# Well, I knew my medical insurance was expensive, and now it's official



## clifffaith (May 22, 2017)

I pay $814 per month for medical insurance from Anthem BlueCross (Cliff has Medicare, that won't be an option for me for several more years). The rate has gone up pretty substantially every year. This year it went from $683 to $814. I grumble and pay it. I recently received mail from Anthem that starts out "Please read this required notice from the Department of Insurance". It goes on to say that "The Insurance Commissioner has determined that the rate for this product is unreasonable or not justified after the Department of Insurance reviewed information in the rate filing submitted by the insurer. Although the Insurance Commissioner has determined the rate to be unreasonable or not justified, state law does not give the Commissioner the authority to reject this rate. Under state law, the insurance company may still impose this rate, notwithstanding the determination that the rate is unreasonable or not justified."

Back in the day when they could reject you for preexisting conditions, Anthem was the only one who would insure me because I had a history of migraines. I'd been with Healthnet for at least 20 years before that, but once Cliff retired they cut me loose. At that time I opted into a High Dedectible/HSA Compatible plan. We started to do research after receiving this letter, but no one wants to talk to us now because the 2018 rates haven't been set. So I guess I'll join the hoards looking to make a change during Open Enrollment this fall.


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## Patri (May 22, 2017)

I heard on the radio today that many companies are raising their rates 30-50% because of the uncertainty of the future...ie how many people will enroll next year, how healthy they will be, what program will be in effect etc.


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## PamMo (May 22, 2017)

Yes, it sure IS expensive! We (DH and I) have a $6,500/pp deductible, and monthly premiums of almost $1,400. Every plan we looked at would cost us $25,000/yr if we had a major health problem. Fortunately, we're healthy and don't need to use the system, but we still have to pay almost $17,000 for insurance this year, which was the lowest price we could find. We're expecting rates will go up next year.


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## vacationhopeful (May 22, 2017)

I used to pay around $675 ... before the ACA.

Then, I had to get a 'real' policy per ACA .. that was $1500 for the same... so I downsized to $1000 per month. Had to change all my doctors because, they closed up their offices

And again. ... the next year, as my less than 1 year policy would not be offered. Back to the Marketplace and another ... chop out, downsize to get to around $1100 per month. And again, all my doctors left closed their offices and had to FIND another new doctor.

And again ... this year, new policy, new doctors and another, "cut out" options to get to $1100 per month policy ... after they insurance provider cancel last year's policy (ok, NOT OFFER THAT POLICY).

3 months later, for April now qualify for Medicare .... And I have to figure out which options and etc. Just spent 3 hours on the phone today to get Part A & B (or whatever) signed up. So, I am ON MEDICARE ... and still got a BILL for ACA's $1100 policy for April ... They have my birthdate; I am paying for an individual policy; do they even know what Medicare is? Or do they think I am THAT OLD & DUMB to keep paying them?

I decided to just send it back ... marked CANCELLED .... and call every couple of days and WHINE & complain ... and cancel again. And call & cancel again. And call & cancel again ... Think they know what call blocking is? I know they did not suggest or provide me with ANYTHING regarding Medicare ... they KNOW I am OLD .. that I will just keep paying them $1100 per month.

These ACA agents ... are commissioned possessed...IMHO.


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## klpca (May 22, 2017)

Our family has unfortunately had some major health issues this year. An overnight visit - ER/ICU/medical procedure - was $92,000 before the "negotiated rate", and ~$35k after. I feel that the insurance cost cannot be discussed without discussing the cost of the underlying medical care. I don't know what the answer is, but after paying for coverage for over 35 years that we rarely used, I am so very thankful that we have insurance. I am worried that it may not be available to us in the future.


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## TUGBrian (May 22, 2017)

got a notice last month to announce mine is going up over 40% starting in July.

and I have the cheapest HSA plan blue cross offers.  5000 deductible..no perscription/dental/etc  all out of pocket.

laws of economics are finally catching up.


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## dougp26364 (May 22, 2017)

I'd love to comment but, every time I start to write it out, it gets to close to political. Let's just say both mine and my wife's employer sponsored plans premiums keep going up, the deductibles have grown considerably and the benefits have shrunk. It wasn't great before but I'm worse off now than I've ever been in the past, and it wasn't always so great in the past.


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## VacationForever (May 23, 2017)

Without getting political... USA health insurance system is broken.   I would love to see a form of Universal Health Care that is based on negotiated rates, much like Medicare. People do have to pay for health insurance, but may get either subsidies and/or tax credit back depending on income level of individuals.  The main issue that I see is that there is not a real negotiated reimbursement rates outside of Medicare system.  Right now if someone has not worked their 40 (or whatever) credits by the time the person reaches Medicare-eligible age, the person may pay full freight, which is about $1K per month.   I studied this quite a bit for a friend who has been toying with the idea of bringing his elderly parents over from Venezuela.   This is much lower than someone in their 60s pay in the private market with worse medical benefits compared to Medicare.


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## Panina (May 23, 2017)

It seems the insurance companies are able to charge whatever they want.   I agree the system is broken. 

I am part of a group plan that I was able to stay on after my husband passed away. I pay full freight , no subsidies from the company.  I pay their actual cost to keep me on the plan.  $7,200 a year, great coverage $200 deductible and can get coverage in any state, every doctor I wanted to go to accepts the insurance.  Since the ACA took effect my rate has stood the same.  Everyone thought I was crazy not to take the subsidies as my insurance rate the first year would have been thousands less.  I opted not to because once I left my husbands plan I could not go back on and ACA to me was risky.

My current significant other, with his deductible, his insurance costs more then double of what I pay in the ACA system.   He can only see selected doctors , which each year changes, in our state.  If he gets sick, out of state, he can only go to the emergency room and pay hundreds in a co payment, thats if he met his thousands in deductible. His insurance is the same company I have. 

Makes you wonder, we both have the same insurance company but from different sources. Seems the private sector negotiates better.


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## Bucky (May 23, 2017)

The hospitals and insurance companies are forcing us to consider some form of universal healthcare IMO! 

I spent 14 days in the hospital last October where I had surgery to implant an LVAD. The bill for the hospital, doctors, etc was $850K.

I recently spent another 10 days in the hospital where they did a cardiac ablation! Haven't received a bill for that yet but I'm sure it will be several hundred thousand. Shoot, just the medivac flight to the hospital, only 36 miles away, was a little over $45K.

This cannot continue for much longer IMO. Unsustainable charges and payments. Thank God that I have Medicare and Tricare which paid for it all.


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## Brett (May 23, 2017)

_"USA health insurance system is broken"
"This cannot continue for much longer"
 "I agree the system is broken"_

This NY Times best seller book details why Americans pay significantly more in health care costs than other developed countries 

*https://www.amazon.com/American-Sickness-Healthcare-Became-Business/dp/1594206759*

unfortunately it's going to get worse before it gets better


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## macko420 (May 23, 2017)

This is why I love TUG!  Honestly, this is the first discussion about insurance where people are having an actual intelligent discussion about this instead of calling each other some horrible name that I have seen in the last 2 years
THANK YOU!  I, too, am struggling with health insurance payments.  I am self employed and get mine thru the Marketplace but also have pre-existing conditions so I am very grateful to have this as an option.  Anyway - I am worried sick (no pun intended) about what is going to happen..


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## VegasBella (May 23, 2017)

VacationForever said:


> Without getting political... USA health insurance system is broken.   I would love to see a form of Universal Health Care


Agreed. The issue is very complicated and involves multiple factors. It's not just an 'insurance' issue. As explained in the book mentioned above, it has to do with various multiple players in the healthcare system, not just insurance.

Personally, I pay more for insurance than I do for my mortgage. Insurance is my largest monthly expense. I know a big part of that is because of my high income and good health I am subsidizing others. I don't have a huge problem with this but I would like for my money to actually help other people who need it rather than line the pockets of CEOs. And I would like many other factors of our healthcare system reformed.


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## vacationhopeful (May 23, 2017)

macko420,

We all have learned to listen and converse about many topics ... I now have Medicare.

I spent time and energy for months which turned into years counting the months til I turned 65 last month. Not that I was retiring or starting social security, but because the health insurance _thing_ has become a monster which any individual or family is forced to make decisions so as to afford or get into a group/corporate policy. I was paying over $1100 monthly for a policy during early 2017 ... no help ... way MORE than any monthly mortgage bill I ever had in my life. And every year, the current policy gets 'phased out/cancelled' and another end of year HUNT had to be done. The is NO policies for individuals NOT issued thru the ACA.

I have seen couples who have run small businesses for years where one spouse had to get a job with health insurance ... any job. And I have seen others keep a job which they HATE, because they can't find another job WITH health insurance. And I have another person, who changed jobs .. turning multiple job offers down because the new companies would only start health insurance after 90 days of employment. He started a new job and 2 weeks suffered a gall bladder attack & followed by surgery ... seems his new employer LIED to him  ... no health insurance coverage.  Seems he felt COBRA was too expensive.


