Frustrated With Medical Costs

I believe every person should be able to receive good health care for a reasonable price. Good health care is a necessity, not a luxury.

I believe insurance companies are a business that have one goal: making money.

I believe mental health should receive as much compensation as other physical issues from insurance companies. Psychiatric disorders are diseases, they are not character flaws.

I believe medical care costs are extremely high. Many people with long term serious illnesses have to declare bankruptcy.

I believe a person should be able to take advantage of Functional Medicine and other medical care that is considered experimental by insurance companies. This care needs to be affordable.

I believe my insurance company should not have the power to decide what medical care I receive by allowing payment only on certain treatments or medications.

I believe the premiums for medical insurance are extremely high, without receiving fair coverage. My husband and I own a small business and have paid premiums for many years.

I believe there needs to be major changes in our health care system.

Please explain to me why a government run health care system couldn't be better.

Thanks!
Caramel

Like socialism, it doesn't work. You want a system like Medicaid? That's Government run and paid for. Look at the posts by people here at PsychCentral who live in England and Canada. They have huge, long waiting lists and get "generic" help whereas we more often can choose who we want to help us in our communities.

Everything costs money. The Government only has as much money as we pay taxes. If everyone is getting their bills paid by the Government, who's paying the Government's bills? It's very much like the Social Security problem, especially now with the Baby Boomers getting ready to swamp the system; we can't all get money from the "Government", we ARE the Government. There is no "Them" because "Them" is us!

Life is difficult, there are no guarantees.

Hi Perna,

Thank you for helping me see the other side of this issue. I will read the posts from people in England and Canada. It is frustrating to me that a group of knowledgeable people can't get together and solve our health care problems.

Thank you for taking the time to answer my question!

Caramel

Caramel,
I live where many Canadians spend vacation time or live part time. They LOVE their healthcare and have no complaints. That is my personal experience when talking to them about it.

I also know several folks who live in the UK who also LOVE their National Health System, which ironically used US finances to fund it initially. Here is a link to the NHS site: http://www.nhs.uk/Pages/HomePage.aspx .

Even if those two national healthcare systems didn't work, I see no reason why a country like the US could not make a system that works well and is affordable for all. For one thing, Medicare and Medicaid could be discontiued because those covered under them would be moved to the national healthcare system.

Now that healthcare has been diluted to become more exclusive, and something less meaningful and less helpful, and insurance is no longer where investor's make a boatload, my hope is that a national plan is created. I'm not holding my breath, just hoping

In Arizona we have a system that a least pays the co-pays (sometimes the entire cost), depending on income & insurance, for most generic psych meds for Serious Medical Illness patients. It was better, but funding got cut way back this year.

I agree the healthcare system is not right.. something is wrong when I can buy a medication from a store pharmacy drug-club cheaper than what it costs me thru my Medicare Part D. Then on top of that is the $$ that is charged to Medicare by my Plan carrier!

I think the biggest problem with the U.S. Healthcare system is the same as with our business and other systems; we pay our people a lot. Health insurance companies are mostly paper pushers and that costs a huge amount of money. Think of your doctor's offices and how many clerks they have versus nurses; mine has more. I have a $2600 deductible to keep my insurance costs lower. We visit the doctor every 3 months or, 4 times a year; if we paid, out of pocket, the $80 it costs to visit a doctor without insurance, that would be $320. I pay only a little less, each month than that in health insurance. The health insurance, like social security, should be insurance, not pay for one's needs. I think one should budget for day-to-day needs like medical, in the same way one does car, rent, food, etc. Health care is a fact of life and a "choice" not a right. I don't think kids in their 20s' who'd rather have fast cars or fancy apartments should be forced by a government to have insurance if they didn't want to make that choice; but I don't particularly want money I pay to the government going to pay for their health and/or retirement care in that case.

