Thursday, February 04, 2010

Health Care Options for Middle Class Americans

1. Don't get sick.

2. Go bankrupt.

3. Die.*

* Please complete option 2 before completing option 3.



(S)wine said...

that's it baby. brevity has always been your forte.

Erin O'Brien said...

I don't think many people realize that their employee health insurance costs will soon be tied to their "wellness."

If you're fat, or if you smoke, or if you're tan, or if you salt your food? You'll be paying more more MORE!

It's just starting at larger corporations and MAN are these invasive programs. Do you use butter? Do you trim the fat from your meat? Got colonoscopy? What's you're LDL? Oh yeah, many "wellness" programs include spouses too.

Sure, you can say "none of your beeswax," just get ready to pay MORE.

Bill said...

i'm middle class. i don't belong to a union. i have great health care. i normally get a dr appt within a day. i have kaiser as my provider. it's not cheap but i cut back on cable tv options, cell phone use, texting, long trips, etc. health care should be an important part of the middle class budget. i have several canadian friends. very difficult to 1, get a dr, 2, get appts scheduled, 3, get almost any surgery. you know about the canadian premier who is in the us now for heart surgery. go figure. while visiting a friend at stanford, a couple of years ago, i met and made friends with an uninsured 35 yr old who was shot and is paralyzed in both legs. stanford saved his life, kept him for a long time, provided therapy, etc. no money, no property, no insurance and he received some of the best care on the planet. go figure.

Erin O'Brien said...

Fine, Bill, but are you willing to pay more for your insurance than the next guy if your cholesterol level is higher than his? Or if your wife goes to a tanning salon and his doesn't?

Anonymous said...

Why wouldn't people with riskier behavior pay more for health insurance? If you have more traffic tickets, don't you pay more in auto insurance?

Really Erin, you wait for government to help you and I'll take charge of my own destiny. We'll see who gets better results.

Besides, our governemnt is broke. We're going to have to raise taxes and cut benefits. jemison

(S)wine said...

Erin, mine are like that starting this july. For the record: i am a state of NC employee working at NC State University w/Blue Cross Blue Shield family plan (80/20, monthly rate: $535!!). As of July, if my BMI is above 35, I will be dropped to 70/30 and pay more. If I'm a smoker, I go to 70/30 and pay WAAY MORE.

This is...a benefit? I ask people to take a look above at my monthly rate. On a state employee's salary. I have a wife and one child.

This country? She sucks my Romanian bollix, my friend. But you knew that already.

(S)wine said...

Also? To Bill. My wife is Canadian (from Toronto via Ottawa). Your example of Canadian healthcare is just merely one of the bad ones. They have them, we have TONS of them. Overall, from a Canadian citizen who's only lived here 2 years, the Canadian healthcare is very good. There isn't one fucking system out there that will have perfect examples, so I wish people would wake up and see what kind of system WE have here. You said your insurance is high but good. Why does it have to be high? Why do I have to give up buying certain foods in favour of canned beans so I can make my premium? I agree w/the cutting of the cable, etc. But trips? Travelling? That's bullshit. You're basically taking apart your own argument about how good Kaiser is. If it requires people to tweak their lives to such a degree in order to pay for healthcare that is...GOOD...then something is wrong. This country is bankrupt, though, so the fucker can't even spend money on snow/ice removal in states like ours. Long LIve the Central Banking maggots!

Erin O'Brien said...

Hey jemison? I didn't ask for anybody's help. I did 60 grueling minutes on the cardio machine this a.m. and I'll do the same again tomorrow. I've been regularly working out for 15 years. I quit smoking in 1993.

How about you?

Don't feel you have to answer. Your employer will probably be taking care of that soon enough. Then we'll see how righteous you are.

(S)wine said...

Jemison, I will more than likely give you the "smoker" designation, but the BMI charts by which insurers go is bollix. Some of us are tall and athletic and have lifted weights all our lives (I am 6'3" 228 lbs.; I run 5 miles /day for 6 days / week at 8:18 min. mile) and we register near "obese" when consulting the BMI. See the fallacy?