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## elaine (May 23, 2017)

years ago, my mother did not qualify for Medicare, but my Dad hit 65 and cobra ran out ( which covered my Mom). She had all her physicals, etc. before it ran out and went without Ins. for 18 mths until she hit 65. Her premiums would have been $1000+/mth with $5K deductible and pre-E not covered. Luckily, it worked for her. I kept my job instead of being a stay at home Mom in order to have good health ins after seeing my parents.  As a kid of a self-employed parent, I NEVER recall having regular physicals, etc. and we only saw the Dr. if we were REALLY sick. I only got treated for allergies/asthma at age 22.


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## bluehende (May 23, 2017)

As many have said the real problem is the underlying cost of health care.  There are many things that insurance companies can be criticized for, but as long as health care is 16% of our economy it will be a huge drain on consumers.  I will try very hard to stay non political.  I worked for a company that made products that we always talked about value in use.  In other words we can charge a lot of money if it has high value to the consumer.  When it is your life on the line the value in use is astronomical.  As long as the profit motive interacts with our lives we will not solve this problem.


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## Talent312 (May 23, 2017)

IMHO, part of the problem is that docs+hospitals run up bills by gaming the system.

A few years ago, DW spent 3N in a hospital for a TIA (MRI; observation; no surgery).
The insurance company paid ~$30,000, which I'm sure they applied to their new wing.
Their food wasn't even edible. I had to bring her food from outside. 

It seems to me that hospitals are like TS salesmen.
We were only out $100 + the food, so how can I complain?

.


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## macko420 (May 23, 2017)

One thing that has increased costs is how you need to be referred to any specialists by your primary care dr.  This often requires you to visit them first and even if it doesn't, there is still paperwork to do the referral.  This increases the need for office staff, etc.  If you don't go thru this process, your insurance might not pay for the visit with the specialist.  It didn't used to be like that

Another thing that really bugs me - the constant bombardment of commercials for expensive meds!  It's not like we can buy them over the counter.  Why are they spending massive amounts of money to advertise to an audience that may not be interested in the product.  I'm sure that contributes to the astronomical cost of meds.  I would like to see this practice discontinued.  Tired of hearing how any particular med is going to kill whoever takes it....


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## WinniWoman (May 23, 2017)

bluehende said:


> As many have said the real problem is the underlying cost of health care.  There are many things that insurance companies can be criticized for, but as long as health care is 16% of our economy it will be a huge drain on consumers.  I will try very hard to stay non political.  I worked for a company that made products that we always talked about value in use.  In other words we can charge a lot of money if it has high value to the consumer.  When it is your life on the line the value in use is astronomical.  As long as the profit motive interacts with our lives we will not solve this problem.



It's a double edged sword because without the profit motive there is no incentive for innovation.


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## bluehende (May 23, 2017)

mpumilia said:


> It's a double edged sword because without the profit motive there is no incentive for innovation.



Now to put a third edge on the sword.  Americans are paying for all of this innovation by the price we pay.  I am not sure how much more innovation we can afford.  We pay twice as much for our healthcare and our outcomes are not as good.  If we do not change soon the price we will pay long term is going to be ugly.


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## Bunk (May 23, 2017)

It's ironic but to some extent, Medicare has a rule against preexisting conditions.  As I understand it, along with Basic Medicare, you can get either Supplemental or Advantage coverage.  Medicare Advantage is significantly cheaper and is a good choice for the "younger seniors" who are not very sick.
But I was told that if you are on Advantage and want to transfer to Supplemental because you are now sick, the insurer does not have to accept you if you try to transfer with a preexisting condition.


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## clifffaith (May 23, 2017)

My birthday is December 30th; I turn 62 this year. Anyone know if my first SS payment starts that month, or does it start the next? (Cliff is 18 years older so we have always figured I'd take SS ASAP; then back issues that often render me unable to walk without a cane and the slowdown of our business pretty much have forced our hand that way anyway). Same with Medicare three years after that-- does it start in Dec or Jan? I remember my dad crowing that he got to count me as a dependent the whole year I was born, even though I was born two days before the end of the year.


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## vacationhopeful (May 23, 2017)

Medicare starts the MONTH of your birth .. I just signed up last month.


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## b2bailey (May 23, 2017)

I have been a supporter of Obamacare because it got my husband through brain cancer treatment and two surgeries. However, I just spent some time with my nephew and learned he (age 27, perfect health) recently cancelled his marketplace policy because he could no longer afford $325/mo premium and his share of rent on a San Diego apt.


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## vacationhopeful (May 23, 2017)

b2bailey said:


> I have been a supporter of Obamacare because it got my husband through brain cancer treatment and two surgeries. However, I just spent some time with my nephew and learned he (age 27, perfect health) recently cancelled his marketplace policy because he could no longer afford $325/mo premium and his share of rent on a San Diego apt.



Did you ask him how much was his cell phone bill monthly?
Is he driving a newer car? And does he have insurance on the car?
Could he get a part time job?
Has he cut out primo coffee and lattes?
Did he look for a cheaper apartment? 

His premium is less than $85 per week.


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## SmithOp (May 23, 2017)

clifffaith said:


> My birthday is December 30th; I turn 62 this year. Anyone know if my first SS payment starts that month, or does it start the next? (Cliff is 18 years older so we have always figured I'd take SS ASAP; then back issues that often render me unable to walk without a cane and the slowdown of our business pretty much have forced our hand that way anyway). Same with Medicare three years after that-- does it start in Dec or Jan? I remember my dad crowing that he got to count me as a dependent the whole year I was born, even though I was born two days before the end of the year.



SS at the end of one full month AFTER your birthday month.  My wife turned 62 in Oct, first check was Dec 1st.  You should get one Feb 1st.

Medicare is different from SS.

PS, don't forget to cancel ACA when you go on Medicare, I did taxes for a person that assumed it would be canceled automatically, now owes $750 refund of PTC.


Sent from my iPad using Tapatalk


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## VacationForever (May 23, 2017)

Bunk said:


> It's ironic but to some extent, Medicare has a rule against preexisting conditions.  As I understand it, along with Basic Medicare, you can get either Supplemental or Advantage coverage.  Medicare Advantage is significantly cheaper and is a good choice for the "younger seniors" who are not very sick.
> But I was told that if you are on Advantage and want to transfer to Supplemental because you are now sick, the insurer does not have to accept you if you try to transfer with a preexisting condition.


Advantage plan can only throw one out if the entire plan goes away but an alternative plan within the same provider will be provided, unless the medical network shutsdown entirely.  Most remain on their Advantage plans even when they get very sick. Yes, 2 years after one starts Medicare and not already on Supplemental, then insurer can reject the applicant or raise rates.  The worst thing about Supplemental plans is that they can also bump one's rate the following year when the person gets sicker.

Advantage plans are HMO plans.  They are not necessarily inferior to Supplemental plans.


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## isisdave (May 23, 2017)

Brett said:


> _"USA health insurance system is broken"
> "This cannot continue for much longer"
> "I agree the system is broken"_
> 
> ...



Also, An American Sickness


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## rapmarks (May 23, 2017)

Medicare begins on the first of the month of your birthday month.


Sent from my iPad using Tapatalk


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## funtime (May 23, 2017)

Run, don't walk! over to Kaiser Permanente.  Blue Cross jacked my mother around for 6 months and I called Kaiser for her and they had her insured in 1 day on their Senior Advantage Program for 1/3 the cost we used to pay.  We love Kaiser.  They give great service, are affordable, are convenient.  They were there for my mother when she broke her hip. You owe it to yourself.


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## VacationForever (May 23, 2017)

funtime said:


> Run, don't walk! over to Kaiser Permanente.  Blue Cross jacked my mother around for 6 months and I called Kaiser for her and they had her insured in 1 day on their Senior Advantage Program for 1/3 the cost we used to pay.  We love Kaiser.  They give great service, are affordable, are convenient.  They were there for my mother when she broke her hip. You owe it to yourself.


A prime example of an Advantage plan being superior..Kaiser gets 5 star ratings in CMS Comparehealth.


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## artringwald (May 23, 2017)

clifffaith said:


> My birthday is December 30th; I turn 62 this year. Anyone know if my first SS payment starts that month, or does it start the next?


My first SS check arrived exactly one month after my birthday. If you want to claim it in December, you'll have to start you paperwork in September. If you can wait until you're 70 to claim it, your monthly check will be 64% higher. Financially, the worst case scenario is living until you're 100, and not having enough monthly income, so wait if you can.


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## artringwald (May 23, 2017)

Talk about the crazy costs of medical care, DW occasionally gets severe migraines. We were on a Mediterranean cruise, and she went after hours to the ship's urgent care, and got charged $316.76 for IV drugs and a couple hours of observation. When the same thing happened while on a trip with a stopover in Seattle, the ER did almost identical treatment. After they buggered up the insurance billing, they sent us a bill for $4410.35. 

Fortunately, our total cost for both was $0. Travel insurance covered the former, and Medicare with supplemental covered all of the later (after reducing it to $518.13).


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## WinniWoman (May 23, 2017)

bluehende said:


> Now to put a third edge on the sword.  Americans are paying for all of this innovation by the price we pay.  I am not sure how much more innovation we can afford.  We pay twice as much for our healthcare and our outcomes are not as good.  If we do not change soon the price we will pay long term is going to be ugly.




