<p>The problem with the HMOs is that you can really be in trouble if you want to go out of network for treatment of serious issues. I know this, having already gone the route myself, and fought the fight for my brother. In his case, it was an absolutely ludicrous situation with no HMO doctor wanting to touch him, but the roadblocks were still set up administratively just because that is the way HMOs are. In my case, I did not have HMO at the time, and am thankful because we are out of network for care for serious things. We pay dearly for this privilege even with insurance, but at least it is doable. With restrictive HMOs it would not be, or would be a fight every single time. When you or a family member has a serious medical condition, you want to go to the best for treatment, not just consultation. That is really why we have insurance, to cover such catastrophic instances. I really am not as concerned with the everyday stuff; I can go with a list of approved doctors for 99.99% of the stuff. But to me for the serious stuff, I want to go to the best.</p>
<p>We’ve gone out of network for certain physicians, who offer innovative care options and as a result can afford to make patients submit their own paperwork.</p>
<p>I agree completely with cptofthehouse. Veryhappy, you are right, in that one case. We had a possible serious health situation with one of our family members. We had a consult, exam, and expensive labwork. I would estimate that one time cost to be 2,000. Honestly, I don’t even know how that bill was paid, because I know that we paid a small amount of money, yet we have a high dedcutible to go out of network, but this is beside the point. The point is, that if there had been a serious diagnosis, having the out of network doctors would have been the way we would have wanted to go. That medical care (with the specialists we chose) would have been impossible without a PPO.</p>
<p>I truly feel your pain and frustration, northeastmom. We’re also self-employed & currently pay around $12000 per year for family coverage. Our renewal is at the beginning of 2009, so we can’t wait to see how bad it’ll be. It’s a stretch for us to pay these premiums, but at least we can pay them. What about the self-employed who can’t afford these premiums? Something has to be done.</p>
<p>shellfell, are you in a HMO? Family of 4? I wish we could roll back to 12,000 per year. Isn’t that sad?</p>
<p>Would it be cheaper to just insure you and hubby and go individual with the kids? Some colleges and even highschool have offered strong plans for kids and young adults at good prices. I know some states have excellent options for kids. It’s us middleaged folk that get whammed big time as the old folk have the medicare. I know people taking the hit on SS early just to get the medicare.</p>
<p>cpt, we earn way too much to benifit from our state’s healthcare plan. I know someone who finally got her kids on it, but it took years. They probably earn half of what we earn and they have three children. I feel sorry for when college hits them in 2 years. They have no idea about what this will cost! Even our community college is 5k per year plus books, and they will need to get the kid a car/auto insurance to get there!</p>
<p>Our hs offers nothing other than accidental health insurance coverage. We still need to keep him on. I guess if they are both in college at the same time, or one is finished we could look into college plans. I don’t just don’t know.</p>
<p>What do you mean about taking the hit on SS early just to get medicare? I am not familiar with what you are talking about.</p>
<p>Barrons, I’m not surprised that you got flamed, but you’re at least partially right, IMO. I’m not sure what you mean about “chronically ill” people - a young person with a chronic condition deserves to have it managed, if possible - but the amount of health care dollars spent on people in their last year of life is unbelievable. My 80 year old mother in law - a wonderful person - has multi-organ cancer, and will not live another year. There is literally no hope. Yet she has had two operations in the past month, two rounds of chemotherapy, and three separate hospital stays. I understand managing the pain, but why the heroic medical intervention to extend her life for a few more weeks? She is going to die in the near future. She knows that, we know that, and there aren’t any other options. But the full court press continues.</p>
<p>My in-laws are fully covered, so it’s not a financial burden to them, and the doctors are basically putting them in the position of looking at the situation in a way that makes it seem like not having the operations, etc. is tantamount to suicide. It’s a tough situation as it is, but it seems that the profit motive on the health care end is making it even worse. And of course, the cost of the treatment is coming from somewhere. There’s no free lunch here either.</p>
