Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Saturday, March 27, 2010
ObamaMama it's Health Care Reform!
In case you haven't heard, we've got ourselves health care reform.
What do you think?
Will this be a good thing for psychiatric patients?
Will this be a good thing for psychiatric docs (the shrinks among us?)
Personally, it's been so much commotion and so many pages, it's been way too much to follow (and no one asked my opinion anyway). I think I'm happy for movement, we've been stuck for so long with a system that just doesn't make sense. I'm told most people are happy with their health insurance. Are you?
Go for it, write in our comment section!
Posted by Dinah on Saturday, March 27, 2010
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You ask if I'm satisfied with my health insurance. Of course! I'm Canadian!
I'm covered by universal doctor-and-hospitals insurance, which paid for my appointments with my psychiatrist.
I live in a province with a mix of private and public medication insurance with universal coverage. I used to be on the public plan, then I got medication which led to being able to get a good job, and now I'm on the private plan.
Through my job I also have insurance that covers dental care and $500 per year of appointments with a psychologist.
I'm doing really, really well.
I am on Anthem Blue Cross on an independent policy, one of the ones scheduled for a 39% increase in rate May 1st. I already pay almost $800 a month. In addition, Blue Cross sets the "normal and reasonable" rate for everything, so that it takes me about $10,000 in medical expenses to meet my already pretty high $2,500 deductible. How does that work? If a doctor or service charges me (and I pay) something like $300, Blue Cross will say "normal and reasonable" for that service is $75 so I pay $300 and they credit my deductible with $75. Why was it that outrages like that were not addressed in the new bill? I am 58 years old facing rates over $1,100 and with a psychiatric hospitalization on my record I doubt I can change plans. The new bill will make all insurance companies accept me in 2012. Great, but meantime I will be paying $1,100 and increasing rates, and maybe even in 2012 there will be no affordable insurance for me. Meanwhile, though I am teaching full time, it is as a sub with no insurance. Without a job which includes same-rate-for-all-member insurance I am in a bad spot. If I work every single day as a sub I can make $19,000 a year minus mandatory deductions for the teachers retirement plan, etc. and owe $11,000 plus just for medical insurance. What about food, utilities, auto, house insurance, etc?
I am happy with my health insurance (BCBS of Mass), despite the expense. I've never had an issue with coverage, never had to fight for payment, but perhaps that's because I have it through my employer.
Healthcare reform was needed because market forces were not enabling everyone to obtain coverage. That being said, I question the cost, the increase in my taxes, and whether it was really well thought out. I suspect it will take a while to work out the kinks.
I just hope I don't end up paying more for less. I haven't had a problem with my health insurance.
Not sure how this will impact psych patients. So many psychiatrists these days don't take insurance or Medicaid so I don't see how this will solve that problem. Allowing more people on Medicaid isn't going to do much if there aren't physicians who will take it.
I don't know much about it yet, except for that if you don't have insurance, even if you can't afford it, you'll be fined, which sounds damn unconstitutional to me, and I've also heard from my inlaws they know of one employer who is likely going to drop health insurance coverage for his employees, and take the fines on his side, because he's heard that the fines he'll have to take will be LOWER than his current cost of covering his employees. So he'd rather drop the coverage, leaving his employees out in the rain . . . has he thought of the fact that, the little I understand about the bill, won't his employees be individually fined on their side of things too?????
That's all I know and have heard so far . . . . my husband says he's heard about some good things, like completely wiping away pre-existing exclusions, and that some parts of the bill won't take effect for a few years.
But all the stuff I say and have heard in my first part, sounds REALLY HUGELY unconstitutional and extremely unfair and HORRIBLE, to me . . . .but as I say, I know next to nothing about this, and need to dive in and educate myself (a little late, I should have done so earlier and petitioned my congressmen and senators a long time ago. Still can, because changes can always be made but it's harder after the fact.)
