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Old 09-14-2012, 07:33 PM
 
Location: Anthem, AZ
2,118 posts, read 2,996,953 times
Reputation: 654

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Our 36 year old daughter is in remission from none Hodgkins lymphoma. She was diagnosed about 7 years ago.
She is employed by a large mortgage lender in AZ. She recd a letter from United Health Care saying her benefits have e ceded her premiums too much and they are dropping her on Jan. 1.

I thought the whole purpose of group health plans were to share the costs across the group? Ten people pay in for years and almost never need services and that helps cover the one with catastrophic issues? I guess not. Her husband has a plan at his employer (which happens to also be my employer) and he can cover himself andd the 3 kids. Our daughter is left uncovered.
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Old 09-14-2012, 07:50 PM
 
Location: Port Charlotte, FL
3,961 posts, read 8,478,850 times
Reputation: 1855
Quote:
Originally Posted by Harbor Hopper View Post
And that was with my insurance company paying 80%.
Wait, if $10k was your 20%, then the total bill was $50k??? For ONE night and some tests??? Did I hear that correctly?? Your insurance didn't discount the bill (standard allowance for certain items?) Usually that will save around 50% of what the medical facility charges the insurance co, which then saves you a ton out-of-pocket.[/quote]

It was a nightmare. I was having severe chest pains for over 4 hours. I called my doctor and he said to go to the emergency room immediately. They took me in right away in a wheelchair and did an echocardiogram and blood work and hooked me up to a bunch of equipment. They then took me by ambulance to the hospital where I had to stay overnight with all kinds of monitoring equipment on me. They did blood work every 4 hours, 2 more echocardiograms, a cat scan, a stress test, and lots of other heart tests. The total came to a little over $10,000 for me out of pocket. In the end it was discovered that it wasn't a heart problem but GERD. They did every test imaginable to be sure I wasn't having a heart attack or heart problems. My heart is fine. I can't imagine if I had to stay in the hospital more than one night or had to have an operation. Just doesn't make sense does it. Some of the tests were not covered at all by the insurance company.
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Old 09-14-2012, 11:37 PM
 
Location: In a little house on the prairie - literally
10,202 posts, read 6,056,511 times
Reputation: 4516
Quote:
Originally Posted by TamRE View Post
Wait, if $10k was your 20%, then the total bill was $50k??? For ONE night and some tests??? Did I hear that correctly?? Your insurance didn't discount the bill (standard allowance for certain items?) Usually that will save around 50% of what the medical facility charges the insurance co, which then saves you a ton out-of-pocket.
It was a nightmare. I was having severe chest pains for over 4 hours. I called my doctor and he said to go to the emergency room immediately. They took me in right away in a wheelchair and did an echocardiogram and blood work and hooked me up to a bunch of equipment. They then took me by ambulance to the hospital where I had to stay overnight with all kinds of monitoring equipment on me. They did blood work every 4 hours, 2 more echocardiograms, a cat scan, a stress test, and lots of other heart tests. The total came to a little over $10,000 for me out of pocket. In the end it was discovered that it wasn't a heart problem but GERD. They did every test imaginable to be sure I wasn't having a heart attack or heart problems. My heart is fine. I can't imagine if I had to stay in the hospital more than one night or had to have an operation. Just doesn't make sense does it. Some of the tests were not covered at all by the insurance company.[/quote]

And tell me exactly why there is so much opposition to universal healthcare in the USA? I just don't get it when one sees this type of stuff.
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Old 09-15-2012, 04:49 AM
 
Location: Vik
392 posts, read 413,798 times
Reputation: 396
Quote:
Originally Posted by avb3 View Post
Until recently, I was not aware of the reality of the cost of health insurance in the States.

I am Canadian, and we, as you may know, have universal healthcare coverage. Interestingly enough, we spend a 1/3 less as a percentage of GDP on healthcare, with better results... we live longer. Our taxes are now lower, and we pay no healthcare premiums.

I'm now at that age of looking at snowbirding it. Seeing what you pay, I guess I should consider myself lucky that it will cost me about $1500 for 6 months. On the other hand, it is cheap a heck for healthcare in Mexico and Guatemala, and that is a short plane ride away. I am contemplating having just emergency evacuation/stabilization insurance, and if any thing else develops, to either come back to Canada or become a medical tourist to Central America.

I guess this doesn't add a ton to the thread, but I do consider myself lucky not looking at the huge premiums your looking at. I didn't know before.

We live in Norway, and we have the socialized health care system, pretty much the same as you in Canada. We pay 7.6 % of our gross income for universal health coverage. This is mandatory and deducted from your pay check. We pay appr. $ 13k per year for this. In addition there are deductables for everything. Nothing is for free.

And when we go overseas we are not covered for anything!

