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Author Topic: Medical question. Cut my hand open.  (Read 30524 times)
Der Helm
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Reply #140 on: August 30, 2008, 09:04:44 PM

Now that you mention it, my health insurance company wants 2400 for a whole year of insurance. Bad news being that I only make 700 per month and pay more than 500 for rent etc. You do the math.

"I've been done enough around here..."- Signe
Furiously
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Reply #141 on: August 30, 2008, 10:51:19 PM

When I was insured by one of the big three US defense contractors, I had a $5000.00 per year max and a 20/80% split for costs.

Under my wife's (Which we have to pay about $300 a year each for me and my son), I have a max $100.00 deductable.

I'm just pissed my appendics had burst before I was covered under hers. Also, if you want to get into the ER quick. Tell them you have abdominal pains on your right side and have been suffering for about 2 days.

Jimbo
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Reply #142 on: August 31, 2008, 05:22:29 AM

When I was insured by one of the big three US defense contractors, I had a $5000.00 per year max and a 20/80% split for costs.

Under my wife's (Which we have to pay about $300 a year each for me and my son), I have a max $100.00 deductable.

I'm just pissed my appendix had burst before I was covered under hers. Also, if you want to get into the ER quick. Tell them you have abdominal pains on your right side and have been suffering for about 2 days.

And you just stated the number one reason people come to the ER, abdominal pain.  And that doesn't make me want to jump up and bring you right back (there is more warning signs than just having right side pain, plus some people slip up and tell me the appendix is allready out).
Baldrake
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Reply #143 on: August 31, 2008, 07:49:10 AM

... but it caps out at around $5000...
I'm sorry, but I'm obviously rather dense and need to keep asking questions. So this means that if you have medical expenses beyond $5k in one year, you have to pay? I.e., if you get anything serious at all?

Bottom line, I'm getting the idea that if you want decent coverage, you will need to be spending at least $1,500 / month per person (either paid by you or your employer.) And that coverage is available for less, but won't really cover you if you get seriously sick. Is this a fair summary?
taolurker
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Reply #144 on: August 31, 2008, 09:25:49 AM

Speaking from example, being right now I am covered by insurance from my job, that is a deduction from my paycheck of $120 monthly. It's a decent plan, but has a deductable and co-insurance like every other American Health care plan.

In America, even if you are "covered" by insurance the patient still needs to pay the deductable first, and then after that pays 20% to the insurance's 80% of expenses after that. Usually the coinsurance cap is $5k, so after that it's sometimes all covered by the insurance, but again this can change for coverage. Max for one year is usually around $100k.

Getting sick in this county means debt, plus of course there's the massive amounts of red-tape and paperwork, hoops to jump through, or restrictions associated with the insurance. Seems the insurance profit from it, as do the doctors with their Mercedes, but rarely do sick people actually have the Medical system help them beyond terminal medical necessity.


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Nebu
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Reply #145 on: August 31, 2008, 09:52:47 AM

Getting sick in this county means debt, plus of course there's the massive amounts of red-tape and paperwork, hoops to jump through, or restrictions associated with the insurance. Seems the insurance profit from it, as do the doctors with their Mercedes, but rarely do sick people actually have the Medical system help them beyond terminal medical necessity.

Physicians are underpaid for the stress and demands placed upon them.  Some of the highest suicide rates, drug addiction rates, and divorce rates of nearly all professions.  If you think being a physician is such easy money, give it a try.

I urge you to look at two things over the past 10 years: physician salaries and increases in both insurance company salaries and middle management numbers.  The latter two will show you where your healthcare dollars are going.  Big business is driving up the costs of medical care, not physician salaries.   If you didn't know, the highest paid employee in most hospitals has an MBA, not an MD.
« Last Edit: August 31, 2008, 09:57:13 AM by Nebu »

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Lantyssa
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Reply #146 on: August 31, 2008, 10:15:32 AM

... but it caps out at around $5000...
I'm sorry, but I'm obviously rather dense and need to keep asking questions. So this means that if you have medical expenses beyond $5k in one year, you have to pay? I.e., if you get anything serious at all?
Yep. Awesome, ain't it?

Hahahaha!  I'm really good at this!
DeathInABottle
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Reply #147 on: August 31, 2008, 10:20:33 AM

Jesus Christ.  Why in hell hasn't the USA just followed the Canadian model already?  Is the HMO lobby really that powerful?
Engels
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Reply #148 on: August 31, 2008, 10:23:07 AM

Jesus Christ.  Why in hell hasn't the USA just followed the Canadian model already?  Is the HMO lobby really that powerful?

because canadians are fuckin phucken russian communists who eat babies and will spawn the antichrist. Jeeze Louise, haven't you been paying attention?

