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Post by AztecWilliam on Jul 30, 2009 21:10:36 GMT -8
Tonight on TV Dick Morris reported that his 78 year old uncle has colon cancer. A particular drug, didn't write down the name, has been effective in treating the disease. The uncle is now doing well. But, claims Morris, his uncle would be dead now if he were a citizen of Canada or the UK. The reason? Cost.
The medicine costs $50,000 per year. Whenever critics of Obama's socialized medicine plan (let's be frank, as Barney Frank was recently; this is where the whole Obamacare thing is headed) bring up rationing they are ridiculed. But increasing the number of persons covered by insurance by 40 million or more with no increase in health care resources is inevitably going to mean rationing.
Morris's uncle, at 78, is unlikely to get that costly medicine.
Remember, you or I could be that uncle in a few years. At 78 we may be deemed too old for such costly care. Never mind that a 78, if he stays alive and in reasonably good condition, can still contribute a lot to society for years to come.
Let's be honest about what Obamacare will mean.
AzWm
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Post by AlwaysAnAztec on Jul 31, 2009 8:50:34 GMT -8
Find the name of that medicine and check with your insurance company to see if it is listed in their formulary. I bet it isn't.
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Post by Bob Forsythe on Jul 31, 2009 10:53:33 GMT -8
Find the name of that medicine and check with your insurance company to see if it is listed in their formulary. I bet it isn't. Well, the uncle's probably on Medicare. I'm not sure what the rules are for such drugs. But I do agree that a lot of insurance companies would probably tell you that you are on your own. I have heard that it depends on the stage of the cancer with many insurance plans. If the person has an 80 percent chance of survival, they get what they need. If there's, say, a 33 percent chance of survival, the insurance companies will refuse to pay for the treatment. =Bob |
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Post by sportnlyf on Jul 31, 2009 13:20:59 GMT -8
AzWm, are you suggesting that rationing of care does not already exist? I have been deeply involved with this as a result of a rare condition that our son developed three years ago and which he finally received brain surgery for at Johns Hopkins Hospital in Baltimore two weeks ago.
Under his HMO, a series of "in-plan" specialists pretty much dismissed his symptoms of vertigo or mis-diagnosed them, always as something far less serious and less costly to address. After over two years of this BS, he finally saw an "out-of-plan" specialist who made the right diagnosis. That same doctor told us:
"The healthcare system in this country is no longer run for your benefit or the benefit of the healthecare providers, it is run for the benefit of the insurance companies who recently reached the point in which they are receiving 51 cents of every dollar spent on healthcare, more than doctors, hospitals and drug companies combined. I will work closely with you on this, but you have to be the number one advocate for your healthcare, because they will initially deny almost every referral or request which we have to appeal immediately, because they will then have 30 days to respond which just eats up more of the clock. In the meantime they will just hope you give up and go away."
I don't know if this doctor's information on the distribution of healthcare cost is accurate, but he was right on in his description of how the insurance company would respond. Every referral was denied initially, which we would appeal. After considerable time, calls and letters from us and the doctor, (all of which amounted to unncecessary time and expense for everyone) the appeal would be reversed. The process was hideous as we actually had to keep working to educate the RN caseworkers and their in house reviewer (a moonlighting GP)who denied referrals because they personally had never heard of the condition and did not do any research to learn about it. Eventually, they insisted that our son have surgery performed by someone they contracted, who had assisted but never performed the surgery. When asked what she would do in our situation, she said, "I'd go to the guy at Johns Hopkins who discovered this in 1995, devised the surgical procedures for it and has performed 80 of the 300 such surgeries performed world wide. Would you like me to write a letter to the insurance company to that effect?"
At about the same time, the insurance enrollment period came up and at the suggestion of several doctors, our son paid considerably extra to switch from an HMO to a PPO within his health insurance company.
Three years of insurance company BS to finally receive proper treatment for a debilitating condition.
