"First, as noted, they don't have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday."
*cries*
I have to shortly begin the task of painfully calling fifteen different bureaucrats to track down why certain things were applied to my annual deductible instead of being waived as they say specifically they will be on page 11 of my Brochure of Benefits. And it's pretty just little me fighting for my $250. My chances? Oh, so not good.
why certain things were applied to my annual deductible instead of being waived as they say specifically they will be on page 11 of my Brochure of Benefits.
Because they're hoping you won't complain, and because denying and misprocessing your claims costs them less money than paying your claims.
And especially because you are a small fish who will quickly cave when faced with the choice of either spending thousands in lawyer fees or just waiving your rights. The same goes for the IRS. Small fish are easy pickings. Rich people with lawyers are poison and are left alone.
yeah i'm fighting over $80 right now but it's the fucking principle and i will prevail.
one thing i've done: fuck 'em. get an HSA with HDHP. save, save, save. get the insurer's rates, without the insurer's schemes.
people say HSA-HDHP will put the stake in the heart of the first-dollar insurance model, cuz if you're healthy, you save. incentives? what the hell are those?
sorry don't mean to get all RON PAUL up in the place.
Uh, doesn't the Health Savings Account still leave you completely fucked for any *real* medical costs?
I mean, what if you get a $20K bill for an unexpected "fell-and-broke-my-leg-needed-traction" expense? Nobody has that kind of reserve, and that's a CHEAP medical bill in the US.
you can't even use HSA without HDHP. the $20k bill would cost me $6,400. My current reserve is $4,153. With 2008 contrib I have that kind of reserve. Call me nobody.
The thing you get is: Negotiated pricing. So off-the-street you pay $150 for a doctor's visit. Like all insurers, my plan has a negotiated rate of $85. Blood draw: $100. My plan: $10. So for $100/mo I get negotiated prices.
The other thing you get is: The most favorable tax treatment Congress has.
The one thing I didn't get this year is tax deduction for premiums, cuz I was W2 vs. 1099. Now that's a law that needs changing.
If I have an expected fell-and-broke-my-leg-needing-traction, they send two guys and a few hundred thousand dollars worth of equipment to scrape me up, put me on a wheely bed and drive me over well-maintained roads to a place where literally millions of dollars worth of medical equipment and trained professionals will set the bone, tape it up and give me the requisite drugs, fluids, food and related care until such time as I can leave under my own power. Then I go back in a week or two, get the plaster cut off and hobble home.
All that costs me one phone call. What's this "negotiated pricing" thing you're talking about?
Even including taxes, we pay less for health care than you do.
Less per capita, less per procedure. Less overall, but that comes from a smaller population, and so doesn't count. And our standard of care is not only better, it's so much better that the difference is enough that we're continually shocked at the backwards third-world conditions Americans are so proud of.
I suspect you're mistaken about care standards, which I suspect are nearly the same for those who can afford care. Impoverishment by illness in America is a function of cost, not quality. Every system has a means of rationing. Ours is just $.
Unfortunately, I can't find a breakdown of how much of the money that the province took out of my paycheque for taxes-in-general (EI and CPP are marked out separately) last year went to OHIP premiums. It might be more than 29%[1] of the taxes-in-general deduction, and at that point, I'd be paying more for baseline minimum health care than you are (remembering that if you were me, you'd be paying $1285--$1200 for the year and $85 for the annual checkup, 'cause cervical cancer sucks).
But (even leaving aside all the stuff that didn't happen but could have--see unexpected bone-snappy) that's leaving aside the three other doctor's visits I made last year, and the one blood test. So if you're not particularly healthier than me, but are also lucky enough to not break your leg or anything, that's about $1550. --- [1] And yeah, I realize that's income-based. If I couldn't find a job, or couldn't work because I was sick, or couldn't find a long-term contract and had the squidgy little two-week gaps between jobs[2], then I'd pay less. If I was making more money--touch wood, I need to find out when I hear back about the job I interviewed for--I'd pay more. [2] Because EI doesn't kick in for the first two weeks, and you do pay taxes on EI.
With your history of cancer, you probably could not buy my insurance. I bought it on the open market, which is vicious, absolutely vicious. Any history of serious ailment probably results in denial.
It's also well-established that Canadians pay less for similar outcomes. All other countries do. Here's the chart that I focus on:
So you've got two more years on us. We're a diverse nation with a lot of problems. But the spending is the obvious wtf here.
that says a whole lot right there.
this shows (http://www.thehealthcareblog.com/the_health_care_blog/2007/08/managed-care-re.html) a whole lot of fatties in the south and east. or just expensive doctors?
Clarification: She does not have, and has not had, cancer. She's counting $85 for an annual checkup to *check for cervical cancer* - ie, a pap smear.
It's what you do to make sure that, if something goes wrong, it does so while you still have a chance to do something about it. It's not something you do if you actually have cancer.
Mah-bah-wha? I don't have cancer. I've never had cancer.
Oh. Hang on.