<p>My MIL’s family lives into the three figures routinely and would take umbrage at your statements. They feel very strongly, all of these old folk, that elderly should have every bit the same options as the younger ones. They’ve put in their money into the insurance, and they want to use it when they need it.</p>
<p>My MIL’s close friend died at age 98 (still too young, she sadly says) after two expensive bouts of cancer. One gained her a good 7 years, the other 3. So who is to say. If the medical options and interventions are more painful than they are worth, they certainly can be stopped. In some cases, it can extend your life. The friend I am refering too, decided that chemo was not for her, but the radiation was. </p>
<p>Disabled folks too are getting up in arms about those talking about it not being “worth” it to keep them alive and as well as they can be. They feel that they too have the right to the medical technology out there and are being discriminated against not getting the help they need to have the same pursuit of happiness we all do. I can’t disagree with them.This is the cost of technological advances. The problem I see is that the very expensive technology is advancing, but the simple solutions that are just as important, if not more so, such as caretakers are becoming less available.</p>
<p>“Disabled folks too are getting up in arms about those talking about it not being “worth” it to keep them alive and as well as they can be.”</p>
<p>The question is “worth it to whom?” Certainly not to our manage-to-care-less folks. But there are simple solutions - not “easy” solutions, but simple ones. We can cover everyone, and have funds left over, simply by eliminating private insurance companies, and treating pharmaceutical companies as the public utilities they are.</p>
<p>I have seen some of what barrons and kluge are talking about. I happen to agree with them where there is no hope. Frankly, I would not want to be put on a respirator, have 5+ surgeries, and be placed on dialysis, etc. to end up living 2+ years in a nursing home. Others disagree.</p>
<p>I am sorry about your predicament NSM. Healthcare was one of the main reasons we decided to move to Canada. With pre-existing conditions and all that, there is simply no way for us to have heath coverage if we want to retire early. </p>
<p>Does anyone know if Obama’s health care plan will address the issue of affordability & pre-existing conditions ? I know McCain’s won’t. I apologize if this had been discussed in depth elsewhere in this forum.</p>
<p>munchin, thanks. I don’t know just how affordable it will be, but more affordable that premiums are now. He says that nobody with a pre-existing condition will be turned away. I have not read anything more specific than that. I think it is unbelievable that you chose to move out of the US for this reason!</p>
<p>^It was one of the several reasons, but it figured prominently. We were both jobless for a stint post 9/11 and we can’t get health care insurance for the life of us no matter how much we are willing to pay when Cobra was going to run out. Thank god that h found a job in the nick of time. </p>
<p>We get excellent health care now, without any waiting for services that I read about. I also have no paper work to file and do not need to worry about any coverage or out of network issues. I hope we’ll have that eventually for every American.</p>
<p>I hope so too! Can you imagine, 18,000k per year now for a family of four!</p>
<p>I can imagine what a drain it is on a household budget. I bet it will continue to go up at about the same rate in the future too. That was certainly our experience. </p>
<p>$18,000 was about what our employer paid for a Blue Cross ppo before we moved. We are a family of four too. In addition there was a $1500 deductible and some other restrictions. </p>
<p>Let’s hope the Dems get elected and Obama can deliver his campaign promises, because the McCain plan won’t do enough to address this serious problem.</p>
<p>I agree. I do hope Obama is elected. McCain’s plan won’t help us at all.</p>
<p>Actually northeastmom, $12000 was last years’s premium. For 2008, we’re closer to $14000. We’re in a ppo plan, but with higher co-pays than the plan we used to have (whose premiums would’ve been $17000 2 years ago). I’m sure we’ll be pricing different plans before making a decision about next year’s coverage, but it’s hard to find decent coverage with a reasonable premium. Obviously, I’m preaching to the choir here.</p>
<p>Okay, I understand now.</p>
<p>It’s fine when anyone wants to decline drastic measures. I get worried when they are not offered. Insurers would love that scenario. It’s a problem when a financial party in interest has its snoot in who gets drastic measures. Having been in some dire medical situations with my family, I can attest that some of those measures do work and give an excellent quality of life thereafter. I’ve seen too many have to fight for treatments that were considered not worthwhile. I don’t have a word to say to anyone who declines treatment; that’s an individual call. But the treatments should be available for all.</p>