<p>Opie–principals and superintendents are not equivalent to CEO’s–maybe hospital administrators, maybe senior doctors. People who are instrumental in providing…medical care. The actual care. Not the gateway to getting it. There is nothing, repeat, nothing, in public education that is equivalent to for-profit insurance. And yes, claims will still need to be processed with single payer—one set of forms, not hundreds of different ones. One set of regulations, not hundreds which change at the whim of the profit-seekers. If you can’t see the difference, well, I don’t know how to explain any plainer. Keep working on your analogies, they brighten my day with their breathlessness.</p>
<p>“one set of forms, not hundreds of different ones.”</p>
<p>excuse me, don’t most medical providers and carriers pay off the standard medical codes? One code established to aide in the processing of claims… I can look it up for you as to when it started…
The basis for all claim forms is the same… patient name, indentifier (ss # or group #) date of service and diagnostic code… poof! a claim is paid. </p>
<p>“One set of regulations, not hundreds which change at the whim of the profit-seekers.”</p>
<p>Regulations are established by our state and federal lawmakers, with oversight by your state OIC. Contracts and terms of contracts must be approved by your state’s OIC. An insurance carrier cannot change the game, even to your favor without risk of fines from the OIC. In a way you could say we have government run hc now AS every product introduced or product change must be approved by your OIC. Don’t like how your insurance works in your state, vote the guy responsible for oversight out.</p>
<p>" If you can’t see the difference, well, I don’t know how to explain any plainer. Keep working on your analogies, they brighten my day with their breathlessness."</p>
<p>Thank you for the sharp jab, I am sure that I am worthy of such a comment.
If it makes you feel better let me be your pincushion. I have not missed the point, I simply continue to refer to the truth of the situation which is someone has to pay for the free healthcare and quite frankly it is simply silly to think that the few dozen ceos and their disappearance from the scene will be more noticable than a fart in a thunderstorm… a little noise, that’s all.</p>
<p>Personally, I’d rather have a few overpaid CEOs, than a health care system run by government drones who must spend ever-increasing amounts of tax dollars to justify and increase their annual budgets.</p>
<p>opie, I’ve selected Regence HSA, high deductible. DS will not be eligible for our plan since he will no longer be a student. He also will file as an nondependent this year ( we really should have do that last year). Some of the complications is that he has been in Canada as a student for the last 18 months, and will be going to India as a pseudo independent contractor. He does not have a job lined up after this brief stint. </p>
<p>the broker that I am using suggest that we use BS/BC because of their national reciprocity with other BS/BC organizations. Other plans may be slightly cheaper but their coverage is basically regional. </p>
<p>Any suggestions?</p>
<p>oldman,</p>
<p>Are you in WA? Regence is pretty good as things go for individual. Double check as WA just signed off on an age 25 dependent status, regardless of school enrollment. Double check with your hr. </p>
<p>If he is going overseas for an exended length of time, look into international health insurance. The Blues won’t do that great of a job for overseas work. Overseas is different than north america. Work is different than vacationing as far as coverages go in some cases. There are special policies that provide coverage overseas. Your broker might know. There’s somebody in the midwest that writes that type of policy, i’d have to look it up, I think it’s peterson and peterson. If I find the company, I’ll let you know. but there are at least two that write health coverage for that type of situation. Could be important as it could cover airlift back to states for care if there’s a problem. </p>
<p>National health care in other countries is not free to us citizens in most places. they bill and they bill hard… Double check the travel clauses in your regence plan.</p>
<p>“National health care in other countries is not free to us citizens in most places. they bill and they bill hard…”</p>
<p>Daughter was hospitalized in London for 5 days - specialists, scans, tests ad infinitum. All they ever asked for and got was our address and phone number.</p>
<p>Son needed medical care in Canada - $0</p>
<p>Son needed in-hospital care in China - $100.</p>
<p>Of course, i realize we were subsidized by native taxpayers but we were not impacted at all.</p>
<p>Opie–every insurance company has a totally different set of extremely complex regulations on what it will and will not cover. I’m not sure how you can’t know this. It means each health provider must negotiate treatment for each patient based on that patient’s insurance, which might pay for different drugs, different hospital stay lengths, different procedures, different specialists, etc. than the next patient’s insurance. Doctors must then figure out a way to get the treatment the patient needs paid for. My H spent hours a day on the phone with different insurance carriers, as does virtually every doctor today. Additionally, they do employ more office workers to administrate the highly variable and constantly changing insurance forms. This is wasted money.</p>
<p>CEO salaries are one part, albeit a small one, of why are present system is needlessly costly. Of course, medical care must be paid for one way or another–but our present system is inefficient and costly in dollars and lives.</p>
<p>Again, those with Cadillac insurance will defend it; those without will suffer, and the vast majority, with insurance that is limited and costly, will keep their fingers crossed that nothing really bad happens to them.</p>