"To some questions there are no answers."

We can't afford health insurance. We can't afford medical care. We can't afford to be on waiting lists for health care. We can't afford the  innovation to cure more illnesses. We can't afford higher taxes.


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## Talent312 (May 23, 2017)

My b-day falls mid-month, which meant my 1st month of SS eligibility was the next ensuing month, and my 1st benefit would be paid in the 3rd week of the following month. IOW, a little more than 2 months after my b-day.

BTW, I didn't wait becuz my break-even point at which waiting would begin to yield more $$ was about age 84. Before then, waiting would'a cost me $$. Sure, if I lived that long I'd have shorted myself but who knows... Besides, I'm getting a pension with a built-in 2.65% COLA.

.


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## artringwald (May 23, 2017)

Talent312 said:


> My b-day falls mid-month, which meant my 1st month of SS eligibility was the next ensuing month, and my 1st benefit would be paid in the 3rd week of the following month. IOW, a little more than 2 months after my b-day.
> 
> BTW, I didn't wait becuz my break-even point at which waiting would begin to yield more $$ was about age 84, and while yes, I'd be nice to have the additional amount, at that point, I doubt I'd be active enuff to need it. As it is, I'll be getting a pension with a built-in 2.65% COLA.
> 
> .


A pension with a built-in 2.65% COLA? Wow! I have a nice pension, but I don't think they've increased anybody's pension in years. Most companies are working hard to eliminate pensions.


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## lizap (May 23, 2017)

The rising cost of health care insurance will continue until people have had enough.  This has been politicized, but really providing decent, basic healthcare should not be a political topic. Why does the cost continue to rise at the level it does?  Because it can; there's no system of checks and balances, no controls.  It will continue to rise until people have had enough..


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## GregT (May 23, 2017)

This is indeed an interesting topic, and I thank the TUGgers who have personalized it -- we all read so much crap in the papers, and this is the real world experience here on TUG.

From the perspective of the corporate world, I do have a balancing view.   I am the CFO of a healthcare company here in San Diego.  We have several cardiac diagnostic tests that are widely utilized, and I would bet that any TUGger who has had open heart surgery or a stent implanted has been tested with our product.  It is a life saving product and I am proud to be CFO of this company.  I would without hesitation have our products used on me, my brother, my children, my parents, and know that they would have a better outcome because of these diagnostic tests.

In the United States, we sell our product directly to the hospital (and we have a U.S. sales force that we hire and pay to support those sales).  Internationally, we sell through distributors, who in turn re-sell to the hospitals at a marked up price.

On average, we charge about 33% more from the products that we sell directly to the hospital in the United States than a hospital in Europe will ultimately pay for the same diagnostic test.   The difference is because of the reimbursement amount that the hospital is paid by the insurance company.  European insurers (ie, their governments) pay less to the hospital than a U.S. insurance company.  Because of this, many European hospitals do not buy our products, preferring a cheaper (inferior?) product from a different source, purely for cost reasons.  We've seen situations where sales in November and December dry up in the U.K. -- because the NHS ran out of budget for tests like ours and so procedures get canceled.  Tough stuff if your open heart procedure is in November.

But why do we charge 33% more in the U.S. than we know is being paid in the rest of the world for the same test?

It's not greed -- this is part of the business model -- and although it is unfortunate, this is the reality of the situation:  the United States subsidizes the rest of the world's health care systems.    We spend ~$10M in R&D every year (about 25% of our Operating Expense budget) to try and create better tests.  We hope to be successful, but it takes time and is uncertain.   And that U.S. price premium funds it -- and the rest of the world will still get to buy that next generation test -- and pay less for it than the U.S. consumer.

There is alot of interest in a single payer system in the United States -- if every other country does it, why can't we?  Well, this is a glimpse of what I believe would happen.  The United States government, like every other government (and like Medicare) would reimburse less for the usage than current private insurers pay.   There really would be decrease in new products, and budgets really would -- even more than today -- determine what treatments are available.  Finally, fear of litigation is pervasive in the medical world -- we all recognize the need to protect our patients, but we need to recognize the significant related compliance cost that this brings from doctors and hospitals that fear litigation.

So I hope we fix what is currently broken, continue to protect those that are most vulnerable, reward those who have maintained coverage even if not sure they needed it, and manage the unnecessary costs that burden our products.

Sorry for the rambling message, and my thanks to my fellow TUGgers for sharing their experiences above.

Best,

Greg


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## b2bailey (May 24, 2017)

vacationhopeful said:


> Did you ask him how much was his cell phone bill monthly?
> Is he driving a newer car? And does he have insurance on the car?
> Could he get a part time job?
> Has he cut out primo coffee and lattes?
> ...



At $85 per week -- it's more than his weekly grocery allotment. That doesn't seem right. He works in food service for min wage plus tips. Drives his mom's hand me down car which is 20 years old.


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## moonstone (May 24, 2017)

I find it sad that Americans have to pay so much in health care insurance. Nobody should have to choose between eating (or paying their rent/mortgage) or paying for heath insurance or medical treatment. I have family in Calif. who pay more in health insurance (family of 4 with 2 pre-teens -all healthy) per month than what their mortgage payment is!

Many years ago we met an elderly man camping in the next site to ours who was a professor at the local university and presumably making good money. He was forced to sell his home when his wife was diagnosed with cancer so he could afford the treatments. I don't remember what, if any, insurance he had from his work.  His wife eventually passed away and this poor old man was left with nothing -no home (lived in a 22ft trailer), no savings & no wife! He worked quite a few years after he should have retired just to build up his SS income for his retirement.

Not to get political but I am so glad to be a Canadian with our health care system and coverage.  My Mom spent over 5 months in hospital a few years ago and my Dad's cost was $0.00!!


~Diane


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## Bucky (May 24, 2017)

GregT said:


> This is indeed an interesting topic, and I thank the TUGgers who have personalized it -- we all read so much crap in the papers, and this is the real world experience here on TUG.
> 
> From the perspective of the corporate world, I do have a balancing view.   I am the CFO of a healthcare company here in San Diego.  We have several cardiac diagnostic tests that are widely utilized, and I would bet that any TUGger who has had open heart surgery or a stent implanted has been tested with our product.  It is a life saving product and I am proud to be CFO of this company.  I would without hesitation have our products used on me, my brother, my children, my parents, and know that they would have a better outcome because of these diagnostic tests.
> 
> ...



Great post Greg. I can almost guarantee you that I have had your product used on me. More than once!

I would assume and always have, that the hospitals always bill astronomical fees because they know they are only getting a certain percentage back from the insurance companies and Medicare. No different than the drug companies that overcharge to fund research and development.


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## Brett (May 24, 2017)

moonstone said:


> I find it sad that Americans have to pay so much in health care insurance. Nobody should have to choose between eating (or paying their rent/mortgage) or paying for heath insurance or medical treatment.
> .
> Not to get political but I am so glad to be a Canadian with our health care system and coverage.  My Mom spent over 5 months in hospital a few years ago and my Dad's cost was $0.00!!
> 
> ~Diane



taking pity on Americans is OK  as long as you realize the $0.00 cost for staying 5 months in a hospital was paid through your taxes.   Google
"Canada health insurance taxes" and you will find many believe Canadians are the ones paying more for their health care!


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## Talent312 (May 24, 2017)

artringwald said:


> ... There is a lot of interest in a single payer system in the United States -- if every other country does it, why can't we?  Well, this is a glimpse of what I believe would happen.  The United States government, like every other government (and like Medicare) would reimburse less for the usage than current private insurers pay...



Not to politicize, but to interpret... What you are saying is that health care costs would go down, but that's a bad thing becuz your company, drug companies, and others who game the system would spend less on R&D...

My take: So be it. Let your shareholders and overseas customers pay the price.
But then, hospitals don't mind becuz they can soak insurance companies for new equipment and new buildings.

The health cares system awash in money being taken out of the hides of consumers, in which insurance companies are complicit. Insurance companies, who should emphasize cost-control, won't do it becuz they don't want to be blamed for choking the system and besides, most of their money comes from employer-group plans in which employees are captive audience.

.


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## lizap (May 24, 2017)

Brett said:


> taking pity on Americans is OK  as long as you realize the $0.00 cost for staying 5 months in a hospital was paid through your taxes.   Google
> "Canada health insurance taxes" and you will find many believe Canadians are the ones paying more for their health care!




I suspect there is a large portion of Americans who would be willing to pay more in taxes for guaranteed healthcare.


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## moonstone (May 24, 2017)

Yes as lizap says,  I don't mind paying a relatively small amount (I'm retired on not a large pension) of income tax (with health care costs in there) so that no matter if I am in the hospital for 5 hours or 5 months my cost will be the same. People should not have to go bankrupt to pay for their (or family members) cancer treatment. I know that if I am in a really bad health situation my husband wont have to sell our house to pay for my treatment. It doesn't matter if your income is 20K a year or 200K a year you get the same treatment and at the same cost. Although there are private treatment options available for those who can afford it but you aren't necessarily getting better healthcare, but maybe faster.

