View Full Version : What I hate about our healthcare system, Obamacare included
I got a call from DS29 today, asking if I had heard from his siblings that live in the same town as he does (Burlington, VT). I said, no, I hadn't. Then he started crying, saying he had fallen down a flight of basement stairs. Anyway, all's well that ends well, his siblings and friends convinced him to go to the ER because of the bump on his head and he said his shoulder hurt. They tested him for a concussion, put 6 stitches in his scalp and gave him a sling for his fractured shoulder and sent him home.
But when I was asking his brother, DS33 about this, he said, "we were all debating about whether or not he should go to the ER because he doesn't have health insurance."
I said, calmly, to my son, "whenever there is a head injury, there's no question--you GO TO THE ER!!!!" (I didn't scream, but I was thinking screaming.)
So, there are two things I can hear people thinking (and I know who you are):
a) It's ridiculous that people have to make the choice between risking their lives and paying huge ER costs
and
b) It was his choice--he's an adult--why doesn't he buy health insurance.
I guess my thought is, sure, it's easy to second guess and do the Monday morning quarterback thing, but what good is that going to do if your loved one dies because they didn't want a high ER bill? Yes, I told my son, "you know, Obamacare is there for people like you who don't make much money." But that didn't make him feel better NOW. People, especially young people, don't expect these kinds of "interruptions" in their lives.
So I told both DS33 and DS29, don't EVER put money into the equation when you're thinking about whether or not to go to the ER!!! Heck, I have so much debt now, a few thousand more isn't going to make a big difference--I'll just add it to the list!! I just kept thinking, WHAT IF they decided not to go to the ER because my son doesn't have insurance and he had a Natasha Richardson ending.
Why can't we just GO to the ER when we have to? Yes, there should be cost-sharing and we need to take responsibility for our actions, but would these choices be relevant in Europe?
I was talking to a managed care payer on a market research project yesterday and he was bemoaning the fact that because of Obamacare and the resulting super-high deductibles insurance companies are now charging (not sure Obama is to blame for that but that's an issue for the Policy board) people aren't going to the doctor because they can't afford, or don't want to pay, the deductible. So they forego the healthcare they need--an unintended consequences of the latest chapter of the dysfunctional American healthcare system.
That's just crazy. Yes, we should be responsible for our actions. But does mean we are "responsible" for accidents and acts of God?
There has to be a better way.
I had a patient die on me a few months back. He slipped and fell in his bathtub, struck his head, had a bit of a headache afterwards.
Went to bed.
His wife called us 4 hours later, because he was feeling worse.
We got there 5 minutes later. He went into convulsions as we were talking to him.
He pretty much died in the ambulance on the way to the chopper.
If you strike your head when you fall, get it checked out and monitored. Even a teeny bleed will kill you from the pressure.
I had a patient die on me a few months back. He slipped and fell in his bathtub, struck his head, had a bit of a headache afterwards.
Went to bed.
His wife called us 4 hours later, because he was feeling worse.
We got there 5 minutes later. He went into convulsions as we were talking to him.
He pretty much died in the ambulance on the way to the chopper.
If you strike your head when you fall, get it checked out and monitored. Even a teeny bleed will kill you from the pressure.
Exactly. Words of wisdom, bae.
If you choose not to have insurance, you need to own the decision - which means you're going to deal with the bills or bankruptcies or whatever if you get hurt. I don't mean that in a mean way - just that you shouldn't be making decisions like this after you've fallen down the stairs. I'm glad he's ok.
I'm glad we have the (unfunded) mandate the ER has to take you - it wasn't always that way and hospitals would shuttle around and dismiss patients knowing if they were the ones that performed treatment they were likely not to be paid. And people died. Although I'd like single payer much better.
A nice, reasonable response, creaker. I agree. A single payer system would be best, and yes, for sure I believe that one has to own the decision not to buy healthcare. I just feel that "money" and "optimum health" shouldn't be in the same sentence.
iris lilies
7-21-14, 9:14pm
A nice, reasonable response, creaker. I agree. A single payer system would be best, and yes, for sure I believe that one has to own the decision not to buy healthcare. I just feel that "money" and "optimum health" shouldn't be in the same sentence.
I'm glad that your son is ok.
