OUR COUNTDOWN TO FASCIST MEDICINE

What I mean is that insurance companies cover certain conditions, procedures, complications, etc. but not all. But the fact that the insurance company refuses to pay for it does not mean that you are not allowed to have a medication or treatment or procedure elsewhere. Under some government plans, once the insurance company (i.e. government) says no or not now, then you can't have it period. You would have to go to another country. In the case of an HMO where the doctor works ONLY for the HMO on salary, his hands are tied, but he can still refer you to somebody who can help you.

No insurance policy is going to pay for anything and everything. Even so-called 'all perils' policies exclude some things.

You might not have to take no for an answer though if your doctor is willing to agree that you need the treatment. You can usually successfully fight an insurance company if you have a medical condition that compromises your health if not treated and they cannot show that the condition is specifically excluded. I should know. As an adjuster I denied a lot of claims on behalf of the insurance company that were worked out in mediation or were overturned by a judge. Also as an advocate for an insured party, I was able to get coverage for people after an insurance company had denied it.

But in those rare cases where an HMO ties a doctors' hands, there is nothing in this government healthcare plan as advertised that assures us that such denials won't happen anyway. And you might then have no options to seek treatment elsewhere.

That must be a tough job Foxy. No wonder you are a conservative.

The latest thing here with the swine flu is that you go online, give your symtoms and if they fit you get a bottle of pills in the post. No doctors. Why would a doctor want patients coming into his personal space with swine flu?

It is well known that the aim of all bureaucrats is to avoid any personal dealings with the objects the bureaucracy is created to deal with.

My concern is that with a national health care system that could ultimately insures most everyone, since private insurers may not be able to handle the competition, the government decides to manage related things, such as organ donation, and hospice advisability. In other words, many older people may then remember when medical science was available for older people, since it would then be deemed not cost effective. My opinion is that many government bureaucrats have a penchant for being autocratic, with a focus on expediency.

Let us be intellectually honest and admit that some demographics in the country have a lesser longevity from a genetic predisposition, and other demographics have greater longevity from a genetic predisposition. Money can then be saved on those with a greater longevity.

Yeah I worked claims for eight years before I completely burned out and ElStud and I went back into business for ourselves in 2003. (It took him more than 30 years.) Not only tough duty but emotionally stressful and draining.

Are they really diagnosing and treating swine flu by phone? Actually, unless a person is very ill, that makes a lot of sense. Here we pack everybody into an emergency room for hours and hours to be sure that everybody is exposed to all represented communicable diseases.

That is my concern too, Foofie. It is almost a given that much of the personal touch will be squeezed out of the system.

When my hubby was diagnosed with cancer four years ago, he was advised that if he was five years older, the recommendation would be to not treat him as he would likely die of some other malady before the cancer would kill him and that option was open to him now. (Yes we have government healthcare through Medicare). He opted for treatment and is now cancer free four years later and looks younger and in fact is younger in many ways than many people younger than him. But he comes from a family of long-lived people burdened by few genetic issues--his mother died on her 100th birthday. The cancer, by the way, turned out to be a much more viscious variety than is commonly found, but because it was caught very early and treated immediately, he is alive today.

It is almost a given that if everybody is forced into the same government system either by decree or by default, that the healthcare system may not be able to give such options and folks like him may be advised just to go home and take painkillers as the President suggested might be the case for some.

but you trust the government to wage war? you trust the government to "keep you safe?" why? they can't do anything right. that's what you are proposing.

this whole "government is the problem" is just the same old reaganesque nonsense. which has been sold to you by... wait for it... people who want to run the government.

have you noticed how some of the representatives and senators who are against the whole thing, mostly republicans, are former doctors and surgeons?

have you ever wondered why a doctor, after making a huge investment in that profession, would chuck it in to go to work for the government? something worth thinking about, don't you believe?

as far as who does what for who? all i can tell you is that money is what makes the decisions in late life illness. in the final 3 months of my mothers life, she prayed for god to take her. she begged my father and i to "let her go". it was all over but the crying and she knew that. she was ready to move on. but no. somebody else made that decision for her.