Chrissy said...

i think u have a pt. there.. as it is if u have any pre condition, insurance companies charge up the yin yang... so, yes, i can see them charging extra if your cholesterol or sugar level is up... and what about dependents having a pre condition? another whammy..i think i hear ca-ching in the background...

Anonymous said...

Sorry kids--I was at the Y swimming. I usually do a mile four times per week. I am almost exactly your age Erin and in excellent physical condition.

My employer provides health insurance for me and my 6 year old with a high deductible. It is a given benefit in my field as it is with most professions. Last year I paid all medical expenses for her and my annual checkup.

But getting past the ad hominems (project much Swine?), my point is people expect healthcare without any input. Benefits without any economic consequences. I'm not worried about the two or three hundred dollar medical bill--I'm worried about the thirty or forty thousand dollar bill. That's what health insurance is for--and anyone making a living wage should be able to afford a high deductible health insurance policy.

Insurance is, at its basic level, spreading the risk. Those who add to the risk by engaging in elective risky behavior should pay a higher amount to enjoy the benefit. And you guys will never convince me that government is going to fix this--I saw the same scenario unfold in 1994.jemison

Dean said...

Bill sez: "i have several canadian friends. very difficult to 1, get a dr, 2, get
appts scheduled, 3, get almost any surgery."


Untrue. There are parts of the country where it might be difficult to
get a family doctor, but as with the US, that's an economic problem.
In the US, you can't get a doctor if you're poor. In Canada, you might
not be able to get one if you're in a rural area. But in both
countries, you'll be able to see a doctor at a clinic.

I and my entire extended family have NO problems getting appointments
with family doctors, appointments with specialists, or any surgery we
need. Chris' grandfather had a hip replaced at 96 - he'll be 100 this
year, and is still going strong.

We all pay $132 per month for a family.

Erin O'Brien said...

Jemison: "people expect healthcare without any input. Benefits without any economic consequences."

Who? Not me.

"elective risky behavior" will include everyone eventually.

-people who engage in extreme sports

-motorcycle owners

-people who live in high-crime areas

Then there's the rest of it. These "wellness' surveys have sections about stress, sleeping habits, "happiness" evaluations.

My silver ball tells me that we will all have a rating of some sort one day. Our "number" will be determined by actuary tables and there will be plenty of categories over which you have no control:

-If you smoke, big rating deduction.
-If you exercise, rating addition.
-Family history of cancer: deduction.
-Low LDL: addition
-Vaccinated as a kid: addition
-Avid skier: deduction.
-Pre-existing condition: Shit Out Of Luck.

If you're Rush Limbaugh, you won't care about any of it. For the rest of us, see the content of my post.

Anonymous said...

Now you and your silver ball are just making shit up. Remember the purpose of insurance--if everyone is rated higher then there is no net change in the risk analysis...jemison

The Shitty Astrologer said...

Oh LoLz Erin...sometimes I wish humans didn't come with brains, life might just be a little easier to reason with that way.

Erin O'Brien said...

Jemison, believe this.

There's nothing "elective" about family history.

Heidi said...

Just in case anyone things we don't pay for health care in Canada... we here in Quebec are taxed to the eyeballs... I'm paying plenty thanks. And happily, I have a doctor I can see pretty much whenever I need to. I feel pretty lucky up here.

Anonymous said...

One of your seven factors, Erin. Listen, I'm a tax and spend liberal. I supported health care reform in 1994 and 2009.

But to blindly say that people shouldn't be held accountable for their behavior (smoking) is folly. Hell--I fly gliders and scuba dive--but I'm willing to pay extra for life insurance because of that.

As for the other factors you listed, my point is two-fold. First, if everyone is going to be rated riskier because of something, then the risk analysis is moot--you simply can't state one person is a higher risk than another. Second--many of the factors you stated we have no control over we do. And to the extent people exercise such control, the marketplace will reward them.

As for pre-existing conditions--you stated earlier you weren't asking for help. I take you at your word. The only way to force a business in a free marketplace not to act in its own best interest is through government regulation. While I favor that and believe it would increase the pool of insured and bring down the overall costs--our political leaders have shown they will not impose such conditions on health insurance companies.jemison

Erin O'Brien said...

