a thought about what is fair and what is convenient

Automatic Washer - The world's coolest Washing Machines, Dryers and Dishwashers

Help Support :

Hi David~

"I just paid $2350 for my 6 month insurance premium"

I am 38, partnered,and a non smoker. Like you, I am self employed. Your premiums seem very high to me.

Is your plan 80/20 after your deductible is met?
My Plan has a $2500.00 deductible. I have no copay for doctor visits and it is a 100% plan after my copay is met. I chose this plan because I wanted to know the maximum out of pocket for me should I be hospitalized, would be $2500.00 if my copay is not met.

I am insured through United Health Care and my premuims are $122.00 a month.
 
This is a very fascinating thread....

Anyone other European or South American members have some insights on medical care/insurance in your respective countries? It's great to learn how these things work in other places......
 
Insurance is a rip-off in many cases. I paid on a policy for seventeen years without a claim until four months ago. I thought my deductible was between $1000 and $1500. Find out it's $250. My fault for not being aware, although I DID ask the agent a few years ago what could be done reduce the cost. It's in THEIR interest to say "Sorry, not much." Which explains why the premium is now $408/month. For hospitalization ONLY -- routine dr. visits, dental, prescriptions are NOT covered. The "Good Neighbor" people.

I figure I've paid in excess of $25,000 for policy and out-of-pocket to cover an incident that netted the hospital and doctors $15,102 (after "disallowances").

NOW the agent tells me raising the deductible to $1000 will cut the cost by ~$100/month .. but warns not to make that change until the current "incident" is finished or it'll trigger a recalculation of the whole thing.

I've not been impressed. If I'd had the $25,000 plus compounded interest, I'd be $10,000 ahead where I am now. Roughly.
 
I'm all in favor of Universal Health Care for the USA. It's long past time for it to be put into place.

Re: nutcases on the streets and public transport of SF: Yes, they are probably more numerous and mover visible in that city for a number of reasons:

1) Mild climate (which LA shares)

2) Compact urban center (which LA and other cities lack)

3) Traditional liberal tolerant atmosphere which leads to looking the other way if people want to live on the streets (and some prefer the streets to shelters).

4) Liberal atmosphere which oppposes using the police to "clean up" the streets, which in most other cities means incarcerating the homeless. There have been major political battles over this issue in SF.

5) California's move back in the 60's (thanks Ronnie Reagan) to shut down state mental hospitals and outsurce mental health treatment to "half-way houses" and drug regimens, etc. Sure, it's a nationwide practice now, but I believe California pioneered this dubious approach.

6) San Francisco traditionally attracts people who are somewhat (or very much) out of synch with the rest of mainstream American society. There's an old saying, that at one point the rest of the country tilted up and let everyone who wasn't firmly grounded slide down and populate California.

7) Some US cities have actually given the homeless one way bus tickets to other cities that are judge better equipped to handle the problem. I believe this happened with Chicago sending homeless people to Salt Lake City. Don't know if it's happened with SF as a destination, but it wouldn't surprise me.

8) The homeless problem is really one of urban centers. You do not see many, if any, homeless in the various more well-to-do suburbs of San Francisco. The police in those towns do crack down, and it's easy enough for somebody to hop a BART train and end up in downtown SF (or Berkeley) to try to panhandle the next treat (food, drugs, you name it).

9) San Francisco has been a magnet for runaway teens ever since the 60's "Summer of Love". If their home communities took better care of them, they wouldn't be running away in the first place. Shame on the rest of the USA!
 
Like most Canadians, I complain about the health care system and the "way it used to be" - it's a national hobby. All in all though, it's pretty good. But while we were in Germany a couple of weeks ago, my partner developed an infection in his leg - these happen every few months, hiv related and come complete with fever etc. Off to Emergency we go, just outside of Hamburg. As one who spends way too much time in emergency rooms, the German version was very impressive. Spotless, efficient, amazing. The most shocking part though was that they don't take credit cards! They asked for our friends address to send the bill to and we were done - now that just doesn't happen on this side of the world...
 
