Post by fishkybizniz on Oct 19, 2015 14:28:27 GMT -8
Hi all. As if our medical battles are not enough, some of us have financial battles to get the care we need. How are your medical benefits working for you? Do you have to fight to see a specialist? What about medications and specialized treatments? Do your doctors get control to manage your case with little push back or is your medical plan always forcing compromise?
Post by fishkybizniz on Oct 19, 2015 18:41:34 GMT -8
I'm on a company plan. So far, an excluded medication was declined but given my medical circumstances, they are trying to work it out. My coverage includes concierge services to help with log jams. The worst problem I had was the provider pharmacy. I had so many repetitive mistakes they filed a formal complaint. Typical high level decision makers deal. They ink an awesome partnership forgetting the training to make it work. I've never had avacate service before. I hope every kind of medical will start providing avacate teams for members after surgery and complicated medical problems. When we become medically incapacitated, we don't have the strength to avacate medications and services until we get stronger.
Obama Care has hurt the medical industry. First off, it caused the government to make deals with the insurance carriers for a lump sum fee. The insurance carriers then dictate what they will pay the doctors for the medical service. they make it a nightmare for anyone to get services unless the doctor fights for it. A couple friends of mine are doctors and they were explaining this to me. It used to be the doctors could work out fees with the insurance carriers like Blue Cross, Etna and others. It was easy to get an order for cat scans or other things. Its just become a money game anymore and the patient is the victim. My wife has Blue Cross, Blue Shield. Even with the best coverage that she has, its a nightmare for any type of service. She goes round and round with BC, to get the approvals needed with the doctor. The doctors again have to fight for a lot to get approved. I don't know what the answer is. All I know its costing all of us a lot of money for nothing. High deductibles are killing people too. Its a sad situation and don't know what the future holds for the medical industry.
Very interesting. So the healthcare was better with the republican government or are they all just crappy? Canadian elections were yesterday and we now have a Liberal government. Health care funding is supposedly better with the Liberals so we're going to have to see!
I support the changes made. Because of Obama Care, my $3 million thus far in medical bills, have only cost me $15,000 out of pocket. Because of Obama Care, my medical equipment was covered. My tub bench, $1000. My wheelchair, $6000. Because they were prescriptions, and had valid reasoning, they were covered by insurance.... Oh, if I had to have a "cheap" GOP wheelchair.....Or the over the counter tub bench....
Booo on those who don't fully understand politics....
I support the changes made. Because of Obama Care, my $3 million thus far in medical bills, have only cost me $15,000 out of pocket. Because of Obama Care, my medical equipment was covered. My tub bench, $1000. My wheelchair, $6000. Because they were prescriptions, and had valid reasoning, they were covered by insurance.... Oh, if I had to have a "cheap" GOP wheelchair.....Or the over the counter tub bench....
Booo on those who don't fully understand politics....
This is also interesting because I also imagined obamacare being beneficial to those with disabilities. It may not be perfect but like you said, a big saving in money like you've had is way better than nothing!
Post by kilg0retr0ut on Oct 22, 2015 10:23:11 GMT -8
I won't complain. I'm lucky to have the care I've had. They tell me I deserve it. While true I've worked hard all my life and paid into the different safety nets, I never thought I'd be using them. I hate the fact that my injury cost so much to deal with. Insurance companies are there for just this reason, but It still bothers me. Without the help I'd be so swamped in debt, I'd be kaput. It's a nasty game of money and insurance companies will do everything within the law to hold on to it. I try not to take it personal. I'm just a number to them.
I don't really understand Obama Care, so I won't comment except to say I like the idea that more people have insurance.
Very interesting. So the healthcare was better with the republican government or are they all just crappy? Canadian elections were yesterday and we now have a Liberal government. Health care funding is supposedly better with the Liberals so we're going to have to see!
