So with the new year, all of our medical co pays reset, and.....

[Rolltydr]

I guess I'm a little perturbed about all this socialized medicine talk, as we really have it pretty good compared to Canada and other countries.?

Hmmm. After reading this and many other threads over the past few months, I’d have to say pretty much all of the Canadian posters and many of the US posters trying to navigate our private insurance/ACA/Medicare/Medicaid quagmires and totally outrageous prescription drug costs, would disagree with you.


Harry

 

[bbodb1]

bbodb1,
I apologize if I offended you, as that was not my intention. I guess I'm a little perturbed about all this socialized medicine talk, as we really have it pretty good compared to Canada and other countries.
Essentially, physicians look for all procedural charges that can be rightfully billed for a visit. Some reimbursements seem disproportionate to the care received, but physicians do have a guideline as to what is acceptable, and they know what the reimbursement will be.
Maybe the injection cost encompasses risk from an adverse reaction? I'm sure there's a rythme and reason for it in the medical realm.
If you're paying $100 a month for two people to be insured (minus what your company pays), you've got a good deal, and the $4000 family deductible is pretty standard. That's what mine is, but we kick in way more than $100 for our insurance.
At any rate, how is your ear issue?

@Beach57 - On no! Quite the opposite in fact as I appreciate your insights into how health insurance works! It is frustrating to ask questions like the ones we have considered in this thread (and others like them) to insurance companies and/or physicians offices and never really feeling like you got an answer that provided some useful insight. Thanks again for your efforts here!

I agree with you in that socialized medicine is not the answer for any number of reasons but one of the most important reasons (at least from my perspective) is this: innovation in the medical field is not strongly associated with countries that rely on the socialized medicine approach. Would we be better off if we could untangle the insurance companies from the healthcare process? There is a strong feeling of "yes" I hear but I am also aware of the adage of being careful what you wish for as well.

There was a time when health insurance existed and worked with the health care field. It seems now that insurance dictates to physicians and hospitals - that pendulum has swung too far in the direction of the insurance companies.

With respect to the ear issue, well everything is starting to bloom here and my allergies are kicking up so I can't really say if the ear issue has been successfully addressed. The lovely month of March is not so lovely where my sinuses are concerned....

 

[VacationForever]

Hmmm. After reading this and many other threads over the past few months, I’d have to say pretty much all of the Canadian posters and many of the US posters trying to navigate our private insurance/ACA/Medicare/Medicaid quagmires and totally outrageous prescription drug costs, would disagree with you.

Harry

I am against socialized medicine because I like having choice, whether it is doctor, medication or when and how I get treatment. Personally I have not had an issue in navigating through US's private insurance, ACA and Medicare. Internet has a wealth of information and since I like research anyway, I have enjoyed the whole journey of understanding various options and then selecting the best options that meet our needs.

 

[Beach57]

Hmmm. After reading this and many other threads over the past few months, I’d have to say pretty much all of the Canadian posters and many of the US posters trying to navigate our private insurance/ACA/Medicare/Medicaid quagmires and totally outrageous prescription drug costs, would disagree with you.


Harry

I am going by nightmare stories from my relatives in Quebec, who have had to come to the US and pay out of pocket for timely care. They have watched their friends die in middle age from cancer as biopsies and MRIs are delayed for months. No thank you.
Also, mammograms stop for women much earlier than in the US.

 

[Beach57]

@Beach57 - On no! Quite the opposite in fact as I appreciate your insights into how health insurance works! It is frustrating to ask questions like the ones we have considered in this thread (and others like them) to insurance companies and/or physicians offices and never really feeling like you got an answer that provided some useful insight. Thanks again for your efforts here!

I agree with you in that socialized medicine is not the answer for any number of reasons but one of the most important reasons (at least from my perspective) is this: innovation in the medical field is not strongly associated with countries that rely on the socialized medicine approach. Would we be better off if we could untangle the insurance companies from the healthcare process? There is a strong feeling of "yes" I hear but I am also aware of the adage of being careful what you wish for as well.

There was a time when health insurance existed and worked with the health care field. It seems now that insurance dictates to physicians and hospitals - that pendulum has swung too far in the direction of the insurance companies.