Money is a difficult subject to discuss and I think health care in the United States has a lot to do with money. We all know people who abuse the "system" and we all know ways in our heart of hearts where we've wasted our own money in the past or think we have or are glad of "free" money, etc. It's like the environmental issues we're facing. It's about choices. This country though is the best country to be in, in my opinion, because it allows choices. Communism and socialism don't work because they don't allow choices, they try to eliminate need and, ultimately struggle, and it is struggling, in all it's pain and triumph that I think is one of the most important human attributes. We only learn and grow through struggling with things, not with letting someone else (government) do away with that and say, "Oh don't you worry your pretty little head about that, we'll take care of it". Getting one's say and having "liberty and the pursuit of happiness" as guides; everyone has different ideas about what that is and that makes it messy. I don't want to give up getting dirty and messiness, the mud wrestling of representative government/politics for someone else telling me what's good for me and telling me what doctor I can see and what that doctor is allowed to do for me! People forget that it's not JUST about money but there are people in there too and you dictate what doctors can do, how they practice medicine and you get a whole lot less variety and personal interest in there and that makes being a doctor less interesting to the more talented and you get mediocrity instead of good medicine. Kind of like what happens when Government gets too big :-)

I'd like to see the system privatized (and the social security system also) at least that way the Federal Government wouldn't be able to steal the funds.

However, the insurance companies lobby heavily in Wash DC, and contribute to candidates (all kinds) funds. I'd like to see only private citizens and non-profits be allowed to lobby, and of course, keep the governing at the State level. It's just not right to have the insurance claim agents and the lawyers dictate what type of care we get.

I heard one news coverage (Mind you, I work hard at not seeing any of them) where a man was complaining because his hospitalization/health care premiums were $438. a month for his family of 4... and how he couldn't pay it anymore. Well, I pay that for just me, and it increases 18% each year. Open season is coming up soon (November?) and I'm seriously considering cutting it way back. If the National health care mandates go into effect, I will cancel mine and proceed to go onto the backs of the Fed Govt (tax payers) instead of carrying my own weight. I'm not alone in this thinking. Those who pay their own way are being weighted with undo stress in paying for the rest, and the others are being rewarded for being a ward of the Fed Govt.

I think the doctors and medical personnel in this country could manage our health care (system) in a profitable and caring way, both. But there's no chance of that. I think we're in too deep to find a reasonable answer.

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I do not think I want the government making my health care decisions for me any more than I want the insurance company doing it. I do think we need reforms, ideally the government would act as a "watchdog" in my opinion.

The hospital charging $30 for two 500mg Tylenol is not acceptable in my opinion. It's highway robbery. A $60 "linen" charge for a paper sheet on the bed and hospital gown is also exorbitant. Why can my insurance company negociate a surgery from $5,000 to 3,500 but an unsured person pays more? The government is aware of these problems since they pay them via Medicade and Medicare. These are the problems that I'd like to see addressed.

We have a govt run system is Oz and though there are long waits for non-urgent surgery out system works really well.

We have the option of having private insurance, which I have because I want to choose my doctor or use the doctor I am referred to by my GP.

Our system pays for 80% of medications for low income earners, 95% for pensioners & unemployed and has a safety net which means once a pensioner or unemloyed person has spent $300 on meds the meds are free for the rest of the calender year. This year we had spent $300 by March.

What I object to in our system is the administrators of the public hospitals running the hospitals like a business and are stopping people from getting treatments they need and closing hospital beds so that they have a surplus at the tax year end and receive a bonus from their employers.

The system does work, and it is a matter of not actually expecting private cover treatment from a public system. The Public hospital system saved my life several times and I am very grateful to it. And I am very grateful to live in a country that actually looks after its people. All countries should do that.

