I just don't see how we can make it better than that, you know?

What we need is a system more along the lines of what Great Britain, France, Germany, Norway, Canada ... and the rest of the industrialized world ... has. Private companies trying to provide a government-mandated service is only a recipe for disaster, given that the private companies are purely profit driven.

We can no longer compete in a global economy by continuing to ration health care to only those who can afford it. By doing so, we continue to sacrifice our most important and tangible asset ... our down-trodden work force that makes us competitive.

Literally, I can't get real estate insurance from any insurance company OTHER than the state-run at this point at either of my homes. The first because it's on a barrier island. Fine, I can somewhat understand that, except for it's been through 3 Cat 3/4 hurricanes now with ZERO damage while the rest of the island had heavy damage. Even my neighbors had major claims (lost roofs, etc). I had none due to the design of the building. Nope, insurers are interested. At my other home, it's because it's a condominium. Despite not being near water and being so far inland that no hurricane could cause a storm surge high enough to reach it, they won't cover it.

So I'm stuck with Citizen's Insurance, a.k.a. State of Florida. Excessively high rates, and gov't-worker levels of incompetence and service.

Also, look at the costs of our private insurance system today. $0.30-0.40 of every dollar spent on healthcare goes to the overhead of administrating/filing/billing/collecting/paying insurance claims. Considering we spent $2.2 TRILLION on healthcare in 2007, that'd leave us with $88 BILLION dollars to spend on healthcare if we removed the overhead. I say this, but at the same time I fear what socialised medicine would look like here. I've been in other countries and found their systems vastly superior overall. I'm all for socialized medicine but I'm VERY afraid what that would look like by the time all of the political back-scratching and reach-arounds happened.

Thankfully the pain turned out to be caused by a muscle spasm, not a cardiac issue. A chest x-ray confirmed that my heart and lungs were perfectly healthy.

The nurses a doctors there didn't waste a minute when the situation could have been potentially life threatening that's how it should be.

I didn't have to pay anything either.

"If you think dealing with an insurance company is difficult now, wait until the government runs it. Instead of taking 2 weeks to sort out a problem, it will take 2 months."

I'm from Ontario, Canada. What kind of problems do ill people and their families need to talk to a bureaucrat about?

Cost of procedures and tests never came up with anything we've ever dealt with.

I worded it poorly - I meant that the PEOPLE IN CHARGE aren't seriously considering single-payer.

"Profit"!! Too funny.

I asked her how she felt about having to wait in line for her surgery. She looked at me like I was nuts. "Well, other people were SICK," she said.

And that, folks, is the secret of affordable universal healthcare. Unless you have a population with this kind of attitude, I don't see how either corporations OR governments can make it work.

When I first moved to Vegas, I was pleasantly surprised to be able to get same-day xrays. That disappeared within a year with the influx of people into that HMO. By the time of that same opthamologist thing, we had to wait two weeks for xrays.

You are lucky to have a clinic without waits. And, of course, if everyone had equal access to care, they'd be in line with you.

You want free health care? It comes out of your paycheck, bud.

I've heard that as of right now, some 60-70% of America wants Single Payer once they understand what it is. That seems to me to be a "serious proposal," and that's why the Insurance mafia is so frightened of it.

The food is bad, and there's not enough of it!!!

Government can handle libraries, cops, firefighters and a bunch of other things fairly well (as long as the "free marketeers" don't louse them up by deploying idiots and criminals to intentionally destruct them). Bush and his crew show exactly what the "C.E.O." mentality really does - and it appears that even a "vastrightwinger" isn't impressed with it.

I generally prefer my local library to Border's, paying for a fire department rather than signing a contract under duress with a "private" company while my house is burning, etc. I even bet the "government's" army is more efficient and affordable than the corporate subcontractors (Halliburton, KBR, etc) sucking off the government teat these many years.

Only reason I can think he's hushing up so much is that the insurance companies and other related grifters have made some serious investments in Congress, regardless of party affiliation. And you can bet that the same is true of Congresspeople investing in those companies. Full disclosure and removal of any politicians making decisions here while at the same time owning stock or other relations with these insurance mammoths.

Now when I go shopping, I pay at least SOME attention to price. But for some reason (cough bribes cough) the government put it into law that they could not negotiate the CHEAPEST prices when they shop for drugs.

If the John McCains of this country are forced to reduce the number of houses down to a level they can count them in order for all of our fellow countrymen to have proper medical care, please explain why this isn't a good idea?

Slave masters are an obstinate bunch.

Frankly, I'd rather leave the fate of my health to a publicly-accountable "board" that needs to act consistently than a faceless, selfish bureaucrat who is wont to curry favors depending on who you are.

"Same access to care".... that's amusing.

But you are correct that the ranks of those without *any* medical safety net are rising. The current scummy plans bounced about by most Republicrats are just rearranging deck chairs on the Titanic in service to their Medical "Insurance" overlords. They are dying with their last gasps of "preapproved" air, but the sooner they go the way of private fire departments, the better.

I'm a very healthy person - but the entire point of insurance is that you can't be sure what maladies will strike you. His arm wasn't majorly broken, but imagine it had broken in a slightly different way that left a bone splinter floating in his arm. That's surgery. That's costly. And that doesn't leave you a lot of CASH for other medical needs.

Still, I don't agree with you that that is what is wrong. What's wrong is that the cost of medical care is escalating far beyond what most normal people can afford.

You have to remember it's "Healthcare" your paying thru the nose for.....why don't they call it "Sickcare" so's not to let them wiggle off the hook.
Socialized medicine is on the way.....lots of Docs will probably head back to Canada.

@tard: And "so many" is...? I never see actual numbers backing up this argument. perhaps because all the actual studies show there aren't any.

Like Tux pointed out, if you remove the things that pervert the market (like people being insulated from the cost of the services they consume), then everything will be right again.

We need to make medical insurance back into insurance, and stop treating it as some kind of weird corporate collectivism.

I mean, really?

So we all agree with Bernanke that seniors should just learn to deal with "the problems that come with age?" It's OK to stop treating old people because, you know, it's expensive and they're going to die anyway?

We all agree it's OK to spend trillions of dollars we don't have to insure everyone when the country is completely and utterly bankrupt and the value of the dollar is dropping like a fracking space station?

You know they aren't actually reforming health care, don't you? They're just setting up a new government insurance plan to pay for everything. Tell me how this addresses the core problem of health care being way too expensive?

@HogwartsAlum: I was shocked at the price of his ambulance too. I once needed one because of extreme dehydration leading to system shock (I was having severe breathing difficulties). It cost me $60.

America should be fucking outraged at the state of its health care system.

Now, if you have a PARTIAL refund for being BELOW a certain number of visits, or cost by maintaining a healthy lifestyle...now THAT actually might be a good plan.

@emis: "The family may not be financially destroyed, just emotionally when a sick person in Canada is no effectively treated and dies because the rationed money and resources are allocated from a single person with a serious case over to multiple people with less serious cases."

Please stop smearing your unsubstantiated bullshit across my coutnry. Alternatively, show me a single Canadian hospital, anywhere that isn't run on a triage system. You know, the exact polar opposite of what you're touting.

Even better, how about you explain that small minority of cases I mentioned above, where the Canadian government flew patients to the US and had them treated at US costs - which the government ate? Surely they wouldn't have been treated if what you say is true.

@HogwartsAlum: "The preventive care costs so much that people don't go to the hospital until they have no choice. So instead of being able to get medicine to treat their condition, they get sicker and sicker until they have to incur those hospital costs."

