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I dont know exactly what to make of this political football.
But, there are a few things I have experienced that makes me thing our Health care system is some big issues. For one. I noticed something interesting when my wife left her job a few years back. When the cobra papers came in, they wanted around $600 a month for her health insurance to be continued. Yet, I was able to insure her privately for about $160 a month. The plans were pretty similar as far as coverages go. So why the disparity? Not to leave the doctors out. I had another eye opening experience. I had tendonitis in my elbow. I went to a Dr and was exampined and given a shot of cortizone. The whole visit lasted about 20 minutes. When I got the bill, I was shocked. The bill broke down like this:
Once more, the Insurance company said I had to pay it because it was considered part of my deductible as a - get this - surgical procedure. I dont know how we compare against other countries and I dont really care. But the idea that our Health care industry is based on our capitalist principals is hogwash. If your hurt, you go to the closest hospital. If your not insured, you pay much more. Twice as much as an insurance company would for the same treatment. There isnt any comparitive shopping, nor any benefit to doing so if you have insurance. Your usually stuck with the insurance company your employer provides, and the medical practitioners they contract with, unless your willing to pay through the nose yourself. I dont care what happens in Canada, I just know, what we have isnt working as well as it could and should. I suspect that we could do alot to fix the system with a few regulations. For example, require hospitals and doctors to have 1 price, regardless of insurance or private pay. A visit to a Doctor should cost the same for the insured as the uninsured. Doctors and hospitals should be one some kind of fee schedule and maybe a rating system. Some kind of fee averaging rating or something, indicating how expensive the Dr is overall so you can compare one doctor's prices to another. Just a few thoughts randomly tossed out there. |
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[*]$15 for the medication[*]$100 for the office visit[*]$180 for the Dr to give the injection
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The entire point of the article has been lost here.
The issue isn't whether health care is expensive. It is. You're dealing with high end technology. High over head. People who have to get expensive schooling and training for nearly a decade. And then you have the legal problems and market factors entering into the price. But Stossel is taking direct issue with the way that these "quality" surveys are determined. They repeatedly say that the U.S. system doesn't "perform," but then use a completely biased and ridiculous way of making this judgment. "The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes." So, if the government ensures everyone gets the same level of inferior care, or if everyone has to wait four months for routine surgery, according to these surveys, the system performs better than ours according to these reports.. |
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1. Malpractice actions - these are the biggest offender, forcing healthcare costs through the roof. Lawyers like John Edwards have enriched themselves off the pocketbooks of insurance companies who have to pay up every time some doctor misses a diagnosis that caused Aunt Maude's dysentery to act up. Who do you think pays for that? Follow the trail - malpractice insurance companies raise premiums, doctor has to pay those, doctor raises prices, you pay more. Doctors also are being forced to practice defensive medicine to protect themselves from lawsuits, which means more tests and multiple diagnoses and prognoses for you every time you visit. They must cover every possibility in order to avoid being sued. This drives costs up as well.
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I have to go on a side track, sorry...
This is the biggest myth of all, and just burns my britches every time it mentioned. Give me an example of a state that enacted tort "reform" where insurance rates went down. You can't. Even the insurance companies openly admit that tort reform will have little or no effect on malpractice insurance rates. |
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Uh...
That's baloney. You know zip about this subject. I personally view the documentation of three dozen healthcare providers per day and I can tell you that their malpractice insurance rates are COMPLETELY dependent on how often they and/or their colleagues in their specialty get sued. Malpractice insurance rates can climb into the six figures annually. So... Wrong again. |
| FACT: Limiting a patient's right to sue will do nothing to control insurance rates. A 1999 Center for Justice & Democracy study, Premium Deceit; The Failure of "Tort Reform" to Cut Insurance Prices, co-written by J. Robert Hunter, was the first-ever exhaustive look at the impact of tort restrictions on state-by-state insurance costs over the last 14 years. According to Hunter, "Despite years of claims by insurance companies that rates would go down following enactment of tort reform, we found that tort law limits enacted since the mid-1980s have not lowered insurance rates in the ensuing years. States with little or no tort law restrictions have experienced approximately the same changes in insurance rates as those states that have enacted severe restrictions on victims' rights." Following the release of Premium Deceit, spokespeople for the American Tort Reform Association (ATRA) agreed. Both ATRA's president and general counsel said in published statements that lawmakers who enact restrictions on consumers' legal rights should not expect insurance rates to drop. |
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Uh...
