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A buddy of mine from Yale undergrad days went on to Yale Law and graduated top of his class. Right out of law school he got a job at Blue Cross, where he worked his way up the legal ladder to the top over a 35 year career. His sole purpose, his raison d'etre, was for his large legal department to find legal ways to DENY claims. He was very good at it apparently. When he retired, early, they gave him a golden handshake of $22 million.
I ran into him and he told me this and I asked..."How the fuck can ONE lawyer at ONE HMO receive that kind of obscene retirement bonus? His answer was, "You are so goddamned naive about how K-Street works."
Q.E.D.
Both insurances contributed to the surgery and hospitalization, but only the union policy covered prescription drugs.
The drugs over the first year of recovery would have cost about $40,000 without my union coverage.
The prescription drug policies in this country urgently need to be addressed. How can an immune suppression drug cost
$2250 per month retail and $15 a month through a union health plan? It's insane.
The family's likely to run into another painful fact of our Capitalist society, and that's court costs being borne privately. I won't go into the issues of the tort system (you've already heard the conservi-tard spiel that unlimited awards damage business, bleh), but what can kill this in court will be Cigna's legal team delaying and delaying, until the family's funds to support their legal team dry up. Since Lawyers don't work for free (or, rather a *VERY* rare few will work pro bono for the right case), it's entirely likely once they money's gone they will be too.
What I feel is needed isn't as much a revisiting of the penalty phase of tort claims, but the speeding up of the 'discovery' and Trial phases. It's intentional inflicting of emotional distress to so prolong the effort that you break the finances of already poor people, or stress them into early graves.
In addition, hospitals and critical care centers, have nurses working there as independent contractors. So any mistakes by them don't implicate the hospital.
No advanced civilization, no self-described 'christian nation' would embrace profiting on sickness and death. The US is #37 in healthcare and #41 in press freedom. We are not the 'good guys.'
Obama excused the telecoms for bald violations of the Constitution and in the process forever shut the door for prosecution of the bush administration for those violations; after pointedly promising just the opposite. There has not been established any reliable means to judge whether Obama will decide to 'modify' his promises or not. I am not sanguine that Obama will make a dent in such an unconscionably monstrous juggernaut as the Pharma/insurance monopoly. He will simply allow them to remain ensconced in a different, but no less string-pulling guise.
Supporter enthusiasm for charismatic promises does not translate to firm commitment on Obama's part, as the telecom and offshore drilling about-faces so clearly illustrate.
The program is still in the hands of private insurers, still adherent to profit-motive, still controlled solely by the pharma/insurance industry. Still going to cut corners on patients to save money for the private corporation shareholders.
It is dangling the "universal healthcare/single payer" mirage and giving us the same shameless corporations repackaged as 'new and improved.' They are not; they have invested heavily in Obama and expect a concomitant return.
For Obama to lead the vote for telecom immunity, to vote for an unconscionable FISA bill, and to veer 180º on offshore drilling, he's had to cast aside a host of alleged personal principles. I know not what he might do once the oath has been administered, but so far, he's come up short in standing his ground on real time issues; deferring to an abusive corporate line. It does not bode well.
There are always going to be cost/benefit issues with any health care system.
I think prisons have health care. So if you get cancer.........rob a bank.....if you don't get caught you can buy health care.....if you get caught, they lock you up then you get health care, food, and a cot.
It is a joke and the whole system is about not delivering healthcare or coverage for its customers. Yet the people I talk to in this little town all shake at the thought of a Universal program cause it is socialist don't you know.
When I get sick, when I need surgery, when I need emergency care...I am always looked after, with the best of care, hospitilization, & prompt treatment according to my ailment.
With illness or disease, one obviously worries about being ill, how it will affect one's life and work and family...the one thing I have never, in my 50 odd years, had to worry about is putting out money for receiving health care. Oh, well, except in the last few years, for the odd doctor's note, but that would be it...and trust me, I've had my fair share of illness, surgeries, emergency visits, tests, etc.
What on this good earth the people in the U.S. are afraid of in terms of having guaranteed health care for everyone...is totally beyond my understanding.
The nightmare stories I've read over the years, from U.S. citizens talking about their lack of health care, are unbelievable.
Moral issues and issues of social concern or fairness are relevant only from the point of view of the people who buy insurance. Their point of view has nothing to do with the business of the business of insurance.
All other bets are off. Arguing with them is tantamount to arguing with a stop sign. It doesn't hear you. It has no emotion concerning you. It's just business.
If that leaves someone cold, the recourse is to get active. I notice that in Athens, dissatisfied youth took to the streets. We don't do that here, we're sophistimicated and sit at ergonomically correct computer desks. We can do better. The street is right out the door!
Take a deep breath.
