# No Health Insurance



## Rose Pink (Jul 28, 2012)

My DD graduated from grad school in May.  Despite valiant efforts, she has not been able to find a job, any job.  She has been on the college's student health plan through a major insurance company.  Her coverage ends mid-August.  She has decided to move back home--no job, no money--and try to get a job here where people know her.

She called the insurance company to sign up for COBRA to cover her in the interrim.  Insurance company says college did not elect to have COBRA coverage.  So, no COBRA.  The insurance company says they do not cover our state (and even if they did, they would not cover her due to her medical conditions) and gave her a website that listed insurance companies with plans Utah.  DD called them all.  Not one--not one of them--will insure her because of pre-existing conditions.  She is too old to be on our health plan.  She was advised not to even apply for insurance with these companies because then she will have a denial on her record making it even harder to get insurance in the future. 

One company advertised it will cover the hard to insure, but first she must be six months without insurance, have a denial from another insurance company and then it will not cover any pre-existing conditions.  I hate to even ask how much this policy would cost.

State medicaid is not an option, either.  

Any suggestions?  I just hope and pray she doesn't get sick and have to go the ER.  We will cover her maintenance meds until she can get a job.

Even if she manages to get a job with benefits as soon as she gets home, there is usually a waiting period before health care insurance kicks in.

I am worried sick.  DD is in hysterics.


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## vacationhopeful (Jul 28, 2012)

Walmart seems to insure its employees. At this point, insurance thru ANY major employer is BETTER THAN NOTHING. She would not be the first applicate to have a college degree. :ignore: 

Are they any relatives she can live with in a differnet state while she job hunts for a "real job" where she might get some type of coverage?


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## glypnirsgirl (Jul 28, 2012)

vacationhopeful said:


> Walmart seems to insure its employees. At this point, insurance thru ANY major employer is BETTER THAN NOTHING. She would not be the first applicate to have a college degree. :ignore:
> 
> Are they any relatives she can live with in a differnet state while she job hunts for a "real job" where she might get some type of coverage?



Walmart does not offer insurance until you have been employed with them for 2 years. And they do not hire anyone full time for 2 years, either.

My bonus son, with a Summa Cum Laude BA, works there.

The states that I know of that have health plans are Oregon, Vermont and Massachusetts. There may be others.

Once the full benefits of the new health plan come into force, insurance companies will be required to cover pre-existing conditions. And there will be insurance pools to which she can subscribe. 

This is a terrible dilemna to be in.

elaine


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## Patri (Jul 28, 2012)

Can she not even pick up a high deductible plan?


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## UWSurfer (Jul 28, 2012)

DW works at Target...eligible for insurance after 6 months.


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## pjrose (Jul 28, 2012)

So discouraging, but I hope once all the provisions of the new plan become effective she and others won't fall between the cracks like this.

Meanwhile, check out this faith based option,
Medi-Share.org 

{{hugs}}


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## bshmerlie (Jul 28, 2012)

Actually Target Distribution has an excellent management training program for recent college grads. They pay well and medical coverage begins immediately. They will not care what the degree is in. Although they are not easy to get into. She will have to be a star student and a natural leader. They interview hundreds and only hire the very best.


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## pjrose (Jul 28, 2012)

Ps, re meds, generics are really cheap at some big chains, $4.00 at target I believe.


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## Rose Pink (Jul 28, 2012)

bshmerlie said:


> Actually Target Distribution has an excellent management training program for recent college grads. They pay well and medical coverage begins immediately. They will not care what the degree is in. Although they are not easy to get into. She will have to be a star student and a natural leader. They interview hundreds and only hire the very best.


Where would she apply?  The local Target?  She does have retail experience including supervisory experience.


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## Timeshare Von (Jul 28, 2012)

I'm going through an insurance policy change effective 8/1 and my new policy has an RX benefit through BidRx.  It is also available to non-policy owners.  I've shopped some of our current meds and many of them are less than my current mail order 90 day supply . . . and that is w/o any policy benefit since we're not in their system as subscribers until 8/1.  You may want to look into them for her meds . . . registering without a BidRx member number and shop them to see what her RXs might cost you through them.


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## Rose Pink (Jul 28, 2012)

Thanks, Yvonne!


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## am1 (Jul 28, 2012)

Move to a country with universal healthcare is an option.  Or with low cost health insurance. 

I have lots of friends without any kind of insurance.


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## MichaelColey (Jul 29, 2012)

Starbucks is one company known for offering medical insurance to part time employees.  It looks like there are quite a few others, as well:

http://ptmoney.com/the-ten-best-part-time-jobs-with-benefits/


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## ricoba (Jul 29, 2012)

MichaelColey said:


> Starbucks is one company known for offering medical insurance to part time employees.  It looks like there are quite a few others, as well:
> 
> http://ptmoney.com/the-ten-best-part-time-jobs-with-benefits/



Starbucks is a company that came to my mind as well.


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## pgnewarkboy (Jul 29, 2012)

Rose Pink said:


> My DD graduated from grad school in May.  Despite valiant efforts, she has not been able to find a job, any job.  She has been on the college's student health plan through a major insurance company.  Her coverage ends mid-August.  She has decided to move back home--no job, no money--and try to get a job here where people know her.
> 
> She called the insurance company to sign up for COBRA to cover her in the interrim.  Insurance company says college did not elect to have COBRA coverage.  So, no COBRA.  The insurance company says they do not cover our state (and even if they did, they would not cover her due to her medical conditions) and gave her a website that listed insurance companies with plans Utah.  DD called them all.  Not one--not one of them--will insure her because of pre-existing conditions.  She is too old to be on our health plan.  She was advised not to even apply for insurance with these companies because then she will have a denial on her record making it even harder to get insurance in the future.
> 
> ...



I wish your daughter the best of luck.  It is important that she gets the treatment that she needs.  You don't disclose her illness but if she is hysterical she must have some pressing, immediate medical needs.  She may very well have to take action before she finds a job with health insurance.  That action means getting medicaid or some other form of assistance.  You say medicaid is not an option.   You give no reason.  If her needs are pressing you may want to revisit the medicaid issue.

You and your daughter need to assess what it will take for her to get aid.  In most cases she must be able to show expenses are much higher than her income - even if she has low or no income.  To reiterate, she must show low or no income, high expenses she cannot meet, and have next to zero assets of any kind before she can get medicaid.  Your state has rules for medicaid.  Find out what they are and see if you can meet their guidelines.  Living at home rent free may actually hurt her chances at getting assistance.


If the most pressing issue at the moment is prescription medicine she SHOULD try to get deals from the Pharmas for her most important meds.  I know someone who is low, low, income and gets some meds for free after providing income tax returns proving lack of income.   It is a shot worth taking.   The meds are provided to his doctor who in turn gives them to him to take.  She will therefore need to have a doctor FIRST.  ER's will NOT act as a primary care physician. Once again, living at home rent free may be a hindrance. 

Too many young people are falling into the same problem your daughter has. Many of those who have health insurance through a company pay very high premiums in order to get a plan that doesn't pay a nickel until after a pharmaceutical deductible is met.  The pharmaceutical deductible alone could run $1000 or more.  The medical deductibles run $2500 or more.  That means that many of these people, with insurance, cannot afford to see a doctor or get prescription meds.


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## Passepartout (Jul 29, 2012)

It is just soooo hard to not politicize this dilemma. In American society, there are winners and some people will fall through the cracks. I know. After losing my job- and insurance- 3 years ago, it was COBRA at 8X what I'd been paying while working. That ended after 18 months. Then I was able to get 'insurance' 6 months at-a-time, $10,000 deductible with no preventative care and minimal prescription discount. I bought it in case of getting 'hit by a bus' or the 'big C' and paid cash for every visit to a doc (and a couple of ER visits) for 1 1/2 years- postponing what wasn't 'important' and sweating that something bad might happen.

Finally- I survived long enough to qualify for Medicare and a supplement that covers preventative care and  'scripts for the most part.

Rose, I wish your daughter well. I hope she can find employment soon that will provide care, income, dignity, and peace of mind for both of you. I know it's of scant comfort, but your DD cannot be turned away from an ER for 'lack of ability to pay' if her situation is dire. Millions of people are forced to take that route even though they would or could buy insurance if it was offered. We can only hope that the ACA will make that a reality, and soon.

Jim


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## ace2000 (Jul 29, 2012)

This is the sad reality that our current medical system is in right now.  Hopefully, let's just hope the upcoming changes will make it better.


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## vacationhopeful (Jul 29, 2012)

My family practice group - about 20 DRs and NPs - has their billing desk in their waiting room. You get to hear some interesting tibbits as people pay their bills.

Last year, one fellow stated that he was *to pay in total only $42* for the office visit as he had no insurance. The billing clerk acknowledged that was what was written in his folder. 

This practice does NOT accept credit cards and does NOT bill. Cash or check along with processing your insurance infor. I also get Free Samples of one of my $4/day scripts, if I ask and the group has a stash from the Pharm sales person. My "script" coverage has me paying $3.75/day.

TALK to your regular family practice doctor and see if they have a policy to help your daughter out a bit.


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## bshmerlie (Jul 29, 2012)

Rose Pink said:


> Where would she apply?  The local Target?  She does have retail experience including supervisory experience.



Go on-line for Taget Distribution.  She would be looking for a Team Leader position or a Group Leader position if she has extensive management experience.  Target separates their Distribution side from the Retail side.  Distribution pays a lot more.  I worked for them for ten years and they are a very good employee friendly place.


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## Kal (Jul 29, 2012)

If you haven't looked at the Affordable Care Act please do so.  There are important provisions concerning elimination of pre-existing conditions and state-by-state insurance pools.  Assuming those provisions will work for you, set those effective dates as the endpoint of your search for coverage.

Unfortunately, if you live in one of those states where the governor could care less for insurance pools to cover your DD, then that might call for her relocation.

Just yesterday I was looking at a few invoices (EOB) and was shocked by two points:

First, the "retail" pricing for services is absolutely outrageous.  The price charged by the provider vs the actual labor hours (minutes) in providing a service is obscene.  I don't know how ANY person could pay those charges. Obviously you know I'm speaking to the choir here.  

