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Talking Heads #6
"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.
(http://seniorlearn.org/bookclubs/graphics/talkingheads.jpg)
A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.
Our Sixth Selection is: (http://seniorlearn.org/latin/graphics/cycling5.gif)
Health Care Reform~! Are We on the Fast Track?
7 Ways Health Reform Is Going to Affect You (http://health.usnews.com/blogs/heart-to-heart/2009/06/10/7-ways-health-reform-is-going-to-affect-you.html)
Newsweek June 10, 2009
Change is coming to medical care in America, and it may be a done deal by summer's end. From Capitol Hill to the White House, enthusiasm is running high for President Obama's plan to morph with lightning speed the current patchwork, private-public blend of healthcare into something closer to a single-payer, government-run system. Steadfastly promising to bring high-quality, affordable care to everyone, the president assures people that they will keep their own doctor and insurance if they want, see a return of some $2,500 to their pocketbook, and become decidedly healthier. But restructuring will inevitably call for sacrifice on the part of most individuals.
Change is coming at last to Health Care in the US. What do you think the problem is? What needs to be done in your opinion? Are you willing to sacrifice what you have now?
Those of you in different countries, how does your health care work (or not?) Let's weigh the pros and cons. Everybody agrees something needs to be done, but what?
Is nationalized medicine the answer?
Let's discuss!
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Welcome!! What's the #1 topic on everybody's mind today? Health Care Reform. But what will it mean to YOU? Will something change?
Check out the article above, 7 things we should know about proposed health care changes.
What do YOU think is the major problem in the US today? If you are not in the US, tell us how your health care works, the good and the bad.
Let's discuss the state of Health Care which is about to change drastically in the US, what are YOUR thoughts?
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Checking in.
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I'm just marking my place for now. Health Care reform is an important subject to me. Our country should not have such an unfair system as the current mishmash of coverage/noncoverage.
Nan
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Marking my place, also.
I don't understand why all the emphasis is on amounts for payment instead of amounts being charged.
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Oh a good subject. My favorite bee in my bonnet is why drugs and hospitals and the private industries that own MRI's and CT scans, etc. why do they charge so much.. If they are all non profit, why do they pay their CEO's obscene amounts of money.. Why does my dermotologist charge me for at least a dozen different things to medicare, when he spends about 10 minutes with me and freezes one small spot on my face. Why does my husbands internist charge for surgery when all they do is do a finger stick for liver enzymes.. We could get a better grip on health care if they would stop being so creative in charges.
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STEPH, I'd challenge that 'surgery' charge for a fingerstick. It was either
a mistake or someone is cheating the insurance people. Mistakes do happen. When I was auditing hospital medical records, I found an instance where a woman patient had been charged for a penile implant. Needless to say, it was corrected by the hospital immediately.
"enthusiasm is running high for President Obama's plan to morph with
lightning speed the current patchwork
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If President Obama can do anything at 'lightning speed' in our government,
I will consider the man a miracle worker!
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My TV is currently on and I pick up a few things every now and then. The screen just showed something regarding Obama's plan. AMA doesn't want to be reimbursed by Medicare's low rates. I for one am grateful for Medicare's low rates. And a similar govt. plan for all might be the only way we can control the high costs of medical care.
I've been using a Cpap for 3 months -- (sleep apnea). The DME (equipment supplier) gave me a chin strap and billed Medicare $76 for it -- after I had returned it to thembecause it didn't help. When I called them on it, they gave me a different one and said they wouldn't bill Medicare. (I later saw the first on the internet for 1/3 the cost.)
Do you all check your Medicare claims online at MyMedicare.gov? I think that site gives more info than what you get in the mail. And much much sooner.
And what about doctor office bills -- talk about being unable to read a bill!! Jargon.
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I pay my rheumatologist directly at the time of each visit. The office immediately files the charges with Medicare and our supplementary insurance. I usually have my refund within two weeks. I don't mind doing it that way because they are SO quick.
In May, I got a Medicare & insurance statement from an anesthesiologist for services performed at my colonoscopy in April 2008. And then they had the gall to send me a bill saying I had 30 days to pay the balance. I really hate that!
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About three weeks ago, I called to get an appointment for an Annual Checkup. I anticipated it being some time in August, but refused to take the appointment I was offered in November!!!
Yesterday, I called to chat with the appointment person. She "patiently" (as in 'I'm talking to an old lady') explained that Medicare will only pay for an annual physical every two years.
After my insistence that the basic thing I need is to have lab work to be sure meds are at an appropriate level, she was able to give me an appointment in mid-September.
When I asked how to get an appointment during the warm weather months, she said insurance insists on 366 days between "wellness" checkups.
I haven't decided what I think about all this, yet.
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When I was teaching I had school board paid health insurance. When i retired, by law, I could keep the same insurance, but had to pay it myself. (And if I dropped it, I could never get it back.) When I became eligible for Medicare, the monthly school insurance premium dropped slightly, about as much as the medicare payment, and is my secondary insurance. Drugs, with copay, are covered by the school insurance. Other than my monthly medications, I really haven't had a medical bill since becoming eligible for Medicare. My question: Is this the norm, or not? All my medical providers accept assigment.
When you look at what's charged by the doctor and what's allowed by Medicare you really have to wonder how such things are figured: for example
Hospital sleep study -- charge 5,000 allowed 700
One synvisc shot to knee 700 300 --- takes about 5 minutes
Audiology exam 126 43 --- about an hour
Dermatologist visit 47 47 -- he's got that right :-*
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Thanks for that info. on MyMedicare.com, PEDLN. I didn't know about that
and it's a good idea. You know, I wrote a letter to my care provider once time
explaining why, in future, I would request a second opinion on any lab/test
results that recommended any type of surgery or a hospital stay. So far, the
testing facility had invariable sent findings that resulted in an unnecessary
hospital admission, an unnecessary minor surgery, and an unnecessarily extended major surgery. Funny, I did not hear a word back from my provider, but within a few months that testing facility had been taken over by another group. I couldn't help but wonder. BTW, Pedln, your dermatologist is a rare
sould. My (former) dermatologist wouldn't say 'Good morning' for less than
$80. >:(
CALLEIN, I don't think a follow-up to assess the effectiveness of medication
qualifies as a 'wellness' checkup. The monitoring of some medications is vital
and new medicines should be checked until the doctor knows how they are performing.
You might want to take this up with your insurance company, or change companies.
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Babi, I fully intend to take it up with my doctor in September! He has never suggested timing for monitoring medications - but he will when I tell him the situation.
I don't know how many doctors are one of several in a joint practice or "clinic" but I suspect those who are have little knowledge of the way the business office runs things.
I've been able to speak to his nurse and get a quicker appointment when I needed something for a sinus infection. However, this isn't urgent - so I'll "have my say" when I see him.
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Obama is right to insist on a government insurance program as an option. Opponents love to shriek "socialized medicine" to try to scare people who forget that we have had socialized education for hundreds of years.
The private insureres have had it made all these years, setting their own rates, turning away sick customers, and rejecting claims. One whistle blower said her instructions were to reject EVERY Claim, even if it was later appealed , to keep a healtheir cash balance in the coffers.
As the mom of the front desk /appointment person in a busy medical practice, I beg you not to take out your frustration on the staff. They deal all day with people who are not feeling well to begin with and then have to deal with the restrictions of their insurance.
I think before this battle is over, we wil all be nuts. But don't let them settle for a sham halfbaked reform. Let your rep and your senator know that you want to see how a government plan option will stack up against private plans. Nobody has to join it, but it should be an option.
Soapbox put away. For now.
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bellemere, I am well aware of the limitations placed on the staff. The lady with whom I talked could not have been nicer or more patient with me...and I told her I appreciated her help.
I think this is an issue to be taken up with my doctor - and I will be equally nice to him because he has taken good care of my family and me for many years.
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I meant no disrespect to anyone in my plea for patience with medical office staff people, it was directed to all of us who are trying to cope with this absurd system.
I really believe one answear to the appointment difficulties is the increased use of physician assistants and nurse practitioners, who can order tests and renew presecriptions. I am always so pleased when I deal with them. They are not as rushed, and really take the time to educate you. I hope ;any new health plan includes incentives for more medical practices to include them, especially for monitoring.
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BELLEMERE
Nobody has to join it, but it should be an option.
That was precisely my objection to the first 'natioanl health care plan'.
Everybody had to join, whether they wanted to, or needed to, or not. I have
an engrained dislike of being told I have to do anything.
Also, I don't want a plan in which the government pays
all the bills, which is simply another way of saying the taxpayer pays the
bills, with bureaucratic inefficiency adding to them.
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Right on! Our Massachusetts system, while it is going through a struggle phase as it gets underway, does require everyone to buy some kind of health insurance. Just as some kind of car insurance is required. Plans are scaled according to income. the indigent get state help inpaying the premiums. Not perfect, but it is a new system and will have to work harder on controlling costs.
But back to cost control. Making use of physician assistants and nurse practitioners makes so much sense for those of us seniors who really need regular tests and medication monitoring. I go for blood pressure monitoring and potassium testing every four months. I get a feeling that mey highly trained (and very nice) doctor is almost wasted on this stuff. A P. A. could order the tests and check them for normal range; then alert the M.D. if something is out of range. And renew prescriptions that the patient has been taking for a while with no adverst side effects. And they usually have the time to discuss diet and exercise practices with the patient. Has anyone else had experience with them? What do you think?
the whole subject of over treatment and inapporpriate treatment was covered by Dr. Antal Gawadi in a New yorker article in May. Read it! If it doesn't make your blood boil, it should.
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The group of family physicians that we see has a PA. I've seen him several times, and he is very nice and thorough. This practice is set up so that he is the one who sees the walk-in patients (but only those who are established patients). It's certainly an idea that works for us.
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I had valve replacement about 11 years ago and the surgical group had a nurse? nurse practicioner? PA? I'm not sure which. But he was top dog. You rarely saw the surgeon, but Nurse Scott was really in demand and everyone deferred to him and followed his directions. I haven't had any major surgeries since, so don't know if this is common practice with surgical groups or not. But it certainly is beneficial for patients who have questions, etc. He was the surgeon's voice.
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I, too,prefer to see my Nurse Practitioner to the MD who's formally "my doc"...I've never met the man. He replaced the doc I did have who left to be an ER doc...paving the way for retirement, I guess.
At any rate, she's top notch. She refers me to and gets me appts with specialists when I need them...ie, an OB/GYN when she found nodules she felt she knew what they were but wanted the OB/GYN to examine me..he did; they were what she'd thought and he removed them there in the office, etc. THAT's the kind of medical care I like.
Callie: I don't ask for a physical each year. I ask for an appt to "followup on my medications/or high blood pressure or cholesterol and check appropriateness." It seems to be all in how the doc's office codes and bills medicare and the supplements.
I heard Pres. Obama speak of his plan. We have a neighbor/friend who's very conservative, and always railing about "socialized medicine"...while enjoying military complete coverage...which he admits is "socialized medicine"....but Mr. Obama explained that one payer doesn't mean it has to be socialized. It can be like Medicare...people pick own docs, etc.
The insurance companies now have too much control, I think, over what docs you use, what hospitals, etc. One large employer in this area...John Deere...threw all their retirees into chaos several years ago when they totally changed what docs they covered/what hospitals. So people who went to the local cardiologists , cardio vascular surgeons could no longer do so. They had to drive 60 miles for heart care. They were not happy campers.
There also, as others have said, needs to be more enforcement and checking for fraud...and nailing the docs/clinics/facilities that do the fraud. If some of these crooks were sent to jail, maybe the other docs/clinics would take note.
jane
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jane, as usual, says it all for me - and better than I would.
Years ago, when I started out working in a doctor's office, I filed insurance. The insurance companies had a lot of control - even then. Remember when, in order to get lab work or x-rays paid for, you had to be a hospital in-patient? That's when all this mess started, IMHO. When you were having surgery, you had to go in the hospital the night before so you could get your preadmission lab work done.
I blame most of the problems and cost-inflation directly on the insurance companies.
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I worked briefly in regional health planning, before it was done away with by the Reagan administration. We made citizen recommendations to the public health council, among them, capital expenditures by our local hospitals. this was when the M.R.I. was just coming onto the scene. Every hosiptal had to have its own M.R/I. even if there was one in a hostpital nearby that could not utilize it fully. Hospitals have to borrow to build or buy expensive equipment. this is not hard; the state gives them loans. Then, to make the payments they have to raise their room rates. Then the insurance companies have to raise their premiums. And on and on it goes. Our recommendation for a mobile M.R.I. to serve two or three hospitals was very unpopular. Today, all the hospitals has its own.
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That may be true in large urban centers, but here in the rural areas, all hospitals don't have their own MRI. Ours comes here in a large semi truck and is available x number so days a month as it travels all over NE Iowa. AND, we're a very progressive hospital for a town of 5200....but serve many, many more from smaller towns in our several county area. We have a large number of specialists who come to the hospital to see patients...cardiologists, ophthalmologists, oncologists, orthopedic surgeons, rheumatologists, etc. It saves our elderly and working people many hours of travel time. A dialysis unit has just been added.
jane
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Sounds like your area has found creative ways to meet the needs of a dispersed rural population.
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today I watched Obama address a large groiup of doctors from the ana. They were enthusiastic, a supposedly difficult audience for him, but one that carried him along with cheers as well as claps.
obama knows he has to act FAST, this year, for instance, or NOTHING will happen at all. This is his prime objective now. health care is at base responsible for much of our financial mess. . . since so much of it is supported by business.
as for medicare advantage, which I have with my HMO, Insurance companies and pharmesuticals have been milking it for all they can get here in the US while selling drugs elsewhere for less. if ot outright fraud, I believe these companies are close to it.
I keep wondering why it should be. It is a form of insurance and I don't thinkit should be related to business any more than religion is to government. there is a mistake here in combining them, especially with unemployment at nine per cent.
claire
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We have medicare and then AARP supplement, and with one exception we only use doctors who will accept the payments as full pay. MDH has now told his internist office that he will no longer allow his blood work to be done by Quest. Who bill you immediately and then complain when medicare etc dont pay in their stated time.. But yes, the internist office does in fact still charge for surgery for the finger sticks.. Since when we are home, it was happening every week, it was a minimal charge that adds up, plus of course it simply is not surgery.
I love the idea of the portable machinery. Makes so much sense, but then medicine does not really understand why this works so well.
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JANE
It seems to be all in how the doc's office codes and bills medicare and the supplements are coded
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You are absolutely correct about that, JANE. And wherever possible, the coders are taught to select the codes that will bring in the most money. It's a good idea to check into that aspect whenever you run into problems with billing and/or insurance co. denials.
Here is a link to an article about Obama's recent speech on his health plan. I
think it is the one Claire was referring to. However, it seems to point to a
more negative reaction from the AMA and a couple of senators. The views
expressed by the senators sound like scare tactics to me.
http://news.aol.com/health/article/obama-presses-doctors-to-back-health/527687?cid=14
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After seeing all the problems with bills some of you have been having, I'm glad I opted for an HMO and not the Medicare pay for services type plan. I have a great HMO, with a choice of several doctors, and I never have to pay a dime. The only problems I've had with the HMO is that some doctor's I've liked have left the plan. But I was not disappointed with the doctors I chose as replacements.
I haven't decided yet on exactly how I stand on what kind of national health plan would be best, but I feel so bad when I hear of people who have to give up their prescriptions in order to have enough money to buy food. At one time I was taking an expensive prescription, and found I saved a lot of money by buying it through a Canadian pharmacy. They were a reputable firm, and required an order from my physician. Yet our government would not allow the use of Canadian pharmacies.
I think it's really a shame that a country like ours which spends trillions of $$ on armaments and wars cannot have a decent health care plan for its citizens.
Marj
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Marj I think it's really a shame that a country like ours which spends trillions of $$ on armaments and wars cannot have a decent health care plan for its citizens.
I think so too, I like our Canadian system, of course has flaws but these flaws are not so bad when you consider that we don't pay out of pocket, our taxes do.
If I look at the total health care I have received during my life, I have to admit that I have never seen a better health care system in the dozen countries I have travelled in. I don't know how it is in the Scandinavian countries which I hear it is the best health care system in the world.
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After seeing all the problems with bills some of you have been having, I'm glad I opted for an HMO and not the Medicare pay for services type plan.
We chose not to go with the HMO since we want to be able to choose our own doctors and we've thus chosen the standard Medicare and a supplement. We've also never had a problem with payment, never been refused our insurance and seeing a doctor, whether here in Iowa...and from the local docs to the specialists at the Univ. of Iowa Hospitals or in Montana, or Texas or Alabama.
I suspect the billing problems are local doctor/hospital coding errors, as I said earlier.
The only things I can recall that we've paid for out of pocket were the refraction part of the routine eye exam ($18.00) and, years ago, a dietician visit because my husband was dx'd as diabetic.
jane
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I like my 'Provider', too, Marj, but I do have co-pay. It is quite reasonable
and my few prescriptions are quite cheap, so I am satisfied.
The ones most in need of a viable health care plan are not those on Medicare, but those who cannot afford insurance. That includes my younger daughter, who is diabetic and in a low-paying job. She is fortunate in having some doctors who will 'go the extra mile' for her, but that's not the same as knowing
you can get whatever help you need when you need it.
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We have a Medicare Advantage HMO-type)plan for our health care and prescriptions and it has been great. My primary care doctor has never, ever , refused my request to see a specialist. In"c;hoosing my own doctor" I would be a little hesitant, not having anything but word of mouth from friends or somebody, this way I at least have the recommendation from him and his colleagues. I have a copay, as well as a monthly premium.
The New Yorker articel covered a town that has the lowest per capita income in the state, and the hightst medical costs. Why? Overtreatemtn and the entrpreneu;rial spirit of the local doctors who invest in surgical centers, ;hospitals, home health agencies, and refer patients to them to increase their income. If this practice cannot be curtailed. any health care reform will fail. (That was the conclusion of the author)
What do you think?
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What do you think of the point the article makes that grandma might have to wait for care or not be admitted at all? Two workers here at my house in the last month, the chimney sweep and the window washer, have both said they are against nationalized health care. They don't want their care at the expense of somebody else, like me?
What do you think of that one? I was quite surprised at some of the points in the article: like a national computer database for each person, maybe even a chip in the person? What do you think of those ideas?
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No chips in me, thank you!
It is true that the type of national health care plans practiced in Canada and
Britain result in long delays in optional treatment. Which may also mean long
delays in getting released back to work after an illness or injury. However, the plan Pres. Obama is advocating does not seem to be that kind of plan. It seems to be aimed more, at curbing some of the practices that result in excessive costs. We would all like to see that happen.
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Leaving town in an hour, but to answer a few questions. I'm all for a national datebase -- digitized records, etc. Have you never watched a doctor plow through your chart trying to find a specific record? And sometimes he doesn't find it. I think overall it would benefit the health care providers and the patients.
I know privacy's a problem. What i what someone to know i'm a goofy old lady. it's not obvious? But the other day I read an articel about medical id theft -- and it usually originated in a clinic office, by a staff person. I think automation offers more than it take away.
When grandma is readmitted twice within a certain time period, medicare thinks the docs didn't do it right the first time and wan to to offer lower payment for the second admit. Docs not happy.
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A lot of objection to health care reform seems to center on "long waits for care" as in Canadian system. If I were to call today for an appointment with a specialist, e.g. a dermatologist, I would be given the "first available appointment," probably 6 or 8 weeks from now. That is just to be seen. And the same specialist doctors seem to load up their appointment calendars with"I want to see you again in three months" kind of appointments, so they are booked up to the gills. Is this a revenue strategy? Or high quality medical care? Nobody knows.
I think maybe President Obama is perhaps stressing universal coverage too much. Well insured affluent voters don't really care about the uninsured, especially since many of them are poor, or immigrants, or others that some people consider undesirable anyway. Instead, to gain political support, he must stress cost control over everything, since that affects the voters directly in increased premiums and deductibles. As long as doctors don't have to be accountable to anybody, even to their peers, for their treatment decisions, costs will continue to go up.
and we will continue to pay more and more for less and less.
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I wonder why, when universal health care is mentioned, everyone seems to say something bad about the Canadian and British versions.
Those aren't the only model out there. Why aren't people also talking about the Japanese system?
Japanese Pay Less for More Health Care : NPR (http://www.google.com/url?sa=t&source=web&ct=res&cd=1&url=http%3A%2F%2Fwww.npr.org%2Ftemplates%2Fstory%2Fstory.php%3FstoryId%3D89626309&ei=IE46So3nCZSUlAe9593yDQ&usg=AFQjCNFh-vjdtJ_vncgjdz06h-dU1yYU6g)
Japan's Universal and Affordable Health Care (http://www.google.com/url?sa=t&source=web&ct=res&cd=2&url=http%3A%2F%2Fwww.nyu.edu%2Fprojects%2Frodwin%2Flessons.html&ei=IE46So3nCZSUlAe9593yDQ&usg=AFQjCNGUuhhjb82SUzYZyiHzW1tnPUBUoA)
or Germany's
Managed care - a solution for Germany's health care system? (http://www.google.com/url?sa=t&source=web&ct=res&cd=1&url=http%3A%2F%2Fgateway.nlm.nih.gov%2FMeetingAbstracts%2F102194792.html&ei=YE86SuWTEoTmlAf88vTsDQ&usg=AFQjCNFBpKQW7mYrzOjiuTIEUDXY-hZv3g)
I think it's because the insurance companies and pharmas don't want to give up their golden eggs with the system we have now. It's about their $$$...not our health, as far as I can see. Scare people with "socialized" medicine...even if the people have no clue what that really means...or what single payer can mean.
If people are left uninformed, they can be frightened.
jane
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Hi everyone,
I have just viewed with interest this discussion group. Although I think some reform of the medical field exists, I am wondering what the big rush is to pass National Health Care. Will the government just print more money to finance it. What about the majority of Americans that oppose it.
Much discussion is needed pros and cons before rushing this through Congress. I think all of the Administrations policies have been rushed through in only 5 short mos. without much transparency to the American people.
The following article was of interest to me. This is a bipartisan poll, whatever party one belongs to. I think it is time to band together as Americans and ask more transparency from a man who promised this to the American people during his campaign
http://www.nytimes.com/2009/06/18/us/politics/18poll.html?_r=1&partner=MYWAY&ei=5065#articleBodyLink
LATEST NY TIMES/CBS NEWS POLL
Obama Poll sees doubt on budget and Health Care
"A substantial majority of Americans say President Obama has not developed a strategy to deal with the budget deficit, according to the latest New York Times/CBS News poll, which also found that support for his plans to overhaul health care, rescue the auto industry and close the prison at Guantánamo Bay, Cuba, falls well below his job approval ratings.
A distinct gulf exists between Mr. Obama’s overall standing and how some of his key initiatives are viewed, with fewer than half of Americans saying they approve of how he has handled health care and the effort to save General Motors and Chrysler. A majority of people said his policies have had either no effect yet on improving the economy or had made it worse, underscoring how his political strength still rests on faith in his leadership rather than concrete results.
As Mr. Obama finishes his fifth month in office and assumes greater ownership of the problems he inherited, Americans are alarmed by the hundreds of billions of dollars that have been doled out to boost the economy. a MAJORITY SAID THE GOVERNMENT SHOULD FOCUS MORE ON REDUCING THE FEDERAL DEFICIT"
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Before I retired I owned several retail stores. A large one was in a shopping area very close to Disney. There are a lot of marginal people in this area. They drift from place to place. Everything is ok, unless... one tiny health problem emerges. Then they sink deeper and deeper in debt. I saw them lose their apartments because of an abcess tooth.. a car because someone got a bad cold that would not go away.. a job because of an unexpected pregnancy that ended up in tragedy. We need some sort of universal health care to pick these people up and help them. They dont want welfare, they want to work, but their skills are minimal, so that they are hired only by small retail that cannot afford hospitalation for themselves, much less their workers.
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Talking Heads #6
"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.
(http://seniorlearn.org/bookclubs/graphics/talkingheads.jpg)
A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.
Our Sixth Selection is: (http://seniorlearn.org/latin/graphics/cycling5.gif)
Health Care Reform~! Are We on the Fast Track?
7 Ways Health Reform Is Going to Affect You (http://health.usnews.com/blogs/heart-to-heart/2009/06/10/7-ways-health-reform-is-going-to-affect-you.html)
Newsweek June 10, 2009
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To some degree, Bellemarie, doctors are accountable to their peers for their
treatment decisions. Hospital physicians may have to explain their decisions to
a hospital review board. The AMA hears complaints/charges brought against doctors, and is able to revoke their licenses if serious charges are confirmed.
When it comes to billing, however, any doctor may charge whatever he wishes. The more affluent his patients, the higher the charges.
Thank you for bringing up other systems, JANE. The British/Canadian models are the only ones I'd heard about. Quite likely the reason for that is, as you point out, the insurance companies and drug companies make sure we hear about them.
Exactly, STEPH. This is one of the richest countries on earth, and we should
be better able to help those in dire need, through no fault of their own.
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We have to keep in mind that the President is not Tr;ying to pass "National Health Care;, e.g. a 'single payer' system. He advocates ONE health plan run by the governemtn as one of the many choices people can make when selecting a health care plan. Medicare Part B is an example of such a plan. Available to everyone, forced on no one.
I laughed at the senator who said"If you like the servce at the post office, you will love national health care"
Scare tactics again. But John Stewart pointed out that "a person comes to your house, picks up a piece of ;junk that you have written, puts it on a plane to Hawaii, and it gets there., for 44 cents. " How can you beat that?
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The post office.. well if they would stop the cheap rates for mass mailers that send stuff noone wants and the catlogues, that keep coming when I have never ever ordered anything from them, life would get a good deal cheaper.I cannot remember the last first class letter that I have gotten. I think Thank you notes for some gifts were about it.
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Steph, I do agree with you. We do need a form of universal health care that addresses those who cannot afford insurance and also those who cannot get it individually because of their health conditions. I think we all know people who would be uninsurable if it weren't for the fact that they or their spouse worked and had employer group coverage or they have Medicare. Often those people without insurance or who can't afford it don't talk about it.
I think that a single payer plan that the US developed could be much different from that in Canada or England - but the insurance companies want to scare us with the myths of waiting lists and rationing. I have a son who has no insurance and no ability to get it under the present system in our country - I'm sure he wouldn't mind waiting lists for optional treatments if he could get in to see a doctor for regular health care issues.
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Health Insurance companies make obscene amounts of money. Insurance in general makes obscene amounts of money.. They are lobbying so hard now that I am sure our more aggressive congress people are swimming in campaign money. It is so sad. I am quite sure our founding fathers never considered lobbiers.
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I want to see an option for National Health Care. I have been upset with Medicare, since Newt Gingrich and his team took annual physicals off of what Medicare will pay. For years I have heard and read, that preventive health care, including an annual physical, save money. Not being able to have a yearly physical, results in people not knowing they have something until symptoms show up. In many cases by the time they show up, it can be too late. Then Medicare ends up with a much larger bill, than they would have had if they had an annual physical.
I am a military widow. We had 3 military bases in this area. All of them have been deactivated. If I could get an appointment with a doctor, it would require a 100 mile trip for each visit. I am no longer able to drive 100 miles in one day, as the result of numerous health problems. I do order my prescriptions, by mail, from a military source. It charges me $9.00 for a 3 month prescription for most medicines. C~ertain med cost me $30.00+
I am very happy about the push for a better health plan.
Sheila
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I have a friend who is also a military wife. She feels like you do. There is simply not a base anywhere close.
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The latest NYT poll shows the American public overwhelmingly in favor of a government plan as one option for health insurance. So the scare mongers have come upwith:
You may not be able to keep the health plan you have, even if you are satisfied with it. "
The reasoning goes that the govenment plan will be so competitive that everyone will want it, and drive the private insureres out of business. they are saying very plainly that it is our money they want.
But if you have your insurance throught your employer, there is not guarantee that you will be able to keep it anyway. More and more businesse, especially the smaller one, are reducing what they will pay for the plans, or stopping to pay health insurance altogether. And fierce competition between private insurers is sure to drive some of them completelu out of business. A government run plan is not obligated to pay dividends to stockholders; does not have to pay huge marketing costs; does not have to pay obscene salaries to their executives, and is not going to go awya in tough times.
That is awful about the military widow stranded without doctors. she is required to go to a base for health care? I thought they could go anyplace and their insurance would pay.
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Not to mention, Bellemere, that many large retailers hire people only on a
part-time basis, so they do not have to provide insurance coverage for them.
It's cheaper for them to hire two people working 20 hours a week then one
working 40. Or hire one person but only allow them to work 35 hours a week.
The net profit line is what matters.
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The under 35 hours a week is a trick of many stores like Sams and WalMart. Simply not fair to the employees. Some others do a much better deal. Darden ( restaurants like Red Lobster and Olive Gardens) used to let you work as little as one day a week if you wanted insurance. You never got pay, but you did get to buy insurance cheap. We used to know a lot of people that worked or small retailers and they did that. Dont know if they still will allow it or not.
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It seems like the big private insurance companies are determined to deny us the chance to choose a government program if we want it. They may succeed. They only want the govt. involved in business when they go broke, like AIG. Then they want taxpayer money, and plenty of it.
No plan should be free to everybody. That is crazy. Even a gvt. plan can charge premiums, as Medicare does for Part B. Free plans should be for the destitute.
If people want an option for a gvt. plan theywill have to push their senators and reps hard. In my state , it would be preaching to the converted : Senators Kennedy and Kerry.
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bellmere, in my state, it would be like preaching to a rock - Senators Alexander and Corker (I'm sorry to have to say).
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Article in our morning paper which apparently goes back to Mayt 26... about the millions and millions of dollars those "trusted" insurance companies some find so wonderful have bilked their customers out of by overcharging patients for "out of network" docs. Ah, yes...such trustworthy companies...no wonder they're advertising like mad about the "horrible gov't run" health plans. Sounds to me like some squaking about making loosing the goose that's laying all those golden (big $$$) profit eggs.
http://www.lawyersandsettlements.com/case/medical-out-of-network-overcharge.html
updated on May-26-09
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My state will be a split one. Martinez is a no and Nelson will be a yes.. Darn.
Ah yes insuranced companies do not want you to know the different ways they make sure to make lots and lots of money.. I cant understand the senators who talk about not having health plans when they get one that is spectacular.
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Wisconsin Senators have come out for single payer. My Congressman is "iffy" but is scheduling discussions on the issue.
Right now my husband and I have very good insurance and are very satisfied, so when that question is asked in surveys, that is the honest answer. However, that coverage is government based, so, we are among the lucky. If we had worked for private companies, or had been unable to work as long as we did, or, for that matter, had worked in the current type of economy - wow, we'd be in trouble based on our income and health histories.
And our children are very vulnerable. One cannot afford coverage, and we're hoping he will qualify for a new state program that will give him some basic coverage for a low fee.
For years I worked for an employer who kept me 1/2 hour below the limit for providing benefits. I know how unfair that can be. It was done deliberately, because it was a permanent job. I was lucky that my husband did have benefits with his job that covered me.
So, we support single payer and universal coverage. And I make sure to keep my federal and my state legislators so informed.
Nan
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STEPH
I cant understand the senators who talk about not having health plans
when they get one that is spectacular.
If you think their insurance is spectacular, are you aware of their retirement
program? They serve a couple of terms, and continue to draw a salary for the
rest of their lives. I think we could pay off the national debt if that were curbed.
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Amazingly enough they even get raises when the rest of the legislature does.. Almost as bad asmy home state of Florida, who lets you retire from government and spend 30 days down, then go back to the same job.. plus retirement pay. Hows that for feeding off the publictrough.
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And since Congress holds the purse strings, there's no way in the world
we'll ever be able to persuade them to give up that trough. And no President can afford to cut his own political throat by taking them on. No wonder people
are so eager to be elected to Congress, whether they are qualified or not. So
what if they never get re-elected. They're in!
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Please don't fade away, Janet. There has been much said and written lately about just what this reformed health plan will contain. And what I've read and seen in the media is that the "government plan" would be an option.
Many of us of a certain age have been in a government plan -- Medicare, and I for one am grateful for it. I compare my situation with other retired teachers from my district who do not have Medicare because they never or their spouses never paid into social security. They have the private plan from the school district, but when retired, pay for it themselves. (I use that insurance as a secondary.) They must pay deductibles and co-insurance for everything. I don't pay anything. My deductibles are picked up by my secondary ins. The non-medicare retirees don't have a secondary, just a primary.
There's a lot going on out there that I don't know about, and I don't doubt that when the big reform comes, it's probably going to cost us a bit more than it does now. I speak only for mysef when I say, "maybe it should. At least today, I can't complain."
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Janet: "You know he would never stand for having a federally appointed commission making health care decisions for him and his family. Then why should we?..."
If you have Medicare, you already have a single payer option. While it's not mandatory, unless you have certain older retiree policies, you can't get any other coverage. It's not offered. (In fact, that's one of the reasons Medicare was started - insurers would not cover the elderly or if they did, the elderly couldn't afford the coverage.)
If you have private insurance, then you have a profit-driven entity making your health care decisions. Unless you are wealthy, you do not really make your own health care decisions.
I suspect if the job situation doesn't improve soon, more people will understand why universal coverage and single payer are the only way to effectively provide health care to everyone.
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There is no question that some form of affordable coverage is desperately needed by a large portion of our population. My own daughter is among
them. There is also no doubt that any government program, with its bureaucratic management, is going to be more costly and usually less efficient.
There is a long history of goverment 'management' to back this up. And Janet
is right that a program once started is easily changed later down the road.
Someone has mentioned other national insurance plans that have been more successful than the British or Canadian models. Does anyone have more
information about those, about how they are set up? This is a very weak area for me, and I'm not at all sure I would understand the technicalities if I tried
to research them. I need a 'for Dummies' version. ??? :-\
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jane posted links to the Japanese medical system and, I think, the German system (I may be wrong about this one) earlier in this discussion.
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Baabi, the Medicare system, and Social Security also, have administrative costs that are substantially lower than the administrative costs of private insurance. Think about it - each insurance plan has its own claim process, its own rules and coverages, its own deductibles, copays and coinsurance rates. Thus, each doctor must hire extra staff to maneuver these multiple systems. Each time a person's policy changes, often annually, the person and all his medical providers must learn the changes. A government plan like Medicare would be much more consistent.
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The President sees health care reform as inextricably linked to the economic recovery.. So now is the time.
When I retired, i was offered the Medicare Part B insurance, for doctors and for expenses uncoverd by Part A. I had the opportunity to join some other plan.. But I want with the "government plan" with additional private supplement, and although the premium goes up each year and is deducted from my SS check, it has been satifactory. My private suppliement also goes up.
I think a government plan should be an optionand all the wailing about "everhone will be forced to join" is purely speculation as to the future. I think the private plans, may be forced to cut some of their nonmedical expenses like marketing, executive salaries, dividends to stockholders. etc. Even now, some insureres will go under as private companies compete more fierce. Every private company has one goal: "Increase market share" meaning take business away from other companies and make it ours.
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I saw her posts about the systems,MARYZ, but if their were links I must not have
stopped to read them them. Perhaps I can go back and find them.
I take your point, NL, but for paperwork you can hardly outdo the government. I
have worked for agencies under contract to the government, as well as for companies
that had to comply with all the paperwork demands,so I have been on both
sides of the picture. Those demands tended to increase rather than decrease,
and were generally geared to make things easier for the government reviewers
than for the providers.
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I am happy with my own medicare and the supplement, but they do go up each and every year. I see no problems with a single payer.. By the way,, weird health things.. Ifyou go to the emergency room in a hospital in Italy,, you dont pay. No idea why.. You pay for any prescriptions, etc, but the actual emergency room is free. I thought that was strange.
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Boy, that is strange. Obviously, the difference in ideologh between America and Italy. There, health care is considered a right; here it is considered a market commodity. But the underlying debate is
"What is the proper role of the government in a market oriented society?" Because that is what we have, and it has many benefits. No country on earth has our standard of living, a wider choice of options for everything you buy. Just look at the toothpaste aisle in the CVS. But the mistake is to treat health care as just another consumer good, that people are free to choose, or go without. That amounts to "buy or die" doesn
t it?
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I receive my medicare through a provider, with a very nominal co-pay. My
costs do not go up each year; in fact, last year they went down. One of the
advantages, perhaps, of not being under direct govenment management?
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Babi, are you a Medicare person? Because if you are and you are in a Medicare Advantage plan, it is possible that the government, not you, is paying increased costs for you to have that plan. So be careful, if you are part of the Medicare Advantage program, because your own costs may increase in 2010 as Congress is working to change the way payment is made to Medicare Advantage plans.
If you are in an employer retiree plan, it may not happen. Yet. But retirees are having their plans changed, reduced or eliminated every year. Some Chrysler retirees are facing that right now.
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I like being able to choose my own doctors. I belonged before Medicare toa plan where you had a listof doctors.. I had a lot of problems with the fact, they listed like one specialist for various things. The gastro they insisted I use, spoke very little english and insisted on a variety of things they simply are not done any more. I vowed when Medicare started, I would use he one where you picked and I have.
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Steph
How do you go about choosing your own specialist? Say, a gynecologist? Do you consult the state Board of Registration of Physicians to see if there have been complaints filed? OR do you have friends whose advice you trust? I heard the best way was if you are a friend of a veteran nurse at a local hospital. That is how I learned that one popular local doctor was referred to by nurses as Dr. K.O.D., for "Kiss of Death" Around here, the consensus is that a Boston physician would be the best choice, especially one affiliated with Harvard Medical School. What do you do?
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Medicare is my only insurance source, NL. My costs may indeed go up, but look what the Japanese are paying under their national health insurance program.
Under the Japanese plan, 68.5% of costs are paid through premiums/payroll taxes and by out-of-pocket payments. (The out-of-pocket payments come to 12.2% of that total.)
Is this really affordable for those people who are presently uncovered here,
because they can't afford insurance?
Of course, if our Senators and Congressmen would take a cut in their huge salaries, we would have the money to offer health coverage to the indigent. Fat chance of that happening.
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Choosing doctors. If you know a long time nurse , that is a perfect way to judge doctors, but nowadays where we live. They mostly have hospitalists, so the nurses dont know the internists etc. I got really lucky in that when we moved to where we are, I got sick within two weeks.. Food poisoning,, I asked a pharmacist and he recommended a local family practitioner. She and I met and it was instant karma.. I trust her and like her. She is down to earth, likes alternative medicine and generics. She lets me choose all sorts of vitamins, etc as long as I tell her what I am doing.. All in all, I am happy. When I was diagnosed with an aneurysm atwo years ago, I had a horrid time finding a specialist who would see me after the hospital. I finally got a recommendation from my husbands radiologist.. Saw a wonderful man , who reassured me that my aneurysm is small and harmless. Thank heaven.
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Babi, if you only have Medicare, but have it through a private plan rather than original Medicare, then your coverage can change every year. The standard Medicare premium for Part B is $96.40, which is about 25% of what the "premium" would be.
I don't know what Japan's total health costs are, but most countries that have single payer and/or universal coverage have a much lower cost per person for total medical costs. So 67% of the US medical costs may be higher than 67% of Japan's. As I said, I don't know that particular country's.
It is said that every family that has insurance pays about $1000 of their premiums toward the uninsured - in other words, their premiums are increased because of the cost to providers, who then must charge higher fees, which result in insurance companies paying more.
I don't know what the answer is, but it seems logical that having fewer insurance companies and more people in the plans would spread the costs out more fairly.
Kaiser Foundation and FamiliesUSA have good information on the insurance situation in this country.
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When I check our medical bills as they come from medicare and medigap, I am struck by the difference in what they say they charge andwhat medicare, etc pays.. My husband has had a lot of radiation for skin cancer and it is amazing the cost of one treatment.. They pay only a fraction of this..Insurances are quite interesting if you try and figure out what they pay. I realized the other day that in our travels, we have not passed a hospital in years that was not adding on.. Maybe if they would stop playing "Can you top this" with all of the equipment and actually sit down and cooperate in what sort of specialty each one should have.. I know in Orlando that two of the major hospitals are both starting heart transplants. There is no way that we have enough hearts to do that sort of thing. Sad..
