On June 27 2012 21:23 BluePanther wrote: My personal interest: Will Scalia secure enough support to kill Wickard? My brain and gut say no, but I hope he does out of curiosity's sake. Wickard overruled would be a HUGE win for Republicans/states-rights, regardless of what else happens in the decision.
As much as I'd like to see Wickard overruled, I don't see it happening. There will be a lot of language that limits Wickard, but the outright overruling of Wickard isn't necessary to get rid of the individual mandate because the question presented is different.
I know the odds are unlikely, but any retreat from wickard is interesting and affects people more than they realize.
And that's the most distressing part about the Democrat/liberal position on Obamacare and the individual mandate. Having the Court strike it down is a true, unequivocal win for freedom.
On June 28 2012 05:41 Romantic wrote: I called, got an appointment for the next week, and had a cavity filled with tooth colored composite filling for $100, which is ~11 hours at minimum wage in Washington. No waiting in the office. Hell, the receptionist was even really cute. Does that help? lol
And this is why crap like Michael Moore's "Sicko" pisses me off. It totally misrepresents how good the US healthcare system is for most people. As another example, I had a badly infected ingrown toenail last month. I called up a specialist's office, booked an appointment for that day, got the partial toe-nail removal surgery done that day, and was on my way to recovery. No lines. No waits. I just got it done.
I had one when I was in junior high. The doctor even stayed late because it was really bad and he didn't want me to wait for his next opening (I ignored the infection for a long time because I am dumb). Really nice guy.
The absolute worst experience I've ever had with American health care was when I was very young and the family was on Medicaid. Doctors treated you alright. You could tell they weren't happy about taking Medicaid patients, but it was alright. Welfare office treated you like shit though.
On June 28 2012 02:48 Domus wrote: I am from Europe, and when I read things like this, the USA almost looks alien, so similar yet so different. Just explain to me, what is the justification and where is the civilization in letting people become more ill, die, or in a completely desperate financial situation because of something that they did not choose (becoming ill)? All I can say is that if this is not implemented in the USA, then the US citizens are missing out on one of the greatest merits a society has, keeping each other healthy.
i don't generally approve of taking money away from the poorer sectors of society to give to the richer sectors of society, which is exactly what the mandate does.
If the system is in any way similar to the European system, then it is actually there to protect everyone, including the poor, and give them access to good healthcare, just like the middle-class and the rich have access to it. It does not change my situation whatsoever if the USA implements this, all I can say is that I am very happy about the system we have in Europe, and it is worth investing in, and I wish it for all Americans too to have access to such a system.
well, i've heard all the horror stories of various European healthcare systems and i'm not exactly eager to change my currently awesome healthcare for... well for what they've got which by all accounts is a lesser system. now im not exactly the most educated person on the issue, but im pretty sure a lot of what i've read ain't lies.
it is illegal in the US to refuse ER treatment. people still get treated, they just have to pay for it. also, the mandate requires the young, who are traditionally the poorest and use healthcare the least to pay for the old, who are traditionally the most wealthy and use healthcare the most. not fair, yo! why am i paying for grandpa when grandpa has got more money than me?
So, barring the obviously flawed conflation of "horror stories of various European healthcare systems" with "by all accounts", what about the 46 million or so individuals who were without health insurance before Obamacare? Where's your lamenting the "horror stories" of fellow US citizens, because there are millions of them.
Most of them are likely voluntarily uninsured or illegal immigrants. I use voluntarily uninsured in a wider sense than simply not wanting health insurance. If you want health insurance, claim you can't afford it, but buy yourself a new TV and regularly dine out don't tell me you actually want health insurance. Every one wants insurance, some people just choose other things more.
I bought a book called Generation Debt by an American liberal author; many of the stories involved, "I spend all my money on partying and vacations and now I can't afford to get my tooth removed and I have college debt. I am so scared. Government please help" lol. Reading their honest testimony probably made me less sympathetic to them. I wouldn't call that person involuntarily uninsured.
Yes...of course! 46 million people do not have insurance because they are out partying! So poverty simply does not exist in the USA, good to know! Don't you see how flawed your argument is? Anyway...I guess I am done discussing this in this thread. It is quite clear what type of people are against it. The type that says, well, everything is fine with ME, I am doing ok, everybody else should just take care of their own problems! This train of thought is so self-centered, and self-obsessive, such strong individualism has really let mankind take a turn for the worse...
When did we say we are all rich folks who have no problems? I cannot speak for any one else, but when I make mistakes I don't blame society and demand free things. When I was younger my family was poor, I've probably experienced much worse "first world" poverty than most people on TL.
