Since the politicians seem to have no ideal how to fix our health insurance/medical coverage in the US I thought I'd start a discussion here. Maybe those of us living in the real world dealing with it might have a better view or ideal of changes that could help out.
I'm not being political it seems they are all equally unable to offer any fixes that don't conflict with their party lines while the rest of us deal with it.
One of the first things I want to bring up is the difference between medicare and medicaid, since most of us don't have any ideal I sure didn't until I qualified for medicare.
Medicare is the medical coverage you get when you've worked a full lifetime and either retire at 65 or get disabled while working. But it require you have worked many years paying into the system before you qualify for it. It's the one most of us will have when we're older (yeah I know if it's still around, that line's been going on since my Mama was a kid). Even if you have a secondary insurance policy you pay for yourself (as I did) at that point medicare automatically become your primary insurance and you're subject to it's rules ( your other insurance will quickly inform you that they will no longer cover anything unless medicare says yes) Feeling screwed over yet? You will...
Medicare covers 80% and leaves you or your secondary insurance responsible for the rest but that's after certain other circumstances such as a very low deductible that usually will be met in your first doctor's visit of the year. Anyway if you do require hospitalization be ready to owe at least a couple of grand on it no matter your insurance coverage (some kind of crazy rule they have set up) I guess spending 2-3 days in the hospital is seen as some kind of vacation they want us to be sure and never consider!
There is no coverage on medicare for dental, vision or hearing so best try and have that covered some other way or save lots of money up. I could go on but let's look at the other one.
Medicaid is the government medical coverage given to those of extreme low income (as in don't do any work... ever) It cover's pretty much everything with no co-pays or repercussions for misuse of it. I'm not against helping those who need it far from it but some responsibility needs to kick in here.
How many of you have seen a parent carry their child into the emergency room with an injury worried sick about it (and the bill) and also seen the ambulance pull up and a half grown or grown person being unloaded moaning and groaning about how they need pain medicine immediately?
There was no need for them to use an ambulance which costs lots of money but they have a medical card (medicaid) so it doesn't cost them a thing. Even when the doctor sees them first since ambulance entries go first usually and says there's nothing apparently wrong, maybe a pulled muscle or such, they still demand pain meds as well as a prescription for more pain meds. We all know what's happening and also who gets to pay for it it all. That same poor parent worried about paying the bill for their kids broken arm will cover it with their taxes while they make payments to the hospital for their own visit.
Am I the only one who things this is wrong?
If an ambulance is used routinely for rides to get pain meds without a true medically proven reason I thing they ought to lose their free medical card and get to face the bills like the rest of us. Maybe I'm harsh but what do you think?
Any better suggestions out there? Please share them with us.
COMMENTS
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Nekirena
16:37 Mar 23 2014
I completely agree with this:
If an ambulance is used routinely for rides to get pain meds without a true medically proven reason I thing they ought to lose their free medical card and get to face the bills like the rest of us. Maybe I'm harsh but what do you think?
A few months after giving birth to my son, I had a kidney infection that my insurance would only cover the doctor visit, not the antibiotics or the test (was rounded out to about $1250- which I didn't have) and I was advised by my doctor to drink tons of water and cranberry juice. I did and a week later, I was crippled with pain and couldn't move. My step mother ended up calling an ambulance (mind you- she just had heart surgery the month before and couldn't drive) and I was rushed to the ER with the kidney infection becoming septic.
The visit, the ambulance, the antibiotics, and the tests cost close to $6000 total. That doesn't count the entire day I spent there- $900 for "holding a bed"- $6900 TOTAL. At the time I was a single mother, disabled veteran AND working as much as possible to make ends meet. All the money I made went to my (at the time) infant and rent/bills. There was no way in hell I could afford even 1/4 of that.
However, I will say... One of the ER nurses saw me there a few weeks before with my son (he had respiratory issues when he was born) and I was frightened about his health and if I could afford the bill ($1300). She had a rep come in and helped me apply for Mass Health and Network Health "Together" and was approved for it within three weeks. They covered our bills because it was documented I was working and disabled, as well as the sole caretaker for my son.
Sadly, that isn't always the case. I know people who work damn hard and can't even afford to see a doctor annually. Then people I know who have never worked a day in their lives, are pill poppers, and that not only have full coverage (dental/eye/phycial/meds/ect) and just slum around the house all day, but scam the system and become "pain pill addicts".
It's a messed up system. It makes hard workers look bad and lazy people look fantastic. It's depressing and it's horrible. Unless you make a 5-6 income a year, you're looking at being in debt from medical bills.
The messed up part about all of it is the most debt can be matched up to Educational debt and Medical debt, yet they want Americans to step forward and help "build our country back to her glory"? I think the European system has the upper hand. They don't try to bankrupt their citizens with medical bills. I think there should be some similarities placed to match our system to theirs.
For instance; Children's and Adolescence's medicine (antibiotics, vaccines, ect) shouldn't cost an arm and a leg; to raise a child is expensive and a parent(s) shouldn't have to worry about keeping their child healthy or feeding/providing a roof over their head (some bills are 1-2 times MORE than monthly rent). Second, minor's should receive their medical benefits without repercussions. Medical debt is ridiculous. No one should be scared and worried if they will or won't die because they can't afford their medications. That should be the same for people are unable to work due to disabilities (and the elderly).
I think if medical costs were cut literally in half then the debt toll will lower massively. There is no reason why procedures should be that expensive. Medicines, live saving medicine, shouldn't be so expensive. There is no reason medicine or medical treatments that are dire or necessary should be priced so high. None, whatsoever.
Nekirena
16:41 Mar 23 2014
*Life saving.
Nightgame
18:45 Mar 23 2014
I honestly feel that all US children under 18 or 25 if in school should be covered by the medicaid program regardless of a parents income.
If the parent/guardian earns over 250,000 a year then they could be charged a reasonable premium for that coverage but if you're earning less than that it's hard to make ends meet in many places with kids.
I disagree with the difference in the medicaid/medicare program and yet every time the politicians start talking it's the medicare program they want to reduce. Let's be honest they are blaming the program that working folks earned instead of dealing with the program that's wasteful to the extreme.
sahahria
18:53 Mar 23 2014
THIS. This is the reason I am doing low cost Acupuncture. It is why many Dr's are looking at doing their own low cost clinics. Will it take the place of hospitals and insurance? Sadly not for a long time. But it can lower cost of lesser things like cold/flu and pain. This is a huge relief on the current system. However, being low cost we can't always pay for advertising such as pharma companies.
Nightgame
21:41 Mar 23 2014
That's true Sahahria, and I agree those drug companies deserve to recoup their investments but what about when it goes way beyond what they spent and they still keep the costs so high many that need the drugs cannot possibly get them?
There is a whole group of people in this country that do not qualify for the fully paid medical cards yet their insurance if they have any, has high co pays and deductibles that mean they have to budget their health costs against rent and food.
I have to admit we've been lucky here in my area with a good family doctor that when my sister was without any health care coverage of any type treated her for 50 dollars a visit way below the normal rate for him and super below the other doctors in this area. We also have a friend that's a dentist that will let us make payments on any work we have done. Not the kind that runs you though a credit company loan just pay him each month until you pay it off. Bless both of these men who see their jobs as more than a way of becoming rich or sending money overseas.