Oh, my in-laws are currently considered almost un-insurable, and pay roughly $2500 a MONTH in health insurance premiums, not counting a small additional amount for a separately purchased catastrophic and hospitilization policy (what? the hugely expensive one doesn't even cover much hospitalization? I'm not sure, but it sounds to me like it doesn't cover much . . . . given the heart attacks and such, and one shot a month she needs that's $1800 a mo cash, which ALMOST pays for the premium, well, $700 shy of it anyway . . . ugh). When I heard this a few months ago, I was shocked. I was like, is this the USA? Is that LEGAL? $2500 a bloody MONTH in health insurance premium for a policy that sounds like it doesn't even cover much hsopitalization even?? ramped up from 1200, to 1500, to 1800, to 2100, to 2300, to the current, over the last some-odd years, pretty dang rapidly, roughly. I'd asked her for a guest post on my blog, but . . . she and I have a difficult history anyway.
I just could NOT believe what I heard. And they're working him to death. I think they're just under 50 employees, the current laws for health insurance treating employers of that size differently than employers of 50+ . . . they are cheapskates, and always have been, and will work my father-in-law to his death, and won't care one bloody minute except for the fact that they won't have another worker who can do as good as he.
UGH. How do they expect people to EAT, with premiums like that? They expect you to drop the policy, to price you right out of the dang thing, is what they expect. It's LUDICROUS. And then, if they want to FINE people for not paying for insurance they can't afford . . . . I need to look into that side of things more, about the new legislation. I think in my in-laws' case, it ought to be declared a bloody crime. I'm afraid with as many health care costs as I have, even at my age, that I'm less than a decade from that kind of pricing and we aren't old enough to be getting the kind of pay or overtime to get near that. We don't even GROSS that.
Here's the deal. We all have to think about this. I love how the anti-healthcare reform "it's Socialism" movement is composed of so many people that also say "Hands off my Medicare" and "Don't touch my Social Security." Like it or not we pay for healthcare - either through taxes or through premiums to insurance companies or both. But we currently pay for the uninsured through increased premiums and public taxes that subsidize ER's. So the idea of mandatory insurance for all so that people who are currently "gaming" the system by not purchasing insurance and saying they'll get it when they get sick or who rely on ERs makes sense because it takes them out of the ERs and opens up the possibility of their being able to use a doctor for their primary care. If we all pay now then in the end it becomes more cost-effective. The idea of not losing one's home or having to declare bankruptcy because of huge medical bills makes sense. Will everyone be covered? Nope - there will be some that fall through the cracks but far fewer than now. I find that Medicare works pretty well (with the exception of the parts that were put together by the insurance companies and big pharma.) Here in Massachusetts we have something called "assignment" which means that if a Dr. charges $1500 for a procedure and the insurance says that their customary charge for it is $1000. That $1000 is all the doctor will get - the insurance company's $800 and the 20% co-pay until you meet total out-of-pocket. I feel that if insurance companies are going to still be invovled with healthcare (and I personally support a singlepayer or "medicare for all" system)then the salaries should be capped at a dollar amount. Yes you will lose some grossly overpaid administrators BUT you will also keep and attract people with a true passion for what they do. Where I live in Western Massachusetts there are doctors who could make ten times as much money elsewhere but choose to live here because of the quality of life. We all have a responsibility to each other for certain things to make life livable. Healthcare is one of them. I listen to the "smaller government is better" crowd and wonder what they will do if they get their way when roads start to really crumble and there is no money to fix them at all. So - accept this new system and let's all try to make sure it works.
