She feels that she was treated better in New York City, but her bills were astronomical in comparison to her bills for her London treatment. Her point can probably be summed up with her asking, “Would the elderly woman in my ward in London who repeatedly pleaded “Can someone help me please?” after being left on her dirty bedpan for almost an hour, recommend a version of the National Health Service to Americans?

Cost vs. quality….the major dilemma. Your thoughts on her accounts?

Source:
“A tale of 2 sickbeds: Health care in U.K. vs. U.S.” – MSNBC, September 22, 2008

Post from: EveryJoe

One Journalist’s Treament in London: A Case For or Against a National Health Care Plan?

Originally written September 8, 2008
No Group Coverage? Well You’re Just SOL!
In the last five years, I’ve had the following conversation more times than I can count on two hands…

Other Person: “How’s business going?”

Me: “Oh, pretty good. I’m really busy, and I really love my job.”

Other Person: “Good. I was hoping with _____ (fill in the blank with any of the following: the economy, the war in Iraq, 9/11, the housing slump, etc.) that you were staying busy.”

Me: “Yeah, I just keep plugging along. Actually, I figure the most likely thing to put me out of business is health insurance.”

Other Person: “Yeah, rates keep going up.”

Me: “Well, I can plan for rate increases. What I can’t plan for is if someone in my family gets a serious medical condition. We don’t qualify for group coverage, and with the individual coverage we have, our insurance company can effectively get rid of us if one of us gets a serious condition.”

Other Person: “They can’t do that, can they?”

Me: “Technically they can’t deny us coverage. However, they can make our rates so unaffordable that we would have to switch companies. And here’s the catch with individual policies…when we switch companies, the new insurance company can exclude the pre-existing condition that caused us to switch in the first place.”

Other Person: “Really? I had no idea?”

Obviously, I’ve paraphrased, but that is essentially the conversation I’ve had over and over with people that have group coverage. I think that is why many people are opposed to the idea of universal coverage. Many people with group coverage don’t realize that many of the country’s uninsured or under-insured, lack the ability to even qualify for decent coverage.

There will always be a certain number of people who can afford health insurance, choose not to pay for it, then get sick, and cost tax-payers a lot of money. And the opponents of universal coverage will trot those examples out at every opportunity.

But I’m here as proof that many hard-working, self-employed Americans are one illness (for them, their spouse, or their dependents) away from financial disaster.

I just read John McCain’s health care plan. He wants to use tax credits along with the free market and guaranteed access plans to “fix” health care. IT WILL NOT WORK! Would you let the free market run your fire department? Police department? I hope not. The free market exists to make a profit. I like profits. I think they’re swell. I’d like to make more. However, I strongly believe that it is wrong to profit from health insurance. The lure of profits in health insurance influences decisions from their middle management that are scandalous. Who hasn’t heard a horror story of someone they know being denied basic benefits?

As for guaranteed access plans (or GAP’s), we have those already in Iowa. GAP’s are a decent temporary solution to get more people insured. Take a look at Iowa’s plans, though. I’m pretty sure you wouldn’t want one, especially with what they cost.

I’m not completely sold on Obama’s plan either, but it is much closer to universal coverage, and I think it is a step in the right direction. He’s got my vote on this issue.

Post from: EveryJoe

An Everyday Perspective on Group Health Insurance Coverage

Want to stay healthy?

Trigon has the most doctors to choose from. So you can get one you like.

Need a good doctor? **Be aware that this video contains the anatomically correct name for a male reproductive organ.**

Post from: EveryJoe

Health Insurance Commercials…for a Laugh!?

Are you struggling with debt or dealing with a pile up of bills because you are uninsured? Or, are you insured, but for some reason have found that your insurance doesn’t cover your medical expenses

I wonder what people who are struggling with medical bill debt think about reforming the U.S. health care system.  Do they support universal health care, or are they more in favor of a private health insurance system.  Perhaps the growing number of people in medical debt (and the growing medical debt issue overall) is yet another symptom of how private health insurance might be a failing proposition for many American families.

Post from: EveryJoe

Nearly Half of Working Americans in Medical Debt

Monthly premiums for Medicare drug plans will increase by 10%, or about $3, in 2009. Seniors, on average, will pay $28/month dependent upon their particular plan. The Centers for Medicare & Medicaid Services says the increase is right in line with the increase in drug costs, but the Medicare Rights Center says that the increase is higher than the Social Security cost of living increase and that the government should be doing more to negotiate drug prices with pharmaceutical companies.

Are you enrolled in a Medicare drug plan? If so, what do you think about the 2009 increase?

