Americans with medical insurance refusing / delaying health care

Sorry no link.

Just listened to a segment on Jim Lehrer news hour. Doctors are reporting a big increase
in Americans WITH health insurance postponing health care. They can't afford the co-pays, the prescriptions, or the deductible. Many end up with expensive care later or trips
to the emergency room.

They focused on a young couple with kids. Both parents need health care. They decided to get health care for the husband
because he was in more pain.

Scary stuff. America has the most advanced medical system in the world but its people can no longer afford it.. even Americans with jobs and health insurance.

It's a shame, and I hate to hear that news you posted. Wow.

I'm past my deductible for the year and my insurance will not give me a straight answer on whether they will cover the surgery my doctor says I need to repair it.

Last time I talked to them I told them if they didn't fix my goddam ankle pretty soon, they were going to be covering a gastric bypass instead. :grr:

AFTER insurance. Our insurance, which costs us $120 every month plus whatever his employer pays, still leaves us with 30% of any bill, testing, etc., even after that first $1000 out of pocket so - between it all, we can't afford to treat.

We only have the insurance in the hopes that if either of us were seriously injured or gravely ill, we might still have a shot at treatment - but we know that's not guaranteed either.

People who need to see our doctor because of her specialties, but who cannot afford to see her because she isn't "in network". We had a huge flurry of tests ordered last month because many of our patients had finally met their obscenely high deductibles, and could finally get tests run that should have been done months ago. And don't get me started on how poorly one of the major insurance companies treat patients--when they are diagnosed with a possible food allergy, the insurance company refuses to pay for a diagnostic test that would let us know exactly which foods are causing the problem! The insurance company would rather have the doctor simply prescribe drugs to mask the symptoms rather than getting to the root of the problem.

the same exact "condition" returned. I bet we pay "full boat" for the next surgery too! That just seems wrong to me. I think "the system" concentrates too much on treatments after the fact when it should concentrate on wellness/preventative care.

There are so many things wrong with that statement I don't even know where to start but since I've bothered to respond, I'll skim the surface for you.

#1. Many, MANY patients are not able to accurately convey their symptoms to health professionals for a whole plethora of reasons. These reasons may be cultural, age-related, mental, developmental, emotional, physical or even sensate. Example: A profoundly retarded 22 year-old female presents with abdominal discomfort. The possible causes are way too many to enumerate here, but if you think you can nail the diagnoses on the first time with an impressive degree of accuracy I say get your ass into medical school tomorrow and get on it - the world could use your skills.

#2. Every human being is different. Until exactly every single human being on the planet experiences every single malady in the exact same way with the exact same symptoms physicians will never be able to diagnose accurately on the first try every time. Example: A 49 year old female complains of occasional, seemingly random bouts of incidents where she feels a nondescript but intense feeling that something horrible is about to happen to her. What's your diagnosis, swami?

#3. Without getting too complicated, conditions and afflictions of the human being are quite fond of the layered look. Sometimes one condition can mask another. Sometimes they can masquerade as another ailment altogether, in fact many perpetuate that way.

#4. The human organism is not a car. It's about ten thousand times more complicated than most people with no medical education would ever imagine. The most complicated machine, the most complicated computer, doesn't even come CLOSE to matching the complexity and number of variables found in the individual human being.

Because of these factors and more, it is the best course for the patient, and reduction of cost thereto, to make an educated assessment based on the available information and begin treatment with the most likely and/or least invasive course of treatment. Beware the physician who thinks of zebras every time he/she hears hoofbeats - it's usually just a horse. Treatment should always begin with what is most probable and thereafter a number of factors like invasiveness, quality of life, long term gain, etc. come into play.

This isn't Star Trek where the doctor can simply wave a wand over the patients body and see what's wrong. It's simply not possible or even desirable for a physician and the medical community to be required to make the snap diagnoses you call for.

I paid rolls royce prices for years of care until I decided the doctors who declared me 100% disabled (as recently as last April from a "prestigious" back instituted) were incompetent.