Jemison, how's this: You come on back over here after you get your "wellness" questionnaire and recommended program guide and tell me how you feel about it then.

Dreamfarm Girl said...

Yep. Both my daughter and son just graduated college and got jobs. I was far more excited about having health care benefits than their actual paychecks. it's stinkin ridiculous.

Once Known as The Badger said...

Why is anyone against a good health care system? No one complains that we send trillions of dollars to fight a war with no end, but health care seems to stir up some really weird antagonistic, wild eyed arguments from the right wing. It's good for PEOPLE, not corporations. Corporations don't care about PEOPLE; their accountants don't allow it.

DogsDontPurr said...

I think insurance companies already do determine the rate based on your risk factors. When I signed up for Kaiser, I had to fill out a multi page questionnaire about my life style and my pre existing conditions and previous health issues, even if they had been resolved. They also determined my rate by where I lived. When I lived in a poor neighborhood, known for it's drive by shootings, I paid a lot more per month as compared to now, when I live in a high end, health conscious neighborhood.

So, I don't understand what all this worry is over a new health care plan. It doesn't seem much different than we have now. I think the only valid worry is that it will undoubtedly result in higher taxes or increased costs somewhere else.

Erin O'Brien said...

Oh Mr. Jemison, make sure you read the comment right above this one.

Matt Conlon said...

Hard to believe, but I just got back from a dinner with an independant health care broker.

My health care through work went from around $600 to over $1,400 a month.

Bill said...

swine: you should be able to buy caviar and filet minon if you want. you shop for them. if you want the best health care (not insurance) you'll have to pay for it my friend. just like the canadian pol who's having his heart surgery here. if you really think that doctors should be paid like taxi drivers (as in cuba), best of luck you you. it might not be fair but all health care is not the same. some countries cover everyone with shitty service. the wealthy won't be going through those systems.

another great topic for your peeps to discuss erin.

Sean Craven said...

Hey, as a blue-collar dude who worked until his back gave out? Welcome to my world.

Bill said...

helmets, smoking, seatbelts, transfats, sugar, salt. don't worry about a thing. the gov will make sure you're safe.

Bill said...

i direct you to the following article from a canadian newspaper. of course i realize that there are horror stories everywhere and we all have our biases.

Bill said...


Erin O'Brien said...

So what's your point, Bill? Plenty of peeps come to the US for health services. Nobody comes here to get health insurance. We have the shittiest health insurance system in the developed world.

Anonymous said...

Other than bitch about it, I don't see what your solution is Erin. Especially if you aren't looking to the government to constrain private businesses to adjust risk based on information they have. Until a public option model is put in place companies will continue to try to limit their exposure to risk. I personally think a public option is a good idea but that's a different argument.

Auto insurance companies already take into account where the insured lives.

And you still haven't answered why a person who willingly engages in risky behavior shouldn't pay more for health coverage. Put another way, why should people like you and I subsidize others who willingly increase their exposure to health problems?

Wellness questionaire? I'd be happy to inform my health insurance company of my health--they can take my blood pressure and measure my cholesterol. I have no reason to be concerned about this and if it results in a lower premium then I am being rewarded for being active in maintaining my health.

Erin O'Brien said...

Was that you, jemison?

Whomever it is, I'll use smoking to clarify my point: Consuming tobacco is a legal activity, which means as a society we condone it. We all benefit from the taxes it generates; and to an extent, we're all responsible for the troubles it generates.

Why should someone who smokes pay a higher deductible when they slip and break their ankle? That is simply discrimination and it's wrong.

I "bitch" about this because there is power in my voice and if we all sit in the corner like frightened mice, we'll never ever get any closer to a sane system in this country.

I cannot tolerate the holier-than-thou attitude all of this silently condones either. I am not better than the obese man or the disabled man or the smoking man.

Every one of us does something "elective" and "risky," whether it's consuming raw fish or smoking or BASE jumping. You start pointing at the easy targets like the smokers and you will soon find yourself in the cross-hairs.

Anonymous said...

I'll ask one more time in the hope that you will answer.

How do you propose to stop private businesses from using information?

Morally, you are not better than a smoker, a drinker, or an obese person--but business decisions (unless they are regulated) are not moral decisions. jemison

Anonymous said...

