-
Website
http://capitolfax.com/ -
Original page
http://capitolfax.com/2007/07/31/horror-story/ -
Subscribe
All Comments -
Community
-
Top Commenters
-
wordslinger
96 comments · 42 points
-
Rich Miller
147 comments · 56 points
-
LoopLady
16 comments · 6 points
-
theoriginallynns
16 comments · 2 points
-
dupage dan
28 comments · 2 points
-
-
Popular Threads
We should be concentrating on the many many success stories and not the headline grabbing stories about the few who were without coverage.
I repeat: Thankfully Mrs. Thompson got the health care she needed.
The BS some of the companies try to pull is beyond belief.
People need some level of care; however the SJR stories of people making in excess of $100,000 and getting health coverage through state plans; essentially choosing self employment and "rolling the dice" health care wise is irresponsible and covering six figure self employed people who choose not to provide their own coverage is not how state plans should work. Most of us have made sacrifices from what we would like to do to what provides reasonable benefits. I have a family member that is uninsurable through no fault of their own and will soon be off the parent's insurance as school will be finished; the choice has already been made get something that has insurance benefits at whatever cost including a lower income. Something needs to be done that makes everyone accountable. Many people with a low co-pay go to the doctor for every scratch driving up health care costs while many with 80/20 insurance knowing some of the cost is out of pocket are less hesitant to go. A health plan that has a minimum contribution toward care and a cap so that no one is bankrupt sound workable. The minimum contribution can be salary based. Unfortunately as with all things the poor are taken care of and the rich take care of themselves and the middle class continues to struggle.
My nephew, aged 33, pays $130 a month for an individual BCBS policy with a fairly high deductible. He does get a deduction on his federal income tax as an individual (vs group) policy holder so the real cost is closer to $100 a month. If he were in his fifties, I assume $300 would be a fairly reasonable price, for an individual policy holder, today. Ms. Thompson appears to have dropped some reasonably priced coverage.
Could it be cheaper. I don't know. All the French, regardless of income, get cancer care free, according to a recent Business Week article on health care. But their tax burden is very substantially higher, including a VAT (sales) tax that is about 10 points higher than our sales tax.
There is no free lunch. But one thing Blago could do is ensure community rating and guaranteed access to health care for all Illinoisians. That means everybody pays the same for the same level
of policy and nobody can be turned down for insurance, regardless of health history. Illinois, despite its strong liberal voter base, has been slow to provide even this basic type of health insurance security to its citizens. Too many pigs at the trough, I guess. And the health insurance industry is no doubt providing a lot of extra feed for those pigs on the side.
I have been very, very blessed. My dad always had great insurance through his company, and since he was corporate he had top-level plans. My wife works for the state, so I have good insurance through her.
The worst story I can remember is that my aunt, whom I miss very much, was devoid of healthcare for much of her life and wound up dying because of a veritable lack of preventive care. And because Medicaid premiums went unpaid to many Metro East doctors, clinics and hospitals, she had a hard time finding a doctor or clinic in the Metro East that would take her card. It was aggravating to watch one of the best people I've known and will ever know succumb to such bureaucratic baloney.
I will pray for Mrs Thompson's full recovery. I sincerely hope that she can get the care she needs. I am certain, however, that case studies like this one will continue to pop up and will continue to show some of us the great divide between personal responsibility and socialized control of responsibility.
They explained to me the catastrophic bills that could come my way if I were to simply fall down the stairs. My parents told me I was being completely STUPID for not getting health insurance. But I thought could not afford the insurance at the time. SO my father insisted I pick up a second job to pay for the insurance. SO I started waiting tables one or two nights a week to pay the insurance costs. Fortunately for me, I had my parents educating me about the ways for the world. Fortunately for me, I had the capacity and work ethic to pick a part time job to may my own bills.
Fortunately for me, I had the willingness to work an extra few hours a week to pay my personal bills.
I am very sorry for the sickness and financial strain it has caused Mrs Thompson.
However, it is not the fault of the taxpayers or the Governor that I was uninsured during the brief period before may parents told me how ignorant I was..............
You have to wait. A long time. One of our students suffered from chest pain. He couldn't get any attention from the state clinic because they triage everyone. There are more patients than doctors, so the system forces you to deal with cold bureaucrats who make your life or death calls - not you. They took his blood pressure, listened to his heart, and told him he had nothing to worry about. He complained and gave great details about his concerns - they didn't even listen because they say everyone feels they have needs, so they depend on their tests only.
So he was sent home, and it was my job to worry about him. He didn't get better, so we asked and got homeopathic pills. Not real medicine - cheap homeopathic crap. You see, drugs are also rationed in Germany. They cost, so you don't get them unless a test tells them otherwise. Instead you see a lot of fake medicine in Germany available over the counter and useless.