I'm not going to go in depth about the political aspects of the healthcare conundrum, as I seem mired in the debate every day!

I will say that I'm not so hopeful about the chances of Hillary's particular solution as adequately addressing the challenges most Americans face, in meeting their healthcare needs (although, sadly, it would IMHO have been just the ticket fourteen years ago)...

NeptuneBob, I remember mentioning to you, in another time and place in history, that I hold Dennis Kucinich in very high regard. You bring up the concept of divorcing one's healthcare options from one's employer, which I believe is still such an alien concept for many of us, that we fail to recognize the merits of it. Peter brings up the frequently unrealized parasitic effect the insurance corporations have on such an essential aspect of our everyday well-being, and it's mindful to remember that the corporatists have no real interest in healthcare reform, much less our health.

IMHO, single-payer is the only feasible way to go, and is the only type of solution that is long-term in its focus.

Peter also mentions the very real concern of rejecting corporate control over our health and well-being, simply to replace it with equally heavy-handed government intrusion and interference with our medical choices. It's not just incompetence, the potential for fraud, or the influence that particular forces within any particular administration can exert, especially when these forces place more importance on moral judgements and have little interest in science to begin with. It ain't just reproductive rights that they're looking to restrict, boys!

Compliance with globalist initiatives like Codex Alimentarus are a serious concern for those of us interested in holistic and alternative therapies. It's essential that basic preventive staples such as vitamins and minerals, and herbal remedies like St. John's Wort, echinachea, etc. be kept as affordable, available, and as unrestricted as possible, as a matter of national sovereignity as much as social responsibility and a commitment toward progressive attitudes regarding prevention, natural healing, etc.

Finally, I'd like to tell you about an interesting sign I saw a few weeks ago, on the wall in the waiting room at my mother's gastroenterologist. Under the usual directives regarding insurance cards, copays, etc., it clearly stated:

"Please note, that if you are not covered by any insurance policy or choose to submit an insurance claim for your treatment, you will note that individual charges billed for today's treatment will be substantially and markedly lower.."

This is the sort of overt statement and fundamental disregard for any rationality in how chicanery in public policy affects our daily lives, undermines the public trust, and leads many to conclude that there is just something so different in what Americans are willing to put up with, that true reforms and positive change can never occur, with the current paradigm.

It is what may well lead someone like me to vote for someone like Ron Paul.
 
"I heard that Dennis Kucinich is popular in San Francisco, is he?"

As a matter of fact, he is, Nep. Quite popular.
 
So glad to hear there are Kucitizens in San Francisco!

It can be hard to be Kucitizen here in Pittburgh which is turning into a Hillary town. We have some cousins in Ireland and when my mother went to visit over there a few years ago she was ill and had to see their doctor the cousins told her she might have to pay, but the charge was less than 20 dollars. She also said that the Irish cousins could not believe that the US did not have free care as they do over in Ireland (this is in the southern Republic of Ireland). Oxydolfan do you work in health care? I transcribe medical records and though I am on the "edge" of health care many reports say "The patient was to take medications but could not because of insurance" so I know many people are affected. There are a few people though who have excellent benefits because they work for the right employer and have no medical problems in their family and like the system the way it is - seems like everyone who works for Fox News does. Maybe we should all apply to work for Fox News.
 
Neptune Bob:

"At the very least, somehow health insurance has to be "divorced" from one's employer. I have worked in several places where some of my coworkers were miserable and unhappy on the job but stayed there because of the health insurance."

You make a very good point, but whatever we do with health insurance, I want employers to bear some of the cost. America's workplaces contribute to many people's health issues. There are chemicals people must breathe in if they want to keep their jobs, there is repetitive motion, there is unholy stress, there are all kinds of workplace factors that can undermine good health. While I don't believe that employers should pick up the entire tab for their workers, they should share in the cost of maintaining good health for all.
 
