patrick.net

The providers have spoken, and they are saying they would rather lose patients than deal with Medicare.

This is true.

This lady was better off without their “help”, and you are too.

This is not.

btw, my mom has been on Medicare/MediCal since 2003 or so. Access to general care in her area is *very* limited but access to meds has been very good.

My takeaway from this is we need a system MORE like Canada's, not less, but YMMV, LOL.

Troy,

I'm glad your mom at least has good access to meds. And yes MMMV. But it is more than just "what have they done for me lately." that must come into play. What about all the waste and other problems inherent in seemingly every government spending program? For example as department of education has grown, performance of American students vs. international peers has been declining. Money, bureaucracy and Washington are not solving anything.

AdHominem says

What about all the waste and other problems inherent in seemingly every government spending program?

What about all the waste (aka rent-seeking) in the private sector? Medicare actually runs a pretty tight ship. Single-payer would bring immense cost savings immediately, at the expense of the current billing infrastructure employment base.

As for gov't spending, pay peanuts and you'll get monkeys. I'm getting tired of your anti-gov't fixation. Good luck with it and good-bye.

Nomo,

Clearly you have strong opinions as well. I would be happy to discuss the facts. But as far as statistics go... Statistics don't lie, but liars use statistics (see Al Gore).

Let's deal in realities. Why did the clinic above not accept Medicare? Why did the pharmacy above not accept Medicare?

The clinic is free to take or not take any plan they want. The lady is free to use or not use medicare. The lady was free to check if medicare was available at her clinic and pharmacy before she signed up. Why are the strong proponents of freedom in America so upset about people making their free choices? Either you want freedom or you don't.

bob2356 says

The clinic is free to take or not take any plan they want. The lady is free to use or not use medicare. The lady was free to check if medicare was available at her clinic and pharmacy before she signed up. Why are the strong proponents of freedom in America so upset about people making their free choices? Either you want freedom or you don’t.

I do want freedom. Do you? If I can't meet my own needs, and no one is willing to help me... Then these needs shall go unmet. That is fair, and just in this world. To say otherwise is to oppose nature or God or the laws of the universe. And you can only do that for so long before nature, God, or the universe invoke justice on you.

On one hand I feel sorry for this woman, because the system she depended on has let her down. She paid into it her whole life probably (and now you want her to pay out of pocket?) On the other hand, when you depend on something as untrustworthy as the US bureaucracy you are bound to fail. In that sense she put her faith in the wrong thing. And so will you if you give the control of your health to government or any other third party payer.

@Ad--

Would you like me to fill this thread with all the anecdotes about people who were dropped from their insurance company as soon as they developed cancer? Or who were denied coverage because of a "pre-existing condition"? Because trust me, there are PLENTY of horror stories out there.

The point is that one unverified story is worthless. You're going to make a decision about the entire US population based on 1 woman's situation--that may or may not be true?

Love the anecdotal evidence.

"Under her new “coverage” she was told she would have to pay out of pocket for her prescriptions or go elsewhere because the independent pharmacy she has used for the past 15 years does not do Medicare D plans."
-this is true of private insurances as well. Many insurance providers don't have contracts at certain pharmacies. However, with multiple prescription drug plans available, this woman should have researched which plan is accepted at her pharmacy. Most pharmacies accept some type of Medicare D plan because they pay the same, if not more, than do private plans. Medicare.gov will provide the insurance companies and contracted providers on their site if one looks. There are also 800 numbers, insurance reps, etc who can help with this endeavor.

-most drug plans have formularies. If the medication isn't on the formulary, the plan must continue to provide the med until the new enrollment period starts. Yes, prior auth is needed. But this is the same with private plans as well.

No, Medicare isn't perfect. But it's better than nothing. I'm not saying that it's the woman's fault, but had she done her research she probably wouldn't be paying out of pocket right now.