This, right here, is my pet theory on why we tend to be in better health north of the border. While it's still true that nobody sees the doctor when they're feeling fine, I can't count the number of times my wife has had joint pain or something of the sort, and just popped into the doctor to get it looked at ASAP. If we were in the States, there's no way we would go anywhere but the ER for fear of costs - and then only if we were obviously dying.

@emis: Bullshit.

Not only is every party who decries the Canadian system failing to turn up these massive droves of cross-border health shoppers, we're actually doing a brisk business in US patients who come up here because it's cheaper and better than that available in the US. (My favourite story was the Globe and Mail series on how private health care was a good thing - honest! - because a whopping 33 patients had been sent to the US for necessary surgery in one year. At the government's cost.)

Further, your claim is plainly absurd to anyone who takes ten seconds to think for themselves - patients who are such a high risk that they're turned down by a government-funded program sure as hell won't find private insurance.

Now that we have private healthcare, the waits in the hospital are only long because there are never enough lab techs. But I've never had to wait long for an appointment at all. The time I'm given is the time I'm seen (unless there was an emergency and they're running late). It's a freaking miracle...seeing as the practice is SUPPOSED to have 4-5 MDs but is now down to 2.

@johnva:
I might be able to get a plan like that but I'm pretty sure my company won't give me an extra $500/month if I cancelled coverage with them so it's definitely not worth it.

I guess I'm kind of surprised that given all of the things that are covered for me with a very low deductible for $750/month, three isn't a cheap option that doesn't cover anything until I've spent $5k or even $10k.

@emis: So you're healthy, that's great. The insurance company sees you as pure profit, but what is going to happen when/if you do ever get sick? Are you *sure* they'll continue paying for your healthcare? If other people's experiences are to be believed, don't count on it. Expect them to find ANY way possible to keep the money you've paid over the years and deny you treatment any way they can. They may not be able to, but be sure they'll try.

@SacraBos: Because it's never worked in other countries either, like Canada, Japan, the UK, etc. At least the elected officials and their minions would be answerable to you every few years - what can you do about the current administrative beurocracy that currently manages your health care? You have *no* say over that, other than to leave them and go to another beurocracy who also has no accountability to you. Great choices, really. No, I'll take the government, where at least I have a say in who runs it in my vote.

In terms of actual monetary value, I think life insurance policies come out to LESS than corporate jets.
Of course, Mr. Jim Averageperson doesn't have 13.34 million dollars in the bank account which he WAS planning to buy a 747 with, but since he got sick he can spend it on Super-Awesome-Make-You-Not-Die pills.

If the insurance company deems your policy invalid, do they refund the premiums they collected over the years?

Moral of the story. Healthcare can suck everywhere and depends as much on the doctors as on the system providing the care.

Real Moral of the story. Anecdotal stories are irrelevant. What is relevant is the the US spends more on healthcare per citizen than any other developed country, yet per citizen we receive less healthcare than most other countries. Measures of health care quality in the US show that every one is at risk of receiving poor healthcare delivery. See for example.
http://www.ahrq.gov/qual/measurix.htm

Wait times for top specialists can be very long in the U.S., too. I have a neurological condition, and if I need to see my neurologist for something that isn't my yearly appointment (scheduled a year in advance) the wait times are typically 4-5 months. What causes long wait times is NOT the fact that the payer is socialist vs. a private insurance company, but the fact that there aren't enough doctors providing a service that is needed (for whatever reason).

Also, while wait times for elective procedures can suck, it's better than NEVER getting the procedure because you're uninsured and can't afford to pay for it.

I think they ARE fighting it, though. The Republicans are completely set against the public option, which means that that is what the insurance industry wants, most likely (since Republicans generally do whatever the corporations tell them to do). And just this week, former insurance lobbyist Tom Daschle is doing his best to try to sabotage the public option from the Democratic side. The insurance industry might try to go for a crippled public option if they think it's inevitable that it's coming, but what they're really gunning for is for the government to just force everyone to buy private insurance (in other words, another massive subsidy for themselves). They want us to try the failed Massachusetts experiment nationally.

I'm a bit of a pessimist too, but it's definitely never going to happen if we don't fight for it. I'm trying my best via the political route. I just hope that Obama stands firm behind the public option (which was a campaign promise of his), because then it might actually have a shot. He's a lot more personally popular than Congress is, and he's got a lot more to lose by not passing the public option. I've been perplexed and pissed that he's not out there a lot more stridently with his bully pulpit. I know he's a cautious guy by nature, but he really needs to push Congress around on this one.

She had a bone marrow transplant about 3 months before she died. Right before she was supposed to have the procedure done, the hospital told her that the insurance company would not pay, so unless SHE could straighten it out, they would not do the procedure.

How can something like this happen? Are people really just dollar signs to both of these parties?

I spent the rest of the day on the phone getting things worked out, but how can they put a patient with a serious illness through something like that?

Even with insurance, you could be screwed. I vote for scrap the whole thing and have the government run it.

Insurance companies are there to make more and more money every year for their shareholders - hospital systems are in the same business today. Guess who will be the ones to pay so that the both of them can make greater profits?

The system doesn't work, and all of this BS in congress now won't solve the problem.

Not that all conservative churches are run that way, obviously, but that it does present a real problem in the "giving" statistics that hasn't yet been particularly well-addressed. If you break out religious giving entirely, THAT presents a serious problem since Americans of all stripes give massively to religious charities and religious charities are massively important in charitable work in the US. But if you treat all religious giving as equally charitable, that's obviously foolish and creates an equally false picture.

/off topic

I'd much rather make payments to a private doctor each month for his health plan knowing that when I get sick he'll take care of me. Knowing the government is going to "manage" healthcare scares me to death. It's another tax and on top of that will cause a split to occur and we'll have public healthcare and public health care.

When I get sick, I'll go to India and pay out of pocket.

I've already heard horror stories from friends of 'pre existing conditions' being denied by health insurance companies when the condition was NOT pre existing at all.

I hope Congress at least passes a law (without loopholes) where everyone will have coverage, at a reasonable cost, and no one can be denied due to any condition--whether pre existing or not. (but I know I'm only being hopeful...)

It's true that if done right, the competing public plan is the best option currently on the table. The problem is that I'm a pessimist and I put the chances of it being done right without a single-payer system at somewhere around zero. Even so, going this routh may open the door to a single-payer system in the future. If I remember correctly, other countries have made this stop on the way to single-payer health care.

The government has been very little right in health care for 40 years. Are they really going to start now? I'd like to think so, but I'm not holding my breath. Right now they seem to be working on another ineffective patch on a broken system.

As for roads, the reason they've been so bad is due to the trucking industry who continually lobbies for lower taxes for them. All the while doing the lion's share of the wear and tear on our roadways.

I kid you not.

1. Medical malpractice is in need of some serious reforms. The premiums have gotten so large that many doctors are working a substantial portion of the time just to pay the premiums. Premiums in excess of $100,000 a year are not unusual for some specialties, even when the doctor has never had a claim. I would suggest at the least a cap on pain and suffering damages. By all means, let the patient recover the actual costs but not turn the proceeding into a lottery.

2. Malpractice premiums are also driving some doctors out of certain practice areas. A group who many considered the best ob/gyn group in suburban Maryland simply dropped the obstetrics portion of their practice rather than continue to pay what they considered outrageous premiums. I know from personal experience that it was only the tremendous skill of one of the members of that group that allowed one of my children to be delivered as a live birth and it's a shame that they felt so beleaguered by the insurance industry that they withdrew their skills from the market.