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The danger of two hospitals starting heart transplants is that unless the skills of the transplant team; surgeions, nurses, anesthesiologists, technicians, etc. are fully utilized in constant practice, they are not retained well. The incentive is on the docs to perform more heart transplants, in some cases maybe marginally necessary in order to achieve a higher rate in essentially the same population.
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Steph
Getting sick in a new town is tough. But you found your general practitioner through a combination of word-of mouth (a knowledgeable pharmacist, not a common occurence) and sheer luck. And you found a cardiologist through the recommendation of a doctor. Not bad. \I belong to a Medicare Advantage plan and pick from a list of specialists who accept our insurance. My primary care doctor always recommends someone and so far, that has worked out fine. Only once have I been tempted to go outside network for a consultation on macular degeneration. My retina specialist gave me the name of his professor at Mass. General Hospital, again that old Harvard Medical School reputation.. I called first and lo and behold, they said they would take my insurance! I never followed up; I am doing okay with the retina specialist here.
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Talking Heads #6
"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
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A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.
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Health Care Reform~! Are We on the Fast Track?
7 Ways Health Reform Is Going to Affect You (http://health.usnews.com/blogs/heart-to-heart/2009/06/10/7-ways-health-reform-is-going-to-affect-you.html)
Newsweek June 10, 2009
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Janet, I saw that article also. Interesting. How will they resolve their problems?
There's always a "but" to these articles - why would this country adopt the problem areas of someone else's plan? If the USA plan is developed with thought, we can take the best of these other countries' plans and adapt them to suit our population. The devil will be in the details that will be fleshed out after Congress passes a basic plan.
We cannot continue as we are, because the costs, already higher than in other countries, are out of control now and we don't cover everyone. As more employers drop retiree plans and cut employees' benefits, the number of uninsured and underinsured will increase, and the costs to treat them in emergency rooms will increase, etc.
Something has to be done that addresses the high costs, both in care and in administration costs. I only hope Congress is up to the task. Unless our members of Congress lose their financial ties to the insurance industry, however, no meaningful reform will be impossible. That's why we need to educate ourselves and to constantly contact our representatives in Washington and challenge them to meet the needs of the population.
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jobs
why should health insurance be connected to employment? Universal health care, something like medicare has nothing to do with jobs. It has been convenient in the past but if we no longer have people who are not covered at all. . . . and may not have jobs at all . . . . what's the point. Universal heath care ceates lower costs since the pharmacies and the hospitals have to bid against the government for their contracts. It is said that they will go out of business that way.
they have been gouging us for decades. it's time the playing field is leveled.
claire
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As I understand it, health insurance became employer-linked during World War II when salarie increases were prohibited under wartime labor restrictions. So instead, employers could offer health insurance to compensate their workers.
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Ah, that's an interesting bit of information, BELLEMERE. I didn't know that.
Makes sense. And of course, once we had it, we would be most reluctant
to let it go.
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I suspect that part of the overwhelming costs have to do with improper usage.. I know in some countries, the doctors can opt out of the system and go private.. thereby setting up a side by side system. I know in our system, that number of people with no insurance use emergency rooms as their primary provider, thereby clogging up the system. My husband had to go through the emergency room in our local hospital in January. He had fallen at the gym and got quite a head cut, etc. and at 74, they whisked him off and rightfully so. When I went there to find him and find out what happened. I had to wait in the waiting area for maybe 20 minutes. I could not get over the number of people who wandered in at 5:30 am in the morning. Not one seemed to have any sort of emergency situation. One had a cold and couldnt sleep.. so the emergency room was a solution??? another had cut his hand maybe three days ago and decided on the sput of the moment, maybe it needed stitching?? Someone else had a headache.. on and on.. I just sat there amazed at why they were in the emergency room. There should be somewhere where these people could go for care or better triage..
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Steph, as a rule hospital emergency rooms cannot turn people away. So, people who do not have insurance and do not have money, and thus cannot get in to a doctor's office or clinic, go to the emergency room. If a community does not have a free or low cost clinic, they have no where else to turn.
Others, of course, abuse the emergency room, maybe because they don't want to miss work by taking time off to go to the doctor (or because they can't take off), or don't have a regular doctor, or any number of reasons. It's frustrating because most of us know what is appropriate for an ER, or think we do anyway, but it's hard to judge, also.
I agree, there should be some sort of clinic system that people can go to if they don't know where else to turn. My own health insurance has an on-call nurse, 24 hours a day, on the phone, that is a good initial source for deciding what needs to be addressed right away and what can wait. But, of course, that's part of my health plan, not available to the uninsured.
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Yes, My AARP medigap has the nurse and she is really helpful to me.. I do know now that you can also call a help line at a lot of hospitals and get an answer about many probems..Since my husband was a patient of the MD Anderson Cancer center in Orlando, they provided us with so many souces of information and that was included. There is also in many areas, a visiting health nurse who have a hotline.. I still think that most areas would benefit from another area in the hospital that took on all who came in and triaged them into who needed help and who didnt. We have drop in clinics here in Florida, but I think you need insurance for them. Never been to one, so not sure.
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It seems a snag in the progress of health reform legislation is over "taxing health benefits." What is that? Who would pay that tax? Based on what? I am really confused. I know that this is something the President wants to back up his insistence that any reform plan be paid for. Can anybody enlightent me on this proposed tax on health benefits?
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while I hate the idea, I guess it is a fair way to get this thing paid for. That is, the people who get the benefit pay the tax. But I thought it was paid by the employer. Thus weakening the incentvei to provide insurance for workers.
the two issues, access for all and cost control are almost mutually exclusive. If a bill passes that only guarantees access and does not control costs, it could wind up being worse than no bill at all. Rationing is a bad word, but can we guarantee everybody an additional heart transplant if they have already had one? Should every mother have the right to choose a more expensive Cesarian delivery if there is no medical justification for it? Should a 92 year old get a hip replacement? (Actually ;happened in a family I know. the woman lived eight months.) With a shortage of organ donations, who goes to the top of the waiting list? The child? The mother of a family? The war veteran? Should fertility treatments be covered for a single mother who already had a child or children? These are rationing decisions. But Americans want everything, and they want it now, and they want it paid for by someone else.
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By far the largest share of current Medicare costs are incurred in the last six months of life. In the meantime, the cost of rehab for substance abuse, or mental illness, even in children is "capped" at predetermined amounts by most insurers. those people are not politically powerful, and can be safely ignored. Rationing is simply making decisions based on evidence that a given course of treatment is or is not effective. Health care today is rationed by a differnt method: political clout and money.
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Janet, do you have the site that shows the quote by President Obama? I'd like to read that.
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I think I too would like to see that quote. I did not realize our President was commiting political suicide. He is, after all , a politician.
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I think that Obama was referring to his grandmother.. She had some extensive stuff done in her last few months. In many areas, if you are refused treatment, you can acquire it privately.. Not saying it is right, but it makes sense to me. The use of statistics is a valid one.. We know someone who had a heart transplant.. He had always been bipolar and off and on suicidal. He recovered nicely from the transplant, but went completely off his head and spends his time in a nursing home on Medicaid.. Happily thinking he is about 12 and his Mommy is coming for him.. Such a waste of a heart.
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It would be hard to make health policy for 200 million people based on each person's spirit. All a government can do is give guidelines based on proven effectiveness.
We seniors already use up a disproportionate share of health care resources. As the aging population increases with the baby boomers, that trend will accelerate. Costs will go up continually if each person demands that "everything possible" be done. We can't all have it all, even if we choose to. That's the message and it is a tough one to accept.
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Thank you, Janet. However, you say "Obama made no reference to the fact that under the proposed plan, a government appointed commission will be making those decisions. And that is what bothers me -- having some faceless bureaucratic gatekeeper, who does not know me or my health history, deciding that I am "too old" to have a certain procedure, based simply on my age."
Can you produce that plan that says that? Because as far as I know, nothing formal has actually been put up yet. There are bills that are being worked on, some being introduced, but I know of none that specify such rationing as you describe that are up for a vote. Our Congressman is still working on this topic and gathering information and stories from constituents, so I suspect a lot of work has to be done before any bill is introduced.
I have heard and read comments by people who are anti to any public involvement in health care raise that issue as a tactic to scare people, however.
Clearly, right now we have faceless heads of insurance companies deciding whether procedures are being covered and whether people are even able to get insurance, and we have rationing in the form of leaving out substantial numbers of people from coverage. In fact, it seems the people who have the least restrictions and best coverage are those on Medicare, which is a single payer universal coverage, government system.
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That is exactly right. the hip replacements we talked about must have been paid by Medicare, a single payer goverment program. It would be interesting to know what a private insurere might rule about a hip replacement for a very elderly person.
Nobody likes the idea of rationing. but it seems that The Almighty in combination with Science has dealt us seniours a rather tricky hand. Longer and longer life spans combined with more and more health problems for which there may be at least possible solutions. What's missing is the means to pay for it all.
'
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I had a mother in law with Alzeimers.. When she was 97... she stopped eating and the nursing home wanted us to have a surgery implant to feed her.. We talked to the doctor and he was a very nice man, he said he would not do it to his own mother.. We didnt. She drank liquids by herself and lived several more months.. but she was at the stage where she knew noone, could not walk or talk or anything. She just lay and slept mostly.. There is a stage where there is no quality of life at all.. Very hard time for MDH
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Steph, that must have been a hard time.
We all should consider a healthcare power of attorney and living will. Hard to do, sometimes, but vital if we want our wishes to be followed.
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How awful for you to see a loved one in that position. My own mother was lucid until just a day or so before she slipped into a coma and died. On one of those last days she said to me ;"Honey, this dying business is for the birds." How do you answer something like that? I just couldn't think of anything.
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John's dad has Alz., too. Definitely not a fun way to go - at least for the family.
Bellemere, the answer to the question is: "You're d...ed right!"
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My mother in law would not consider that she might get ill or die. so she had nothing except for an old will.. After all we went through with her and going to court,etc. We made sure that we have medical powers of attorney,durable powers.. wills, trusts, everything that will help us and our sons cope. We also prepaid a cremation service, etc. Both of our boys got upset since we have provided them with copies of the cremation, etc and they are aware as to where to find all assets and medical stuff if both of us go at once.. Neve again would I want to put anyone through what we did.. There is nothing worse than having a total stranger being able to ask personal questions so that we could pay her bills with her money. Whew..
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there are rumors that the President will order Congress to stay in session after August 1 until they pass a Health Care Bill. Can he legally do that? How will they survive if they cannot decamp to Martha's Vineyard or Lake Tahoe or wherever. Maybe he should lock them in a room with no food until they reach a good consensus.
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Good question, BELLEMERE. I've always been under the impression that the
President could extend the Congressional session, but I'm not sure whether
that is a Presidential legal right. In may simply be that if the President asks you
to do something, not many people are going to say 'No'.
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Actually given our congress they say no all the time.. I think Teddy Kennedy will have a lot of influence on them staying in session. He is highly respected in the Senate. Not my favorite human, but he has been a good senator over the years.
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I think I have figured out what "taxing health benefits" means. If your employer pays a portion of your premiums, that amount would be considered income to you, and would become part of your taxable income. It is , actually, so I guess it would be fair.
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Makes sense to me to tax the benefits. I know that when we had a car supplied by MDH company, we were taxed on that.. Reading the paper and laughing over the doctors yelling about the MRI's and Ct's in the offices. I did that only once and it was double what the hospital charged.. and I have no idea who read the results. From then on I specified hospital or independent. Doctors just see that sort of thing as a profit center. I knew a doctor who did Mammos and read them himself..Now there was a real risk
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It seems that taxing the health benefits would meet the cost control goals of the President, yet he has not gone on record for it. Unions are against it. But those benefits have been exempt from taxation from a very different time: World War II, when salarie increases were prohibited. Now is a differnt time. I am tring to find out who in Congress is in favor of this. anybody seen anything about the identity of the proponents? They are probably being castigated by union lobbies. I have always been a firm advocate of health care reform, but if it is passed withoug some cost control, it will be a disaster.
Has some doctor really got an MRI in his office? When they wre firest being acquired by hospitals they had to be in a special room with very thick lead-lined walls to prevent " scatter. Not your typical office building. Maybe the docs have managed to get that requiremtn dropped.
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No, what the doctors do is rent a space in a medical building.. They generally go together on that sort of equipment.. They buy it and then all plege to send all of their patients to it.. They also do the same with labs for blood, etc.. There are way too many tax advisors who get doctors to invest in this sort of profit center. Same for kidney dialysis. Since it is always paid for by the government,, a number of foreign doctors love this..
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I do know,..and benefited from the knowledge...that a patient cannot be billed for services that not to the benefit of the patient.
I once broke a bone in my elbow. The x-ray was read by the young
intern on duty, and my arm was casted based on his reading. The
fracture did not heal, and I had to have surgery and another six weeks
in a cast.
Somewhere along in here I got a bill from the radiologists. You know, the
group that reads all the hospitals x-rays as a safety back-up. I sent them
a letter that I owed them nothing, as I had received no benefit from their
services. The treatment I received was based on the reading done by the
doctor on duty, and the treatment had not been successful. The reading
done by the radiologists was solely for the benefit and protection of the
hospital. I didn't hear from them again.
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Ah Babi, you have cleared up a puzzle of mine. When I had surgery about 15 years ago, I was not yet on medicare and had private insurance.. I was extremely careful to call and verify each and every doctor and the hospital before the surgery. Then to my amazement, I got a bill from a totally unknown medical service. I called them and asked them what they had done for me.. They hemmed and hawed and never answered meto my satisfaction. I sat down and wrote a note to the insurance company telling them of the puzzle. They did not pay the bill and I was never billed again. Still have no idea who the people were or what they did..
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It is standard practice, STEPH, for a hospital to have all x-rays reviewed by a
group of radiologists. This is for their own protection, really, ...a quality control
mechanism. It can also be a help to in-patients, as the specialists may catch something that was missed before the paient leaves. For the most part, tho', it's so the hospital can prove a specialist reviewed the films, in case of a
lawsuit.
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The last mammogram I had done, I was recalled and I know that they had all of the previous one and then did a new type that really hurt. But the good thing with that I was told on the spot that all was well.. So sometimes xrays can help with a lot of nervous results.
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ah,but the bill as original and the bill as law will be quite different.. Always is..
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wow, this is tough reading for a layperson. I particularly studied the passage relating to keeping one's current plan. I am interested because I have a Medicare Advantage Plan, founded by Tufts University and it has been fine. i should add that we have no seriuos health problems so far. As far as I can tell, the individual can keep a Medicare Advantage plan, but the plan may not market itself to new members after the passage of the bill, which is designed to have every plan meet certain standards. I couldn't find anytthin about a Medicare Advantage plan being forced to carry prenatal benefits for its members. Hello? why would senious need that ? And it cannot insure members' children at all. I know that I was very surprised when my monthlypremium went DOWN a couple of years ago. Evidently the plans were awarded a huge government subsidy, which the reform bill woudl remove, and our premiums would go up again. But I expect it to anyway.
I am really having a tough time figuring this bill out. But I am not giving up.
I was disgusted to hear that a congressional rep was gloating that "this will be Obama's Waterloo" as if the entire point of opposing the bill was to deal the President a blow, not to find a better way for the american people.
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Now is the time, while the Bill will be under discussion, to contact your
Representatives with the points raised here. Obviously, no one in their
right mind would insist on maternity insurance for the elderly!
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Janet is absolutely right. We all owe it to ourselves to understand the provisions of the proposed health care reform bill HR3200 The whole thing, in the Library of Congress version , is available online. it is such heavy legalese, however , that I have been looking for fair and unbiased summaries of the bill's provision. this is not easy. The opponents are bombarding the intenet with doomsday misinterpretations, everything from economic collapse to forded abortions to eithanizing grandma and always the good old reliable red herring, "socialism" t But I did find a few. Hint: the fairest reports refer to "Presiden Obama" or "the President" the most biased oppontens refer to "Obama"
Here are some I found: MSNBC has put together a "timetable" of what would happen and when under the proposed bill. Google MSNBC and Health Care Reform Timetable. I found this very helpful.
Second, Ezra Klein of the Washington Post has a summary of the main provisions of the bill, but not all. Google Washington Post Ezra Klein Health Care Summary.
Finally the staff of the House Education and Labor committee has a fairly plain language summary of the whole thing. Perhaps this is the most partisan of the three that I found, but it is complete; it is in plain language and I now understand o lot of fine points I never heard of before. Google ed/labor committee Affordable Health for All, or something like that.Finally I was steered to these by the St. Louis Examiner "Summary of summaries" a very short succint, but not complete report by their staff.
So put down that summer novel and start studying before you fire off any mail to Congress.
G
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Hey Babi, haven't we seen a few stunts by some women trying to see how late in life they can have a baby? What is the record now, 60 plus? Every loony tune seems to want her fifteen minutes of reproductive fame, it seems.
'/
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We desperately need health care for all. We are the last of the so called civilized nations that have nothing to work as a net for all of our citizens. Turning it into a political football drives me nuts. Opposing it because Obama wants it is so foolish. I know that it could be improved, but we need to pass some basic plan and then work on it..
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Bellemere, I haven't read the bill. Just got back from vacation.
I can say, however, that the subsidies to the Medicare Advantage plans are being gradually eliminated already, as well they should, because it costs Medicare more per person for those in the Advantage plans vs. those in original Medicare. Medicare Advantage and Medicare Part D are hastening the day when Medicare goes "in the hole."
n
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Steph, let your rep know what you think should stay in the bill and what needs to go, or be changed. I am looking at the subsidy for the purchase of insurance that will go to low income people. It wil subsidize people making up to 400 percent of the poverty line. i think that should be lower; 300 per cent should be enought. I lke the idea of a Health Care Exchange, a lot like the stock exchange where people can choose their plans. and that you can keep the insurance you have if you like it. But your Plan may have to change. they will not be able to discriminate against peole with pre-existing conditionsl Goodl And they must also pay out a certain portion of there priemium income by (GASP) actually paying claims. Bur I saw no mention of giving Medicare the power to negotioate prices with the drug companies. What happened to that?
Meanwhile my own G.P. , for fifteen years now, tells me he is going to retire in a year or so to spend more time organizing hsi collection of rare and antique books, and visiting his mother in Costa Rica! His mother? What about ME?
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BELLEMERE, thanks for the tips. That will be a great help. As for the nuts
who think they want a baby at 60+, how many could possibly succeed?
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I honestly believe that women over 45 and anyone with multiple children should have to undergo extensive psychological testing before these physicians are allowed to do in vitro or any other procedure.
We are not eligible for Medicare advantage where I live . Just regular medicare... and have very few medigap as well.But I like our AARP medigap very much.
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60+ having babies!! That's carrying the national obsession with looking and being "young" to major extremes!!!!
I wonder how much of the medical industry is taken up with people's efforts to "stay young and beautiful."
At any rate, this is a wonderful and very useful and informative discussion. Since the President was on TV was it night before last addressing this very subject, I think we'll want to leave this open when the various bills begin to appear so we can discuss some of the suggested ramifications, some of which look somewhat threatening. Let's leave it open, this subject could not be more important or au courant.
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Yes , this discussion has legs as they say. It would be helpful if the papers would start putting the various plans side by side and comparing them.. But that wont happen until the end.
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The only Plan that has passed anywhere is the House Plan, 3200
Amazing that it passed. Say what you will about Nancy Pelosi, she sure knows how to herd that bunch of cats.
Let's leave it open. Some pundit will give us a comparison of the final versions, and there will be plenty of bloviating by both sides.
I confess to being a liberal on the access question and a conservative on the cost issue. I also confess to thinking that it is too costly as it stands now. I also know that I dont want additional savings to come out of Medicare. But I also know that they probably have to.
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This site has a lot of information on health care reform, Medicare, etc.:
http://www.kff.org/
and they have a bill comparison that was updated about a week ago:
http://www.kff.org/healthreform/upload/healthreform_sbs_full.pdf
It's one source anyway.
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Right, the HR 3200 is not passed; just published in a final form agreed on by the three House Committees.
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Here's a better site for comparison, and it was updated yesterday, according to the site.
http://www.kff.org/healthreform/sidebyside.cfm
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You worried me. I thought I had missed something important, but the bill was not brought up. The bluedog dems are balking. I feel strongly about access. I owned retail stores , know I could not afford health care for the help, but knew they needed it so desperately. It is such a catch 22 for small business owners.
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Why do you think this costs so much? Other countries give access to health care to all their citizens, and we are much much richer than all of them put together.
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Our health care is the worlds most expensive. We just love new and different and new machines. Other countries are slower to adopt all of the new stuff. Prescriptions seem to be controlled in many cases by the government, which helps a good deal.
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I just wonder at the fact that all these countries with health care for all are not going trillions of dollars into debt. and none of them are scrambling to adopt our system, instead of the one they have. I know that well-heeled Canadians come across the border for electibe treatment in our hospitals sometimes but I believe they are bringing their Maple Leaf health insurance card which our hospitals gladly take. they know the money is good.
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I have no direct knowledge, but have read about the number of people going to other countries to have surgery.. Seems that it is so much cheaper in most countries even without their insurance.. Also good.. Anyone have any experience with this??
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It's politics, and will probably be changed.
Republicans are branding a public option for health care as "government run healthcare" as if it is a bad thing. The Democrats are stupidly trying censorship rather than admitting the truth and pointing out that Medicare already is public health care.
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Hooray.. You said it. I am a recipient of government health care as a medicare senior. I pick my own doctors and hospitals. Thus far nothing has ever been turned down that has been submitted, although with my husband having radiation, I am always amazed at how the hospitals gouge people. What they charge for a 30 second treatment and of course the doctor who isnt even there gets a fee as well.. Its like my mamm. There was one charge for the mammo.. A second double fee for the recall and now I just got the notice from medicare for the doctor who read them.. They are digital for heavens sakes.. Incredible.. Mammos used to cost 90.00.. that is before I was on Medicare and paid them that day.. They charge medicare triple that without any hesitation.
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Unless there is some kind of public option for health care, it will again be open season on consumers' wallets for the private healthe insureres. The status quo will get worse and worse. A public plan would be free to experiment with new deliveryh systems instead of fee for service. Everybody loves to call it "socialized" medicine,"
congressmen are free to communicate anything they want to their consitutents. "Franking" means they dont have to pay any postage for it.
I think there is a little of the "drawbridge " mentality among supporters of the present system. "I've got mine, Jack" and who really cares about uninsured people when what we have is so satisfactory.
Again, I think the subsidy for health insurance should go down to 3 times the poverty level, as in the Massachusetts Commonwealth Care option. Would save billions. And health insurance employers' benefits should be taxed as income, perhaps at a lower rate than eanted income. That would generate more income. And malpractice insurance costs should be addressed. This is a litigation obsessed society and becoming more so. At the very least, "pain and suffering" awards should be capped. the trial lawyers wouldnt like that, but people could still be compenated for medical ngegligence.
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I agree about the medical malpractice. There are certainly mistakes in medicine all the time, but the number of law suits that are stupid are amazing. It is obviously not the doctors fault if your child is not perfect in most cases, but the number of people who sue because they had a child with a problem is amazing.. The number of people who sue and win when the accident was their fault is amazing to me.. I mean I remember a person in Massachusetts who was breaking into a pawn store and got caught up in a glass skylight, fell through and promptly sued the building owner.. He actually got money.. I could not believe it.
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What about the birdbrain who sued McDonald's after she drove away witha cup of hot coffee between her knees and burned herself? On the other hand we have the surgeon who left a patient on the table while he went out to the ATM to cover a check, and then came back and finished the operation? He lost his medical license of course and an undisclosed settlement was announced. I thought he should do hard time!
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Would love to see a breakdown of who are the uninsured and the underinsured? But I suspect they are mostly just people who do not have stable employment; or are laid off and too young for Medicare; the existing system doesn't have to be destroyed but it has to be stretched.
The idea of member owned co=ops is interesting. As private organizations they could perhaps receive large grants form foundations like Gates and the like, which cannot be received by either government or profit making insurance companies.
Is anyone really worried about illegal aliens? Or irresponsible young people? 46 million is a lot of people to characterize as irresponsible, profligate in their spending and unwilling to pay for health insurance. As for the people who have no need for health insurance, I can't comment. don't know anyone like that.
I still maintain there is a streak of drawbridge mentality in opposition to some aspects of the health care plans proposed. But keeping the insurance you have sounds like a great thing, but the trend is toward more expensive premiums and reduced beneifts in health insurance.
The insurance you have may not be the insurance you will have in five or six years.
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You want uninsured. Go to small retail businesses. They generally have under 10 employes in small stores and simply cannot afford to buy health insurance for their help. They pay minimum or close to it as well. Not because they are greedy, but they simply do not make enough money to even insure themselves.
Small restaurants.. they never buy insurance for their employees. There are a lot of small business owners that would love to insure their employees, but simply do not generate enough money to do so.
And yes there is quite a bit of "I've got mine" and it mostly in the Senate and house of Representative. Most people would love to have their insurance, which continues the rest of their lives..
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I agree that most of the uninsured are not by choice. As for people who have enough money to cover their own medical costs - only multi-millionaires can do that. Those people who think they are healthy and thus don't "need" insurance are ignorant of the costs of something so normal as having to have their appendix removed. Then they need a bailout by the rest of us. And Bellemere, you're right, those of us who have great insurance now and want to keep it are foolish if we not recognizing the reality that such great insurance will either be nonexistent or unaffordable a few years down the road if nothing is done to the whole system.
The ranks of the uninsured are growing every day by thousands as people lose their jobs or employers have to stop covering their employees. And this is before all the "horrors" of health care reform.
Then there is the issue of the underinsured. I believe that health savings accounts are counted as those who are insured - but I know people in those health savings accounts who will be broke before they reach the level where their catastrophic coverage kicks in. There are a lot of issues here - it's not simple.
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I had a semi=serious idea of how to capture the young immortals, who we certainly need in the "Pool" of insured people. HOw about: no health insurance, no car insurance, thus no car registration. But I suppose some would be clever enough to get around that.
Another underinsured group: rural folks, trying to maintain marginal farming or small trades. When a region is sparsely populated, the insurers don' t want to insure the residents. I guess they can't collect enough in premiums.
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I had read that in many counties, the small farmers cannot find insurers that will cover them. All boils down to how many, I would guess. Another arguement for some sort of drive to make them cover all people, not just the ones they want to.
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So now what? The Congress is going on recess? So am i, and will be away from the computer unless I use the Falmouth Public Library on a rainy day at the beach.. I guess those opposed to the reforms will use the month to put forward their views in television ads emphasizing fear of the refomrs and the supporters will emphasize the fear of no reform. Opponents aren't going to waste any money on Massachusetts;, we are a lost cause. Our congressonal delegation is unanimously for reform. so those of you in "swing states" are going to see some interesting spins, that will keep this discussion going. We will have to find a rumor control site to keep us informed. Anyone know of an unbiased one?
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As for people who have enough money to cover their own medical costs - only multi-millionaires can do that.
NL, you are right about that, of course. It's more a case of well-to-do
people not needing government assisted insurance. They can certainly afford
private insurance and should not be part of a government mandated 'universal'
insurance.
BELLEMERE, I've always found "Hoaxbusters" good at rumor control. Whether
they get involved in political disputes, I'm not sure.
It's beginning to look like we are going to stay on this topic until the bill either
passes, or not.
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New thing is that people are showing up at the town meetings and booing loudly about health reform. I read one news report that indicated that he had interview two of the booers and they did not even come from that congressmans district.. Hmmm.
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Yes, I read that the "Just say No" shouting is designed to prevent questions being answered or legitimate concerns being expressed. Another old trick from the community organizers playbook is to hire a venue that is too small to accommodate all the people expected to show up; get your supporters there an hour ahead of the meeting to fill all the chairs; removing some chairs if necessary, and this will result in the press reporting "a packed house" or " a standing room only crowd" opposing the issue.
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Oh, yes, another is the
"ad hominem" attack, from the Latin "to the man" . Work an unpopulare person into your attack rather than addressing the issue: "do you want Nancy Pelosi determining whether you should get a heart transplant?" or " Barney Frank would like to abort more babies using government funds!" I bet you will hear worse before this is over. Will a;ny of the congressmen remember that they were elected to lead, not merely to cave in to shouting mobs or dirty money?
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I have gotten three emails from unknown people who urge me to go to town meetings in south Florida and will supply me with query point, and banners. Amazing.. dont know how they got my email address.. I hate that.
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Wow, Steph! what postion do they want you to support? Can you fix your SPAM filter to get rid of stuff like that?
Here in Mass., everyone is just going to the beach. Complcency reigns, we are hopeless cases.
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STEPH, I'm glad that discrepancy was picked up and reported in the news. It's
important that people should be aware of manipulations such as Belemere
describes, so they won't be frightened off. I'm hoping a lot more news stories
will appear revealing such shenanigans. (Neat old word, 'shenanigans'.)
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Talking Heads #6
"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.
(http://seniorlearn.org/bookclubs/graphics/talkingheads.jpg)
A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.
Our Sixth Selection is: (http://seniorlearn.org/latin/graphics/cycling5.gif)
Health Care Reform~! Are We on the Fast Track?
7 Ways Health Reform Is Going to Affect You (http://health.usnews.com/blogs/heart-to-heart/2009/06/10/7-ways-health-reform-is-going-to-affect-you.html)
Newsweek June 10, 2009
Great word indeed.. They were all from conservative groups wanting me to rally as a senior about end of life issues.. So.. I would guess it came through some sort of seniors group of some type. Since I believe we have made provisions for our end of life issues, I just dumped them. I do so hate to raise my spam filter. I miss emails from some of my corgi web friends if I do that.
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Remind your Corgi web fans to identify themselves some way in the subject
line, STEPH. That spam filter is essential! After a quick scan for legit. e-mail, one 'delete all' clears the deck.
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It s funny. My lap top is slightly newer than my pc.. So.. the laptop has a spam setting that I can refer all to in case I want to and I do.. Then i can quickly separate out things. My older PC does not have that option. I have to raise the filter and I never see the rejects. Darn.
I cannot get over the number of people who are at the town meetings, who actually say.. " I dont want the government to interfere with my medicare" What the heck do they think medicare is??
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I think I can understand that reaction, STEPH. It comes from experience in
which every time some company wants to make a change, it's to their advantage far more than mine.
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I agree that new and improved generally means the company loves it.. As far as computers are concerned, it drives me nuts..
At this point, the only medicare that will change was already in the works. That pertains to the small amount of people who have the medicare plus program. It is not available in our area.
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"Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law."
My problem in reading that article, JANET, is that it never does explain what
is being referred to by "in such coverage". I agree that offhand, I don't like
the idea of telling a private company they can't insure a person who wants
their insurance, but we don't know what is being referred to here.
As for having to compete with lower rates, that sounds like an excellent
idea to me. Insurance companies have gotten overbloated with profits
precisely for lack of competition. I don't at all mind the idea of their having
to cut back to stay in business.
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I think that needs to be read in context with other parts of the bill - I thought that the reform means that new policies under reform have to follow certain rules that the existing ones don't, so that people can keep their present policies but others cannot get into them. The public option is to be there alongside the private plans under the new system of private policies. I don't read it as saying no one can go into a new plan, just not the plans that were set up before reform.
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The amount of money that is made by private insurance companies on hospitalization is obscene. Anything that reins it in would be helpful.. Same goes for pharmaceutical.. I sold off every single stock that was attached to pharmacy companies and tobacco about 10 years ago. Took some doing on the mutuals, but got it done..
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Now that the official White House website (whitehouse.gov) has requested citizens to report other citizens who post anything "fishy" (read anything critical of) regarding the proposed health care legislation, I have removed all comments which I have previously made on this website. I do not wish to end up on the White House hit list. I weep for our country!
Good bye.
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Janet, there's a difference between being critical of and "fishy."
There has been a lot of false information out there, some misinterpretations, and some definite criticism. The criticism is needed. The false information should be explained and corrected. There is also a lot of confusion. I think your over-reacting.
http://www.whitehouse.gov/realitycheck/?e=10&ref=text
If this is the site you are referring to, it's an informational site.
The Republicans also have sites with information, as does the insurance industry.
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My reaction to Palins remark on her blogs that a committe would not judge her son or her parents was akin to yelling Fire in a crowded theatre. The woman is mad and should not be allowed to say that sort of nonsense. I have lost any respect I might have had for her. I am ashamed of a woman who would use her child for that sort of nonsense. It is just not true.. End of life issues could be discussed with your doctor. It is only so that they have a clear view of what you want. How dare she, use downs syndrome that way.
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"fishy' does not sound like a word that the White House communication office would use.
I also weep for my country, which is witnessing the decline of civilised, informed debate in favor of the Big Lie. Joseph goebbels first enunciated the doctrine that a lie repeated often enough and loud enough will beat the truth.
Our democracy became a model for the world, but it is becoming a disgrace. i truly believe that political ideology and disruption techniques block the ability of people on both sides of the question , to have their concerns addressed. The rhetoric I hear , not on this board, but in the beach and in the bars of this town in supposedly liberal Massachusetts., is shocking. It is all about "getting Obama." "He will be gone by 2013 anyway. , we can junk the whole thing.
Craziest was: "Obama visited his grandmother in the hospital and a week later she died. Coincidence?"
People who have good health insurance are concerned; they have a right to be heard and to ask that their coverage be protected as an integral part of any reform. If it ain't broke, don't fix it. but to junk the whole reform and let the uninsured "eat cake" is wrong. There are too many things that are broke.
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Bellemere well said.. I watch the tv for the crowds but dont begin to understand what is happening. Many of the people who stand up and scream do not seem to be the type who have health care.. I just read about a man complaining about medicare and his prescription. That is the prescription end of medicare and that is all done by different forms of insurance.. Blame the insurance company if they dont want to use named drugs.
Why are people so frightened of universal health care. We are close to the only first world country that does not have it. The nordic countries, which noone ever mentions all have forms of health care and do just fine. Hearing over and over about Canadian problems makes me curious.. Has anyone checked the prices of regular drugs in canada against ours. I have.. My husband takes a drug that cost 110.00 a month.. In Canada you can get three months for the same price.. Hows that for ripping off the consumer.
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I greatly admired Obama's plea re. the health care reform issue. He simply said that where we disagree, it should be about something real, not about
false representations. There is so much 'false representation' going on I am
afraid many people will be sadly misled.
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I hope any caring physician now would be willing to discuss "end of life issues" with a patient who requested his help. But he would have to be willing to sacrifice his own income to do so, because he could not bill Medicare for that . And his group , if he is in one, would have to agree. I believe under the new proposed reform, he could be reimbursed by insurers for that service. Am I right?
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Bellemere, that is the way I understand it - it would be a covered service, but the patient's choice on whether to have that conversation.
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Yes, actually medicare I believe would pay now for it, but regular insurance does not. Actually we went to an attorney and got it all drawn up. wills, power of attorney and end of life issues along with a living will.. I consider it a necessity. I want to be able to be assured that I will not be left as a human breathing machine, not knowing anything. I remember the last days of my father s life and his eyes begging us to do something..
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Yes, I think that consultation should be voluntary. And should be explicitly so stated in any final plan. some people might prefer just to have it with a family member. But I am a little curious about what should go in a "living will" . I have one, but I just kind of guessede at what "extraordinary measures" were. A medical esplanation would have been welcome. Guess I need to haul out the whole package; will, proxy, etc and review it with a lawyer.
On that cheerful note, I think I will go out for a walk and clear my head; probably a good health measure at this point.
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I don't have a living will, but my children are aware of my wishes and agree
with them. And I suppose my local hospital still has a policy of asking for a pre-surgical decision as to the use of machines to sustain life, though I haven't had
reason to confirm that for many years.
I was looking at the 'poll' on AOL re. Palin's comment about "death panels "and was surprised to see how many of those who 'voted' believed her.
The more I hear from Palin, the more I am assured my first instincts about her
were accurate.
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Palin reminds me of McCarthy.. Scary thought, but there it is. She will say anything to get her conservative base to believe.
Living wills.. ours generally covers broad ideas.. We are each others health surrogate, which most hospitals ask for nowadays before surgery.
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I just had the same thought about Sarah Palin! and I remember that some people thougth Joe McCarthy was practiaclly a saint.
She is a shameless self=promoter, nothing more. The elevator does not go all the way to the top, that's for sure.
Give her enought rope, and hopefully she is on her way back to Wasilla for good.
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Oh, you are discussion health care reform here I see!
Our discussion of Frances Perkins, who was the first female cabinet member ever in a presidential administration, succesfuly pushed through Congress with the help of FDR (hahaha) such programs as social security, unemployment compensation, minimum wage, and many more.
One regret she had for the rest of her life was she was not able to get a health care bill passed.
The fight goes on.
We are having a mini-town hall on the subject right now here:
http://seniorlearn.org/forum/index.php?topic=587.200
Join us with your ideas! We'd love to hear from you.
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Apparently back in April of 2008, Governor Palin signed a proclamation for "Health Care Decisions" Day. That was to encourage people to have advanced directives.
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I love it.. Palin cannot even remember what she signed.
A good friend just sent us an op-ed column from Vermont. It seems that somewhere all over Vermont are clinics set up.. With some givernment money. They are staffed fully. You can go whether you have insurance or not. They ask the non insurance to pay what they can afford. You see a nurse practioner or a Physicians assit ant.. Then a doctor if necessary. They concentrate on everyday health problems and are proactive on preventive medicine.. Fascinating article. Never heard of them. Is anyone here from Vermont?? Do you know anything about them??
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Hi:
Just peeked in to read some of the discussions. Although I am not going to comment as to what is in this proposed legislation, the pros or cons, I would like to comment on Stephs last post
I don't know about Vermont, but these clinics are apparently set up in parts of New York.
My twin grandson had a near fatal accident on a Good Friday before Easter. After falling down stairs and slitting his wrist on some metal that was being used while under construction, he didn't lose his cool and told his twin brother to get a belt and use as a tourniquet immediately and then fetch his mother. The mother, being frantic took him immediately to one of these nearby clinics which saved his life. While stabalizing him, they immediately summoned a doctor who arrived in short time to take care of him. A longer trip to the hospital emergency room might have been fatal. This clinic also does the same as the one Steph described in Vermont.
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These are Community Health Centers set up in very rural or very underserved urban areas. They do get subsidies to treat people who have not insurance, and they also take all kinds of insurance. I believe new doctors with loans to pay back to the government can work them partially off by serving in them.
It looks like the parts of current bills that must go are: Anything referring to end-of-life issues. People have been terrorized by the misinformation around this question. Better to just let it go. Also, any move to raise taxes on the middle class.
The various committees should just concentrate on the two, and only two , things President Obama asked for: Cover everyone, and make it pay for itself. The simpler the better.
But regarding advance directives: this is going to be a big probem.
Whoever thought people would live so long? some huge proportion of Medicare funds are spent on care in the last few weeks of life. Our local Concil on Aging instituted a birthday party a few years ago for cenenarians. Usually 2 or 3 came. This year there were something like 35, and others not well enought to come to the party. Advanced medical care and technology have dealt us seniors today a very tricky hand to play. Save fpr retirement? What if retirement lasts for 30 or 40 years? How much will people have to save up? And medically, the question is even more troubling. The birth rate is going down; fewer babies; fewer p eople in the working population and more and more in retirement? What will happen?
I can still recall that Medicare, when it was proposed , was bitterly opposed by doctors and the entire medical establishment. It was going to be the end of civilization as we know it!
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In today’s Town Hall meeting in Colorado, Obama stated that entitlements and defense consumed the largest amounts of our budget, and that the expenses of Medicare and Medicaid must be reigned in. But in just a few years, the oldest “baby-boomers” will be Medicare eligible, and although I don’t have figures, it is my understanding that the “over-65” population, for several years, will be much larger than it is today. And, from the sketchy reading I did today, not all boomers are well-off big spenders. Some are close to the poverty line. Surely this will have an effect on health reform in the years to come.
