<p>I knew that someone would bring up that zombie claim about infant mortality. It’s bogus. And the way to know it’s bogus is to look at maternal mortality. It’s pretty easy to count whether a woman dies in childbirth. No dispute there-- she’s dead, or she’s alive. The US maternal mortality rate is, as both romani and I mentioned, a scandal. </p>
<p>We don’t even need to look at infant mortality rates to know that our system is disgustingly broken- maternal mortality does a good enough job of showing this.</p>
<p>Maternal mortality rates DOUBLED between the mid-80s and the mid-00s. That should disturb everyone.</p>
<p>Which, in turn, can be linked to the way U.S. health care is administered –
C-sections are quicker than vaginal deliveries, and so more attractive
to a provider’s bottom line.</p>
<p>I’m not asserting that any health care practitioner actively thinks this way
(tho’ it’s possible), but the $y$temic pressure clearly exists.</p>
<p>At the end of the day, I don’t see any way around the fundamental conflict between the provision of quality health care and the for-profit model.</p>
<p>“During this time I have been to the doctors (primary, gyno, urologist) at least 10 times, had 11 urine tests, blood tests for diabetes, a bladder and kidney ultrasound, one trip to the ER - where I had a cat scan and an pelvic ultrasound, and IV pain killer and an IV saline flush. I have been on 4 different antibiotics - one which made me sicker and my symptoms worse than I was before, anti-spasmatics, pain meds and anti-anxiety meds. Finally at the urologist, who I wouldn’t have been able to see as quickly if not for my gyno making the appointment, a urine test to test for abnormal cells and one to test for blood and infection of any kind, and a csytoscopy to examine my bladder.”</p>
<p>Under an Obamacare plan in many states (certainly a single-payer system), voluminous care by many doctors and many expensive tests like cat scans, csytoscopy will be much harder to get. You have to hope the urologist you want to go to, as recommended by your gyno, is in your network. I would expect the wait times will be much longer in the future. That quick appt with the urologist might not be as feasible in a system where the demand will far outstrip the supply of providers in many places. </p>
<p>It is going to be a new world for people who get sick with complicated diagnoses.</p>
<p>CF, you keep missing my point about me paying for sick people. A small subset of the individual market should not have to shoulder the burden of uninsured people with preexisting conditions. The cost of treating this population should be spread out over the entire population, which is why I am recommending separate insurance pools for those with preexisting conditions.</p>
<p>I did not see one plan on the NY exchange that did not have a full compliment of every speciality known to man. Many of my doctors were on most of the plans offered in my region. In fact, several of the plans on the exchange are the same plans with same network I could have through my H’s employment with NYS. The plans available to us (I believe there are 10 different ones I can choose from, all at different price points, copy’s, deductibles, etc.) are set up just like the marketplace exchanges. The only difference is that NYS picks up the majority of the premium and co-pays, deductibles and OOP Max are different on exchange plans than plans offered to NYS employees. </p>
<p>We select what plan we want every year during open enrollment or do nothing and keep the plan we have. Just like on the exchanges.</p>
<p>And before my gyno called the Urologist I told him to make sure he was in my network. If the I he wanted to call wasn’t he would have called on who is. It’s also why having a PCP and a gyno, if you are female, is so important. They know who to call and all the different kinds of insurance their patients have. </p>
<p>GP, the cost of insuring sick people is spread out throughout the population. Employee subsidized plans are just as expensive because they do also cover sick people. Now comprehensive Indy insurance costs about the same as employer subsidized ins.</p>
<p>If you are so poor, you can’t pay OOP for a mammogram, you are likely on Medicaid. Look, many people cannot afford the costs of an ACA policy and the deductibles that go with them, but do not qualify for Medicaid. They were able to afford the old policies.</p>
<p>“In fact, several of the plans on the exchange are the same plans with same network I could have through my H’s employment with NYS.”</p>
<p>Everything I have read about the exchanges in NY would indicate this statement is not true. The network of doctors and hospitals are not at all similar to most employer-provided insurance policies.</p>
<p>It remains to be seen though, whether you will be able to see those doctors when you need to, once all 30-50 million additional people are covered.</p>
<p>They are in my region. I know because I looked and looked up all my doctors and all my doctor friends who are specialists. There were pages and pages with many many doctors listed under each speciality. So are all the major hospitals in my region in the networks here.</p>
<p>And unless all 30 to 50 million new enrollees are suddenly going to move to Albany NY, I think I will be fine getting into seeing a doctor when it’s necessary.</p>
<p>There are two insurance companies offering plans on the exchange in Maine. Anthem’s list of providers is excellent. Maine Community Health’s list is horrible. There is only ONE hematologist in the entire area, for example! None of my doctors is on the list. My sons’ psychiatrist said that MCH is offering to pay doctors such low amounts that it’s laughable.</p>
<p>Emilybee: No need to be snide. There are no such statistics published yet (as to how many individual policy holders no longer carry insurance because the expense went up). </p>
<p>Neither the government nor the insurance companies have issued any such numbers. </p>
<p>We also don’t know the demographics of how old or sick those who signed up on healthcare.gov are (although Humana issued a warning saying that only the sick are signing up). </p>
<p>We also don’t know how many who signed up are paying the premiums. </p>
<p>But along with the stories I’ve read in newspapers, it stands to reason that when the price of something goes up, fewer people will buy it. Thats just basic economics.</p>
<p>Bay, I have always has to wait to get into see a specialist. I have always had to wait to get an appointment with my primary and my gyno, unless it is an emergency. I had to wait 5 days to see my gyno when my primary suggested he thought it time I see him for my symptoms. If I had called the uro on my own who knows how long it would haven taken to get in. But my gyno knew it was important I see one quickly and voila! That is why it is so important to have a PCP and a gyno to get you into see specialist if needed. This is nothing new. Most won’t even see you without a referral, and while my insurance dies not require it, I’m not foolish enough to think I could get in as soon as a doctor calling on my behalf.</p>