<p>OP, not health care system is free. But the US health care system as it is now, is not sustainable and is horribly inefficient. By most objective standards the US population is worse off healthwise than other western nations. Some may not be due to the hcs but some certainly are.</p>
<p>A very high %age of our health costs are devoted to persons in the terminal stages of their lives, when care should focus on pain management and humane care rather that extension of life for a few more days or weeks. In terms of drugs, I am sure Canadians, English, Germans etal happily allow US consumers to financially support international pharma while they by the same at cut rate prices. And those who complain about national health care conveniently ingnore the fact that Medicare is national health care whose admin costs are about 2% while the private sector admin costs exceed 25%.</p>
<p>I think a good compromise would be for a national health care system for major medical issues involving surgery, long term/hospital care. Every employer would then have to provide health care insurance for EVERY employee to cover preventative and routine medical care. Employers would have to offer proportionate health care to part-time employees, ie 20 hrs/wk = 5/9th of premium by employer.</p>
<p>And for those proponents of the existing US hcs, it too is not free. Employers are paying for their employees. And taxpayers are paying for the uninsured through Medicaid and emergency care costs that cannot be paid by the uninsured.</p>
<p>A personal anecdote that illustrates how screwed up our hsc is. I had minor surgery in a hospital to remove a deeply embedded thorn in my thumb. The proceedure took about 10 mins total in a nondescript room equipped like a normal drs office. The hospital bill came to $2750. I called the hospital to make sure they were not billing me but billing my insurance co which they said the were doing. OKAY! Because the amount seemed a bit high I asked them if that is what the insurance co would be paying. She told me that the negotiated rate was $275 or 10% of the billed amount!!! I followed up asking her what I would have had to pay if I did not have insurance and was told $2750 but I would get a whopping 10% discount if paid w/i 30 days. Now if that is not screwed up i do not know what is.</p>
<p>“Opie–every insurance company has a totally different set of extremely complex regulations on what it will and will not cover. I’m not sure how you can’t know this. It means each health provider must negotiate treatment for each patient based on that patient’s insurance, which might pay for different drugs, different hospital stay lengths, different procedures, different specialists, etc. than the next patient’s insurance”</p>
<p>do you mean the network contracts for service that your H sign into? if so, it is on your husband to learn or hire somebody to learn for him the details of service. questions about services can be answered quickly. Your complaining about things that in reality are your H responsibility if he wants to belong to a network of providers. It is not that hard as you make it to be. He was smart enough to pass medical school, he can read a contract. You could just go indemity only couldn’t you? </p>
<p>It’s not a real arguement for 99% of approved methods…is it? 
</p>
<p>But keep slinging it… ;)</p>
<p>“National health care in other countries is not free to us citizens in most places. they bill and they bill hard…”</p>
<p>Daughter was hospitalized in London for 5 days - specialists, scans, tests ad infinitum. All they ever asked for and got was our address and phone number.</p>
<p>Son needed medical care in Canada - $0</p>
<p>Son needed in-hospital care in China - $100.</p>
<p>Of course, i realize we were subsidized by native taxpayers but we were not impacted at all."</p>
<p>from the us state department website:</p>
<p>Check your overseas medical insurance coverage: Ask your medical insurance company if your policy applies overseas, and if it covers emergency expenses such as medical evacuation. If it does not, consider supplemental insurance.</p>
<p>Insurance, Medicare & Medicaid, Medical Evacuation</p>
<p>Obtaining medical treatment and hospital care abroad can be expensive, and medical evacuation to the U.S. can cost more than $50,000. Note that U.S. medical insurance is generally not accepted outside the United States, nor do the Social Security Medicare and Medicaid programs provide coverage for hospital or medical costs outside the United States. </p>
<p>If your insurance policy does not cover you abroad, it is a good idea to consider purchasing a short-term policy that does. There are health insurance policies designed specifically to cover travel. Many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas including emergency services such as medical evacuations. The names of some of the companies offering short-term health and emergency assistance policies are listed on the Bureau of Consular Affairs website at [Medical</a> Information for Americans Abroad](<a href=“404 - Page Not Found”>404 - Page Not Found). </p>
<p>MEDICAL FACILITIES AND HEALTH INFORMATION: While medical services are widely available, free care under the National Health System is allowed only to UK residents and certain EU nationals. Tourists and short-term visitors can expect charges that may be significantly higher than those assessed in the United States. </p>
<p>Well, maybe I’m wrong or maybe there’s a bit more to your story detail wise? It seems that when you check the advise is to make sure you have coverage, but to each his own. Neither of us are responsible for our advice in this forum. But it sure seems to me that the warning signs indicate differently than your experiences…</p>
<p>
</p>
<p>orignaloog,</p>
<p>The only thing “screwed up” in your anecdote is the cost of the procedure. If the total had been $275 rather than $2750, the experience would not have been noteworthy, other than in a satisfactory way. It sounds like you had your medical problem taken care of pretty quickly in a well-equipped facility, your insurance co. was billed, and even a discount was offered.</p>