Another concern, long-term care. Medicare does not include it, Medicaid does pay for it. With a larger aging population, regardless of how healthy they are as a result of exercise and good living, there will be more instances of debilitating conditions like Alzheimers, Parkinsons, diabetes. Will anything change in how we handle long-term care needs.
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If you are admitted to a hospital they will ask if you have a living will or who will be making decisions for you if you are unable. I have a living will filed with my hospital and my physician. I discussed the details with my physician because the withholding of nutrition or water might cause more suffering. A non-medical person probably would not have these facts.
The proposal in the health plan states that this is voluntary. It would also cover the expense of discussing hospice care.
Had lunch with friends yesterday and gave them each a copy of the health reform proposals which compared each. They kept talking about socialism, doctors killing off the old folks, and such nonsense. I asked them if they were concerned about socialism why they were accepting medicare (and for that matter Social Security). Certainly these women in their 70s and 80s had long since received more money for their health care than they had ever put into the system!
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Thanks for the advice about the health clinics. They sound wonderful.. They also sound like something we should encourage.. Why do all the young doctors want to be specialists. We really need internists, family type doctors. Someone to look at the whole person. My husband has been ill off and on for the past years and it has been horrid trying to keep track of the various doctors. We finally found an internists who is willing to coordinate all of them, whether they like it or not..
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The doomsday scenario of end of life care has really been bugging me. finally I had some insight. Instead of viewing the problem as "too many old people" the problem can be viewed as "too high costs" and could be attacked from that angle. Make technologh cheaper and more efficient; that is something America knows how to do. If end of life care is less costly, the problem will not be so scary. Look at the hand held calculator, once a hundred dollare miracle of technologh, now banks, etc. give them awayfor nothing. Americans still have the greatest "know how" in the world . altthough for how much longer is questionable.
so controlling the cost has to be the priority before we start talking about plug pulling. Anyone see merit in that?
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Control the cost? Of course, bellmere. IMHO, that's the whole point of the reform issue. The costs are insane.
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Internists are specialists. We have two in our county here in SW Wyoming.
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I agree that internists are specialist, but here in central Florida, they act as family physicians. We have literally hundreds of doctors locally. Way too many, i suspect. Anyway, this particular practice has several internists and they act as your basic physician, schedule tests and steer you to specialists as you need them.. Seems to be working well for MDH.. He has chloresterol issues, liver enzyme problems , and several forms of skin cancer.. Plus a few mysterious type things. So this way I dont worry that he is being overmedicated..
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More from the If I Were King department. The manned space program: a great ride for the guys on board; what do the rest of us get for our billions? Other countries, e.g. France gather data from s pace using highly efficient satellites. Do we really need the glamour boys and gals in the orange jump suits? Do we des[erately need to go to Mars? If we could put a man on the moon in a decade, could we find cost-saving medical technologh in a decade?
My plucky little R.N. niece has just started her own business: home infusion, for people to stay in their homes and receive intravenous medicines, even some chemotherapy, without going to a hospital, at much lower cost.
Re living wills. I think most people who have one explicitly say they do not want to be kept alive by artificial means if there is no reasonable chance of recovery. Does anyone, I wonder, have a living will that states the opposite: Keep me going, using every available means, for as long as possible. I suppose in theory they could.
On an unrelated note: The European Union countries with their "socialized medical care" allow the purchase of supplemental private insurance for things like private hospital rooms, etc. and also have made health insurance reciprocal among all the countries. An Italian who gets sick in France gets treated same as a French citizen, the insurance benefits being about the same all over Europe.
In Mexico, training for student nurses includes instruction in spending a few minutes at the bedside talking with the patients to try to help them feel better!
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This was sent to me by a good friend and I am thinking that we all might want to read and save the links that she places here.
Ann,
There are several excellent open government sites that synopsize bills – I use them at work. They have no partisan ax to grind and simplify the language but give enough info to help decide what parts of a bill to read in more detail and what the bill will actually do.
http://thomas.loc.gov/cgi-bin/bdquery/z?d111:HR03200:@@@D&summ2=m& - Thomas is the site that tracks all Federal legislation
http://www.opencongress.org/bill/111-h3200/show
govtrack – site is down on the recess for hardware upgrade but it a nonpartisan tracker
There may be lots of valid questions on HC reform, but I loathe being lied to or having facts spun to keep talk show host ratings high or legislators in office. Look at motives and follow thee money – its pretty interesting.
Regards, Karen
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Steph,
Palin reminds me of McCarthy.. Scary thought, but there it is. She will say anything to get her conservative base to believe.
What Palin said about "death panels" must have had some substance to it, since now the committee says they are taking that out of the reform bill. Kathleen Sabillus, who is in charge of the health reform stated Sunday that it meant doctors would get reimbursed for giving consultations to family members on how to proceed with a loved one who is approaching death. Don't most doctors consult with the family already and get an enormous fee for just stepping into the room? Is this more government waste in spending?
bellemere, I just had the same thought about Sarah Palin! and I remember that some people thougth Joe McCarthy was practiaclly a saint.
She is a shameless self=promoter, nothing more. The elevator does not go all the way to the top, that's for sure.
Give her enought rope, and hopefully she is on her way back to Wasilla for good.
I am NOT a Republican or conservative, but I don't understand why people feel the need to personally degrade Palin? I have been a democrat my entire voting life and can not understand this attitude. I don't mean any disrespect in asking.
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Babi, I greatly admired Obama's plea re. the health care reform issue. He simply said that where we disagree, it should be about something real, not about
false representations. There is so much 'false representation' going on I am
afraid many people will be sadly misled.
I think there may be false representations going on because NO ONE including Obama knows what is in the reform bill of 600-1,000 pages. A member of the health reform committee was on Sunday's news being interviewed and he admitted that this is NOT President Obama's bill, that the President told this committee to come up with something. If people were well informed then they would not have to worry about the false misrepresentations or being misled. Professors, and top insurance ceo's have read the bill and can not even begin to understand it. Obama did say to help pay for it they would have to cut 40% of Medicare. Until someone is willing to deduce this down to fewer pages and simple reading, I will reserve judgement. I agree we need health reform, but I don't want rationing and I don't want to be told which surgeries I am allowed to have because of my age or illness. So far this administration has failed with the bail outs, the stimulus and the cash for clunkers, I don't want to imagine what this country would be like if they fail with health reform. Obama admitted at a town meeting he did not know for certain how they were going to pay for it fully. He joked about not pulling the plug on grandma, but for alot of grandmas and grandpas, it is not something they want to hear as a pundit at a town hall meeting at a time they are filled with confusion and concern. Canadians may have cheaper drugs, but they are coming here to have surgeries they are being denied under their health care system there. Their system is rationing health care, so let's not be too ready for reform to the point we get something that could be worse than we have. Something this complex should not be rushed through. All polls are showing 78% of Americans are not in favor of this reform at this time, and I think in large part it is because they have not been able to be given the true facts of what it consists of. This is still a work in progress, so how can it be accepted at this time?
It reminds me of the saleman who tells me this is my only opportunity to purchase the item and I must act NOW! Anytime anyone pressured me to act now, a red flag came up. If they are confident about this bill and have the votes of the democrats in the house then why does it have to be immediately before they have a clearer understandning? No one can tell us what it is, they just rebut what is being said against it.
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Steph: Please send a couple of those internists our way -- they can enjoy the wide open spaces, high desert, hunting/fishing, the mountains ;D
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Kidsal,, we have two major hospitals here plus a research facility and a third childrens hospital being finished now.. So that is why the number of doctors. Specialists love to be near teaching hospitals or hospitals that do special surgeries. M.D. Anderson of Texas has a cancer branch here. E.I. Dupont has a childrens speciality opening. So I would love to send you some of the doctors, especially the ones that english is probably their third language, but they wont go.
BellaMaria.. I have been a feminist and a supporter of most women my entire life. I worked very hard when young to help legalize abortion and other problems. Sarah Palin simply works the system and I am personally offended by her. I have never felt about anyone I did her. The winking and parading of children. The baby who needed anything but being paraded in huge crowds.. The hypocrisy of abstinence when her daughter was having a baby.. No, I simply cannot abide her. So thats that.. Sorry.
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It looks like we are not going to have the choice of a public plan; the insurance companies are salivating at the idea of 47 million new customers, many of them subsidized by government funds but somehow that is not socialized medicine. All those elderly people screaming no government health care with their Medicare cards in their pockets!
Sarah Palin? Her vocation as a rabble rouser is disgusting. What constructive idea has she ever offered?
Canadians coming for elective surgery? How do you think they pay for it? Their egg money? They bring their Canadian health insurance cards with them, of course. \
Rationing willhappen, public or private plan. Aetna, Blue Cross, they all deny certain things based on state of health or age. "Surgical risk" etc, lots of good reasons. "
Consultation on end of life issues would be reimbursable to doctors as a covered service. No one likes to think of dying, but there it is.
Shortage of general practitioners? Yes, that will go on if fee for service does not cover such consultations. \
I am one of th few who wil lose something, my Medicare Advantage Plan, which has bee satisfactory. But even I can see fluff in it: reimbursment for Weight Watchers, nice but not necessary; health club discounts while I prefer to suppor my community YMCA; a new pair of glasses every year for very low price ; not necessary for most people.
Co-ops: these could be a good compromise. For a time.They will have tremendous marketing start up costs, but will be eligible for grants that cannot go to private corporations or government entities. Some areas of the cont;ry will welcome them, I can see them in Vermont or Maine or Minnesota and Wisconsin. Others will consider them communisitic. I believe my retirement plan. TIAA CREF is a mlutual co-op and it is the greatest.
Do you think it is time to "pull the Plug " on this discussion? Or at least suspend it until the recess is over? I need time to stud;y it all, and want to thank Adoannie for forwarding the sites.
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Do you think it is time to "pull the Plug " on this discussion? Or at least suspend it until the recess is over? I need time to stud;y it all,
Let US NOT decide to pull the plug on this discussion, but rather leave it in place until it is no longer being visited and/or accessed.
I’ll be the first to admit there is much I don’t understand about this whole reform movement, but I think it would be unfortunate if it did not offer a public plan. Now they are talking about co-ops; on CNN this am a gentleman from Washington State was expounding on how successful they were there. If they go that route, I think they’ll end up with a lot of weak entities as opposed to a stronger platform with just one public program. Why not start with the public program and then slowly build a network or co-ops if there appears to be a need for such.
Steph, I’ll ditto all your remarks about Sarah Palin.
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All the comments about the “end of life” counseling bring to mind a Children’s/YA book that was popular several years ago, and is still highly recommended as a class read. The Giver by Lois Lowry -- have any of you read it? It’s not really sci-fi, but more a tale of a future society where life is deemed to be free and enjoyable because we no longer have to make decisions.
While visiting family earlier this month I started a book recommended by my DIL – Complications: a surgeon’s notes on an imperfect science by Atul Gawande, a surgical resident. It’s very anecdotal. He talks about training, learning, performance, patients, mistakes, but overall there seems to be a focus on expectations and outcomes.
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Steph, I too have been a femiist my enitre adult life. I worked for Hillary Clinton's headquarters thorughout the campaign up to the very day she dropped out. I am not for legalized abortion and so I don't find Palin offensive what so ever. I don't see her as working the system, no more than any politician. I do feel because she is a woman she has taken udwarranted attacks especially by other women. I didn't feel she paraded her children, and I for one enjoyed seeing she was proud to show the public her new baby. I saw him as a new baby, nothing more. I am able to look over his disability and see the joys the family had in holding him. As for her daughter Piper, I loved seeing her, as much as I saw Carolline Kennedy when she was a child. I applaud Bristol for coming out and going public with her teen pregnancy and to inform the teens out here that it is not all galmor and glitz, it is a tough job to be a teen Mom, it changes your llife and you have to be responsible for another human being when you are just barely a young adult yourself. I did not see it hyprocritcal, I saw it as an opportunity to get the message out that abstinence is a full, foul proof way to prevent unwanted pregnancies. My daughter in law got pregnant when she was in her senior year of high school. She chose to keep our beautiful now 13 yr old grand daughter rather than take the easy route and abort. My daughter in law now works as a case worker with unmarried, teen mothers in a Healthy Start Help Me Grow program to help these mothers and babies have productive lives regardless of their circimstance. I don't see her pulbic work as being hypcritical. She, like Bristol Palin, took an opportunity to help others to possibly not be in the same situation they found themselves in. Ideally, I think every parent teaches abstinence to their teens, and realistically, they hope they will at least use some form of protection if they choose to not abstain. We give them the information, but as many parents know, they don't always practice it. I am willing to see the Palin's situation as a "teaching moment." Baby Trig has made more people in this country more aware and sensitive to Downs Syndrome, he has heightened the compassion in people by being visual.
As I stated, I voted Democratic my entire adult life, this election has caused many a person grow to hate and act out in defense of party loyalty like I have never witnessed before. I am a Christian before I am any political party member. My mother taught me if I don't have something nice to say about someone, then don't say anything at all. Personal attacks on the Palin family shows the lack of discipline and Christianity in this country. It saddens me to see it and hear it. Since this election I will never allow myself to be attached with any one party ever again. Neither party has shown me they can put the best interest of the American people first. This health care reform bill they are trying to pass is NOT UNIVERSAL or we would all have the same coverage as any congressman/woman, senator, and the President. WHY are they not willing to give every American the same health care program they themselves have? WHY aren't we entitled to have the same as them? What makes them better than us? We elect these politicians to work for US, to speak for US, to do what is in OUR best interest....instead they put theirselves, their party and their special interests ahead of US. As you stated, No, I simply cannot abide them. So thats that....respectively.
I was directed here to discuss health reform, I was disappointed to see the personal attacks on Palin. My apologies for allowing myself to be sidetracked. As a feminist, I just could not sit back quietly and see another woman being personally attacked, regardless of who she is. Men are wise, if they disagree they diplomatically state their differences rather than take personal attacks at each other. When women are able to do that, we will get further along in all sectors of life. Hillary, Palin, Pelosi, etc. etc. all women trying to make it in the political arena and being ridiculed, degraded, and mocked, yes, by other women. Men won't take us seriously and see our intelligence or accomplishments, when we don't take each other seriously.
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Sarah Palin has a find future as a mother, a spoksperson for her view of family life, and a speaker to audiences of conservative values. As President of the United States ? I don't think so. And maybe Eunice Kennedy Shriver did more for the lives of Downs Syndrome people than she ever will.
But truy, she is a distraction from the Health Care Reform. I cannot see anything controlling cost escalation. I am waiting for the other shoe to fall for my own insurance fate. If there is a public option with a Medicare supplement, I may be the first enrollee.
Funny, Bellemarie, our names so similar, our views rather different. My name, bellemere, is French for mother in law, and a tribute to the five nice guys who married my daughters.
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bellemere, Yes, it is funny how close our names are similar and our views rather different. My name is Italian and stands for "beautiful Maria", my father who was Italian named me Annabella Marie after my Mom, Annabelle who was southern. She wanted me named after her and he wanted it to be Italian so they agreed on Anna-bella (Anna beautiful). I go by my middle name Marie, so for my screen name I chose "beautiful Marie" As for your views on Palin I will chuckle and say, many a women were not taken seriously in politics and called worse, I am discussing the first woman cabinet member Frances Perkins and she had many hurdles to jump. I suppose many thought she would not go far and surprise! Eunice Kennedy did indeed do much for the cause, but now that she is gone it won't hurt to have anyone especially a public figure such as Sara Palin to further the cause. I won't count her out or in at this point as far as her political future. I don't see Palin as a distraction to the reform, she obviously made a strong argument against the "end of life" portion because they are now saying it will be taken out. This Independent doesn't mind listening to either party for different points of views. I just don't approve of personal attacks on anyone.
We all have a personal vested interest in this health care reform bill. It seems the biggest supporters of it (liberal dems) are now backing down because the President has sent a subtle message he may not be for what they were aiming for. Like I said, this is a very complex program, everyone needs to take a deep breath, slow down and get it right. Americans will accept it as long as they see it not catering to the special interest groups and taking more from them. It should never be about a party loyalty, it should be about the American people.
Five daughters, wow how nice! I have one, and two daughter in laws. We women don't always agree in politics, but we do respect each other and agree to disagree at times.
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Steph, I agree with you about Sarah Palin. I cannot respect her. I also cannot respect the Republicans who nominated her - that they had so little concern for our country that they would actually consider someone like her as vice president, the next in line.
And Bellemere, I agree with you that people are confused, which makes them anxious. The bill needs to be simplified. But I disagreee with you about the polls. I'm not sure what you are referring to, but on an NPR program today, the polls are certainly not what you are talking about. People do want reform. However, some are confused. Others want reform as long as it doesn't affect them. Well, that's just plain selfish.
I have great health care. It costs me next to nothing, just an occasional co-pay and not very often. But I recognize that it's unfair that I have such good coverage, while my children don't have any.
I don't think you can say the current administration has failed at anything. There are so many things wrong that are leftovers from the previous administration - 7 months is not a very long time. The Cash for Clunkers is very successful - too bad there are not more programs like it that give people hope.
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Are we all agreed that everyone should have health insurance, and that the insurance should provide the same quality of care for all people: elderly, poor, disabled, rich, healthy, young, No tiers of care unless a person wants extra luxury private hospital rooms with jacuzzis! With no discrimination for pre=existing conditions, no caps on servce for chronic disease, either. No forced decisions about end of life care.
Now. Does anyone think we can have it without paying more in either premiums or taxes?
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Yes, I do agree that that is what we all want.. And no, I wish I felt that it would not cost us more in taxes.. I want it anyway. I also know that in the Medicare system, that south Florida is famous for fraud.. When I hear examples, I realize that Medicare is not run well. No idea why, but they allow the strangest programs to slip through. We need better organization of the benefits.. Again I am not a bureaucrat, but surely they can figure out how to straighten out the fraud program.
Since one of my best friends went through a
Downs syndrom child and I know what it cost the family and the child over the year, I have strong opinions about bringing out a baby with this into the crowds and noise and overstimulation.
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Bellemere, we may have to pay more taxes, but then, if everyone has coverage, there will be less emergency room visits, less unpaid bills at the providers, and a healthier work force, because a good share of those without insurance are working adults. (Think the restaurant cooks, waitresses, home care workers, etc.,) Right now you are paying a significant cost in increased premiums to cover the uninsured already. That cost would be shifted, spread out over a larger population.
People who are uninsured but are able to pay often pay higher fees to see the doctor or get care than what insurance companies pay the providers. Then they are even less likely to afford buying insurance because they don't have enough money to add one more bill to their budget.
If it takes higher taxes in order to get everyone covered without pre-existing conditions, then it will be. However, look at the NPR site that shows a comparison between countries and what they spend. We should be able to provide everything and pay no more per capita. As I said, right now we pay next to nothing for our health care - great for us, but unfair to others who must pay much more.
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Men are wise, if they disagree they diplomatically state their differences rather than take personal attacks at each other.
BELLEMARIE, I agree with most of what you say, but my eyebrows flew
up when I read the above. Diplomats do behave like that. The rest of the
tribe are perfectly capable of name-calling, usually accompanied by foul
language, and sometimes followed by a punch in the nose. And just think
about the political ads that turn up every election year!
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I think that Bellamaria is objecting to personal attacks on the Palin family. That is wrong; families should be off the radar for political disputes. But if that is what they want, they have to stay out of the public eye and not give interviews, press conferences, etc they expose themselves to unfair criticism.
Public statements are fair game, however. If someonw wants to speak out,that is their right, but not to yell "fire" in a crowded theater. Any statement by a political figure can be attacked or defended.
So: the views of participants in this discussion are eminently reasonable, if not identical to current proposals. I hop you are all not preaching to the choir, but letting your elected officials know how you feel.
Removal of the public option for insurance is handing the insurance companies an unprecedented windfall. Government money , lots of it, in the form of subsidies to people to buy insurance. Taxpayer money handed out with no taxpayer control.
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Perhaps one of you can answer my question, or direct me to where I can find the answer.
Watching CNN this am, there was again reference to Medicare and Medicaid. My question(s) --
Will everyone be required to have/purchase health insurance, whether public or private?
And, if that is so, would there be a need for Medicaid?
How is that handled in Massachusetts, where everyone is required to have insurance?
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I am not sure, but I will find out. I know that if someone cannot afford private, employer sponsored health, the are assigned to something called the Commonwealthe Connection for find insuranse they can afford. I believe MassHealth, the Massachuseets name for their Medicaid program is part of the Connection/ Simple it is not,and there are real questions about cost. Recently, the coverage for legal immigrants was eliminated, and many liberals were upset. But the state's financial posigion dictates cuts in EVERY program, including health, and legal immigrants are an easy target since they can't vote.
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Okay, every individual is required to purchas health insurance. If they did not do so in 2007, they lost the personal exemption of $219 on their state income tax return. In subsequent years, that rises at a rate of 50 percent of the average cost of a health plan that is offered in their region. This happens every year they don't join, up to a maximum of $912. I dont know what happens after that. Exemptions: Approximately 2 percent of the population has been deemed unable to purchas any health insurance at all, and they are automatically exempt. Other exemptions, like for people whose religion does not allow medical care, are considered on an individual basis and usually granted.
Also, every business with 11 or more employees has to offer a health insurance plan, and it has to be one that allows purchase with before tax dollars. If the employer does not, he pays a fee into the Free CAre Pool of
$295 per employee. So far the state has gone after bout 800 employers for not offering any plan, and collected something like 7 million dollars. They will continue to pursue this, to raise the revenue necessary to subsidize insurance for people.
Interstingly, the big increase in individual enrollment has come from people who decided to take up the insurance their employers were offering, instead of declining it!
Medicaid still exists, as "MassHealth" It get s federal money and adds to it. A goal of the program originally was to insure all the children in loww income families, and it got a waiver from the feds to do that. But the overall Medicaid enrollment spiraled up as the economy tanked.
So as far as universal coverage, the state is doing a good job. I have read estimates as high as 97 percent coverage'
Covering the cost has been tough, and continues so. Some measures have been : higher premiums and copays for the HMO plans; an increase in the tobacco tax; a tax, for the first time ever, on sales of alcoholic beverages in package stores (fondly known in Mass. as "packies") and an increase in the state sales tax on practically everything except food and clothing.
So we struggle on, but everything depends now on an upturn in the econmy We went into this when things were pretty good, and cost estimates seemed realistic. But state tax revenue is way down, and need for help is way up as people lose their jobs and homes. Hopefully, we will muddle through. Is Mass. a model for the nation? Who knows.
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Nahum,
The Cash for Clunkers is very successful - too bad there are not more programs like it that give people hope.
It has not been a success. The car dealers are upset and their businesses could fail due to this program. They were promised the reimbursement in 10 days and its already been 2 months, their business can not withstand the deficits it is imposing on them. The government projected that the one BILLION allowed for the cash for clunkers would hold out until Oct-Nov and it ran out in one month, and they had to go back and ask for 2 Billion more. If they underestimated for a simple program as reimbursing car dealers who participated in this program, and they underestimated the stimulus package, then by all intents and purposes they have not got a clue what its going to cost them to reform health care.
I want reform, I am willing to pay a little more in taxes, but I also want to choose my own doctor, keep my present insurance, make my own choices and have the surgeries needed without a panel deciding if it is cost efficient for me to have it. This administration is in a quandary at this point because the President has decided to no longer be with his liberals when it comes to the "public option" yet why they label it "public" when in all essence it is "government option" I don't understand. They are now inter fighting because they feel he has thrown them under the bus.
How can we as Americans, make a clear decision on whether this health reform bill would be good for us individually, when they can't decide what will or will not be available to us or in the bill?
One thing that EVERYONE seems to agree on is that in order to help pay for this bill they HAVE to cut Medicare and Medicaid, which means those who have it must be prepared to lose some benefits. Which benefits they will cut, seems to be reimbursing doctors for certain procedures, which will then lead to doctors refusing to do the procedures if they aren't going to get paid.
Just like cash for clunkers.....if they are not getting reimbursed for participating in the program...they will NO longer be willing to do it. The average American can not afford to take advantage of the incentive to buy a new car because even if they have a "clunker" it is either already paid off and they can't afford to take on a new car payment, or....they are still paying on their "clunker" and can't afford a higher car payment.
Can people who have Medicare afford to pay more to make up for what this reform bill will take away from them? For those who do not have medicare and are happy with the insurance they have NOW, well don't feel too secure, because if this passes, your insurance company may be forced out of the competition and fold or forcing them to increase your rates, sending you into the government plan, whatever that may end up being.
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bellemere, Wow if your small few paragraphs confused me trying to explain Masshealth care, imagine what 1,000 pages of unfinished work is doing to those who are willing and able to read it? Thank you for taking the time to post it.
For those of you who choose to hate and bash Sara Palin for whatever reason, I will refrain from reading your personal attacks on her and pray you will find it in your heart to hate the politics not the person. She is a human being just like all of us, she is a mother, a wife, a friend, a daughter, a Christian, and yes a politician. She does not deserve the personal attacks on her or her family. NO other politician has ever had to go through what this woman has in the past year. All she did was accept the nominee for Vice President. She is allowed to have her veiws and ideas just like we are and just like any other political figure, she has the right to express them and stand up for them.
There are many things I don't agree with President Obama, and many I did not agree with Bush but, I could not bring myself to hate or personally attack either of them. Many have, and I pray for them too. This is exactly why I will never align myself to one party ever again.
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I think I read that the Ford and GM dealers are very happy with the sales that are resulting from Csh for Clunkers.
Is that just around here? Or nationwide.? Any good news is welcome at this point.
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Bellemere, many thanks for your very concise and easily read explanation of the Mass. Health plan. You certainly answered my question as well as increasing my understanding.
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Pedlin, that was all 2008 data, 09 is not yet compiled.
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I found these interesting articles that gives us an insight to the success of "Cash for Clunkers"
I think the verdict is out.
WASHINGTON (AP) -- The Cash for Clunkers program, as expected, has been a boon for carmakers -- especially those in Japan and South Korea.
Government data shows that while 54 percent of the top-10-selling vehicles were manufactured domestically, eight out of 10 carry Japanese or South Korean nameplates. The Toyota Corolla is the most popular car bought under the program. Only the Ford Focus and the Ford Escape cracked the top 10.
American automakers are dominating one area -- trade-ins. All the top trade-ins were made by U.S. companies, with the Ford Explorer four-wheel-drive leading the pack.
The government data show that fuel economy of vehicles bought under Cash for Clunkers is now 25 miles per gallon, while the mileage of trade-ins stands at 15.8 miles per gallon.
Meanwhile, dealers across the country are reporting that reimbursement issues continue to stall the wildly popular incentives program. They have submitted requests for rebates on 338,659 vehicles sold, at a cost of about $1.4 billion to the government, according to sales data summarized by Transportation Department officials.
David Wilson, a Toyota dealer in Orange County, Calif., told Automotive News that he has been paid for only three of 92 claims he submitted before Aug. 2, leaving him on the hook for about $374,000. In total, he has 450 unpaid claims filed for $1.9 million.
"I'm worried the government will run out of money before we get paid," he told the publication.
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The reason why they are running out of money is not because of the success of the program its because of the cost in the start up that is why they ran out of money in the first week.
Washington is busy patting itself on the back for the cash for clunkers program. Congress, meanwhile, is preparing to pour another $2 billion into the program. Spurred by government stimulus rebates of up to $4,500 per clunker, folks are rushing to car dealers to get a piece of the action. Yet, what no one in Washington is talking about is the actual cost to taxpayers of each clunker. Certainly, it's more than $4,500 per car.
Reading the C.A.R.S. "clunker" legislation, the program details reveal that a significant amount of the $1 billion program's funding is used by Department of Transportation (DOT) to administer the program.
First, DOT created and staffed an entirely new organization with three divisions to administer the clunkers program.
Second, the funding was allocated to cover extensive Help Desk telephonic support, promotional materials, mailers, travel, Web site development and maintenance. Plus, extensive administrative and managerial staffing was also funded. There is staffing to manage the contracts, to review the auto dealer submissions, to develop Executive Branch and Congressional reporting, and to provide investigatory oversight for the program.
Federal government staffing for 3 divisions doesn't come cheaply. Add to it other administrative and overhead costs for office space, telecommunications, power, equipment and furniture, as well as costs for meetings, photocopying, paper, pens, help desk support. When the government's costs of running the program are totaled up, each clunker is likely to cost taxpayers around $6,000 per car.
And there's more: A quick look just at staffing reveals staggering costs. The National Highway Traffic Safety Administration (NHTSA) was given approval to staff up for the completion of a series of four Forms connected with the program (Forms 1070, 1071, 1073 and 1075). Estimated staffing for these 4 reports was 160,353 man hours, or approximately 78 employees.
These 78 employees might be contracted out with a private sector vendor (which thepPresident has made clear is not a choice he prefers). Or, they may be pulled from existing projects, which increases the execution risks for those assignments (perhaps critical infrastructure?). Or, the government might hire new employees. At a fully loaded cost, including all compensation and benefits, that works out to approximately $150,000 per employee.
Even the most modest estimate means that DOT will have used approximately $12 million of the funds from the clunker program just to handle 4 of the forms for car dealers. Of course, there are many more forms connected with the clunker program. Get the picture?
Then there is the government's Help Desk Support, which is usually provided by the private sector and often funded on a per call basis. But, often minimum values are built into each contract, protecting the help desk provider, who must man the phones, regardless of calls received. If DOT uses an existing government vendor, contracts would still have to be modified to add funding and requirements for this new task, which requires the efforts of contracting officers, program managers and administrative support.
The administrative costs are huge on the record keeping side also. The law states that the records have to be kept for a period of five years, which would involve storage of hard copies and electronic media. One of the off-site record storage entities would need their government contract modified to add funding for this new task.
Clunker funding was used to develop the official Web site (www.cars.gov), but also, undoubtedly, the contract has an ongoing requirement to support the Web site and its transactions. The cost for the Recovery.gov Web site contract was approximately $18 million to upgrade and modify an existing Web site -- so, one can only imagine what the price tag is on a rush-job, creating a robust Web site, capable of handling millions of hits, as well as forms processing and data storage.
Add up all the various government costs of administrating the program and it will likely come to several hundred million dollars, which makes the true taxpayer cost of each clunker approximately $6,000.
In addition to the high costs comes tremendous execution risk in the Clunker program and the likelihood of fraud. Perhaps, one of the most disturbing parts of the Clunker program is that the recipient of the $4,500 doesn't need to provide a Social Security number. So, it is possible for illegal immigrants, as well as resourceful folks from Canada and Mexico, to cross our borders, trade in their clunkers, and get American taxpayer dollars. But don't expect anyone in Congress to admit that taxpayers are paying around $6,000 to provide a $4,500 rebate for a foreigner or illegal immigrant to buy a new car.
Before Congress allocates further funding to the "clunker" program, they should demand an audit of the full cost of the program. This time, Congress should insist upon learning the full administrative and overhead costs of DOT to run the program, with special consideration to the long term costs associated with federal employees to run a program of short duration. More interesting, still, would be an audit to determine how many non-American citizens are participating in the program. Once Americans get some transparency on those numbers, we will have a much better understanding of the clunker program and will be better able to determine its success.
When Americans find out just how much this program is costing, and where the benefits are going, watch the enthusiasm evaporate.
Lurita Doan is the former Administrator of the U.S. General Services Administration and commentator for Federal News Radio 1500AM.
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And just one more problem they are now dealing with is:
Cash for Clunkers Causing Car Shortages
Wednesday, August 05, 2009
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With the U.S. Senate considering a vote on putting more money into the government's "Cash for Clunkers" program, some auto dealers are raising concerns about a new threat to the incentive program: tight inventories.
The clunker program, which offers subsidies of as much as $4,500 to consumers who trade in older vehicles and buy new, more fuel-efficient models, sparked a surge in sales in late July, leaving many dealers with lean stocks of cars and trucks on their lots.
If Congress moves ahead and allocates more money for the trade-in plan, light inventories could hinder sales and damp the program's impact until auto makers are able to rush vehicles to dealerships.
Galpin Ford in North Hills, Calif., the country's largest Ford dealership by sales, is running low on Escape crossovers and Focus compacts, general manager Terry Miller said Tuesday. The Focus is the top-selling model under the clunker program, and the Escape is among the top 10 best-sellers, according to the Transportation Department.
It's a similar story in the Philadelphia metropolitan area, where a Dodge dealership and a Chrysler-Jeep store owned by David Kelleher are out of Jeep Wranglers and Jeep Patriots, and are nearly out of Dodge Avenger sedans.
"We've got an inventory issue," Mr. Kelleher said.
Chrysler's stocks are tighter than those of most other auto makers because the company shut down all its plants while it reorganized in bankruptcy court in May and part of June, and shipments to its franchises ground to a halt.
Still, Toyota Motor Corp. only had enough Prius hybrids in stock at the end of July to last 13 days at the current rate of sales, according to Autodata Corp. It had a 34-day supply of Corolla compacts and a 37-day supply of Camrys.
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Imagine how they will miscalculate health care costs and problems. It's our lives, not our cars that are at stake then. If our doctor does not get reimbursed, we won't get his services.
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The point of Cash for Clunkers was to get the money out there right away, which it is doing. The problems will be cleared up. It's a very new, quick program, so not surprising that there are things that need tightning up.
So the car dealers are running out of cars, and GM is hiring back some employees. That's good. There is a lot of enthusiasm in my area - not just in the automobile world, but elsewhere because the money spreads out to other businesses.
I'm not sure where this instant gratification demand comes from - We can't make up for years of financial problems in just a few months.
As for the health plan, although there are bills out there, none are finalized, and I believe that this summer break is being used for fact finding and analyzing the plans, as well as listening to the public's concern. Nothing is perfect from the beginning, nor do things stay the same. Medicare has been a good program, run by the government, but it is constantly being tweaked and adjusted, mostly to the good but sometimes not. Medicare has some room for tightening, one of the goals being to pay for quality rather than quantity. There is fraud, abuse and, in some cases, just plain ignorance that waste money. Unfortunately, there are always those who take advantage, even in private insurance companies - although being private they aren't going to air these negative situations like a public plan must.
The cry I hear is "don't touch mine." So where does that leave those who are uninsured or underinsured?
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Mass. healthcare reform is failing us The Boston Globe
By Susanne L. King
March 2, 2009
MASSACHUSETTS HAS been lauded for its healthcare reform, but the program is a failure. Created solely to achieve universal insurance coverage, the plan does not even begin to address the other essential components of a successful healthcare system.
What would such a system provide? The prestigious Institute of Medicine, part of the National Academy of Sciences, has defined five criteria for healthcare reform. Coverage should be: universal, not tied to a job, affordable for individuals and families, affordable for society, and it should provide access to high-quality care for everyone.
The state's plan flunks on all counts.
First, it has not achieved universal healthcare, although the reform has been a boon to the private insurance industry. The state has more than 200,000 without coverage, and the count can only go up with rising unemployment.
Second, the reform does not address the problem of insurance being connected to jobs. For individuals, this means their insurance is not continuous if they change or lose jobs. For employers, especially small businesses, health insurance is an expense they can ill afford.
Third, the program is not affordable for many individuals and families. For middle-income people not qualifying for state-subsidized health insurance, costs are too high for even skimpy coverage. For an individual earning $31,213, the cheapest plan can cost $9,872 in premiums and out-of-pocket payments. Low-income residents, previously eligible for free care, have insurance policies requiring unaffordable copayments for office visits and medications.
Fourth, the costs of the reform for the state have been formidable. Spending for the Commonwealth Care subsidized program has doubled, from $630 million in 2007 to an estimated $1.3 billion for 2009, which is not sustainable.
Fifth, reform does not assure access to care. High-deductible plans that have additional out-of-pocket expenses can result in many people not using their insurance when they are sick. In my practice of child and adolescent psychiatry, a parent told me last week that she had a decrease in her job hours, could not afford the $30 copayment for treatment sessions for her adolescent, and decided to meet much less frequently.
In another case, a divorced mother stopped treatment for her son because the father had changed insurance, leaving them with an unaffordable deductible. And at Cambridge Health Alliance, doctors and nurses have cared for patients who, unable to afford the new copayments, were forced to interrupt care for HIV and even cancers that could be treated with chemotherapy.
Access to care is also affected by the uneven distribution of healthcare dollars between primary and specialty care, and between community hospitals and tertiary care hospitals. Partners HealthCare, which includes two major tertiary care hospitals in Boston, was able to negotiate a secret agreement with Blue Cross Blue Shield of Massachusetts to be paid 30 percent more for their services than other providers in the state, contributing to an increase in healthcare costs for Massachusetts, which are already the highest per person in the world. Agreements that tilt spending toward tertiary care threaten the viability of community hospitals and health centers that provide a safety net for the uninsured and underinsured.
There is, though, one US model of healthcare that meets the Institute of Medicine criteria: Medicare. Insuring everyone over 65, Medicare achieves universal coverage and access to care, is not tied to a job, and is affordable for individuals and the country. Medicare simplifies the administration of healthcare dollars, thereby saving money. We need to improve Medicare, and expand this program to include everyone.
A bill before Congress, the United States National Health Insurance Act, would provide more comprehensive coverage for all. The bill includes doctor, hospital, long-term, mental health, dental, and vision care, prescription drugs, and medical supplies, with no premiums, copayments, or deductibles.
People would be free to choose doctors and hospitals, and insurance would not be tied to a job. Costs would be controlled because health planning in a national health program can reestablish needed balance between primary/preventive care and high-tech tertiary care. A modest, progressive tax would replace what people currently pay out of pocket. This program would pay for itself by eliminating the wasteful administrative costs and profits of private insurance companies, and save $8 billion to $10 billion in Massachusetts alone.
We must let Congress know we want improved access to affordable healthcare for all, not more expensive private health insurance we can't afford to use when we are sick. Massachusetts healthcare reform fails on all five Institute of Medicine criteria. Congress should not make it a model for the nation.
Susanne L. King, M.D., practices in Berkshire County.
© Copyright 2009 Globe Newspaper Company.
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nlhome,
The point of Cash for Clunkers was to get the money out there right away, which it is doing. The problems will be cleared up. It's a very new, quick program, so not surprising that there are things that need tightning up.
Hmmmm....So, if its a very new, quick program, and needs tightning up...then it proves my point in saying if they can't get it right with a simple reimbursement for car dealers, then how on earth will they get it right for a program as big as health care for everyone? Are we willing to wait however long it takes them to "tighten" up the health care problems after they have passed it through? Will someone's health give out before they tighten it up or tweek it to get it right?
If they ran out of money in one week for cash for clunkers and haven't reimbursed the dealers for months after the were supposed to, then how long is it going to take to cut through all the government red tape to reimburse doctors and hospitals?
I don't think the American people want instant gratification. They want them to take their time and get it right before they go taking away what they already have. They are not fact finding and analyzing plans on this break, the liberals are happy with what they are proposing and do not want anything different, the President and Kathleen Sibillus has really ticked them off because they are considering no "public option" and now they are fighting amongst themselves and the town halls.
I should think as complex as it is, it should NOT be a quick program. They are flying by the seat of their pants on everything they have done so far. So far its all been about jobs, money and businesses, are we willing to let them roll the dice with our health care to see if it will work, when in Mass., Canada, and other countries are models that shows it won't? This is our health, our lives, some don't have time for the tightning and tweeking. Are any of them willling to have the same program they are offering to us? I can answer that question with a definite NO! If its good for us, why isn't it good for them too?
I agree, Medicare is working, so why mess with it and cut it by 40%?
The cry I hear is "don't touch mine." So where does that leave those who are uninsured or underinsured?
The cry I hear is, "Let's have one program for the American people, and one for us government representatives and the President. The people's does not have to be as good as ours." So where does that leave US, underinsured, rationed and denied medical treatments.
I want and propose equal health care for "ALL", one program for EVERYONE!
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Bellamaarie, you are very negative. You don't seem to have much faith in your government or the people who represent you. My Congressman is still listening and talking, and while I might not agree with his final decisions, I believe he is still working on things.
The article you attached is good. I agree, Medicare for everyone would be a much simpler program. It would be easy to incorporate that into the public plan option.