Medications here are charged at the same subsidised rate as it is in the private sector. And the treatment is not decided by the govt, but by the treating doctor

I live in Canada and am very satisfied with publically funded health care. Each province funds the healthcare system a little differently although ultimmately it's all through taxes, each province also has a different system by which individuals pay more specifically for healthcare. I'm in ON and we have a healthcare premium on our provincial taxes. For me it's $700 / year. I think that's a good deal. For that I get unlimited visists with the family Dr. of my choice, a top notch psychiatrist who I see every two weeks, an addictions Dr. who I see everyweek for group counselling, and privately every 3 weeks. I've been in both privately funded adn publically funded rehabs. The publically funded one was better, and had a shorter waiting list than the private hospital. The two time's I've needed referals to specialists - a neurologist and and a haemotologist, I got to see them quickly, less than a week for the neurologist, and about 3 weeks for the haemotologist. I've been IP for psych issues 2 times at a top psych hospital. One time I was in for 7 weeks, and this time I'm in for 4. I don't have any insurance company questioning or balking at my treatment.

I've received excellent medical care whenever I've needed it. Partly that's where I live - I'm in a major urban centre with lots of facilities, and i have an amazing GP. In Canada GP's kind of act as gatekeepers to the other facilities so your GP is important - my GP is on the facullty of the medical school in town and so she knows a lot of the top dr.'s hence her referals are awesome.

The system is not perfect. Yes there are Dr. shortages - especially family dr's. and if you live in a remote area, then your acess is going to be limited. Surgeries are prioritized by need so elective surgeries can have long waiting lists. Psychologists are not covered at all, so if you want to have one you have to pay out of pocket.

My biggest complaint is that medications are not covered, unless you're receiving social assistance or are over 65 in which case they are. Some people have supplemental health insurance through work, whcih covers meds, but a majority don't which can be a real burden.

Yeah the system isn't perfect but compared to what I hear about the US system, I'm perfectly content with public healthcare.

--splitimage

But my private insurance is great! It's when the authorities of the nation have put their finger into the mix where I experience issues, not anything my own insurance company creates.

I can go to ANY doctor without having to have a referral, even specialists.
I have a small co-pay for many of them, maybe $25 a visit.
I have a discounted medications prescription plan included in my hospitalization premiums.
Any emergency room or urgent care center is fully covered, with no co-pay nor deductible.
I have free access to a nurse on the phone 24/7.
I have access to preventative care resources, free, such as nutrition eating plans, in paper form.
I can appeal any negative decision my plan might give me, such as for surgery or procedures they might think is not necessary, and they've changed their minds once they understood.
I can pay my premiums monthly.
I can change my private insurance during open season without any trouble at all. In fact, the hospitalization ins co I use sends me all the available plans from private sources with coverages, fees, deductibles so I can choose the best plan for me.
I don't have to be verified nor submit to a physical when changing plans during open season.
I have free 800 number access to claims in case of delay for authorization at any facility (most doctors call for their own authorization, rather than my having to do so)... but
If I go to an already authorized "preferred" doctor or facility, there's no call necessary...they send me a large booklet of resources each year.
The information regarding coverages is written in layman's language with no "legalese."
I am treated with respect at doctor's and facilities with limited waiting times and on-time appointments.
Doctors file the paperwork, so I don't have to pay and then file for reimbursement. Then my ins. co sends me itemization of who billed them for what and how much, what they paid and verifies I don't owe anything (or in case of a deductible, the only amount I am to pay.)

Yes, because of regulations being put on private companies now, some doctors are not taking ANY insurance.

That's my private insurance.
When I have to see someone under my disability insurance, the above rarely applies. Truly. I've gone to urgent care under both and the difference was remarkable. Now if I have to go I go in under my private, so I am treated, and then inform them (once sure of the cause) that it's govt disability, so my private never pays for anything they aren't responsible for, and I still obtain treatment. (I speak truth. Same conditions, same hours, same staff, different plans = treatment/no treatment. )

Just my experience.

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I pay $875 a month to cover myself and my two daughters. This is a huge expense that is really eating into my savings. I only get this coverage for 18 months and then my COBRA runs out. Not sure what I'll do then. I like to make a lot of my own health care decisions so I would have a hard time with big brother deciding everything for me. But I guess it would be better than having no coverage. Beggars can't be choosers.

A report just came out stating that the USA now has 50 million people on medicare/caid. It also said we have 1/6 of our population receiving their income from the Federal Government. This situation will not support itself, those who are working and paying into the system cannot support it, and might consider giving up since so few are trying to provide for so many.

