+- Mock (https://mockforums.net)
+-- Forum: Serious Shit? (https://mockforums.net/forum-4.html)
+--- Forum: Discussions, Opinions & Debate (https://mockforums.net/forum-11.html)
+--- Thread: So You Think Your Insured ? (/thread-439.html)
- BROTHER - 07-12-2009
found this little tidbit to share:::angrier::
[line]
How I lost my health insurance at the hairstylist⿿sby Downtowner, posted on Tuesday, July 7th, 2009 at 10:35 pm
So you⿿re chugging along doing all the things you do as a responsible citizen, you work, and pay your bills and your taxes, you are there for your children, and fighting for your marriage, you even volunteer. It⿿s spring, 1998, and gradually you just become so tired it⿿s a struggle merely to climb a flight of stairs.
Oh, well, you do have two daughters in college, another nearing the end of her senior year in high school, a son in middle school, a full-time job, a house to take care of, are back in college, and have two dogs, two cats, and oodles and oodles of marital strain.
Fatigue sort of goes with the territory, and like many working moms, you just push past it. You get up, you get the family off in various directions, you go to work, you go to class, you cook dinner, you help with homework, go to games and track meets, do housework, set boundaries for the two kids at home and field frequent counseling-like calls from the two who are not, you try to work through problems with your husband, and you collapse exhausted into bed, get up the next day, and do it all over again ⿿ it⿿s a routine you dare not interrupt with reflections on your fatigue ⿿ there is no time.
Then one day
You show up two weeks later than you should have to the hairstylist (pretty common when you are constantly pressed for time) and instead of the usual lecture about the color of your roots, she turns you around in the chair and says:
⿿I look at people⿿s skin tones all day long and try to decide the best coloring for their hair, and I can tell you this: gray is not a normal human skin tone. Get out of here right now and go see your doctor.
For some reason, though she is not the first person to note you don⿿t look your best lately, this is the one thing that manages to penetrate the fatigue-fog and you do as you are told.
You call on the way, check in, sit down in the crowded waiting room resigned to waiting for a couple of hours, and a mere minute later the doctor, passing by the glassed in sliding windows on the other side of the wall catches sight of you, comes out, and demands to know: ⿿How did you get so anemic? You say, ⿿I am? He says, ⿿Come with me right now takes your hand and drags you back to an examining room.
Later that day, at the oncologist/hematologist office, this new strange doctor takes blood, orders up an outpatient transfusion, tells you that you no doubt have acute myelogenous leukemia, could keel over dead at any moment as long as you are untreated, and should now go home and call him the very minute the HMO calls you and tells you to check into some local hospital or the other ⿿ but should on no account whatsoever check into that local hospital.
You find this direction to avoid hospitalization confusing, in light of the ⿿keel over dead untreated stuff and say so. Whereupon oncologist/hematologist guy says HMO will try to check you into local or even regional hospital ⿿ because it⿿s cheaper ⿿ but in his opinion no local or regional hospital should be treating leukemia, since cure rates double in large teaching institutions. Risk of keeling over dead while he is arguing for your life with HMO is less than risk of dying in local hospital. Then he writes you a list of five hospitals in Chicago that you can allow yourself to be checked into, and says if it⿿s one of these ok, but it won⿿t be, so call me when they tell you to go to a local hospital.
Sure enough, he⿿s right; they do, the very next day. You call him. He works some magic you know naught of (though local rumor tells you later that he informed HMO that he will be sure to make himself available to testify at your spouse⿿s wrongful death suit later) and you get the referral to the large teaching institution later that day.
Telling your childrenno, you won⿿t write the details here, beyond saying that especially for someone who lost a parent at the age of eleven, it⿿s the hardest thing you⿿ve ever done to try to be honest about the prognosis (which is grim) but reassuring about your love for them and intent to fight for your life.
Skip ahead then. On your first day in large teaching institution, you are visited by a social worker, who surprises you by demanding to know not the details of your home life, or about your state of mind on being diagnosed with a more-lethal-than-not form of cancer, but simply: ⿿Who is carrying your insurance, you or your husband?
