Topic: Health Insurance Offer

http://www.washingtonpost.com/wp-dyn/co … 43_pf.html

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: Health Insurance Offer

I'll believe it when I see it, that's all I have to say...

My husband and I are among the unlucky 7% that have to buy their own insurance. We're just fortunate to live in a state that won't let insurance companies drop you if you get sick.

Kristin

Peace, hope, and healing to all!

Re: Health Insurance Offer

In the letter, the two insurance industry groups said their members are willing to "phase out the practice of varying premiums based on health status in the individual market" if all Americans are required to get coverage. Although the letter left open some loopholes, it was still seen as a major development.


Sounds like they want to force everyone to purchase health insurance, just like your auto insurance.  Need a Dr. and don't have insurance, get a what, ticket???  So many people can not afford food, how do the expect them to purchase insurance for their health?  This is not a good time to try and force this issue.

Re: Health Insurance Offer

Kristin wrote:

I'll believe it when I see it, that's all I have to say...

My husband and I are among the unlucky 7% that have to buy their own insurance. We're just fortunate to live in a state that won't let insurance companies drop you if you get sick.

Kristin

Kristin;
My husband and I are in the same group as you. We have to buy our own individual policy. In the 18 months since I first went to the doctor I have had over 30K in out of pocket expenses not including the monthly premium. We just got informed they are raising out out of pocket and the monthly premium. My husband found out that we have no options because we cant change policies. If we change they can cancel our policy. I feel that they are just waiting for us to be late with a payment so they can cancel us. At times I worry what I am doing to my family financially. But I also worry that if we go to some sort of mandatory insurance that it will be rationed and those of us with cc will be deemed not worth the cost of treatment because of poor prognosis/statistics and may be denied some/any treatments.
Jamie

Re: Health Insurance Offer

I thought I would resurrect this thread since I have been reading online about the health care debate and found this:

http://www.pbs.org/moyers/journal/07102 … imony.html

After doing some reading, I think what is abundantly clear is that many people who are in favor of health care reform have had to battle an insurance company, either for themselves or on behalf of a family member or friend and have seen the shortcomings of our system firsthand.

On the other side, there are many who say, I have coverage, why should I pay for other people? What they don't realize is that they can lose their coverage at any time and that we are already paying for other people. If they are laid off, they will be forced to pay COBRA just when they lose a paycheck, does that make any sense? Or many, like Jamie, use up savings to pay for what insurance does not cover. Insurance is great when you are sick, just don't get too sick!

I think this is particularly important for cc patients because many of the treatment options are expensive and/or experimental.

Patty

Re: Health Insurance Offer

I agree that those of us in favor of health care reform have all been touched in one way or another by these battles and short comings.  I think everyone that is pro private health insurance needs to read this.  I had the opportunity to talk to someone who worked for BCBS which at one time was consider one of the best health insurers and was told much of the same as what was stated in that article along with a lot more on how they got away with not paying for things that should have been covered, etc.  He, in all good conscience, could not continue working for them as these practices continued to escalate.  His current employment does not generate the income he had before, but atleast he is happy and can sleep nights knowing he is not a part of all that deceit.

Darla

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.

Re: Health Insurance Offer

I am very conflicted on the proposed health care reform.

COBRA payments and medical co-payments are making it impossible for me to keep my home.  I just found out that my plan changed so that I have a $120 co-pay every time I get an infusion.  It's horrible to have financial stress when you are dealing with terminal cancer.

But on the other hand, as Jamie said, the new system would have to enforce rationing, and who would be the first ones to be rationed?  The elderly and people like us with an incurable cancer diagnosis.  There would be no incentive to keep people like us alive when we cost the gov't so much money.

Re: Health Insurance Offer

Lisa,
I think your fears are overblown re: the Gov't paying and the reform bill in general. It will actually force companies to cover people regardless of their medical condition. Too often they drop people in the middle of serious illnesses that cost them too much-I've never heard of any gov't programs doing that. Also, we already deal with rationing by insurance conmpanies now. All you have to do is read on here about the experiences of many of our friends. The private insurers really pick and choose who is going to live and who will die by denying coverage and calling life saving treatments "experimental". I honestly don't think things will be any different as far as coverage. I think it will actually be better because they will push for more preventative care and people may actually catch cancer and other diseases in the early stages. I'm sure you will be helped by it. COBRA really is a sad joke for most people and it will only be in effect for 18 months. What will you do from that period until you can be on Medicare? You have to wait 29 months from the day you received disability status until you are eligible for Medicare. I hope you get things figured out. I would turn the TV off because a lot of what you hear is just not true. We went to a small gathering with our Congressman the other day and he explained it very well.   Take care, Mary

