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chisue

Half of US Births and Half of US Seniors...

chisue
7 years ago
last modified: 7 years ago

I had no idea that half of these services in the US are funded by Medicaid until I read an article in today's Chicago Tribune business section. Lisa Schencker reported on a meeting between the Tribune and the soon-to-be-replaced acting administrator for the Centers for Medicare and Medicaid Services, Andy Slavitt. (Trump has not named a successor.)

Wow, *half* of Americans can't pay their delivery/medical bills? I'm less surprised by the maintenance bills for Seniors, and I know many poor children and disabled adults rely on Medicaid.

We're a rich country. I'm not complaining about paying for care. I am concerned about how Trump's people will 'save money' as promised to their anti-Obamacare supporters -- many of them Medicare and Medicad recipients. (BTW, Slavitt emphasizes that Medicaid isn't an 'urban' program; lots goes to rural areas.)

Maybe the anti-Planned Parenthood folks will start paying for preventive care and the births for these people (and costs up to age 18). Does the AARP have a plan to prevent further 'warehousing' of Seniors?

This deserves front page attention, not a burial on page three in a later section. This isn't just Business, although health care is currently a third of our economy (per Slavitt).

Comments (42)

  • sjerin
    7 years ago

    This is one of many terrifying worries I have now, Chisue. The only answer for equitable health care is universal health care, run by the government. It works for most every other country in this world and doesn't bring its residents to ruin, as ours, if returned to a business-only model, did and will. We've been with Kaiser (non-profit: read, reasonable cost) members for over 30 years, have no problems seeing doctors, including specialists, having tests or getting meds. I think many in our country have been snowed, and don't do any thinking for themselves. Those who are wealthier can always get their own specialized care if non-profit care isn't for them, and they are the ones bashing care for the rest of us. (Profit, profit.) Let the complaints roll in.... Thanks for posting this, Chisue. It kills me that the efforts made to make health care available to everyone is about to be decimated, most likely. Population control, I suppose.

  • mama goose_gw zn6OH
    7 years ago
    last modified: 7 years ago

    Those figures don't surprise me--I used to work in a hospital
    admissions office, and then for a catering company which prepared and
    delivered subsidized meals to the elderly and disabled. More recently, I
    researched Ohio's Estate Recovery
    plan when my late aunt needed care. She had worked hard for her home and benefits, and she wanted her brothers to inherit her estate. Fortunately she had enough savings
    to cover a part-time home care aide, without involving Medicaid, and we took over the rest of her day-to-day care. If the
    states can no longer subsidize home health aides, meals, and nursing home care, I
    wonder what will happen to seniors. I've read that families will be
    expected to care for them at home, or bear the cost of nursing home
    care. What of those who do not have a loving family to provide care, or to be a presence in the nursing home, to check that the relative receives quality care?


    I'm sure that Ohio has a high level of Medicaid
    recipients, yet more of our citizens voted for Donald Trump. Maybe that
    means that those who voted are paying taxes which support Medicaid, and
    they are tired of paying for those programs. Actually that's not a
    guess--I've heard it from more than friend. neighbor, or relative. I am very proud of my father--he can be a curmudgeonly old grump when it comes to funding Medicaid programs, but even he could not vote for Trump. I would be
    interested to know how many Medicaid and Medicare/Medicaid recipients
    voted, in toto, and how many of those voted Republican.

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  • blfenton
    7 years ago

    Here's a link to the article. Link - Chicago Tribune

    It isn't a long article and is easy to read.

  • Elmer J Fudd
    7 years ago

    The US healthcare system is a mess. The political system is a mess.
    Put them together and you get where we are today with this problem.


    Among
    developed countries, we're at the bottom in a value received for money
    spent assessment. We pay more for healthcare as a pecentage of GDP than
    most other countries, much more in many instances. While Americans with
    adequate coverage (or Medicare) have access to some of the best care in
    the world, others have no access at all.