Found a team of new doctors and started making progress relatively quickly. They think I can make a full recovery although they said it will take much longer because of the sad "care" I got previously.

Needless to say, I think the money should be reimbursed since they exacerbated the damage.

My DH was injured on the job and sent to an INCOMPETENT worker's comp doctor, who's treatment nearly permanently damaged his immune system, and he came very close to having the injured limb surgically removed.

When I informed his employer that the comp doctor was wrong, and my next phone call would be to a lawyer (while he was in the hospital waiting for the verdict on surgery)they suddenly found another comp doctor who did the right tests, prescribed the right care and meds for both the original injury and the damage the first doctor did.

The sad fact is you are more likely to hear medical personnel react negatively when trying to discuss other medical personnel who are poorly trained, or incompetent. It's somehow taken as an affront to the entire profession if you point the bad ones out. This stance is LUDICROUS, and that stance does more to damage the entire community than the instance of bad doctors.

BAD doctors DO exist. But the medical community takes the three monkey stance - See NO evil, hear NO evil, speak NO evil on the subject. And THAT more than anything else is probably a big factor in the amount of malpractice cases out there. They refuse to admit even the possibility of potentially deadly doctors out there, and therefore do nothing to correct the problem.

And then become outraged that anyone would even SUGGEST there is a problem. :eyes:

and can be very difficult to diagnose and treat. I guess that's why "House" is such a popular TV show!!LOL!!

My frustration is only borne out of my own son's situation which is a very simple diagnoses (hydrocele) and procedure that only took 2 weeks post-surgery to return.

A sincere thanks for your 4 point response....so I guess it wasn't a waste of time.

Kind of like my inguinal hernia. They went in, (laproscopically, spelling notwithstanding), put in a mesh, and perhaps damaged a few lymph nodes, because even 6 weeks later, there was some 20 oz. of fluid that decided to collect in the area. Imagine that. The fluid amount of a 20 oz soda bottle in the area in and around one's groin. This was quite enough to... Create another hernia, on the other side. The doctor did'nt want to bother, no other doctor wanted to deal with it, due to malpractice issues. Not for at least a year, I was told.

Not to say that this was all cheap, either. I satisfied the $1000 deductible, but still had the 80/20 where I still had to pay 20% of everything.
So you are telling me that this is 'multi-layered', complicated symptoms?, not like a simple ultrasound didn't see my colon planted in my scrotum. For that, I call bullshit.

Every physician should be required to diagnose with 100% accuracy 100% of the time, the first time, every time. Sure, it'll cost an extra $2,000 to $250,000 in totally unnecessary diagnostics and testing every time a patient walks in the door (that'll really help bring the cost down) but hey - it'll make you feel better.

Again, the human body is not a fucking automobile or a jigsaw puzzle. Sometimes surgery can be performed absolutely perfectly and complications will still arise or the patient can even die on the table. It's a given. That's why you got the big speech before you consented to the surgery.

Bot not pay "the doctor."

Please elaborate.

premium to the insurer. The money in the HSA is my money and yes I'd rather I, not a doctor have my money.

i keep telling myself, that is money that would have gone to insurance company, so really it is ok to use. but it is really really hard for me to use and since we have gotten this insurance i have found it really hard to use. want to save, like i save my other money.

in her mid 50s

bone density, colonoscopy, mammogram, blood work etc

copay is over $600

I wasn't gonna do em in December, I'll probably get them done in the next couple months so my deductible will be half over with the year just beginning

...I mean seriously how many times can you hear about
overprescriptions for drug company frequent flier mile
kickbacks, misdiagnoses, surgical mistakes, and disease
infested hospitals before you start to be a bit
reluctant to throw yourself at the mercy of a system
that isn't very transparent and obviously has problems
in addition to people just not being able to afford it.

I can't say I blame people that put off going to the
doctor. I do too. It isn't wise, but it's a perfectly
understandable reaction to a system that gives the
consumer next to zero opportunity to ensure and verify
that their best interests are being met. 8 years of
Bushco could not have been any better for healthcare
industry oversight (both insurance and provider ends of
it) than it was for financial sector oversight.