Second, the actual payment to the provider (after contract exclusions) by the insurance carrier is outrageously low.  I feel sorry for the providers in what little they receive.  The whole payment process becomes a nasty 
"Catch-22". _[Where is Milo Minderbinder and Yossarian when we need them!  ]_

So, like many many others, I feel the health care/insurance system is severely broken and absolutely unsustainable.  This doesn't help your situation, but MAYBE wisdom will prevail and efforts will be made to enhance the Act before your DD runs out of time.


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## jlr10 (Jul 29, 2012)

vacationhopeful said:


> I also get Free Samples of one of my $4/day scripts, if I ask and the group has a stash from the Pharm sales person. My "script" coverage has me paying $3.75/day.
> 
> TALK to your regular family practice doctor and see if they have a policy to help your daughter out a bit.



This is the best immediate advice.  Most MDs have the sample drugs which they give can give out, especially in hardship cases.  I have a coworker who gets most of her meds as samples from her doctors. 

Doctor's fees can be negotiable, outside of insurance-and even inside for high deductible plans.  The only way to find out is to ask.

Also, depending your her medical condition, you might check with organizations associated with her medical issues.  They sometimes will have advice of how to obtain the needed treatment and medications.


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## Tia (Jul 29, 2012)

Minnesota has something  http://www.dhs.state.mn.us/main/idc...ctionMethod=LatestReleased&dDocName=id_006255

Colorado has something too but there is a waiting period where you have no coverage before being eligible when I was looking a while back .


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## Rose Pink (Jul 29, 2012)

I thank all of you for the time you took to respond both here and privately.  

To answer a few questions, DD has no job, therefore no money to pay rent, buy food, etc.  We paid the last four months of her rent and gave her money for food while she continued to look for work.  We cannot afford to do that any longer.  She stayed in MA through the summer because she had a lease and because she still had medical insurance through the college's plan.  

She will be flying home a week from tomorrow.  We live in Utah.  [Political comment deleted - DeniseM Moderator] It is underfunded and only has open enrollment once or twice a year and is mainly for mothers and children.  I did visit a medicaid office and they suggested she try to get disability!  The woman is not disabled.  She can work and _she wants to work!_  DD tried to contact them just to ask questions and they would not even talk to her on the phone.

I can go on and on about the immoralities of health care in this country (and I have years ago).  First, a private insurance model does not work.  Trying to run health care as a for-profit business with huge bonuses paid to execs and dividends paid to stockholders is insane and immoral.  If I say more, this is going to get political but suffice it to say I consider health care in the same category as public education.  It is for the public welfare and stability of the country. Second, tying it to employment is unfair to employers.  Why should employers have to offer healthcare insurance?  They don't offer car insurance or home insurance or or or.....

The provisions of the Affordable Care Act that would help my DD and many others in the same position, have not taken effect yet--I think 2014 is the date.  And they won't take effect if certain people have their way.


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## Rose Pink (Jul 29, 2012)

Oh, and we will look into the Rx programs and free drugs as well as samples from the doctor.  Thank you!


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## vacationhopeful (Jul 29, 2012)

Try another state. In NJ, if you show up with a trash bag and some clothes in it to a county welfare office (social services is the proper name) and state you are HOMELESS - you get the full bundled. A motel room, medical, food stamps, etc. Then, the state pays for a security deposit, rent, furniture for the unit, electric & other utilities (cell phone). Be here for awhile and YOU get a $4,000 CAR and $1/day insurance.

A single person receives $160/monthly cash benefit, too.

The state JUST changed the rules to make it harder for recently released convicts to get all those bennies.

High school dropouts.graduates whose parents expected them to get a job and work have used this for years .... fight with your parents and get a free apt.  

Trust me - it is true and totally insane.


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## Beaglemom3 (Jul 29, 2012)

Rose,
  I've been reading this with concern. Did your DD leave Massachusetts ?
I can help if she's here in Mass .
   Best,
  B


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## bobpark56 (Jul 29, 2012)

[_Personal comment about a poster deleted.  Discuss issues here, not each other. - _Makai Guy, BBS Administrator]


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## Beaglemom3 (Jul 29, 2012)

Error. Double post.


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## Kal (Jul 29, 2012)

vacationhopeful said:


> ...state you are HOMELESS...


 
How does a homeless person fill out the paperwork.  The name is easy, but an address of "_at the corner of walk and don't walk_" might be a problem.


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## Kal (Jul 29, 2012)

[_ Response to deleted post removed - _Makai Guy, BBS Administrator ]


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## vacationhopeful (Jul 29, 2012)

Kal said:


> How does a homeless person fill out the paperwork.  The name is easy, but an address of "_at the corner of walk and don't walk_" might be a problem.



Just why they get a motel room immediately. Gives them an address. The motel units only keep them for less than 90 days, so they are still a transitant who can be put to the curb - with going to the court for an eviction. So they move to a different motel or motel room with a checkin/out with all their stuff sitting in a shoping cart. 

Motel operator gets $1400-1800 monthly for those rooms with weekly housekeeping.


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## Beaglemom3 (Jul 29, 2012)

Getting back to the OP's dilemma........


Rose,

  If DD is here in Mass (did she leave after Emerson College ?), please direct her to here: 

https://www.mahealthconnector.org/portal/site/connector 

for a program that may be right for her.

 Just an FYI:  In Massachusetts, we are mandated to carry health insurance just as we are required to carry car insurance. There are free or affordable plans for those with no health insurance.

Addendum:http://www.mass.gov/ago/consumer-resources/consumer-assistance/health-care-complaint.html I'd give them a call to verify if what you're being told by DD's former insurer is correct. It sounds credible, but do check with them.

  PM me when you have a chance.
  Best,
  B


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## Fern Modena (Jul 29, 2012)

*Prescriptions*

For discounted prescriptions in Utah, try the Utah Drug Card.

If she is going to go to a doctor for new prescriptions, have her ask for samples, explaining her financial status.  Once she has the meds, go to the web and google the manufacturer's name and "free medicine" or "discount drug program." She will usually need a new prescription and a doctor to sign off on these, but she should qualify.

Also, of course, she should always ask for generics when available, and use the Utah Drug Card to get them.

Hope this helps.

Fern...been there, done that, came out the other side OK.


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## Beaglemom3 (Jul 29, 2012)

This could help in a pinch........

Most CVS stores have "Minute Clinics" staffed by FNPs (Family Nurse Practitioners) who can diagnose and treat many uncomplicated illnesses right there. Cash is accepted if no insurance.

http://www.minuteclinic.com/services/  or Walmart's equivalent:  http://www.walmart.com/cp/Walmart-Clinics/1078904  and http://health.utah.gov/safetynet/public/medicalproviders.htm

 Anything beyond, they can advise and refer.

Beags (former Adult NP with active license)


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## Rose Pink (Jul 29, 2012)

Beaglemom3 said:


> This could help in a pinch........
> 
> Most CVS stores have "Minute Clinics" staffed by FNPs (Family Nurse Practitioners) who can diagnose and treat many uncomplicated illnesses right there. Cash is accepted if no insurance.
> 
> ...


She is in Brighton for one more week but then will fly home.  Her stuff is already packed up and shipped off.  She just couldn't find work.  Not even at the local supermarket.  No work=no money=no rent, etc.  DH and I cannot continue to support her cost of living while she looks for work.  She'll just have to look from home.  People know her here and she is more likely to find work.  

As for the Minute Clinic, she got sick after she came home from a job fair search in NYC, so she went to the MC.  They took one look at her and said "you need to go to the ER.  We're calling an ambulance."  She begged them not to call an ambulance because she had no money.  Her roommate took her to the ER where they gave  her IV meds, etc.  She was worried sick about the ER bill.  I told her to call the business office and explain her situation to see if there was some sort of aid they could give her or at least a payment plan.  I'm not sure what came of it.  I try to let her work things out herself and only step in when she has questions.  That's what started this thread.  She had tried to do all the right things but still could not get any help from insurance companies.

-----------------
I found some leads from a friend of mine today.  There are a couple of clinics iin our area that operate like HMOs.  Pay a set fee and you can be seen as often as needed.  I will look into the costs.  

I also was directed to a network for professionals looking for work.  It is run by our church and DD will be invited to attend.  They meet weekly and help each other. Prospective employers also come to the meetings.  At the very least, DD will not feel so alone.  She'll have positive reinforcement and constructive criticism.  There is only so much a mother can say before it starts to sound like nagging.


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## Rose Pink (Jul 29, 2012)

[political comments deleted - DeniseM Moderator] 

I'm just frustrated.  It is so hard to watch your child do "all the right things" and then not get the expected results.  Get an education and you will get a better job.  So far, that's not happened.  She got the education.  Where are all the jobs?  I know she is not alone.  As a family, we can offer some help such as room and board but medical is the $cary thing hiding under the bed.  She is so demoralized at this point.


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## MelBay (Jul 29, 2012)

Rose Pink, have you tried contacting your insurance agent?  Without going into a lot of details, I do know of an instance where someone with a pre-existing condition was able to get a very high deductible plan through their car insurance agent.  It wasn't cheap, but they got it.

And I agree, there has to be a solution to this _crisis_ - just with the powers that be could agree on what it is without all the bickering. We're talking about peoples' lives here.


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## Rose Pink (Jul 29, 2012)

MelBay said:


> Rose Pink, have you tried contacting your insurance agent?  Without going into a lot of details, I do know of an instance where someone with a pre-existing condition was able to get a very high deductible plan through their car insurance agent.  It wasn't cheap, but they got it.
> 
> And I agree, there has to be a solution to this _crisis_ - just with the powers that be could agree on what it is without all the bickering. *We're talking about peoples' lives here*.


Amen to that!

If she can't get a job with medical benefits, I will call our insurance agent.  It's just that DD has already called so many and been told the same thing: she is uninsurable.  Thank you.  I hadn't thought of going through auto insurance but they may have other types of policies.


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## VacationForever (Jul 29, 2012)

Can she stay put in MA?  Have her stay with friends in the meantime.  I believe she can get insurance in MA.  