A very good friend has been diagnosed with pulmonary fibrosis. Without a lung transplant this condition becomes becomes terminal 2-3 years after diagnosis. This man who has kept himself in extraordinary physical condition is a few years too old to be added to the list for a transplant because of the formulary.
Now AzWm and that paragon of virtue and integrity Dick Morris are going to reveal that Obama's health care plan includes rationing? You mean the kind we already have? You assert that any system we adopt must be identical to Canada's, which by the way, a retired U.S. doctor friend with dual citizenship tells me is superior to ours?
Forgetting that politicians on both sides of the aisle have been prostituted on health care as a result of massive contributions by the insurance companies, can you not reason that if less money went to insurance companies, shareholders and political contributions that there would be more for actual healthcare?
What is the the real fear of having a government run competitor as one of the options available when you make your choice for a healthcare provider?
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Post by aztecwin on Jul 31, 2009 15:41:55 GMT -8
AzWm, are you suggesting that rationing of care does not already exist? I have been deeply involved with this as a result of a rare condition that our son developed three years ago and which he finally received brain surgery for at Johns Hopkins Hospital in Baltimore two weeks ago. Under his HMO, a series of "in-plan" specialists pretty much dismissed his symptoms of vertigo or mis-diagnosed them, always as something far less serious and less costly to address. After over two years of this BS, he finally saw an "out-of-plan" specialist who made the right diagnosis. That same doctor told us: "The healthcare system in this country is no longer run for your benefit or the benefit of the healthecare providers, it is run for the benefit of the insurance companies who recently reached the point in which they are receiving 51 cents of every dollar spent on healthcare, more than doctors, hospitals and drug companies combined. I will work closely with you on this, but you have to be the number one advocate for your healthcare, because they will initially deny almost every referral or request which we have to appeal immediately, because they will then have 30 days to respond which just eats up more of the clock. In the meantime they will just hope you give up and go away." I don't know if this doctor's information on the distribution of healthcare cost is accurate, but he was right on in his description of how the insurance company would respond. Every referral was denied initially, which we would appeal. After considerable time, calls and letters from us and the doctor, (all of which amounted to unncecessary time and expense for everyone) the appeal would be reversed. The process was hideous as we actually had to keep working to educate the RN caseworkers and their in house reviewer (a moonlighting GP)who denied referrals because they personally had never heard of the condition and did not do any research to learn about it. Eventually, they insisted that our son have surgery performed by someone they contracted, who had assisted but never performed the surgery. When asked what she would do in our situation, she said, "I'd go to the guy at Johns Hopkins who discovered this in 1995, devised the surgical procedures for it and has performed 80 of the 300 such surgeries performed world wide. Would you like me to write a letter to the insurance company to that effect?" At about the same time, the insurance enrollment period came up and at the suggestion of several doctors, our son paid considerably extra to switch from an HMO to a PPO within his health insurance company. Three years of insurance company BS to finally receive proper treatment for a debilitating condition. A very good friend has been diagnosed with pulmonary fibrosis. Without a lung transplant this condition becomes becomes terminal 2-3 years after diagnosis. This man who has kept himself in extraordinary physical condition is a few years too old to be added to the list for a transplant because of the formulary. Now AzWm and that paragon of virtue and integrity Dick Morris are going to reveal that Obama's health care plan includes rationing? You mean the kind we already have? You assert that any system we adopt must be identical to Canada's, which by the way, a retired U.S. doctor friend with dual citizenship tells me is superior to ours? Forgetting that politicians on both sides of the aisle have been prostituted on health care as a result of massive contributions by the insurance companies, can you not reason that if less money went to insurance companies, shareholders and political contributions that there would be more for actual healthcare? What is the the real fear of having a government run competitor as one of the options available when you make your choice for a healthcare provider? I have a similar story, but figured out right early with some good advice what to do. We left our FEHBP/Tricare plan and went to a Army Hospital for primary care. It turns out that the Army (or Navy) can do anything that they want even when it is against the Governments guidelines. We have huge