Sources:
image: picapp

“2009 Medicare drug plan premiums announced” – Chicago Tribune, August 14, 2008

Post from: EveryJoe

Medicare Announces 2009 Drug Plan Premiums

While the NAIC should be commended for recognizing that lack of insurance contributes to people skipping doctor’s visits or not filling prescriptions to save money, more research needs to be done to quantify how many Americans with insurance are cutting back on health care service consumption as well. Even the insured may be subject to large deductibles, co-payments, or co-insurance amounts on top of premiums that fewer employers are sharing. Also, many of the insured are now discovering they are “underinsured” for conditions that are serious and expensive, such as cancer. Many policies have instituted lifetime maximums or maximums for particularly expensive diseases, and while a $1 million maximum may seem high, it can be reached in a short amount of time when multiple treatments costing more than $100,000 per year are involved.

Do you know anyone who is reducing their use of health services to save money? Apart from skipping having a prescription filled, is there any other method you have used to save health care money, such as getting a prescription filled at a cheaper pharmacy or switching to generics? What about changing your doctor to one who is in-network or even changing to a cheaper insurance policy?

Post from: EveryJoe

Americans reduce use of health services to save money

Watching Beijing’s Olympics Opening Ceremony (which was heartstopping), I started thinking about health care availability to the thousands of athletes and spectators during the games. I didn’t want to miss too much of the ceremony, so I just did a quick search, but this San Francisco Chronicle article informed me that athletes have access to 200 doctors and 400+ other medical personnel from 41 local hospitals in the clinic in Olympic Village. There is a serious lack of obstetric care, apparently, and although OB care is probably not in high demand by the athletes, it’s still a gross omission.

As for game-goers, I found a link to a handy pocket guide put together by Blue Cross Blue Shield to inform its members where they can access health care while in Beijing.

Just a few interesting resources to consider while you enjoy the games, because all politics aside, it’s a pretty amazing gathering.

Sources:
Image: picapp
“2008 beijing olympics GLOBAL VILLAGE Athletes’ home is a big city all by itself” – San Francisco Chronicle, August 6, 2008
“2008 Summer Olympics: Accessing Healthcare in Beijing Pocket Guide” – Blue Cross Blue Shield

Post from: EveryJoe

Health Care for Olympic Athletes and Fans

At the same time, the New York Times is reporting on Philadelphia area insurers that are offering bonus payments or increased payments to physicians for using tools such as telephone visits, e-mail “visits,” and electronic monitoring of patients’ conditions to improve continuity of care and chronic disease care.

Can we save money by spending more? The statement seems counterintuitive, but paying more for the rightkinds of care and treatment can save money in the long run. For example, e-prescribing is often safer (no messy handwriting, less potential for drug interactions) and less of an administrative burden (less paperwork, faster transmission of information) than prescribing on paper. Checking in on patients daily or weekly and tracking blood sugar or blood pressure over time rather than waiting for the patient’s condition to become a crisis leads to lower spending, just as prevention is cheaper than a cure. With that in mind, both of these programs should be on the right track.

Post from: EveryJoe

Will higher physician payments and bonuses lead to lower costs?

Two weeks ago, California tried but failed to go after a one million dollar fine against a related business entity of Blue Shield called Anthem Blue Cross. According to a report from the Associated Press, regulators in California were “intimidated” by Anthem’s heavy-hitting legal team, but still plan to go after the company.

Apart from dropping people’s coverage, rescission is a huge penalty to providers and hospitals, as it leaves them on the hook for the services they provide. They’ve already billed the services, but now their claims for charges are rejected by the insurance company because the person is retrospectively dropped from coverage. Often, the provider will attempt to bill the individual, but the fact is that the service would have likely not been performed at all if the provider had known the individual was not covered. Alternatively, the provider might have tried to find a less expensive or different treatment for the patient if they thought the patient was paying out-of-pocket.

More states need to start standing up to unethical practices by the insurance behemoths. Insurance is only really insurance if it reduces risk and uncertainty and is there for covered individuals when they need it. If a policy can be revoked on a whim and past charges not covered, insurance companies are not holding up their end of deal which already is heavily in their favor.

Post from: EveryJoe

Blue Shield sued for dropping policyholders

According to the op-ed, private plans now cover more than 20% of all Medicare beneficiaries. The editorial supports the move made by Congress to cut back on the subsidies private insurers make on these plans because they are more expensive for the government and have not been proven to cut costs or provide better care. As the piece states, “Medicare… pays the private plans, on average, 13 percent more” than what Medicare would pay for a service provided under the traditional plan. And why is this happening? Because of Republican political ideology that a private provider can do something much more efficiently than the government. The government is, effectively, subsidizing the private plans so that they can compete with government provided Medicare. In this case, Medicare is actually doing better as a government-run entity than the private plans are doing in terms of providing services efficiently!

I agree with the NYT — that President Bush should stop threatening to veto this bill. Private insurance companies don’t deserve to keep getting breaks such as these from the government. 

Post from: EveryJoe

NYT’s Ed Board Addresses Medicare Advantage & the Medicare Bill