Fair warning...
sitemonitor
Recently had an "event" in one of my eyes. I am a diabetic, controlled by diet (that is a whole nuther story after a visit to the ER
and the shabby way I was treated in a follow up visit to the "doctor" ) But, I was prescribed eye drops to take and I did what the dear doctor told me to do. I have AARP and useless Medicare, but no prescription coverage. Cost of all the tests I had after insurance was around 250 dollars. Cost of eyeglasses was, the cheapest I could get btw, was 200 dollars. Cost of the eyedrops that last about a month and a third, is gaddam 72 dollars. New prescription because the eye pressure is still up, will cost me near 100 dollars. Wow, that is 172 dollars every month and a half. Looked it up on the WalMary pharmacy and the same ingredient is available for four dollars. Walmart some forty miles away, so called my supermarket to find out if I could get the generic. precription written for the brand name, which has an "extra" ingredient added to it, which has nothing to do with the basic medicine in the eye drops. See? Add some crap to the prescription and deny people the advantage of getting the generic. Ran out of the drops which the doctor gave me a sample on Christmas day, simply because I could not see, due to the way it is packaged, how much was left in the bottle. Called the MD to see if he could rewrite the prescription for the generic, but of course, no office on Christmas day, or the following day and so will have to wait until Monday to find out whether of not I can get the generic eye drops, so I will go four days without the drops, because there is a huge difference between one hundred dollars and four dollars and in my financial position, that is really really huge.
I am not a slough off. Me and my husband have worked all of out lives and worked hard. At this age I fear where I will end up, as I think there is more to come as I age further.
Thanks for reading
I urge you to send Obama your recommendations: http://change.gov. Click on Tom Daschle and give him an ear full.
How's about rioting, guillotines and blood running down the streets? Think that is mad enough? Of course, if we riot, they own the government and have jet fighters and bombers which they will use to fight back against our bricks, rocks and clubs. Besides, they will portray us as evil, Commie hooligans, vandals, and troublemakers, punks, gangsters, etc. who wanted to kill the good, honest, leading citizens of this nation, the real Americans who work and make America the great nation it is, whose intelligence and integrity are what keeps our industries working and keeps America number one.
One of my gut fears is that when push comes to shove, Obama is going to side with the corporatists, CEOs, politicians and good honest leading Americans of this nation.
Why don't we have universal health care via the government? The primary goal then would be the health of the American public.
I am also fed up with insurance companies and I am fully covered, dental, visual etc. As my dad always used to say "[Health] insurance companies are just rackets."
For profit health care is horrible. There should not be a profit involved in health care. Medicare's administrative costs are 3% while for profit insurers are racking up upwards of 30%. They collect your money and invest it in the market (playing the float). When you need health care they dip into their investments to pay for it. The market is in the toilet so they're restricting your coverage. Simple. Oh and they also take their profit out of it.
I urge you to lobby Congress and Obama for single payer health care for all legal residents of the U.S.
Another example is cost of AZT for HIV. Back when the drug was first developed, they tried to charge $10,000 per a dose/pill/injection for the drug claiming they needed to recover the cost of research and development of the drug which probably actually came out of university research program. Should be very grateful to those good people that they didn't ask $100,000 or a million dollars each. Of course, humanitarian motives priced it at a measly, and very affordable $10,000.
Government needs to regulate the profit of the greedy pharmaceutical companies as part of the universal healthcare program.
If we never get universal heath care the insurance companies are going to f*ck themselves out of business. They are going to be so expensive that few can afford it. They will cover so little that no one will buy. It will be quite a tight rope walk and I hope I live long enough to see them crash.
I would wager that the soldiers who were assigned the roach and mold-infested squalor at Walter Reed may have a different opinion of the veracity and viability of privatized health care providers; and while dumping homeless patients in the gutters and ignoring patients for over 24 hours in a waiting room may save bed space and insurance forms, it also reduces your attempt at sarcasm to ignorant obscenity.
The trouble is not so much a government-run program, but the incompetence in control of the government running the program. To state it another way, republicans need not apply.
At my next-to-last job, where Fallon was one of two HMO's offered, a guy I knew suffered total renal failure. The doctor told him he'd need dialysis 3 times a week. Guess what Fallon said?
"Can't you go just twice a week?"
You go twice with no kidneys, you die. All dialysis patients need to go 3 times a week.
At my current job, Fallon is our only choice and single person coverage has now skyrocketed to $67 a week (5 years ago it was $31 per week and then Mitt Romney had to get involved, mandating coverage in MA at the prices they were essentially free to jack up to the skies).
That's without dental, incidentally.
Needless to say, when premiums went up, actual coverage went down so that now anything above a splinter is considered frivolous.
Like Michael Moore keeps pointing out, HMO's make their money by denying you coverage and looking for every angle in the book to keep from doing their basic function.
Which is keeping their policyholders alive so they can continue paying those jack-up premiums.
I guess that's what passes for a bargain in health insurance, lower payments for not getting the health care you need.
Social Security disability pays a pittance (Sterling Newberry wrote a couple of years ago that our Social Security benefits would be 70% higher if inflation were still calculated the way it was in the Carter administration). Medicaid has a very high share of cost here in California--you are allowed $600/month "maintenance", and any income over that is share of cost each month. That means you pay nearly everything out of pocket or go without. Medicare has all sorts of costs, deductibles, copayments, etc, too, so I always owe my doctors money.