I should get back to nature, too.  You know, like going to a shop for groceries instead of the computer.  Maybe a condo in the woods that doesn't even have a health club or restaurant attached.  Buy a car with only two cup holders or something. -Signe

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Babies shooting themselves in the head is the state bird of West Virginia. - schild
Bunk
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Reply #149 on: August 31, 2008, 11:48:25 AM

Exactly...  swamp poop

As an employed member of society, I pay nothing for my health care. Gives me full coverage on pretty much any non-elective mediall procedures. I don't have a family doctor, so I go to walk in clinics. They do take a limited number of patients per day, but its not an issue if you don't go to the clinics in the slums. Walk-in visits are free generally, only thing I've ever paid was $90 for a physical. If I have a serious issue, I got ER. Went to ER once for a severe road rash incident, waited about an hour for treatment as I wasn't gushing blood anywhere. Waited an hour another time that I'd had my hockey stick cath between the boards and I butted-ended myself in the "lower abdomen". I've had two surgeries in my life and never paid out of pocket for either. My dental covers all the basics, plus 50% on orthodontics and cosmetic. Even get $200 a year for opital. We do pay for our medications, though there is insurance available to help that.

Now that being all said, we do pay more income tax. My total deductions per monthly are in the $800 - $900 range, which includes taxes, pension plan, unemployment insurance, and the 6% of my salary I put in RSPs (company matches 50% of that). Still sounds a fair bit better than $600 a month for medical insurance, that still has a deducatble.

If I where self employed, I would pay the government a monthly fee for my health coverage, it's free if you are under a certain reported income, but doesn't come anywhere near what Americans pay on the high end. This coverage is manditory, you don't have the choice to opt out of health coverage.


On a diverent note - Sky, having gone through mild sciatica in the past, I do feel for your mom. Not a lot of advice I can give unless you know what the cause is. I was lucky, I had bits of cartlidge broken away between two vertebrae pushing on the nerve, but they worked thier way out and disappeared after about nine months, so I didn't require surgery. Walked with a limp and couldn't golf for a year.

I had my sciatica diagnosed, recieved a cat scan 6 weeks later, had a consultation with a back specialist, and had return visits with my doctor. Total cost to me for those nine months was about $40 for muscle relaxants.


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Tebonas
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Reply #150 on: August 31, 2008, 12:14:46 PM

This thread really scares me. If I have a cut I walk to the nearest ER and get patched up. Never thought there could be another way, as a gainfully employed person there should never even be a thought lost on whether to see a doctor or not. Not in a first world industrialized nation!
Furiously
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Reply #151 on: August 31, 2008, 02:45:34 PM

... but it caps out at around $5000...
I'm sorry, but I'm obviously rather dense and need to keep asking questions. So this means that if you have medical expenses beyond $5k in one year, you have to pay? I.e., if you get anything serious at all?
Yep. Awesome, ain't it?

For me it meant I had to do my co-pays, but after $5K, I was covered completely. (until then I paid 20% plus co-pays).

Trippy
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Reply #152 on: August 31, 2008, 03:36:52 PM

I get coverage through the university.  Free since I'm on the plan by myself, but BCBS of Texas isn't the greatest PPO.  It's okay for things like my regular check-ups, but it caps out at around $5000, if they even cover it, so I've already been fucked by it and expect to again eventually.  If I had kids or a husband (haha) to cover, it would be several hundred more per person each month.
That doesn't sound right. What's your max out-of-pocket expense per year on your plan?
Fordel
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Reply #153 on: August 31, 2008, 07:49:20 PM

Quote
We do pay for our medications, though there is insurance available to help that.


The Govt also price controls the cost of drugs, more or less. Hence all the 'Cheap Canadian Pharmaceuticals!' stuff.




As to the ER visits, this is the part that confuses me some. My experiences with them here, are there are two levels of ER. The real ER, where the people who have stab wounds and heart attacks and the like, and the 'fake' ER, where you go wait for your stitches/shots/cast etc. Most hospitals around here also have their own walk-in clinics in my experience, for the mundane things.

Last time I went to a ER, was when I managed to 'scalp' a decent amount of skin from below my thumb, near the palm. I could see all the things that were supposed to be underneath the skin, kinda freaky. Didn't actually hurt all that much though. So yea, I was driven to the hospital, went to the ER entry way, had a nurse check out the wound, clean/bandage do the 'are you allergic to blah blah' etc. Then she sent me to what amounted to the "Please stitch up my idiotic self inflicted wound" waiting area. About 3 or 4 people ahead of me, waited maybe 45 mins, an hour. Across from us was what appeared to be "Please X-Ray my limb to see if I broke it or not" area. Was rather amusing.  Oh ho ho ho. Reallllly?


Left with a few stitches and directions to clean/bandage as required. Went to my Family Doctor to have them removed after a week or so. Could have easily went to a Walk-in as well.


My confusion is around the 'clog' between mundane and real emergencies in US hospitals.

and the gate is like I TOO AM CAPABLE OF SPEECH
Jimbo
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Reply #154 on: August 31, 2008, 11:14:59 PM

My confusion is around the 'clog' between mundane and real emergencies in US hospitals.

