How I lost my health insurance at the hairstylist's

[Joanne98]

So you’re chugging along doing all the things you do as a responsible citizen, you work, and pay your bills and your taxes, you are there for your children, and fighting for your marriage, you even volunteer. It’s spring, 1998, and gradually you just become so tired it’s a struggle merely to climb a flight of stairs.

Oh, well, you do have two daughters in college, another nearing the end of her senior year in high school, a son in middle school, a full-time job, a house to take care of, are back in college, and have two dogs, two cats, and oodles and oodles of marital strain.

Fatigue sort of goes with the territory, and like many working moms, you just push past it. You get up, you get the family off in various directions, you go to work, you go to class, you cook dinner, you help with homework, go to games and track meets, do housework, set boundaries for the two kids at home and field frequent counseling-like calls from the two who are not, you try to work through problems with your husband, and you collapse exhausted into bed, get up the next day, and do it all over again – it’s a routine you dare not interrupt with reflections on your fatigue – there is no time.

Then one day...

Downtowner's diary :: :: You show up two weeks later than you should have to the hairstylist (pretty common when you are constantly pressed for time) and instead of the usual lecture about the color of your roots, she turns you around in the chair and says:

"I look at people’s skin tones all day long and try to decide the best coloring for their hair, and I can tell you this: gray is not a normal human skin tone. Get out of here right now and go see your doctor."

For some reason, though she is not the first person to note you don’t look your best lately, this is the one thing that manages to penetrate the fatigue-fog and you do as you are told.

You call on the way, check in, sit down in the crowded waiting room resigned to waiting for a couple of hours, and a mere minute later the doctor, passing by the glassed in sliding windows on the other side of the wall catches sight of you, comes out, and demands to know: "How did you get so anemic?" You say, "I am?" He says, "Come with me right now" takes your hand and drags you back to an examining room.

Later that day, at the oncologist/hematologist office, this new strange doctor takes blood, orders up an outpatient transfusion, tells you that you no doubt have acute myelogenous leukemia, could keel over dead at any moment as long as you are untreated, and should now go home and call him the very minute the HMO calls you and tells you to check into some local hospital or the other – but should on no account whatsoever check into that local hospital.

You find this direction to avoid hospitalization confusing, in light of the "keel over dead untreated" stuff and say so. Whereupon oncologist/hematologist guy says HMO will try to check you into local or even regional hospital – because it’s cheaper – but in his opinion no local or regional hospital should be treating leukemia, since cure rates double in large teaching institutions. Risk of keeling over dead while he is arguing for your life with HMO is less than risk of dying in local hospital. Then he writes you a list of five hospitals in Chicago that you can allow yourself to be checked into, and says if it’s one of these ok, but it won’t be, so call me when they tell you to go to a local hospital.

Sure enough, he’s right; they do, the very next day. You call him. He works some magic you know naught of (though local rumor tells you later that he informed HMO that he will be sure to make himself available to testify at your spouse’s wrongful death suit later) and you get the referral to the large teaching institution later that day.

Telling your children...no, you won’t write the details here, beyond saying that especially for someone who lost a parent at the age of eleven, it’s the hardest thing you’ve ever done to try to be honest about the prognosis (which is grim) but reassuring about your love for them and intent to fight for your life.

Skip ahead then. On your first day in large teaching institution, you are visited by a social worker, who surprises you by demanding to know not the details of your home life, or about your state of mind on being diagnosed with a more-lethal-than-not form of cancer, but simply: "Who is carrying your insurance, you or your husband?"

You think this is rather cold for a social worker and inform her somewhat frostily that you are sure the bill will be taken care of – it’s pre-approved.

Social worker looks at you with what you interpret as pity and says it’s really, really important. So you say, spouse, as you work for small non-profit that offers no benefits, but also admit to her that you think marriage is for sure doomed now.

"Good, good!" she says.

And you wonder why, why, on top of extra-lethal form of cancer, must you also get unbalanced social worker?

She must be able to tell from your expression that you think she’s nuts, because she explains, like so:

If you worked for a company that offered insurance, if you carried your family’s insurance, next year your insurer would slap a million dollar surcharge on the company policy for carrying a leukemia patient. The company would get the bill and someone in accounting would question "what is this extra million dollars we are being billed?"