It isn't properly a "doctor" but here in MA we recently
had a dental fraud operation that was giving people
unnecessary root canals and locking them into usurous
medical loans. Think about the lack of conscience
required to give a person a root canal they do not need.
And if it isn't very disturbing to you ask someone you
know who has had one what it felt like.

So in the end the hypochondriacs keep the doctors busy
while the rest of us either cannot afford to get our
ailments fixed or preventative care or just don't believe
that that's what is actually going to happen if they
go see a doctor.

Yeah. Best health care in the word. My foot. If you
are in a clinical trial or go to a teaching hospital,
yeah, but no, our care here for the most part sucks.
I'm sure there are plenty of great, upstanding doctors,
but with so many poison pills mixed in there it's like
playing Russian roulette.

group health insurance, ALL of the copays have...

To see a specialist $40
Primary Care doctor $30
Emergency Room copay $200
Inpatient admit $400

Then there are the copays for ancillary services.

I'm thankful that Imitrex is now available as a generic because my copay has gone from $25 to $10.

as I used to which is a plus. Because insurance would only cover 9 in a month, but I used to have migraines 15 days out of every month. Thats $250.00 bucks a RX. Went to the specialist and he prescribed a $10 prescription that I take everyday and it really has reduced my migraines by 90%

It's down to either shelling out transportation fees and co-pays left and right, or keeping the power on and food in the house. I finally said "fuck it" and am refusing to see any more doctors until we're caught up on the basics without having to beg the utility companies for more extensions.

And you want to talk about shitty hospitals? The last one I was in threw me into an isolation room with a vent that brought in what had to be clouds of diesel fumes from outside. There were times I almost didn't want to breathe and even the nurses could tell something wasn't right. And throughout the whole ordeal my pain management for other issues I have was just horrible, and on and on and on.

It's a total and complete fucking joke and I only hope that the people in charge end up having to pay off a huge karmic debt of their own before this is over. :grr:

and $280 a month payments. WTF can afford that?

I started developing "frozen shoulder" from rotator cuff injury and was losing my range of motion in my left arm. I saw the doctor, got some physical therapy and am fine now. But I waited two months before going in, thinking it would heal on its own. I simply didn't want to spend so much money on the doctor and then the therapist. I finished my treatment at home.

I broke three metatarsals in my foot in 2008. The medical bills have run over $3,200 before discounts and insurance; it has cost me around $500.

Most of the time when I've been injured, I wait several days before even considering going to see a doctor. The broken foot was the exception: the pain was unbearable.

the number of Doctors graduating from medicine. But other than that our system works pretty well.

But I was still a long way off from being able to afford having any work done - I had "decent bennies" but my income was still low enough to just cover the bare bones - food, rent, heat, phone - and the X-rays to diagnose exactly what should be done were $150 out of my pocket, and that set me enough months back that I didn't go back. I knew the actual work with the co-pays would be waaayyy beyond my means unless I won the lottery.

(If I ever DO win the lottery, I'll go have my teeth fixed in Mexico.)

told me unless i was in a large company there was NO good dental insurance.

Very scary... :scared:

America.

My husband is about to turn 35 and BCBS jacked his rate through the roof. And we have a $2500 deductible, so when he wanted some preventative immunizations before we traveled to the Caribbean and Mexico, insurance wouldn't pay. Their solution to the coverage problem? Get the shots from the pharmacy and let me give them to him!! Um, yeah. Luckily, he's a healthy guy, but for the love of pete...and fortunately, since I'm a student, I'm covered through school. Not the greatest coverage, but I get done what I need to.

My best friend broke her ankle and I had to rush her to the ER. Insurance wouldn't cover the ER visit, and disputed the rest of her care. Again, we're grad students, so the $13000 tabs for the ER visit/surgery scared the heck out of her.

