Maybe I’ll Get Better on My Own

While politicians have been debating endlessly over the best ways to reform the American health care system, the plight of American patients has rapidly worsened. A new national survey found that an alarming 20 percent of the population, some 59 million people in all, either delayed or did without needed medical care last year, a huge increase from the 36 million people who delayed or did not seek care in 2003.

As expected, people who have no health insurance — there are some 47 million of them — were most likely to make that difficult choice. But insured people also chose to go without care in ever-larger numbers.

According to the survey, the main reason is soaring medical costs, which have outstripped the modest growth in wages in recent years. High costs are deterring not only the uninsured from seeking care, but also many insured people who are struggling with higher deductibles, co-payments and other out-of-pocket expenses as their employers or health plans shift more of the cost burden to them.

Many patients with insurance said they went without care because their health plans would not pay for the treatment or their doctors or hospitals would not accept their insurance. Both insured and uninsured patients said they skipped treatments because they had trouble getting timely appointments, were unable to get through on the telephone, or could not make it to a doctor’s office or clinic when it was open. No doubt a weakening economy, high fuel prices, the home foreclosure crisis and general economic anxiety also played a role.

http://www.nytimes.com/2008/06/30/opinion/30mon2.html?th&emc=th

They dictate which prescriptions they will pay for, for example. Too bad if a 'scrip is needed that isn't on the approved list, and too bad the one that is would lead to drug interactions for the patient that could have deadly side effects. I know of at least one doctor who has been banned from receiving payments from an insurance company because she went to bat for a patient and told off the company.

I recently paid out of pocket $1200 for a medicine while my insurance company debated whether or not I really "needed" them (it was prescribed by a doctor at the Mayo clinic!).
I was scared of what would happen if I waited the month or so they said it would take to make a decision. I finally got covered, but I'm still waiting to see if I get reimbursed. If I hadn't been able to scrape up the money (with the help of a fellow DU'er btw) I don't know WHAT might have happened.

of health care but the system is in no way structured for consumerism. If the physical therapy doesn't work as planned can we get a refund? The meds don't work can we bring it back? How many doctors or hospitals list their prices? We have no rights but the insurance companies want it to be market based. It can't work and doctors should be the ones at the forefront screaming about this system. Medicine is more than a product.

insurance can't afford to pay for tests. The cost of just normal tests is horrible. So you just go without and hope for the best. Insurance is just for catastrophic care.

And this is just going to get worse.

I have a friend who works in a hospital who is dead set against national health care. She thinks it is fascism.

Personally, I just think it is the right thing to do. Having millions and millions of Americans go without health care is horrible and totally unacceptable.

I hate HATE HATE insurance companies. HATE THEM.

Partly because for the majority of my life I was without insurance and relied on the community and public health services for my medical care--$800 for 2 stitches, $400 to walk into an ER and be sent home an hour later without even seeing a Dr, etc.

These prices are set by insurance companies. They say "Hey, we'll pay you X for Y services" and the hospitals KNOW that the service costs Y+1500, say. But the only way BCBS will pay for the service is by cutting $1500 (or 10,000, or 50) off the price. Their reasoning is that the hospital/dr's office/clinic will get MORE customers through BCBS and in the end come out "on top"

only they (the hospitals) don't.

So they pass the extra 1500 for Y service onto people without insurance, or who are underinsured.

I can blame the hospitals, but at the same time, I can't. They have MRI machines that cost hundreds of thousands of dollars, they have MRI techs that cost dozens of dollars an hour to read the MRI's. They have to make up those costs and the insurance companies AREN'T paying a fair or competitive price for these services.

Now, I have insurance, and I still feel the pinch.

When I had back surgery (with insurance), I paid a $20 copay for a surgery that they billed the insurance over $10,000 for. WHen I was looking at the charges included, one of the charges was for nurse pay. The insurance company paid $15.00 an hour for OR and PACU nurses. Well, I know for a fact that a NEW GRAD operating room RN makes MINIMUM (at this hospital, at least) $25 an hour. PACU nurses generally have to have 2 years RN experience, so they'd be making in the $30+ wage.

But the insurance company only paid $15.00 an hour for those RN's.

As an RN, I feel this because hospitals can't afford to raise my pay because of insurance companies under-paying for services. Nursing Assistants make more than $15 an hour, yet BCBS feels that a seasoned, trained, educated, knowledgeable and safe RN is only worth $15 an hour. The other $10 or $20 an hour is "eaten" by the hospital. That money has to come from somewhere, and usually that money comes at the cost of new and updated supplies, pay raises, hiring new staff, continuing education, etc.

There is no reason that health care should be for-profit. No one should profit so grossly off the illness, injury, disease, and death of others.

E-V-E-R-Y Nurse I know, and 99% of the MD's I work with (as well as the tons of ancillary staff members) ALL believe that our lives would be SO MUCH BETTER as practitioners should insurance companies just GO AWAY and everyone given a universal health care of some type.

Our hands are SO TIED by insurance companies. So many things that we want to do for patients, and need to do for patients, but we can't because the insurance won't pay for it, the patient can't pay for it, the hospital can't pay for it. We (as professional practitioners) have come up with clever ways, though, of describing procedure X like it were procedure M so that way it's covered by insurance. Is it "fraud"? You bet. Is it necessary for a patient's health, wellbeing, and quality of life? You fucking double bet.