This is an interesting thread for those living outside of America. Here in the UK our health service is free at the point of entry. In truth it's paid for out of taxes. As well as income tax we pay a national insurance premium, which is supposed to cover our healthcare. I don't pay anything for my prescriptions and I've never had to pay anything for all the care I've had over the many years of my injury. I get a voucher every five years for a wheelchair. But the good old health services is buckling under the strain of an overpopulated country. It wasn't designed for the amount of people that we have a living here. Our health service is free to the whole of Europe. With free movement of people across Europe, families are moving to the UK in their millions. Many come from poorer countries, such as Romania, Bulgaria, Lithuania. It is estimated that we have over 4 million Eastern Europeans living in the country now, all of them with growing families. The NHS just cannot cope. It is hard to get a doctor's appointment and the hospitals are full up. Spinal Units are creaking under the strain. It is interesting that this thread seems to be more about politics than it is about healthcare, whether it's Obama care, the Republicans, or the NHS and Europe. Immigration from Europe and the swelling numbers of Eastern Europeans are just one reason that Brits voted to leave the European Union. Not only has our health service been diminished, but our social housing cannot cope with the numbers and neither can our schools. An Eastern European with a family who has just come into the country is more likely to get a local government owned house (a council house) before an indigenous British person with less children. We have to provide interpreters at doctors surgeries, hospitals and schools. It all adds to the cost. I still regard myself as lucky to live in a country where my healthcare is free but sometimes that healthcare seems like it's coming from 1/3 world country. This is not a racist rant. This is looking at a diminished health service and trying to explain reasons why it is not what it was. We we are a small island but we are sinking under a tide of migrants. Having said that, a couple of my carers come from Lithuania. Interestingly they both own houses in Lithuania which are rented out. Both of them also have council houses here in the UK. Technically speaking you have to be homeless to get a council house. The whole system needs an overhaul. But it is just too huge. The NHS is massive and almost impossible to streamline. Around 10% of our GDP is spent on health. Total health spending in England was around £129 billion in 2018/19 and is expected to rise to nearly £134 billion by 2019/20. Remember this is just England. We have Wales and Scotland to factor in as well.
Very interesting. So the healthcare was better with the republican government or are they all just crappy? Canadian elections were yesterday and we now have a Liberal government. Health care funding is supposedly better with the Liberals so we're going to have to see!
HI DJ,
I will just say that after 40 years in the chair in Canada, I can only report that the trajectory for healthcare has been uniformly down over that whole period.
We all have urinary problems, right ?
Even twenty years ago there was a Wednesday SCI urinary clinic staffed by a totally devoted urologist who "did the floors" and then the outpatient clinic. If you called with a problem on Monday you were SURE to be "worked in" at the clinic two days later. If we were really in trouble, we went to emergency, said his name and got four star treatment. The head nurse who did the clinic was also specialized, and ALWAYS at the end of the telephone on demand.
Fast forward to today : SCI urinary clinics are scheduled a couple of months in advance, if and when, some urologist (never the same) says they are available to do one. There is no way of getting seen sooner. Emergency is the only resort.
Personally, I have been reduced to self-treatment. I know that Cipro will usually work, and when I feel sick enough to want the treatment, I go to a walk in clinic, convince the guy I know what I am talking about and he, normally, gives me the prescription I want. If he doesn't I go to another one.
As for the wheelchair, I had one I really liked. I used it for a long time. Finally I had to get a change. Because it was nine years since they had seen me, my file was dead. So I had to see a Physical medicine guy for a new prescription. But as the lady said, that might take some time, so we will order the chair and get it ok'd on the back end. Fine. Then she gave me the name of a private clinic (public would be far too long, she said) and that clinic, sent me a letter saying that they were full and would get back to me in TWO YEARS. Yes you read that right. So now I have a chair, but it has not been properly procured. The smart lady at the hospital shop is retiring. (Nobody new would ever take the kind of initiative that got me this chair). And I have virtually no way of getting a proper prescription (obviously new patients in the pipeline are looked after. but that is not the same thing as looking after the population).
Point is, this all used to work, and now it has fallen apart.
Doctors are at the point of revolt.
Patients don't know any better. Think they have "the best system in the world". Heh . Heh.
yeah. right. sure !
Americans take heed ! Your emergency, last chance, low end care, for indigent paupers is objectively better than our "system". And if you have the slightest scrap of real insurance it is way better.
And that is why we now have euthanasia in Canada. One pill. Run the IV. Very cheap.
Do NOT under any circumstances vote for single payer !
P.S. I do not live in the sticks, I live in Montreal
Don't believe me ? Read this blog post from Shawn Whatley, MD, and ex-president of the Ontario Medical Association
here.s a snippet :
"Given all that we spend, Canadian universal healthcare is an embarrassment for the thousands of patients we leave in hallways and who suffer permanent disability from egregious wait times."
I had good health care when I got SCI. The doctors I had were not good. Now that I am disabled and on social security, I can't get care. I'm lucky to have an internal medicine doctor who manages my care. Is it ideal? No. But at least I have one -- count my blessings.
The irony is my family came over on the Mayflower, sorry my family created the United States, and this asshole that is third generation German uses the phrase "Make America great Again." Yeah but he is German three generations out...he himself is an immigrant from Germany -- Hitler recreated! You have a problem with immigrants -- start with yourself!