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Old 05-27-2015, 11:59 AM
 
Location: Vancouver
18,492 posts, read 15,337,259 times
Reputation: 11929

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Quote:
Originally Posted by fusion2 View Post
Yup same thing with my dad - His bladder cancer had spread to his prostate and surrounding lymph nodes and a combination of surgery and oncological treatment has rendered him cancer free 10 years and counting.. A big part of the success was quick diagnosis, operation and treatment..

Always love to hear stories like yours, mine and BK's..
Another part of our health system that some American's don't understand, is how seamless treatment can be.

Everything in both my friends and mother's case was arranged for them. From different specialists, to follow ups. No paperwork really. No haggling with insurance etc. The only thing my mother pays for is a tiny portion of her prescriptions that aren't covered by her insurance that is included in her work pension, and B.C.'s Fair Pharmacare plan which is based on income. She pays in total around $500.00 per year.

My mother received care at home after her brain tumour operation. My friend lives alone so they would send someone by his place to check up on how he was doing.

Speaking of my mother, she is now wheelchair bound, but through the local government health agency receives homecare twice a day, everyday. The costs were around $780.00 per month, which I thought was a bargain, but after a review of her needs they lowered it and capped it at $300.00 per month. A steal.
I can't imagine a private service doing that.
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Old 05-27-2015, 12:53 PM
 
Location: Cambridge, MA/London, UK
3,847 posts, read 5,244,251 times
Reputation: 3333
Quote:
Originally Posted by Natnasci View Post
Another part of our health system that some American's don't understand, is how seamless treatment can be.

Everything in both my friends and mother's case was arranged for them. From different specialists, to follow ups. No paperwork really. No haggling with insurance etc. The only thing my mother pays for is a tiny portion of her prescriptions that aren't covered by her insurance that is included in her work pension, and B.C.'s Fair Pharmacare plan which is based on income. She pays in total around $500.00 per year.

My mother received care at home after her brain tumour operation. My friend lives alone so they would send someone by his place to check up on how he was doing.

Speaking of my mother, she is now wheelchair bound, but through the local government health agency receives homecare twice a day, everyday. The costs were around $780.00 per month, which I thought was a bargain, but after a review of her needs they lowered it and capped it at $300.00 per month. A steal.
I can't imagine a private service doing that.
What haggling with insurance does the average insured american actually do? Why do you think Healthcare systems have billing departments? They do all the negotiation for you. You give them your insurance card, they scan it and as long as its valid they take it from there.

I cant remember the last time I had to fill out any paper work after visiting the doctor.

Of course there are horror stories of certain procedures that were not covered by insurance, similar to horror stories in Canada of certain provincial plans that do not cover certain procedures, drugs, etc...

Alot of the abuses people remember have been curbed due to the ACA. Chances are if you bring up an example of a blatant abuse, there is a legal protection built into the law. The funding mechanisms were very sloppily written by congress, but the coverage levels/protections were very detailed and well written. Just scan through the bill if you dont want to take my word for it.
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Old 05-27-2015, 03:54 PM
 
Location: Gatineau, QC, Canada
3,394 posts, read 5,502,977 times
Reputation: 4438
I just had surgery to remove a pilonidal cyst yesterday afternoon. I've had one surgery for it already and I was impressed by how well done this one in particular was. There's no open wound like last time, which took literally a year to completely heal. The process was pretty seamless and there's a monitor in the waiting rooms telling you exactly what part of the surgery your surgeon is at, should your family or friends get impatient or worried.
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Old 05-27-2015, 04:52 PM
 
Location: Toronto
15,109 posts, read 15,704,812 times
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Quote:
Originally Posted by Jesse44 View Post
I just had surgery to remove a pilonidal cyst yesterday afternoon. I've had one surgery for it already and I was impressed by how well done this one in particular was. There's no open wound like last time, which took literally a year to completely heal. The process was pretty seamless and there's a monitor in the waiting rooms telling you exactly what part of the surgery your surgeon is at, should your family or friends get impatient or worried.
Good to hear Jesse - speedy recovery!
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Old 05-27-2015, 09:02 PM
 
Location: Vancouver
18,492 posts, read 15,337,259 times
Reputation: 11929
Quote:
Originally Posted by edwardsyzzurphands View Post
What haggling with insurance does the average insured american actually do? Why do you think Healthcare systems have billing departments? They do all the negotiation for you. You give them your insurance card, they scan it and as long as its valid they take it from there.