I know the past couple of years, as I said, my private health insurance premiums have gone up 18% each year. With this recent increase on the federal health care system (which does not pay insurance companies enough to cover the medical care provided) I half way fear the increase coming out in October/November. I know for many years my premiums barely rose 6% and one year went down!

Has anyone else considered a stopping point in increase? I mean, have you decided on when (at what price point) you will no longer pay for health insurance?

You know, all these years I've had health insurance for my service dog(s) and in 18 years it's only risen 10% total (from 18 years ago to today.) Shhhh don't tell or they'll subsidize those too!

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The numbers are staggering to be sure, but the biggest problem is fraud. The government pays out millions every year in bogus claims. Fake companies buy names and socials, submit claims for three months then close shop and open under a new name and do it all over again. In the documentary I saw, the company did not even claim to offer any services or drugs, purely non-existant medical supplies like O2, potty chairs etc. All small ticket items that "it would cost too much to investigate". By the time someone on that list gets an explaination of benefits and calls to state that they did not receive the items, the company has moved on to a new name with a new list.

5A you're right (or at least I agree with you.) This is one reason why I support privatized health care. No private business could stay in business with such horribly deficient practices. The private business watches it's costs and losses and all that very closely or they don't last.

Depending upon what occurs in November I will make my decision afterwards, late November, as to whether to have hope for change or to pull totally out of private health care and put that money into my own account for future health care costs. While I abhor debt, I can always negotiate for less cost if I pay cash. . . or offer to make payments (to the tune of what I would normally be paying in premiums) to any facility I may need then. I've thought long and hard about this.

One problem is that I'm not insurable, so if I drop my hospitalization, I can't get it back. I do have other insurance though, through my disability (not SSDI)

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I haven't, but may have to do something drastic when my COBRA runs out. I want to keep covering my daughters, but maybe I will have to think of other solutions. I'm not sure what. For myself, I might go on the private market and buy a policy with a huge deductible, like $3000 or something. That might be all I could afford. (My COBRA insurance has only a $250 deductible.) (JD), had you considered what your stopping point is?

I work for an insurance company that is self funded. We pay 85% after a 200.00 deductible is met. Now the irony of it is my personal insurance only pays 60% after a 500.00 deductible with only 12 visits per year. I work for an insurance company and they give us sh..t insurance. I am so embarrassed by this and frustrated.

Isn't it odd how that works out?!? The worst insurance coverage I'd ever had was when I worked for a hospital. I thought that by working for the same company that paid the doctors I saw I'd actually save money on medical insurance.

Having worked for medical insurance companies, government run medical ins, and hospitals, and then also having more ailments than I can count needing care and prescription coverage.... I can see all the sides presented here. I really like my private insurance when I can afford it though I abhor the cost of it. The problem is that a majority of Americans have no insurance is the issue and it is because of the cost; compounding then the emergency and serious illness care, costs more to treat because there is no preventive care as it was not affordable and there is no choice then. The costs are OUT OF CONTROL for ALL of the various reasons already mentioned above by others PLUS research, education, marketing, and malpractice insurance. A vicious cascade. It would be ideal if private insurance continued for those that preferred to keep their private coverage and there was a government insurance for the majority of those who could not afford it.

The pitfalls for us in dealing with any insurance, all insurance is keeping overhead down and minimizing financial losses. Balancing premiums with payouts, and limiting treatments within guidelines, fact, whether privatized or government run. Both have to look at the bottom line to perpetuate themselves and cover the eventualites as we have a significantly growing, aging population; more payouts with more ailments, treatments, and medications. Limits are needed. The extremely high costs of research (and resulting products: equipment and meds), education, and marketing must come down so that fees and premiums passed to providers can come down, the providers need limits too, so fees are contained for the uninsured and insured (whether private or govt).

I think basic health care is a right, not a privilege and should not be profited from. This is where there are diverging views and why I don't see any limits happening any time. Free enterprise and all. Everyone wants their bucks, but it's effects are economics 101.