Re: OT Compare the candidates

On Sep 9, 3:55�pm, Pogonip <nobo...@xxxxxxxxxxx> wrote:
Mary wrote:
On Sep 8, 4:30 pm, "Annie C" <chern...@xxxxxxxxxxxxxxxxxxx> wrote:
. It is very scary not to have any coverage at all and be one major illness
or accident away from possible ruin. No access to proper preventative care
is a great worry too. �I just paid $238 out of pocket today for one blood
draw. This had to be done. But if we 'd had a negotiated rate, the insurance
co would have paid the lab just a tiny fraction of that and my share, just a
small co-pay. ............ Why is it I wonder that the uninsured have to pay
more per service than those with insurance? I suspect we may be subsidizing
the insured. Ironic, eh?

I don't think you're subsidizing the insured. �I think that the rates
paid by the uninsured, who have no negotiating leverage, are obscene,
but the actual costs of taking a blood draw, for example, are probably
easily covered by the insured rate.

Gotta be scary, though, Annie. �I hope it works out for you.

Mary

Yesterday I filled the two prescriptions for eyedrops I'm to use the day
before the cataract surgery. �*With* insurance, my co-pay was $142.00.
I'm in shock. �I don't know what people without insurance do. �Go blind?
--
Joanne

No.

Look, I've been self-employed almost my whole life. I've gone
long periods of time without health insurance of any kind, including
having two surgeries (neither major).

And when we were in the UK we had a US individual plan. Since
individual plans are not regulated in this state, when Bill got
cancer, the company declared us "no longer insurable" and booted us
off.

But Bill got all the medical care he needed--and good medical
care, Yale Med School doctors, Harvard Med School doctors, on the
transplant list for a liver, you named it--all the way through the
time we were uninsured.

Then in the middle of it, we got insured again.

A couple of things here--first is that a lot of people take
medical bills as if they were written in stone. When I was
uninsured, I never just paid anything. I picked up the phone and
yelled a lot. My guess is that, in general, I paid only a third of
what I was initially charged for any of the things I was charged for.

Second, doctors and hospitals have--with one exception--been more
than happy to work with me when there was a bill coming up and I
needed treatment. They bent over backward for Bill.

Third, the more I listen to stories on this ng, the more
convinced I am that there is enormous variation in this situation by
region.

Bill and I got reinsured becase Connecticut passed a law
requiring every company that offers health insurance in this state to
offer at least one "guarantee issue" plan for the self-employed.

Guarantee issue means they can't turn you down, no matter what.
The law also regulates the rates, making sure you don't pay more than
you would for the plan if you were in a regular insurance group.

Which doesn't mean the plans are cheap. They run about $1000 a
month for a family plan where one of the members is 51 or older.

But my copay was only $20 for doctor visits and $500 for in
patient surgery. Ambulatory surgery had no co-pay at all.

When I started teaching, I switched to the plan offered by my
university, which also costs about $1000 a month.

But my copays are $5, and less for most prescriptions.

I suppose I have two differences from people here.

First, I think your health care is your responsibility. I think
it's entirely normal for people to use their own resources to pay
their own medical costs. I don't resent the idea that I may sometime
have to do that, or have to go without other things I want in order to
do that.

Second, having actually survived through a family catastrophic
illness (Bill's cancer) with no insurance until the very end, I know
that it's possible TO survive. It happens every day. So although I
would really prefer not to do that again, it just doesn't scare the
hell out of me the way it would have in, say, 1995.

Third, I'm increasingly nervous about the drawbacks of the
government systems discussed here. The most important issue for me is
the regulation creep--we have to pay for your health care, so we get
to tell you what to eat and how much to exercise and whether you can
drink and... Larisa thinks it's a "police state" when gays cannot
marry. I think it's a hell of a lot more like a "police state" when
government can make the most intimate personal decisions for me on the
grounds that since it's providing my health care, it gets to regulate
my health.

The other issue, though, is the thing Mique talked about--I don't
konw if anybody here noticed it, but he's talking about waiting times
so long that people die without getting treatment.

I've never in my life had to wait for any medical care I needed,
whether I was insured or uninsured, UNLESS I wanted a specific
doctor, who might be busy.

But the time differential betwen the diagnosis of gall bladder
problems and my gall bladder operation was less than a week. Bill got
onto the transplant list and into pre-transplant treatment literally
overnight, and at the time he had NO insurance at all and no way to
pay for it upfront.

I'm willing to believe that this varies a lot depending on where
you are, and that I may be lucky to be in New England, but there are
more variables here than anybody is considering.

For instance--some of the reason your premiums may be going up
may have to do with what kind of coverage your state mandates.

Among other things.

But in the end, I think that the real issue is that we've got the
wrong issue.

I don't think we have a health insurance problem. I think we
have TWO health insurance problem.

On the one side is serious and catastrophic illness--surgeries,
cancer, some chronic conditions, et.

The second is routine care.

I don't think we're going to "solve" the health insurance
problem by saying that the cream puff and the pork chop are the same
things and trying to cook them both to perfection in the same pot.

Jane Haddam
http://www.janehaddam.com
.

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