American Health Insurance

[Rich]

Brian

Let's say the cost of health care doubles. You continue to get the health care provided "free".

However, it is not really free since there will be an increase in the cost of goods and services that are not part of the health care system. It can be no other way because a rise in tax must happen.

The only way you can get something for free is if the provider of the goods and services provides them for free.

The gov't does not provide health care. Health care is provided (at a cost) by doctors, nurses and so on.

While it is true that you can go to the doctor and have $40,000 of services provided and not have to write a cheque.....that is only because you have already written the cheque. I assume that at some stage in the past you had a job or a business. I assume you consume goods and services other than health care.

There are certainly many pluses when the gov't acts as an agent between tax payers and health care providers. However, people who misconstrue health care as being free only serve to add to the cost of health care.

As a side not you are and have been a tax payer.

You're missing the point again, someone who is let's say born disabled and therefore never able to work would not contribute, therefore to them, it's free

 

[GaryPanic]

Mike

it depends on where you are say the charge is

Yes tax payers do have to pay for this - but should you require hospital help etc

the cost would be far more than what you pay in taxes

if you take a lifetime salary and the tax for the healthcare - and jsut one semi major op...
you would quickly burn through what you would of paid

i am having dental work done at the moment and the cost privately would be I recokon about 3-5 K

4 lots of surgery etc...
wisdom teeth out etc

ok so its a training hospital - even so the cost to have this done in say the US would be out of my and most UK peoples reach (not a stab at the yanks just an obersavation)

 

[Brianwarnock]

i am having dental work done at the moment and the cost privately would be I recokon about 3-5 K

Chicken feed
If Mike had done the maths he would have seen that just 1 of my wife's drugs is >£15000 p.a. then there's 16 (min) visits to the consultant, 16 litres of blood , her other drugs, visits to ear and eye specialists to check on side effects, and they are just the things that spring to mind and ignoring added costs of admin, nurses , GPs etc

I know I had a good job and a decent pension, but give us a break.

That's why I asked my original questions about American Health insurance , but have not recieved any answers.

Brian

Brian

 

[Mike375]

Brian, Gary, Rabbie and Rich

I am well aware that the costs of the medical services provided might for some people far exceed taxes they paid and of course that would be very much the case for someone who was born with a disability. However, these are individual circumstances and just as the case with insurance there will be many people who over their life consume a very small amount of medical services.

But as to being free the key point is that the prices paid for other goods and services are greatly influenced by the levels of taxation. Of course in different individual circumtances the costs of medical services provided might dwarf any and all other goods and services. However, that is do different to any other form of insurance. One does not sell Income Replacement insurance, car insurance etc as an investment but for some people the investment return is huge.

 

[MrsGorilla]

I give up on the argument, a pity non of the American forum members haven't answered my genuine questions in my first post, but no doubt they spotted which way the thread was heading.

I didn't answer because I'm not an expert on the healthcare system and don't know a lot of the answers. All I know is I pay my part of my premiums, my employer pays the rest, and I have insurance.

I do know that it used to be the case that if you were diagnosed with some kind of chronic illness or disease, if you had to change insurance companies after that (due to a job change, etc.) that they would make you wait 6 months or a year before they would pay for any charges related to that particular problem because it would be classified as a preexisting condition. They would pay for any other charges, like going to the doctor for a checkup or a cold etc., but not the preexisting condition. So what you had were loads of people who could have moved on to better jobs at some point but were stuck because they couldn't afford to change jobs and thereby change insurance and have to pay for their expenses out of pocket for the first 6-12 months.

Then, at some point (late '90s I think) a law was passed that if you had to change insurance but could prove that you had uninterrupted coverage up to that, the new insurance couldn't claim previously diagnosed illnesses as a preexisting condition and had to give coverage from day one for it.

As far as whether your wife would be denied continuation of coverage if she is deemed to be "too high risk" (which I think was one of the original questions) I'm not sure. It seems like that sort of thing should be illegal, which means it probably isn't.

Also, I think someone else mentioned earlier that if you don't have coverage, some places will still treat you but it depends on where you go. Also, I think you'll still owe it out of pocket even if they do treat you (and you're scrupulous enough to attempt to pay it). That happened to my cousin, he had to have an emergency appendectomy in his early 20s and had no insurance so he owed thousands of $ for several years after.

It's too bad we don't have someone that know more who would be willing to chip in. It's practically a full-time job trying to figure all this crap out.

 

[Mike375]

Cindy

Your comments on "changing insurer and continuing cover" are correct.