    I share
    chisue's concern but not her alarm. It took a long time to get into the
    mess we're in and it will take a long time to get out. The problems are
    so profound and multifaceted that I expect it will neither be ruined nor
    fixed under a Trump administration, whether it lasts for four years or
    eight years.

  • pkramer60
    7 years ago

    I was on the phone this morning with my Uncle and Aunt in Germany. They, like many Europeans and Canadians, cannot understand why the US, one of the richest countries in the world does not have single payer-universal health coverage. The elderly, the poor, children, veterans and the disabled so often struggle between food and meds.

    What are we so afraid of in having this basic right....the right to good health.

  • Elmer J Fudd
    7 years ago

    pk, I don't think Germany has a single-payer system (implying that the government runs the provision of services or is the only source of payment to service providers). Rather, it has a multipayer system that involves both governmental and private insurance payers. I lived in a neighboring country with a similar system. Reimbursement rates, coverage provisions, etc., are set by the government and are the same no matter what insurance provider is used. Some service providers prefer to see only patients with private insurance (for which reimbursement can be higher than for those having only governmental coverage).


    I do think that would work here. In many countries there, when people are unemployed or below certain income levels, the monthly premiums for health insurance are paid by the government or is simply provided directly.

  • Jasdip
    7 years ago
    last modified: 7 years ago

    Our healthcare is paid as long as we're in the hospital, at the doctor's office, or meds are being administered at the hospital. Many, many people who need life-saving meds, are finding that their medication is not covered by the province. People are using up their life-savings, re-mortgaging or selling their homes, going into debt to afford the medications they need.

    We were just told that the medication hubby needs (Hormone therapy along with the radiation) to blast his tumour is not covered. The radiation is, as it's done in the hospital, but the monthly hormone drug is not, and it's "several hundred" dollars. The urologist is going to try to cut a deal with the drug reps. If hubby was 65, he said it would be covered, but he's younger than that, so it comes out of our pocket. How, I don't know.

  • Texas_Gem
    7 years ago

    Mama- I understand, I have yet to meet a single person who is getting "affordable" healthcare since the ACA went into effect. Our premiums cost us almost 2000 a month. A month!!!!

    If it weren't for some fortuitous raises and the generosity of our family, we wouldn't even be able to have a house or afford rent.

    Before my husband got a raise, we paid more each paycheck for health insurance than we brought home. It's ridiculous. The ACA certainly hasn't helped my family!!

  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    ACA was about access to insurance, coverage level choices, and then also subsidies for low income people. The more people are covered and the fewer uncovered, costs should decline. That hasn't happened yet. And, costs do vary significantly from state to state.

    Whichever way you get there, medical insurance is expensive when the covered individuals have to pay the entire cost. For my career and into retirement, my coverage is through a large nationwide employer's group. I was able to look back through pay-stubs beginning in 2000 and while the total cost has increased over the years, it was never low and today is higher than what you're describing.

    I know several non-low income people, several who are self-employed
    and a few others who were young retirees whose Cobra coverage couldn't
    reach until Medicare age, who are now able to get insurance coverage that was
    unavailable before.

  • chisue
    Original Author
    7 years ago
    last modified: 7 years ago

    Why don't US businesses fight harder against having to help pay for employees' health care insurance? It's one of the things that make other nations' businesses more competitive -- job drain for the US.

  • nicole___
    7 years ago

    My sister worked for Kaiser. She said they had trouble keeping doctors since the ACA kept wages lower than a doctor would make in a private practice. I had a Canadian friend who had cancer radiation complications. Her intestines kept fusing. She'd stay in the hospital until she was emaciated and almost dead, then they'd operate on her, removing a section of fused intestine until it happened again. She hates the care she gets in Canada(also says she pays $150 a year to get her plan, it's not completely free or usable if she gets sick outside of Canada).

    Germans are taxed 50% of their income....? and health care is free....not exactly....

    There is NO perfect solution...anywhere in the world. There never has been.

  • Elmer J Fudd
    7 years ago

    I'm not sure I understand what you're saying, chisue. Can you give an example or say it another way?