3. The state medical boards who license physicians need to take some responsibility for impaired or incompetent doctors. There needs to be a weeding out of the malpractitioners and the state medical boards have not been up to the job.

4. All of the above costs. The premiums are reflected in your bill; incompetent or impaired doctors who are allowed to continue to practice jack up the costs for everyone else; and malpractice coverage needs to be based on claims history for the insured, not for the class of practitioners..

5. UK has a blended system which is both good and bad. There is the National Health to which everyone contributes and private health insurance which is relatively inexpensive (because NHS picks up everything expensive) and which is offered as a perk in many companies. NHS is very good for emergencies and procedures which are time sensitive. It's not so good for elective procedures. For example, if you have a knee problem, say cartilage tears, that is not life threatening, you'll wait in queue for a very long time before you are scheduled for an MRI and arthrosporic surgery in the NHS system, but if you have private insurance, you can get the work done immediately. Penetration of private insurance in the London market is reported to be around 25%. It's less outside of London.

6. The very fact that Canadians deem it necessary to come to the United States and pay cash for some procedures indicates that there are issues in Canada as well. That's not a put down of the Canadian system but it does indicate that there are some needs not being served.

7. The US insurance system is badly in need of some form of regulation and reform. The rates paid for services by the insurers to doctors (including Medicare and Medicaid in this rant) bear little relation to the rates quoted by the physician. A procedure for which the physician bills $600 may result in a reimbursement of $100. Those without insurance are paying that $600 (or not paying it) and that's messed up on several grounds. A reasonable quote and a reasonable rate of reimbursement based on that quote would eliminate a lot of the headaches. Hospitals are the worst in this regard. Stories about $20,000 per night for a hospital stay, $40 for a Tylenol are much too common. Granted, the insurance companies aren't paying these rates and the hospitals are prohibited from balance billing, but the numbers make no sense.

8. A recent and not particularly happy trend is for physicians to open "boutique" practices where they refuse to take any insurance and limit their practices to patients who pay an annual fee. This goes well toward creating a two-tier system of medicine where those who can afford it get the "better" care while those who rely on insurance or government payments are limited to those doctors whose reputations are not sufficient to justify a cash-based practice.

9. A side issue, but the cost of medical education in the United States is obscene. By the time a person comes out of medical school, goes through internship and residency programs, and possible fellowship training, the debt load on that person can be in the hundreds of thousands of dollars and all that debt has to be recovered somehow. (Disclosure, I am not a doctor and no one in my family is a doctor.) Might it not be useful for the government to fund medical school with a commitment from the physician to serve (something like the VISTA program) for a few years? I know we do this on a limited basis but maybe it should be expanded.

OK, time to get back into my restraints.

Ha, the company that bought us out is based in Sweden; but our insurance didn't change.

Sucks!

I had had ONE 10 pill Rx for Ambien and I disclosed it, it was seriously ONE time in the 4+ years I had had that insurance plan, and I had NEVER taken any Rx sleep aid before, or even discussed sleep issues with my many different Docs. The Dr. who prescribed it had listed my diagnosis code as 327.13 which is defined as:

Recurrent hypersomnia
A condition characterized by recurrent hypersomnia and hyperphagia and marked by such symptoms as mental confusion, excessive sleep requirements, restlessness, and hallucinations.

He choose this code, or rather his BILLER did, b/c he got paid MORE than he would have with a less urgent and severe diagnosis. I spoke to the actuarry at Blue Cross (with whom I'd had my previous insurance through various jobs for over 15 years) and He said it didn't matter if I could get the Doc to revise the diagnosis, it was now "part of my record" as was my diagnosis of having migraines b/c BLUE CROSS mixed my Rx record with my husband's.

I'm just lucky Blue Cross denied me outright rather than after I'd paid premiums for years and then sought any medical care which they very likely would have denied after the fact based on my "pre-exsisting" condidtion.

He choose this code, or rather his BILLER did, b/c he got paid MORE than he would have with a less urgent and severe diagnosis. I spoke to the actuarry at Blue Cross (with whom I'd had my previous insurance through various jobs for over 15 years) and He said it didn't matter if I could get the Doc to revise the diagnosis, it was now "part of my record" as was my diagnosis of having migraines b/c BLUE CROSS mixed my Rx record with my husband's.

I'm just lucky Blue Cross denied me outright rather than after I'd paid premiums for years and then sought any medical care which they very likely would have denied after the fact based on my "pre-exsisting" condidtion.

Plus we pay about ten times more in premiums, copays, and non-covered costs than we'd pay in taxes at the same income in Canada.

Oh, and as for the myths about choices and wait times...I've consistently waited longer and had less choice in the US than in Canada because of what limits my insurance has placed because of what docs are in their network. Just yesterday I found out that there's only one perinatologist in all of Austin in our PPO.

When they cancel a policy do they have to pay back all the premiums that have been paid? Otherwise arent they taking money for a service they arent providing?
I fail to see how they can't be made to run the investigations at the time of signinig of the policy to make sure both parties know exactly where they stand.

KK

Yes it is. And do you know what would fix that? Government regulation of malpractice insurance so that the insurance companies can no longer make obscene profits on it. Premiums have nothing to do with with claims in an unregulated insurance system. Premiums have to do with how much the insurance companies can pull out of your pocket.

@johnva: I have to say Johnva I agree with and respect all of your comments on this thread. It is time for real change with healthcare. It really can't get much worse that the way we have it! It is a disgrace to our people!

Funny you say that, considering how unhealthy most of our food is. The massive rise in obesity should at the least give one pause.

Proper nutritional education would be an incredibly useful thing to add to our school system. So might basic medical knowledge.

Not that I think we need it, but your implication that socialized food would lead to starvation has no actual evidence. I know people who moved to the US from communist Russia. They like it better here, but they were not living a life of poverty.

- Ideological opposition? That's nice that you have that luxury. Not everyone does.

- If you think the government would do it worse, why do the statistics on spending vs. outcomes say otherwise on the care that our government is currently paying for (Medicare, Medicaid, VA, military)?

- The bank crisis was caused by PRIVATE greedy idiots, not the government. I'm not happy with the bailouts either, but they were likely necessary.

- You discount all the people on government health care who couldn't currently get care from the private market.

- You'd rather have the devil you know over the devil you don't know? That's remarkably...cowardly. Sorry for the tone - can't think of a better word for it.

Exactly. Republicans actually don't believe in free-market competition; they believe in crony capitalism where the game is rigged to benefit the people who currently have the most money. The "free market" stuff is just propaganda they use to keep their rank-and-file supporters in line. And it works pretty well, judging from the comments in this thread.

But you're right - insurance companies don't want to have to compete with a public plan, because they know they would LOSE. That's why I support the public option - because I think it could be a transitional path to getting us to true single-payer.

Someday Americans will read about the present era and be aghast and disbelieving that health care was ever "optional," a luxury, or a perk only for those lucky enough to be employed by a robust organization with good benefits.

