What an absolute disaster .....

[02sled]

3 minutes ago, Capt.Storm said:

People talk about long wait times in Canada...do you find that to be true?

It depends on the urgency of your need. I waited 6 weeks for an initial appointment with a specialist but I wasn't about to die or suffer. If your need is urgent you go to the top of the list. When I went to the emergency room when they took out my gall bladder I walked in and collapsed on the floor in a ball of pain like I had never felt before. Next thing I know I am waking up with a doctor and nurse attending to me. It was apparently about 30 minutes later when I came to. I was in surgery that night.

Another time I was waiting in emergency for a bad cut to my arm and was probably there about 2 hours. The guy they wheeled in with a heart attack and the other guy that arrived by ambulance with a huge gash in his leg from a chainsaw went before me.

One draw back to the system is that you get idiots that run to a hospital for some of the stupidest things that they don't need to be there for which does slow things down. I can typically get an appointment with my family doctor within a couple of days for non urgent and he does hold a window open each day for urgent situations.

Some people complain about waiting for an MRI for example to look at why they have intermittent back pain since they are prioritizing the guy who finds he can't walk.

 

[Capt.Storm]

1 minute ago, Zambroski said:

Well, that describes the "screwing" sort of...but how did it come to that.  My educated guess:  He let his coverage lapse after he lost his job.  If that coverage lapses for even one day, you are no longer considered to have prior coverage.  And it's a bit of a screw job...but if anyone explained the coverage correctly when transition with COBRA, he'd be getting fleeced, but would still have all pre-existings covered under the new plan.

Yeah..the details are always in the pudding I guess.

[Zambroski]

6 minutes ago, Capt.Storm said:

Z,

It has always bothered me that health insurance companies are for profit..maybe that's just me.

But that said I do understand why that has to be with the current system.

We need a social system.  But our demographic and people who are just constantly in and out of the health system for trivial issues would cause a huge stink because social plans don't allow for unlimited visits for runny noses and coughs or "boo-boos".....and the liberal media would call everyone racists....and off we go again.. 

[Capt.Storm]

1 minute ago, 02sled said:

It depends on the urgency of your need. I waited 6 weeks for an initial appointment with a specialist but I wasn't about to die or suffer. If your need is urgent you go to the top of the list. When I went to the emergency room when they took out my gall bladder I walked in and collapsed on the floor in a ball of pain like I had never felt before. Next thing I know I am waking up with a doctor and nurse attending to me. It was apparently about 30 minutes later when I came to. I was in surgery that night.

Another time I was waiting in emergency for a bad cut to my arm and was probably there about 2 hours. The guy they wheeled in with a heart attack and the other guy that arrived by ambulance with a huge gash in his leg from a chainsaw went before me.

One draw back to the system is that you get idiots that run to a hospital for some of the stupidest things that they don't need to be there for which does slow things down. I can typically get an appointment with my family doctor within a couple of days for non urgent and he does hold a window open each day for urgent situations.

Some people complain about waiting for an MRI for example to look at why they have intermittent back pain since they are prioritizing the guy who finds he can't walk.

 

That all sounds reasonable to me and really no better here with our high priced HC. 

 

[02sled]

11 minutes ago, Zambroski said:

How was he "getting screwed"?

By being denied coverage for his wife since she had a pre-existing condition and when he lost is last job he lost coverage for her and now couldn't get coverage for her so his family was now spending I think he said about 45% of his income on her medication since he couldn't get coverage. Her health condition developed while he was working for the former employer.

[Capt.Storm]

1 minute ago, Zambroski said:

We need a social system.  But our demographic and people who are just constantly in and out of the health system for trivial issues would cause a huge stink because social plans don't allow for unlimited visits for runny noses and coughs or "boo-boos".....and the liberal media would call everyone racists....and off we go again.. 

I hear ya!

I been in er waiting rooms and have always looked around wondering wtf was wrong with 3/4 of them.

[02sled]

One of the things that the province has done to try and help ease the burden of people needlessly going to the emergency room is start a program (Tele-health). You call a 1-800 number and speak to a triage nurse who would be the same type of nurse that would assess you upon arrival at the hospital and prioritize your care. The nurse will discuss your symptoms with you and ask pertinent questions over the phone. They will then give you advice on what you should do, like tell the guy with a headache to take some Tylenol rather than go to the hospital or perhaps you may be told to call for an ambulance of perhaps make an appointment with your family doctor. If you're in doubt what to do it's good to be able to get some free advice from a triage nurse.