I have to ask, though, why do you believe that since he pays nothing now toward his health care, the "single payer" option will continue to cost him nothing? Very curious, this point of view.
The Affordable Care Act has "taxed*" your son and he has chosen to ignore the tax. If it appears on his 1040 form, will he be any more likely to pay out?
*Thank you, Justice John Roberts for this new concept of a fee to simply exist in the U.S.
I'm glad that your son is ok.
I have to ask, though, why do you believe that since he pays nothing now toward his health care, the "single payer" option will continue to cost him nothing? Very curious, this point of view.
The Affordable Care Act has "taxed*" your son and he has chosen to ignore the tax. If it appears on his 1040 form, will he be any more likely to pay out?
*Thank you, Justice John Roberts for this new concept of a fee to simply exist in the U.S.
iris lilies, yes, I guess he will be penalized on his 1040. That's his choice. I'm typically not a mom to make excuses for my children. But, I would assume that an alternative healthcare plan might take the worry out of emergency situations. Maybe I am just using the healthcare system as a scapegoat for my own fears for my son... who knows.
I don't know. In my mind (or, as my DH says, in my little pea-brain) I envision a world where the tax base covers a very basic level of healthcare, like trips to the ER if you have an accident. But in this world, you pay through the nose for healthcare and have to make tough choices, or you don't get healthcare, and pay a penalty back to the government. Seems convoluted to me.
rodeosweetheart
7-21-14, 10:01pm
Seems convoluted to me.
It seems convoluted to me, too, Catherine. I am so sorry this happened to your poor son. I know all my kids, and I at times, have foregone medical care that we needed for the reasons you state. I am really really glad he went to the ER.
I have no position on whether he should or should not have bought insurance--poor guy, I just hope he can heal up soon.
Have your kids in Burlington thought about emigrating to Canada? It can't be that different than Vermont, right?
ApatheticNoMore
7-21-14, 11:24pm
Doesn't the ER often eat the cost if you can't pay anyway? Because I've always heard that ERs are PRECISELY the place people go if they don't have insurance, this was notorious as a problem, wasn't it, ERs flooded with the uninsured? Not that that really works either as ERs should be for emergencies, not every uninsured person with a health problem. And some of that may have changed some under Obamacare. Urgent care will also take you for cash, though it's not cheap.
What I hate about the healthcare system? Everything. Mostly the cost of health insurance. I'm pretty much resigned to in the long run ending up with junkier and junkier policies costing more and more (because that's all I've seen) - until maybe I can't afford anything eventually I guess, but that's not yet now.
mschrisgo2
7-22-14, 1:11am
As far as health "insurance" goes, when I really looked carefully at what "basic" $500/month!! ObamaCare "insurance" would provide for me, the first, oh, any where from $5000 to $10,000 wasn't covered! So, I'd end up paying the whole ER bill anyway...why fork out the $500 every month for "emergency coverage"? Just sayin'.
ERs are required to stabilize patients without regard to the ability to pay. They are not required to eat the cost if you are unable to pay, but rather can treat the bill as any other bill you don't pay, even sending it to collection agencies as needed. My step sister has had many issues through the years stemming from how poorly she's been paid for the work she does and the consequent inability to afford adequate healthcare. While she's kept collection agencies at bay by paying them $15 a month, at times, the inability to pay and its consequences have been sources of stress themselves. With ACA she's finally able to afford decent healthcare, so hopefully she'll be able to catch up with the past debts and do away with this additional, unnecessary burden.
I have to wonder about all the undocumented people here that use public hospitals to give birth. Are they sent a bill?
iris lilies
7-22-14, 11:21am
I have to wonder about all the undocumented people here that use public hospitals to give birth. Are they sent a bill?
Does it really matter? Won't they "treat the bill as any other bill you don't pay?"
Hospitals have a number of avenues they can pursue, depending on the nature of the service provided and the cause of the need. For example, if an indigent woman gives birth, the hospital of course can send the woman a bill. If the woman gives a bogus name or address, it would be handled like anyone else who gives a bogus name or address. In some cases, the credit is purchased by a collection agency, which seeks to identify and pursue payment. My mother did a lot of such investigation and collections work. If the woman is identified but has no assets nor attachable income, then they can go after the father if identified. In some cases, states have special funds for indigent care for certain kinds of situations, such as victims of crime. If the care provided can be related back to some workplace accident, then the employer can be pursued for payment. And so on.