Does anyone remember when the over-the-counter allergy pill "Allegra" used to be prescription-only? About 12 years ago I went to the doctor with sinus congestion and was prescribed this now over-the-counter medicine. I never had an allergy test to show it was necessary or warranted, but he prescribed it to me just in case. About 1 year after that I hit a financial rough patch and I missed paying my health insurance premium. My health insurance was cancelled. I called them up after getting the letter to have my insurance reinstated, but was required to re-apply all over again. Of course, you have to list any 'allergy' medicines you've been prescribed previously and I had to admit being given Allegra that one time -- besides, they knew anyway. They agreed to provide me with health insurance again, but they would only insure me if I signed a rider excluding any coverage for "allergies" or anything "allergy-related". In the Great State of Oklahoma, there is no time-limit on how long coverage can be excluded for pre-existing conditions in the individual health insurance market. To this day, my health insurance company refuses to remove the rider. Over the past 11 or so years, they have used this rider for "allergies" to deny any benefits for poison-ivy and an eye infection I once got from some now recalled contact lens solution. In addition, when I go to the doctor, if they write anything in the chart that has the words 'possible allergies' or 'allergic reaction' the health insurance company denies benefits for the entire visit. It turns out, that almost anything can fall under the generic phrase 'allergies or allergy-related'. Yet, the only excuse they neededed to get away with this was a 1-time lapse in continuous coverage and a 1-time prescription for the now over the counter pill Allegra.

Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show "intentional fraud."

The answer from all three executives:

"No."

@giggitygoo: I have NEVER denied that "rationing" takes place in socialized systems. I just think that it takes place in a more equitable way than it does now (where it's "rationed" based on ability to pay). Rationing will always be necessary unless we continually increase how much we spend on healthcare in aggregate (and we can't afford that). The question is how we will divide up the limited resources. I'd rather we provide for everyone up to a minimum standard of human rights and then let people pay more if they can and want to for upgrades, etc.

Or, to take a pure industry example, AT&T was MOST innovative when running Bell Labs, which was NOT profit-driven but was driven by pure science. When AT&T cut down Bell Labs and made profit a mandate, the innovation coming out of Bell Labs dropped way off. (As did, incidentally, the profits that Bell Labs inventions brought to AT&T.)

@thnkwhatyouthnk: I know my life is worth at least three and a half corporate jets! :P

But you have no evidence for that belief. It's merely a faith-based statement. The average single-payer system in a first world country pays 3% to administrative overhead. Our private system in the US pays 24% to administrative overhead. So even if the US government pays 6% to administrative overhead, on the theory that the US government is twice as wasteful and incompetent as European governments, we'd STILL only be paying a quarter as much to overhead.

It's obscene that the markup on Zoloft is, what, 25,000%? But that a quarter of health care costs go to administrative overhead is a far larger slice of the pie.

Which is why insurers don't want a public option. "Competition" isn't something they want; it's merely a buzzword.

Maybe most of you are desensitized to it because it's been this way for so long but the amount of drug advertising I see on TV drives me crazy. The drug companies are basically asking you to self diagnose and beg your doctor to give you whatever magic pill they have this time.

Another part of the "prescription drug costs" is that many americans I'm sure are on medications they don't really need to be on because they "asked their doctor" about it and the MD (getting kickbacks from the pharma company) just wrote a script even though he knew it wouldn't change much.

The patient probably thinks the drug helped a lot, the promises these ads make help to propogate the placebo effect.

1) For *BOTH* of my wife's pregnancies we have gotten denied from the insurance company for delivery costs. Later they decided to pay.

2) My wife was denied coverage for doctors that the hospital provided despite the fact that the hospital stay was covered. They never paid that bill, stuck to their claim that it was non-emergency and out-of-network despite the fact that she had been admitted.

3) For both of my children is was months before we stopped receiving bills from the hospital because the insurance companies finally figured out that they were covered.

4) My daughters NICU coverage was denied at first because she was not *technically* premature (by 3 hours).

5) Multiple times we have had bills rejected for no apparent reason that took weeks or months to resolve.

6) My wife was summary booted from my insurance because they claimed she took too long to return some paperwork certifying that she didn't have other insurance. She ended up getting bills for a pap smear for almost 6 months for $120. When it was all resolved the bill was $12 which we cover as a co-pay, the insurance company didn't have to pay a dime ( except in the hours of irate phone calls from myself and my wife ).

And I'm sure I'm forgetting stuff. I agree that something has to change. The facts are damning and the government will have to step in eventually. We are quickly racing to moral bankruptcy when it come to health care in this country and I would prefer my children never have to go through this same mess themselves.

But doctors are easy to fool. Their insurers just say "Uh....um.....LAWYERS! SUING YOU!" and that ends the discussion.

@Emis

And what about the people who don't have the almighty insurance card and have to pay through the nose for health care? They don't get the benefit of the co-pay you have.

Some of the times I was most thankful for the Canadian system was when I had to see a doctor but had no insurance through work. I was able to get a full physical (including bloodwork, etc) and get a couple of other things checked out without having to pay a single penny.

There some long wait times for certain procedures in Canada, in these instances you can pay a private provider yourself to get treatment faster.

Also, who are these millions of people who support government healthcare? Most americans I talk to believe it will be a colossal mistake and one of the worst things Obama could ever do. They worry about the massive cost of the reform against the already ballooning national debt, and I understand where they are coming from.

At the same time, there's no guarantee a government run system is going to be more expensive than what we have now. The whole focus here is to make health care affordable for everyone. I have always believed everyone has the right to basic health care.

BTW-The public insurance option is off the table now in our debate in Congress.

Not true. Single-payer is "off the table" (apparently because it's too threatening to the insurance industry and would work too well), but the public option absolutely is not. They are not the same thing.

- The U.S. has TOO MUCH redundant equipment like MRIs. We don't need nearly as much as we have right now, and we're all paying for it.

- The main reason other countries with socialized medicine acquire these things at a lower rate is because the total funding for their systems is far less than what we spend on healthcare here in the U.S. If we continued to fund our healthcare at a high rate, we could have the best system in the world (and it would be true this time).

- The problem is much more complex than you make it out. People spending lots of money on routine care is NOT the root problem; chronic disease is a much bigger issue. So it's not really true that people overutilizing care is what's causing the bulk of our problem.

- Malpractice insurance IS a problem. That is an industry that is nearly as evil as the health insurance industry itself. It should be reformed. But it's not the whole problem.

- Tying health insurance to jobs is quite a policy dilemma: on the one hand, a lot of people would be better off if it weren't tied to jobs, and they could shop for a policy that better fit them. On the other hand, a lot of people wouldn't be able to get health insurance if it weren't tied to their jobs.

You've identified several major problems. There are many more that need to be fixed.

I don't think any of your suggestions takes into account that healthcare is rising 10-20% per year for most people.

Taxpayers already pay for nontaxpayers in our current system. Poor people and unemployed enjoy free healthcare and don't have to worry about fighting claims with the insurance company. Personally, I'd like to get in on some of that "free healthcare". There is a link above that shows universal healthcare in most countries works about as well as our private system, while costing about half as much.

Why it's EVER legal, at all, to deny a pregnant woman medical care is completely beyond me. Does anybody benefit from babies that didn't receive good prenatal care, or moms too poor from medical bills to buy decent food etc.? (I mean anybody *besides* health-care-execs.)

;)

Yeah, god, I couldn't stand that either. ::shudder::

@mariospants: To be fair, I do pay $750 a year at tax time for my health premiums (and an additional $10 per month to pay for extras such as a private room etc.). I just wanted to point out that in my experiences, the system works just as well the american one with the added advantage that one doesn't have to be concerned with "how to pay for this damn thing".

The ambulance was only $300?

Wow. I called an ambulance when I had a kidney stone (I didn't know that's what it was) and it cost something like $1100. No job or insurance at the time.

Next time I'll just suffer.

