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-   -   We need medical reform NOW!!!!!!!! (https://thetfp.com/tfp/tilted-politics/97264-we-need-medical-reform-now.html)

pan6467 11-09-2005 10:12 PM

We need medical reform NOW!!!!!!!!
 
Ok, so I don't know if many of you know but I was hospitalized for 5 days being told I had cancer (not much was done and I didn't really need to be there) and then I had a medialoscopy for the biopsy and I have Sarcoidosis.
I missed roughly 3 weeks worth of work.

That's the background.

So when I was in the hospital they told me I might be eligible for numerous programs because I have no insurance and work part time while I go to school.

Well, the Medicaid/Medicare people called (and I believe they just signed into law that P/T uninsured workers were eligible). They asked if I had any dependant children, I said "NO". They asked if I was disabled before or now because of this illness, again "NO". They did not ask me how much I made or what I did, they said I was ineligible because I was not disabled.

Then I looked at the Hospital information that they had provided for me to recieve financial help. I have to have made less than $9,300. I've made barely 11 for the year and I barely can live on that especially when the majority was made in Mar-Jul because I didn't have school and there were a bunch of F/T on vacation and leaving that I filled in for. My normal schedule is basically 16-24 hours a week (2-3 days).

Point is, I now have over $20,000 in medical bills and no way to pay them. I will watch my credit that I have rebuilt for the past 6 years be destroyed.

What's the purpose of having worked my ass off, going to school to better my life and yet being told what little I make is too much to recieve any benefits.

I could be like many drug addicts and alcoholics I work with and find the right doctor and get put on disability for my disease or a mental disorder I research and convince everyone I have. But instead I choose to better my life and the second I get sick everything I have built for 6 years is gone.

This is fucking bullshit.

If I had nothing, I would get it all free. If I didn't work and claimed disability I would get it all free. Instead I am bettering my life and facing horrid credit because I won't be able to pay.

Makes no sense the so called greatest country ever on the face of the Earth would rather watch somone bettering themselves and trying financially destroyed, than to work with them.

Marvelous Marv 11-09-2005 10:38 PM

I'll try to word this in a way that doesn't kick you when you're down.

First of all, I admire that you've tried to do the right thing for six years. That's the American way.

The illegal alien way would have been to move to California and turn up at the emergency room speaking Spanish. Then everything would have been free. (Just another aspect of what you've already said.)

Hell, I don't have a clue as far as any decent advice goes. Maybe appeal your case like hell. Sometimes that works.

Good luck.

Mojo_PeiPei 11-09-2005 10:40 PM

I got a personal question for you pan, why don't you have insurance through your school? Or is it not an option? At any rate I don't even know if school insurance would cover something that sounds hardcore like what you had. Sorry man, and I agree that the current system is pretty whacked out, you being one of the 40 million people that don't have insurance.

Cynthetiq 11-09-2005 10:57 PM

many people are just one or two paychecks away from bankruptcy here in the US just because of they way people live their lifestyles. On top of that ANY kind of medical emergency really sinks most people's boats even those that live modest lifestyles against their incomes.

Having watched the medical industry slowly circle the drain for the past 20 years as with insider eyes and information, it's a crying shame, but I will not accept socialized medicine as I don't care for it when I was in the UK just visiting and watching my mother in law be berated while she legally entitled to services she's seens similar to the illegal aliens here.

since I've found that I'm highly asthmatic choices for jobs are limited to those that will provide medical benefits, no if ands or buts about it. Does it suck sometimes, sure, but life isn't a movie with a happy ending all the time.

good luck and I hope you have a speedy recovery both physically and financially.

pan6467 11-09-2005 11:30 PM

First, Thanks to all who posted the well wishes and for those who will. It is deeply appreciated.

Quote:

Originally Posted by Mojo_PeiPei
I got a personal question for you pan, why don't you have insurance through your school? Or is it not an option? At any rate I don't even know if school insurance would cover something that sounds hardcore like what you had. Sorry man, and I agree that the current system is pretty whacked out, you being one of the 40 million people that don't have insurance.

The school doesn't offer it, certain companies have fliers out there but the cost is very high, esp for a single male smoker aged 38.

As for Socialized medicine..... I don't know if I would favor that, but I am a firm believer that we need medical on a sliding scale.

Trust me, as the bills have come in (and I realize I can't afford to even try to make a payment plan because I truly live barely within my means as it is), I have truly given thought to saying fuck it, dropping out of school, giving everything to my mother and claiming homelessness. That's not a solution, but watching the credit I rebuilt from garbage and worked my ass of to fix be destroyed because I fell ill seems like a punishment by society and the greed of those running the Health industry.

I mean if a society bankrupts hard working people because they fall ill, what kind of society is that? To me it is "3rd world" and I am not sure I want to belong to a society that does this.I find it against everything I ever believed America to stand for.

The doctors were cool in that the after surgery office visits they put me down as a house case and non-billable. I must say the people I have worked with have been cool but they have their regs and rules and I unfortunately am not able to get around them.

Now I see why people sue for medical malpractice over the slightest thing, you start getting these bills you have no chance in Hell of paying so look for a reason to blame the doctor and sue your way out of the bills.

I find it extremely pathetic the President can keep cutting taxes for the rich and cuts social programs where someone working, going to school falls prey to illness and is wiped out.

Fucking pathetic excuse, the system HAS TO CHANGE.

//end rant sorry, but I am extremely disillusioned right now, as I am a taxpaying citizen and I need some of my tax money that pays for these programs that are supposed to help me to help me. It's not the taxes I mind paying, I believe it is my share and responsiblity to help....... but when I need those services that I am paying into with my taxes then I should have a right to them.

jorgelito 11-10-2005 12:59 AM

Pan,

I am speechless - I really don't know what to say. I am sorry this happened to you and the scary thing is, you're not the only one.

I definitley agree we need to "fix the system" while simultaneously skeptical about socialized medicine. I have school insurance but I still don't feel secure. I have worked real hard, saved, sacrificed and delayed gratification because I am responisible. It really bothers me that this type of system "punishes" those who do the right thing and "rewards" those who don't.

Damn Pan, sorry this happened to you. I definitley feel your pain and understand what you're going through.

Good luck and take care.

Paq 11-10-2005 03:13 AM

pan, so sorry to hear of your troubles, i wish you a speedy recovery.

with that said, i wholeheartedly agree that there needs to be a fundamental change in our medical system. A while back, i had 2 hairline cracks in a bone in my hand and even WITH insurance, i still had to pay roughly $800 out of pocket over the course of 1 month, and considering what i do/make, well, that's a considerable chunk for me. sadly enough, what i paid for was basically what i was doing before i went to the doctor..basic brace/cast and no use until it felt better. I basically paid for peace of mind that nothing else was severely hurt.

with that said, i don't know what i would have done if i had to shell out $20K. i don't know what i would have done. I am like you, i work hard, i paid for school, i am not in debt at all, i live within my means, nothing ever goes on credit, i have a credit score in the top range, and to think that all of that could become shit if I simply had appendicitis...that, to me, is mind boggling.

I don't think socialized health care is the answer, but on the other hand, i know the system we have right now will collapse very soon. it is simply something that is too complicated to be glossed over with any meaning.

Also, i seriously think there will be a bigger change in the health insurance system. Rates have almost doubled within 3 yrs for me, a single, nonsmoking, no medical problems white male..and i went to a higher deductible, higher copay adn 70/30 instead of 80/20 plan...just to get a rate that is only double what it was before.. the only thing i can think of that has had a similar increase in such a short time is...well, gasoline.

so yeah, i'm seriously waiting for a fundamental change..the system just cannot stand anymore.

tecoyah 11-10-2005 03:44 AM

Pan....My father in law also has Sarcoid....and hes doing well...just to add a bright spot.

The medical industry in this country is totally screwed up, and will self destruct in the next ten years...in my opinion. I dont know the answer to fixing it....but then, I was not elected to do so.

Makes you think about the reasoning behind attempting to tackle Social Security.

highthief 11-10-2005 03:46 AM

Move to Canada. Or the UK. Or any other western nation in the world - I believe they all have some form of socialized medicine. I'm always amazed at how different the US is in this regard with the rest of civilization.

pan6467 11-10-2005 07:08 AM

I must not be in need enough...... and Fuck it I'm not an immigrant.... so I'm fucked.

I guess the GOP figures if you make $12,000 a year that you should be able to afford $20,000 hospital bills, going to school and working a job......

(BTW I don't work full time because if I did my income would be too high to get ANY financial aid for school.... thereby cutting my own throat in trying to get ahead..... Just wanted to add that because I am sure someone will tell me to work 2 jobs or cut what luxuries I may have.....)

At least some GOP are starting to realize the social cuts are getting to extreme.

I know let's fucking cut the rich's taxes, start a fucking war we will throw billions upon billions upon billions into, then cut education, healthcare and social programs for those trying to get ahead and work their asses off just to make it.

FUCK the people trying to make it Goddamned I'm George W. Bush and I'll give the top 1% tax cuts and have the rest of you all pay........

Quote:

House Drops Arctic Drilling From Bill By ANDREW TAYLOR, Associated Press Writer
Thu Nov 10, 2:50 AM ET



A solid phalanx of Republican moderates drove House GOP leaders to drop a hotly contested plan to open an Alaskan wilderness area to oil drilling as a sweeping budget bill headed toward a vote Thursday.

A plan to allow states to lift a moratorium on oil drilling off the Atlantic and Pacific coasts was also axed.

Still, passage of the broader plan cutting $54 billion from federal benefit programs through the end of the decade remains a challenge, even after the provision permitting oil exploration in the Arctic National Wildlife Refuge was dropped.

The Senate has included ANWR drilling in its budget bill and GOP leaders are likely to push hard for the final House-Senate version of the bill to include it.

Many of the same moderates opposed to the drilling plan remain opposed to the bill's provisions curbing Medicaid's growth, tightening eligibility for food stamps and cutting student loan subsidies.

"I have to represent my district," said Rep. Tim Johnson, R-Ill., who represents farmers opposed to cuts in commodity payments as well as the University of Illinois campus, which is upset about cuts to student loans. "At this point, I am very, very skeptical."

The overall bill is a top Republican priority. The Senate last week passed a milder version of the bill to curb the automatic growth of federal spending by $35 billion through the end of the decade.

The House plan cuts more deeply across a broader range of social services, though Republican leaders say the effects will be modest to programs like the Medicaid health system for the poor and disabled. It will still grow much faster than inflation even after beneficiaries face increased copayments and the likely loss of some benefits.

"We are not cutting Medicaid for those truly in need," said Rep. David Dreier (news, bio, voting record), R-Calif.

Top Republicans such as Budget Committee Chairman Jim Nussle, R-Iowa, and Majority Leader Roy Blunt, R-Mo., worked into the night Wednesday refining the bill in an attempt to bring uneasy lawmakers on board. Florida Republicans were especially active, helping kill the offshore drilling plan and loosening proposed restrictions on food stamp benefits for legal immigrants.

The decision on the Arctic refuge was a big setback for those who have tried for years to open a coastal strip of the Arctic National Wildlife Refuge, or ANWR, to oil development. It was a victory for environmentalists, who have lobbied hard against drilling. President Bush has made drilling in the Alaska refuge one of his top energy priorities.

The House Rules Committee formalized the change late Wednesday by issuing the terms of the debate when the House takes up the budget package Thursday.

The decision to drop the ANWR drilling language came after GOP moderates said they would oppose the budget if that language remained.

Protection of the Alaska refuge from oil companies has been championed by environmentalists for years. The House repeatedly has approved drilling in the refuge as part of broad energy legislation, only to see the effort blocked each time by the threat of a filibuster in the Senate.

The budget bill is immune from filibuster, but drilling proponents suddenly found it hard to get the measure accepted by a majority of the House. That's because Democrats oppose the overall budget bill, giving House GOP opponents of drilling in the Arctic enough leverage to have the matter killed.

Twenty-five Republicans, led by Rep. Charles Bass (news, bio, voting record) of New Hampshire, signed a letter asking GOP leaders to strike the Alaskan drilling provision from the broader $54 billion budget cut bill.

The moderates knew they had leverage, given the narrow margin of GOP control of the House. It only takes 14 Republican defections to scuttle a bill, assuming every Democrat opposes it.

Still, removing the Arctic oil drilling provision may incite a backlash from lawmakers who strongly favor it, which is a big majority of Republicans. House and Senate GOP leaders are likely to push hard for the final House-Senate version of the bill to include it.

Marnie Funk, a spokeswoman for Senate Energy Committee Chairman Pete Domenici, R-N.M., said Domenici considers the Senate-approved ANWR provision "one of the most critical components" in the budget package.

The food stamps change was the only concession to lawmakers upset with a spate of cuts to social programs. GOP leaders bowed to pressure from Cuban-American lawmakers from the Miami area to loosen new restrictions on food stamps benefits for legal immigrants.

Immigrants who are disabled, over the age of 60 or applying for citizenship would be exempt from proposed rules extending the waiting period for food stamp eligibility from five to seven years.
Highlights added by me.

LINK: http://news.yahoo.com/s/ap/20051110/...E0BHNlYwN0bWE-

And again I appologize for my attitude and swearing but this is fucking unbelievable. I guess what I pay in taxes and the fact I am working to better my life isn't good enough.

BigBen 11-10-2005 07:21 AM

When Americans scream bloody murder about Canadian Healthcare, they talk about waiting lists.

Pan, how long did it take for you to get into surgery after the initial cancer diagnosis?


You would not have to have paid anything if you and I were neighbors. You just would have had to wait a little longer, I imagine.

powerclown 11-10-2005 07:34 AM

I agree that it could be better.
Independent health insurance is available in the US for $150-$250/month.
Have you looked into payment plans for your bill? Good Luck.

Ace_O_Spades 11-10-2005 07:45 AM

Quote:

Originally Posted by BigBen
When Americans scream bloody murder about Canadian Healthcare, they talk about waiting lists.

Pan, how long did it take for you to get into surgery after the initial cancer diagnosis?


You would not have to have paid anything if you and I were neighbors. You just would have had to wait a little longer, I imagine.

I recently had an experience dealing with surgery with respect to canadian health care.

On a thursday I went to the Doctor's office, he said I needed surgery on my hand to realign the bone and plate it into place. On the friday I went under and had the surgery. The only way it could have possibly been faster was if I went in the same day... a little unrealistic for something not so serious.

Canada's health care system gets a bad rep, unnecessarily. I agree with bigben: if you were my neighbour, you'd be paying less for your education, getting more in student financial aid, and gotten your health problem cared for without charge.

host 11-10-2005 08:19 AM

Quote:

Originally Posted by pan6467
........I could be like many drug addicts and alcoholics I work with and find the right doctor and get put on disability for my disease or a mental disorder I research and convince everyone I have. But instead I choose to better my life and the second I get sick everything I have built for 6 years is gone.

This is fucking bullshit.

If I had nothing, I would get it all free. If I didn't work and claimed disability I would get it all free. Instead I am bettering my life and facing horrid credit because I won't be able to pay.

Makes no sense the so called greatest country ever on the face of the Earth would rather watch somone bettering themselves and trying financially destroyed, than to work with them.

pan, I am sorry for you, and at the same time, relieved that you are not facing any imminently life threatening illness, such as cancer of the lung or other cancer.

What I know of you is only what you have volunteered in your posts on this forum. I am motivated by recent personal experience and by what I know of you here, and by my usual "frankness", to lay the following out to you. Please do not take it personally. I admire you for what you are doing with your life, and I take the same side here on almost all of the issues that we discuss.

My wife, at about your age, before we were married, was a single mom after divorcing, with two pre-teen sons and no strong skill set. With some financial support from retired, upper middle class parents, and her own part time retail job, she successfully completed nursing school and achieved an R.N. level.
About a day after graduating, she was diagnosed with breast cancer and underwent an almost immediate mastectomy and forced her rapid recovery and entered her new profession, saddled with a heavy medical debt because she lacked health insurance coverage. Her circumstances delayed breast reconstructive surgery for at least a year later than it should have begun.

My wife seems at least as proud and independent and hard working as you seem commited to being. We knew each other much earlier in our lives, reunited (via classmates . com) after being out of contact for 27 years, and we married a few years ago. Four months later....my wife suffered a sudden and massive stroke that left her unable to speak and paralyzed on the right side. Thankfully, she enjoyed total medical insurance coverage, but she lost her $50k annual income and was reduced to receiving 30 percent of what she formally earned, and is now on SSI disability, which pays less than 25% of her former earnings. Some incidental medical bills have gone unpaid, and I do not fret about her credit status....we had not merged our credit histories when she was stricken, and she will not qualify for credit now, with her low income.

As proud as my wife is, Pan....she has found herself in circumstances where she has had to seek help from her parents. Life deals many of us some shitty cards, and.....these posts prompt me to advise you to lean on your family in your time of need:
http://www.tfproject.org/tfp/showpos...6&postcount=37

http://www.tfproject.org/tfp/showpos...9&postcount=28
and...to quit smoking.

There does need to be reform in the health insurance coverage and in medical provision payment schemes, but, until there is, we must rely on the comfort and support of our families, if we are fortunate enough to have that option.
We grow up, we try to be independent, but in the end, almost all of us will find ourselves, if we live long enough, under the financial or emotional care of our children, who will, as we decline, even make key decisions for us. We are always our parents children and they are always our parents.

Should we all not have to turn inward for help from our families, if they possess the resources to help, before we turn to the government or to charitable alternatives, first, especially if we are motivated primarily by pride?
(This is a general question, Pan, I do not pretend to know your circumstances well enought to direct the question to you.....)

Don't we owe, a "family first" approach, to all of those in similar circumstances who have no family, or family with the means to potentially help? Should our bankrupt government or inadequate funds for indigent patients, or a system that pays the medical bills of the uninsured, but puts further upward pressure on the costs of those who are lucky enough to have
health insurance, be asked, or worse....compelled to pay the medical bills of those who don't exhaust the option of seeking help from family first?

Isn't part of the problem of the cost to society of caring for the elderly, the fact that, unlike in past generations, family balks at it's former, universally accepted obligation to provide such care?

This may not be the best time to discuss this with you, Pan....but....you brought it up....I have no hostile or even opposing history with your POV on other issues, I am as liberal/left tilting on societal issues as anyone has been here, and I've seen sudden medical crisis up close, so I can empathize. You have just had a tough break, you don't deserve it, but you are in better circumstance, from what you've previously posted, than the majority of folks in your shoes.

host 11-10-2005 08:39 AM

Quote:

Originally Posted by powerclown
I agree that it could be better.
Independent health insurance is available in the US for $150-$250/month.
Have you looked into payment plans for your bill? Good Luck.

Peform a public service, here pc....direct us to one or more of the plans that you mentioned.....with deductibles that are in line with a $12k annual income, and with minimal restrictions on qualification for coverage, i.e. restrictions as to waiting periods with/without pre-existing conditions, prescription riders and dedcutibles, geographic or age related restrictions....etc.

Is it really "sound" advice to refer someone with $12k annual income to a $2400 annual medical insurance payment that would predictably inculde unaffordable decutibles and prescription costs. What, in your POV, would Pan be insuring himself <b>against</b> by paying 20 percent of his income for this "coverage"? Would he receive adequate medical attention without this coverage? <b>Yes.</b>. Would deductibles and prescription costs and loss of wages during a serious illness, most likely put him in the exact same financial circumstances as if he had no insurance? <b>No. He would most likely find himself in worse circumstances, because he sacrificed so much to pay $200 monthly, for insurance that ultimately made no difference in his post medical treatment life, anyway</b>.

Everyone who demands it, receives medical attention, and deductibles exist to discourage the poor from seeking care, if they are foolish enough to be paying for coverage, out of pocket. That is the dirty lil secret that advocates of the status quo, do not want folks who are duped into paying for ultimately unaffordable coverage. Maybe it is a hidden blessing that the majority of Wal-Mart employees make too little to even consider paying for their company's inadequate offering. If you have no assets, you don't need to pay for insurance that only partially protects you against loss of....<b>assets</b>.