9 (edited by Lisa Mon, 24 Aug 2009 10:48:39)

Re: Health Insurance Offer

Mary, I don't trust the same government that runs the DMV, Post Office, and Cash for Clunkers to efficiently run a health care system smile  Medicaid and Medicare don't reimburse providers for the real costs of care, and Medicare forces people to purchase supplemental insurance anyway.  Both programs bleed cash from the US Treasury.   There is no reason to doubt that a new government run health care system would be any different.  In fact, the Congressional Budget Office says that it will cost money, and lots of it, and won't save any money.    We already know that cholangiocarcinoma is not a cancer that can be really caught in its early stages, except by accident.  We don't have enough CT machines and MRI machines in this country to screen every single person once a year - and that it what it would take to catch some cancers early.

BC/BS has not yet denied any procedure or medication for me.  Yes, I am concerned about what to do between when Medicaid kicks in and BC/BS runs out.   But I'll cross that road when I come to it.  Should we upend the entire health care system based on those cases that slip through the cracks?  Or should we address the cracks in the system, like the gap between COBRA and Medicaid?

My relatives are Canadian, and they tell me of the wait times that they have for procedures.  It's ridiculous.  My aunt had a very painful foot condition, and had to wait 9 months for surgery.  My other aunt had breast cancer and had to wait three months for surgery. 

This is a link to the official Canadian gov't agency for wait times for surgery:
http://www.health.gov.on.ca/transformat … ic_mn.html


Also, the death rates from cancer in Canada and the UK are greater than they are here. 

I think we do need insurance reform, especially tort reform, but I don't think we need socialized medicine.

I think we have a respectful disagreement here... smile

Lisa

Re: Health Insurance Offer

Lisa, I agree. It's all very scary. And yes we are becoming very socialized. You mentioned the clunkers and I will add the Loan Modification. I tried and its a crock! T and I are 76 and 69  and we still don't understand Medicare. Thank goodness we seem to have good insurance companies....so far. NOBODY who has served their country, paid their taxes for years, no one in this country should have to go through what a lot of our friends are going through. I feel so bad for those of you who do not know where you will fit in. That is not the America we were raised in.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: Health Insurance Offer

I live in a country with socialised medicine and love it. I never have to worry about a thing. I am not being rationed. I get scanned so regularly that I know the radiologists at hospitals and they know me. I have had 2 major surgeries, loads of ercps. I get my gemzar and the nurse just hands me pills for vomiting...I dont even have to go to the pharmacy. Since cc is so rare, my doctor is working in conjunction with Sweden's cc specialist and I will have meetings with her at the start of new treatments and when I request it. I am sent before the surgery team after every scan, without fail.

Sweden doesnt have a cyberknife machine, but if I get my tumors to a small enough size, I can be sent to france...everything from hotels, flights,and treatments paid for.

I found a phase II study about adding Erbitux to gem and cisplatin and brought it into my doctor. This was already being discussed as part of my new treatment plan, though they hadnt decided yet. Let me repeat...a phase II trial. Most insurance companies would deny coverage because it was only phase II. I had Avastin in my first chemo regime which is also a new and expensive drug that many cc patients dont get. All these new drugs are given without consideration to cost, just on if they could possibly help.

The overall thinking is that spending the extra money will pay for itself over the years through being a productive member of society. Keeping parents with their children, keeping people in the workforce, and having a healthier society will pay for more expensive treatment...or so they think in Sweden. Plus they see health as a right for everyone. They take pride in that everyone from politicians, royalty to autoworkers get the same treatment. You can go private, but it is so looked down on that rarely do people use private doctors.

I have never been told no to any treatment I have question due to cost, just no because it could not be used  given my circumstances and tumor location and size.

I wish people would not be so scared of rationing through a government plan, because frankly insurance companies ration far more than the socialised medicine I receive. The one thing I will say, is that it also has to be far more cost effective. I have to go to a hospital 3 hours away for a PETscan. Theyrun the PET machine 2 days a week and cover a very large region. It is frustrating to have to make the journey, but think of the money that is saved by consolidating resources. I think many people are so used to wanting things NOW and in the hospital 10 minutes away from their house, they dont understand the absolute waste in duplicating services and how that impacts on prices.

