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Will we really be better off?

Janice
14 years ago

Here's an article to read, before we get too excited about the 'change' that is coming

especially if we're already on Medicare or on our way to it!

Here is a link that might be useful: Doctors on overload, now--and then!!

Comments (9)

  • cyn427 (z. 7, N. VA)
    14 years ago
    last modified: 9 years ago

    Sadly, the issues he anticipates are already a problem. My health insurance has refused to pay for the pathology lab's charge when a suspicious mole was removed (an extra $125 out of our pocket). They refused to pay for the anaesthesiologist for my colonoscopy despite the doctor's repeated attempts to get them to do so (almost $1000 out of my pocket-I'd like the insurance co. CEO to have that procedure without meds). They did not cover all the costs for a mammogram (another several hundred dollars). My parents had private insurance in addition to Medicare and thank goodness for Medicare. We never had any problems. Always went to their own doctors and none of the doctors seemed to have issues with the government program either. The VA (another government-run program) was also terrific to my father, although he quit going once we took his keys away because it was not nearby. So, that is my long-winded way of saying it may not be as bad as many are painting it. It may even improve things if there is a public option which offers people a choice.

  • cyn427 (z. 7, N. VA)
    14 years ago
    last modified: 9 years ago

    Oh, and I am not sure that I would want a surgeon who complained about cleaning procedures before and after an operation. No desire to go back to the days of rampant infections that killed the patient after a successful operation. Also, not sure how that would be affected by health reform.

  • hostarhodo
    14 years ago
    last modified: 9 years ago

    I do not understand. What kind of a colonoscopy did you have? When I had mine done, I had to take the prep for 2 days before, than again that morning, and off to the hospital. Waited, answered questions, waited some more than it was my turn. The doctor did his thing, said I may feel a bit, awake and talked to the nurses and the doctor during the procedure, it was nothing. All done. Had a bit of a upset stomach and diarrhea for a few days, then all was well. No out of the pocket cost to me, no anaesthesiologist in sight. Thank God Canada has medicare. Yes we have high taxes. Are you sure you need the drugs for just a simple procedure, or do they do a good job of selling the patients on the facts that they need all of that, just for the money.

    Also mammograms do not cost us anything.

    Sorry, I apologize, but something sounds fishy, unless your colonoscopy procedures are a lot different than ours.

    Betty

  • cyn427 (z. 7, N. VA)
    14 years ago
    last modified: 9 years ago

    Lucky you living in Canada. Nice to hear confirmation that those decrying your system are wrong. Not sure about the colonoscopy, but the teaching hospital where our doctor is based made the decision. It was my first, so I have nothing to compare with it. I doubt it was anything fishy as Georgetown is a very good hospital here in the DC area. Perhaps they give the light anaesthetic in anticipation of having to remove anything they find (which they do immediately) or just to keep the patient from moving-don't know. It was not heavy sedation at all. It might not put most people out, but I am easily sedated. I will ask about it when I go for my checkup in November. The prep they use only required drinking it the afternoon and evening before the procedure-very effective apparently-disgusting to drink. Had no ill effects at all afterwards.

    As far as the mammogram, Georgetown's Lombardi Cancer Center/Betty Lou Ourisman Breast Health Center now uses digital technology which is apparently more accurate. At any rate, they prefer it. My insurance, however, won't pay for that. Hmmm....so with our present system, in both cases, my doctor is not permitted to decide what is best for me, but rather, the insurance folks do that.

    I think Canada has it right!

  • Janice
    Original Author
    14 years ago
    last modified: 9 years ago

    It is my understanding, from a news interview about 8 wks ago that Canada's health system is imploding!!!
    Those were the words of the head of their system--can't remember her name at this point!

    There's a link (below) that seems to confirm it!

    Cyn, it looks like you have an insurance plan that does not benefit you that well!
    And, I have to agree, my colonoscopy was without discomfort or eventful at all!
    I went into it with trepidation, but if all my future procedures will be like the last one,
    'no worries' here about going through it again. I was fully conscious and able to watch the monitor!