~Diane


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## dominidude (May 24, 2017)

GregT said:


> This is indeed an interesting topic, and I thank the TUGgers who have personalized it -- we all read so much crap in the papers, and this is the real world experience here on TUG.
> 
> From the perspective of the corporate world, I do have a balancing view.   I am the CFO of a healthcare company here in San Diego.  We have several cardiac diagnostic tests that are widely utilized, and I would bet that any TUGger who has had open heart surgery or a stent implanted has been tested with our product.  It is a life saving product and I am proud to be CFO of this company.  I would without hesitation have our products used on me, my brother, my children, my parents, and know that they would have a better outcome because of these diagnostic tests.
> 
> ...



Greg, I really like your post, it seems honest.
I'll tell you what is wrong with the system in our great country and how to fix it in a much shorter posts than yours.
The current US system rewards cures such as those provided by your company, but it does not do anywhere near enough to prevent people from needing those cures in the first place.
Imagine a world in which fire prevention officials didn't exist, and in which you and I had to pay every time a fire truck came to the front of our house.
The more fires, the more loses; the more loses, the bigger the insurance premiums; the bigger the premiums, the higher the profits from insurers; the higher the profits from insurers, the higher the incentive to put out those fires quickly if expensively (see the pattern).
So, to conclude, while I do not necessarily agree that a single payer system would be the end of all problems health related, a single payer system does have strong incentives to prevent disease in the first place, something that our current system desperately needs. If there is a substantial reduction in disease, sorry to say, your company would not need to exist in the first place.
1st Note: if your business depends on US insureds subsidizing the rest of the world, that's not a sustainable proposition. I hope all of the employees of your company have a back up in case that stops.
2nd Note: While it's "Tough stuff if your open heart procedure is in November" in the UK, it's tough stuff 365 days a year here in the USA for Americans who are either uninsured or underinsured and cant afford your company's product. I bet the US population here that is either uninsured or underinsured is about the size of the UK.
3rd Note: It is really cheap to live healthy to old age. The list of what to do is really short. 1) Eat 1200-1600 calories a day, depending on your height, and no more, about half those calories need to come from veggies  2) get enough sleep 3) eat a good amount of fish (about 4oz twice a week). Notice exercise doesnt even make it to the list. What is not easy is having an environment where most people adhere to those three things. Imagine how many fast food restaurants would go out of business, and how many customers would balk at paying $8 for a meal with 300 calories.


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## Brett (May 24, 2017)

lizap said:


> I suspect there is a large portion of Americans who would be willing to pay more in taxes for guaranteed healthcare.



sure 
but a whole lot of political changes must occur for something like that to happen


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## DeniseM (May 24, 2017)

Folks - I know it is really difficult, but we can't go down the "political" road.


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## taffy19 (May 24, 2017)

I know that political discussions are not allowed on TUG and I am so glad about it.  I get sick when I read the nasty comments on Facebook to each other because people do not agree instead of having a civil discussion with each other about what the problems are and how to solve them.

This is fact.  I received a PM yesterday on FB from a Dutch friend who lived in California first and then moved to Canada after her husband retired because that is where their children live.

He needs a knee replacement and has difficulty walking and kneeling but he has to wait six to eight months before it is his turn (her words).  I am sure that he wouldn't have to wait that long here in the USA.  It is the same in Europe too from what I understand.

Our neighbors in Mexico are from the same area in Canada where my Dutch friend also lives.  They spend their winter months in Mexico too.  She has therapy three times a week and she tells me that it is so much better than her far and in between therapy treatments in Canada.

The hospital over there butchered her back operation and she ended up in a wheelchair because they injured her nerves in the spinal cord.  She can hardly stand up but when she goes home again she can walk a few steps on her own with a walker but will have lost all her strength again when she'll come back a year later.  Very sad.

There are several modern or up to date hospitals in Puerto Vallarta ready and eager to receive foreign patients once people will rather go somewhere else than wait for treatment at home if they have to wait so long.

There are some very good dental clinics too in Mexico from what I hear.  One is owned by a Canadian dentist in Bucerias in Nayarit close to Nuevo Vallarta near Puerto Vallarta.  I even read it here on TUG how much cheaper the treatments are in Mexico.

It is becoming a bigger problem the older the population gets and this is fact too.


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## WalnutBaron (May 24, 2017)

I'll echo what others have said about how interesting and engaging this thread is. And thanks to many of you for personalizing your experiences and the truly shocking costs of healthcare in America today. I'm blessed--60 years old and never with a major health challenge for either me or my DW. I'll offer my two cents on how to get this runaway train under control:

This is an industry that is inherently immune to the laws of supply and demand. Good old-fashioned competition just doesn't work--and here's why: right now DW and I are shopping for a new refrigerator. Since it's a major purchase, I've checked Consumer Reports to see which are the best-rated. We've shopped online, gone on the message boards and review sites to see what others who own the brand and model we're looking at say about it, and are now checking various retailers to see what their delivery costs and service capabilities are. But when I have a medical emergency--whatever it may be--I not only have no time to do my due diligence, but time is of the essence, especially if it's a life or death kind of issue. Literally the only factor keeping my healthcare provider(s) from charging whatever they darn well please is the pre-negotiated rates for products/services by my insurer. If it was just me, the doctor/hospital/specialists/drug and medical supply companies could and most likely would hang me out to dry. Competition is out the window because my insurer directs me to which provider and hospital I'm allowed to see. The invisible hand of Adam Smith is not just invisible in the healthcare industry in America, it's non-existent.
The tort attorneys are killing us. I'm old enough to remember when attorneys were not allowed to advertise--until a Supreme Court ruling in 1977 changed all that. Even forty years later, that ruling is controversial because it allows so-called "ambulance chasers" to pre-dispose people to sue doctors and medical companies for so much as a hangnail. One organization has estimated that the passage of federal tort reform would lower healthcare premiums by about 3.5%. It's doesn't sound like a lot, but every little bit helps.
There is no doubt in anyone's mind that greed runs rampant in the healthcare industry. This particularly egregious example comes from an article published just today in Bloomberg BusinessWeek about a drug company--Alexion--which charges an almost unbelievable $500,000-$700,000 per year for a drug called Soliris. The drug companies will often trot out the old saw that they need this kind of pricing flexibility to offset massive R&D costs, especially for drugs that help a relatively few patients, like Soliris does. But the BusinessWeek article contends that so-called "orphan disease" drugs are in fact highly profitable for the drug companies. The article itself is pretty damning.
Thanks to the overly-extensive lobbying strength of the AMA in Washington, bad doctors are not only able to continue to practice despite substance abuse issues, questionable training, and other things, but their patients have no way of knowing they have been disciplined. This is yet another example where the patients are hampered from being able to conduct simple due diligence. Bad doctors should be exposed and then at least let the free market determine their eligibility to continue to practice. But free market principles don't apply since these doctors are shielded by laws advocated by the AMA.
Greg's earlier comments about the effects of a single-payer system ring true. By its very definition, healthcare gets allocated and healthcare availability decisions get made by government bureaucrats and not healthcare providers.
So what's the solution? Of course, there is no easy answer and this issue is incredibly complex. But I would offer a few suggestions that would at least have a positive effect on the outrageous costs in the American system:

Pass federal tort reform that limits jury awards.
Repeal the ability of tort lawyers to advertise their "services" in a way that encourages frivolous and costly lawsuits that we all end up paying for. Ultimately, the only winners in the current system are the tort lawyers themselves.
Substantially shorten the time period for drug patents, allowing generic imitators to come on to the market much sooner. The drug companies will tell us that this would completely undercut their incentives to conduct the R&D necessary to develop drugs, but I think that theory ought to be tested by allowing the free market to have a greater hand in controlling drug costs.
Remove the veil from bad doctors and bad hospitals. Expose the bad ones, and allow the free market to laud the exceptional ones.
Require doctors and hospitals to post their fee schedule for routine medical procedures and make these fees available online such that online consolidators such as esurance.com can immediately show consumers what those costs are. Yes, some will say that this is impossible because every patient is different and every situation is different. Fair enough. But that doesn't mean something like this could not be done to at least provide some level of price comparison to see the light of day.
Substantially shorten the inordinately long and costly drug testing and approval process by FDA. Many will say that this process protects us, but the recent experience of the expedited process for approval of Zmapp to respond to the Ebola crisis shows it can be done--and should be done much more often and with greater dexterity.
Not being in the medical field, I am sure some of my prescriptions (pun intended) for fixing our broken system are short-sighted. But we've got to start somewhere, because what we've got is not only unconscionable, but unsustainable in the extreme.