Other thing I found out is that I often have ultrasound with contrast in addition to my MRI and CT scans. Doctors in the US have not heard of ultrasounds with contrast. But if you look on Pubmed, you find out they have the same diagnostic accuracy as MRI and CT scans but they cost MUCH less. Why doesnt the US use this technique, because they need us to use the more expensive equipment so every hospital can have the mri and ct machines no matter how small the hospital.

kris

Cancer is a word, not a sentence.

36 year old patient with buckets of hope

12 (edited by Darla Mon, 24 Aug 2009 17:57:16)

Re: Health Insurance Offer

Kris,

That was well stated & I totally agree with everything you said.  Unfortunately here in the US I am part of the minority of people who feel that it could work like that here, too. 

Darla

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.

Re: Health Insurance Offer

Kris,
I am so glad that you are getting such good care in Sweden.  But Sweden is not the US - the US has many times the population of that relatively small country.   We have many challenges that Sweden - a relatively insular nation - does not have.  And our politicians would not be caught dead (haha) on public medicine.  They will keep their own gold-plated plans, as they keep their other gold-plated perks that are denied to us common folk.

I am certainly not saying that our health care system does not have problems.  It does - such as the gap between COBRA and Medicaid. 

The devil is in the details of the plan that apparently many members of Congress haven't even read.  One part that steams me is that citizens are required to pay into the plan in order to get benefits, but illegal aliens are not required to pay into the plan, but they will still be covered by it.  How is that fair to the US, legal, taxpaying citizen?

By the way, I don't care what race anyone is, but if a person is coming to this country to live here permanently, it is only fair that he or she does it leagally.

If I immigrated to Sweden illegally, would I get the same health care that a legal citizen or resident of Sweden gets?  Just wondering!

Re: Health Insurance Offer

I was nervous about resurrecting this post but I am glad to see the debate has continued in a respectful way. This is a complex issue and I have been doing a lot of reading. I found this paper on the history of the health care system in the U.S., it is long but well worth reading:

http://www.cfeps.org/health/chapters/html/ch1.htm

Patty

Re: Health Insurance Offer

There is a helpful feature on this site that lets you compare the plans being discussed:

http://www.kff.org/healthreform/sidebyside.cfm

Patty

Re: Health Insurance Offer

I also think that it does not make sense to tie insurance to employment, see this article from 2007:

http://www.usatoday.com/money/industrie … -net_N.htm

I know people who are working just for the insurance because their spouses have jobs that do not provide insurance and they could not afford to purchase it separately if they quit. I think American workers would have more choice and power in terms of their work if they didn't have to depend on their employer for health insurance and it would also help small businesses compete for qualified workers.

Nowadays people change jobs much more frequently than they used to and when you change employers, you have to change insurance, learn all about the new insurance coverage, you may have to change doctors, etc., and that is not a very efficient system. I had the same doctor from the time I was born until he retired when I was in my teens. Since then I cannot count the number of doctors I have been through. Having a long term relationship with a doctor is very important to your overall health.

Patty

Re: Health Insurance Offer

Well, I am going to stop replying to myself now and go to bed, I promise!

Patty

Re: Health Insurance Offer

Oh Patty, don't stop replying to yourself.  I enjoy every bit of it.

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: Health Insurance Offer

Lisa,
Yep, sweden covers everyone...illegal immigrants, exchange students.Like I said, they see health as a right.

Yes, Sweden is smaller, but that doesnt mean it wouldnt work. The problem is that Americans dont want to pay for it. It is a mentally issue. If I had a baby, I would get 18 months off of work at 80% pay with  my job guarunteed when I returned. Hans gets over 6 weeks paid vacation. He got sick leave when I was rediagnosed so he could spend time with me. All these are paid through higher taxes. In Sweden, there is a deep belief in a good quality of life for everyone, not just those in white collar jobs. Taxes are roughly 50%, but you are truly taken care of cradle to grave. Free education including college. When you are older, the gov. supplies an equivalent to Meals on Wheels, a nurse that stops by to check and administer medicine, and someone to help do laundry and clean the house...all in an attempt to keep people in their homes and independent. When Hans dad became sick, the government installed ramps, took out the bathtub and installed a special shower, widened doors for wheelchair, installed a garage door opener, supplied an oxygen tank system which ran in the basement and tubes were connected throughout the house. They adapted the toilet and supplied a hospital bed and even supplied feet that his mother could attach to her bed so it would be the same height as the hospital bed so they could still sleep next to each other. When you need more care, you are placed in a nursing home that corresponds to the level of care needed.

Homelessness really doesnt exist except for people with drug issues. If you commit a crime while on drugs, you have the option of going into a year long drug treatment residental program to get off drugs instead of going to jail.

