Personal Responsibility and Healthcare

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At 29 years old, I was fit,healthy, and had absolutely no foreseeable need for health insurance. I was employed with a small, local business that didn't provide what I considered to be an affordable group health insurance plan, so I purchased a catastrophic health insurance plan provided by a local hospital group for approximately $100 per month. As I was healthy enough to run half marathons and endlessly entertain my three year old daughter, the last thing I was concerned about was having a problem with my health. One evening I went to bed with an abdominal ache and woke up with severe abdominal pain. One emergency appendectomy later, I was suddenly receiving bills for nurses, doctors, hospital rooms, drug administrations, anesthesia, surgery suite rentals, an ambulance ride, etc.... You can't keep the ambiguous bills straight for even a routine procedure like an appendectomy. Luckily, my catastrophic insurance plan looked at my bills, decided what portion of the total for each bill was reasonable to charge for the procedure and then agreed to pay a percentage of the "reasonable" amount. So, my insurance paid for a percent of a percent of my medical bills....the irony here is that the insurance plan was for the hospital group that did the procedure. The overall total for an appendectomy was about $25,000, and my out-of-pocket financial responsibility came in at about $9000. I was a healthy 29 year old in and out of the hospital for an emergency surgical procedure in about 8 hours. Two months after, the only evidence was the small scarring leftover. I'm currently a 32 year old fit, healthy man, but had I not had insurance my debt would have been much greater or paid for by other tax payers. If republicans had their way and I had not had insurance and the hospital could have refused treatment, I would be dead.

Recently, my brother sliced his hand wide open on a drinking glass that broke in the sink while he was doing dishes. Being without insurance he refused to go to the hospital to be treated. The resulting treatments for infection and stitches were more costly than if he had just gone in for treatment, but he was so afraid of accumulating outrageous debt that he avoided the best solution.

The point is, nobody can foresee what will happen with their health. It doesn't have to be some outrageous event that causes the need for insurance, it could be doing the dishes or going to bed at night. If you don't have health insurance then you are gambling with your financial future, the financial future of your family, and the financial future of our country. This all sounds like a damn good reason to have a single payer plan that we can just have in the background and take it for granted when we need it!

jusden79's picture
jusden79
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Jul. 12, 2010 11:56 am

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Thank you for your example

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Recovering cons...
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I have no health insurance, as I am self employed and can't afford it. At 57, I thought I might need a thorough checkup. Thinking it was going to cost thousands, I consulted my sister-in-law who is director of nursing at a county hospital. I went there and paid up front for and EKG, sonogram on my abdomin, chest xrays, and blood work consisting of 10 different tests , like blood sugar, liver function, cholesterol, etc and everything was A-OK. Liver was a little fatty from long term drinking was the most serious. The whole thing cost me less than 400.00. If you can negotiate before hand and pay cash (or equivelant) most hospitals will greatly reduse their pricing due to not having to do all the stinking paperwork required of the governmednt and or insurance companies. Doctors that except medicare and medicaid cannot do that or they will be charge with fraud. So, it is the government and insurance cos. that have driven up the cost of medical care and obamadon'tcare is going to do nothing to elliviate that.

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camaroman
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Excess paperwork as a result of a For-profit health insurance system. Tell me, how does a president in a single term turn around a system that is decades and decades in development? Does he try and push through a complete reform that all uninformed Republicans will cry "socialist" over? Most Republicans can't even tell you what the definitions for Socialism or Communism actually are. Obamacare is a far cry from what we need and what I would like to see, however, when you end up in the hospital without the ability to negotiate pricing beforehand, you would be an idealistic, irresponsible fool to be uninsured.

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jusden79
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Good example..... nicely put.

delete jan in iowa
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Feb. 6, 2011 12:16 pm
Quote camaroman:Doctors that except medicare and medicaid cannot do that or they will be charge with fraud. So, it is the government and insurance cos. that have driven up the cost of medical care and obamadon'tcare is going to do nothing to elliviate that.

How many people work in the health insurance field doing billing or telling doctors they can't do X, Y, or Z? What does it cost to administer thousands of health insurance pools? What value to they add to providing actual health care to patients? Aren't they just bureaucrats conservatives sneer at as wasteful if they worked in government? But, gee, they get a free pass if they work in the private sector!

How can Canada spend 60% of what we spend per capita to cover EVERYONE while our system fails to cover 40-50 million people? Conservatives have so long been told government can't do anything right and the private sector is always efficient, that they are BLIND to the grotesque defects in our private health care system.

BTW, good luck with your lack of health insurance. Maybe when you're a bit older and your health fails, you won't be so enthusiastic about your cash-for-care days. You probably won't then be shopping around to make cash deals looking for bargain heart or cancer treatment. You'll probably want the best care. Why do I suspect, even if it saves your life, you'll then STILL curse ObamaCare!

