Information on working terriers, dogs, natural history, hunting, and the environment, with occasional political commentary as I see fit. This web log is associated with the Terrierman.com web site.
Thursday, July 16, 2009
What the GOP Will Not Tell You About Health Care
"Our job is not to protect the insurance industry, it's to provide quality, cost-effective, health care."
Despite all the downsides of private health insurance (and no experience with the VA, so no comment there), I don't really think Medicare has the best interest in mind for citizens, just the bare minimum. The papers and waivers the patients need to sign make no sense to them--would that change if a younger generation were reading it? For example, Medicare recommends a Well Woman exam only every 2 years and has a schedule of payment exactly so UNLESS you fulfill one of a few qualifications that deem you "high risk," such as having abnormal paps within 7 years, being exposed to DES in utero, having multiple sex partners before age 16, and a few others I can't remember. Because of the age of Medicare patients, the doc for whom I work recommends against skipping a year between appointments, because of the risk of cancer. In fact, my grandmother died of ovarian cancer because her doctor told her to not come that year...I'm sure that's not the only reason, but had she been a regular patient, something might have been caught before she wasted away in front of us.
That's just my experience...Medicare isn't the best system out there and doesn't really seem to care about the whole picture. With insurance reimbursements continuing to decline (in the 80s, as much as 75-80% of a doc's charges were paid back, currently a doc is lucky to get 15-20% of a charge reimbursed), Medicare's 80/20 plan isn't that bad, even though they won't pay for such measures as testing for a new glasses prescription.
I could go on, and I do have mixed feelings about a lot of things (as well as things I really don't know everything about)...but yes, something does need to change, although I don't know if the government's single-payer system is the right answer.
Viateco, you are pretty young, have probably not had too many reasons to use health insurance, and so are not yet too aware of the economics of old age or the realities of infirmity.
This is not to be critical, it is simply to say that for nearly everyone under the age of 35, poverty is a rumor, old age a fable, and sickness is something that happens to someone else. If you want to know about Medicare (a health care system I have been writing about for about 20 years), there is a lot written. It is, far and away, the most popular health care system in America, and the largest, and it is particularly popular among the elderly who will KILL you if you try to take it away.
First, let me ask you this one: What is the median income of someone over 65? I have been asking this of reporters and Hill staffer for a long time, and the younger they are, the farther they are from the truth. Here's the answer: less than $18,000 from ALL sources.
OK, now let me ask you what pirvate health care insurance costs for someone age 70? About $550 a month -- if they can get it at all.
I will let you do the math for rent, food, transportation, clothes, telephone, entertainment, prescription drugs (not fully covered by most health plans), nonprecription medications, cable TV, etc.
Your concern for maintaining doctor incomes is touching but misplaced. Doctors do fine under Medicare and Medicaid. In fact, they would have to: Medicare and Medicaid pay for about half of all health care in the U.S. Your numbers about doctor reimbursement are absurd and unsupported. Medicare pays as well (on average)as private insurance, and for some things better. There is not one health care system in America for Medicare and another for everyone else -- they are the same. Your local hospitals, hospices, clinics and specialists all take Medicare and Medicaid, same as anything else. No doctor takes every kind of insurance, but most doctors (and all hospitals) take Medicare and Medicaid.
I cannot speak to your grandmother, but you should know that ALL insurance plans limit coverage for "well patient" checkups. If they did not, hypochondriacs would visit every day, and doctors would rip off the system even more than they do for "well patient" visits. Health care visit protocols are written *because* it has been shown that fewer doctor visits are good medicine. Yes, read that again. It's not about money: it's about the fact that the very business of going to doctors is what causes so much illness because the doctor is not trying to treat the patient, he or she it trying to maximize billing. Read more about that here >> http://www.time.com/time/nation/article/0,8599,1908477,00.html?xid=rss-topstories
Finally, let me point out that if your grandmother (or you) want to go to a doctor more often than an insurance plan will pay for, you are free to do that. Just pay out of pocket. And, in fact, if you prefer to not avail yourself of the public health care plan to come, you can stay with your private insurance plan if you want. The difference, of course, is that as soon as you get sick with cancer under a private insurance plan, they are free to drop your coverage. Medicare is health care coverage that can never be taken away. Private health insurance, however, is predicated on a simple economic model: Selling it to you when you do not need it, and canceling it as soon as you do.