I think that you'll find that these plans waste the money of those who are restricted to life on Wal-Mart wages, as that company's own plan offerings are to it's own workers. Your advice, in my experience, is uninformed, BS. Insurance coverage is priced for people who can execute a cost/benefit analysis of what they are protecting (of their own assets and credit status) vs. what they risk losing if they are unisured. Pan will receive no benefit in doing other than ignoring the bill collectors if he ends up left to his own current ability to pay. His credit status will be wrecked, even with a "payment plan", he will not be sued because he will not be viewed as worth the litigation and collection costs, and, after seven years, unfavorable info related to this debt will disappear from his credit report, vs. ten or more years if he foolishly opts for unnecessary bankruptcy "protection".

Our current system will provide care for Pan, with or without him paying $200+ per month, as you suggest. Ironically, he will have no expense and at least equal care if he is uninsured. The issues here are "peace of mind" issues, and....compared to life or death medical crisis, they are a superficial, BS distraction. The "hit" to his credit status is already a given, and a "payment plan" or bankruptcy filing, or the hardhsip of paying for insurance that he can't afford, with deductibles and other limits, and prescription costs that he cannot afford, are all window dressing that seem adequate viewed from your window, powerclown, or from the Bentonville, AK executive office window of a Wal-Mart officer, but they are impractical, BS concepts that are symptoms of being too insulated and out of touch with real, low income, life.

My wife and I are fully insured, and a sudden medical crisis still sucks a bunch. There is no incentive for anyone without major home equity ($50k or more) or other major assets to protect, to pay appreciable costs for out of pocket health insurance coverage, today. We are all one illness away from financila devastation. The "payment plan" or other effort to instill a sense of repayment obligation in the psyche of the low asset citizen is propaganda, intended to help the well to do avoid a "back door" tax. The system is broken, and it will get worse until diplomacy and domestic priorities overcome corporatism draped with the flag of militarism, and the 32,000 lobbyists on "K" Street.

Cynthetiq 11-10-2005 08:45 AM

Quote:

Originally Posted by host
There does need to be reform in the health insurance coverage and in medical provision payment schemes, but, until there is, we must rely on the comfort and support of our families, if we are fortunate enough to have that option.
We grow up, we try to be independent, but in the end, almost all of us will find ourselves, if we live long enough, under the financial or emotional care of our children, who will, as we decline, even make key decisions for us. We are always our parents children and they are always our parents.

Should we all not have to turn inward for help from our families, if they possess the resources to help, before we turn to the government or to charitable alternatives, first, especially if we are motivated primarily by pride?
(This is a general question, Pan, I do not pretend to know your circumstances well enought to direct the question to you.....)

Don't we owe, a "family first" approach, to all of those in similar circumstances who have no family, or family with the means to potentially help? Should our bankrupt government or inadequate funds for indigent patients, or a system that pays the medical bills of the uninsured, but puts further upward pressure on the costs of those who are lucky enough to have
health insurance, be asked, or worse....compelled to pay the medical bills of those who don't exhaust the option of seeking help from family first?

Isn't part of the problem of the cost to society of caring for the elderly, the fact that, unlike in past generations, family balks at it's former, universally accepted obligation to provide such care?

This may not be the best time to discuss this with you, Pan....but....you brought it up....I have no hostile or even opposing history with your POV on other issues, I am as liberal/left tilting on societal issues as anyone has been here, and I've seen sudden medical crisis up close, so I can empathize. You have just had a tough break, you don't deserve it, but you are in better circumstance, from what you've previously posted, than the majority of folks in your shoes.

Host, something we finally agree upon.

Dems tout "It takes a Village", Repubs tout "Family Values" yet both require exactly what you are stating of "Family First," and no one is willing to truly do so.

Most Americans including myself will try hard to not go to parents in time of need. Again, exactly as you state as a matter of pride.

In my travels around the world I see more and more that the family both immediate and external are crucial to the survival of most individuals from cradle to grave. Examples I have seen in Icelandic, Spanish, Filipino, Indian, Chinese, Japanese, Korean, cultures (i'm sure there are more.)

powerclown 11-10-2005 10:42 AM

Quote:

Originally Posted by host
Peform a public service, here pc....direct us to one or more of the plans that you mentioned.....with deductibles that are in line with a $12k annual income, and with minimal restrictions on qualification for coverage, i.e. restrictions as to waiting periods with/without pre-existing conditions, prescription riders and dedcutibles, geographic or age related restrictions....etc.

For the briefest of starts, one might google 'independent health insurance'.

Cynthetiq 11-10-2005 10:44 AM

Quote:

Originally Posted by host
Peform a public service, here pc....direct us to one or more of the plans that you mentioned.....with deductibles that are in line with a $12k annual income, and with minimal restrictions on qualification for coverage, i.e. restrictions as to waiting periods with/without pre-existing conditions, prescription riders and dedcutibles, geographic or age related restrictions....etc.

Quote:

Originally Posted by powerclown
For the briefest of starts, one might google 'independent health insurance'.

Onus is on you now as someone asked you to put your facts where your mouth is, not "google these words" and "oh sorry you didn't find it but I know what I'm saying is fact."

Basically, I'm singling you out now because you've been asked kindly to provide hard evidence to back up your statement and the above retort is not acceptable.

powerclown 11-10-2005 11:06 AM

.............
Aetna
Humana
Celtic
eHealthInsurance
Anthem
Ohio Dept. of Insurance (w/Links)
Golden Rule Health Insurance

It took me less than 5 minutes to find this information.
I would imagine one is bound to find even more helpful information if one so chooses.

kutulu 11-10-2005 11:15 AM

pan:

one thing you also didn't see is the fact that your bill is twice as high as it would be or an insured person. ins companies will only pay a set rate for serivices. They make up for this by charging the uninsured twice as much for hte same service. So really you got screwed twice.

Cynthetiq 11-10-2005 12:47 PM

and just so we can see which of us is being the former of my sig, now where is this so called cheap insurance???

http://img.photobucket.com/albums/v1...tiq/health.jpg
Quote:

Originally Posted by powerclown
.............
Aetna
Humana
Celtic
eHealthInsurance
Anthem
Ohio Dept. of Insurance (w/Links)
Golden Rule Health Insurance

It took me less than 5 minutes to find this information.
I would imagine one is bound to find even more helpful information if one so chooses.

I clicked on EACH link you provided and sorry I don't see ANYTHING that resembles the request that host or myself made to you. It just leads to forms that I need to fill out, and if and when I fill them out, they do not give me any amount that seems livable on $12,000/year

I picked Aetna and populated it with information as an idividual M/36 in California (they didn't have NY but here they are $48.44 for our company employees)

I'm actually in the process of open enrollment for insurance right now at my company and it's $39.00 each pay period (biweekly) costing me about $975 for just myself, since my wife is included it's double that. Our cheapest si $15.95 biweekly and it doesn't cover much but hospital stays and a handful of doctor visits. $975 from a FORTUNE 500 company with over 5,000 employees, even at that rate someone making $12,000 (hopefully that's takehome) it's a large amount.
http://img.photobucket.com/albums/v1...iq/health1.jpg

From what I can see from the Aetna quotes, while I can pick lower coverage, I'd probably end up putting more out of pocket somewhere. My thought it that the plans offered are very confusing and not simple in anyway shape or form. At the maximum $250/month is HUGE for someone only making $12,000/year basically making them choose between eating and healthcare coverage, and that doesn't include prescriptions, doctor copays, and transportation to doctors, missed work, etc.

kutulu 11-10-2005 01:13 PM

well we all know that health care is a priviledge and that all poor people could be rich if they just got off their asses once in a while

/sarcasm

powerclown 11-10-2005 02:03 PM

So what's your point, Cynthetiq?

If you think I'm an asshole because I dare to offer solutions then more power to you. I've been called worse. Never once did I say that health care is affordable on $12k/yr. What the hell would be? I feel for the guy. I would imagine it is a fucking hellish situation to be in.

Let me relate a story quickly: my brother has over $50k in school debts, and he has found, after doing more than googling on the internet, a payment plan that is workable for him. He makes $27k/yr. So forgive me if I'm not the resident TFP professional insurance salesman with all the answers.

All I am suggesting is that Pan do a little research. Get out the phonebook and call around. Use the internet if you want. Get in touch with an insurance person. Ask school, family, colleagues etc etc.
There are resources.

raveneye 11-10-2005 02:26 PM

Pan, my first thought is to give the dean of students a call and explain the situation. These guys have a lot of resources at their disposal, he might be able to pull a few strings to help get you a payment plan that will make everyone happy and not affect your credit rating.

Cynthetiq 11-10-2005 03:16 PM

Quote:

Originally Posted by powerclown
So what's your point, Cynthetiq?

If you think I'm an asshole because I dare to offer solutions then more power to you. I've been called worse. Never once did I say that health care is affordable on $12k/yr. What the hell would be? I feel for the guy. I would imagine it is a fucking hellish situation to be in.

Let me relate a story quickly: my brother has over $50k in school debts, and he has found, after doing more than googling on the internet, a payment plan that is workable for him. He makes $27k/yr. So forgive me if I'm not the resident TFP professional insurance salesman with all the answers.

All I am suggesting is that Pan do a little research. Get out the phonebook and call around. Use the internet if you want. Get in touch with an insurance person. Ask school, family, colleagues etc etc.
There are resources.

my point was that you claim something and then don't bother to post something to back it up especially after you've been asked to. It didn't take me all of 5 minutes to get the Aetna quotes to at least come to the point where you stated of $250/month and then I found below that as well.

one of the main issues here in the politics forum is the hit and run quips and then the converse of the deluge of links and quotes.

Marvelous Marv 11-10-2005 06:25 PM

Quote:

Originally Posted by highthief
Move to Canada. Or the UK. Or any other western nation in the world - I believe they all have some form of socialized medicine. I'm always amazed at how different the US is in this regard with the rest of civilization.

Something tells me Canada and the UK aren't going to be anxious to pick up the slack.

If they ARE, I have a few million illegal aliens I can send them.

Marvelous Marv 11-10-2005 06:28 PM

Quote:

Originally Posted by host
My wife and I are fully insured, and a sudden medical crisis still sucks a bunch. There is no incentive for anyone without major home equity ($50k or more) or other major assets to protect, to pay appreciable costs for out of pocket health insurance coverage, today.

While I am in the quite unusual position of agreeing with you on almost everything in your post, I would like to point out that a person should buy medical insurance if they ever WANT to own a home sometime down the road.

You sure won't buy your first home with a lousy credit score, or if you do, you'll have a very unattractive interest rate.

Marvelous Marv 11-10-2005 06:32 PM

Quote:

Originally Posted by Cynthetiq
Most Americans including myself will try hard to not go to parents in time of need. Again, exactly as you state as a matter of pride.

In my travels around the world I see more and more that the family both immediate and external are crucial to the survival of most individuals from cradle to grave. Examples I have seen in Icelandic, Spanish, Filipino, Indian, Chinese, Japanese, Korean, cultures (i'm sure there are more.)

You're speaking the truth. I provide a service that some people find it hard to do without. I have lost count of the times I've been asked to extend credit, or provide the service for free.

These people have no problem asking me, a total stranger, for such favors, but "Oh no... I can't ask my mother for money."

I also don't consider a person a good risk for credit if they can't put anything on a credit card because they're all maxed.

Sorry for the threadjack.

scout 11-10-2005 06:58 PM

While I'm somewhat sympathic, you are able to work. Have you ever thought about cutting back school to part time for a bit and get a full time job to better support yourself while you pay off these medical expenses? You are not the only one to have to work your ass off to pay bills and get a good education. I realize at this moment you feel you are the only one to ever have such a tough time but I'm confident you can and will do whatever needs to be done to overcome. Bitch a little then get the job done, that's the American way. It's merely a setback, it's not the end of the world. I wish you the best!

pan6467 11-10-2005 07:38 PM

As for family, my mother, while having money does help all she can. She is very proud of how I have taken back control of my life, but she has her own life and problems.

As for my father, while we love each other, we have let each other down in many ways. He once told me that he would help if I ever went back to college and proved to him I could do it. Well a 3.5 GPA and Dean's list every time must not have proved anything. I did go to him for help with college so that I wouldn't be so loaded with loans. He and my stepmother turned me down. She runs my father (as my mother did) and she has issues with my sister and I.

Kind of funny how she can drive a new Mercedes every year but when it comes to allowing dad to see his kids, that's another story. She is the type when she finds out my sister is coming in from Prescott, she'll make sure her and dad are on vacation.

My father is a very great self made man, but when it comes to family he isn't exactly the closest person (he is the perfect case study of a workaholic) and when it comes to his wife (as with my mother so....) he lets them call the shots and just does what the wife tells him. Sad how someone can be so great in business but such a puppet at home.

So .... the family won't be of much help.

As for asking for a payment plan that is an option, I have thought about and am looking into one of those credit managers that supposedly are non profit and don't charge. However, I am skeptical, in that what I say I will be able to pay and what in reality I will be able to pay are 2 different issues (as like I said before my schedule depends on how many f/t call off, vacation and so on and how often I can fill in.

Right now, I'm 3 weeks behind in school and so I have to catch up while staying with the class at the same time. Plus, one of the problems I have with the sarcoid is fatigue and extreme chest pains (it is a known cause for chronic fatigue syndrome because the body is working harder).

I do like the idea of going to the Dean of Students and pleading my case, Thank you for the suggestion Raveneye. :thumbsup:

I don't know what the true options are, if I work more, I get less financial aid for college and what I get now barely pays (as it is all in loans)..... I am not eligible for any scholarships as I have talked to the school about them (being that I have a great GPA) and was laughed out the door basically being told I am a white, single with no dependants, non athletic, male and there are no such things no matter what my GPA is.

As for insurance, I had looked into it, but I could not find any affordable insurance. The best I had found was a very basic plan that would offer a 70/30 and had a high deductible (I think $2500), the cost of which was just not affordable to me.

This country and the attitudes of the Right are just not what I believe in anymore. I find it pathetic we are cutting social programs so deep that we are basically destroying people. All in the name of greed, the poor don't deserve anything, you're poor because you're a lazy asshole, blah blah blah.

I do have a question for the Right who believe that this situation is more my fault and I should find the money by cutting any "Luxury" I may have.

If I don't pay my bill, sure my credit is fucked, but in the long run who do you truly believe pays the bill of the poor who can't??????????

Is it not better to have the security netting and make sure these people get the help and not worry about the money, or shall we continue to put the burden on the rich????

Because in the end when people like myself cannot pay, the burden goes to those with insurance in higher premiums, goes to the taxpayers who have to pay more (well, you have Bush so.... ok the country's deficit skyrockets more), because these doctors and hospitals are going to get their money somehow........ if not by me or the poor who make too much to get help, but make too little to pay, then by the people who do pay, the government and by eventually cutting services to people in this situation......

And is that what mankind and living is about, to deny people healthcare and peace of mind for profit???????

God I hope not, because if it is then there truly is no hope for any of us.

pan6467 11-10-2005 07:47 PM

Quote:

Originally Posted by scout
While I'm somewhat sympathic, you are able to work. Have you ever thought about cutting back school to part time for a bit and get a full time job to better support yourself while you pay off these medical expenses? You are not the only one to have to work your ass off to pay bills and get a good education. I realize at this moment you feel you are the only one to ever have such a tough time but I'm confident you can and will do whatever needs to be done to overcome. Bitch a little then get the job done, that's the American way. It's merely a setback, it's not the end of the world. I wish you the best!

So then I have student loans to pay, a job if I am lucky pays $7 an hour and have no desire to do and I still won't be able to pay off either then.

By going to school, I have been given the drive to better my life because I will be doing something I believe in and truly want to do. I have self respect, the respect of my coworkers and family and the respect of other addicts I work with. That means more to me than any amount of fucking money.... I know for some on this board they can't grasp how, nor can they lower those self righteous, know it all, egotistical beliefs they have, that they just know they would never be in my position and if they were they would handle it soooooo fucking much better.

If I do as you say, and you'll see it as a character flaw but fuck that self righteous attitude...... then I'll be miserable and will have truly given up, because the drive will have been sucked right out of me.

If I work more, I get less in financial aid and then I can't afford school so I'm in the same boat.

And no I am not the only person who is in this boat, and many who are give up. I refuse to give up and will pay off $5 a month if that is all I can, but I refuse to have people tell me "I need to work harder" or "I derserve this" or "fuck what you want to do, do what you have to do".

I am doing what I want to do because when I get through with school I'll be in a far better position. And because unlike the self righteous who spew the "not government or my problem" bullshit (sorry we are on this Earth together, we have an inherent and God driven duty to help each other IMHO), I believe by bettering myself and being in a job I love, I can help others better and be a more positive example for other who are trying to rebuild their lives.

If I do what you tell me or suggest that "I need to do", then I'm going to be miserable and not give a fuck and to be honest, I'll just find a doctor who will put me on SSI and I'll have you pay for it all anyway. Because that attitude is not conducive to those who are trying to better themselves and show society that they are viable and that they feel and want does matter and is equal to the feelings and wants of the Bill Gates' and Warren Buffetts' (both of whom have come forward for medical refom).

You give people no hope, you kill their spirit and destroy them...... and is that what we as a society truly want? Is fucking money more important than people's well being and happiness????? God forgive those who believe it is.

pan6467 11-10-2005 08:12 PM

As my favorite songwriter, RAYMOND DOUGLASS DAVIES of the KINKS wrote:

Quote:

Man made the buildings that reach for the sky
And man made the motorcar and learned how to fly
But he didn't make the flowers and he didn't make the trees
And he didn't make you and he didn't make me
And he got no right to turn us into machines
He's got no right at all
'Cause we are all God's children
And he got no right to change us
Oh, we gotta go back the way the good lord made us all

Don't want this world to change me
I wanna go back the way the good lord made me
Same lungs that he gave me to breath with
Same eyes he gave me to see with

Oh, the rich man, the poor man, the saint and the sinner
The wise man, the simpleton, the loser and the winner
We are all the same to Him
Stripped of our clothes and all the things we own
The day that we are born
We are all God's children
And they got no right to change us
Oh, we gotta go back the way the good lord made
Oh, the good lord made us all
And we are all his children
And they got no right to change us
Oh, we gotta go back the way the good lord made us all
Yeah, we gotta go back the way the good lord made us all
Shouldn't we view each other as equals and God's children and get over the fucking greed?

Shouldn't we allow those who, like I, want to move forward in society the chance to do so, without giving them guilt trips to work harder, STF up and do what you have to do even if it destroys everything you believe or dream.... because that rich guy over there, his dreams and the greed he blieves in mean more because he has more?

Why turn us into machines that have no dreams and hopes and desires in the name of fucking money? Is money your God?????? Is money going to save you from a severe natural disaster or when you need your fellow man's help and they turn their back on you because you don't have enough money or because you treated them like shit because they didn't have as much as you??????

It just boggles my mind people put money over everything........ so fucking sad, to me that's a worse life than anything I will ever live.

Of course, money is just like any other drug addiction....... and some people realize it and change and find true love, hope, wisdom and courage and some die greedy with greedy fucking heirs, who never gave a fuck about them, just the money because that is what heirs were taught to care about.

Lebell 11-10-2005 08:32 PM

Pan,

I was very sorry to read this news.

Hang in there.

-lebell

Elphaba 11-10-2005 10:08 PM

Pan, I've held back because I simply do not know what to say and I suspect I will be in your shoes soon. It is long overdue that we join the other Western nations in a national health plan. Some still believe that the US has the best health care in the world, but a recent study demonstrates that we don't even make the top five.

I promised you I had your back, but I have little substance to match my words. All I can promise you now is that I will do my best to support you as a friend, and beat the drum for national health care for as long as it takes.

Damn little help that is to you right now. :(


"Drowning in a River of Tears" - Eric Clapton

scout 11-11-2005 04:07 AM

Quote:

Originally Posted by pan6467
So then I have student loans to pay, a job if I am lucky pays $7 an hour and have no desire to do and I still won't be able to pay off either then.

By going to school, I have been given the drive to better my life because I will be doing something I believe in and truly want to do. I have self respect, the respect of my coworkers and family and the respect of other addicts I work with. That means more to me than any amount of fucking money.... I know for some on this board they can't grasp how, nor can they lower those self righteous, know it all, egotistical beliefs they have, that they just know they would never be in my position and if they were they would handle it soooooo fucking much better.