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## Brett (May 25, 2017)

WalnutBaron said:


> I'll echo what others have said about how interesting and engaging this thread is. And thanks to many of you for personalizing your experiences and the truly shocking costs of healthcare in America today. I'm blessed--60 years old and never with a major health challenge for either me or my DW. I'll offer my two cents on how to get this runaway train under control:
> 
> This is an industry that is inherently immune to the laws of supply and demand. Good old-fashioned competition just doesn't work--and here's why: right now DW and I are shopping for a new refrigerator. Since it's a major purchase, I've checked Consumer Reports to see which are the best-rated. We've shopped online, gone on the message boards and review sites to see what others who own the brand and model we're looking at say about it, and are now checking various retailers to see what their delivery costs and service capabilities are. But when I have a medical emergency--whatever it may be--I not only have no time to do my due diligence, but time is of the essence, especially if it's a life or death kind of issue. Literally the only factor keeping my healthcare provider(s) from charging whatever they darn well please is the pre-negotiated rates for products/services by my insurer. If it was just me, the doctor/hospital/specialists/drug and medical supply companies could and most likely would hang me out to dry. Competition is out the window because my insurer directs me to which provider and hospital I'm allowed to see. The invisible hand of Adam Smith is not just invisible in the healthcare industry in America, it's non-existent.
> The tort attorneys are killing us. I'm old enough to remember when attorneys were not allowed to advertise--until a Supreme Court ruling in 1977 changed all that. Even forty years later, that ruling is controversial because it allows so-called "ambulance chasers" to pre-dispose people to sue doctors and medical companies for so much as a hangnail. One organization has estimated that the passage of federal tort reform would lower healthcare premiums by about 3.5%. It's doesn't sound like a lot, but every little bit helps.
> ...



sounds like you're putting most of blame in health care costs on lawyers and lobbyists
I'll check back in when you turn 65 and go on Medicare,  it's possible you could change your mind about all those "government bureaucrats" and the single payer system!


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## foundyoubyaccident (May 25, 2017)

I bave some opinions on our healthcare systems and insurance.  While the affordable care act was beneficial for some people, it was not for all.  How can we reduce costs?  My very first thought is to change the hospitals themselves.  There is no reason I  can think of to have to pay $10.00 at the minimum for a $.01 aspirin.  http://www.rd.com/health/wellness/wildly-overinflated-hospital-costs/
I worked for 2 contracts with the government, medicare and ACA.  I have seen the cost rise on both!

The best advise I can give my friends and family... If you plan on down sizing and selling your house, do it 3 years before you go on Medicare.  Otherwise you end up paying even more for part b and d.


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## pagosajim (May 25, 2017)

foundyoubyaccident said:


> The best advise I can give my friends and family... If you plan on down sizing and selling your house, do it 3 years before you go on Medicare.  Otherwise you end up paying even more for part b and d.



Can you elaborate on this?  Fits my situation well and I'm curious as to why there's a timing issue here.


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## Bunk (May 25, 2017)

dominidude said:


> 3rd Note: It is really cheap to live healthy to old age. The list of what to do is really short. 1) Eat 1200-1600 calories a day, depending on your height, and no more, about half those calories need to come from veggies 2) get enough sleep 3) eat a good amount of fish (about 4oz twice a week). Notice exercise doesnt even make it to the list. What is not easy is having an environment where most people adhere to those three things. Imagine how many fast food restaurants would go out of business, and how many customers would balk at paying $8 for a meal with 300 calories.



Since obesity creates significant health costs that are born by the taxpayers, does anyone have a problem with barring food stamp users from buying soda and other sugary drinks with food stamps?  Mayor Bloomberg tried to get USDA approval to do that in 2011 and 2013 and the USDA denied his requests.


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## rapmarks (May 25, 2017)

pagosajim said:


> Can you elaborate on this?  Fits my situation well and I'm curious as to why there's a timing issue here.



Medicare is income based, when your income crosses a certain threshold, you pay two, three, or four times as much per month for Medicare, as well as a surcharge for part D.  Selling your house may course large capital gains, resulting in an increase in Medicare premiums.


Sent from my iPad using Tapatalk


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## bogey21 (May 25, 2017)

dominidude said:


> It is really cheap to live healthy to old age. The list of what to do is really short. 1) Eat 1200-1600 calories a day, depending on your height, and no more, about half those calories need to come from veggies  2) get enough sleep 3) eat a good amount of fish (about 4oz twice a week). Notice exercise doesn't even make it to the list. What is not easy is having an environment where most people adhere to those three things. Imagine how many fast food restaurants would go out of business, and how many customers would balk at paying $8 for a meal with 300 calories.



There is some truth here.  In my late 70s (I'm now 82 gong on 83 and all is well) I saw the light and took my weight down from 205 to 155 by eating pretty much as described above.  In addition I focused on reducing stress.  I agree that formal exercise is not necessary.  I do avoid elevators and climb stairs when I can, take long walks with my dog and park as far away from the entrance when going to Kroger, Walmart, etc.  IMO fast food and drinks with sugar are dangerous.

George


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## foundyoubyaccident (May 25, 2017)

pagosajim said:


> Can you elaborate on this?  Fits my situation well and I'm curious as to why there's a timing issue here.



Sure, 
*If your yearly income in 2015 (for what you pay in 2017) was* *You pay each month (in 2017)
File individual tax return* *File joint tax return* *File married & separate tax return*
$85,000 or less                                   $170,000 or less                                $85,000                                                 or less $134
above $85,000 up to $107,000             above $170,000 up to $214,000         Not applicable                                        $187.50
above $107,000 up to $160,000            above $214,000 up to $320,000        Not applicable                                            $267.90
above $160,000 up to $214,000           above $320,000 up to $428,000         above $85,000 and up to $129,000            $348.30
above $214,000                                  above $428,000                                above $129,000                                         $428.60


I saw one beneficiary paying about 535 bucks a month, they  still had to buy marketplace insurance for his wife.  Needless to say, it ended up costing them 5 times what they had been paying threw his former employer..  to go back, to my reason why..So they sold their on of their houses, it ended was taxable and received a Form 1099-S .  My grandparents have run into it twice now.  

Most home sellers don’t even have to report the transaction to the IRS. But if you’re one of the exceptions, knowing the rules will help you hold down your tax bill.  There 
are three tests you must meet in order to treat the gain from the sale of your main home as tax-free:


Ownership: You must have owned the home for at least two years (730 days or 24 full months) during the five years prior to the date of your sale. It doesn't have to be continuous, nor does it have to be the two years immediately preceding the sale. If you lived in a house for a decade as your primary residence, then rented it out for two years prior to the sale, for example, you would still qualify under this test.
Use: You must have used the home you are selling as your principal residence for at least two of the five years prior to the date of sale.
Timing: You have not excluded the gain on the sale of another home within two years prior to this sale.

I don't know your situation exactly, but if it is like my parents and grandparents, you won't want to get stuck paying extra everywhere.


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## WinniWoman (May 25, 2017)

rapmarks said:


> Medicare is income based, when your income crosses a certain threshold, you pay two, three, or four times as much per month for Medicare, as well as a surcharge for part D.  Selling your house may course large capital gains, resulting in an increase in Medicare premiums.
> 
> 
> Sent from my iPad using Tapatalk



Even if you buy another house? Even downsizing, for many people the downsized house can cost the same or more than the old house.


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## VacationForever (May 25, 2017)

rapmarks said:


> Medicare is income based, when your income crosses a certain threshold, you pay two, three, or four times as much per month for Medicare, as well as a surcharge for part D.  Selling your house may course large capital gains, resulting in an increase in Medicare premiums.
> 
> 
> Sent from my iPad using Tapatalk


High income penalty hit only afects that one year as Medicare uses 2 year old data to calculate the penalty and because there is a lag, you may be able to get the income penalty removed.  Downsizing home also does not mean an increase in income.  My large home is listed for sale, at 200K less than I paid for.  It won't affect our income level for rhe year.

Even when/if your income is much higher before you turn 65 and then "normal" or low at 65, you simply need to write to Medicare to indicate that your current year income is not what they have used from 2 years prior.  We did that for my husband and I want to almost say "easy peasy"... they revised his rate down from $504 to $134 effective first of the year.


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## ace2000 (May 25, 2017)

foundyoubyaccident said:


> I saw one beneficiary paying about 535 bucks a month, they  still had to buy marketplace insurance for his wife.  Needless to say, it ended up costing them 5 times what they had been paying threw his former employer..  to go back, to my reason why..So they sold their on of their houses, it ended was taxable and received a Form 1099-S .  My grandparents have run into it twice now.
> 
> *Most home sellers don’t even have to report the transaction to the IRS. *But if you’re one of the exceptions, knowing the rules will help you hold down your tax bill.



As you mentioned, mostly everyone reading this will *not* have to worry about what you've described above.  But, it is good to know!


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## wilma (May 25, 2017)

Bunk said:


> Since obesity creates significant health costs that are born by the taxpayers, does anyone have a problem with barring food stamp users from buying soda and other sugary drinks with food stamps?  Mayor Bloomberg tried to get USDA approval to do that in 2011 and 2013 and the USDA denied his requests.



Why single out food stamp recipients? Why not charge higher insurance/medicare rates for people who smoke and/or are obese?


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## ace2000 (May 25, 2017)

wilma said:


> Why single out food stamp recipients? Why not charge higher insurance/medicare rates for people who smoke and/or are obese?



I've got mixed feelings about this.  There are plenty of higher risk behaviors and dietary choices that impact health.  It's a slippery slope.