The insurance company would explain to them that the million is for you, and it is yearly, but is, ahem, "fixable." They will say "as long as she is on your insurance (wink, wink) this charge will be there. So what you have to ask yourself (more wink, wink) is whether this employee is worth a million dollar a year salary on top of what you are already paying her."

Social worker said she had seen small business owners go almost broke trying to cover this charge, and had even heard of one who defiantly did go broke, throwing all of the employees out of work. But more usually, she said, they just fire you.

"Wait, wait!" say you, "Isn’t it illegal to fire someone for their health history? Suppose I’m all well and working?"

She looks at you with more pity, says yes, so of course they will have to find "cause" to fire you, which any employer can always do.

"But I am a very, very good employee!" you protest.

"Yes," she says, "but they can always find some cause." The real problem she goes on to explain, is that you will find a new job, that company’s insurer will slap them with the surcharge, they will take their turn at firing you, until you’ve been through six or seven jobs in a year, fired "for cause" from all of them, which of course looks very, very bad to a prospective employer.

"So in a year or so of this, you will not just be uninsurable, you will also be unemployable."

She asks who your husband works for, since they’d probably try to do this to him too. You say he is a cop working for a municipality, which pleases her. "They have all sorts of layers of officials, elected and otherwise, to work their way through to get to the decision, then once they do they have to get past his union, so it will take much longer to get him fired." She also, though, offered sympathy for the fact that what with the police union and the municipality fighting out whatever "cause" they got him on in such a public profession, it was sure to end up in the local papers and disrupt all our lives – including the children’s – when they did get that far.

You remind her you seem headed for divorce, and she says, well, okay then, just carry the COBRA to the limit and keep on working for small not-for-profits that don’t offer insurance.

You ask her what you are supposed to do for health care and she says sooner or later the insurance companies would force you onto Medicaid – either by means of making you unemployable and broke, or by means of you being uninsured and going through any and all assets you have paying medical bills until you are broke and sick enough that you can’t work, and end up on Medicaid.

You are rather horrified, but have other things (like trying to stay alive and simultaneously on top of what your teenage children are up to from the hospital many miles away) on your mind, and besides, this all seems so uncivilized and melodramatic and "worst case scenario" and...unlikely, somehow, so you set this aside for now.

Continued>>>
http://www.dailykos.com/storyonly/2009/7/7/751100/-How-I-lost-my-health-insurance-at-the-hairstylists

[Phoebe Loosinhouse]

1. Gripping. And extremely revealing about how and why people lose their jobs due to illness

even when they are performing on the job.

This is the type of story that cuts through all the fog. Thank you so very much.

[Javaman]

16. then their homes and finally declare bankruptcy.

This situation, although not exactly, happened to a neighbor of mine.

We are all one paycheck away from homelessness and one major illness away from destitution.

[pleah]

2. K&R

[abluelady]

3. I'm Sure You're Not Alone

Which just emphasizes the need for universal health care. It is unbelievable to me that all Americans cannot see this type of situation.

[daleanime]

47. 60+ % of us do...

problem is 95% of the money is apposing it:scared:

[LiberalEsto]

Speechless...

and terrified

[CoffeeCat]

34. Me too..

I've come to the conclusion that the best thing you can to is try to stay healthy, so you don't need
the system.

Of course, that's a crappy strategy--because untold numbers of healthy people end up with serious illnesses.

But it's all I got.

[NBachers]

39. I made it into my late '50's

before I came down with genetic glaucoma. Up to that point, I was healthy and without insurance. Nobody I ever worked for had insurance, and I was too busy trying to survive and pay bills to afford it.

The only real adult medical care I had was during the four years I spent in Federal Prison. I've seen people go back into the joint as a routine part of their health care plan.

So I ended up blind in one eye, and not telling anyone about it. By the time I had to go to County Hospital because I thought I had a brain hemorrhage, it was too late.

So here I am with one single worn-out eye that could go at any time. I've finally got an insurance job, but with constantly rising minimums and co-pays, I'm still skipping doctor visits.

I owe mega-thousands for the County Hospital bills. The City will be after me at some point.

I've been in your shoes.

Sooner or later, you'll need it.

[CoffeeCat]

42. I know that and I recognize that...

It's just a matter of time, for each of us--that we will find out how awful our health-care system is. Even if
you have insurance, you can still get screwed and find yourself in deep debt.