The medical system here is really sub-standard. A friend of mine that got cancer had to wait 6 months for treatment. He finally paid treatment himself out of his own pocket. There is long lines for all kinds of treatment, and try to guess what the rich do...the fly to the US fro treatment!

Just food for thoughts before you start supporting socialized health care...
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Old 09-15-2012, 09:11 AM
 
Location: Sunny FLA
686 posts, read 1,405,853 times
Reputation: 292
Thanks all. I see we are not alone in our situation. Hopefully we don't get sick. However I'd love to have an 80/20 plan. It would help. 10K vs. 50K, we could handle with payments. They wouldn't have any other choice. Everyone who wrote about their issues (costs and health), in the end, it's only the health that really matters
Appreciate it!
(Vikingen, Norway? CD really gets around!)
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Old 09-15-2012, 12:27 PM
 
Location: Vik
392 posts, read 413,798 times
Reputation: 396
Quote:
Originally Posted by daFrogMan View Post
Thanks all. I see we are not alone in our situation. Hopefully we don't get sick. However I'd love to have an 80/20 plan. It would help. 10K vs. 50K, we could handle with payments. They wouldn't have any other choice. Everyone who wrote about their issues (costs and health), in the end, it's only the health that really matters
Appreciate it!
(Vikingen, Norway? CD really gets around!)
Hi daFrogMan,

Oh, yes we live in Norway, but we have a house in PC
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Old 09-16-2012, 04:24 PM
 
1,736 posts, read 1,588,049 times
Reputation: 1130
Quote:
Originally Posted by Vikingen View Post
We live in Norway, and we have the socialized health care system, pretty much the same as you in Canada. We pay 7.6 % of our gross income for universal health coverage. This is mandatory and deducted from your pay check. We pay appr. $ 13k per year for this. In addition there are deductables for everything. Nothing is for free.

And when we go overseas we are not covered for anything!

The medical system here is really sub-standard. A friend of mine that got cancer had to wait 6 months for treatment. He finally paid treatment himself out of his own pocket. There is long lines for all kinds of treatment, and try to guess what the rich do...the fly to the US fro treatment!

Just food for thoughts before you start supporting socialized health care...
Very far from my experience. As well as rather...incomplete, to put it kindly.

The 7,6% does not only cover health care, it also covers a pension, generous unemployment benefits, over a years paid parental leave, sickness benefits, child benefits, bereavment support, as well as a number of other benefits, insurances and coverages. Health care is not even the biggest budget post from those 7,6 %. That is pensions, most years followed by the total social support expenses. Health care sometimes hits number two, but is often only the third biggest budget post.

The deductibles cannot total more than $ 300 in a year. All non-elective health care beyond that is free at the point of delivery.

For health care, one is, of course, covered in pretty much every country with a UHC system, through mutural agreements.

If you get any kind of life-threatening illness and the public hospitals cannot offer immediate treatment, you can go to a foreign hospital and the local health authority has to foot the bill. You can always pick which hospital you want to be treated at, and have the trip covered. Less co-pay unless you are over your yearly $ 300. Most people simply log on to fritt sykehusvalg and get booked in where there wait is short or nonexistent. A queue buildup triggers bulk purchases from the governments at private hospitals anyway.

Excepting certain very low-priority treatments, such as surgery for light snoring, dandruff treatments etc.

By far the most frequent reason for treatment abroad is plastic surgery, liposuction or aestetic dental treatments. People who go abroad for medically necessary treatment normally go to Germany or Switzerland. The US is normally too expensive and outside of cancer treatment, does not compare well in results. Still got a good reputation for plastic surgery though. Aso, the US does have a very broad coverage of specialities that smaller countries cannot easily match, so people do occasionally get shipped to specialist units in the US.
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Old 09-17-2012, 01:04 AM
 
Location: Vik
392 posts, read 413,798 times
Reputation: 396
Quote:
Originally Posted by Grim Reader View Post
Very far from my experience. As well as rather...incomplete, to put it kindly.

The 7,6% does not only cover health care, it also covers a pension, generous unemployment benefits, over a years paid parental leave, sickness benefits, child benefits, bereavment support, as well as a number of other benefits, insurances and coverages. Health care is not even the biggest budget post from those 7,6 %. That is pensions, most years followed by the total social support expenses. Health care sometimes hits number two, but is often only the third biggest budget post.

The deductibles cannot total more than $ 300 in a year. All non-elective health care beyond that is free at the point of delivery.

For health care, one is, of course, covered in pretty much every country with a UHC system, through mutural agreements.

