an insurance question for the Americans, PART TWO

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ivy6
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   Posted 2/1/2010 2:17 PM (GMT -7)   

GDen
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   Posted 2/1/2010 2:30 PM (GMT -7)   
nasalady said...
GDen said...
Rider Fan said...
vietvet said...

ivy, it's kind of like the 'stockholm syndrome'. we have been in an abusive relationship for so long that Americans have a heck of a time wrapping their minds around what you guys accept as normal and just. we've come to accept what we know, and fear what the rest of the world considers natural. not surprising since the insurance industry spends billions to create that fear. fear is a powerful weapon, and a fairly easy one to use.
I nominate for quote of the day! Well said.

Everything's all roses in Canada? How exactly has the insurance industry spent these "billions" to create this "fear"?


By supporting those political candidates who are willing to create the fear via false statements like "they're going to pull the plug on Grandma" or "they've put chemicals in the flu shots to sterilize the poor".

Stuff like that.

Those were directly funded by insurance companies? It's people like Pelosi who vilify the insurance companies. Myself, I'm thankful they exist, protecting us from exorbitant medical bills.

It was the insurance companies they came together years ago and created the high-risk pools, without which people with pre-existing conditions would be out of luck. To get any assistance you have to be destitute (assets $2K or less).

As for spreading misinformation, perhaps you're referring to the nonsensical hysteria Bill Maher spread on his show about how dangerous he thought vaccines are.
Cimzia, Asacol


GDen
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   Posted 2/1/2010 2:35 PM (GMT -7)   
ivy6 said...
Quite often, when our (Aus) media does a thorough report on the US health care debate, the commentators take great care to explain that the US does not have a culture of looking after the underdog, as we do here, and that partly explains why there is so much resistance to nationalised medicine - people in your country seem to think "why should I have to pay for someone else's health care?", whereas we tend to subconsciously engage in a mental contract where someone else will look after us in our hour of need, and we'll look after them when we're stronger.

No, actually it's more private here. Look at all the drugs companies that will subsidize or even provide free Asacol, biologics, etc. for those with lower incomes. Then there are assistance programs like PAN. And numerous hospitals have charity programs.

People in the US don't think "why should I have to pay for someone else's healthcare", otherwise they wouldn't buy insurance (where risks and costs are pooled) in the first place! Nor would they donate to charities that fund research into cancer and numerous other diseases.

As for looking out for the underdog, our enormous generosity both public and private to the victims of Haiti speaks volumes.
Cimzia, Asacol


ivy6
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   Posted 2/1/2010 2:36 PM (GMT -7)   
Oi. Keep it intelligible for the foreigners, please?

GDen, I hardly understood any of that?!
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ivy6
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   Posted 2/1/2010 2:42 PM (GMT -7)   
GDen, I'm going to wait for VV to come and comment: he'll probably be able to explain what I'm trying to say better than I can... I hope he can be a cross-cultural interpreter for me :-).
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Nanners
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   Posted 2/1/2010 2:43 PM (GMT -7)   
Just a reminder to all posters, Ivy6 is just trying to understand the american insurance policies.  Please keep all political types of comments out of this thread.  Thank you for your understanding.

Gail*Nanners* Co-Moderator for Crohns Disease & Anxiety/Panic
Crohn's Disease for over 34 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium, Vit D, and Xanax prn. Resections in 2002 & 2005. Also diagnosed w/ Fibromyalgia, Osteoarthritis, & Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
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GDen
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   Posted 2/1/2010 2:44 PM (GMT -7)   
ivy6 said...
Oi. Keep it intelligible for the foreigners, please?

GDen, I hardly understood any of that?!

What don't you understand? No need for personal attacks. What I posted is extremely easy to understand.
Cimzia, Asacol


GDen
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   Posted 2/1/2010 2:45 PM (GMT -7)   
ivy6 said...
GDen, I'm going to wait for VV to come and comment: he'll probably be able to explain what I'm trying to say better than I can... I hope he can be a cross-cultural interpreter for me :-).

"cross-cultural". LOL. I understand everything you've posted.
Cimzia, Asacol


ivy6
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   Posted 2/1/2010 2:49 PM (GMT -7)   
Thanks, Nanners :-). I really don't want to hear about US Democrat vs Republican issues -- I can listen to the American media if I want to hear that.

btw, I will try to have another stab at trying to explain what the media commentators were saying. You seem to place more emphasis on the individual than we do in Aus: individual rights, individual responsibilities, carrying your own weight and being responsible for your own finances and own problems and not wanting the government to get involved in your personal affairs.