If I do as you say, and you'll see it as a character flaw but fuck that self righteous attitude...... then I'll be miserable and will have truly given up, because the drive will have been sucked right out of me.

If I work more, I get less in financial aid and then I can't afford school so I'm in the same boat.

And no I am not the only person who is in this boat, and many who are give up. I refuse to give up and will pay off $5 a month if that is all I can, but I refuse to have people tell me "I need to work harder" or "I derserve this" or "fuck what you want to do, do what you have to do".

I am doing what I want to do because when I get through with school I'll be in a far better position. And because unlike the self righteous who spew the "not government or my problem" bullshit (sorry we are on this Earth together, we have an inherent and God driven duty to help each other IMHO), I believe by bettering myself and being in a job I love, I can help others better and be a more positive example for other who are trying to rebuild their lives.

If I do what you tell me or suggest that "I need to do", then I'm going to be miserable and not give a fuck and to be honest, I'll just find a doctor who will put me on SSI and I'll have you pay for it all anyway. Because that attitude is not conducive to those who are trying to better themselves and show society that they are viable and that they feel and want does matter and is equal to the feelings and wants of the Bill Gates' and Warren Buffetts' (both of whom have come forward for medical refom).

You give people no hope, you kill their spirit and destroy them...... and is that what we as a society truly want? Is fucking money more important than people's well being and happiness????? God forgive those who believe it is.

I wasn't trying to be rude, just perhaps giving you another way to look at it. I am truly sorry you took it the way you did. I guess I find it hard to grasp the attitude of "everyone owes me free health care just because I go to school". I'm really not trying to be snobbish or have a bad attitude. I'm only 4 years older than you. I remember when I went to school I worked two jobs and raised a family, all without any public assistance other than Pell grants and they wasn't much. It wasn't that I didn't qualify for assistance, but I knew if my parents found out I or my family was receiving public assistance all hell would break loose as this would be a major embarrassment to them and to the extended family. And they wasn't going to help me unless the world was about to end lol. To be honest I'm still paying about $4500 in student loans but I've about got it licked! Yea sometimes I thought it was impossible and I would never get out of school. Some years I only went part time, other years I was able to pick up a few "extra" credits, but it all worked out in the end. At the time it was rough, but I made it. I appreciate more now what my parents taught me then about self sufficiency. I've said all that to say this I guess .... I hope you the best and I truly hope it all works out for you. As you stated, if you have to send them $5 a month to get through it then that's what you have to do. Hang in there, it's gonna get better! Good luck!

pan6467 11-11-2005 07:32 AM

It's cool Scout, and no I am not sayinbg that the world owes me anything but the allowance to follow my dreams to better society the best way I feel I can.

I am very set on a sliding scale medical pay. I don't believe that anything should be "free", everyone has a right to make money and to live as best they can.

Trust me I have no hate for money, I have a hate for putting GREED over people, and that is what the healthcare profession is doing, and our government is allowing them to do.

Right now we are just fucking numbers and statistics to these companies that care only about the bottom line and how much profit they can make so that the CEO's and board members can live in the lap of luxury. Unfortunately, what they do not see (whether it is self blindness or they are just so greedy they do not care about the future) is that they themselves (or more likely their children and grandchildren) will become numbers also and that their lives will be seen as nothing but "how much profit can we make off you in your lifetime"? In other words, they are building a system where everyone is just profit to them and life, liberty and the pursuit of happiness will mean nothing because from the second you are born to the last breath you breathe the system will be sucking you for as much profit as possible.

I can't look at life that way. People have an inherent right to be happy and free, and above all else America was supposedly built on the basis that people had the freedom to pursue their individual happiness..... (It's even in the preamble of the US Constitution.)

I believe in self suffiency, and my life was being built upon it, however, how can I dream of self sufficiency when all I am seen as is someone who owes more than I will probably be able to pay off in many years. And with Sarcoidosis I can have very painful flareups and need more medical attention at any time for the rest of my life. So even with insurance the way prices are and the fact they keep exponentially going up because these companies have to make profit from the people and insurance companies that can PAY, I could feasibly max out my insurance before I die. Then what? I lose everything I have ever worked for because I have an illness that I did not cause?

Now being a smoker, if I had lung cancer (God forbid) then an argument can be made I did that to myself and therefore I should be held more accountable. But, Sarcoidosis is not a result of something I did to myself so to take profit from my illness and to hold me in debt and perhaps eventually take everything I will have ever worked for because I happen to have gotten it, then is that not just plain greed and saying "too bad so sad, you lost life's lottery...... fucking pay?" So you are punishing me, for something I cannot control..... Is that truly what we want to be in society?

I have psoriasis (another auto-immune disease), and I have refused to take medications that could clear it up because I feared the health effects...... watch the commercials for the one med they advertise heavily for..... "may cause fatal skin infections, may cause liver damage, may cause cancers, and this that and the other thing....". So these miracle drugs that the machine prescribes for people actually may cause more damage in the long run.

I have had Doctors tell me those incindences are very rare...... welll Goddamned.... only 20 - 50 out of every 100,000 people get Sarcoidosis and out of that only 3 white non Scandinavian males get it (plaus it is even rarer in the northern US, as it is more common in the Southern and South Eastern states)...... so gee willikers... I think I have already shown I am a rare case.

But these meds are also "new" and the true effects won't be seen for years after many people have taken them. Look at Celebrex or Vioxx......

But the way these companies see it is that these meds may help or cure one problem but they will probably cause more down the line so more profit will come from these people than maybe what was originally going to. (And if you think that is just a paranoid ramble wait 20 years and see...... I can almost guarantee the long term side effects of all these toenail fungal meds, and penile dysfunction meds, and psoriasis meds and bi-polar meds and whatever band aid med you maybe on.... will kick in and be worse than the original problem.)

Don't get me wrong there are many good meds out there also, that truly do help. We should never stop developing meds, but we should be careful so that the long term effects do not cause worse problems for the patient.... but then that would hurt long term profit.

So in the end what is the solution? I personally believe getting back to treating the individual as an individual and not as a profit margin or as a number and just prescribe whatever the med is at the time.

Our healthcare was the greatest because we had great doctors and a health profession that treated the individual not just the disease.

We cannot as a society grow and develop into anything better if we keep punishing people for falling ill and treating them as profit margins.

Like me, I work and will work in a form of the medical profession. But thankfully, I will be in one of the last fields to be able to treat the individual as an individual (although the vast majority of addictions counseling is moving towards corrections because there is no money in the true treatments of individuals. Why? Insurance won't pay (or in the very best of cases has very low maxes and high copays), plus most addicts have wasted whatever they had on the drugs and life before they realized they were at rock bottom, very few addicts will stop while they are still at the top. So there is truly no money in the business, unless again you go into corrections or treat the very rich (like the Hazeldons and Betty Ford Clinics in the world.)

So if profit is all you want and care about .... then this isn't the business. Because I can guarantee the recovery rates are extremely low.

Whereas, myself, my profit will come in knowing I have helped someone to better their life and be more productive in society and therefore moving the economy far more positively than they had before I helped them.

So if the healthcare profession truly was about helping people and not just their profit and future profit of just themselves, they would see by treating the individual and allowing them a better healthier life, the individual would be able to contribute better to society and thus society itself would be richer.

The industry has to change or we will all go bankrupt feeding the machine.

Anyway, I am rambling now so........

pan6467 11-11-2005 07:55 AM

To take the bitchiness off the thread for a post......... (sorry for caps but ....)

I WISH TO THANK EVERYONE WHO HAS POSTED THEIR GOOD WISHES EVEN IF WE DO NOT SEE EYE TO EYE.

EACH OF YOU HAVE SHOWN A TRUE STRANGER COMPASSION AND THAT MEANS A LOT TO ME, MORE THAN YOU MAY EVER KNOW.........

FROM THE BOTTOM OF MY HEART I TRULY THANK EACH AND EVERY ONE OF YOU, AND I HOPE SOMEDAY, IN SOME WAY I CAN HELP EACH OF YOU........


THANK YOU, THIS IS THE GREATEST PLACE ON THE NET BECAUSE OF PEOPLE LIKE YOU

AngelicVampire 11-11-2005 08:21 AM

So does no one really support a UK/Canadian style health care system where all non-trivial (breast enhancements etc for cosmetic reasons) are provided for on the state. Everyone pays taxes and can get a minimum level of care for any illness. If you want better/faster care you can go private however its an addition for people who want to do so rather than a necessity.

I really feel for you man, it's a shame and tragedy that one of the most advanced nations in the world cannot provide basic medical care to its citizens. Ok there are some things that I don't think should be free such as birth control (in non-necessary situations) and non-necessary surgeries (again like breast implants or pec implants in purely cosmetic situations). However for the most part isn't universal healthcare more of a benefit than a flaw?

flstf 11-11-2005 08:41 AM

Pan, I am sorry to hear of your medical bill nightmare. Something of course has to be done about the out of control healthcare costs in our country soon. I know it doesn't help you now but we will probably have nationalized healthcare in the not too distant future. My wife and I recently payed off our adult daughter's emergency room visit hospital bill. An hour or so with xrays gets up to a few thousand dollars very fast.

Quote:

Originally Posted by powerclown
Independent health insurance is available in the US for $150-$250/month.

The least expensive plan my wife and I could find is over $300 per month for $10,000 deductible, meaning that anything over $10K a year, they will pay 80% of approved covered costs. We own our house outright and must protect ourselves from financial disaster.

Rekna 11-11-2005 09:52 AM

Pan, are you sure if you worked more hours you would loose your financial aid? I'm making roughly 25k a year and I still qualify for the max $8500 in student loans a year. Though i'm also a grad student so that might affect the financial need formula some.

One thing I would do is talk to the hospital imediatly. I know when I went to the dentist recently and had to get 3k in dental work done they gave me 15% off because i was paying out of pocket. They may be able to reduce the ammount you have to pay since you are uninsured and cannot afford it.

pan6467 11-21-2005 12:23 PM

THIS IS FUCKED UP!!!!!!!!!

I just got off the phone with "Quality Assurance Medical" or whatever (They are the ones that find grants and what not to help people pay)..... Anyway, they called me to see if I was still working and if I planned to continue working..... when I said yes, the lady told me, that if I decided not to work, she could find money for me to pay.....

WTF IS THAT???????

I can't get any help if I work, yet if I don't work, and can't pay any other bills I can get help on my medical bills........

WOW..... WTF, so I'm fucked because I choose to better my life...... maybe when I see the doctor Wednesday I'll tell him how excrutiating the pain is at times (no lie there) or how I have insomnia and a stiff neck. Maybe I can get on disability, get everything fucking paid for, even school, open my halfway house/therapeutic community and place it under some type of partnership where I am just the manager/live in partner........

Yeah, I'll just abuse the system now..... fuck the people who would rather not have any type of universal healthcare, I'll just join the system and take everything I can....

Except for a few things, my pride, the fact I couldn't allow myself to do that, the fact I LOVE my job helping other addicts more than anything else I have ever done or how much money I have ever had and the fact that I'm bettering myself despite the people who would rather have systems like this than universal healthcare even if it were on a sliding scale basis.

They need to face the facts, government is going to pay the bills one way or another for those who can't, and people in my position given the chance...... I have a feeling the majority would jump at it. Especially knowing school financial aid would be there also.

Cynthetiq 11-21-2005 02:45 PM

It is.

But my personal take on it is when you can use the system that you've paid into for quite some time, use it. You paid for it fair and square, not much can be said for the generational welfare families.

Ustwo 11-21-2005 03:24 PM

Quote:

The University Student Health Insurance plan provides worldwide coverage, with the student's choice of provider. Discounts may be available if the provider is part of the Private Healthcare System (PHCS). The plan is independent of McKinley Health Center and benefits are not contingent upon McKinley Health Center referrals. The fee for the plan is automatically assessed along with other tuition and fees. For the 2005-2006 plan year, the graduate student fee is $230.00 per semester and the undergrad student fee is $167.00 per semester.

Tuition and fee waivers do not apply to the Student Insurance fee.

Each semester during the Enrollment/Change Period, students can apply for an exemption from the Student Insurance fee, purchase dependent coverage, apply for graduate dental and/or vision coverage, request an extension of prior coverage and apply for open enrollment reinstatement. Go to "Important Dates" regarding the Enrollment/Change Period.

Necessary forms can be downloaded from this web site. Due to a form inventory being conducted, all forms printed from this website must be mailed (807 S. Wright, Suite 480) or faxed (217-244-9886) to the Student Insurance office. Students wishing to come in person will be required to use different forms. To avoid long lines in our office, it is strongly suggested that students obtain the necessary forms from this website and submit the forms by mail or fax.

We are located on the fourth floor of the Illini Union Bookstore building. Use the northeast entrance to the building, not the Bookstore entrance (view map). We can be reached at 217 333-0165; or insure@uiuc.edu
My former school.

What school do you go to?

Personally I think you have a bit of martyr syndrome going, you have outs but instead are taking the high road even if it leads you to the cross. Getting nailed to crosses, even figuratively, sucks, you have your outs, use them.

Edit:As a side note, I've said on this board before, that the people who get screwed by health care are the working lower/lower middle classes. If I could change it, if they asked if you had a job and you said no, thats when they say they can't help you, not the other way around.

pan6467 11-22-2005 07:17 PM

Quote:

Originally Posted by Ustwo
My former school.

What school do you go to?

Personally I think you have a bit of martyr syndrome going, you have outs but instead are taking the high road even if it leads you to the cross. Getting nailed to crosses, even figuratively, sucks, you have your outs, use them.

Edit:As a side note, I've said on this board before, that the people who get screwed by health care are the working lower/lower middle classes. If I could change it, if they asked if you had a job and you said no, thats when they say they can't help you, not the other way around.

I really don't need you trying to pick a fight, you and I both got the warning letter, so please just go about your own business UsTwo. You have no respect for me, and I just don't like your attitude.

I am not a martyr, I am trying to do what is right. So just leave me alone.

Ustwo 11-22-2005 09:27 PM

Quote:

Originally Posted by pan6467
I really don't need you trying to pick a fight, you and I both got the warning letter, so please just go about your own business UsTwo. You have no respect for me, and I just don't like your attitude.

I am not a martyr, I am trying to do what is right. So just leave me alone.

Quite frankly this doesn't belong in politics UNLESS you are trying to be the martyr. This isn't a what can I do post, this is a SEE HOW BAD THE SYSTEM SUCKS POST, well the system sometimes does suck, all systems suck at some point. You have a way to make it not suck for you and you refuse to take it on a moral high ground. If thats not being a martyr I don't know what would qualify.

Quote:

Audio pronunciation of "martyr" ( P ) Pronunciation Key (märtr)
n.

1. One who chooses to suffer death rather than renounce religious principles.
2. One who makes great sacrifices or suffers much in order to further a belief, cause, or principle.
a. One who endures great suffering: a martyr to arthritis.
b. One who makes a great show of suffering in order to arouse sympathy.
Its pretty textbook.

pan6467 11-23-2005 04:36 AM

You're just trying to pick a fight UsTwo and you know what, it's not working. You got the message from BerMuda same as I..... I think you first post was to antagonize and your second to further try to pick the fight..... I'll let a Mod decide.

Cynthetiq 11-23-2005 05:47 AM

On it's face, Ustwo is right, the definition of a martyr is what fits.

as for you two picking a fight... pan please use the ignore feature of the board.

pan6467 11-23-2005 06:38 AM

One posts bad policy and its effects on politics so that the people can see why policy needs changed.

That is my purpose a personal account to show why policy needs changed.

Elphaba 11-25-2005 07:27 PM

Quote:

Pan posts:I just got off the phone with "Quality Assurance Medical" or whatever (They are the ones that find grants and what not to help people pay)..... Anyway, they called me to see if I was still working and if I planned to continue working..... when I said yes, the lady told me, that if I decided not to work, she could find money for me to pay.....

WTF IS THAT???????

I can't get any help if I work, yet if I don't work, and can't pay any other bills I can get help on my medical bills........
Pan, I have trouble finding the martyr position of which you are accused. Please tell me if I am missing something here:

* You can only get medical help if you are NOT working.

* You can't pay your rent, buy groceries, or pay any other expenses other than medical, if you are NOT working.

"On it's face," your situation appears to be between a rock and a hard place, NOT martyrdom.

pan6467 11-25-2005 08:46 PM

Thank you Elph. and that is exactly where I am at. As I stated above policy needs changed and my speaking out may get someone else thinking and doing something to change policy also. I don't see how martyrdom is even close. my choice is I work and live or I don't work and starve but my medical bills are paid for. How that is being a martyr is beyond me.

It was just UsTwo personally attacking me, childishly. I could post the letter/personal message that we both recieved from a mod to not antagonize each other, and I have IM'd mods about it, but I guess the warning meant nothing.

Perhaps, he felt it had been a month or 2 and he could get away with it, while I have not replied to any of his posts in other threads and in fact have gone out of my way to avoid even refering to him or his posts directly.

Sorry but, I am upset about being attacked on here needlessly, it was wrong and I truly believe I need an appology.

PS I won't be bullied off here, if he attacks me again I'll just leave..... I don't need to have assholes attack me when I open up about an illness and personal problem. I posted it on here to show policy needed changed and to have a debate... not be attacked and called names.

ArellaNova 11-30-2005 10:47 AM

I think your case is a perfect example of why there is a demand for the support of the private insurance industry.

Government let you down. Government wants to provide for everyone, but it can't. The insurance industry is in the business of risk management. Their livelyhood depends upon providing you an adequate service.

For example. I am in the same boat. Working part time and going to school part time. I can't afford massive health care coverage either, but I sacrafice some shopping, and possable vacationing to purchase my own minimum health care plan. Now I have to pay out the wazoo if I get an infection, but major emergencies -like cancer- are covered to a specific amount. I am buying assurance that for *some* drastic measures I wont go personally bankrupt.

Locobot 11-30-2005 01:05 PM

Quote:

Originally Posted by ArellaNova
I think your case is a perfect example of why there is a demand for the support of the private insurance industry.

Government let you down. Government wants to provide for everyone, but it can't. The insurance industry is in the business of risk management. Their livelyhood depends upon providing you an adequate service.

For example. I am in the same boat. Working part time and going to school part time. I can't afford massive health care coverage either, but I sacrafice some shopping, and possable vacationing to purchase my own minimum health care plan. Now I have to pay out the wazoo if I get an infection, but major emergencies -like cancer- are covered to a specific amount. I am buying assurance that for *some* drastic measures I wont go personally bankrupt.

*cough* *gag* what? Demand for the what? Who is demanding this besides the private insurance companies? How could a for-profit company better serve the medical needs of population than a non-profit system run by the people themselves? What you're arguing for is actually the status quo in the U.S. - the Republican medical plan - which includes MORE middlemen MORE bureaucracy and MORE people cut off from medical care than a universal state-run system.

Insurance companies' primary purpose is to serve their share holders, not provide medical care. Insurance companies can, and do quite often, themselves declare bankruptcy (a much less punative process than a personal bankruptcy) in which case you've lost your medical coverage and have to start anew with a different company.

I garauntee you Arella, if you have medical catastrophe your insurance will run out long before your need for medical care will. You'll find yourself in a position similiar to Pan's where you'd be better off not working, not contributing, and dropping out.

Ustwo-I love how you complain all the time about people abusing the social welfare systems, yet when someone like Pan refuses to do so he becomes a "martyr."

Ustwo 11-30-2005 02:17 PM

Quote:

Originally Posted by Locobot
How could a for-profit company better serve the medical needs of population than a non-profit system run by the people themselves?

DMV, Post Office, IRS - Run by the people for the people. :crazy:

Quote:


Ustwo-I love how you complain all the time about people abusing the social welfare systems, yet when someone like Pan refuses to do so he becomes a "martyr." You are a contemptible hypocrite Ustwo and you've never contributed anything to this board that would remotely justify your constant presence.
At first I was going to answer your first, misguided, point but then I had the misfortune of continuing to read.

I could get quite insulting with you, you are not a hard target, but I will wait for the inevitable.

