3201

No I’m suggesting that those who were against it will just blame the reform. Those who were for the reform will blame the compromises. Another day another battle of pointless finger pointing.

3202

Jesus Christ. Why don’t you people just give up on this idea of for profit health care. It doesn’t work! The only way to get basic coverage to everyone is to mandate it. No matter what system of rules and regulations are set up to try and contort the market to try and incentivize providing that basic care in all cases they will always be exploited, gamed or perverted by companies chasing profit.

3203

This is preaching to the choir. Talk to the Republicans.

3204

Or individuals gaming the system. If you have guaranteed issue, then you must have either a really tight enrollment window with a long lookback period or a massive mandate penalty for going uninsured.

Look at states that have tried guaranteed issue w/o those factors. It has hammered the premiums on the non-group market (see NY, NJ and MA) etc.

The reason is that if you can buy insurance at any time and pay the same premiums as everyone else, then it’s stupid to buy insurance till you’re sick or need it. It’s not longer insurance. And the evidence is that people do behave this way.

3205

If I may complain about healthcare…

Currently my co-pay in MA with my employer provided healt plan is $100 for the emergency room.

Thing is, even if you try to not use the emergency room now, they send you to the emergency room. Last week my wife had a door slammed on her finger and thought it was broken. We called her PCP and tried to schedule an appointment to have it treated, specifically to avoid the $100 co-pay (a dr visit is only $50! Yippee. Fuckers.) The office would not even let us talk to her doctor, and insisted she go to the emergency room. I said “But I don’t want to pay a $100 co-pay, can we at least get a referral?” They refused, I pleaded, and then they hung up on me.

What the hell?

EDIT: Also, I pay $400 a month, family plan, for this insurance. My employer pays 60%. I have never once used it, as I’m never sick. I don’t even get checkups, because the co-pay is too expensive. The only reason I pay is because of that paranoid fear that if someone suddenly gets cancer or hit by a car I don’t want to lose my house.

It sucks. I could really use that $400. I have no savings and barely manage to pay all my bills each month.

3206

Well unless your doctor’s office had an X-Ray machine, she’d have to go to the ER. I’m with Kaiser and they don’t have X-Ray machines in doctors’ offices but YMMV.

3207

That’s the exact reason they gave. Still, why can’t I get a referral to avoid paying the $100?

We’re in the “let’s see if it gets better” mode now because we can’t afford the co-pay.

3208

Because they’d be obviously lying with the referral and they probably don’t want to get fired? You honestly don’t have $50 more to pay to get an X-Ray?

3209

True. This is likely another reason for public run basic health care. Everyone pays and everyone is covered. It’s also just better for society if everyone has coverage and is healthy. How do models like the Bismark one handle this sort of thing? Do they have an enrollment window?

3210

How is it a lie? If I see my doctor and he says I need an MRI I get a referral to a place with an MRI and pay nothing extra. Why is an X-Ray different?

And yeah I can always charge the copay. More debt. I’m trying to pay off my debt. The economy sucks. Costs are going up and my salary isn’t.

3211

In case of a suspected broken bone, the only way to properly examine your wife is by getting her an X-Ray. It’s a waste of everyone’s time and money for the doctor in clinic to see her.

I completely understand about taking on more debt, but you don’t want the bone to heal improperly because then they’ll have to break it again. Look up more info on webmd.com.

3212

It’s a waste of everyone’s except for Wallapuctus and his wife, you know the ones who pay for all of it.

3213

I understand the point of the absurd ER copay, its to keep everyone from running to the ER for a sniffle so actual emergencies can be dealt with.

I tried to do things properly. I called the PCP, they weren’t equipped to treat the problem, and I tried to get a referral to some facility with the gear to do what we needed. This is how I’m supposed to do things, right? Why are they trying to force me to an ER which just costs everyone more money?

3214

Maybe there’s simply no such thing as a referral to the ER. Perhaps they could refer you to a clinic of some sort that does X-rays. Of course then you’ll have to make an appointment which could take several days blah blah blah.

3215

Do you have anything like Patient Firstnear you? I use it all the time because it’s fast, convenient (no referral or appointment needed) and cheap. I’ve never been able to see a regular doctor when I need to (i.e. within a few days) and the ER is expensive so this fills that niche.

I was seen by a Physician’s Assistant once in an emergency when my doctor was unavailable for several days and that was a fiasco. She diagnosed me with tendonitis, but a doctor friend who I talked to about it over the phone pointed out that I probably didn’t because there are no tendons on that part of the leg! It turned out to be a fracture, which the PA probably would have figured out if she had x-rayed it, like I asked…

3216

You probably didn’t intend it this way, but you’re making a pretty good case for a single-payer system which requires everybody to pay into it as soon as they’re able (i.e., once they start getting a paycheck) and keep paying into it for as long as they can.

Just sayin’.

3217

Wallapunctus, the bottom line is that your wife needs an X-Ray. An X-Ray machine takes X-ray technicians to operate, which clinics don’t have.

The way Kaiser LA treats broken bones by the way is far more efficient than what you would get at a clinic. There’s a large room with about 20 tables. Every patient with a suspected broken bone is sat at a table (sometimes sharing) and an x-ray tech goes from table to table, taking the X-Rays. The doctor who is following him then looks at the X-Ray real time and then diagnoses the break. Another person comes behind the doctor and gives the patients the cast they need. It was pretty impressive.

It also demonstrates why going to the ER is more efficient overall. A doctor is not necessary to do the X-raying, a much cheaper X-Ray tech can do that. And an even cheaper medical tech doing casts can put the casts on. When you have a doctor doing all of that, it costs more.

Why there is a higher co-pay for going to the ER, I don’t know. You would think it would be lower, but like you said, I guess it’s to keep the hypochondriacs out.

3218

Lorini: For various reasons that I’m not clear on, ER visits are almost always much more expensive than doctor’s visits.

3219

I can literally feel my blood pressure rising with Wallapunctus story. It’s positively fucking mind-boggling. Somehow it being “just” a broken finger makes it look worse, maybe because it bares the whole kafkian scam without needing to pound us with the kid-with-cancer drama.
At this point I’d be seriously looking into emigration. If breaking a bone has any bearing on anyone’s life beyond the time lost and the annoyance of wearing a cast for a month, they don’t live in what qualifies as a civilized country in the 21st century.

3220

Amen. But don’t forget you guys are all socialists and socialists are really really bad people. Don’t forget!!

<sarcasm>