That was not critical at all. I appreciate different points of view, and you're right...I am pretty young by most standards, and fortunately have grown out of the "I'm invincible" stage, which is why I'm trying to give this a little thought. Like I said, though, I don't know everything and am glad I don't :) Which is why your questions about senior citizens are very true and given some thought. I am extremely lucky to be young, with relatively few health problems, as well as motivated enough to keep my body healthy, financially secure enough to do so to some extent, and parents that care enough and are able to help out as well as let me fail if I need to. I'm probably not quite the person to whom this whole health-care reform is directed. Medicare is indeed a GODSEND in that it can't be taken away, and can't charge higher premiums, and because of this, it really has to work with what it's given. So yes, as with everything else, it has it's many good points, as well as things that we (I?) don't necessarily like about it.
Your points are well-taken, and I'd like to respectfully disagree with one, in that I feel that the doc I work for is in the minority: everything he does is FOR the patients, not for himself. There are very few of these doctors out there now, and they are unfortunately, losing in a system that forces them to treat patients more as business clients rather than patients. Unfortunately, minorities and gut feelings about 'maximizing billing' are not researched quite as well, so I have nothing to go on in terms of studies. All I have is the experience of working for them since I was a teen, their words and actions, and those of their patients.
And I fully agree about paying out of pocket if you can to see the doc, or even paying to see a good doc who isn't in-network. It's your choice, and I can't tell you you're wrong. Would it be right to allow for one annual preventative appointment and then allotting a certain number of "Emergency" appts to prevent an abuse of "OMG my eye is red, you've seen me a million times before for this but I need seen again"? (Sadly, I did have to deal with that patient a few times EACH MONTH.) Or is that just making people save up their "bank," so they'll just ignore a potential serious problem until it's too late?
...and after reading through all that, I don't know if I responded to your post as much as I did just continue on my own soapbox from my first one :/
3 comments:
Despite all the downsides of private health insurance (and no experience with the VA, so no comment there), I don't really think Medicare has the best interest in mind for citizens, just the bare minimum. The papers and waivers the patients need to sign make no sense to them--would that change if a younger generation were reading it? For example, Medicare recommends a Well Woman exam only every 2 years and has a schedule of payment exactly so UNLESS you fulfill one of a few qualifications that deem you "high risk," such as having abnormal paps within 7 years, being exposed to DES in utero, having multiple sex partners before age 16, and a few others I can't remember. Because of the age of Medicare patients, the doc for whom I work recommends against skipping a year between appointments, because of the risk of cancer. In fact, my grandmother died of ovarian cancer because her doctor told her to not come that year...I'm sure that's not the only reason, but had she been a regular patient, something might have been caught before she wasted away in front of us.
That's just my experience...Medicare isn't the best system out there and doesn't really seem to care about the whole picture. With insurance reimbursements continuing to decline (in the 80s, as much as 75-80% of a doc's charges were paid back, currently a doc is lucky to get 15-20% of a charge reimbursed), Medicare's 80/20 plan isn't that bad, even though they won't pay for such measures as testing for a new glasses prescription.
I could go on, and I do have mixed feelings about a lot of things (as well as things I really don't know everything about)...but yes, something does need to change, although I don't know if the government's single-payer system is the right answer.
Viateco, you are pretty young, have probably not had too many reasons to use health insurance, and so are not yet too aware of the economics of old age or the realities of infirmity.
This is not to be critical, it is simply to say that for nearly everyone under the age of 35, poverty is a rumor, old age a fable, and sickness is something that happens to someone else. If you want to know about Medicare (a health care system I have been writing about for about 20 years), there is a lot written. It is, far and away, the most popular health care system in America, and the largest, and it is particularly popular among the elderly who will KILL you if you try to take it away.