-Many physicians and clinics accept Medicare. However, just as with private insurance, some don't. I've seen many people choose a Medicare advantage plan (HMO/PPO) in an area with no providers. It's important for people to do research before they choose any insurance. People who live in rural areas often must drive many miles for providers - but that's not the provider's fault.

For the record,

I do like statistics. It just rubs me the wrong way when people use "statistics" to "prove" the US has "the worst health care in the west."

I am a scientist. So for the past 10 years or so I have seen how "scientists" use statistics to "prove" everything from why this medication is statistically better than that (despite ten times the cost and the fact that the thing that makes it better is that if 1400 people take it for one year 2 less of them may have a heart attack-never mind the other side effects) to humans are making the planet warmer by raising cows. So yeah, I put A LOT of faith in statistics, especially in hands of "scientists" who are NEVER biased or anything like that.

Really, would you really rather get sick in Berlin than Boston? Would you rather have a premature baby in Calgary than Chicago? Why do people come here from all over the world to for their care?

You can drink all those statistics with the Koolade. But that doesn't make it true.

If you read my posts you will recognize that I too believe something needs to be done to make health care more affordable. I just don't drink the Gubmint Grape Single Payer Koolade. Nor We have the Worst Health Care in the West Watermelon Koolade. But if you repeat it enough it might come true?

When was the last time someone got on a boat in Florida and paddled to Cuba for the Health Care?

Listen Mr. Quack. I'll ask the questions here.

First off, Name me which country on the above chart you would rather receive your health care in? Second, can I arrange a one way ticket for you? Third what will your statistics buy you, the best health care in the world? or are they even worth the paper they were printed on? Got anything from Pfizer and Goldman Sachs to support it?

Now you are using Ad Hominem. congratulations. You sir are the one who keeps repeating a dead meaningless argument and when it doesn't work you resort to Ad Hominem.

Do you really think health care is so much better elsewhere? Why not put your money where your mouth is?

BTW, I'm not sure if you know this but statistics helped create the malinvestment in mortgage backed securities. The best and the brightest math whizzes calculated risk of default and determined there was no way you could lose money on these investments. Wonder of these same guys work on health care and environment data? Gotta love statistics. Did you know that statistics show that you are more likely to die in a hospital than at work? There you go, we all need to work more and we'll live longer. Maybe that is why we are so sick in America, we just don't work enough compared to those HARD WORKING EUROPEANS! Gotta love statistics.

Again Mr. Quack,

Do you really think health care is so much better elsewhere? Why not put your money where your mouth is? YOUR ACTIONS SPEAK LOUDER THAN YOUR WORDS. They are the best evidence of all!

Did you know that statistics show that you are more likely to die in a hospital than at work? There you go, we all need to work more and we’ll live longer. Maybe that is why we are so sick in America, we just don’t work enough compared to those HARD WORKING EUROPEANS! Gotta love statistics.

Quack,

Since you love statistics. I thought I WOULD share some with you if it makes you feel all warm and fuzzy and safe to have "data".

from http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf

In 1960 Private payer portion of health care expenditures was over 75%, with less than 25% being paid by Federal taxpayers. In 2007 private pay had fallen to under 54%, and government spending on health care had balooned to over 46% of all health care expenditures in the US.

During this same time the total amount of spending on health care in the US has ballooned from $27.5 billion to over $2.24 TRILLION. As government has gotten more and more involved in health care, costs have sky rocketed. Costs are up because government intervention has driven them up. And like a self fulfilling prophecy more and more people are becoming dependent on the government to "provide" for them.

What we need is a government that will protect us, so that we can provide for ourselves. Not a government that protects itself so that we can provide for the elites.

Quack,
The data show decreasing private pay and increasing Federal pay as percentage of total expenditure. This correlates with increasing costs/overall expenditure. Pretty simple really and while inflation is a factor it is not a factor in decreasing private pay, and drastically disproportionate increase in Federal spending on health care.

But that is why both of us ignore statistics (at least the ones that refute our points) and also the reason I knew your arguement about statistics would lead to this point. If you can't see that government is driving up costs, and reducing quality of care then you won't until it is too late.