problems with what we have for a system and many things need to be addressed. Those for profit insurance plans are a huge part as you say. Where we part ways is on the merits of Canada's system. It is fine until you really get sick. I have seen the proof myself in the hospital in Seattle where I went for Prostate Surgery and Radiation Therapy. There were large numbers of Canadians getting care at the same facility as I was and they were paying full price. I had many chances to talk about it since I had 36 days of visiting with other patients while I was undergoing the radiation treatments. They were generally happy with what they had until they got really sick. I never had a discussion about age as it affected the rationing in Canada, but most patients were my age or older. Might be just the type conditions or it may have been age rationing. Now I suspect that you will have a different take on some aspects of what I have experienced and what your son has gone through. I would be willing to bet that you would agree that we should be very careful and deliberate about what sort of reforms that we enact. I am leery of a government option for the masses even though my own experience with FEHBP/Tricare have had positive outcomes after some manipulation. I just don't think that the expense would make any sense on a large scale. I don't think that much about the Insurance Industry since I don't have to deal with it but some change is surely in order along with tort reform and modernized record keeping. Bottom line is take our time and get it right. |
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Post by Bob Forsythe on Jul 31, 2009 15:45:33 GMT -8
Where we part ways is on the merits of Canada's system. the problem is that you always bring up the Canadian system when there are other systems that do a lot better (read, Germany and France). =Bob |
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Post by aztecwin on Jul 31, 2009 15:50:51 GMT -8
Where we part ways is on the merits of Canada's system. the problem is that you always bring up the Canadian system when there are other systems that do a lot better (read, Germany and France). =Bob I did not bring it up. |
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Post by Bob Forsythe on Jul 31, 2009 16:58:18 GMT -8
the problem is that you always bring up the Canadian system when there are other systems that do a lot better (read, Germany and France). =Bob I did not bring it up. True in this particular thread, but you often bring it up as an example. =Bob |
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Post by aztecwin on Aug 1, 2009 5:14:58 GMT -8
True in this particular thread, but you often bring it up as an example. =Bob I do when the need to show the problems comes up, but not this time. Now if I was Joe, I would accuse you of making stuff up.  |
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Post by Bob Forsythe on Aug 2, 2009 17:05:11 GMT -8
True in this particular thread, but you often bring it up as an example. =Bob I do when the need to show the problems comes up, but not this time. Now if I was Joe, I would accuse you of making stuff up. Sorry Pooh, but sportnlyf totally kicked your ass. I will admit that it was rather stupid of me to insert myself into this conversation because by doing so I gave you the opportunity to ignore what sportnlyf wrote in favor of attacking me. Respond to his comments, not mine. =Bob |
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Post by aztecwin on Aug 3, 2009 10:51:18 GMT -8
I do when the need to show the problems comes up, but not this time. Now if I was Joe, I would accuse you of making stuff up. Sorry Pooh, but sportnlyf totally kicked your ass. I will admit that it was rather stupid of me to insert myself into this conversation because by doing so I gave you the opportunity to ignore what sportnlyf wrote in favor of attacking me. Respond to his comments, not mine. =Bob Joe would say you just make stuff up. I don't see a conflict with sportnlyf. Are you paranoid or something? |
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Post by Bob Forsythe on Aug 3, 2009 16:01:57 GMT -8
Sorry Pooh, but sportnlyf totally kicked your ass. I will admit that it was rather stupid of me to insert myself into this conversation because by doing so I gave you the opportunity to ignore what sportnlyf wrote in favor of attacking me. Respond to his comments, not mine. =Bob Joe would say you just make stuff up. I don't see a conflict with sportnlyf. Are you paranoid or something? No conflict other than the fact that he blew away your and William's arguments about rationing. Also, you wrote this: Where we part ways is on the merits of Canada's system. It is fine until you really get sick.It's no different here as you admit in your response to him. But while admitting that, you continue to argue in other posts that the status quo is fine except for needing tort reform and some "streamlining". It's not fine. We have the most expensive medical care system in the world and the results of that care do not support the claims from those bought off by the medical industry lobbyists that it's the best in the world. Certainly cancer sufferers here have a higher survival rate, but at what cost? Many of them go bankrupt in order to get