I work for The Veterans Administartion. I see Military Veterans everyday who had risky lifestyles. The VA mission is taken from the Lincoln quote "To care for him who shall have borne the battle and his widow and his orphan." There are American veterans choosing everyday whether to pay their utilities or pay for their medication. Yesterday I saw a person with a rare neurological disorder that is treated with an "Orphan" drug. In the US that drug costs over 5000 monthly. He has obtained a months supply in Canada for 250 dollars. If I get arrested and sent to prison with that condition my healthcare would be provided by the taxpayers. The US congress has voted against the importation of pharmaceuticals because they are beholden to the pharmaceutical companies. Anyone that believes insurance rates are about anythinhg other than enriching shareholders of those companies is delusional. Health is moral obligation, not a business decision. See: about 90% of the western world.


Erin O'Brien said...

Good christ, if a "tax and spend liberal" is ready to lay down and hand over his privacy to corporate America without a word, we're more screwed than I realized.

I never said I could stop it, Jemison. This here is free speech, and it obviously captured your attention. Good. That's how it's supposed to work.

The only way to change something like this is to start with outrage and go from there. So here's my outrage. Maybe others will read it and pass it on. Maybe it will eventually turn into action. Maybe I'll be a part of that action.

In the meantime, all I can do is keep on keepin' on.

Bill said...

wouldn't it be great if there were all of these altruistic doctors willing to work for next to nothing so we could all get excellent health care for nothing? might as well put free housing, transportation, and food on that wish list. i do agree with you about discrimination based on your life style! i've noticed, too, that my life insurance premiums are based on that as well. there are so many sides to this issue. i guess the question is: how do we improve the insurance system without fucking up the health care. I don't know!

Anonymous said...

I never said I was willing to lay down my privacy--have you ever heard of HIPPA? But to request catastrophic coverage from a company, yes, I would gladly share with them information, especially if it results in a lower cost. I do it with my homeowner's policy, my life insurance policy and my car insurance policy.

And a quick survey of cigarette revenues versus expenditures lays waste to your opinion that we all benefit from the tobacco taxes. The highest revenues from tobacco taxes in my state (FL) I could find were from 2005:
$465,772,000.00. CDC estimates annual smoking related costs for the country at large at $75 billion (yes, with a b). For Florida alone, the estimated health costs are $6 billion with another $6 billion in productivity losses. You may quibble with the numbers but that's a large gap between revenue and expenses.

Actions have consequences. jemison

Erin O'Brien said...

My last commentary on this.

Your employer is dying to get his hands on your health records, baby, and he's getting closer all the time.

Bill said...

i've owned a couple of businesses. i aways provided insurance for the employees. the cost is higher with a group plan. individual plans are less expensive for a healthy person because the group plan doesn't ask about pre existing conditions. it makes sense. that's the way it worked a few years ago. who knows what the pols will come up with. i'd definitely bet that it won't be cheaper.

Anonymous said...

My last response: Read what you linked to and you will see the participant has the power to authorize the disclosure of the information and that all federal and state privacy laws apply (e.g. HIPPA which I mentioned earlier).

I don't know what kind of work situation you're familiar with but my employers already know a lot about me--we work together every day. But they can't simply go digging through my medical records without violating laws and potentially being held civilly accountable.

Lastly, "outrage" is one thing; but grown ups get past that and try to work together to cobble solutions to problems. Simply ranting against the big bad corporate bogey monster doesn't get us anywhere.

In the end, we are asking our health insurers to potentially pay large sums if they insure us--without some incentive to cover everyone and thereby reduce the risk across the board of course they are going to want information. What if I found out today I had terminal pancreatic cancer--should I be able to go to a life insurance company and purchase a $10 milion dollar policy and scream foul if they want to ask a few questions? jemison

Anonymous said...

"The best thing about beating one's head against a wall is that it feels so good when one quits."

Jemison, the access to data is a shell game. They are just looking for rationalizations to ass rape the consumer. Have you considered a career in lobbying for the industry?

Put the mothers outta business, nationalize healthcare, there's a solution.

And the analogy about life insurance is not parallel. Apples and oranges as it were.