I don't see anywhere where Medicare will be cut by 40% or that services will be cut drastically - remember, the Medicare population is growing by leaps and bounds right now with the baby boomers moving into it - that's a big block of voters. There will be changes, but I'm optimistic that benefits will continue to be reasonable.
"Will someone's health give out before they tighten it up or tweek it to get it right?"
That's happening right now - so let's continue to wait while more people suffer? No, we need to move and keep moving. More people are becoming uninsured every day.
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nlhome,
Bellamaarie, you are very negative. You don't seem to have much faith in your government or the people who represent you. My Congressman is still listening and talking, and while I might not agree with his final decisions, I believe he is still working on things.
I am not at all negative, I am realistic. I have very little faith in the government, no matter which party they represent. These representatives we elect do not put our best interest first, they put their own interest and special interest groups ahead of us. That is why there is this outcry at the town meetings, the seniors feel like they are being the last on the list of who to care for. They feel they are not being heard. 60,000 members of AARP have cancelled their memberships since July because they see how AARP is becoming just like the government, not putting their interests first.
If this administration had it their way they would have already passed this reform AS IS and we wouldn't even get the choice to voice our opposition. They have put us in surmountable debt, and we had NO say in it. I put faith in MY own instincts and what I see as real. Calling me negative because I am pointing out what is being reported is not the way to have a balanced discussion. The townshall people have been called many names because they are choosing to stand up for their own interests.
This reform they are proposing will NOT insure ALL! And no one seems to be able to answer why EVERY AMERICAN, rich, poor, immigrant, government worker or the President are not entitled to THE SAME HEALTH CARE PROGRAM? Why are their lives any more important than mine, yours or the next person's?
I say what's good for them is good for ALL!!!!!
I heard Obama at a town hall meeting last week say he would definetly have to cut medicare by 40%. Did it make the papers, who knows. I will attempt to find it though if it is in print.
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You know, Bellamarie, I was thinking. Cash for Clunkers, as I said, was a "quick and dirty" plan, passed to jump start and not to last. Whatever health care plan we end up with will not be started up that quickly. The Medicare Modernization act that set up Medicare Part D was passed in 2003, but Medicare Part D was not started until 2005, and actually didn't go into effect until January, 2006. Other parts of the Medicare Modernization Act went into effect sooner or later. The bill wasn't just passed on one day and put into effect a couple of months later. There was time to work out a lot of the procedure, and it's been an ongoing process to tighten it up. But from the start, people had drug coverage. We can argue that it could have been done more efficiently and cost effective (I would) but the point is that older people finally have some prescription drug coverage. There were some additional changes to Medicare that were passed in, I believe, 2007 or 2008 that are just being implemented in 2010. So we really can't compare the two programs, because the goals are short-term vs. long-term.
I would like to see the actual reference to 40% cuts in Medicare.
I don't see this as a demand for equal and substandard health care coverage, but rather access to affordable and good health care.
I also would like to know how many of the seniors who are against health care reform are aware that their coverage is already provided by the government and how many are listening only to the opposition talking points rather than reading and listening to more objective information.
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Well Cash for Clunkers is very successful here in central Florida and all of the dealers involved seem very happy. All of the dealers with used cars are actually trying to offer a version of it for buying a newer used car.. That is always a sure sign that someone is happy.
I could be wrong, but I thought that the President was referring to fraud in medicare. He hopes to reduce the cost by clamping down on fraud. Wish I thought that was easy, but the fact is no matter how hard you try to make it,, there are people who immediately set out to find a different type of graft. Sad but true.
History shows that many candidates for public office have been vilified in many ways. It is actually rare in any election not to find a percentage of people who just hate.. I will probably start an argument, but just think of Rush Limbaugh.. Terrible man, untruthful and loves to start fights.. But look at the people who just love him.
Look at the woman yesterday on the news who refered to Barney Frank as a nazi.. As he said.. I am a gay jew.. what world are you living in..
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nlhome,
I also would like to know how many of the seniors who are against health care reform are aware that their coverage is already provided by the government and how many are listening only to the opposition talking points rather than reading and listening to more objective information.
I think the seniors are more informed and more intelligent than you give them credit for. You sound very much like the media and politicians who are miminizing the intelligence of the seniors, saying they really have no idea what they already have. Yes, medicare is going to be cut. You have the internet as well as I do, if you are willing to really get all the facts you would be searching for them the same as I do. Having a closed mind and faith in your respresentative is fine if that's the way you want people to have control of your health care, I just don't choose the same path. I want ALL the facts! I want health care reform where EVERY AMERICAN has the exact same coverage. WHY is that not possible? Why are the President, congressmen/women and senator's lives more important than mine or yours? They will not accept their own reform program they want to propose to us, because they know it is not going to cover them they way they want to be covered. Plain and simple THEY see themselves MORE important, and their lives more valuable than ours. They were elected by US, to represent us, and our best interests, Not to make us second class citizens to them. If we dare to ask to have the same as them and object to this program we are denegraded, called names, and insulted. That is NOT democracy.
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I am just no good at posting URLs for newspaper articles, but if anyone is interested, the New York Times, august 9 has an editorial on the Massachusetts reform that is not nearly as pessimistic as Dr. King's. One thing I learned is that withing 5 years, the state intends to move from a fee=for service delivery system to one in which groups of doctors work together to p rovide all the care a patient needs for a flat fee. This is the delivery method that will truly bring about health care reform, and is recommended by Dr. Cortese, of the Mayo clinic.
So if you google something like New York Times Mass. Health Care Reform August 9, 2009 you should be able to bring it up.
I still have faith in government to achieve some benefits for people. Democracy is a very messy form of government. someone said it is the worst possible form of government except for anything else.
Medicare was bitterly opposed by physicians and eventually it make them all millionaires
this week the same paper's magazine featured an account by an American woman who had to bring her husband to an emergency room in France. the receptionist was typically French snotty; the care was phenomenal. X rays, doctor, EKG, discovery of severe peumonia, antibiotics, everything possible. When she offered her Master Card as payment, the receptionist said We will send you a bill. The doctor apologized for having to bill her since she was not a citizen of the EU She got the bill six months later; it was for $220.
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Just a reminder, folks, we don't want SeniorLearn to run into any copyright trouble. If y ou could provide a link to your articles that would help. I think copyright law allows a (fair use) paragraph to be copied. Also, that will help the folks who use dial-up as opposed to broadband, whose pages don't load as quickly.
Just saw your post, bellemere. Is this the editorial?
Massachusetts Health Care (http://www.nytimes.com/2009/08/09/opinion/09sun1.html?_r=1&scp=2&sq=massachusetts%20health%20care&st=cse)
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Steph,
Look at the woman yesterday on the news who refered to Barney Frank as a nazi.. As he said.. I am a gay jew.. what world are you living in..
I watched that woman at Barney Frank's town hall meeting and she did NOT call Barney a nazi. She referred to Obama's health program as Nazism, and asked Barney why would he be in favor of a nazi program? He very rudely shouted at her and instead of answering her intelligently he said he would defer to his heritage and asked her "what planet are you living on?" He then interrupted her and said he refused to talk to her because talking to her was like talking to a kitchen table." His respond was typical of how they deal with opposition. Steph you speak of hate, yet YOU expressed nothing but hate for Sara Palin. I don't hate people, I hate the policies they are trying to impose on us when the majority of Americans oppose it. Do we want our representatives resorting to the same poor behavior as the people who are actly poorly?
So you know for a fact that EVERY car dealer is satisfied in central Florida. That is interesting when just this morning on the news they reported yet again how the car dealers are upset because they are not being reimbursed. My articles are stating facts, you are stating your opinion. While I respect your opinion, you are not correct in stating EVERY car dealer in cental Florida is happy. And is it a success if by any slim chance you are correct, then is it okay to say its a success if in YOUR area everyone is happy? What about the rest of the country? You may want to read that article where it shows Japan and North Korea are benefiting more than the United States. Again, facts you can not dispute.
Hating Sara Palin and bringing in Rush Limbaugh pretty much shows me where you stand politically and so it is fruitless to try to have an informative and intelligent conversation with you. I am so glad I have opened my eyes throughout this entire decade and have chose no longer to be affiliated to any one party. It feels good and free to be INDEPENDENT, it allows me to see both sides good and bad and be open to accept or oppose what I see is NOT respresentative for Americans.
The President is in a real bind here, because he campaigned as a moderate democrat and got the support of moderate democrats, some conservatives and independents and now that he is governing from the liberal left and even throwing them under the bus with the "public option" there is party in fighting. And we are suppose to have faith in them?? Its like kids fighting for control of their parents or granparents health care when neither are looking out for their best interest.
I don't feel I need to argue or persuade anyone in this discussion. I'm only trying to show what the facts are as they are being reported. Opinions are fine, but if you don't have facts then you are not able to make informed decisions. I can see some don't want the facts so I won't waste my time providing them. I have stated I am for a health care reform for ALL Americans. Anything less is not democratic or fair.
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pedln, Thank you for the reminder, I usually do post the link. I have a new computer and am having a bit of a challenge in getting around the new system of windows. My apologies and will be more than happy to post links along with the articles. No one would want to put Senior Learn into copyright problems. It is a wonderful site and what would we do without it?
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Like for most Jews I know, any charge of Nazi sympathies is a bomb fuse. And with good reason.the lady should have used another analogy. but if she was at Barney's district meeting, chances are she was Jewish herself. Barney is touchy, abrasive, loud, sometimes tactless, but brilliant, dedicated, and brave.
I would say that remark comes under the heading of a personal attack.
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Here are the links where I found my articles posted above. The google link I am providing will give you many similar other links on these topics.
http://www.google.com/search?hl=en&source=hp&q=Cash+for+Clunkers+Causing+Car+Shortages&btnG=Google+Search&rlz=1R2ADFA_enUS339&aq=f&oq=&aqi=
http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/03/02/mass_healthcare_reform_is_failing_us/
http://www.foxnews.com/politics/2009/08/14/asian-carmakers-doing-especially-cash-clunkers/?loomia_ow=t0:s0:a16:g12:r2:c0.508218:b27138392:z0
http://www.foxnews.com/story/0,2933,537071,00.html
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bellemere, I completely agree with you on the point you make about the word Nazi being used is a fuse bomb. I have no idea if the woman was Jewish, I was only correcting the fact she did not call Barney Frank a Nazi. I don't approve of any ethnic names being used. I felt she was pointing out this program in her opinion is in comparison to Nazism. He heard the word Nazism and went off on a complete meltdown. He has always shouted and acted aggressive in any interview I have seen him in if there is any opposition to his ideas. EEEEKKK brillant, dedicated and brave are not the words that I would use to describe him. lolol But then we do tend to disagree on many things so I can respect your feelings for him.
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The friend who saw the video of the Barney meeting said the inquiring lady presented a poster of President obama with a Hitler mustache drawn on. And that the audience roundly cheered Barney
s answr.
I am strongly in favor of health reform now. I know that nothing much will change for me, and that my life is drawing to a conclusion. But I want it for my children and grandchildren.
Incidentlaly, massachusetts does not have a government option as part of its reform.
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Sometimes we need to look in our own backyards. Today I learned something that really shocked me. I live in a small city in Southeast Missouri on the Mississippi River. It is a regional center for shopping, higher education, and medical treatment; we have two hospitals and a rehab hospital. We have a lovely new bridge connecting our state with Illinois -- the Bill Emerson Memorial Bridge, named after the late congressman. (The next closest bridge is over 30 miles away.)
There are counties south of us that are very poor, with a low per capita income. Likewise in Southern Illinois. (Many say Illinois is actually two differnet states -- northern and southern.) There are three counties in southern Illinois that have NO MEDICAL FACILITIES, HOSPITALS, CLINICS, OR WHAT HAVE YOU. And guess where those people go for medical treatment. You got it. To the emergency rooms at the hospitals in the state across the river. Perhaps I shouldn't have been shocked, but I was -- that a county in any state could not provide some kind of medical clinic.
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A sad state of affairs. Community Health Centers were conceived to serve just that kind of area. I cannot believe they have none. One of our most rural western Mass areas almost lost its small community hospital a few years age. One of my fellow health planners asked the Boston bigwigs to accompany him on a night ride over the icy roads to the next nearest hospital 24 miles away, and imagine a child having an asthma attack in the car! The hospital stayed.
Please consider: Without a public plan as a choice, if people are required to buy insurance, tons of government subsidy money will be funnelled to the pockets of the insurance company , their stockholders, and their high salaried excecutives. no incentive whatsoever to hold down costs. Who wants to sabotage a gravy train like that? they say they will be driven out of business. Well, if they cant reduce costs, good bye ande good luck. Maybe even
AIG will want to start selling health insurance.
And I doubt if Barney's questioner really knows much about
Naziism. Be a good idea for her to read The Rise and Fall of the Third Reich, with stories about the brownshirts disrupting public meetings with shouts and brawls.
And whateveer happened to Communism as the Big Threat?
A lot of the major health insureres used to sell different kinds of insurance, fire, business, loss prevention, etc. but some, like Aetna and Cigna saw where the money was : health care and now that is all they sell.
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Well, Bellamarie, you sound just as closed minded as you seem to think I am. Actually, I have talked to people who don't understand that their Medicare is government run. I have heard people say that on TV interviews. I have read letters in my newspaper written by people who I know receive Medicare or Veterans benefits. So I know people are confused - I just don't know how many.
"They will not accept their own reform program they want to propose to us, because they know it is not going to cover them they way they want to be covered." and
"If we dare to ask to have the same as them and object to this program we are denegraded, called names, and insulted. That is NOT democracy"
Where exactly does Congress say they will not accept the "reform program"? That's a fact? Since nothing is anywhere near final, I don't think that's a fact. It's another of those "talking points" as far as I can determine. Congress gets the same health care as other federal employees right now. You can look that up on the federal health benefit site. Which people in Congress are calling others names and insulting people because they want the same benefits as their representatives have? I have not heard any of that.
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bellemere,
The friend who saw the video of the Barney meeting said the inquiring lady presented a poster of President obama with a Hitler mustache drawn on. And that the audience roundly cheered Barneys answr.
I am for certain it is on YouTube rather than take anyone else's word for it. I was addressing the post of what Steph said, about what the lady and Barney's words being said. I ask...Does it make it right the way Barney or the lady acted because they both got applause? If that is the case, then bad behavior, aggressiveness, name calling, and rudeness has become acceptable not only by these town hall people, but the representatives too. That's a new low for our expectations of someone we elect to listen to us and respresent us. When I watched I was saddened by both the woman and Barney Frank, I certainly did not feel applause was in order for either person's behavior.
You know this health reform is in trouble when the President has resorted to using scripture to guilt us, and the religious leaders into supporting him. What happened to seperation of religion and state? It is his moral obligation to protect this country from bankruptcy, OOPs sorry I forgot, after his enormous bail outs, stimulus, omnibus, cap and trade, cash for clunkers, etc. we are already in bankruptcy. But what's another trillion or two or three or ten added to the deficiet, our children and grandchildren can shoulder the burden years after he has left office and we are gone. That's a fine tribute to leave to them.
nlhome, My husband works for the Federal Government the U.S. Post Office, we do NOT have the same health program as the congressmen/women, senators and the President. It is a fact they are not putting themselves under the same health care reform program they want for us. They have been asked time and again why they aren't and they have NO response.
No one knows how many seniors are not informed of their medicare coverage being government run, but I would say by the thousands turning up at these town hall meetings there are more informed than not. I can tell you since July, 60,000 seniors have cancelled their AARP because they are informed. You haven't heard the insults being said?? I have, and it has been reported nightly. I suggest you try tuning in and turning your channel to get more newsworthy. Its all over the internet, newspapers and YouTube for all to see, if you really want to be more informed.
Tonight there was the former Canadian President of the AMA being inteviewed and he said their health program is failing miserably. He said there are ONE MILLION people waiting on a list to get in to see a specialist and another ONE MILLION waiting on a list to have surgeries. He said the cost has skyrocketed to a point this will bankrupt their nation. He suggested the United States not use them as a model for health care reform.
I respect each and everyone of your posts and opinions, but I can clearly see in this discussion it is predominantly liberals. So I will respectfully adjourn and leave you to your personal attacks on Palin and say it was interesting and thank you for your insights. I can only hope the articles and facts I posted, will help you with being more informed and open minded.
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http://usgovinfo.about.com/od/uscongress/a/congresspay.htm
Members of Congress get the same menu of health insurance. They may be able to afford a more expensive choice. Also, depending on where they live, their options may be different. http://www.opm.gov/insure/index.aspx
Since there is no program out there yet, no bill passed, the Senate is still working on one to look at, I think it's a false issue that Congress members have refused to say they will move to that. After all, if the promise that people can stay with their existing coverage, and that existing coverage serves all federal employees, then what's the issue?
One of the Congressmen in our state has refused to participate in the federal plan until people get the same access to coverage as he does.
Our State of Wisconsin employees get to choose from a menu also. This is quality health care, but people must select a plan that fits their budget and that is available where they live and that covers their choice of doctors. So a rural person may have fewer choices and they may not be as inexpensive as those who live in larger cities.
That's one of the reasons why it's unrealistic to believe that everyone will get the same exact coverage. Every area of the country is different. That exactly equal health care would probably have to be the totally socialism that most people seem to object to. One size does not fit all - I'm sure we've all learned that in the department store dressing room!
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Ah, no I did not mean that each and every car dealer was not happy or unhappy with what is happening. They are way too busy at this point. I think that Cash for Clunkers has worked reasonable well and I think that other parts of the stimulus are working as well.
Medical Care. I think it is nice, but unrealistic to think that we are going to all get the same care. I wish that would happen, but it is not. I do believe that we desperately need some sort of universal system. Probably at the beginning, it should be a mild form, progressing over the years just as social security and medicare have.
My medicare and medigap work perfectly for us thus far.. the prescription program works well for me, but not my husband. I can take generics, but he needs a specific high cost drug..
I dont hate anyone other than a man who came into my mothers life and stole from her when she was dying ( but hopefully he is also dead by now). Sarah Palin is more of an annoyance than anything. I worked for Hillary and worked quite hard right up until she threw in the towell. I would work for her again. I will work for Alex Sink in Florida who may run for Governor and is intelligent and caring. I did not work for abortion as much as the right for a woman to choose.. I had several friends when I was a teen, but went to the illegal part of life and I know how hard that was for them.. So I wanted everyone to have the right to choose.
So.. Bella,, hopefully I am not quite an unintelligent as you think me to be.. I am just a human.. quite liberal.
S
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Here an email sent to me this morning.
Last week, millions of Americans watched President Obama talk about health care reform during a town hall meeting in Portsmouth, New Hampshire. We've included just a few of the President's statements.
Obama Myth #1: You can keep your doctor; you can keep your health care plan.
The non-partisan Congressional Budget Office (CBO) has estimated that nearly 6 million Americans currently covered by an employment-based plan would not have coverage under the current reform proposals.
Obama Myth #2: The AARP supports ObamaCare.
In response to the President's claims, the AARP issued a statement which asserted that "indications that we have endorsed any of the major health care reform bills currently under consideration in Congress are inaccurate." However, 60,000 AARP members have discontinued their membership - so one might assume it is a business decision for them.
Obama Myth #3: 46 million Americans are uninsured and uninsurable.
According to the Census Bureau, of the 46 million Americans who are uninsured:
10.1 million are individuals who have income of $66,000 for a family of four, but who elect to remain uninsured.
9.3 million are non-citizens who generally do not pay tax.
6.4 million who are enrolled in Medicaid or S-CHIP but reported to the Census taker that they were not. (This phenomenon is known among statisticians as the Medicaid undercount.)
4.3 million are eligible for Medicaid or S-CHIP but have not enrolled.
5 million are childless adults, mainly healthy, young adults who simply do not wish to pay for insurance.
In short: Most uninsured Americans are uninsured by choice, not by circumstance.Myths such as these confuse and frustrate Americans who simply want the best for their country.
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I think this is a great discussion, it's kind of a Town Hall Meeting right here online, (without the shouting), and a lot of great points have been brought up as well. I'm still obsessing over the war veteran's widow not having care nearby.
I want to be sure we are all on the same page here in discussing the issues but keeping the personalities of those speaking out of it? Remarks referencing "you" or another speaker negatively are not necessary. Let's continue to show the world we can discuss the issues without attacking the people giving their opinions, because some of the stuff being posted here is most valuable and it would be a shame to lose posts because of personal references.
OK?
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Tonight there was the former Canadian President of the AMA being inteviewed and he said their health program is failing miserably. He said there are ONE MILLION people waiting on a list to get in to see a specialist and another ONE MILLION waiting on a list to have surgeries. He said the cost has skyrocketed to a point this will bankrupt their nation. He suggested the United States not use them as a model for health care reform.
At 83 if we didn't have our Canadian Health Care System I would be dead. All my friends and family see a specialist whenever we need one. I don't understand former Canadian President of the AMA The American Medical Association had a Canadian President?
If we have the second place in the world for longevity, that surely is a sign that we are doing something right in the health field.
I know the Canadian Health Care System is scrutinized right now by Americans, just remember that we don't have a Socialized Health Care, people equate Socialized Medicine with a Communist system.
I wonder what Canadians would say if we were told that our Health Care System would go private, I think there would be a revolution. >:(
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AdoAnnie, I suspect some of those "mythbusters" are myths themselves. I'm not sure where it came from, but I don't trust the numbers.
Those of us who experience the uninsured or work with them, know that they don't really have a choice. I truly suspect those numbers are more wishful thinking than reality. The number of uninsured that is quoted, 47 million, is a figure from before the latest job losses and economic downturn, so I understand the number is actually going up.
As for keeping your healthcare, I think that is naive to believe that anyone will continue to be happy with their health care in the future if there is no reform. I don't think it's realistic to promise that people can stay where they are, with or without health care reform. But with reform, people will be able to move into good, affordable coverage. Without reform, more and more people will join the ranks of the uninsured or underinsured.
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I believe that people who say they want tokeep their health care mean they want to keep their doctors. I don't think they feel any bond with their insurance companies. I think the questions on those polls should ask " Would you ever change your insurance company for a better plan if it meant you could keep your doctor?
When Massachusetts started requiring people to buy health care, the largest increase in enrollment was in a group of employed people who elected to take up the coverage offered by their employers that they formerlhy declined, not wanting to pay their share of the premium. They were young, healthy and knew they could rely on the emergency rooms if they broke their legs skiing or racked up their SUV on the highway. .
Also, if Massachusetts had a government option health plan, we would be a lot closer to universal covedrage with controlled costs.
this from NPR interview with Howard Dean: the extolled plans of Germany, Switzerland, etc, are not government plans; they are private. But they are closely regulated, given cost reduction goals, told how much profit they cn earn; told how much they can pay their administrtors; and their marketing plans are monitored for deceptive practices. Mayb that is our answer? Use the regulatory route and the fiscal route of corporate taxes to penalize private plans whose rates exceed the rate of inflation.
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When Massachusetts started requiring people to buy health care, the largest increase in enrollment was in a group of employed people who elected to take up the coverage offered by their employers that they formerlhy declined, not wanting to pay their share of the premium. They were young, healthy and knew they could rely on the emergency rooms if they broke their legs skiing or racked up their SUV on the highway. .
What a good point, bellemere. I know there are people who cannot now afford insurance, but for those who can, it’s really a matter of personal responsibility, isn’t it. I don’t know about the other 49 states, but in Missouri you must either have car insurance or demonstrate financial capability before you can register your car. Seems to me there’s not much difference with health insurance.
Several years ago one of my adult children elected not to buy health insurance, and it upset everyone in the family, me especially. Scared me to death. This was a person who skied, biked, hiked, you name it. “You could bankrupt your sisters and brother and all of us,” I told her. “Oh, no one would make you pay for my care, Mom.” Yeah, right, like we'd let her wither and be warehoused, and not dig into our pockets to pay for the right treatment. Fortunately someone with greater powers than me made her see the light. But that was a long time ago. Now she’s gainfully employed, insured, in the public health arena.
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I have been down in Florida for the last 21 years, so dont really know any more about other states , but in Florida especially in tourist heaven, around the Orlando area, there are thousands of small business people.. Mostly in the tourist business. Probably 90% have no health care for themselves or their employees. I know one woman who works one night a week as a bartender for Darden, just so she can buy into their system of coverage.. She actually pays them to work, but says it is worth it for the peace of mind. Her husband has a small store and she works there the other 6 days..
So I think there are a lot of people here who need some form of health care. I also discovered something I did not know last night. We have a dear friend who has Parkinsons and has been having a lot of problems otherwise. Her doctors wanted a MRI with contrast and Medicare said.. No... just a plain MRI. She had no idea why and neither do I. I guess medicare has some rules that I know nothing about.
I cannot imagine AARP endorsing any medical plan. They have a medigap plan they peddle, that we belong to of course.. But they really try hard not to take sides in issues.
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Steph, your friend should maybe go on line and find the Florida SHIP counselors and see if they can help her with Medicare. There are appeal processes. Usually medically necessary procedures are paid for, unless the procedure doesn't fit the diagnosis or the doctor hasn't provided the necessary documentation, or the doctor just assumes that Medicare won't pay for it.
Unless she is in a managed care plan. Then there may be another issues.
SHIP counselors are found in every state and can be located on the Medicare site.
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Nice to hear from a Canadian here. Good to know their system is working well for her.
My Canadian friends complain about government beaurocracy just like we do. but they don't want our health system.
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I really shouldn't watch those clips on YouTube, too upsetting. When I see those looks of sheer hatred and hear the screaming rage, it just brings back memories of an earlier shameful time in our history, the civil rights struggle, and I hope it is not motivated by that. And the angriest people are the elderly, and (sorry) all white, and maybe not rich, but don't look as if they missed any meals lately. Ane they have Medicare, ther are pretty well off for health care. Why are they spewing so much hatred?
I can't help but think they are motivated by fear, that they may have to pay higher premiums for their Medigap? In order to subsidize "those people" as the code implies.
I loved the op-ed piece by Kathleen what's her name, the conservative columnist with a level head. "Will someone please return Hitler's mustache to the prop room?"
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I was distressed yesterday by an article that talked about a town meeting, where the representative explained at great length that the VA benefits are not even part of the health bill and will not be touched. After the meeting two elderly vets were interviewed and neither one believed him.. Why oh why would they do that.
I find the guns anywhere in public as frightening. I am afraid that one gun in person and I would leave. I think that people who carry guns to public places are not entirely put together and I dont want to die because someone is a hater ...
Thanks for the medicare tip. I passed it on to my friend.
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If the new health bill won't pass without the public offering, why don't they just offer that one part and see what happens? IMHO, we would still have folks without health coverage. If they cannot afford it now, what makes Pelosi think they will be able to afford it later???
How about we start slowly with this and do just what I suggest? Why not take care of just the folks who don't any coverage and then go from there??? We could have something like Medicare but only for those under 65.
We have had no trouble with our Medicare or our Gap insurance which is not cheap but better than nothing and it includes prescriptions with no donut!
We have had a rather unusual year here in downtown Gahanna, OH, where my husband was dying of congestive heart failure, with an ejection fraction of 10 to 14 %. He was asked if he would consider a heart pump implant and he said yes. So, we have a very healthy 75yr old who lived through very serious surgery on March 5th. He has batteries to wear and carry around every place he goes. But that's not a bad way to livel, he says. Better than the alternative, as he says. Oh, did I tell you that he has a wound site which requires cleansing in a very sterile atmosphere every other day. This is not easy but, again, its better than the alternative.
Do you think this would have happened to a 75yr old man anywhere else on this planet?? My husband is one of the oldest men in the this study and has nothing else wrong in his body. No diabetes, no arthritis, no liver or kidney problems, not even an allergy unless you count mild tape problems.
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He sounds like an ideal candidate and seems to have proved the doctors right. I think your general health is truly important in some of these transplant cases.
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He is to be congratulated on the succesful outcome of the surgery. Medicare patient, I take it? A government=run program . He is also llucky in his underlying good health/ he must be what my husband calls "a tough old bird"
My problem with no government option: A plan that requires everyone to get insurance, means they are required to buy insurance form private companies. some people will need a gvt. subsidy to do so.. Thus the Reform becomes a vehicle for transferring taxpayers
money to the private insurance companies, with thier high administrative costs, shareholder dividen requirements, high executive salaries., and enormous advertising and marketing costs.
I was sort of intrigued by the proposal of Senator Olympia Snow (what an unforgettable name, huh?\
She said, as you recommend, Annie, skip the governmentprogrma for now; have a built-in trigger. If the private insurance costs rise more than the rate of general inflation for more than three years in a row, because they dont reduce costs, then Bam! The public program would go into effect. I wonder if they woud take the challenge. her suggestion seems not to be going anywhere.
At least the public debate seems to be getting less rancorous. I saw on PBS a spot showing an Idaho congressman visiting his district and people voicing their opinions about the Health Refome in very civil tones, and treating him respectfully. is it something in the air up there?
Good to see, anyhow?
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The problem with waiting for three years to see if the insurance rates go up, is
that insurance rates are already so high that many people have none at all.
It is these uninsured people that desperately need the help, and simply saying
we'll pass a law that everyone has to have insurance still does not make it possible for this low-income group.
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No, it does not. Low income people will require a subsidy. That will be taxpayers' money. and the insurance companies free to raise their rates whenever. What a windfall for the insurance companies, all that taxpayer money!
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The idea of putting low income people who are not used to fighting for their rights into the grip of insurance companies, who love to get premiums and hate to spend money is scary to me. I just have read too many horror stories from people who have complicated problems and the insurance company says no, right up until the patient dies..
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I think that the US must be the only developed nation in the world without universal health care. Many different forms, but industrialized countries do supply health care for their citizens. It's just embarassing to be the outlier if you ask me. I'm a physician who has worked in the UK and Canada and the US. Sure there are limits and drawbacks to the UK and Canadian systems but less than the limits and drawbacks here. The trouble is that those with insurance don't want to lose any benefits, and certainly some care would have to be rationed if universal health care happened. Also the fear of "socialism"is so profound. I guess this ongoing present debate has just shocked me to realise how entrenched the present system is, and sadly I have come to realise that no meaningful change is going to happen.
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Dana, I feel sad, too.
But I'm also angry, as I have family who will be suffering if nothing is done.
So I keep writing and calling and talking, and I have added my name to an add in support of health care reform with a public option, and I will keep doing so. I believe Congress must get its focus back on the people.
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The government will be setting the rate of the subsidies, tho, BELLE, not
the insurance companies. Just as in Medicare payments to physicians, the
govt. does not pay the full private practice rates. And already there are
so many insurance companies competing for clients, one can reasonably hope
that the competition will force a lowering of rates.
And of course I see a lot of ads from attorneys, claiming they can make
the insurance companies 'pay up'. It's probably a toss-up as to which would
cost more, the attorneys or the insurance loss.
Sure there are limits and drawbacks to the UK and Canadian systems but less than the limits and drawbacks here.
I find Dr. Dana's observation to be both encouraging and comforting, esp.
since I, too, like NL, have family who are in great need of affordable insurance.
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I am discouraged, but not despairing At least here in Mass. we have made a start. I remember reading that Canada actually began universal coverage province by province, and maybe that has to happen here. I am reallylooking forward to the next stage here, to see if the state can actually bring down costs by changing the fee-for-service system.
I would like to know the site where i can sign on to a petition such as you describe. There was an impromptu rally here both honoring the memory of Ted Kennedy and urging support of health care reform.
I can't help thinking that there is something more going on here than just worry about health insurance. It seems lke a passion for the status quo, for no change. Some people are not able to deal with the tremendous changes in demographics, and in technology . Our senior generation has seen more of that than any other in history, and can be scary. People feel as if they are losing control. They want Beaver back in the kitchen eating cookies whilie his at home mom vacuums in her pearls and high heels, as one columnist put it.
If nothing is done, more and more families will go bankrupt from medical bills they cannot pay. More employers will drop insurance as too costly. That is a certainty.
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Babi, the subsidy by the government would in my opinion be much worse than having the government pay the claims as it does in Medicare. The government now subsidizes the Medicare Advantage plans, which are private companies that offer Medicare benefits, so that these plans cost Medicare 13% more than it would cost Medicare to cover those persons in the traditional plan. Some of the Medicare savings in the health plan would come from eliminating these subsidies - then would those companies be able to compete?
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I have no idea, NL. The intricacies of government and big business are far
beyond me, and even those most knowledgeable recognize that this is not
going to be 100% satisfactory no matter what is done. Perhaps what Bellemere suggest is the most viable solution. Individual states working out a
plan that works best for them, eventually leading to a consensus for a national
plan. Something is desperately needed.
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Some states would do a good job. Unfortunately I live in a state that would not do anything. Floridas big motto is no new taxes. Which is flatout stupid, but there it is. They will do anything to stay on the voters good side and we have so many older people who cling to no taxes. They dont seem to notice our schools are horrible.. more and more people are without work or hope.. Disabled are forced out of group homes.. And we pay higher and higher fees..( But that it seems does not count as taxes).. Maybe outside pressure would help. But our current governor is into being tanned,,,and liked, but not actually doing anything.. Not an intellectual to put it mildly.
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Oh, Steph, so funny I think your gov. is into being tanned, likeable and President. But we have a brown one now, do we need a tan one later?
Everyone hates taxes. But you are right, those fees are the same thing.
A speaker on 60 minutes studied the health care systems around the develpd world and had some great observations. None of them with the exception of theUK are government run, government just pays the bills. All care is privately provided. the shocker was that out of 23 countries surveyed, USA was 23rd in life expectancy at age 60.n Also, he validated the decision of Massachusetts; it is a moral obligation to provide access to health care for all. Then it is a practical obligation to find a way to pay for it. But the vision of health care as a human right has to come first, and has to be the goal.
In a way you can understnd the antipathy to taxes on the part of Florida senious. Many of them are living longer than their money, or afraid they are going to. It is a very frightening prospect. We all face it, but in florida, with so many seniors, it tends to dominate the political process.
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I am a senior , but I marvel at the number of seniors around me that complain so vigorously about taxes and liberals and yet enjoy the fruit of many liberal policies. Some of it seems to be the idea of change.. I like change, but a good many elders regard it with great suspicion.
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Well, you know that saying, "if it ain't broke, don't fix it" and we all at one time or another believe that.
Again, I think we need to resolve our poverty stricken citizen problem first. Those who don't have insurance should be insured wherever it can be done. Isn't that what Medicaid is for? Is the government telling us that these uninsured folks can't get insurance through medicaid? Well, offer them something else that they can afford or just cover them through a program that is for them only.
Another thing that really roasts me is the government ignoring some of the things that could be changed that would bring down the cost of care down now. One is torte reform! The lawyer lobbyists are still going strong. When drs have to pay as much $100,000 to $400,000 a yr just to protect themselves so that they can practice, there is something bad in the henhouse. So far, in the past four years, I have lost 4 doctors who have closed their practices and become hospitalists. The hospitals that they work for pay the insurance fees and they have the availability of hospital lawyers.
Our university hospital where I live has a different way of handling their ER patients. They question them about their reason for coming and then separate the true emergency patients from the less seriously ill patients. They each have their own waiting rooms and a separate staff tending to their problems. This does cut down on the waiting period that all other ER's seem to have.
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Hi Bell,
I thought you lived in Ohio not MA??
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Annie, glad to hear Ralph is doing so well. Your university hospital seems to be going in the right direction. The hospital here has convenient (or prompt) care right next to the ER, and that's where they start out, but a nurse who works there was telling me that if the patients have a headache, they have to be seen to ER; if they have abdominal pain, they have to be sent to ER.
Steph, you are right about tort reform. And it seems to me that that alone would cut down expenses if it relieves drs. from running so many tests.
Do you think the events of this past week -- the Kennedy memorial and funeral and additional coverage about his public service and health care goals with motivate some of the laggards or quite public officials to rethink their positions? They sure inspired me.
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I have to admit that the Kennedy funeral was inspiring, but I hear that is only to a certain percent of the population. A lot simply wanted to remember the young heedless Teddy. He was not my favorite Kennedy but he grew into a great statesman.
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Annie, poverty alone is not enough to make one eligible for Medicaid. The rules
vary by State, but age, dependency, disability, etc., are all elements in determining eigibility for Medicaid.
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I am a late comer to this discussion; don't know how I missed its beginning. So far i haven't read all the past posts but I do have some comments to make. I would have made notes if I had known about this discussion. An August 24 interview on NPR with T R Reid of the Washington Post discussed his experiences with health care in other industrialized nations. which is recounted in detail in his book, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. http://www.npr.org/templates/story/story.php?storyId=112172939 has the discussion which may be heard online. He makes some interesting points; I believe it was in France that he asked his physician where the billing office was. Reply, there is no billing office; the medical records are computerized and the gov't pays immediately on receipt of the entry for the latest visit. French doctors don't have to pay for malpractice insurance and they don't have to pay for medical school either. In one of the countries where he sought medical care for his back he was referred to an acupuncturist; he was surprised that this treatment helped relieve the pain.
For me the question relies on some basic, irrefutable facts. One: America is the only Industrialized Nation (IN) where peolpe do become bankrupts as a result of illness. Second American medical costs are the highest in the world and are going higher; this includes all aspects: physician visits, hospital stays, drugs, medical education, insurance, and the cost of caring for the uninsured in the most expensive setting, the emergency ward.
I am on the list to read his book; maybe it would make a good discussion.
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Thank you, thank you, that is the man I saw on Sixty Minutes while half-dozing in front of the TV.
My French friends get great health care. the wife told me she has to pay something for her prescriptions but she sends in the receipt and gets the money back in a few days.
I wish I knew how they retire at 55 with complete health care. My friends had relatively modest jobs; she was a teacher in a "maternelle" a nursery school; he was an accountant for the National Railway . (Socialized trains! They are magnificent, clean, super fast, always on time)
On the bad side, they have a lot of unemployment. But even the unemployed don't have to worry about health care. They get the same as working people.
Oh well, only the police are allowed to carry guns, they never get to have any ward. and the women are too skinny.
Ado Annie, I live in Massachusetts maybe you have me mixed up with the writer who has a similar name.
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Jackie, thanks for that link. I had seen TR Reid in some TV interview (not 60 min.) but was glad to see the NPR link. And am glad that NPR had the print transcript available, which I've printed out to read a leisure.
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Dont pay for medical school. That would certainly help.. Our nephew is a pulmonary specialists.. When he got out of med school, he already owed over 150,000.00 dollars and then had years of residency and further training. He is just now at 40 getting clear of all the debt. Makes for such a long long time. Since he deals in hospitals only with really ill people, it is interesting to talk to him about end of life issues. He says that families spend of their time fighting about what Mom would want.. He is a great believer in everyone clear on what Mom or Dad wants.
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Hasn't someone already posted in here the quote from Bismarck?:
"Laws are like sausages; it is better not to see them being made."
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Oh Babi, I love it.. I must post that somewhere to remember..
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Talking Heads #6
"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.
(http://seniorlearn.org/bookclubs/graphics/talkingheads.jpg)
A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.
Our Sixth Selection is: (http://seniorlearn.org/latin/graphics/cycling5.gif)
Health Care Reform~! Are We on the Fast Track?
7 Ways Health Reform Is Going to Affect You (http://health.usnews.com/blogs/heart-to-heart/2009/06/10/7-ways-health-reform-is-going-to-affect-you.html)
Newsweek June 10, 2009
Here’s one to read – about how a health care provider that’s trying to do things right became the unwitting source of “death panel myth.” Gunderson Lutheran Hospital in LaCrosse, WS strived for residents to plan ahead and have advance directives. Realizing that doctors often spent more than an hour advising patients about this, and then following up, they contacted members of Congress about a bill that would allow Medicare to pay doctors for these consultations. And then the S H T Fan.
The Unwitting Birthplace of the 'Death Panel' Myth (http://www.washingtonpost.com/wp-dyn/content/article/2009/09/03/AR2009090303833.html)
For some reason, this may be a little slow downloading -- give it a chance
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Wow, that is amazing! The doctors had such good intentions. I guess it is true that "No good deed goes unpunished." Sarah Palin should be ashamed of herself.
