posted on March 19, 2002 03:40:59 PM new
As many HMO's have gone bankrupt and others are falling on hard times(it's true), those that are trying to stay alive will soon do away with small co-pays for doctor visits and drugs. $25 doctor co-pays and $45 brand-name drug copays will become commonplace. Partially to blame are those individuals who run to the doctor every time they bang their knee or their child has a sniffle. Some families have dozens of yearly office visits, mostly for colds and minor things easily treated at home. Small co-pays encourage frequent unnecessary visits and demand for unnecessary medications(overprescribed antibiotics are creating resistant bugs). Blue Cross/Blue Shield of Florida has had a tenfold increase in one night hospital stays over the last two years as those without outpatient benefits are talking their doctors into admitting them to the hospital so their insurance policies cover the cost of MRI's and other expensive tests. Another interesting change will be PPO's that require referrals for more and more specialists. Many Medicare doctors are now refusing to take new patients as they are being paid less and less with decreases totaling 17% over the next three years.
posted on March 19, 2002 04:43:58 PM new
Well, the Republicans are jumping up and down in their usual Happy Dance when they get their way. Because of the skyrocketing cost of prescriptions, many hospitals and pharmacies will no longer accept Medicare or state Medicaid. Yes, what the Republicans couldn't do to trash Medicare in Congress and the white House all of these decades, now they can have thier sweet buddies, the drug companies, charge so much for drugs that hospitals and pharmacies ruotinely loose money filling prescription drugs with Medicare. The end result that makes Republicans so happy? Medicare can be around all it likes, but no one will be able to use it - absolutely worthless. Oh, except that we keep making those insurance payments anyway.
posted on March 19, 2002 04:47:18 PM new"Partially to blame are those individuals who run to the doctor every time they bang their knee or their child has a sniffle. Some families have dozens of yearly office visits, mostly for colds and minor things easily treated at home."
Christ Almighty! And who's to blame for that, I ask anyone? If you are a parent and your kid gets too sick, the state will take the kid away from the parents due to "neglect" and "child abuse"! And don't you DARE be a single parent with the other one waiting around like a vulture for you to make the slightest mistake and take you to court and you loose custody! Happens every day. You damn sure don't keep your kids at home when they get a sniffle! Not unless you want to get rid of them.
posted on March 19, 2002 05:07:00 PM newAnd now a brief interlude while Borillarcomposes his next rant...
Where are you getting your information, Stusi? Kaiser-Permanente has begun something similar to it. Whereas my parents' doctor visits used to be free, they're now ten dollars per appointment. Their prescription drugs are up from one dollar to five dollars per Rx, with some exceptions we've not yet encountered that push the Rx prices up to fifteen dollars each. In both their cases, Kaiser's still a remarkable bargain -- neither of my parents is chronically ill in ways that can be effectively treated, but Kaiser *is* a bit of a social staple for them and if the costs of doctor visits rise to the heights you mentioned in your post, I'm going to have to come up with more economical outlets -- line-dancing at the Newark Hogwalk Corral & Bar, perhaps...
posted on March 19, 2002 05:09:28 PM new
Managed Care doesn't work. That's all it boils down to. Just added another layer of middlemen to grab their piece of the pie.
posted on March 19, 2002 05:16:21 PM new
plsmith- Recently published articles in the NY Times and other papers have stated what we in the health insurance field already knew. After creating two medical advisory boards for private companies and corresponding with hundreds of doctors around the country for several years, I am now on the other side of the industry.
posted on March 19, 2002 05:27:31 PM new
"Managed Care doesn't work."
Darn it, Katy, it works in my household!
"Recently published articles in the NY Times..."
Well, that explains why I haven't read about it, Stusi. Those dirty fuctards that deliver the NYT here daily have become experts at hurling it beneath my van. Sometimes whole weeks go by before I get out the rake and retrieve them...
posted on March 19, 2002 06:00:07 PM new
plsmith/KatyD- managed care works when it pays a large portion of one's hospital expenses; it doesn't work when as many as 600,000 doctors are filing class action lawsuits against the HMO's for various reasons or when they get financially strapped by offering unlimited low co-pays.
posted on March 19, 2002 06:32:15 PM new
Actually,I agree with KadyD on this one. Managed healthcare is a farce thought up a while back to keep the trend towards price caps and price regulations from going into effect. "Try these HMO's!" they said. "We'll save lot's 'n' Lot's 'n' LOT'S of Money $$$ doing it THIS way instead of that COMMUNISTIC/Creeping Socialism way of doing it!"
... and so, with another lie, the voters were swayed by Republican bull-hockey, and eventually swindled to the poorhouse (set up by Newt Gingrich) and death. Boo-oo-ooooo! "That Creeppin' Socialism Boogieman's gonn' Get-CHA! Don' go NOWHERE's near that monster, no-siree!"
Truthfully, ONLY the government stepping in, taking over pricing and profits allowable will we "fix" this problem.
posted on March 19, 2002 07:05:55 PM new
Yup. They did a damned good job of regulating it too! It wasn't until the public got hoodwinked on "deregulation" promises that the voters discovered the depth that they had been lied to by the Republicans all these years. Californians may not re-elect some Democrats, but I doubt that they'll be so stupid as to elect another republican anytime soon.