Anonymous said...

RJ--I make my living (and a good one at that) suing insurance companies.

I said early on I was in favor of a public option but Washington has clearly signaled they aren't going to do any such thing.

And the analogy with life insurance is in fact spot on. Access to information is the argument (see supra).

Sausage Fingers said...

Take a look at the blog I wrote called - A man looks at 50.
I like the last line.

lovey said...

The one about charging more for weight is what gets me. It's true that health conscious body builders can be technically obese. So many medications cause weight gain, so it is a side effect in some cases.

Not to mention that obese people earn much less than average weight people. How can you effectively lose weight to get healthy without good medical care? How can you afford healthy food choices if you are spending so much money on health care? Fat is cheap. It's a catch-22. Many obese people end up on Medicaid because they become bankrupt from their share of medical bills when they are working.

And health care should not be a business decision. It's a moral issue. An ill or sick person who is not engaging in such things as sky-diving has a right to care for their illnesses. The drug companies are corrupt. One of my prescriptions, Provigil, was supposed to go generic in 2006. The company (Cephalon) tried to extend the patent on this novel drug by patenting the granulation. Four drug companies figured out how to produce the generic drug without the patented granulation. What did Cephalon do? They paid nearly one billion dollars to the four other companies to not produce the drug until 2012. Meanwhile, the drug price has skyrocketed. My prescription is $750 a month before insurance. Cephalon will make about $7 billion on this back room deal. The Federal Trade Commission sued, but it will take years in the courts to do anything. This is what the feds should be going after..this flagrant criminal behavior that drives up health care costs. It shouldn't be allowed to happen, and the government needs to have a way to stop this practice immediately instead of through the courts.

Amy L. Hanna said...


O'Brien summed it up perfectly in her firing shot.

We're ALL pawns of corporate greed and are pretty much on our own given the impudent and incestuous relationship between politicians and lobbyists.

That is precisely why we are seen as MARKETS rather than as HUMAN BEINGS.

The REAL "risk behavior" some of you ought to be finger-wagging instead is this rather informally codified codependency if any real healthcare legislation is to make it to signage AT ALL.

The latest SCOTUS ruling ain't going to be helping matters in the long run either, as We The People have obviously been underbid if not further undersold.

I'm done.

(S)wine said...

bill dude, it's as if you're reading bullet points off the republican agenda.

how's about we think or try to change the system to offer people affordable health care. your assertion that good healthcare should be expensive is horseshit. it should be affordable. it ain't. we should aim to make it that way. why? so people can have decent lives in this country. otherwise, people with your attitude, and this country in general, is a piece of shit.

and oh mr. Bill, one last thing...America is really a third world country with kick ass marketing and advertising. sounds to me like you've bought into "America" full on.

your product is defective. not to mention broke as shit. can you send it back? i doubt it.

cheers, i'll be whistling dixie and drinking whisky in Oslo. have fun paying your balls off for that awesome health care system you talk about. you know, the one where you have to fucking write on your flesh which diseased kidney the motherfuckers need to remove in the operation.

Bill said...

swine: lol! i don't have any bullet points and any agenda i have is my own. i've definitely bought into the good ole u s of a though. have fun in oslo. ha det!

Velociman said...

Amazingly enough, Erin, I use a different option:

1. Get sick.
2. Use the health insurance I pay for with the sweat of my brow.
3. Get the best medical care in the universe.
4. Get well.

I tried to keep it to three steps, but getting well seemed kind of important, so I included it.

All the best!


Bill said...

dean: i just read your post from a while ago. you forgot to mention that chris's grandfather, who go the hip replacement at 96, actually needed the hip replacement when he was 89. but i'm glad he's living a nice long life and the last five he's been hip pain free.

velociman: you nailed it.

(S)wine said...

bill, i said IT'S AS IF...only because your own agenda sounds very much like the conservative bullet points, that's all.

velociman, one question you may perhaps not have thought of: what happens when the awesome health insurance for which you pay with the sweat of your brow and the strength of your back goes up so much that you can no longer afford to pay for it?

i work for the U.S. gob'mint and my Blue Cross Blue Shield co-pay has increased 22% in the last 16 months, as coverage has been dropped from 90/10 to 80/20. I am not a smoker. I run 5 miles/day, 6 days/week. 6'3" and 225-ish lbs. Starting this July, they'll set rates based on BMI calculations.

but back to my original question: what is your plan when you cannot afford your good health ins.?