I see where the proposal of Olympia Snow is finally getting some attention. She suggest that non=profit agencies could begin sellin health insurance if the private companies do not come up with policies that are affordable by 95 percent of the peopoe in the area they serve. Affordbility being something like 15 percent of the average income in that area. (I think that is right) Takes a woman, right?
A mandate for everyone to have insurance is necessary if we are going to get the young healthy bpeople under the tent; we need them to balance the old and sick.
Think of it! If there is such a mandate, the private insurance companies get to feast on 45 million new subscribers who have to buy their insurance, at a price they set! With the government subsidizing some of it! What a bonanza!
Would you call this "socialized capitalism?"
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Socialized capitalism? I love it. Hurry up, Bellemere, and copyright it. Sounds like it should be the new buzzword.
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I loved the article.. They had such good intentions.. But somehow this country in the last six months or so has become so polarized that it is scary.. Screaming about the President talking to school children. What is wrong with this picture.. Our county is not going to permit watching. I am ashamed I live here and plan on writing to the paper in protest. Wont do any good, but will make me feel better.
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Here’s another article, an editorial by conservative columnist David Brooks. It’s well thought out – I always like the Shield and Brooks portion of Jim Lehrer’s Friday Newshour. But I’m putting this up because of two links that Brooks put in this column. I have not yet had a chance to read them, but one is David Goldhill’s essay, “How American Health Care Killed My Father,” in the current issue of The Atlantic. The other a report called “Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth.” This report was written by a bipartisan group of battle-tested experts and is found on the Brookings Institute website.
David Brooks (http://www.nytimes.com/2009/09/04/opinion/04brooks.html)
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Steph, you are so right about the polarization of this country -- very scary. And I would add mean-spirited, as well. The hoopla over Obama's upcoming talk to school children really angers me. And also scary, the sheep-like-following by so many who are calling on parents to have their children opt out of hearing it.
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Pedln: A very profound thank you for the article by David Brooks. Like you I look forward all week to that portion of the program when Shield and Brooks analyze and comment on the major issues of the week. David Brooks is conservative but he is not an ideologue and he has an easy going manner I much admire. Mark Shield and David Brooks should be required viewing for all the politicos.
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Imagine telling children that they can't trust their own President to talk to them. What does that say to them about the election process, the leadership of our country, and their respect for others?
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I live with Universal Healthcare. Its terrific competition for private insurers. Lots of people use the Universal system with supplementary insurance for immediate elective surgeries. Private insurance here is so reasonable if you wish to take advantage of it.
I have been shocked by the scaremonger emails circulating about the evils of Universal Healthcare.
I have to say because of the propaganda culture and the power of drug and Health industries in the USA IMHO Universal Healthcare will never happen. I truly and sincerely hope I am proved wrong.
Carolyn
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Carolyn, the US has a huge population, 350 million Americans compared with 30 odd million Canadians and 5 million in New Zealand and I think reaching a concensus on health care in the US is practically impossible.
Compared with Americans, Canadians had 19% more physician visits in 1990. Low-income Canadians averaged 26% more visits; more visits were received by low-income Canadians at every level of health status
Sorry but I lost the source but Google has a lot of information on this.
It's hard to compare the US situation with any other country in the world. I pity the poor and the elderly in the US though and I wouldn't want to move South of the Border for that reason, otherwise our two countries are so connected it's hard to tell one from the other sometimes.
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Eloise, those numbers are from 19 years ago. Hardly relevant at today's prices, etc. Also, it would be interesting to know how the percentages were arrived at. 19% calculated how? Based on per capita?
Also, what would help, even from that long ago, would be outcomes of those appointments - more or less hospitalizations? More or less infant mortality? Etc. As you say, hard to compare.
The comparisons that come from WHO are more up to date, I believe. The numbers are per capita, meaning costs totaled up and averaged per person in the country.
There is a site on NRP.org that compares various health care systems around the world. That was most interesting to read.
The elderly in the US have Medicare - that's our "government option" and it works well. It's underfunded and it needs to be updated to address fraud and waste, but that can be done easily, compared to redoing the rest of the health care system.
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Our system is not proactive, but reactive and when you dont have insurance, you show up in the emergency room.. Probably the most expensive way to treat small problems. We need basic care in each community.. We need family doctors, not all of these specialists. If even 1/4 of all of those cosmetic plastic surgeons did something else, we would have enough doctors. But they just love the non insurance type stuff. Our system is beyond broken.
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Steph: How true. Yet it is being defended so vehemently that one wonders where are America's brains? I was considering retiring to Canada because I love the Victoria area and the health care was a big plus. But my retirement fund lost 1/3 of its value in the dot.com bust and I moved to Oregon instead.
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When my son was in high school, all the boys were herded into the auditorium to listen to recruiting speeches by all three branches of the armed forces. They even took quickie 'aptitude" test; a lot were told they seemed to have a talent for electonics. Parents only heard about this session after the fact. This was during the Viet Nam war.
President Obama is a living example of the benefit of staying in school and studying. Yes, he probably got breaks getting into some great schools, by he had to work to stay in. And Presidents Ronald Reagan and George Bush also thought it important to encourage students.
Yes, I am troubled too by the mean spirited atmosphere of the debate ABOUT HEALTH CARE. I call it "Drawbridge mentality" I've got mine; I don't care about anything else.
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David Brooks and Mark Shields are great. The Lehrer News is my news source; I look forward to it every night, even when David and Mark are not on. I also enjoy their sometime subs, Rick Lowry and Ruth Marcus. Yes, sometimes they beat a subject to death, and I yawn, but never do they distort or misinform. They are truly jounalists, not entertainers.
Margaret Warner and Gwen Ifil are fearless in asking tough questions of their interview subjects. Thank heaven for PBs news
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Bellemere, during the past year I had 6 Specialists visits 4 of them because of a bad fall last winter, one visit to my GP two or three visits to a Walk-In clinic for a minor problems. I was seen within the hour and I never had to pay a cent, never filled a form and most physicians took the time that was needed without rushing.
No, our system is not perfect, we are going broke, we loose too many doctors who move South of the Border, but I never heard of Canadians going broke because of health issues. The poor and immigrants are just as well taken care of as the rich.
Seniors especially benefit from our health care system. We pay a franchise every month for our medicine but my pharmacy bill comes to about $600 a year, that's all. In Switzerland where my son lives, they pay $600 a month just for insurance, but the poor don't pay for health care.
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I heard a snippet on NPR today: Every second someone in America goes bankrupt because of medical bills. It can't be true, However this report from the Washington Post is frightening enough: http://voices.washingtonpost.com/health-care-reform/2009/06/new_study_shows_medical_bills.html
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Jackie, Medical Bankrupcy is rising each day.. It is by far the commonest way people go bankrupt.. Our medical systems ( especially hospitals) have a lot to answer for.. If you are homeless and go through emergency rooms, they dont even try to collect, but if you have anything,, even the smallest house or a low paying job, they come after you with all teeth bristling. Sad.. and the word non profit is sort of weird when applied to health care.
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I followed the speech to the joint houses of Congress with great interest. The President came out swinging. His explanations were lucid, and the urgency in his tone was compelling. I was apalled by the Congressman who yelled "You lie!" as the President was speakingl Never heard anything like that in my life. And the remark recognizing that some members see political capital to be gained by defeating this effort instead of improving it was right on target.
There is a small contingent of conservative congresspeople that are beginning to act in an almost deranged manner. Very worrisome, they do hold positions of responsibility and represent a lot of Americans. I understnand the above gentleman was from South Carolina. What must the people think of his behaviour? And shouldn't he get a censure of some kind from his peers in Congress?
And ex-governor Palin continues to peddle her Death Panel threat , this time in the Wall St. Journal.. Why would they give her a platform?
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Did anyone post this about the "death panel" rumors? http://www.nytimes.com/2009/08/14/health/policy/14panel.html
I think it says much about the psychology of people who can't find any reason to try to arbitrate differences. There are many on the right who's attitude seems to be "My way or no way" and i find that similar to Al Quaidda's supposed agenda. Seems as if we are in a fight to the death over the future, whether it should be forward or whether it should return to the past. Why is this kind of thinking so often aligned with religious fundamentalism? Other examples are the Amish and the Hassids. The kind of thinking that sees each contest has only two outcomes, winning or losing.
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Yes, sad that so much of this stuff has a religious tinge, although surely only an extremist wing of religions. But I speak as an agnostic; when was the last time you heard of a band of agnostics hijacking a plane or murdering a doctor on orders from God? We are probably the most peaceful of all minorities!
Let us hope the cooler heads prevail msherlock. There actualy even tougher questions ahead for the country, namely, Afghanistan and the Israel-Palestine struggle.
If we cant accomplish health care for all our people, what are we going to do to solve those questions?
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He did get a censure from many of his peers, Belle. His own party
leaders insisted he apologize, which he did. In the news coverage of that
major blunder, the Senator from South Carolina looks well aware that he
he in deep trouble and may have self-destructed as far as his career goes.
Good question...why would the Wall St. Journal give space to Palin's
opportunistic bandwagon?
JACKIE, how on earth did the Amish get into this? They have never
insisted on pushing their ways onto others; they just insist on their
right to live their own lives as they choose. No 'fight to the death'
there. And please, BELLE, people who commit murder 'on orders from God'
are psychotic. You can't brand a whole belief system on the actions of
a brain sick member. Psychotics have also been found among atheists and
agnostics. I do hope we're not going to drag religion into this.
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Babi: If I've wronged the Amish, I apologize to the entire community. What I was expressing was the universality of the attempt to turn back the clock based on a religious foundation. The Hassids are not threatening death to the unbelievers, either, although the situation in Israel seems complicated by their insistence that they are living as God demands. Psychopaths have "answered the call" and are ready recruits I'm sure but the policy wonks are the ones who are pulling the strings and I refuse to believe that it is piety that spurs them on.
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Sensible comments, Babi! My feelings exactly.
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Yes, religion should not be brought into a discussion unless it is the stated topic. I wanted to say that agnostics cannot use God as their excuse for their deeds. they have to find something else: historical imperative: Josef Stalin; intrusion of government, Timothy Mc Veigh; general misanthropy, the Unibomber. But today is the anniversary of a horrific deed by men who, according to all we can find out about their motivation, truly believed in a god, and that their actions would be pleasing to him, and would earn them eteeternal life. And the hundreds of suicide bombers in Iraq and Afthanistan and London and Bali and Palestine and Israie - they are not described as psychotics. ;Until they commited their suicide bombings, they were teachers, students, doctors, housewives, merchants. How can we ever come to terms with religious extremism of this sort? We simply cannot blame it on mental illness; they were not insane. It is a mystery to us. And one more reason why religious extrmism of any sort is to be feared by us all.
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These comments have helped me refine my thoughts on this subject. Please do not condemn me for fuzzy thinking.
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Haven't been here for a while, just spent some time catching up! Love Sheilds and Brooks, Jim Lehner news hour and NPR also. Now live in S. Carolina and horrified by the support for Congressman Wilson described by our local paper--apparently most of the calls to his office to-day were in favour of his outburst!!
I am beginning to think that our President is too timid to take stands on issues --he wants consensus and for everyone to agree. Won't happen.
I do think also that religious fanatics are responsible for much of the trouble in the world. It also seems to be quite easy to convert someone into a religious fanatic. Until the London underground bombings I had thought that suicide bombers must come from a deprived and hopeless background. Why else would they want to kill themselves? Wrong.....these guys that blew up the subway came from comfortable backgrounds in Britain, one even was teacher of the year or citizen of the year or some such in his Yorkshire community! It boggles the mind--they were so easily brainwashed. But when you think about it, I guess we are all so easily brainwashed it's scarey......look at the Germans in Naziland ....
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Yes, it appears that the health care reforms can win if the final bill is attached to a budget reconciliation bill, which cannot be filibustered and which only requires a somple majority, I think 51 votes.
Move On.org , an organization that understands hardball, is raising enormous sums of money for Congressman Wilson's opponent, over $800,000 in just 48 hours.
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"..the policy wonks are the ones who are pulling the strings and I refuse to believe that it is piety that spurs them on."
Unfortunately, this is all too true, BELLE. Whether it is political leaders
looking for a cover for their agenda, or people looking for a 'cause' to excuse
their crossing of moral and ethical barriers. Anything, religion or patriotism or
any other high-sounding theme, will serve to allow them to turn their backs
on humane compassion.
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A young friend of ours who was career navy got through to the congressmans web site before it crashed. He was furious that a career military would be that rude to the President, who was in fact his commander in chief. Interesting reaction and not one that I would have thought of.
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But today is the anniversary of a horrific deed by men who, according to all we can find out about their motivation, truly believed in a god, and that their actions would be pleasing to him, and would earn them eteeternal life.
Painful but true. Since these perps are acting in "good" faith one must look to the source of their beliefs. It is the cynical leaders who manipulate them for their own ends, power, power, power. If women ran the world, what would it be like?
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Probably just the same, Jackie!
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I don't believe that!
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So what's the consensus here on using parliamentary maneuvers to get the bill passed? is it unfair ? Or just realistic. Should the proponents keep working for consensus ? Or face the fact that the opponents see political capital to be made by defeating the President? What would you do if it were your call?
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It has often been said, in one way or another, that the female of every species
tends to be the more practical and pragmatic gender. Which, IMO, generally means they tend to look instinctively to the protection and survival of the species, and to h___ with any fine ideals that tend to kill us off.
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Hear! Hear!
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bellemere: Seems as if the opponents are so deeply entrenched that there is little room for compromise and the best plan, if adoption of a health care reform bill is the object, is to plow straight ahead.
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Sadly, I think you are right. so on behalf of the millions in need whose voices are not heard in all this screaming lunacy, I think they should use every legal means to get it passed.
Maureen Dowd in today's Times says there was one word missiing from Congressman Wilson's "You lie..........boy"
Incidentally, I belong to a Medicare Advantage plan. I have always been satisfied, but since the President talks about these plans as "waste" I have been lookin at it differently. We get "discount memberships " at some sports clubs; I always prefer to support my community YMCA. We get our Weight Watchers dues refunded if we complete a program, whether we lose weight or not. Nice incentive for some, but a good walk migh be just as effective. We get a pair of glasses for about 60 dollars every year, whether our prescription changes or not. A great boon for some , like a certain husband , who loses glasses, but not strictly necessary. My doctors accept all insurance, so I wont lose them. I can change.
So what about the reconsiliation route? Good or bad?
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I wish he could get bipartisan support, but that is not going to happen. We have become a nation of anger.. I dont understand why at all.
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As I said, the "drawbridge' mentality: I've got mine; if you don't have yours that's not my problem.
And if it passes withoug apublic option, the insurance companies are going to be rolling in money.
And if all the comfortable Medicare enrollees are confident that the statis quo will preserve their Medicare, I wouldn't bet on it.
Would love to see the govt. junk the manned space program, the Afghan was, the tobacco subsidies, the tax breaks for the oil companies, and pay for the health care reforms.
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bellemere
Would love to see the govt. junk the manned space program, the Afghan was, the tobacco subsidies, the tax breaks for the oil companies, and pay for the health care reforms.
Quite a nice selection, Belle, of things to junk and be able to pay for the health care reforms. One more thing that would almost pay completely for the first few years would be to address "torte reform". But the lawyers have a very strong lobby and this will not happen.
And, they could stop subsidizing the farmers of America which means that all the large agricultural companies, such as the Garst Seed Co., who have bought out all the small farmers in eastern Indiana and western Ohio, would have to stop raking in that money, paid by our taxes, every year.
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bellemere
Would love to see the govt. junk the manned space program, the Afghan was, the tobacco subsidies, the tax breaks for the oil companies, and pay for the health care reforms.
Quite a nice selection,Belle, of things to junk and be able to pay for the health care reforms. One more thing that would almost pay completely for the first few years would be to address "torte reform". But the lawyers have a very strong lobby and this will not happen.
And, they could stop subsidizing the farmers of America which means that all the large agricultural companies, such as the Garst Seed Co., who have bought out all the small farmers in Iowa, eastern Indiana and western Ohio, would have to stop raking in that money, paid by our taxes, every year.
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Oh Bellemere, I do agree. I live in Florida who wants to keep the manned space program, but I think the unmanned makes so much more sense..I hate all war under any circumstances, so agree there as well.. We need universal health care and we need to make sure we can somehow cut out the excessive profits from the health care industry.
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Yes, I think the French with their Ariane satellite system are getting as much scientific information from space as we get from the glamor boys in the orange jumpsuits space walking around and dropping their wrenches. (I'm awful, I know . They are very brave, but what's the point?)
How about the subsidies to corn farmers to make high fructose corn syrup; it is in everything and is contributing to the whole obesity thing.
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I have never understood farm subsidies.. Why not simply raise whatever will make you money without the government helping..
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If I remember correctly, the farmers are being paid not to raise some crops. Can't remember how that works.
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Basically, I think the idea is that overproduction lowers the price of the crop.
Paying people not to raise that crop lowers production and supposedly helps keep the farming economy stable. How good an idea that really is, I have no idea.
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Actually what I meant is that who gets to pick the crops.. Why should we pay farmers not to raise tobacco.. I know it was considered a money crop in the south, but surely by now they know that they should not raise it.. I think we encourage them to not find a new way to make money.. Produce crops , especially organic or baby veggies make good money for farmers willing to try new things.
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Back in the dark ages of no pesticides, my family did quite a bit of canning. Vegatables and fruits were at the local city market plus many folks had Victory gardens and our whole neighborhood was busy getting ready for winter. I think we were eating organic and not knowing it. Remember Carson's book about pesticides??
http://www.nrdc.org/health/pesticides/hcarson.asp (http://www.nrdc.org/health/pesticides/hcarson.asp)
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I remember the Victory gardens; they were a WWII phenomenon. Patriotic
people planted gardens and saved their grease and aluminum foil. I can
remember cutting up potatoes for planting, and complaining because the kids
next door stole our watermelon. Ah, memories!
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I grew up in the country and we had a very large garden and orchard. We did eat organic, because I used to complain as a child that our apples did not look like store apples.. Dad insisted that they had much more taste,.. I know that tomatoes did.. Nothing like a squashy white bread, mayo, salt, pepper and very very ripe tomato sandwich. Best eaten over the sink.
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A tomato sandwich! Oh, Steph, they are to die for!!
When I lived in Atlanta, I listened to a talk show that featured Ludlow Porch. Ludlow could make your mouth water for a tomato sandwich at 5am!
Ludlow was a comedian and author. He always said "The government only has to do two things. Keep our borders safe and run the post office." I agree with that!!
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We sertainly have ranged far and wide in this discussion. I think it has been characterized by civility; common sense; and a surprising range of knowledge on the part of contributors. When something is a mystery to one person, but another seems to be able to enlighten us.
Also I detect a note of nostalgia for a world that is, like Scarlett's , gone with the wind. It is a challenge to us to make judments about government policy based on the today world; nothing is going to bring back Leave It to Beaver. (Or the Lone Ranger, for even farther back)
Their always will be a difference of opinion on the role of government vs. the role of the free market. My feeling is that the free market does a great job of supplying most needs, but that it is not up to supplying the needs for health care of people today, withoug some government "intervention"
I hope people can continue to find consensus and not use talk radio show hosts as their source of leadership in our democracy. They are paid to entertain and have no responsibilities for truth or accuracy.
And I have enjoyed the little sidebar stuff, like tomato sandwiches. My job in our Victory Garden ws to pick the awful cutworms off the tomato plants. Almost killed my appetite for tomatoes.
Let's see what congress does now. I am betting on Olympia Snowe; she is a woman like us; she comes from a beautiful but not very affluent state, and does not seem to be so rigidly ideological, more practical. I think she can lead members of her party to lend support to the final bill. Maybe.
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Health care.. Years ago we did not even have health insurance and I brought two sons into the world with no insurance.. Just saving up each month.. Now, that would be so far past a normal delivery that you would be bankrupt from that. We need to get a handle on costs.. Non profit hospitals really arent.. We need to look at all of the clever new inventions and really look at whether they are really a help or simply a new way.Our country needs to get their act together and if I see one more senior on the news with a no socialized medicine sign, when they get medicare I am going for the throat.
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My family had no "health insurance" either. But we did have Dr. Bob, who brought us into the world and took care of us, house calls and all, right up to our blood tests for marriage. But as Dr. Relman, the former editor of the New England Jounal of Medicine said, There really was not a lot that doctors could do in those days. Miracle drugs developed during the ww2 and advances in technology made real health care possible. I would add, tremendous advances in public health. (
The government telling you what to do, like have your child vaccinated; clean up you water supply, no selling of flammable pajamas for kids, and mandatory inspection of meat production. on and on, all bitterly opposed by somebody. Greatest good for the greatest number?
But Dr. Bob is long gone.'
My son in law put it succinctly/ Doctors are going to have to make less money. Hospitals are going to have to make less money. Insurers are going to have to make less money. And drug companies are going to have to make a lot less money. Not a pretty picture from their point of view, is it? No wonder they are fightning to kill this effort.
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About three months ago, I was emailed a blurb-news??? that claimed that we are being charged for drugs sometimes 4000 times more than they cost the pharmaceutical companies. I will look to see what Swopes says and bring it in here.
Cut worms?? My gosh, I haven't heard anyone speak of those since I lived in Texas way back in the dark ages. We didn't have them in Indiana where I grew up but when my husband and I moved to Texas, what a mess. They were ugly little things, weren't they?? ??? And, they destroyed our first tomato crop due to our not knowing they were there.
Health insurance in the 40's didn't exist but I do remember my grandmother carrying some thing under White Cross. Something with a high deductible, high being $100. ??? Something else I can search for.
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Our father's cutworm pesticide: Pick them off and drop them into a can of water with a lot of old cigarette butts in the bottom. Need I tell you what that looked and smelled like at the end of my chore? Child abuse?
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Cutworms.. whew, have not thought of them for years.. Just as bad when we lived in New England was beetles, which loved my tea roses and made such a mess. I did hate those things.
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As to the article on Rx's and high prices, here's what I found on Snopes.
http://www.snopes.com/medical/drugs/generic.asp (http://www.snopes.com/medical/drugs/generic.asp)
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Wow! Thanks for that link, ANNIE. I buy very few prescription drugs, generic, at WalMart so my costs are already very low. But the info. about the Costco
pharmacy is something I'll be happy to pass on.
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I take generics, but mdh has to use a chloresterol lowering drug that is horribly expensive. The others affect his liver. The difference between even the cheapest drug stores, including wal-mart and Canada is scary.
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I read the Gary Trudeau "Doonesbury" strip for laughs now and then. Mike is trying to stop his feisty elderly mom from burning her Medicare card; she opposes "government-run health care," and feels she must be philosophically consistent.
As this conversation has ranged far and wide, there is a tendency on thepart of all of ;us to "nostalge"", isn't there? It is hard to focus on the future when ours is limited. And no generation has seen more upheaval in society than we have. But in the health care debat, our focus has to be on our children and grandchildren, I think. Does the generational divide have old people afraid of the young? Is that the cause of all the "unrest"? I wonder.
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Hmm, if anything I think that many of us are worried about our grandchildren and their access. Health care becomes more and more of a problem and we seem to have less and less as an answer.
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My concern is definitely my younger daughter. No health insurance, diabetic
and other health problems, bound to get worse.
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So now this debate enters the next stage. I believe the Senate has 3 or is it 4 bills to consider. I guess most of the fur is going to fly over the "public option." I can't see real cost control without it or something like it. Passing abill without a public option will be handing the big insurance companies something like 40 MIllion new customers who have to buy insurance, and the companies hav e no limit on what they can charge for premiums. That doesn'g sound like cost control to me.
Incidentally, are the veterinarians in on this? some heartless person left a tiny baby kitten in my trash can. We discovered it, and cannot keep it, for many reasons. so I called the Humane Society and they said I could bring it there and they would treat it and try to find a home - for a donation. When my husband asked what the customary donation was, they said they usually ask $75 dollars! We can't afford that and they said, " whatever you can afford is okay" So tomorrow he goes to a new start in life.
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Hmm. Thats a new wrinkle..Charging you to help an animal. Not done locally. I called several to see.. They are overrun just now however. Lots of people losing homes and moving into apartments with a no pets rule. Lots of broken hearts on that one. I give to help animals each year and this year there are so many ways to give money.
Our charities this year are food for humans and animals. Both a necessity.
Yes, the so called public option should rein in insurance companies and I dont know what else will.
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I agree about the public option, but the insurance companies are speaking louder than we are. So if you haven't contacted your Senators and your Representative in Congress, no matter what you believe is right on this topic, now is the time to do so. I know people say it doesn't matter, but it does. Besides, it's like winning the lottery - you certainly can't win if you don't buy a ticket - so even if it seems like blowing into the wind to contact your Congress folk, you definitely won't make an impact unless you at least send that email or letter or phone call.
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We lost Ted Kennedy and I thougth John Kerry was behind the public option. Now I read that he is "on the fence" Gotta call and get him off. Our reps, however , have not givn up on it.
Our governor is not allowed to name an interim senator, so that gives the Democratic Party the 60 votes in the Senate needed to block a filibuster.
Just read of the firing of the CEO of a small community hospital. His salary was over a half million dollars.
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I at least contacted our Senator Cornyn about the public option. I hope it
helps. I observed that expecting the insurance companies not to take advantage was about like expecting a cat not to scratch. I urged him to please trim their claws with the public option.
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A typo in my last message cocerning an interim successor to Ted Kennedy. I said our governomr was not allowed to name one. Well, now he can, and he did, so if the Democrats can resolve their differnces there will be 60 votes, veto proof.
A columnist this morning says that the Obama administration has a "progressive" view of government as having a rational, analytic basis "what makes sense for the greatest number of people" similar to the view of FDR and to some extent Johnson and Clinton. But our constittion gives ultimate power to our elected legislators, whose interests are much narrower, and short term, based largely on their reelection prospects. They are so vulnerable to special interests who all have their own private agendas, especially if it is a major economic force in their districts, and if it has big money to donate to candidates.
If you are contacting your legislators, use the phone. My environmental activist daughter says "one phone call is worth 10 emails" I didn't know that. So I followed up my email to John Kerry with a phone call; took only a second to go on record infavor of the public option.
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Thanks for the advice on the phone. I got in touch, but truthfully in Florida, I hold out no hope for all three,, the senators.. hmm. one just got appointed to be a place holder for our stupid governor who wants to be a senator now and the other ,, maybe, but I doubt it. Our representative is a woman who gets reelected each time and I have no idea why..
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Good move with the phone Steph. And didn't you love Babi
s remarks to Senator Cornyg/ oh,do you spell it? About the cats. Loved it.
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Steph, just keep calling and encouraging others to call. You never know when those calls will start to make an impact.
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Steph,
Just a heads up for you, in case you aren't aware. All statins used to lower cholesterol can harm the liver, even the healthy organic one advertised as harmless, Red Rice Bran?, harms the liver. It is a statin also. Just read an article about that. If anyone wants to read it, I could look it up.
I am using Cholestoff made by Nature Made. It is made of sterols and I have had a 25 point lowering of my cholesterol after taking it twice a day before meals for three months. Now, the dr said to go ahead and use it and we will see if it comes down anymore.
I am still stuck on the government staying out of this health care situation. Does anyone here think that the co-ops might work better??? They are supposedly owned and run by the clients who buy their product and are non-profit. But the government would be keeping an eye on them. And to do that, the government would probably imbed government workers.
Now, as to co-ops, we had an electric co-op in Georgia and they were found to be charging us way too much for our utility and were threatened with jail if they didn't lower our charges per ohm or whatever!
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I don't understand "imbed government workers" Is that like undercover FBI agents, or spies? I don't think that would happen.
The government plan is, remember, a means to an end. The end goal is lower costs. Co-ops seem to work well for small, common interest groups; we have dairy co-ops here, they have been working for years. My retirement plan is TIAA CREF, which has some characteristics of a co-op and it has been great. But to cover a multimillion population with a vital service like Health care' that kind of structure would be too loose and weak to get real competition going.
I know some people really believe that private industry does everything better than the government. That is questionable. I see that the war in Iraq had been full of fraud and abuse by private contractors, whose employees make tons more money than the soldiers who used to perform those duties. And great public universities like North Carolina and Michigan have not made great private colleges go out of business.
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Adoannie, any health plan will have to have the government involved at some level. Medicare was started because older Americans could not get affordable health care or insurance, in many cases could not get insurance coverage at all. Now all ages are having difficulty getting affordable health care. People who are in their late 50's up to age 64 in my area cannot find insurance at any reasonable cost and, if they have had any health issures at all, are pretty much unable to find any insurance.
Insurance companies are set up to make profit. Co-ops may be a nice idea, but they probably can't do it on their own without government support and oversight.
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ANNIE, you don't know how I wish I had known that about the statins
before I messed up my digestive system, on doctor's orders! I can only
suppose they didn't really know either, and lowering cholesterol is a
big deal now. Pardon my cynicism, but I can't help wondering how much
the pharm. industry has to do with big medical trends and imperatives.
Back when hormones were the latest, newest thing, a doctor permanentlymessed up my younger daughters life by ordering the strongest one in the
maximum dose. I still get angry when I think about it.
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Yes, I knew that about statins, but mdh chloresterol is very very high.. So what they do is prescribe and he gets liver enzyme checks every single month. I am using red rice yeast. Thus far I test normal all over the place.. My chloresterol was not very high at all.. It is now down to within normal range. So I take COQ10, fish oil and flaxseed oil ( I much prefer flaxseed itself, but it is hard to get). So we are careful. Honest.. My nephew is a doctor and he keeps strict track of his Aunt and Uncle.
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So nice to have a doctor in the family....especially a nice one who watches
over his aunt and uncle. :)
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Yes, he and his new bride came to visit a few weeks ago. They agreed that Florida s way too hot and humid for them.. I told them that late August and September is a horrid time of year and they should come back in February from Pittsburgh.. They are sweet and funny. My late brother would have been so proud.
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The Times today discussed the fears of Medicare enrollees that the Health Care Reform would end up taking away some of their benefits and giving health care to poor people and illegal immigrant.
Thye point out that all four bills wouold actually improve Medicare, by reducing their payments for drug coverage and medical care; The House bill proposes eliminating that "doughnut hole" in the drug coverage, (a real nightmare for those who take expensive drugs) and eliminagting copays for preventvie carel the kind of "checkups" that forestall more expensive care later.
Some of the bills propose lower payments to hospitals; oppostion says that might make hospitals les open to taking Mediacare patients, a practice that could have terrific backlash against a hospital The congress would very soon have to address that if it happened.
Pickin' up my phone again romorrow.
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Yes, yes, I am so glad that more and more writing is being done that medicare is not harmed in the way the right is portraying it. If I hear death panel or organ replacement one more time, I will scream. The bills are not addressing these issues.. Why of why is it fair to frighten people like this.
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I received a response from Senator Cornyn's office, basically an article from
one of their newsletters on the subject. It seems Sen. Cornyn, who is on the
Finance Committee, feels that the plan proposal now in front of the Committee would be disastrous for Texas (..and presumably for other States..), in that it would send Medicaid costs up by billions.
I sincerely hope the plan now in the hands of the Finance Committee is not
the only one being promoted. If their fears regarding Medicaid are well founded, the plan is not going to be acceptable to most of our States. It is
the States that foot the Medicaid bills.
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Medicaid is actually a partnership, feds contribute a basic amount; states have the option of adding to it as much as they feel they can add. I think I read where Mississipi adds the lowest amount, New York the highest.
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I read that 61 percent of Massachusettw Medicaid funds go to nursing homes. Another big chunk goes to care for the disabled. And of course, our burgeoning prison population gets Medicaid. Who wlse is going to insure them? And another huge chunk goes to group homes for developmentally disabled and mentally ill people. I don't know the exact percentages of each of the last groups, but i think it is pretty sizeable. Do you know what percentage of Medicaid goes to nursing homes in your state?
Now it is a very common practice, one recommended by lawyers and estate planners, for people to deed their homes to their children in order to be sure of getting medicaid help if they have to go to a numrsing home. In other words, keeping the assets for the children and making the taxpayers pay for your nursing home care. This makes us all tempted to practice this deception. Back when
Senator Kennedy was first getting into Health
Care reform, he proposed an affordable insurance policy for long term care tha people could buy for about 70 dollars a month. Don't know what happened to that. WE have to make decision aout this soon. ther is a five year "look back" provision in Medicaid; they will attach the house if it was transferred less than 5 years before your application for Medicaid care in a nursing home. We honestly dont know what to do.
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Medicaid costs will go up whether or not there is health care reform. People who lose their jobs or cannot get insurance and then get seriously ill will end up on Medicaid as their money is used up, and that is happening to more and more people.
There definitely is a five-year look back for Medicaid. The people who get stuck in that are the middle income folks. Poorer folks don't have an estate to worry about, wealthy individuals either can afford the nursing home or the long term care insurance, plus they have the legal help to adjust their assets so they can get Medicaid.
I don't know what we would do about our home - if we were to do that to prepare for the potential of nursing home stays, then we'd be asking the taxpayers to pay for our care so that our children can inherit.
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Aren't we talking about taxpayers providing medical care? I would put my home in my children's name, althougth I no longer own a home. The system must be changed and if it will help bring change about then I will do it. Besides, the income which purchased the home has already been taxed. It is not as if one were cheating. Simply alloting assets to their place in advance of one's death. Practical and pragmatic, to me.
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People on Medicare are already receiving health care paid for by the taxpayer - it's a way of sharing the costs between the individual and the taxpayer. But, Medicare isn't enough, so people pay a lot out of pocket or for supplementary coverage, unless they are low income and low assets. Then they get more government help. Some people look at this as the same as highways, schools, libraries, etc. The cost of having a healthy, educated and functioning society. Long term care may be no different, at least in some ways. But there is an element of fairness, too.
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Basically, the government's income is all from the taxpayers. Face it, bottom line, we pay for everything, including government itself. And those debts the government runs up...those are ours, too.
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I keep learning about medicaid.. But we do have friends and she has a particularly ugly form of Parkinsons.. She has been in a nursing home for about 15 years now.. Still alive, still alert, but cannot move or talk much.. They had a good deal of money, but the costs of private care has used it all up and her husband has now sold their last asset, the house and moved into a teeny apartment, so he can use the house money to keep her where she has been for so many years. So I can see what some people will do to stay off medicaid. Hard decisions.
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It seems to be a moral decision; how can we allow our fellows/ourselves to become beggars in order to support greedy vultures whose prey is the needy?
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Well, we could start by demanding torte reform and get rid of those horrible fees that drs have to pay to insure themselves against someone suing them. The law lobby does not want this to happen.
And, we would make sure that the people who can't afford insurance are put on something like Medicaid. Within the welfare system, maybe?? Oh, it already it, isn't it?? Those of us who are paying for their own insurance right now should be able to continue doing so if we like what we have.
At this time, the health system, cannot refuse to serve anyone who comes to their door. Well, at least, the hospitals' doors. But even that is controlled by number and the hospital can close their doors at a number that means they are full and the EMT's must find another hospital to submit their patient to the emergency room.
We have at this time a serious shortage of nurses and techs. Nurses are retiring by the truckload. What worries me is that if my dr is close to retirement, and he/she doesn't like the new healthcare bill, he/she will retire early. And then we will all be in a terrible mess.
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Those of us who like our insurance are lucky. For now. If nothing is done, it's likely that our insurance will not cover us as well or be as available, unless we are on Medicare. Every year my employer's insurance costs more, and increases co-pays and out-of-pocket maximums. Some employers are dropping insurance coverage for their employees. Others have dropped promised coverage for retirees. The percentage of people happy with their current coverage will decrease, even without reform.
The uninsured have access to emergency hospital services, yes, but not the maintenance or preventative care at clinics and doctors, which could mean they would avoid the more costly emergency services. And those services for the uninsured cost all of us in increased rates at hospitals and through insurance premiums, and taxes, because someone has to pay for that. It is estimated that a family's health insurance premium has an additional $1,000 in premiums a year because of the cost to the system to pay for the uninsured.
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Yikes! That seems high, but is probably close to accurate.
I read where the Senate Finance committee has failed to pass the public option. And that insurance companies are spending 1 million dollars a day to try to kill it althogether. Where is that money coming from? Your premiums? Denied claims? Senatory Olympia Snowe (love that name) is stillpresenting the "trigger " option: if the private companies don't control costs within a certain nmber of years, the public plan would go into effect. Is this just anothr method of killing it> Or would it work? They are getting a huge number of new customers with this bill, many of them on government subsidy. Hello? Socialized capitalism?
And what about the quality provision? Doctors' networks? I have a primary care doctor who has never spoken to my gyno, the urologist I see frequently, the dermotologist I see once a year, or the Women's Health Center where I get my mammograms. And what will promote an increase in the number of primary care physicians? How about scholarships to med school, or interest free-loans to set up a primary care practice? How about overtreatmen? Is the doctor who orders more tests and procedures a better doctor than the one who orders fewer?
Whew! dont want my blood pressure rising. I am outta here, as thekids say.
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It seems logical to work on health care as a system, as a whole, with clear goals including the cost of physician's education and eliminating the ne4ed for malpractice insurance. With objectives such as that a single payor is the answer. Maybe overhauling health care would result in a surplus of lawyers who could then enter med school? I shall continue to dream, it's so much better than reality.
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Right. It is a system, with interrelated elements. In all the yelling about health insurance, what's being overlooked is improving health CARE.
I think there will always be a need for some malpractice insurance,. Doctos can be negligent. What do they call the dunce who graduated last in his Med school class? Doctor.
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Harsh, Bellemere. The last place graduate is still the winner on a long list of qualifying tests. Take, for example, a list of IQ scores for Mensa members. The one with the lowest IQ is still in the 98th percentile.
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Perhaps I was too harsh. But doctors can be negligent and can break the law. And their mistakes can have fatal consequences for a human life. They have to be accountalbe. It sometimes isn't enough to say, "Sorry." And go on to do more harm.
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There is a case of criminal negligence playing out now. An MD who lost his right to perform surgery in Oregon managed to obtain a license in Australia where he is charged with manslaughter http://www.piurl.com/1uNF Malpractice doesn't begin to cover this sort of abuse.
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There are a small percentage of doctors who have no moral values. They seem to be bright, but they enter practice and immediately spend time figuring out how to outwit the system and get lots of money for doing nothing. Miami seems to be full of them for a variety of reasons.. Fraud in that part of our state is increasing each year. For every one they put in jail, five more seem to pop up.
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Has anyone here read John Grisham's book "The King of Torts" about the torte lawyers and how they work?? That was quite an eye opener for us and it still goes on. The lawyers are the ones making all the money in that field. Scary stuff, discovering how lawyers are advertising just to bait the people to find out what is going to make a big case against different entities,ie, doctors, cigarette companies, auto makers, etc, etc.
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A plague on both their houses. Your state Board of Registration in Medicine is required to publish its decisions to suspend or revoke medicl licences. they have plenty of work . Reading the allegations is most instructive, from violation of Drug Laws involving prescriptions for pain killers like Oxycontin; sexual molestation of patients. removing the wrong organ (went in for a gall bladder, took out a kidney) slapping a nurse in the face with a file folder, and more and more common , drug addiction.
Not pretty reading.
This is a peer group process. Only if there has been a violation of civil law does it get prosecuted.
Doctors in our town got together and told a patient-molesting gyno to get our out of town. He obligingly moved to the next county and was finally arrested for the same thing.
Two great films from the lawyers point of view: A Civil Action, with Robert Duvall and John Trevolta, both terrific. and The Verdict with Paul Newman. The latter drew a criticism from our doctor friend; they had a sleazy guy with a villain's mustache play the guilty doctor and for the lawyer they got Paul Newman! The first prents a corporate polluter; the second a flagrantly lying doctor.
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What is the ratio? One in ten, one in twenty, is a psychopath. Probablilty suggests that the professions would have a certain number of these ogres; given that many of them are of superior intelligence skews the numbers even higher. Since their modus operandi is manipulation, well, what more needs to be said.
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Mass Medical Society nails about 200 a year, half of those for drug or alcohol abuse. They offer temporary suspension and treatment or supervised d practice. The others are for a mixture of irregularities, most not prosecutedbut some are seriuous evough to bring revocation for years or for good. But some are subject to civil lawsuits.