My husband and I are self-employed, 57 years old, and do not qualify for any kind of subsidized insurance. We pay BCBS of Texas $1,029 per month in premiums for a policy that has a $10,000 per person per year deductible. The policy also covers my youngest son who is 22 years old. So, in addition to paying over a $1000 a month in premiums, we pay for every other medical cost we engender all year until we've paid whatever sum BCBS considers acceptable and relevant out of the $10,000 deductible for each of us. Like someone said earlier, just because a doctor charges, let's say $4,000 for some tests and procedures does not mean that BCBS considers these charges acceptable. They usually give us credit towards the deductible of appx. 50% of these charges. Meanwhile, the doctor demands payment of the full amount. None of us have ever met the deductible on this policy. We pay the premiums and we pay for everything else. Our policy does not cover substance abuse or mental health. That has been a huge problem for my husband and my son in the past. In addition to his psychiatric appointments and counseling appointments that were not covered, my husband has presented to ER's and treatment centers several times in the past for alcohol detox, and although he had no insurance coverage, he presented his insurance card to hospital personell when he was admitted and these ER and treatment center presentations are on his records. He has maintained sobriety by taking Naltrexone since 2008, but again, this Rx also reveals his pre-existing alcoholic condition. This situation has prevented us from being able to shop for better coverage elsewhere. Maybe, when the exclusion for pre-existing conditions is eliminated, we'll be able to change policies. But will the premiums and deductibles be lower? Doubtful. Fortunately, we're pretty healthy for the most part. Of course, we cannot afford to pay out of pocket for any of the preventive screenings or tests that are recommended for our age group, like colonoscopies or mammograms, so I am hoping that nothing serious will develop for any of us before we qualify for "better(?)" coverage. So, basically, we're paying the premiums and then paying all our incidental medical costs out of pocket. Oh, and by the way, we have no dental or vision insurance, so we pay for all of that, as well. I am scheduled to have microsurgery for epi-retinal membrane removal on Monday morning. It's a random event that I did nothing to cause, but my choice is to either have it done or to continue toward complete blindness in my left eye. The entire cost, including retina specialist, hospital room for outpatient surgery, (appx. an hour and a half), anaesthesioligist, lab work, etc., is estimated to cost a little less than my $10,000 deductible, so I will have to pay for the whole thing out of pocket. Will health care reform make a difference in my life? I hope it will, but have no assurance at this point. I did support the legislation, however. There are many people who are worse off that I am. They deserve a break!
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I have medicare and it's ok but it only pays 55% for psychiatrists while it pays 80% for real doctors. There is also $100 per month premium and a $200 per year deductible and no psychiatrist in my county will take it.
When I had surgery I got a bill for $22,000.00 and that was just for the hospital the surgeon also wanted money. I had to use charity to pay the %20 that medicare would not pay.
My therp says she will start taking medicare in six months, I think this is because of the new health bill. As is it I pay out of pocket but on a sliding fee scale.
I like single payer and I think everyone should be able to buy into medicare but medicare does have some big gaps. It does not cover dental, eyeglasses or hearing aids.
It looks like we will end up with two pools. Sick poor people on a government program and rich healthy people in private insurance plans.
I think Sarebear makes an excellent point about the fine. From what I've read the fine is 1% of a person's income, that's if they get caught. It would make no sense for a young, healthy person to pay for health insurance. I would risk the fine. It's cheaper than endless monthly premiums, and I could sign up when I get sick and need it (which sort of defeats the purpose for insurance if the company is forced to take you when you get sick). We need young, healthy people in the insurance pool to keep premiums down. This plan doesn't sound like it will accomplish that.
Also, those who support this plan are not addressing the problem with physicians who do not take Medicaid (and more and more who aren't taking Medicare). Are they going to force physicians to take Medicaid & Medicare like they're forcing people to buy health insurance? Maybe, instead of making it easier for people to qualify for Medicaid, they should fix the problems with Medicaid that exist right now. It all sounds nice on paper, but considering the problems with psych patients getting psych treatment at present, I don't see how this improves anything.
I was expecting FauxNews when I clicked to comments but instead there are just a lot of comments about what is and isn't working now, how most people aren't completely sure what the new regulations are and their ultimate outcome, and a bit of hope mixed in.
I skimmed, but I didn't see one comment about how this will be the downfall of humanity. Shocking. I'm so glad I'm moving from one of the most conservative counties in the country to CA--maybe I'm trading one extreme for the other, but I think I'll be able to handle extreme fiscal liberalism more than I've been able to handle the extreme social conservatism 'round these parts.