We're not communist or socialist here, but I have the impression that we are a little more communal in mindset? Just a bit different, basically, and that is reflected in different policies and different types of national debates.
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GDen
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   Posted 2/1/2010 2:58 PM (GMT -7)   
ivy6 said...
You seem to place more emphasis on the individual than we do in Aus: individual rights, individual responsibilities, carrying your own weight and being responsible for your own finances and own problems and not wanting the government to get involved in your personal affairs.

Because in the US we think the gov't does a poor job at most things. The DMV is notorious for lousy service and long waits. Social Security is rapidly going bankrupt. Our public schools are failing. Medicare is rife with fraud and also going bankrupt. Our deficits are skyrocketing. So, we don't have much confidence in their handling healthcare.
Cimzia, Asacol


GDen
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   Posted 2/1/2010 3:00 PM (GMT -7)   
Hey ivy -- I noticed your profile says you're on a disability pension. Just curious -- who provides it what does it take to qualify? Just wondering how it compares to Social Security disability in the US.
Cimzia, Asacol


HabsHockeyFan
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   Posted 2/1/2010 3:11 PM (GMT -7)   
Ivy6....I missed the last post and thought I would give you my quick 2cents from my being in the insurance industry.
Offering insurance to your employees was once considered a benefit that would entice you to work for one company over another. Over the years, the benefit turned to a sense of entitilement in which everyone expected to have their coverage provided by the employer.
When medical cost trend increases were flat to minimal, employers managed to continue to offer coverage to their employees as a way to retain their employees.
Then costs started to rise and the PPO and HMOs were created so employers were not hit with the growing costs of medical care. These were meant to steer the insured to providers that contracted at a fixed level of cost. Employees were given a better benefit to go to a contracted provider over a non-contracted provider. Originally, the network providers were few and far between and were selected on a limited basis. Then employees became unhappy with limited choices (I want my doctor in the network) and the employers listened to that...forcing the networks to contract with more and more providers. Nowadays, most PPO networks have a high percent of the doctors so the steerage to the contracted dosctors no longer saves on cost increases becuase they are still giving a higher benefit to utilize those doctors.
Over all of this time, the US population never had to see the effect of inflation of medical costs. Now that PPOs are no longer effective and providers have found ways around contracts to help with their budgets, there is no place left to minimize the costs (for example in the last 5 years the frequency of a million dollar claim has changed from 1 in every 100,000 covered to 25-30/100,000 covered). Reducing the level of benefits has not been successful as we, in my admitted sense of entitlement, do not want to share in costs. Therefore, the only other way to make up for cost increases is to increase premium rates. Since this was avoided for so long, the increases seem even larger to most folks.

I simplify it this way to many of my friends.....what if a gallon of milk cost $1.00. Then the cost rose to $1.50 unless you shopped at ABC Grocery chain. ABC would still cost $1.00. But you only have XYZ Grocery near you so you fight to have them charge only $1.00. Now every grocery is back to charging a dollar, but the cost of making milk is now $2.00. Now we all pay $2.50 a gallon and are stunned at the increase from $1.00 to $2.50 because we never saw the incremental increase. Now we are mad at the groceries and the farmers and the cows. Nope....we tend to only look at it this way for healthcare for some reason...groceries and gasoline and necessities increase with less fuss.
Dx'd '90 (emergency rupture), symptoms ignored long before that, '03 fistulas and bad flagyl reactions, B12 weekly, Pentasa [until I surrender to the bigger meds]
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ivy6
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   Posted 2/1/2010 3:20 PM (GMT -7)   

LMills
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   Posted 2/1/2010 3:28 PM (GMT -7)   
GDen said...


People in the US don't think "why should I have to pay for someone else's healthcare", otherwise they wouldn't buy insurance (where risks and costs are pooled) in the first place! Nor would they donate to charities that fund research into cancer and numerous other diseases.


Actually, I've heard plenty of Americans say that. Let's not misrepresent people by making that generalization here.
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hld4good
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Total Posts : 193
   Posted 2/1/2010 4:36 PM (GMT -7)   
The media worldwide and here in the U.S. is a very poor source of accurate info about our healthcare.
Age 58, Crohn's since age 21
3 bowel resections, 1980,88,95
1 fistula repair, 2005
probiotic
digestive enzymes
L-glutamine powder 3 times a day
sublingual B-12 and B complex
2 T. cod liver oil
2 tsp. tart cherry juice concentrate
Multiple vitamin, 2,500mg vit. C, 1,000mg calcium mag.


