CapitolFax.com - Latest Comments in Horror story

Re: Horror story

AliceBlue — Sun, 05 Aug 2007 18:29:54 -0000

Saying Mrs. Thompson made a "bad choice" is counter to free market thinking. If there were a free market, there would be no need to make a choice between insurance and a business she finds satisfying.

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.

Donâ€™t forget that Medicare isnâ€™t free â€“ 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 isnâ€™t a condition for obtaining it.

Why shouldnâ€™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 â€œan independent external review upon denial of a claim.â€ That doesnâ€™t exist now, while other states do give this protection. Another feature will prohibit (insurers) â€œfrom 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.

Re: Horror story

joe — Wed, 01 Aug 2007 00:39:33 -0000

steve schnorf - how ignorant or misleading you are, many not-for-profit hospitals compared to pharmaceutical companies and insurance companies are enjoying bigger % increases in their profits. And many of their not-for-profit CEO's compensation is inreasing by hundreds if not millions of dollars a year,go to www.wherethemoneygoes.com. The 11 largest not-for-profit Catholic health care systems reported sitting on over $32 BILLION in cash and investments last year, while the 13 largest not-for-profit Catholic systems reported making a profit of over $4.3 BILLION last year (3 times as much as 4 years ago). That's after losses on Medicaid, uncollected bills, community benefits etc. The 13 most profitable not-for-profit health care systems reported making a combined profit of over $6 BILLION last year and had over $35 BILLION in the bank. Try again selling your stuff, this time with facts.

Re: Horror story

From the Sidelines — Wed, 01 Aug 2007 00:20:20 -0000

My mother has worked at the same job for 36 years with no health coverage. She has always been covered under my dad's plan. My dad retired earlier this year and my mom will remain covered under his plan for 4 more years, until he turns 65. At that time they will both lose coverage and he will go on Medicare. My mother is six years younger than my father and will be without health insurance until she turns 65. She has severe heart problems that have required multiple surgeries, and will most likely require future surgeries. In the past she has attempted to get health insurance coverage and been denied. Later when she explored coverage, she was quoted a price that was higher than her current salary and had exclusions for pre-existing conditions. Needless to say, she is terrified of the possibility of life without health insurance.

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.

Re: Horror story

Steve Forbes — Wed, 01 Aug 2007 00:02:48 -0000

For years at Forbes we have provided what have been, in effect, Health Savings Accounts. The insurance itself is a bargain (relatively) because the policy deductible is high. What makes the plan so attractive, though, is that we give everyone who works here $2,000 each year, which covers most of the deductible.

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/f...
[Forwarded and linked by Extreme Wisdom]

Re: Horror story

Bruno_Behrend — Tue, 31 Jul 2007 23:58:05 -0000

As a better-than-average-health 46 year-old with a gold plated health plan (through wife's company), my only complaint about the health system is the utter and complete waste of time focusing on 'insurance' over 'health care.'

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.

Re: Horror story

steve schnorf — Tue, 31 Jul 2007 23:00:38 -0000

After hearing all this I believe health care should be free to all but the very wealthy. Hospitals may have to operate at a loss, but they can afford to do that, right? Most of then are non-profit anyway. And I see no reason why doctors should get paid so much more than teachers, and doctors usually golf on Wednesdays, not work. No one should have to pay health insurance premiums unless they are high salaried, because insurance companies are nothing but grave robbers, and they pay their executives way too much. The idea that people don't adequately value something they get for free and overutilize it is absurd. And don't try to tell me that we'll have to raise taxes to pay for this. Get rid of some of the waste in government and get rid of all the slackers and quit flying the Governor around everywhere and there will be plenty of money to pay for health care for everyone who needs it. And, by the way, there's a lemonade spring over by the big rock candy mountain.

Re: Horror story

joe — Tue, 31 Jul 2007 22:15:00 -0000

response to supposed healthcare worker. What's your CEO make this year compared to 2 or 3 years ago? What is your hospital and does it belong to a system? Why no mention--stand tall stand proud. How much does your hospital make off arbitrage, how much did they make on interest on their investments? Your last sentence proves my point, to make it up--your hospital screws the uninsured--something Blago won't address.Have a good day compassionate healthcare worker.

Re: Horror story

Lainer — Tue, 31 Jul 2007 20:57:01 -0000

Thanks Cassandra. (By the way, I'm a "she.") My daughter has been seizure free and healthy for over 2 years now.

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.