You think this is rather cold for a social worker and inform her somewhat frostily that you are sure the bill will be taken care of ⿿ it⿿s pre-approved.
Social worker looks at you with what you interpret as pity and says it⿿s really, really important. So you say, spouse, as you work for small non-profit that offers no benefits, but also admit to her that you think marriage is for sure doomed now.
⿿Good, good! she says.
And you wonder why, why, on top of extra-lethal form of cancer, must you also get unbalanced social worker?
She must be able to tell from your expression that you think she⿿s nuts, because she explains, like so:
If you worked for a company that offered insurance, if you carried your family⿿s insurance, next year your insurer would slap a million dollar surcharge on the company policy for carrying a leukemia patient. The company would get the bill and someone in accounting would question ⿿what is this extra million dollars we are being billed?
The insurance company would explain to them that the million is for you, and it is yearly, but is, ahem, ⿿fixable. They will say ⿿as long as she is on your insurance (wink, wink) this charge will be there. So what you have to ask yourself (more wink, wink) is whether this employee is worth a million dollar a year salary on top of what you are already paying her.
Social worker said she had seen small business owners go almost broke trying to cover this charge, and had even heard of one who defiantly did go broke, throwing all of the employees out of work. But more usually, she said, they just fire you.
⿿Wait, wait! say you, ⿿Isn⿿t it illegal to fire someone for their health history? Suppose I⿿m all well and working?
She looks at you with more pity, says yes, so of course they will have to find ⿿cause to fire you, which any employer can always do.
⿿But I am a very, very good employee! you protest.
⿿Yes, she says, ⿿but they can always find some cause. The real problem she goes on to explain, is that you will find a new job, that company⿿s insurer will slap them with the surcharge, they will take their turn at firing you, until you⿿ve been through six or seven jobs in a year, fired ⿿for cause from all of them, which of course looks very, very bad to a prospective employer.
⿿So in a year or so of this, you will not just be uninsurable, you will also be unemployable.
She asks who your husband works for, since they⿿d probably try to do this to him too. You say he is a cop working for a municipality, which pleases her. ⿿They have all sorts of layers of officials, elected and otherwise, to work their way through to get to the decision, then once they do they have to get past his union, so it will take much longer to get him fired. She also, though, offered sympathy for the fact that what with the police union and the municipality fighting out whatever ⿿cause they got him on in such a public profession, it was sure to end up in the local papers and disrupt all our lives ⿿ including the children⿿s ⿿ when they did get that far.
You remind her you seem headed for divorce, and she says, well, okay then, just carry the COBRA to the limit and keep on working for small not-for-profits that don⿿t offer insurance.
You ask her what you are supposed to do for health care and she says sooner or later the insurance companies would force you onto Medicaid ⿿ either by means of making you unemployable and broke, or by means of you being uninsured and going through any and all assets you have paying medical bills until you are broke and sick enough that you can⿿t work, and end up on Medicaid.
You are rather horrified, but have other things (like trying to stay alive and simultaneously on top of what your teenage children are up to from the hospital many miles away) on your mind, and besides, this all seems so uncivilized and melodramatic and ⿿worst case scenario andunlikely, somehow, so you set this aside for now.
You live. In fact you are cured!
A year later you are divorced. You are struggling to get by as a single mother, and you are making the COBRA payments.
Your ex comes by to pick up your son and tells you that the municipality he works for⿿s administrator told him in absolute shock that the insurance company slapped a million dollar surcharge on the municipality⿿s insurance policy, and said it would go on yearly until you are off, but since you had exercised your right to COBRA it would ⿿do no good if your ex was gone. The administrator said he was so shocked and offended that he went to ALL the other carriers possible, and one by one they all gave him back a ⿿no bid with the proviso that they would welcome the opportunity to bidjust as soon as that leukemia patient⿿s COBRA rights expire. So barring leaving all the municipality⿿s employees naked of insurance they were absolutely trapped.
Social worker begins to seem less melodramatic to you.
Your COBRA rights expire.