Honestly, in all seriousness, whenever we had a student with a medical need, we sent them back to the US. The reason was that there was really NO medical care available under the German system.
We had a bike accident, which is common when American students try to ride bikes, (we are awful bike riders, btw). Broken leg, bleeding, the whole schmear. We would consider the situation an emergency. Not in Germany. We had to get a taxi to the state clinic, where we sat and wrapped towels around the wound. She was treated as if she was complaining about a cold. The same cold ladies looked at the wound and scheduled a doctor visit after confirming that it looked like a broken leg. Big deal. After the doctors set her leg and stitched up her injury - we flew her back to the US.
My personal experiences are a counterpoint to all those who believe that universal health care is some kind of an answer. It isn't. A country as efficient and as cooly analystical as Germany can't make it fly. Health care is rationed by aides who don't see you as a person. Instead of dealing with an HMO playing games, you deal with a government acting like an HMO that doesn't play games. You lose if they decide you lose.
It is incredible to me that people who demand 100s of different cars to drive are willing to take their most precious asset - their health and lives - and give it up for a one-size-fits-all mentality that never works as promised.
Anyone out there thinking that their health care situation will improve, that costs will go down, that cutting edge medicine will be available, that surgeries will be timely, that chemotherapy will be available are absolutely stupid.
I know. Universal health care is a fraud.
A few years later, out of work and lapsed COBRA, he was diagnosed with Alzheimer's. Now he's 64, not eligible for Medicare.
While he's slowly slipping into oblivion, the good news is that his disease seems to blot out bitterness for the system he once tried to fix.
Three weeks after I started working at the newspaper, my daughter had a grand mal seizure for the first time in her life and had to be rushed to the hospital. I had to tell the hospital people we were uninsured because I had just changed jobs. One of their caseworkers helped us apply for Medicaid for our daughter.
Since my daughter had had a seizure, she now had a “pre existing condition†which my employer’s health insurance would not cover and no other private insurance would cover for at least a year or more. So she stayed on Medicaid for two years, while I went without insurance and kept my fingers crossed trying to find something affordable.
I hated having my daughter on Medicaid mainly because it was nearly impossible to find a doctor for her. We ended up having to go to a low-income clinic where the staff was obviously overworked and underpaid. Nothing against them, and thank God they are there doing what they can, but I knew we had to find something better, and eventually I did get a state job with a reasonably affordable (not free – hope you’re reading this Cassandra) HMO plan.
Believe me, I understand people’s frustration with the cost of private health insurance, but my experience with Medicaid/All Kids did NOT endear me to Blago’s grandiose health insurance plans. What good is “universal coverage†when doctors won’t take it?
Now, if Illinois (like 40 other states) had a budget surplus, and its current Medicaid program were well-managed and paid its bills on time, and our governor were more trustworthy, it would be different, and I would not object to expanding state funded coverage. But not now, and not with this governor!
Naturally, most posters have had problems with the current system.
But what we need to ask ourselves is whether or not the proposals being sold to us would really have solved those problems.
The answer would often be "no".
Let me tell you about my story. My wife fell deathly ill and was rushed to the hospital in the early hours of the morning. She was in the hospital for 2 weeks and on home care for 4 months. The doctors were great, nurses outstanding, and the insurance company paid their fair share.
I also feel bad for Ms. Thompson and wish her a speedy and full recovery. However, as unfortunate as it is, she made a conscious decision to cancel her insurance and now must live with the ramification. $300 may be alot of money but did she cancel her cable TV, get a smaller car, eat at home more often or make other lifestyle changes that would have allowed her to pay for insurance.
Dad had a lot of trouble getting full coverage because just as he'd be working somewhere long enough to be fully vested in their plan, they'd let him go and he'd have to start all over again at another place. Portability of benefits is a big deal.
Community rating, guaranteed access, and
subsidized health insurance premiums would take care of most of these problems. Everybody doesn't have to go on Medicaid. But every taxpayer should be eligible for the subsidies and should have the access to care guaranteed.
My nephew (see post above) by the way is a starving filmmaker and probably would qualify for some type of public assistance Medicaid/free care. But the family wouldn't hear of it. To keep him out of that system, we'll pay the premiums and the co-pays. No way would we go public.
One can always find examples of how a system designed to protect us fails. There are examples of utter failure in the current system as well as examples of the single payer system. Mr. Moore's mocumentary is another example which points at our system's failures without consideration of the daily miraculous successes.
Now what to do? To transfer the health care portion of our economy to the government is likely the most inefficient thing we can do. Without the free market system mechanisms in place we will watch what happens in each and every governmental entity. Waste fraud, inefficiency, etc.