Just as long as we don't get another @#$%^&!!! like George Bush or any Republican of similar ilk taking over our government. If we do, all the money, probably 4 times normal would not do us any good as none of it would reach the level of the common people. Bush would embezzle most and what was left would be stolen by his crooked doctor friends like Frist.
Should add that there are also a lot of corrupt Damnocrats who would be no better running single payer, universal health care. The ways of corruption are many. Given what I've seen of the current genration of politicians, they all seem to be cut from the same stripe, both Republicans and Damnocrats, self-serving bastards who care nothing of their obligations to those who voted them into office.
"France's model healthcare system
Although the French system faces many challenges, the World Health Organization rated it the best in the world in 2001 because of its universal coverage, responsive healthcare providers, patient and provider freedoms, and the health and longevity of the country's population. The United States ranked 37.
The French system is also not inexpensive. At $3,500 per capita it is one of the most costly in Europe, yet that is still far less than the $6,100 per person in the United States.
An understanding of how France came to its healthcare system would be instructive in any renewed debate in the United States.
That's because the French share Americans' distaste for restrictions on patient choice and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine." Virtually all physicians in France participate in the nation's public health insurance, Sécurité Sociale.
Their freedoms of diagnosis and therapy are protected in ways that would make their managed-care-controlled US counterparts envious. However, the average American physician earns more than five times the average US wage while the average French physician makes only about two times the average earnings of his or her compatriots. But the lower income of French physicians is allayed by two factors. Practice liability is greatly diminished by a tort-averse legal system, and medical schools, although extremely competitive to enter, are tuition-free. Thus, French physicians enter their careers with little if any debt and pay much lower malpractice insurance premiums.
(continued)
http://www.boston.com/news/globe/editorial_opin...
They were also correct about the war.
After 10 years battle just finding insurance, in which one insurance company dropped everyone enrolled in my state, and another insurance company turned out to be fraudulent (took our payments, never made any to doctors or hospitals, so treatments were stopped), the last group plan I was able to enter was a small group in Cigna's which despite being a national company used the excuse of our small group to doubl monthly payments within a matter of years, and then finally forced me out by insisting on a $1,000 a month plan -- which didn't cover another $400 a month in treatments.
So I have no insurance, and I just refuse to open the bills from the last trip to the emergency room when I was uncovered.
First, Nataline Sarkisyan had leukemia and had had two bone marrow transplants (both paid for by CIGNA) - she was not cured of her cancer. Her liver failed due to complications from the second bone marrow transplant. A liver transplant was a long-shot for her.
Second, there are far more potential recipients of livers than there are livers available for transplant. At the end of 2007, UCLA had over 500 people on its wait list for livers - I have seen nothing to show that Sarkisyan was number one on the list. At UCLA, one-fifth of all those on the waiting list die without getting a transplant. http://www.ustransplant.org/csr/current/publicD....
Third, CIGNA did not stop UCLA from performing the transplant, assuming a liver was actually available. The hospital could have performed the surgery and sought the money later. Did they actually refuse to do a transplant until they got a guarantee of payment? I've seen nothing to imply that. It seems more likely that no liver was available.
Fourth, government health care would not necessarily have guaranteed a transplant for Sarkisyan. Under England's National Health Service, for example, she would not have qualified for a transplant because her chances of survival were too low. http://www.dh.gov.uk/en/Publicationsandstatisti...
Let's be clear about this. The American people have voted for candidates on the basis of health care for all since at least JFK. And you, regardless of party, have done nothing (except for LBJ who got very minimal healthcare for the aged and very poor--and you've worked at eroding that). Nixon promised it, Clinton promised it. Joe Biden had single-payer healthcare as his official position before he accepted the nomination for VP. Now it's gone from his website. Oh well, a good idea.
Don't blame the other party--that's a Washington sucker's game. Mugabe plays the same game in Zimbabwe, blaming Western interests for the death and destruction he's wrought on his people. We won't buy your excuses.
We have a higher infant mortality rate than Cuba--we're 41st in the quality of infant survival. Think of all the babies you've condemned to die because of your petty politics. It's a wonder that you sleep at night.
Our old people don't do much better. We're 45th in terms of life expectancy. The needless deaths of this country's citizens are on your head.
And yet your inaction has led to unbelievable waste. The US spends far more per capita on health care costs than citizens of any other country--far more.
If there were a national referendum process in this country, we'd have single-payer healthcare for all. But you refuse to do the will of the people--and yet you make us, the taxpayers, pay for your own top-notch healthcare.
Crooks. Murderers. You make me sick with your petty stupid little games to enrich yourselves and your friends. May you rot in Hell, every single one of you.
When will America wake up? I have been waiting for 25 years .....
Second, I suspect that drug costs are part of the reason many folks with MS end up on disability - the drugs seem to run $21,000 to $29,000 per year, plus doc visits (specialists!), possibly infusion costs, and of course the occasional MRI. I think all of the manufacturers have fairly active programs to try to keep people receiving medications, but they're still very expensive. Also, the drugs won't have "generic" versions because it's not really patents protecting them - they're under some sort of orphan drug protection instead.
I'm sure that you can find good and bad stories about medical insurance companies. I've never had any problems with Cigna. But, as the old canard goes, your mileage may vary...