With respect to the ear issue, well everything is starting to bloom here and my allergies are kicking up so I can't really say if the ear issue has been successfully addressed. The lovely month of March is not so lovely where my sinuses are concerned....

We are sickened here in NY at the high salaries the Excellus execs make. There is no job any one of them does that's worth millions per year.

Sounds like you have eustachian tube dysfunction and possibly middle ear fluid from inflammation and post nasal drip perhaps. Good luck. That condition can take weeks to resolve in adults. FYI. Any persistent unilateral hearing loss should be investigated by an ENT or audiologist. Sometimes it's a sensorineural loss brought on by a virus. Sorry, just my two cents'worth.

 

[bogey21]

I am against socialized medicine because I like having choice, whether it is doctor, medication or when and how I get treatment. Personally I have not had an issue in navigating through US's private insurance, ACA and Medicare. Internet has a wealth of information and since I like research anyway, I have enjoyed the whole journey of understanding various options and then selecting the best options that meet our needs.

I'm with you on this but also understand there are others that don't have either the expertise or patience to follow the course we have chosen...

George

 

[Rolltydr]

I am going by nightmare stories from my relatives in Quebec, who have had to come to the US and pay out of pocket for timely care. They have watched their friends die in middle age from cancer as biopsies and MRIs are delayed for months. No thank you.
Also, mammograms stop for women much earlier than in the US.

People in every country, regardless of the type of healthcare they have, die from cancer and many times it is the result of not being found soon enough or attacked aggressively enough by the doctors. My wife’s family has experienced that right here in the US. The rate of cancer deaths is actually higher in the US than in Canada. The US ranks 5th in the most cancer deaths with 352.2 deaths per 100,000 people, while Canada is 11th with 334 deaths per 100,000. That’s not a huge difference but it is enough to show that more Canadian citizens aren’t dying from cancer due to their healthcare system.

Global cancer data by country | World Cancer Research Fund International

Explore rates of cancer according to country, including statistics for men and women, and discover which country has the highest cancer rates

www.wcrf.org

It’s good that you enjoy research and have the time and ability to get the information you need to make good healthcare decisions for yourself. Unfortunately, a lot of people can’t for many reasons. I don’t know that I am for a complete change to a socialized system at this point and I know it would never pass anyway. However, I do believe everyone, regardless of their station in life, should have the same access to healthcare. In my opinion, your life should not depend on your ability to pay, your mental ability to understand the choices available to you, pre-existing conditions, or any other factors. That’s the way I feel and I am well aware that many, maybe even most Americans, disagree.


Harry

 

[Beach57]

Thank you for the stat sheet Harry. I was not aware of these numbers.
My Canadian relatives are not happy with the healthcare (husband is a native and wife was born in the US).
Medicaid gives qualifying patients the care they need. No one has to go without. Even upon losing a job, NY residents can find very affordable insurance through our state's exchange program.
Perhaps I speak out of fear for myself. Both my parents died fairly early on from conditions that are often hereditary. I am getting on in age myself, and truly like my healthcare as it is. I would be remiss in not admitting that I sometimes receive preferential treatment because of my status as a well known medical provider and strong self advocate. It's not a perfect system, but I'm pretty well satisfied.
Everyone is entitled to their own opinions and I respect your's.

 

[Brett]

Thank you for the stat sheet Harry. I was not aware of these numbers.
My Canadian relatives are not happy with the healthcare (husband is a native and wife was born in the US).
Medicaid gives qualifying patients the care they need. No one has to go without. Even upon losing a job, NY residents can find very affordable insurance through our state's exchange program.
Perhaps I speak out of fear for myself. Both my parents died fairly early on from conditions that are often hereditary. I am getting on in age myself, and truly like my healthcare as it is. I would be remiss in not admitting that I sometimes receive preferential treatment because of my status as a well known medical provider and strong self advocate. It's not a perfect system, but I'm pretty well satisfied.
Everyone is entitled to their own opinions and I respect your's.

That's great that you have good healthcare coverage from your employer.
Unfortunately many people do not have covered health insurance and must pay a significant out-of-pocket amount for healthcare

 

[geekette]

...Even upon losing a job, NY residents can find very affordable insurance through our state's exchange program.

what is the monthly premium for "very affordable insurance"? and is it a full policy or a skinny policy? For myself, $875/mo is not at all affordable. That is premium only, does not count costs to use insurance.