    I have 'Golden Rule' under United Health Care. I love it! I have a $1,900 deductible, which is met
    pretty quickly with some of the prescriptions I have. After that, everything is paid for, in full!
    The plan costs me $275 a month.

    Last year, I had tests that amounted to about $45,000 billed, but were paid for by my insurance.
    Had I not had the insurance, we would have been 'up the creek'!

    Hubby's Medicare Advantage, which Obama will get rid of and will take over half of the benefits he
    currently has away! We've been very happy with his plan, as well!

    Medicare Advantage is from a private insurer and costs the same as the government plan but is a much
    better plan--with many more benefits! That will end for us and any others who have chosen this option,
    thus far!

    We've also been able to use our HSA, health savings card to pay for medical expenses during the
    period our deductibles have not been met. This has been a tax-free option. This will also be taken away
    by Obama's administration!

    Do I believe a plan that none of those voting for it have read, will be a better system for most of us--no way!!!
    And, how irresponsible and absurb to think we CAN trust those who have so little concern for those 'details'
    so as not to take the time to read it through, themselves, before endorsing it for the rest of us!

    If it were such a good plan, then those with the governmental Cadillac Plans would be willing
    to give up what they have and get on the roles like the rest of us will be forced to do!

    It should be required of the 'gander' what they think is good for the 'goose'! And, it should be the
    law that it is!

    I am not optimistic about our health-care future--at all--can you tell?

    Here is a link that might be useful: Canadian Health Care in Crisis

  • Janice
    Original Author
    14 years ago
    last modified: 9 years ago

    While seeking to find out who the woman was I heard say the Canadian system 'is imploding'
    I found this interesting video and article below it, too!

    Here is a link that might be useful: 'Access' is the problem in Canada

  • hostarhodo
    14 years ago
    last modified: 9 years ago

    As far as access to healthcare in Canada, the major problem is the shortage of doctors and nurses. Most doctors specialize in their fields and the younger ones want to live close to the cities, where they have access to the "finer things in life", such as entertainment, shopping, etc.

    The medical staff in most areas are getting close to retirement age, and there is just no one to replace them.
    Years ago there was an overload of nurses, they displaced a lot of them, some went into office positions, created new fields. Diabetic clinics, Victorian Order of Nurses, Pallative Care, Nursing Homes, plus many more all headed by Nurses who used to work in the hospital and such.

    All those things are great, needed and are good services, but hands on nursing suffers, plus all the nurses spend more time doing paperwork then ever before, checking monitors. So much for computers and equipment saving time, nowadays everything has to be documented to cover your butt.

    Our outpatient dept is closed a lot these days because of the doctor shortage. Isn't it amazing how people think doctors should work 24hrs a day. Bet those same people do not work on their so called days off, let alone overtime.
    I worked at the hospital for 30 years and I tend to defend the doctors and nurses because I have seen how many hours they put in.

    My daughter had a problem with a cyst a few weeks ago. She went to the doctor and the next day she was at a hospital 1 hr away for an appointment with a specialist. Now that was service.

    Less than 2 years ago my Dad had circulation problems with his legs, took him to the Doctor and on to the hospital 1 hr away to see the specialist who said it looked like amputation was inevitable, that was Friday afternoon. Friday midnight Dad was in a hospital 2 1/2 hours away.

    Sometimes the system works. For some it doesn't.