That's baloney. You know zip about this subject. I personally view the documentation of three dozen healthcare providers per day and I can tell you that their malpractice insurance rates are COMPLETELY dependent on how often they and/or their colleagues in their specialty get sued. Malpractice insurance rates can climb into the six figures annually. So... Wrong again. |
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Conclusion Like earlier Stable Losses/Unstable Rates studies, this updated version analyzes what medical malpractice insurers have taken in and what they’ve paid out over the last 30 years, including during this decade when doctors were hit with skyrocketing medical malpractice insurance rates. Its findings are startling. While insurer payouts per doctor directly track the rate of medical inflation, medical insurance premiums do not. Rather, they rise and fall in relationship to the state of the economy. This has been true for the last three decades and true for the last few years. Not only was there no “explosion” in lawsuits, jury awards or any tort system costs to justify the astronomical premium increases that doctors have been charged in recent years. These rate increases were rather driven by the economic cycle of the insurance industry, driven by declining interest rates and investments. |
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3. I, too, had tendinitis, back in 1999. In both elbows. I knew what it was and rather than opting for the cortizone shot, I treated myself by wearing an elbow sleeve and by ceasing the activity that caused it. Finally went away after about a year.
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4. Fee schedules? What you're advocating is socialistic healthcare, just like Hillary wants. What you don't realize is that the unintended consequences of this will result in very poor quality of healthcare in this country.
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6. COBRA is designed as an incentive to find new employment or to purchase your own plan. I'm glad you found a cheaper alternative,
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it's a market issue that the government should stay out of. Governments are not good at "helping" markets. They are better at hurting them.
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Of course doctors in "high-risk" specialties are going to pay higher premiums. Tort "reform" isn't going to change that. The real issue, which you have failed to address, is whether capping claims has any effect whatsoever on insurance rates. Based on those states that have enacted tort reform, there is none. Rates have continued to skyrocket. In fact, some insurance companies have found that their liability has increased with award caps because litigants go straight for the maximum award, where they didn't before.
No one is arguing that malpractice insurance rates are astronomical. The question is what's causing them to rise, and what to do about it. Many states have enacted tort reform, so we have some real-world examples of how well it works. Show me ONE example where rates declined or levelled off due to such "reforms". |
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I would hope everyone realizes on average about 50% of a doctors income goes to malpractice insurance.
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4. Medical malpractice premiums have not increased rapidly over the last several years. "In fact, when adjusted for inflation, malpractice premiums dropped by nearly a third from 1991 to 2000. It would take a hike of 50 percent to bring rates back to their 1991 level. Insurer pricing practices, under-pricing in a soft insurance market followed by sharp increases as the market becomes more competitive - are the key culprit in the severe rate increases that are now occurring." According to the 2000 Statistical Abstract of the United States, page 125, the Average Physician Salary has increased from $112,200 in 1985 to $199,600 in 1997. Average Malpractice Premiums increased from $10,500 to $14,200 in this same period of time. Thus, the percent of doctor's salary for malpractice premiums decreased from 9.4% to 7.1%. According to the Health Care Financing Administration, doctor's salaries went up 41.7% from 1988 to 1998 while medical malpractice costs only went up 5.7% during this same period of time. Health care costs went up 74.7%. |
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First of all, stop attributing the tort reform canard to me as I didn't bring it up. You did.
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Originally Posted by fossten
1. Malpractice actions - these are the biggest offender, forcing healthcare costs through the roof. Lawyers like John Edwards have enriched themselves off the pocketbooks of insurance companies who have to pay up every time some doctor misses a diagnosis that caused Aunt Maude's dysentery to act up. Who do you think pays for that? Follow the trail - malpractice insurance companies raise premiums, doctor has to pay those, doctor raises prices, you pay more. Doctors also are being forced to practice defensive medicine to protect themselves from lawsuits, which means more tests and multiple diagnoses and prognoses for you every time you visit. They must cover every possibility in order to avoid being sued. This drives costs up as well.