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## TM42 (May 25, 2017)

dominidude said:


> Greg, I really like your post, it seems honest.
> I'll tell you what is wrong with the system in our great country and how to fix it in a much shorter posts than yours.
> The current US system rewards cures such as those provided by your company, but it does not do anywhere near enough to prevent people from needing those cures in the first place.
> Imagine a world in which fire prevention officials didn't exist, and in which you and I had to pay every time a fire truck came to the front of our house.
> ...


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## TM42 (May 25, 2017)

TOTALLY agree with this! Having worked in the wellness arena, I was continually amused at how employees would complain to no end about participating in healthy eating or exercise programs, then want to complain even more about how much they had to pay! There is a direct correlation here people! Keeping yourself healthy and getting some exerciser will go a LONG WAY towards better health! Too many employees feel it is an employers obligation to provide them with health insurance, and then want nothing to do with controlling those costs! Not picking on lower income people, but lets start by restricting food stamp use for healthy foods instead of potato chips and junk foods! I would rather the difference be spent on gym memberships![/QUOTE]


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## ace2000 (May 25, 2017)

TM42 said:


> *Not picking on lower income people*, *but lets start by* *restricting food stamp use* for healthy foods instead of potato chips and junk foods! I would rather the difference be spent on gym memberships!



Ahem...you just contradicted yourself.   And where do you draw the line on junk food vs non junk food?  It goes a lot further than chips and soda.  It gets complicated.

I would think the only way to make inroads down this path, is to somehow make the food companies financially accountable for the health care issues they are indirectly responsible for.  That seems more fair.  It would be similar to what has been happening to the tobacco companies.


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## vacationhopeful (May 25, 2017)

Bunk said:


> ... users from buying soda and other sugary drinks .....



In the city of Philadelphia, Pa ... the city government enacted a 'Sugary Drink Tax' earlier this year. It basicly about doubles the cost of that beverage (per ounce)... whether from a fast food place to the supermarket to the corner store. The tax money goes to the school district.

And yes, LOTS of people complained and swore they would NOT buy sodas in the city ... and the wholesalers & stores forecasted closed businesses and fired employees ... but generally, the people just paid a bit more AND MAYBE, they drank less sugary drinks.


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## rapmarks (May 25, 2017)

mpumilia said:


> Even if you buy another house? Even downsizing, for many people the downsized house can cost the same or more than the old house.



If married, you get five hundred thousand off the profit, so wouldn't affect most, but certain areas have really high housing.  My friend, single, sold house on cape cod she had lived in over thirty years, and made more than $250,000 profit, had to pay capital gains tax, and Medicare went up for a year.  She did buy a replacement house, but that had no effect on taxes



Sent from my iPad using Tapatalk


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## Chrisky (May 25, 2017)

"





iconnections said:


> He needs a knee replacement and has difficulty walking and kneeling but he has to wait six to eight months before it is his turn (her words)."
> 
> You do not mention where your friends live in Canada, but I have to totally disagree with that comment.  My DH had 2 hip replacements.  The first one could have been scheduled within 3 weeks of visiting the surgeon, but DH put if off because of a trip we had already planned.  After this first replacement, we had a physiotherapist visit our home for 8 weeks, to evaluate his recovery and add exercises for him to do.  The second hip replacement took place within 4 weeks of visiting the surgeon, and the same process happened with the physiotherapist.   In our province we have designated hospitals that do only hip and knee replacements, some specialize in oncology, and others in cardiology. They have found that this works more efficiently in caring for the patients.
> 
> I am sure we probably pay more taxes than in the US, but our taxes are based on income, and of course people with low incomes pay less etc, etc.  Now that we are retired, we pay even less taxes, and the younger generation pays the taxes to cover the retiring generation.  I have truly never heard of any Canadian having to sell their home or mortgage their home to cover medical expenses.


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## TM42 (May 25, 2017)

vacationhopeful said:


> In the city of Philadelphia, Pa ... the city government enacted a 'Sugary Drink Tax' earlier this year. It basicly about doubles the cost of that beverage (per ounce)... whether from a fast food place to the supermarket to the corner store. The tax money goes to the school district.
> 
> And yes, LOTS of people complained and swore they would NOT buy sodas in the city ... and the wholesalers & stores forecasted closed businesses and fired employees ... but generally, the people just paid a bit more AND MAYBE, they drank less sugary drinks.





I agree with the tax idea when it is clear that the product has no benefit, but the proceeds need to go to better health initiatives!!!! Not against better schools, but putting the money back into schools doesn't solve the base problem!


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## vacationhopeful (May 25, 2017)

TM42 said:


> I agree with the tax idea when it is clear that the product has no benefit, but the proceeds need to go to better health initiatives!!!! Not against better schools, but putting the money back into schools doesn't solve the base problem!



Actually, it does help. Many families in the city did cut back on those sugary drinks. Yes, many families do shop and buy cheaper soda products across the city limits .. just like some people pick up way cheaper smokes in the Carolinas. But that daily soda at lunch or at the movies ... the "walk by, pick up, then buy and slam down" soda purchase becomes ... so the bottle water is CHEAPER and gets brought MORE.

I think RETRAINING the population .. via PASSIVE negative reinforcement training .. does work. Less soda consumption is a BETTER HEALTH INITIATIVE with the government NOT being the watch dog, no Public Health lectures/directives and it happens in the home, work, fast food and schools every day.


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## Brett (May 25, 2017)

vacationhopeful said:


> Actually, it does help. Many families in the city did cut back on those sugary drinks. Yes, many families do shop and buy cheaper soda products across the city limits .. just like some people pick up way cheaper smokes in the Carolinas. But that daily soda at lunch or at the movies ... the "walk by, pick up, then buy and slam down" soda purchase becomes ... so the bottle water is CHEAPER and gets brought MORE.
> 
> I think RETRAINING the population .. via PASSIVE negative reinforcement training .. does work. Less soda consumption is a BETTER HEALTH INITIATIVE with the government NOT being the watch dog, no Public Health lectures/directives and it happens in the home, work, fast food and schools every day.



I'm thinking the extra tax on sugary drinks IS the GOVERNMENT watch dog but hey, if it's PASSIVE NEGATIVE and it works it's all good


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## WinniWoman (May 25, 2017)

I personally think government should stay out of our lives as much as possible.And I am against most taxes. But- hey- who cares what I think. Doesn't matter. 

(As for sugary drinks- I have a 82 year old friend in great health that has drank a sugary soda every day of her life as well as sugar in her tea and a piece of cake at night after dinner. She is slender and very youngish. Not one single health issue)


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## Bucky (May 26, 2017)

I got a good laugh reading this thread talking about MedicaidMedicare recipients and what they should and should not be allowed to purchase!

Having spent a lot of time in the hospital lately I cannot tell you how many overweight medical professionals I have seen! If you cannot get them to eat healthy how can you possibly expect the rest of the people to?


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## Maple_Leaf (May 26, 2017)

mpumilia said:


> I personally think government should stay out of our lives as much as possible.And I am against most taxes. But- hey- who cares what I think. Doesn't matter.
> 
> (As for sugary drinks- I have a 82 year old friend in great health that has drank a sugary soda every day of her life as well as sugar in her tea and a piece of cake at night after dinner. She is slender and very youngish. Not one single health issue)


I know someone who was successfully treated for fatty liver with a low-carb diet. In his case the culprit was orange juice, not pop. The doctor said orange juice is frequently a problem since rarely is it served in those little shot glasses like back in the '60s, and it's perceived by patients to be a healthy alternative to pop.


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## Patri (May 26, 2017)

Bucky said:


> I got a good laugh reading this thread talking about MedicaidMedicare recipients and what they should and should not be allowed to purchase!
> Having spent a lot of time in the hospital lately I cannot tell you how many overweight medical professionals I have seen! If you cannot get them to eat healthy how can you possibly expect the rest of the people to?


And they are out back puffing away during smoke breaks.


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## Talent312 (May 26, 2017)

Bucky said:


> Having spent a lot of time in the hospital lately I cannot tell you how many overweight medical professionals I have seen!



The nurses I've seen have been thin + boney, which I ascribed to the quality of hospital food.
Considering the $$ they rake in, they should be able to set up a Longhorn Steakhouse.

.


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## artringwald (May 26, 2017)

Patri said:


> And they are out back puffing away during smoke breaks.


We often go to Rochester, MN where the Mayo Clinics are located. It's amazing to see so many doctors and nurses walking down the street while smoking cigarettes.


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## ace2000 (May 26, 2017)

Let's face reality... unfortunately smoking, eating an unhealthy diet, and lack of exercise are ALL major factors associated with the high health costs in America.


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## clifffaith (May 26, 2017)

Maple_Leaf said:


> I know someone who was successfully treated for fatty liver with a low-carb diet. In his case the culprit was orange juice, not pop. The doctor said orange juice is frequently a problem since rarely is it served in those little shot glasses like back in the '60s, and it's perceived by patients to be a healthy alternative to pop.



LOL, I knew about where you lived before I checked. I was born in Ashtabula, OH on Lake Erie, as were Mom, Dad and every living relative. We moved from there when I was 2, and after living almost 60 years in the Los Angeles area people ask where I was born when I call Pepsi or 7Up pop!