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Quote camaroman:So, it is the government and insurance cos. that have driven up the cost of medical care and obamadon'tcare is going to do nothing to elliviate that.

Gee, are you that dense that it never occurs to you that it's people like YOU who drive up health care costs? YOU might be lucky that at 57 you're not seriously ill. But back in 1986 REAGAN signed a bill that any hospital receiving federal dollars had to provide emergency treatment to everyone regardless of ability to pay.

You can claim to be some self-sufficient healthy person today, but at 57 your odds are running out. Even as you bash ObamaCare today, I bet there's a side of you that counts on government medical care in the future.

Perhaps all those who supported universal health care should just f*ck you to all those who didn't…. your parasitic days are over.

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Feb. 29, 2012 2:19 pm

jusden79, "Obamacare is a far cry from what we need and what I would like to see, however, when you end up in the hospital without the ability to negotiate pricing beforehand, you would be an idealistic, irresponsible fool to be uninsured."

Oh, really, even if one can't afford it? My point is that medical care woukld not be nearly as expensive if the for profit insurance wasn't involved. How do you think health ins. corporation CEOs are able to make millions if not tens of millions in salaries and NEVER even see a patient or provide any type of medical service?

Pier, "Gee, are you that dense that it never occurs to you that it's people like YOU who drive up health care costs? YOU might be lucky that at 57 you're not seriously ill. But back in 1986 REAGAN signed a bill that any hospital receiving federal dollars had to provide emergency treatment to everyone regardless of ability to pay. "

FUCK YOU!!! I haven't cost the taxpayers one fucking cent in medical care or anything else. I paid for the preventative care that I responsibly took upon myself to get. My point was that doctors cannot negiotiate with their patients that do pay cash or they will face medicare fraud charges for discrimination unlike hospitals can. We spend twice as much per patient on medical care in this country than any other industrialized country in the world. Why do you think that is?

My mother was covered with medicare and the best insurance supplement to that that money could buy. She faught cancer for 2 years and lost her battle anyway? But the hospital and doctors and all associated with the treatment of cancer got their fucking money. Did it help her?NO!!!

Insurance corporations, hospital corporations, and government have all contributed to the astronomical unnecessary increases in the cost of medical care. That was my point, dipshit.

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Quote camaroman:
Quote Pierpont: "Gee, are you that dense that it never occurs to you that it's people like YOU who drive up health care costs? YOU might be lucky that at 57 you're not seriously ill. But back in 1986 REAGAN signed a bill that any hospital receiving federal dollars had to provide emergency treatment to everyone regardless of ability to pay.

FUCK YOU!!! I haven't cost the taxpayers one fucking cent in medical care or anything else.

Not yet... and it might not be ever, but then it might be a lot. I wasn't speaking about you specifically but the uninsured generally. It's called the Free Rider problem… that's Heritage Foundation's language when they proposed an individual mandate back in 1989. As I wrote earlier, good luck with your lack of health insurance. Maybe when you're a bit older and your health fails, you won't be so enthusiastic about your cash-for-care days. You probably won't then be shopping around to make cash deals looking for bargain heart or cancer treatment. You'll probably want the best care which chances are you won't be able to afford. Why do I suspect, even if it saves your life, you'll then STILL curse ObamaCare!

We spend twice as much per patient on medical care in this country than any other industrialized country in the world. Why do you think that is?
Because of all the economic parasites in the health insurance industry that contribute nothing but have to be paid? Obviously one big fix for our system is to get as many of the health care dollars actually providing health care and not being diverted to paper pushing flunkies, high CEO pay, advertising, or profit for shareholders.

Insurance corporations, hospital corporations, and government have all contributed to the astronomical unnecessary increases in the cost of medical care. That was my point, dipshit.
I could not help but notice that Free Riders are not on your list.

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Feb. 29, 2012 2:19 pm

That , I agree with. My girlfriends sister-in-law is fighting cancer as we speak. One of the treatments they wanted to give her was a series of shots ( of what I don't know). Their insurance company would not cover them because they were experimental or not proven. They cost $20,000/shot!!!

What do you think would or should happen if someone discovered a pill that cost next to nothing but would cure all types of cancer? I bet the drug companies would try to suppress it or steal it to prevent its marketing. Because I have figured out that the money in cancer is in the treatment not the cure. Why are they called Cancer Treatment Centers of America instead of Cancer Cure Centers of America?

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Quote camaroman:Because I have figured out that the money in cancer is in the treatment not the cure.
I do wish her luck.

The problem with a market approach to health care is it's a double edged sword. It can spur innovation but the desire for profit will also suck up every available dollar because there's always a market that believes that extra dollar might make a difference to extend life. It's similar with defense. There are no end of scenarios that "need" to be protected against. Soon companies and their stooges in Congress invent scenarios to insure even more funding until we're spending about as much for our military as the rest of the world combined... and even that's not enough for the GOP.

