You're insured? but are you covered? ...USA Today

[JohnWxy]

http://blogs.usatoday.com/oped/2009/09/column-the-tragedy-of-the-underinsured.html


Just 21 months into my mother's cancer treatment, she had reached her medical insurance policy's cap for chemotherapy — $100,000. As if dealing with cancer were not enough, she now had to deal with the reality that our health care system had left her financially exposed.

Lost in our daily debates on health care reform is the devastating impact our current system has on people like my mom.


She, like 25 million others, was underinsured. They, along with the 46 million uninsured, are forced into a high-stakes game with their lives. Many of these people have jobs yet are left out of our system. Along with other disparities in health care, our employer-based system also discriminates. Where you work matters greatly.


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Her policy also had bizarre limits on what drugs could be given on a single day, which resulted in multiple visits to her oncologist. These limits, along with the $100,000 lifetime caps on radiological scans and chemotherapy, made her care far more convoluted. Treatments were often delayed or changed, depending on her coverage.

[wilt the stilt]

1. we have the best system in the world

USA USA USA

[JohnWxy]

3. that's what John Boehner says anyway...

[Doctor_J]

7. Irony #2 - the budget-busting price for chemo

is so high BECAUSE OF Big Insurance. If we could buy drugs at competitive prices, the chemo would be much less expensive.

[wolfgangmo]

15. The US is the only industrialized nation with NO health care SYSTEM

Health care we have. System we do not.

[stuball111]

2. That's another often missed factor...Underinsured...

Doesn't happen in a Universal system,,,

[Doctor_J]

8. And I don't think the plan the president outlined in his speech helps this

:shrug:

[dflprincess]

4. And that's what I keep saying about the "reform" being talked about

we'll get insurance (even if we have to be forced to buy it) but with the high out of pockets (aka "cost sharing" in HR3200) we still may not have access to health care. And we're really not being told what will be covered. Will you & your doctor finally get to make the decisions or will your carrier still get the final say?

[JohnWxy]

5. IF the REpublicans (lobbyists) get their way what do YOU think?

If we do nothing, your premiums will almost double in ten years (if your employer doesn't drop group insurance cuzz he can't afford it) and your deductibles will go up and there will be more "trick" clauses which means as now, you think you are covered until you get sick then you find out how much is NOT going to be paid by your insurance.

about 50% of individual bankruptcies are due to massive medical bills (even for those who have insurance).


So, is this system working? Is it going to get better - on it's own?

[dflprincess]

9. HR3200 allows annual deductibles of up to $5,000 for a single person

and $10,000 for a family of four in addition to thinking that a premium equal to 11% of your income is "affordable". Both the deductibles and premiums may go up annually based on inflation rates. Currently the bill sets the income cap for any subsidiess at $43,000 for singles and $88,000 for a family of 4 (note that as your income rises the more you'll be responsible for until you hit the cap and have to pay all the out of pockets yourself). Services not covered by your policy (i.e. vision, dental) will not count toward your deductible.

While preventative (pap smears, mammograms) will be covered, any follow up treatment a test may indicate you need will not be until you hit your deductible. The same is true for chronic conditions - any routine care you need will not be paid for until the deductible is met. More employers and are going to these "consumer driven" plans and early indications are that they may actually cost everybody more because people who have policies with high deductibles are just as apt to put off care as the uninsured.

With deductibles this high, there will still be a lot of underinsured people. There will also be people who wind up paying medical bills with credit cards - just like today. It may take longer, and there will be fewer, but there may still be medical bankruptcies. The bills currently being given the most consideration by Congress are not only a gift to the insurance companies but, to some extent, the credit card companies as well.

What we need is a system that does not require payment at point of service, or has very minimal copays (like $10 or $20). We are not going to get a handle on medical costs if people still have to stall on getting care because they're worried about the cost. There is growing evidence that these high deductible "consumer driven" policies result in more ER visits, more admits and longer hospital stays.

"Reform" that only provides insurance but does not improve access to care is not reform - it's the system we have now and it doesn't work.