[Capt.Storm]

1 minute ago, 02sled said:

One of the things that the province has done to try and help ease the burden of people needlessly going to the emergency room is start a program (Tele-health). You call a 1-800 number and speak to a triage nurse who would be the same type of nurse that would assess you upon arrival at the hospital and prioritize your care. The nurse will discuss your symptoms with you and ask pertinent questions over the phone. They will then give you advice on what you should do, like tell the guy with a headache to take some Tylenol rather than go to the hospital or perhaps you may be told to call for an ambulance of perhaps make an appointment with your family doctor. If you're in doubt what to do it's good to be able to get some free advice from a triage nurse.

Sounds good- if people actually call first.

[Zambroski]

14 minutes ago, Capt.Storm said:

Yeah..the details are always in the pudding I guess.

I was a financial and insurance broker for 10 years before I sold my brokerage.  The stories I have are amazing.  And they come down to two problems:  People that don't read or want to understand coverage limitations EVEN AFTER IT WAS EXPLAINED TO THEM IN DEPTH.  And our healthcare system that was designed to take every nickel from every possible source while providing the minimum amount of real benefit.  Inusrers and hospitals are amazingly corrupt...at a level nobody would believe.

Personal case:  About ten years ago, I was on a golf trip and my wife called and said our daughter had started throwing up and couldn't hold anything down.  I did the regular suggestions....put her to bed, keep liquids in her, etc....I said it was probably just a stomach virus...it would pass.  Well, she calls me at midnight in a panic (as women tend to do) reporting no change...well shit!  I'm three sheets to the wind and five states away trying to win a poker game.  So, I said, "take her to the hospital."  So she does...those fucking idiots, once presented with a "gold standard" inusurance plan ran a full body CAT scan and an amazing amount of tests to the tune of $14,000!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  Diagnosis?  Stomach virus.  Medication and treatment recommended? Pharma grade Pepto and rest!!!!!!!!!!!!!!!!!!!!

When I got the bill duplicate I flipped out!  I called my own insurance company and asked them to deny...which they were very happy to do.  I then went right down to the hospital and was immediately put in front of their administrator because of my knowledge and the stink I was about to cause.  End story, Charges dropped down to $800.

NOW....you tell me where and why we are so fucked up here.

Edited June 28, 2016 by Zambroski

[Capt.Storm]

What i have been seeing a lot around here is that now there are urgent care centers popping up all over for minor stuff..went to one for a breathing problem and was taken care of very fast.

[02sled]

13 minutes ago, Zambroski said:

Well, that describes the "screwing" sort of...but how did it come to that.  My educated guess:  He let his coverage lapse after he lost his job.  If that coverage lapses for even one day, you are no longer considered to have prior coverage.  And it's a bit of a screw job...but if anyone explained the coverage correctly when transition with COBRA, he'd be getting fleeced, but would still have all pre-existings covered under the new plan.

His coverage was contingent upon his employment with his previous employer as it was part of a group plan. He no longer qualified for that coverage since he was no longer an employee. A large number of our companies customers are private health care insurers and I have worked with many of their management teams. They admit that navigating what is covered and not under what conditions varies so significantly from one to another it's like speaking a foreign language.

[Capt.Storm]

3 minutes ago, Zambroski said:

I was a financial and insurance broker for 10 years before I sold my brokerage.  The stories I have are amazing.  And they come down to two problems:  People that don't read or want to understand coverage limitations EVEN AFTER IT WAS EXPLAINED TO THEM IN DEPTH.  And our healthcare system that was designed to take every nickel from every possible source while providing the minimum amount of real benefit.  Inusrers and hospitals are amazingly corrupt...at a level nobody would believe.