Doctors are just human beings, after all. "I did n't mean to make a mistake" is not a justification when someone is dead or permanently damaged.
Very few doctors go through life with no complaits against them.
Maybe a doctor who goes a certain nmber of years with no complaits shoud get a reduction in premiums, like a safe driver does on car insurane? Hey, whom do I write to with that idea?
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I don't know whom you need to contact but good luck; you should get a share of the savings for such an innovative cost reduction idea.
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There are so many fair and honest doctors, but for some reason they hate to punish their bad boys. It was explained to me once by a friend who is a doctor, that all doctors make mistakes and they are reluctant to punish.. figuring it could have been them.. Does not help the situation.
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Senator Snowe appears to be maddingly coy about her vote to endorse the Finance Committee's bill. She says her prime concern is affordability. If it is not truly affordable, then the "must buy" mandate is unfair. She does have a point. She comes from Maine, and if people leave the gorgeous shoreline tourist towns, like the 'Bush family's summer home of Kennebunkport, the interior of the state has pockets of shocking rural poverty. Even in the tourist towns, supposedly well to do, there are loads of small business men, lobster fishermen, restaurant owners. etc. who do not have a lot of employees, are seasonal, and could not afford to offer health insurance,. Sp what is the solution.? Drop the mandate and lose tons of people who are low risk and could afford it if they wanted to make it a priority, or raise the level of subsidy which is now up to families of 4 making 66,000 a year> That means even more money into the pockets of the insurance companies, if there is no government public option insurance. Is there another way?
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I am convinced we must have a public option to keep the insurance companies in line.. They are soooo greedy.
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The insurance companies may be getting a bit sensitive to all the (well-earned) criticism. One of them (don't recall which one) is now putting out ads
about how they really want to make people happy. ::)
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Insurance companies have had it so good for so long they dont see it as greedy, just "money on the table" for them. Insurance is the only business that makes money by NOT giving customers what they pay for!
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Truer words were never spoke, bellmere!!
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Bellmere,, Oh me, you are so right.
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This week the fur realy begins to fly. The insurance interests are determined to fight the cost saving features of the bill because they figure , rightly, that some of it will come at their expense/ And there are FIVE bills up for debate. Ridiculous. We will have to listen to so much hot air from both sides, instead of reasonable compromises. Makes you sick, if you can afford to get sick. The conservatives in particular seem motivated solely by a desire to hand the president a humiliating defeat.
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When did our legislatures decided that fighting , not whether the bill is good or not was the important thing. I am ashamed of them. Why do we vote.. So that we get this nonsense of conservative and liberal.. Health care should not be a political football, but a right of every citizen.
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Between the politics and the lobbyists, we are gonna be sorry that this even came up.
I read somewhere this weekend that at the end of the ten yrs that it will take to get this done, they will still have 25 million people without insurance. Doesn't sound too promising to me.
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Because of all the competing interests, the lack of will by Congress and, sad to say, poor leadership by the Democrats in keeping to the goal, it appears our "reform" will be keeping all the things bad about our system and destroying what is good. I am dismayed by what is going on and saddened that the President cannot get Congress to work for the good of the people in this matter. I have bad feelings about this.
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if we dont get reform now, some financial pundits predict that at some point in the future, fifty percent of all the money spent in this country will be spent on health care, if current trends hold. Think of that. Where will the money come from for education, roads, etc. That must be an exagerration, but the trend is still there. Call them! Early and often. One phone call equals ten emails, remember.
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It is discouraging. I'm finally finishing the biography of Frances Perkins, and she tried to get health care for everybody as part of the New Deal, along with Social Security. And this was back in the 1930s. :-\
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Yes, Frances Perkins had many good ideas. But, when I look around SS and Medicare are both failing so maybe that wouldn't have happened if it had been passed back in the '30'. Frances gave up healthcare to get social security.
And ten years later, my family benefitted from SS, when my father died and my mother was left with two children and a mortgage. Back then, SS was sent to my mother and she was also paid benefits for my brother and I. Kept us afloat, believe me. Fortunately, Mom had just started a new job with our school running the cafeteria.
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Social Security would be just fine if they would simply extend the tax to every cent of salary.. instead of putting a cap on it. The high earners can be taxed in that way to help all when they retire. If we could just get a way to cut out the huge fraud involved in medicare we would again be just fine.
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Steph,
I like your ideas! Why don't you send them to Congress?? Maybe they would wake up and smell the roses.
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Neither Social Security nor Medicare are "failing" but they do need some adjustments in funding.
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I really dont understand why they dont adjust social security. They did that for years. It used to raise every year or so. Now it does not as far as I know.
The corruption involved in mostly medical devices is amazing in south FLorida. I dont quite understand why medicare does not investigate the people who apply to be a provider. It seems to take them years to figure out that something is wrong.. Seems strange to me. Just like the people who keep claiming social security after the person who actually was supposed to get it dies. I thought they kept track with death certificates.
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It takes a woman! Kudos to Olympia Snowe for having the courage of her convictions. She voted for the Finance Commitee's version in spite of the fact that it doesn't have exactly what she would want in health care reform. But it took guts to cross that party line.
Now, am one of the first victims of health care reform. My premiums, if I want to stay with my Medicare Advantage nprogram will go from 109 to 145 next year. so I am shopping. If my doctors' group continues to accept them, i may stay, and cut back somewhere else. What is a good Medicare supplement plant? Does anyone advocate "going bare" with only Medicare?
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I'm happy with my own provider, BELLE, but some people like to stick with
Medicare and a supplemental insurance program. I suppose it depends on the
individual circumstances, and of course the integrity of the provider. As STEPH
points out, some providers apparently are just in for a fast buck.
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I take it you do not have Medicare, even Part A, the hospital insurance. and
Babi, are you not yet 65 or are you 65 with a government or state employee or labor union retirment plan?
I certainly intend to keep Medicare both parts A and B and am thinking of looking for a new Medicare supplement.
Interesting discussion of the public option tonight on the News Hour. Republicans vow never to vote for a plan that has one: certain
Democrats vote never to vote for a plan that doesn
t have one. Oboy.
Possible: the
trigger mechanism , suggested by Olympia Snowe that would start a public plan in any area if costs were shooting up because of no competition. Even more interestin: the suggestion to let states start a public option of ther own if they cannot get the private companies to hold down costs. Our state employees have a great insurance plan.
We could just open it to others and voila! Public option. No new beauracracy or anything.
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If you want some advice on switching from Medicare Advantage to a Medicare Supplement, or vice versa, a good place to start is with your state's SHIP counselors. http://www.medicare.gov/Contacts/staticpages/ships.aspx
These counselors are trained in Medicare and insurance. In some states they are volunteers, while in others they are paid, but they are knowledgeable and neutral.
One way to compare Medicare Advantage and Medicare supplements is to calculate the maximum out-of-pocket with the Advantage plan and compare it to the cost of the Medicare supplement premium and any co-pays. Another thing to consider, especially for those whose health is not good, is that the monthly Medicare supplement premium is a budgetable cost, while the ups and downs of co-pays and co-insurance in many of the Advantage plans (particularly private fee for service) can be hard to adjust for and may not be accurate.
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We use the AARP program as our medigap program and love it. My husband has had numerous surgeries, etc for the past three years and we have never owed a penny. They pick up where medicare leaves off. They do not however pay for eye exams or dental..
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I have been reading all of the interesting posts concerning keeping Medicare Original plus a supplement or changing to an Advantage plan.
I looked into selecting an Advantage plan for the last two years since the monthly cost is so much lower than what we pay for the for our supplement. Every time I come up with almost identical costs for each plan and we are still in my husband's supplement plan plus we have Medicare Original.
We have Original Medicare and a supplement with an Rx plan included that is merely co-pays for each Rx instead of having to deal with the donut for Rx. This makes the two most expensive plans, Medicare Original w/ supplement or Advantage's PPFS, pretty close in cost. Our supplement is really high but since we are both needing many Rx's it evens out. Also, I am not at ease, deserting the company supplement as we are so well covered, up to 2 million, by the catestrophic supplement. So, we will stay as long as we can with this arrangement.
In the past year, I read somewhere that our company may be dropping Rx coverage and I don't know where I read it so am waiting for the big ball to fall. We have not received our offerings for next year yet.
Fortuneately, my husband is a vet and can get his generic Rx's from the VA so that will be somewhat of a help. But, he takes two very expensive non-generic Rx's that we will have to pay for. Mine are mostly generic but I would have to depend on whatever the different pharmacies are offering here. This could wipe out any gain from changing to an Advantage plan. Well, we will see what the company offers if they ever get their annual insurance plans out to us.
I am interested in looking at the SHIPS as I have never heard of that group of people.
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No, Belle, my 'provider' is a Medicare contract probider, Texas
HealthSprings, that so far have proved to be responsive to all my
problems. I have Medicare A and B, and I just turned 74.
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HAPPY BIRTHDAY, BABI!!
Yes, you and I have similar plans. We are paying almost all of my husband's pension for our supplemental but thank God, he has the pension.
I have friends in Atlanta who are paying 1.5X what we pay and they are in a big city with many choices. What makes them need catastrophic coverage is her Post Polio Syndrome. She is 76 and already using a wheel chair when going anywhere. She is not needing it in her home yet.
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Last night, I watched Lou Dobbs interview a congressman who wants us to do a common sense program of letting the illegals who are living and working here become legalized. Frankly, he made a lot of sense to me. Did anyone else see this???
Steph,
Which AARP supplemental plan did you choose? Does it include your Rx's??
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thanks so much for the responses. regarding notice of changes for next year, I believe there is a " deadlin" for companies to contact you, and I thought it was Nov. 1. That begins the window of time for changes to premium prices and coverage changes. We just got ours from our Medicare Advbantage Plan. Big jump in premiums; no change in copays; little reduction in covered services.
Yes, we have a counselor program called SHINE, and I am going to make an appointment.
the counselor is my neighbor, a retired exec of an insurance company; really knows the fine points.
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Prescription drug and Medicare Advantage plans must send out their annual notice of change this month. People must read everything that comes from their plans, because the information about changes for the next year may be stuck in with their monthly bill or explanation of benefits.
Almost every state has some prescription drug plans and some Medicare Advantage plans that are ending, at least in some counties, so people may have to switch plans or be stuck in original Medicare and/or without a drug plan. Those with the "extra help" may have to switch as well or they could end up paying a premium in their old plan.
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We just got our changes.. from the prescription plan. I use the same AARP prescription plan as well as the medigap. My husband goes to VA for his meds.. and when we cost it out, his one very expensive prescription is the same price in the end as what it would cost him from the plan.. So I cannot convince him to join the plan. We both use the medigap however.
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I think we are all talking about the same things: let's see, Medicare Part A, the hospital coverage, with a ded;uctible. Part B, the coverage of doctor's fees, services like xrays and the deductible in part A for the hospital; Part D, the prescription coverage, purchased through private supplers with different copays according to the "tier" of the drugs.
Medigap, the generic name for plans that cover the 'gaps" inB and D and Medicare Advantage, the plans that cover these but have added benefits.
You have t practically be an economist to get a true comparison of some of these things, don't you?
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Just one clarification: Medicare Advantage is your Medicare A and B provided by a private insurance company, rather than the traditional Medicare. So Medicare Advantage plans must offer the same benefits as Medicare A & B, with different cost sharing amounts possible. Medicare Advantage plans sign yearly contracts with Medicare, so premiums, co-pays and deductibles can change significantly from year to year, as can these added benefits. These are the plans that cost Medicare about 13% more per person than traditional Medicare, so that all Medicare beneficiaries pay more in premiums.
Medicare Advantage plans cannot be supplemented, and some of the private fee for service Medicare Advantage plans can end up costing more over a year than if a person were paying the premium for a good medicare supplement - because of co-insurance. I think some areas of the country have really good and stable Medicare Advantage plans, while other areas are not well-served by those plans.
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nlhome,
If what you say is correct, why do the people in Congress insist on telling us that the Advantage plans have failed miserably??
After researching the Advantage plans, I found that we were better off staying with Original Medicare and a supplement. Our company Aetna supplement covers are Rx's nicely plus picks up 80% of what Medicare doesn't pay.
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The Advantage plans may fail, if they do not get that average 13% subsidy from Medicare. What that subsidy does is increase premiums for everyone on Medicare, and that is one of the areas where the "savings" would be made in health care reform. And the subsidy allows these plans to compete with traditional Medicare with an "advantage." So when they are offered at a low or even no additional premium beyond the Medicare premium, it's easy to see why people sign up for them, but then they are often stuck, especially if they become ill and incur a lot of out-of-pocket costs and have a limited out-of-pocket max that doesn't apply to all services.
The private fee for service Medicare Advantage plans are especially confusing and, in my area, have large co-insurance payments required for things like oxygen, physical therapy and certain Part B drugs for cancer treatment. They offer things like dental and hearing aid and vision coverage that are not part of regular Medicare, and healthy people do well with these kind of plans. However, as people age or develope chronic illness, they don't necessarily benefit from the Advantage plans and would be better served by Medicare a Medicare Supplement. However, it may not be possible to get into a Medicare Supplement at that point because of underwriting requirements.
Just my thought, as we listen to the arguments about a public option. Medicare is a public option, and if these advantage plans can't compete without the subsidy, then no wonder the insurance companies are fighting tooth and nail to keep a public option out of the reform.
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I dont understand why the government decided to do the Medicare Advantage plans to begin with. Seems weird.. I like our medicare plus a medigap and for me the same company for the prescription. I can use what doctor I want, when I want.. works for me. I had one before medicare that I had to use their doctors.. Which worked well for the internists.. Not so well for the specialist. I ended up with a dermo whose english was rudimentary to put it mildly. Never again..
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I was told when I asked about the Advantage plans offered by Aetna that the Advantage promised to pay the drs in 30days and the drs really liked that. Although they were getting less, 85% total. If one had a bill with the dr for $100, an Advantage play paid $85 in a month. The original Medicare plus a supplemental would pay $86.40. So, they didn't get as much from the Advantage plan but it was paid in 30 days which saved them from having to rebill. That might be worth $1.40!
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Adoannie, who told you that about the prompt payment? That's interesting.
Also, not necessarily true for all plans. In our state, there are areas that will not accept certain Medicare Advantage plans, although they take others and definitely accept Medicare and a supplement. With the crossover between Medicare and supplements, often a provider files one electronic claim and payment comes both from Medicare and the supplement, IF the provider accepts assignment.
Medicare Advantage plans are a reincarnation of Medicare + Choice plans that were started years ago, so that seniors would have "choice." Most of those plans dropped out, some of then abruptly, so then this "Medicare Advantage" was developed, with the subsidy. Plans have yearly contracts, so change every year and can drop or add plans. This year, where I live, 4 plans are not available next year, which means those people in those plans must find another plan, IF they read their mail and find out what's going on. Otherwise they will probably end up in traditional Medicare without the protections of an advantage plan or a supplement. If their Medicare advantage plan also had drug coverage, they could lose that if they don't pay attention.
My theory is that as people age, they don't necessarily want to review their medical plans every year. They want to do other things in retirement. But, maybe I'm just lazy.
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NLHOME,
AETNA TOLD ME THAT. ::)
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ADO, then I think I'd ask your providers how they feel. It may be true. For Aetna anyway.
There are also sales people who don't really understand what they are selling. Medicare Advantage plans, except for the special needs plans for certain chronic diseases, cannot ask health questions when they sell a plan. It is, after all, annual enrollment or open enrollment, and anyone can move around to plans offered in their areas regardless of health (nursing home patients and renal disease may be different). So the companies cannot ask about health issues. That means that the customer needs to ask how the plan would work with their specific issues. The plans always stress their low copays for doctor and other regular procedures - the devil is in the details of more expensive treatments.
I'm sorry, I'm just in the midst of making some decisions right now, and I'd rather be reading my book then wasting my eyes on insurance choices. I get annoyed by this whoe process.
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I've just gotten the yearly update from my provider. They've changed
the name of the plan, and so much else I wonder if they've changed ownership as well. Everything is going up, up. A med that has been costing me $4.00 will now be $30. Since I queston whether I still really
need it, I may drop it.
I could do a comparison of providers available in my area. I've done it
before; that's how I first found this one. But like NL says, it is so tiresome.
It is unlikely that most of the changes will have any major effect on me,
so ...I may or may not.
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Generally our medicare provides a booklet with all of the plans listed and what counties they are in Babi,, Would that help?? I got my prescription plan revision the other day. We are going to have a small co pay this year. I suspect this will be the slippery slope for me. We will see.
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Babi, don't let the insurance companies win. Look for a different plan. The companies count on people not wanting to make the effort to switch. And don't drop that med without consulting your doctor - he/she may have some other suggestions.
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Last year I had a long talk with one of the billing office ladies in my dr's office and she said to stick with the original Medicare and my supplement. Now to do that, I have to continue with what we have, Medicare Plus w/ Catastrophic coverage for $626 a month for two of us w/major changes(higher copays) in the RX's plan inside the supplementary and a limit of $2,000,000 for each of us. Or choose a Medicare Choice at $471 a mo for the two of us, with unlimited coverage and also includes RX's with the same copays that we have had in the past. And, again, the coverage is 85% of the amount that Medicare allows for a that dr or that procedure. We are responsible for whatever is owed after that.
This is getting really nasty, isn't it. I have spent the last three years trying to see if we could actually save any money by changing plans but am always afraid that we would end up paying out the same amounts, no matter what we choose.
This Medicare Choice offered to us this year is not the same as last years Advantage plan. And, we are only offered that one. Its an Aetna PFFS plan with Rx's. Lockheed Martin has worked this out for the retirees in our area. They offer more if one lives in the area of the company's address.
I am still not finished with my assignment for "The Last Dickens" so much say good night, sleep tight!
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I find the idea that Medicare differs from area to area as unpleasant as can be. This is supposed to be a uniform plan for all.. The Advantage makes no sense to have only in certain areas..
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I know I had a plan comparison available the last time I made a choice,
STEPH, but I'm not sure now whether it was on-line or in booklet form.
Probably the latter, as I find those easier to flip back and forth for
comparison.
Don't worry, NL, I will talk with my doctor about what I want to do
before dropping that med. There was a time, tho', that I stuck with a
medicine too long and am still paying the penalty on that one.
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Oh, and let me tell another fact about the offerings that we received. We can choose the PFFS plan but must apply to Aetna for it and wait and see if we will be accepted. Whoa! With the history that we both have had in the past 11 yrs, I am staying with what we have for now!
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Good, Babi. I too always want to be sure the medicine is the best option. Fortunately, I don't need any regular prescriptions. Yet.
Steph, if you go on line at Medicare, you will see that Advantage plans vary in offerings, premiums, etc. county by county, not just region by region. The same for prescription drug plans. First and foremost, the private plans need to make a profit. Medicare doesn't control drug costs - in fact, it is prohibited from doing so. That's why Part D really isn't the most efficient or economical way to offer the drug coverage - but it makes the insurance and drug companies happy.
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As I must several meds daily, the costs are important. I have Med Advantage/Oregon. Used to get my meds at Costco, supposed to have the lowest mark-up. But, it is open only M-S, closes at 7 PM and is quite a distance. Plus the membership cost. When I switched to Walmart, just down the road a ways, I found that there are many of my meds which cost only $4 for a 30 day supply, $10 for 90 days. Open every day til 9. I can order refills online. They will even deliver though I haven't needed that service. There are long lines at Costco and Walmart so that's a wash.
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Reading over all these endless struggles with "plans" and "choices" makes me want to cry. Will the health reform bill do anything to make this maze clearer for seniors? How much worse could a single payer system be?
I really believe it is a matter of too much money going into health care all down the line. Hospitals are going to have to make less money: doctors are going to have to make less money; insurance companies are going to have to make less money; and pharmaceutical companies are going to have to make a hell of a lot less money. Then maybe we can control costs and have a rational system. I said rational, not rationed. Somehow rationality has taken on a bad reputation. Let's have hysteria instead!
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Bellemere,
Lets have hysteria?? ::) I think we already do have a mixed up message being delivered to the seniors in this country.
We should all remember to read every piece of paper that comes across our thresholds referring to what we can buy now. The rest of it, about the oncoming new health care reforms, hasn't been decided yet so we must deal with the NOW
in our healthcare offerings.
According to the talk on TV, we will start paying for this wonderful new healthcare reform next year but won't be able to get it for three or five years?? Am I hearing things?? Actually, its the people who are working who will be paying for it and we have a millions out of work and therefore not contributing from paychecks. And, we, the seniors, won't be charged?? since we don't have paychecks?? or are they going to get into our SS and take it from there?? AS BELLEMERE SAID, "LETS HAVE HYSTERIA!"
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I am amazed about the reactions to the plan in Florida. According to surveys released today, Florida has the third largest amount of people who have lost their health plans this year. All due to losing their jobs.. What are they planning to do? We simply must have some sort of safety net.
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Steph, what plan are Floridians reacting to? there are four at last count, I believe. Is the reaction against specific elements of reform, such as the mandate to buy,a/ I think that is in all of them. the public option? That is is some of them.
I called my Medicare Advantage and asked how come such a big increase in premiums. Over thirty percent. The poor little service rep started out by saying, :We've been instructed to tell members: folowed by the eompany line about passing on increased costs. I had to laugh, wondering if my call was "monitored for quality control" and if he flunked.
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IIn today's Oregonian is a report from the St. Petersburg Times Politifact.com (which checks determine the truth in politics today) about the potential cuts to Medicare Advantage seniors. See it here: http://www.piurl.com/1vzt
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re: link www.piurl.com/1vzt
tried it several times to no avail. do I have it wrong?
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Tried to use tinyurl but it obviously didn't work Here's the unexpurgated version: http://www.politifact.com/truth-o-meter/statements/2009/oct/16/americas-health-insurance-plans/health-insurers-group-says-medicare-advantage-bene/
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Talking Heads #6
"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.
(http://seniorlearn.org/bookclubs/graphics/talkingheads.jpg)
A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.
Our Sixth Selection is:
Health Care Reform~! Are We on the Fast Track?
7 Ways Health Reform Is Going to Affect You (http://health.usnews.com/blogs/heart-to-heart/2009/06/10/7-ways-health-reform-is-going-to-affect-you.html)
Newsweek June 10, 2009
Soooooo, on top of paying more than an Advantage plan member, I am subsidizing the Advantage plans. Now, who's idea was that?? Very interesting article, Jackie.
IMHO, some of the things offered by some of the Advantage plans, ie. dental, eyes and gym memberships might be subtracted from these plans. Not all Advantage members use those benefits. Well, my 84 yrs old SIL does go to the gym through her Advantage plan. But she is probably 1 in a million who does use that benefit.
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I think that in Florida, they are simply reacting to anything that changes their lives. Noone seems to be against the health plan for rational reason. Way too many senior citizens on the news protesting government health care.. They drive me nuts.. What the heck do they think medicare is??
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Ado, Medicare Advantage was designed supposedly to give seniors a "choice" but the original Part C plans didn't succeed, so then they were revamped into "advantage" plans with the subsidy. Some can compete with Medicare, but the newer plans definitely need the subsidy. The insurance companies are the ones that benefit most, because they draw the younger and healthier into their plans - unfortunately those same people will get older and less healthy, and then even the subsidies won't help unless the members are encouraged to go elsewhere. If they can.
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This a post that I read on Here&Now. This is a decent common sense suggestion.
"Why don’t we ( the U.S. ) just start health care reform slowly and carefully. Extend Medicare as it is back to people who are 55, giving us a chance to adjust to the new numbers of people and figure out what “bugs” we have. When we have accomplished that (probably 24-30 months) then we can extend back to 45, and 35 and so on, back to the start. It should speed up as we learn.
It will be understandable to nearly everyone,and gradual enough to avoid congestion and crisis." Here&Now-08/14/2009
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It does sound sensible until we remember how bitterly Medicare was opposed when it was passed. that would happen again at every attempt to extend it. But your point is well taken, that we of a certain age wont benefite financially from the current Health reform effort. I hope it will result in better care and even out the inequities between different parts of the country.
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The uninsured are all ages. What do we tell the younger ones who cannot get insurance or who can afford it? Wait until you're 55? Right now I feel sad everytime I hear someone say they cannot wait until they are 65 so they can get Medicare. I hate that people have to wish their lives away in order to feel secure. This can be done, but politics and insurance companies have to take the back seat. That won't get done if everyone has to be pleased.
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Take a look at the way Grainger Hospital is handling the cost problem. The article is from this month's Time Magazine.
http://www.time.com/time/magazine/article/0,9171,1930501,00.html
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Yes, read the Grainger Hospital article. Very interesting approach.
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So now every insurance company with a Medicare
Advantage plan is going all out to recruit new members. Presentations in hotel conference rooms all over the county. the booklet: Medicare and You for Massachusetts includes a cosely typed chart extending over 12 pages for us to compare. Hello? If i'm having trouble what about people who are truly impaired ins some way trying to figure out the best deal. I am calling for an appointment with the SHINE counselor this week; I wonder if even he can navigate this maze/
It looks like to me that myplan is anticipating reduced rembursement from Medicare for next year, and is trying to stay ahead of the reduction. But to go from 109 to 144 for a monthly premium? same coverage, no new benefits. Outrageous.
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My gosh, Bellemere, it sounds like you do need some help. Too many choices!!
NLHome
After reading the lady's ideas about pushing the Medicare onto those 55 and older to begin with, I think the way to rush the most needy to the feeding trough would be to offer those of the poorest another type of insurance. Maybe a deductible before it kicks in or a public option type of insurance. We will always have to pay for the poor and it can be divided among (those who make over a certain amount ($300,000?) a year.
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Have not gotten our new numbers on our medigap yet. All of our Advantage programs locally , you must use their list of doctors. Since I like my doctor very much and she does not like groups, I will stick with the medigap.
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I don't know, BELLE. My Advantage plan is raising the costs of
everything. And one of my meds is being moved into a higher cost bracket, ..about six times higher. Fortunately, it was only $5. to begin with.
I considered switching plans, but I don't want to lose my doctors. That
particular family of physicians has been caring for me and my family for
the last 40 years, except for a hiatus when they dropped out of the network. I'll put up with a good deal to stay with them.
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Yes, Babi, it is important to me to keep my primary care doctor. However, he willprobably retire sometime soon to enjoy his hobby of collecting rare books! By coincidence, he has a son in medical school;I wonder when he will be starting in practice and if he has his father's dedication.
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Your doctor's son will have the latest traiing, BELLE, and hopefully will
have his Father's dedication. Still, experience is something that only
comes with time.
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I had to laugh. Thus far in life in the last 20 years, I have been through one Primary physician, one dentist and one dermo.. They all died and were all roughly my age. Now a second dentist has retired and my primary again is my age.. Hmm. As we age this gets to be a problem.
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We started with a young primary doc about 20 years ago when he first opened his practice. We loved him, but then the stinker decided to go out of private practice and work only in the clinic for city employees. John really chewed him out - told him that we had assumed he would take care of us the rest of our lives - and that he would outlive us. It was a hard decision for him. We stayed with another doctor in the practice (a young woman) so we wouldn't have to start all over again.
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I finally got my new numbers. My Medicare Advantage Plus has increased 45% over last year. Slighr5 changes in coverage are not enought to make up the difference but what can I do? The local Senior Center is offering appointments for consultation on your medicare options. That is a resource that may be available near you.
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How can they possibly justify 45% in a year. The insurance companies are just trying to get their raises before health care is passed.. They should be ashamed. This is getting outrageous.
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I guess I would have to laugh,too. In the past six years, our family doctor, pulmonologist and cardiologist have closed their practices or moved to a different hospital. Are they running from us?? We were able to still see the cardiologist, thank God and have found replacements for the other whom we feel comfortable with.
I think that I am going to call Aetna who carry our supplemental insurance for my husband's last employer and see why we would have to be accepted in their Advantage/Choice plan when its the plan that Ralph's old employer is offering to all their retirees. That makes quite a difference in our monthly cost. About $200 and that's a lot. Oh, and they have changed from Caremark to Medco for Rx's. I have not heard of Medco; has anyone here heard of them?
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I didn't know any insurer required you to use a particular pharmacy, ANNIE. My provider has a formulary of the meds they will pay for, but
I can go wherever I like to get the prescriptions filled. I've never heard
of Caremark or Medco; I go to WalMart Pharmacy, by choice.
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Sorry, Babi, I meant to say also, that these two are mail away pharmacies. Other than that we can go to any local pharmacy, too.
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AdoAnnie, John's retirement plan uses Medco for prescriptions, and we've been satisfied with them. Costs, of course, depend on your particular plan, but the service from Medco has worked well.
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Thanks, Maryz, you have relieved my worry buttons.
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;D
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Our mail in is: Prescription Solutions. I like them, but h ate the call in feature. Use the on line instead.
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Ado, I always renew my Rx at the online site. When an Rx runs out of refills, I still order online, and Medco contacts the doc's office for approval. I don't have to do anything else. I get prescriptions from three doctors, and all of them are very good about responding to Medco. I rarely have to do anything but click a few times on their web site.
If I have any complaint at all, it's that they send me an e-mail to let me know when an Rx is available for renewal, but they will only identify it by Rx number - not by the name of the medicine (those @#$$% privacy things). I can never find the number on the bottle, so the e-mails are worthless to me. I just delete them. And when I get down to about 2 weeks left on my 90-day supply, I go online and reorder. If the prescription doesn't need to be okayed by the doctor, I usually get the pills within a week. I have it all charged to one particular credit card that I don't use for anything else - and they do that automatically.
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Yes, mail in prescription services are great, especially for us in harsh winter climates or those anticipating giving up driving because of vision problems. Now if someone would just mail me my food (and occasional bottle of Cabernet) I woud be all set.
does anyone download books from iTunes? Do you have to have an Apple product, like an iPod to do that? Or can you download regualr audiobooks into an iPod? and is there a required conneciton speed to download books? I am getting tech=y I know.
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I have four MACs and we can download from ITunes plus a couple other site. I download to my computer as I don't own an IPOD. When we disucussed "The Mystery of Edwin Drood" I downloaded the book and listened to the book being read by an actor who did all the voices. It was like going to a play. I might have the website that has some older books and its free!!
Yes, its LIBRIVOX! Here's link:
http://www.archive.org/details/edwin_drood_0901_librivox
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I l ove my cassette player and buy used audio books on the time. Use them in the gym,, on my daily walk, etc.. Sometimes I can pursuade my husband to listen to one as we go places in the rv..
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We started listening to audiobooks on tape when traveling 15 yrs ago and now we are up to books on CD's from the library. I use them other places, like when I'm walking, exercising or for centering me when I go to sleep. Better than any pill that I know of!
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Do you think we are ready to leave this topic? We seem to be drifting away from it anyway.
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I think that until congress gets off their duff and does something, we have discussed it to death. Hopefully they will soon vote.. Such chickens..
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Babi, I think we've about worn it out. Certainly the Congress has.
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I think the fuss of it all wore us out. But it will remain a relevant topic, whether or not we discuss it actively. There are more specific bills now in Congress. We older folks do need to pay attention, not so much for ourselves but for our children and grandchildren. We do hold a large percentage of votes.
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Before we move on I'd like to know if anyone has AARP medicare Advantage insurance? Since my present policy costs so much more I'm looking around.
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Y es, MDH and I have AARP.. It is a United plan.. Excellent. We love it.. your own choice of doctors, etc. That is important to us with his skin cancer..I also use their prescription plan and like it as well, but I use generics..
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There is a difference between the AARP medicare supplement insurance and the AARP Medicare Advantage plans. At least where I live, it's absolutely vital to check with your providers to see if they will accept the Advantage plan. (Medicare Advantage is actually Medicare A & B, NOT a supplement.)
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With the recenly annonced raises in premiums, the private insurance companies have given the not holding down costs and couldn't if they tried.
O yes, we have certainly discussed this a lot. But the bill we will see pnassed hasn
t yet taken final form. Until it does, let
s suspend it at have a Talking heads about maybe something else?
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I have secure horizens which is an advantage plan. I'm not sure what that means but at five dollars for most of my regular drugs and ten dollars co-payments for doctor visits and free lab work, I'm content.
claire
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I like my coverage just fine but the increase of 45% is ominous. Has anyone else seen their premium cost increase?
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Talking Heads #6
"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.
(http://seniorlearn.org/bookclubs/graphics/talkingheads.jpg)
A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.
Our Sixth Selection is:
Health Care Reform~! Are We on the Fast Track?
7 Ways Health Reform Is Going to Affect You (http://health.usnews.com/blogs/heart-to-heart/2009/06/10/7-ways-health-reform-is-going-to-affect-you.html)
Newsweek June 10, 2009
winsumm, the concern in advantage plans would be the co-pays for some of the more expensive things, like therapies or hospital, Part B drugs, oxygen, etc. But remember to read your notice of change for any changes for 2010, also, because the plans can change co-pays, premiums and even covered drugs every year.
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I can't figure it out but in the end I believe in medicare for everyone. why not???
and as for micromanaging it. . .not my pay grade.
claire
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I dont pretend to understand the Advantage program or why it was adopted. Seems to me it is bound to just increase over and over..I would rather take the regular medicare and then get the medigap coverage. At least that has worked for us.
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I guess we need to sit back and wait for the axe to fall and just hope its okay. Needless to say, I have very little confidence in Congress.
Here's an old email to think about.
Let me get this straight.
.....we're going to pass a health care plan written by a committee whose chairman says he doesn't understand it, passed by a Congress that hasn't read it but exempts themselves from it,to be signed by a president that also hasn't read it and who smokes, with funding administered by a treasury chief who didn't pay his taxes, all to be overseen by a surgeon general who is obese, and financed by a country that's nearly broke. What could possibly go wrong?
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Very clever propaganda; sounds as if it written by one of those spin doctors who delight in torpedoing anything that's proposed by the other party instead of working to make it better.
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ANNIE, I had to copy that old post and e-mail it to my son. He'll love it.
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To each his own, Jackie. I looked this up on Snopes but they don't mention it.
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Ah,, actually I believe that almost every law that congress ever passes is not read by them. At best it would be their staff.. It would be wonderful if legislators actually knew what they are doing, but I dont think that is going to happen. Just think of the tax laws and how they get twisted. The minute they pass the health bill, the lawyers will start looking for the loopholes especially the litigators..
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Annie: I meant that attacking an idea by finding the most egregious description strikes me as negative and divisive, designed to dumb down the discussion. Definition of propaganda:
information that is designed to mislead or persuade
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Hey Babi,
Hope your son enjoyed it. Propaganda or not, it works for me. ;)
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medicare advantage. my hmo seems to have it and schedules me for checkup ever three months with a though going one incluidng tests once a year. costs me ten co payment each time and labs are free.
some things work out pretty well. I still have not returned the stool collection kit though. I forget how to use it each time and have to read the directions. yuck.
claire
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Winsumm,
Sounds like you have a pretty good policy. How does it work with Rx's?
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my prescrips are old stuff and all but one are five dollars or even less. the other one is 20.88 reduced from thirty something. I have them delivered for three dollras because of my immobility so that area is good. New style drugs give me bad side effects so I don't have anything expensive to begin with. I use all generics.
generics of halcion, tylonal codeine, thyroid, valium. vitamines, over the counter stuff like lanacan for iches etc. As long as I don't require anything more complicated I'm fie. Chemotherapy is super expensive as is the pain killer associated with it. it's best to be semi healthy with only aging problems, aches and pains etc. I try to keep the paiinkillers down with the chiropractor but that is thirty one a visit and should be at least four a month . . .most of the time.
claire
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I agree that generics are helpful for me as well. I take verapamil and lisinopril for Blood pressure. Both are old, but work well and the newer ones tend to have side affects for me. I also was delighted when Fosamax ended up with a generic.. Hooray. However my husband has problems with chloresterol drugs and takes one that costs the earth, but his liver enzymes get out of wack with most of the drugs.. I have a good friend with Parkinsons.. She is in the donut hole and her drugs are running over 600.00 a month. Now her husband is quite ill and they are testing him with all sorts of things and his drugs are sky high. Get sick when you are older and life gets complicated.
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With all the laws constantly under consideration, I don't think anyone
could possibly read them all, much less study them carefully. That is what a congressman's staff is for. They study the proposed legislation and give their employer a synopsis of the key points. The ones that will get the Senator/Rep.'s close attention will be those that most concern
them.
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On the one hand it is appalling that they pass laws without reading them. On the other hand they would have time for nothing else if they read everything that came before them.
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nnnnn
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You don't think that the congressmen/women should be reading these giant tomes??
My gosh, and what they get in a nutshell is probably filtered by their staffs??
These men and women that we elect only work 3 days a week and if they care, they should be reading a condensed version. I believe that there are companies out there that would condense those long pages into something that a congressman/woman could understand. And at least they would have a bird's eye view of what they are getting ready to vote on.
And another thing, I am getting so tired of the speed readers using their fingers to read through the bills and then we never hear what was in those bills. Phooooey!! ;)
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This what AARP sent me today, although I cancelled my subscription and told them why months ago.
H.R. 3962 is not a perfect bill, but many of its provisions go a long way toward improving the life and health of older Americans and their families, such as:
- Ensuring seniors' access to doctors so they can see the doctor of their choice or find a doctor if they need one;
- Preventing insurance companies from denying affordable coverage to anyone because of their health or their age;
- Saving seniors from having to pay thousands in out-of-pocket costs for their prescription drugs by closing the Medicare Part D coverage gap, or "doughnut hole"; and
- Ensuring that people who already have coverage through their employers, including retirees, don't lose that coverage.
This definitely has a positive connotation to it. Did anyone agree with the conservatives who were en masse in DC yesterday?? I just want the Congress to slow down and not push this through tomorrow. And, since its our country's healthcare reform plan, shouldn't we be asked our opinion of the final bill. That would require that we read it,too. :)
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Did everyone notice the full moon the past couple of nights? One group of mostly Medicare recipients storming
Washington screaming "No government health care" and an opposing group actually trashing Senator Leberman's office, certainly a great way to get the Senator's vote. (those in the latter group got themselves arrested; None of the others could be charged with anything except being loud.)
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I used to like Leiberman, but I have no respect for him anymore. He is in it for whatever he can get. I find his dispicable and would not vote for him if I lived in that state. I also was not happy with Facebook, who let Sarah Palin take over one of the groups with her self publicity. Dropped the group immediately
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To people who want the whole healthe care reform effort to "slow down" , how much longer should we prolong the suffering of 40 million people going without health care because they can't get insurance? A year? Two or three? How about five or ten or forever? How long would you go without health insurance if you were one of them? It really is a case of 'if not now, when?"
The question is asked, " is it fair to make young people pay for the health care of older people?" by mandating that they buy health insurance? they are not just taking care of "old people", they are taking care of themselves, too, in a responsible way, rather than making the rest of us pay their emergency room bills through our health insurance premiums.
Generations do have mutual obligations in a civilized society: Don
t we of the older generation have a moral obligation to pay for the education of young people, through our taxes supporting schools and universities?
Months and months and years and years have gone into studies of possible reform; this is what has emerged. Let's see if the country will turn its back on the people who are so badly deprived.
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They began talking about health care programs in the 1930s. Hardly think we need any more time to think it over. I am a retired Federal employee and have the same health care package as those in Congress. My premiums just went up $25 a month. But at least I do have good health insurance.
I live in an underserved area in the West. Most of our doctors will not take Medicare patients let alone anyone on Medicade. We have some people layed off from their jobs. What on earth they do for health care I don't know.
It is sad when there is such a need that so many are trying to sabotage reform. It seems that many believe that it is every man for himself.
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Ironic that Obama was elected on a platform of change. Everybody hates change. but what did they think he was going to change, the draperies in the Lincoln bedroom?
Now change is happening and it is uncomfortable for us. We don't know for certain what the future will bring to our health care system. We do know that the present system is a road to disaster, with more and more of our gross national productivity going into our health care. the trend of upward costs has never wavered in my memory; I can't imagine what the percentage of a family's income will go for health care in the next generation if the trend isn't stopped and reversed. Half? or more?