2 things that were at work here

1) unlike oregon, tennessee doesn't have a death with dignity law. one quick injection and she could have gone in peace with her dignity in tact. but instead of a fine person meeting her maker in harmony, she was starved to death via her dnr. yeah. good ol' compassion at work. it pissed me off pretty good; but it crushed my father to see this ending to his wife of nearly 60 years.

2) the doctors, hospital, labs and suppliers made tens of thousands in additional income. i know this because i helped my father, who was also in very poor health, with the my mothers final months and the bills that came with it.

he was still trying to sort it all out, which i wrapped up for him, when he died 14 months later. he'd had a final massive stroke which short circuited what was left of his brain. he never recovered consciousness. instead he lay like a meat puppet with broken strings in a hospital bed. more human dignity and compassion.

and again, instead of following his wishes, he was not given a $5 injection to end his life like an enlightened being. instead he was just another big money maker. i know this to be because once again i singlehandedly sorted out his bills and affairs. a lot of people made a lot of money out the unnecessary suffering and lingering of others.

ever wonder why it's usually the same politicians who rail against "death with dignity" laws and "healthcare reform"? another thing worth thinking about, i guess.

you mentioned that a person like yourself could be denied healthcare. now isn't that the same as being "denied coverage" per your earlier example? so, why is it okay if it's blue shield, but very, very bad if it's a government sponsored plan? denied is denied.

as far as my personal health situation. i'm a realist. by 41 years old, i'd had at least 2 heart attacks (tho a 3rd is seriously suspected), both of which were of the semi-silent type. all i knew was that i felt like crap, had a burning in my chest (which i wrote of as a hiatal hernia thanks to an incorrect diagnosis 7 years earlier), my jaw was tight as a drum and had lower back pain.

after the second (or third, depending), the surgeon did the quad. said, "i'll see ya in 15 years. 10 if ya keep smoking.. bye!)

so, to me it is unlikely that i will see the mid 80s that my parents lived to. and if the medical consensus right now was that i have 6 months to live, but i could have 9 if i did some crazy expensive thing, with more crazy expensive recovery and medical costs....ehh, i'd have to say, "thanks, but no thanks to that bridge to nowhere".

but then i accept that all life has an expiration date, so death doesn't frighten me much. and i really don't want to put my wife and family through the same kind of **** i did with my parents.

in other words, different people have different reasons to support a full reform of the medical, drug and healthcare landscape.

it's not all blind obama love as some would have you think, nor is it all a bad idea as they try to frighten you into believing.

if you take a minute and look around, most of the politicians who are totally against national health are also big proponents of unregulated free enterprise. they usually say something like "competition is good for the country".

so ask yourself this; "why is it that in this case, they now fear competition?".

billing.

I dont' agree that most of the politicians who are against government controlled healthcare are also big proponents of unregulated free enterprise. They are not opposed to necessary regulation. But they do understand that the proper role of government is to equally protect our Constitutional, civil, legal, and human rights under the law and regulation should be toward that end. Regulation should prevent one enterprise from doing intentional economic violence to another. It should not give any enterprise advantage over another.

I was kidding. Mostly.

Because the competition is not between equals. One competitor is the federal government. Competition is only good in the free market. The federal governement is not the free market.

It's kind of like Obama motors giving a $9000 gift, courtesy of the taxpayers of course, to anybody who will cash in their old clunker on a new Chevy or Chrysler. Ford Motors, who took no bailout money and isn't a drain on the taxpayers, is not getting any such help with taxpayer money.

THAT is unfair competition courtesy of the government.

No reason to think healthcare partially owned by the government will work out any differently.

I have rarely seen public opinion turn on an issue as rapidly as it has for the issue of government controlled healthcare.

Gleanings from the week's political cartoons:

so, let's say that national health was set up as an independent agency, similar to the u.s. postal service.

would that be unfair competition?