 

[Rolltydr]

Thank you for the stat sheet Harry. I was not aware of these numbers.
My Canadian relatives are not happy with the healthcare (husband is a native and wife was born in the US).
Medicaid gives qualifying patients the care they need. No one has to go without. Even upon losing a job, NY residents can find very affordable insurance through our state's exchange program.
Perhaps I speak out of fear for myself. Both my parents died fairly early on from conditions that are often hereditary. I am getting on in age myself, and truly like my healthcare as it is. I would be remiss in not admitting that I sometimes receive preferential treatment because of my status as a well known medical provider and strong self advocate. It's not a perfect system, but I'm pretty well satisfied.
Everyone is entitled to their own opinions and I respect your's.

Thank you and I respect yours, also. I do have a couple questions for you since you have a good working knowledge of the subject.

You say you are getting on in age. Do you mind me asking if you are on Medicare yet? If so, why would you be opposed to expanding Medicare to all who want it? As I stated above, at this point, I’m not all in for a single payer system for everyone so let’s assume we continue with the current public/private system with some tweaks. It seems that most people like their Medicare and it is one of the most popular government programs. So, why limit it to those over 65?


Harry

 

[bogey21]

So, why limit it to those over 65?

One reason might be a shortage of Doctors willing to take Medicare patients. A number of years ago when my PCP retired and I had to find a new one it wasn't easy. Some Doctors were not taking Medicare Patients at all. Others were not taking new Medicare Patients. My guess is has to do with the reimbursement rate paid to Doctors by Medicare....

George

 

[Rolltydr]

One reason might be a shortage of Doctors willing to take Medicare patients. A number of years ago when my PCP retired and I had to find a new one it wasn't easy. Some Doctors were not taking Medicare Patients at all. Others were not taking new Medicare Patients. My guess is has to do with the reimbursement rate paid to Doctors by Medicare....

George

That’s interesting. I attended a seminar a couple of years ago before we went on Medicare and the presenter said that 95% of doctors accepted Medicare. I remember him saying there were 2 doctors in the Birmingham area that did not accept it at that time. Birmingham has a large medical community with UAB (University of Alabama in Birmingham) being one of the foremost research universities in the country. The Kaiser Family Foundation says 93% of doctors nationwide accept Medicare. I see you’re located in Ft Worth, TX. Do you know if the acceptance rate is much lower in that area or Texas in general? I know Texans don’t like to be messed with!

 

[Beach57]

what is the monthly premium for "very affordable insurance"? and is it a full policy or a skinny policy? For myself, $875/mo is not at all affordable. That is premium only, does not count costs to use insurance.

$875 is agreeably steep, especially if it's for one person. My sister pays $200 a month (fifty-five years old, very part time occasional employee with a husband on Medicare). She has good insurance through Excellus, which includes a reimbursement for a local gym membership. Low co-pays.

 

[Beach57]

Thank you and I respect yours, also. I do have a couple questions for you since you have a good working knowledge of the subject.

You say you are getting on in age. Do you mind me asking if you are on Medicare yet? If so, why would you be opposed to expanding Medicare to all who want it? As I stated above, at this point, I’m not all in for a single payer system for everyone so let’s assume we continue with the current public/private system with some tweaks. It seems that most people like their Medicare and it is one of the most popular government programs. So, why limit it to those over 65?


Harry

I'm fifty-eight years old. Medicare was originally brought to market over half a century ago to help the "elderly" who were no longer in the workforce have coverage for hospitalizations and acute care. To this day, many rehabilitative services and durable medical products are not covered. The problem is, there are so many folks over sixty-five on Medicare. It used to be that most people would die by age eighty. Now that number is often over ninety. There are far more people on social security and Medicare than there are working. To me, it's a cost concern. I don't know how our country could shoulder this. I don't have numbers at the ready, but it doesn't seem to be financially feasible.

 

[geekette]

$875 is agreeably steep, especially if it's for one person. My sister pays $200 a month (fifty-five years old, very part time occasional employee with a husband on Medicare). She has good insurance through Excellus, which includes a reimbursement for a local gym membership. Low co-pays.

