hot/cold packs are no longer valid medical treatment at 1 year).

I found that one insurance company alone was spending nearly 1 billion on hot/cold packs in Florida - outside of the valid treatment window.

That's what's going on. People are actively gaming the private system (and gaming the public system).

Actually yes, there was just some big scandal about doctors false billing here...my mother-in-law got her record printed off to check and saw a bunch of visits that never happened...apparently it is quite rampant.

On the issue of auto accidents though, depending on your province, there are quite often 'caps'. In Alberta, soft-tissue damage awards are capped at $4000.

I'd like to see a better system of accounting for billing costs etc, rather than scrapping the whole thing and actually believing that private companies are going to be completely up front about the whole process.

From the NY Times:
http://graphics8.nytimes.com/images/2006/12/30/business/31view.L.jpg
Out of interest.

Yikes.

Actually yes, there was just some big scandal about doctors false billing here...my mother-in-law got her record printed off to check and saw a bunch of visits that never happened...apparently it is quite rampant.

On the issue of auto accidents though, depending on your province, there are quite often 'caps'. In Alberta, soft-tissue damage awards are capped at $4000.

I'd like to see a better system of accounting for billing costs etc, rather than scrapping the whole thing and actually believing that private companies are going to be completely up front about the whole process.

I used to joke with the State Farm guys that people from Quebec are noodlenecks.

You're allowed to sue for damage awards in Quebec, but not in British Columbia.

There are roughly 50 times the number of neck injury lawsuits in Quebec, as opposed to BC, per 100,000 drivers.

So, either speaking French makes your neck prone to injury, or the difference in laws makes the people game the system.

So, either speaking French makes your neck prone to injury

That is the Gods honest truth that is, right there wot you just sed!

National Heath Service, it's the only way to go. Just watching Michael Moore's film 'Sicko' reinforced my faith in it! I find it amazing just how terrible the American system is, while it is pretty easy to get a decent standard of healthcare here in the UK.

You'll have to explain that a bit, puleez.

Referring to special-coverage mandates, meaning the elimination of things that special interests have talked legislatures into requiring for health care plans. Things like in-vitro fertilization, acupuncture, even simple pregnancy benefits ought to be optional. A normal couple in their fifties probably doesn't want to engage in more child rearing, so why sock them with premiums for birthing babies. Florida eliminated those mandates and introduced a policy that concerns itself with primary care and catastrophic expenses for major illness. It's supposed to cost about $150 USD. Not bad, when you consider that the national average is more like $450 USD.


Oooh, now that I like. Except wait...tax deductions aren't 'free' either! OMG! You don't understand how taxes weeeerk! :p

We have some tax deductions here for medications (which isn't covered under the health care plan), but you have to spend an incredible amount per year to even qualify. That sucks ass.

Gimme a break --- I'm not the one complaining about 'free'. Reread what I wrote. Not a 'free' mentioned in the money sense. I might have slipped in a mention of freedom of choice, but that's different.

Our incompetent lawmakers in D.C. could give us a tax break for buying an individual health care plan, but they choose not to. A low cost plan would be attractive on its own merits, but a low cost plan that would save me a couple hundred to a couple thousand dollars in taxes would be even more attractive.

Mmmm? Flesh this one out for me too, I'm interested...

Insurance is used when something goes really wrong. You use it to make yourself whole again because you can't afford to do it yourself. You wreck a car, burn down your house, and you get insurance to cover it. You don't use it to get an oil change, paint the house, buy a new roof, etc.

Use health insurance for catastrophic problems. Buy a health care plan to cover the little things. Or just pay for the little things yourself. A doctor's office visit is about $100 for a check up. But you don't need to do that every time you have a runny nose.

Anyway, Florida has focused on covering both ends of the spectrum with primary care and catastrophic insurance, so more power to them. Maybe this point is irrelevant.

So they would still get coverage for those 'uninsurable conditions'? Why a grace period? Is this to deal with the unemployed who couldn't afford the fees?

But should anyone ever have the 'right' to decline coverage for their children, for example? What about those with mental illnesses who decline without full knowledge of the consequences? Under this plan, how would you be dealing with people on fixed incomes, or who are unable to work who could not afford a plan?
Guaranteed issue is probably one of the most expensive parts of insurance. In auto insurance that's taken care of by having an assigned risk pool. The insurance costs more, but bad drivers can buy it.

Guaranteed issue in most states only guarantees that someone will avoid getting insurance/care until they are sick enough to need it. At that point, they put an enormous burden on the system.

I'm not sure how this needs to be handled, yet, but I do think varying the premiums for well and sick applicants is essential. That's nothing new for the insurance industry. In fact, they vary rates based on credit scores now.

The grace period would give anyone a chance to sign up at "healthy" rates. The folks that choose not to, would have to take their chances and may be required to sign up at "sick" rates, should they become sick later on. And parents are responsible for their kids, so maybe a one time open enrollment at healthy rates when the kid turns 21 is the answer. Or maybe a couple along the way.

From the NY Times:
http://graphics8.nytimes.com/images/2006/12/30/business/31view.L.jpg
Out of interest.

I blame Dr House.

I am happily party to pissing obscene amounts of money per annum into the NHS, whilst recieving soulless, uncaring and often mediocre treatment in return for this.

Being a legal citizen in Germany, I voted for the first poll option, though it doesn't really fit 100%.