We would like absolute certainty in our lives; unfortunately this is an imperfect world, so we are not going to get it. I hope this measure passes, followed by some kind of reconciliation of the adversaries so we can move forward and confront the truly terrible problems like Afghanistan. There
s one formidable challenge for those wanting certainty in the future.
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It seems that many believe that it is every man for himself.
I agree, KIDSAL. It does seem that many people would rather see masses of people doing without rather than give up one iota of what they have. It's distressing.
Well, a vote is scheduled for today on one version of the bill. We'll
see how it goes. Really, haven't you noticed in your lifetime that as
much as people are uncomfortable with change, when it does occur
they do manage to adjust?
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I agree. Many people seem resistant to change and predict dire things. But then once the change occurs,, none of the things are what really happens. We need to care for everyone. Not just the people who are comfortable.
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I am not against change when there is careful thought given to the consequences of the offered solutions. But when the people in charge begin to threaten the folks who are having trouble deciding on which way to go, it would seem to me that the pros could relax and give the cons some time.
No, it doesn't have to be years but it does need to be a few days or weeks for this particular bill. One of the things that they are trying to decide on are our Medicare benefits which are so helpful for the disabled and the seniors. And, the Medicaid state programs which are so helpful to the poor including young families with children.
I have family who have benefited from Medicare and from Medicaid. To cut their benefits would be a crime.
Link to Ohio Medicaid benefits: http://jfs.ohio.gov/Ohp/consumers/whoqualifies.stm
Delaware Medicaid benefits: http://www.workworld.org/wwwebhelp/de_medicaid_overview.htm
New York Medicaid benefits: http://www.hrsa.gov/reimbursement/states/New-York-Eligibility.htm
Indiana Medicaid benefits: http://www.statehealthfacts.kff.org/profileind.jsp?sub=54&rgn=16&cat=4
I have had experience with all four states and wouldn't want them to change anything without careful considerations.
We don't need to rush this. We all would like a decision but with bipartisan consideration.
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There will be no "bipartisan" plan. The Republicans have put up roadblocks all the way.
And Medicaid and Medicare will deteriorate, not because of reform, but because reform is not enacted. There is no way they can be sustained unless the whole system is reformed.
The President wasted valuablel time by trying to get bipartisan support - what he should have done was got the support of the American people, and the politicians would have had to go along. But he played politics, and what we have now is a disturbing, confusing couple of bills that don't address the real problems of high cost and exclusion of too many people from the system.
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nlhome, sad to say but you are probably right. I used to be interested in the "single payer" plan but am not too sure if that is the way to go anymore. What do you think about it??
As I said earlier this week, some of the bill before the House sounds good but why are they insisting on rushing into this decision? This bill is 1990 pages long. The Constitution only took 6 pages.
Cspan.com or .org, has the whole 1990 pages in auditory form should anyone want to listen to it. Last week, I heard a reading of just a small part of the Medicare bill when it was presented and was just bowled over at how difficult it was to understand.
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The Constitution only took 6 pages, ANNIE, but look at the more than
two centuries of laws and amendments it has taken to interpret, sustain and enforce it!
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The Constitution also had to start amendments right away.. But the House did vote.. Hooray for that. Now the chicken Senate needs to stop diddling and vote.
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AdoAnnie, I think the only way we can truly reform the system is to move to a single payer system. There are a number of such systems around the world that we could use to build one that would suit us.
In the meantime, we already have a "public option" that could easily be opened up - Medicare. It was originally designed with the idea that first the elderly, then children, then the rest of the country would have Medicare. But Congress lost the will to do it. Makes sense to me that we could have it has the public option, and if private insurance companies could do better, great. However, since the Medicare Advantage plans need an average subsidy of 13% above the cost of traditional Medicare in order to "compete," I wonder....
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nlhome,
I was not aware of how Medicare was supposed to end up a single payer. That was a surprise. When I was interested, I was interested through the WI senator who proposed one but haven't been to his website lately to see what he intends to do.
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Medicare.. Did not know that originally it was meant to be expanded. Makes sense though. That way you can add in private coverage like Medigap and still have everyone basically covered.
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Cuts in Medicare and Medicaid sound really scary. I suppose doctors can refuse to take medicare and Medicaid patients at lower rates. But with the demographics of an increasing elderly population, and the economics of an increasing proportion of poor peopl as the income gap widens, just who are they going to have left to serve? The inconvenient truth is that doctors and hospitals are going to have to make less money. . It's up to them to come up with innovative ways of providing care that save money and improve outcomes for patients. I firmly believe they can do it, if they put their minds to it. Examples are the Mayo and Cleveland clinics.
Just look at all the other problems this administration must face: the wars, the unemployment, the envionmental dangers. I just hope the president will do more leading and less following in future.
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Bellemere, I'm with you ("I just hope the president will do more leading and less following in future.")
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Kind of sad, he truly wants to believe in consensus and it just isnt going to happen. The political parties do not want to play nicely.. and thats that.
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For better or for worse, Obama does strive for a 'higher ground'. I can
only admire that and wish him well. Any gains he makes in that direction can only be for the better.
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Lest we forget:http://www.scoutsongs.com/lyrics/taps.html
We are getting ready to attend the Vets Day celebration at the elementary school where two of our grandchildren attend. They have added a new feature, coffee and donuts before the ceremonies. Ralph didn't expect to be here this day so its a double celebration for him. He's a Vet and he's alive!! Thanks to many prayers from all of you and a heart pump. Wow!!
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Must have been a very happy Veterans' Day for Ralph. PBS carried an note that last year , 2200 veterans died because they had no access to health care.
what happens to disabed vets once they are discharged from the service? They can get Medicare and Medicaid? Apparently there is no lifetime Veterns' health program.
Somehow I thought there was.
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Talking Heads #6
"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.
(http://seniorlearn.org/bookclubs/graphics/talkingheads.jpg)
A two week forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.
Our Sixth Selection is:
Health Care Reform~! Are We on the Fast Track?
7 Ways Health Reform Is Going to Affect You (http://health.usnews.com/blogs/heart-to-heart/2009/06/10/7-ways-health-reform-is-going-to-affect-you.html)
Newsweek June 10, 2009
There is a VA health program, but like anything else it has its red tape and rules and, if the medical need is not service-related, financial eligibility rules too. I would guess that some of the vets are unable to get into the system for one reason or another. They need advocates. Our county right now is cutting the program that helps veterans here apply for benefits - supposedly it won't hurt the veterans, but for some of them even a phone call returned a day later might be the final straw...
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The VA takes very good care of all the vets from all the wars. I have heard bad and good concerning about their hospitals but most vets have access to the VA Medical Centers and ours here in Columbus,OH, is really a good one.
Two of our largest VA hospitals have been reported in very bad shape and I have seen the pictures which are awful. But it is my understanding that repairs are being made quickly. I certainly hope so.
My BIL is taken care of by the VA hospital and center in Indianapolis and he is receiving marvelous care although he is not in the hospital itself. The man has heart disease and diabetes which might have been caused by his exposure to Agent Orange. He receives money from the Agent Orange settlement each month. They have provided him with a wheelchair plus an electric chair for getting about outdoors. They are now providing his dialysis three times a week. They will pick him up if my sister or her daughter can't get him there on a busy day. They provide all of his meds. He is a Vietnam vet who has a purple heart plus a medal of honor. I am saying too much so I will stop. This is quite enough for now.
But I can't quit! :D My husband who is a Korean vet gets care and his wound supplies(from his heart pump surgery back in March) from our VA center here. The people there are just wonderful.
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Just curious about veterans who are discharged from the service and then get sick with something not related to their military service. If they are working, do they rely on thier employer based insruance? If they are over 65 do they get Medicare? If they have a prmanent disability not related to service and cannot afford insurance can they get Medicaid? As a general rule, VA facilities treat veterans with service-related problems, right?
Other vets are in the same boat as the rest of us?
there is a big VA hos;pital near me whcih treats alcoholism, drug addiction, and post traumatic stress syndrome. Are those conditions tied to their service? I think progably the PPTSD must be. What about the others?
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Veterans with service-related disabilities are treated at the VA for those problems. Others, depending on their income, also get treatment for their problems. They get Medicare if they are 65 and have enough work credits. They can get Medicaid if they ar4e low income, although I think the VA provides better.
Like anything else, there is no simple answer. It often depends on the circumstances.
My husband is a veteran, has always received his health insurance through work and now as a retirement benefit. If we were low income, he could go to the VA for help with medical issues. The VA care is good in our area.
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I guess that I didn't make the story of my husband very clear. He was not injured during his time in USAF, but VA are taking care of his supplies that he needs to keep his perc site clean and sterile. This is a lifetime of wound care and those supplies would cost us $300 a month if it weren't for the VA. Medicare doesn't pay, at this time. I had forgotten that he could get some things from the VA but my sister who is married to vet in the wheel chair suggested that I call them. Success!!!
VA will also fill Ralph's Rx's when they are generically available but they charge more than our insurance charges so for now we will stick with our insurance.
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The history of America is rife with unintended consequences of bills passed. That shouldn't prevent us from acting. We have to start somewhere and as abuses come to light in the future we can make corrections. Crying that this is wrong or that was left out should go only so far. We need to have a line drawn in the sand and say this is where it stops. The bill goes forward now, as it is, and we will continue to make up policy as we go along when we find the flaws.
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Makes good sense to me, JACKIE.
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Reading of the Senate discussions and versions, I'm confused - where's the reform? It's just more red tape and confusion. In the end, the insurance companies will come out ahead. I think it's sad.
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Isn't red tape and confusion SOP for Congress? I just hope they muddle
through with something reasonable, and then as JACKIE says we can plug up the holes as we discover them.
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I've spent a career as a "red-tape cutter" and find the government programs easier to deal with, usually. The problems with government programs come when private companies are given too much control, as in Medicare Part D. What I see in health care reform is too much insurance company involvement - Congress is afraid to deal with the industry. While no one says so, I believe it's because they don't want to risk a market decline in that area.
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NL and Babi,
I am still worried about this bill being passed with so many new ways to implement health care. And the new news is that we will have the government looking over the insurance industry's shoulder to make sure everything is copacetic. I can just hear the cases before judges with the government on one side and the insureres on the other blaming each other for mistakes that are being made.
And if I understand you, its easier if the government is running it all? If that is so, why are all these expensive mistakes already being made by the medicare and medicaid systems not being investigated??
I firmly believe that if Congress had instigated torte reform plus thoroughly gone after the medicare and medicaid errors that are made every day, we would be okay. Unfortunately that is not even being considered.
Yes, we need to get everyone covered and maybe the only way to do so is with a single payer insurance. Of course, that's not going to happen because the insurance lobbies have too much power. It seems as if the next election's results are the only thing that is important here.
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I'm not saying everything is better with the government running it entirely, although I see in other countries that they spend less for good outcomes, but it is easier to address inequities with the government.
I believe there is some consideration for tort reform.
I agree that there is fraud and abuse with Medicare and Medicaid, and that is really annoying because it isn't being pursued as much as it should be. However, we don't know how much fraud and abuse there is in the private insurance world because they aren't going to share that information, while the government has to.
What annoys me is that when the big companies, such as the drug companies, are fined or punished, while the amount seems big to us, it is a drop in the bucket compared to their earning from such fraud. The government uses a law from the Civil War era, the false claims act, to prosecute much of the fraud. But the companies pay the fines and then that becomes part of their cost of business. I believe that the people who countenance such large-scale fraud should be imprisoned - because if there is no personal responsibility, then the executives in charge can just look for another devious way to get more money out of the programs.
There are fraud and abuse programs in every state, where people are supposed to report instances where they think there is fraud. Of course, then Medicare has to investigate, and that takes employees and money, and.....
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I never said that, ANNIE. That it is better if the government is running
it all, I mean. If I'm not mistaken, the government running anything in
the private sector, means it will be more expensive, inefficient, and
badly run. Imagine our countries big businesses run by a bureaucracy!
[shudder]
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Sorry to include you in that comment, Babi! :'(I was just aiming my comments to both of you because I was too lazy to separate your comments. Mea culpa, mea culpa??
Yes, the government needs to stay out of our business but it looks to me as though they are just taking on more and more of our private industries plus this healthcare decision.
nlhome,
Seems that when we do catch anyone cheating on Medicare or Medicaid, we never hear the results. Did you see the program about the Medicare cheaters and how easy it is to make money making false claims? What a shocker that was to me!
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Although I didn't see that program, I have read about it and have listened to a speaker discuss some cases.
Medicare used to send explanations of benefits whenever it paid a claim, then it went to monthly statements, now they are quarterly, and not all claims are included. So, how do people even know what Medicare and their insurance pay for them? Especially if there is no amount due that would rais an eyebrow or two.
People who are computer literate, have a computer with Internet and a good connection and want to spend the time can check their claims on line.
We kne of a dentest who was charged with insurance fraud - it wasn't just Medicaid, it was private insurance fraud too. As I said, the government does reports on fraud, but how do we know what problems private insurance have? They wouldn't want to upset investors.
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Oh, yes the new way to save the trees, by Medicare!
nlhome
Now we get the quarterly on one or two or three pieces of paper with my husband's listed first and mine listed last. I don't know about all of you, but I used to keep our EOBs plus bills paid or still pending in separate folders. Now, if I need to challenge any of these, I have to search both of our folders and then online. Last time that I called, the private insurer couldn't answer my questions because they hadn't been paid yet so that part wasn't included on the Medicare EOB but on the private insurer's. Go figure! I sure can't. One can't even have a common sense conversation with the poor operator who just doesn't get it. Very frustrating!
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nlhome and adoannie - we get a Medicare EOB for every claim. Sometimes there are two or three on an EOB, but usually for the same date of filing (not necessarily the same date of service). Maybe each state is handled differently.
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Did you see the program about the Medicare cheaters and how easy it is to make money making false claims? What a shocker that was to me!
It doesn't really surprise me, ANNIE. The plain fact is that the govt.
gets so many of these claims it is simply impossible to check out each
one thoroughly. The clerks who handle the claims will have guidelines
on how to proceed, and personnel costs will be a major consideration.
That's one reason why they publicize so much the need for people who suspect fraud to report it.
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maryz, do you have original Medicare or a Medicare Advantage plan?
I think sometimes the Medicare carrier that processes claims for original Medicare has its own schedule, but I know some claims don't make it on to the Medicare statements here. There are different carriers around the country. But getting a statement once a quarter is frustrating.
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nl, we have original Medicare. Our supplement is through John's retirement.
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As the Health Care Reform debate comes to a boil, it becomes easier to see how the entire effort has been taken over by the private insurance industry and their lobbyists. Think of it: Millions of people will be required to buy health insurance , and all of that business will go to private insurance companies, which can charge whatevere they want. If I had money I would be buying stock in AEtna right now! and to top it off, the government will be subsidizing the purchase for low income people. What a windfall!
A badge of shame to Joseph Lieberman - the Medicare buy-in for 55 and older gives a break to all those who are "downsized" in order to give jobs and benefits you younger less expensive people. But is you ever drive into Hartford Ct you will see all the huge private insurance buildings that dominate the economy of that state!
If it actually passes, let's see what the regulatory process can do with the insurance companies. That is how it is done in Germany;' all the insurance is "private" but strictly regulated as to what they can charge, make as profit, pay their execs. We may still have a chance to rein in costs that way.
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Trying to visualize what this is going to look like in final form. Most of it doesn't even take effect until 2014. But from the moment the President signs it, there is one important provision that takes effect immediately: no child can be refused health insurance on the basis of a pre-existing condition.
There are some restriciton on insurance companies: They must pay out, in claims, 85 percent of what they collect in premiums and cannot "cap" benefits in the case of a long illness. When the fog finally clears, maybe we can make some sense out of it.
But a lesson has been learned for senators: When the vote is close on your side, and your vote is critical, you can hold out for a bribe in the form of financial benefits for your state, and a boost for your reelection. Politics as usual.
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I heard this morning that the U. S. Attorney General might look into the provision providing Nebraska with federal benefits that no other state can have. They think this might be unconstitutional. Even the other senator from Nebraska didn't think that was right. I hope they deny it.
Marj
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So many of the posts here talk about "the government" as if it were some alien force, distant and removed from us, working its will on us helpless people. This is a democracy, the government is us. We get exactly the government we deserve by our inaction, passivity, selfish attention to our own narrow interests. Look at the low level of voting, what is it, a third of eligible citizens vote? In Iraq and Afghanistan, hardly models of democracy, people risk their lives to go to the polls and vote. The streets of Iranian cities are seeing wild demonstrations of citizens who want a more democratic form of government. Yes, the governement should not be taking over banking, car manufacturing, etc. But they had to bacause the vaunted private management ran the industries into the ground. Nobody wants to strangle pri ate enterprise, but the corporations have to be more sensible and not always grab for the short term profit. The private insurance industry, coupled with Americans' demand for every possible form of medical treatment gave us the best health care system in the world for those who could afford it. And almost a third of our population can't.
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But a lesson has been learned for senators: When the vote is close on your side, and your vote is critical, you can hold out for a bribe in the form of financial benefits for your state, and a boost for your reelection.
Nothing new there, BELLE. SOP for politicians. And your other statement is equally true.
This is a democracy, the government is us. We get exactly the government we deserve by our inaction, passivity, selfish
attention to our own narrow interests.
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I believe that we can still let our congressmen/women know how we feel. Just go to Congress members.gov and find yours now and say what you do or do not want in this bill. I, for one, want to take the government paying for abortions so my voice will be heard. Whether or not, anyone is listening is not knowable.
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Yes, it is never out of line to contact your rep or senator about your views. One thing to remember: one phone call is worth ten emails. Always request an answer.
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I believe I've always gotten a reply to a letter or e-mail to a political
figure. Send by an aide, no doubt, and assuring me my concerns are
of interest to the politico in question. The last one I received, as I
recall, referred me to a recent article in which the pol. had expressed
his opinions on the subject. He disagreed with my views, but I thought
the reply showed they were making an effort to be reachable.
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I usually receive an answer to my concerns, either by email or snail mail.
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So now the "reconciliation process" when they come back. More of the same fighting, name-calling and deal-making that has been going on for so long? Don't know how much more we can take.
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I guess I am having an epiphany of sorts; why, oh why , didn't they just expand Medicare to cover everyone? Workers ow have a deduction from thier paychecks for medicare; the system is in place. Medicare, a government funded program that reimburses private hosptals and doctors for providing care. Its costs have risen, but according to James Suriowicki, economist , they have risen at a much slower rate than the costs at private insurers.
As I understand it, insurance will now be sold b;y private companies but now they will not be able to take anything in to account settin premium orices except age, region, and whether or not you smoke. A far cry from all the slicing and dicing ofpopulations they are so good at. the new system is called community rating, and all that actuarial expertise is now useless. We could easily get along without the private companies, but Joe Lieberman, whose state floats on the insurance industry, obviously could not.
I think the new bill contains something for every demagogue, rather than something for all the people.
How nice that the wealthy enterainer, Rush Limbaugh was able to obtain good care in his recent health evergency. "Best health care system in the world, he says,
Nothing wrong with this system. " the doctos who know better must have had tobite their tongus
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It'd never work, bellemere - it's WAY too simple and logical and obvious. ::)
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I think the single payer system, particularly Medicare for all, would be the best, too. Insurance companies could be in a supplementary role then, either as Medicare carriers (the insurance companies that handle the claims for a fee) or providing supplemental coverage as they do now for Medicare. I suspect that most of the Democrats, at least, know that we need something like that. However, I believe they fear the effects on the stock market, if insurance companies were curtailed like this, but they don't have the courage to come out and say that.
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Well, Bellemere, you have solved the problem. I wish that you could get the ear of the those dodos in DC! Lets see, what about adding torte reform to that package. That would bring down the drs' costs and also the medical bills we receive with a 10-20% add on to pay for the drs' insurance protection from law suits.
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I think tort reform is needed. I would like to see doctores whose careafully kept records show they acted consistently within proper protocols should either be immujne from malpractice suits; or should get a big break in their primiums. I would also like (and this would be controversial) more mandated mediation of claims rather than jury trials where the lawyers trot out all their manipulative techniques to get ordinary juries to award scandalously big money. I do not believe patients should give up their rights to sue, however.
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Also great, bellemere!
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Okay so when I run for president my health care platform will be Medicare for everhyone with a job and Medicaid for everyone without one. Problem solved. Private insurance companies can insure houses, businesses, cars, airlines, ships, trips to the moon and movie stars' legs. Keep your greedy capitalist hands off my health care!
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Ah Bellemere, I do agree on lawyers. At the urging of my sons went to see a accident type attorney. All he wanted to hear was how much money my own insurance company was kicking in. He admitted freely that the person who hit us has no money and minimum insurance. My insurance company has been very helpful thus far and I have no intention of suing them for the amount they have already promised me.. If Idid, he would get 1/3.. He must have taked one look at grieving widow and thought he could snow me. Bah..
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Good for you, telling off the ambulance-chaser! You are sounding like our Steph
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TELL ME YOUR STATE. I WILL RUN YOUR CAMPAIGN! JUST KIDDING ;)
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Ado Annie, thanks for the support! I am in Massachusetts which alreaady has universal health care and is struggling through the second year, tweaking and making adjusments, but the economy is making it verydifficult. However, our state chose to put "people first"
withe universal coverage , and then ot figure out how to pay for it all! With predictable results, but we are not going back!
I just read that the big Harvard Medical
School hospitals in Boston are putting limits on the amount of money their doctors can make from sitting on boards of health-care related companies, and giving talks sponsored by them. Never knew they could make 5 thousand dollars for going to a one-day annual board meeting! No heavy lifting, as they say. Now that is all in the past.
Also the Mass Health program, our Medicare, supplies counseling and medication to people who want to quit smoking, and has cut the rate of smoking among low income people by 13 percent. Not much, but it will make a big differcnce in theri health.
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Nice to hear some good news, ANNIE. :)
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Did anyone hear about the Mayo Clinic in Arizona refusing to honor Medicare claims?? They will no longer take Medicare patients either. You will have to pay them with check or cash or credit card.
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Ado annie, we have to look closely at that! Seems to come under the cost reduction banner. But what a pain in the butt for us to have to make the Medicare claim for ourselves! Does the Mayo offer a trained social worker to help those of us who are hopelessly illiterate in these manners, like me?
When we get treatment at a hospital in a foreign country, our Medicare Advantage program covers it on the base of a credit card receipt. No checks.
and only if it is urgent or emergency care.
It seems "shared sacrifice" means something unpleasant for everybody. Oy, veh!
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I've been going to my rheumatologist for about 6-7 years. His office does not "accept" any insurance, including Medicare. Payment is expected at the time of the visit (credit cards accepted). The office files the insurance for you, almost immediately, and reimbursement is usually received within a couple of weeks. I saw him in midDecember, and got my Medicare reimbursement check today. So I have no problems with that.
Of course, we're fortunate that we are able to pay at the time of the visit. I know that's not an option for lots of folks. I don't know what this office would do with folks who have no way of doing that.
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I read the article about the priary care clinic in Phoenix; yes, they are not accepting Medicare for primary care visits any more. they still accept them for specialist care, lab work, etc. The reason givn is that the Medicare reimbursment is not adequate to cover the costs.
Many doctors give this reason for not accepting Medicare patients. And for not accepting poor people's Medicaid insurance, which is even stingier in some state.
But who sets the costs? The provider does. If your neighbor has a huge mansion, two Caddies in the driveway, a swimming pool, vacatons in Europe or the tropics every few monts, and then says, "My employer is not paying me enough to cover my costs," what would your first thought be?
Patients have no idea what the actual cost of their care is, do they? Each component of the medical syste is "selling" something to some other coponent, and charging as much as they can. The bitter truth is that there will be no reform, and no cost control unless hospitals, doctors, drug companies and equipment manufacutrers, and insurance companies, make LESS money. They will fight like tigers to keep that from happeinin, even though if they dont, and the upward trend continues, Medicare will be GONE by 2017, if not sooner, according to some economists. Think what that is going to mean.
Can't stop this rant without saying that I think primary care doctors are not making enought money; one of the consequences will be a lack of primary care internists, pediatricians, ob/gyns and geriatricians. I dont know how accurate this is but someone told me the average income for a primary care doctor is only about100thousand Some Wall St guys make that in an hour.
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Our family care doc (whom we thought would outlive us) left private practice to work for the city and manage the clinic the city provides for its employees. He was working himself to death, keeping up his practice and working part-time for the city. And, like you say, these docs are the ones who are getting the shaft.
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My dr's nurse tells me she only has three yrs to go before retiring and along with her will be many drs and nurses from her generation. Their fear for the medical system and the patients is the fact that there aren't enough primary care drs now and not many nurses either and it can only go downhill from now on.
I read about a young new dr who on graduating from school and training was offered a job of taking care of one whole town and the town would pay his debts for medical school. He will be overwhelmed, sad to say. I hope he gets much joy from helping these folks.
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Don't you think forgiving the school loans of priary care doctors is one good way to increase the supply? Right now they can get reibursed for gvt. loans by serving in the army or in a a dr satically underserved area; some end up working in prisons, a real fun scene.
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OH, yes, I do approve. Was just telling the story and giving my opinion, Belle. I think this is a wonderful way for small towns to help new graduate drs and nurses.
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Have you read anything by Atul Gawande? He a young surgeon, associated with an academic medical center in Boston. I've read parts of his Complications, but my public health daughter referred me to a recent New Yorker article by him that compares early 20th century agricultural reforms to what we are or may experience with health reform. Mainly he talks about the government agricultural pilot programs begun in this period, one of the most successful being the county extension programs. Apparently many of the pages in the volumes of the health bills describe a number of pilot programs. Gawande does not go into great detail on individual programs, but does point out some included in the bills. His message is that the small program approach worked well for agriculture; it could also work for health.
Testing, testing by Atul Gawande (http://www.newyorker.com/reporting/2009/12/14/091214fa_fact_gawande)
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I do hope Congress is giving this subject as much attention as we are.
:(
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Too many patients with similar problems who can't use the same solution as the guy next in line. And, it will be lines, everywhere we go.
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I have been reading Atul Gawande for a long time, both his articles and his books. I missed the article your daughter referred to when my subscription lapsed for a month. But this weeks has some letters from three people, discussing the aricle, I wil have to hit the librar to get filled in.
The only way legislators willknow we are paying attention is to tell the, earlhy and often. having said that, I realize that I haven't called our guys for a while, maybe because i know where they stand.
Another responsible voice I read, but don't always completely agree with is David Brooks. He describes the "Tea Partyy" view that the government is being taken over by an " educated class" that is not taking their views into account. Most strangely, I have heard this from friends of one of my daughters: they hate Barack Obama; they thing the "edcuated class" looks down on them. But these are all women with college degrees; some with professional credentials like registered nurse, certivied financial planner, etc, and most of them are working hard to put their children through good colleges! Producing more members of the "educated class
that they scorn. Health care is just one of their "anti" issues. They don't believe in global warming; they don'b believe that the Supreme Court was right in recognizing women's right to choose abortion, and they definitely don't believe in gun control. This in an affluent suburb far from any inner city crime scenes. I I find it very puzzling.
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Bellemere, I find your daughter's friends' attitudes puzzling too. It sound like "we've got ours, we don't care about yours."
Click on the link Testing, Testing -- above. That is the New Yorker article by Gawande.
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Still struggling with the insurance and medical bills. The insurance company has promised me a pay out, but they are not willing to help with sorting out the medical liens, etc. Hmm.. My older son and I are debating. I think I need to talk to both the hospital and medicare.. I dont mind doing all of this, but I really assumed that the insurance company helped a lot more than they are.
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I didn't know that your insurance wouldn't just pay the hospital and doctor bills as they were sent in. This must be very trying for you, Steph.
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Lots of stress, but I do honestly think that the insurance company knows how to do these things and I am mostly getting annoyed that they want to push it off on me. They say their responsibility ends with the PIP ( uninsured motorists) and the larger payout is for me to decide. Makes no sense.
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Trying to get my mind around the catastrophe in Haiti. Just incredible, people who had nothing to start with, being hit this way.
that humanitarian Rush Limbaugh is discouraging people from donating without some assurance that "the government" is not just trying to get their name and address to add them to "a list" \
We are giving to Doctos Without Borders and I will be happy to be on their list.
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That man has become a fruitcake and I am being nice here!
We donated to the Red Cross as we have confidence in their being able to use the money wisely.
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Did he really say that the President's appeal for help for Haiti was " a black president's attempt to burnish his reputation with black voters'
I heard that second hand, never listen to him my self.
And did an Iowa senator or congressman want to send all the illegal Haitian immigrants back to Haiti to be rescue workers? With no food or wather they wouldn't ve very efficient, would they?
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Limbaugh seems to be off the deep end in his hatred for the current administration. Why people listen and believe is beyond me.
The thing in Haiti,, they need to get down to the basics to make that country into something that will actually work. Haiti turns out the most venal politicians on earth. All reports I read say the government is not functioning at all. Bet they will, when money comes in to be spent. And it wont get spent where it is supposed to.. Their Presidential palace when the country is so poor was simply an abomination.
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Couldn't agree more, Steph. And one feels so helpless when they show pictures.
Did you see the news headline that Venezuela was hit two days ago by a 5.6 quake? Haven't heard the talking heads even mention that one.
I did hear a reporter compare a 5.6 with a 7.3. I think he said the 7.3 was ten times worse than a 5.6. I had no idea.
We had cousins in the quake that hit Northridge, CA a few years ago. They were not damaged or hurt but their neighbors were in bad shape. My cousin went around the neighborhood helping people do repairs or removal of the damage. Needless to say, he felt quite blessed.
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Massachusetts voters go to the polls on Tuesday to elect a senator to take Ted Kennedy's seat. I tis very close. the Republican candidate, calls himself and independent thinker, but says he will vote to kill the curren thealth cre bill passed by the House and the Senate and undergtoing final conference. This would end health care reform for our lifetime and possibly for our children's. Millions of people will go without insurance, and those with indurance will pay huge increases in premiums to cover the care of the uninsured. And some of those "uninsured' could affort the subsudized insurance offered in the bill, but would rather not pay even those premiums. It is very close, an enourmous question hangs in the balance. Masschusetts will continue workijg out our uniberal health care problems; the rest of you are goin to have your chance at health reform scuttled by this one Massachusetts man. Stranger than fiction, huh?
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Its truly sad that they turned the health bill into a political dog fight. Why cant they simply vote on how they feel. Seems unknown.. We would never have had a constitution if our founding fathers had simply taken opposite sides and did not discuss anything.
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BELLE, I trust you plan to vote for the other guy, right? Will that one
seat really have that much influence, do you think?
Obviously there are strong 'feeling' on this issue, on both sides. I am
reading a book now (sci/fi) titled "Haze", about a planet where the
lawmakers must not involve themselves in the emotional views of
their constituents, but consider only the greater good of the planet
as a whole. Sounds incredible, doesn't it?
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yes I plan to vote for "the other guy" who is a woman, Martha Coakley, the state's attorney general. She has been on the winning side and sometimes the losing side of really important issues: at least she has engaged her talents on behalf of the people of Mass. I like that she managed to get millions of dollars from the shady contractors on the Big Dig, Boston's mammoth highway project, and also millions from Goldman Sachs for their shaky mortgage practices. She is a fighter.
Your book proposes a radical view of the duty of public servants. should they be guided solely by the emotional reactions of their consittuents, or by principles that promote the general good of the public. Good question.
It seems to me that ex-presidents, free of worry about re-election, are free to do more real good than they ever did as presidents: Carter, and now Clinton. Maytbe the presidency is just a baptism of fire for our future Great Men and Women.
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Regarding the Founding Fathers, they too had their dirty trade off deal: the continuation of slavery, without it theywould have lost the Southern states. Instead of being settled at the beginning of our country, it had to wait for a bloody war. I guess compromises are the life blood of politics.
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I agree about the founding fathers, but they did not knee jerk. Slavery at that point seemed to be a sensible solution for the southern states. It wasnt, but it took almost 100 years to understand that.
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Jefferson said that while writing the Declaration of Independence the thougt of slavery went off like an alarm bell in his head. Yet he, too, kept slaves.
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Amazing the complications. Even though we owned everything in common and according to the estate lawyer, there was no need to file the will, I am now told that because of the medical bills, a probate attorney must file it in order to obtain the money.. Oh well. Geico is paying for the attorney.
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Glad things are moving along for you. Maybe you will be able to resolv everything soon.
Massahchusetts did indeed vote to elect Scott Brown, a relatively inexperienced state legislator, to the U.S. Senate. He has vowed to be the deciding vote agians the Health Care Reform bill. but people were not so much mad at the Health Care bill, to me it seem s that they are mad at .........everything! It's the strangesp phenomenon I have ever seen.
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I agree, bellemere, people are angry and they are responding to it in ways that may hurt them later, in many situations. They are not thinking, they are reacting emotionally.
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I t oo am amazed at the anger in everyday life. Its like if national health is passed, they will lose something. The most interesting thing is that if they lost their jobs, they would be the first to yell.
Also Massachusetts has some sort of health program in place already.. Hmm..
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Yes, Massachusetts has universal health care and Senator-elect Brown voted for it. He reportedly said,"WE have Health Care in Massachustts. Why should we pay for people in Texas?" Don't know why he picked on Texas, but doesn't that sound like the mind set today? "I've got mine, too bad for you"
Interesting to see what happens now, isn't it?
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Yes, the Ive got mine attitude is sort of scary. But I really dont understand how he could vote yes in Massachusetts and now declare no on national. Ah politics.
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Frankly, although I support health care reform and believe we desperately need it, there is much in the current bills that were passed that is just plain wrong. Anyone in Congress interested in reforming the system knows that.
I know the common wisdom seems to be that the little true reform in the bills is better than nothing, as a start, but that was the attitude with the Medicare Modernization and Improvement Act that brought us Medicare Part D. Yet Part D and the Medicare Advantage plans as set up in that act are draining Medicare, and the corrections and adjustments to make Part D better and Medicare Advantage less costly to the government are way too slow in coming. Congress and the President needed to get it right from the beginning, and they didn't.
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Congress and the President needed to get it right from the beginning, and they didn't.
That's hard to do, NL. I think you would have to have uniform brilliance
and a touch of the seer to know all the questions, much less find all the
answers.
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could you state what specifically you think in the Health Care bill is (or are) the most contentious? Is it the mandate that everyone buy insurance? Is it the amount of the subsidy that the governemtnt must come up with for low income people? Is it the restrictions on the insurance companies that will prevent them from denying coverage for pre=existing conditions? Is it the tax on "Cadillac " plans? Is it the r equireent that insurance companies pay out a certain percentage of their premium income in claims? Is it the cuts in Medicare payments to hold down costs? Is there any room for compromise in any of these things?
I have lost faith in our legislative system to do anything for p eople. The cost of getting eleted and reelected dominates the thinking of the representatives. And will do so even more after the Supreme Court decision handing our elections over to big corporationst. Why bother even to vote?
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bellemere
I have lost faith in our legislative system to do anything for p eople. The cost of getting eleted and reelected dominates the thinking of the representatives. And will do so even more after the Supreme Court decision handing our elections over to big corporationst. Why bother even to vote?
I feel that I must vote to complain about what's going on in Washington. But, maybe, I will just complain anyway.
Did you know that if you choose Original Medicare for your Medicare coverage that you pay part of the premium for the Advantage insured folks? Frankly, I think they need to get rid of some of the perks in the Advantage insurances. I have a friend who's Advantage program thru Aetna is paying for her to go to the YMCA(at the cost of $400 a year) and frankly it tics me off. Her former job, working for the state, was able to give her more than most of us get from Aetna. For instance, our company insurance, with Aetna,(Original Medicare supplement) gives me $10 off a year to go to a fitness center without a pool. Isn't that special?? And, we are paying $650 a month for that privilege.
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Bellemere, One of the things you listed is a problem, I think:
the requirement that everyone have insurance. Rather than fine people, I think (leaving children out, because I think parents MUST have their children insured) that the penalty/limited enrollment that is used in Medicare would be more appropriate. There are people who don't sign up for Part B because they are healthy and don't want to pay the premium. Later, when they decide that "hey, I'm sick, I need insurance" they are (unless very low income) limited to enrolling to January-March of every year, with coverage starting July l, and they pay a penalty for late enrollment. Similar rules apply to Part D. And for Medicare supplements - if you miss the initial enrollment period, then a person is subject to waiting periods. I think that type of regulation would be more acceptable to people that the concept of a fine.
As for much of the other, I believe that as long as insurance companies are primary in our health care system, there will be unnecessary costs and there will be uninsured and underinsured people. It's one thing to deny someone insurance who remained total uncovered until they got sick. It's another to deny someone who has remained covered through employment and COBRA and is looking for individual coverage but has a medical condition--that's unfair.
A tax on "Cadillac" plans seems reasonable to me - for years we had employer-paid coverage on which we paid no income taxes, while others who had to pay for their own insurance because their employer did not provide it had to pay their premiums out of after-tax dollars, and could only deduct a percentage of the premiums off their income tax. So basically what we had was $14,000 in extra, non-taxed income.
I think the cuts to Medicare Advantage Plans are reasonable. It's unfair for others in Medicare to pay higher premiums so that these plans can get a subsidy. Other reductions in Medicare, if they prove too damaging, will be corrected rapidly - the Medicare population is growing every year and their voice will be heard. I also believe we all need to do our part to stop fraud and abuse.
But, who knows.
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Good point about fraud and abuse. isn't the bulk of fraud the overbilling by providers? It is hard to see how patients can do much about that.
I think the mandate is fair, as we must all carry car insurance if we want to drive. With everyone paying , the healthy balance out the claims of the people who get sick. And the uninsured must still be cared for by the system, which passes on the costs to people paying premiums.
I can't believe people are worried about the deficit. The cost of the Iraq war, a totally misguided effort, was never complained about. and foregone revenue adds to the deficit, as in tax cuts for the very wealthy. Nobody seems to complain about that.
I really believe the anger is very, very complex, reflecting a fear of the new international conditions we can't control and also anger at the "elite" or educated people in the governemt. I don't know how to get beyone that. We can't turn government over to uneducated people, no matter how well meaning they may be.
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The Medicare Advantage program irks me. I have plain Medicare and dont really understand why I should be paying others bills.. I do vote and always will.. A treasure of ours to always be fulfilled.
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Bellemere, yes, most fraud is by providers, as far as I know. I think the important thing is to be aware of our own accounts, which for those of us with computers will become easier. But most people don't really know what is charged against their Medicare number unless they get a bill from a provider, because Medicare only sends statements quarterly, and those are not necessarily complete.
Most states have a Medicare and Medicaid fraud program where people can report claims of fraud.
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I got the darndest bill yesterday. It seems to be from the EMT service. They were the rescue crew and heliocoptered us from where the accident was to Orlando. I get a bill that has been turned down for an ambulance. Since I know for sure no ambulance was used and they already billed 16,000.00 for the helio.. I will call Monday and see what the heck is going on.. By the way we did not buy the helio.. just took a 20 minutes ride to the trauma ward..
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MY GOSH, Steph! $16000 for a helicopter ride! I never paid as much but mine was as a tourist. :o Does Medicare cover that?
We have a friend who fell off a river raft and broke his leg. He was rescued by the EMT's who sent a whopping bill for it. And, it was not covered by his insurance.
I wonder if the owner of that dog who was rescued yesterday in the LA river has not identified himself for fear of being sent a helio bill? :o
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I was told by someone who used to work at the hospital, that if we had not had insurance the bill for the helio would have been around 1000.00 Can anyone pronounce goudging??
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Is it any wonder that Medicare is going broke? :(
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Bellemere, Medicare wouldn't pay that amount for the ambulance. And in this case, they probably won't pay at all because other insurance should.
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one of the proposed restricitions on insurance companies in both bills is the prohibition against denying coverage to children with pre-existing conditions. The insurance companies can live with that IF there is a mandate requiring everyone to have insurance. that will give them enough premium income to cover the claims. Uninsured people who get sick will always be cared for. there has to be some real incentive for them to buy health insurance.