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Feb. 29, 2012 2:19 pm

So, Was I undercharged or are other people being overcharged by medical care providers when third party payers, ie health insurance corporations, government , are respnsible for payment of medical care and not the patient. And how does obamadon'tcare address that?

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Quote camaroman:

So, Was I undercharged or are other people being overcharged by medical care providers when third party payers, ie health insurance corporations, government , are responsible for payment of medical care and not the patient. And how does obamadon'tcare address that?

Hey, I'm not a fan of ObamaCare. I'm for Single Payer. ObamaCare preserves many of the dysfunctional aspects of the US for-profit health care system. My point simply was you might be healthy at 57. But that's not the same as being healthy at 17. There's a clock that's ticking. You might be lucky... maybe not. I'm now 60. Of my 5 best friends in high school 3 are dead… one from a motorcycle accident, but the other two from cancer. Of the others who survived one has MS, the other has had 2 heart attacks. Sure, you might beat the odds as I have. But the clock is still ticking... and all of us die of something. So what are you hoping for... to beat the odds long enough to make it to a government sponsored health care program called Medicare and once YOU are safe, you can then, again, bash the very concept of government health care and preach to the rest of us about the virtues of the market or your cash-for-care system?

Sorry CM, on some level you make me want to puke.

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Pierpont
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Should health care be a right or a priviledge? As it is right now and still will be under obamadon'tcare,, some get as a right paid for by the government, at taxpayer expense, while those same taxpayers have to pay for it as a priviledge to a for profit insurance corporation or face bankruptcy. Which is it.

So, was I undercharged for paying for my own preventitive care or are other people being over charged because of the third party payer system that continue to exist? And how does obamadon'tcare address that? It doesn't. Some will still get it as a right paid for by taxpayers while those same taxpayers have to pay for their own or face bankruptcy.

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Quote jusden79:

If republicans had their way and I had not had insurance and the hospital could have refused treatment, I would be dead.

If it is truly a life-threatening emergency, the hospital can't refuse treatment--whether you can pay or not. That's EMTALA. Now, as I've been asking on the other thread with workingman, if we cannot afford EMTALA, why do we have it?

Quote jusden79:

The resulting treatments for infection and stitches were more costly than if he had just gone in for treatment, but he was so afraid of accumulating outrageous debt that he avoided the best solution.

Therein lies the crux of the problem with American medicine and how it is distributed. There are some in America that could get that treatment at little to no cost to them without insurance--they are covered by government subsidies. And, the other point about government subsidized patients is that, in many (in fact, in most) cases, they are the most expensive patients. The elderly patient, the poor patient, the chronically disabled or diseased patient, the burn patient, the trauma patient, the heart patient, the cancer patient, the kidney failure patient, the pregnant patient, etc.--all of them are more likely to be covered by government than insurance right now.

There's a statistic that I have repeatedly used that is mentioned in Barack Obama's book, The Audacity of Hope--and, as I've also stated, it's a statistic that I have never seen even Barack Obama use even when the discussion was concerning universal health care. 20% of the U.S. population take up 80% of the medical budget. And, of those 20%, a substantial part of that 80% is already paid for by government. That leaves the 80% that take up 20% of the medical budget for insurance corporations to make a profit off of without having to cover the bigger part of the budget--government already does that. Thus, the collusion. And, the real pertinent point to that is that the same payer is paying for both parts--the taxpaying consumer--being double charged as America's way of (poorly) providing health care to (most of) its people--with some, such as your brother, being outliers (probably too rich to get government subsidies and too poor to afford a comprehensive health insurance policy--like many taxpaying consumers).

Is it fair? Should government be in the business of giving some people the right to health care as others have to risk bankruptcy for the same service? Should health care--NOT 'health insurance'--be considered a right? These are questions that I have been asking here in thomland for years. Some people think that I am repeating myself--and discredit that. But, in speaking for myself, I repeat myself because I haven't really seen all the issues that I am addressing being answered--by the left or the right, by the way.....

Quote jusden79:

If you don't have health insurance then you are gambling with your financial future, the financial future of your family, and the financial future of our country. This all sounds like a damn good reason to have a single payer plan that we can just have in the background and take it for granted when we need it!

Point taken. Also, consider this, the health care industry wants to overprice their services so that you will have to get health insurance. And, if that doesn't work, provide an Obamacare with an individual mandate. As has been discussed here, American health care already costs more than anywhere else in the world--up to twice as much per capita than most other advanced, civilized countries and America doesn't even do a good job covering everyone with that. Obamacare care is just going to force 40 million people to either buy health insurance--or pay a 'penalty tax'--in both cases, adding more money to the equation for both corporations and government when we are already spending more on health care than anywhere else. And, in an already strained economy, that will factor into less money for taxpaying consumers to spend on anything else. Will that factor into 'more affordable care' as the title to the legislation suggests? Despite what all the free marketeers try to say, this isn't a 'free market product'--it's a highly regulated product. And, what I have noticed with this form of corporate-government collusion (there are others--such as the defense industry and the prison industry) that isn't based on a 'free market' premise, when there is more available funding, the industry just makes more costs and charges occur....it never goes down. Plus, also as has been brought up, what's going to keep those CEO's making millions--to hundreds of millions--of dollars without seeing, or before financing, one patient? Health insurance and health care are not the same thing....

