Health Care and your experiences

[RavenSky]

I recall some years back a repeated go-round with the lab. They got a date wrong and got a claim rejected. I didn't meet the deductible that year, it was going to be entirely out of pocket, I just wanted the insurance to approve it so the charge would be what's appropriate, not the ~10x amount the lab wanted. The lab just kept blindly resubmitting the bill without fixing the problem and ended up dropping the whole thing when the insurance company finally rejected it as too late rather than duplicate.

Which actually illustrates yet another problem with the US system. Doctors and hospitals have people employed full time just to sort out all of the many many different requirements of the many many different insurance companies.

Single payer cuts costs just on this point alone, to say nothing of reducing headaches for people who should be concentrating on their health.

After my daughter's accident, she had casts and multiple surgeries on both arms, among other injuries. The amount of insurance paperwork was absolutely mind boggling, and physically impossible for her to do.

 

[Keith&Co.]

From discussions with Bilby, I gather this has been discussed ad nauseum before, however, I am curious about how you access health care.

For 20 years i had whatever the military had at the base i was stationed.

I used to laugh at people who fought health care reform by protesting 'You won't be able to pick your own doctor!'

Who the fuck cares? I never understood that. For 20 years, i showed up a sick call and got a corpsman, then escalated to whoever had the authority to prescribe something and send me home. I thought picking a doctor seems like something of a luxury to be considered AFTER we're sure we'll have ANY doctor. At some ccommands, we got an 'independent duty corpsman,' which means an enlisted who was really really good at saying, "Take two aspirin and sleep it off."

Retired now, working for a military contractor, i've got a $3000 deductible. The insurance pays pretty close to nothing until after i pay that.
Between my diabetes, chronic eye bleeding, and the various specialists we require, my family usually meets that around May.

The company has a 'matching funds' policy with regard to my HSA. At the start of the year, they put $1300 into the account, and take monthly withdrawls from my pay so that i make at least a matching contribution by the end of the year. However, it's not really the company paying matching funds. What they do is loan me $1300 at the start of the year, so i have SOMETHING in my HSA, and i can pay the loan back over the year, along with making my contributions.

 

[tantric]

i have a few stories....let's see, when i was first out of college i worked as a temp, meaning i had no health insurance. i came down with a kidney stone - the mind destroying pain kind. i ran to the ER where i was xrayed and told, 'you have a large stone that you won't be able to pass. we're giving you some narcotics to help with the pain." stop. i said, 'if i can't pass it, what's going to happen, what are you going to do?" the doc replied, "we won't do anything until you're in a life-threatening situation. so until the stone moves enough to block your ureter and you go into hydronephrosis, you have the pills." i'm trying really hard at this point to not channel marx. "well, when that happens, you'll use the sonic thing to break it up?" doc replies, "that procedure is patented and costs an additional $10,000, paid up front, above the cost of the surgery. if you can''t afford that, the other option is making a small incision and using a tiny laser to zap the stone. that only requires $700 up front." i had to mortgage my soul to get the $700, but i did. i had it in my bank account and paid with a debit card, which they really didn't like. i swear, lord buddha as my witness, that as the nurse was getting ready to versed me, billing called and tried to get me to give them a credit card number. my nurse hung up on the bitch.

i became diabetic in grad school. i was used to just going down to the clinic and getting my insulin every month, talking to my doc every other month. when my life crashed and i was flat broke later, i was at a loss as to how to get insulin. when i ran out, i waited a day and went to the ER. i told the docs my situation. the doc got a vial of my type of insulin and gave me a shot (good for a day) and wrote me a prescription for the same and gave it to me. i asked, "can i get a few refills?" he said, "no, you need to be under the care of a regular practitioner". after he left, the nurse came back in and handed me a vial of my brand, saying, "they only use it once, then throw it away, i should have thrown it away, but i got it for you, don't tell anybody". good thing, too, because i was to find out that those vials of insulin i got for free with insurance cost $120 each, for a one month supply.