Me, since I up and quit my job to move, I'll be freelancing for my current employer, so I'll need to find private individual health insurance while I search for a new 8-6. I'm nervous a bit but mainly because I haven't researched it yet. Not a clue how this affects me because I've been waiting for the s---storm to subside. I'm tired of the sides demonizing each other and I'm only going to read the paper until they all start acting like adults.
I love how the anti-healthcare reform "it's Socialism" movement is composed of so many people that also say "Hands off my Medicare" and "Don't touch my Social Security." Like it or not we pay for healthcare - either through taxes or through premiums to insurance companies or both. But we currently pay for the uninsured through increased premiums and public taxes that subsidize ER's. So the idea of mandatory insurance for all so that people who are currently "gaming" the system by not purchasing insurance and saying they'll get it when they get sick or who rely on ERs makes sense because it takes them out of the ERs and opens up the possibility of their being able to use a doctor for their primary care. If we all pay now then in the end it becomes more cost-effective. The idea of not losing one's home or having to declare bankruptcy because of huge medical bills makes sense. Will everyone be covered? Nope - there will be some that fall through the cracks but far fewer than now.
I don't like that pre-existing conditions in adults don't have to be covered until 2014. That seems like a long way off for someone with a psych diagnosis. If my husband or I become unemployed and lose employer-provided health insurance, I'm going to have a mighty hard time getting new coverage. Plus, the private plan that I have now is extremely arbitrary in what it will cover and how much it will pay physicians. And as soon as Mental Health Parity went into effect, it jacked the Mental Health copays up (only mental health--not other specialities) by 50%. I'm certain it was out of greed to keep a profit. I'm glad Obama and the Democrats went to reform this stuff. But there was more work to be done.
You guys pay so much in insurance. Canadian medicare is funded through a 6% payroll tax. If I earn $50,000 per year, my insurance premium (shared with my employer) is $3,000 per year. If I earn $10,000 per year, the premium is $600. Per year.
No deductible. No fuss about pre-existing conditions. We can see whatever doctor we want: they are all in-plan. And we do get good medical care. A young friend of mine is dying of cancer, but not for lack of effort on the part of our medical system. He needed an unusual surgery, so they flew in an outside expert in to do it and to teach the surgeons at his hospital. He says he's gotten really great care.
Why do you guys make things so complicated for yourselves?
Ok, the 6% payroll tax is only doctors and hospitals. So it’s comparing apples and oranges.
In Québec, there’s a public medication insurance plan. The premium varies between CAD$0 and CAD$585 per year depending on household income. There’s a $15 monthly deductible on medication, and everything over $80 per month is covered. So if your prescription medication costs $10 per month, you pay the $50 monthly premium plus $10 per month. If your prescription medication is $250 per month, you pay the $50 monthly premium plus $80 per month. If you are getting chemotherapy and your prescription medication is $15,000 per month, you pay the $50 monthly premium + $80 per month.
I’m not on the public plan because I have a private plan at work. The premium is about $1,500 per year (shared between me and my employer) and covers medication, dental and various non-medical professional services.
Doctors can make more money in the US — specialists in particular — but that’s not the whole story. When my sister was trying to decide whether to practice in the US or Canada she picked Canada, largely becuase the US was so depressing to practice in.
Kudos to Alison Cummings: 'You ask if I'm satisfied with my health insurance. Of course..." In my case I'm Australian.
I pay a levy from my tax. I work, make a good income (read here top tax bracket), and I don't begrudge the unemployed, disadvantaged or challenged in any way, access to health care, paid by the state (the collective me at large). That you do really bothers me. I have private insurance and don't rely on the state, but if I did, I would have best standard treatment, maybe not in single ward, but if I need a transplant of any sort I will get it. I'm not going to get dumped somewhere in a hospital gown or turned away from A&E.
I saw Sicko, and yeah it made me sick. What is fair about that system. The rich are getting richer and the poor get the picture.
Get over yourselves! Your system has been shameful. Obama is the best thing that has happened in years in MHO. There is NOTHING wrong with those who can, paying for those who can't. "I'm not paying for your lifestyle choices, pass me the botox and restalyne darling, while his toe gangrenous falls off" makes me vomit.
Shame Shame Shame.
