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Index » Regional/Local » USA/Canada » Health Care Page: Previous  1, 2, 3 ... 263, 264, 265, 266  Next
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OlderThanDirt

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Location: In Transit
Gender: Male


Posted: Oct 31, 2008 - 12:23am

 BlueHeronDruid wrote:

She's struggled. Had her own health issue in the midst of it. Decided to only practice what she likes about medicine. Took a few years, but the practice is growing. By no means a rich woman, nor one wanting or needing to be.
 
I really don't know how the "Boutique" docs are doing, but I see a good possibility that the Pebble Beach/Carmel patients could make it quite profitable.  Until the docs overpopulate themselves.  The next level down are the "we don't accept Medicare payment" docs, who think (maybe rightly so) that Medicare does not pay them enough.  I don't know of any but the "boutiques," though, that don't accept any kind of health insurance.

Hey, past my bedtime.  Talk to you later.  {#Hug}{#Sleep}

Alchemist

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Location: San Jose, CA
Gender: Male


Posted: Oct 31, 2008 - 12:06am

 Alt-Ctrl-Tom wrote:

I'm with ya.  I quit my soul-destroying corporate senior management job 20 months ago, and continued the insurance out of my pocket for 18 months.  Then, while going through a budgeting exercise a few months ago to see how I could stretch my dwindling savings further and continue to avoid/postpone returning to a "career" that I had come to despise, I decided to cease being insured. 

The primary reason: my monthly insurance cost me more than my mortgage.  It was the single largest expense: more than shelter, more than food, more than utilities, more than transportation, more than entertainment (cable tv, DSL internet, music purchases) - more than any two of those combined.  The singular ridiculousness of that fact - mostly just in case I get horrifically ill/injured - caused me to cease my insurance coverage.  I only wish I had done so sooner.

So, I'm now marginally employed in a part-time job that has the beauty of an absolute lack of management responsibility, corporate bullshit, corrupt impossible and  irrational executives, and dishonest self-interested ladder climbing weasels - though unfortunately it has me not making enough to cover the cost of living - and now I'm among the uninsured. 

Sure, if something horrific happens, and I'll be wiped out - but if I'd continued to purchase my own health insurance to address that risk, my complete insolvency would've have been a certainty.  So, I'm uninsured and fine with it.  Fucking crooks.
 
Though if you're wiped out then you'll have free health care - rather a perverse system!

I knew a guy once who was an adrenaline junkie - hang gliding, motorcycle racing, you name it.  He made over $100 an hour (20 years ago) consulting but couldn't see any reason to buy health insurance - he knew the hospitals had to treat him if he darkened their doorstep.  Which he had occasion to do on more than one occasion.  I think of him when someone claims 47 million Americans have no "health care", rather than "health care insurance".
BlueHeronDruid

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Location: planting flowers


Posted: Oct 31, 2008 - 12:05am

 OlderThanDirt wrote:

Just curious.  Those started around here about 5 years or so ago, and a lot of people we know had to find new doctors.  I've wondered how it is working out for the doctors that went that route.  My guess is probably pretty well.
 
She's struggled. Had her own health issue in the midst of it. Decided to only practice what she likes about medicine. Took a few years, but the practice is growing. By no means a rich woman, nor one wanting or needing to be.

OlderThanDirt

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Location: In Transit
Gender: Male


Posted: Oct 31, 2008 - 12:01am

 BlueHeronDruid wrote:

Nope.
 
Just curious.  Those started around here about 5 years or so ago, and a lot of people we know had to find new doctors.  I've wondered how it is working out for the doctors that went that route.  My guess is probably pretty well.

OlderThanDirt

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Location: In Transit
Gender: Male


Posted: Oct 30, 2008 - 11:56pm

 NoEnzLefttoSplit wrote:



exactly, who needs doctors?

 
{#Lol}  Actually, it was in a small hospital about two blocks from where we lived, L was born in a larger hospital about 12 miles away.  Her mom remembers the bill being somewhere around $50.  No one we knew had health insurance in those days, so the medical providers were limited to whatever the traffic would bear.

Yes, we can cut our insurance costs by choosing higher deductibles and co-payments.  That usually makes a lot of sense, but many people want their insurance to pay for every little case of sniffles, every scraped knee, every bottle of medicine.  That raises the costs considerably, usually more than the "nickle and dime" medical costs would warrant.  Everyone needs to  cost it out, choose a level of coverage that suits their needs most economically.

BlueHeronDruid

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Location: planting flowers


Posted: Oct 30, 2008 - 11:56pm

 OlderThanDirt wrote:

Does she also charge an annual "subscription" fee?  The "boutique practice" I referred to earlier works as you describe, also charges an annual fee of up to $15,000, depending on the level of service desired.  Hospital and prescription costs are not included.
 
Nope.

NoEnzLefttoSplit

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Gender: Male


Posted: Oct 30, 2008 - 11:33pm

 OlderThanDirt wrote:



(and that was one of the more expensive vets.
{#Lol}

 


exactly, who needs doctors?