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Yeah, "B.S." straight from the doctors mouth.
I got my info straight from doctors in my family. I would trust this, as opposed to a law office that wants to color things in there best interest (against tort reform) average salary of $199,000?! You do realize how meaningless that is. The few highly specialized doctors who make millons bump up the average for the rest. It's like saying the average income in the US is $125,000. Because we have a few very extremely rich people (like Bill Gates) that average (spread around) is going to jump up. |
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Originally Posted by shagdrum
I would hope everyone realizes on average about 50% of a doctors income goes to malpractice insurance.
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Second, show me ONE example of a country with a socialized healthcare system with a quality of care that rivals ours and I'll cede you a point. Until then...
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So your saying that we are not able to give high quality health care and universal health care coverage at the same time?
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| Our civilization holds that some aspects of life should be off-limits to the market. Government, the police and fire departments, and the military should not be for sale; nor should profits be made selling sexual intimacy, or children for adoption. Our constitution recognizes a compelling public interest in religious free speech, and in unfettered discourse on public policy. Here, commercial interests have no standing. They should have none in medicine. |
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So, while I don't trust the government to handle our healthcare directly, I do believe they have a role in reforming a system which has become corrupt and bloated, simply because no one else can or will do it. That means regulation, and possibly a change to a non-profit system. I know these words strike fear and loathing into the hearts of die-hard disciples of free-market capitalism, but the free-market is not the answer to all things. It certainly is not working in the case of health care. |
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Yes, the system is corrupt and bloated. But, when the government tries to "reform" anything, they just bloat it and add corruption. In fact, much of the corruption and bloated system can already be traced back to the government. The answer is not more government in health care, but less.
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I honestly dont know what the answer is. Its a very complicated issue, but having 47 million americans uninsured isnt acceptable to me.
Further, those 47 million, when they do need medical care, pay through the nose because insurance companies are able to negotiate lower rates, the uninsured are not. ALl I know, is that what we have now isnt working well, and isnt going to get better, only worse. So something needs to be done. |
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I honestly dont know what the answer is. Its a very complicated issue, but having 47 million americans uninsured isnt acceptable to me.
Further, those 47 million, when they do need medical care, pay through the nose because insurance companies are able to negotiate lower rates, the uninsured are not. ALl I know, is that what we have now isnt working well, and isnt going to get better, only worse. So something needs to be done. |

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So don't try that "people with insurance pay lower rates" argument. It is inaccurate and misleading.
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Its a fact. Insured pay less then uninsured for the same procedure. People on government programs didnt enter into my statement. If 2 people go to the hospital for a broken leg and receive the same treatment, one insured one not, the bill for the uninsured will be dramatically higher.
While those who are poor may have their bill forgiven by the hospital, that wont apply to the family who is scraping to get by without insurance and lose thier house because someone has a heart attack or other serious illness. |
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How about US news?
One of the consequences of higher health insurance costs, Altman noted, has been the rise in the number of uninsured, which reached 47 million in 2006, a 5 percent increase over the previous year. Health Insurance Costs Rise Again Thats my source - Ive never even been to Michal Moore's website. Here are a few more. How about the CDC? Good enough for you? Or are they working for Michael Moore too? In 2006, there were 43.6 million Americans of all ages who did not have health insurance (at the time of the interview), or 14.8 percent of the population. http://www.cdc.gov/od/oc/media/press...07/b070625.htm I know better then to quote Michael Moore around here. ![]() shagdrum, I agree we have the best doctors and the best medical care in the US, however, that care doesnt extend to 100% of the population. I dont buy into the "its good enough" argument. I am sure you wouldnt buy that argument either if your family was one of those without insurance. |
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Sorry, those figures are incorrect. Mine are based on the United States Census. But as I've said to you before, I could hit you over the head with facts and you'd believe whatever you want. Jesus Himself could appear in front of you and you'd say He was just shilling for Bush.
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Well, call the CDC and tell them. I didnt make it up, im sure they didnt either. I didnt bring bush into this whatsoever. I dont care if there is 1 million without healthcare, its too many. I believe we can do better. What in the HELL is wrong with beliiving we can do better as a nation?