Opposition to governmental takeover aside, the rational approach is to whittle away at the problems. Corporate benefits aside, small businesses provide the largest percentage of jobs in our economy and have the largest challenges in providing health care to their employees. A decent health insurance plan will cost approximately 4.00 per hour based on a 1750 hr work year. A lot of money for those at the lower end of the pay scale.
Let's get to work improving our system, rather than using the governmental catch all.
I work for one of those "not-for-profit" hospitals and, let me say, "No, we don't make exorbitant profits."
Here is how it all works from the inside:
1) In order to meet our OPERATING BUDGET (salaries, healcare, electricity, training, cleaning supplies, ...) we need to charge patients $X per day per bed for inpatients.
2) In order to meet our CAPITAL BUDGET (improvements, regulatory needs, ...) we need to charge patients $Y per day per bed for inpatients.
So, to function as a hospital, we need to charge $Z ($Z = $X + $Y) per day per bed.
Now lets look at re-imbursements:
1) Health insurance companies, being the capitalist that they are, NEGOTIATE a re-imbursement plan for services. This is based on what THEY are paying throughout there service area. For a national company, this is about 1/2 of $Z.
2) Medicare/Medicaid/Public Aid pay on a fixed plan that hasn't changed in YEARS. This also amounts to about 1/2 of $Z. They also tend to pay 90-180 days after service....
So, from insurance we get anywhere from 1/2 to 3/4 of $Z. From the gov't. we get 1/2 of $Z. And lets not talk about the "compassion care" which contributes $0 to the mix.
We use investments to help offset some of the extra costs, but to make up the difference, the non-insured pay the price.
Great Idea!!! A dose of "Reaganesque" capitalism would be a huge improvement in this state. Thanks for thinking of it :c)
We are number one in spending - per capita. The closest per capita costs of the next country to the U.S. is nearly half on what we pay today.
We are number one in administrative cost than any other country in the world. Let's hear it for the effeciency of our private sector. As a fiscal conservative I like giving my insurance company 21% of every dollar that my small business spends on health care. Do not forget the bokers 5-7% fee. The sicker you are the more they make. Now that is the American way! Profit and greed is what makes this country great. How dare the Medicare program's bloated bureacracy is only 3% and they only pay their Director $185,000 versus the tens of millions that the CEOs of our finest insurance industy CEOs make. How un-American
Let's hear it for the many different ways that I pay for health care: $1,100 in additional costs a year from cost-shifting due to the growing number of uninsured. This will only continue to grow; $642 a year for health care coverage on my auto insurance and another $72 a year for health care coverage for my homeowners policy; another $100 in this year's property tax increase to pay for health care coverage (9.4% increase) for city, school and county workers; smaller wage increases due to the year 11% increase in my small businesses health care premiums, and the list goes on. It is great to see how effecient the insurance industry is in taking money from from us.
Lets hear it for the good ole private sector - where the private health insurance industry is number one in their creativity and ability to ration care so much better than all those god-less communist western-industrialize countries who health care indicators are better than our 37th standing. What is wrong with 37th?
I think it is time to have our postal system be run by the private health insurance system: 47 million Americans would not receive direct mail service; 85million Americans would only receive some mail service since they would be undermailed (underserved).
Stay the course. Pay more and get less and cross your fingers that you do not get sick.
As a fiscal conservative not only are all stories shocking and should not be happening in the greatest country in the world, but it is an economic imperative to eliminate the fraud and waste in the private sector and get those free-loading businesses to share in the responsibility in contributing to the cost of health care insurance to their workers.
Whenever friends who had the same condition complained they could not get insurance, I would show them what I had found. They all refused to sign up because it was too expensive.
I am extremely sorry when anyone gets sick. But what I do not understand is how single payer will be any cheaper than most policies in effect today. Just because you pay for it in taxes does not make it free. Does anyone think that Ms Thompson would have paid less than $300 a month in a single payer system? She just would not have had the choice.
I do find our health insurance system odd. I have bad eyesight and an eye condition that might eventually degenerate, so I get yearly checkups to see how it's doing. Each time I get out of the clinic, they say they'll send me a bill for the parts of my checkup Blue Cross won't cover. I ask them what those are and they don't want to tell me. I ask them what amount I am going to wind up paying, for a simple check-up, and they don't want to tell me. I imagine if I blew up and DEMANDED the truth, they would have to explain to me the cost of my visit, and how my coverage is or is not adequate to the routine procedures performed. But everything about the experience is aimed at getting me out the door with as few questions about that as possible. They are good people but clearly they like me as uninformed about the financial underpinnings of their business as possible. I worry someday that, even WITH insurance, I'm going to be mailed me a $1,000 bill, with minimal explanation, and told that's what I need to pay.