I do understand that right now, I am fortunate. But I am only 45...it's only a matter of time.

I hope your situation doesn't worsen. Take care.

[Laelth]

4. Very useful and informative story. More people should read it. n/t

:dem:

-Laelth

[Turbineguy]

5. A glimpse of life in the Republican Paradise.

Insurance companies should go after fraud, naturally, but fraudsters usually have some sort of plan that takes work and costs money to unravel. Better and more profitable to go after people who get sick. After all, in a Republican Paradise people choose to get sick and they choose their disease.

[Phoebe Loosinhouse]

6. This is truly one of the MOST illustrative stories

I have EVER read with so many sad/evil side streets to go down. I checked it out over at DKos and it's currently their top rated diary. I hope this goes viral because of the various points it covers. The moral is, if you get ill with a catastrophic, major or chronic illness you are well, thoroughly, and most likely, forever screwed as far as employment goes.

I would love to see the insurance company get the bejesus sued out of them for violating HIPPA in disclosing to the employer who the sick employee or family member of an employee is.

[wolfgangmo]

22. Good idea but...

... there are no teeth in the HIPAA laws for insurance companies. Doctors, on the other hand ...

Here is the fine for completely and totally ignoring Hipaa - "Civil penalties are usually monetary fines. HIPAA allows fines of up to $100 for each violation of the law, to a limit of $25,000 per year for violations of the same requirement." (source; http://xnet.kp.org/permanentejournal/sum03/hipaa.html )

$25,000 per year is a lot for a doctors office or individual but it isn't even a blip on the radar screen of an insurance company.

Criminally tho' - "for misuse of patient data the fine could be $250,000 plus jail time." But you have to prove that there was misuse, which insurance companies have successfully argued that imposing a surcharge on a company is not a misuse or violation of HIPAA. They do this by not disclosing the name but by giving out "general demographic information" with enough layers of detail to it to make it easy for HR to identify the "culprit."

Frankly I plan on getting my insurance by laying a bet off with my bookie. It might be expensive up front but at least I know he will pay off if he loses.

Final thought - given that insurance companies are going to screw you in health insurance my suggestion would be to get a very high term life policy, hold on for 2 years to get past the suicide exemption clause and then eat a gun. This is, of course a joke and no one, especially any insurance asshole investigators reading it, should take it seriously. I am sure that no one would EVER do something like that just to fuck with you assholes. Ahem.

[Butch350]

29. bejesus sued out of them for violating HIPPA

The customers of the insurance company would eventually absorb the costs of the lawsuit.

The health Insurance industry manages your lives not you!

[Iterate]

7. A lesson about the consequences of a predatory insurance system.

A collective, single-payer system changes the dynamic completely by making lower-cost preventative care, research, and the health and well-being of the insured its priority.

[The Backlash Cometh]

8. Try to write this for a storyline in Nurse Jackie.

I think more people need to hear about the conversation you had with that social worker.

I hope things get better for you.

[midnight]

9. All the pieces of the puzzle for why the system of delivering

America's world class health care is not working. The system is fixed. It is only for those who are not seriously in need of medical treatment. This story is so important. It is written by one who knows, and even though exhausted has a gift. Her gift is to pass on in a coherent manner the evil of those who prey on the one in need. Those who know how to protect those in need can only do so much, but those who are running this evil show have all the tricks in place. They have written all the rules, and they know how to put them into play. Heal this country and remove the cancer on our delivery system to medical treatment-remove the insurance co.

[EC]

10. This also reveals why

anyone over 45 has a hard time finding a job with insurance benefits...just as I found out. Premiums increase quite a bit for anyone over 45 and an employer is not going to take on that hit - they'll hire someone younger and less experienced over someone older who knows the job inside and out...

[fasttense]

52. It also applies to those who have their own health insurance.

If you tell a prospective employer that you don't need their health insurance (cause you're a 20 year vet, the VA covers you and your cancer), they still consider you a million dollar risk. You could decide to drop your VA and be perfectly eligible to enroll in their health insurance plan at any time. And besides, are the interviewers listening when you say you don't need their health insurance and have your own? Did they bother to note that? Or did they simply assume you would be a burden to their health insurance and reject your application?