Everything is paid for by taxes. Americans would never go for this because we have the American dream in which we are told if you work hard you will be successful and the concept of pulling yourself up by your bootstraps. We are more individualistic, not community centered. But how much do you think Americans pay out of their paycheck when you add taxes,insurance, deductibles, childcare, and education. The quality of life her is amazing. Though I do complain since it has made everything samey-samey. There is not much individuality here. The need to treat everyone the same and give the same quality of life means nobody whats to stand out too much so everyone has the same house, the same car, the same look.

And please let me defend Sweden as being insular. It has a very big global outlook. People are incredibly aware of what is going on in the outside world. In fact, Sweden is known for its diplimats in international circles...probably since any form of extreme emotion is very frowned upon here. And one town on the outskirts of Stockholm has actually taken in more refugees than the entire US has....each given the same medical attention and education as Swedish residents.

It isnt perfect, by any means and I cant wait to move back to the US, but I cant because of healthcare. I dont qualify for any programs unless I divorce Hans...no thanks.
Kris

Cancer is a word, not a sentence.

36 year old patient with buckets of hope

20 (edited by magic Tue, 25 Aug 2009 03:15:19)

Re: Health Insurance Offer

Well, Ill jump in and say we have a different system again ,not perfect but not too bad.When studies have been done of Western nations,Australia and France have come out best.
I have studied health systems as part of postgraduate study and Joel studied health systems with his degree in politics ----- the US system really needs reform,it must find a solution that works and that is acceptable but at present the money that is spent on health per head of population seems to be going into the wrong pockets.
Forgive me for putting my 2 cents worth in but I have real concern for the people on this board and debts and health problems should not go together.
I agree with Kris,Sweden is definitely not insular.Countries with smaller populations tend to be more outward looking.
                                                                Janet
addit -you may think what does someone outside this country know-but we nurses are always concerned

Re: Health Insurance Offer

What I meant by Sweden being insular is that it really isn't on the radar of most people.   People don't learn Swedish as a second language as they do English.  People aren't clamoring to get in to Sweden, and Sweden doesn't have the influence as a global power like the U.S.  does.  I don't have anything against Sweden - it sounds like a wonderful country.  I'm half Finnish myself and would love to visit Scandanavia.  But it certainly doesn't face the same challenges that the U.S. does.

I do agree with you that it is a mentality issue.  We Americans were raised with the idea that anyone can be successful.  Our Revolution was based on a rebellion against British taxation, among other things, so the idea of higher taxes and the gov't taking care of us from cradle to grave does go against the grain of the American psyche.  Our Founding Fathers believed in less government, not more, and carefully structured the Constitution to keep government intrusion in our lives to a minimum.

As I said before, I am still conflicted about health care reform.  I do need the help, and sometimes we can't just pull ourselves up by our bootstraps.  I'm literally going broke and in danger of losing my home because of insurance premiums and co-pays. 

However, when I think of health care reform, I think of the long lines and poor service provided by other gov't agencies such as DMV, Post Office, DSHS.  If the gov't can't provide enough staff to meet demand for something as basic as the Dept. of Motor Vehicles, how can it guarantee doctors and services for the increased demand of "free" health care?

My uncle is a dentist in Ontario, and he basically takes a month off every year after his quota is made. He is only paid a certain amount by the gov't, and after that, any service he provides he is not paid for. 

This is a very interesting discussion, and something that we are all intimately concerned about.

22 (edited by Darla Tue, 25 Aug 2009 09:58:48)

Re: Health Insurance Offer

I also agree that it is a mentality issue, but one that we need to look  beyond.  I do realize the differences between the US and smaller countries,  but our health care system as it is, is broken, and I for one would gladly  pay higher taxes to be taken care of from birth to death.  In the  long run it would actual cost less than the way it is now.    I don't think the quality and care would be much different  than it is now and could possibly be better.   I think  the quality of life would improve and people  would be happier & less stressed,  too,  as an added benefit.  So anyway, this is just my 2 cents worth for what it is worth!  smile

This really is an interesting discussion and although we alone  can't solve anything, maybe  we can all learn a little if we all keep an open mind. There are pros & cons  to both sides.

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.

Re: Health Insurance Offer

If the plan is so good, why are the politicians proposing the plan exempting themselves from it the way politicians exempted themselves from the general social security program?

Re: Health Insurance Offer

I have to agree with you on that point, Louise.  It is questionable.   As Kris mentioned, in Sweden everyone is treated the same.

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.