FunGuy
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   Posted 2/1/2010 4:53 PM (GMT -7)   
Isn't about 35% of medical insurance going right into insurance industry overhead. CEO multi-million dollar bonus', sky scrapers, lobby money and the like? Out of the top 35 industrial nations in the world, from the USA all the way down to Costa Rica, ONLY the USA allows medical insurance companies to be FOR PROFIT. Everywhere else it is illegal, a CRIME. The government does many things well, social security has lost money due to our aging population, recession and the "borrowing" of funds by certain administrations. It will be easy to fix social securtiy. Medicare will be a bigger problem to fix due to costs like the decision not to allow medicare to negotiate for drug prices and so forth.
As far as lawsuits increasing costs; I understand that these suits add only one or two percent to healthcare costs and are not a pressing priority now. Sure they should be addressed but they aren't the big dog.
 


hld4good
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Date Joined Jan 2010
Total Posts : 193
   Posted 2/1/2010 6:06 PM (GMT -7)   
And the American Bar Association would like us to continue believing that.
Age 58, Crohn's since age 21
3 bowel resections, 1980,88,95
1 fistula repair, 2005
probiotic
digestive enzymes
L-glutamine powder 3 times a day
sublingual B-12 and B complex
2 T. cod liver oil
2 tsp. tart cherry juice concentrate
Multiple vitamin, 2,500mg vit. C, 1,000mg calcium mag.


vietvet
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   Posted 2/1/2010 6:15 PM (GMT -7)   
Ivy, to refer back to your original thread, yes, the Aussies were there with us, side by side, in a God-forsaken place trying to make a difference for those who can't or won't help themselves......much like the situation we are in again. 500 killed, and thousands injured, not counting emotional and chemical casualties. in Sydney, yanks were treated like royalty when we were there on r&r. you threw more than one shrimp on the barbee for us....thanks!

ok, Gden, hundreds of millions......in less than a year! put a few years together, a few hundred million here, a few hundred million there.....pretty soon we're talkin' real money.

http://money.cnn.com/2009/11/18/news/economy/health_care_lobbying/index.htm


they've been fighting this in earnest since the clinton's attempt back in '94. ok, so i said insurance industry. i admit, i'm biased. there are a lot of interests that see the gravy train coming to an end, and it is a result of their own avarice. insurance, pharma, and even hospitals have cashed in. i doubt there are any surviving hospitals that are still being run by the good Sisters of Mercy. but, the insurance industry isn't just health care. it's homeowners, automobile, health and disability, and even warranty. you give them money and they make a bet with you that you won't be able to convince them that you have a valid claim. if they can tell you 'no' and get you to go away with a whimper, it's money in their pocket

Ivy, there just isn't a way to discuss this without bringing politics into it. Habs' dissertation is all well and good if everyone is honest and working for the common good. as fun guy said, many of Gdens institutions 'on the brink' could be safe and healthy if certain administrations wouldn't give huge tax cuts for the wealthy. the greed in this country nearly took the world to it's knees last year.

as for Gden's video.......michael moore has a way of letting his subjects hang themselves with their own rope........i think i'll let that video and that crowder guy stand on their own merits.....or lack thereof. spend a little time there on youtube looking at the comments below and some of his other videos. anything further that i might say would be anti-climactic.

vv

ivy6
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   Posted 2/1/2010 6:19 PM (GMT -7)   
Can we keep this on topic, please?

I just wanted to know about employers' role in providing health care; didn't want to spark a political debate.

Am I right in summarising that it came about because of union activity and a need to attract people to work during WWII, and as a means to encourage people to work for one company instead of another?

What happens if you're self-employed?
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Lynnwood
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   Posted 2/1/2010 7:10 PM (GMT -7)   
It's basically the same if you're self-employed -- you have to pay the employees + the employers part of the health insurance if you get it through your own company. You have to pay Social Security just like your employer would if you were employed, if you anticipate getting something from it someday.

Sometimes there is a professional organization where people work in the same field and you can get group insurance at lower rates through these professional organizations.

Alternatively, you have to purchase personal insurance just like an unemployed person.
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MMMNAVY
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   Posted 2/1/2010 8:27 PM (GMT -7)   
No more posts to this topic. They will be deleted.


Forum Co-moderator - Crohn's Disease/Thyroid Disorders:_All comments have the caveat contact your local health care provider.

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Post Edited (MMMNAVY) : 2/1/2010 8:40:29 PM (GMT-7)

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