So, if you have had any medical problems and are 45 and older, you will never find a job unless it is part time with no benefits.

[Phoebe Loosinhouse]

11. Is it too late to move this to a bigger forum like GD or GDP?

I hate to think of anyone missing this post and this outstanding Kos Diary.

I would rec this a hundred times if I were able to!

[phantom power]

12. Tales from The Best Health Care System In The World (tm)...

:eyes:

[wolfgangmo]

24. Best health care system in the world?

Bwahahahahaha. Snort. Choke.

Stop it. Seriously. If I laugh any harder I'm going to pee myself.

By any measurement the US has the worst health care system in the world.

Fact. We spend more than twice as much PER PERSON than any other country.
Fact. For that expense we don't cover anyone, which means that we ration care more than any other industrialized country in the world.
Fact. For that expense we get health outcomes that are right up there with the 3rd world. In other words, they suck.
Fact. America is the ONLY industrialized nation where the doctor does NOT have final say in medical matters. In every other country if you need it you get it. Period. For example, in Canada Docs have final say and it is AGAINST THE LAW for an unlicensed clerk (insurance company flack who is trained to say no) to double guess them. Clerks making medical decisions is SOP in the USA.
Fact. The number one cause of bankruptcy and foreclosure in America is medical bills. This is mostly for people who had insurance at the start of their disease/problem.
Fact. Innovation is languishing in America. The number one cited reason for not starting a company is the lack of health care for the self employed.
Fact. Jobs are being effected by health care costs. Toyota located their multi billion dollar car plant and R&D center for North America in Canada. When they announced that the US was not getting the plant Toyota took the unusual step of issuing health care costs as the deciding factor. Canada doesn't have them. We do.

Either Americans are stupid, hate other americans or too lazy to do anything about it. Probably all three.

[OwnedByFerrets]

27. All three, according to which group you ask.

[Stuckinthebush]

13. Jesus. God! I'm so angry

THese are the assholes that the GOP and some dems are trying to protect?

We don't want to put these assholes out of business, now do we? I'm so angry.

Why is there even a damn debate about single payer health care? This is outrageous.

[juno jones]

14. K&R!

From the uninsured in the peanut gallery.

[winyanstaz]

15. I had a dear friend sent home to die of leukemea...

and she was given five months or so to live. So she went to a Naturalpath. That was almost 20 years ago now and my friend is still alive and doing well.
I have also given up on getting medical care as I do not trust Dr's or hospitals anymore. (my husband was also sent home to die by the main stream medical establishments and we went totally natural and he lived another nine years and did pretty good. He did not die from what they told him he would die of but from a massive heart attack while in the hospital for a cold..with the dr playing grab-ass with the nurse on the other side of the curtains while he had his heart attack! Once they hooked him up to an empty oxygen tank and another time to a broken heart monitor and another time I found they had put him on a bed that still had blood and ??? from a previous patient!!)
I don't take pills..I use herbs and I am doing much better this way.

[truedelphi]

18. What you say is the guldarn truth but unfortunately

With Obama's new buddy Mike Taylor as head of FDA those herbs will be hard to obtain.

People who can grow herbs wil still have them, I imagine, but for city bound people who need them, it will be hard.

This government belongs to Wall St, health insurance "providers" and Monsanto.

"Yes we can" has become "No we won't!"

[wolfgangmo]

25. Point of clarification.

They are called Naturopathic Doctors (ND's) or Naturopathic Medical Doctors (NMD's) and there are people out there who only took a correspondence course who call themselves the same thing. Only trust one who graduated from a school that is federally accredited ( through the CNME - http://www.cnme.org/programs.html ) because they are the only ones who went to medical school, through clinical rotations, and residency.

And yes virginia they are trained to help out with metabolic and functional medicine including cancer care. For my money they are the best trained docs for integrated care.

[truedelphi]

17. Trying to explain a similar scenario to the young thing at WH comments line

And she LAUGHED at me.

Fuck everyone of those sold out legislative pigs now inside our government because we thought the Democratic party had principles and was for the people.

F___ that expletive deleted to HELL and back to HELL and while he deals with getting Monsanto that real good bill of legislative goods, Michelle has time for organic gardening.

I WANT MY GOVERNMENT BACK!

Universal Single Payer Health Care Now!