For all parents here, regardless of the Affordable Care Act, always ensure that that you keep your children on your health insurance or buy on their behalf until they can obtain their own insurance thru employment or private pay.  I paid for my son's individual plan all the way thru college as college plans usually cover the bare minimum and won't qualify for HIPAA plans after the kids leave college.  Someone with full insurance can continue thru HIPAA coverage after they lose their prior insurance or post-COBRA.  All pre-existing conditions are covered under HIPAA plans.


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## rosebud5 (Jul 29, 2012)

How old is your DD? I believe the part of the act where she can be covered under your insurance is in effect as long as she is 26 or less, unless you have one of those grandfathered group plans.


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## pianodinosaur (Jul 29, 2012)

Many physicians see patients without medical insurance.  The fees are usually negotiable.  Free sample medications are often available as well.  One physician in our community opened up an office that caters specifically to a Spanish speaking population with no insurance.  He does not even accept insurance, Medicare, or Medicaid.  His prices for office visits are clearly posted.  He is very busy and is doing very well as he has minimal office overhead by avoiding insurance entirely.  There are also several urgent care clinics in our town that also cater to patients with no insurance.  All patients who show up in an Emergency Room must be seen and stabilized regardless of ability to pay according to EMTALA.  It is much easier, quicker, and cost effective to see a patient in the office than in an emergency room.

[Political comment deleted - DeniseM Moderator]


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## isisdave (Jul 29, 2012)

Here are some ideas, in no particular order:

You can't include her because she's over 26, right? I think there are some states where the limit is higher (29?); you could all move there.

I understand there are a couple of states whose insurance plans are required to take everyone. I am pretty sure one is New York, and another is New Jersey. I suppose you have to live there.

But what about Massachusetts? Don't they have Romneycare?  Can't she get insurance there?  I thought I heard that everyone got coverage.

Here in California, you CAN get state pool coverage if you've been denied and without insurance for six months.

There is private, short-term, high-deductible, temporary coverage (six months). How about if she re-enrolls in a community college so she can buy insurance there?

You CAN get better insurance that (as a US resident) will cover you out of the country.  If her condition is not one that flares suddenly, this might work ... take a trip to Canada or Costa Rica or Panama if it starts to be a problem.  See Bupa for this.

She could see about joining the Peace Corps or another volunteer group that will provide health care until 2014, when anyone is supposed to be able to buy insurance, depending on the election results.

If her condition is likely to become critical suddenly, and she elects to get the wait-six-months-and-pray plan, she could go, in the interim, to Costa Rica, Panama, Ecuador, or similar, which are places where it it cheap to live, and medical care is available at very low cost, and the quality is good. Europe is fine too, but it's more costly to live there.

And of course, you should contact an insurance broker, both in Utah and in Massachusetts, and ask them what the options might be.  This is not the first time this has happened.

Best of luck.


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## VacationForever (Jul 29, 2012)

I went to the health insurance website and saw that college students health plans may qualify as group insurance and if so she should be able to get HIPAA insurance.  It is quite a bit more expensive than regular individual insurance plans but that is the safety net for people with pre-existing conditions.  Have you checked with the health insurance companies?


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## DeniseM (Jul 30, 2012)

I have deleted/edited several posts which strayed off into the politics of insurance.  Please stay on topic - thanks!


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## ampaholic (Jul 30, 2012)

I know a young man who works as a janitor at the local HMO - simply because he gets his HMO membership included.

Even a receptionist at a Dr. office or HMO etc. might get coverage included in their employment.

Just thinkin ...


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## ace2000 (Jul 30, 2012)

I know you're focused on the Health Care side of the equation, but have her do some analysis on the job search - this should be done very delicately.  Is it the type of degree she has?  Is it her resume that has problems?  Could it be her references?  Could it be how she interviews?  Or it probably is just the lousy economy.  But, anyhow, there's a slight chance that there could be a problem somewhere.

Good luck!


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## Rose Pink (Jul 30, 2012)

Even though I have not responded to each reply individually, please know that I have read them and appreciate the time you took to reply.  I will show them to my daughter when she arrives next week.


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## Rose Pink (Jul 31, 2012)

I went to the place my friend told me about.  It looks like a real possibility.  There is a $40 enrollment fee, a monthly fee of $45 and then $10 per visit.  This is much less expensive than the 20% discount my doctor gives for cash up front.  They said her labs would be extra but at their cost which is $20 for LFTs.  

With that and the great websites tuggers have given me for meds, I think her day to day needs can be reasonably met.  Now, let's just hope she doesn't end up in the ER.

Also, the branch manager at my CU asked about her by name today and said she may have an opening.  Keeping my fingers crossed for a job for her.


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## ace2000 (Jul 31, 2012)

That's great Rose!  Good luck!


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## pjrose (Jul 31, 2012)

Encouraging news on both fronts! 

Once the medical stress is out of the way and if she gets a decent job, then you can all breathe more easily while she hunts for a publishing position.


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## pianodinosaur (Jul 31, 2012)

Rose Pink said:


> [political comments deleted - DeniseM Moderator]
> 
> I'm just frustrated.  It is so hard to watch your child do "all the right things" and then not get the expected results.  Get an education and you will get a better job.  So far, that's not happened.  She got the education.  Where are all the jobs?  I know she is not alone.  As a family, we can offer some help such as room and board but medical is the $cary thing hiding under the bed.  She is so demoralized at this point.



Rose Pink:

This truly is a heart breaking situation.  The education industry may be guilty of fraud.  The majority of law school graduates cannot find work as lawyers.  An organization of recent law school graduates has filed suits against several law schools on grounds of false advertising.  These young people went deeply into debt chasing an illusion that was crafted by law schools to encourage law school applications and justify outrageous tuitions.  I hope DD is not deeply in debt for her education.


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## Rose Pink (Jul 31, 2012)

pianodinosaur said:


> Rose Pink:
> 
> This truly is a heart breaking situation.  The education industry may be guilty of fraud.  The majority of law school graduates cannot find work as lawyers.  An organization of recent law school graduates has filed suits against several law schools on grounds of false advertising.  These young people went deeply into debt chasing an illusion that was crafted by law schools to encourage law school applications and justify outrageous tuitions.  I hope DD is not deeply in debt for her education.



Oh, she most certainly is.  Makes me sick to even think about it.

I've also heard of culinary students successfully winning a lawsuit against their school for the same reasons as you mentioned.


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## pgnewarkboy (Aug 1, 2012)

I don't know about the lawsuit against some law schools for false advertising.  It may be that some schools are guilty of false advertising.  I don't know DD and am not commenting on her in any way.  This is a general discussion.

The value of graduating law school is a very complicated issue.  Particularly the question of getting a job.  Many people go to law school with no desire to be lawyers.  They never take the bar.  If you go to law school to be a lawyer several things have to be in place before you get a "job".  You need to go to an accredited school and one with a good reputation.  You need to graduate high in your class.  Nothing different here from graduating from any college or professional school.  What has changed in the law in the last 20 years or so  is that you also need to specialize.  Some areas of specialization have more job openings than others.

  One more thing, you have to pass the bar exam and get a license.  You can get a job "pending" passing the bar.  That luxury is afforded to  recent graduates.  It is not afforded to others.  The more time that passes between graduation and getting a license the harder it is to get a job in the profession pending  a license.  Some recent graduates get a job then lose it because they don't pass the bar and get a license in a reasonable time.  What is reasonable is up to the firm that hired the lawyer.


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## pgnewarkboy (Aug 1, 2012)

pianodinosaur said:


> Many physicians see patients without medical insurance.  The fees are usually negotiable.  Free sample medications are often available as well.  One physician in our community opened up an office that caters specifically to a Spanish speaking population with no insurance.  He does not even accept insurance, Medicare, or Medicaid.  His prices for office visits are clearly posted.  He is very busy and is doing very well as he has minimal office overhead by avoiding insurance entirely.  There are also several urgent care clinics in our town that also cater to patients with no insurance.  All patients who show up in an Emergency Room must be seen and stabilized regardless of ability to pay according to EMTALA.  It is much easier, quicker, and cost effective to see a patient in the office than in an emergency room.
> 
> [Political comment deleted - DeniseM Moderator]



Many doctors see patients without insurance?  I can't say I actually know how many do that.  I haven't read a survey or done a survey.  I am very skeptical that there are many.  If many doctors saw patients without insurance our society wouldn't be in the pickle we are in on health care.  Anecdotally I am not personally aware of ANY doctor in my area that will see a patient without insurance.  I am aware of doctors that charge a boutique annual fee to see them in addition to being paid by insurance . I am sure that there must be some doctors that will see some patients without insurance.  Many?  Not likely.  Certainly not enough to make a difference for the millions of people that can't get medical care.


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## vacationhopeful (Aug 1, 2012)

My brother is a lawyer and licensed since 1983. He graduated from an Ivy League college with an engineering degree.

His wife plays racquetball. They live in Nebraska.

Guess who carries the benefits for the family. Guess who makes more money. For the last 10 years. They both love their careers and are happy.


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## pgnewarkboy (Aug 1, 2012)

vacationhopeful said:


> My brother is a lawyer and licensed since 1983. He graduated from an Ivy League college with an engineering degree.
> 
> His wife plays racquetball. They live in Nebraska.
> 
> Guess who carries the benefits for the family. Guess who makes more money. For the last 10 years. They both love their careers and are happy.



They live in Nebraska so it would have to be his wife that makes more money playing racquetball.    You can get benefits playing racquetball?  Cool.


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## vacationhopeful (Aug 1, 2012)

pgnewarkboy said:


> They live in Nebraska so it would have to be his wife that makes more money playing racquetball.    You can get benefits playing racquetball?  Cool.



Cool is she has been sponsored and NATIONALLY RANKED (in the top 3 female players in her age group) for over 30+ YEARS.  She has earned the "Lifetime Acheivement Award" given at the annual Nationals recently. She can put that ball EXACTLY where she wants it - at a zillion miles per hour - floor, ceiling, front wall, side wall, back wall, cornors.

What a varied group we have here at TUG.


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## pkyorkbeach (Aug 1, 2012)

If you live in CT I found a person who sells individual policies with Anthem.  Very nice, not pushy and explains the policy so you understand.  Great for a person turning 26 and no longer able to stay on parents insurance.