As a by the way.....All I know is I pay my part of my premiums, my employer pays the rest, and I have insurance. You are paying all of it. What would be better is if the employee directly paid as opposed to increasing costs etc by assigning part of their salary to the employer. The vast majority of employees feel things are free if the employer "pays"....but not so.

It is worth mentioning that the number of American medical specialists who go to Australia and England to further their knowledge is very small (I am being polite). However, the traffic the other way is huge.

Just hope the Englishmen remember that when they get the "free treatment" and how their system is so much better than the American system.

Mike

 

[WayneRyan]

Brian,

"Can I ask the Americans if people are refused health insurance? what do they do then?"

Currently, my wife and I both work. I don't know the exact numbers, but we each pay like
$80 - $100 uS per month. Our employers subsidize the rest. Overall medical insurance/care
is a very minor part of our budget. It might not even rank in the top 10 household expenses.
I have no complaints at all.

When you're working (especially for a large company), it is rare to be refused. A
"pre-existing" condition however is grounds for refusal. One of the biggest factors in
my impending retirement is the fact that I'd be denied medical insurance for the next
12 years (Age 65 is automatic). I had open-heart surgery a few years ago and there is
no way (once I retire) that any insurance company will take me on.

So ironic as it may seem, I'll continue to work ... if only for the insurance.

BUT I REALLY CAN'T SEE ME WORKING FOR 12 MORE YEARS!

Overall, I have no complaints with either the current insurance setup, nor the
quality/availability of medical treatment in the U.S.

As a side-note, a person off-the-street with no insurance incurs a bill of $2,000 US
for some treatment. They pay the whole thing.

As an insured person, the Insurance would settle with the doctor for something like $700
(it pays to have volume), and the insured person might be out only 10% of that at worst
case.

In my case, legalities get my maximum outlay to $2,500, but I had additional disability
insurance that more than made up for it. I had a lot of posts here in those days.

Prescriptions are like a flat $20 copay.

I should really be more up on this, but these are just some generalities to get your
thread back on track.

Wayne

 

[Brianwarnock]

Thank you Cindy and Wayne for your replies, I guess I'd still be working if I lived in the US, assuming ageism didn't force me out.

brian

 

[ShaneMan]

Thank you Cindy and Wayne for your replies, I guess I'd still be working if I lived in the US, assuming ageism didn't force me out.

brian

Brian,

You know my current situation with Kate. Her Dad does have health insurance on her but they are doing the dodge and weave on paying. I am not aware of anything being paid to either hospital and we are over $400,000.00 and still climbing. We just got back from MD Anderson, last week, and the insurance had not paid anything on the prior bills so before MD Anderson would treat her they (MD Anderson's buisness admins) took Kate's Dad aside and talked to him for about 45 mins. Dad then came back to Julie and I and asked if we had $3750.00 dollars. (their divorce agreement stated they split medical expenses 50/50), cause MD Anderson said they are not going to do any of the scheduled procedures without paying a little over $7000.00 first. This was after we got up at 2am and drove 5 hours to get there. I don't trust our (USA) insurance as far as I can throw a bull by the tail.

In 1985 my son was a near drowning at my ex father-in-laws ranch. Two and half days later he died. His insurance, Farmers Ins. Group, came to me and told me they would cover all my expenses and that there would be enough money left over to make it worth my while. I told the adjuster he nor anyone else had enough money to make it worth my while. A few weeks later Farmers found out that the boy who had died was related to my father-in-law (they did not know this up to this point due to the two last names not being the same). After they found out, they dropped my father-in-law, after he had paid his premiums for 18 years and then contacted me and said they were not going to pay for anything. Know why? cause we have a law here that in order for me to get them to pay I would have to sue my mother and father in law and it would be a jury trial. In this this trial, by law, the insurance could not be mentioned, so the jurors would be lead to believe that the kids are suing the grandparents for their child drowning on their land and they would have never known the real story that we were suing cause the insurance would not do what they said they would do for a person who paid them premiums for over 18 years. We ended up settling out of court for $12,000.00. It didn't even cover the hospital stay much less anything else like air vac'ing, ambulance, doctors, test, and the list goes on and on.

