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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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  #1  
Old 08-26-2008, 12:05 PM
ZorroSF ZorroSF is offline
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Census: Number of uninsured dropped in 2007

Quote:
The Census Bureau reports that the number of people lacking health insurance dropped by more than 1 million in 2007, the first annual decline since the Bush administration took office.

http://www.msnbc.msn.com/id/26404454


I don't mean to be overly pessimistic considering we already feel that way while we're on this forum, but I had to sadly laugh at those figures. It makes me wonder how many uninsured people died last year, so the white house could advertise those figures?
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  #2  
Old 08-28-2008, 05:38 AM
Grumpy Grumpy is offline
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Hi Zorro,
I think all insurance on healthcare is a mistake. Having insurance does not guarentee a person good healthcare-it does the opposite. It takes away ALL power from the consumer. Insurance has contributed to the rise in costs of healthcare by demanding all these unnecessary testing, doctors having to hire staff to take care of the paperwork, Cover your *** unneccesary testing, delays in treatments for conservative measures that we know in many cases will not work but drives up the cost- PT is one, and temporary procedures like the radiofrequency thing I'm getting Sept 5 which is only going to delay the surgery-not stop it.
If there wasn't any insurance, the power returns to the consumer and they can say YES or NO-then the medical profession has to return to satisfying the consumer-not the insurance company.
Many of us are suffering from cronic pain with no confirmed solution yet they make us go to the pain doc every single month (ca ching ca ching $1200 a year down the tubes just for pain meds) .

Mammograms...this is the biggest joke and waste of money. I stopped getting them after my best friend was Dx with breast cancer, that also spread to her brain and lungs...she had a negitive mammogram the week before she passed out and was rushed to the hospital where they found the cancer. and this is only one story...I have more.Yet they push them on women giving them false security. The only true way of testing for breast cancer is a breast MRI, which I now get every other year. And yes, I'll pay for it out of pocket if my insurance won't cover it.
If everyone checked their bill after a hospital stay, you will find stuff added to that bill that you never got...but people don't do this since insurance pays the bills. But they don't know what you got and did not get-only you. Once (in Florida) in a 3 day stay in the hospital, $3500 of a $6,000 bill (this is back in '94) was testing I never got. SOMEONE has to pay for all the FREE healthcare we are giving out to anyone who walks into the hospital in an emergency. People arriving by plane from other countries, sick, that head right for the hospitals in Miami, get free healthcare. It was on the news that a hospital got sued in Miami for finally kicking out a foreigner with a $12 million dollar bill, plus a bunch of legal bills trying to get him out. THIS has got to stop! You should be able to prove you are an American citizen. YOU, ME and our neighbor is paying for this guy!

Not only that, but MEDICARE actually made the cost of medical care go UP. Sure, people 65 and over don't have to pay, so everyone else has to pay for them. Young families with 3 kids and a high mortgage...this is not fair but the AARP is a strong special interest group. And there is no control over the charges. Case in point: my friends mother in law was 92, one leg, blind, and wanted to MOVE ON if you get my drift...she broke her hip while turning in bed...guess what the doctors did? Yup-a new hip paid for by all of us, which she didn't want. Oh, and yes, she died a week later.

If all insurance was stopped, the doctors wouldn't need all that help in the offices doing all the insurance paperwork, and we would have total control.Then people can get medical savings accounts, tax deductable, with what they were paying the insurance companies for insurance that is crappy anyway. Oh, and yes, we need TORK Control...so the lawyers can't sue for $30 million dollars cause some unproven problem can't be blamed on the doctor which drives their malpractice thru the roof. If there was tork control, the stupid lawsuits would stop overnight.

Back in the 1950's the medical system was not broken and doctors made housecalls cause the people were the customers. The system didn't get broken till insurance and lawyers entered the field. Medicare made it worse-and a Federally Insured program would be a disaster-the last nail on the coffin.

I have the best insurance-the cadillac of insurance-am I getting good healthcare? NOT. Cause I am not in control of my own health. I have to do what the insurance companies tell me I have to do, and in what order.

