NQR healthcare

[Stagecl]

Whether a health care system is a socialized one or an out of pocket one, everyone pays in a different way, ie. higher taxes or higher premiums. The advantage of an out of pocket system is that a generally healthy person isn't paying for everyone else.

In the USA, the ER's can not deny health care to anyone which is the same as Canada.

[Zora]

We need to clear up the Tricare issue, though. Tricare is a private insurance company with whom the government has contracted to provide care for military members, dependents, and retirees. They bid on the government contract, and the motive was profit. The government thought it would be cheaper to contract it out than to keep doctors on staff at the hospitals and clinics. (That hasn't proved to be the case. But that's another issue.)

The government dictates what minimum services will be provided. For example, Tricare cannot refuse to cover you because of pre-existing conditions. They must cover all eligible military members and dependents. Tricare negotiates with hospitals, doctors, etc., and sets fees that will be paid to the hospital or doctor (like a PPO..preferred provider organization.) You must go to a proider that is in the plan, or your co-payments are higher, etc. Tricare is paid a flat fee per individual in the plan (by the government), and again we must note here that their motive is profit. So, I don't see how this would qualify as a "government run plan." I believe the fees paid to doctors cannot exceed the fees paid by Medicare, so maybe that is what you mean by government run.

On average, our Tricare premiums are much lower than our civilian counterparts would pay. I don't know what (if anything) active duty members pay, but our premium is $460 per year for the two of us.

I have received excellent care under Tricare, since it has been provided largely by local hospitals and doctors. They have never hesitated to refer me to a specialist or elsewhere when I needed to go, and the cost to me is $12 per visit or procedure. We receive our medications through the base clinic for free. If I need something from a pharmacy downtown (for something the base doesn't carry), the cost to me is between $9 and $12.

It is true that some doctors and hospitals have dropped participation in Tricare, due to low or slow reimbursements. (There's that profit thing again.) That is a matter for congress to address, and they have had ample notification that there are problems. It has been an ongoing issue over the last 10 years.

My husband's neice had a seriously premature baby that must have cost a million dollars to treat...all paid for by Tricare. Their out of pocket was zero. Then they griped becasue Tricare wouldn't pay for a helmet to reshape her head which was flat from laying on her back for so long.

I have zero complaints about Tricare, and wish my son could have a plan like it without having to risk getting killed in a war.

If that's what people are complaining about as "government run healthcare"...bring it on!

[meg]

sandra -

the problem is very basic. the majority of our elected officials - BOTH democrats and republicans - care more about furthering their respective party's agenda than fixing the mess.

sadly, until the infighting and finger pointing stops - we will get NOWHERE.

[meg]

one more thing - in spite of it all - i wouldnt want to live anywhere else but the good old USA.

[newellyn]

Thank you to our friends from Canada. Boy that "socialized health care" just sound horrible doesn't it.

This card carrying liberal's advise to anyone approaching Medicare age is to not sign up for that socialized health care plan, way too scary.

My hope is that the Democrats will stop pandering to the conservatives who want to plant the boogey man in everyone's closet and get something done, now.

Now that I've vented, I realize this subject could get ugly so I'll return to my studio and quilting subjects which are in calmer waters.

[marycontrary]

This is a very emotional issue for me. At one time I would have argued against government run care, but no more. After 27 years my husband lost his job at a major company. At one time that company promised health care coverage for retiree's. No more. We are fortunate enough to still have health insurance available to us -- at a cost of over $1000 per month PLUS co-pays, deductibles and "our share" for prescriptions, medical procedures and hospitalizations. I went back to work, but the coverage offered by my employer at a lower cost just is not adequate for two people "our age", so we must keep the plan with higher premiums. You just don't usually get to late 50's/early 60's without some medical conditions and the realization that you could begin to have more health problems at any time.

So here we are, income severely decreased, health insurance premiums and health costs extremely increased. And at the same time insurance companies are raising premiums 39% for those who need it most -- those who are unable to get coverage under a group plan and who must buy individual policies. Heaven help them if they have any medical conditions such as arthritis, diabetes, whatever, because either their premiums will be too high to ever afford OR the coverage will not be available for them at all because of "pre-existing" conditions. And you want to hear what the rationale was for raising premiums this high -- you'll love this -- because there are so many younger, healthier people who are forgoing health insurance because they cannot afford it, and this is causing higher costs for the insurance companies, so they must raise the premiums for individuals.

And at the same time, the major health insurance companies had an increase in profits of over 50% last year -- true story. And these profits were figured AFTER their CEO's received their multimillion dollar salaries and bonuses. There is something terribly wrong with this picture, and allowing for-profit insurance companies to have any say in fixing it just will never work.