[McCamy Taylor]

19. Your only protection now is to work for a HUGE employer with a union,

So that the sheer volume of clients insured makes one or two sick people less unattractive to insurers. But any company that big (say GE, Lockheed, the City of Houston) would probably be better off self insuring, since they can afford to absorb the costs of a liver transplant.

"High risk" insurance pools suck. They only pay for themselves if you are on a lot of medication right now and get a lot of ongoing medical care. They are impractical as "what if" policies.

[ChiciB1]

20. Bless You... I Feel Your Pain & So WISH There Was SOMETHING

that will change things. I have a somewhat similar story about anemia, fatigue, thyroid stuff... BUT my insurance is intact and I'm covered for all my tests. Monday I go in for more tests, but at least I know that my PPO is approved!

I am eternally thankful that my husband worked for a Union Company and the insurance is better than most at a decent price. However, I DON'T expect it to last much longer!

Our so called "leaders" dance to a different drummer and he's bought and paid for!!

It's SICK!!

[LittleGirl]

21. Yep, this is exactly how it is

I have seen this happen to friends and I cannot believe that anyone would defend this system. It's barbaric. This needs to go viral.
Well done.

[checks-n-balances]

23. Joanne, is this from your blog or someone else's?

I couldn't tell. In any case, thank you for sharing this on DU. It's overwhelming just to read, let alone have it happen personally.

[cutlassmama]

30. I can't tell either, but I know it's true. I've seen it happen personally.

[rosesaylavee]

51. This is from a blog: Progressive Fox based in St. Charles, IL

http://www.progressivefox.com/?p=721

[OwnedByFerrets]

26. But, but, but many of our elected officials say socialized medicine

is bad. :mad: SOB's make me so farking mad. Why is it that my tax dollars can pay for THEIR health care, but my tax dollars cant pay for MY health care?
Its the question we ALL should be calling up and asking our ELECTED officials every day.

[RoccoR5955]

33. I remind them that police, fire, and military are also socilaized

And would they like to put these services into private, corporate hands.

[OwnedByFerrets]

57. And already have in many places....to disasterous results....

when the firemen have to check a list first to see if you are "eligible" to have a fire put out on your property, something is very badly wrong.

[sasquatch]

28. Yep, another victim of the GOP/DLC economic and social clusterfuck

Fuck the boomers, they brought us this goddamned nightmare.

[Name removed]

40. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[PatSeg]

31. As I read this, I became absolutely numb

knowing that it is very likely that I got fired over a year ago because of insurance as well. I knew the company on the verge of bankruptcy was trying to eliminate most full time employees because of the cost of benefits and I had had numerous medical bills for a chronic illness. All of a sudden the bogus reasons for the termination are starting to make sense. Perhaps my sin was getting sick. This will take a while to process.

[CoffeeCat]

36. I am so sorry...

I can only imagine how you feel. It really is so unfair.

I know this, as you said, will take a while to process--but I hope it's
comforting to realize that your termination had nothing to do with you.
You did nothing wrong.

I know it still hurts--but firings can shake your confidence, and maybe, in
some small way, it is a relief to know that it wasn't anything you did--it's
just our terrible system of which so many people are victims.

[PatSeg]

37. Thanks

I was devastated at the time. The job was pretty lame, but ironically I needed the insurance. I went into total isolation for a while. Self esteem can be a very fragile thing. In the long run, it turned out for the best, but at the time it was a crushing blow.

The funny thing is I got sick again and without insurance I was admitted to the nearby hospital much easier than when I had insurance. With insurance they kept releasing me from the ER even though I wasn't better and I would end up right back there. Without insurance they admitted me without hesitation evidently knowing that the county would pick up the tab.

[RoccoR5955]

32. Take the damn insurance ganifs out of the equation.

We need health insurance for WE THE PEOPLE, not them, the corporations.

No private option, the insurance thieves have made too much money as it is. Let the bass turds go broke for all I care. They deserve it. And let's hope their shills get bounced out of office!

[NJCher]

35. My heart aches for this person

Isn't it bad enough to be diagnosed with a horrible illness like this, let alone have to go through all this with the insurance companies and the jobs and on and on?

And the feeling that your illness puts your employer and work colleagues into an untenable situation! This is like a 2009 version of the Scarlet Letter.

This is what the profit motive does when it is allowed into the healthcare equation.