As the proportion of government spending has doubled, overall cost has increased to nearly 83 times what it used to be. And you dismiss it?

Just as I dismiss your "data." "every single country in the world says your wrong" First, you can't prove that, and second even if you present opinion polls and other "statistics" they are no more or less meaningful than my strong evidence that as government proportion of spending has increased WE ALL PAY MORE. I believe it is even driving up costs in other countries too because as we devalue our dollar (and export less and less) the world becomes poorer too.

Like I said, the way you are thinking you will never see it till it is too late.

It is kinda like “as carbon emmissions go up, average temperatures also go up.” You buy that one?

As government takes more responsibility for health care, it has driven costs up. Same same.

AdHominem says

It is kinda like “as carbon emmissions go up, average temperatures also go up.” You buy that one?

It's actually nothing like that. There is no similarity at all.

AdHominem says

Same same.

Oh, now I get it. Same, same. Why did't you say that in the first place??

Its okay tatu have some more koolade.

AdHominem says

Let’s deal in realities. Why did the clinic above not accept Medicare? Why did the pharmacy above not accept Medicare?

Why doesn't the clinic accept Medicare? Let's ask the clinic.

Why doesn't the pharmacy accept Medicare? Let's ask the pharmacy why it doesn't accept the insurance provider that the customer chose under Part D.

AdHominem says

On one hand I feel sorry for this woman, because the system she depended on has let her down. She paid into it her whole life probably (and now you want her to pay out of pocket?)

Yes, she did pay all her working life into the Medicare system. But that doesn't guarantee care, any more than having health insurance guarantees that there will be a local provider to care for a patient. You're angry at the government for something that free enterprise is responsible for.

And yet, you continue to support free enterprise and blame the government. Ad hominem... I mean ad nauseum.

Ellie, seeing as how she was forced to pay into Medicare, it is not Free enterprise that is to blame. It is HER and HER GOVERNMENT.

AdHominem says

Ellie, seeing as how she was forced to pay into Medicare, it is not Free enterprise that is to blame. It is HER and HER GOVERNMENT.

Is it the government's fault that she doesn't live near providers? That she chose a prescription drug plan that her pharmacy doesn't use? You say that you want less government, but you say that the government should force participation by private companies.

Perhaps you should discuss things about which you have more knowledge. But that would take the indignant wind out of your sails.

Actually I did not say what you said I said.

But what I will say is this, government should very rarely have to force anyone to do or not do anything other than do no harm to your neighbor. Too bad she was FORCED all her life to pay into a system that is now not working very well for her at all.

I can speak for myself. So please go back to your koolade.

Oh, by the way. I like that you are now implying that it is her fault for living in a rural area. (she lives in the same town as the clinic that she has gone to for 15 years, but doesn't do medicare) She should have gotten housing in the government approved tenements right comrade?

AdHominem says

Quack,
Since you love statistics. I thought I WOULD share some with you if it makes you feel all warm and fuzzy and safe to have “data”.
from http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf
In 1960 Private payer portion of health care expenditures was over 75%, with less than 25% being paid by Federal taxpayers. In 2007 private pay had fallen to under 54%, and government spending on health care had balooned to over 46% of all health care expenditures in the US.
During this same time the total amount of spending on health care in the US has ballooned from $27.5 billion to over $2.24 TRILLION. As government has gotten more and more involved in health care, costs have sky rocketed. Costs are up because government intervention has driven them up. And like a self fulfilling prophecy more and more people are becoming dependent on the government to “provide” for them.
What we need is a government that will protect us, so that we can provide for ourselves. Not a government that protects itself so that we can provide for the elites.

So there has been no price increases since 1960 except health care?? There has been no changes in health care to increase the prices since 1960? Do you even have the vaguest clue what the standard of care in 1960 was? You are a scientist of what, astology?