@Shoelace: you were too busy wishing death on the CEOs to realize your agreeing with them. they said they would continue to try to rescind policies due to "intentional fraud"

@johnva:
Yes and no. I just did some back of the envelope calculations and it looks like I've paid the insurance company about $45k over the past five years. That's $250/month from me and another $500/month from my employer. I've been to the doctor maybe 3-4 times in that time period for a standard physical. If I had the option of having my company simply give me the $500/month that they contribute to my premiums along with picking up an insurance plan where they don't pay for anything unless I exceed $5k in a year I'd do it in a heartbeat.

The whole point of insurance is that the company takes the *risk* of a claim in exchange for the premium.
That means if you're not sick, you don't get the premium back.

The Universal Healthcare route is great but be aware of the issues. Generally healthy people subsidizing generally unhealthy people - and taxpayers paying for non-taxpayers. And when someone sues over a mistake, it's the government fighting back using the taxpayers' money.

There are alternatives to recission...
You could pass the risk of recission to the company by having mandatory medical checks prior to paying your premium.
You could obviate recission by paying higher premiums to cover fraudsters and ordinary people who 'forgot' to mention their pre-existing conditions.

Or take control of your medical history and disclose it to your carrier.

You can keep your Canadian health care thank you very much!

@Eldritch: I'm living in Canada now and recently I had a kidney stone (first one, and hopefully never again, the pain was indescribable). The ambulance picked me up within 2 minutes and I was whisked into a bed and treated with a doctor, pain relief and xrays within minutes. After a night's stay with constant nurse supervision, they sent me home with my pain relief prescription. Total cost? $45 for ambulance and $30 for the kind of drugs they find on hollywood actresses.

I dunno. The least a government can do is use the money to help its citizens stay healthy and happy and universal medicare seems like a good way to do that.

Um ... so does America's tort law system.

This is a routine function of the legal system in dealing with health issues. I understand if it's a little distasteful, but for people familiar with the health care system or legal system, it shouldn't be surprising or upsetting.

@suva: the problem is that private insurance companies don't really operate in a regular free market. They don't have to compete with each other b/c for the most part your insurance is determined by your employer. If people were able to choose health ins as freely as auto ins you'd see a big step up in quality of care.

I've never considered Ayn Rand principled.

There's also NO RULE WHATSOEVER that says in a country with socialized medicine, you can't ALSO have private supplemental insurance for those people who DO want that "highest tier" of care.

And, in fact, most Anglophone nations with socialized care DO have supplemental private insurance available.

The preventive care costs so much that people don't go to the hospital until they have no choice. So instead of being able to get medicine to treat their condition, they get sicker and sicker until they have to incur those hospital costs.

A lot of policies don't cover birth control, either, which can get kind of expensive. Which is ridiculous, because as you just said, $5,000 for anesthesia, $40 for a Tylenol, etc. etc. So much cheaper just to cover the freaking pills!

Each link discusses the real facts about universal and private healthcare. It examines universal healthcare in other countries, like Canada, Germany, and so on, and has real, conclusive stats to show. I've asked the consumerist team, repeatedly, to link to these posts/articles, as health insurance is a very serious consumer issue.

Which might reduce the demand for health care in the long run, I suppose. But more realistically, would end up with the government ad-hoc covering all the people having sex who can't afford their spawning bills.

I think we've identified the largest cost contributor.

I'll tell you what. I'm willing to give you a call anywhere in the country and I've got a situation I went through personally a couple years back. I've got all the documentation for it. You'll have 10 minutes to make a decision based on what the doctor COULD explain to you in English. Why, it'll be even easier for you because you DON'T have to worry about the long-term personal effects of the decision!

America is a country of specialists, information is the key. Nobody can know everything, 'nuff said.

As far as baseless lawsuits, even in states with tort reform they jack insurance rates. I've got a pediatrician in the family along with an OB Nurse that can testify to that.

Oh and as someone that has worked for the insurance industry, it's a f*cking black hole of double and triple cross-billing, hiding profits in non-profits, et al.

Don't worry though, because we can't get real reform in this country one way or the other we'll end up with the worst of both worlds: a government paid for, privately administered, insurance plan. You'll be able to shop for insurance, and even buy "supplemental" insurance, but it'll all suck, even the supplemental. Considering the way it is now, you probably won't notice much of a difference except you won't hear about the "uninsured."

At one point her insurance attempted to claim her arthritis was a pre-existing condition, which required my dad to put his lawyer pants on and call them up to point out that they had covered my sister on the same policy SINCE THE MOMENT SHE WAS BORN and my mother for at least a decade before that, and that there was definitionally NO SUCH THING as a pre-existing condition for her since at no point did she pre-exist without that policy.

This is actually limited by law in the U.S. The insurance companies got so enthusiastic about refusing to cover maternity services adequately, doing a "treat and street" where they basically wanted you to leave the hospital as soon as you delivered, that they were KILLING BABIES. That being the kind of thing Congress will actually pass legislation about, you are guaranteed by law a 48-hour stay for a vaginal delivery and a 72-hour stay for a C-section.

Because, in fact, insurance companies CAN'T be trusted not to kill babies.

So using your basic argument, the entire food industry needs to be socialized as well. That would end starvation in our country, wouldn't it? Where do you stop, once you start making anything that someone makes/provides an entitled "need" or a "right"?

Here's how it should work: if an insurance company cancels your coverage because of "incorrect or incomplete information", you should be entitled to receive a FULL REFUND of the money you paid over the years for their so-called coverage.

Perhaps THAT would stop this rescission nonsense...

Why do so many Americans travel to India, Mexico, Cuba, et al. to get operations, because it's actually affordable?

The Canadian health care system used to be much better from what I understand, and the funding has been cut over and over. However, it could easily outpace the US system if any politician took the time to actually put more money into it instead of taking money out of it. I think a similar system could thrive in the US if people wanted to try to implement it. Yes, there are more people to cover, but there's also a lot more people to pay taxes on it. Also, part of the Canadian system is control of prices of medication and the cost of procedures, as well as insurance for the doctor. If you get those under control, you'd be surprised how cheap a private healthcare system can be, at its core.

The message here is clear, that even though this type of specialized care was not available (simply because of geographical limitations in the Province), OHIP was at the ready taking care of it's Citizenry.

It was just simply the most expedient thing to do. My hat is off to the Canadians.

BTW-The public insurance option is off the table now in our debate in Congress.
This leaves us with our existing model of Managed Medicare where the Government gives the Blues a pile of money, and they do everything possible to keep you (and everyone else) away from it.

It's a shame that Private Insurance hasn't grown and consolidated to the point of being "too big to fail".

Of course the gov't looks for the lowest bidder. They try to maximize their dollars. The gov't will have (purely random number here) $3 billion per year and expect to spend it all, get the most bang for their buck, and look toward the next year when they have another $3 billion.

They won't contract with the lowest bidder, deny claims like crazy, and hope to keep $1 or $2 billion as profit.

The equipment thing probably won't happen here, however how financially viable is it for a public health system to spend $80k/yr to keep someone alive that may soon in 2 years or 10 years. In statical eyes that money would be better spent on people who have short term illnesses and can productively give back to the system through taxes.

There comes a point where you are considered a loss if its not your own money. Many insurance companies attempt to and do do this right now, imagine how bad it could get in a public health system where you can't switch to another provider or find a cash-only treatment center.

I see this a lot with medicine costs, thought that can easily be subsidized. The problem gets to be with other services such as tests, hospital stays, hospice care, etc.

seriously, why would you want to spend 80k/yr for a patient that is going to die soon anyways when you could spend that money on productive members of society that will be able to pay their taxes once they get better?