Most of the uninsured in the US are young people\illegal immigrants, and most of them are employed but at or near the poverty line. Being young, most of them likely do not need the insurance and\or it would be very cheap if they wanted it.
The difference here is I take in to account how they could solve their problem rather than immediately telling the government to throw public money at them. My parents could have had insurance for the family and improved their earning ability. Instead they chose, day after day, to spend money on cigs\alcohol\weed\gambling\going out to eat\seeing movies\new electronics we could never afford instead of buying health insurance or paying to go to a community college.
Just a specific response to your story...It is completely anecdotal and says nothing about the situation others are in...but let's take your situation...You are an innocent child here in a shitty situation. But I take it your parents did not get sick. What would have happened to your life if you or your parents got a serious illness, like cancer. Think about what your life would have looked like?
Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
In terms of care, the biggest difference that I can think of is that the on-call specialist would have been called in to perform surgery on you that night (unless you were in a really small town where there was none).
@Rye - I have insurance from work and live in the U.S:
I dislocated my shoulder last year while snowboarding. Being that I was not familiar with insurance, I asked the doctors and nurses about how much things would cost me. They told me they didn't know how to answer my question, as they deal with billing. They also did not warn me that painkillers (I was in some serious pain, and morphine was not doing it) would cost a lot.
The bill ended up being about $10,000USD. $2,000 of that was for the method of popping my shoulder back in, $8,000 of that was for painkillers. My insurance covered pretty much the whole thing (thank god), except for a small deductible. It also covered the ambulance cost (couple of hundred) and would have covered the emergency room stay if needed.
If I didn't have insurance at the time, that would have bankrupted me.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
Why? The injury was not life-threatening, a cast would have been enough, but might not lead to the best result...
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
They might. And then the insurance company denies his claim for not obtaining pre-auth. Which becomes patient responsibility to pay for the entire surgery for the next 6 months or 2 years that it takes to appeal it 5 times. Seriously, I see this shit all fucking day.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
They might. And then the insurance company denies his claim for not obtaining pre-auth. Which becomes patient responsibility to pay for the entire surgery for the next 6 months or 2 years that it takes to appeal it 5 times. Seriously, I see this shit all fucking day.
Emergency care is never pre-authorized. It is simply done, and then billing is dealt with after the fact. As for whether there's insurance coverage, I can't imagine that insurance companies would regularly contest emergency care. It's an invitation for a bad faith lawsuit. As a lawyer, I'd love to go after an insurance company who did it. Talk about easy pickings.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
They might. And then the insurance company denies his claim for not obtaining pre-auth. Which becomes patient responsibility to pay for the entire surgery for the next 6 months or 2 years that it takes to appeal it 5 times. Seriously, I see this shit all fucking day.
Emergency care is never pre-authorized. It is simply done, and then billing is dealt with after the fact. As for whether there's insurance coverage, I can't imagine that insurance companies would regularly contest emergency care. It's an invitation for a bad faith lawsuit. As a lawyer, I'd love to go after an insurance company who did it. Talk about easy pickings.
If only you could see how many ER visits I see denied as not medically necessary or for no pre-auth. Does requiring pre-auth on something that the patient comes to the ER for make any fucking sense at all? No, absolutely not. Do they still fucking deny shit for that CONSTANTLY? Absolutely yes.
On March 23 2012 14:16 Kuja wrote: The healthcare system is so broken; I for one am not in favor of obama-care. If people are important to society they will be able to pay their medical bills. If they're not i don't want to pay them for them. Seems to be moving closer to socialism everyday. Away from democracy.
I hate that arguement " I dont want people to live because its medicine today communism tommorow" bullshit. Any american who has experienced systems in countries that actually take care of their people think its an amazing idea and to be against the idea of healthcare for everyone is quite frankly abhorrent.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
They might. And then the insurance company denies his claim for not obtaining pre-auth. Which becomes patient responsibility to pay for the entire surgery for the next 6 months or 2 years that it takes to appeal it 5 times. Seriously, I see this shit all fucking day.
Emergency care is never pre-authorized. It is simply done, and then billing is dealt with after the fact. As for whether there's insurance coverage, I can't imagine that insurance companies would regularly contest emergency care. It's an invitation for a bad faith lawsuit. As a lawyer, I'd love to go after an insurance company who did it. Talk about easy pickings.
