Folks that know me understand that I'm a fan of health policy. And we have a big problem with people not receiving adequate healthcare in this country because they don't have insurance (or have bad or incomplete insurance). Last week was "Cover the Uninsured Week" and we had some speakers at the med school.
But considering my personal experience, I wonder whether the folks who steer clear of insurance companies don't have the right idea after all. This last week the Boss tried to get our insurance company to reimburse for some covered prescriptions that we paid full price for (because they hadn't yet given us our number). I wasn't actually on the phone, but it seemed that the lady was calling the Boss a liar when she said she had already received a check from the company for the wrong amount. Her screen told her that they had denied both claims and the fact that Boss claimed to be holding the stub of a check complete with account number and claim number was moot. Why an account number and claim number is not sufficient to access the relevant records in a database is anyone's guess. My theory is that the company is trying to increase the number of insured Americans by decreasing premiums after doing away with all business records.
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Coach, I am giggling at your joke, but not at the reality of the situation.
Oh, boy, have you opened up a can of worms for me . . . I never profess to be anything but the simple-minded girl that I am, so can someone PLEASE explain the insurance racket to me, once and for all!!!! Who thought up insurance? Why doesn't it ever seem to work like it is supposed to? Who can tell me? We have to pay for insurance . . . I get it. The whole deductible thing, I don't know . . . We are owing a lot of money to the hospital from when Aaron was in the hospital about five months ago. We're paying for that as well as for the doctor who delivered Aaron and hospital fees for having him delivered. Now, I know these things would cost a lot more if we didn't have insurance, but still . . . the whole insurance / cost of health care situation concerns me. I'd fear to think if anyone in our family needed some kind of very costly medical treatment. And the nation is full of honest, hard-working, average joes like us. It seems like a never-ending problem. I have a friend who has trouble getting coverage because he is a diabetic - that whole pre-existing condition business. Scott will be chaning insurance soon due to a change in job. I don't look forward to all that entails. Anyway, I could talk on an on about insurance woes, if only I knew what I was talking about. So please, someone enlighten me.
This too is a confusing thing for me! Like Amy, I have never understood the whole insurance racket! It seemed like a good idea to offer insurance to guarantee payments for procedures etc so we get the medical help we need and the docs get paid. But I think really and truly, the only ones benefiting (the most anyway) from insurance are the insurance companies. There are people out there who pay religiously their insurance premiums and are never sick/never see the doctor etc. The companies make BIG bucks off these. Then, there are those of us who go in for our routine checkups etc and often end up haggling with the insurance for LONG periods of time to pay for those covered procedures (don't get me started on United Healthcare and that $65 bill we are being taken to collection for 2 yrs later because United still refuses to pay it though they have ALL the paperwork they need to see it was necessary procedure!) and then there are those who pay their premiums and have some severe illness etc that the companies LOSE money off of these patients. But then, like Amy said, these same people end up be excluded from insurance coverage at times due to "pre-existing conditions".
The alternative is probably national health care systems. Having been formally on medicaid, you see WHO is there not who you prefer. Sometimes this can be a bad thing. Countries such as Cananda, Germany, England, New Zealand, Australia, Mexico, etc have national health care systems. Their residents don't pay for most healthcare. But, each system has a set list of covered and non covered procedures. And, the waiting list can sometimes be extensive to get in to see a doc for those even routine things a person needs done. And private sector insurance in these companies can be exhorbitant. Canada also doesn't cover pharmacuticals. The patient pays that all out of pocket.
And speaking of the docs/medicines available. I have been told that those countries that have national healthcare systems barely pay their docs a living. So more and more of these docs leave those countries (causing longer delays in getting in to see a doc) and come to the US where they can "make it big". I know it seems like being a doc is going to get your rich but think of the medical school bills these guys have? and then they have their overhead etc so most end up barely breaking even as well.
But, without the insurance companies funneling money into the pharmacuetical companies for R & D, we're back to 19th century medicine where we may have good docs but poor quality medications to treat us with. It's like a never-ending vicisious cycle. And there is no clear cut easy answer.
Ok... I will hush and go away now. :) Thanks for letting me vent too!
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