I'm not against state-run health care, personally though I think a merge of the two systems would be more beneficial then eliminating one system for another. Don't be misled, that is what they are doing. Its not a matter of what the Right says or what anti-social medicine groups say. Its pure, cold, hard, unforgiving math.

You have no idea what you're talking about.

Why do so many Canadians feel sorry for our health care system?

@Ariella Kadosh:
May I have the honor of holding them down for you? *gets giddy with excitement & anticipation* These mother f'rs have stolen at least a few quality years from my health and caused me to go bankrupt with their delays & prior authorizations my health could no longer wait out.

@giggitygoo:

The have nots (and the almost have nots - the underinsured) are rapidly increasing in number. Basic health care should be a given, just like basic education. The current system not only leaves many out in the cold, even those with coverage are not happy because they are tied to their current company. So many people are afraid to move jobs, start their own company, etc. because they are worried about health insurance.

The major problem with health care in the US is really three fold: one, we don't buy health insurance. We buy prepaid medicine. Most people just want to walk into the doctors office, have them run as many tests as necessary, and then just walk to the desk and pay their $30 copay. You talk about premiums going up... how many unnecessary tests were just done? Someone is paying for those tests. Would you ever go to an auto mechanic and say "do everything you want boys"? No, but that's how we treat our health insurance... because we have no immediate incentive to keep the costs down.

The second reason is malpractice insurance - its obscene. Not only do doctors have to pay for concurrent medical malpractice (ie, for your current patients) but they also then have to pay malpractice tail insurance (in case a lawsuit gets filed after the policy expires). Oh, and tail? That costs around 180% of the annual policy... so basically 60% more a year (most policies are 3 to 5 years). And, to cover against malpractice, doctors run all the tests they can to cover their butts. Oh, and the patient doesn't care, because they just pay their $30 copay.

Last... why is my health insurance tied to where I work? If this is such a great idea, lets do the same with the rest of our insurance - auto, life, home/renters...

Almost as sad as here in the US when poor people die because the the resources are rationed to the single person with the serious case because he has insurance and they don't.

Every system, including our current one, "rations" resources. Our system just rations it in favor of people who have more money.

With that line of logic, every industry would be more efficient without profits. (Think how cheap houses could be if homebuilders were non-profit! Food too! Cars!) This is the same fallacy that gained a following the the early 20th century ("industry for use, not for profit.") Granted, the healthcare system in the US is seriously screwed up and needs vast reform, (Also clearly some insurance companies are acting in bad faith and need to be regulated) but saying socialized medicine doesn't require sacrifices is simply not true. When any service is free, it has to be rationed in some way - that's just basic economics. This is why nations with socialized healthcare have boards to make decisions on whether treatments are "worth" it for the elderly. (Britain's social health care administration actually places a monetary value on people's life in terms of money/time) It's one thing to believe that this rationing is worth the gain, but to deny it exists is foolish.

1997 was the year DTC (television) ads were finally permitted, with almost no restrictions.

Although, yes, the process leading up to that started in the Reagan years.

All this does is add to the pool of uninsured who add to the burden the system has to bear, making it more expensive for all parties involved who have to continue subsidizing the growing numbers of uninsured.

This is the short term/high profit logic that continues to get us in trouble.

Truman actually wanted a universal-ish healthcare system, but opposition forced him and Congressional supporters to cut it down to only "at-risk" groups like the elderly. And the AMA refused to allow fee caps.. and thus, Medicare was born.

There's not really anything inherent in the Medicare that makes it more expensive than anything else.. it can be affordable. But doctors and insurance companies make too much money from the fact that it isn't.

Given the fact that single payer and other universal coverage setups are more cost efficient than our current system, it's an option that should be seriously considered.

The solution should still be on passing laws, tort reform for example, that will help ease the cost of providing healthcare.

Tort reform will do nothing to lower the costs of health care. Nothing. It will, however limit the ability of victims who have been irreparably harmed from being reasonably compensated.

It's insane that it costs $20k for a night in hospital. Be it through tax breaks, etc., the government should focus on a lower cost health care system rather than socialized medicine.

Booga Booga Booga! SOCIALISM!!!! OFGRUN!

Every western industrialized country in the world has some for of universal healthcare. Every single one of those countries spends LESS on healthcare than the US. Many of those countries provide better healthcare than the US in almost every regard.

Given a choice between better, more widely available care at a lower cost versus Free Market Uber Alles, the choice looks pretty simple to me

This is just a symptom of a larger issue, which is the immorality of "for profit" healthcare. Until we make healthcare a non-profit industry, greed will always triumph over doing the right thing for the patient. The balance sheet rules all in "for profit" businesses today. That is how MBAs are trained to think: shareholder value above all and screw anyone that gets in the way. It's even enshrined in US law: a CEO can be sued for NOT making shareholder value his/her #1 priority.

You're making false assumptions about people who don't believe the same thing you do. Agree or not, there's a valid principled argument that people should not be forced (key word here) into giving their money to support other people. Keep in mind that conservatives give far more money to charities than do liberals despite making less money. ([abcnews.go.com]) So the whole "hate the poor" nonsense is exactly that - just an irrational ad hominem attack on those who think differently. It's one thing to make an argument for your own agenda, but you're just deluding yourself if you think everyone on the other side are a bunch of evil cartoon Nazi vampires who just don't care as much as you do.

@johnva: You'd be screwed and bankrupt if you ever had a really bad problem. No one who isn't very wealthy can self-insure and be safe from bankruptcy in this country.

It's a risk/benefit scenario, true. Still, he has a point.

1. My brother got many services half off when he paid cash(debit card) up front when he broke his arm w/o insurance. That was half off the INSURANCE charge rate.
2. Many dentists that don't deal with insurance have substantially lower charge rates than ones that do.
3. No source, but I remember reading that billing is something like 30% of the cost of medical care. Insurance companies do whatever they can to deny or reduce payments to the providers.
4. Average HC insurance premium: $4.7k, $12.7k for a family.

Take somebody healthy like my brother. He didn't spend $4.7k for that arm. He paid less than $500, including the x-ray, setting, cast. It wasn't a majorly broken arm.

So, if my brother did like the op mentioned, at the end of Year 1, he'd have ~$4k left in his HSP. $8k the next. After a 'mere' 5 years, he'd have enough money to pay CASH for what my Dad's melanoma cancer treatment.

Now, to end up, I wouldn't go without any healthcare insurance - instead I'd get a 'high deductible' insurance plan - you know, insurance that's supposed to act like insurance. You pay the deductible then they cover everything else.

You must be new here.

Please take a peak at some projects like Massachusetts' Big Dig.

A lady was killed when the ceiling fell on her car... it was proven to be incompetence all around. Where are the REAL consequences????

And to say that "goverment isn't about monetizing" is absolutely the most ridiculous thing I've ever heard. They, like any other payer, will look for the CHEAPEST method to pay out.

We have the same type of life insurance laws in America. If I have my policy for 2 years it doesn't matter what was wrong with me before, what I wrote on the forms, etc... I could even put my head in a vice press and they will still pay out, they must pay for death or any reason at that point.

Health care for profit does NOT mean denying service! That's just completely illogical. Heath care PROVIDERS want to provide service to patients, that how they make their profit :)

That's like saying Burger King refuses to sell hamburgers because they're for profit... see? makes no sense!

It's INSURANCE companies that deny claims, insurance companies have no business making any health care decisions, they should all be made by the providers.