You go on ICHIP, the program for uninsurable Illinoisans. It⿿s easy, because your disease is on the short-list of twelve or so that automatically render you ⿿uninsurable for life. You discuss the horrible policy benefits with your car insurance agent ⿿ who is also a trusted friend. She tells you she is also on ICHIP (though it was much harder for her to get on it - she had to get three denials from private insurers) and the entire benefit it provides is to ⿿get you through the door of a hospital since if you really do get ill you will get benefits so minimal that you will be forced to pay the vast majority of the bills until you are bankrupt and forced onto Medicaid.
Social worker begins to seem downright reasonable to you.
The day comes when you weigh the many, many hundreds of dollars you are paying on a monthly basis, through ICHIP, but to the very insurance company that once charged your ex⿿s employer a million dollars (coincidentally, the exact bill for your treatment over your year of leukemia fell just short of that million, by about ten dollars, so this company was out exactly nothing) of what is starting to smell like blood money, against your daughters continuing in college and your son eating on a regular basis.
You get a second job.
Your daughter gets sick with Type I Diabetes while uninsured and you weigh those hundreds of dollars to the insurer you now thoroughly detest and you drop that insurance and buy her insulin and syringes and test strips and trips to the doctor instead. You are now so broke that if you would just give up and quit your two jobs and collapse already you are certain you would qualify for Medicaid. But you are stubborn and you go to work.
Your mother ⿿ who though she has been a strict vegetarian since birth has very high cholesterol that will not respond to diet and who has been on high blood pressure medication for decades - survives her third heart attack and you consider the fact that your father died at 39 of a heart attack and you think that probably you are not far away from one yourself.
Your oldest sister says while visiting Mom at the hospital that she has been on high blood pressure and cholesterol medication for a decade too.
Your nearest-in-age sister, also a strict vegetarian, goes to get her cholesterol checked and sure enough is placed on high cholesterol and high blood pressure medication. She is also diagnosed as almost completely deaf in her left ear, as your father was at a very young age, and as you suspect you are too. She gets a miniscule hearing aid. You are careful to not put the phone to your bad ear.
Your little brother is diagnosed with cholesterol that doesn⿿t go down in response to a diet (you get hilarious stories about your sweet and gentle sister-in-law⿿s brutal enforcement of said diet) and high blood pressure. He goes on medication.
You go to the drug store and test your blood pressure when you wake up with the blood pounding in your ears one day and, sure enough, it⿿s crept up to high borderline. You try a myriad of things and finally hit on running every day and cutting all of the salt out of your diet to get it to the high end of ⿿normal. You check it once a week.
You struggle ⿿ much ⿿ with your weight and the overwhelming need for naps and your ridiculously dry skin and your thinning hair. Your late-twenties daughter, who has just been diagnosed with a completely non-functioning thyroid gland, goes on thyroid medication and lectures you that these are all exactly her symptoms, so you should get your thyroid checked. You know it, and are aware (as your daughter is not) that your mother and sisters have all also been on thyroid medication for years, but you can⿿t afford it ⿿ or the regular doctor visits and monitoring that go with it.
You go to coffee with your friends. They have not had an easy time of it lately with their own and their husbands⿿ health. In fact, it⿿s been a horrible couple of years. Your heart bleeds for them and you can think of no words sufficient to describe their courage and grace. And yet sometimes you feel jealous that they have access to medical care, and then you just feel guilty and small-minded, because they need this care, and they are wonderful, wonderful people who have worked hard for the lives they⿿ve built and who give much back to their communities.
But stillyou hear about one friend⿿s breast cancer, and you remember that your oncologist/hematologist warned you that all leukemia patients who survive eventually die of some form of cancer ⿿ because the chemo drugs are ⿿the strongest carcinogens, in the strongest doses, known to man. And you remember that your maternal grandmother died of ovarian cancer, and your nearest-in-age sister was successfully treated for ovarian cancer at the age of 24. But you know you can⿿t afford a tenth of the screenings you should be having on an annual basis ⿿ not even once.