I believe our medical experience here is among the best in the world. Our doctors, hospitals and etc. I would stack up against anyone but one of our biggest lobbing groups, if not the biggest, in the country is insurance. They have manipulated the laws and have the American people believing they are loosing money hand over fist and it's due to the outrageous cost that the medical community is putting on them. However if you look at the Fortune 500 list, count how many of those companies are insurances. I heard that one of Blue Cross Blue Shields top executives retired just recently and his bonus alone was something like 16 million dollars. Medical cost may need to be policed but IN MY OPINION our real problem is the insurance companies themselves. They have the upper hand right now. They tell doctors, hospitals, everyone what they will and will not do and no one stops them. For well over ten years now, insurance companies pay less for services than they did 20 years ago but in the meantime premiums have gone up. Who's keeping the difference?

Ok, I'm done with my rant. There's an old country saying that says "a man with an experience is never at the mercy of a man with an argument." I have experienced our health care system on many levels and it has always been excellent care with top professionals. Getting the insurance companies to pay for it, well now that's a whole different story.

 

[Brianwarnock]

Shane's reply opened up a whole bunch of questions, but I think I will just say thank goodness we have the NHS with all its faults.

Brian

 

[ColinEssex]

Last friday night at 12:15am I dialled 999 for an ambulance, I was having a heart attack.

I had a doctor here within 5 mins, and 4 paramedics within 10 mins. I was stablised, and taken direct to the coronary care unit. I had 3 nurses working to wire me up and get me monitored. I had a chest xray within the hour and was seen by a doctor after about 45 mins.

The hospital staff monitored me every 30 mins for BP, pulse rate etc. I stayed there till last tuesday, the food was excellent and the ward was cleaned and disinfected every day, the nurses and doctors couldn't have done more.

I was transferred to Basildon cardiothoracic centre on tuesday, I had an angiogram and as a result of that I had 2 stents inserted into a heart artery.

Private medicine in the UK does not deal with emergencies, they only deal with the planned and rehab cases.

Having 'tasted' the NHS from the perspective of being a patient, I now know that despite all it's admin failings - if a patient needs urgent medical treatment, they get it, no holds barred.

My diagnosis was an Inferior Myocardial Infarction.

Isn't it ironic - I started this thread just 1hr:45mins before it happened.

Col

 

[GaryPanic]

don't start one on funeral costs then ...(lol)
glad to hear you got decent treatment - - time to lay of those kebabs

gary

 

[ColinEssex]

don't start one on funeral costs then ...(lol)
glad to hear you got decent treatment - - time to lay of those kebabs

gary

Oddly, we eat very healthily - meat and 2 veg daily, the odd chinky once a month and very little fried food - chips once a week. Never a cooked breakfast and a sarnie for lunch.
I've never had a kebab - I don't fancy the meat being out to the elements all day.

I tell you though, having a coronary is a good wake up call.

I'm still here to tell the tale (although there will be some Yanks who wish I wasn't)

I now have 5 different drugs to take every day - all given to me for free (at the hospital) - although I will have to pay for them when I renew the prescription - it'll cost £26 ($52) per quarter - the value of the drugs retail is several hundred £'s

Col

 

[ColinEssex]

Now for the thread on the rising numbers being killed riding a motorbike. . . . . . . . . .


Col

 

[Mike375]

Col

That is amazing. I was going to post on the weekend about your absence from the thread and say I was hoping you were not out testing the English health system.

 

[ShaneMan]

Oddly, we eat very healthily - meat and 2 veg daily, the odd chinky once a month and very little fried food - chips once a week. Never a cooked breakfast and a sarnie for lunch.
I've never had a kebab - I don't fancy the meat being out to the elements all day.

I tell you though, having a coronary is a good wake up call.

I'm still here to tell the tale (although there will be some Yanks who wish I wasn't)

I now have 5 different drugs to take every day - all given to me for free (at the hospital) - although I will have to pay for them when I renew the prescription - it'll cost £26 ($52) per quarter - the value of the drugs retail is several hundred £'s

Col

Hey Col,

Here's one Yank (actually a rebel ) that is telling you I'm glad your still here and that you come around here and hang out with us. Hope your recovery goes well.

Shane

P.S. You gotta hang around a little longer. We're suppose to met in front of Virgin Records someday.

 

[Rich]

Have you ditched the fags now?
Take it easy

 

[Rabbie]

Col

I may not agree with you on everything (a bit boring if we did!) But best wishes for a speedy recovery.

 

[ColinEssex]

Col

I may not agree with you on everything (a bit boring if we did!) But best wishes for a speedy recovery.

Thanks Rab, an MI is not something I'd reccommend.

Has anyone else here had a similar experience?

Col

 

[ColinEssex]

Have you ditched the fags now?
Take it easy

Still got the fags - I bought loads in Spain last year, s'pose I'd better lose them somewhere I must have about 800 at least.

Col