NoEnzLefttoSplit

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Gender: Male


Posted: Oct 30, 2008 - 11:31pm

 Alt-Ctrl-Tom wrote:

I'm with ya.  I quit my soul-destroying corporate senior management job 20 months ago, and continued the insurance out of my pocket for 18 months.  Then, while going through a budgeting exercise a few months ago to see how I could stretch my dwindling savings further and continue to avoid/postpone returning to a "career" that I had come to despise, I decided to cease being insured. 

The primary reason: my monthly insurance cost me more than my mortgage.  It was the single largest expense: more than shelter, more than food, more than utilities, more than transportation, more than entertainment (cable tv, DSL internet, music purchases) - more than any two of those combined.  The singular ridiculousness of that fact - mostly just in case I get horrifically ill/injured - caused me to cease my insurance coverage.  I only wish I had done so sooner.

So, I'm now marginally employed in a part-time job that has the beauty of an absolute lack of management responsibility, corporate bullshit, corrupt impossible and  irrational executives, and dishonest self-interested ladder climbing weasels - though unfortunately it has me not making enough to cover the cost of living - and now I'm among the uninsured. 

Sure, if something horrific happens, and I'll be wiped out - but if I'd continued to purchase my own health insurance to address that risk, my complete insolvency would've have been a certainty.  So, I'm uninsured and fine with it.  Fucking crooks.

 


Is it possible to get health insurance with a high deductible in the States? I have to foot any bills up to a cumulative total of €800 p.a. myself before the insurance kicks in. As a result my premiums are down to €350 a month (still quite high but a lot lower than most). Lately, I've been thinking about raising that deductible.

What I like about the idea is that it avoids a huge amount of paperwork for all concerned and that is what saves money.


Servo

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Location: Down on the Farm
Gender: Male


Posted: Oct 30, 2008 - 11:13pm

Alchemist wrote:
My wife is a physician, and I hear no end of the ever increasing paperwork and government mandates that interfere with her ability to help patients.
 
My PCP is leaving private practice for a hospital job.  He is citing similar reasons.  The main difference is that where you wrote "government mandates", he's saying "insurance company antagonism".

The only new government mandates that I can think of from the last decade is HIPAA.  In this age of personal information for sale, HIPAA is well worth the extra work.  But since deregulation, insurance companies seem to serve nobody but themselves.

I want assurances that Medicine is being practiced by skilled, qualified people, and not hacks and poseurs.  I want insurance to be an equitable business relationship, not a hostage situation.  I want my practitioners to see Medicine as a higher calling, and not as the road to riches.

I know that a freshly-minted MD who isn't independently wealthy has a huge tab to pay off.  Maybe that's part of the problem too.  IMHO education is the single best investment that any person or nation can make.  I believe that the society that makes access to knowledge proportional to one's ability to learn, and not one's ability to pay will see a return on investment that far beyond the monetary amount.


OlderThanDirt

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Location: In Transit
Gender: Male


Posted: Oct 30, 2008 - 10:31pm

 BlueHeronDruid wrote:

This is why my physician (and friend) practices without a net. No insurance accepted. Meaning: she can spend time and attention with her patients (who can afford to pay up front) and have only an office assistant. Her practice is growing - but not among Medicare recipients, as you'd imagine. One schedules appts. with her by the quarter-hour or more. Our insurance pays a bit towards this. But her attention is priceless. 
 
Does she also charge an annual "subscription" fee?  The "boutique practice" I referred to earlier works as you describe, also charges an annual fee of up to $15,000, depending on the level of service desired.  Hospital and prescription costs are not included.

BlueHeronDruid

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Location: planting flowers


Posted: Oct 30, 2008 - 10:24pm

 Alchemist wrote:
My wife is a physician, and I hear no end of the ever increasing paperwork and government mandates that interfere with her ability to help patients.  She says if she had known back in college how bad things would get she would have chosen a different field (and this is from a tireless patient advocate).  She read Hillary's entire health care reform screed and noted not a single clinician (a doctor who sees patients) contributed!  

The government has screwed up medicine, and it will only get worse if they seize more control.

 
This is why my physician (and friend) practices without a net. No insurance accepted. Meaning: she can spend time and attention with her patients (who can afford to pay up front) and have only an office assistant. Her practice is growing - but not among Medicare recipients, as you'd imagine. One schedules appts. with her by the quarter-hour or more. Our insurance pays a bit towards this. But her attention is priceless. 

OlderThanDirt

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Location: In Transit
Gender: Male


Posted: Oct 30, 2008 - 10:17pm

 Alchemist wrote:
My wife is a physician, and I hear no end of the ever increasing paperwork and government mandates that interfere with her ability to help patients.  She says if she had known back in college how bad things would get she would have chosen a different field (and this is from a tireless patient advocate).  She read Hillary's entire health care reform screed and noted not a single clinician (a doctor who sees patients) contributed!  

The government has screwed up medicine, and it will only get worse if they seize more control.

 

It kinda makes you long for the good old days, like 1941.  My mom told me my birth cost my parents $14.