I have lived (not visited to see the Eiffel Tower, lived and worked) in France, Canada, and currently New Zealand. I can assure you the health care in those places is just fine. Better in some respects, worse in others. I can also assure you that people from first world countries are NOT coming to the United States for health care with the exception of very, very limited experimental procedures that are being done at the most advanced research centers and not available in other places. Try to get your US insurance carrier to pay for one of these, good luck. Lots of well off people from third world countries come to the US for health care because they can't go to any other first world country. Everyone else in the first world has public health care that is available only to the citizens of that country.
I agree with elliemae. You contradict yourself constantly.

Good, perhaps you could get together for some koolade. Talk about how great medicare is and stuff.

I'm curious, what would her premiums be if she had to shop for health insurance like the rest of us? Or pick certain jobs based on benefits provided? Considering most of health care is used by this age group what would insurance companies do if they had to start covering these folks and all of their meds, hip, knee and valve replacements, the CABG's, the MI's, the strokes, etc. It's an expensive population.

Medicare was designed for a much shorter life expectancy and now that folks are living longer THANKS TO MEDICAL ADVANCES we are now seeing the effects. Someone's gotta pay for it.

How's this for a medical story not related to insurance at all. My spouse's great aunt suffered a stroke in Cuba, Alabama. Ambulance arrived and drove the 45 minutes to Meridian, MS only to find out there were no beds available so they then had to drive 2 hrs to Birmingham, AL. If you know anything about strokes and MI's timing of treatment is everything. Needless to say her outcome was not good as she dies a week later due to lack of timely care. Rural healthcare in general stinks.

AdHominem,

I had a baby summer of 2006. Was paying about $350/month for family coverage. My out of pocket was about $500 TOTAL for prenatal care and delivery. Fast forward to this past March, another baby, this time paying $500/month in health insurance premiums (quite the increase, huh?) and my coverage has declined. My out-of-pocket this time around was $2,500.

Can I blame the government for the steep increases?

AdHominem says

Oh, by the way. I like that you are now implying that it is her fault for living in a rural area. (she lives in the same town as the clinic that she has gone to for 15 years, but doesn’t do medicare) She should have gotten housing in the government approved tenements right comrade?

When one lives in a rural area, one often must do without.

But, let's play. Which Medicare plan does she have? Does she have a secondary? Does that secondary require pre-auth's? Did she choose her prescription plan based on her need? Which plan does she have? Does it have a mail-in pharmacy - 'cause they all do. That saves people who live in rural areas from going without their meds. Does her local clinic offer full service, including walk-ins? Did she discuss her insurance coverage with them prior to choosing her medicare plan?

Are you implying that people who live in rural areas don't qualify for section 8 housing? For publich housing programs? There are multiple programs that offer subsidies for people who live amongst us.

AdHominem says

Oh, by the way. I like...you...

You like me! Right now, you really like me!

Leigh says

AdHominem,
I had a baby summer of 2006. Was paying about $350/month for family coverage. My out of pocket was about $500 TOTAL for prenatal care and delivery. Fast forward to this past March, another baby, this time paying $500/month in health insurance premiums (quite the increase, huh?) and my coverage has declined. My out-of-pocket this time around was $2,500.
Can I blame the government for the steep increases?

Obama, Osama, gubmint, capitalism, communism, the Jews, the Christians, the Moslems.Take your pick.

elliemae says

AdHominem says

Oh, by the way. I like that you are now implying that it is her fault for living in a rural area. (she lives in the same town as the clinic that she has gone to for 15 years, but doesn’t do medicare) She should have gotten housing in the government approved tenements right comrade?