    Betty

  • cyn427 (z. 7, N. VA)
    14 years ago
    last modified: 9 years ago

    I think that is the truth to everything, Betty. Sometimes it works and sometimes it doesn't. Our Medicare Advantage (which my parents had) was supposed to lower costs, but according to the AMA and MedPAC (independent) it has not. The gov't subsidies to Medicare Advantage goes toward increasing the private insurance company's profits for shareholders rather than providing expanded benefits. The Wall Street Journal reported that 23% of United's total revenue comes form medicare Advantage. No wonder the insurance companies want to keep it. There is also no definitive evidence that those with M.A. receive better quality care than those in the Fee-for-Service traditional Medicare. Which benefits exactly will be lost, Janice? I haven't seen a full accounting and I am interested to hear. There are many people who cannot afford any insurance at this point, those who fall between the cracks-not poor enough for Medicaid, but unable to afford a $1900 deductible plus $275 each month. Our insurance is actually not too bad (husband works for the government-bureaucrat, not elected, so not a "Cadillac" plan), but it does not always cover cutting edge technology of which there is a lot in the DC area. Still, there are things I think should be covered that aren't. We may switch plans. He has two plans from which we can choose.

    Unfortunately, reform should have been put in place years ago, but it was blocked every time it was brought up. Now, the president is dealing with that, the inherited economic mess which could have been (would have been according to most economists) a depression like that in the 30s, and a deficit run up so high by a war that was not ever included in the budget that our grandchildren will be paying for it. I think he is doing pretty well and I am hopeful that we will end up with something better than the current situation. It won't affect most people, but it sure will help many.

    I do agree that our reps need to read what they are passing!

  • Janice
    Original Author
    14 years ago
    last modified: 9 years ago

    Sorry it's been so long but I've been VERY busy these past weeks!!

    You know, the MESS we are in right now, is so very complicated! The problems we have did not come about overnight,
    and are not solely the blame of one party or President or within the past few years. They have been mounting for many,
    many years and are far beyond what is being discussed these days.

    But, the problem, as I see it, and am guessing regarding the lack of doctors in any government-run health-care
    system is that without a promise of monetary reward for services provided, many of our young people
    will see no advantage of incuring serious debt, to be educated for a field that is and will be
    lacking the incentive of 'significant' income. It's the way it is! Real life, tells us that unless
    someone has a 'carrot' dangling to spur them on a very hard course, they will settle for medicority,
    since it's the easier course.

    Most physicians, enter the field in horrendous debt because the extended years of their required
    education. Not ALL doctors are living 'the dream' of financial wealth, at least not early on.
    If they 'seem' to be, it is most likely that they are living in increased debt to have the lifestyle
    they want to project indicating 'success' they hope to achieve, but like many in our culture today,
    are living WAY BEYOND THEIR MEANS.

    Those who are now in the system as doctors who have been in the saddle for awhile, are already
    scheduling stacked appts., where 4 or 5 persons are coming in at the same time. Most are seeing
    Physicians assistants when they do finally get in the examining rooms and will only see the
    physician if it is an extremely serious situation! It's how they are already preparing to handle
    the reduced income they will experience with a government plan, hoping to increase their profit by
    doubling and tripling and more their patient load on any given day.

    As far as some of the benefits or 'advantages' of our Advantage plan we will lose, there are a few of the comparisons
    that come to mind. But, we have a THICK book on our benefits as compared to regular Medicare, and unfortunately
    I just don't have the time to relay all of that to you on this forum. You can go to Anthem's Medicare Advantage
    site and read what they have to offer, if you're interested--we're very happy with our plan through them.

    Here are some of the comparisons of Medicare Advantage to government run Medicare:
    Better co-pays, i.e. $30 for specialist and $15 for primary care as compared to 20% of the billing under Medicare.

    With Medicare Plan D you pay extra for a drug plan, above the $97, and a deductible amount along with copays
    while with the Advantage plan it is included at no extra charge, (under the same $97 deducted from SS check) with
    a copay as well!

    With Medicare Plan D (drug plan) you have a deductible but not with Med. Ad.

    Medicare--Covers med. and hospital cost depending on which of the plans, A or B you choose.

    With Med-Ad you have all plans under one head, with lower over-all costs, not sourced out with separate entities
    you have to deal with and having add'tl paper work and costs involved.

    Free gym membership at the YMCA included with Med-Ad.!! Now, if hubby COULD only use it,
    it would be wonderful!!!