i did some scrambling and found a program where i could get 3 vials for a mere $12, but i had to have a prescription for three months worth. i made an appointment with a general practitioner. because i didn't have insurance, i was required to pay the full $125 fee upfront, before even seeing the doc. i did so, saw him and told him what i needed. he signed his name, gave me the paper end of service. i very carefully did not key the word 'extortionist' in his sportscar parked out back, no, i didn't.

background: in this country, junkies are the new lepers, the diseased you get to feel righteous about persecuting

my sister is, without a doubt, junkie xl. recently she fucked up and killed her bowels and had to go to the hospital to have them removed, bit by bit. they were giving her minimal pain meds because she has a history of abuse. then they took her off food entirely, vein feeding for the next two weeks. she went bugfuck, total withdrawal, begging the nurses to give her even ice to chew on (the wouldn''t, which is just stupid, but better cruel now than sued later). her doc came around for a talk and i got him aside and asked if she could be given a benzodiazepine to help with her cravings. he said, i swear, "no benzodiazepines can only be given orally and she can't have anything by mouth" i was nonplussed. it never occurred to me that i might look stupid. i replied, "did you get your medical degree off the back of a cereal box? cause if you did, i hope you kept the receipt. son, they owe you a refund" it went downhill after that. when i asked to speak with his manager, he lost the power of speech entirely.

 

[barbos]

braces_for_impact Obamacare does nothing for unemployed?

The problem is having enough money for the premiums.

So ObamaCare does (or rather did) something for unemployed?

My experience with US health care system was satisfactory except I did not have anything serious. But I was slighly screwed couple of times because I was in different state from my insurance. I think this is stupid.
I know a little bit about "Universal" health care system in Russia, it's utter crap unless you have money and live in biggich city, in which case it's just crappish.

 

[barbos]

From discussions with Bilby, I gather this has been discussed ad nauseum before, however, I am curious about how you access health care.

For 20 years i had whatever the military had at the base i was stationed.

I used to laugh at people who fought health care reform by protesting 'You won't be able to pick your own doctor!'

Who the fuck cares? I never understood that. For 20 years, i showed up a sick call and got a corpsman, then escalated to whoever had the authority to prescribe something and send me home. I thought picking a doctor seems like something of a luxury to be considered AFTER we're sure we'll have ANY doctor. At some ccommands, we got an 'independent duty corpsman,' which means an enlisted who was really really good at saying, "Take two aspirin and sleep it off."

Retired now, working for a military contractor, i've got a $3000 deductible. The insurance pays pretty close to nothing until after i pay that.
Between my diabetes, chronic eye bleeding, and the various specialists we require, my family usually meets that around May.

The company has a 'matching funds' policy with regard to my HSA. At the start of the year, they put $1300 into the account, and take monthly withdrawls from my pay so that i make at least a matching contribution by the end of the year. However, it's not really the company paying matching funds. What they do is loan me $1300 at the start of the year, so i have SOMETHING in my HSA, and i can pay the loan back over the year, along with making my contributions.

Should not you be getting free health care as a veteran?
As for diabetes I heard of a free cure which works well (tested on rats) You need to to go on starvation diet for 3 months (25% less calories than normal norm for human) After that you can eat normal (that is not getting fat).

 

[braces_for_impact]

The problem is having enough money for the premiums.

So ObamaCare does (or rather did) something for unemployed?

My experience with US health care system was satisfactory except I did not have anything serious. But I was slighly screwed couple of times because I was in different state from my insurance. I think this is stupid.
I know a little bit about "Universal" health care system in Russia, it's utter crap unless you have money and live in biggich city, in which case it's just crappish.

Part of Obamacare included a medicaid extension. Medicaid is used for the poor. It generally has no out of pocket costs, but is more difficult to obtain medical care, because it pays bare minimum and so some doctors do not accept it. Part of Obama's health care reform included covering more of the poor in the states with medicaid, in order to cover more people, and the federal government would reimburse that cost to the state for a few years, and then pay another percentage of that amount for a few more years. Nevertheless, some states (all Republican governors) turned down the medicaid expansion on ideological grounds, citing the costs to their state after those funds dried up. This is easy to do when you yourself have the best coverage money can buy. This is just one of the difficulties with the health care act, in that states didn't have to establish health care exchanges and were allowed to refuse funds that would have given their population health care, which weakened the entire system. Then they get to complain what a disaster the health care law is. Politics at it's finest.