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## pgnewarkboy (Aug 1, 2012)

vacationhopeful said:


> Cool is she has been sponsored and NATIONALLY RANKED (in the top 3 female players in her age group) for over 30+ YEARS.  She has earned the "Lifetime Acheivement Award" given at the annual Nationals recently. She can put that ball EXACTLY where she wants it - at a zillion miles per hour - floor, ceiling, front wall, side wall, back wall, cornors.
> 
> What a varied group we have here at TUG.



I used to play racquetball regularly many years ago.  It is a tough sport requiring speed, endurance, strategy, and skill.  That's why I gave it up!  Congrats to your sister-in-law. Her dominance for so long is an awesome achievement.


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## pkyorkbeach (Aug 1, 2012)

Last fall my daughter was vERY sick, no medical insurance.  Gram gave her 60.00 for the doctor office visit. Daughter told doctor I have no insurance so the antibiotic needs to be a cheap one.  She was very sick with a 105 fever that night. I went to the pharmacy to fill her prescriptions the antibiotic was almost 225.00 and another medicine along with it.  I paid out of my pocket close to 300.00.  Her job of 15 hours a week does not cover student loans let alone getting sick.  She is a GREAT person with a lot of education but the jobs are scarce.


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## Rose Pink (Aug 1, 2012)

pgnewarkboy said:


> Many doctors see patients without insurance?  I can't say I actually know how many do that.  I haven't read a survey or done a survey.  I am very skeptical that there are many.  If many doctors saw patients without insurance our society wouldn't be in the pickle we are in on health care.  Anecdotally I am not personally aware of ANY doctor in my area that will see a patient without insurance.  I am aware of doctors that charge a boutique annual fee to see them in addition to being paid by insurance . I am sure that there must be some doctors that will see some patients without insurance.  Many?  Not likely.  Certainly not enough to make a difference for the millions of people that can't get medical care.


I believe most doctors will see people without insurance.  You just have to pay upfront.  For example, I went to the medical clinic where DH and I go and asked what their prices were without insurance.  $85 deposit up-front and the rest after the visit because they don't know what the office visit is going to cost until after the doctor sees the patient.  There is a 20% discount for paying at the time of visit.  

That is much more expensive than the other clinic I mentioned.  It costs $45 a month plus $10 per visit.  That's less expensive than my insurance premiums and co-pays! Unfortunately, that does not cover treatment for catastrophic illness such as hospitalization.

DH has a dentist friend who lives in Louisiana.  She does not accept insurance.  Apparently, the dentists in the area (or the state, I can't remember) decided as a group not to accept dental insurance because the reimbursement rate was so low.  I don't know if it is still the same now, but that is what was told us several years ago.


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## Rose Pink (Aug 1, 2012)

pkyorkbeach said:


> Last fall my daughter was vERY sick, no medical insurance.  Gram gave her 60.00 for the doctor office visit. Daughter told doctor I have no insurance so the antibiotic needs to be a cheap one.  She was very sick with a 105 fever that night. I went to the pharmacy to fill her prescriptions the antibiotic was almost 225.00 and another medicine along with it.  I paid out of my pocket close to 300.00.  Her job of 15 hours a week does not cover student loans let alone getting sick.  She is a GREAT person with a lot of education but the jobs are scarce.


Sounds like your DD and my DD are in the same position. 

As are many, many others.


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## Timeshare Von (Aug 1, 2012)

This news story from California talks about medical facilities offering discounts for not having them file through insurance.

We've been on COBRA for about a year for medical and w/o dental for the same period.  Our dentist was willing to give us his "reimbursed" fee that he would ordinarily receive from the insurance company.  And because we paid (by CC) at the time of visit, we also got a 10% discount on that.

Fortunately, we had no other work besides cleanings and we saved a pile of money by not paying insurance premiums (even our former 30% when we had employer supported dental insurance).

I really hope it works out for your daughter!


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## pgnewarkboy (Aug 1, 2012)

Rose Pink said:


> I believe most doctors will see people without insurance.  You just have to pay upfront.  For example, I went to the medical clinic where DH and I go and asked what their prices were without insurance.  $85 deposit up-front and the rest after the visit because they don't know what the office visit is going to cost until after the doctor sees the patient.  There is a 20% discount for paying at the time of visit.
> 
> That is much more expensive than the other clinic I mentioned.  It costs $45 a month plus $10 per visit.  That's less expensive than my insurance premiums and co-pays! Unfortunately, that does not cover treatment for catastrophic illness such as hospitalization.
> 
> DH has a dentist friend who lives in Louisiana.  She does not accept insurance.  Apparently, the dentists in the area (or the state, I can't remember) decided as a group not to accept dental insurance because the reimbursement rate was so low.  I don't know if it is still the same now, but that is what was told us several years ago.



Maybe how many doctors will negotiate upfront fees is area dependent.  Like I said, I really don't know.

Of course, there are many expensive tests and procedures today that do not require hospitalization.  In my area you don't go to a hospital for an MRI and many other tests and procedures.  I would be extremely surprised if $45 per month included an MRI or other numerous expensive tests.  That is where the real expense comes in - testing and non-generic medicine.  Even generics can be very expensive.  Both my children have insurance and they get clobbered with the deductibles, the co-pays, the drugs they won't cover and on and on into eternity.


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## laura1957 (Aug 1, 2012)

pgnewarkboy said:


> Many doctors see patients without insurance?  I can't say I actually know how many do that.  I haven't read a survey or done a survey.  I am very skeptical that there are many.  If many doctors saw patients without insurance our society wouldn't be in the pickle we are in on health care.  Anecdotally I am not personally aware of ANY doctor in my area that will see a patient without insurance.  I am aware of doctors that charge a boutique annual fee to see them in addition to being paid by insurance . I am sure that there must be some doctors that will see some patients without insurance.  Many?  Not likely.  Certainly not enough to make a difference for the millions of people that can't get medical care.




There are a "Rural Health Center" here that have "pay as you can" prices.  I do think the minimum is $10. per visit.  All you have to do is show them your last couple pay stubs, or explain that you dont have any income.


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## bogey21 (Aug 1, 2012)

pgnewarkboy said:


> The value of graduating law school is a very complicated issue.  Particularly the question of getting a job.  Many people go to law school with no desire to be lawyers.



After I graduated from college I finished the 1st year of Law School at nights.  I had no interest in becoming a lawyer.  I just wanted to understand the law and our legal system.  It was one of the smartest things I ever did.  The knowledge and insights I picked up in Law School were invaluable during my business career, particularly when dealing with attorneys!

George


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## Rose Pink (Aug 1, 2012)

pgnewarkboy said:


> Maybe how many doctors will negotiate upfront fees is area dependent.  Like I said, I really don't know.
> 
> Of course, there are many expensive tests and procedures today that do not require hospitalization.  In my area you don't go to a hospital for an MRI and many other tests and procedures.  I would be extremely surprised if $45 per month included an MRI or other numerous expensive tests.  That is where the real expense comes in - testing and non-generic medicine.  Even generics can be very expensive.  Both my children have insurance and they get clobbered with the deductibles, the co-pays, the drugs they won't cover and on and on into eternity.


No, the fee does not cover, as I previously mentioned, lab fees or coverages for catastrophic healthcare.  That's why I am keeping my fingers crossed that DD does not incur a costly flare-up before she can get insurance through an employer.

Have your children look into the websites for discounted drugs that other tuggers have posted here.  It may help them.

Because there will be a gap in coverage, she is concerned about getting her pre-existing conditions covered.  She asked me about that and I don't know.  It seems each employer negotiates his/her own policy with the insurance companies and so time periods as well as what is covered may vary.


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## ace2000 (Aug 1, 2012)

My opinion is that health care is going to get very complicated over the next couple of years.  This thread supports that.


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## geekette (Aug 1, 2012)

pgnewarkboy said:


> Many doctors see patients without insurance?  I can't say I actually know how many do that.  I haven't read a survey or done a survey.  I am very skeptical that there are many.  If many doctors saw patients without insurance our society wouldn't be in the pickle we are in on health care.  Anecdotally I am not personally aware of ANY doctor in my area that will see a patient without insurance.  I am aware of doctors that charge a boutique annual fee to see them in addition to being paid by insurance . I am sure that there must be some doctors that will see some patients without insurance.  Many?  Not likely.  Certainly not enough to make a difference for the millions of people that can't get medical care.



when I was unemployed and uninsured, my doctors would see me without insurance.  Not sure how easy it would be to get A New Doctor without ins, but the ones I had an existing relationship with welcomed me.

In one case, chiropractic, the charge to SelfPay was only $10 above my insurance co-pay.  I didn't have problems getting affordable care so my gamble to forgo COBRA worked to my advantage.  I realize that not everyone can/would/should roll the dice that way, but wanted to interject that it IS possible to see doctors without insurance.  I have done it without ridiculous charges.  Paying for COBRA would have been the ridiculous charge in my case.


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## pgnewarkboy (Aug 1, 2012)

Rose Pink said:


> No, the fee does not cover, as I previously mentioned, lab fees or coverages for catastrophic healthcare.  That's why I am keeping my fingers crossed that DD does not incur a costly flare-up before she can get insurance through an employer.
> 
> Have your children look into the websites for discounted drugs that other tuggers have posted here.  It may help them.
> 
> Because there will be a gap in coverage, she is concerned about getting her pre-existing conditions covered.  She asked me about that and I don't know.  It seems each employer negotiates his/her own policy with the insurance companies and so time periods as well as what is covered may vary.



I have passed along the drug info to my children.  My son s insurance excluded his big toe for 6 months because he went to a doctor for an infection in that toe.


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## Passepartout (Aug 1, 2012)

You are much more likely to be able to negotiate with an independent provider than one that is part of a large hospital or group. The bean counters are too separate from patient care to negotiate. DW and I both had a respiratory infection last Spring. She went to an ENT at our large medical care group. Strep Throat was diagnosed, an antibiotic prescribed and insurance was billed almost $300. I went to a 'doc-in-a-box', same diagnosis, same script prescribed. I paid cash, $85. Ymmv.

Jim


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## Rose Pink (Aug 1, 2012)

geekette said:


> Paying for COBRA would have been the ridiculous charge in my case.


 


pgnewarkboy said:


> My son s insurance excluded his big toe for 6 months because he went to a doctor for an infection in that toe.