Wish the rest of the country would wise up to that as well.
posted on March 19, 2002 07:49:38 PM new
"Californians may not re-elect some Democrats, but I doubt that they'll be so stupid as to elect another republican anytime soon. "
I hate to tell you this, Borillar, but California is on the verge of electing an ultra-right-wing Republican as governor come ballot time. Bill Simon is poised to unseat milquetoast Gray Davis, who is perceived by many as having no spine, no hardcore democratic values and, above all, the personality of a deceased librarian.
posted on March 19, 2002 10:21:26 PM new
Until we realize the economic reality that some people are just going to have to be excluded from our health care system, the system will not work no matter what we do other than going to universal insurance.
Managed care and PPO's don't work. The only thing managed is what the health care providers are paid and what is not covered.
What do you do when you can't afford co-pays, or the procedure isn't covered ? You just don't consume the health care.
The problem is only going to get much worse as new high tech procedures come on line.
There are going to be many people who have cures just waiting for them, but do not have the coverage or the money to receive them.
posted on March 19, 2002 10:25:05 PM new
I remember handing over one Blue Cross Card to the Doctor/Pharmacist/hospital and everything was covered. NO co-pay, no partial coverage. They would say, "Oh, you've got Blue Cross" and act like I had the key to the city.
Sigh.
posted on March 20, 2002 12:24:09 AM new
Pat, Simon is another scarey ultra conserative. White, rich, and backed by the Christian Coalition. His campaign was managed by them. Again we're hearing a platform of family values. He's going to turn California around and save us.
posted on March 20, 2002 06:34:50 AM new
REAMOND- There are "reduced-fee medical savings plans(not insurance) which get all procedures "re-priced" way down through agreement with the PPO. The reason that they agree is because they get paid immediately by the member, rather than waiting for payment from the insurance company. The remaining balance can be submitted to a "supplemental" insurance plan for reimbursement. There is relatively little out of pocket, there is little concern about pre-existing conditions and the premiums are much lower than traditional insurance.
posted on March 20, 2002 09:26:51 AM new
Managed care does not work because the idea that someone will take what they need and leave enough for all violates human nature. ANYONE I know who has an HMO, has told me they had a sniffle so they went to HMO. Perhaps a compromise could be reached where you would have a sliding scale of co-pay prices based on the number used, or a co-pay pre-banked "credit" of a certain amount. If 3 doctors certify you have a chronic condition, these "rules" would not apply.
A secondary consideration in all of this is the increase in drug usage. My friend takes his kid to the HMO every time she has a sniffle or scratchy throat. This kid has already had more antibiotics than I've had in my life. God forbid she gets sick 10 years from now and needs the most effective antibiotic affect she can get. Not to mention the increased virulence of infections attacking the general population.
posted on March 20, 2002 09:39:53 AM new
Grey Davis IS a spineless piece of $%^T! When Enron came to him, just after the California energy crisis came about, they threatened him with blackouts unless he paid thier ransom. You see, Enron in California first took over the energy companies that had been deregulated. Then, immediately upon acquiring those energy suppliers, sucked over 3 Billion Dollars away from them and into the main Enron corporate account. That left a 3 billion dollar shortfall, naturally, when it came time to buy electricity from the scam that enron played and Bush determined to stay away from and do nothing about. So, Enron, in the guise of the local deregulated electricty companies that they owned, came up to Grey davis and said: "We need 3 Billion Dollars to buy electricity, as we are nearly bankrupt. And if you don't give us the money, your state will experience blackouts and its going to be YOUR FAULT!"
So, instead of getting into the media and exposing this multi-billion dollar scam for what it was and who was playing in it, he turned to Bush. But Bush said: "Let the Market Do its Magic Work!" or some such nonsense; meaning he wouldn't lift a finger to proscecute this obvious crime against the state of California.
Then the jackass went and paid the extortion money! All 3 Billion Dollars of it, and all of it TAXPAYER'S MONEY!
That is why Grey Davis is OUT.
But to put a REPUBLICAN in charge??
That's putting a Thief to guard the treasure!
With a Republican in charge, you Californmians can deregulate even MORE!
Listen: the next time that you Californiains want a Bailout of some sort -- don't come looking up here to the Pacific Northwest like you usually do! We're still bailing you out from your "deregulation" scandal! Yes, we ended up being kind enough to sell you our hydro-electricity, but at a substancial extra cost to us, which has raised up electrical costs 20% for homeowners and 30% surcharge for businesses! Thanks a lot!
posted on March 20, 2002 02:36:49 PM new
stusi- The plan you mention is no solution, not even close. It only covers people who have high enough wages to divert money to the plan or who have enough disposable income to participate. It is basically premised on those who can afford the coverage get it, those who can not afford it do not get coverage. Which brings us back to my original premise- some people are going to have to be excluded from the health care system, or we have to go to universal coverage.
posted on March 20, 2002 06:21:18 PM new
REAMOND- Such a plan would cost a family of three less than $200 per month. On the whole that is very affordable compared to most other plans. It was not suggested as a solution for everyone but rather for those with high premiums and/or pre-existing conditions.
