What a terrible story. I’m happy for him that he had coverage or seemed to have coverage during the ordeal instead of having to try and suddenly come up with stacks of cash to stay alive at all back in 2013.
Man, someday my countrypersons to the south got to wake up & get a true single payer system for this stuff.
I really like the system up here. It just makes you feel good, knowing people can look after themselves utilizing it. It simply works & every criticism of it to date boils down to “it ain’t perfect” & many criticisms are answered with improvement. Guess what else ain’t perfect? Everything. That is no reason to live in fear of financial destruction over medical matters.
Isn’t fear related to the medical matters themselves enough, when times get rough like that? That at least can be a useful fear.
$50 a month? That is actually crazy cheap. My insurance is employer
subsidized and I pay much more than 50 a month. Heck, cobra is 10x that
much.
I don’t feel sorry for people having to either buy insurance or pay a
penalty. When they eventually get sick, it is my broke ass that has to help
make up the difference.
The problem here as I understand it is that his insurance coverage was retroactively cancelled due to a “hidden” pre-existing condition based on the premise that his condition could have been diagnosed earlier even though it hadn’t been. So it wasn’t that they wouldn’t sell him coverage – they did, and he thought he was covered. Trouble is, he wasn’t actually buying insurance, he was just falling victim to a bunch of scam artists.
In this instance maybe, but here in the UK (I don’t know about the US) declaring bankruptcy is a good solution in personal terms, but has all sorts of employment and business implications.
Small firms for instance - if a director declares bankruptcy, they are barred from acting as a director for 3 years.
Whole thing is pertinent as the UK insurance model looks to the US model for “profit ideas”. Recently my insurance tried to tell me a back condition I have is “chronic”, a lot of people would just say “ok it’s chronic, whatever that means” - what it means is they won’t pay for treatment any more.
I jumped down their throats, and because it only “flares up” occasionally, it’s not “chronic”, so they will treat it. The oily bean-counters have driven this clever strategy where it’s very hard to prove something isn’t “chronic” once it’s tagged as such in the system - you would have to have medical testimony etc.
So they lie in wait. You get physio for something, and they tag it. You get physio a year later, and it’s warming up to be “chronic” in their little world. Another session, and it’s chronic. The medics eventually determine you need an intervention / operation and kaboom, the answer’s no - it’s chronic.
This. [quote=“Cowicide, post:84, topic:25064”]
This ignorant madness needs to STOP.
[/quote]
I was close to apoplectic by this point. Thanks. And it truly is madness. Can I afford to insure myself or my family? What do I think is appropriate coverage? Will my insurance cover scenario X? Why do my healthcare options vary based my income or career? Will I go bankrupt if I become sick or injured? Why the fuck are these questions even questions?
I’d be more in favour of the kicking in of boardroom doors, the pointing of guns at the backs of necks, and a cheery, Morning, Fuckers! You work for US, now. It’s nationalizin’ time!’
It seems there are two issues: Pre-existing conditions and Bill the predate coverage. The article was not clear on those two things were are separate issues. He may have been fortunate not to have been covered by ObamaCare at the time of his diagnosis, depending on where he sought care. I was stunned to learn that in our market, neither of the two ObamaCare offerings covered care at the advanced cancer hospital which is where most complex cancers are treated here. Both plans only cover care at local hospitals which do not have the same level of resources that are available at the University-based cancer center which is staffed by the medical school faculty. My wife has had two cancers over the past four years and was diagnosed at a local hospital which said it was inoperable and sent her home to write her will. We sought a second opinion at the medical school and found it was operable and the treatment suggested at the local hospital was totally wrong. We still get insurance from my former employer (we are in our 60’s but not eligible yet for Medicare). We live in abject fear that the company will dump us into the ObamaCare exchanges which will not allow her to get the care she needs. The coverage isn’t available at any price. If you have private insurance, Medicare or Medicaid, you are covered for the top hospitals. If you are on the exchanges, you can only get care at what they call “narrow networks.” We have a system of “haves” and “can’t gets.”