Or you hear about a husband⿿s heart surgery and you think you might well need that one too ⿿ your mother, her sister, and one of your own have all had that particular surgery. But since you can⿿t afford the surgery, you don⿿t bother to try to have the tests you can⿿t afford either.
You don⿿t go get your hair done any more. You can⿿t afford it. So you do it yourself.
But you mostly fret about that because you will love forever the hairstylist who probably saved your life ⿿ even if you did end up uninsurable for the duration of that life in the process.
diarist⿿s note: Yeah, ok, this is my story. If you are annoyed by my writing it entirely in the second person, please be advised that I did it deliberately, because, quite frankly, this could be you.
Anyone can be uninsurable in America.
In about as much time as it takes to get your hair done.
I⿿m not looking for sympathy here ⿿ I⿿m alive and not everyone manages to survive the insurance fiasco that masquerades as ⿿care in our country. Besides, I⿿m so stubborn I⿿m planning on living until I⿿m old enough for Medicare. So I⿿d like to direct your sympathy to those who are still alive, but may not make it through another decade of having their ⿿care rationed by the insurance company accountants.
I know I⿿m not exactly breaking news here, so please, do not tip, do not rec, go directly to your friends and neighbors and explain to them that their medical care is a disaster waiting to happen, give them their congressperson and senator⿿s contact info and get them to call or e-mail.
- Middle Finger - 07-13-2009
I hate those kind of stories ... everyone knows we need reform, and I hope we get good reform soon. It looks like everyone might get a "public option" from the Government that will compete with the private carriers.
- Cynical Ninja - 07-13-2009
You really need to get your national health care sorted, the movie Sicko proved conclusively what an unfair, corrupt, profit chasing fuck up it is.
- LKTraz - 07-19-2009
Oh wow....I SOOOOOOOOO want health care like the top notch care you get in Cuba. The whole world is trying to flock there to get cured!
Hahahahahahahahahahahaha! [u]Michael Moore [/u]as the source of anything more than the laughter of disbelief? Give me a break.
Do we have a problem with health insurance? Yes.
Are any of the plans to fix it currently on the table the answer? No.
Rate caps on procedures and frivolous lawsuits would go a much longer way toward fixing the problem. Much of the reason procedures cost so much stems from the inception of "UCR" payments.
In this system if a provider charges say $100 for a particular service the insurance will only pay the UCR (Usual and customary fee). This payment says that the rate for the service should only be 80% of the actual fee and they will pay 80% of that 80%. Sound complex? Yup.
So let's see:
$100 x 80% = $80
$80 x 80% = $64
Now since the provider only actually get 64% of what they feel they should charge they simply inflate the shit out of their charges in order to get what they really wanted for their service.
Add to this that we are a very litigious society the costs for malpractice insurance are at a confiscatory rate which makes doctors and hospitals up those rates even more so as to subsidize those inflated insurance charges.
Also, in consideration of the possibility of lawsuits being filed providers will order every test under the sun so as to avoid the possibility that someone will sue because they "missed something" because they failed to do such and such test.
This makes what should have been a $100 charge skyrocket to $5,000 or more.
- BROTHER - 07-19-2009
Do you have insurance?
- Cynical Ninja - 07-19-2009
LKTraz Wrote:Oh wow....I SOOOOOOOOO want health care like the top notch care you get in Cuba. The whole world is trying to flock there to get cured!
Hahahahahahahahahahahaha! [u]Michael Moore [/u]as the source of anything more than the laughter of disbelief? Give me a break.
Do we have a problem with health insurance? Yes.
Are any of the plans to fix it currently on the table the answer? No.
Rate caps on procedures and frivolous lawsuits would go a much longer way toward fixing the problem. Much of the reason procedures cost so much stems from the inception of "UCR" payments.
In this system if a provider charges say $100 for a particular service the insurance will only pay the UCR (Usual and customary fee). This payment says that the rate for the service should only be 80% of the actual fee and they will pay 80% of that 80%. Sound complex? Yup.
So let's see:
$100 x 80% = $80
$80 x 80% = $64
Now since the provider only actually get 64% of what they feel they should charge they simply inflate the shit out of their charges in order to get what they really wanted for their service.