Lack of clarity: the cervical cancer test isn't because I've had cancer. It's because during my annual check-up--and the annual checkup of any adult woman unless there's some strange exception I don't know about, possibly the annual checkup of any sexually active female--you *check* for cervical cancer.
It wasn't meant to be "You get an annual checkup because you already have cervical cancer". It was meant to be "You don't skip the annual checkup even though it'd save you $85 (although it wouldn't, I misunderstood your plan), because it's a really good way to find out very early on if you happen to be *getting* cancer, and then you can do something about it ASAP."
...do you know if women actually have to pay for pap smears in the States?
*goes back to staring at the cost of a long life chart*
basically if it's service, you pay for it, or someone pays, (apparently that's a hard concept for Canadians to comprehend), but in this case, it's very likely that any insurance would want to charge you little or nothing for a prevention exam, because no insurance wants to pay for the actual cancer!
On the other hand, I'm just... it's weird. I'm sitting here and if I'm reading you right, it sounds like anyone who doesn't have a special insurance plan and who walks in off the street or makes an appointment with their doctor or what have you needs to pay a hundred and fifty dollars for an appointment, and another hundred dollars to get blood taken for testing if that needs to be done to see what's wrong.
And because you have a particular insurance plan where you pay a hundred dollars a month, it only costs you eighty-five dollars to go see your doctor if you need your annual checkup or you're worried about something or you think you might be sick (or if you actually are sick), and you only pay another ten dollars if they need to draw blood for testing for anything.
Do I have that right?
(Ah! Le mot juste. I'm feeling like Cordelia Naismith, here, finding out that there were places on Barrayar where people didn't have free access to information and education.)
You have it right. Anyone who doesn't have a special insurance plan (almost any insurance plan that has an agreement with the particular doctor to act as a preferred provider) who walks in off the street or makes an appointment with a doctor pays the doctor's posted price.
And because I have an insurance plan, it only costs me eighty-five dollars to go see your doctor. It's like a 40% savings.
Actually my program covers one annual checkup per year for free.
And yep, blood draw is ten dollars. You pay $100. I pay $10. You have it right. Prices with insurance are 20%, 50%, even 90% cheaper. So even while my insurance doesn't pay for me, it radically lowers what I pay.
This is why I think manditory catastrophic insurance plus manditory medical savings is not so far-fetched as a cost-controlling technique.
I don't think he necessarily thinks we need to be taxed more, only that we should put more money into health care. It's possible to do so, by cutting back in other areas.
![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
(no subject)
Date: 2008-02-12 07:07 pm (UTC)*cries*
I have to shortly begin the task of painfully calling fifteen different bureaucrats to track down why certain things were applied to my annual deductible instead of being waived as they say specifically they will be on page 11 of my Brochure of Benefits. And it's pretty just little me fighting for my $250. My chances? Oh, so not good.
(no subject)
Date: 2008-02-12 07:14 pm (UTC)Because they're hoping you won't complain, and because denying and misprocessing your claims costs them less money than paying your claims.
(no subject)
Date: 2008-02-13 01:05 am (UTC)(no subject)
Date: 2008-02-12 07:54 pm (UTC)Yeeg. I hope it goes inordinately well for you.
(no subject)
Date: 2008-02-13 04:04 am (UTC)one thing i've done: fuck 'em. get an HSA with HDHP. save, save, save. get the insurer's rates, without the insurer's schemes.
people say HSA-HDHP will put the stake in the heart of the first-dollar insurance model, cuz if you're healthy, you save. incentives? what the hell are those?
sorry don't mean to get all RON PAUL up in the place.
(no subject)
Date: 2008-02-13 04:17 am (UTC)I mean, what if you get a $20K bill for an unexpected "fell-and-broke-my-leg-needed-traction" expense? Nobody has that kind of reserve, and that's a CHEAP medical bill in the US.
(no subject)
Date: 2008-02-13 04:24 am (UTC)The thing you get is: Negotiated pricing. So off-the-street you pay $150 for a doctor's visit. Like all insurers, my plan has a negotiated rate of $85. Blood draw: $100. My plan: $10. So for $100/mo I get negotiated prices.
The other thing you get is: The most favorable tax treatment Congress has.
The one thing I didn't get this year is tax deduction for premiums, cuz I was W2 vs. 1099. Now that's a law that needs changing.
(no subject)
Date: 2008-02-13 04:44 pm (UTC)If I have an expected fell-and-broke-my-leg-needing-traction, they send two guys and a few hundred thousand dollars worth of equipment to scrape me up, put me on a wheely bed and drive me over well-maintained roads to a place where literally millions of dollars worth of medical equipment and trained professionals will set the bone, tape it up and give me the requisite drugs, fluids, food and related care until such time as I can leave under my own power. Then I go back in a week or two, get the plaster cut off and hobble home.
All that costs me one phone call. What's this "negotiated pricing" thing you're talking about?
(no subject)
Date: 2008-02-13 04:48 pm (UTC)(no subject)
Date: 2008-02-13 04:51 pm (UTC)Less per capita, less per procedure. Less overall, but that comes from a smaller population, and so doesn't count. And our standard of care is not only better, it's so much better that the difference is enough that we're continually shocked at the backwards third-world conditions Americans are so proud of.