That's a nice sentiment, but with that line of reasoning shouldn't every human need not be serviced by a for-profit industry? Housing is a need - should the government be everyone's landlord and home builder? Food is a need - should food production and distribution be socialized? (Read: Great Leap Forward to see how a previous attempt fared) If anything, healthcare is less of a need than food and housing. Also socializing healthcare (or anything for that matter) has many unintended bad consequences that proponents seem not to mention. No one wants to see people suffer - unfortunately life just isn't that simple.

What if we treated medical care more like buying a car or burger?

(Me, seven months ago): "Well, Mr. Ambulance Driver, I realize that I'm having a heart attack, but can we drive around and compare prices for angioplasty at a few of the local emergency rooms? That would be swell."

I understand your point for simple preventative care, but even in that case -- what's a good price for a cholesterol check? I know there's a difference between a $9 burger and a $1 burger, but how does a cheaper lab test compare to the more expensive one?

Let work with REALITY here, not fantasy.

The very poor and the elderly in America have access to the same care that those with private insurance have.

It's the lower middle class who lose their private insurance because of job loss that are NOT insured--those are the folks who need help in this country, not the uber poor.

Andrewe, how often have you required medical care?

I'm in America--I've never called an insurance company either. I visit my doctor every year for a physical, once in a while he may recommend an additional set of tests, sometimes they are at a nearby testing facility. Once I needed a minor surgery and was referred to a specialist at a nearby hospital.

In all cases I simply showed my insurance card, then paid a small "co-payment", it usually about $20-50 and is paid to your primary doctor.

I wish I could find the story for that guy in the UK who was denied heart valve repair--they effectively told him he wasn't worth it... so he arranged for the procedure to be done at a private hospital in the UK--I won't get into why those are necessary with the fabulous national health service available there--and got his procedure done, then paid with a check.

He's alive because he was willing to write that check to a private health care provider, if he left his life in the hands on the national health system he would be dead.

Please note that I say that he was willing "write the check" and not pay for it... the check bounced according to the story IIRC.

You have no idea what you're talking about.

Why do so many Canadians come to the US for health care?

It seems only fair.

The only problem is, profit is one of the main drivers of technological and scientific advance.

I was going to bring that up. If people think it's devastating to have a medical catastrophe while they've got shitty insurance, they should try it with no insurance at all!

Profit driven health care where your health is the very last thing that your insurance provider cares for.

Profit driven health care providers--more procedures = more money. So you're more likely to see better equipment, more doctors to perform more procedures, more medications, more care... but I agree that if we're talking about the providers (not the insurance company who pay)

So I'm in favor of screws to the insurance providers, insurance providers have no business making any decisions regarding providing health care to the people they insure, that's what the doctors and health care providers are for--the insurance companies need to just pay out, and then statistically determine if they need to raise premiums based on the costs.

Or health care administered by politicians who are directly accountable to the public.

I'm not sure where healthcare "rationing" comes into play. I am sure that becoming sick or injured in Canada will never destroy a family for financial reasons. Didn't I just read that over half of American personal bankrupcies are due to medical bills?

The family may not be financially destroyed, just emotionally when a sick person in Canada is no effectively treated and dies because the rationed money and resources are allocated from a single person with a serious case over to multiple people with less serious cases.

IF all you had was a finite amount of money and resource due to something other then the government's budget, I would say that is a sad reality, but fair.

However, if those resources are simply due to group of bureaucrats decisions, then it's just sad and it's not fair.

The terminally ill, elderly, or medically risky might have a very different opinion.

My sister has a form of brain tumor, she says talked with many patients in support groups from Canada and the UK who have to come to the US for treatment (at their own cost) because the health systems there don't have enough equipment, specialists or desire to keep people with her condition alive because of the success rates--meanwhile she's not only survived, but actually thrived over the past 15 years since her diagnosis, all thanks to her will and the care available here in the US.

I think the worst part is the lack of equipment she described--people having to drive hundreds of miles to get an MRI at a major city hospital that could be done at any US hospital or even outpatient testing facilities here.

The answer from all three executives:
"No."

Each one of them should burn for that type of statement.

It really is disgusting--it would be one thing if insurance companies are on the brink of collapse due to "unintentional fraud", which I guess could be defined as forgetting to give complete information, or accidentally providing mistaken information, but if any of them has a salary over 6 figures and they would support their company denying people coverage when they need it, then they should be sick over the methods used to support their gains.

We're not talking about someone not getting a fancy car, or having to pay back giant credit card fees, whatever... we're talking about medical treatment.

@catastrophegirl - brand new homeowner: I work customer service for a medicaid company. I can't answer for every state, but the states I do handle all cover insulin pumps. In fact there is a lot of things that medicaid covers that you wouldn't expect.

Exactly. I used to work in a company that dealt with Medicaid and I saw how much those products cost. Do you know what the most expensive item was? Wheelchairs. They cost anywhere from $5,000 to $30,000, depending on the size/accessories. The price breakdowns were crazy too; the wheels were a few hundreds dollars, the seats themselves sometimes had to be made to fit someone specifically, so those were an insane amount (and they charged extra if you wanted to sit on a comfortable material), and they even overcharged on simple things like the screws and basic hardware.

Because it has the word "socialism" in it and everyone's knee jerk reaction is to freak out about Communists and terrorism.

I'm not sure where people get the idea that socialized medical care is bad.

The way is see it that Americans can have quality care for every single citizen for less cost than what insured people have to pay.

People often use the Canadian system to demonstrate the horrors of socialized medicine. Sure we have a few gripes, mostly about waiting times. But this has a lot to do with our government cutting medical school capacity years ago. The US has also drawn away much of our medical talent due to the much higher earning expectations there. We simply have a shortage of practitioners. Otherwise the system works very well for everyone.

I think of my rambunctious childhood and my many trips to the ER. I likely would have destroyed my family even if we had private insurance. I think the biggest inconvenience we ever experienced in my family, after dozens of ER trips, was having to call a cab to get to the hospital because my injury wasn't urgent enough to require a $300 ambulance call.

When Canadians tout their healthcare system it is not gloating. We really want to see all Americans be treated as well as we are. There are just so many heartbreaking stories about the uninsured and insured alike coming from the US.

I agree that "high risk pools" (the Republican proposal) could do that, because they would dump the unhealthy people on the taxpayers. I don't agree that that would necessarily happen if there were a public option open to everyone (healthy or unhealthy). Then the public option would also be attractive to healthier people, if it were cheaper than private insurance and/or offered better benefits (and it very likely would be, since it wouldn't have a need to turn a profit and would only need to break even and maintain solvency, and because it could benefit from economies of scale and increased negotiating power). But you're right - it needs to be carefully designed to prevent adverse selection. This is a major reason why I favor single-payer healthcare reform over the public option style-plans. But the public option may be the best we can hope to get, politically.

The first thing we do is kill all the insurance executives.

Rep. John Dingell (D-Mich.) said that a public insurance plan should be a part of any overhaul because it would force private companies to treat consumers fairly or risk losing them.

Dingell is full of shit. They treat healthy customers "fairly". They'd only be at risk of "losing" their sickest customers, which (surprise!) they're already trying to lose.

Private insurers are probably hoping that the government opens up a "competing" insurance company that won't turn anyone away. Makes it easier for private insurers to continue cherry-picking the healthiest for their premiums, while passing the costs of treating the sick to the public sector.

In short, it's looking to be another instance of corporate welfare: the government spreads the risk across the public as a whole, and a select group of corporations will reap all the profits.