Rock on health reform and care for the masses.
A blog post by an American ER doc:
To those who are not living in the U.S., not all Americans pay high premiums. I don't pay high premiums, and I'm not wealthy. I wouldn't trade the health insurance I have now for the Canadian system. I can see who I want, when I want. I don't have to go through my primary care physician to see a specialist. I have a PPO so if I want to make an appointment with a specialist I don't have to ask anyone's permission, I just make an appointment and go. My co-pays are low and I suspect my taxes are quite a bit lower than what I would pay in Canada. So, I'm not a fan of this plan.
I agree we need health care reform, I just don't think this is the right way to go about it. I think they should have addressed the problems with reimbursement which would have improved access for low income people. But, they don't want to address that and unless they force physicians to take low income patients, then this isn't going to do anything but make it more difficult for those patients to find a treating physician because they're going to now be competing with all the new patients who will be added to the rolls. I know parents who have a hard enough time trying to find a pediatrician who would take CHIP, and had great difficulty. Is this going to improve their access? If so, how?
Another thing that really bothers me about this, is all of the pork they tacked on to buy people's votes which I understand has become the American way.
Our system has a lot of problems, but I still wouldn't trade it for what other countries have. My grandparents didn't have to wait 3 months for a hip replacement, and they didn't have to wait for cataract surgery like I understand happens in other countries. We have a lot of things we need to improve on, but we do a lot right, too. It's not all doom and gloom in the U.S. like some in other countries would like to believe. If a person has good health insurance, they're probably better off in the U.S.
What about my stupid situation of being $2800 in debt for two hip MRI's, done a week apart . . . the ins. co told me to send in an appeal letter after I talked to them, that I haven't been competent to write so my therapist and I are working on it tomorrow, along with the financial aid letter for the MRI place to consider tiny payments that they normally wouldn't consider (usually they want payments that would pay the balance off within a year, but have a financial aid plan for people in hard position you send em papers from a packet they send you list all your bills, a bank statement, I'm afraid they'll see we have more payments than income lol but we've gotta try to scrape up $50 a mo somewhere . . . . anyway, along w/those papers I've been stumped at drafting the letter for this too, just haven't been able to deal with it . . )
See, I learned in Feb (the weekend I learned this, I couldn't keep any food down for 4 days, and this turned out to be in the middle of a 13 pounds lost in 13 days period, I was highly stressed ugh. . . .) that the reason the ins. co. was treating this IN NETWORK MRI facility as OUT OF NETWORK and paying very little, leaving us with, I thought an $1800 balance (learned it was $1000 higher when I called to explain to the facility, UGH UGH) was because the MRI's hadn't been done within 15 days of the order.
Well, the doctor had ordered me to have a cortisone shot in the right hip, and then to go have the two hip MRI's 3-4 weeks after that, giving me both orders at the same time. The MRI's NEVER would have been within 15 days, and why a flag wasn't raised when the facility called to authorize the thing I don't know . . .
In hindsight, I should have checked myself before such a procedure, but both the doc's office and the facility assured me they'd take care of EVERYTHING . . .
So now I'm in debt for almost $3000 due to no fault of my own, and the doctor's office, when I called to yell at them, which the secretary was unhappy with, they'd never heard of any such 15 day rule, and my ins. co. is a big one. In fact, my ins. co. had gone farther and strongly implied if not outright said that they had wanted the order to be submitted by the doc's office themselves and not just the MRI place, which is WAY out of procedure for the doc's office, besides never having heard of the 15-day thing, and they're an orthopaedic practice, so they need MRI's all the time.
Maybe it's just because I'm on a wierd HSA plan that goes to a different office, the claims, I don't know.
UGH. This has been a big huge mess and it's stupidly insane.
This ins. co. isn't known for giving a rat's @$@ so even if I get an appeal sent off, in 30 days I don't hold much hope of the response being positive, but since I was following the doctor's orders and doing what he told me, maybe there's a slim chance . . . .
The more I think about the healthcare reform the more depressing it seems. Most people know little about it which makes it seem like it was rammed through before the American public could protest too much about the particular devilish details.