Personal case:  About ten years ago, I was on a golf trip and my wife called and said our daughter had started throwing up and couldn't hold anything down.  I did the regular suggestions....put her to bed, keep liquids in her, etc....I said it was probably just a stomach virus...it would pass.  Well, she calls me at midnight in a panic (as women tend to do) reporting no change...well shit!  I'm three sheets to the wind and five states away trying to win a poker game.  So, I said, "take her to the hospital."  So she does...those fucking idiots, once presented with a "gold standard" inusurance plan ran a full body CAT scan and an amazing amount of tests to the tune of $14,000!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  Diagnosis?  Stomach virus.  Medication and treatment recommended? Pharma grade Pepto and rest!!!!!!!!!!!!!!!!!!!!

When I got the bill duplicate I flipped out!  I called my own insurance company and asked them to deny...which they were very happy to do.  I then went right down to the hospital and was immediately put in front of their administrator because of my knowledge and the stink I was about to cause.  End story, Charges dropped down to $800.

NOW....you tell me where and why we are so fucked up here.

Yep..I do believe every word of what you said.

Once they see that you have great insurance ..money signs fill their eyeballs!

[Zambroski]

1 minute ago, 02sled said:

His coverage was contingent upon his employment with his previous employer as it was part of a group plan. He no longer qualified for that coverage since he was no longer an employee. A large number of our companies customers are private health care insurers and I have worked with many of their management teams. They admit that navigating what is covered and not under what conditions varies so significantly from one to another it's like speaking a foreign language.

And he let his COBRA or "gap coverage" lapse because either he didn't know how to do it (poor exit interview by inept HR people) or he couldn't afford to keep it because that coverage more than doubles what he was paying through a job he now doesn't have to help pay it  .  Shitty system.  BUT...if he knew he needed it because of his family's condition, he had the opportunity to keep it and should have.  It is what it is.

[Zambroski]

3 minutes ago, Capt.Storm said:

Yep..I do believe every word of what you said.

Once they see that you have great insurance ..money signs fill their eyeballs!

Did you know, health providers have a computerized ranking system that identifies your plan as soon as they put it in their system?  Basically, it reads out how much they can get away with.  Gold plans = JACKPOT!!!!!!!!!

SHITTY FUCKING SHITTY OF THE SHITTIEST.

[racer254]

Z,

Don't you get sick of explaining this crap to people?  All the while, you have the media saying things that are just simply false.  There may have been extenuating circumstances for about 1% of people with certain conditions, but I didn't know anyone who couldn't get health insurance if they needed it.  The prices were sometimes outrageous is all.

[Capt.Storm]

Just now, Zambroski said:

Did you know, health providers have a computerized ranking system that identifies your plan as soon as they put it in their system?  Basically, it reads out how much they can get away with.  Gold plans = JACKPOT!!!!!!!!!

SHITTY FUCKING SHITTY OF THE SHITTIEST.

Don't get me started.

my wife has been working for the same hospital system for 37 years...and we have to jump through hoops like you would not believe.

I have a hospital a few miles from me that i cant use for er...instead I have to drive into the city to where she works..or else pay big money.

[Zambroski]

8 minutes ago, racer254 said:

Z,

Don't you get sick of explaining this crap to people?  All the while, you have the media saying things that are just simply false.  There may have been extenuating circumstances for about 1% of people with certain conditions, but I didn't know anyone who couldn't get health insurance if they needed it.  The prices were sometimes outrageous is all.

Sometimes.  And a lot of times I won't.  I just don't feel like it.  "I know what I know" and while that's not everything by a long stretch...I rarely open my mouth (post) about something I haven't "schooled" myself on extensively.  These forums give me a place to do what most are here to do.....vent.  These places are hardly valuable databases of intellectual information.  But, there are some moments of knowledge in here...just gotta sort through the garbage rhetoric, which a lot of members believe that their ability to spew shit and "cut and paste" makes them some type of educated superstar.  Reality?  Imbeciles....and a the largest part of the problem for the most part.

Now, I don't feel like explaining this anymore either.  

Edited June 28, 2016 by Zambroski

[racer254]

Just now, Zambroski said:

Sometimes.  And a lot of times I won't.  I just don't feel like it.  "I know what I know" and while that's not everything by a long stretch...I rarely open my mouth (post) about something I haven't "schooled" myself on extensively.  These forums give me a place to do what most are here to do.....vent.  These places are hardly valuable databases of intellectual information.  But, there are some moments of knowledge in here...just gotta sort through the garbage rhetoric, which a lot of members believe that their ability to spew shit and "cut and paste" makes them some type of educated superstar.  Reality?  Imbeciles....and a the largest part of the problem for the most part.