Trust me, having insurance is not the end all, and does not guareentee good health care.
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Old 08-28-2008, 12:04 PM
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Terry Terry is offline
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Tort reform is a nice concept for the insurance companies. As typical the insurance companies are behind tort reform. They have duped the American public with the McDonald's case. Most people who sue are trying to recuperate costs. My accident, where a neighbor's dog collided with my bicycle, cost me $74,000 out of pocket. This money was taken out of my retirement account and, will be the difference between me working until I am dead, vs., having some money for my retirement. If people are allowed to act without impunity and, the insurance companies are allowed not to have to pay, many will have no recourse at all. I don't think, if you are injured in an accident, that you would not want to be able to collect some damages. The insurance companies are behind tort reform. They are getting incredibly wealthy and wish to continue getting more. I will agree with tort reform in class action lawsuits. This is where companies are forced to shell out millions of dollars in attorney fees while the supposed victims (you and me) get a $1.00 off of our next purchase.

Your other issue of health care insurance is also questionable. As an employer I pay $9,000 for single - $14,000 for family per year. Most of my employees are unable to save this kind of money in health savings accounts. I do give them the opportunity to have a health savings account through AFLAC and regular AFLAC insurances for cancer, disability, hospitalization, etc. I think the biggest cost increase will be the obese and morbidly obese people in this country along with lifestyle choices. People who smoke, excessive use of alcohol, lack of good nutrition, lack of exercise, etc. Also, uninsured and under-insured Americans are driving up the costs. I am 51 years old, 179 lbs which is ideal body weight, 16.8% body fat, don't drink, don't
smoke, don't use illicit substances, and watch what I eat and, regularly exercise. I am a heart attack waiting to happen though as, my triglycerides are over 500 and cholesterol over 300 with a 7 -1 ration. I am on two medications that cost me $100.00 per month in co-pays to pay for each month for my maintenance. I would not be able to afford these meds without the benefit package I have. Plus my Blue Cross came through and did pay for my 4 level ADR surgery after all was said and done though they denied it twice.

If you figure out how to solve the health care crisis in this country you can get rich. Most politicians have been sitting with the pink elephant in the living room for years without tackling the huge problem that is going to occur when us baby boomers retire and live to ripe old ages. I get sick of tax cuts to the wealthiest Americans imaginable while the poor get their programs cut and we are talking about limiting benefit programs for the middle-class. God forbid that we should make people who make a little more, pay a little more. We are our brother's keepers. Pay me now or, build more prisons. Either way, we pay. Train people to work to get them off of welfare or, keep them on welfare. Either way we pay. Get people out of poverty or, have them take from the haves. Either way we pay. There are no easy answers.

Terry Newton
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1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
Maverick Disc S1-L5, L4-L5
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  #4  
Old 08-31-2008, 02:17 PM
Grumpy Grumpy is offline
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Hi Terry,
Tort reform isn't that you can't sue, it sets limits. Guidelines. No more 200 million dollar lawsuits for a hangnail.

Health care needs to be put back to the consumer. If it was,prices would drop considerably. There are many things that need to be changed back using common sense before any real savings can be made, but one of the first needs to be that non us citizens need to put the money up front before getting any treatments. Us Paying for people right off the plane from other countries raking up millions of dollars worth of treatment HAS TO STOP.

Many doctors are even changing their way of operation not dealing with insurance companies where you pay a once a year fee to be on retainer & pay a small fee on a per use basis, and if you have insurance you take care of all the paperwork (doc saves on personel), and you sign a waiver where you agree up front not to sue so the doctor automatically saves $200,000-$300,000 worth of malpractice insurance (why we need tort reform) . I would go for this if my doctor went this route.

Shouldn't your neighbor's house insurance pay for your accident?
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3 level ACDF done separately (one level failed) & 1 Posterior, repair w/rods, 3 level lumbar herniations, DDD T10 Down- 2 shoulder repairs
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  #5  
Old 08-31-2008, 02:25 PM
Grumpy Grumpy is offline
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BTW Terry, if you go to the IRS website, you will see that taxes have increased on the top earners, not decreased. Read Below (if this doesn't come out right, go to http://www.treasury.gov/press/releases/reports/factshee...cometaxes.update.pdf