(no subject)
Date: 2008-02-14 01:23 am (UTC)(no subject)
Date: 2008-02-13 06:36 pm (UTC)Unfortunately, I can't find a breakdown of how much of the money that the province took out of my paycheque for taxes-in-general (EI and CPP are marked out separately) last year went to OHIP premiums. It might be more than 29%[1] of the taxes-in-general deduction, and at that point, I'd be paying more for baseline minimum health care than you are (remembering that if you were me, you'd be paying $1285--$1200 for the year and $85 for the annual checkup, 'cause cervical cancer sucks).
But (even leaving aside all the stuff that didn't happen but could have--see unexpected bone-snappy) that's leaving aside the three other doctor's visits I made last year, and the one blood test. So if you're not particularly healthier than me, but are also lucky enough to not break your leg or anything, that's about $1550.
---
[1] And yeah, I realize that's income-based. If I couldn't find a job, or couldn't work because I was sick, or couldn't find a long-term contract and had the squidgy little two-week gaps between jobs[2], then I'd pay less. If I was making more money--touch wood, I need to find out when I hear back about the job I interviewed for--I'd pay more.
[2] Because EI doesn't kick in for the first two weeks, and you do pay taxes on EI.
(no subject)
Date: 2008-02-14 01:48 am (UTC)It's also well-established that Canadians pay less for similar outcomes. All other countries do. Here's the chart that I focus on:
So you've got two more years on us. We're a diverse nation with a lot of problems. But the spending is the obvious wtf here.
that says a whole lot right there.
this shows (http://www.thehealthcareblog.com/the_health_care_blog/2007/08/managed-care-re.html) a whole lot of fatties in the south and east. or just expensive doctors?
(no subject)
Date: 2008-02-14 02:00 am (UTC)It's what you do to make sure that, if something goes wrong, it does so while you still have a chance to do something about it. It's not something you do if you actually have cancer.
(no subject)
Date: 2008-02-14 02:43 am (UTC)Oh. Hang on.
Lack of clarity: the cervical cancer test isn't because I've had cancer. It's because during my annual check-up--and the annual checkup of any adult woman unless there's some strange exception I don't know about, possibly the annual checkup of any sexually active female--you *check* for cervical cancer.
It wasn't meant to be "You get an annual checkup because you already have cervical cancer". It was meant to be "You don't skip the annual checkup even though it'd save you $85 (although it wouldn't, I misunderstood your plan), because it's a really good way to find out very early on if you happen to be *getting* cancer, and then you can do something about it ASAP."
...do you know if women actually have to pay for pap smears in the States?
*goes back to staring at the cost of a long life chart*
(no subject)
Date: 2008-02-14 05:33 am (UTC)basically if it's service, you pay for it, or someone pays, (apparently that's a hard concept for Canadians to comprehend), but in this case, it's very likely that any insurance would want to charge you little or nothing for a prevention exam, because no insurance wants to pay for the actual cancer!
(no subject)
Date: 2008-02-14 01:09 pm (UTC)We just know exactly who pays, and it's usually not the patient or the doctor. :)
(no subject)
Date: 2008-02-13 05:59 pm (UTC)On the other hand, I'm just... it's weird. I'm sitting here and if I'm reading you right, it sounds like anyone who doesn't have a special insurance plan and who walks in off the street or makes an appointment with their doctor or what have you needs to pay a hundred and fifty dollars for an appointment, and another hundred dollars to get blood taken for testing if that needs to be done to see what's wrong.
And because you have a particular insurance plan where you pay a hundred dollars a month, it only costs you eighty-five dollars to go see your doctor if you need your annual checkup or you're worried about something or you think you might be sick (or if you actually are sick), and you only pay another ten dollars if they need to draw blood for testing for anything.
Do I have that right?
(Ah! Le mot juste. I'm feeling like Cordelia Naismith, here, finding out that there were places on Barrayar where people didn't have free access to information and education.)
(no subject)
Date: 2008-02-14 01:20 am (UTC)And because I have an insurance plan, it only costs me eighty-five dollars to go see your doctor. It's like a 40% savings.
Actually my program covers one annual checkup per year for free.
And yep, blood draw is ten dollars. You pay $100. I pay $10. You have it right. Prices with insurance are 20%, 50%, even 90% cheaper. So even while my insurance doesn't pay for me, it radically lowers what I pay.
This is why I think manditory catastrophic insurance plus manditory medical savings is not so far-fetched as a cost-controlling technique.
(no subject)
Date: 2008-02-14 01:26 am (UTC)ObQuibble: You pay $10. Uninsured people pay $100. *WE* pay $0.
(no subject)
Date: 2008-02-12 07:44 pm (UTC)(no subject)
Date: 2008-02-12 09:17 pm (UTC)(no subject)
Date: 2008-02-12 11:29 pm (UTC)(no subject)
Date: 2008-02-13 12:03 am (UTC)(no subject)
Date: 2008-02-13 02:50 am (UTC)