 
Insurance companies look for any reason to drop you. That's how the insurance model works.  To make a profit, they must only insure those who are not likely to make a claim.  To stay in business, they must take in more in premiums than they pay out in claims.  This is exaggerated even more when large bonuses and payouts to share holders must be made. That is why the private insurance model does not work for healthcare.  That is why people like my DD and others noted here on this thread cannot get health insurance without an employee group policy.

Yes, Cobra is ridiculously expensive (and my DD couldn't even get that) but having a gap in coverage can also put you at the mercy of being denied coverage.  I feel like the insurance companies own us.


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## geekette (Aug 1, 2012)

Rose Pink said:


> Insurance companies look for any reason to drop you. That's how the insurance model works.  To make a profit, they must only insure those who are not likely to make a claim.  To stay in business, they must take in more in premiums than they pay out in claims.  This is exaggerated even more when large bonuses and payouts to share holders must be made. That is why the private insurance model does not work for healthcare.  That is why people like my DD and others noted here on this thread cannot get health insurance without an employee group policy.
> 
> Yes, Cobra is ridiculously expensive (and my DD couldn't even get that) but having a gap in coverage can also put you at the mercy of being denied coverage.  I feel like the insurance companies own us.



Yeah, that gap is puzzling.  Unfair.  Annoying.  

I thought that the changes coming prevented denial based on pre-existing?  right, no help right now, but I'm hoping things like this don't happen to people in the future.  

I'd like to see insurance get out of the way completely as people need Health Care and ins lies between patients and doctors, preventing Health Care.  yet, big bonuses for ins execs...

Were I your daughter, I might write a letter to some of those insurance execs whose companies are turning me down.


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## pgnewarkboy (Aug 1, 2012)

*Israeli Health Care System*

The israeli health care system was recently praised.  As a result of that praise numerous journals such as one by Kaiser Permanente and Newspapers have explained the basics of how it works.  Here is an excerpt from one such article:



Israel created a national health care system in 1995, largely funded through payroll and general tax revenue. The government provides all citizens with health insurance: They get to pick from one of four competing, nonprofit plans. Those insurance plans have to accept all customers—including people with pre-existing conditions—and provide residents with a broad set of government-mandated benefits.

Health insurance does not, however, cover every medical service. Dental and vision care, for example, fall outside of the standard government set of benefits. The majority of Israelis—81 percent —purchase a supplemental health insurance plan to “use the private health care system for services that may not be available in through the public system,” according to a paper by Health Affairs.

Now, let’s get to the costs. As you can see in the chart below, Israel’s health care costs have hovered around 8 percent of its gross domestic product for over two decades, while other countries’ have seen theirs rise:





Israel’s lower health care spending does not look to sacrifice the quality of care. It has made more improvements than the United States on numerous quality metrics, and the country continues to have a higher life expectancy:


Source: New England Journal of Medicine

How’d they do it? Jack Zwanziger and Shuli Brammli-Greenberg took a crack at that question in a 2011 Health Affairs paper. The answer, they say, has a lot to do with “strong government influence:


The national government exerts direct operational control over a large proportion of total health care expenditures, through a range of mechanisms, including caps on hospital revenue and national contracts with salaried physicians. The Ministry of Finance has been able to persuade the national government to agree to relatively small increases in the health care budget because the system has performed well, with a very high level of public satisfaction.

The Israeli Ministry of Finance controls about 40 percent of Israel’s health care expenditures through those payments to the four insurance plans. The  ministry decides how much it will pay the health plans for each Israeli citizen they enroll, making adjustments for how old a person is and how high their health care costs are expected to be.

It’s then up to the health insurance plan to figure out how to provide coverage within that set budget. If they spend too much—have a patient who is constantly in the hospital, for example—they will find themselves in the red. It’s that set budget—a capitated budget, in health policy terms—that seems to be crucial to the Israeli health care system’s success in cost control.


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## BocaBum99 (Aug 1, 2012)

Rose,

I would have your daughter continue with her graduate education.  There may be an option for your daughter to get student health insurance by attending school part time.

She doesn't even need to do well.  Just needs to be enrolled.  That could be a much cheaper option than attempting to get a job coincident with the termination of your insurance plan.

Or, check out a local community college that is on a similar plan.


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## am1 (Aug 1, 2012)

BocaBum99 said:


> Rose,
> 
> I would have your daughter continue with her graduate education.  There may be an option for your daughter to get student health insurance by attending school part time.
> 
> ...



Also possibly postponing when the loans need to be paid back?


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## Tia (Aug 1, 2012)

Agree and believe insurance companies look for any reason to not pay on a claim also. I know people who stay working to keep their health insurance, so in this way insurance companies do control your decisions. Believe it's much more about salaries/bonuses then shareholders.

Health insurance is very very complicated currently just trying to figure out the billings/copays/deductibles etc from multiple providers



Rose Pink said:


> Insurance companies look for any reason to drop you. That's how the insurance model works.  To make a profit, they must only insure those who are not likely to make a claim.  To stay in business, they must take in more in premiums than they pay out in claims.  This is exaggerated even more when large bonuses and payouts to share holders must be made. That is why the private insurance model does not work for healthcare. ...... I feel like the insurance companies own us.


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## rapmarks (Aug 1, 2012)

my sister is still working at 66, partly because her daughter who has a preexisting condition can only get high deductible insurance that costs 1000 a month and was laid off from her job in New york City. (Cobra has run out)  she worries too much about her daughter,and pays for this insurance, which is why she is still working.  She was brought to the hospital sunday night, unable to speak and with extremely high blood pressure.


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## pianodinosaur (Aug 1, 2012)

Tia said:


> Agree and believe insurance companies look for any reason to not pay on a claim also. I know people who stay working to keep their health insurance, so in this way insurance companies do control your decisions. Believe it's much more about salaries/bonuses then shareholders.
> 
> Health insurance is very very complicated currently just trying to figure out the billings/copays/deductibles etc from multiple providers



It's not just health insurance that function that way.  Automobile insurance, flood insurance, and homeowners insurance are also very difficult to comprehend.  They stay in business by denying claims.  I never understood why health insurance is tied to employment until I began looking into the history of insurance companies.  I doubt that model will remain viable over the next twenty years, but I may be wrong.

Meanwhile, let us hope that there will soon be a cure for what ails Rose Pink's DD.


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## Rose Pink (Aug 1, 2012)

pianodinosaur said:


> Meanwhile, let us hope that there will soon be a cure for what ails Rose Pink's DD.


Thanks.  She has autoimmune conditions as well as mild asthma.  She very rarely needs a rescue inhaler but that alone makes her uninsurable.  She functions well.  Can work.  Is intelligent and motivated.  Her past employers have praised her and written good recommendations.  She could go back to working in the supermarket but really wants to do something other than go back to her high school job.

Right now the stress of graduating without a job/income/medical insurance and the need to move back home is taking its toll.


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## Rose Pink (Aug 1, 2012)

pgnewarkboy said:


> The israeli health care system was recently praised. ....


A friend of mine likes the New Zealand care system.  The government pays for basic health care.  They can buy a catastophic plan to cover the rest.


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## am1 (Aug 1, 2012)

That New Zealand plan sounds great.  Maybe a middle ground between Canada and the US.

A job is a job even if it was a high school job before. 

Insurance companies may always try to deny claims but most people op for the cheapest insurance possible.  

A business and its management has a duty to make as much money for its shareholders as it can.


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## stmartinfan (Aug 1, 2012)

I noticd this info in the recent AARP bulletin.  It's not just for retirees.  I don't know the availability and cost in your area but might be worth checking out.

Here's the piece from the Bulletin

No health insurance?  Go to findahealthcenter.hrsa.gov to locate a federally funded health center that provides medical and dental care with sliding scale fees based on your ability to pay.

When you go to the site, you search by your location and clinics are listed.


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## DG001 (Aug 2, 2012)

RosePink,

I know your daughter has already decided to move back home, so this information probably won't help her much. But for what its worth...

MA does offer healthcare to everyone, but the health connector pools are not cheap. Premiums run between $400 to $650 a month for a single, closer to $1200-$1500 for a family (of course, this depends on age and sex - but not on preexisting conditions). This was as of a couple of years ago, things have probably gone up now.

There is a subsidized portion for working adults - I think the income cutoff for single-member households is around $32K. This kicks in after 6 months of employment at that income level. The premiums are about $120 a month. 

We had a nanny a couple of years ago, and we built in the healthcare payments as a part of her salary, but she had to wait to be eligible, so she did not have any insurance for six months. Actually, the nanny we had was in a similar position as your daughter - but she left us after eight months because she found a good job in her field. 

Brighton is probably more expensive than some of the other "safe but affordable" areas around Boston, so if she wants to stay on in MA for the insurance, she can look into moving a bit further away. 

Good luck to you both, I hope everything works out!


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## Rose Pink (Aug 2, 2012)

am1 said:


> A business and its management has a duty to make as much money for its shareholders as it can.


Yes, within compassionate limits.  That is why the for-profit model does not work for health care.  Making money at expense of people's lives is, frankly, immoral. 

I had a college professor (way back in the day) who said that all great fortunes were built at the cost of human lives.  IOW, human lives were turned into money.  He gave examples such as the railroad fortunes, the oil and mining fortunes, even baby food.  I'd never thought of it that way before but he made a very good point.

I do believe, that "making as much money for its shareholders as it can" needs to be tempered with creating a positive work place for the workers while providing a living wage.  A business can make money for shareholders but that should not come because of sweatshop conditions and poor wages, for example.  As far as health care is concerned, that profit should not come at the expense of people's lives.  

Just my two cents.



stmartinfan said:


> I noticd this info in the recent AARP bulletin.  It's not just for retirees.  I don't know the availability and cost in your area but might be worth checking out.
> 
> Here's the piece from the Bulletin
> 
> ...


Thank you.  We will look into that.  Guess I should read my AARP bulletin and magazines.  I tend to just look for the crossword and sudoku puzzles.  



DG001 said:


> RosePink,
> 
> I know your daughter has already decided to move back home, so this information probably won't help her much. But for what its worth...
> 
> ...