  • Texas_Gem
    7 years ago

    Elmer- I'm not sure if you were addressing me or not but our coverage is through husband's employer, which is a small (around 50 employees) company. They do cover some of the cost.

    Why exactly did these self employed people and young retirees not purchase individual plans before the ACA? I know several self employed people who have always had coverage through an individual plan. The only difference after the ACA is that their cost, like mine and everyone else I know, went up dramatically.

    While I'm quite certain you can easily afford those kind of premiums with your (I'm guessing) over 6 figure income, we can't. Even after raises, over 30% of our income goes to premiums alone.

  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    nicole, I think you have some misconceptions.

    -At least in California, Kaiser, (which is a health insurance company, a physicians practice, and a hospital chain all rolled into one) has been the cheapest available source of medical care for the last 50 years or more. Kaiser membership is still cheaper than most other ones and before ACA, Kaiser would accept many individual applicants that other insurers wouldn't. Comparing Kaiser care to PPO type care is like comparing a hot dog stand to a 3 star restaurant. They limit treatment, argue about what's necessary, and have wait lists. Doctors leave Kaiser because the pay scales are below what they could get elsewhere and many don't like the bureaucracy and treatment practices. On the other hand, Kaiser has a lot of foreign trained doctors who are less competitive in the job market for more desirable jobs and so they wind up there.

    -very few Germans pay 50% income tax rates. The average German pays less income tax than the average American. It is true that their social taxes and VAT increase the tax burden. But they also have excellent governmental services, like most European countries and unlike what we have here. Their infrastructure is modern and convenient, not decrepit like ours.

    TG, I don't want (or need) to get into much detail, but I was (and am) a partner in a partnership so I didn't HAVE an employer, I WAS the employer (in a shared role with my partners). While my company paid almost all the health insurance bills for employees (I think we covered 80%), we partners individually pay the entire amount for our own coverage. But it's cheaper than what's available otherwise because we have a large group and with a lot of young people in it.

    Normally group rates are lower because, it being insurance, the claim experience involves a large number of people that averages down the expected cost. Pre-ACA, occupational orgs like Dog Trainers Association of Texas (I made this up) might have gotten group rates from an insurance provider that allowed members to get good priced coverage. Pre ACA, for onesy/twosys, insurance companies charged rates that didn't factor in average group experience (young people as well as old ones) and often excluded preexisting conditions.

    An explanation I heard was when ACA came in, they knew their new customers could include many people who hadn't had coverage (or medical care) in some time and they were fearful what the claims experience might be. In some cases, those fears have proven to be true and some companies are withdrawing from some states.

  • Elmer J Fudd
    7 years ago

    Addendum for what I left out...


    It's too expensive. Even those with middle class income can't afford health insurance. I get it. I think everyone should be covered. Many ways to do it, they all cost money, but getting more people covered will reduce the cost per capita.


    An easy way for those who don't want government involved - require all employers to provide medical benefits for employees working over 20 hours a week. Yes, that will make goods and services more expensive. Nothing is free. Can't be done? Nonsense, this very thing is required in dozens of countries all over the world.

  • sjerin
    7 years ago

    Whoa, Elmer! As I said above, I'm a Kaiser member and almost everything you've written is INcorrect. Where do you get your "info"?? My dh's niece finished many years (and certifications/degrees) of medical training, is highly sought-after and chose to work for Kaiser.

  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    My info is from two docs I know who have worked there, family members who have been (and still are) members there (since the 1950s). Cost information is from being an employer seeing medical insurance costs.

    Kaiser's reputation is better than it used to be but it's not my cup of tea. The horror stories are there to hear. I prefer to choose my providers, choose where I go.

    Young docs tend to go there as a lifestyle choice. The incidence of docs on staff who went to medical school in India, China, Middle Eastern countries, etc is disproportionate to the medical community in general. What conclusion do you draw from that?

    I'm glad you've had a good experience and hope you continue to.