Yes our current system sucks but it could be worse, and we might be in for that worse.
There might be some good things to it but I'm not sure they've set about those correctly from the sound of it, it sounds more like a high ideal than what will work for the working poor, in practice . . . . . . .
In the mental health arena, especially since, as many say, a segment of psychiatrists choose to not take insurance at all. I am OH so nervous about my appointment with mine at the end of the week - I'm quite pissed off at her.
A copule of you are talking about having to pay the difference between what insurance pays and what the provider charges. The practice of an in-network provider charging you the difference between what they billed and the insurance company's negotiated rate is known as BALANCE BILLING. Know that in many jurisdictions, this is ILLEGAL on the part of the _in-network_ provider. Check your local laws and court rulings.
If you're working with an _out-of-network_ provider, you *are* liable for everything insurance doesn't pay. Yeah, in-network doctors, particularly for psych, can be not worth the time and copays, but it sounds like some of you are having a real rough time! I hope this and future legislation makes it better for you.
I am so worried. First, my co-pay is going up to $50 to see my shrink. United Health Care has decided that they are using a system where you can go to a specialist for $50, but if you go to a "preferred" specialist, that is, a specialist that has a two-star rating, one star is for cost efficiency and the other is for results, then you only have to pay the $30 I paid all last year.
My deductible has gone up to $2000 and I now am having $3500 taken out over the next year for miscellaneous and uncovered medical expenses.
The thing is, it doesn't matter how educated you try to be (I was just reading my certificate of coverage), you really don't know what will be paid for and what won't be. For example, freezing a wart was considered a surgery and was not covered since I had not met my deductible. It cost $179!!! Yet, the person at the dermatologist told me that if I changed to be a "self-pay" customer, it would only be $50! What????????
I need the heavily discounted rates my insurance brokers with docs, I'll just have to suck up some expenses and that is what I use my flexible spending for.
I am so afraid I'll need to be hospitalized at some point and it will ruin me completely.
As far as the penalty everyone is talking about, well, not everyone is this way, but there are people that would rather use their money on a new SUV or a nice vacation rather than contribute to their or their children's medical or dental care. I'm for the penalty. I am sure there will be guidelines.
Right now I am not only worries about myself, I have a sister that is full of gallstones and can't get surgery because she is uninsured because her husban'd employer wouldn't cover her. I also have a father on Medicare who has had a rough year health-wise and I worry about him.
I know that people act like longevity is a good thing, why anyone would like to live longer and longer is beyond me, but I'm ready to go now. Life is just too damn stressful.
I'm not even sure my apt. Monday with the shrink doesn't need prior auth even though the director of HR told me I didn't need it.
I don't trust anyone to give me the right info and the system is so convoluted and complicated it is hard to figure it out!
One more thing. Those doctors that have the luxury of not taking insurance, well, "lucky you!", especially for standing on your principles of confidentiality and keeping a third party out of the therapy......
Thank God that there are plenty of your colleagues who pick up your slack and allow you the priviledge of being on your high horse or I'd be totally screwed. Yes, I paid $200 a session for a couple of years to see my shrink before he got on my insurance (flexible spending, saved the day again), but with deductibles going up for meds and everything, I just wouldn't be able to afford it now.
Sometimes I think not setting aside money in my flexible spending account and going on a nice $3000 plus vacation would make me feel better than I currently do, but I keep believing.
Borderline, bipolar, anxious and depressed,
Thank you all for you your input. It's striking how wide the differences in coverage are!
For Anonymous who thinks that the US health insurance program is good enough because they personally don't pay high premiums and they can make an appointment to see a specialist whether they need to or not: a post by a US primary care physician.
Alison, I work in the health care field in the U.S. so I have a decent amount of awareness about the pros and cons with our system. What I do know is that our government has a difficult enough time running our postal service, so I'm a bit skeptical of their ability to handle our entire health care system.
However, I will say if I or my child had a mental health issue I would probably prefer your system. I think other countries are much less into overmedicating than we are. More restrictions in that area of medicine might not be such a bad thing.