Does it really matter?
Kind of does to me. Our property taxes now have a $250 a yr charge for indigent health care. If more and more people flood in who have no means of support, it will only go up as time goes by.
A twenty-some dollar a month contribution to the community's general health doesn't seem excessive to me. There are always taxes and charges that individuals would rather not pay, for whatever reason. I pay taxes to maintain parks that I will never set foot in, and I'm happy to do so. Maybe other taxpayers disagree. Keeping other humans alive and healthy seems like a pretty good bargain for $250.
I would be happy to pay it too if I was convinced that a good percentage are not taking advantage of our generosity.
I would be happy to pay it too if I was convinced that a good percentage are not taking advantage of our generosity.
I understand that, but how do people take advantage of hospital services? Sign up for a room because they feel like a change of scenery? Do a night on the town in the X-ray department? For the most part, unless it's real healthcare fraud, where people are stealing drugs, the only rip-offs taking place are at the healthcare services and administration level.
I envision a world where the tax base covers a very basic level of healthcare, like trips to the ER if you have an accident. But in this world, you pay through the nose for healthcare and have to make tough choices, or you don't get healthcare, and pay a penalty back to the government. Seems convoluted to me. I also envision such a world Catherine (and sorry to hear about your son - glad he's OK). Would like to see something in place that everyone has access to, and everyone pays into - in taxes and in monthly premiums that are truly affordable and not based on some convoluted income scheme, premium subsidy scheme, and very high out of pocket costs that many can't afford even if they can get heavily subsidized premiums. But for now the ACA is better then naught and if your son can get that (or Medicaid as VT has that), he probably should. I know there are probably lots of low cost plans in VT that may be affordable to him even if he has a lot of out of pocket costs IF he has to use the plan. But I agree, it's crazy to have a new system in place (ACA) were low income people don't feel that they can access the health insurance they are paying monthly fees for because they can't afford the actual out of pocket costs they must pay before insurance even kicks in. So they go without actual medical care because they can't afford it. But, in an emergency, it is better then nothing - especially if you do have some assets that can be taken or wages that can be garnished for re-payment.
how do people take advantage of hospital services?
In our neck of the woods, many women have been crossing over the border as long as I've been here with full intention of giving birth in the US so that their newborns are instant citizens.
In our neck of the woods, many women have been crossing over the border as long as I've been here with full intention of giving birth in the US so that their newborns are instant citizens.
Here in Calif Medicaid (with financial help from the Feds) picks up the tab for emergency illegal immigrant healthcare to the tune of approx. $2 Billion/year - which is mostly maternity care for births according to this Kaiser article http://www.kaiserhealthnews.org/Stories/2013/February/13/Medicaid-illegal-immigrant-emergency-care.aspx
There are also illegal "birthing centers" that are set up in homes or hotels so that wealthier tourists who come here both legally and illegally can give birth here so their child can become a US citizen. It's a form of medical tourism. Many have been shut down recently. http://www.huffingtonpost.com/2013/01/30/maternity-tourism-los-angeles_n_2578253.html
catherine
7-23-14, 12:00pm
In our neck of the woods, many women have been crossing over the border as long as I've been here with full intention of giving birth in the US so that their newborns are instant citizens.
Oh.. I see.. Yeah, we don't have a huge problem with that in New Jersey. Although there are a lot of immigrants who come here to live, we're far from the border.
Last week, I saw a billboard in Spanish with the message - "Are you pregnant? Call to see if you qualify for Medicare".
gimmethesimplelife
7-25-14, 11:19pm
I hear stories like this and my first thought is why are any of ourselves wasting our precious live energy on America - is it worth our life energy when you get right down to it to the things that are important - health care, jobs being shipped overseas so the wealthy can be become even more so -count me as one who never drank the cool aid even when things were in better shape - too many things even then just didn't seem right and I was in the wrong social class to ignore it.
My latest though? Yesterday I was had the chance to go to Mexico with a neighbor who was saving lots money picking up meds. Turns out that that pharmacy had a cream that they could offer me for all of $2 that can mimimize the appearance of my recent surgical scar. $2. I would have gladly paid this out of my own pocket. Why was I not told of this? And how do I forgive not being told this as a part of the discharge process?