  • nicole___
    7 years ago
    last modified: 7 years ago

    Elmer....my sister works for Kaiser in California. She's a nurse. I was quoting her.

    I was getting Kaiser here in Colorado through my employer, which is now too expensive with the "new" health plans. I go through an insurance company and pay for a catastrophic plan now.

    My MIL was "dating" a German citizen who gave us the tax information. :0) He was not happy, but made a huge income, it all worked.


  • pkramer60
    7 years ago

    Elmer, I know you dearly like to be correct in all instances but you are incorrect. What you have described is a hybrid universal health, common in many countries. Everyone is covered by their government, whether administered by that government directly or through outside sources. This is considered single payer. It becomes hybrid when an individual purchases a private supplemental plan of their own choice. Some governments will reimburse private doctors, some not. Most E.U. countries operate this fashion, and also some Asian countries.

    About 15 years ago my mother was in an accident while we where in Londan, badly scaping her shin. When the bleeding would not stop, the hotel called their MD, who bandaged her and gave her a shot of antibiotic. I inquired for the bill and was kindly told that National Health even treated Yanks for free while visiting. The doctor even called the next day to check on her. That does not happen here!

    A few years later Mom became deathly ill in Germany and was admitted to hospital for two weeks. The only invoice we received was for phone charges! To say we were stunned is an understatement.


  • chisue
    Original Author
    7 years ago
    last modified: 7 years ago

    It seems to me that one reason products from other nations are less expensive than those made in the US is because US employers must contribute to their employees' health insurance costs -- including all the HR overhead to administer the coverage.

    In some instances employees *have* no health care. In others, though, health care is provided by taxes and government administration.

  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    pk, what of what I said do you think is incorrect?

    It's been some years (actually a few decades) since the years I lived nearby and had colleagues in Germany, so I'd double-checked with Wikipedia before making the comment. The first sentence in the article says "Germany has a universal multi-payer health care system with two main types of health insurance: "Statutory Health Insurance" (Gesetzliche Krankenversicherung) known as sickness funds (Krankenkassen) and "Private Health Insurance" (Private Krankenversicherung)".

    If you think the Wikipedia article is wrong, you can change it.

    Single payer is like Medicare for senior citizens in the US. This isn't that.

    Healthcare in Germany

  • sjerin
    7 years ago

    We (and friends who switched back to Kaiser, not to mention other friends,) have very different experiences from you, then.

    Taking a job at Kaiser is a lifestyle choice? What does that mean? The niece is American and lives in the NW. You and I live in a very diverse area which I love, so I am not surprised to see docs of many ethnicities. Years ago I would hear various accents, but not so much anymore as these people grew up in the states.

  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    sjerin, you overlooked some of my specific comments and questions but that's fine. Kaiser has long been an efficient and low cost provider of medical services in California. It is what it is. Its efficiency is achieved by keeping a tight control on spending and on the provision of services. Its reputation is for low cost to members and efficiency, not for quality. Quality is better than it used to be (Kaiser horror stories are numerous and legendary whether you know of them or not), but it's still Kaiser.

    Kaiser is medicine for the masses and has characteristics not terribly different from integrated systems like the government run NHS in the UK. Some people, me included, want to be able to have options and choice of individual providers and can afford to pay more to have that. If you're happy, great.

  • susanjf_gw
    7 years ago

    fil passed away in may and we're still getting his bill for about $44,000 from Medicaid/nursing home....and we dumped everything he had, sent them every cent/info and we were assured he be accepted, now they asked for this....he ended up in a nursing home...

  • wildchild2x2
    7 years ago
    last modified: 7 years ago

    Kaiser is fine for general medical needs, wellness care, having babies etc. But it becomes a disaster when you have an illness that is hard to diagnose or requires a lot of lab work,scans etc. to diagnose. If it's costly there will be a lot of delay.