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Quote camaroman:

FUCK YOU!!! I haven't cost the taxpayers one fucking cent in medical care or anything else. I paid for the preventative care that I responsibly took upon myself to get.

You are playing the odds and at 57, you're going to lose my friend. Then you'll end up with huge bills that we will pay for. I'm really surprised that you of all people, a Libertarian, would put all of us - that have been responsible - at risk for your healthcare bill....and I'm not trying to be snarky about this either. I'm self employed too, and there are plenty of things I'd like to buy with my $400 per month insurance payment, not to mentionn my $5K per year HSA contribution, but even though I was fit as a fiddle for 51 years, I've had some health problems lately and while I've had to drain my HSA, I would have had about $20K per year bills each of the last two years. Your health clock can run out and when it does, it won't be pretty. The problem I have is not life threatening, just painful, thus I would not have the option of the emergency room, just daily pain.

An industry acquainance of mine was healthy, then got throat cancer out of the blue and I watched him wither away and die over two years with no health insurance. He managed to get some througth begging charities,and contacting his Congressmen, but I doubt he got the best he could had he had insurance and he died at 52. I'm sure his wife was left with the bills.

Quote camaroman:

My mother was covered with medicare and the best insurance supplement to that that money could buy. She faught cancer for 2 years and lost her battle anyway? But the hospital and doctors and all associated with the treatment of cancer got their fucking money. Did it help her?NO!!!

I agree, they should scale their own earnings and payment based on whether their efforts were a success, kind of like a Salesman who makes a modest salary til he cracks a good account. Obviously with Med school debt, they need to make more than a sales schumck, but ownership of a health issue, and payment based on the successful outcome or not, not just a menu of services thrown at the problem...

Quote camaroman:

Insurance corporations, hospital corporations, and government have all contributed to the astronomical unnecessary increases in the cost of medical care.

And the AMA. There are good simple ideas that could help, but they are all blocked by lobbyists....like posting prices for standard services, where patients can shop around is one.....or getting rid of the antitrust exemption for health insurance companies......or automatically giving you YOUR OWN records, X-rays, test results AUTOMATICALLy each visit so you can go to other Doctors more easily....Thom or someone said one time that in France you get ALL YOUR records on a thumb drive, each visit and you can keep all your records. Portability, where YOUR records aren't treated like they are the property of the provider. I don't kow if this is government rules or just Doctors protecting their turf....

One thing I've gotten used to is getting blank stares at a Doc's office when you ask what things cost.......I wanted to get an MRI, and to get the best deal with my HSA funds, I wanted to know how much that would cost, and my Doc's office couldn't even tell me what it cost...."You have to get the Doc to order it first..."...So I would have to make another appointment, get the Doc to make an MRI reccomendation, THEN I could get the cost.....I said forget it, I'm sure the insurance company has a database of low cost MRI providers.......HA!...stupid me!....They said they had no idea what a particular MRI would cost in my area.....not even a range....and this is BC/BS a huge insurance company........I thought it would be in their best interest to know the low cost providers....naive me......it's really no wonder the prices continue to skyrocket!...they don't care what the costs are, they just raise their premiums every year to cover it!........and I said forget the MRI!

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al3
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Jul. 31, 2007 4:01 pm

That is the problem with third party payers.

So far no one has answered my question. Was I undercharged for the medical sevices I paid for or are people being over charged in the third party payer collusion between corporations/government. Some people get medical care paid for by the government at taxpayer (your) expense, while that same taxpayer (you) has to pay an insurance corporation, with a Ceo that makes millions to tens of millions and never sees a patient or delivers any medical service or face bankruptcy. As Kerry (a doctor I know) has said many times---"20% of the U.S. population take up 80% of the medical budget. And, of those 20%, a substantial part of that 80% is already paid for by government. That leaves the 80% that take up 20% of the medical budget for insurance corporations to make a profit off of without having to cover the bigger part of the budget--government already does that. Thus, the collusion. And, the real pertinent point to that is that the same payer is paying for both parts--the taxpaying consumer--being double charged as America's way of (poorly) providing health care to (most of) its people--with some, such as your brother, being outliers (probably too rich to get government subsidies and too poor to afford a comprehensive health insurance policy--like many taxpaying consumers)."

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Why the Web of Life is Dying...

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