the treatment. One of our posters pointed out a while back on AT that he went through something like 17 operations and wound up a half-million in debt even though he had what he considered to be "good" health care insurance. The problem is this - even people who do not live paycheck to paycheck and sock away a lot toward retirement and their kids' college funds are one serious illness away from seeing those good habits go down the drain. But I'll tell ya what. I would support a bill without a public plan if it capped insurance premiums at 7 percent of the policy holder's income, denied the insurance companies from rationing based upon prior conditions and the use of "experimental drugs" or "experimental surgeries" and required insurance companies to maintain insurance at very cheap rates that are paid by a fund set up by the Feds and administered by the states for those who lose their jobs. And yada, yada, I know you may bring up tort reform, but in the two states that have instituted tort reform, premiums keep going up. My latest retirement association newsletter says that they've started negotiations with the HMOs but we should expect an increase of 8-12 percent, depending upon the plan. I'll accept tort reform if you'll accept tying premium increases to the inflation index. =Bob |
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Post by sportnlyf on Aug 3, 2009 23:34:22 GMT -8
One update from this fly fishing friend re: Canadian care is that his wife regards their emergency and critical care highly and rates it as generally timely, but says the wait for optional procdures is long and getting longer in their system. At the same time, I think that is largely beside the point as I've not heard anyone say, "we want a program just like Canada's."
My aim would not be to see insurance companies eliminated from the system. It would be for a non-profit governement option to be offered as an alternative so that Americans would have a choice when it comes to their healthcare dollars.
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Post by aztecwin on Aug 4, 2009 4:36:19 GMT -8
One update from this fly fishing friend re: Canadian care is that his wife regards their emergency and critical care highly and rates it as generally timely, but says the wait for optional procdures is long and getting longer in their system. At the same time, I think that is largely beside the point as I've not heard anyone say, "we want a program just like Canada's." My aim would not be to see insurance companies eliminated from the system. It would be for a non-profit governement option to be offered as an alternative so that Americans would have a choice when it comes to their healthcare dollars. There is a possibility that care in different parts of Canada are different. Folks in Alberta and BC flock into Washington State for treatment. I would say also that a government non-profit is not a good option. A private non-profit like Kaiser (as Bob says) would be a good option and would place pressure on the for profits to get more competitive. We have that now. We need reform, but we have to be real careful about what we do and perhaps a step by step incremental approach to health care reform would allow us to access the effectiveness of each step and avoid the disaster that seems to be Obama's ill conceived plan. I think you have a "groupie" in =Bob. ;D |
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Post by Bob Forsythe on Aug 4, 2009 17:01:15 GMT -8
One update from this fly fishing friend re: Canadian care is that his wife regards their emergency and critical care highly and rates it as generally timely, but says the wait for optional procdures is long and getting longer in their system. At the same time, I think that is largely beside the point as I've not heard anyone say, "we want a program just like Canada's." My aim would not be to see insurance companies eliminated from the system. It would be for a non-profit governement option to be offered as an alternative so that Americans would have a choice when it comes to their healthcare dollars. There is a possibility that care in different parts of Canada are different. Folks in Alberta and BC flock into Washington State for treatment. I would say also that a government non-profit is not a good option. A private non-profit like Kaiser (as Bob says) would be a good option and would place pressure on the for profits to get more competitive. We have that now. We need reform, but we have to be real careful about what we do and perhaps a step by step incremental approach to health care reform would allow us to access the effectiveness of each step and avoid the disaster that seems to be Obama's ill conceived plan. Translation - just claim we have to be careful and do it step by step until such time as we've killed it. You have health care for life and therefore have no dog in this fight. But of course you'll claim, yet again, that anyone could have had what you have if they'd just spend their 20 in the military. It's quite clear, Pooh. All you are really interested in doing is defeating Obama on health care so you and the other right-wingnuts can take him down. You have no desire at all to give a rat's ass about the collective health of this country. The only thing you want is to avoid paying taxes while you benefit from taxes. I'm sorry, but I really find your moral values to be rather sad. But feel free to continue reading the Bible for an hour a day and assuming that what's taught in there is open to your interpretation. =Bob |