(S)wine said...

bill, you never addressed my 'call to arms' that we make good healthcare affordable to all. why? this country, although now broke as shit and owing everything to the Chinese and Japanese and Russians and English and even the Norwegians, still has billions to pump into the pseudo-war that is Afghanistan (never mind that clusterfuck that is Iraq), but nothing into Education and Healthcare. why is that, you think? why shouldn't that be feasible, you think? why not shore up our infrastructure, bridges, roads, etc.? why let corporations run this ... GREAT country of yours? (ours). i love the "don't let a politician get in between you and your doctor" line...when in fact we're letting "a CEO get in between us and our doctors." think about it. it's shit all around, my friend. but you've bought into the marketing, so things are the "best in the world/universe."

this is another thing that also makes me laugh about the patriots...every fucking thing here is the best in the world, or universe--as velociman says up a few posts. really? the BEST, eh? i love how people think in black and white and extremes.

having lived in the states now over 3 decades (i AM a citizen, by the way and have been for over 26 years), and as a person who was born and lived in a communist country with its own, horrible ills and shortcomings and lack of any kind of freedom, i can tell you quite honestly that Americans in general are ill-educated and quite pompous about everything being the BEST in the universe.

that makes me laugh (it used to incense me, but i grew up) to hear nowadays, and leaves me shaking my head at the comical mental picture i have of all of us going down the drain socially and economically while still proclaiming greatness, divinity, and overall dominance.

it's a great picture.

Erin O'Brien said...

Bill, I assume you are joking, but just to be clear: you don't know Dean or Chris or her grandfather. Dean didn't "forget" to mention anything, and in the future, you'll be real careful about saying anything dicey about the virtues of non-anonymous commenters here, right?

Good. That's what I thought.


I am laughing so hard over the "sweat of my brow" portion of Kim's comment I can hardly see.


Other than that, good for all of you who've not yet been bit by our healthcare system. Neither have I--at least not real hard. One day, however, you will get bit (as will I) and you too will see how badly it sucks.

Bill said...

swine: we could make health insurance available to everyone but everyone keeps saying "affordable". what's affordable? and, how do you make people use it if you force them to have it? i know a guy, about 40, a personal trainer, no insurance. he has a cable bill of about $200 per month. a cell phone bill of about $100 a month. spends about $40 at starbucks. says he can't afford health insurance.

erin: you're right. i don't know chris or her grandfather. i do "know" that elective surgeries in canada take a very long time to get scheduled. i don't think i was impugning anyone's virtues or even being "dicey" but i'll bet getting that hip replacement scheduled was not a piece of cake.

lovey said...

I agree Erin. I unfortunately, am one that has been "bit hard" by medical costs.

I laughed at the sweat of my brow comment. Three years ago, I was working full-time, usually 70 hours a week. Now, I am near bankruptcy because of medical costs.

I became ill; it is not due to my risky behaviors--I don't smoke, drink, do drugs, etc.. The copayments with my insurance at work ate up over 50% of my income. I had to hold out on lots of treatment because I could no longer afford the copayments. This made me sicker, to the point I couldn't work anymore full-time, and I lost that insurance when I had to quit for medical reasons. For six months, I paid high COBRA payments and high deductibles. That ate up all my savings, and started me into credit card debt.

After 6 months of this, I was "lucky" in that I qualified for social security disability. However, there is a 2 year wait for Medicare, so I had to go on Medicaid.

For two years, I had to live on $375 amonth, that the state of Michigan left out of my SSDI after my Medicaid spend-down. Some months, the state wiped out any income I had with their screwed up policies. I had to go deeper in credit card debt just to survive. At that time I was on oxygen to survive, so I had to meet my spend-down every month.

Finally, a month ago, I qualified for Medicare, and now my medical costs are down to about 15% of my income. But my next move is bankruptcy court.

I am in much better health, and I beat the odds in that 90% of people with my condition die within 3 years. I don't regret any choices I made, as I made them to survive.