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Well, call the CDC and tell them. I didnt make it up, im sure they didnt either.
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You really are a glass is completely empty kind of guy, aren't you? Can't look at it like, we have over 90% of the people in this country who have health insurance, eh?
I wonder, why weren't you crowing about this stuff when Clinton was president? After all, there were "millions of people" without healthcare coverage back then, too. Of course, his wife tried a government takeover of our healthcare system back then, and the smart people of this country didn't go for it. You wanna vote for her and see her try it again? |
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Why is it that whenever someone wants to demonstrate the horrors of government-run healthcare, they always cite Canada, and then imply that if Canada's system is so bad, then ALL government-run healthcare systems must be bad?
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Why is it that whenever someone wants to demonstrate the horrors of government-run healthcare, they always cite Canada, and then imply that if Canada's system is so bad, then ALL government-run healthcare systems must be bad? As if all government-run systems are equal? That's not the case. Germany has nationalized healthcare, and the wait times and quality of care are as good, if not better than the U.S. Speaking of which, the whole argument about wait times may be a myth. There are many procedures that Americans have to wait for, but it's because of delays by the insurance companies.
Here's an interesting article: http://www.businessweek.com/magazine...8/b4042072.htm The Doctor Will See You—In Three Months The health-care reform debate is in full roar with the arrival of Michael Moore's documentary Sicko, which compares the U.S. system unfavorably with single-payer systems around the world. Critics of the film are quick to trot out a common defense of the American way: For all its problems, they say, U.S. patients at least don't have to endure the endless waits for medical care endemic to government-run systems. The lobbying group America's Health Insurance Plans spells it out in a rebuttal to Sicko: "The American people do not support a government takeover of the entire health-care system because they know that means long waits for rationed care." In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn't clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August. "I completely freaked out," Susan says. "I couldn't imagine spending the summer with this hanging over my head." After many calls to five different facilities, she found a clinic that agreed to read her existing mammograms on June 25 and promised to schedule a follow-up MRI and biopsy if needed within 10 days. A full month had passed since the first suspicious X-rays. Ultimately, she was told the abnormality was nothing to worry about, but she should have another mammogram in six months. Taking no chances, she made an appointment on the spot. "The system is clearly broken," she laments. It's not just broken for breast exams. If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. "Waiting is definitely a problem in the U.S., especially for basic care," says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy. All this time spent "queuing," as other nations call it, stems from too much demand and too little supply. Only one-third of U.S. doctors are general practitioners, compared with half in most European countries. On top of that, only 40% of U.S. doctors have arrangements for after-hours care, vs. 75% in the rest of the industrialized world. Consequently, some 26% of U.S. adults in one survey went to an emergency room in the past two years because they couldn't get in to see their regular doctor, a significantly higher rate than in other countries.[Something that contributes greatly to your costs and mine] There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada. The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. "Their wait might be uncomfortable, but it makes very little clinical difference," he says. The Commonwealth study did find one area where the U.S. was first by a wide margin: 51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close. Few solutions have been proposed for lengthy waits in the U.S., in part, say policy experts, because the problem is rarely acknowledged. But the market is beginning to address the issue with the rise of walk-in medical clinics. Hundreds have sprung up in CVS, Wal-Mart (WMT ), Pathmark, (PTMK ) and other stores—so many that the American Medical Assn. just adopted a resolution urging state and federal agencies to investigate such clinics as a conflict of interest if housed in stores with pharmacies. These retail clinics promise rapid care for minor medical problems, usually getting patients in and out in 30 minutes. The slogan for CVS's Minute Clinics says it all: "You're sick. We're quick." |
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There is another side to that. There isnt any incentive to compete among most doctors. Do you chose a doctor based on any real criteria? Do you look at cost or quality of service? I think what most people do when choosing a new doctor is check to see who is signed up with their insurance company and is local to them.
We are not good consumers when it comes to medical care, and there isnt really a system to evaluate a doctor like we would a plumber or other professional. Even if there was, there is no incentive or reward to bother worrying about the costs of one doctor over another. |
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I watched Stossel's 20/20 special, and I'm convinced that one of the biggest reasons for high healthcare prices, at least with the little things, is the very existence of health insurance. Think about it - with insurance, there's no incentive to shop for bargains b/c someone else is paying the bill. There is no incentive for providers to keep costs down because somebody else is paying the bill. Insurance actually quells the free market.
