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.
I'm not sure why you think the surgery would be "emergency care" it would be the stitches, x-rays, some sort of cast, and some painkillers. Hospitals use their screening procedures to determine what is an emergency, emergency care stops a lot sooner than what you get with insurance. He was told the surgery was optional and then decided to have it the next day, that doesn't sound like an emergency care situation to me or the guy who works at an insurance company. They would of gone with the "hope it heals right" route if he had no insurance and he would of been charged for all the expenses of the previous night ending up in a shocking amount of debt. You are painting a rosy picture of the American health care system and I'm not sure its warranted. I have always had great insurance and have no worries, then again a friend of the family is currently over 100k in debt due to stage 4 Leukemia. The system really doesn't work for everyone, and if the poster from the UK was one of those voluntarily uninsured young people he would have some really tough decisions to make about how much debt to take on or to risk his arm healing wrong because he got assaulted.
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.
I'm not sure why you think the surgery would be "emergency care" it would be the stitches, x-rays, some sort of cast, and some painkillers. Hospitals use their screening procedures to determine what is an emergency, emergency care stops a lot sooner than what you get with insurance. He was told the surgery was optional and then decided to have it the next day, that doesn't sound like an emergency care situation to me or the guy who works at an insurance company. They would of gone with the "hope it heals right" route if he had no insurance and he would of been charged for all the expenses of the previous night ending up in a shocking amount of debt. You are painting a rosy picture of the American health care system and I'm not sure its warranted. I have always had great insurance and have no worries, then again a friend of the family is currently over 100k in debt due to stage 4 Leukemia. The system really doesn't work for everyone, and if the poster from the UK was one of those voluntarily uninsured young people he would have some really tough decisions to make about how much debt to take on or to risk his arm healing wrong because he got assaulted.
I have a bunch of clients who have had injuries requiring fixation surgeries such as the one described above. Here in the US, those surgeries are almost always performed immediately in the ER, regardless of whether the individual has insurance.
Not really a fair poll... I mean, I'm not against the idea, just the method. Penalizing for failure to purchase something is far worse than taxing and providing a service. It just sets a terrible legal precedent that is endless in scope.
I support most of the ideas within the bill, but I still dislike the bill.
(Vote): I'm all for it! Yay! (Vote): I'm against it! Grrrrr!!!
I mostly like it, but I'm not all for it. It's not executed perfectly in the bill. Regardless, I hope it passes. Waaaay too much uncompensated care in this country.
Not really a fair poll... I mean, I'm not against the idea, just the method. Penalizing for failure to purchase something is far worse than taxing and providing a service. It just sets a terrible legal precedent that is endless in scope.
I support most of the ideas within the bill, but I still dislike the bill.
Same here...
I'm guessing the Court will strike down the entire law tomorrow.
5-4 with a split majority striking down the mandate. scalia and thomas will write own concurrences, a plurality by roberts/alito. not sure if kennedy will join but for predictions sake i will have him writing a 4th opinion striking it down. kennedy's opinion will be the binding one, whether it's his or roberts's.
all 4 libs will vote to dissent for every reason they can possibly think of, with a joint dissent in substance (maybe a few choice words in solo dissent)
Not really a fair poll... I mean, I'm not against the idea, just the method. Penalizing for failure to purchase something is far worse than taxing and providing a service. It just sets a terrible legal precedent that is endless in scope.
I support most of the ideas within the bill, but I still dislike the bill.
Well, it's not a fair world, bud!
For the record, I agree with you. The concept of universal healthcare makes sense, but I'm not sure if the execution is sound.
On June 28 2012 13:25 BluePanther wrote: 5-4 with a split majority striking down the mandate. scalia and thomas will write own concurrences, a plurality by roberts/alito. not sure if kennedy will join but for predictions sake i will have him writing a 4th opinion striking it down. kennedy's opinion will be the binding one, whether it's his or roberts's.
all 4 libs will vote to strike down for every reason they can possibly think of, with a joint dissent in substance (maybe a few choice words in solo dissent)
i'm less sure of the others.
Somehow. I don't think the libs are going to vote to strike down the individual mandate, sir.
I truly hope the courts strike down atleast the individual mandate.
As an American, I am terrified of the idea that the government can not only order me to purchase a product, they can do so in such a facist manner. Hey, insurance companies, you are GOING to do this, but in return we will FORCE every american to buy your product...
No. Just no.
It is a fact that our health care system, especially in regards to the costs, needs improved. It is also a fact that there are far better ways to improve it that don't involve selling the very Soul of America.
On June 28 2012 13:25 BluePanther wrote: 5-4 with a split majority striking down the mandate. scalia and thomas will write own concurrences, a plurality by roberts/alito. not sure if kennedy will join but for predictions sake i will have him writing a 4th opinion striking it down. kennedy's opinion will be the binding one, whether it's his or roberts's.
all 4 libs will vote to strike down for every reason they can possibly think of, with a joint dissent in substance (maybe a few choice words in solo dissent)
i'm less sure of the others.
Somehow. I don't think the libs are going to vote to strike down the individual mandate, sir.
sorry, fixed it. i meant strike down the lower courts decision, but that was confusing in context
On June 28 2012 13:25 BluePanther wrote: 5-4 with a split majority striking down the mandate. scalia and thomas will write own concurrences, a plurality by roberts/alito. not sure if kennedy will join but for predictions sake i will have him writing a 4th opinion striking it down. kennedy's opinion will be the binding one, whether it's his or roberts's.
all 4 libs will vote to dissent for every reason they can possibly think of, with a joint dissent in substance (maybe a few choice words in solo dissent)
Eeep, this is one of the biggest differences between the English legal system and the US system. How political some of the Supreme Court's issues are (due to the constitution empowering them to moderate the legislature). Too political for my blood. The English judiciary very often leaves topics alone because they are too political, but the US court is happy to step in.
Then you get this nasty divide of judges into clear political ideologies. Not that it doesn't happen here, but when people are openly talking like it is a mini congress rather than a place for strong judicial reasoning and politically independent legal analysis, you can't help but question its adherence to the principle of separation of powers.
Cenk Uygur may be a biased commentator and he may not be particularly experienced, but he does seem to know some stuff about law (I think he studied it or maybe even practised it?), and his argument that Justice Scalia is primarily motivated by political reasoning rather than judicial, on the important political cases, was fairly scathing and seemed convincing.
On June 28 2012 18:50 Ironsights wrote: I truly hope the courts strike down atleast the individual mandate.
As an American, I am terrified of the idea that the government can not only order me to purchase a product, they can do so in such a facist manner. Hey, insurance companies, you are GOING to do this, but in return we will FORCE every american to buy your product...
No. Just no.
It is a fact that our health care system, especially in regards to the costs, needs improved. It is also a fact that there are far better ways to improve it that don't involve selling the very Soul of America.
Every single time you pay taxes you're being "ordered" to purchase a product not to mention car insurance...
EPT