DEPARTMENT OF THE TREASURY
Office of Public Affairs
March 2, 2005
FACT SHEET:
Who Pays the Most Individual Income Taxes?
The individual income tax is highly progressive – a small group of higher-income
taxpayers pay most of the individual income taxes each year.
• In 2002 the latest year of available data, the top 5 percent of taxpayers paid more than
one-half (53.8 percent) of all individual income taxes, but reported roughly one-third
(30.6 percent) of income.
• The top 1 percent of taxpayers paid 33.7 percent of all individual income taxes in
2002. This group of taxpayers has paid more than 30 percent of individual income
taxes since 1995. Moreover, since 1990 this group’s tax share has grown faster than
their income share.
• Taxpayers who rank in the top 50 percent of taxpayers by income pay virtually all
individual income taxes. In all years since 1990, taxpayers in this group have paid
over 94 percent of all individual income taxes. In 2000, 2001, and 2002, this group
paid over 96 percent of the total.
The President’s tax cuts have shifted a larger share of the individual income taxes paid to
higher income taxpayers. In 2005, when most of the tax cut provisions are fully in effect
(e.g., lower tax rates, the $1,000 child credit, marriage penalty relief), the projected tax
share for lower-income taxpayers will fall, while the tax share for higher-income taxpayers
will rise.
• The share of taxes paid by the bottom 50 percent of taxpayers will fall from 4.1
percent to 3.6 percent.
• The share of taxes paid by the top 1 percent of taxpayers will rise from 32.3 percent to
33.7 percent.
• The average tax rate for the bottom 50 percent of taxpayers falls by 27 percent as
compared to a 13 percent decline for taxpayers in the top 1 percent.
Share of Individual Income Taxes and Income, 1990-2002
Share of Individual Income Taxes
[Share of Adjusted Gross Income]
Top 1% Top 5% Top 10% Top 25% Top 50% Bottom
50%
2002 33.7
[16.1]
53.8
[30.6]
65.7
[41.8]
83.9
[64.4]
96.5
[85.8]
3.5
[14.2]
2000
37.4
[20.8]
56.5
[35.3]
67.3
[46.0]
84.0
[67.2]
96.1
[87.0]
3.9
[13.0]
1995
30.3
[14.6]
48.9
[28.8]
60.8
[40.2]
80.4
[63.4]
95.4
[85.5]
4.6
[14.5]
1990 25.1
[14.0]
43.6
[27.6]
55.4
[38.8]
77.0
[62.1]
94.2
[85.0]
5.8
[15.0]
Source: Internal Revenue Service. Percentiles based on adjusted gross income.
Projected Share of Individual Income Taxes and Income in 2005
Share of Individual Income Taxes1
[Share of Adjusted Gross Income]
Top
1%
Top
5%
Top
10%
Top
25%
Top
50%
Bottom
50%
With Tax
Cuts
33.7
[16.5]
54.1
[31.0]
65.8
[42.1]
83.6
[64.7]
96.4
[86.1]
3.6
[13.9]
Without
Tax Cuts
32.3
[16.5]
51.7
[31.0]
63.6
[42.1]
82.4
[64.7]
95.9
[86.1]
4.1
[13.9]
Source: U.S. Treasury, Office of Tax Analysis.
1Estimates of taxes paid ignore any behavioral responses to the
tax cuts.
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  #6  
Old 08-31-2008, 09:01 PM
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Terry Terry is offline
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Quote:
Originally posted by Grumpy:Shouldn't your neighbor's house insurance pay for your accident?
I would never give up my right to collect damages if some doctor screwed me up. That's a leap of faith that I'm not willing to go on.

