Universal Healthcare
- Thread starter Chuckinden
- Start date
No it shouldn't, but it has to because plenty of the actors in the industry will whether policy does or not. This is reality not fantasy.Good Lord! Policy should place financial gain over the dignity of human life.
That's possible but I don't think that's what happened. It ended up, they told her, that someone had entered a coding error. It ended up being solved because someone finally got involved, took the time to personally seriously research the case and found the error. Others simply said, "You owe it so pay it!"
So how much was the amount in question and how many hours did your wife spend getting it eliminated?
It wasn't the amount because it was only $175. It was a matter of principle. The insurance company wouldn't pay it because they said it was a bogus charge, It was simply $175 tacked on the final bill with no explanation and NOBODY could ever tell us what it was for.I even ignorantly paid the $175 at first but they refunded me the money (without me asking) saying I didn't owe it. Then they started hounding me to pay the $175. "We can't tell you what the $175 is for but BY GAWD you are going to pay it!" She would discuss it with one rep who would look at it and say, You don't owe this and you won't be getting another bill." Next month, another bill. Same thing over and over again for two years.
The old "wear them down until they finally give up."
I'm sure she spent a couple dozen hours on the phone.
I'm not criticizing, I was just curious how much the bill was. I completely get doing something for principle.
Doctor bought Chik-fil-A for the whole office charge.
just hope they don't send it to a collection agency and have your credit score drop 200 points.
What I'd really like to see, is some healthcare plan reward the people who take the time and resources to take care of themselves, driving down the cost of healthcare for everyone else. The most I've ever seen is some Northeast Health Insurers give out up to $300 in gift cards/year if you did online courses, donated blood, took classes.. But that's it.
For the general population, it's largely the same cost for everyone, give or take. But person A might cost the system $1,000 a year in routine visits and maybe a specialist visit. While Person B could cost the system $80,000 because they smoke, are fat, or refuse to get checkups that could prevent issues down the line.. Shouldn't person A, be rewarded? And wouldn't it further incentivize people to take their health seriously?
For the general population, it's largely the same cost for everyone, give or take. But person A might cost the system $1,000 a year in routine visits and maybe a specialist visit. While Person B could cost the system $80,000 because they smoke, are fat, or refuse to get checkups that could prevent issues down the line.. Shouldn't person A, be rewarded? And wouldn't it further incentivize people to take their health seriously?
I agree with that approach to a point, but how do you account for genetics? There are people that exercise, eat healthy, and basically do everything right, but have bad genetics. Those people can end up with high medical bills just because they lost in the genetic lottery.
Just read a column in the NYTimes that highlights something a few people have already mentioned in this thread. The main issue with our healthcare system, which has plenty of issues, is cost and waste. And one thing you quickly zero in on when looking at costs is end of life stuff. What percentage of all healthcare spending in the US comes in the last few months of life, when you're simply at best delaying the inevitable, and at worst accomplishing nothing?
"In their last month alone, half of Medicare patients go to an emergency department, one-third are admitted to an I.C.U., and one-fifth will have surgery — even though 80 percent of patients say they hope to avoid hospitalization and intensive care at the end of life.
Medicare spending for patients in the last year of life is six times what it is for other patients, and accounts for a quarter of the total Medicare budget — a proportion that has remained essentially unchanged for the past three decades.
It’s not clear all that care improves how long or how well people live. Patients receiving aggressive medical care at the end of life don’t seem to live any longer, and some work suggests a less aggressive approach buys more time. Despite a popular misconception, doctors don’t die much differently: Physicians use hospice care and die in hospitals at rates similar to everyone else."
https://www.nytimes.com/2017/05/10/...nytcore-iphone&smid=nytcore-iphone-share&_r=0
If there was ever an impossible riddle to solve, it may be this one. Everyone can view this objectively, neutrally, rationally - until it's a loved one that is at the end of life. Who wants to say "Nah, let's not do anything else, go ahead and let Mom die now"?......
"In their last month alone, half of Medicare patients go to an emergency department, one-third are admitted to an I.C.U., and one-fifth will have surgery — even though 80 percent of patients say they hope to avoid hospitalization and intensive care at the end of life.
Medicare spending for patients in the last year of life is six times what it is for other patients, and accounts for a quarter of the total Medicare budget — a proportion that has remained essentially unchanged for the past three decades.
It’s not clear all that care improves how long or how well people live. Patients receiving aggressive medical care at the end of life don’t seem to live any longer, and some work suggests a less aggressive approach buys more time. Despite a popular misconception, doctors don’t die much differently: Physicians use hospice care and die in hospitals at rates similar to everyone else."
https://www.nytimes.com/2017/05/10/...nytcore-iphone&smid=nytcore-iphone-share&_r=0
If there was ever an impossible riddle to solve, it may be this one. Everyone can view this objectively, neutrally, rationally - until it's a loved one that is at the end of life. Who wants to say "Nah, let's not do anything else, go ahead and let Mom die now"?......