<p>The high cost of medical care is the problem, imo. If costs were more reasonable, then people with major problems would not go bankrupt, young singles could self-insure without bearing too much risk, and premiums could remain as they are. Would a single-payor system lower the cost of removing a thorn from a thumb?</p>
<p>I would hope a single-payer system lowers administrative costs, insures everybody, eliminates pre-conditions, let’s doctors treat the patients the way they see fit (the latter may not happen).</p>
<p>Here are what some advocates of single-payer say…</p>
<p>[What</a> is Single Payer? | Physicians for a National Health Program](<a href=“http://www.pnhp.org/facts/what_is_single_payer.php]What”>http://www.pnhp.org/facts/what_is_single_payer.php)</p>
<p>Hmmm. I would pay more under this single-payer system.</p>
<p>Opie–my husband worked for a hospital, on a van which went to housing projects and homeless shelters. If (and it’s a big if) the parents of his patients had insurance, he had no choice of what insurance it was–that was a function of the hospital.</p>
<p>And you’re right, most doctors could choose not to deal with specific plans. And then we can complain when our doctor won’t see us. what he needed to deal with (before he got out of the business) is the same thing all doctors do. There is nothing unique in his experience. That is the reality of medicine, which may not be something you’re familiar with.</p>
<p>How is that better than single payer?</p>
<p>Under a government insurance plan, who wouuld you (personally, I mean) choose to cover and what coverage? Would you allow someone 25 and healthy with a good job to have a different option than someone 50 working minimum wage? The details matter a lot in something this large.</p>
<p>Opie: students studying abroad in the United Kingdom for more than six months are eligible for NHS benefits. Might be why woody’s D wasn’t charged.</p>
<p>I’d bet hospitals in the UK and elsewhere with socialized medicine are a little, or a lot less obsessed with billing, and insurance info isn’t the first concern when treating someone, as it is here. </p>
<p>Most years I attend a medical ethics conference, and usually the conclusion, no matter what the issue, is that we need national health insurance. The inequities are too great, and shameful in an industrialized society. Yes, we have cadillac care that is the envy of the world, when insured with a good plan. But I know people who have very little preventative care, as in cardiac testing and so, because deductibles are so high in some employer and many private plans. </p>
<p>Uninsured in this country can be heartbreaking. Insured with a dollar limit on care can be heartbreaking, cruelty. Follow Late to School’s thread.</p>
<p>“Opie: students studying abroad in the United Kingdom for more than six months are eligible for NHS benefits. Might be why woody’s D wasn’t charged.”</p>
<p>So would it make sense that the cost would be built into the fees for study abroad? Again, there is nothing free in the free healthcare. Something is paid somewhere or I will fly to london using the money to pay for the procedure for airfare and lots of beer, then I will get my liver replaced for “free” 
</p>
<p>this is where it can be confusing as if a cost is built into another cost, you might think it’s free, but you’ve already paid for it.</p>
<p>“There is nothing unique in his experience. That is the reality of medicine, which may not be something you’re familiar with.”</p>
<p>No, I’m familiar, I just think differently than you, that’s all. One man’s problem is another man’s great day… perspective…</p>
<p>It’s like listening to kids of doctors whining about not making as much in the profession than their dads did, compared to kids coming from working class families who EVEN with that lower doctor’s pay will make several times what their dads made in their jobs… perspective… it’s a funny thing… coming from a ditchdigger’s perspective, having to understand some different plan variations to get paid is still a holiday… compared to digging holes…</p>
<p>"Most years I attend a medical ethics conference, and usually the conclusion, no matter what the issue, is that we need national health insurance. "</p>
<p>because it feels good. No arguement from me about that. The problem is how do we HONESTLY pay for it? I hate CEOs, but CEO pay isn’t a driver of healthcare, claims are. The cost is the delivery of service. Should we restrict doctors, nurses and caregivers incomes to provide healthcare to everyone? Should we limit hospital expeditures to provide more service rather than expending monies for better service. </p>
<p>The real problem is we can’t pay for what we want to provide, unless we gut everyone involved in healthcare and it’s delivery. The math still says we put more than 80% into the delivery treatment system… the other admin side is for the people who process and provide customer services… Yes ceo’s get paid but what is the real percentage of their take… </p>
<p>Our politicans won’t really address that because unless we deficiet spend, we can’t provide what we all want. Unless we reduce to all and honestly as much as we all say we would be fine with that…we would be right up to when the single payor says “NO” that is not a covered service, when before it was… What I’ve found in my more than 20 years of dealing with this is nobody, I mean nobody is actually willing to lessen themselves in reforming hc. Everybody assumes if we cut the other guy’s out of the system or lower their pay, the problem will be solved… as long as you don’t cut mine… </p>
<p>I still want the same pay, with increases be I a doctor, nurse, cna administrator or xray operator… but I want healthcare fixed. And I don’t want to pay more taxes for it, too.</p>
<p>Can we cut administration costs which are close to 20% if we go to single payer? </p>
<p>Right now, not only are paying for the insurance infrastructure, but we are paying for the doctors’ administrators too.</p>