(and that was one of the more expensive vets.
{#Lol}
Alchemist

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Location: San Jose, CA
Gender: Male


Posted: Oct 30, 2008 - 10:06pm

My wife is a physician, and I hear no end of the ever increasing paperwork and government mandates that interfere with her ability to help patients.  She says if she had known back in college how bad things would get she would have chosen a different field (and this is from a tireless patient advocate).  She read Hillary's entire health care reform screed and noted not a single clinician (a doctor who sees patients) contributed!  

The government has screwed up medicine, and it will only get worse if they seize more control.
OlderThanDirt

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Location: In Transit
Gender: Male


Posted: Oct 30, 2008 - 10:00pm

 bokey wrote:

  My dad  pays a little under $300 a month for medicare and Aetna as a supplemental, but he was an uber geek for  defense contractors during the glory days of retirement funds and has some crazy benefits, the likes of which no American will ever see again.I don't know what the same coverage would cost some guy trying to scrape up the payments out of what is left of his IRA.
 
That's comparable (times 2) to what we pay, and for what it's worth to us, I guess it's warranted.  I think I said this before, so stop me if you've heard it - my last procedure at Stanford was an outpatient thing.  Into the OR at 8am, on my way home at 1pm.  I still don't know how they justified charging almost $47k for that, but it only cost me something like $213.  And because of it, I get to live for a few more years.  I guess I shouldn't complain.


bokey

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Gender: Male


Posted: Oct 30, 2008 - 9:49pm

 OlderThanDirt wrote:

There are many doctors in our area who will not take new Medicare patients, even those with private, supplemental "Medigap" policies.   L's doctor left the group with which she had practiced for several years to start her own "boutique" practice.   L discovered that finding a new doctor that would take her was not easy, and practically impossible without the supplement.   Our cost for the supplement plus Medicare part B is about $650 per month.   Makes me wonder what all those MC deductions from our salaries are being used for.
 
  My dad  pays a little under $300 a month for medicare and Aetna as a supplemental, but he was an uber geek for  defense contractors during the glory days of retirement funds and has some crazy benefits, the likes of which no American will ever see again. I don't know what the same coverage would cost some guy trying to scrape up the payments out of what is left of his IRA.

OlderThanDirt

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Posted: Oct 30, 2008 - 9:43pm

 ScottFromWyoming wrote:




Wouldn't surprise me.  {#Lol}
ScottFromWyoming

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Location: Powell
Gender: Male


Posted: Oct 30, 2008 - 9:39pm

OlderThanDirt wrote:

There are many doctors in our area who will not take new Medicare patients, even those with private, supplemental "Medigap" policies. L's doctor left the group with which she had practiced for several years to start her own "boutique" practice. L discovered that finding a new doctor that would take her was not easy, and practically impossible without the supplement. Our cost for the supplement plus Medicare part B is about $650 per month. Makes me wonder what all those MC deductions from our salaries are being used for.




OlderThanDirt

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Gender: Male


Posted: Oct 30, 2008 - 9:18pm

 bokey wrote:

 It's abused by doctors and is difficult for the elderly to understand.

 It's far from perfect, but is a heck of a lot better then the VA ,IRS or SSA in my experience.
 
There are many doctors in our area who will not take new Medicare patients, even those with private, supplemental "Medigap" policies.  L's doctor left the group with which she had practiced for several years to start her own "boutique" practice.  L discovered that finding a new doctor that would take her was not easy, and practically impossible without the supplement.  Our cost for the supplement plus Medicare part B is about $650 per month.  Makes me wonder what all those MC deductions from our salaries are being used for.

bokey

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Gender: Male


Posted: Oct 30, 2008 - 9:00pm

 rosedraws wrote:

This is so well said.

My questions:

- Isn't Medicare a totally successful program?

- Is it really not feasible to run a National Health Care that way?

- What are the current costs to the government, brought on by the uninsured?
 
 It's abused by doctors and is difficult for the elderly to understand.

 It's far from perfect, but is a heck of a lot better then the VA , IRS or SSA in my experience.

rosedraws

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Location: close to the edge
Gender: Female


Posted: Oct 30, 2008 - 8:52pm

ScottN wrote:

United Health Care, located here in the Minneapolis/St.Paul metro. pays it CEO about $100 Million/year. Yes, I have my zeroes correctly counted. Start there. I am a capitalist; a small business owner. I believe in a free market, generally. I believe the source of the problem here lies in the inherent contradiction of having a vendor whose interest is in minimizing costs and maximizing income and profits be the source of care. No system works everywhere, and the free market has not worked here. We have public schools, libraries, roads, bridges, and on. Health care should be available to all. Gov't can legislate proscriptions and rules to avoid abuse. The idea that a free market, and competition that comes with it, will inevitably benefit the consumer has been completely co-opted in the case of health care....and we are all paying.

This is so well said.

My questions:

- Isn't Medicare a totally successful program?

- Is it really not feasible to run a National Health Care that way?

- What are the current costs to the government, brought on by the uninsured?

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