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Post by aztecwin on Aug 5, 2009 12:22:22 GMT -8
There is a possibility that care in different parts of Canada are different. Folks in Alberta and BC flock into Washington State for treatment. I would say also that a government non-profit is not a good option. A private non-profit like Kaiser (as Bob says) would be a good option and would place pressure on the for profits to get more competitive. We have that now. We need reform, but we have to be real careful about what we do and perhaps a step by step incremental approach to health care reform would allow us to access the effectiveness of each step and avoid the disaster that seems to be Obama's ill conceived plan. Translation - just claim we have to be careful and do it step by step until such time as we've killed it. You have health care for life and therefore have no dog in this fight. But of course you'll claim, yet again, that anyone could have had what you have if they'd just spend their 20 in the military. It's quite clear, Pooh. All you are really interested in doing is defeating Obama on health care so you and the other right-wingnuts can take him down. You have no desire at all to give a rat's ass about the collective health of this country. The only thing you want is to avoid paying taxes while you benefit from taxes. I'm sorry, but I really find your moral values to be rather sad. But feel free to continue reading the Bible for an hour a day and assuming that what's taught in there is open to your interpretation. =Bob Is this like the personal attacks that Obama made on the Cambridge Police without knowing a thing about the circumstances? I get a chuckle out of the weird way your little mind works. I have excellent care that I paid for. That care is very expensive and could not be expanded to everyone. Why don't you just accept that we all want better care for all legal residents without any of the rationing for some segments of the population that is proposed in ObamaCare. What do you think is worse, taking down Obama or taking down Bush? We all want Obama to succeed in doing what is right for the country. The problem is he is proposing socialism and therefore it is in the best interest of the country to have him taken down. You don't want Obama pulling the plug on your 92 year old Mother do you? |
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Post by Bob Forsythe on Aug 5, 2009 17:18:34 GMT -8
What do you think is worse, taking down Obama or taking down Bush? We all want Obama to succeed in doing what is right for the country. The problem is he is proposing socialism and therefore it is in the best interest of the country to have him taken down. You don't want Obama pulling the plug on your 92 year old Mother do you? Nothing to suggest that his health plan would do that. Just another fear tactic from the right. But, of course, fear is the only thing the right has to offer these days. =Bob |
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Post by aztecwin on Aug 6, 2009 4:33:32 GMT -8
What do you think is worse, taking down Obama or taking down Bush? We all want Obama to succeed in doing what is right for the country. The problem is he is proposing socialism and therefore it is in the best interest of the country to have him taken down. You don't want Obama pulling the plug on your 92 year old Mother do you? Nothing to suggest that his health plan would do that. Just another fear tactic from the right. But, of course, fear is the only thing the right has to offer these days. =Bob Any plan that expands access to a limited resource at taxpayers expense results in rationing and is socialism. We need carefully thoughtout change. We don't need expanded government control over our healthcare. |
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Post by NTU on Aug 8, 2009 15:30:38 GMT -8
Got news: Your health care is already rationed by the insurance company bureaucrats far more than it would be under any single payer system. But that's ok. I really think that if you feel that strongly about it, you should start a crusade to abolish Medicare. After all, how can we possibly allow the government to be involved in health care?  |
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Post by Bob Forsythe on Aug 8, 2009 18:43:38 GMT -8
Got news: Your health care is already rationed by the insurance company bureaucrats far more than it would be under any single payer system. Actually he has not been rationed by the insurance companies because he's received "socialized health care" since the time he enlisted. It's the one thing Pooh cannot get by - he had coverage of himself and his kids since the time he enlisted and has had it since he retired from the Nav before the age of 40. Pooh likes to bitch, but he has never been without government run health care during his entire adult life. He just wants to complain that others don't have what he has simply because they didn't float on boats for 20 years. =Bob |
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