I cant remember the last time I had to fill out any paper work after visiting the doctor.

Of course there are horror stories of certain procedures that were not covered by insurance, similar to horror stories in Canada of certain provincial plans that do not cover certain procedures, drugs, etc...

Alot of the abuses people remember have been curbed due to the ACA. Chances are if you bring up an example of a blatant abuse, there is a legal protection built into the law. The funding mechanisms were very sloppily written by congress, but the coverage levels/protections were very detailed and well written. Just scan through the bill if you dont want to take my word for it.
First off how many forms do you think someone using their health insurance in the US has to fill out when they are NOT just going for a yearly check up but have a serious illness?

Claiming ANYTHING with private insurance requires work. Receipts, signatures, reading and really understanding your policy. Imagine the amount of coverage complexities for someone going through cancer treatment.

People in Canada do deal with private insurance. We are not unaware of how private insurance works for our homes, cars, dental etc.

Sometimes it goes smoothly...after filling out the claim form or forms, sending them off. Waiting, waiting and waiting to be denied in error.

In the example of both my mother and my friend the LAST thing we needed to add to the stress was dealing with claims and insurance companies. We simply didn't have to.

Horror stories in Canada about not being covered? Please share.

The fact is, in Canada people who get serious illness don't have to deal with the stress of private health insurance, UNLESS it's part of an extended plan they have with a PRIVATE insurer.

This is only one story and of course not typical, but it show you a situation that can NOT happen in Canada.


http://abcnews.go.com/Health/termina...ry?id=22302395
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Old 05-27-2015, 11:39 PM
 
Location: Cambridge, MA/London, UK
3,847 posts, read 5,244,251 times
Reputation: 3333
Quote:
Originally Posted by Natnasci View Post
First off how many forms do you think someone using their health insurance in the US has to fill out when they are NOT just going for a yearly check up but have a serious illness?
None if they read their coverage ahead of time and choose an in network provider. Being the active person I am, I have been through more than one surgery in my lifetime. Send in my card, pay my co-pay and the hospital system takes care of all the billing.

Plus I work for a large HC System now and have an understanding of how the billing/reimbursement process works.

Quote:
Claiming ANYTHING with private insurance requires work. Receipts, signatures, reading and really understanding your policy. Imagine the amount of coverage complexities for someone going through cancer treatment.
I have two cancer survivor parents. Both received their care in Central Florida. My parents split their time between Jamaica and Florida and my father just finished up his final chemotherapy round 4 months ago at the Florida Hospital Cancer Institute. So I know exactly what forms he had to fill out.

Also being self employed he received his Health Insurance coverage through the ACA Federal Health Exchange. When he started his treatment we sat down, reviewed his plan and chose a specialist team based on his coverage. Other than his out of pocket costs (Co-pays) he has not provided one piece of documentation on his own, all has been handled by Florida Hospital.

Quote:
Horror stories in Canada about not being covered? Please share.
Milton mother with two months to live devastated after OHIP fails to cover cancer treatment - Toronto | Globalnews.ca

OHIP won't cover cancer drug - Toronto - CBC News

Brampton woman denied OHIP coverage for life-saving cancer drugs

OHIP won

Oh look I can play the google some random stuff on the Internet game as well. Unlike you I have real life experience dealing with the HC System and do not have to rely on a google education. Plus I really hate reaching for rare examples to discredit an entire HC System. One that I have personally used in Ontario myself and have decent things to say about the care provided.