If only you could see how many ER visits I see denied as not medically necessary or for no pre-auth. Does requiring pre-auth on something that the patient comes to the ER for make any fucking sense at all? No, absolutely not. Do they still fucking deny shit for that CONSTANTLY? Absolutely yes.
Wow. I need to expand my practice. Does your company get sued regularly? There has to be some enterprising plaintiff's lawyer out there that gives your company fits.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
They might. And then the insurance company denies his claim for not obtaining pre-auth. Which becomes patient responsibility to pay for the entire surgery for the next 6 months or 2 years that it takes to appeal it 5 times. Seriously, I see this shit all fucking day.
Emergency care is never pre-authorized. It is simply done, and then billing is dealt with after the fact. As for whether there's insurance coverage, I can't imagine that insurance companies would regularly contest emergency care. It's an invitation for a bad faith lawsuit. As a lawyer, I'd love to go after an insurance company who did it. Talk about easy pickings.
If only you could see how many ER visits I see denied as not medically necessary or for no pre-auth. Does requiring pre-auth on something that the patient comes to the ER for make any fucking sense at all? No, absolutely not. Do they still fucking deny shit for that CONSTANTLY? Absolutely yes.
Wow. I need to expand my practice. Does your company get sued regularly? There has to be some enterprising plaintiff's lawyer out there that gives your company fits.
That is so funny, I was thinking something similar...Like..these two dudes together have the perfect basis to form a profitable company ^^.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
They might. And then the insurance company denies his claim for not obtaining pre-auth. Which becomes patient responsibility to pay for the entire surgery for the next 6 months or 2 years that it takes to appeal it 5 times. Seriously, I see this shit all fucking day.
Emergency care is never pre-authorized. It is simply done, and then billing is dealt with after the fact. As for whether there's insurance coverage, I can't imagine that insurance companies would regularly contest emergency care. It's an invitation for a bad faith lawsuit. As a lawyer, I'd love to go after an insurance company who did it. Talk about easy pickings.
If only you could see how many ER visits I see denied as not medically necessary or for no pre-auth. Does requiring pre-auth on something that the patient comes to the ER for make any fucking sense at all? No, absolutely not. Do they still fucking deny shit for that CONSTANTLY? Absolutely yes.
Wow. I need to expand my practice. Does your company get sued regularly? There has to be some enterprising plaintiff's lawyer out there that gives your company fits.
That is so funny, I was thinking something similar...Like..these two dudes together have the perfect basis to form a profitable company ^^.
The laws governing insurance companies are incredibly punitive when insurance companies breach their obligations to their insureds. There's always an exemplary damages component and provision for the payments of the insured's attorney fees. That's why insurance bad faith is such a big deal in the world of personal injury law. If you can catch an insurance company doing something bad, you can really make it rain.
On June 28 2012 07:32 Rye. wrote: Ive not read the full details about how Obamacare works, but from what i understand it sounds ok.
Here is my experience of the NHS in the UK. This happened about 5 years ago.
I was a student at university, (22 yrs old), walking back to my flat after being in the pub. I didn't really have much in the way of money. £5 for a pint and a curry was my Wednesday treat.
On my way home i was attacked by some nasty blokes because, and i quote what he said, "coz I dont like students". The result was a broken arm and a huge cut above my left eye, and several broken ribs.
I was taken in an ambulance to the nearest hospital where within 30 minutes i had the cut above my eye stitched up and covered. Afterwards, as it was fairly late (11pm ish) they took about 12 X-Rays and then put a temporary cast on my arm and told me to come back the next day when the specialist would be in.
The following day i showed up at the specified time and took a seat. About 40 minutes later my name was called and i went into the doctors office. Looking at my xrays, he said the break wasn't clean and the two halves of my bone (ulna) were not lined up nicely. He said i could have a proper cast put on and hope it heals well enough :S or i can have an operation to align the bone and have a metal plate put on it. He recommended the operation, as if i opted for the cast and the bone didn't heal correctly, i would have to have an operation anyway. And in his opinion the break was kinda bad and he didn't think it was likely to heal well.
So i went with the operation. They did some routine tests, but he didn't like stuff he was hearing so he sent me for an ECG which showed I was fine. With the doctors happy with my general health, I was put in a bed that day (Thursday) given some lovely and welcome pain killers, and i promptly fell asleep. (as you can imagine i had not slept much Wednesday night, so i managed to sleep for a long time, waking when food came round, then sleeping again.
I woke up very early Friday in pain and was told my operation would be in a few hours. They gave me some nice pills and a few hours later i was getting wheeled off. they were very nice doctors, and asked me to count down from 10 to 1. i remember cold traveling down my arm.