[JohnWxy]

13. If you have ideas to improve on that plan send them to the committee or your representative

keep in mind you have to be able to get "blue dog" democrats (Republicans in sheeps clothing) to agree to them.
(I hope you have a prayer to spare).

NOne of the plans attempts to cover everybody. I think it's a laudable goal. But as I said above, you have to get the "Blue dogs" to sign up to it, if you want to get something passed.

Here's an interactive comparison of the bills in House and the Senate:

http://www.washingtonpost.com/wp-srv/special/nation/health/compare-health-plans-2009/

[truth2power]

19. Getting this passed is the same as getting nothing passed...

Why should there be any attempt to get the blue dogs on board? What difference does it make?

As someone said down thread, let the system collapse. It will in any case unless we get universal single payer.

[SharonAnn]

16. And remember, the deductible resets every calendar year. You face it all over again.

[Blue State Blues]

6. but we'll have choices, right?

lots of policies to choose from. thousands of pages of contracts to read through to make those choices. levels of coverage to choose among. because we all can know today exactly how much care we will need tomorrow, right?

I've said it before, I'll say it again, If you cannot afford to buy good insurance, you cannot afford to have bad insurance.

[JohnWxy]

10. Feeling lucky are you? about 35% will not have group coverage in 10 yrs because their employers

won't be able to afford group coverage. Those who feel lucky - they won't lose their coverage - will see their premiums double. So, many of them won't be able to afford coverage anyway. About 40% to 50% will not have coverage in 10 yrs - without reform. good luck!

Let's just do nothing and go down the tubes. But at least the health insurers will keep making good profits.


"SAVED" from Health Care Reform

[dflprincess]

14. The only bright side (and not a very bright one) is that if we go to 50% uninsured

there really would be no choice but to extend Medicare to all.

The main point of the current bills floating around appear to be to prop up a system that's on the verge of failure. Rather than continue to shovel money into the pockets of the crooks that have been cheating us for years (and will continue to cheat us) we should do nothing and let the whole system collapse.

All we're going to get out of this "reform" are the same kind of crappy insurance policies we have now with no guarantee that we will get improved access to care. There is no defense for the scam Congress is trying to foist on us.

[JohnWxy]

18. I have to wonder what the insurance companies think they are accomplishing by killing reform. We're

just going to have a collapse which will require dramatic action by adding people to medicare (a real solution to the problem but one the health insurance scam industry certainly won't like). But, it is of course, the correct thing to do.

Just like Wall Street bankers, their greed will be their undoing! Unfortunately we'll have to go through much pain (in human terms and in terms of the economy) to get their.

[JohnWxy]

11. you've got bad insurance now. How long will you be able to afford that?

the experts vs the public on health insurance reform

[JohnWxy]

12. U.S. spends about double the average per capita for industrialized nations for health care

BTW there is a whole industry growing up tohelp peole figure out the insurance policies available now.



http://www.americanprogressaction.org/issues/2009/02/pdf/HealthCareinCrisisCharts.pdf#page=2

[comtec]

17. Hasanyone ever proposed a Single Government-run drug company?

That is anything that is either Generic OR the researched WAS EVER PAID FOR IN ANY WAY by government research funds -that is EVERYTHING - the government has the legal right to create.

Surly the BIG BAD PHARMAs can compete with a few simple generic medicine factories. After all, they're private and the private sector can do anything! But so can the government.

hell lets even say that ONLY people on Government based health care - medicare, Tricare, that solid-gold system congress uses, etc, can use these generics.

Medicare D MUST buy these generics whenever possible - which would of course be FREE because it's government owned and run. And if it's a government health-system, there is no point in charging itself for said drugs.

Think of it, drugs made IN THE USA by AMERICANS for Americans. but ONLY for those on the EEVVIILLLL US medical system.

Oh and of course, ONLY government drugs would be used in those dirty COUNTY hospitals, after all they don't pay their bills quickly enough to the pharmas anyway. and the people who use County hospitals are poor anyway. no profit there.

That would leave the big-bad-powerful pharma to fuck everyone else

unless THEY bought into Medicare as well...but why would they? that would mean using the "inferior" Government drugs, and medical, and dental, and optical services. and NO ONE wants THAT... right?