I didn't just sit back on this issue either and watch this happen to me. Over 18 months ago, I advocated for people in my category with the legislators in Lansing. I helped write a bill in the MI legislature to remedy a great injustice that those who have worked and go on disability get to live on half what a person who has never worked does.

But what happened? The MI legislature stole all the monies that would have reformed the Medicaid system. They received $2.2 billion from the stimulus for Medicaid, and with "creative bookkeeping" put it in the state's general fund and called it "flexible stimulus monies". Then they cut Medicaid services to many. At least one woman has died because of the impact of these cuts. Medicaid dollars are going to everyone in the government with cushy jobs, while the elderly, disabled, medically needy, and children go without.

An illness changing your life can happen in an instant. I am so tired of the "holier than thou" attitudes. It doesn't matter how hard you work, the system is set up to get you in the end.

And this, ladies and gentlemen, is the reality of the American health system.

Bill said...

excellent, though provoking, post, lovey!

Erin O'Brien said...

Lovey ... wow ... just ... wow.

All best to you.

Erin O'Brien said...

An example of "the sweat of my brow" courtesy of Mr. Kim Crawford (AKA Velociman).

lovey said...

Oh, and for all that money spent, I had to go through hell to get good care. Although at times I was treated better because I paid COBRA premiums to meet my spend-down deductible (and the last year was 150% of "normal" of COBRA premiums because I was in the disability extension), basically, I was a Medicaid patient.

At times I had to travel 2 hours to see a specialist, as none in my area would take Medicaid, even as a secondary. There were no dentists within 90 miles who took Medicaid, even before the state cut dental services to Medicaid recipients. And some of my local specialists were swamped with patients because they were the only provider in the area to take Medicaid.

It took 14 prescriptions from 5 doctors and eight months to only have a piece of medical equipment, necessary for my survival, denied. A hearing I had took 5 months for an "expedited hearing".. And the paperwork...My Medicaid file for the last two years is broken into two files that are a foot deep each. The State of Michigan has spent more processing my paperwork than paying.

If I was paying so much of my income in comparison to others, I should have had cadillac care. But I had crappy care most of the time, and only through my research and determination, and being a pain in the ass did I get the needed treatments to stay alive and get well.

I did become an "example" of what is wrong with health care today, and went to legislative meetings as the "example". The legislators knew all about me, and in two years, did nothing to help me or people like me. It was the state, not the feds who made life horrible for me. If I had been in California, as I am now, as I moved back in with my elderly mother, I would have had no spend-down -- $900 more a month to live on. These types of inequalities between states also need to be eliminated.

Please don't generalize that everyone on Medicaid/Medicare is using the system. Many people need the assistance to survive. The bad apples make everyone look bad at the cost of those who are medically needy.

Bill said...

lovey: thanks for taking the time to provide all of this detail. it really is educational.

e: thanks again for bringing up the subject. as contentious as this is, it is good to discuss. i like trying to write in <140 characters. can't do it on this subject.

Cosmic Navel Lint said...

I just think it's tragic that "the richest country in the world" can't provide healthcare-at-the-point-of-need to ALL its citizens - and certainly where the US prides itself on its system's phalanx of HMO/Insurance company refusals-to-authorise-treatment, get-out-of-paying clauses, previous condition gotchas and other voodoo designed to trip you up and deny you the treatment you might need.

Having all the Nukes is all very well and good - but if you've got a 3rd World healthcare system - which you have, certainly when compared to Europe and Australasia - then frankly, having all the Nukes ceases to be a proud boast and begins to look quite sick - with is ironic, as so do 47+ million of you who can't get/are denied health insurance.

That you guys should be sitting here debating the ifs, whys, wherefores & the likely conditions under which you'll actually get the treatment you might need, when you need it, just beggars belief.

Any country which makes something so fundamental as good health a pay-to-play and political/partisan issue deserves to design itself into parody - which is what's happened here: try substituting 'healthcare' for 'going to the toilet' (along with healthcare, something for which all humans - regardless of your politics - have a requirement) and see just how bizarre the rest of the Western industrialised world views just what a farce your selective healthcare system is.