Our company...that is a healthcare plan...does this. If you smoke you pay an additional $80/mo surcharge for your insurance, if your spouse smokes it's an additional $80/mo surcharge. There are free smoke cessation classes that if you complete and test out to be smoke free you are refunded all paid surcharges for that calendar year. You, and spouse if covered are required to take an annual physical where you are tested for tobacco use, the default is that you do use if you fail to comply with that requirement. What we pay in premiums is dependent upon our participation in our "Vitality" program which awards points for taking wellness classes, getting annual physicals, maintaining a healthy weight, blood pressure, cholesterol, dental visits, immunizations like flu shots, and for daily physical activity. There are four levels...bronze, silver, gold and platinum and the higher your obtained level, the lower the premium we pay. The difference in premiums between bronze and platinum are pretty substantial...like 40%. The exact difference is dependent upon plan and if it's family or just individual coverage. We also earn cash value for the points we accumulate in the program that can be exchanged for items like Amazon gift cards, Garmin fitness monitors, etc.
I'll say that despite what I view as quite generous incentives to stay healthy, it's amazing how many people don't participate in the program. About half never do enough to move out of a bronze category...and it doesn't take much to move from bronze to silver.
While I agree with the premise you suggest regarding things like tobacco use what we have seen in practice what happens is that the idea expands to include "risky behaviors" like motorcycling, snow skiing, marathons, triathlons, extreme sports, etc.
Lastly...while sounds good and reasonable that people who partake in behaviors that result in higher healthcare costs to be required to pay more it is impossible to get away from the fact that we all use the same healthcare system and that healthcare is going to be delivered to all regardless of ability to pay. If you show up at the ER, you're going to be served. Hospitals and providers all do billions of $$$ of charity care every year but we all pay the cost of that charity care. The higher the cost to the consumer, the more that are forced to seek care in our ERs...that drive up the costs that are shifted to the paying consumers. The other option is to shut down those ERs.
Unless you are willing to take the step to deny care to those who cannot pay you can never insulate yourself or any risk group from the costs of those unable to pay for healthcare.
Good point. There's a lot of things to account for. If everyone is healthy up to their 60's, Ok sweet.. but eventually, the body WILL break down and it will cost money to preserve life. Even the healthiest person will become a burden at some point.
As for Genetics, living a healthy lifestyle is always going to improve the body than a poor lifestyle. Or rather, someone with bad genetics who just doesn't care, will only expedite the process.
Still, minimizing health costs, basically being a good civil servant in a way, should be rewarded. And I'm not talking about giving people thousands. I mean once a year, if you choose to do this, you HAVE go for a routine physical, maybe also get checked out by a heart specialist or a nurse practitioner as well.. If they deem your health levels have been maintained, you get a check cut for $200.
Obviously it will never happen. too many factors. Still, it'd be nice if the people who took care of themselves were rewarded. I can think of at least a dozen things I've done this year, some of which cost me money, that will only keep me healthier down the line.
For example: I bought pricey orthotics because of flat feet and bad ankles. I'm walking around in $200 moon-boots that scream "I'm old and not hip, don't touch my dick!".. I should be rewarded for that!
For example: I bought pricey orthotics because of flat feet and bad ankles. I'm walking around in $200 moon-boots that scream "I'm old and not hip, don't touch my dick!".. I should be rewarded for that!
I agree that good behaviors should be rewarded, and I'm good with these reward systems even if they are only a few hundred bucks. The point that I really meant to make is that even people with good health habits can have expensive medical bills. Although on average, they are probably less than having poor habits.
When my grandfather could no longer take care of himself at his old folks home, we had to put him into a place that provided 24-hour support. I'm not sure what else we could have done other than saying "suck it up and piss all over yourself until you die". He spent several months there before he passed.
My point is, end of life costs are going to be expensive even if you aren't doing expensive surgery and the like.
My point is, end of life costs are going to be expensive even if you aren't doing expensive surgery and the like.
I think the appropriate term is death with dignity. I think most people including myself would rather die on their own terms rather than hooked up to machines and be kept alive just because we have the technology to do it. Citizens should have a right to die if and when it is their choice.
While I agree on the merits of what is written here, what cannot be determined are the number of people that pulled through and lived years longer due to the treatment they received.
I'm reminded of my grandmother who was close to 90 when we were all called to go see her because she only had days to live. The old gal lasted another 7 years. While we didn't take any extrodanry steps to save her she was hospitalized at the time. While this was 30 years ago, had it been today that period of hospitalization would have been quite expensive.