I guess I am one of the lucky ones, living so close to Mexico as I do. I don't know how people muster the courage to live further away from the border and deal with US heath care. I am not equal to dealing with it and would move heaven and earth to avoid trying.
Just my two cents. Rob
Catherine, I agree it's the hospital administrations that are the rip-offs, and feel totally entitled to be doing that.
happystuff
7-27-14, 1:06pm
As far as health "insurance" goes, when I really looked carefully at what "basic" $500/month!! ObamaCare "insurance" would provide for me, the first, oh, any where from $5000 to $10,000 wasn't covered! So, I'd end up paying the whole ER bill anyway...why fork out the $500 every month for "emergency coverage"? Just sayin'.
We actually pay slightly more than $500 a month for health care (not Obama care) and I don't feel like I can go to the drs at all. I do make the rest of the family go, but I don't because *I* do the bills. My dh had what was ultimately a bout of diverticulitis a month ago and they made him get a cat scan. He then became unemployed and we just got the bill yesterday.... our portion = over $2800.00...on just the cat scan! We still have the portions of other bills to pay as well as Rx's, etc. I'm scared NOT to carry the health insurance for any possible catastrophic medical event, but I'm damn scared to use it for the catastrophic financial burden we end up in for even simple little visits.
And, no I haven't read the entire thread... just reading this far gets upsets me and feeling totally helpless. :(
iris lilies
7-27-14, 1:39pm
That's one thing among many I questioned in the wisdom of the Obamacare bill, the assumption that $6,000 deductible was simply ok/the norm for all. When the stats I saw had peopele going bankrupt for average medical bills of (I think it was) $13,000--so suddenly $6,000 is ok for everyone. Hmmm, I don't understand that because to me, there's not that much difference between $6,000 and $13,000. Even though I think that the average family with children should well be prepared to pay that much for medical care out of pocket beause I don't think $6,000 - $13,000 is catastrophic, it will keep their and everyone's costs down.
jobs being shipped overseas so the wealthy can be become even more so
I love irony, but hypocrisy not so much. Funny, the one who brags about hiring foreign workers because they cost less is... you.
That's one thing among many I questioned in the wisdom of the Obamacare bill, the assumption that $6,000 deductible was simply ok/the norm for all.There was no such assumption; it was merely the end-result of the ascertainment of what was practicable.
ApatheticNoMore
7-27-14, 2:51pm
Practicable = ok with insurance companies, drug companies, hospitals, medical industrial complex etc.. Whether 6k seems at all reasonable depends on if one has it yea, but depends on if one is sick enough that it;s not just a once in a couple decades thing but a yearly thing. It's hard to see that being reasonable.
I pay between $300-$400 a month for insurance. The cost to use it is small as it it's just a small copay for doctor visits or lab work, however I seldom do, it almost never seems worth taking a whole day off work for the type of subtle problems no physicians are any darn good at diagnosing anyway - complete waste of time. If I just need antibiotics or something then sure I'll get them.
It's hard to see that being reasonable. It is harder for some folks than for others to understand the inherently mutual aspect of insurance.
ApatheticNoMore
7-27-14, 4:09pm
Maybe you can afford 6k out of pocket a year every year in addition to premiums. It doesn't change the fact it's not at all realistic on many people's real budgets. It's easy to assume 6k "isn't that bad" if you have it AND/OR if you see it as a one time thing, but even the budgets that could afford it as a one time thing could easily get blown out of the water if they got really sick and saw a few years in a row of that.
It doesn't change the fact it's not at all realistic on many people's real budgets. So what you're saying is that it improved things for some folks, but not for everyone.