Re: Horror story

Anon — Tue, 31 Jul 2007 20:09:21 -0000

To all of you, especially the younger people that are posting on this site, are you aware of the ICHIP program? It is the high risk health insurance plan for the state of Illinois. It often is cheaper than people are paying in the private sector, and is for people who have pre-existing conditions...there also is a plan for people under 65, diabled and on Medicare

Re: Horror story

Esteban — Tue, 31 Jul 2007 19:33:31 -0000

I think we miss the point somewhat when we get
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.

Re: Horror story

getting too old for this — Tue, 31 Jul 2007 19:14:49 -0000

First, best wishes to Ms. Thompson for a speedy recovery and return to good health.

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.

Re: Horror story

liberal louisa — Tue, 31 Jul 2007 17:38:13 -0000

I used to work taking medicaid applications and it was always horrific to have to tell someone that they didn't fall into a "category" so they didn't qualify. This was after AMI(Aid to the Medically Indigent) was done away with. I felt so strongly about it that I called the Governor's office about it(which was Edgar it was back in 91) I told the person who I spoke to that I didn't think it was right that although a person didn't have children in the home or was disabled or elderly that they didn't qualify. He sputtered and said something about people with kids getting sick more, but the thing was that I was turning away people with cancer who weren't necessarily considered disabled. I don't think it's right that someone has to fall into a "category" as in the case with Ms. Thompson, who still had a child in the home. Disease doesn't discriminate as to whom it strikes and one person's life isn't worth more than another's.

Re: Horror story

The Horse — Tue, 31 Jul 2007 17:07:06 -0000

She gambled, she lost, she was treated... what is the horror?

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.

Re: Horror story

ZC — Tue, 31 Jul 2007 16:24:03 -0000

I have been blessed to have had health insurance my entire life, and much better, just to be a very healthy individual. As such, my interactions with the health care system have been mercifully few.

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.

Re: Horror story

Capitalist Pig — Tue, 31 Jul 2007 15:48:57 -0000

Unfortunately, the HMO is the closest example we have to state managed insurance. It get's worse...not better.

Re: Horror story

HMO Fighter — Tue, 31 Jul 2007 15:23:32 -0000

I had cancer, a very, very rare form of cancer. I was insured by an HMO. I went to the only doctor in the Midwest who had dealt with my form of cancer. The HMO decided this was not medically necessary, that I see this particular doctor. I had to threaten them with a lawsuit to get them to continue to cover my treatment with someone who actually knew what he was doing. Thankfully I prevailed in my fight with the insurance company and with the cancer, as I am OK now.

Re: Horror story

Jeff — Tue, 31 Jul 2007 15:12:45 -0000

My experience is nobody wants to pay for health insurance. 13 years ago I was denied coverage due to a preexisting condition that I did not want to disclose to a new employer. I did some research and found some affordable $200 a month catastophic policy. I was ready to sign up when my next employer found a way to cover me.

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.

Re: Horror story

Rich Miller — Tue, 31 Jul 2007 14:57:44 -0000

HCFA, nice rant, but let's stick to the topic at hand.

Re: Horror story

manny — Tue, 31 Jul 2007 14:54:23 -0000

the thompson woman lives on the southwest side of springfield in her own home, paid tuition to send her kids to private high school paid to send them to collee---chose to baby sit for kids in her home rather than go out into the workforce---dropped what sounds like fairly ordinarily priced insurance doesn't seem to have a plan to pay her bills and wants the government to help her---talk about the nanny stae---there are consequences for bad decisions and the taxpayer shouldn't be responsible for them

Re: Horror story

Health Care for All — Tue, 31 Jul 2007 14:52:18 -0000

Let's stand up for our great insurance system.
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.

Re: Horror story

Southern Right — Tue, 31 Jul 2007 14:45:15 -0000

Healthcare Worker 1/2 to 3/4 payment of an inflated rate is still too much. Your industry has dodged the issue of transparency for decades.

Re: Horror story

Fan of the Game — Tue, 31 Jul 2007 14:29:01 -0000

I have good health insurance and have used it only for minor surgeries and scrapes. No insurance nightmares here.

Re: Horror story

Capitalist Pig — Tue, 31 Jul 2007 14:21:47 -0000

Steve,
Great Idea!!! A dose of "Reaganesque" capitalism would be a huge improvement in this state. Thanks for thinking of it :c)

Re: Horror story

Healthcare Worker — Tue, 31 Jul 2007 14:09:13 -0000

Joe wrote, "Many hospitals charge the uninsured 3 to 5 times as much for the exact same care as they charge people with insuranceâ€“leading to exorbitant profits."

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.

Re: Horror story

plutocrat03 — Tue, 31 Jul 2007 13:23:57 -0000

First of all I wish the best outcome for Ms. Thompson and family.

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.