Quote:
The fact is, in Canada people who get serious illness don't have to deal with the stress of private health insurance, UNLESS it's part of an extended plan they have with a PRIVATE insurer.
That is great and only 3 countries on earth do not have Private Insurance based Healthcare systems and one of them is in the process of reform to introduce a system that has more private insurance involvement in the market. The citizens of all those other nations seem to figure it out fine, so your fear of Private Insurers is strange to me. I am not suggesting that the Canadian system is a bad one, I am saying there are multiple ways to reach the same result, at times with even greater success.

Quote:
This is only one story and of course not typical, but it show you a situation that can NOT happen in Canada.


Terminal Cancer Patient at Center of Health Insurance Nightmare - ABC News
Terrible abuse of power in the case of the insurer. Since you are interested though, click on the change.org page. The Insurance company heard their appeal and authorized the treatment. So persistence and the protections in the law worked. I am happy to see that, you should as well.
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Old 05-28-2015, 12:32 AM
 
Location: Alberta, Canada
3,593 posts, read 3,330,269 times
Reputation: 5454
Quote:
Originally Posted by edwardsyzzurphands View Post
None if they read their coverage ahead of time and choose an in network provider.
That's the thing: Canadians don't need to read their coverage, and "in-network provider" is a foreign concept. Here in Canada, it's "any doctor, any hospital, any time." It does get a little sticky when trying to find a GP who is accepting new patients; I'll grant you that. But for emergency and subsequent care, there is no "in-network" question.

Quote:
That is great and only 3 countries on earth do not have Private Insurance based Healthcare systems and one of them is in the process of reform to introduce a system that has more private insurance involvement in the market. The citizens of all those other nations seem to figure it out fine, so your fear of Private Insurers is strange to me. I am not suggesting that the Canadian system is a bad one, I am saying there are multiple ways to reach the same result, at times with even greater success.
I agree, and I'm not entirely sure if Canada wants to keep company on this issue with Cuba and North Korea--the other two countries that outlaw any form of private care.

We look down on the US's health care system, but we look up to those of the UK, of Australia, of Germany, of France. And yet all of those systems allow a parallel private care system. Why do we not do the same in Canada? Yes, I'm aware of the fear that those with money will jump the queue, but if that is not a concern in these other countries we admire, why should it be in ours?
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Old 05-28-2015, 12:55 AM
 
Location: State of Transition
102,052 posts, read 106,836,948 times
Reputation: 115779
Quote:
Originally Posted by Natnasci View Post
There are government lists of what surgeries are covered by province.

Here is B.C.'s

Services Not Covered by MSP - Benefits
Mental health care isn't covered, it said. How do people pay for mental health care? It's very expensive. It also said vision and dental isn't covered. Is there a separate insurance program people pay for, to cover those?
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Old 05-28-2015, 01:00 AM
 
Location: Canada
7,233 posts, read 9,205,954 times
Reputation: 9789
Quote:
Originally Posted by Ruth4Truth View Post
Mental health care isn't covered, it said. How do people pay for mental health care? It's very expensive. It also said vision and dental isn't covered. Is there a separate insurance program people pay for, to cover those?
Psychologists are not covered. Psychiatrists are, at least that is how it is in Manitoba. Vision and dental are not covered here either under the provincial plan but most people are covered for those things through their jobs.
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Old 05-28-2015, 01:01 AM
 
Location: Canada
7,233 posts, read 9,205,954 times
Reputation: 9789
Quote:
Originally Posted by ChevySpoons View Post
That's the thing: Canadians don't need to read their coverage, and "in-network provider" is a foreign concept. Here in Canada, it's "any doctor, any hospital, any time." It does get a little sticky when trying to find a GP who is accepting new patients; I'll grant you that. But for emergency and subsequent care, there is no "in-network" question.

I agree, and I'm not entirely sure if Canada wants to keep company on this issue with Cuba and North Korea--the other two countries that outlaw any form of private care.

We look down on the US's health care system, but we look up to those of the UK, of Australia, of Germany, of France. And yet all of those systems allow a parallel private care system. Why do we not do the same in Canada? Yes, I'm aware of the fear that those with money will jump the queue, but if that is not a concern in these other countries we admire, why should it be in ours?
Very true.
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