I agree.
gimmethesimplelife
7-27-14, 5:30pm
[QUOTE=Yossarian;180486]I love irony, but hypocrisy not so much. Funny, the one who brags about hiring foreign workers because they cost less is... you.[/QUOTE
The only problem I see with your post here is that if medical care ( for the most part, now that I have Mediciad this has changed somewhat), dental care and optical care were priced within reach of the masses there would be no real need for trips to Mexico. It's too bad you are not in Arizona as if we had a few hours and some receipts you might just walk away with a different take on America. Who knows? At any rate, since I love and respect myself my trips to Mexico will continue. And something that I think is really cool? We have started a neighborhood survival pool/ regular trips to flee to Mexico for scrips, dental, etc. (survival by the way was not my suggestion but the idea of the one presenting the idea at the neighborhood meeting here). Rob
gimmethesimplelife
7-27-14, 5:42pm
Maybe the wisest choice with health care, for those of us who can? To become permanent travelers - making sure one never sets down in any country with nightmarishly priced health care. I can see where this choice is not for all but there are those who do it and it seems to prevent some stress and grief in their lives. And another reason for me to remain single when you get right down to it! Rob
iris lilies
7-27-14, 6:44pm
There was no such assumption; it was merely the end-result of the ascertainment of what was practicable.
haha I think I'm reasonable for my assumption that the makers of the bill placed the deductible at $6,000 as do-able because that's what the bill says, ya know?
Next you'll be saying that the makers of the Obamacare bill want citizens who buy insurance through the federal exchange (not through a state exchange) to earn tax credits even though the bill clearly states otherwise.
Say one thing, mean another. That's hardly great bill writing and I think in this age of "we've got to pass it to know what's in it" our legislators fail big time. Vote the monsters out.
haha I think I'm reasonable for my assumption that the makers of the bill placed the deductible at $6,000 as do-able because that's what the bill says, ya know?No, it isn't. The bill doesn't provide any reason why $6,000 was chosen. You're simply wrong.
Say one thing, mean another.Read something that isn't there.
iris lilies
7-28-14, 11:06am
No, it isn't. The bill doesn't provide any reason why $6,000 was chosen. You're simply wrong.
Ah, then you must believe that the makers of the bill thought a $6,000 deductible to be not do-able by those insured (?) How odd of the makers of the bill to codify this concept in the bill, then.
Read something that isn't there.
You mean like the Virginia appeals court that read something that isn't there? That court read section 1401 of the ACA where it states that the only people eligible for financial help are those who are "enrolled ... through an Exchange established by the State under 1311" to mean that of course, people enrolled in the Federal exchange NOT established by the State can get subsidies.
I am kidding here, a little. Whether making a close literal reading or interpreting the thing, this ACA bill is a massive cluster-f**k.
Ah, then you must believe that the makers of the bill thought a $6,000 deductible to be not do-able by those insured (?) You are incorrect. That had nothing to do with how that number was arrived at.
How odd of the makers of the bill to codify this concept in the bill, then.Naively or intentionally refusing to acknowledge the political realities of the world we live in will never lead to a clear understanding about what's going on.
You mean like the Virginia appeals court that read something that isn't there?The Virginia court didn't say anything about what we were talking about, the $6,000 number.
Whether making a close literal reading or interpreting the thing, this ACA bill is a massive cluster-f**k.A necessary reality of our divided nation. For the foreseeable future (and really going back almost 15 years), there will be (has been) very little, if anything, that there will be such ubiquitous agreement about such that the result won't reflect a compromise on the merits, in some way.
awakenedsoul
7-28-14, 1:00pm
I haven't read all the posts. In response to the original post, it sounds like this was an expensive lesson for your son. When I was his age I also didn't have health insurance, either. You do learn from these experiences, though. My brand new car was totalled by an uninsured driver when I was in my twenties, and I needed to drive to work. I had to start selling things. (I owed more on the car than it was worth. I had just bought it.) Let's just say I've never bought a new car since!
I don't know how many people have savings accounts with their deductibles saved. I do, now, but I didn't get to that point until I was in my late 40's. As you get older, and you see what can go wrong, many people try to protect their assets and themselves. I'm not trying to be mean, but it's important to be responsible and have your insurance in place, and your deductibles in an account. Otherwise, you're taking a huge risk and can lose everything. 29 is pretty old. I'm sorry this happened to your son, and I'm sure it was traumatic. I hope he can sell some stuff and prevent something like this in the future.
And yes, I have avoided doctors and doctor visits because of the cost. I do all kinds of self care, daily. But, if you break a bone, or hit your head, you have to go. It is very expensive, and complicated.
For me, part of maturing was spending money on things that aren't fun, but are necessary. I used to hate buying home insurance. Now I have a different attitude. But, that's after years of listening to Suze Orman, Dave Ramsey, and finally paying off debt.
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