It is a combination factor:

Lack of insurance--for some people the only care they get is the ER.  Family doctors and urgent/walk-in clinics do not have to see a patient if the choose not to, and if you can't pay, most won't take you.  Emergency departments that receive funds from Medicare or Medicaid, have to agree to see all patients and stabilize them.  Very few emergency departments won't participate, so we all have the posters on the wall stating we will see and treat you.  25% of US has no insurance, so they come to the ER.  Of course we will send you a bill, but some people would rather just not pay the bill and deal with a collection agency and bad credit than to be sick.  We actually have stabilized on this sectors use of the ED, it is the people with insurance that have made the ED's busier.

Lack of Patience--a child gets sick and vomits and runs a fever.  It is the weekend, your doctor is closed, your kid is screaming, and you don't want to deal with it, and you want your child fixed now.  It is an unrealistic expectation that we have magic wands I can wave on a patient and make them better (I so have wanted to carry around a wand that sprinkles stripper dust and lights up, and wave it over people when they have crazy requests, but administration is a bunch of assholes who won't see the humor in it).   The people who vomit one time, so they come in instead of trying any home care.

Dispute with a doctor--this can be a chronic or acute illness or injury (chronic--long term and you have a diagnosis of something, acute means it is new), you have seen doctors for it, but you aren't happy with the treatment and want a second opinion.  How the hell a ER is supposed to give you a second opinion when you have been to specialty hospitals is another reason I need the wand...  Or it could be that they just didn't get the education from the office visit due to a lack in communication (this happens with antibiotics and how they work, or what type of home care they needed).  Lack of communication is a big issue on this part.

Population is getting older--I'm not sure the age mean any more, but I see a lot of people that are in the 40's and up, which means more stroke, heart, lung, etc... problems.  I'm also seeing a lot of people alive and warehoused in a nursing home that are kept alive at all cost, instead of letting them die with dignity.  A couple of doctors from India made the comment that we just can't let our elderly go, that we can't let them die with dignity.  Many family members request that you do all that you can do to keep them alive.  Some patients that are in nursing homes end up comatose or demented and if it was not for medical/nursing care they wouldn't be alive, but we are forced to keep them alive at all cost.

Service--Emergency Departments will have a doctor and some nurses at a bare crew even in the slowest of hospitals, they will have lab support, radiology support (including CT, Rad, and Ultrasound), and pharmacology support (meaning you get drugs now), so what might be a long drawn out visit at diffrent departments can be done in one stop, and USA'ers love convenience.  ED's are probably too successful.

Boarding of patients--you might check in and be placed in a chair or bed in the hallway, and wonder why it is so full that you have to wait here instead of normal room.  A lot of time we have done the ED part and we are waiting on a bed upstairs.  Pt's from the ER suck for getting money out of them, so the hospital isn't keen on getting them upstairs that quick, they would rather fill up on direct admits from another hospital (which is usually and established patient that has money), transfers from other surgical departments (that have scheduled and screened and know they are getting paid) or procedure departments, or anywhere but from those huddled masses that will run up a bill, bitch about it, and then not pay.  So they get stuck waiting down in the ER.  Even with states that have a patient to nurse ratio it usually doesn't apply in the ER, so instead of admitting them to the floor and letting them wait in the hallway there until a bed comes open, they keep them down in the ER.  Which screws the other urgent care (like sprains and cuts) that need a bed to get in, get seen, get treated, and get out.  We don't mind that at all, just that we have all the other shit and patients that we can't get rid of because the hospital won't take them yet.


We usually sort people on how sick they are, from level 1's who are going to die if we don't do something, to level 5's which are non threating routine stuff like, "I ran out of meds, can you write me a refill?"  Triage is fluid, and it changes from the moment you step in till the moment you leave.

Do most of you think the cost of health care is because the doctors make too much money?  I don't, I know we don't get paid enough, but the managers of healthcare and the insurance agencies make way too much and have way too much power on how things are done.  The doctors need better pay for many of the services they provide, unfortunately, preventive and medicine type problems are not paid as well as doing a procedure in our health care system.  This leads to the family doctors taking a beating and having to work a ton of hours, while the specialist have it made to make a ton of money and not work as many hours.

sinij
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Reply #155 on: September 01, 2008, 10:10:38 PM

Quote
Do most of you think the cost of health care is because the doctors make too much money?

No pharmas and insurances make too much money. Current US model does not make sense right now, when operating in ideal mode it would collect most money from the patients while delivering least possible care. The system is broken when treating people is seen as an avoidable loss.

You also can't expect market to regulate something that is seen as non-optional; dying or staying ill because treatment is too expensive is not going to regulate market because people are not willing to do it.
« Last Edit: September 01, 2008, 10:12:29 PM by sinij »

Eternity is a very long time, especially towards the end.
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