For every health care professional that I meet that is against government-run health care it is astonishing how many I run into that are for it. As for Anonymous above - whenever one prefaces their comments with "I work in field X so I know a fair bit about it" let me state that you DON'T know. There are a ton of different specialties and areas in medicine today and any dr, nurse or other healthcare professional that professes to know it all is so full of hot air that we could make it to the moon on it! Anonymous - if working in the healthcare field makes you such an expert please explain to me why so many nurses and other medical professionals don't take care of themselves? They smoke, they are overweight, if they are diabetic their diabetes is totally out of control and so on. Medicare works - it's the Republicans who screwed the doctors and hospitals this time with that 21% cut by not approving extensions. Here in the U.S. we have the LOWEST income taxes of any developed country and we complain about our taxes. Sure we have quantity of life but we don't appear to have much quality as opposed to other developed countries. While the so-called "Obamacare" isn't perfect - it's a start. Medicare and Social Security weren't perfect when they started either yet over time they have evolved to an acceptable system. This "me, me, me" society we live in shows what a state we are in at present. Let's wake up here folks.
To the last anonymous, you make alot of good points.
But as far as something being a good start and evolving over time, that might have happened in the past but we live in a different world. Perfect examples are NAFTA, the welfare Program under Clinton, and the Patriot Act. Tell me how they have been improved?
As one who is about to lose my job, Obama's plan is better than not doing anything. But that is kind of like saying that Prozac is better than Zyprexa.
Anyway, if I can't afford Cobra (I won't be eligible for a subsidy unless Congress extends the act), I don't see how Obama's plan helps me now. Most of it takes effect in 2014.
People in countries like Alison's don't have that worry if they lose their jobs. Frankly, that is disgraceful that people in the U.S. do.
He could have done so much more and he had the support of the public. But then there is is reality which translated means special interests.
Anon, I don't profess to "know it all." Where did you get that from what I've said? Lest there be confusion, I'm not professing to know everything about the U.S. health care system. That's ridiculous.
The reason I even mentioned that I work in the health care field was because Alison directed me to a link to an opinion of a physician in the U.S. My point which was badly misunderstood was that I get that there are a lot of problems and that I, like the physician she linked me to, also see the problems on a daily basis. I don't know everything nor does anyone else. I see a lot that's wrong, but I also see a lot that's good. I don't agree that Obamacare is going to improve the situation.
I don't think most physicians support this plan. As someone else pointed out, of the physicians who support it some of those don't even take health insurance much less medicaid. Will they suddenly start taking care of the indigent under Obama's plan? It will be interesting to see what happens.
RE my link to Musings of a Dinosaur: that was in reference to the comment that one of the wonderful things about being healthy enough to have moderate premiums and wealthy enough to afford them in the US was the ability to make an appointment to see any specialist at all for any reason at all without consulting with a GP first to determine that a) a specialist is needed and b) that the correct type of specialist is seen. Dinosaur disagreed that this was a wonderful thing.
RE most doctors not supporting the current health insurance package: the AMA supports it, though with reservations.
"“The pending bill is imperfect, but we cannot let the perfect be the enemy of the good when it comes to something as important as the health of Americans,” said J. James Rohack, M.D., AMA president. “By extending health coverage to the vast majority of the uninsured, improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens, and promoting clinical comparative effectiveness research, this bill will help patients and their physicians.”
“While the final product is certainly not what we would have devised, we strongly support the parts of this bill that are desperately needed by millions of Americans who are struggling to get or keep health insurance coverage,” Dr. Rohack said. “We will continue to work with Congress and the administration to solve important issues that cannot be addressed through the reconciliation process.”"
All I know about the US health insurance reform bill is that nobody really likes it. Even its supporters are holding their noses. My comment was that you guys just make things so complicated for yourselves when it doesn't have to be. You had a terrible health insurance system before and now you have an arguably somewhat less terrible one.
There seem to be many misconceptions about single-payer systems, such as the misconception that government exerts control over who you see. In fact, we are freer to choose our own doctors than people in the US because they are all in-plan.