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## dominidude (May 26, 2017)

ace2000 said:


> Ahem...you just contradicted yourself.   And where do you draw the line on junk food vs non junk food?  It goes a lot further than chips and soda.  It gets complicated.
> 
> I would think the only way to make inroads down this path, is to somehow make the food companies financially accountable for the health care issues they are indirectly responsible for.  That seems more fair.  It would be similar to what has been happening to the tobacco companies.


My understanding is that the single most important thing to watch out for is the number of calories.
In other words,  a person can eat a diet of mostly salad and vegetables and still be obese,  because they consume too much of it.
And a person can eat hamburgers,  potato chips,  drink sugary drinks, etc,  every day,  and have a normal weight if they maintain the total number of calories they inget daily in a healthy range.
From my view point,  the problem is not cheap greasy food and sugary drinks, the problem is cheap food.
Taxing food companies is one way to make food more expensive,  but that's probably not going to happen. However it happens, we need to find a way to eat fewer calories,  while still getting all the nutrients we need.
My guess is that our health care insurance system will continue to  be broken for a long time, because it seems to me that this is not an issue that can be fixed by government,  instead our culture needs to change,  and that won't happen overnight.


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## WinniWoman (May 26, 2017)

Maple_Leaf said:


> I know someone who was successfully treated for fatty liver with a low-carb diet. In his case the culprit was orange juice, not pop. The doctor said orange juice is frequently a problem since rarely is it served in those little shot glasses like back in the '60s, and it's perceived by patients to be a healthy alternative to pop.



Interesting. I know what you mean about the shot glasses. My husband is an orange juice drinker and loves a nice glass every morning. I usually drink a half tumbler of grapefruit juice every morning.

Low carb- hard to do. Not that I am high carb, but I love my weekly pasta fix!


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## WinniWoman (May 26, 2017)

ace2000 said:


> Let's face reality... unfortunately smoking, eating an unhealthy diet, and lack of exercise are ALL major factors associated with the high health costs in America.




I work in healthcare and I can tell you it is very stressful and yes- many employees smoke and sometimes don't eat very healthy type lunches.


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## Tia (May 26, 2017)

Medical personnel are ordinary people. Think there has to be a personal cost and motivation to make a change. I know we get a discount on our health insurance based on an annual health screening if you meet certain criteria and they offer free health care coaching. 






Bucky said:


> I got a good laugh reading this thread talking about MedicaidMedicare recipients and what they should and should not be allowed to purchase!
> 
> Having spent a lot of time in the hospital lately I cannot tell you how many overweight medical professionals I have seen! If you cannot get them to eat healthy how can you possibly expect the rest of the people to?


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## Tia (May 26, 2017)

artringwald said:


> We often go to Rochester, MN where the Mayo Clinics are located. It's amazing to see so many doctors and nurses walking down the street while smoking cigarettes.



I know a clinic worker in Rochester who wears a scrub type outfit that some might guess she's a nurse when she's a office assistant, no nurse  schooling or back ground. I can easily imagine she walks around smoking on the way to/from her car. Housekeeping  and other services wear color coded scrub type uniforms where I'm at,  can't assume they are all doctors/nurses unless you can read the name tag. I have heard male nurses referred to as doctor  and aides with a 6 week certificate as nurses . (maybe I'm being too picky but.....)


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## Bucky (May 27, 2017)

Whatever they make is not nearly enough! My nurses literally saved my life during my last stay. Probably would have bled out without their professionalism!


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## Patri (May 27, 2017)

Tia said:


> Medical personnel are ordinary people. Think there has to be a personal cost and motivation to make a change.


And in the towns I have lived, too many police officers are overweight. They could never chase a suspect. I think long ago a fitness standard applied, but I doubt that is now true.


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## Carol C (May 27, 2017)

vacationhopeful said:


> Did you ask him how much was his cell phone bill monthly?
> Is he driving a newer car? And does he have insurance on the car?
> Could he get a part time job?
> Has he cut out primo coffee and lattes?
> ...



Yikes...the nephew probably doesn't want to be grilled by his aunt! I'm surprised you didn't ask her to ask him if he smokes and to give up smoking! I remember when cigs were 50 cents a pack...aren't they something like 5 bucks a pack now? Who can afford that? Plus the "lifestyle illnesses" that are caused by smoking...that cost is passed onto all insured people, even if they do not smoke. Smoking and crappy "food" and sodas full of high fructose corn syrup are causing so much cancer, heart disease, diabetes and other "lifestyle illnesses" in the USA...but some folks never learn or just don't seem to care to take personal responsibility. 

IMO one of the biggest problems = ripoff pharmaceutical companies. And the publicly traded drugstore chains. Example: my hubby takes 5 pills and ran out of one so we had to get a quick 30 day RX which we were forced to buy from a retail chain instead of our mail order company we use that's been so great for generics (RX Outreach, in Missouri...highly recommended). Anyway...the same pill would have cost $45 for a three months supply via RX Outreach, but since we needed 'em right away and had the doc call it into CVS, we were asked to pay $186 for three months worth of same drug...also a generic! I told them to put it all back and just sell us a month's worth...still cost $62 but we had to pay the piper since we didn't keep better track of when we'd run out. Thankfully only one of his meds has to be bought from a drugstore chain/retailer; the other 4 meds he takes are generic and bought in 90 day shipments from RX Outreach.


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## dominidude (May 27, 2017)

It's the pharmaceutical companies, oh no, wait, it's the insurance companies, oh no, wait, it's cigarettes, oh no, it's sugary drinks and fast food companies (the list goes on, and on...)

Oh, but I know who it couldn't be, it could never be us hurting our own health and wanting others to cover our healthcare bills. 

It could never be like that (sarcasm intended).

That's why this will never be "resolved"


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## bobpark56 (May 27, 2017)

mpumilia said:


> Interesting. I know what you mean about the shot glasses. My husband is an orange juice drinker and loves a nice glass every morning. I usually drink a half tumbler of grapefruit juice every morning.
> 
> Low carb- hard to do. Not that I am high carb, but I love my weekly pasta fix!


Don't drink that grapefruit juice if you are on statins. They clash. (I miss my grapefruit.)


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## bogey21 (May 27, 2017)

Ever since I (purposely) lost a lot of weight (205 to 155) I tend to observe the weight of other people when I am eating in say Subway or shopping at Walmart or Kroger.  My observation is that 7 out of 10 people are overweight and 5 out of 10 massively so.  If being massively overweight really does lead to health problems, there are a lot of people out there who are rolling the dice.

George


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## VacationForever (May 27, 2017)

I do like my PCP to be fit and give me flak if I am not doing what it takes to be healthy.  My former PCP who was taking care of me for the past 15 years until I moved, was a triathlete.  He had no qualms in saying to me that I had put on 10 lbs since my last visit and I needed to work on losing weight.  Mind you, my BMI is between 20 to 21, so I am not overweight but I could be leaner and fitter.  He kept me on my toes.  I have several health issues which he would remind me that losing some weight would make me feel better, which was true.

When the PCP is unfit and unhealthy, it is more likely that the doctor would not harp on the patients to lead a healthier lifestyle.


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## vacationhopeful (May 27, 2017)

Carol C said:


> Yikes...the nephew probably doesn't want to be grilled by his aunt! <snip>.



IMHO, if the nephew (or niece or other form of friend or relative) is over 17 and not in high school ... and asking anyone for money, they truly should expect to be grilled ... by the bank, credit union and particularly, RELATIVES. There is NO FREE RIDE in life and if you ask, hint, beg, cry and any other way ask for assistance (cash, food, lodging, cars, loans) ... you are opening yourself and your prior choices for review.

As for NOT wanting to be grilled by his aunt ... his bad.


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## WinniWoman (May 27, 2017)

bobpark56 said:


> Don't drink that grapefruit juice if you are on statins. They clash. (I miss my grapefruit.)




Not on any medications thankfully.


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## Bucky (May 28, 2017)

Always amazes me how we can be so critical of some people and so supportive of others!

I belong to several heart forums because of the LVAD I have implanted. When someone posts asking if others still smoke, they get flamed by most responses. People telling them that it kills and they are stupid for doing it.

But, when they post about wanting to lose weight, they get great positive advice!

What's the difference? They both will eventually kill.

Probably because smoking is just a plain nasty habit and over eating isn't. LOL.


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## WinniWoman (May 29, 2017)

Bucky said:


> Always amazes me how we can be so critical of some people and so supportive of others!
> 
> I belong to several heart forums because of the LVAD I have implanted. When someone posts asking if others still smoke, they get flamed by most responses. People telling them that it kills and they are stupid for doing it.
> 
> ...




Just an FYI- I had read years ago that weight was not an indicator of mortality. Illness/medical issues- yes. But heavier people actually lived longer than their thinner counterparts.

Lots of slender people die every day of various illnesses.


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## Bucky (May 29, 2017)

Then why is it listed as the second leading cause of preventable death, only behind tobacco use?