    I have a very good friend who has cerebral vascular disease. It took over 2 years for them to come up with a diagnose. It was a year before they finally ordered an MRI. Before that was done there was a CT scan instead that showed nothing. It was well into her 3rd year before they finally ordered a catheter angiography. It was around a month before she got the results. They confirmed that her cranial arteries are narrowed plus she has an aneurysm. it was suggested it be checked yearly or more frequently if any more symptoms showed up. That was 5 years ago.

    Contrast that with my private health insurance. I see my doctor, he orders a test and within days I have an appointment to have it done. I was able to drive from his office to the lab on the same day for a CT scan he requested. For an MRI i waited maybe 3 days. My Kaiser friend waited almost a month (once ordered) to get hers.

    Elmer is right , Kaiser is for the masses and people love it until they get seriously ill. Then the delays could kill you.

    Now my friend is on disability. She had Medicare along with Part B once her disability was approved. For but for the first time she experienced what having a private primary care doctor was like. She's always been among the working poor. Kaiser was as good as it got and most of the time she didn't have that. Then they bumped her to MediCal (Medicaid for the rest of you). Now she is back at the bottom. Only clinics accept it around here. So she is back at an Indian Health Center for her care. Well meaning, caring. doctors and nurse practitioners but hardly set up to manage her life threatening illness. She can barely walk with a bad knee. Now if it was me my doctor would have me seeing an orthopedic specialist immediately. They are sending her to physical therapy. Yeah that's the plan. No diagnostics. That was over a week ago. Still waiting for the referral.

    MediCal is broken. Having health insurance has little to do with health care if you are a low income senior and an honest citizen who doesn't know how to game the system.

  • eccentric
    7 years ago

    Jasdip - I am sorry to hear about your husband's insurance situation. Have you looked into Trillium?

    Also, from your post it sounds as if your husband's doctor said that if your husband was 65 the cost would be covered (under the ODB) - if that is the case, I would still check it out as coverage is constantly changing - and not for the better. The ODB does not pay for many of the drugs that people need post 65. There is an OHIP website where you can type in the name of the drug that your husband would need to see it if would be covered.

    My husband has only two prescription - both eye drop related. He pays the annual deductible and then the ODB pays most of the cost of the eye drops (note most of the cost). The ODB will only pay for generic drugs if the drugs come in that form - if they only come in brand name then the ODB will cover the cost. Guess who cannot take generics - me. It is not the medicinal ingredients but the non-medicinal ingredients. Many seniors have the same issue.

    However in my case it is a moot point because although I am over 65 the ODB will not cover my 2 prescriptions.

    My husband does have some coverage as part of his retirement benefits but it comes with a huge deductible - and we would most likely only spend the deductible amount, unless something seriously changes (hopefully not).

    He does not have vision any vision coverage though. I have to get new reading and distance glasses so I paid for them.

    Should he die I would be covered for one year only. I did look at private coverage but the cost would (at the moment) be far more than what I would spend in a year.

    Health care really differs depending on the province in which you live. Many things covered say in B.C. are not covered in Ontario.


    Under my husband's current health provider (it changed last year) certain drugs have to be pre-approved by the new company, even if they were covered by the last insurer.

    I hope that you are able to get some relief. I am concerned about the word "hormone" as part of your husband's required treatment. If you have a good pharmacist maybe ask him/her about the drug.

    I do know a young woman who has been receiving assistance from Trillium for many years (she is now 38 - drug costs per year are about $4,000).

    I won't say not to worry because you can't help it.
















  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    watchme, I think you've said you're in the Bay Area. If your Medical-using friend is too, she should be able to be treated at either Stanford or UCSF. Both have fabulous clinics, state of the art facilities and top drawer docs. Or, any other medical school system if she's closer to another.