Another factor I've not seen mentioned is the cost and questions around Alzheimer's disease and other dimentia. My wife and I have watched my dad and her mom both pass away from Alzheimer's and we have both said if either of us are ever diagnosed that we would prefer death over the burden we would be placing on our families. We all said that we lost dad 5 years before he finally passed. I am sure that dad too would have preferred being allowed to die vs the years he spent as something other than the man he had been his first 80 years.
I find it ironic that we view it humane to put down our beloved pets when their quality of life is diminished but we require our human loved ones to endure the effects of disease and advanced aging.
Many of my parents' generation passed away at what would be considered a young age today - mid 60s. Hardly any heroic attempts were made to prolong their lives. Maybe if today's technology was available then it would have been different. They just died at home from "old age." No one even asked what they died of. It was just understood that they died of "old age."
I am in my mid 70s now and don't feel like an old man or really even think of myself that way. Other people certainly see me and see a guy with one foot in the grave of course. And I am often shocked at that old guy staring back at me in the mirror.
I don't have any aches or pains. I can still do normal household chores if I choose (but I prefer to pay someone else to do them.) I can still hop in the car and go anywhere I wish (and if you don't like the way I drive, stay off the sidewalk. :stuck_out_tongue_winking_eye. I still keep up with current events and ***** about the world going to hell in a handbasket.
But when I reach the stage when the above is no longer true, I'm more than ready to pass on. I've pretty much seen all and done all I've wished. It's not so much the old folks fearing death and clinging to life. We know where we stand in the cycle of life. It's the family trying to hang on to them for as long as possible - if they are loved (and don't have a large estate to be divvied up.).
I am in my mid 70s now and don't feel like an old man or really even think of myself that way. Other people certainly see me and see a guy with one foot in the grave of course. And I am often shocked at that old guy staring back at me in the mirror.
I don't have any aches or pains. I can still do normal household chores if I choose (but I prefer to pay someone else to do them.) I can still hop in the car and go anywhere I wish (and if you don't like the way I drive, stay off the sidewalk. :stuck_out_tongue_winking_eye
. I still keep up with current events and ***** about the world going to hell in a handbasket.But when I reach the stage when the above is no longer true, I'm more than ready to pass on. I've pretty much seen all and done all I've wished. It's not so much the old folks fearing death and clinging to life. We know where we stand in the cycle of life. It's the family trying to hang on to them for as long as possible - if they are loved (and don't have a large estate to be divvied up.).
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This is what is starting to stress me out as the grays come in. "How the hell is this happening to me? I'm not supposed to be old." My midlife crisis is picking up speed, btw.
Just means it's time to buy a Corvette and start courtin' bimbos.*
*just now noticed starchief's 'Vette post
Just beans, onions and cornbread. Preferably cornbread sticks.
Ida, this is my idea of health care after 6 pages of people's opinions
No arguing and name calling after six pages...don't recognize this place...paddock is slipping.
How do they test for tobacco use, and can they distinguish a heavy smoker from somebody who smokes an occasional cigar or pipe?
Yep. At a health fair at work a few years ago, they measured our height, weight, waist/hip ratio, body fat %, blood pressure, pulse, cholesterol, etc. The nurse told me I was a world-class athlete.
I don't smoke, don't drink, and I eat well, etc.
Yet I'm a very heavy user of medical resources. I have multiple chronic conditions that have required multiple surgeries, ER visits, hospitalizations, and routine monitoring via scans and scopes.
AIDS might be more easily treated than what I have.
About 10 years ago my primary care doctor was a Russian woman. When we went over my complex medical history and I mentioned I was from Kentucky, she asked - in all seriousness - if my parents were relatives before getting married.
So the stereotype of Kentucky even makes it to Russia.
They can smell a heavy smoker as soon as they enter the room. Might not smell the other until they step closer.
Some good points made without all the name calling and sniping. There is no easy or right answer. Health care is not going away and we have to find a way that is better for all of us.
I appreciate all those that participated in the thread.
I wasn't sure if you were serious or sarcastic in your first post. Sorry to hear that you have a tough condition.
I was thinking about a guy I know, thin build, walks to work every day, never smoked. Doesn't drink, eats well (mostly vegetarian). Anyways, he fainted while going to a concert one night. Went to his doctor, had a work up. Triple bypass a few weeks ago. Bad genetics.
One thing that I've learned by working in a hospital is that no one knows what anything really cost. Some will know what the reimbursement is and if they take the time, can calculate that he labor cost. As someone said earlier, Medicare and Medicaid reimbursements have set the standard and they aren't based on anything.