Shane,

I'm going to shop around for new insurance, your plan looks pretty good. My current plan is through the American Veterinary Medical Association. When I signed up it was a good deal - a pool of about 40,000 veterinarians had a lot of negotiating power to get a good insurance deal. This seems to have changed in less than 10 years, and my rates just went up 11% according to a letter they sent me this month.

Nathan and Keven,

Thanks for the description of Australia's and Germany's systems. This is a very interesting topic and I think the U.S. system definitely needs to be reformed. I just think their is currently too much partisan politics going on to have any meaningful reforms.
 
Another Australian view:

Nat has summed up the Aussie situation very well. I would like to add a few extra points.

1. Pharmaceutical - All prescription drugs go through an approval process called PBS - Pharmaceutical Benefits Scheme. Drugs which are approved under the scheme are heavily subsidised, if your income is below a certain level you get a Health Care card which entitles you to pay no more than (approx) $5 per item, otherwise you pay no more than about $28 per item. Even several expensive drugs which cost hundreds of dollars per course, are only charged at $28 or whatever the cap is now. Drugs which have not yet passed the PBS process are still available, but are not so heavily subsidised. There is also an annual cap per person or per family - I think it's about $200 per year now. Beyond that cap, prescription meds are free. Because of this system, Australia has among the cheapest medications in the "first world".

2. The system is paid for through the federal tax system. There is a medicare levy of about 2.5% or 3% on your taxable income, after deductions. There is a threshold income below which you don't pay the levy, though I don't know the threshold.

3. Community Health centres - these are a more local model which get some funding from each of Federal, State and local government. They vary in what services they offer and whether they provide for all their community or only for people on low incomes (with Health Care card.) A couple of years ago I had a rough time emotionally and had counselling by someone who came to my house weekly for six months, plus an intensive course on coping with anxiety and depression, plus a few sessions with a psychologist, plus medication for a few weeks before I got going with the other stuff, plus about every 6 months there is a "SHADES" graduates' course, follow up sessions for those of us who have completed the Self Help Anxiety Depression Education Sessions. (It works, I am 100% fine now.)
All this valuable help - I had to swipe my medicare card once at the beginning, no charge for any of it at all. Not one cent.

I don't recall the actual figures now, but the following is approximately correct - health care in the US consumes about 10% of the US GDP. In Australia it is about 4%. Yet our health outcomes are demonstrably better.

And if you don't like to use the medicare system, we also have a full private system too. Unlike Canada, we also have private hospitals, run by companies for profit.
If you have low income, you will probably rely entirely on the Medicare system.
If you have middle income, you can either remain on Medicare, or choose to pay for private health insurance for which there is a partial tax benefit.
If you have a high income there is a strong tax incentive to takeout private health insurance, though it is not compulsory, you can stay with medicare if you wish.

Having said that, the really top level emergency health care is in the public hospitals paid for by medicare. If you are seriously injured in a car accident, you will be treated in a public hospital, by public doctors in the acute phase, though if you have health insurance the after care may include your own doctor visiting the hospital, or you may be transferred to a private hospital when you are well enough. If you have private insurance, it will conribute some funding to the public hospital.

It works.

Chris.
 
Thanks, Chris.

"It works."
That is it, exactly. It works. In Western Europe. In Canada. Down Under.
No reason why it can't work in the US...the Americans just have to open their eyes, look at what is really going on and then reject the lies and deceptions which the christianists and republicans feed them.
Let's hope things get better, soon.
 
Chris it's often brought up here in Canada by some, usually the wealthy that we (Canada) should allow for profit hospitals to operate. The fear of most people is that these for profit hospitals will siphon off the good doctors with higher wages etc. My question to you is...since Australia and the UK etc operate both systems, what is the incentive for anyone to bother going to a "for profit" hospital and pay added insurance for it. In other words what are they giving people that the regular public hospitals aren't?
 
wait a minute guys, looks like you all have fallen into the same trap all the media hype has been drumming up...

HEALTH INSURANCE IS *NOT* THE PROBLEM!!!!!

The real problem is that health care costs too much. The reason why some people do not have health insurance is because it costs too much...because of the escalating cost of health care, subsequently the insurance has gotten costlier, and out of reach unless your employer foots the bill for it.