Add to this that we are a very litigious society the costs for malpractice insurance are at a confiscatory rate which makes doctors and hospitals up those rates even more so as to subsidize those inflated insurance charges.
Also, in consideration of the possibility of lawsuits being filed providers will order every test under the sun so as to avoid the possibility that someone will sue because they "missed something" because they failed to do such and such test.
This makes what should have been a $100 charge skyrocket to $5,000 or more.
Your health care system will never get get better, fairer or more efficient as long as yankee fuckwits like you defend the rights of health insurance/care providers to make massive amounts of cash while denying people essential healthcare to save money and this includes people with insurance up the ying yang.
I will continue to enjoy first class socialized healthcare while you pray you don't get seriously ill because it will land you in financial ruin sucker.
Cuba DOES have a cheaper, fairer, better healthcare system than the US - FACT.
- LKTraz - 07-19-2009
Uh dumbass libertard......
I wasn't DEFENDING the insurance system.
LEARN TO READ AND THINK BEYOND YOUR NARROW MINDED PRECEPTS!
I was merely illustratig just HOW the system got into the shambles it's in at this point.
Just how many breakthrough medical procedures HAVE come out of Cuba?
Artificial heart....wait, that was from the USA
Well there's always the medications that can now control the progression of MS.......nope, USA also.
Ok........leeches to suck a boil on the ass dry! I KNEW I could find one!
If you could comprehend more that your pointed little head says to you as you fume about "those uncouth, non-understanding people" who are NOT ultra left like yourself, you would see that I am suggesting viable solutions to the problem at hand.
- BROTHER - 07-19-2009
LKTraz Wrote:Uh dumbass libertard......Duh!::irk::
I wasn't DEFENDING the insurance system.
LEARN TO READ AND THINK BEYOND YOUR NARROW MINDED PRECEPTS!
I was merely illustratig just HOW the system got into the shambles it's in at this point.
Just how many breakthrough medical procedures HAVE come out of Cuba?
Artificial heart....wait, that was from the USA
Well there's always the medications that can now control the progression of MS.......nope, USA also.
Ok........leeches to suck a boil on the ass dry! I KNEW I could find one!
If you could comprehend more that your pointed little head says to you as you fume about "those uncouth, non-understanding people" who are NOT ultra left like yourself, you would see that I am suggesting viable solutions to the problem at hand.
WHAT IS YOUR SOLUTION! TIME IS OF THE ESSENCE FOR MANY.
- LKTraz - 07-19-2009
Re-read the post.
- BROTHER - 07-19-2009
LKTraz Wrote:Re-read the post.Great.......National Health Care!::fuckyeah::
- LKTraz - 07-19-2009
No........how did you miss the part about rate caps and limits on litigation?
- BROTHER - 07-19-2009
LKTraz Wrote:No........how did you miss the part about rate caps and limits on litigation?Easily, I have no insurance for eye-care!::bigg::
- LKTraz - 07-19-2009
BROTHER Wrote:Ya needs ta buy LOTZ-O carrots then!LKTraz Wrote:No........how did you miss the part about rate caps and limits on litigation?Easily, I have no insurance for eye-care!::bigg::
- BROTHER - 07-19-2009
LKTraz Wrote:lol::thumbs::BROTHER Wrote:Ya needs ta buy LOTZ-O carrots then!LKTraz Wrote:No........how did you miss the part about rate caps and limits on litigation?Easily, I have no insurance for eye-care!::bigg::
- sally - 07-19-2009
Ordinary Peephole Wrote:You're not the only person to tell me that they are happy with socialized health care and the myths about long waits and poor care are just that, myths. In fact many people have told me that. Meanwhile I'm paying $1500 per month for a family of four with the premium going up every year. If I don't pay it and happen to get cancer then I will have to give up all my assets and everything I everworked for, leaving me with barely a pot to piss inbefore getting any assistance. Sure that sounds much better ::thumbs::LKTraz Wrote:Oh wow....I SOOOOOOOOO want health care like the top notch care you get in Cuba. The whole world is trying to flock there to get cured!