There is constitutional authority for the U.S. Government to establish post offices and post roads. "The postal powers of Congress embrace all measures necessary to insure the safe and speedy transit and prompt delivery of the mails." The government can farm out the process to contractors, and does, but the U.S. mail was never intended to be private enterprise any more than the U.S. Armed Forces were intended to be private enterprise. It was considered too vital for the common defense and the general welfare to be left up to a hodgepodge of regulations and procedures among the various states.

There is no constitutional authority for the U.S. to establish or operate a national healthcare system and yes, if it provided services more cheaply than private enterprise can do so, courtesy of the U.S. taxpayer, that would be unfair competition.

The assigned risk pools in various states are the opposite. The state governments get together with the insurance companies and agree that the state will help provide insurance to high risk persons or businesses that the insurance companies cannot afford to insure. The government premiums will be higher than normal to help cover their increased risk, and in return for not having to ensure these high risks, the insurance companies agree to charge lower premium rates to their good customers. It is a win win for everybody. The insurance companies don't have to carry unacceptable risk, good risks pay lower premiums, and the difficult to insure are able to get insurance even though they pay a premium for it.

If the government is going to get involved in healthcare, it seems to me that this would be the way to go about it.

That's exactly how it works here.
But most is paid by the insurance comapnies. (Mrs Walter recently got changed her medication: instead of some pills for $90, of which she had to pay $8 [her insurance is covered by mine] she got new pills, for §370, and lasting only two weeks instead of one month. But now, she gets them totally free.)

And not only our doctors here can refer you anywhere - you can go to any doctor or hospital you like. And that's paid by the insurance (only if you go from here to foreign countries, it's better to ask in advance).

What DTOM and I are discussing is something different though.

In his case DTOMs insurance refused to pay for a specific treatment. What you are saying is that insurance in Germany pays for referred treatment. What we are discussing is that his insurance refuses to pay at all.

However,

Under our system, DTOM can still go wherever he wants and to whomever he wants to get the treatment he wants, BUT, he will have to pay for it himself unless the insurance company can be persuaded to pay.

Under some national health insurance plans, people are not given that option unless they go out of country. There are suggestions that Obamacare will also not allow treatment anywhere once the person has been turned down for it. And that would be taking away a freedom that I consider unacceptable.

I don't know of such (which doesn't mean that it might exist).
In Europe, if you pay for it you get everything - legally (or illegally, if it's against the law).

There are, of course, a couple of treatments, which insurances (both private and mandatory) refuse to pay. Then .... see above.

My the free market seem to be a religion idea for some people!

First there is no such thing as a free market as government always set the rules and in fact end up favoring one group over the other more often then not.

The group they are now favoring seem to be the insurance companies and the drug companies at the great expense of the American population. as a whole.

The current system we have by whatever name is not working as well as many other systems with single payers around the world.

That is a fact and calling it evil to move in a direct that work better because it is less "free market" then our poorly working system is silly.

Somehow I do not see Canadians or the English or the Germans demanding to move away from their systems toward ours and for good reason.

I don't agree that our system doesn't work as well as others around the world with single payer systems. I see many thousands of people coming to the USA for treatment that wasn't available or that was denied to them or the delay was unacceptable in their own country. I don't see manyAmericans seeking health care outside our system.

I don't disagree that our government at times sets rules that makes the free market system less fair. I have not yet seen that happen without unintended bad consequence, however.

But I am open to being convinced. I have been wrong in the past and I could be wrong now. But it will require better information than vague unexplained statements of fact and/or an obvious contempt or misunderstanding of America to convince me.

Yes if you are rich you can get the best care in the world in the US so for .000001 percent of the world population our system is wonderful.

And there are also middle class Americans going to third world countries for treatments that they can not get here because of the cost. Google the stories.

Sorry this system of our smell for 90 percent of the citizens and the problems of delay or whatever in single payer systems are claims place for the most part out there by the insurance and drug companies doing their very best to convince us to hold on to a system that benefit them not us.

After going without a needed drug for 6 months fighting with my insurance company do not try to give me a story about how wonderful our current system is even for those with insurance programs.