Interesting that you mentioned nannies in your post.  I told DD she could always apply for a nanny position as she is very good with children.  Her dream job is to work in children's publishing.  She loves being surrounded by books.  As for staying in the Boston area, she would need a job/income first.  She is completely without income at this point.  We've covered her living expenses for the past few months but can no longer do that. If she should get a definite offer, we would loan her the first months rent but she would need to have a definite and firm offer.


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## ace2000 (Aug 2, 2012)

Rose Pink said:


> Her dream job is to work in children's publishing.


 
And I just had a conversation with my college aged daughter last month, and her dream is children's publishing also.  No kidding.

My advice was for her to go into elementary teaching first, and then see if the publishing can work out from that.  Of course, she's going to have to enjoy working with kids.  

She's very artistic, and I really don't see her in a typical 9-5 job.  We'll see.


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## bogey21 (Aug 2, 2012)

Rose Pink said:


> Yes, within compassionate limits.  That is why the for-profit model does not work for health care.  *Making money at expense of people's lives is, frankly, immoral.[/*QUOTE]
> 
> Whoa.  I agree, but.....  Yes, our system is cumbersome, frustrating, and takes a lot of work to navigate around.  Can't argue with that, but immoral?  We have Medicare at one extreme (Everything that is submitted for payment gets paid, necessary or not.  Trust me.  I know.  I am on Medicare and see it first hand with the claims filed on my behalf.) and the Insurance Companies, both for profit and not for profit) who try to put some discipline into the process.  Somewhere in between there has to be a reasonable alternative.
> 
> George


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## ace2000 (Aug 2, 2012)

bogey21 said:


> and the Insurance Companies, both for profit and not for profit) *who try to put some discipline into the process*.  Somewhere in between there has to be a reasonable alternative.


 
George, exactly.  They get a lot of blame, however, people don't realize it's the insurance companies that keeps the pricing in check.  Yes, they are companies out to make a profit, but the alternative is government run health care.  We're moving in the direction of the in-between.  Some government and some profit mixed together.  Maybe it will work (I hope).


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## Rose Pink (Aug 2, 2012)

bogey21 said:


> Rose Pink said:
> 
> 
> > Yes, within compassionate limits.  That is why the for-profit model does not work for health care.  *Making money at expense of people's lives is, frankly, immoral.[/*QUOTE]
> ...


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## flexible (Aug 2, 2012)

We empathize with the OP. Not sure if this an appropriate question to ask here. I am NOT asking about what the laws SHOULD BE  BUT hoping someone knows what the law is for our situation.

*Is access to U.S. Veteran's MEDICAL BENEFITS (RX, doctors etc) "means tested" meaning there are LIMITS to your income to be eligible?*

*IF my husband Ken IS ELIGIBLE*, he would then be able to go to the* local clinic that has a RETINA SPECIALIST who comes from a distant area *about once a month to give the wet macular degeration shot that we now drive over 150 miles round trip to the NEAREST qualified medical professional (we pay with private insurance). The convenience of getting the shot near home would be huge.

One day while visiting my husbands's brother (89 years old) at his retirement complex, another resident said "_*Why aren't you getting your RX from the VA (U.S. Veteran's Administratioin*_?"

Ken's brother had NO IDEA since he always used his own insurance or paid cash after 1945. 

Ken joined the Merchant Marines during WWII since he was under 18 years old and the U.S. Armed Forces only accepted people over 18. *In the 1980s Ken received a DD-214 *(If I remember the form number) when *Congress RETROACTIVELY declared that Merchants Marines* *service during a brief window of time (WWII)* on possible certain areas/ships? that took bombs and U.S. Armed Forces to areas (Ken was on the ships taking troops & bombs from SFO/LAX to the South Pacific) and thus were reclassified? to have served under the U.S. Coast Guard. DD-214 discharge papers stated "end of hostilities" and included had the date Ken's left Merchant Marine Service. He was in Yokohama near Tokyo Bay when http://www.bay-journal.com/usa/macarthur-speeches.html . I am not sure IF the EXACT number of days served as a Veteran is another factor in eligibility for VA medical benefits.

We told Ken's brother we'd call or visit the local VA office. A few years ago we were told: Sorry, gosh you didn't SIGN UP for medical benefits before ____ (some date about 10 years ago) prior to a U.S. Presidential order declaring Veteran's Medical benefits to be income eligible. If your income was BELOW _____ you could sign up NOW but SORRY you don't qualify to sigh up now.

The income chart varies by area. Veteran's in San Francisco have higher limits than our area.

------
Last week while waiting in Walmart's RX line we chatted with another customer. When they mentioned they had VA medical benefits, we explained our story. They said "_The VA office in this town doesn't know anything about anything. Call the VA office in a big city like San Francisco_."

Perhaps the answer is ONLINE. I just haven't been able to find it. I am not sure what phone number we would call to ask either.


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## isisdave (Aug 2, 2012)

The whole system is a mess, and that's why it is going to be so hard to make it any better.  DW and I are involved in nearly every aspect: we're both consumers and insureds, she's a healthcare provider and my job is at a company that makes medical devices.

Insurers pay her the same rate since about 1995, and less than she got in 1992. One insurer has given a 3% raise in 20 years, most of the others have kept the same rate, and a couple have cut it 15%.  In the meantime, she's become a practitioner with over 25 years of experience, and gets the same pay as someone freshly licensed into the business.  Who would advise their child to go into an industry with this kind of "advancement" plan?

Insurers limit her ability to practice.  We're very near a huge military base, but TriCare says she can't be on their panel because "we have plenty of providers."  What difference does it make to them if they have 100 or 200; it doesn't cost them anything extra? (Answer: it limits access to service; a certain number of patients just give up.) DW has a specialty that few other providers have, and we get several calls a week from TriCare members we can't help.

Your doctor gets about $75 for your short visit. He has to pay for an office, staff, insurance in case you sue him, supplies, and equipment. So he can spend 12 minutes with you.  If he got more per visit, he could spend more time. Would we rather have cheaper visits, or more thorough ones?

As self-employed people, we've paid our own insurance for the last 20+ years. The cost is now more than our mortgage, and it features $3500 deductibles. We're over 60 now, so that explains some of it.  And yet I can't complain. Our child, now 20, has had two hospital admissions in his life, and insurance paid a total of about $165,000. Between those and a couple of relatively minor other things, I think we're still ahead of the game.

Part of the problem is that we have cures or treatments for most of the cheap illnesses.  Technology is advancing against problems that are complex and fairly widespread, but new technology is fantastically expensive, as I have learned from being in this business.  When a hospital buys a piece of medical equipment, I'd guess about 20% of the cost is actual manufacture; the rest is the years of research and an incredible amount of testing of even the simplest stuff to make sure it's safe.  Still, I'd rather have an American or German instrument than one made somewhere because it's cheaper.

So the problems extend over the whole industry, and since everyone's ox will have to be gored to change it, I can't see how agreement will ever come. The next administration will always campaign on undoing whatever the current one institutes. I think the only hope is to establish a plan for the future ... say 15 years out ... with a transition plan to get from here to there. Businesses can be very flexible if they know what the rules are, and that the rules won't change much if they make plans based upon them.

Apologies. Just saw how long this became.


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## geekette (Aug 2, 2012)

To my knowledge, NO, if one is eligible for VA bennies, income is not a concern.  My husband did not lose his benefits as my (our household) income rose.

Please note, however, that they have been kicking out those "not disabled enough" (my ex-husband, who became diabetic while serving, was kicked out of vision and dental, for example, because his % disability was not high enough).  To my knowledge, he did not regain access to vision and dental when we divorced (lowering his income substantially).

I don't know anythign about deadlines and presidential orders, nor time-served requirements, but certainly find the nearest VA to ask.  And then call another to ask and compare info.

Good Luck!




flexible said:


> We empathize with the OP. Not sure if this an appropriate question to ask here. I am NOT asking about what the laws SHOULD BE  BUT hoping someone knows what the law is for our situation.
> 
> *Is access to U.S. Veteran's MEDICAL BENEFITS (RX, doctors etc) "means tested" meaning there are LIMITS to your income to be eligible?*
> 
> ...


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## ace2000 (Aug 2, 2012)

isisdave said:


> Insurers pay her the same rate since about 1995, and less than she got in 1992. One insurer has given a 3% raise in 20 years, most of the others have kept the same rate, and a couple have cut it 15%.  In the meantime, she's become a practitioner with over 25 years of experience, and gets the same pay as someone freshly licensed into the business.  *Who would advise their child to go into an industry with this kind of "advancement" plan?*


 
You're kidding?  Doctors get paid more than just about any other profession.  They go through a lot of schooling, but please don't ask us to have sympathy for what doctors make.  There's too many people out of work right now to share your pain.

http://www.profilesdatabase.com/resources/2011-2012-physician-salary-survey


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## Passepartout (Aug 2, 2012)

Flexible, There is no income limit for VA benefits. Medical care was a promise made to veterans in exchange for our service. Unfortunately, due to the huge influx of veterans from the Iraq and Afghanistan period, there is a giant backlog of new applications for service. It will take some serious time for Ken's application to be reviewed before being either accepted or denied. Obviously the sooner he applies, the sooner his application gets reviewed. He can apply at any VA service center in person with his DD-214.

I am a veteran, but have chosen to forgo VA benefits since a) I can afford my own care, b) I have no service connected disability, and c) I feel there are more deserving vets than I. All the above may change later in the week.

Jim


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## flexible (Aug 2, 2012)

Passepartout said:


> Flexible, There is no income limit for VA benefits. Medical care was a promise made to veterans in exchange for our service. Unfortunately, due to the huge influx of veterans from the Iraq and Afghanistan period, there is a giant backlog of new applications for service. It will take some serious time for Ken's application to be reviewed before being either accepted or denied. Obviously the sooner he applies, the sooner his application gets reviewed. He can apply at any VA service center in person with his DD-214.
> 
> I am a veteran, but have chosen to forgo VA benefits since a) I can afford my own care, b) I have no service connected disability, and c) I feel there are more deserving vets than I. All the above may change later in the week.
> 
> Jim



WOW! 
Thank you.
We will get his application in asap.
Ken has LONG TERM CARE insurance so he can live out his days our lake view home he built.
BUT it would be an nice to know he can POSSIBLY receive medical care close to home if need be when he gets OLD. He's be 86 in 3 weeks so he is still very young.