Now, I don't feel like explaining this anymore either.  

Ha Ha.   Classic.

[Mainecat]

Big Healthcare owns congress. Cost controls were removed from the ACA because of that.

[Capt.Storm]

People do rip the systems off also.

I already told the story about one of my sister i laws...but i'll do it again.

I think she is 63..64.

Anyways she is fine..perfectly healthy.

She has  chosen not to work for the last few years.

She has over 400k in ira's..roths..stuff like that.

She keeps no money really in savings and checking accounts.

She draws like 6 or 700/month from her x's ss..well it's not actually ss he is retired from a fed prison system in pa. so it's diff then reg ss...but still she draws that instead of her own ss,which if she did might fawk up her beanies.

She gets food stamps ..medicade for hc that is really good and help through h.e.a.p. which pays a good part of her heating and electric.

Yet some on here saw no problem with all that.

 

 

Edited June 28, 2016 by Capt.Storm

[Mainecat]

1 hour ago, Zambroski said:

I was a financial and insurance broker for 10 years before I sold my brokerage.  The stories I have are amazing.  And they come down to two problems:  People that don't read or want to understand coverage limitations EVEN AFTER IT WAS EXPLAINED TO THEM IN DEPTH.  And our healthcare system that was designed to take every nickel from every possible source while providing the minimum amount of real benefit.  Inusrers and hospitals are amazingly corrupt...at a level nobody would believe.

Personal case:  About ten years ago, I was on a golf trip and my wife called and said our daughter had started throwing up and couldn't hold anything down.  I did the regular suggestions....put her to bed, keep liquids in her, etc....I said it was probably just a stomach virus...it would pass.  Well, she calls me at midnight in a panic (as women tend to do) reporting no change...well shit!  I'm three sheets to the wind and five states away trying to win a poker game.  So, I said, "take her to the hospital."  So she does...those fucking idiots, once presented with a "gold standard" inusurance plan ran a full body CAT scan and an amazing amount of tests to the tune of $14,000!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  Diagnosis?  Stomach virus.  Medication and treatment recommended? Pharma grade Pepto and rest!!!!!!!!!!!!!!!!!!!!

When I got the bill duplicate I flipped out!  I called my own insurance company and asked them to deny...which they were very happy to do.  I then went right down to the hospital and was immediately put in front of their administrator because of my knowledge and the stink I was about to cause.  End story, Charges dropped down to $800.

NOW....you tell me where and why we are so fucked up here.

Good example. I have many as well.

Now many here will say health insurers are "losing" money.

[jtssrx]

1 hour ago, f7ben said:

http://www.investors.com/politics/policy-analysis/minnesota-shows-everything-wrong-with-obamacare/

 

There is no doubt that Obamacare is a disaster .....it is indefensible and most knew this would be the outcome. Those who are young and healthy are saying fuck you and paying the fine. The risk pool is such that premiums are skyrocketing. Coverage for most under the ACA is nothing more than an extremely costly catastrophic coverage plan. p

 

The only people who are benefiting from this disaster at all are those who are receiving the full subsidy. So the government took control of an industry ....wasted trillions of dollars and we are left with a situation far worse than what we had.

Dumb tucks like MC like it because they like anything Obama does. They won't like it when we have single payer and the good care we had is gone. They will respond and tell me what an idiot I am that single payer is the answer. However I say look no further then the VA for your answer on single payer. 

 

When you look at industry as a whole the only thing holding back anything in this country is government. Government run single payer healthcare isn't a free market. Once the Feds control it the doctors will get lazy simply because tgen incentive to earn a lot goes out the window.  

[Zambroski]

18 minutes ago, Mainecat said:

Good example. I have many as well.

Now many here will say health insurers are "losing" money.

They aren't, they are just making a lot less.  Typicallly large insurers operate at between 88-92% loss ratios.  At least that's all their gonna admit to.  Watered down simplistic number about 10% profit.  Now that's after they couldn't find any other way to spend their money!!!

Do some of that math!  Holy huge bucks!   Oil, pharma, banking and insurance run our government.

[Capt.Storm]

Edited June 28, 2016 by Capt.Storm

[Capt.Storm]