 

[Keith&Co.]

Should not you be getting free health care as a veteran?

TRICARE isn't quite free, not for the family, and i'd rather not deal with the VA. Maybe when i retire-retire.

As for diabetes

I have type I diabetes. It's genetic, not a result of overeating. Surprised the shit out of the doctor when they finally diagnosed it.

 

[barbos]

TRICARE isn't quite free, not for the family, and i'd rather not deal with the VA. Maybe when i retire-retire.

As for diabetes

I have type I diabetes. It's genetic, not a result of overeating. Surprised the shit out of the doctor when they finally diagnosed it.

I am not surprised they were surprised, type 1 is usually develops at the young age in children.

 

[barbos]

American system is designed to be obfuscated. and complicated in order to make people pay more.

 

[T.G.G. Moogly]

American system is designed to be obfuscated. and complicated in order to make people pay more.

That's quite generous of you calling it a "system," something it lacks entirely.

Once when I was between jobs and needed a short term catastrophic policy, I purchased one for the family. After three months, at which time I was permanently reemployed with coverage, I received a phone call that I owed more money on that short term policy that I had bought almost three months ago. The lady at the other end told me that unless I sent in the money the policy would be cancelled and I would be without coverage. I was surprised because I had bought the policy and had all the paperwork in order. It was like a dealer telling me I owed them more money for the car I bought with cash three months ago.

But she insisted I owed more money, that the cost had been a mistake, and that the coverage would be cancelled unless I sent more money. She was obviously preying on me and I knew it, but had the advantage of having new coverage. So I told her to go ahead and cancel the policy, that I wasn't going to send anymore money. There was this long silence after which she stammered around trying to explain to me that I would be without coverage, blah blah blah.

That's how the "system" works in the U.S.

 

[barbos]

American system is designed to be obfuscated. and complicated in order to make people pay more.

That's quite generous of you calling it a "system," something it lacks entirely.

Once when I was between jobs and needed a short term catastrophic policy, I purchased one for the family. After three months, at which time I was permanently reemployed with coverage, I received a phone call that I owed more money on that short term policy that I had bought almost three months ago. The lady at the other end told me that unless I sent in the money the policy would be cancelled and I would be without coverage. I was surprised because I had bought the policy and had all the paperwork in order. It was like a dealer telling me I owed them more money for the car I bought with cash three months ago.

But she insisted I owed more money, that the cost had been a mistake, and that the coverage would be cancelled unless I sent more money. She was obviously preying on me and I knew it, but had the advantage of having new coverage. So I told her to go ahead and cancel the policy, that I wasn't going to send anymore money. There was this long silence after which she stammered around trying to explain to me that I would be without coverage, blah blah blah.

That's how the "system" works in the U.S.

Maybe it WAS a mistake and you paid less than you should?

 

[Playball40]

Please tell me you at least got the kids on Florida Kid Care. When my business was going belly up and my husband was the only one with a salary, we qualified (that in between stage, like you) for Florida Kid Care. I paid $15 per month for all five kids and it included dental. I didn't even have to change their pediatrician. It's only for the kids so it won't help you but it was a lifesaver for us. It's been years, so for all I know Rick Scott has gutted the program, but it is worth a look.

I live in the US. My job was shipped overseas last November, so I don't have healthcare at all. Any appointment I make will ask what insurance I have, and if I tell them none, I must fork out several hundred dollars in advance to be seen - if this particular medical practitioner will see people that don't possess insurance. If I have a medical emergency, the Emergency room cannot refuse me stabilizing treatment, and assuming I survive, a nice social worker will come around and knock some of the balance off, but I'll be on the hook for thousands of dollars. Because I cannot pay, it will be reported to my credit (as it has been already from a past period of unemployment) and my credit score now resides in the shitter. So anything that requires credit: car, apartment, etc. will cost more or I'll do without.

I currently have a bone spur in my neck pressing on a nerve, along with several bulging and collapsed discs and arthritis in my neck, all of which causes severe pain and headaches. I am currently about to exhaust my unemployment. I'm on food stamps, and my girlfriend (a good woman that deserves better) is working her ass off trying to make ends meet. But, as a household, we ourselves and our two kids make too much money - so I don't qualify for medicaid.