Paq 11-30-2005 02:56 PM

Quote:

Originally Posted by Locobot
*cough* *gag* what? Demand for the what? Who is demanding this besides the private insurance companies? How could a for-profit company better serve the medical needs of population than a non-profit system run by the people themselves? What you're arguing for is actually the status quo in the U.S. - the Republican medical plan - which includes MORE middlemen MORE bureaucracy and MORE people cut off from medical care than a universal state-run system.

Insurance companies' primary purpose is to serve their share holders, not provide medical care. Insurance companies can, and do quite often, themselves declare bankruptcy (a much less punative process than a personal bankruptcy) in which case you've lost your medical coverage and have to start anew with a different company.

I garauntee you Arella, if you have medical catastrophe your insurance will run out long before your need for medical care will. You'll find yourself in a position similiar to Pan's where you'd be better off not working, not contributing, and dropping out.

Ustwo-I love how you complain all the time about people abusing the social welfare systems, yet when someone like Pan refuses to do so he becomes a "martyr." You are a contemptible hypocrite Ustwo and you've never contributed anything to this board that would remotely justify your constant presence.

^^^^

agreed about all the insurance stuff bc i have seen them cut off people who have had VERY treatable illnesses that, through no fault of their own, costed over the normal $1,000,000...That, to me, is astounding.

as for the Ustwo comment, i have found that the /ignore feature is great...i haven't even noticed he's gone other than when someone bitches about something he says.

Cynthetiq 11-30-2005 02:59 PM

Quote:

Originally Posted by Paq
^^^^

agreed, but i have found that the /ignore feature is great...i have'nt even noticed he's gone other than wehn someone bitches about something he says.

And more people should use it accordingly.

flstf 11-30-2005 03:20 PM

Quote:

Originally Posted by Paq
^^^^
as for the Ustwo comment, i have found that the /ignore feature is great...i haven't even noticed he's gone other than when someone bitches about something he says.

IMHO it would be a mistake to ignore what Ustwo has to say especially in regards to the medical industry. I disagree with much of what some others post as well on political matters but still want to read their opinions. Even most of the ones I disagree with seem to be very smart people.

Paq 11-30-2005 03:36 PM

flstf, while i have read his stuff, i find that my life is much happier w/out his 'input' either way. i have, on occassion, agreed with what he was saying, or could, at least, see where he was coming from, but i find that every time i do, i turn around and read another post on how someone is making a martyr of themselves or how some people are lazy and good for nothing or just things that make jerry falwell seem open minded.

So, for the sake of me and any of my comments, i just use the /ignore feature anymore. Every now and then, i'll go throguh and read his stuff, but on the whole, i would rather not

Ustwo 11-30-2005 04:17 PM

Quote:

Originally Posted by Cynthetiq
And more people should use it accordingly.

And due to the lack of comment I take it locobots type of reply is now acceptable and I can reply in kind? I don't care who I piss off with my opinions and a lot of opinions here piss me off too, but do we now accept personal insults and perhaps just use ignore?

pan6467 11-30-2005 05:11 PM

DMV runs fine in Ohio, they have nothing to do with cost (except to add maybe a small $2.00 surcharge).... as for lines, maybe that's because the government needs more locations.... as it is still a government office.

Post Office gets mail out on time.... just they lost footing to technology because they were slow to pick it up... but they kept costs down and do a damned good job. Hey for 37 cents I can have a letter mailed anywhere in the US (and Canada I believe) and it'll be there within a week or less (I get letters from my sister in Prescott Az within 3 days of her mailing them).... that's not shabby. Plus, they are cheaper than UPS, FedEx..... so how are they bad? OOO I forgot they're bad because they are easy targets, they prove that they can do a job effectively, and rather cheaply.

IRS.... it's the ultimate government run beaureucracy. The IRS is bogged down by the government's tax laws..... people tend to throw stones at them for enforcing the law.... but that's all they do is enforce.

I don't see how your examples are even pertinent as all 3 run pretty effectively.

LOL Ustwo you personally come in here and insult me and then get all offended when someone calls you out.

It is true you bitch about people abusing the system and when I say I could but choose not to because I am bettering myself you call me a martyr and personally attack me. You are a hypocrite and cannot stand anyone who upstages you.

You got the same PM from Bermuda I did and YOU broke it and not a damned thing happened to you. If you had attacked me in any other thread I would have ignored you, but you chose this thread and to kick me while I was down. Well I'm up now and the kicking won't be so easy.

You start the fight and then you wait for others to get into trouble. You are an immature bully. And for all who think so...... I think it is time to use the ignore and just shut the UsTwo off. IF enough people ignore him and turn him off my guess is that he'll either just leave and find somewhere else to pick fights and bully, or he'll keep making new nicks until he gets caught and banned. It's not like we'll miss anything of substance as he never brings any facts to debate, just picks fights.

Goodbye UsTwo..... you're own hatred will destroy you.

Loco thank you...... but please be careful don't want you banned because of him. I'll bite the bullet...... he attacked me he was warned and he chose to make it personal.

WE were both told to basically leave each other alone.... yet the second he could kick me he did..... and nothing happened to him..... so I'm answering back and ending it by ignoring him and waiting because he'll attack again under a new nick.... my guess is that he has the new nicks waiting, if he hasn't used them already........ and he'll keep attacking till even those who like him start seeing him for what he is.

You want to see less fighting in this forum, make a rule that people need to back up their facts, something UsTwo does very little of.

SecretMethod70 11-30-2005 06:35 PM

Quote:

Originally Posted by Ustwo
And due to the lack of comment I take it locobots type of reply is now acceptable and I can reply in kind? I don't care who I piss off with my opinions and a lot of opinions here piss me off too, but do we now accept personal insults and perhaps just use ignore?

No, and it is about to be removed. It was originally overlooked. Let this be a reminder to avoid personal insults...I know you all are capable of being more civil than that.

MoonDog 11-30-2005 06:36 PM

Someone stole my thunder when they recommended that you talk to your school. They can often point you to a person or office within the school that might be able to help.

I believe that my school had student insurance as well. I was looking it up just a minute ago, and the premium for the year is $1,257. It isn't the greatest plan - maxes out at $25,000 in covered expenses, but pre-existing conditions are covered. Maybe your school has something similar? Still seems to expensive for what you earn in a year.

I have no real experience in Medicaid/Medicare qualifications, although it is my understanding that borderline cases are often automatically denied, forcing people to demand a hearing, hire a lawyer, etc., before they are allowed coverage. Maybe someone could point you in the direction of a law firm that handles these types of cases?

On a personal note, my grandfather died of sarcoidosis, and you have my sympathy for the pain you have/are experiencing. I assume you are on Prednisone? Maybe the docs have cooked up something better since my grandfather passed?

To address the "topic" of the post, my father is a doctor, and he believes that there is a need for universal coverage. I believe it too, but I have no idea which method/proposal is going to be best for us, or how we can overcome the industry lobby to get it done! I think it is obvious, however, that such a program will have to be paired with reforms that address the litigious nature of American society as well.

Finally, I have to agree with some on the fact that this post - as is - might have been better located in Tilted Living. Not taking a swipe here, although it may seem that way. I just felt as I read through the posts that this was different than our "normal" discussions here. Maybe its just the more personal nature of the post?

In any case, best of luck in finding a solution. :thumbsup: (most appropriate emoticon I could find!)

pan6467 11-30-2005 08:17 PM

Quote:

Originally Posted by MoonDog
Someone stole my thunder when they recommended that you talk to your school. They can often point you to a person or office within the school that might be able to help.

I believe that my school had student insurance as well. I was looking it up just a minute ago, and the premium for the year is $1,257. It isn't the greatest plan - maxes out at $25,000 in covered expenses, but pre-existing conditions are covered. Maybe your school has something similar? Still seems to expensive for what you earn in a year.

I have no real experience in Medicaid/Medicare qualifications, although it is my understanding that borderline cases are often automatically denied, forcing people to demand a hearing, hire a lawyer, etc., before they are allowed coverage. Maybe someone could point you in the direction of a law firm that handles these types of cases?

On a personal note, my grandfather died of sarcoidosis, and you have my sympathy for the pain you have/are experiencing. I assume you are on Prednisone? Maybe the docs have cooked up something better since my grandfather passed?

To address the "topic" of the post, my father is a doctor, and he believes that there is a need for universal coverage. I believe it too, but I have no idea which method/proposal is going to be best for us, or how we can overcome the industry lobby to get it done! I think it is obvious, however, that such a program will have to be paired with reforms that address the litigious nature of American society as well.

Finally, I have to agree with some on the fact that this post - as is - might have been better located in Tilted Living. Not taking a swipe here, although it may seem that way. I just felt as I read through the posts that this was different than our "normal" discussions here. Maybe its just the more personal nature of the post?

In any case, best of luck in finding a solution. :thumbsup: (most appropriate emoticon I could find!)

Thanks for the well wishes Moondog and yes, sarcoidosis can be very serious. Luckily, I have no lung damage and am not on anything yet (yes they treat with prednisone and then Chemo drugs if the pred. doesn't work), but have to be checked every 6 months.The pain while still there I am getting used to, I'll have twinges where it feels like an alien is trying to burst through my chest, or I'm being stabbed from the inside in the side belly area, but with deep breathing and calm it goes away pretty quickly.

Now, whether I have Sarcoid elsewhere (as it can affect everypart of your body) I don't know. From what I've read most white males who get it, get it in the lungs and it eventually goes away.

There is some personal nature on this, yes. Because people like you have wished me well and I have thanked them and updated my health.

However, this thread also is to talk about the need for healthcare reform and as I stated, when a policy needs changed and you can add a personal story that sayd "look what the system is doing and this needs changed" then politics (in this case) is the right forum.

I'm not asking for sympathy, pity, or anything but to address my personal situation and show why it needs changed.

Politicians use personal stories and bring out people to show their personal stories and why we need to change a policy..... EVERY politician does it. This is similar.....only I am able to discuss first hand and can explain, answer questions and offer my opinion and the facts given to me, to hopefully influence some people to realize healthcare needs fixed in the US.

There is no martyrdom..... I choose to live and better myself. But I also choose to spend as much time as possible to work for healthcare reform. If someone chooses to call me a martyr because I choose to work and expose the system instead of not working and getting my medical bills paid for as I live in a homeless shelter and lose everything I have worked for then so be it.

As for school insurance..... for a male student my age (38) the cost is out of my range, the quote I got was close to $150 a month and that still was with a high deductible and 70-30 not 80-20.

And at $20,000+ that would still be $6,000 so I'd still be heavily indebt.

The program needs changed. You can't tell someone who is trying to better their life that they need to not work so they can get their medical bills paid. My not working would mean, I would end up homeless as there is no way I could possibly get disability.... nor is there a need for me to be on disability.

That's what the point of this thread is to expose the system and say they are trying to tell someone to give up hope and just become a part of the welfare system or work, go to school then go bankrupt, have their credit destroyed and so on.

It's a catch 22. I work I lose any help, face collections, bad credit and so on, but better my life and self esteem...... I don't work I get my medical paid for but I end up homeless and trying to get into the welfare system and my self esteem goes out the door.

I choose to work. I choose to fight and expose the system and work to get others to demand we find a newer better system.

Elphaba 11-30-2005 10:11 PM

Pan, thank you for sharing your personal story. You have encouraged me to share a bit of mine. It is likely that we will lose our insurance at the end of the year, and no private insurance company would ever consider insuring my husband with a cancer history, or myself for that matter for other chronic issues.

Getting older and self-employed... I guess some would say that we shouldn't have followed a dream, but stayed on the money train. No regrets here, but hub and I are in for "interesting" times.

pan6467 11-30-2005 11:56 PM

Quote:

Originally Posted by Elphaba
Pan, thank you for sharing your personal story. You have encouraged me to share a bit of mine. It is likely that we will lose our insurance at the end of the year, and no private insurance company would ever consider insuring my husband with a cancer history, or myself for that matter for other chronic issues.

Getting older and self-employed... I guess some would say that we shouldn't have followed a dream, but stayed on the money train. No regrets here, but hub and I are in for "interesting" times.

Elph,

I truly wish you and your hubby the best.

Yes, the insurance industry is all about profit margin now. We're numbers and with cancer or major illness the insurance gets maxed out fast and people lose everything they have worked hard for.

It's not right.

It's not what America was ever supposed to be about.

Look at Christopher Reeve, he died almost broke. If it hadn't been for Robin Williams' generosity he would have.

We as a nation can do better.

We as a nation MUST do better.

Our kids and grandkids will be the true victims if we do not change the process and system NOW.

Those who fight for the status quo do so for 1 of 2 reasons.....

1) they make more money the way the system is and they know a change would mean less money for them

2) they are just plain ignorant to the facts, would rather believe the hype that a true universal healthcare would hurt us, and choose to laugh at everyone else's "misfortune" because those people weren't as prepared as they are, plus it's only the poor affected.

But when it happens to them, and the way the system is right now, it WILL happen to anyone not ultra rich..... then they'll cry louder than anyone. Only because they were so adamnant about not changing the system when others were affected... their cries will fall on deaf ears.

NOONE working hard to better themselves and society should face bankruptcy because of a greedy system that takes advantage of others pain and suffering. Not when we have the power, the tools and the ability to help our fellow brothers and sisters live life without that fear.

GM is going bankrupt because of it, mom and pop stores the backbone of the country are going broke, the people are going broke....... but the few in control wish you to believe it is better they go broke than it is to fix the system.

If we do not fix the system and soon, we will destroy ourselves.

Who do you think pays for the medical bills of people uninsured? The taxpayers, those with insurance, every single one of us.

And are we to call ourselves a truly civilized nation if we deny true medical treatment not just emergency services to those who need it?

There are those who fight against change, and yet they have no true excuse except for greed.

Is greed what we are put on this planet for?

The funny thing is the party that espouses God and Christianity so loudly are the ones tthat Christ would expose for using others misery to make their fortunes. If need be I'll quote chapters and verses wher Jesus condemns people for such actions...... and yet the party that supposedly is built for him, the Neocons who want the Christians to believe what they are selling so they wave and thump the Bible for them...... are the ones leading them away from God's will.

As Lennon sang in the song "INSTANT KARMA".....

Quote:

Why in the world are we here
Surely not to live in pain and fear

flstf 12-01-2005 06:20 AM

Quote:

Originally Posted by pan6467
Those who fight for the status quo do so for 1 of 2 reasons.....

1) they make more money the way the system is and they know a change would mean less money for them

2) they are just plain ignorant to the facts, would rather believe the hype that a true universal healthcare would hurt us, and choose to laugh at everyone else's "misfortune" because those people weren't as prepared as they are, plus it's only the poor affected.

I know several people who are against government provided healthcare who genuinely believe that the government is so inefficient that they will make the situation much worse.They are not laughing at anyone but are concerned (and rightfully so) that the federal burocracy will bring everyone's medical care down while now at least most can get decent care through their employers etc...

I agree that almost everything the government does is less efficient than the private sector. However the medical/insurance industry is so out of control that I believe the government will have to eventually provide universal healthcare. As I've said before the medical industry just doesn't seem to be capable of operating in a competitive manner.

I don't think that it is just the religious right who are resisting this change. I imagine the trial lawyers will still want the ability to sue for malpractice only now they would have to sue us (the government) which may not be possible. All polititians are being lobbied by other medical industries amd groups who have a vested interest in keeping things the way they are. Our polititians seem to care more about getting contributions (and re-elected) than doing what is right for most of us. Just look at the latest bankruptcy rules they passed making it more difficult to file even though a large percentage of those filing is because of medical bills. They did this even though the credit card companies are showing record profits.

ArellaNova 12-01-2005 09:23 AM

Quote:

Originally Posted by Locobot
*cough* *gag* what? Demand for the what? Who is demanding this besides the private insurance companies? How could a for-profit company better serve the medical needs of population than a non-profit system run by the people themselves? What you're arguing for is actually the status quo in the U.S. - the Republican medical plan - which includes MORE middlemen MORE bureaucracy and MORE people cut off from medical care than a universal state-run system.

Insurance companies' primary purpose is to serve their share holders, not provide medical care. Insurance companies can, and do quite often, themselves declare bankruptcy (a much less punative process than a personal bankruptcy) in which case you've lost your medical coverage and have to start anew with a different company.

I garauntee you Arella, if you have medical catastrophe your insurance will run out long before your need for medical care will. You'll find yourself in a position similiar to Pan's where you'd be better off not working, not contributing, and dropping out.

Ustwo-I love how you complain all the time about people abusing the social welfare systems, yet when someone like Pan refuses to do so he becomes a "martyr."

My faimly happens to be in the business so I have an insiders view on what is the objective of private insurers, and also as a consumer myself. As I said, I pay for my own private coverage. The private coverage doesn't guarentee that if something horrible does happen I don't have to pay a cent. That is unrealistic to expect from anyone. It does, however, cover me up to a certian amount. For example, if I were, unfortunatly, in the situation described above, I would only have had to pay 12 thousand instead of the full 20.

I don't beleive you understood my use of the word "demand". I meant demand as in "supply and demand". Insurance companies supply a service (called risk management) and there is a demand for such services because shit happens.

You beleive that government programs are "non-for-profit"? This seems ludicrous to me that you would beleive this and I would like to understand why. If the Government ran under a non-for-profit basis they would take charitible donations instead of taxes.

Yes, it is you who are paying for it. And it is me. I, in my taxes, pay for the risk management (by the government) of thousands of other individuals. I also pay for my own. The taxes I can not help. The individual coverage is just self-responsability.

Indeed, I would be better off - as an individual - scamming the system and letting apathy take over my own beleif in individual economic enterprise. I could save myself thousands of dollars by choosing to live off of the "forced donations" of others.

I would choose not to.


As far as the companies declaring bankruptcy. That is why you shop wisely. Is it the companies fault that they fell under? Yes. Did they foce you to buy their policy? No.

Pan's situation is not ideal, but we all choose whether to take precautions or not. Nothing may ever happen to me in my lifetime and I may die peacfull in my bed, having wasted thousands of dollars on healthcare coverage that I never used. Okay then, I will take that over being sick, or having the risk of being uncovered anyday.

ArellaNova 12-01-2005 09:46 AM

Quote:

Our kids and grandkids will be the true victims if we do not change the process and system NOW.
The same with Social Security. The same with rising Taxes. The same with social morality deteroriation - or rising social acceptance (whichever side you see it from)

Quote:

2) they are just plain ignorant to the facts, would rather believe the hype that a true universal healthcare would hurt us, and choose to laugh at everyone else's "misfortune" because those people weren't as prepared as they are, plus it's only the poor affected
True Universal Healthcare hasn't done much for Canada. It is not the idea that people should be helped that "they" are fighting. It is the realistic view that "life sucks, and there is only so much we can do, lets not make a system that would take away the good things about our society, like individual freedom of choice, and the free market."

It's only the poor that are affected? Is that just your opinion, or are there statistics or studies behind there, somwhere.


It COULD happen to ANYONE. The world could end tomorrow. And, to point out the futility of it all, we are all going to die anyway. I like it when everything is in a realistic perspective that way.

Quote:

There are those who fight against change, and yet they have no true excuse except for greed.
Do you equate greed with entreprenurial ambitions?

Quote:

And are we to call ourselves a truly civilized nation if we deny true medical treatment not just emergency services to those who need it?
I would refute that Doctors need to eat to, and because everyone who got free or government sunsidized health care is busy suing them they are not having such an easy time of it.

Quote:

The funny thing is the party that espouses God and Christianity so loudly are the ones that Christ would expose for using others misery to make their fortunes. If need be I'll quote chapters and verses wher Jesus condemns people for such actions...... and yet the party that supposedly is built for him, the Neocons who want the Christians to believe what they are selling so they wave and thump the Bible for them...... are the ones leading them away from God's will.
Do you expect Christians to be perfect? I say then that you ask to much of mere mortals.

The conservative movement is built for God? News ot me.

NeoCons have their opinions, same as liberals, and there are devout Christians on both sides. I would ask, why bring Christianity into a matter of economics and political reform.