I pay $430 a month for my "employer provided" health coverage and even at that rate, what they DON'T pay for is ridiculous. :grr:

knowing that I will be paying several thousand dollars on my own and then 20% after that.

I much preferred what I had in Oregon, where I had high co-pays but didn't have to worry about deductibles. Deductibles have to go!

are not only paying for your premium, but for your health care as well out of your pocket, so the insurance company seldom has to pay a claim for you. What a sweet situation for them. This has to stop. If private insurance is allowed to continue as our health plan and it appears that it will be under Tom Daschle, then we need some strict regulations like going back to the $100 deductible like it used to be.

instead of deductibles.

So, for example, the most expensive plan would have no co-pays or deductibles, the next one would have a $10 co-pay, and so on up to $100 co-pays for the cheapest level premiums.

denied coverage in the future once they develop what could be regarded as a preexisting condition. Also, like in my case I didn't use my insurance fearing that I needed it for the big disease, so I didn't want to be canceled or not renewed before then.

I have Kaiser. I need a fibroid removed that is causing some serious side effects -- I am looking at some permanent nerve damage in my left leg. My co-pay is too much for me to handle right now. I still really don't know what I am going to do. :( :cry:

I was with Kaiser years ago. It was worse than no health care at all. I actually stopped doctor appts for 6 months until open enrollment so I could choose another provider.

We have a $2900 deductible and the only "benefit" that we get out of our health insurance "coverage" from Anthem is fully paid preventative care for everybody once a year. Other than that we might as well have no coverage unless you count our HSA, to which my employer contributes. Other than that and our (thankfully) one and only regular prescription (my wife's birth control pills) we pray every day that none of us are going to need to visit the doctor or, god forbid, go to the ER/hospital if we can help it in any way. I can't say that we have ever really postponed anything since none of us have needed much in regards to medical care and don't utilize any medical services unless absolutely necessary.

At the risk of "jinxing" us most of us are (right now) usually in good health although last year was particularly rough for my one year old (now two year old) daughter who seemed to have a lot of cold/flu-induced asthma episodes and required one overnight stay in the hospital (on Valentine's Day of all days!) and several trips to the doctor, at least until we got things under control. However, since we now do daily 15-minute treatments of Pulmicort and have some other medicine that seems to work well when she gets congested, she seems to be doing much better.

Still, all being said, my wife and I would PREFER to have HMO coverage like we used to have with M-Plan (and paid the same amount for) but, sadly, M-Plan went out of business the year before last and we're priced out of any comparable coverage with Anthem. With our high-deductible plan, we almost really have no actual coverage since we have to pay 100% out of pocket (sans any provider/insurance discounts) until we meet our deductible but yet we don't really want to meet our deductible either, especially not all at once like last year (thankfully, we got nearly all of it written off by the hospital and used our "stimulus" check to pay off the remaining balance *whew*).

My wife and I would GLADLY welcome any kind of universal/subsidized ("socialized") health insurance.

The Women's Health Center is charging $370 for a mammogram.

Insurance says I'm 100% covered for a mammogram to the tune of $70.

That's $300 out of pocket.

My doctor wants one every year. Insurance will only cover me every OTHER year until I reach 50 or 60 or something. It keeps changing. And I have so called *good* insurance.

And this is only one test, one part of the yearly physical.

and it stayed $5 for years.

In the past 8 years it's gone to $20 for our general practitioner, $40 for a specialist, and anywhere from $7 for a cheap generic up to $75 for some medications. And some medications they refuse to cover at all. And my husband's contribution to his coverage has gone up considerably.

When B*sh stole office, his message to the insurance and pharmaceutical industries was: "Belly up to the trough, it's feedin' time for my good buddies."

:puke:
The last 8 years should stand as incontrovertible proof that there clearly IS at least some difference between the two major parties. Clinton/Gore might have been a little less progressive or triangulated more than I might have liked but government generally ran quite smoothly under them, we were kept safe, and more people than usual enjoyed a decent standard of living.

Hopefully, Obama can help restore some level of sanity to our country, particularly in terms of healthcare.