Currently, I'm under 25 years old, "within the education system", i.e. at university, and earn negligible amounts of money, so I'm covered by my parents' health plan.

I shall probably earn more money soon while retaining my student status, so I'll have to pay a certain monthly amount for our mandatory health insurance, but it'll by rather little (~4% of my income, IIRC) and my employer will pay the rest (~17%, IIRC).

Once I'm out of the education system and earning money regularly, I'll pay the full amount of health insurance (~13% from both employer and employee). Depending on my insurance company, I'll most probably be able to insure my potential kids and non-earning partner with it for no extra fee, too.

If I get unemployed, I have to pay a certain monthly amount, AFAIK it's €135 for students (over 25) at the moment.

If I'm on governmental welfare / support, they pay for my health insurance.

There are special conditions for very low income, employees of the state and freelancers / self-employed, of which I'm not too well informed.

Similar mandatory insurance systems are in place for retirement funds, unemployment insurance and insurance for the case of having to be placed in institutional care at old age.



This all means that I go and see the doctor, go to the hospital and get medicine as needed, with no considerations as to money. Since a few years, I have to pay a quarterly fee of €10 for my first doctor's visit within that year's quarter and obtain a referral for every other visit, and pay a cover charge of €5 for prescription drugs, in order to prevent "social doctor visits", which have apparently been soaring among the elderly - you know, going to see the doctor to chat with the like-minded in the waiting room, and have someone who listens to your complaining.

Thanks for the response, Myrm!

I get health insurance through my dad's employer -- we are on a PPO. It has so far helped in covering the costs of every medicine and procedure that my doctors have recommended for me, so I find it satisfactory. However, my deductible is quite high, and when my family is paying it off (before the insurance kicks in), I find myself paying upwards of $50 a piece for blood work. With the amount of check-ups and blood work I get done, this proves to be quite a burden. During the first half of this year, I had a $250 and a $180 bill land on me just for a series of blood work tests I had done.

I pay cash for all of my doctors visits but hold catastrophic insurance that I pay for from my own pocket.

So what happens if you fall off a ladder and break your leg, or a headache turns out to be meningitis? If you chose not to get insurance, how is your care paid for?

I've fallen off a ladder before. Straight on my back. It knocked the wind out me, but I got up. I'll live.

Meningitis? Don't think I need to worry about that...

Like I said, I'm still covered through my parent's for a while. After that I'll probably set aside some money in a savings account.

No one plans for this. Unless you're one of those hypochondriacs or desperate attention seekers.

I have rarely needed health care intervention...but rarely is not never. Two pregnancies, a car accident when I was younger and the odd illness that needed medication. Certainly not excessive...yet had I been required to pay for even that care, I doubt I could have done so.

Hmm. I'm not at risk of pregnancy being male, and I'm a pretty good driver (but shit happens). I'll have to decide when the time comes, but honestly I don't want to pay a shit ton of money for something I'm not going to use.

I was reading a book and I wondered about how people on NSG access/pay for health care. I'm adding a poll but please answer in thread how you access health care and what you like or don't like about it. Does the way in which your healthcare is funded/paid for affect your decisions about when to go to the doctor/etc.?


This is not my homework

We pay my policy out of pocket, it is around $550 a month just for me. My husband's is provided through his employer.

I don't like that to get my 6 month ct scan in May I tell the imaging clinic I don't have insurance and they charge me $600 cash. If I tell them I do have insurance my co-pay is $780. How screwed up is that?

I wonder what I am paying for at times. :rolleyes:

I get my healthcare through the free National Health Service, and through my wife, who is a nurse in the aforementioned health service.
This has nothing to do with health care, but everything to do with what people perceive as "free". Plus, it was so ridiculous, that I had to find a way to post it...
The exact question was "Should Congress quit funding for Public Television and NPR, Public Radio?" You can read Mr. Guess's answer.

http://bp3.blogger.com/_I_1MV9aXK5k/SE3SASnXXrI/AAAAAAAABRc/Cs5f2ucOOPk/s400/200806091407.jpg

Huh?

I've fallen off a ladder before. Straight on my back. It knocked the wind out me, but I got up. I'll live.

Meningitis? Don't think I need to worry about that...

Like I said, I'm still covered through my parent's for a while. After that I'll probably set aside some money in a savings account.
Alright then. Say you needed chaemotherapy. Or you do if you had an injury that was your fault that required urgent and expensive medical attention?

This isn't a trick question. I'm genuinely interested what people do without universal healthcare do when they need to shell out big bucks and don't have health insurance, apart from grin and bear it if it's not life threatening.

Alright then. Say you needed chaemotherapy. Or you do if you had an injury that was your fault that required urgent and expensive medical attention?

This isn't a trick question. I'm genuinely interested what people do without universal healthcare do when they need to shell out big bucks and don't have health insurance, apart from grin and bear it if it's not life threatening.

When my daughter was sick and we didn't have insurance we went to the hospital. They admitted her, gave her the best health care they were capable of, surgeries, tests, feeding tube, all that jazz. When the bill came we called them and told them we didn't have the money to pay, they put us in touch with the charity program and a few churches who covered nearly all of our bill for us. Not being able to pay doesn't mean you can't get health care, it just means you will owe a shitload of money.

Say you needed chaemotherapy.


T'is Chemo not Chaemo. Sorry had to be an ass :p