If I had to guess (and this is mearly a matter of opinion) you are in a situation that you did not expect. It is tragic. It is costing you dearly - not only in resources, but in emotions and daily life as well. You are angry. You see the people who are billing you for your medical expenses as being unmerciful. You see the system as choosing to screw you over by its inherant nature.

If that is the case there is no help for you. You said at the start that you work hard to put yourself through school. If at all possable, don't cease that. Don't cease trying to understand the world God has put before you. Don't become so wrapped up in bitterness that you demand everyday that society change because you were hurt.

Rather stretch yourself. Adapt and overcome. Having been through this fire you will know no end to your personal growth if you can just keep your eye on what is important.

I disagree with your solution to your problem, for it is your problem we are discussing here, not societies. We are all self-interested people. Something only matters to us when it affects us "close to home". The solution to your problem lies within you and how you coose to work in the system that you are presented with.

Understand, I am not apathetic. I have no idea what you are going through, personally, but understand its traumatic and life changing nature. I have nothing but hopes and good prayers for you. Good Luck.

pan6467 12-01-2005 11:19 AM

Quote:

Originally Posted by ArellaNova
The same with Social Security. The same with rising Taxes. The same with social morality deteroriation - or rising social acceptance (whichever side you see it from) .

If society is deteriorating, I would argue that is is not lack of morals, bur greed and fear. The fact there are more people living in the US that are unable to achieve advancement. The fact that multinational conglomerates and faceless companies own the shops and places of employment. That there is very little community involvement or loyalty from these places.

America was built with communities and pride. It is now built on greed.

There is your moral decay.


Quote:

True Universal Healthcare hasn't done much for Canada. It is not the idea that people should be helped that "they" are fighting. It is the realistic view that "life sucks, and there is only so much we can do, lets not make a system that would take away the good things about our society, like individual freedom of choice, and the free market."
I maybe wrong, but from the way the Canadians on this forum talk and others I have met, their healthcare works better than ours. Britain, Japan, Sweden, Norway, France, Germany, Italy, and on and on.... all have a form of socialized medicine, all pay less, and all have lower infant mortality rates. (We're 42nd in the world...... link: http://www.cia.gov/cia/publications/.../2091rank.html)

The reason theose countries are attacked about their healthcare is because it works and the US right and Healthcare industry are scared to death if the people knew we'd get it here. (and my next post will show this.... this post is to answer you directly.)

Quote:

It's only the poor that are affected? Is that just your opinion, or are there statistics or studies behind there, somwhere. It COULD happen to ANYONE. The world could end tomorrow. And, to point out the futility of it all, we are all going to die anyway. I like it when everything is in a realistic perspective that way.
No, I argued that eventually everyone but the ultra rich will be affected. Who do you think pays the poor's healthcare? With hospital, medicine, doctor rates as they stand now, it does not take long to reach that million dollar ceiling and lose everything.

Where did I say it only happens to the poor?




Quote:

Do you equate greed with entreprenurial ambitions?
NOt at all, but in the healthcare industry, absolutely there is no doubt.

Quote:

I would refute that Doctors need to eat to, and because everyone who got free or government sunsidized health care is busy suing them they are not having such an easy time of it.
Lawsuits are not as costly as the Right would have you believe. There maybe frivilous lawsuits but my feeling is they get thrown out. Name 1 frivilous lawsuit against a hospital or doctor that has made any news whatsoever. Just 1.


Quote:

Do you expect Christians to be perfect? I say then that you ask to much of mere mortals.

The conservative movement is built for God? News ot me. NeoCons have their opinions, same as liberals, and there are devout Christians on both sides. I would ask, why bring Christianity into a matter of economics and political reform.

No I am saying that these Christians the Right has suckered into supporting their party are being led down a road that is taking them farther away from Christ's teachings.

I bring Christ in because 1) the healthcare industry is run for greed, how is that helping people? What would Jesus Do?

2) I bring Jesus in to show "devout Christians" how the neo Cons are suckering them in. The Neo Cons fight for Jesus, "the US was founded on Christianity... the Left is Godless, immoral, and so on..."

those are their cries to get that religious vote.... is it not?

So then why would a party so in tuned with what the Bible says about Homosexuality, abortion, sex in the media, and so on, be ok with a basic human need ran for extreme profit?

Where does Jesus say "Make sure they have that HMO card and can pay the deductible, before you help them"? Where does it say that?

I argue Christ preached we should help our fellow brothers and sisters and in doing so the reward is far greater in Heaven.

But it seems to me that this party, that refuses change, that claims they are "the friend of the conservative Christian" "God's Party", believes that man's illnesses are there for him to make great profit on. And for those who can't pay, well they can lose everything, get sicker and die..... more for us.

So where is the Christian outrage against this party that treats man as profit?

The Neo-Cons have sold this group a bill of fluff and have gotten them silent on the issues that provide profit.

Quote:

If I had to guess (and this is mearly a matter of opinion) you are in a situation that you did not expect. It is tragic. It is costing you dearly - not only in resources, but in emotions and daily life as well. You are angry. You see the people who are billing you for your medical expenses as being unmerciful. You see the system as choosing to screw you over by its inherant nature.
Actually, I didn't expect this, who does? It is costing me dearly.

Am I angry? No, because I could have refused treatment, I knew the cost.

Do I see those people as unmerciful? Not at all, they have done all the system could allow to help me.

I see the system as flawed, as destructive and as eventually a force that will bankrupt America, run for greed, not for what it's true purpose is, and that is to help keep people healthy and productive.

When the system tells someone to stop working so that their bills can be paid.... one has to wonder who would pay the bills then, why would they want me to stop working, and why is society letting this farce continue?

Are you saying I'm the only one going through this? Am I the only one who has been told to stop working?

I'm not I'm just being vocal and saying the system needs changed now. Before it is too late.

Quote:

If that is the case there is no help for you. You said at the start that you work hard to put yourself through school. If at all possable, don't cease that. Don't cease trying to understand the world God has put before you. Don't become so wrapped up in bitterness that you demand everyday that society change because you were hurt.
I am not wrapped up in bitterness, I am quite happy and thankful. However, I am being very vocal about the system and demanding change.

Nice spin though. Get it to look like I am the bitter one, that I am the loose spoke, that the system is ok, it's just me. Then offer nothing that shows how the system works.

Quote:

Rather stretch yourself. Adapt and overcome. Having been through this fire you will know no end to your personal growth if you can just keep your eye on what is important.
You obviously know nothing about me.

Quote:

I disagree with your solution to your problem, for it is your problem we are discussing here, not societies. We are all self-interested people. Something only matters to us when it affects us "close to home". The solution to your problem lies within you and how you coose to work in the system that you are presented with.
Again, make this my problem and that way you can dismiss it. It is very much a societal problem.

If say 1,000,000 uninsured people go to the hospital, get the treatment I gotand can't pay and are told to not work so that the bills get paid and 250,000 (a low number I have a feeling) say okay. And so they stop working.

How is that scenario helping society? Is that not more tax money to pay for those bills, is that not higher insurance premiums to pay for those bills, more homeless housing, more tax dollars in the form of welfare that is shelled out? More crime from those who have lost everything because of the inherent greed of the system?

So it is very much a societal problem. Not just mine, because I'll survive...... but I see the need for change and I will not be silent about it. I will be very vocal and demanding change and I will share my story, my experience to others and hopefully others will and people will see the truth about the system and not what the Right and the Industry spin as the truth.

Quote:

Understand, I am not apathetic. I have no idea what you are going through, personally, but understand its traumatic and life changing nature. I have nothing but hopes and good prayers for you. Good Luck
I don't believe you are apethetic. I think you don't see the true toll the system and the industry's greed is extolling from the nation.

You believe the status quo to be perfectly fine in a pure capitalistic society. But America is not a pure capitalistic society. America is founded on social supports to keep it strong.

It all boils down to this..... and I have yet to see a defense of the system, except attacks on me, my character, on this not being a society problem because, I'm the affected one and I speak out in anger and whatever......

So because I can relate what I see as wrong with the system, since I can say the system is fucked up and give explicit accounts and detailed examples.... it's just all me.

Yet, there is not one argument on here how the current system is what it claims. There is not one example truly defending the industry.

Instead it is attacks on me. I need to prove why we need change?

I am....... it is the side that refuses change, that lives on the greed, that shows no defense only attacks.

Claiming this is not a societal problem, this is not political...... when the truth is it is very much a societal problem, it is very much a political problem and it needs changed and it needs voices to come forward, that won't be silenced, that can't be bought off, that can share their experiences to change it.

People are paying for my medical care, people would be paying more if I stopped working...... keep watching the premiums raise, keep watching as more and more uninsured decide to drop out so that their bills will be paid for.... how long does this have to go on before people see the need to start demanding change?

pan6467 12-01-2005 11:27 AM

I don't know how well this will come out as there are charts and I suck at ccping charts....

Here's the link: http://www.eriposte.com/health/other/healthcare_US.htm

It compares our healthcare spending to 23 other "civilized nations" and how we finish last in just about every category. We spend more of our GDP on healthcare than any other nation and we get less results. And yet these 23 other nations have some form of Universal Healthcare.....

so 23 - 1 and we show worst...... which system works best???????

Quote:

HEALTHCARE IN THE UNITED STATES: PART I

MYTHS VS. REALITIES IN HEALTHCARE SPENDING and HEALTH METRICS - UNITED STATES v. OTHER WEALTHY CAPITALIST COUNTRIES

Healthcare costs have been soaring in the United States for some time now. In that context, I came across some data published by some bloggers on healthcare spending in the U.S. vs. health metrics and how it compares to data from a bunch of other wealthy capitalist countries. The data is limited, but at face value it shows interesting trends which appear to contradict what is commonly stated by some conservatives - namely that public spending on healthcare is to be avoided because it is less efficient and less effective. Indeed, the data suggests that the opposite could be true in some cases. (In Part II, I highlight myths versus realities on prescription drug costs (for brand-name drugs) in the United States).

I. REFERENCES

II. DATA

III. EXCLUSIONS

IV. RESULTS

IV-A. INFANT MORTALITY

IV-B. LIFE EXPECTANCY

IV-C. PRACTICING PHYSICIANS

IV-D. HEALTHCARE SPENDING

V. TENTATIVE CONCLUSIONS

VI. AFTERWORD


--------------------------------------------------------------------------------

I. REFERENCES

The main references for the data/charts shown below are the following:
[1] Brian Weatherson, Crooked Timber, 11/20/03
[2] Kieran Healy, Crooked Timber, 7/14/04 - via Kevin Drum (Political Animal)
[3] Kevin Drum, Political Animal, 5/20/04

II. DATA

Brian [1] provides much of the data I use for the charts in this page. Here is the crux of what Brian found:

For amusement I was traipsing through the OECD health stats for various countries, and I was stunned by one of the things that springs out of the data - health care systems that are government run or funded tend to be cheaper despite being just as effective in every respect, and more effective in some respects. I'm sure someone somewhere has analysed the data properly, but even a crude analysis suggests the empirical case for having a government run or funded health care system is quite strong.

Brian shows a table with a wealth of useful information - I am not reproducing the table here. What I have done is import his data (mostly from 1999, taken from the OECD - Organization for Economic Cooperation and Development) and chart it into relevant graphs. Although the data is not up-to-date, it is quite acceptable for this preliminary analysis.

III. EXCLUSIONS

Brian provides data for 30 countries - mostly from Europe and North America. What I did was to reduce the country list to 24 - Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom, United States.

I excluded the following countries - Czech Republic, Hungary, Mexico, Poland, Slovak Republic and Turkey. I believe there are good reasons why these countries could be excluded for this preliminary "analysis" (for lack of a better word).
(a) Countries that have only recently become capitalistic ("New Europe" as opposed to "Old Europe") or those that are not part of the traditionally wealthy, capitalistic economies (Mexico, Turkey) should not be compared one-to-one with the richer, capitalistic economies of the West.
(b) Even if the exclusion seems arbitrary (which I don't believe it is), my goal is to compare the wealthier, capitalistic nations amongst each other, to see how the U.S. fares in comparison. In itself, this is a justifiable comparison. There is no specific requirement that the system in the U.S. has to be compared with every country possible for the objective of this study is to understand whether a more efficient and effective system is possible, not to quantitatively judge every system that exists.

IV. RESULTS

Brain [1] already summarized the results in brief. I show the same results in chart form to highlight some key points.

IV-A. INFANT MORTALITY

The U.S. had about the worst infant mortality compared to the 23 other wealthy capitalist countries, even though healthcare spending as a percentage of GDP was highest in the U.S. Note, though, that total healthcare spending as a percentage of GDP was not a very good predictor of infant mortality as a whole.

Also, the U.S. had almost the lowest amount of public healthcare spending among these countries. Interestingly, higher public spending on healthcare seems to have a slight (positive) correlation to better infant mortality, but only slight.




IV-B. LIFE EXPECTANCY

The U.S. had close to the lowest male and female life expectancies at birth compared to the 23 other wealthy capitalist countries, even though healthcare spending as a percentage of GDP was highest in the U.S. and public healthcare spending as a percentage of total healthcare spending was almost the lowest in the U.S. Higher public spending on healthcare (as a percentage of total healthcare spending) and higher healthcare spending as a percentage of GDP were more generally associated with better life expectancies - but there are exceptions.




IV-C. PRACTICING PHYSICIANS

Although higher healthcare spending as a percentage of GDP in the 24 wealthy capitalist countries was more generally associated with more practicing physicians per 1000 population, the U.S. was again an exception - there were significantly fewer practicing physicians in the U.S. per 1000 population when compared to the amount of healthcare spending/GDP.

Note that physician count was not very strongly dependent, however, on the percentage of total healthcare spending that was public spending.




IV-D. HEALTHCARE SPENDING

Even though the U.S. had nearly the least amount of public healthcare spending, the per capita healthcare expenses in the U.S. and the total healthcare spending as a percentage of GDP in the U.S. were the highest among the 24 countries examined.

The former was true even when data in the timeframe of 1990-2001 was charted (last chart below).



CHART FROM REFERENCE [2]



V. TENTATIVE CONCLUSIONS

Now, I am more than willing to acknowledge that it is hard to draw definitive conclusions from the data above, for several reasons, including such factors like:
(a) The data being limited,
(b) The error bars on the data not being known
(c) Potential nuances in the collection and interpretation of the data.
(d) The types of health issues that dominate in one country compared to the other (which in turn depends on the culture, lifestyle, environment, etc.)

But, having said that, at the minimum there are some interesting trends here. The trends appear to suggest that there are inefficiencies in healthcare system in the U.S., to the point that the ideological reliance on private spending/plans over public/spending plans is NOT so easily justifiable. Indeed, if the trends above are real, then it is quite possible that more public spending on healthcare could indeed be a more efficient use of money and might get more effective results - if well managed.

I would say that this data calls for more systematic analysis of healthcare costs in the U.S. and a real debate on this - that involves not just ideological biases but lots more data and reality.

Thanks to Brian Weatherson, Kieran Healy and Kevin Drum for educating us!

NOTE: In Part II, I highlight some key points on the myths vs. realities of high prescription drug costs (for brand-name drugs) in the U.S.

VI. AFTERWORD

Kevin's words [3] are appropriate:

FRENCH HEALTHCARE....The Economist provides a capsule summary of healthcare in France:

Its hospitals gleam. Waiting-lists are non-existent. Doctors still make home visits. Life expectancy is two years longer than average for the western world.

....For the patient, the French health system is still a joy. Same-day appointments can be made easily; if one doctor's advice displeases, you can consult another, a habit known as nomadisme médical. Individual hospital rooms are the norm. Specialists can be consulted without referral. And while the patient pays up front, almost all the money is reimbursed, either through the public insurance system or a top-up private policy.

For family doctors too, liberty prevails. They are self-employed, can set up a practice where they like, prescribe what they like, and are paid per consultation. As the health ministry's own diagnosis put it recently: “The French system offers more freedom than any other in the world.”

And despite the Economist's scary headline, which proclaims that "crisis looms," the French system provides this service to everyone in the country and does it for less than half the cost per person of the U.S. Even if they decide to raise taxes to cover a growing deficit in their healthcare fund (the subject of the Economist's article) their costs will still be less than half ours per person.

Now, there are undoubtedly drawbacks to the French system. They probably have fewer high-tech machines than we do, and the comparative cost figures may be skewed by the American love of elective procedures. Still, there would have to be a lot of drawbacks to make their system less attractive than ours.

So why not adopt it? Well, that would be socialized medicine. Can't have that, can we? After all, everyone knows that when you socialize something it automatically declines slowly into anarchy and uselessness. Right?
Sorry the charts didn't come out.... perhaps a Mod can help.... if not simply click the link.

pan6467 12-01-2005 11:34 AM

Here's part 2 no charts in this one. Please debate the facts.... don't attack the source, that's not debate. That's being defensive and trying to put the other side on a defensive so that they can make a mistake and you can then capitalize on it.... all the while your side shows nothing, proves nothing, and claims victory. But who wins? Not the people, not society as a whole....


LINK: http://www.eriposte.com/health/other...ondrugs_US.htm

Quote:

HEALTHCARE IN THE UNITED STATES: PART II

MYTHS V. REALITIES ON PRESCRIPTION DRUG COSTS
IN THE UNITED STATES

Healthcare costs have been soaring in the United States for some time now. In Part I, I charted some data that was generated by Brian Weatherson (Crooked Timber, 11/20/03) and Kieran Healy (Crooked Timber, 7/14/04 - via Kevin Drum) that compared U.S. healthcare spending and health metrics versus those in numerous other wealthy, capitalist countries. That data showed how, contrary to commonly transmitted conservative fables, higher public spending on healthcare could potentially bring significant benefits to Americans.

In this page (Part II), I cover some relevant issues related to the high prescription drug costs in the U.S. I applaud the pharmaceutical industry for bringing more and more life-saving drugs into the market, but note with some chagrin that greed, rather than high R&D costs, is the main reason for high prescription drug prices for brand-name drugs in the United States. Businesses should be run with profitability being one of the key goals, but profitability should not be an excuse for greed.

I. KEY REFERENCES

II. SPENDING ON PRESCRIPTION DRUGS IN THE U.S.

III. DRUG PRICES AND PRICE INCREASES OF HIGHLY USED BRAND-NAME PRESCRIPTION DRUGS

IV. CAUSE OF HIGH PRESCRIPTION DRUG PRICES

IV-A. INDUSTRY CLAIM: Very High R&D costs are a big reason

IV-B. REALITY: GREED, NOT HIGH R&D COSTS, are a big reason

1. R&D costs by themselves are not really "high" when compared to total profits

2. Industry R&D costs are significantly subsidized by taxpayer-funded research

3. Industry R&D costs are significantly subsidized by lower tax rates and Government subsidies

4. Industry is not really as innovative as it would lead you to believe -- with only a fifth or less drugs being really new (versus "me-too" drugs)

5. Pharmaceutical Industry is usually the MOST profitable industry in the United States (so much for "high" costs!)

6. Rather than R&D costs, the biggest chunk of industry costs comes from advertising and marketing (especially non-innovative drugs)

7. The Pharmaceutical industry is subsidized by highly preferential monopoly power (via astonishingly generous patent "laws") granted by the Governments they successfully lobbied

V. PHARMACEUTICAL INDUSTRY TODAY: FACING A "PERFECT STORM"? PERHAPS, PERHAPS NOT

VI. TENTATIVE CONCLUSIONS


--------------------------------------------------------------------------------

I. KEY REFERENCES

The main references used here are the following:
[1] Marcia Angell, "The Truth about the Drug Companies", New York Review of Books, Vo. 51, Issue 12, 7/15/04
[2] Families USA, "Sticker Shock: Rising Prescription Drug Prices for Seniors"", June 2004
[3] Public Citizen, "Rx R&D Myths: The Case Against the Drug Industry's R&D 'Scare Card' ", July 2001
[4] Progress Report, Center for American Progress, 7/2/04

II. SPENDING ON PRESCRIPTION DRUGS IN THE U.S.

Per Ref. [1]:

Americans now spend a staggering $200 billion a year on prescription drugs, and that figure is growing at a rate of about 12 percent a year (down from a high of 18 percent in 1999).
...
From 1960 to 1980, prescription drug sales were fairly static as a percent of US gross domestic product, but from 1980 to 2000, they tripled. They now stand at more than $200 billion a year.[6] Of the many events that contributed to the industry's great and good fortune, none had to do with the quality of the drugs the companies were selling.