Here's just a couple of articles referring to overweight complications

https://www.wvdhhr.org/bph/oehp/obesity/mortality.htm

https://www.niddk.nih.gov/health-information/weight-management/health-risks-overweight

http://articles.mercola.com/sites/a...irectly-attributable-to-being-overweight.aspx

Like I said


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## VacationForever (May 29, 2017)

mpumilia said:


> Just an FYI- I had read years ago that weight was not an indicator of mortality. Illness/medical issues- yes. But heavier people actually lived longer than their thinner counterparts.
> 
> Lots of slender people die every day of various illnesses.


I believe what you read is that slightly overweight outlives underweight people.  The main reason is that when one falls sick, the underweight person has less reserve to lose and more difficult to recover.


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## WinniWoman (May 29, 2017)

http://healthland.time.com/2013/01/02/being-overweight-is-linked-to-lower-risk-of-mortality/

http://www.cnn.com/2013/01/16/health/weight-study/index.html

http://www.dailymail.co.uk/health/a...s-nourishment-stress-says-obesity-doctor.html


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## foundyoubyaccident (May 29, 2017)

Here is an idea, that no one would endorse, but could actually work in my opinion _*VERY CRAZY*_ opinion. 

Have all the obese people like myself, daily use crack cocaine.. (i've heard it causes weight loss)
After so long, and the weight is gone, put them in rehab..
Teach them to eat healthier, get off the drugs, exercise... whatever they do in rehab.

So lets quit crying about fat people and offer solutions, maybe not as crazy has mine, but solutions to the problems we are all facing whether it be being fat or paying for fat people.


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## vacationhopeful (May 29, 2017)

10 years ago, my new doctor YELLED at me to lose weight. He was 80+ years old and put me on the favorite 2 meds many of us have ... blood pressure & satins. And the doctor demanded I come see him EVERY 3 months. So I lost 50lbs plus over 2 years .... and have held steady on the weight. I told the guys I worked with, I was going to be a PAIN in their butts ... but I needed to get approved for longterm care insurance. After the 2 years, I applied and got a much lower rate for LTC .. but regarding my RN sister (living on the West Coast), I got to call her up and gloat (she told me I would NOT get approved for LTC and if I did, it would be a HIGH premium).

And my knees stopped hurting me. And my sugar level dropped down.

PS For the first month, I brought a QVC pre-package 30 day diet with food shipped to my house. Portion control and smaller meals. No, I did not renew ... but it "trained me" to eat smaller portions and keep bad food OUT of my house. And I still LOOKED at the bakery items ... I just don't buy them.


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## SmithOp (May 29, 2017)

foundyoubyaccident said:


> Here is an idea, that no one would endorse, but could actually work in my opinion _*VERY CRAZY*_ opinion.
> 
> Have all the obese people like myself, daily use crack cocaine.. (i've heard it causes weight loss)
> After so long, and the weight is gone, put them in rehab..
> ...



No need to be so drastic, there are programs that are structured to support people that WANT to lose weight and get healthier.  

I'm on this program, lost 18.5 lbs so far in week 15, and have transformed my eating and exercise habits.

https://www.bluemesahealth.com/



Sent from my iPad using Tapatalk


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## bogey21 (May 29, 2017)

What I did to lose weight was pretty straightforward.  First, I trashed all my alcohol, ice cream, sugary soda, TV dinners, etc. If eating out with friends I basically went vegetarian, drinking only water.  When eating alone I pretty much limited myself to a 6"  Subway and a bowl or two of granola with raisins and skim milk daily.  It took a while but I eventually lost 50 pounds.

George


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## Sugarcubesea (May 29, 2017)

bogey21 said:


> What I did to lose weight was pretty straightforward.  First, I trashed all my alcohol, ice cream, sugary soda, TV dinners, etc. If eating out with friends I basically went vegetarian, drinking only water.  When eating alone I pretty much limited myself to a 6"  Subway and a bowl or two of granola with raisins and skim milk daily.  It took a while but I eventually lost 50 pounds.
> 
> George


Good for you George, my doctor just emailed me a 60 day plank excessive to try. Starting out with 20 seconds holding the plank and eventually getting up to 2 minutes. I'm going to give it a try wish me luck as I need it. LOL


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## Bucky (May 30, 2017)

mpumilia said:


> http://healthland.time.com/2013/01/02/being-overweight-is-linked-to-lower-risk-of-mortality/
> 
> http://www.cnn.com/2013/01/16/health/weight-study/index.html
> 
> http://www.dailymail.co.uk/health/a...s-nourishment-stress-says-obesity-doctor.html



Bet you would run out of links on this point of view than I would!


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## pwrshift (May 30, 2017)

As a Canadian, when in Fort Lauderdale this March, i got a taste of what you all seem to go through with medical help when I had a 3 day stay involving cat scans and MRIs, a private room with a personal shower, constant doctors and nurse visits, blood tests, great food, and more.  There were only 2 people in the ER when we arrived and I was seen by a doctor within minutes of arriving.  My wife waited in the ER until they decided to admit me as I had a 'tiny' stroke.  She said 2-3 people came in for a 'quote' and left as they had no insurance and it would have been too expensive for them.  Scary.

I have no idea what this all cost as it all went to my Canadian company's employee insurance for coverage of anything not covered by our government medical coverage.  My doc here guessed it would have been $200,000.

In Canada our medical system is far from perfect.  Patients often can't find a seat in the ER and the wait time is decided by a triage nurse as to how serious your problem might be...you could be there for hours.  There are not PRIVATE rooms, but our company insurance allows extra for two person rooms but the hospitals are usually so busy you have to stay in a ward of 4-6 patients.  But when you leave you haven't had to take out a mortgage on your house to pay the bill as there isn't one.  The drug prescription I had to get in FL cost $142 USD... the refill cost $30 CDN in Canada but was covered by the healthcare plan...and they paid me the $142 usd for the US prescription.

There was mention of a cardiac ablation treatment taking 10 days in the USA in this thread ... I had one in Canada in 2014 and was only an out patient...released that day...and all covered by our medical system...so I assume that poster had other complications.  It's strange that most Canadians seem negative about healthcare here until they consider what it would cost in USA.  Medicare doesn't come cheap here though...it's part of our annual income taxes which can be as much as 46%.


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## Bucky (May 31, 2017)

pwrshift said:


> There was mention of a cardiac ablation treatment taking 10 days in the USA in this thread ... I had one in Canada in 2014 and was only an out patient...released that day...and all covered by our medical system...so I assume that poster had other complications.  It's strange that most Canadians seem negative about healthcare here until they consider what it would cost in USA.  Medicare doesn't come cheap here though...it's part of our annual income taxes which can be as much as 46%.



That was probably me and yes, there were a lot of procedures done before they finally decided on the ablation. They did a left and right heart cath. They also loaded me up with a drug cocktail that took 3 days to get fully into my system. Then they did the ablation and after that I had a major bleeding episode that required five nurses tag teaming me to get stopped after several hours! I was so bruised up and weak there is no way I could have went home that day, safely that is.

I paid into Medicare my whole life and I retired from the US Army after a very long career. Because of this Medicare and Tricare picked up my cost.

The fact is that nobody should have to mortgage their house or declare BK to receive healthcare in any country.


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## rapmarks (May 31, 2017)

pwrshift said:


> As a Canadian, when in Fort Lauderdale this March, i got a taste of what you all seem to go through with medical help when I had a 3 day stay involving cat scans and MRIs, a private room with a personal shower, constant doctors and nurse visits, blood tests, great food, and more.  There were only 2 people in the ER when we arrived and I was seen by a doctor within minutes of arriving.  My wife waited in the ER until they decided to admit me as I had a 'tiny' stroke.  She said 2-3 people came in for a 'quote' and left as they had no insurance and it would have been too expensive for them.  Scary.
> 
> I have no idea what this all cost as it all went to my Canadian company's employee insurance for coverage of anything not covered by our government medical coverage.  My doc here guessed it would have been $200,000.
> 
> ...



Do you know how lucky you were if you were seen quickly in Fort Lauderdale ER and given a room.   During January, February, march and April the fervent prayer is to not get sick.  My husband was kept in a hallway outside the emergency room desk for 24 hours.  He was on a narrow cot, he was never given water, no iv , he had to use the public restroom.  People were lined up back to back on cots throughout the hallway, no rooms were available.  Ambulance attendants bringing new patients in constantly. Noise, bright lights, and everyone too busy to even answer a question.
This was going on up and down the coast, all hospitals were overcrowded. We pled to let him go home.  Among the things he was told, what are.you complaining about, that man has been in the hall four days,   You can live for 21 days without water.   He was finally released with a bill of nineteen thousand dollars, and we spent the next several weeks going in for outpatient tests and procedures.


Sent from my iPad using Tapatalk


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## ilene13 (May 31, 2017)

Diane I lived on the Canadian border, in The Buffalo, NY, area most of my life.  My husband is a physician, so I am cognizant of what occurs in the medical community.  Many Canadians, who can afford it come to Buffalo for surgery.  There is no wait. I currently have a friend whose sister is on disability in Hamilton waiting for a hip replacement.  That is not great medicine to me.


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