Alison - You hit the nail on the head when you said "There seem to be many misconceptions about single-payer systems, such as the misconception that government exerts control over who you see." The problem is that those who had the most to lose (private insurers) seized upon that ignorance to fan the flames of fear. Of course no system is perfect and yes in countries with universal care (single-payer or otherwise) there will always be people who fall through the cracks. Sometimes it is their own fault; sometimes their doctor's fault. The anti-healthcare reformers ran an ad on tv here in the States that highlighted a woman who supposedly couldn't get treated in Canada for her cancer. I remember reading in the Globe when up there on business about Canadians denied care - but once you got past the headline you found out that it was because, when their doctors referred them to the hospital they refused to go and tried non-approved remedies first. Then, when things got really bad, they expected the Canadian govt to step in and pick up the pieces of a situation that they (the patients) had made worse. Interestingly enough when you talk to people here in the States who are opposed to "Obamacare" and then break down the components piece by piece asking them if they'd like this or that in a healthcare plan, a majority of them are for all the components - as long as they don't know it's part of the Obama healthcare plan. Sounds more like politics to me...
Alison, less than 1/3 of physicians are members of the AMA. There is a reason for that. I wouldn't assume they represent the majority of what U.S. physicians think.
Anon, of course it's politics. It's politics on both sides. One side is no more righteous than the other in that regard. Unfortunately, the public as usual is caught in the middle.
Well, I read that that insurance exchanges for people who can't get insurance will open around June. But you have to have been uninsured for 6 months.
Also, there is no mention of cost. Currently, in my state, similar type plans cost around $12,000 per year. If they still cost that much, they will be worthless to most people.
And even if they are affordable, making someone wait for 6 months could be quite a hardship for alot of people.
I would take evil socialized medicine any day compared to this nonsense.
This was not "health care reform" as much as it was "health insurance reform."
All this means is that we will all be forced to pay into a system that gets more and more people on psychiatric drugs - drugs that do NOT work... drugs that cause more harm than good, in fact much more harm than good.
In the area of mental health, it would be nice to see real reform - treatments that work - recovery and wellness, versus more disease management.
For almost a year, the President and Congress have met behind closed doors - hardly transparent with their agenda...
Who did they meet with?
Pharmaceutical companies, that's who....
What does this mean?
Well, it looks like we will now have more than 29 million people on antidepressants - drugs that are clinically no better than placebo...
And it looks as though SAMHSA and other federal agencies will be working with these drug companies to target more and more children - with early "detection and intervention"..... making sure that children and youth are placed on mind-altering, brain-damaging, body-injury, spirit-numbing drugs... like candy!
The President and Congress worked with Pharma to get this done... against the will of the American people....
We are on the fast-track now to becoming a drug-addicted nation... with drugs that are similar to street drugs - addictive, and brain disabling "treatment" for everyone....
Other than that, I have no opinion... and, "NO", I am not a scientologist - I'm a concerned dad... a concerned citizen who is watching his own nation go down the tube with conventional psychiatric treatment.
Duane Sherry, M.S., CRC-R
I just found out that the fact that I was diagnosed as Bipolar in 2005 will automatic rejection for health insurance, despite my current psychiatrist not agreeing with the diagnosis. As a result, I am stuck with Blue Cross's 39% rate increase May 1st.
The recent Health Insurance Reforms are a good first step. It will help many people. Starting with pre-ex and children is a great start. The bill does not truly address cost reductions.
I am a health insurance agent with decades of experience. I also am BP 1 and have another chronic rheumatology condition. So I am an expert as an agent helping consumers and expert as a mental health patient.
Mental Health parity needs to apply all the way down to small group and individual plans. Also, in my opinion all physicians should be mandated federally to accept Medicaire and Medicaid. Then patients will have access to care and all doctors will help with the heavy lifting.
I have been lurking here for awhile. You are a fun group and I was fascinated reading the blog of the doctor who left her family and went to New Orleans post Katrina.
P.S. I LOVE Lithium.
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