The claim that drugs are a $200 billion industry is an understatement. According to government sources, that is roughly how much Americans spent on prescription drugs in 2002. That figure refers to direct consumer purchases at drugstores and mail-order pharmacies (whether paid for out of pocket or not), and it includes the nearly 25 percent markup for wholesalers, pharmacists, and other middlemen and retailers. But it does not include the large amounts spent for drugs administered in hospitals, nursing homes, or doctors' offices (as is the case for many cancer drugs). In most analyses, they are allocated to costs for those facilities.

Drug company revenues (or sales) are a little different, at least as they are reported in summaries of corporate annual reports. They usually refer to a company's worldwide sales, including those to health facilities. But they do not include the revenues of middlemen and retailers.

Perhaps the most quoted source of statistics on the pharmaceutical industry, IMS Health, estimated total worldwide sales for prescription drugs to be about $400 billion in 2002. About half were in the United States. So the $200 billion colossus is really a $400 billion megacolossus.

III. DRUG PRICES AND PRICE INCREASES OF BRAND-NAME PRESCRIPTION DRUGS MOST USED BY SENIORS

Ref. [2] provides an idea of how the prices of common prescription drugs have been increasing in recent years. Key points to note:

The prices of the 30 brand-name drugs most frequently used by the elderly rose by 4.3 times the rate of inflation in 2003. On average, the cost of these 30 heavily prescribed drugs increased by 6.5 percent from January 2003 to January 2004, while the rate of inflation, excluding energy, was 1.5 percent during that same period.
...
Of the 30 brand-name drugs most frequently used by the elderly, all but four have been on the market for over three years. The prices of those 26 drugs increased, on average, by 3.6 times the rate of inflation, or 21.6 per-cent, from January 2001 to January 2004. Inflation for the same period was 6 percent.
...
Not only did the prices of these brand-name drugs increase rapidly, but they also increased often. Fifteen of the 30, or half, had more than one price increase in the one-year period from January 2003 to January 2004. Eighteen, or more than two-thirds of the drugs marketed for the three-year period of January 2001 to January 2004, increased in price more than three times.

As one might expect, PhRMA (the Pharmaceutical Research and Manufacturers Association) has been quick to denounce the Families USA study for focusing on wholesale prices, rather than retail prices that includes discounts. For example, they state here that:

Families USA has chosen to misinform consumers and policymakers by citing only undiscounted prices, while ignoring pharmaceutical companies’ patient assistance programs that offer free medicines, pharmaceutical company discount programs for seniors, and other discounted prices that are widely available to seniors.

Millions of patients without access to needed medicines have been helped through PhRMA member companies’ patient assistance programs. In 2002, an estimated 5.5 million patients received 14 million prescriptions free of charge through these programs. Families USA never mentions these programs. While Families USA concentrates on making political points by misinforming consumers, PhRMA’s member companies are working to help patients unable to afford medicines get the medicines they need. That’s why we’ve created www.helpingpatients.org as a one-stop source of information about patient assistance programs and other types of assistance.
...
They also go on to deride Families USA for ignoring the benefits that new drugs bring (in terms of saving more lives), the under-use of prescription drugs (!) etc.

First of all, the issue of "benefits", while relevant is overblown. By definition, all new products bring some "benefits" to some (or many) consumers, risks to some and no benefits to others. Obviously, PhRMA will agree that it makes no business sense for them to guarantee "immortality" with a new drug if it costs $10 Billion per pill for the consumer. In other words, the bottom line is (and should be) whether or not the company makes enough money to continue to fund more research, make new/improved drugs and remain profitable - and NOT whether the benefits are so great that one should not complain about the price at all. Benefits cannot be divorced from price - but the question is whether the price is fair compared to that paid by consumers for other kinds of benefits they get from other products (e.g., unaffordable car prices may prevent those who need to commute several tens of miles to their jobs from doing so - and thus potentially forcing them into poverty through lost jobs. Does this mean, that the benefit from a car is so vast that no one should complain about high car prices - especially if the price of the same car model significantly increases every year (faster than inflation) rather than decrease (either due to competition or model age)?...)

Secondly, the claim - that using average wholesale prices [AWP] to calculate price increases is misleading - is itself...misleading. Families USA explains why:

Some people suggest that AWP is not an accurate measure of drug prices paid by consumers because so many consumers enjoy discounts negotiated by discount card vendors, managed care organizations, and other bulk purchasers. For example, beginning in June 2004, Medicare will endorse multiple vendors that will market "Medicare approved" drug discount cards. These cards will be available to seniors and others in Medicare, similar to the senior discount cards that have been marketed for years.

The availability of discount cards does not negate the importance of AWP as a measure of price and, particularly, as a measure of price increases. AWP is the base price frequently used by payers and discount card vendors when negotiating with drug manufacturers. It is often the base from which consumer discounts are calculated. Changes in AWP signal changes in the base price charged to insurers and other payers and changes in the price from which discounts are calculated. As a result, increases in AWP have a direct bearing on prices paid by a wide range of prescription drug purchasers, including consumers using a discount card. Therefore, AWP continues to be a good measure of drug price inflation.

This has also been pointed out by AARP, in their own study which also highlighted high prices of prescription drugs:

[The study] focuses on the price that drug manufacturers charge wholesalers because that is a substantial component of the final retail price. A change in the price the drug manufacturers charge to wholesalers generally results in a similar percent change in the price that you, the consumer, pay.

Talking about discounts or lack thereof, it is also interesting to note the following, as Ref. [1] points out:

For obvious reasons, the elderly tend to need more prescription drugs than younger people—mainly for chronic conditions like arthritis, diabetes, high blood pressure, and elevated cholesterol. In 2001, nearly one in four seniors reported that they skipped doses or did not fill prescriptions because of the cost. (That fraction is almost certainly higher now.) Sadly, the frailest are the least likely to have supplementary insurance. At an average cost of $1,500 a year for each drug, someone without supplementary insurance who takes six different prescription drugs—and this is not rare—would have to spend $9,000 out of pocket. Not many among the old and frail have such deep pockets.

Furthermore, in one of the more perverse of the pharmaceutical industry's practices, prices are much higher for precisely the people who most need the drugs and can least afford them. The industry charges Medicare recipients without supplementary insurance much more than it does favored customers, such as large HMOs or the Veterans Affairs (VA) system. Because the latter buy in bulk, they can bargain for steep discounts or rebates. People without insurance have no bargaining power; and so they pay the highest prices.

It must be clarified that Families USA focuses on drug prices of brand-name drugs, and not generic drugs. They explain the reason for this.

Brand-name-only drugs—drugs for which there are no generic or co-marketed alternatives—are the primary drivers of inflation in prescription drug costs. Since 1999, Families USA has monitored price increases among the 50 drugs most frequently used by seniors. Our studies have consistently found that prices for generics rose only slightly and that prices for brand-name drugs increased by many times the rate of inflation. Because frequently prescribed brand-name drugs are the principal contributor to drug price inflation, they are the focus of this report.

Clearly, this qualification is important. I believe it is relevant to focus on brand-name drugs because these are the ones which presumably are the main results of the drug companies' R&D and investments and therefore play a key role in enabling them to be profitable. Put another way, brand name drugs ostensibly represent the results of the drug companies' innovation and they are the ones that the drug companies have the best justification to price higher.

A final point on pricing and comparison to inflation. One may ask why drug price changes rather than medical inflation - are compared to general inflation. The answer is simple. In this section, we are trying to understand if prescription drug prices are reasonable or not - not whether general medical costs are high or not! Familes USA answers this question in a more nuanced way in their report (page 13).

IV. CAUSE OF HIGH PRESCRIPTION DRUG PRICES

IV-A. INDUSTRY CLAIM: Very high R&D costs are a big reason

As Ref. [1] points out:

Boiled down to its essentials, [the message from the Pharmaceutical Industry] is this: "Yes, prescription drugs are expensive, but that shows how valuable they are. Besides, our research and development costs are enormous, and we need to cover them somehow. As 'research-based' companies, we turn out a steady stream of innovative medicines that lengthen life, enhance its quality, and avert more expensive medical care. You are the beneficiaries of this ongoing achievement of the American free enterprise system, so be grateful, quit whining, and pay up." More prosaically, what the industry is saying is that you get what you pay for.
...
As a spokeswoman for one company explained, "Price increases are not uncommon in the industry and this allows us to be able to invest in R&D."

As Ref. [3] points out:

PhRMA’s central claim is that the industry needs extraordinary profits to fund expensive, risky and innovative research and development (R&D) for new drugs. If anything is done to moderate prices or profits, R&D will suffer, and, as PhRMA’s president recently claimed, "it’s going to harm millions of Americans who have life-threatening conditions."

IV-B. REALITY: GREED, NOT HIGH R&D COSTS, are a big reason

Don't get me wrong here. I am all for the pharmaceutical industry to be profitable and for people who own those industries to make a great living. Indeed, the pharmaceutical industry needs to be thanked for extending the lifetimes of human beings across the globe. That is a noble thing worth applauding.

However, I just think the facts should be made clear on why drug costs are high, and it needs to be pointed out that contrary to Wall Street's so-called "wisdom", greed and profitability are two separate things when we are talking about what is good for the country as a whole.

1. R&D costs for the pharmaceutical industry are not really "high" when compared to total profits

As Ref. [3] points out:

Using government studies, company filings with the U.S. Securities and Exchange Commission and documents obtained via the Freedom of Information Act, Public Citizen’s report exposes the industry’s R&D claims:

The drug industry’s claim that R&D costs total $500 million for each new drug (including failures) is highly misleading. Extrapolated from an often-misunderstood 1991 study by economist Joseph DiMasi, the $500 million figure includes significant expenses that are tax deductible and unrealistic scenarios of risks.
The actual after-tax cash outlay – or what drug companies really spend on R&D – for each new drug (including failures) according to the DiMasi study is approximately $110 million. (That’s in year 2000 dollars, based on data provided by drug companies.) (See Section I)
A simpler measure – also derived from data provided by the industry – suggests that after-tax R&D costs ranged from $57 million to $71 million for the average new drug brought to market in the 1990s, including failures. (See Section II)
As Ref. [1] points out (bold text is eRiposte emphasis):

Drug industry expenditures for research and development, while large, were consistently far less than profits. For the top ten companies, they amounted to only 11 percent of sales in 1990, rising slightly to 14 percent in 2000.

2. Pharmaceutical industry R&D costs are significantly subsidized by taxpayer-funded research

As Ref. [3] points out:

Industry R&D risks and costs are often significantly reduced by taxpayer-funded research, which has helped launch the most medically important drugs in recent years and many of the best-selling drugs, including all of the top five sellers in one recent year surveyed (1995).
An internal National Institutes of Health (NIH) document, obtained by Public Citizen through the Freedom of Information Act, shows how crucial taxpayer-funded research is to top-selling drugs. According to the NIH, taxpayer-funded scientists conducted 55 percent of the research projects that led to the discovery and development of the top five selling drugs in 1995. (See Section III)
3. Pharmaceutical industry R&D costs are significantly subsidized by lower tax rates and Government subsidies

As Ref. [3] points out:

In addition to receiving research subsidies, the drug industry is lightly taxed, thanks to tax credits. The drug industry’s effective tax rate is about 40 percent less than the average for all other industries. (See Section VII)
Drug companies also receive a huge financial incentive for testing the effects of drugs on children. This incentive called pediatric exclusivity, which Congress may reauthorize this year, amounts to $600 million in additional profits per year for the drug industry – and that’s just to get companies to test the safety of several hundred drugs for children. It is estimated that the cost of such tests is less than $100 million a year. (See Section VIII)
4. The pharmaceutical industry is not really as innovative as it would lead you to believe -- with only a fifth or less drugs being really new (versus "me-too" drugs)

As Ref. [3] points out:

Drug industry R&D is made less risky by the fact that only about 22 percent of the new drugs brought to market in the last two decades were innovative drugs that represented important therapeutic gains over existing drugs. Most were "me-too" drugs, which often replicate existing successful drugs. (See Section VI)
As Ref. [1] points out:

...the pharmaceutical industry is not especially innovative. As hard as it is to believe, only a handful of truly important drugs have been brought to market in recent years, and they were mostly based on taxpayer-funded research at academic institutions, small biotechnology companies, or the National Institutes of Health (NIH). The great majority of "new" drugs are not new at all but merely variations of older drugs already on the market. These are called "me-too" drugs. The idea is to grab a share of an established, lucrative market by producing something very similar to a top-selling drug. For instance, we now have six statins (Mevacor, Lipitor, Zocor, Pravachol, Lescol, and the newest, Crestor) on the market to lower cholesterol, all variants of the first. As Dr. Sharon Levine, associate executive director of the Kaiser Permanente Medical Group, put it,

If I'm a manufacturer and I can change one molecule and get another twenty years of patent rights, and convince physicians to prescribe and consumers to demand the next form of Prilosec, or weekly Prozac instead of daily Prozac, just as my patent expires, then why would I be spending money on a lot less certain endeavor, which is looking for brand-new drugs?[4]
...drug companies no longer have to rely on their own research for new drugs, and few of the large ones do. Increasingly, they rely on academia, small biotech startup companies, and the NIH for that.[7] At least a third of drugs marketed by the major drug companies are now licensed from universities or small biotech companies, and these tend to be the most innovative ones.[8]

5.The pharmaceutical industry is usually the MOST profitable industry in the United States (so much for "high" *any* costs!)

As Ref. [3] points out:

Drug industry R&D does not appear to be as risky as companies claim. In every year since 1982, the drug industry has been the most profitable in the United States, according to Fortune magazine’s rankings. During this time, the drug industry’s returns on revenue (profit as a percent of sales) have averaged about three times the average for all other industries represented in the Fortune 500. It defies logic that R&D investments are highly risky if the industry is consistently so profitable and returns on investments are so high. (See Section V)
As Ref. [1] points out:

In fact, year after year, for over two decades, this industry has been far and away the most profitable in the United States. (In 2003, for the first time, the industry lost its first-place position, coming in third, behind "mining, crude oil production," and "commercial banks.") The prices drug companies charge have little relationship to the costs of making the drugs and could be cut dramatically without coming anywhere close to threatening R&D.

...

The top ten drug companies (which included European companies) had profits of nearly 25 percent of sales in 1990, and except for a dip at the time of President Bill Clinton's health care reform proposal, profits as a percentage of sales remained about the same for the next decade. (Of course, in absolute terms, as sales mounted, so did profits.) In 2001, the ten American drug companies in the Fortune 500 list (not quite the same as the top ten worldwide, but their profit margins are much the same) ranked far above all other American industries in average net return, whether as a percentage of sales (18.5 percent), of assets (16.3 percent), or of shareholders' equity (33.2 percent). These are astonishing margins. For comparison, the median net return for all other industries in the Fortune 500 was only 3.3 percent of sales. Commercial banking, itself no slouch as an aggressive industry with many friends in high places, was a distant second, at 13.5 percent of sales.[11]

In 2002, as the economic downturn continued, big pharma showed only a slight drop in profits—from 18.5 to 17.0 percent of sales. The most startling fact about 2002 is that the combined profits for the ten drug companies in the Fortune 500 ($35.9 billion) were more than the profits for all the other 490 businesses put together ($33.7 billion).[12] In 2003 profits of the Fortune 500 drug companies dropped to 14.3 percent of sales, still well above the median for all industries of 4.6 percent for that year. When I say this is a profitable industry, I mean really profitable. It is difficult to conceive of how awash in money big pharma is.

Drug industry expenditures for research and development, while large, were consistently far less than profits. For the top ten companies, they amounted to only 11 percent of sales in 1990, rising slightly to 14 percent in 2000. The biggest single item in the budget is neither R&D nor even profits but something usually called "marketing and administration"—a name that varies slightly from company to company. In 1990, a staggering 36 percent of sales revenues went into this category, and that proportion remained about the same for over a decade.[13] Note that this is two and a half times the expenditures for R&D.

These figures are drawn from the industry's own annual reports to the Securities and Exchange Commission (SEC) and to stockholders, but what actually goes into these categories is not at all clear, because drug companies hold that information very close to their chests. It is likely, for instance, that R&D includes many activities most people would consider marketing, but no one can know for sure. For its part, "marketing and administration" is a gigantic black box that probably includes what the industry calls "education," as well as advertising and promotion, legal costs, and executive salaries—which are whopping. According to a report by the non-profit group Families USA, the for-mer chairman and CEO of Bristol-Myers Squibb, Charles A. Heimbold Jr., made $74,890,918 in 2001, not counting his $76,095,611 worth of unexercised stock options. The chairman of Wyeth made $40,521,011, exclusive of his $40,629,459 in stock options. And so on.[14]

6. Rather than R&D costs, the biggest chunk of pharmaceutical industry costs comes from advertising and marketing (especially non-innovative drugs)

As Ref. [3] points out:

The industry fought, and won, a nine-year legal battle to keep congressional investigators from the General Accounting Office from seeing the industry’s complete R&D records. (See Section IV) Congress can subpoena the records but has failed to do so. That might owe to the fact that in 1999-2000 the drug industry spent $262 million on federal lobbying, campaign contributions and ads for candidates thinly disguised as "issue" ads. (See accompanying report, "The Other Drug War: Big Pharma’s 625 Washington Lobbyists")
...
The drug industry’s top priority increasingly is advertising and marketing, more than R&D. Increases in drug industry advertising budgets have averaged almost 40 percent a year since the government relaxed rules on direct-to-consumer advertising in 1997. Moreover, the Fortune 500 drug companies dedicated 30 percent of their revenues to marketing and administration in the year 2000, and just 12 percent to R&D. (See Section X)
As Ref. [1] points out:

...the magic words, repeated over and over like an incantation, are research, innovation, and American. Research. Innovation. American. It makes a great story.

But while the rhetoric is stirring, it has very little to do with reality. First, research and development (R&D) is a relatively small part of the budgets of the big drug companies—dwarfed by their vast expenditures on marketing and administration, and smaller even than profits...The prices drug companies charge have little relationship to the costs of making the drugs and could be cut dramatically without coming anywhere close to threatening R&D.
...

Drug industry expenditures for research and development, while large, were consistently far less than profits. For the top ten companies, they amounted to only 11 percent of sales in 1990, rising slightly to 14 percent in 2000. The biggest single item in the budget is neither R&D nor even profits but something usually called "marketing and administration"—a name that varies slightly from company to company. In 1990, a staggering 36 percent of sales revenues went into this category, and that proportion remained about the same for over a decade.[13] Note that this is two and a half times the expenditures for R&D.

7. The pharmaceutical industry is subsidized by highly preferential monopolistic laws (via astonishingly generous patent "laws") granted by the Governments they successfully lobbied

I am all for patents and intellectual property rights, but again, let us not forget that fostering innovation is only one of several roles that any Government has. I realize how naive this sounds in these times, but the goal of good Government is to benefit the majority of the people in the country - not the minority. Patent laws should be robust enough to stimulate innovation but not so egregious that there is a significant disincentive to really innovate or bring real benefits to the majority.

I admit I don't know yet where exactly the line should be drawn, but it is obvious that when an industry is ridiculously profitable and yet claims it has too high costs because of innovation/R&D and needs to raise prices or get Government subsidies to continue to operate, the line has been crossed. What I am highlighting here is that the current patent laws as they apply to the pharmaceutical industry are doing less to foster real innovation and doing a lot more to promote greed - and these laws must therefore be changed.

As Ref. [3] points out:

The industry fought, and won, a nine-year legal battle to keep congressional investigators from the General Accounting Office from seeing the industry’s complete R&D records. (See Section IV) Congress can subpoena the records but has failed to do so. That might owe to the fact that in 1999-2000 the drug industry spent $262 million on federal lobbying, campaign contributions and ads for candidates thinly disguised as "issue" ads. (See accompanying report, "The Other Drug War: Big Pharma’s 625 Washington Lobbyists")
As Ref. [1] points out:

...the industry is hardly a model of American free enterprise. To be sure, it is free to decide which drugs to develop (me-too drugs instead of innovative ones, for instance), and it is free to price them as high as the traffic will bear, but it is utterly dependent on government-granted monopolies—in the form of patents and Food and Drug Administration (FDA)–approved exclusive marketing rights. If it is not particularly innovative in discovering new drugs, it is highly innovative— and aggressive—in dreaming up ways to extend its monopoly rights.