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## am1 (Aug 2, 2012)

Rose Pink said:


> Yes, within compassionate limits.  That is why the for-profit model does not work for health care.  Making money at expense of people's lives is, frankly, immoral.



I agree the model does not work when it comes to health care. Or at least basic  health care.  But that does not mean that the current companies should ignore their duty to their shareholders.


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## geekette (Aug 2, 2012)

am1 said:


> I agree the model does not work when it comes to health care. Or at least basic  health care.  But that does not mean that the current companies should ignore their duty to their shareholders.



Shareholders are people like you and me.  Agree, they put up money out of faith in the company.

Exec compensation is an entirely different matter and it makes me sick to my stomach to see millions in bonuses for A Person, who also has a high salary, stock options, etc.  Sure, bonuses for "performance" that might generally mean denying needed tho costly treatments and denying coverage to those that will probably require more care than others of their same age.  That eye on the bottom line is real people getting kicked to the curb.  Even as a shareholder, it would be difficult for me to stomach profitability at the expense of "the uninsurable" (can't quite state it as "unprofitable to cover" but that is what it is - a human being that is seen as detrimental to the bottom line).

I don't own any health insurance stocks.  Maybe I should so I can participate in exec compensation discussions and voting.  I feel it's out of control, considering how that profit is made.


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## Sandy VDH (Aug 2, 2012)

Saw  this when I was in the SSA offices change the name on my SSN.  It is an option for people with pre-existing conditions who can't get insurance elsewhere.  However there is a 6 months no insurance waiting period.

This is the press release from the SSA

http://www.ssa.gov/pressoffice/psa/pre-existing-conditions-60sec.html 

and this is the site you find out more info.

https://www.pcip.gov/


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## pgnewarkboy (Aug 2, 2012)

Passepartout said:


> Flexible, There is no income limit for VA benefits. Medical care was a promise made to veterans in exchange for our service. Unfortunately, due to the huge influx of veterans from the Iraq and Afghanistan period, there is a giant backlog of new applications for service. It will take some serious time for Ken's application to be reviewed before being either accepted or denied. Obviously the sooner he applies, the sooner his application gets reviewed. He can apply at any VA service center in person with his DD-214.
> 
> I am a veteran, but have chosen to forgo VA benefits since a) I can afford my own care, b) I have no service connected disability, and c) I feel there are more deserving vets than I. All the above may change later in the week.
> 
> Jim



If you have a service connected disability there  is no income limit.  If you don't there is means testing.  There are a few limited exceptions to means testing for certain recently discharged combat vets without service connected  disability.


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## bogey21 (Aug 2, 2012)

ace2000 said:


> Doctors get paid more than just about any other profession.  They go through *a lot of schooling*, but please don't ask us to have sympathy for what doctors make.



"a lot of schooling" *and a lot of debt*.  My Daughter's husband is in his 2nd year of residency (equals long hours and minimal pay) after 4 years of Undergraduate School; 4 years of Medical School; and over $150,000 of  Student Loan Debt which will take years to pay off.  If there wasn't a decent payoff after all this, we would have a big time shortage of Doctors and we would all be compaining that it is next to impossible to get to see a Doctor.

George


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## Passepartout (Aug 2, 2012)

pgnewarkboy said:


> If you have a service connected disability there  is no income limit.  If you don't there is means testing.  There are a few limited exceptions to means testing for certain recently discharged combat vets without service connected  disability.



Thanks. Good to know. Many combat vets have disability they don't even know of. For instance, I have tinnitus. Ringing in the ears. I have heard of many combat vets that have received 10% disability with no more than this. I have not applied, and more to the point, I have no desire to sidetrack Rose Pink's thread seeking answers for her DD. I doubt she's a veteran.

Jim


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## flexible (Aug 2, 2012)

pgnewarkboy said:


> If you have a service connected disability there  is no income limit.  If you don't there is means testing.  There are a few limited exceptions to means testing for certain recently discharged combat vets without service connected  disability.



pgNewarkBoy,

Since my husband (85) and his brother (89) are WWII veteran's the deciding factor would be whether they had service connected disabilities?

Would it make sense IF some of the veteran's at his brother's retirement complex receive VA Medical benefits BECAUSE they registered for them prior to "means testing" being applied.

Ken and his brother are unlikely to ever qualify unless "means testing" is dropped.


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## pianodinosaur (Aug 2, 2012)

Dear Rose Pink:

I understand that it is one thing to treat asthma and autoimmune diseases and another to live with them.  Some problems are not a whole lot of fun to have.  However, I do know people with asthma, SLE, SICCA, and rheumatoid arthritis.  Most of them are gainfully employed and have health insurance.  This is not meant to minimize DW's very real problems.  However, with perseverance, she will overcome them.


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## ace2000 (Aug 2, 2012)

bogey21 said:


> "a lot of schooling" *and a lot of debt*. My Daughter's husband is in his 2nd year of residency (equals long hours and minimal pay) after 4 years of Undergraduate School; 4 years of Medical School; and over $150,000 of Student Loan Debt which will take years to pay off. If there wasn't a decent payoff after all this, we would have a big time shortage of Doctors and we would all be compaining that it is next to impossible to get to see a Doctor.
> 
> George


 
How is that different than anyone else going extra years for any type of graduate degree?  They all can rack up the student loan debt.  

The difference is a medical doctor can start off in the neighborhood of 200K, and a specialist can double that amount very easily in just a few years time.

I'm not saying that a doctor shouldn't be compensated well.  My point was that it's hard to feel sorry for someone making that kind of money and complaining about their income.  Especially on this thread.


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## Kal (Aug 2, 2012)

ace2000 said:


> How is that different than anyone else going extra years for any type of graduate degree? They all can rack up the student loan debt.
> 
> The difference is a medical doctor can start off in the neighborhood of 200K, and a specialist can double that amount very easily in just a few years time.
> 
> I'm not saying that a doctor shouldn't be compensated well. My point was that it's hard to feel sorry for someone making that kind of money complaining about their income. Especially on this thread.


 
You forgot one major difference.  Given the shortage of doctors, once out of school, the job is all but certain.  However, a graduate with a PhD in say liberal arts, may not even get a job whatsoever.  Both individuals still have enormous student loan debt to pay off.   Setting aside a part of the $200K would be easier than setting aside a part of nothing.


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## ace2000 (Aug 2, 2012)

Kal said:


> You forgot one major difference.  Given the shortage of doctors, once out of school, the job is all but certain.  However, a graduate with a PhD in say liberal arts, may not even get a job whatsoever.  Both individuals still have enormous student loan debt to pay off.   Setting aside a part of the $200K would be easier than setting aside a part of nothing.



I think we're saying the same thing here.


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## pgnewarkboy (Aug 2, 2012)

flexible said:


> pgNewarkBoy,
> 
> Since my husband (85) and his brother (89) are WWII veteran's the deciding factor would be whether they had service connected disabilities?
> 
> ...



Your husband should get specific help on this from a Veterans Service Organization (VSO).  They should be able to explain what he is or isn't entitled to get.  My suggestion is to contact one like VFW before speaking to VA.  I hope they can clarify things more for you.  There is probably a local chapter near you.


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## flexible (Aug 3, 2012)

Rose Pink said:


> My DD graduated from grad school in May. Her coverage ends mid-August.


 Since DD was hospitalized before her insurance ended is it possible some little known law would require that she can COBRA the insurance? Or it that impossible as RosePink mentioned in her first post? I sure hope a solution appears soon for DD & Rose Pink.



pianodinosaur said:


> It's not just health insurance that function that way.  Automobile insurance, flood insurance, and homeowners insurance are also very difficult to comprehend.  *They stay in business by denying claims.*  I never understood why health insurance is tied to employment until I began looking into the history of insurance companies.  I doubt that model will remain viable over the next twenty years, but I may be wrong.
> 
> Meanwhile, *let us hope that there will soon be a cure for what ails Rose Pink's DD*.



*We are praying for Rose Pink's DD too and hoping to see her post an update with an optimistic progrosis.* I need to read her post again to understand if DD insurance would be ENDING as soon as she moved home OR had already ended. If I understand correctly, patients can not be refused by ER/Hospitals in the U.S. but followup care choices depends on which insurance plans doctors accept. The complexities Rose Pink and her DD face are heart breaking. So many factors are involved. 

RE: pianodinosaur's comment: *They stay in business by denying claims.* Last year one of our tenant's property suffered such severe wind damage that the entire awning attached to the home flew off. We were not home and I dreaded filing a claim because the last thing I need after returning home after many month's absense is to fight an insurance company. To my surprise, I called the insurance company in the morning and the adjuster called back that afternoon stating he had already sent a check to me. That I would NOT lose any rights by cashing it on receipt. If the repairs cost more than the check, to just call back and speak with him. We were very surprised by both the amount (much larger than we expected) and professionalism on his part. Since I called about the same time the Joplin, MO tornadoes occured maybe it was just they wanted to reduce their backlog of incoming claims. Or maybe because the property had the same insurance carrier for 50 years?

I can think of many examples where my claims were unfairly denied though. Mostly health related claims where the reasons for denial never made sense.

In the late 1980s while working for an airline in Florida I decided to get two FL insurance licenses - Property/Casualty I think was called 220 & Life/Heath was another. 220 was very complex, life/health was a fairly easy test. I ended up transfering to California with my airline job and never used them. 

Have nearly all insurance products changed drastically since the global financial crisis since about 2008? Or just evolved to provide more profits for the insurance companies? When the policy information comes in the mail, I am lucky if I have time to file them away in Health insurance, Long Term Care Insurance, Homeowner's, Auto insurance etc. I am not asking for politcal reasons but am *wondering if others who READ all of their policy documents see significant changes*. When I was notified that my health/RX carrier for 2011 decided to NO LONGER provide insurance to my 'category' (whatever that meant) I had to call Sacramento (California's state capital) speak with people on 800 numbers to discuss options for POSSIBLE options based on my zip code (County of legal residence). I am beginning to think I'd get a better deal with NO RX coverage because it seems to cost me ONLY about $5 less than IF I had NO HEALTH/RX insurance. But I realize I am lucky because IF a major health problem occurred I'd rather have it then not have it.