As far as the neighbor's insurance needing to pay for my injuries yes they should have stepped up to the plate. They didn't agree to help me out with anything. They agreed to settle only when I sued, and, only in mediation, before we went to trial. Their attitude was, I had a pre-existing condition so, naturally, the 100 lb. German Shepard/Rottweiler slamming in to my front wheel causing me to catapult end over end, shattering my clavicle and, landing full force on my spine had nothing to do with my condition. Insurance companies force people to sue them daily. Most people cave in. I am a fighter and chose to not allow them to wipe out part of my retirement savings. Your example of a $200 million hangnail is not very accurate. If you wish to sign over your rights to sue have at it. I lost 4 years of my life to agony and three major surgeries. I didn't get enough money for what I went through as the homeowner's had a lousy $100,000 dollar liability policy. As I stated earlier most people sue to get their money back. You can only collect the policy limits on people's coverage. Only unless it is a big corporation that is being sued can you collect more money. I would have no wish to see companies cause harm to people as they are protected by a cap on what can be collected. In Michigan Governor Engler helped big business by allowing people the opportunity to not be able to sue pharmaceutical companies except in Federal court if at all. There was no collections for the people who lost their loved ones due to the Cox II inhibitors. If you wish to help out big businesses over the average person feel free. When the government starts reducing our social security and Medicare benefits so the wealthy can stay that way I'll run for office. These folks who bought their way in to office also voted themselves the best benefits that yours and my money could buy them. In Michigan the legislatures put their raises in to law so they occur automatically. While our State has been in the tank for years due to the Big Three the lawmakers raises keep going up year after year. When confronted with this their excuse is that they cannot do anything about it as it's the law. You sound like you need to learn more about who Tort reform would really help. BTW, I'm just one of the shrinking middle class folks.

Terry Newton
__________________
1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
Maverick Disc S1-L5, L4-L5
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  #7  
Old 09-01-2008, 10:48 AM
ZorroSF ZorroSF is offline
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I don't believe in insurance. It's a scam just like the banking interest system. It's all about making money out of nothing. I think the easiest way to push for universal healthcare like canada is to adopt the german system. It's not perfect and requires everyone to pay insurance pre-tax (unless you earn enough and you can opt out), but at least citizens could visit a doctor instead of waiting until it's too late and be forced to walk into an emergency room like in the USA. I think we also need to study the story how Canada's healthcare system came about. The CBC created a docu-drama called:

CBC_Prairie_Giant_The_Tommy_Douglas_Story

Tommy Douglas faced an uphill battle just like we are and he still fought off the extreme capitalists to create Canada's universal healthcare system. It was no easy task for him.


Grumpy made a good point, we are all paying for one another's insurance in some fashion. However, I believe with proper oversight in the medical community, we wouldn't have hospitals and doctor's billing the daylight out of the insurance companies. We also wouldn't have insurance companies determining who should get treated and who shouldn't. That was a large topic covered in Michael Moore's movie Sicko. Sicko was a bit sensationalist, but it did cover the truth using extreme circumstances. Under normal circumstances you and I are the one's getting shafted because like terry stated critical care isn't allowed until every treatment option is prescribed.

I also have to laugh at the treatment options for spine care. Anyone can tell you the run up to operation is the time your spine takes a turn for the worse. All it can take is 6-12 months and there's a possibility your options for minimal surgery can change to invasive. Also uninsured people who would be able to see a spine doctor 5-10 years earlier may be able to hold off surgery another 10-15 years because an MRI would have revealed a herniated disc.The patient then would undergo PT and be made aware not to participate in high impact activities.

There's umpteen reasons for a universal healthcare.
__________________
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1/2006 DDD L5/S1

Prodisc St. Mary's 12/2006 not diagnosed properly pre-op and now have DDD L4/L5, facet calcification L5-S1/L4-L5, mild scoliosis and left knee pain. DDD: C3 through C6
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Old 09-01-2008, 06:36 PM
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Harrison Harrison is offline
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Zorrow, can the US hire Tommy? Is the Canadian system comparable to the US population in terms of demographics and disease? I don’t think so for a long list of reasons.

Sorry for not addressing all the good points in this topic and going for Zorrow’s jugular. Zorrow, I am usually with you 110%, but not on this crucial issue. If you read my posts on this topic, you’ll be bored – but here goes anyway with my two cents.

US Taxpayers cannot afford any permutation of universal healthcare, as:

- We citizens are financing two wars and our "treasure chest" is broke;
- Our leaders are raiding the US treasury to finance Freddie and Fannie failures;
- Social security for baby boomers? Are you serious?!
- Government continues to grow larger and larger, which defies logic and any accounting (seriously; try finding where the $ is spent);
- Government (repubs and dems) are great at talking, but cannot plan, execute and deliver any multivariate plan, especially healthcare;
- Any new system will still involve for-profit empires like BCBS, as we Taxachusetts folk have learned.

Please don’t support a plan that only worsens our problems! Unless, that is, we really have some glimmer of hope (AKA tangible plan) that some leader can actually deliver on the hundreds of projects that must be delivered along with the ethereal dream of universal health care.
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