I woke up later, a nurse came and checked on me, then a doctor came and said everything went fine. Loads of my friends showed up, but the pain killers and recovering from the general anesthetic,.. and the numerous kicks to my head, left me short of things to say.
Friday passed and on Saturday after a few checks they let me go home. They gave me a bag filled with pills and instructions for how many and how often i was to take them. I went back to my parents house (my real home) and was pampered by my parents. ( :D ) I was told to take 4 weeks off uni, but after 2 i was missing friends and too many lectures. It took me 4 weeks to recover fully during which i kept losing balance and was pain. A month after the operation i had a few more X-Rays. I got to see them and my arm looked awesome; a metal plate and 6 screws going into my bone.
So, the point of this story..... well, at no point was money or insurance ever mentioned. NHS paid for it automatically. The level of care was great. i will never say a bad thing about the NHS....well, the food sucked but i wasn't really caring about anything like that at the time.
Now that its 5 years later and I've got a job, I'm paying tax, and on my wage slip is "National Insurance" and it really isn't that much being deducted. Its not that I'm now paying for the treatment i had; Everyone pays National Insurance if they are working.
My questions to someone from the USA who knows about stuff... What would have happened had i been in the USA when this happened? How would it be different? How much would that all cost with and without insurance? What would Obamacare mean for someone who has this happen to them?
As I said at the top, I haven't read much about Obamacare, but I hope my story shows that there are huge upsides to systems like the NHS, as well as showing the NHS in a good light.
Oh.. they also said if after a year the metal plate starts bothering me, like when doing a sport or something, then i can have it removed. again, this would be free.
Rye
As someone who works in an American health insurance company let me just say that your experience would undoubtedly have been much less pleasant.
You'd probably have to get the doctor to get the surgery pre-authorized because the insurance company would want to know the medical necessity for not just putting it in a cast and depending on how generous they felt at the time may or may not authorize it.
You'd also have to pay any deductible/coinsurance that your plan has, as well as deal with probable out of network anesthesiologist/ambulance charges. Admittedly most of these out of net providers will write the balance off after whatever the insurance company pays but technically they can come at you for their entire billed amount which is usually a shitload more.
If you had that happen without insurance in America... well... yowch. Probably a cheap ass cast and no surgery, that's for sure.
That part is just wrong. The surgery would have been treated as emergency care in the US and taken care of immediately.
They might. And then the insurance company denies his claim for not obtaining pre-auth. Which becomes patient responsibility to pay for the entire surgery for the next 6 months or 2 years that it takes to appeal it 5 times. Seriously, I see this shit all fucking day.
Emergency care is never pre-authorized. It is simply done, and then billing is dealt with after the fact. As for whether there's insurance coverage, I can't imagine that insurance companies would regularly contest emergency care. It's an invitation for a bad faith lawsuit. As a lawyer, I'd love to go after an insurance company who did it. Talk about easy pickings.
If only you could see how many ER visits I see denied as not medically necessary or for no pre-auth. Does requiring pre-auth on something that the patient comes to the ER for make any fucking sense at all? No, absolutely not. Do they still fucking deny shit for that CONSTANTLY? Absolutely yes.
Wow. I need to expand my practice. Does your company get sued regularly? There has to be some enterprising plaintiff's lawyer out there that gives your company fits.
I have no idea I am a peon, although I get threatened for suing like once or twice a week. Most of the time they just say they are going to contact the state insurance comisioner's office.
On June 28 2012 02:48 Domus wrote: I am from Europe, and when I read things like this, the USA almost looks alien, so similar yet so different. Just explain to me, what is the justification and where is the civilization in letting people become more ill, die, or in a completely desperate financial situation because of something that they did not choose (becoming ill)? All I can say is that if this is not implemented in the USA, then the US citizens are missing out on one of the greatest merits a society has, keeping each other healthy.
i don't generally approve of taking money away from the poorer sectors of society to give to the richer sectors of society, which is exactly what the mandate does.
If the system is in any way similar to the European system, then it is actually there to protect everyone, including the poor, and give them access to good healthcare, just like the middle-class and the rich have access to it. It does not change my situation whatsoever if the USA implements this, all I can say is that I am very happy about the system we have in Europe, and it is worth investing in, and I wish it for all Americans too to have access to such a system.
well, i've heard all the horror stories of various European healthcare systems and i'm not exactly eager to change my currently awesome healthcare for... well for what they've got which by all accounts is a lesser system. now im not exactly the most educated person on the issue, but im pretty sure a lot of what i've read ain't lies.
it is illegal in the US to refuse ER treatment. people still get treated, they just have to pay for it. also, the mandate requires the young, who are traditionally the poorest and use healthcare the least to pay for the old, who are traditionally the most wealthy and use healthcare the most. not fair, yo! why am i paying for grandpa when grandpa has got more money than me?