    One Kaiser story I have (of many) concerns my aunt, the family tightwad (which is why she had Kaiser). Anyway, she was having back pains and saw her Kaiser GP. He told her she wasn't getting enough exercise and suggested taking a daily walk. Fair enough. A week goes by, pain is getting worse. She gets another appointment and sees her doc again, he says she's fine but gives her stretching exercises to do after her walk. More time goes by, pain is getting unbearable, she goes in to see the doc again who finally refers her to the orthopedic department. X-rays disclose she has several fractured vertebrae and signs of osteoporosis. She was given pain pills, dietary recommendations and a brace. She was told to rest and avoid activity (the opposite of what she was doing). As I remember, it took a month and the several visits in to Kaiser before she was able to see the right person and have her problem diagnosed. That's not the kind of medical care I would find acceptable. She had other incidents like this, as did members of her family.

  • wildchild2x2
    7 years ago

    Elmer your advice about getting treated at s Stanford or UCSF is well and good. I love the care we've recieved thee since we are in network. But if you go to a list of Stanford doctors accepting new MediCal patients you will be hard put to find one. When she first told me of her troubles I thought maybe she just wasn't utilizing all resources available to her. So I tried. You do a search for those accepting MediCal. Then you see the letters EPO next to their names. Existing patients only. The only places left are the Urgent Care type clinics or health centers for the indigent.

    It's difficult for those of us who have good insurance with choice to understand the reality of managed care. My friend doesn't drive. She had to go on permanent disability. She has to to the bus to get anywhere. Imagine waking with a bad stomach bug and having to travel hours on a bus or buses to see a doctor. Then taking a number and waiting several hours more to be seen. Until one has had to rely on VTA for all their daily activities they can't imagine. There is Outreach paratransit. Guess what. The rules have changed. You have to be 65 years old or lack the skills to take public transit now. She's 62. Three more years until she's eligible unless she gets dementia or can longer walk. Then what will it matter? This poor gal falls through the cracks where ever she turns. I do my best to help her but I have my own family responsibilities and health needs to take care of. Low income housing? Fell through the cracks. She lives in a remodeled garage with a motel sized fridge, a microwave and a toaster oven. Over half her disability check goes for rent. Makes it hard to eat well. She has a lot of pride too. So I often cook too much and ask her to take some so it doesn't go to waste. We go out for a meal and I order more than I can eat and offer the untouched "planned for leftovers" to her. We try to go places where the senior specials can feed her for two or three meals. I find reasons to treat her. "You watched my dog this afternoon, let me buy you dinner". She was born and raised here. Always worked, never asked for a dime except for the disabled child she raised alone after a failed marriage. Has no family that are competent enough to help her. I am the nearest thing she has. She never complains, never whines and pushes herself to do all she can.

  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    Yeah, I know nothing about MediCal, I'll leave that to you.

    The Stanford Medical system has opened primary care and other specialty locations all over the area. It's not necessary to go to the hospital on campus or the outpatient center in Redwood City (though we have a few docs there too). I just got a new internist (my existing one retired) at one of the neighborhood locations and she's great. All the internists and fam medicine people there are accepting new patients. As for Medical, I don't know.

    I'm sorry for your friend. I wouldn't want to live on a low fixed income in this very expensive area.

  • chisue
    Original Author
    7 years ago

    People will always complain, and all care is NOT equal, regardless of the 'system'. All the same, government-funded (tax-funded) health care has been in place for a LONG time in other first world nations. A British nurse came aboard our plane to give me a *free* pain shot enroute Venice-London-Toronto. I'd had a kidney stone for two days -- developed before our ship reached Venice. Worst pain EVER. The pilot would have put us off if I could not have gotten the shot. We were dumbfounded that this was free. That was 23 years ago.

  • mojomom
    7 years ago

    Elmer said" TG, I don't want (or need) to get into much detail, but I was (and am) a partner in a partnership so I didn't HAVE an employer, I WAS the employer (in a shared role with my partners). While my company paid almost all the health insurance bills for employees (I think we covered 80%), we partners individually pay the entire amount for our own coverage. But it's cheaper than what's available otherwise because we have a large group and with a lot of young people in it."

