Ok I'll chime in here. I have had no problems with private insurance at all. My son had two major heart surgeries, one at 10 days old and at one year old. Since then he's had hundreds of follow up visits over the last 11 years. While I haven't tallied everything over the years I would conservatively say there have been more than $400,000 in claims. While it has been a huge pain in the *** to deal with, in the end I have never paid a penny more than my policy stated and all debts were settled with the doctors after much debate and many disputes. You could say I am "one of the lucky ones", but I say that I read the damned policies (three different ones as I changed jobs) and understood who was responsible for what when I signed up for it. I get so tired of people whining about procedures not being covered and claims being denied when they should have taken the time to understand what they were buying BEFORE they bought it. I call that personal irresponsibility.
BillWill, Don't worry you can search and fnd that I have plenty of irrational, flaming posts on Hornfans. They mainly were during the election last year or about abortion. Those are two pretty hot button issues for me. So here are just a few things I thing should be reformed. I believe that all people should personally pay their health insurance premiums. The cost is often hidden from the employee, so they have no idea just what is being given to them, or how great a 'benefit' it is, or the true costs. All they see is when their copay goes up. I also believe that health insurance should NOT be for routine things. Health insurance should be for catastrophic situations. Not unlike car insurance. I don't have car insurance to pay for my gas, or my oil changes. I have car insurance for the unforseen hazards of driving. A car accident e.g. I also believe each health insurance provider should have to take a certain percentage of policies holders who have a pre-existing condition. These should be noted NOT just from individual policies, but also in group policies. I would believe that would level the playing field. For instance, I have a pre-existing condition, but because I am a part of a group insurance plan, not only do I get insurance, but I really am not 'counted' as a pre condition policy holder. If I am not mistaken this would eliminate the necessity of 'gap' insurance. It means that if you insurance lapsed, you could still find an insurance policy, and that your high risk should be spread over the entire base of the companies policy holders. This would have to be some type of formula to keep the pre existing condition folk essentially spread out in the system, without locking them out if every company was 'full.' The next thing that must happen is an increase in health care providers. We need to rethink the way that PAs, and NPs are used. As stated I have a pre existing condition and I go to a specialist FAR more than I go to a GP, because of said condition. I do not however very often see the specialist. I see his NP. She does a wonderful job, I am THRILLED with my care, and she is able to consult him on an as needed basis, which has happened from time to time. We need more collaborative care such as this. We also quite frankly need more doctors. We need many more GPs, but we also need more specialists. We also need doctors that are going to work. I've tried to google to find ONE good clear cut sourc with hard numbers, but can't really do so. I do find articles referencing, (and a cardiologist friend of mine from whom I will try to get a better link source) that females now are 50% of med school graduates, but work fewer hours and have shorter career spans than their male counterparts. The same studies seem to indicate that female doctors are more effective as well. This is NOT to try to knock female doctors, but it is to say that we need each and every person who takes up a medical school slot to be productive after they graduate. We obviously also need them to be effective. We also need to increase the number of medical schools in the US to help with the increase of doctors. I would also like to see more reform in care from local and state governments. As I have noted, I see health care as a state issue, NOT a federal one. I also believe that hospitals, particularly state run ones, need to do a better job working with religously based health groups. There was a time when the State welcomed the health care given by Catholic Hospitals, Methodist hospitals, etc.. Now it seems there is increasingly animousity between the two. We need to welcome all those who offer care. The state should be encouraging local health clinics as well. I believe that doctor's employers should encourage their doctors and nurses to work with local free clinics. BigWill, those are just a few of the thoughts that I have. They aren't perfect, and I in no way proport to be an expert. I do believe that people who passionate care for others should be able to come together to have some meaningful positive reforms. Cheers.
blackman, You should try telling that to me as a patient who was diagnosed with arthritis when I lived in Arlington Texas. In that city of close to 300,000 there is ONE rheumatologist and it was a 6 month wait for a new patient to get to see him. Also, you might tell my good friend who is a cardiologist at Scott and White, and works call at Scott and White, and Metroplex in Killeen, and who also teaches, and who also lectures around the country, and for his department who needs more doctors, but can't hire more because there aren't doctors to hire..