First, let me ask you this one: What is the median income of someone over 65? I have been asking this of reporters and Hill staffer for a long time, and the younger they are, the farther they are from the truth. Here's the answer: less than $18,000 from ALL sources.
OK, now let me ask you what pirvate health care insurance costs for someone age 70? About $550 a month -- if they can get it at all.
I will let you do the math for rent, food, transportation, clothes, telephone, entertainment, prescription drugs (not fully covered by most health plans), nonprecription medications, cable TV, etc.
Your concern for maintaining doctor incomes is touching but misplaced. Doctors do fine under Medicare and Medicaid. In fact, they would have to: Medicare and Medicaid pay for about half of all health care in the U.S. Your numbers about doctor reimbursement are absurd and unsupported. Medicare pays as well (on average)as private insurance, and for some things better. There is not one health care system in America for Medicare and another for everyone else -- they are the same. Your local hospitals, hospices, clinics and specialists all take Medicare and Medicaid, same as anything else. No doctor takes every kind of insurance, but most doctors (and all hospitals) take Medicare and Medicaid.
I cannot speak to your grandmother, but you should know that ALL insurance plans limit coverage for "well patient" checkups. If they did not, hypochondriacs would visit every day, and doctors would rip off the system even more than they do for "well patient" visits. Health care visit protocols are written *because* it has been shown that fewer doctor visits are good medicine. Yes, read that again. It's not about money: it's about the fact that the very business of going to doctors is what causes so much illness because the doctor is not trying to treat the patient, he or she it trying to maximize billing. Read more about that here >> http://www.time.com/time/nation/article/0,8599,1908477,00.html?xid=rss-topstories
Finally, let me point out that if your grandmother (or you) want to go to a doctor more often than an insurance plan will pay for, you are free to do that. Just pay out of pocket. And, in fact, if you prefer to not avail yourself of the public health care plan to come, you can stay with your private insurance plan if you want. The difference, of course, is that as soon as you get sick with cancer under a private insurance plan, they are free to drop your coverage. Medicare is health care coverage that can never be taken away. Private health insurance, however, is predicated on a simple economic model: Selling it to you when you do not need it, and canceling it as soon as you do.
P.
That was not critical at all. I appreciate different points of view, and you're right...I am pretty young by most standards, and fortunately have grown out of the "I'm invincible" stage, which is why I'm trying to give this a little thought. Like I said, though, I don't know everything and am glad I don't :) Which is why your questions about senior citizens are very true and given some thought. I am extremely lucky to be young, with relatively few health problems, as well as motivated enough to keep my body healthy, financially secure enough to do so to some extent, and parents that care enough and are able to help out as well as let me fail if I need to. I'm probably not quite the person to whom this whole health-care reform is directed. Medicare is indeed a GODSEND in that it can't be taken away, and can't charge higher premiums, and because of this, it really has to work with what it's given. So yes, as with everything else, it has it's many good points, as well as things that we (I?) don't necessarily like about it.
Your points are well-taken, and I'd like to respectfully disagree with one, in that I feel that the doc I work for is in the minority: everything he does is FOR the patients, not for himself. There are very few of these doctors out there now, and they are unfortunately, losing in a system that forces them to treat patients more as business clients rather than patients. Unfortunately, minorities and gut feelings about 'maximizing billing' are not researched quite as well, so I have nothing to go on in terms of studies. All I have is the experience of working for them since I was a teen, their words and actions, and those of their patients.
And I fully agree about paying out of pocket if you can to see the doc, or even paying to see a good doc who isn't in-network. It's your choice, and I can't tell you you're wrong. Would it be right to allow for one annual preventative appointment and then allotting a certain number of "Emergency" appts to prevent an abuse of "OMG my eye is red, you've seen me a million times before for this but I need seen again"? (Sadly, I did have to deal with that patient a few times EACH MONTH.) Or is that just making people save up their "bank," so they'll just ignore a potential serious problem until it's too late?
...and after reading through all that, I don't know if I responded to your post as much as I did just continue on my own soapbox from my first one :/
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