"Socialized medicine" should be music to the ears of any American.


Cher

[Wednesdays]

38. K&R

:kick:

[omega minimo]

41. K&R eightyfuckingfour

[HCE SuiGeneris]

43. Such freedoms that are treasured here in the good ole U S of A

are reserved now only for corporate "person hood". A pox on the lowly citizen for desiring such a luxury!

:argh:

[LynneSin]

44. I'm a bit challenged by this article, no VERY CHALLENGED

First, I'm with the rest of you that healthcare in this country sucks.

But I have been working for over 20 years now for some major companies and a few small ones. I've seen plenty of co-worker deal not only with their own life threatening illnesses but that of their spouse and/or children. And never ONCE have I seen any of them strangely 'fired' from their job for reasons I can't explain.

I mean let's separate fact from fiction. Perhaps it's late and I missed something in this store about a future where people are fired because of illness (either their own or family member), but I have never ever met anyone even remotely faced with this issue. Maybe they just do it different than the way we do here in Delaware.

[unapatriciated]

55. It happens more in small companies (like I worked for) than in "major" companies.

My boss used to call my son the "million dollar baby" and reminded me often on how much he was costing the company. He used my son as a selling point for HMO's (I worked for a small Commercial Insurance Brokerage firm) to his clients, I know this because he would bring me along on occasion to explain how to utilize HMO's (he stopped doing that after I started asking for his help with their constant denial of coverage). One day at a staff meeting he stated he would either have to cut benefits or find another way to cut cost. Soon after that my position was the cost he decided to cut.

So it's fact not fiction, when it comes to small and medium sized companies.
It is a little harder to do in major or unionizes companies but they still try.
If you got the time, I got the facts in regards to my own personal experience.

"never ONCE have I seen any of them strangely 'fired' from their job for reasons I can't explain."
Are you saying you have seen firings of co-workers who are ill or have a seriously ill family member?
Just cause there was a plausible excuse doesn't mean the cost of the illness wasn't the underlying cause that lead the company to find an excuse.

[ToolTex]

45. I sent the link above to several wingnuts I know, and they sure went off.

Here is what a couple replied, and my answer back to them.

"And the moral is ... no one's found a way to pay to cure everyone of everything.

Maybe it's late and I'm tired, and that's why this feels like such a mean and cold attitude. But you know, when I'm 80, I don't expect to be able to go out and get a $1 million life insurance policy either (cheaply).
I remember when my wife was teaching english to Russian immigrants. She had a man that was livid that he went to the hospital and they wouldn't accept him because he didn't have insurance. What kind of country is this where you have to pay to get hospital care, he asked. In Russia, anyone can (could) go to the hospital and get check in, he assured her. She asked what they would do for you, and he said they'd give you a cot there to sleep on.

Am I cynic or a realist? If I have something real, real bad that's expensive to treat, I expect to die. If it costs even $5 million to save me -- it's hard to make a case that I'm worth that much, certainly why should the government be on the hook for me? In fact, it's easier for me to defend it for a child of ten, if it's a cure and not just an ongoing treatment, than it is for me at fifty. Maybe there's some Chinese autocrat in me. But I don't know where this notion came from that we all have a right to extreme care in all cases -- how far back can you remember? Did people have this same opinion back then?"

AND

"And you think that gov't run health care won't be rationed?"

MY ANSWER BACK:

"Here is what I just answered a friend that works for an oil company, and selfishly thinks he is protected. I can add that I don't think my Medicare has ever been rationed, or that I've ever been denied a procedure by Medicare. I am denied drugs that my doctors order by my private drug insurance company, quite often."

"Actually, I think you have been completely brain washed by the $1.4 mil a day being spent lobbying against single payer health care.

Just tell me why it is worth that much to perpetuate that cash cow.

Surely you know that hospitals charge the uninsured four times more than they charge insurance companies for the same non-emergency procedures.

I think you get your logic points from Fox Propaganda and Murdock.

You know of course, that when you compare to Canadian system, and long waits for services, that they have provencial systems, and that the waits are in the provs that fund very low. And ... That even in the well funded provs, like BC, they spend less than 1/3 what the amer system costs under Medicare; which costs about 1/2 of private, for profit health care.