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## Rose Pink (Aug 3, 2012)

flexible said:


> *We are praying for Rose Pink's DD too and hoping to see her post an update with an optimistic progrosis.*


Thank you for the prayers.  My daughter's medical conditions are auto-immune.  Basically, what that means is her immune system makes antibodies that attack her own body.  There are many types of autoimmune diseases based on what part of the body is or has been assaulted.  Type 1 diabetes is an example of an autoimmune disease.  The body attacks and destroys it's own insulin-producing cells thus making the person dependent on exogenous insulin for the rest of his life.  Rheumatoid arthritis is another example.  Another example is Hashimoto's Thyroiditis where certain thyroid cells are destroyed.  The person takes levothyroxin (Synthroid) for the rest of her life. This medication is not expensive and a simple blood test a couple of times a year is usually all it takes to monitor the dose.

In addition to Hashimoto's (not a big deal) my DD also has idiopathic urticaria.  She breaks out with painful hives for no reason she can ascertain.  It's quite painful and can be disfiguring if her face is involved.  She never knows when this is going to happen.  She can go months without any major problems and then--wham!--she looks and feels like she's been in a car wreck with a semi.  She caught the flu (or something) on a trip to NYC (thinks it was the bus people) and had a fever.  The heat from the fever (she thinks--but it could also have been the pathogen) triggered a major hive attack.  She went to the Minute Clinic to get some antibiotics for her sinus infection.  The NP took one look at her and assumed this was a major allergic attack requiring ER treatment.  That was probably over-reaction on the NP's part but if you aren't used to seeing this, it would be easy to do.  The ER gave her IV drugs to calm the hives.  

Anyway, she takes many meds, both Rx and OTC for this condition.  They suppress her immune system.  It can get expensive.

There is no cure.


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## Renny30 (Aug 3, 2012)

Rose,

Most (possibly all) states have federally funded health care centers. I used to provided Medicaid outreach support in a facility in NJ.  

I've posted a link below. You can do a search for MA and Utah (I thought that's where you said you were) and see what's closest. The wait on appointment days can be long, but the staff in such facililities are usually very caring and in the case of the facility where I worked, highly trained. You may wait, but once you get seen the care is good. Patients pay a nominal amount based on income and billing is always an option. They also have good relationships with neighboring hospitals for testing (MRI's, etc) and the fees are based on the federal scale as well.

All the best to you and your daughter. This thread has been heartbreaking. I hope this information helps.

http://findahealthcenter.hrsa.gov/Search_HCC.aspx?byCounty=1


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## amycurl (Aug 3, 2012)

Rose, I had the pleasure of spending nearly an hour at the Social Security office this morning (see my post from 2 weeks ago about stolen wallet,) and there was an ad that ran as part of their programming loop about the Pre-Existing Conditions Insurance Program. It seemed to describe folks just like your daughter. I don't know if you've gone to the website yet, but here it is:

www.pcip.gov

It's a governmental program, but made be run differently by different states. I thought of you immediately once it hit the screen.

Also, there is a system of free health clinics, usually staffed by volunteers, across the country. Using my network, I came across this local organization in Utah, which is where I think you are:
http://www.chc-ut.org/

These organizations not only usually give excellent care, but also usually are experts (or involve volunteers who are experts) in helping folks like your daughter navigate an incredibly complicated system

Hope this helps, and continuing to hold you both in The Light.


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## Sandy VDH (Aug 3, 2012)

amycurl said:


> Rose, I had the pleasure of spending nearly an hour at the Social Security office this morning (see my post from 2 weeks ago about stolen wallet,) and there was an ad that ran as part of their programming loop about the Pre-Existing Conditions Insurance Program. It seemed to describe folks just like your daughter. I don't know if you've gone to the website yet, but here it is:
> 
> www.pcip.gov
> 
> It's a governmental program, but made be run differently by different states. I thought of you immediately once it hit the screen.



I posted the exact same thing back in post 98.  Not sure if OP has looked at it, as I have seen no comments.

http://tugbbs.com/forums/showpost.php?p=1337413&postcount=98


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## Rose Pink (Aug 3, 2012)

Sandy VDH said:


> I posted the exact same thing back in post 98.  Not sure if OP has looked at it, *as I have seen no comments.*


I am sorry if I snubbed anyone.  I did not mean to.  I have posted that I read each and every comment and I appreciate the time tuggers have taken to post even though I don't respond to each one, separately. 

I will be sharing them with my daughter when she gets here on Monday and I'll let you know which direction she decides to take--or which is available to her.


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## pianodinosaur (Aug 4, 2012)

flexible said:


> Since DD was hospitalized before her insurance ended is it possible some little known law would require that she can COBRA the insurance? Or it that impossible as RosePink mentioned in her first post? I sure hope a solution appears soon for DD & Rose Pink.
> 
> 
> 
> ...



I am glad that you had a good experience with your property damage claim.  Unfortunately, our experience has not been as pleasant.


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## puppymommo (Aug 4, 2012)

I speak as a person who has excellent health care insurance, earned through DH's 20 year service in the Marine Corps. We have it (unless Congress takes it away) for life. We will not even have to switch over to Medicare at 65.

I don't know if the current troops will receive the same thing. Tricare covers 75% after a $75 (maybe $100) deductible per person. We pay no premiums.

The thing that got me thinking about all this was that I received our Explanation of Benefits forms for prescriptions for both myself and DH. I only had 2 prescriptions, but one was for $291.91.  My cost was $12.

Then I got to DH's EOB.  The cost for one of his schizophrenia medications was $1923.08.    That's per month. Our cost $5.00. We often hear about persons with mental illness who go off their medications. But I wonder how frequently they simply can't afford them.

I'm grateful that we have such good health insurance but I wish everybody did. I wish OP and her DD all the best.


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## Tia (Aug 4, 2012)

We pay $460/month out of my paycheck + my employer pays their share for health insurance with a $2000 deductible, $2500 max out of pocket individual that the deductible does not count towards. _Lucky to be able to afford/have it_. This keeps going up with less coverage, which is probably typical am guessing .


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## pacodemountainside (Aug 4, 2012)

puppymommo said:


> I speak as a person who has excellent health care insurance, earned through DH's 20 year service in the Marine Corps. We have it (unless Congress takes it away) for life. We will not even have to switch over to Medicare at 65.
> 
> 
> Are you sure you do not have to make Medicare primary when you hit 65? A couple friends have Tricare and  had to. There is no reduction in benefits and maybe an increase. Just more work for DOCs billing department.
> ...


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## puppymommo (Aug 4, 2012)

> Are you sure you do not have to make Medicare primary when you hit 65? A couple friends have Tricare and  had to. There is no reduction in benefits and maybe an increase. Just more work for DOCs billing department.
> 
> Also,  have to pay $99 Medicare Part B premium!
> 
> I do know with most private plans you have to go on Medicare at 65.



About 8 years ago they instituted "Tricare for Life" after much lobbying by veteran's groups. They had been promised health care for life and finally got it. I'm pretty sure Tricare for Life is primary to Medicare and I'm pretty sure that the benefits are somewhat better.  Otherwise veterans wouldn't be preferring it to Medicare.


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## shorts (Aug 5, 2012)

Medicare is primary with Tricare for Life as a supplementary to Medicare. It is very good coverage. But you do have to take Medicare A and B at age 65 in order to keep Tricare coverage.


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## dwojo (Aug 5, 2012)

Rose Pink if you have insurance check to see if your DD can be added. As a result of health care reform my insurance lets me keep dependants on it until they are 26.


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## bogey21 (Aug 5, 2012)

puppymommo said:


> I only had 2 prescriptions, but one was for $291.91.  My cost was $12......The cost for one of his schizophrenia medications was $1923.08.  That's per month. Our cost $5.00.



Great for you, and believe me I don't begrudge your benefits.  But just remember that the better the benefits for some, the higher the cost for others.  All things being equal I prefer being one of the ones paying the higher premiums (or taxes) and not needing the benefits.  My point is that there is no free lunch.

George


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## pharmgirl (Aug 5, 2012)

If your daughter needs chronic medicine that is expensive, most pharmaceutical companies will giv eyou the med at no cost , just. Need to fill out some forms to show your income falls under a certain amount and get doctor to sign form

Think we would all be better off with only catatrosphic insurance what used to be called major medical and pay routine dr visits out of pocket
Have a son who is an orthopedic surgeon at a major hospital many yea rs of schooling, residency, fellowships etc .  Need so much office help just to communicate with insurance companies , not going to doctors but money is eaten up by paperwork and time
Medicare and Medicaid pay a ridiculously small amount to doctors who spend their lives treating patients


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## pgnewarkboy (Aug 5, 2012)

pharmgirl said:


> If your daughter needs chronic medicine that is expensive, most pharmaceutical companies will giv eyou the med at no cost , just. Need to fill out some forms to show your income falls under a certain amount and get doctor to sign form
> 
> Think we would all be better off with only catatrosphic insurance what used to be called major medical and pay routine dr visits out of pocket
> Have a son who is an orthopedic surgeon at a major hospital many yea rs of schooling, residency, fellowships etc .  Need so much office help just to communicate with insurance companies , not going to doctors but money is eaten up by paperwork and time
> Medicare and Medicaid pay a ridiculously small amount to doctors who spend their lives treating patients



A visit to the doctor may be doable for many people to pay out of their pocket once a year.  It becomes unbearable when you are actually sick and the doctor orders TESTS and more TESTS.  Testing is extremely expensive and most people cannot afford to pay for the testing.  Of course, there are the prescription drugs.  If you are sick and need them it gets very expensive.  Catastrophic plans often have separate deductibles for prescription drugs.  People can very easily go broke just paying for tests and prescription drugs - that is not a medical catastrophe, it is a financial catastrophe.


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## Tia (Aug 5, 2012)

pgnewarkboy said:


> A.....  People can very easily go broke just paying for tests and prescription drugs - that is not a medical catastrophe, it is a financial catastrophe.



http://www.dailykos.com/story/2012/...l-bills-cause-62-percent-of-nbsp-bankruptcies

Says 62% of bankruptcies are due to medical bills in 2007


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