And there is nothing peculiarly American about this industry. It is the very essence of a global enterprise...

The enormous benefits the pharmaceutical industry has obtained through over-friendly treatment in Congress (and the White House) starting with the ("pro-business") Reagan administration is further highlighted in Ref. [1].

These [industry-friendly] laws mean that drug companies no longer have to rely on their own research for new drugs, and few of the large ones do. Increasingly, they rely on academia, small biotech startup companies, and the NIH for that.[7] At least a third of drugs marketed by the major drug companies are now licensed from universities or small biotech companies, and these tend to be the most innovative ones.[8] While Bayh-Dole was clearly a bonanza for big pharma and the biotech industry, whether its enactment was a net benefit to the public is arguable.

The Reagan years and Bayh-Dole also transformed the ethos of medical schools and teaching hospitals. These nonprofit institutions started to see themselves as "partners" of industry, and they became just as enthusiastic as any entrepreneur about the opportunities to parlay their discoveries in-to financial gain. Faculty researchers were encouraged to obtain patents on their work (which were assigned to their universities), and they shared in the royalties. Many medical schools and teaching hospitals set up "technology transfer" offices to help in this activity and capitalize on faculty discoveries. As the entrepreneurial spirit grew during the 1990s, medical school faculty entered into other lucrative financial arrangements with drug companies, as did their parent institutions.

One of the results has been a growing pro-industry bias in medical research —exactly where such bias doesn't belong.
...
Starting in 1984, with legislation known as the Hatch-Waxman Act, Congress passed another series of laws that were just as big a bonanza for the pharmaceutical industry. These laws extended monopoly rights for brand-name drugs. Exclusivity is the lifeblood of the industry because it means that no other company may sell the same drug for a set period. After exclusive marketing rights expire, copies (called generic drugs) enter the market, and the price usually falls to as little as 20 percent of what it was.[9] There are two forms of monopoly rights—patents granted by the US Patent and Trade Office (USPTO) and exclusivity granted by the FDA. While related, they operate somewhat independently, almost as backups for each other. Hatch-Waxman, named for Senator Orrin Hatch (R-Utah) and Representative Henry Waxman (D-Calif.), was meant mainly to stimulate the foundering generic industry by short-circuiting some of the FDA requirements for bringing generic drugs to market. While successful in doing that, Hatch-Waxman also lengthened the patent life for brand-name drugs. Since then, industry lawyers have manipulated some of its provisions to extend patents far longer than the lawmakers intended.

In the 1990s, Congress enacted other laws that further increased the patent life of brand-name drugs. Drug companies now employ small armies of lawyers to milk these laws for all they're worth—and they're worth a lot. The result is that the effective patent life of brand-name drugs increased from about eight years in 1980 to about fourteen years in 2000.[10] [eRiposte emphasis]

V. PHARMACEUTICAL INDUSTRY TODAY: FACING A "PERFECT STORM"?
PERHAPS, PERHAPS NOT

Ref. [1] suggests that the U.S. prescription drug industry is apparently close to facing a "perfect storm" now:

If 1980 was a watershed year for the pharmaceutical industry, 2000 may very well turn out to have been another one—the year things began to go wrong. As the booming economy of the late 1990s turned sour, many successful businesses found themselves in trouble. And as tax revenues dropped, state governments also found themselves in trouble. In one respect, the pharmaceutical industry is well protected against the downturn, since it has so much wealth and power. But in another respect, it is peculiarly vulnerable, since it depends on employer-sponsored insurance and state-run Medicaid programs for much of its revenues. When employers and states are in trouble, so is big pharma.

And sure enough, in just the past couple of years, employers and the private health insurers with whom they contract have started to push back against drug costs. Most big managed care plans now bargain for steep price discounts.
...
State governments, too, are looking for ways to cut their drug costs.
...
Recently the public has shown signs of being fed up. The fact that Americans pay much more for prescription drugs than Europeans and Canadians is now widely known.
...
The industry faces other, less familiar problems. It happens that, by chance, some of the top-selling drugs —with combined sales of around $35 billion a year—are scheduled to go off patent within a few years of one another.[16]
...
Even worse is the fact that there are very few drugs in the pipeline ready to take the place of blockbusters going off patent. In fact, that is the biggest problem facing the industry today, and its darkest secret. All the public relations about innovation is meant to obscure precisely this fact. The stream of new drugs has slowed to a trickle, and few of them are innovative in any sense of that word. Instead, the great majority are variations of oldies but goodies—"me-too" drugs.

Of the seventy-eight drugs approved by the FDA in 2002, only seventeen contained new active ingredients, and only seven of these were classified by the FDA as improvements over older drugs. The other seventy-one drugs approved that year were variations of old drugs or deemed no better than drugs already on the market. In other words, they were me-too drugs. Seven of seventy-eight is not much of a yield. Furthermore, of those seven, not one came from a major US drug company.[18] (eRiposte emphasis)
...
To be sure, profits are still beyond anything most other industries could hope for, but they have recently fallen, and for some companies they fell a lot...Nevertheless, the industry keeps promising a bright new day. It bases its reassurances on the notion that the mapping of the human genome and the accompanying burst in genetic research will yield a cornucopia of important new drugs. Left unsaid is the fact that big pharma is depending on government, universities, and small biotech companies for that innovation. While there is no doubt that genetic discoveries will lead to treatments, the fact remains that it will probably be years before the basic research pays off with new drugs.
...
The hints of trouble and the public's growing resentment over high prices are producing the first cracks in the industry's formerly firm support in Washington. In 2000, Congress passed legislation that would have closed some of the loopholes in Hatch-Waxman and also permitted American pharmacies, as well as individuals, to import drugs from certain countries where prices are lower...But the bill required the secretary of health and human services to certify that the practice would not pose any "added risk" to the public, and secretaries in both the Clinton and Bush administrations, under pressure from the industry, refused to do that.

The industry is also being hit with a tidal wave of government investigations and civil and criminal lawsuits. The litany of charges includes illegally overcharging Medicaid and Medicare, paying kickbacks to doctors, engag-ing in anticompetitive practices, colluding with generic companies to keep generic drugs off the market, illegally promoting drugs for unapproved uses, engaging in misleading direct-to-consumer advertising, and, of course, covering up evidence. Some of the settlements have been huge. TAP Phar- maceuticals, for instance, paid $875 million to settle civil and criminal charges of Medicaid and Medicare fraud in the marketing of its prostate cancer drug, Lupron.[19] All of these efforts could be summed up as increasingly desperate marketing and patent games, activities that always skirted the edge of legality but now are sometimes well on the other side.

Given all that an idealist might think that the pharmaceutical industry would develop a genuine interest in reforming itself. As Ref. [1] points out, the answer so far is a resounding NO.

How is the pharmaceutical industry responding to its difficulties? One could hope drug companies would decide to make some changes—trim their prices, or at least make them more equitable, and put more of their money into trying to discover genuinely innovative drugs, instead of just talking about it. But that is not what is happening. Instead, drug companies are doing more of what got them into this situation. They are marketing their me-too drugs even more relentlessly. They are pushing even harder to extend their monopolies on top-selling drugs. And they are pouring more money into lobbying and political campaigns. As for innovation, they are still waiting for Godot.

The news is not all bad for the industry. The Medicare prescription drug benefit enacted in 2003, and scheduled to go into effect in 2006, promises a windfall for big pharma since it for-bids the government from negotiating prices. The immediate jump in pharmaceutical stock prices after the bill passed indicated that the industry and investors were well aware of the windfall. But at best, this legislation will be only a temporary boost for the industry. As costs rise, Congress will have to reconsider its industry-friendly decision to allow drug companies to set their own prices, no questions asked.

For the moment, as long as Congress and the White House are both controlled by Republicans, it is unrealistic to expect that the problem of high prescription drug costs is going to be alleviated. Indeed, given that the hidden goal of the egregious 2003 Medicare Bill was, arguably, to make it worse for most taxpayers and consumers - using intimidation and fraud as the preferred tactics to push this Bill through to benefit Big Pharma (particularly the numerous companies that have themselves been involved in some form of fraud or another) - any hope that prices won't go up even higher in the future is wishful thinking. Already, as Ref. [4] has pointed out, prices have gone up since the Medicare Bill was passed, largely (already) negating any supposed benefits from this Bill for consumers. So, in the immediate future, the Pharmaceutical industry looks to be in good shape to weather the "perfect storm".
[ASIDE: The excellent Center for American Progress has been covering the Medicare Bill scam and other issues relating to Medicare rather comprehensively here.]

VI. TENTATIVE CONCLUSIONS

High prescription drug prices (for brand-name drugs) in the U.S. have little or nothing to do with high R&D costs in the pharmaceutical industry. While it is worth applauding the pharmaceutical industry for bringing more and more life-saving drugs to the market, it is a fact that the industry is usually the most profitable one in the U.S. and continues to complain about profitability despite that. It is an industry that benefits substantially from Big Government, taxpayer subsidies and monopolistic laws, while reaping the ensuing windfall of record-high profits, unmatched by any other industry in most years. Thus, the main reason for high prescription drug prices is simply the age-old reason: greed. Needless to say, greed cannot be addressed until those who incentivise greed remain in power. It is as simple as that.

With the Republican Party controlling both houses of Congress and the White House, and ideological right-wingers in the party currently running the show, we can fully expect prescription drug prices (for brand-name drugs) to continue to keep going up, with marginal, if any, relief for consumers and seniors in the short-term. Unless conservatives with a conscience take over the reins of the Republican party, or power changes hands, persistent activism through educating and motivating the masses is likely to be the only approach that has some probability of bringing good results (namely lower and fairer prescription drug prices, that allow pharmaceutical companies to make good but reasonable profits).

dksuddeth 12-01-2005 03:31 PM

the best way to lower health care costs anywhere is to get rid of the health insurance industry.

pan6467 12-04-2005 06:20 PM

Here's another example of why medical reform is necessary:

Pres. Bush seems to believe that the Avian Flu bug is serious enough to warrant Martial Law. So he puts plans into effect. (This is based on a premature fact that this will mutate to become human spread.)

Now, in our country we have people with no insurance who are scared to go see doctors because of the cost. Some of these people may get infected, some of these people may actually be travellers on airlines and on the highways and infect others, who like they, are not insured and move to another city and spread it there and so on. Not to mention the kids at school, the coworkers and everyone else they come into contact with.

So because these people do not go to see medical personnel when symptoms appear, they spread it even faster. The spread maximizes and people wait until they have full blown sickness before they get help. Thus, the infection could have been passed on to 100's (and that's very low, but don't want someone to focus and attack this because I said too high of a number here) real fast.

Now, we look at countries with universal healthcare. Someone starts showing the symptoms, goes to the hospital, can be quarantined right away and the spread can be minimal.

Now, we look at third world countries where they have few doctors..... infected people go unnoticed until the disease has spread beyond control because of lack of good medical support.....

Another question is, if in fact 1000's or 1,000,000's do get infected in the US, do those with insurance get better treatment?

Is the treatment based on how much insurance will cover?

Who is going to pay for those uninsured?

Are you Neo-Cons, who support this system and refuse any reform, willing and brave enough to tell people who don't have insurance that they deserve to die because they are leeches on the tax system?

Are you brave enough to stand behind your policies and political beliefs and tell these people, they don't deserve innoculated because the cost to the taxpayer and the system would be too much?

Are you willing to stand behind these beliefs and say the pharmaceuticals have every right to demand as much as they can possibly get for the vaccine?

And what if YOUR insurance company decides the cost is too high so they find loopholes or state that you didn't get approval to see that certain doctor or go to that particular ER (even though that was the closest ER to you)?

See, our healthcare system is fatally flawed to the point where if a pandemic hits, we're far more susceptible to a worse case scenario and equal to the third world in many ways, than our friends in Europe, to the North, and other countries that have public healthcare.

If this Avian Flu is severe enough for Pres. Bush to have Martial Law plans drawn up and ready, then the above scenario is every bit as possible if not moreso.

And what about the government?

Are they going to force the hospitals to treat everyone showing symptoms to contain the virus and the outbreak or is the government just going to intern those who are sick and without insurance to "dying camps" to save the tax payers and insurance companies from the excess cost?

And what happens if you surpass your maximum benefits? Or cannot afford the prescriptions, because the insurance companies call the vaccines "exploratory, unproven drugs", or just flatly decide the cost to them will be so high they refuse to cover and go bankrupt claiming the claims are to high and they cannot pay?

Are you, who believe that medical care is a privelege and not a right, truly going to allow this?

Speak up....... don't be scared to show your true beliefs.

Show the world truly what is more important to you.....profiit or people.

Show the world you are willing to let a pandemic destroy a nice percentage of the country just for greed.

Those countries with Universal Healthcare maybe flawed but my guess is they'll contain it and treat the patients far more humanely.

I have a feeling none of you will. Or you'll come up with excuses and say we can make this one exception because of........

P.S. for those who are going to say I am exagerrating the situation, then Pres. Bush must be also, why else would Martial Law be so important to "contain" this disease?

Ustwo 12-04-2005 07:55 PM

Quote:

Originally Posted by dksuddeth
the best way to lower health care costs anywhere is to get rid of the health insurance industry.

So very true. This post wins the thread.

Locobot 12-05-2005 08:54 AM

Quote:

Originally Posted by ArellaNova
My faimly happens to be in the business so I have an insiders view on what is the objective of private insurers, and also as a consumer myself. As I said, I pay for my own private coverage. The private coverage doesn't guarentee that if something horrible does happen I don't have to pay a cent. That is unrealistic to expect from anyone. It does, however, cover me up to a certian amount. For example, if I were, unfortunatly, in the situation described above, I would only have had to pay 12 thousand instead of the full 20.

I don't beleive you understood my use of the word "demand". I meant demand as in "supply and demand". Insurance companies supply a service (called risk management) and there is a demand for such services because shit happens.

I did understand your use of "demand" but I also understand that there are no alternatives available for people who seek healthcare (aside from dropping out) so standard concepts of supply and demand do not apply. That is why I scoffed and choked at your usage. No one is demanding health insurance for any other reason besides necessity, and there is no limit to the supply. If a customer is too much of a risk simply charge more, weasel out of coverage through legal means, or go out of business when "shit happens."
Quote:

You beleive that government programs are "non-for-profit"? This seems ludicrous to me that you would beleive this and I would like to understand why. If the Government ran under a non-for-profit basis they would take charitible donations instead of taxes.
I'm not really interested in the sort of semantic quibbling you seem to seek here. Government does not operate with the purpose of creating a profit for itself. In almost every sense it is forbidden from doing so, so yes I believe the government is a non-profit entity.
Quote:

Yes, it is you who are paying for it. And it is me. I, in my taxes, pay for the risk management (by the government) of thousands of other individuals. I also pay for my own. The taxes I can not help. The individual coverage is just self-responsability.

Indeed, I would be better off - as an individual - scamming the system and letting apathy take over my own beleif in individual economic enterprise. I could save myself thousands of dollars by choosing to live off of the "forced donations" of others.

I would choose not to.
If you really would be better off earning less than $6000 a year (far less than half of the poverty level), which is the only way you would be eligible for state medical aid, then I don't believe that you're able to pay for your own private insurance currently.
Quote:

As far as the companies declaring bankruptcy. That is why you shop wisely. Is it the companies fault that they fell under? Yes. Did they foce you to buy their policy? No.

Pan's situation is not ideal, but we all choose whether to take precautions or not. Nothing may ever happen to me in my lifetime and I may die peacfull in my bed, having wasted thousands of dollars on healthcare coverage that I never used. Okay then, I will take that over being sick, or having the risk of being uncovered anyday.
After Enron, Worldcom, etc. it's obvious that there are no accurate indicators of a corporation's economic health even the week before they go bankrupt. Even the biggest, oldest, most reputable insurance company could fold tomorrow without notice.

You keep talking about people choosing to not have medical coverage, yet we've clearly illustrated in this thread that no one is making this decision. In your best case scenario you've "wasted thousands of dollars" and yet you fail to see fault in the system?

pan6467 12-06-2005 11:29 AM

Amazing, my previous post and challenge to those who support healthcare the way it is has not gotten any response.

I take it from their silence:

They either don't believe that can happen....... which then leads one to ask why Bush would need a Martial Law plan for when it does....

or

They cannot answer the challenge because they see the inherent and catastrophic problem our current healthcare system has.

So again, I ask what happens when the bird flu strikes and people with no insurance get it?

Who pays?

What about those who do have insurance and can't afford the deductible, or don't have insurance at all, and don't go to the doctor as soon as symptoms occur, instead they keep working and doing whatever, all the while infecting everyone else they come into contact with?

Seems to me if we have a President deeming this worthy of Martial Law plans (instead of preparing ways to pay for the cost to help citizens by finding an innoculation everyone can afford and working to make sure the hospitals can handle it) that it is important enough to worry about this scenario...... guess not.

Guess when the insurers start filing bankruptcy because they won't be able to afford the costs and the executives million dollar salaries, these people will then worry about healthcare reform...... a bit late though.

Cynthetiq 12-06-2005 11:34 AM

the rhetorical question who pays?

we all pay. Who pays for uninsured motorists? Who pays for insurance fraud claims? Who pays for those who abuse the healthcare system?

We all pay for it. If we don't pay for it in direct premiums we pay for it in other soft costs.

flstf 12-06-2005 11:35 AM

Quote:

Originally Posted by pan6467
Guess when the insurers start filing bankruptcy because they won't be able to afford the costs and the executives million dollar salaries, these people will then worry about healthcare reform...... a bit late though.

I'm sorry pan but I can't resist. The government will probably bail out the insurance industry. The executives will most certainly golden parachute themselves to a wealthy future no matter what happens. :|

pan6467 12-06-2005 11:38 AM

Quote:

Originally Posted by flstf
I'm sorry pan but I can't resist. The government will probably bail out the insurance industry. The executives will most certainly golden parachute themselves to a wealthy future no matter what happens. :|

You're right and by doing so it will probably cost the government far more than if they had worked a way to have universal medical care. Just a guess.

pan6467 12-08-2005 06:13 AM

Still waiting to hear defnse of the current system and how we're going to pay for this nasty pandemic.......

The silence from the people opposed to scialized healthcare and supporters of the current system is deafening and very apparent they cannot answer and defend their stance.

dksuddeth 12-08-2005 06:39 AM

Quote:

Originally Posted by pan6467
Still waiting to hear defnse of the current system and how we're going to pay for this nasty pandemic.......

The silence from the people opposed to scialized healthcare and supporters of the current system is deafening and very apparent they cannot answer and defend their stance.

pan, your question as stated cannot be answered. you want an explanation of the current system yet are looking for reasons to oppose socialized medicine. What do you think we have right now? we have socialized medicine.

do I defend the current system? hell no. its atrocious.
how do we fix it? abolish the health insurance industry.

it is the health insurance industry, hell its the insurance industry period, that is causing the problem. It's also how we have socialized medicine. and socialized disaster insurance, auto insurance, anything with insurance.

samcol 12-08-2005 06:54 AM

Quote:

Originally Posted by pan6467
Still waiting to hear defnse of the current system and how we're going to pay for this nasty pandemic.......

The silence from the people opposed to scialized healthcare and supporters of the current system is deafening and very apparent they cannot answer and defend their stance.

The current system is socialized, and as it moves farther to the left everyday it continues to get worse and worse. More government is not the solution here. There are over 132,000 pages of government regulations in medicare compared to 17,000 pages of tax code. I can't even comprehend how much money is being lost in bureaucracy.

Quote:

Big Challenges Ahead

Managed care is the accepted method of delivering medical care today – to the frustration of many. Read up! There are 132,000 pages of Medicare regulations, compared with only 17,000 pages of the tax code. A compliance plan to guard against mistakes in filing government forms is offered by your friendly attorney for a mere $7,000.