One of my granddaughters was born with a bit of hip dysplasia; had to wear that bar between her feet for a few months. The insurnce company said that henceforth she would not be covered , for any hip problems. Her father is a doctor and her mother a nurse; their insurance was through the national nurses' association.
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One of the reason Medicare works is because there are no such restrictions when a person becomes eligible. That's why, sad to say, many people can't wait to turn 65, because they finally will get insurance that covers them, and usually at a price they can afford.
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Was told by a most unpleasant person who worked for the EMT company, that they only write ambulance, they meant the care my husband received while waiting for the heliocopter. I told her they might want to be sure of the code and and then resubmit to the insurance company. She decided she wanted a death certificate, since I could be lying. I was really really annoyed, but I sent her a copy. Want to bet that I get another bill in the next few days, since she was intent that I should pay her and I simply wont..
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I don't really understand why the fact of the patient's later death has
anything to do with the service rendered by the EMT, BELLE. That
service was what it was; later events don't change it. I'm glad you
suggested she re-check the services codes. Those can be tricky, and
it does sound to me as though the person you talked to might not be
all that knowledgeable.
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Not knowledgeable and not very tactful. Did she even express any sympathy for your loss and your own injuries?
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Absolutely not a word of anything other than noone tells them if people die.. It doesnt make a difference to medicare, but Geico has paid an attorney to open a probate and that makes the bills payable from the Estate of >>>>>. I was trying to show her that she needed to readdress the whole bill.. Ah well.. she will not get paid one minute faster with this sort of nonsense and one more letter like the last one and I get in touch with the tv reporters, the newspaper fix it guy and anyone else I can find. I am truly tired of being a victim with this.
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Steph, that might be a good idea - getting in touch with one of the TV consumer reporters. Have him/her follow you through this process of dealing with the various providers and insurance companies in a situation like yours. If you could handle the exposure, it might make for a very good series. And it would help you get through all the hassle you're going through and help somebody else, too.
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I agree, but am not quite sure I could manage to make it through. Some days it is all I can do to get up , etc and if I did not have the dogs to feed, walk, etc, not sure how my days would go.
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It's wonderful, isn't it, how simply being needed can help keep us steady.
Commitments, responsibilities....they may seem a burden, but they can
really be a blessing.
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I understand, Steph - and my heart goes out to you.
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Amazing, my corgi-l which deals in our much loved dogs has several widows. One of them decided to start a Corgi-wives becoming widows group and the response has been overwhelming. There are a lot of us, all with different stories to tell and a need to tell them..
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An intriguing group choice, ...widows with corgis. A group like that can
be a great help, if it is disciplined enough that all those who need to talk
will also be ready to listen. For some, I think the need to talk is so great that for a while they cannot listen to others.
On the other hand, I have met people who are always like that. ;D
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Silly question: Is corgi the plural and if so , what is the singular? corgus or corga? ;)
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Corgi is singular.. Corgwyn is the welsh for several.. But in the states, they generally just use corgi to indicate any and all. I have two,, surprisingly in our group, it is common to have at least two and many have three and four.
So far we are telling our stories and now progressing into things that helped. Books that some of us liked.. For me it is a journal that I am keeping on my grief and now progress. Helps to write down the frustration for me.
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That sounds like a wonderful support system for you, Steph.
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The journal sounds like a good outlet, too. I've always found I can
express my thoughts more clearly by writing than by impromptu
speaking. (Less chance of mis-speaking, too. :-\)
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Babi,
You have hit on the point of why this forum is so different than most forums. One can write what one thinks and then maybe reread and change it at will. I have always thought that our way of using posts instead of threads or strings plus our ability for thinking over anything we post has made us more aware of good manners and sometimes, deeper thought.
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My deepest thought today is that the President is giving up on health care reform in favour of job creation. That makes sense, but I feel bad for all the people who now will have to wait even longer to get affordable health care. I hope the obstructionists don't take a vow to block anything he wants to do about creating jobs.
I went to the urologist for a checkiup and prescription refill and she said, she was going to code it as a nurse visit because I am doing well and she didn't have to deal with anything. How many doctors would do that? To the detriment of their own income? I like this doctor for the way she treats me and now for her honesty and concern for health care costs.
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What a nice and thoughtful doctor. Very unusual, you are lucky indeed.
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My thought is that much of new job creation comes from small businesses, and unless we have affordable health care for those owners of the small businesses, for themselves first and then for employees, then they cannot make enough money to hire more people to expand their businesses and people can't afford to work for them.
We have such short-sighted people in Congress.
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Absolutely right. But as we have seen here in Massachusetts, unless there is amandate that everyone buy insurance, young healthy people won't buy it, even if the small business they work for offers it. Thy would rather take their chances with emergency care, and , of course, parents who will jump in if necessary.
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I have always thought that our way of using posts instead of threads or strings plus our ability for thinking over anything we post has
made us more aware of good manners and sometimes, deeper thought.
I believe you're right, ANNIE, and a very good thing it is. I've rarely
tried to enter a 'thread', or 'string', and found it most unsatisfactory.
Here, we really get to know one another and appreciate their opinions.
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I understand there are some states where there are laws proposed to forbid making insurance mandatory. I shake my head sometimes at the way the political parties play games.
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I agree. In Florida we are getting ready for a governors race and of course.. one of the candidates for nomination has decided he will sue the government if they pass the health bill.. Of course he has never done anything but run for office and gets his insurance from the state, but thats ok.. he has his, why should he care about anyone else.
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Perhaps the " reconciliation" route is the right one. If this health plan does not get passed, nothing will be done for another generation. so many good things in it, incentives for more efficient, better care, restrictions on denials for pre existing conditons, etc. that will never see the light of day again. to some, reconciliation will seem like " stong arm " tactics. But in the face of avowed oppostion to anything proposed by the Obama administration, anything legal shoule be considered fair play. Any bill can be passed with a simple majority if it "has significant impact on the budgetary situation of the governent" (or words to that effect) and this surely applies to health care reform.
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This HCR bill has too much impact on the US budget and much more on my budget. I don't think its well thought out nor that it will improve the situation we have now. This bill needs to reviewed and rewritten. Talk about scare tactics! We need to do it right, not halfway! And where is our copy? NO TRANSPARENCY HERE!! I want to read of all the good OR bad things in it before its voted on. Surely we have that right. With the technology we have today, there is no reason for this not to be on .gov!
Did anyone else receive this in mail??
http://www.pnhp.org/
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There are copies of the bill over the web. Opencongress.org has one with provision for comments. I found it hard to read, I am not knowledgeable about some of the terms used. But there are impartial interpretations of the various measures too. I stess impartial: there area still types talking about death panels and communism.
The oppostion has no interest in "rewriting" a health care reform bill. they are only interested in a political victory and a defeat for the President.
I just don't know why I get so upset about this> Continuing the status quo won't affect me except in steadily rising premiums for my Medicare supplement. It is my grand children and children who will have the tough time.
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I agree, Bellemere, it our children and grandchildren who will suffer the most if health care reform is not passes. Too many people cannot get health coverage, or lose it when they lose their jobs or move or divorce, etc. We are selfish if we think only of ourselves. Besides, that statement "if you're happy with your current coverage, you don't have to change" is ignorant. No one's health insurance will stay the same if nothing is done to reform health care - it will cost more and more and cover less and less. For all of us.
I wish the current bills made much more change and improvement than they do, however. I fear they are too timid and too protective of the insurance industry.
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Adoannie, if you want to look at some information about the bills, try the Kaiser Family Foundation site: www.kff.org
I think they even have a site that compares the current bills: http://www.kff.org/healthreform/sidebyside.cfm
And there is a poll that is interesting: http://www.kff.org:80/kaiserpolls/8042.cfm
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Thanks for the links, Belle and nlhome. I will spend some time reading some of these.
Did either of you read the link that I put here which is the drs' of America suggested bill?? Very interesting and didn't 2000 pages to write.
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annie for some reason my quirky computer could not open your link about a bill propsed by doctors. Could you summarize it for us?
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Annie, I had trouble clicking the link, so copied it instead and put it in the URL bar. Worked fine. This site is about the 17,000 doctors in favor of a single-payer system, or a Medicare for All system. It makes sense to me, but it would be a long time coming. In the meantime, much as I would like to see total health care reform, there are urgent health items that can be done piecemeal, and should be done as soon as possible. The issues of policy cancellation and pre-existing conditions are crucial and should be at the top of the list.
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Belle,
Here's a better link. I can not open the one that I left here either.
http://www.pnhp.org/facts/single-payer-resources (http://www.pnhp.org/facts/single-payer-resources)
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Dr. Steffie Woolhandler (love that name) has been a long time advocate of single payer health care. She teaches at Harvard School of Public Health. I heard her speak along with a Canadian and a French doctor a few years back
I remember the French doctor saying that he inserts the patients' ID card into a reader and the entire health history comes up on the screen After the appointment, the doctor punches in a code for the procedure or treatment and the bill is paid in 30 days or less.
At the dermatologist practice last week (5 doctors)I counted 30 women in front of computers in the front office; an untold number running around in a back office, at least two nurses for each doctor; three physician assistants, and that is just what I could see. Imagine this replicated thousands and thousands of times. And how many people in the insurance companies on the other end? Staggering.
But the sensible solution of Medicare buy-ins for people with jobs and Medicaid subsidies for people without, will never happen. All we can do is nibble around the edges of this crazy system and try to keep up with our rising payments and reduced coverage.
The news gave some time to the convention of the Tea Party, actually more than one tea party and we learnede that it cost 500 to attnd One person came in full Sottish regalia, kilt and tam the whole works. \
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forgot to thank Annie for pointing out the Physicians site.
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Bellemere, I saw that news article. I have the impression that those particular tea partiers are being exploited.
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Seems like a third party is not a good idea. Remember the Perot Party??
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I am trying to pin down the cause of so much anger and fear. Even the staggering deficit resulting from the Iraq war didn't cause such concern. One "pundit" thinks the unhappy people are the same people who, in the 60's, could not support any antiwar efforts; thougth the civil rights people were asking "too much, too fast" and were shocked and repelled by the "sexual revolution" (some aspects of that shocked me, too, and still do)
Remeber the McCarthy era, when the Hearst papers and others used "communism" to whip up hysteria in a confused and fearful public? Now we have the same activity on radio and TV. Plus witnessing the huge technological changes that were so hard to understand and accept.
The more things change, the more they stay the same?
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HERE'S AN INTERESTING LINK ABOUT BILL MOYER'S PROGRAM TONIGHT.
http://www.pbs.org/moyers/journal/02052010/profile3.html
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We were out this evening, but Moyers is recorded for us to watch tomorrow. We never miss his Journal.
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Preview of coming attractions: the 800,000 Blue Cross subscribers in California who just saw their premiums go up by 39 percent while the parent company reported profits last year of 2 1/2 BILLION dollars. No government interference there, for sure. We can all expect similar treatment if the health care reform bill does not pass. God Bless America.
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MaryZ
Glad you were able to see the Moyers program. What did you think of it?
Belle,
Ours goes up every year. This year its new monthly amount is $625. That's $7500 a year. This is my supplementary insurance. I also have Medicare(original) which went up this year,too. The parent company involved here is Lockheed-Martin plus Aetna. This is all due to the LM company refusing to recognize my husband's employment time. I feel lucky to have anything.
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Interesting, as always, AdoAnnie. He does find interesting, well-spoken, non-screaming people.
Guess I'll record it again tomorrow and watch the Olympics opening. Or maybe the other way around - then I can fast-forward through the commercials. ::)
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BELLE and ANNIE, perhaps it's time to write your congressmen again,
pointing out these facts. Both of your posts would be good reminders
of their responsibility to protect their constituents. A 39% premium
boost ought to be illegal.
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AdoAnnie, have you ever talked with a SHIP counselor in your state to see what other options you have for your supplemental coverage?
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nlhome,
What is a SHIP counselor?? No, I haven't but if its possible to reduce our montly fees for medical, I would certainly be interested.
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The SHIP program is a system of volunteer and paid counselors who help people with their Medicare and supplement issues. You can find your main number on the Medicare site, and I believe it's also in the Medicare and You book. It is the state health insurance counseling and assistance program. Each state does it a little differently, so I can't say exactly what information you will get, but it's free and confidential and neutral counseling and help. In our state, people who have trouble paying for their supplemental coverage can call and get information on alternatives that may cost less but still provide good coverage. It never hurts to check.
You can go to www.shiptalk.org, and on the leftside of the page there is a way to search for your state's main office, it should be a toll-free number or website.
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Thats downright interesting and I may take advantage of it to get this bill and accident stuff straight.
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Good advice, NL. Looking for an alternative insurerer is the first
thing I do if a current provider...of anything...raised their rates so
outrageously. I don't continue with any program that I feel is gouging
me. That includes insurance companies, energy companies, credit cards and health care providers. With rates like that, I'm surprised Blue Cross
hasn't lost all it's customers!
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Have you been asked what you think of the Health Care Reform by any pollster_ I haven-t Nor any of myt famioly and friends. and yet theRepublicans keep trum,peting The American People oppose this bill. Obver and over they refer to The American People. Did they poll in the poor neighborhoods of big cities or the very rural areas where poor pdople live and go without health insurance- I think the carefully tailored their audeience to the well to do, in order to get the response they wanted to their polls. But government is not by poll. I hope the administraion does use the so called recondiliationmethod to pass the bill by majority vote.. the same method was used to pass the Bush tax cuts for wealthey people. Nobody asked me about those, either.
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I know that one of our Senators says that he is constantly asked for "tallies" on the calls he gets on this subject, for and against. He was speaking to a group of constituents who mostly favored reform, and he suggested that they get people to contact him. I think people are more apt to contact Congress when they are against something rather than when they are for something, and I suspect, although I have no facts, that many of those against reform are listening to the emotional talking points against rather than the facts. I know that those who talk to me about how awful the reform is are woefully uninformed, to the point that some believe the reform has gone through already and that's why they are having problems with their insurance coverage.
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Yes, I have noticed that my emails from conservative friends tend to be uninformed or worse yet.. informed by very inaccurate ideas. Amazing the stories floating around.. Still insisting on this.. The US has the best health care in the world....just not true, but they get so indignant if you bring it up.
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Ladies and gentlemen, may I hesitantly suggest that we have ridden this
horse almost to death. Surely there are other topics of interest waiting
out there to engage our minds. Is there really any new information for us
in this one? How say you?
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Well, things have heated up again, and there is a possibility that something actually will get passed. It will be interesting to watch.
As this is more a books discussion site rather than current events, maybe it is time to find something new. However, we should not forget how important it is to keep in contact with those who govern us.
Me, I am looking for a few good States(wo)men. We've discussed several who have been such in our history - will we see any come out of this current Congress?
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Actually, hasn't this always been a site where topics of interest found in magazine articles are
discussed? Sometimes it's current events, other times just whatever looks interesting.
Anybody know why a Hopi reservaton is sitting inside a Navajo reservation? Can anybody
explain the term 'top down Calvinism' to me?
I hope you are right, NL, and something will get passed. Do you know anything about a
the new govt. (?) programs that are springing up, advertising coverage for 'about' $3.
a day?
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Wow, Babi, where did you see that? Give us a link!
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$3 a day/$90 a month? Sounds like a discount plan to me, and certainly not a government plan.
Unless the ads are a come-on for a Medicare Advantage plan, because this is the open enrollment for people who want to get into or out of Medicare Advantage (Medicare Health Plan). Those are the plans that people choose to get their entire Medicare coverage from a private company. Some of these plans are really good; others are not so good because they have high co-pays and high out-of-pocket maximums so that people with a lot of illnesses spend more than if they were in original Medicare plus a Medicare supplement. The open enrollment period ends March 31, so expect to see some ads advising "act now" but of course, unless you really want to change plans, it's probably not necessary.
The Medicare Advantage plans are part of the reason that Medicare is losing money so fast, as they cost Medicare more per person that original Medicare.
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Babi, we do seem to have chewed this over pretty much. but as NLhome says, it is just getting to the final home stretch. Maybe once it is either passed or defeated, we could ask our administrator to table it for a while, maybe even a year and then call us back to discuss what we see as the pros and cons of the passage-or nonpassage of Health Care Reform.
I nderstand the oppostition plan strts with malpractice reform,
capping awards, and the cpngressional budget people have estimated this will restrain costs by less than one half of one percent.
Dont forget to keep calling those offices. the count a phone call as worth ten emailis.
On my way home tomorrow from Mexico, where a doctor charges fifty dollars for a house or hotel call.
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Can't, ANNIE. It's something I've been seeing advertised on TV. I
suspect NL is correct. The ads are prefaced with Obama making a speech
somewhere on the subject, and use the term "government approved" which
is not the same thing as a government plan.
This is why I wanted to know more about them. I suspect the ads are
a come-on for some less than dependable programs.
I'm willing to see this through to the end, BELLE, assuming, of course, that the end
is not far away. I see Pelosi is cracking the whip at the Democrats; I hope it helps.
(I'm having trouble posting this reply. I'll come back a little later and try again.)
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YAY! Success!
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There are some compelling arguements for dumping Medicare Plus. It is not what it was set out to me. A good example of how insurance companies can skew what was supposed to be a good thing. Thats why I really support the public option.. Would help to keep them in line.
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You know, Steph, the thing that bothered me about all those plans that were presented to us as a choice instead of Original Medicare, like the Advantage and the Plus programs, was that the providers on their lists could stop taking the insurance that you were carrying at anytime they chose.
I guess that we should keep this folder open until the fat lady sings. Its still one of the more important things in our lives right now.
What we need is some more debt!
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Our governor, Deval Patrick has the guts to tell health care providers there are going to be caps on what the state will pay them for services. Do they not realize what controlling costs means? It means they are going to make less money. Maybe fewer staff, with computerized records replacing dozens of people pounding on computers in the back office. Less purchases of expensive technology and maybe sharing arrangements for MRI's etc. Maybe lower salaries for administrators. Maybe postponed capital improvements: one of our hospitals just spent millions on very fancy private rooms and closed its adolescent psych residential service. Maybe less glamourous marketing, fewer three color newsletters and expensive fund drives
yes, only a real publci option would force them to reduce their overhead costs to bare bones, but it is not gonna happen.
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Yes, I realized the other day when my daughter in law and I went to Orlando, that nowadays the only cranes in town are at the two major hospital complexes. Several years ago there were at least 10 cranes busy building various high rise residentials and commercials. Nobody has money now except hospitals. Something wrong with this picture.
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Back in the '80's, Red Skelton was appearing in Atlanta. At that time, Atlanta was experiencing a building boom. The first lines out of his mouth were:
"You know know they out to make the crane the state bird. There's one on every corner here."
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Yes we need to leave this open until, in the immortal words of our own Pat, Congress gets its act together.
We'll be opening, however, a new Talking Heads to run concurrently this weekend, which will have a shorter run on another topic.
Having just come off COBRA, I wonder sincerely how anybody manages. If a young person has been laid off or fired how on earth does he afford those premiums? Ours ( my husband retired on December 31 and his health program did not retire with him) were $1,300 a month. How on earth does any young person with a mortgage no job and children to educate manage COBRA? Yet that's what everybody says, oh get COBRA, no problem, just get COBRA. And starve?
And then there's the Advantage Plans mentioned above. You get Medicare A if you want Medicare. Then you must pay for B, if you want an Advantage Plan (drugs, dentist) you have to have B. B does not include prescription drugs so you need, variously, D, C or other letters or an Advantage plan. The new Supplementary plans, which are different from Advantage Plans, do not include drugs. I have read more materials, studied more spreadsheets, read entire BOOKS, talked to Medicare, the State Ombudsman for this stuff, Social Security, enough research to have a PhD and still at the end I know almost less than I did when I started. IF you get a good/ smart person at Medicare, they can answer your questions.
IF you don't, and you get somebody reading the same spreadsheet you have in your hand it's no help.
The Medicare Advantage plans vary by county and state. You can look yours up on the Medicare website, which IS useful. Some doctors as AdoAnnie mentioned above can drop that plan, not you, that plan, I guess it's about the same thing, tho: they dislike being harassed I guess. Here locally we have doctors who won't take two famous companies we've all heard of. Why I don't know but they won't.
The good thing about the Medicare sponsored Advantage plans is you can change once a year and cannot be denied. That's the good part, unless you have end stage renal disease and are on dialysis, if so there are special plans. I've got the mantra memorized.
Can you deduct from your taxes what you have to pay IN for B?
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Ginny,
Yes, you can, if the IRS doesn't notice! hahaha!
We have been in both positions where you and Winston were yesterday and you are absolutely right about calling everyone in the world before making a decision. I complained about our supplementery plan which includes Rx's at $625 a month for the two of us. But, if you take out an Advantage plus plan which covers Rx's, you will have the donut hole of $4500?? to pay-plus your monthly cost of $240 a month just to be on the whole plan. And you will be paying somewhere the same amount that we are, IF you are taking many Rx's. Ralph has one med that he is on that costs our company $1700 for a 90-day prescription. We only had to pay a $40 co-payment for that. And there are other non-generic drugs that many folks have to take to keep them going that cost more than that.
We,too, have several insurance companies that the drs here will not honor. Even Medicare is now refusing to pay what they were paying to some drs. The drs took them to court. I don't know who won.
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Why, of course, GINNY! Why did no one think of that before? Simply run a concurrent site for
another Talking Heads topic. Well, I always knew you were brilliant. :-*
I'm beginning to realize, ANNIE, that my low prescription costs are probably why I am doing
so well with my Advantage plan. I haven't needed any supplemental plans and my costs have
been minimal, thank goodness!
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Healthy people do well in Medicare Advantage plans. The problem is, as people age they usually get less healthy, or they develop chronic illnesses or cancer, and then those Advantage plans can become very expensive. And by that time, it's difficult to move into a Medicare supplement unless certain things happen that give a person guarantee issue.
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Ginny, will you be posting a link to the new Talking Heads discussion?
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Yes, I will, and Jane will feature it in the Newsline too. :)
There better not be any donut holes in our insurance! There's nothing mentioned about them now and I asked the agent ( of course you have to call the insurance co to get more info) about the Medicare projected out of pocket costs thing, too. So far there's no 240 a month costs either, but maybe different states have different rates.
We'll find out, it may be the hard way, in for a penny (literally). :)
Of course we don't have any $1700 prescriptions either, bless his heart, Ann.
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I have medicare and my medigap is from AARP , so is my prescription plan. I do have the doughnut hole, but since I am on generics, get away free for copay if I order by mail and pay a 7.00 co pay at the drugstore. But I will say that I like AARP.. I like that you can pick your own doctors.. and hospitals, etc. My husband before the accident last year had several surgeries and tests and not a penny floated down to us.. He also had a lot ofradiation for the past few years with the skin cancer. Again,, no bills for us.. So I am satisfied. It is not the cheapest plan, but it works.
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Now, the company has changed online pharmacies and we have no RX's to send them. Oh, good grief! I have to return to the dr's office and have them run off all of our Rx's and then mail them to the new pharmacy to get the 90-day rx's. This is a pain in the backside!
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The doctor's offices are not going to be too happy about being asked to run off Rx copies for all your company's patients, either. I imagine they are going to catch a lot of flak on that one.
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Here in Massachusetts, a bunch of us are havin' a little fun with Senator Scott Brown, calling his office asking him respectfully to change his mind on Health Care Reform and vote for the plan as he did in Massachusetts. He ran on the boast that he would be the opposition vote that would kill the plan. He received a ton of out of state Tea Party money, so he is all bought and paid for, but still, we can needle him a little!
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Annie, let us know how much the doctor's office charges you for copies of your prescriptions. And then try to get your insurance company to pay the charge. hahaha
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Most times my doctor just rewrites the prescription for the 90-day fill, or for pill splitting if that's what the insurance wants, and provides that. It's a routine request for maintenance drugs, I'm sure.
Sometimes, if a person switches pharmacies, the new pharmacy contacts the old pharmacy to transfer the prescription.
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Bellemere, I think that's a great idea to contact Senator Brown's office like that - to remind him that he also said that he would represent the people who voted for him. The more people who contact him, the better.
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I love the idea of calling or emailing the office. If I lived there, would join it.
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the Scott Brown staff person who answered the phone seemed a little stunned. Brief pause before he thanked me and said he would let the Senator know. they have to be polite.
Out 0f state? Go ahead anyway and call, and respectfully request that he consider the good of all americans and support the health care reform. 201 224 4543 Only takes a few seconds.
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I got the medicare payout sheet and the medigap one in the last few days. I got mad enough to write to both of them.. The rehab center got me a wheelchair when I left since I could not walk for long periods at that time. I recovered rapidly and only had the wheel chair for about two weeks. I called, they came and got it and gave me a receipt, but I see in my bills, that they had managed to bill and be paid for.. for two months. I am not even the tiniest bit amused. Probably wont do any good, but maybe because of the accident and the insurance paying, someone will stop them..
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My program sends me statements about the amount of money that has been spent on
prescription, but I've never gotten a description of what they've paid out for other purposes.
I would think that they would want us to have that information, precisely so we could let them
know if they've been overcharged. But then, perhaps they have a set payment for each service, in which case they can't be overcharged.
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Steph, nice watchdogging!
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Yes I can see watching the papers sent is something definitely needed, good for you Stephanie.
Ann, gosh, what a mess.
We've opened a second concurrently running Talking Heads, here:
http://seniorlearn.org/forum/index.php?topic=1203.msg63141#msg63141
The article is a hoot and it raises all kinds of issues, let's find out how many of you multi task when somebody calls you on the phone. The real issue IS do you want to look at the person you're speaking to? The Video Phone? SKYPE?
Would you want us to see you as you type here? Is technology bringing us closer or something else? The very issue of multi tasking while talking on the phone itself is symptomatic, I think.
I think these are fascinating questions, it may be that you have some opinions, too. (It's certain to be that you know more about ipods and kindles and notepads than I do). Come on down and let's discuss them all if you like.
Do you use/ have SKYPE? Do you want it? How are our statements different here than they would be face to face with our listeners? Let's discuss it there.
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I don't have Skype, and don't really need it, with a land line and a cell phone and computer email. Thats plenty of communicating. I got a Facebook account and never used it, but still keep hearing from people who want to be my "friend" I have a Twitter account, and can't think of how I would ever use that either' As for multitasking, yes, while on the phone I doodly notes, not much of a task but I guess it qualifies
I really am trying to limint my computer exposure to things like
Facebook. I really think there is a lot of mindless "communicating
going on. Don't have much more to say on the subject, sorry. Oh, and I never
text message. Does anybody?
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As for health care, twice I have heard that the bill is bad because it "gives something to people who don't want to work" I assume that means all 35 million people who will have to have insurance if the bill passes. That's a lot of people who don't want to work.. Maybe the cause of unemployment? (that was meant sarcastially)
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It's easier to think people don't deserve help than to think we're not providing help to those who need it. If that makes sense.
I hear a lot of people complaining about those who abuse the system, but I don't know that many who do.
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I know in Florida, the biggest abusers of Medicare are in Miami.. They have the highest rate of scams in the country. If Medicareadministrators were more sensible. They would establish an office down there to check on claims.. They dont and then they complain about the scams. You need to send a few of the crooked doctors and lawyers to jail.. Then maybe the city would calm down and remember it is in the US, not Cuba.
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Our state Medicaid program is called MassHealth. It is the health insurance for poor people. Well over half of it, maybe even 2/3 goes to pay nursing home bills for "Poor people:" in many cases people who have transferred their assets, like their stocks , bonds, houses, bank accounts, to thier children in order to "preserve their estate" which sounds much more dignified than sticking the taxpayers with your nursing home bill so your kids can inherit your money. If the state detects that his has been done less than five years ago, they can lien the estate and get back the money they spent on the deceased person's nursing home care. Seems like their shoud be a better way.
\\\
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The way it works here is that when people apply for Medicaid in a nursing home, they have to be asset eligible - $2,000 plus certain exemptions like funeral trusts. The agency that processes the application looks back 5 years to see if the applicant transferred any assets for less than the value (gifts, etc.). If so, the applicant is not eligible for an amount of time that would use up that value of the asset transfer. Then when the person is eligible for Medicaid, if there is a home that hasn't yet been been sold, the state can put a lien on it. If there is an estate, the state can file a claim when the person dies and get back some of the money spent on the person's care.
Married couples have special protections that allow the person who does not go into the nursing home to keep more assets. That way the spouse who is not in the nursing home does not become impoverished.
But now there is also a way people can get to keep more assets if they have certain types of long term care insurance that pays their way for several years before they go on Medicaid.
There are also Medicaid programs to keep people in their own homes longer. That may become the way to save money over spending it in a nursing home.
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Boy, I agree - expanding Medicaid and Medicare to cover more care at home would be the way to go, both for cost effectivness and comfort of patients.
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OH I do agree. Even the best of assisted living centers are still not home..
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I am a retired Federal employee so I have the same insurance as the Senators. I also have Medicare and have a supplemental with Blue Cross. I am so fortunate. The woman who cleans my house - self employed and makes good money. Had a terrible time getting insurance because of a pre-existing condition (high blood pressure). Finally she found an insurance company -- outrageous premiums. So far they have denied every bill she has sent them.
Our hospital is just barely running in the black because of all the people using it as a clinic -- no insurance. Many people lost their jobs here recently and with it their insurance. I can't imagine having asthma or diabetes and not being able to see a doctor!
Someone took a survey of the Senators. Most would be denied insurance due to pre-existing conditions.
Don't I remember something about "for the least of us" and " do unto others"??????
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I was talking to the youngest son of a friend of mine. He is 50, unemployed felt awful for weeks, went to a clinic doctor and discovered he is diabetic.. Whew.. I suspect that this will be hard on him even if he finds a job right away. Preexisting hurts so many people.
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What a dogfight this legislation has encountered.
We must be the laughing stock of the civilized world with their smoothly functioning single payer health care systems and longer life expectancy . If this is the way our governement is going to function, fueled by ranting talk shows and special interests, I see a bleak future for any progress. Where are the grownups?
The desire to take down a young president seems to be the only consideration of some opponents. Can't understand the degree of hatred,unless it is for a reason I don't even want to think of. Let's hope it gets done, the country has a lot of other problems to solve.
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I agree, Bellemere. I don't understand the hatred and the out-an-out lies people tell about health care reform. Many of the people I hear talk against it locally are people who don't have good health care now or who pay high premiums for very poor coverage. They are responding to some of the exaggerated reports out there, not looking for the facts.
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The number of people I see in the rallies on TV against health care tend to be on medicare.. They seem to be furious about all people receiving some sort of health care. Its like if you dont work, you should never get sick. In this economy there are a lot of good honest people who want to work, can find it and that doesnt stop the getting sick stuff.
Keep your fingers crossed for me in the next week or so. The lawyers tell me that they are now paying out of the insurance settlement to medicare and I may be done with all of this.. Only been 4 months.. Whew.
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Steph, I certainly hope it all gets resolved quickly. To think of suffering the loss of your husband, plus your own injuries, and then to have this insurance hassle is really incredibly hard.
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All of the past four months have taught me one hard lesson.. I am tough and can survive just about anything.
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It's always good to know that, Steph, but such a terrible way to learn.
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What's the story now on pre-existing conditions? Twice now, in the past few days, I've heard reference to stories about children who had pre-existing conditions and would now be covered. That makes me wonder if some kind of deal has been made letting that aspect of reform apply only to children. Does anybody now?
And where is the helpful media when all we want is a 1 - 2 -3 - 4 -- list of what is in the bill?
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I am not sure but I think children enrolled in the CHIP program are insured even with a pre-existing condition. Under the reforem adults would also be covered. The insurance companies make it clear that they can only go along with that, if there is a mandate for everyone to buy insurance, including young healthy people to balance out the claims.
Our local hospital administor in a TV interview explained all the problems he sees with the existing bill and then surprised us al by saying that the only answer is a single payer system!
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I heard T. R. Reid being interviewed in depth re his books on CSpan's BookTV program last weekend. He talked about his book on healthcare which sounded very interesting:
THE HEALING OF AMERICA; A GLOBAL QUEST FOR BETTER, CHEAPER AND FAIRER HEALTH CARE. (288 pp, 2009)
Reid shows how all the other industrialized democracies have achieved something the U.S. can't seem to do -- provide health care for everybody at a reasonable cost. He visited France, Germany, Japan, the U.K. and Canada, where he found inspiration. The dreaded monster "socialized medicine" turns out to be a myth. Many provide universal coverage with private doctors, hospitals and private insurance.
I will certainly be glad when this is all over. Am hoping it will pass. The arguing and squabbling from participants in some of my other discussion groups and just about every TV and radio news and talk show is getting very boring.
Marj
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This may or may not be helpful -- it looks at four different bills, compares. I guess this link requires a subscription to Wall STreet Journal.
Health Reform Point by Point] (http://online.wsj.com/public/resources/documents/st_healthcareproposals_20090912.html)
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I guess I am still so puzzled by all of the lies being told.. An article of faith with some of the groups is we have the best health care in the world and it just isnt so.. Another is how wonderful our hospitals are.. Again our hospitals are mostly in a race for the latest toy. I live in an area with two huge hospitals. All they do is compete. Stupid,, They should have sat down years ago and divided up services.. Then they could become the best at what they do and stop spending money to one up each other.
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I live in an area with two huge hospitals. All they do is compete.
Ditto, ditto, and ditto. Two hospitals, no more than 3 miles apart. And I don't know how many doctor-owned surgical centers for those one-day outpatient jobs. How much do you need in a city of 35,000?
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There are some things which must be exempt from the profit motive. Education is an example, no one expects the public schools to show a profit and there have been serious problems in those efforts to privatize schools, charter schools having mixed results. Provision of health care should be free from profit.
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Oh both of these hospital systems are not for profit..and both are always complaining about money..but both of them are also building like crazy.. Hmm. what is there about not for profit and this sort of activity. We just had a local scandal.. Our not for profit blook bank paid obscene amounts of money to their CEO and even laid off the worker bees this last year while increasing her salary.. The local paper did a good job of exposing what was happening and the CEO although she received a parachute that would choke a horse is still gone..
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Stayed up until after 11 to watch the vote and hear the President's brief statement, very matter of fact, no gloating, thanked every one for their efforts on passing the bill and said good night and God bless. So now he has to take on the unemployment issue, and that is going to be even more difficult. Not to mention two wars. How does he sleep at night?
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It's amazing anybody actually wants that job, isn't it.
At last they finally passed something. Now we'll have to wait to see what sort of havoc the Senate can commit on it.
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It's amazing anybody actually wants that job, isn't it.
Amen, MARY. It's got to be the most thankless job in the world. And it's a catch-22 for
the rest of us. The job is most attractive to the power-huingry, and the power-hungry are
not generally the ones I want to have in charge. Overall, I think we've been lucky to get off as well as we do. We've actually had a number of presidents who had cared more about doing a good job than about being the top dog. I think we've got one now.
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My son is a teacher in a small private school. His share of his employer's insurance plan is 700 dollars a month, 8,400 a year. That is for himself, his wife, (also a teacher) and one baby. Plus, he has a condition that could be called pre-existing, a bicuspid heart valve. This week a cardiologist is checking the baby for the same thing. Thank God for the Health Reform Bill. I believe he may qualify for a subsidy, and if he or the baby run into trouble and need surgery , it will be covered. If I hear one more time,
The American people don't want this bill" I think I will scream.
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Bellemere, I agree. So many people are excited over nothing. They don't realize that they or their children will be helped by the bill.
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Babi, I agree with you, but I cannot get over the number of people who simply hate him.. Conservatives are great haters and I really dont quite understand why.
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I think the radical conservatives feel threatened, STEPH. Fear is a great promoter of hatred and violence.
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I agree that many conservatives feel threatened. One reason might be demographic, the fact that white people are going to be the minority soon. the economists say there is no arguing with demographics, but some don't believe them.
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I live in Florida, so although I am white, etc, we seem to be a minority here. I must admit that I get testy when I enter a store and the clerks english seems sketchy.. And I really do not agree when our latins try to push stupid rule changes and illegal behaviour because it is traditional for them.. Street racing is a good example.. What a stupid way to live and die.
So.. I guess I am conservative in that I really believe that you should come to the US legally and I dont mean the cuban boat people.. You should learn English as rapidly as possible and you should obey our laws.. Hmpph
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Steph, you are right, our laws are for everyone and nobody's culture trumps them. But learning a language is really tough, and until you have found yourself alone in a foreign country not knowing the language and trying to buy something (like Preparation H !) you will never know just how hard. Eventually most immigrants do.
Immigration reform is going to be another big donnybrook. I don't even want to think about it!
Street racing is not a custom inMexico where I visit. they have tons of speed bumps, all over the country. did you know the English call them "sleeping policemen?" Seriously!
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Steph, street racing is not a tradition in the part of Mexico that I visit. There are huge speed bumps all over the place! I heard the English call those "sleeping policemen". Seriously.
Our laws are for everyone and are not trumped by anybody's customs.
Learning a language is tough, and you never realize how tough until you are alone in a country where you don't speak the language and are trying to buy something (in my case, Preparation H!) Eventually most immigrants manage enough English to get by.
Immigration law reform is going to be another donnybrook. I don't even want to think about it!
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The op/ed columnist Ruth Marcus raises an interesting question: Will more health insurance lead to healthier people? So much ill health today seems to be linked to " lifestyle" like overeating and under exercising, not to mention drugs and alcohol and still there are people smoking. Childhood obesity? Seems more like a matter of educating parents than selling them insurance, doesn't it? it will be interesting to see how people react to this.
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Apologies for th e disgraceful double post! My bad!
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I suspect that the people who need to make life changes are not the people who go to doctors.. It is hard to give up old habits.
NO... Puerto Rico is where the street racing is condoned.. Not Mexico.. Puerto Ricans are heavy on the ground in Florida and they are very militant about not learning english.. or doing anything that might be good.. I am sorry to say that I have been keeping track recently because of our accident and the arrests are about 70% latino names.. Young males to be exact..
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Young males have always delighted in risk-takng behaviour to the anger and frustration of the rest of us. I guess Florida has to keep after them, confiscating vehicles, cancelling licenses, fines, some jail time, sooner or later they will get the message, don't you think? They need more than a slap on the wrist.
Remeber the "chicken" game with cars, back in the fifties? An even more stupid way to get killed.
Behavior changes are slow, but look how many people gave up smoking ? (I was on a pack a day_today, I can't stand the smell of smoke. )
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We have a healthcare system paid entirely out of our taxes. Its not completely free at the Family doctor level but there are heavy subsidies and its affordable to all. Kids under 6 are no charge and drugs are free for them. Most of us pay from $33 -$60 to see our family doctors. Low income people and seniors regardless of income are heavily subsidised. My drugs cost me from $3 for three months supply to $8 a month for one drug that has to be picked up monthly. Hospital care is free for all no matter what your income. Dentists are not free and just as expensive as anyone else in the world. Opticians and Optometrists are not free either. Physiotherapy has a co pay charge. Some people are finding it difficult to pay for rehab phsyio if they are on a fixed or low income.
30% of the population choose to take out private medical insurance and use both the private and public system. My DIL goes to a Neurologist in the Public system as he is one of the foremost authorities in the world on her condition. Nobody uses the private system for serious accidents as the public hospitals are far better if you need ICU care. People do use the private system for elective surgery so they can have it done immediately without going on a waiting list. My medical centre ( family medicine centre) has theatres for some small elective surgeries
and they can also set bones etc and have a plaster room. There is a radiology unit too. There is a co pay on these procedures. I would probably find it hard to afford some of the services offered.
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Excuse me if you already told us this, but are you in Canada?
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bellemere, Carolyn (kiwilady) is in New Zealand.
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The New Zealand system sounds really good. I wish people would look carefully at other countries before going on and on about how great our system is.. It is not..thats a fact, like it or not.
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We really appreciate all of the great comments here during this historic time. This discussion will be closed but perhaps in the future when the effects of this new legislation begin to trickle down we may reopen a topic, like Dealing With the New Health Care Legislation.
This topic is now closed, thank you for making it such a viable, and useful discussion. I have learned a lot.
Come on over to Salt! Salt! You Can't Live Without it, Can You Live With It? (http://seniorlearn.org/forum/index.php?topic=1236.0)