The unnecessary wellness cost in the US is for profit. Profit in the unneeded and immoral insurance industry; profit, advertising, and payola in the immoral pharm industry; and profit in the immoral "for profit" hospital and nursing home chains.

So while you allude to socialized medicine, you are happy to have your health delivery decisions made by insurance company functionaries instead of your own private doctor. Foolish I believe.

Now if you are concerned about the cost of single payer health care... The thieft of the wealth of the country over the past several years, squandering the 10 trillion peace dividend, seems to be making it necessary to stimulate the economy even more than the $1-1/2 trillion so far, to avoid 25% unemployment, and what could possibly stimulate the econ more than gov paid single payer health care. Just think of the money your company would save if it didn't have to pay for your health insurance. More oil company profits. Maybe poor Exxon could get it's profit up to $20 billion quarterly.

I guess we could also discuss why corporations have the same rights as humans in USA, even when they have morphed in the last 25 years from being "good corporate citizens" to "max return for share holders and execs," customers and country be damned.

I believe Capitalism has run amuck in America. And if you really believe that you are one of the well-off "insiders," then buddy, you have bought the propaganda and drunk the koolaid. I believe the term for that for about the past 80 or so years is being "a Good German.

Sent from my 3G iPhone"

[cascadiance]

46. Coincidentally, I just saw my hair stylist today...

Fortunately she just commented on tweaking my hair color that she was going to apply, not my skin color!

And on top of that she gave me an "unemployed" discount, but I still gave her a tip.

I'm just thankful that I don't have anything that severe, but I wonder if my age and getting a kidney stone operation last year and likely future treatment for such didn't factor in to getting me laid off this time around too.

This is just another reminder of why we really need single payer health care... NOW!!

[tomm2thumbs]

48. you need to be in a hearing on health care - or your story put on record for them

terrible

[liberal N proud]

49. k&r

[rosesaylavee]

50. Guess what... this woman lives in my area.

Thanks for posting - I will certainly share with as many people as I possibly can. I know which hospital she didn't want to die in. It has a 'reputation' for that. Very clean, very beautiful but very incompetent place.

Her concern about tests - I have that and I have insurance currently. If they find something, my concern would be that the rate would go up beyond what we could pay. So, no tests done and hope for the best.

[adamuu]

53. spread this. it's compelling. n/t

[unapatriciated]

54. Been there done that and it is not fun....

When my son was diagnosed with dermatomyositis in 1991. After three years of long stays and expensive treatments at Children's Los Angeles (and fighting blue cross's denials on almost every claim) I was let go. My son was then put on my ex's insurance( Cigna) which started the fight regarding pre-existing condition. Thankfully California had recently passed laws preventing insurers from using this clause. It was two years before my ex was laid off and six months before he found a job with insurance. Which started the fight about pre-existing condition all over again. I finally landed a union job only to have to educate them on California's recent laws regarding pre-existing conditions. During all of this I used up all assets providing care and had to start using credit cards to purchase his medications. which cost well over a thousand a month. I managed to keep him covered until he was 22, now he is on SSI and medicaid. My point is I chose to fight the Insurance Industries and still ended up in debt big time, many families can not fight them and are pushed on to the public rolls. Sometimes I wish I had listened to the social worker who came to me in the beginning and suggested I get rid of any assets I had now because this diagnoses could be a long and expensive battle.

[iverglas]

56. how it would work in Canada

The same, up to the first visit to the oncologist/hematologist office.

Then the doctor would admit the patient directly to whatever hospital s/he had privileges at -- or, if that was only the local secondary hospital in a small community, say, would arrange admission to the tertiary hospital in the nearest large city, under the care of whatever specialists worked there.

Hospitals in Canada are operated by public foundations (with a few grandfathered exceptions that are subject to the same arrangements with the public health insurance plans). It makes no difference to the public insurance plan where you are treated.

I have to emphasize this.

The type of care, and the place where the care is provided, is decided by doctors, subject to availability.
The public health insurance authorities are not involved in treatment decisions.
The doctor (and the hospital) bills the plan for whatever services s/he decides are medically necessary. Unless there is evidence of fraud or unnecessary or inappropriate treatment, the plan pays the doctor. Medically necessary treatments are covered by the plan.

(An example of medically necessary vs. not medically necessary: vasectomies and tubal ligations are covered, reversals are not; removal of suspected cancerous skin lesions is covered; removal of the two little lumps on my leg and mole on my back that bugged hell out of me but caused no medical concern cost me $200, including tissue examination.)