Hahahahahahahahahahahaha! [u]Michael Moore [/u]as the source of anything more than the laughter of disbelief? Give me a break.
Do we have a problem with health insurance? Yes.
Are any of the plans to fix it currently on the table the answer? No.
Rate caps on procedures and frivolous lawsuits would go a much longer way toward fixing the problem. Much of the reason procedures cost so much stems from the inception of "UCR" payments.
In this system if a provider charges say $100 for a particular service the insurance will only pay the UCR (Usual and customary fee). This payment says that the rate for the service should only be 80% of the actual fee and they will pay 80% of that 80%. Sound complex? Yup.
So let's see:
$100 x 80% = $80
$80 x 80% = $64
Now since the provider only actually get 64% of what they feel they should charge they simply inflate the shit out of their charges in order to get what they really wanted for their service.
Add to this that we are a very litigious society the costs for malpractice insurance are at a confiscatory rate which makes doctors and hospitals up those rates even more so as to subsidize those inflated insurance charges.
Also, in consideration of the possibility of lawsuits being filed providers will order every test under the sun so as to avoid the possibility that someone will sue because they "missed something" because they failed to do such and such test.
This makes what should have been a $100 charge skyrocket to $5,000 or more.
Your health care system will never get get better, fairer or more efficient as long as yankee fuckwits like you defend the rights of health insurance/care providers to make massive amounts of cash while denying people essential healthcare to save money and this includes people with insurance up the ying yang.
I will continue to enjoy first class socialized healthcare while you pray you don't get seriously ill because it will land you in financial ruin sucker.
Cuba DOES have a cheaper, fairer, better healthcare system than the US - FACT.
- Maggot - 07-19-2009
Lets tax the shit out of every American business until they all fold like a deck of cards. The government could take over and when your house is going to be sold for the back taxes again let the government take over and sublet your house with another family from Egypt. We could all make the same wages and food stamps could be issued for everyone.Everyone would bepoor and nobody would berich (except for the polititians) Wages could drop to say 2.00 per hour as the government would be supplying food, housing and free medical care . Money would never be needed again and we could all watch the television proclaim how great the State is and how they help us.
- BROTHER - 07-19-2009
Maggot Wrote:Lets tax the shit out of every American business until they all fold like a deck of cards. The government could take over and when your house is going to be sold for the back taxes again let the government take over and sublet your house with another family from Egypt. We could all make the same wages and food stamps could be issued for everyone.Everyone would bepoor and nobody would berich (except for the polititians) Wages could drop to say 2.00 per hour as the government would be supplying food, housing and free medical care . Money would never be needed again and we could all watch the television proclaim how great the State is and how they help us.How do you come by your insurance?
- Maggot - 07-19-2009
I pay 40% the company eats 60% if this health care thing goes through I will pay 50%. Health care taxes will be passed on to the employees. If the tax goes higher that will also be passed on to the employee. Or if it gets real bad go to 32 hr weeks or freeze current salaries. When a company has to pass on these extra things to the customer we all pay.
- BROTHER - 07-19-2009
Maggot Wrote:I pay 40% the company eats 60% if this health care thing goes through I will pay 50%. Health care taxes will be passed on to the employees. If the tax goes higher that will also be passed on to the employee. Or if it gets real bad go to 32 hr weeks or freeze current salaries. When a company has to pass on these extra things to the customer we all pay.
What haqppens if you become injured. or ill, and you can no longer do your job?
- Maggot - 07-19-2009
I pay disability insurance for up to two years out of my own pocket. The problem with the Government taking over health care is that you cannot sue them for mal-practice in this sue happy culture we live in. My Doctor pays over 250,000 in malpractice insurance each year. The problem is that he passes that on to the consumer or insurance companies as a higher rate. If the insurance company will only pay 80% then this bill gets sent to the person that is sick. Are you somehow thinking that this extra 20% would be paid by the government through our taxes? That when they look at the next years revenue it will not be enough to cover these extras. Are you employed or are you destitute?