We need to be looking at why the cost of health care has risen exponentially higher than the inflation average. One of these may be malpractice reform, but there are much more. Government regulation is part to blame too, among many issues. Back in the 50's and 60's, people could pay for medical procedures out of their own pocket, and only use insurance for the big issues. Nowadays, just getting the case of the sniffles will set you back over a grand! That is certainly not right!

I am all for the free enterprise system of bringing health care to our citizens we currently have if we can just free it from it's constrictions.

REMEMBER...THE GOVERNMENT SCREWS UP EVERYTHING IT TOUCHES!!! Do you really want them running...or should I say screwing up, your health care even worse than it is now?!?!?! I mean really, think about it, they can't keep our highways moving, can't educate our kids, heck, they cannot even run a mail service efficiently, WHAT IN THE H*LL MAKES YOU THINK THEY CAN GET HEATHCARE RIGHT!!!!
 
Steven,

I live in a country which has a higher return on investment (ROI) for capitalists than yours does.
Our people live longer, healthier lives.
Our women enjoy one of the lowest infant mortality rates in the world.
Our workers are more productive than yours...and work fewer hours with more vacation time than yours.
And our government was mainly designed and set up in 1948 by...
YOURS.

Look, I am not exactly crazy about your current government. But your attitude: "The government screws up eveything it touches" is just not in line with reality. Sure, there is waste. Yes, the US government has made some pretty big mistakes (especially lately.) But, and I say this after having lived and visited many countries in this world, the US government is much better than your give it credit for. Try on of the old communist countries of Eastern Europe. Or nearly any African or Arabian country...then you will see the difference. Heck, just go down south of the border...there is a reason all those Mexicans are trying to come to your "screwed up" country.

Oh, and please - I do remember the 1960's. My grandparents lost their house because they couldn't pay for the cancer treatment for my grandfather and keep it. My parents and the other grandfather all worked two jobs to pay for the medicines and treatments for my mother's mom. All hard working, well educated, upstanding Americans.

One point you raise is partially true. The senseless litigation and the absurd health care system in the US has, indeed, led to these terrible prices.
 
To add to Brisnat's earlier comments, there are plenty of mentally ill people about in Australian cities. De-institutionalization has put lots of folk with mental health problems out on the streets. Many of them spend an inordinate amount of time on Australian trains and buses as well. Apart from the poor state of cleanliness, the smells, the constant delays, high ticket costs and other unsavory issues, dealing with unbalanced people and their unsolicited attentions is another reason I NEVER use public transport.

Gizmo is correct in his assertion that most trauma injuries are treated in public hospital emergency rooms. However, most private hospitals do have emergency rooms as well where, for a fee, one can receive emergency treatments. And, yes, they will ask for the money up front. (Not so) Surprisingly, there are a lot of people who prefer to go to a private hospital ER.

Petek is right. The private system is syphoning doctors and nurses from the public system. The level of service in private hospitals is of a much higher standard. The health care system in Australia has become a two-tiered system, one for the haves and another for the have-nots. Certain specialists, such as urologists, will not even process their clients through the public system anymore.

Public hospitals are chronically understaffed and underfunded. Unlike the private system, patients in public hospitals will not receive the same level of diagnostics and are much more likely to be released with underlying health problems remaining undiagnosed during their initial admission. Public hospitals are generally older, less well maintained (flaking paint etc.), dirtier and less attractive than their private counterparts.

People with private insurance don't go on waiting lists, but straight to the front of the line. They get better food, nicer rooms and more one on one attention from their nominated doctors and other clinicians.

Using the private system requires research prior to making a commitment to a procedure. Specialists charge their own fees and some private hospitals may not get full coverage from all health funds. There are co and gap payments, which still can leave private patients out of pocket by thousands of dollars, after Medicare and their private health funds have settled their payments.