When one lives in a rural area, one often must do without. Right you are Comrade.
But, let’s play. Which Medicare plan does she have?
not sure.
Does she have a secondary? don't think so.
Does that secondary require pre-auth’s? Did she choose her prescription plan based on her need? Have no idea.
Which plan does she have? not sure. Does it have a mail-in pharmacy - ’cause they all do. Good point. That saves people who live in rural areas from going without their meds. well unless you need them today.
Does her local clinic offer full service, including walk-ins? walk ins yes, full service? like not sure.
Did she discuss her insurance coverage with them prior to choosing her medicare plan? No.
Are you implying that people who live in rural areas don’t qualify for section 8 housing? No only that for 15 years she was in a good situation. Now Medicare is making it not so good. For publich housing programs? There are multiple programs that offer subsidies for people who live amongst us. That is great. can I get some?
AdHominem says

Oh, by the way. I like…you…

You like me! Right now, you really like me!

Wow, thought we could have a good debate but I guess you ain't open to that? What do you think caused the spikes in healthcare costs in the example I gave.

Many causes. Government intervention (including fraud, waste, abuse, and insulating patients from true cost resulting in demand-supply issues), expensive technology, inflation/lack of sound monetary system, private insurance that does much the same as public insurance and to a large extent is made possible by government intervention through tax breaks to employers that are not available to you and I.

This thread is BS, right from the start.

Adhominen, Where does this woman live? Whats her name? Give me some info so we can verify this story. Anyway even if true its just one story taken out of any context and as you say facts lie when put in the wrong context right? Whats your context? And here's a verifiably true story related to the one you've spun: http://www.highbeam.com/doc/1G1-113694885.html "Article: Rural pharmacies say insurers squeezing them out of business." Pop quiz: who's the protagonist? Who's the victim?

The providers have spoken, and they are saying they would rather lose patients than deal with Medicare.

Right, common sense would lead me to believe this is because they want to charge top dollar. This has to be because the doctor wanted more money or did not want to deal with some extra steps. It would be self destructing to turn down good money.

This lady was better off without their “help”, and you are too.

Well, where else would a person on a fixed income buy affordable insurance? At this age insurance would cost here $750/mo.... I am curious, because not many elderly can afford to go out and spend $250 on a 15 minute visit either. Mind sharing your thoughts on how she was better off?

kentm says

This thread is BS, right from the start.
Adhominen, Where does this woman live? Whats her name? Give me some info so we can verify this story. Anyway even if true its just one story taken out of any context and as you say facts lie when put in the wrong context right? Whats your context? And here’s a verifiably true story related to the one you’ve spun: http://www.highbeam.com/doc/1G1-113694885.html “Article: Rural pharmacies say insurers squeezing them out of business.” Pop quiz: who’s the protagonist? Who’s the victim?

I wish it wasn't true.

AdHominem says

Leigh says

AdHominem,
I had a baby summer of 2006. Was paying about $350/month for family coverage. My out of pocket was about $500 TOTAL for prenatal care and delivery. Fast forward to this past March, another baby, this time paying $500/month in health insurance premiums (quite the increase, huh?) and my coverage has declined. My out-of-pocket this time around was $2,500.
Can I blame the government for the steep increases?

Obama, Osama, gubmint, capitalism, communism, the Jews, the Christians, the Moslems.Take your pick.

@Leigh

No, this is due to the greed of the doctors, insurance companies, lawsuits and pharmaceutical companies. We the people need a government willing to go toe to toe against these entities.

4X says

The providers have spoken, and they are saying they would rather lose patients than deal with Medicare.

Right, common sense would lead me to believe this is because they want to charge top dollar. This has to be because the doctor wanted more money or did not want to deal with some extra steps. It would be self destructing to turn down good money.

This lady was better off without their “help”, and you are too.

Well, where else would a person on a fixed income buy affordable insurance? At this age insurance would cost here $750/mo…. I am curious, because not many elderly can afford to go out and spend $250 on a 15 minute visit either. Mind sharing your thoughts on how she was better off?

She would have been better off if instead of "contributing" to social security she saved her money in a tax free health savings account or some other form of savings that she had control over and could benefit from personally. Instead she was forced to fund the bureaucracy that spent it years ago.

@Leigh @Adhom

I am still trying to figure out how the process works and how the process SHOULD work...any ideas?