Every thread on the West Mall discussing health care is full of right-wingers mocking the government... as though there is nothing at all that the government could ever do well. This gets really, really old to me. Every day, you guys wake up with electricity to your homes and potable water flows from your faucets and showers. You don't think twice about frying up a couple eggs-- you don't worry about salmonella at all. You get in your cars and drive on paved roads. You expect the traffic lights to function. You don't get dragged out of your luxury vehicles, shot, and left for dead. You make your way to the airport and jump on a flight to LA. You read the paper during takeoff and landing and you don't worry one bit about crashing. How does all this happen? Because the GOVERNMENT regulates your utilities, keeps your food safe, paves your roads, polices your streets, and regulates the airlines. Now I understand that every one of these examples has flaws that need to be continuously addressed, but I'm tired of you guys acting like you lose electricity every night, your water and food is poisoned, the roads are impassable, you get carjacked every morning and your planes fall from the sky --- because the GOVERNMENT continuously fails you on every level, every single day of your lives. And this is coming from someone who, like many of you, wants as little government as we can get away with (I voted for Ron Paul). As I have mentioned before on these boards, I'm an ER doctor who sees the consequences of the current (failing) health care system every single day. It is AMAZING that partisan backbiting clouds everyone's thinking to the point that they can't even admit that the current system is totally ******* broken. I'm also amazed that people get outraged over imaginary offenses (mythical death panels) and they hardly even notice real outrages (link). And as long as I'm ranting here, here's a few more arguments that are nonsensical: "But the government is going to RATION healthcare!" Really? I hope so. It seems to me that the alternative to rationing is NOT rationing -- e.g. let's give everyone a nuclear stress test, a full-body MRI, a personal trainer, a prescription to the antidepressant de jour as well as a couple of anti-cholesterol drugs, etc. "SOCIALISM!!!!" Why is it that when Peepaw gets pneumonia and gets hospitalized for weeks, at a cost of hundreds of thousands of dollars, and this gets billed to Joe Taxpayer, no one is outraged. That's, um, socialism, right? But let's say a kid graduates from UT with a degree in computer sciences, but times are tough, nobody's hiring, etc. So he makes ends meet for a while by freelancing. He makes websites, and he does a good job for a reasonable price. But then a few months goes by, and he gets ill, shows up in the ER and -- long story short -- finds out he's got lymphoma. And he'll need chemo and multiple hospitalizations to be whole again. What would defenders of the current system propose that we do with/for this kid (really, I'd love somebody to take a shot at answering this question)? Because right now, that's a life-changing moment. I mean, even if it's a highly curable illness he's looking at 6-figures of debt, bankruptcy, a wrecked credit history, and a lifelong stigma that will make it difficult, if not impossible, to get health care at a reasonable price. So why is it so incredibly anti-capitalistic and anti-free market to suggest that a humane society ought to take care of the kid, and let him get back to contributing to society? How is it "SOCIALISM!!!" to suggest that there's something wrong with this system? For the record, I hope the current proposal fails. We need to scrap the whole system and start over again. majorwhiteapples, I suspect that we're on opposite sides of the political spectrum, but I agree with your thinking: we need bright minds to come up with a completely new system -- and, I would add, they need to do it without the "help" of the corporations that have completely and totally seized the reins of this republic.
Horn 89: don't forget about the terrific work that our armed forces are doing overseas...meanwhile private contractors are literally drinking vodka out of each other's asscracks. But privitization is ALWAYS the answer.
it just occurred to me that most of the folks that believe that the government will f**k up healthcare because, well "because they are the government and f**k up everything", those folks almost always support the death penalty. So the government will f**k up flu shots, but when it comes to deciding when a citizen should be executed, the government is a well-oiled machine. Sense; this makes none.
hornpharmd, No doubt people have died because health insurance companies have denied coverage of procedures, or delayed approval of procedures. There is MUCH wrong with the current insurance system and there needs to be health insurance reform and it needs to be done NOW! I do have a question though. If someone has to approve a procedure, why would the government necessarily be faster than a private health insurance company? I don't think that they will be, nor do I believe they will be demonstrably slower either. Any 'system' has it's flaws, and I would hope that we all want to improve health care delivery systems to be the best they can possibly be. This is where I am pissed that both parties are treating this as a political football and not addressing common sense real reforms that would greatly impact people today. I am a person with a preexisting condition who is able to functoin because my insurance pays for a medicine that I could NOT afford on my own. If I lose my insurance, I lose my ability to do many normal every day tasks like tie my shoes. Before I got on these meds, as a 30 year old who was unable to tie my shoes... man that sucks, let's just put it that way. Thinking that people who opposed the Dems or Obama's plan are some type of ogres without hearts is really not helpful. Let's get meaningful health reform, let's think outside the box, and let's get it done soon but not hurried.
Nice post, Horn89. If we could just weed out the illogical arguments, this debate would be much more readable. Unfortunately, illogical people are often the loudest.
The first claim of the year for my then 4 and 7 year old daughters was routinely rejected by my insurer. The reason... I needed to fill out a piece of paper that stated this service was not the result of an employment related injury. They were 4 and 7 and this went on for several years, it was routine, and it was to keep the cash rather than pay the doctor, it was to make money on the float, nothing more nothing less.
Uninformed, if people aren't getting health care because they aren't covered or can't afford to use the coverage they have, then we are already rationing. That was my point. That said, I'm struck by this notion of your thinking you should be able to obtain coverage which allow a 70 year old to get a heart transplant. If this is "rationing" then, wake up Uninformed, because you are living it with or without reform. Insurance won't cover that treatment, nor would a surgeon perform it, not would a transplant panel approve it. In any event, the widest version of the offered plan still wouldn't deny treatment, only coverage of the treatment. This is exactly what we have today in fact. The plan doesn't seek to "control" medicine, despite your assertion. I don't have time to address most of the rest of your note (I'll attempt to do so tomorrow), but your notion of cost increasing because of "free" treatment is plain erroneous. We can't control costs now because loss is factored into pricing. If we remove that loss and pay in advanced by covering treatment, we can keep prices down.