    Elmer, I am exactly in the same boat and as premiums go up, I get hit twice: (1) I pay 100% of my (and DH's) premium and (2) the partnership's bottom line is reduced (thus my income) by the increased premiums for employees, staff and associates. We've been lucky, our insurance is pretty good and our premiums have been *relatively* stable in recent years, but only because we as a firm actively shop and manage it. Still, some of our partners, especially those whose spouses are employed by the government or in the health care industry, opt to be insured on their spouses plan because it's less expensive and better. Both DH and I are 61, and I'd hate to be out there without workplace insurance. Although I will probably semi retire late next year, I hope to be able to remain in some capacity and work less but enough to stay on the firm plan. And I do enjoy many aspects of my work (particularly research and special projects), just ready to back it down, have less ongoing responsibility and work more remotely.

    ACA has helped my niece and nephew, both underemployed by choice (or lack of drive) are on government subsidized plans, and frankly, while I do love them, I am appalled that they are getting help while others who sorely need it do not. While they do really qualify, my brother (who has several million in assets all inherited (family farms) has never been employed outside the family farm, and doesn't earn 1/2 his salary -- hence raising kids with no work ethic or motivation) can afford to buy them new cars, etc., but they rely on government handouts for their kid's health insurance.

    In contrast, I obviously come from the same background as my brother and could have relied on the family farm as well -- we are only two years apart -- but I obtained a professional degree as did my DH and we've worked in our professions for 30+ years. While we paid for our DD's insurance in her twenties (pre ACA, and she was young and healthy so a goodindividual policy was relatively inexpensive), when she married she and her DH recognized the importance of benefits and when they married made sure that one of them worked for a company that offered good health insurance benefits. DD works for a company with great insurance (albeit a bit too high deductible). She has had some significant health problems over the last few years and it's been great. But even if not, they would have insurance through the exchange, but make too much for subsidied insurance. But I am glad they would have options, especially since DD now has a preexisting condition.

    However, my bottom line isn't how it affects me and mine, we're not rich, but very, very, fortunate. What bothers me is the working poor and some of the horror stories above and others like them. I would like to see universal healthcare and/a single payer system, based on need. But until then, I think it would be an absolute disaster to halt employer mandated plans.

    it is a tough situation and there are no easy answers.


  • wildchild2x2
    7 years ago

    Elmer, We are very happy with Stanford Medical Care. Our personal physician we've had for many years whose group just became part of the Stanford Health care network likes them also. He says he still has the freedom to practice medicine putting his patients needs first. They have also opened a new cancer center in the South Bay. We chose to pay a little more through DH's employee health plan to retain control of our options of who and when to see. We are fortunate that we can do so. Some people think we are crazy not to choose a cheaper plan available to us. But to us it's been worth every extra budgeted penny due to the excellent health care we get. I sleep better knowing that if one of us got a life threatening illness we won't die for lack of care waiting in line or being shifted from department to another with weeks or months in between.

    I know people that will not blink at over-insuring possessions that can be replaced or buy life insurance they don't need but won't pay a dime more for better health insurance.

  • Elmer J Fudd
    7 years ago

    mojomom, my firm doesn't really have a choice because we need to offer the very best benefits to be competitive in the hiring markets. It's expensive but okay, because the partners get the same benefits.


    watchme, I've been to the "Cancer Center" near Good Sam hospital to get some imaging done. It's a very convenient location, though that's not where my internist is. I do go annually to the Redwood City location just off of 101, that's where the Sleep Clinic is. I've been a patient of theirs for almost 20 years, back when they were located on campus.

  • wildchild2x2
    7 years ago

    Elmer, We've used their Sleep Clinic, Back Clinic (Redwood City) and Hearing Clinic (Palo Alto). All services have been excellent. Our primary doc is local. We've been with him for over twenty years. Fortunately he is younger than us and doesn't plan on retiring soon so we hope to have him though our old aging process as long as possible.

  • stolenidentity
    7 years ago

    This pretty much explains the problem (bolded stuffs):

    Wow, *half* of Americans can't pay their delivery/medical bills?

    So the health care delivery systems get paid by charging paying folks, via insurance or write offs, and our gov allows the hcd to charge exorbitant prices to the payers whomever they may be.