This was how it worked when my father went to a walk-in clinic (a private medical practice) in the small city where he was spending the summer, after feeling weak for several days. The doctor determined that his heart rate was dangerously low and sent him straight to the local ER for an electrocardiogram, and told him to come straight back for the results. He then admitted him directly to the ICU at the local secondary hospital. Three days later he was transferred by ambulance to the heart institute at the tertiary hospital in the nearest big city, about 75 miles, to have a pacemaker implanted.


All of the treatment would be 100% covered by the provincial public health plan - doctors, diagnostic tests, hospitalization, treatments, all services in hospital (including all the tissues and suchlike supplies that I understand are commonly charged for separately in the US), all drugs while in hospital.

This was the case for my father when he was admitted to hospital with metastasized melanoma (no indication he had it before it was far too late; the autopsy did not determine the original site of the cancer, but it was likely internal). Admitted to hospital less than a week after first attendance at ER for pain and having several diagnostic tests as outpatient (xrays, bone scan, lung biopsy), six weeks of every imaginable treatment and diagnostic procedure and medical service, plus ambulance transportation home at the end, and four days at home with hospital bed, morphine pump and supplies, visiting nurse and on-call doctor. One out of pocket expense by the end: $25 for a prescription the seniors' plan didn't cover because of the form the drug was prescribed in.

I don't know what the treatment for leukemia is specifically, but my sister and mother are currently being treated for colorectal cancer and lymphoma, respectively. My sister did have a drug expense - her chemotherapy caused a blood condition that had to be treated before the chemo could continue, and the drug is extremely expensive ($1500 each time, needed twice) and is not covered by the public health plan. Her partner's business is struggling and they didn't have the cash. She had enrolled in an optional sliding-scale provincial drug program (Ontario doesn't have a public drug program except for seniors and the very low income) that covered most of the cost. People who work for large or public employers would have had coverage through supplemental insurance at work. I'm not at all happy about the fact that this drug isn't covered, and I'd like to know the reason. (Had she been in hospital, it would have been covered.)

If the patient required daily outpatient radiation treatment at a cancer-specialized tertiary hospital in another city, as is often the case for cancer patients in small towns, transportation would be arranged: my mum and my sister have both had 5 weeks of radiation at a hospital about an hour from their local hospital, and a shuttle bus takes them there and back at no charge. (Cancer Society volunteers take them from their home to the local hospital, about 30 miles, if they want.)

If the patient receives chemotherapy on an outpatient basis (at the local hospital) or wears a chemo pack, services at home may be needed, and will be provided by a visiting nurse. My mum and my sister have both had visiting nurses.

Also, here, if the patient had to be off work and did not have extended sick benefits / disability insurance through work, s/he would be eligible for up to 15 weeks of employment insurance sick benefits under the federal EI scheme. A family member -- all the way to niece or nephew and common-law partner of grandchild/grandparent -- would be eligible for up to 6 weeks of employment insurance compassionate care benefits. If the patient was still unable to work after the sick benefits expired, she would be eligible for Canada Pension Plan disability benefits (CPP is equivalent to US Social Security).


In the end, the patient and her family would still have their home and their savings, and would be out of pocket for essentially nothing. I don't know, but I doubt, that the employer of the partner with the supplemental insurance (if used for sick benefits or drugs) would experience any problems with the policy.


This really, really is how it works under a public health insurance plan.

Think of all the various services -- care by family doctors and specialists in private practice, treatments at different hospitals in different cities, health care services provided in home, transportation -- all accessed directly by the patient via doctors, with no intermediaries for either the patient or the doctors to have to seek approval from or battle with.

Sure, a public plan could impose approval requirements on treatments ordered by doctors. Why would it? It could audit any doctor it suspected of abusing the plan (provincial plans here turn up a couple of fraud causes a year). Why pay for some pointless bureaucracy to gate-keep between doctors and patients? The plan decides which treatments are medically necessary for which covered conditions, and pays for the medically necessary treatment of the covered conditions, and relies on the doctors (who are subject to their profession's codes of ethics in exercising their professional judgment) to diagnose the conditions and prescribe the treatments.

It really, really does work that way in Canada.