The insurance companies have the right to deny coverage to people who they can prove intentionally defrauded them. Anyone else who accurately filled out the pre-screening questionairre or who passed a required medical exam should be exempt from having their insurance cancelled for any reason except non-payment of premiums.

@Esquire99:
Why does anybody respond to this disingenuous FRAUD when he/she posts?

@smileboot:
Amen.

this weekend i counted up all my insulin pump supplies, syringes and glucose test strips that i've been hoarding a couple of months worth "just in case" something happens to my job - there's about $5k in the linen closet and $500 worth of insulin in the fridge. and it might get me through three months in an emergency if i'm REALLY careful with my infusion sets.

if i had no insurance [and there weren't government programs for uninsured diabetics] i wouldn't be able to afford to stay alive

I live in Canada and the government does run my healthcare. For my part I have never had to do anything more than show my health card, ever. I've never had to phone the government. Never had to fill out any forms. Never had to wait for reimbursement.

All of my health care issues are dealt with directly between myself and my healthcare provider. That could be my GP, any walk-in clinic I choose to visit, emergency room, etc.

It's very comforting to know that my health is always priority number one. There is no profit driven middleman (or two) trying to provide me with the least expensive, or no, option rather than the specific treatment that I need.

Frankly I am truly shocked that Americans allow themselves to be treated so poorly. I think that your pets might have more legislated health protection than you do.

It wouldn't be perfect, but it'd be way better than what we have now.

Where I live, in BC, Canada, there's a law in relation to life insurance (maybe other kinds as well, not sure), that states that if a policy has been in effect for two years, it doesn't matter if there's misrepresentation on the part of the insured; if the insurance company didn't do its due diligence then it is bound to abide by the terms of the contract. At least, I think that's how it works, and it doesn't apply to cases of out-and-out fraud. Someone who knows better can correct me!

It seems that some similar law would help this situation, if there's not already one.

@Sunny Yeung: Even simpler... Just blow off the Insurance Comapnies.
Pay the equivalent of your premium into your own savings account at the same frequency that you used to pay the premium.
1) You are not missing the money.
2) You get to pay cash for your medical problem (no-one refuses cash).
3) If I were a woman, I would now have enough money to get my breasts enlarged, because I flicked off my insurance company years ago, and have been saving the premium into my own "health fund".

@johnva: I agree with some of your points. But doesn't Medicare take up something like 16% or 17% of the federal budget (from memory). Maybe the answer is more of a why does it cost so much rather than how do we pay for it. What if we treated medical care more like buying a car or burger? If it were completely private/free market system it would be our responsibility as the consumers to find the lower cost providers. I would love to see a menu with services provided at x in the lobby. :-) Between that and baseless lawsuits I bet insurance companies could save a boat load. I don't want this to seem like an argument in favor of anyone, this post proves the insurance companies have no soul.

God forbid Americans help Americans anymore. Certain parties have sold it hard that helping others from your dime is criminal, and that they are only poor or needy because they expect you to pay for it.

No one EVER wants to be poor. But in this country not only do we have utter disdain for it, but people out there want to make it outright criminal to not have money.

even after taxes they pay far less for health care then we do, get the highest quality healthcare in the world, have little wait time for even elective surgeries and spend LESS than we do with private insurance. Maybe our government cant run it but we can bring in someone from the outside who can.

They have tried this, it never works though because the system is designed from the getgo to be against the recipient and for the provider. Its like Vegas, sept your life is literally on the line.

Heck most companies make it VERY easy to dispute, only to deny it again and again to the point you cant dispute it anymore.

And when the government runs things right, it really works well no offense. NJs DMV was a nightmare while it was privatized. The Government stepped in, took it over and its a night and day difference from what it was. I haven't even waited in a line in the years since they took it over. When I first got my license when it was privately owned, it took me 4 hours to even get my photo taken, they had a queue over 100 people long.

I know what a preexisting condition is, thanks. The problem is that LIFE is a preexisting condition. I, along with millions of other people, was born with a genetic illness. So I get discriminated against by insurers. I understand perfectly their rationale for wanting to do this instead of just charging everyone the same and dividing up their total costs (so they can be more competitive, and more cynically, so they can dump the "expensive" people on the taxpayers and skim extra profit). I just think it's unjust and wrong from a human rights perspective and no different from treating people differently based on the color of their skin. This is why I think that if we actually care about providing healthcare to all, we need to ditch private insurance as the model we use to do that.

I understand why they do it. I just think it's wrong.

I've lived in Japan for 20 years so I know firsthand about the shortcomings of such systems. However, I also know that no families go bankrupt if someone in their family develops cancer or needs a heart operation. I also know that no one is ever refused coverage because of preexisting conditions.

The bottom line is that the private vs. nationalized medical care issue is a debate between the haves and have nots. Those that are covered would rather not surrender their superior coverage so that those who have nothing or poor coverage have an average level of care. Sacrificing having the best for yourself so others aren't in a very bad situation isn't easy, but it is better for the culture and society on the whole.

@Esquire99: The funny thing is, healthcare is expensive for 2 reasons. 1. It is a necessity, and 2. people don't pay their bills.

One of my accounting professors was the head accountant for a large hospital chain, she said their "acceptable loss" was between 40 percent for their ER. that means, 4 out of 10 people who come in, will not pay their bill, so they would charge the other 6 extra to cover the cost of the 4 who didnt pay.

But it seems we mainly agree; my point was that the problem is caused by the fact that our system is set up so that if you don't have health insurance, you're totally screwed. Providers all charge you like 3-6x more if you're uninsured than they charge the insurance companies (this is partly so that they can get the insurers to pay a reasonable amount after they negotiate down), a totally unfair and inhumane situation. And when a single illness could cause you to incur hundreds of thousands or even millions of dollars in costs, you're even more forced to have insurance if you don't want to lose everything you have and end up on welfare and Medicaid. The problem is not so much insurance as it is the fact that we've made insurance the only way to access health care unless you're super-wealthy.

Medicare's not perfect (in particular, its reimbursement rates for doctors need to be raised to be more reasonable), but it's a lot better than private insurance in controlling administrative overhead.

Yep. I kind of hope these asshats are arrogant enough not to shut their damn mouths :)

@suva: Because they can make a buck is why many work in health care. I believe health care should be 100% private, however we need to make simple provisions for people to effectively dispute a bad decision. I would even be in favor of "very limited" assistance for the presently uninsured. I dread the day the government runs health care in any form. (DMV, road construction, I could go on and on) Even if it is removed from private hands someone will always stand to benefit, either through bribes or contracts someone will make a buck. I don't want to start a flame war. That is my opinion as intelligently as I can put it with as fatigued as I am right now.

I don't know why.

Profit driven health care where your health is the very last thing that your insurance provider cares for.

Or health care administered by politicians who are directly accountable to the public.

I'm not sure where healthcare "rationing" comes into play. I am sure that becoming sick or injured in Canada will never destroy a family for financial reasons. Didn't I just read that over half of American personal bankrupcies are due to medical bills?

Besides, who wants to do something basic like go to the hospital to deliver a kid and have to think about how fast we can get the mother and kid out of there because it's costing so damned much.

I think everyone can agree that increasing funding to the US system would not help anything.

I would rather not have our health care go the way of Canada because of a bunch of dumb ass executives not realizing how the winds are blowing.

My sister was just in the hospital for kidney stones and instead of trying to get her well, we're worried about paying for it all and all the specialists and meds. :(