Our current Liberal Federal Government (Liberal being a misnomer), has been flirting with the American health care system for a very long time. Our current Prime Minister has, by stealth, been chipping away at Medicare, making private insurance almost obligatory. During the early 1980's the Liberals did dismantle Australia's universal health care system - then called Medibank. For a couple of years, until they got booted out of office, there was only private health insurance. Then, the Government put a few checks in place to prevent private insurers from leaving their clients without coverage due to ongoing high cost treatments for chronic and terminal illnesses. As far as I remember, pensioners and folks on welfare still had access to free medical care.

As soon as the Liberal Party was replaced by the (then more liberal) Labor Party in 1983(?)- universal health care was immediately re-instated in the shape of Medicare. A happy end was had by all - hip hip hooray!

Cheers

Rapunzel
 
Hi Rapunzel,

Have you been treated in a public hospital recently? Your description of flaking paint etc, may be true in the regional areas (I dont know) But in the last 5 years, I've had my tonsils out, in a private hospital, the level of service was ok, but I was still in a 6 person ward, the doctors and nurses were still short staffed and busy. When I had a bleed 7 days after and had to go back to hospital, it cost $120 to get into emergency, and then it took a full day for the specialist to come and see me. (Where I stayed in bed, in the ward, with blood trickling down my throat for 8 hours)

I compare that to unpacking the dishwasher one morning, when I slipped, stuck a very sharp paring knife into my left index finger, severed the tendon and three of the 4 main nerves. At the PA hospital (Public), I was triaged as soon as I walked in, 40 minutes later examined by a doctor, and then admitted and operated on 3 hours later. Once admitted, I had a single room, there was the same level of care and support, and I ended up walking out with no cost to myself.

Again, I cant comment on the Cairns base hospital, But your comments regarding the public system are unfair. Having attended 4 Public hospitals and 3 private hospitals in the last 5 years, I've never seen any flaking paint etc. The problem with Most South East Qld hospitals is that they're almost brand new, but without all the wards open, rather than being old and run down. Yes there are waiting lists, and yes there can be delays, but that is to be expected with anything that is free.

I travel by Bus, Train and Ferry 3 days a week, and other than occaisional train delays, Most of the services run on time and are pleasant enough to use. In other Australian Cities it can be a different story. In Brisbane, Sydney and Melbourne however I've never experienced the same level of Vagrancy on Public transport as in SF. Again this could be different to regional areas.

My Choice magazines, chronicle the introduction of Medibank in the 1960's and its revision in the 1970's. Both systems required direct payment from the user. The first iteration was similiar to the system we have now, but the user had to make direct payments to the government (Weekly Monthly etc), and depending on how much you paid, affected the costs when you had to be admitted into hospital.

Step Forward to Medibank plus in the 70's and the level of cover was still dependant on how much you paid, there were still safety nets for the low income/unemployed, it just became managed by a government owned entity rather than the government directly. The labour government then came along, made the cost of insurance mandatory through the Medicare levy so it no longer had to be seperately paid. Thus you then have universal health insurance, paid for by the worker.

All 3 systems have always met the following critera:
1) User pays, where user can afford to.
2) A safety net for those who are unemployed or cant afford to pay.

I agree that the system we have now is terrific, yes there are problems, but we are so much better off than most of the world. If there was any attempt to change Medicare from its current form, I would be very angry, and possibley consider voting Labour for the first time ever. However most of the negativity I see in your post, seems to be the retoric that I hear coming from the Labour party in the run up to federal election. The State Labour governements are currently running the Hospitals not the Federal Govt, and having worked for 3 years in Queensland health, the level waste is huge.
 
Thanks Rapunzel, that's what a lot of folks are afraid of whenever they hear two-tiered. I don't think it will ever happen in Canada because universal healthcare is paramount to us. But then you never know do you.
 

Similar threads

volvoguy87
Post Filter Flo GE toploaders.
Replies
1
Views
2
dnastrau
D
Q
Did I make the smart choice?
Replies
9
Views
10
qualin
Q
J
"If we were a dog food,
Replies
1
Views
2
alr2903
A

Latest posts

Back
Top