Question for Americans: Where is the “good guy corruption”? If I were a doctor in these circumstances where a patient told me that they had a condition that I knew could fall through some preexisting condition loophole I would probably do my best to tell them “I didn’t hear that.” And then treat them for the condition that just suddenly developed. This must be happening all the time right?
Ach, it’s so ridiculous. An enduring theme in the UK is that if you can do your job well, you can do your job well. Bankruptcy bars you from directorships, but doesn’t stop you working.
The American practice is really clutching at straws, and diminishes the talent pool to … errr … wealthy kids from established famlies …
Personally, I’d hire a bankrupt person happily. I just wouldn’t give them the cheque book.
Do you have a $6000 deductible to eat through. No you don’t. Once you crunch the numbers it’s inasne what a bad deal it is. Even after you work through the $6000 deductible you then have $20 per doctors visit and the $50 a month.
Not sticking up fkr insurance co, but I work for one… there’s not enough info given to really know what happened. What was the diagnosis code the dr provided on his treatment before he had coverage, etc? Usually the insurance will send letters to the first physician who treated the person to ask them what the original diagnosis is.
And then, you can still rack up catastrophic bills. Only the top “platinum” plans cover out-of-network charges. There’s no way to know when you go to a hospital which specialists will not be covered by insurance, which you may be charged in full, completely outside the $6k deductible. The WashPo documented that in some states, not a single plan is available without out-of-network coverage. With ACA minimums, why are we still banned from buying insurance across state lines?
Also, better not have a medical emergency when traveling to another city or state… really sucks if you’re in a career that involves constant traveling.
US health care: slightly better than before, still the worst on the planet.
Having health insurance does not protect you from catastrophic bills. Having health insurance does not guarantee access to healthcare -in particular, primary care (thanks in part to 30 odd years of a drg-driven fee-for-service payment model). Health insurance doesn’t even cover my entire body (teeth, eyes and brain are “different” and require additional insurance).
Our legacy healthcare insurance system was a flaming wreck going over a cliff.
ACA might put out the fire.
I think that was/is already a provision of the ACA. Perhaps not exactly what you’re suggesting - but they have been ‘kicked off’ their previous, employer based health plan.
From what I remember, the Repubs (negotiating in bad faith all along, btw) added something to the bill they thought would for sure stall the Dems - It was that all Congress people and their staff had to go off their Employer based insurance and get it via ‘the exchanges’. The Dems didn’t argue against it and I’m pretty sure that was part of the passed bill.
Congress and staff will still get employer (the Fed Govt) subsidies/contributions to their premiums at the rate they did before as if they were still on an employer plan. This was really done to retain staff members who might ditch their jobs for the private sector where employers usually subsidize employee insurance plans.
I think the reason we don’t hear about it is because their transition has been pretty seamless. I guarantee if even one GOP’er lost their doctor, something they needed, or had a premium explosion by going on ‘the exchanges’, they’d be all over FoxNews with it. But none of that happened.
Instead, they’re having to crack on with negative anecdotes about shit they heard from some unverified or easily debunked source.
How are you still not getting this? It has nothing to do with when he signed up. It has to do with when he had the procedures.
If he had had the procedure in the 1970s and hadn’t paid his bills yet, should the ACA have retroactively covered him?
Yes, insurance companies are shitty, but you can’t blame the ACA for not being magical and wiping out all debts that ever existed in history before it came into effect. There has to be a cut-off date where it starts coming into effect. That date was January 1st of this year.
You can blame Congress for not passing it a year earlier, sure, but there will always be people who still had debts from before the law. And you can bemoan that it’s not single-payer system, but that still wouldn’t have wiped out historical debts.
How are you not getting that it will continue under the ACA because the ACA did not systematically fix the system.
Sure in this case they took the easy way and denied for preexisting. Which is the one loophole ACA covered because it had to.
These stories will continue because the decisions on how much this all costs and what gets approved and denied are still 100% totally in the hands of for profit corporations.
And yes I can blame the ACA because the only thing it is doing is funneling billions in tax dollars into the most shady scum sucking corporations on the face of the earth.