Once I lost my medical benefits from my job, the opioids I was on reared their ugly head. I always took them as directed, but nevertheless I've been on them for three years, and once they ran out, not only did my pain come raging back with a vengeance, so did opiate withdrawal - something I had never experienced. I was sick like I've never been until my girlfriend suggested I try kratom. Taking the kratom instantly removed the sickness and does as good a job as the prescription tramadol I was on with regards to the pain. So I pay for this out of pocket. There are various governmental agencies trying to outlaw it here (as a schedule 1!) but so far, thankfully it remains legal.

I did qualify for a government retraining program and I am taking classes to certify in A+, Network+ and Security+. I like the tech, and I like the work. It's a struggle to make ends meet, to study and hang on, but I keep working at it. If I graduate successfully in May or June I'll about double my possible salary, be well in demand, and get my health care back. My GF has developed back problems and bulging discs in her back over the last couple of years (honestly, probably from working so hard at physical labor) and is in much the same predicament I am. While this has been one hell of a struggle, if my family can pull this off it will be worth it.

You asked!

 

[braces_for_impact]

Yes, thankfully the kids are covered. I'm glad about that, but Medicaid has always been stupid in that area. Obviously the parents should be able to be kept healthy and promptly get medical attention. After all, time spent sick is often time spent not working. So if the goal is to lift a family out of poverty...

 

[T.G.G. Moogly]

Maybe it WAS a mistake and you paid less than you should?

You don't think it's fishy that someone tells you that you owe them 1/3 more money on a policy, and that they call you five days before the policy expires, and that they will cancel immediately if you don't pay?

 

[T.G.G. Moogly]

Sometimes I delusionally think the best policy would be to make the selling and holding of health insurance unlawful for anyone between the ages of 21 and 65. Make health care obtainable the same way we obtain food - no hidden costs after checkout or before purchase, no submitting bills, no lawyers, no obfuscation, no regulation, no corruption. People younger than 21 but older than 65 are all treated free of charge. Health costs would plummet because people wouldn't be so confused when they buy, same as any other purchase.

 

[Loren Pechtel]

Sometimes I delusionally think the best policy would be to make the selling and holding of health insurance unlawful for anyone between the ages of 21 and 65. Make health care obtainable the same way we obtain food - no hidden costs after checkout or before purchase, no submitting bills, no lawyers, no obfuscation, no regulation, no corruption. People younger than 21 but older than 65 are all treated free of charge. Health costs would plummet because people wouldn't be so confused when they buy, same as any other purchase.

Costs would plummet because the sick would die.

 

[J842P]

I've got it good, in the US. My current job provides medical, dental, and vision, and they are pretty good plans. So my current employer is paying around 450 a month so that I can prop-up a bunch of baby boomers who vote against Universal Health care.

 

[Keith&Co.]

I've got it good, in the US. My current job provides medical, dental, and vision, and they are pretty good plans. So my current employer is paying around 450 a month so that I can prop-up a bunch of baby boomers who vote against Universal Health care.

Tony?

 

[RavenSky]

TRICARE isn't quite free, not for the family, and i'd rather not deal with the VA. Maybe when i retire-retire. I have type I diabetes. It's genetic, not a result of overeating. Surprised the shit out of the doctor when they finally diagnosed it.

I am not surprised they were surprised, type 1 is usually develops at the young age in children.

Type 1 is, unfortunately, being diagnosed more and more frequently in older children and adults. They used to believe Type 1 was hereditary and diagnosable at a young age. They have discovered that - while there does seem to be a genetic component - it actually occurs when the body's own immune system "mistakenly destroys the insulin-producing (islet) cells in the pancreas" - which can happen at any age for reasons not yet well understood. Viral infections are one possibility, and the one doctors suspect in my daughter's case.

My daughter was already a young teenager before the onset of her Type 1. A local lawyer I know was already in his 30's.

Keith, just curious, how old were you at diagnosis?

 

[barbos]

Well, wikipedia says "It typically begins in children and young adults" so older adults are not really excluded.