So people like Hillary want insurance coverage across the country, which will cause prices to go even higher. |
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I didnt see the 20/20 special. But yes, this is part of my point all along. Our health care system doesnt make sense to me because of this. Its not really a competitive market and our consumers are not good consumers either because the real customer of health care is insurance companies.
I dont think just giving insurance to everyone is the answer either. I really dont know how to solve the problems. What I do know, is that what we have now isnt the best we can do. |
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The only real competition in our system is among insurance companies, medical people and employers. Notice, the patient isnt really in that mix?
As a general rule, you get the insurance your employer offers (if they offer). Generally, employers are not looking at providing the best health care for their employees, they are looking out for their bottom line and own self interests. Hospitals, doctors and insurance companies negotiate pricing amongst themselves. The patient is pretty much left out of the mix. Now, you do have the option of not using the employer offered insurance and instead paying for your own choice of insurance out of your own pocket. But even if you choose to do that, the employer doesnt credit you the money they would have spent on insurance for you. You just lose that and spend more to get your own insurance. Moreover, if you have an ongoing condition such a diabetes, you may not be able to get that covered if you go to private insurance. (pre existing condition) So you dont REALLY have much of a choice there. Hence, there is no real competition. And, if your employer doesnt offer insurance, which usually is the case for lower paid jobs, and you cant afford to buy insurance on that lower income salary, then you can get health care if you are in a life threatening situation. But if you cant pay the bills, you face alot of other issues, like your credit being destroyed or losing what little assets you might have. I knew a bankruptcy attorney once. He was a good friend. He once told me that most of the bankruptcies he did involved medical bills and that they were usually the trigger for a BK. You've mentioned tort reform on a few notes. Clearly malpractice insurance plays a part in all this. Doctors order all kinds of tests that are really not necessary, but they are covering their backside. Like I have said before (in another thread) -- I got a cortizone injection in my elbow. 1 doctor visit, medicine was $15, the rest of the bill (after insurance discounts) was $285. Seems high to me. Insurance didnt pay because it was a "surgical procedure" so it went to my deductible. Anytime it costs an insured person $285 for an injection of $15 worth of medicine, there are problems in the system. Plain and simple. |
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The only real competition in our system is among insurance companies, medical people and employers. Notice, the patient isnt really in that mix?
As a general rule, you get the insurance your employer offers (if they offer). Generally, employers are not looking at providing the best health care for their employees, they are looking out for their bottom line and own self interests. Hospitals, doctors and insurance companies negotiate pricing amongst themselves. The patient is pretty much left out of the mix. Now, you do have the option of not using the employer offered insurance and instead paying for your own choice of insurance out of your own pocket. But even if you choose to do that, the employer doesnt credit you the money they would have spent on insurance for you. You just lose that and spend more to get your own insurance. Moreover, if you have an ongoing condition such a diabetes, you may not be able to get that covered if you go to private insurance. (pre existing condition) So you dont REALLY have much of a choice there. Hence, there is no real competition. And, if your employer doesnt offer insurance, which usually is the case for lower paid jobs, and you cant afford to buy insurance on that lower income salary, then you can get health care if you are in a life threatening situation. But if you cant pay the bills, you face alot of other issues, like your credit being destroyed or losing what little assets you might have. I knew a bankruptcy attorney once. He was a good friend. He once told me that most of the bankruptcies he did involved medical bills and that they were usually the trigger for a BK. You've mentioned tort reform on a few notes. Clearly malpractice insurance plays a part in all this. Doctors order all kinds of tests that are really not necessary, but they are covering their backside. Like I have said before (in another thread) -- I got a cortizone injection in my elbow. 1 doctor visit, medicine was $15, the rest of the bill (after insurance discounts) was $285. Seems high to me. Insurance didnt pay because it was a "surgical procedure" so it went to my deductible. Anytime it costs an insured person $285 for an injection of $15 worth of medicine, there are problems in the system. Plain and simple. |