I think those of you who have good employer or government sponsored care just may not realize just how terrible and untenable the situation is out there for a great proportion of Americans. If we walked in the shoes of those who cannot afford insurance, those who have lost everything because of a major illness even though they HAVE insurance, those who are in their "golden years" who find health care eats up what money they have, I truly believe we would all be a lot more open to a government run plan. Just my opinion, but I've been on both side of this. Things just cannot continue the way they are, and for-profit companies will never provide us with the solution we need.

[Stagecl]

Lynda,

I agree that this could get ugly too, but thank goodness we all have our own opinions or it sure would be a boring world:)

[Quilting Heidi]

Lynn I have to say your experience with Tricare is very lucky. I've used Tricare in NC and NY. There is not one hospital in my area that accepts Tricare!!!! We have 5 hospitals within 20 minutes of my house. My experience in NC was that we didn't get the best doctors. My son had several fractures, 8 months apart (yes he was very active). We had to get a new doctor for the 2nd fracture because the first doctor was forced to stop accepting Tricare because the reimbursements for even the little bit they got was so far behind and he just couldn't make ends meet. I had lung surgery and had to travel 1 1/2 hours from home just to find a surgeon that could do the surgery and accepted Tricare. If he hadn't been able to do it the next closest surgeon was 5 hours away! My husband spent 22 years risking his life and we don't even use the one benefit we thought would be so valuable. Now if we ever move back to an area where Tricare is accepted and doctors are good then we'd use it. Right now for us it is useless. Well not completely because we do use the prescription to supplement our meds. I have to say with my current insurance I have never had to worry if the doctor was going to get paid or if things were approved. I've had 3 major surgery's since we've lived her (7 years) and not once did I have to worry about finding a doctor or getting the best care. The experience was like night and day!

[Guest Linda S]

We do need health care reform. I have employer-paid health care, but I'm trying to prepare for retirement. If I want to continue the coverage I have now, it will cost me almost $1100/month. I cannot afford that. I've had the bottom of my spine fused (four vertebrae) and have thyroid disease and GERD. I need health insurance -- can't do without it. If I try to change providers, I'm going to have them tell me I'm too much of a physical wreck for them to take me. Please everyone, no matter what your political affiliation, contact your senators and representatives and make it clear that we need reform. Stonewalling and name calling will not be beneficial to the American people. Cooperation and compromise need to be the order of the day.

[PeggyB]

I hope everyone can get affordable healthcare.

I do want to say that I work for the government. I work hard, I do a good job.

Not everything the govt does is bad. Air Traffic - govt run and our country runs the highest volume in the world and very safe.

I understand frustrations but I hate rhetoric that paints the government as corrupt, inefficient .... I know there is some and there is need for reform but I believe Social Security has been a success - I know people who would have nothing without it...

Why is this a hot button for me? I remember seeing sweet babies in daycare in our government buildings. I remember OKC bombing and this recent incident in Austin. I wouldn't want my grandchildren at a daycare in a govt building. I have friends who will send me emails ranting against the govt. and I think...you know I work for the govt? I work to keep people safe? I work in govt facilities....I am not meaning that opinions expressed here are bad...it is just not a subject I like especially when news/radio rail against govt. and you get somebody bombing a "government" building attacking the ATF, the IRS....well those buildings are full of your neighbors and friends.

Off my soapbox. sorry

[Gator]

Lynn, I'm also glad that your TRICARE is good. Even though TRICARE is contracted it's contracted under government regulations and guidelines. Anyway, here's my last word. There are different branches of TRICARE, we're TRICARE East and I've had nothing but problems. They (TRICARE) told me where to get my diagnostic mamo (I can't get a regular mamo), the problem with their 3 options, one no longer took TRICARE, one went out of business and the other was the Association of Radiologist. I had to have my military related ) shoulder xrayed with dye and my CO-Pay was over 2,000. The supplimental insurance that I pay for wouldn't cover the pre-existing conditon. They (TRICARE) won't let me go to one of the largest military hospitals in the world for treatment because I'm retired military. I did 27 years active service, was promised healthcare and not pay out of my "little retirement" for medical bills. Ok, off my soapbox. I'm grateful to have "something". I support healthcare reform but we have to be very careful about what we ask for and get. This must be a people plan not a "rich politician" plan and by the way the Congressmen who never served a day in the military can go to "military hospitals". I'm done, back to writing to Senators Webb and Wampler.

[Guest The Quilting Diva]

Initially I was all for a national plan.

Now I'm not. Government has enough problems they can't handle, I'm not up for giving them control of healthcare too.

[RitaR]

NQR Laura, love the hair cut. So becoming.. at least if not cut, then the way it is styled.

RitaR

[RitaR]

I have to say I've had wonderful care thru both of them. Not medical thru TriCare, but paying for prescriptions.. and paying what Medicare can't or won't pay. Medicare, after all the terribly nasty stories I've heard, I don't have one complaint for.