    We're a rich country. I'm not complaining about paying for care. We are?? Well I'm not rich, and don't know very many rich folks!

    I am glad that Medicaid is available to the indigent, the elder and the young, and am pretty sure that our representatives will keep this product available to them. The rest of us "rich" folks will continue to pay for it.

    People have lots to say about these types of articles and issues. And forums are great to discuss and yes, complain about them. BUT, better to get your pen out and write to YOUR representatives to advocate change and be sure to put folks in your offices to apply them.

    Folks love to rant and boo hoo but it's few and far to see a solution. Be well everyone, and pay your portion of any bills promptly since the richly covered seem to hang out here.


  • sjerin
    7 years ago

    Elmer, from what you write I could extrapolate that you think we are tightwads and needy. Hey, no offense taken, though that is most definitely not the case. Through 30 years and several surgeries, we've received nothing but wonderful care. My mom in the NW had successful open heart surgery at 85 through Kaiser. I can understand your situation but perhaps it's best not to judge what you don't have experience with.

  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    Thanks, please don't extrapolate. I was talking about my aunt, not you or anyone else.

    The fact remains that many Kaiser members are there because it's at the low end of cost for services and always has been. Many working for large employers and those with union contracts have Kaiser because of the low cost relative to alternatives. As I said, it is what it is - it has sustained its low cost model for a long time but part of how it accomplishes that is by go-slow service and limiting what it pays employees. It's acceptable to some, it wouldn't work for me. I like choosing when, who I see and where I go for medical services. Many others feel the same way. From what I can see having new partial coverage through Medicare, that's the model available for Medicare participants too.

  • chisue
    Original Author
    7 years ago

    Maybe there would be more jobs if employers didn't have to foot part of the bill for their employees' health care. Maybe employees wouldn't be afraid to change employers.

    Stolenidentity is right. We do talk a lot about this, but we need to insist that our elected officials DO something. Now...exactly what do we want? An undefined call for "Change" just dumped us out of a frying pan and into put us into a fire.

  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    And there would be more healthcare if employers were required to provide the benefit for all employees. Or, if a tax were levied on employers and employees to pay for health coverage. Both approaches are used in countries with universal coverage. I'd support these changes, how about anyone else?

    People want benefits and services but don't want to pay for them. When individuals INSIST on always buying the lowest cost alternative for goods and services, employers need to limit costs by limiting employment, salaries, and benefits. And moving manufacturing to lower cost locations.

    There's no mystery about why things are the way they are today. It's all about choices and consequences.

  • sjerin
    7 years ago

    I see you need to have the last word on something you're not part of, Elmer. We are NOT with Kaiser because it's the least expensive; we stay because we like our docs and our care. I'm certainly not going to go into personal experiences here but it's not fair of you to dish an hmo you have never had any part of, and with which many, many people are very happy. I suspect you have closer to concierge care, which this is not, but Kaiser works great for hundreds of thousands of people. It is an example of how a single-payer system works, and works well. We have all heard many non-Kaiser stories of incompetent docs and very long wait times. Our wait times appear to us to be far shorter than friends on other plans, even Stanford plans. :)

    Chisue, I have to disagree with you on the idea that there would be more jobs if employers didn't have to help subsidize healthcare. If recent history has taught us anything, it's that big business is all about keeping as much profit as possible. (Small businesses are a different story and I'm sorry when I see news articles not make the differentiation.) I believe if large businesses thought they could get away with not helping with insurance costs, they would do it in a heartbeat. The only answer is government-sponsered health care, again, as is done in every other economically viable country. Profit must be taken out of the equation, or there will continue to be a growing chasm between those who receive healthcare, and those who do not.


  • Elmer J Fudd
    7 years ago
    last modified: 7 years ago

    "The only answer is government-sponsered health care, again, as is done in every other economically viable country"

    This statement is incorrect.

    I'm happy for you to have the last word on Kaiser, I had my say and this isn't a fight to the death.

    Have a good day! (sincerely)

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