So, barring the obviously flawed conflation of "horror stories of various European healthcare systems" with "by all accounts", what about the 46 million or so individuals who were without health insurance before Obamacare? Where's your lamenting the "horror stories" of fellow US citizens, because there are millions of them.
a lot of those 46 million are young people who do not need and do not want health insurance. and no one said that we shouldn't reform the system, but there are better ways than just mandating kids get comprehensive health insurance when they don't need it.
the horror stories from the US health care system are often about how someone went into really bad debt because they received treatment. I don't see how that can be construed as a terrible problem. the fact is, they got the treatment they needed and now they need to pay for it. it's sad, sure, it's really sad, but that's how the world works. if you don't get health insurance then you have to be ready to go into debt when something catastrophic happens.
furthermore, you ignored the most important point i made, which was:
the mandate literally redistributes wealth from the poor to the rich. any redistribution of wealth is suspect, but that kind of redistribution is straight up medieval.
if you can't get health insurance because you have one of the millions of pre-existing conditions they would deny you coverage for then you have to be ready to go into debt when something catastrophic happens.
To me, this comes down to what I believe the government has rights to do. I personally think the government is here to protect us and...that's about it. I don't think the government should have the right to tax me for someone elses benefit. Personally, I think this is straight up unconsitutional and not what our original founders of the Constitution had in mind when they wrote it, but our entire goverment is going down the pooper and stepping over its boundaries in everything else they do. Big brother to the rescue...
On June 28 2012 02:48 Domus wrote: I am from Europe, and when I read things like this, the USA almost looks alien, so similar yet so different. Just explain to me, what is the justification and where is the civilization in letting people become more ill, die, or in a completely desperate financial situation because of something that they did not choose (becoming ill)? All I can say is that if this is not implemented in the USA, then the US citizens are missing out on one of the greatest merits a society has, keeping each other healthy.
i don't generally approve of taking money away from the poorer sectors of society to give to the richer sectors of society, which is exactly what the mandate does.
If the system is in any way similar to the European system, then it is actually there to protect everyone, including the poor, and give them access to good healthcare, just like the middle-class and the rich have access to it. It does not change my situation whatsoever if the USA implements this, all I can say is that I am very happy about the system we have in Europe, and it is worth investing in, and I wish it for all Americans too to have access to such a system.
well, i've heard all the horror stories of various European healthcare systems and i'm not exactly eager to change my currently awesome healthcare for... well for what they've got which by all accounts is a lesser system. now im not exactly the most educated person on the issue, but im pretty sure a lot of what i've read ain't lies.
it is illegal in the US to refuse ER treatment. people still get treated, they just have to pay for it. also, the mandate requires the young, who are traditionally the poorest and use healthcare the least to pay for the old, who are traditionally the most wealthy and use healthcare the most. not fair, yo! why am i paying for grandpa when grandpa has got more money than me?
So, barring the obviously flawed conflation of "horror stories of various European healthcare systems" with "by all accounts", what about the 46 million or so individuals who were without health insurance before Obamacare? Where's your lamenting the "horror stories" of fellow US citizens, because there are millions of them.
a lot of those 46 million are young people who do not need and do not want health insurance. and no one said that we shouldn't reform the system, but there are better ways than just mandating kids get comprehensive health insurance when they don't need it.
the horror stories from the US health care system are often about how someone went into really bad debt because they received treatment. I don't see how that can be construed as a terrible problem. the fact is, they got the treatment they needed and now they need to pay for it. it's sad, sure, it's really sad, but that's how the world works. if you don't get health insurance then you have to be ready to go into debt when something catastrophic happens.
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It doesn't have to work that way though. In fact, there are quite a few places where the above scenario simply does not exist, because the healthcare system does not charge more than a nominal fee at most for treatment, regardless of what the actual cost for the treatment is. It's been tried, it works, and it honestly isn't any more socialist than the post office.
As for just getting insurance, the issue is not that insurance itself is hard to come by, it's that when you get sick the profit driven insurance company will do anything in its power to weasel itself out of paying for basically anything. Thus you get aforementioned horror stories about people having to sell their homes to afford treatment after the insurance company denied their claims on frivolous or downright absurd grounds.
EPT