Unless you can see or frame this debate in the terms of good health being a societal responsibility, and not just an opportunity for the HMOs to get fat whilst denying you and your family treatment because you forgot to dot an 'i', or cross and 't', or because you've have the condition 'before', then you're just going to remain the poor relation when it comes to comparing the healthcare you actually need, to the healthcare your society actually bestows upon you.

And you don't need me or anyone else to illustrate the immense gap between the two positions...

dean said...


erin: you're right. i don't know chris or her grandfather. i do
"know" that elective surgeries in canada take a very long time to get
scheduled. i don't think i was impugning anyone's virtues or even
being "dicey" but i'll bet getting that hip replacement scheduled was
not a piece of cake.

You "know" wrong. You "know" what has been promulgated by people with
a very large financial interest in having you "know" wrong.

Some of these interests are Canadian. Doctors and nurses advocacy
groups trumpet loud and long about waiting lists, because it is in
their financial best interests to do so.

And in the US, there is a very large and very powerful and very rich
industry in whose best financial interests it is to have you conflate
waiting lists for ELECTIVE surgery with waiting lists for ESSENTIAL
surgery. They are very different things, and when surgery in Canada
is essential, or even important, specialists are seen and surgery is

And yes, waits for ELECTIVE surgery can be long. This in contrast to
the US, where waits for elective surgery are either short (for rich
people) or effectively infinite ( for poor people and in some cases
middle-class people). I'm betting that if you were to compare the
average wait time for elective surgery (the REAL average wait time,
not just the average wait time for those who can $$$ pay) in Canada
and the US, Canada would look pretty damn good.

As I said, my wife's 96 year old grandfather got a hip replacement. He
got one about 10 days after breaking his, and some of that was a wait
for a few days to let his strength come back.

My mother, on the other hand, had to wait some years ago for her hip
replacement. It was elective: I think she waited 3 weeks for it, maybe

I, myself, had had some essential procedures. They have all been
timely. I have had a couple of minor elective procedures. They, also,
have been timely.

Bill said...

dean: thanks.

Anonymous said...

I live in Tennessee,am self employed and have independent, high deductible health insurance with Blue Cross. Blue Cross assigns me to a group composed of other individuals like myself who are actually not a homogenous or cohesive group in any way except that we do not receive health insurance through an employer or other member organization. I do not know who is in my group and thus have no control over their health and lifestyle lifestyle affecting behaviors. However, every year my rates are raised based on the costs incurred by my group. In ten years, I have only met my deductible twice, meaning that Blue Cross paid nothing out for my healthcare. Yet, every year Blue Cross increases my premiums. I pay $616 per month for a single person,$1000 deductible, 80/20 policy, am a non-smoker, excercise, am slim and trim and have no diseases of any kind.

Is it fair that my premiums rise when the costs incurred by my "group" rise? It doesn't seem to be fair. But, if the insurance company did not make a profit off me, how could it pay for the care for the sick members of my group.

Please discuss this. LC

Cosmic Navel Lint said...

Anon above wrote: "... Blue Cross assigns me to a group composed of other individuals like myself who are actually not a homogeneous or cohesive group in any way except that we do not receive health insurance through an employer or other member organization. I do not know who is in my group and thus have no control over their health and lifestyle lifestyle affecting behaviors. However, every year my rates are raised based on the costs incurred by my group. In ten years, I have only met my deductible twice, meaning that Blue Cross paid nothing out for my healthcare. Yet, every year Blue Cross increases my premiums. I pay $616 per month for a single person,$1000 deductible, 80/20 policy, am a non-smoker, exercise, am slim and trim and have no diseases of any kind."

How can being subject to, and at the mercy of, the medical whims and vagaries of a non-homogeneous wider group (the constituency of which you have no say or control over whatsoever) be in any way fair? It can't be.

And you get tapped between $600 and $1,000 per month for this 'privilege' to boot?!

Sorry mate, but that's not healthcare, that's called being scammed - without Lube.

Any healthcare you need should be predicated on one thing and one thing alone: the treatment you need, when you need it, and bugger the costs of it or any other factors. Having your health costs dictated and hijacked by a disparate group of people you've never met is a scandal.