It is a weird system, and I say that having been very fortunate within it. I wish there was a lot more transparency about the true costs and more info upfront about what insurance does and does not cover, so I could be more educated as a health consumer. But my health remains excellent, and my medical costs minimal, so I don't put in that work.
I go to the Paradice...I gamble.. do I eat at Jonah's? or do I go hungry. Most restaurants I know won't give me a meal I can't pay for.
Its all a matter of national, sociatal priorities.
As for me, I had health insurance until late last year when the premium started to get close to my mortgage payment. Last week, on the advice of a friend who knows an insurance broker, I spoke with the broker about resuming coverage with BCBS. Apparently, the county you live in has much to do with your premium.
I live in Cook County, but not far from Kane County. He mentioned that Kane County is much cheaper, so I asked him to compare the plan we were discussing. By moving to Kane County, I could save about 35% on premium coverage to the point where it would actually be affordable for me. I asked why the difference, and he replied "Chicago."
With that point alone, he's speaking volumes about the way insurance companies operate and the use of the system. By the way, I live more than 30 miles from the Loop and about 20 miles from the Chicago city limits.
In the meantime, after reading some of the comments here, I'm going to resume my search for a good catastrophic health plan. The little aches and pains can come out of my pocket.
into these arguments. I think the really
important question is this: Is decent medical
care a fundamental human right? If a majority
says "yes", let's figure out how to bring it about.
Something else I would like to point out is the fact that many hospitals have charity care programs, or can work out payment plans with you if you are uninsured or underinsured.
My husband had to have an operation for an injury while he was on the student insurance plan of the university he attends. (This was before I got hired with the state and put him on that insurance). Since the plan is designed for young, healthy college students, it doesn't cover surgery very well. Thankfully, Memorial Medical Center in Springfield encouraged us to apply for their Community Care program, and they ended up forgiving his entire hospital bill! If you're uninsured or underinsured and need help paying the bill, don't hesitate to ask your provider for help.
My recent visit to address some preventative concerns got me a ream of suggestions for all kinds of tests that I know I don't need. I was assured that it wouldn't 'cost' me anything. I declined, figuring the resources should go to some one who needs it.
Group Insurance AND Single Payer create over-utilization. Placing the consumer in charge of all but the most catastrophic spending dramatically reduce over-utilization.
While we are at it...if we are going to have the government pay for health care, an investment in numerous free clinics and follow-up care centers will be far superior to governmental insurance schemes. Arguing otherwise makes the "Michael Moore Mistake" - forgetting (or ignoring) the fact government is nothing more than the worst HMO...on steroids.
Piling on...if we are serious about taxing something to pay for "health care," then institute a tax on EVERY pound on EVERYONE is who is overwieght and collect it with forced driver's licence renewals or pension check "pick-ups" at the government scales.
Health care costs would plummet.
Money that isn't used is rolled over. If medical bills exceed both that $2,000 and the employee portion of the deductible, traditional health insurance kicks in. Our premiums last year went up only a fraction of the national average. When companies initially put such a plan in place, they often see a decline in premiums. Now that employees will have "skin in the game," employers rightly figure that those dollars will be spent more carefully, more wisely. For instance, why get an MRI when, in certain situations, an X ray would be just as good?
The virtue of HSAs, however, goes well beyond this semi-zero-sum mentality: The way health care is delivered will change as providers find it in their best interest to come up with inno-vative breakthroughs. The traditional cost-plus mind-set will wither away. We truly will get more for less.
http://members.forbes.com/forbes/2004/0726/029....
[Forwarded and linked by Extreme Wisdom]
On one hand I am extremely concerned about the health and welfare of my mother, and for her sake would like to see smoe reasonable plan that would give her and my father some peace of mind. At the same time, I am also concerned that a state sponsored system would have approval delays, not be accepted by her current doctors and place restrictions on what brand of medications she must take.
I don't know if there is a solution to this problem. The proposed health plan may be better than nothing, but somehow I doubt that any health plan developed and run by the current state officials is going to be timely and effective.
Instead, we have 6 health insurance markets, and the only one that works well is Medicare. That has started to unravel since Bush introduced privatized HMOs which have increased costs to taxpayers and greatly reduced services.
Don’t forget that Medicare isn’t free – base premiums are $93 per month, plus optional supplements starting at $120 and Part D Rx at $25 per month. But it is the same price for all but those at the highest income levels, no one can be denied Medicare, and pre-existing isn’t a condition for obtaining it.
Why shouldn’t everyone have this type of access to health care?
Currently there are few protections for people with insurance. Illinois Covered, if it passes, will introduce several features including a right to “an independent external review upon denial of a claim.†That doesn’t exist now, while other states do give this protection. Another feature will prohibit (insurers) “from raising premiums on individuals just because they get sick.â€
Take a look at the features for everyone in the bill - they're worth it for all.