200 would be reasonable, I would take it. Might be exchange plan with subsidy, as $600 was a pretty sure bet on private ins here for a long time. Income below a certain amount would trigger subsidies, so, agree that's decent for unemployed/part timey.

 

[Rolltydr]

I'm fifty-eight years old. Medicare was originally brought to market over half a century ago to help the "elderly" who were no longer in the workforce have coverage for hospitalizations and acute care. To this day, many rehabilitative services and durable medical products are not covered. The problem is, there are so many folks over sixty-five on Medicare. It used to be that most people would die by age eighty. Now that number is often over ninety. There are far more people on social security and Medicare than there are working. To me, it's a cost concern. I don't know how our country could shoulder this. I don't have numbers at the ready, but it doesn't seem to be financially feasible.

This would take some serious study to determine the steps, but theoretically, people that wanted to opt in to Medicare would pay increased Medicare payroll tax in lieu of insurance premiums. This could be phased in by gradually lowering the qualification age for Medicare, while at the same time increasing the Medicare tax. It seems to me that the resulting Medicare tax could be less, in some cases much less, than what many individuals now pay for health insurance premiums.

This is a super simplification of a complex problem but too many other countries provide their citizens with access to healthcare for it not to be feasible, imho.




Harry

 

[bogey21]

I think another problem is that the Government eats about $5,000 per year on each Medicare patient...

George

 

[bogey21]

That’s interesting. I attended a seminar a couple of years ago before we went on Medicare and the presenter said that 95% of doctors accepted Medicare. I remember him saying there were 2 doctors in the Birmingham area that did not accept it at that time. Birmingham has a large medical community with UAB (University of Alabama in Birmingham) being one of the foremost research universities in the country. The Kaiser Family Foundation says 93% of doctors nationwide accept Medicare. I see you’re located in Ft Worth, TX. Do you know if the acceptance rate is much lower in that area or Texas in general? I know Texans don’t like to be messed with!

Sorry. I don't know what the percentage is in Fort Worth or Texas in general...

George

 

[Brett]

I think another problem is that the Government eats about $5,000 per year on each Medicare patient...

George

does that mean you believe the government loses $5,000 a year on each patient ?
or there is $5,000 in waste on each patient?

 

[Rolltydr]

does that mean you believe the government loses $5,000 a year on each patient ?
or there is $5,000 in waste on each patient?

And what is the alternative? Raise taxes so we can pay our bills? Yeah, right. In case someone hasn’t noticed, it seems to me that NOBODY in Washington, from either party, is concerned about deficit spending any more. Look at what has happened with the deficit the last 3 years. I’m not saying they should or shouldn’t, just that you don’t hear anyone in power from the WH to congress talking about it any more so they must think it doesn’t really matter. So, imho, if we’re going to lose money by the trillions, it might as well go for people to receive good healthcare.


Harry

 

[geekette]

....NOBODY in Washington, from either party, is concerned about deficit spending any more. This is not a political statement. It is a fact.

Probably it is best to not pretend that you know what is in anyone's head and put it out there as fact. I doubt completely that you have asked every House and Senate member or you would not have made this statement.

 

[Rolltydr]

....NOBODY in Washington, from either party, is concerned about deficit spending any more. This is not a political statement. It is a fact.

Probably it is best to not pretend that you know what is in anyone's head and put it out there as fact. I doubt completely that you have asked every House and Senate member or you would not have made this statement.

That’s fair. I’ll amend the statement.

 

[bogey21]

And what is the alternative?

In answer to Brett's question I think the cost to the taxpayers like a $5,000 cost to the taxpayers for every Medicare patient....

All I am saying is that if I am correct, Medicare for All will cost the taxpayers a lot of money. If they want to do it, fine. If not, I'm also fine with that. It is their call...

George

 

[Beach57]

200 would be reasonable, I would take it. Might be exchange plan with subsidy, as $600 was a pretty sure bet on private ins here for a long time. Income below a certain amount would trigger subsidies, so, agree that's decent for unemployed/part timey.

It is. Her husband is retired (twenty year age difference). She has chosen not to work much so that the two of them can enjoy his later years. Rather or not this has been the best decision for remains to be seen.