Additional employees are needed to file insurance forms and keep up with regulations in operating laboratories. Even more employees will soon be needed to implement the 1,500 pages of regulations protecting patient privacy – regulations that in reality turn control of all our medical records over to the US government and establish a national medical data bank.

Fines of up to $25,000 and 10 years imprisonment are possible for fraud and for mistakes that are hard to distinguish from fraud.

Capitation depersonalizes medicine. FDA regulations, though designed to help, often delay the arrival and raise the cost of new drugs. An average new drug now requires 15 years of testing and $500 million in costs. Many question whether or not this process is cost-effective. A more liberalized approach to allowing patients and doctors to use experimental medicines could speed up the process and lower costs.

Medical privacy rules are expected to cost $22 billion over 4 years to implement – costs that must be passed on to the taxpayer or to the patient.

HCFA has actually requested authority to carry guns on their audits.

Another challenge to personalized care is the continued influence of technology and super specialization. It’s easy for the patient to be lost in the process and become only an object in a scientific whirlwind. This challenge is not new, but it will continue to affect the practice of medicine to an even greater extent.

Legal challenges through lawyer-driven lawsuits are of epidemic proportion and will continue to plague our profession, thus driving up costs while prompting unnecessary testing. Threats of an actual lawsuit do affect the way we all practice. The National Practitioners Data Bank has been set up to keep all the records of doctors’ misconduct, which is also subject to the errors of politicians, bureaucrats and spiteful lawyers. Rectifying errors and avoiding misinterpretations in this process are difficult, if not impossible tasks. Centralized government bureaucracy won’t solve the problems of ethics and measuring ability in medicine.

samcol 12-08-2005 07:02 AM

Doctor and congressman Ron Paul on how less government is better for the health care industry and I happen to agree. More government broke our system of the best and most affordable health care in the world
Quote:

Free Market Medicine

Last week the congressional Joint Economic committee on which I serve held a hearing featuring two courageous medical doctors. I had the pleasure of meeting with one of the witnesses, Dr. Robert Berry, who opened a low-cost health clinic in rural Tennessee. His clinic does not accept insurance, Medicare, or Medicaid, which allows Dr. Berry to treat patients without interference from third-party government bureaucrats or HMO administrators. In other words, Dr. Berry practices medicine as most doctors did 40 years ago, when patients paid cash for ordinary services and had inexpensive catastrophic insurance for serious injuries or illnesses. As a result, Dr. Berry and his patients decide for themselves what treatment is appropriate.

Freed from HMO and government bureaucracy, Dr. Berry can focus on medicine rather than billing. Operating on a cash basis lowers his overhead considerably, allowing him to charge much lower prices than other doctors. He often charges just $35 for routine maladies, which is not much more than one’s insurance co-pay in other offices. His affordable prices enable low-income patients to see him before minor problems become serious, and unlike most doctors, Dr. Berry sees patients the same day on a walk-in basis. Yet beyond his low prices and quick appointments, Dr. Berry provides patients with excellent medical care.

While many liberals talk endlessly about medical care for the poor, Dr. Berry actually helps uninsured people every day. His patients are largely low-income working people, who cannot afford health insurance but don’t necessarily qualify for state assistance. Some of his uninsured patients have been forced to visit hospital emergency rooms for non-emergency treatment because no doctor would see them. Others disliked the long waits and inferior treatment they endured at government clinics. For many of his patients, Dr. Berry’s clinic has been a godsend.

Dr. Berry’s experience illustrates the benefits of eliminating the middleman in health care. For decades, the U.S. healthcare system was the envy of the entire world. Not coincidentally, there was far less government involvement in medicine during this time. America had the finest doctors and hospitals, patients enjoyed high quality, affordable medical care, and thousands of private charities provided health services for the poor. Doctors focused on treating patients, without the red tape and threat of lawsuits that plague the profession today. Most Americans paid cash for basic services, and had insurance only for major illnesses and accidents. This meant both doctors and patients had an incentive to keep costs down, as the patient was directly responsible for payment, rather than an HMO or government program.

We should remember that HMOs did not arise because of free-market demand, but rather because of government mandates. The HMO Act of 1973 requires all but the smallest employers to offer their employees HMO coverage, and the tax code allows businesses- but not individuals- to deduct the cost of health insurance premiums. The result is the illogical coupling of employment and health insurance, which often leaves the unemployed without needed catastrophic coverage.

While many in Congress are happy to criticize HMOs today, the public never hears how the present system was imposed upon the American people by federal law. In fact, one very prominent Senator now attacking HMOs is on record in the 1970s lauding them. As usual, government intervention in the private market failed to deliver the promised benefits and caused unintended consequences, but Congress never blames itself for the problems created by bad laws. Instead, we are told more government- in the form of “universal coverage”- is the answer.

We can hardly expect more government to cure our current health care woes. As with all goods and services, medical care is best delivered by the free market, with competition and financial incentives keeping costs down. When patients spend their own money for health care, they have a direct incentive to negotiate lower costs with their doctor. When government controls health care, all cost incentives are lost. Dr. Berry and others like him may one day be seen as consumer heroes who challenged the third-party health care system and resisted the trend toward socialized medicine in America.

Ustwo 12-08-2005 07:05 AM

Quote:

Originally Posted by pan6467
Still waiting to hear defnse of the current system and how we're going to pay for this nasty pandemic.......

The silence from the people opposed to scialized healthcare and supporters of the current system is deafening and very apparent they cannot answer and defend their stance.

I stopped reading a while ago, and btw grats on the new job, I bet you can pay your bills now and get insurance.

Anyhow, first there needs to be a pandemic, there isn't one. There could be one and there could be a meteor hitting the earth, both are scary, both will happen, we don't know when, so wondering who will pay for something thats not happened is a bit silly at this point, but also pretty obvious.

You would and will handle the pandemic like a natural disaster. Who pays for a natural disaster?

If its small enough insurance companies, if its too big for them, the government steps in, and its one of the few places where I will agree the government has a place in stepping in.

What that has to do with making all pay gigantic taxes so you can get 'free' health care because you lacked the forsight to get insurance is beyond me.

All socialized medicine will do is make a pandemic worse, because we will have less doctors, less staff, and less resources than we currently have in the US. If you don't know that part of the socialized systems, you need to do more homework.

pan6467 12-08-2005 09:56 AM

Still waiting..... (I'm sure UsTwo had an infinite amount of ... but I no longer read his posts.... all he does is insults.... no debates no facts... so pleas UsTwo save your time and don't reply to me)

Here are the facts:

Bush has this great plan for Martial Law on a pandemic that may or may not hit the US.

Many in America who have no insurance or fear they cannot pay the deductible do not go to see doctors.

Many of these people work in the public.

So, if this pandemic that Bush has people believing hits, what is going to happen?

Because these people have no insurance and work in the public, they will contaminate other thus making the pandemic worse and more expensive.

Who is going to pay their medical bills when they can't?

Who is going to pay for the vaccine, when they can't?

I'm asking who's paying for this, how can you defend a system that is flawed to the point where people will get sicker?

I'm still waiting for an answer as to who is going to pay, and/or what do you think this scenario is going to lead to?

Personally, if it is as bad as Bush wants us to believe (and the fact he wants Martial Law for it.... one would want to believe he believes it will be bad (or he's just power hungry)........ so therefore if it is that bad, then what will happen to our system the way it stands today?

Insurance companies aren't going to take the hit, the executives will golden parachute, bankrupt out and have the government bail them out.....

So that means we will probably be paying more in the long run than if we had just had universal healthcare and been done with it.

It's not rocket science...... it's pretty cut and dry.

Unless you want to say that Bush and his Martial Law is an over reaction..... and this scenario will never happen.

pan6467 12-08-2005 10:17 AM

Quote:

Originally Posted by dksuddeth
pan, your question as stated cannot be answered. you want an explanation of the current system yet are looking for reasons to oppose socialized medicine. What do you think we have right now? we have socialized medicine.

do I defend the current system? hell no. its atrocious.
how do we fix it? abolish the health insurance industry.

it is the health insurance industry, hell its the insurance industry period, that is causing the problem. It's also how we have socialized medicine. and socialized disaster insurance, auto insurance, anything with insurance.


You and Samcol do make good points and show the system we have now does not work, will not work and cannot work long term or in the face of a true crisis.

When a NEED for the people is run solely for profit and they make that need so expensive that people cannot afford it, then you have to change the system.

I have never said I wanted free healthcare, I firmly believe in a sliding scale system.

One of the most serious problems facing the healthcare industry is insurance companies wanting to fight what they pay.

If you go to the wrong hospital, if you see a specialist before you have been approved, if they deem the surgery you need is "experimental" or unneeded yet the doctor knows you need it..... they won't pay, or they'll pay far less and you pay far more.

I am pointing out a fatal flaw in the system, if there's this great pandemic, we're going to say it's okay for the government to pay for people's healthcare then?

So in special circumstances it's ok, but otherwise no?

Who defines these special circumstances? The healthcare industry? the insurance companies? President Bush?

I have shown we are behind in infant mortality, we are behind in the amount of doctors, we are behind the rest of the world (countries that do have Universal healthcare) in many major aspects.

Surely, a country that wants to claim to be the best can do better, can't we?

Or are we so run by our own greed as a whole that we won't care until it affects us personally?

I'm sorry, I don't like the answers and no it has nothing to do with "my" case. My case opened my eyes to how bad the system really is. I expect noone to pay for my healthcare, but in reality those who are insured and tax dollars will be going to pay for it.

I just think we can have a better system.

dksuddeth 12-08-2005 10:29 AM

when you go to a specialist without 'authorization' from the insurance, you get stuck for it. Say you try to get authorization and they still deny...would you still go?

the insurance industy does not care about your heath. it only cares about its costs.

now, if you go to a doctor without insurance, your doctor is going to recomend treatments and he will outline how expensive each one will be, will you choose the most expensive?

the health insurance companies do not allow a free market system to function and there is the problem. removing them is the only way to improve the medical industry.

on to your pandemic questions.....if people are emergency type sick, they are not refused treatment. If these people end up not being able to pay back the costs, the hospitals are either 'out the cost' or receive some compensation from the government. That compensation comes back to us as taxpayers or higher costs for care later on. If we make it so that people MUST pay for the care they receive, people will be careful on when they actually have to go to the ER or doctor and when they will deal with their virus and ride it out. Less patients for a hospital means less income which will lead to lower prices due to a number of issues. Therefore the cost of private healthcare WILL go down.

Cynthetiq 12-08-2005 10:46 AM

Quote:

Originally Posted by pan6467
Insurance companies aren't going to take the hit, the executives will golden parachute, bankrupt out and have the government bail them out.....

So that means we will probably be paying more in the long run than if we had just had universal healthcare and been done with it.

It's not rocket science...... it's pretty cut and dry.

already said it would be us. the taxpayer ends up paying more for cost of goods and services always.

Ustwo 12-08-2005 11:01 AM

Whenever anyone thinks direct government control of parts of the economy will make things better and lower costs I have to question their judgement if not their sanity.

I'm going to leave it at that, smile, and back away.

pan6467 12-08-2005 11:02 AM

Quote:

Originally Posted by dksuddeth
on to your pandemic questions.....if people are emergency type sick, they are not refused treatment. If these people end up not being able to pay back the costs, the hospitals are either 'out the cost' or receive some compensation from the government. That compensation comes back to us as taxpayers or higher costs for care later on. If we make it so that people MUST pay for the care they receive, people will be careful on when they actually have to go to the ER or doctor and when they will deal with their virus and ride it out. Less patients for a hospital means less income which will lead to lower prices due to a number of issues. Therefore the cost of private healthcare WILL go down.

The rest I have no problems with..... it's this part.

If when this pandemic hits (and it's going to be horrid, because Bush has Martial Law plans ready for it), then we are in serious trouble.

What got me started on this train of thought is watching 60 Minutes' bit on it (I was watching the show to see Howard Stern.... great piece on him BTW).... and they said that if it mutates and becomes human borne, we'll have like 30 days to contain it.

Now, the question that has to be focussed on here in the US is this.....

Most people who can't afford healthcare end up waiting until it is seriously bad before they go.

That means as the flu incubated in them they could have passed it on to everyone they met, and so on and so on. So by the time they do go into the hospital, they have infected exponentially far more people than if they had felt safe enough and not scared of the cost to go and get treated as soon as symptoms started showing.

Preventative medicine so to speak.

This is what bothers me, what scares me, what shows the system to be fatally flawed.

We cannot wait for people to get to the point where they are hospitalized before we treat them, in cases like these. We may not have time to. We need to educate the people to feel safe to go in and not worry about cost the second they show symptoms.

If we don't, if we allow people to get to the point of no return before we treat them...... then we'll have a much bigger and worse problem on our hands.

flstf 12-08-2005 12:33 PM

Quote:

Originally Posted by Ustwo
Whenever anyone thinks direct government control of parts of the economy will make things better and lower costs I have to question their judgement if not their sanity.

I will agree that the government is very inefficient and should only have control over things that are absolutely necessary like our national defense. Those of you who are against considering nationalizing healthcare offer very few suggestions on how to fix the present system other than getting rid of the insurance companies.

There is little competition in the healthcare industry. About the only price controls there are currently are the result of insurance companies getting doctors and hospitals to agree on rates for certain procedures. With little free market influence the healthcare costs are spiralling out of control and in the not too distant future even the middle class will be priced out of the market.

In order for a market to work there has to be open and visable pricing and free-competitive service providers. Hospitals and doctors seem to have little of either of these. If we can't figure out how to make the healthcare industry into a free market industry than it is probably best that the government step in and control it.

I don't think we should wait too much longer for these industries to become competitive because healthcare is too important to the nation's overall well being. I would feel differently if there were some good ideas on how to fix it but they have to be better than just outlawing insurance companies.

dksuddeth 12-08-2005 12:44 PM

i have a close family friend who is a doctor and happens to own her own clinic. She has told me numerous times that, between the insurance companies (of which she has discontinued working with a few) and the state medical boards regulations, the costs incurred with both of these entities is a major part of her expense.

Now, looking at medical care in a free market atmosphere all we would have to do is let doctors set the rates without the insurance companies. That alone would induce more people to become doctors. After that, competition between doctors, medical supply companies, pharmas, and anything else associated with the medical industry would keep costs of services as low as possible. People would then be free to pay for only the care that they actually need and it would be less expensive than paying the insurance industry.

Ustwo 12-08-2005 12:56 PM

Quote:

Originally Posted by flstf
I will agree that the government is very inefficient and should only have control over things that are absolutely necessary like our national defense. Those of you who are against considering nationalizing healthcare offer very few suggestions on how to fix the present system other than getting rid of the insurance companies.

I'm a big fan of health savings accounts with pre-tax dollars, but thats another issue.

What I don't see is how the concept of 'Its somewhat broken, lets let the government do it' fixes anything.

It does make things 'fair' because we all get to live with a shity, overpriced system, full of government waste..

It doesn't make it free, (as in freedom) and I'd rather be free than fair.

Are costs high for hospital care? Yep. Might they get too high for the system in the future? Yep

What happens in a free maket when prices are too high? Do they stay high?

Already what insurance companies do is work with the hospitals for a 'fair' fee. The hospitals have little choice but to take it since it beats not having patients. The only people who really get screwed by the system would be someone uninsured who is lower middle class. They basicly have to go broke before the system kicks in. They won't ever be dying in the street of untreated disease, but they lose a lot of money, and unlike the insurance carriers they can't negotiate prices down. Thats all I want fixed.

pan6467 12-08-2005 01:02 PM

Quote:

Originally Posted by dksuddeth
i have a close family friend who is a doctor and happens to own her own clinic. She has told me numerous times that, between the insurance companies (of which she has discontinued working with a few) and the state medical boards regulations, the costs incurred with both of these entities is a major part of her expense.

Now, looking at medical care in a free market atmosphere all we would have to do is let doctors set the rates without the insurance companies. That alone would induce more people to become doctors. After that, competition between doctors, medical supply companies, pharmas, and anything else associated with the medical industry would keep costs of services as low as possible. People would then be free to pay for only the care that they actually need and it would be less expensive than paying the insurance industry.

That is a good idea, but I don't see it happening.

I don't see insurance companies killing the cow, until we have a pandemic or catastrophic problem and then it will be too late.

Nor do I see the medical profession lowering costs.

I am a firm believer of a sliding scale based medical program. I think until a better system is devised that is the only way.

As for asking for the "government to pay for me". I have a right, I pay taxes, I pay probably more of a percentage than some people who make more than I. Plus, I pay the "voluntary tax" when I smoke, when I drink soda, when I drive my car, when I use my phone, etc. So IT is my money also.

We are all on this planet to live and share and enjoy life, yet I guess some people believe only only those who make a certain amount are the only ones worthy enough to live healthy happy lives. And yet, those people are so miserable they must continually bully, attack and just be complete immature idiots to everyone else. Ah, but Karma's a bitch.

Ustwo 12-08-2005 01:15 PM

Quote:

Originally Posted by pan6467
That is a good idea, but I don't see it happening.

Thats because you really don't have an understanding of whats going on, but you like to think you do.

My field has almost no insurance coverage. Of the people who come to me, maybe 1/2 have coverage and of them it pays for, at best, 1/4th of the treatment. Its mostly out of pocket.

And guess what? I haven't raised my fees in two years.

Fee's for the last 15 years have basicly kept pace with inflation.

Fee's overall are lower than they were (in todays and yesterdays dollars) 40 years ago due to advances in the field.

That, my friend, is the free market.

And I do have a dirty secret to tell you. Every now and then someone will have full coverage, its rare, maybe 1 in 100 have it, and I never ask before I give my fee, because when I find out I always think 'damn I could have charged them more'. Its human nature. If I know someone has 5 kids and is paying me out of pocket, I tend to lower my fee, but if I found out they had full coverage do I have the same feelings? Hell no. And the patients, do they dicker over the fee when they have full coverage? Never, not once.

I don't fear my karma at all pan, but if we ever pass some full socalized program and its your loved one waiting 5 months to just see a doctor and a month for the basic tests, and then you are told she is too old to get a transplant, remember this debate, paybacks are a bitch.

flstf 12-08-2005 01:40 PM

Quote:

Originally Posted by Ustwo
I'm a big fan of health savings accounts with pre-tax dollars, but thats another issue.

So am I. I opened one a couple of years ago but can only afford putting in about $3 - $5K per year and I'm 56 so it won't grow very much for me. But all young people should open these and maybe when they get to be my age they will have a lot for medical needs (I think when they get 65 they can use it for any reason). Also if people are spending their own money maybe they will shop better for doctors/dentists. Not much we can do about hospital costs though.

Quote:

If I know someone has 5 kids and is paying me out of pocket, I tend to lower my fee, but if I found out they had full coverage do I have the same feelings? Hell no. And the patients, do they dicker over the fee when they have full coverage? Never, not once.
I have no doubt that you run your personal practice in a reasonable and professional manner and if I lived near your office I would certainly use your service if you had an opening. I would rather you based your charge on competitive reasons instead of out of your sense of fairness but I'd take it either way. :)

MoonDog 12-08-2005 02:06 PM

My father would see Amish patients, who would often have no currency with which to pay him for his time. Dad would, however, take that into consideration, and we would often as a family find ourselves with a half a pig, cow, or other something to pay for his medical time. That worked not just for the Amish, but for some of the poor in the same area who needed to see a doctor, but just couldn't afford it. The whole area is farming, so we would get produce and meat all the time.

That doesn't really contribute to the overall discussion, but Ustwo talking about adjusting fees reminded me of my childhood.

Ustwo 12-08-2005 02:38 PM

Quote:

Originally Posted by flstf

I have no doubt that you run your personal practice in a reasonable and professional manner and if I lived near your office I would certainly use your service if you had an opening. I would rather you based your charge on competitive reasons instead of out of your sense of fairness but I'd take it either way. :)

Oh it is based on competitive reasons, if I go too high people go somewhere else. Fairness is on a individual basis, where we give discounts to big families and the like. Since its mostly not insured, people shop around, and I'm often a second or even third opinion.


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