Good luck to those who are looking.

Ritar

[Zora]

Yes, I get a bit tired of the government bashing, too. We have so many benefits provided by our government...education for our kids, our roads, safety regulations for our workplaces, inspections of our food processing facilities..just to name a few.

If you are experiencing problems with Tricare, please contact your respective representative or senator. You must also look at the level of service you have selected..Tricare Standard or Tricare Prime. We have Tricare Prime, and we have chosen to live in an area where that benefit is available to us. Also, check to see if you are eligible for VA care. Again, Tricare is government contracted, not government run. Our military-friendly representatives and senators need to hear these stories.

To those who have no health insurance or very expesive insurance, I hope this issue is resolved for you soon. It is terribly painful to me to hear these stories. I believe we can and must fix this. Again, I urge you to contact your Senator and let him/her know the challenges you are facing.

[LauraJ]

I desperately want our government representatives to stop being in the back pocket of the lobbyists, banks and big business. I want them to WORK TOGETHER to the benefit of We the People. I'm tired of the untrue rhetoric, jingoism without facts, that is occurring at the expense of people's health care and many other important issues for us, our children and our children's children. Free speech, yes - wouldn't be without it - but it is beyond frustrating when words are extremely manipulated and used for the negativity that it is stirring up in some to be against others.

Can you imagine what could be accomplished in our government when the focus is on the betterment of all U.S. citizens? Wow - what a concept.

[meg]

peggy - when i was complaining about the government - i was referring to the majority of elected officials as the ones who are mucking up the whole works. im sure there are many other hardworking government employess just like you.

[Kueser]

I was just listening to CNN and they explored an interesting concept - NO POLITICAL PARTIES. The idea is that very few people who run for office actually support the party platform which is often so far right or so far left, there is no chance of trying to meet in the middle. Corporations and big business have bought and paid for "our" leaders and the recent Supreme Court ruling has added the final straw.

BTW- You can be covered by a private insurance company and still have your doctor refuse to accept your coverage. What blows my mind is that hospitals charge you one price if you have insurance and another if you don't.

[Darlene Epp]

As a Canadian, it breaks my heart to hear the sad, sad stories of the health care situation in the U.S. In Canada, each province provides it's own health care plan to everyone. Premiums depend on your taxable income. Our premium just went from $96 to $102/month for both of us. That's the first increase I can remember in many years. That's the maximum and would be less if we earned less.

This covers all Dr.s visits, hospitalizations & treatments in hospital, almost all lab tests. It does not cover Rxs, but after a certain amount, they can be deducted from income, as can "altenative" treatments, such as chiropractic, massage therapy, physiotherapy not ordered by a Dr., reflexology etc. We just include our receipts with our income statements and our accountant looks after the rest.

An example: This past Thursday my hubby took me to emergency for chest pains. I was admitted immediately, given at least 3 ECGs, numerous blood tests, blood pressure monitoring, a chest x-ray, IVP CT scan of the lungs, IVP CT scan of the bladder & kidneys due to ongoing infections, medications, 2 different Drs., etc. etc. etc.

The cost? $0.00 Further tests ordered for ecocardiogram and stress tests. Cost? $0.00

What I love about our system is the simplicity of it. I'm sure behind the scenes it's not so simple, but for the patient, there is just no worry or concern. My only concern is the results of the tests, not how much it's going to cost me. We don't delay going to the Dr. because of cost, so health care issues don't get out of hand. There are also "Walk-In Clinics" where you don't need an appt. and the Dr.s on call will see anyone who walks through the door, order tests etc. No charge.

Eighteen months ago, my Dad passed away after surgery and a month of radiation for mouth cancer. He was 5 days past 90 years of age. All the treatments, a month of hospitalization, a private room for the last 4 days and there was NO bill at the end of it all. Just the overwhelming sadness of losing him, accompanied by the tender loving care & hugs of the nurses and Drs.

In 1988 our 18 year old son was in a car accident and in a coma for 4 months. He was in ICU on life support for 10 of those days. He spent 9 months at a rehab facility after coming out of the coma, and another 9 months in a group home before coming home. He has permanent brain damage and is in a wheelchair, on a lifetime income pension through WCB. He now lives on his own with a WCB funded Care Aid provided 5 days a week 9AM to 5 PM, plus Sunday 8 AM to Noon.

The cost to us? $0.00 He pays $57 a month for his provincial BC Medical Plan.

I think one of the secrets to the success of our health care system is that it is run by each Province individually. This makes it easier for "the people" to keep their govt. "on track". It isn't so big as if it was run by the country gov't. as a whole. Our system isn't run "for profit". It is run "for the people".