If you get any kind of life-threatening illness and the public hospitals cannot offer immediate treatment, you can go to a foreign hospital and the local health authority has to foot the bill. You can always pick which hospital you want to be treated at, and have the trip covered. Less co-pay unless you are over your yearly $ 300. Most people simply log on to fritt sykehusvalg and get booked in where there wait is short or nonexistent. A queue buildup triggers bulk purchases from the governments at private hospitals anyway.

Excepting certain very low-priority treatments, such as surgery for light snoring, dandruff treatments etc.

By far the most frequent reason for treatment abroad is plastic surgery, liposuction or aestetic dental treatments. People who go abroad for medically necessary treatment normally go to Germany or Switzerland. The US is normally too expensive and outside of cancer treatment, does not compare well in results. Still got a good reputation for plastic surgery though. Aso, the US does have a very broad coverage of specialities that smaller countries cannot easily match, so people do occasionally get shipped to specialist units in the US.

First of all, the 7.6% you pay - does not cover all of the benefits you describe. The socialized welfare system in Norway is a vast, enormously expensive system that costs far more than whatever the 7.6% would cover. The welfare system is so generous that large amounts of the population is either on welfare, sick leave or has a pension. That is why this country has the highest level of taxation in the world.

Otherwise your description of the medical system in not entirely correct. Let`s say you have cancer, and your doctor(s) prescribes a treatment that is according to the government standard - (there is a per capita value involved - not to be exceeded) - and let`s say that you (or your second opionion doctor) disagree with the level, respond time and treatment methods. What are your choices? Certainly not the "fritt sykehusvalg" you describe - and saying that there are no lines..well, you couldn`t have read the headlines lately...

Without doubt, the highest level of experts, physicians, scientists AND treatment are in the US. That is where the money is!

Claiming that only liposuction, plastic surgery patients go to the US in also not true. There is many examples of stories where parents have taken their children - often at own expenses - to child clinics in the US - for extensive and more advanced treatment than available in Norway. Other stories are also frequently in the media, and in most cases the problem is that the government is reluctant to pay the costs of these treatments.

My point is that socialized health care system is not as perfect as the ones that advocate this system will try to make you beleive. Even in the countries that has socialized medicine there is major discussions of the system, and its shortcomings.
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Old 09-17-2012, 07:45 AM
 
1,736 posts, read 1,588,049 times
Reputation: 1130
Quote:
Originally Posted by Vikingen View Post
First of all, the 7.6% you pay - does not cover all of the benefits you describe. The socialized welfare system in Norway is a vast, enormously expensive system that costs far more than whatever the 7.6% would cover. The welfare system is so generous that large amounts of the population is either on welfare, sick leave or has a pension. That is why this country has the highest level of taxation in the world.
Right? Highest level of taxation? I pay less taxes than I would in New York. Seriously, taxes in Norway are rather better than many other countries. Taxation level is not the same as personal income taxes. Sweden, the UK, Denmark...I'd pay higher taxes in all of them.

And yes, the 7,9 % does cover all the benefits. From the individuals viewpoint. The total expense is greater, but your membership fee in Folketrygden is 7,9 %. The rest is made up from other sources.

Quote:
Originally Posted by Vikingen View Post
Otherwise your description of the medical system in not entirely correct. Let`s say you have cancer, and your doctor(s) prescribes a treatment that is according to the government standard - (there is a per capita value involved - not to be exceeded) - and let`s say that you (or your second opionion doctor) disagree with the level, respond time and treatment methods. What are your choices? Certainly not the "fritt sykehusvalg" you describe - and saying that there are no lines..well, you couldn`t have read the headlines lately...
No, that is not how we do it in the Norwegian health care system.

First off, yes you can use Fritt Sykehusvalg, if you disagree with your local hospital, or change your physician.
Now, you may have a problem if all the hospitals and physicians disagree with you, for example if you are an 80-year old man with prostrate cancer. But if your opinion diverges from that of all the physicians and hospitals, that goes beyond what pretty much any insurance and system will cover. And there are lines, but there are also triage. There is a line for surgery for light snoring, but none for third-degree burns.

Second, no, there is no per capita value.
There is a guideline that you do not spend more than roughly 150 000 $ per year on new or unproven drugs for a patient. Above that, there should normally be a relation between the cost and a demonstrably better effect than that of cheaper treatments. (Nasjonalt råd for kvalitet og prioritering i helse- og omsorgstjenesten ) For example, Nexavar, which cost 210 000 $ per year was not approved, because there were considerable uncertainty whether it had a measurable positive effect. (Drugs and health care treatments are generally far cheaper in Norway than the USA, so that money does go a lot further.)

Also, this is only a guideline and frequently broken.

Quote:
Originally Posted by Vikingen View Post
Without doubt, the highest level of experts, physicians, scientists AND treatment are in the US. That is where the money is!
Quite, quite true. But the results produced are worse by quite a significant degree.

Quote:
Originally Posted by Vikingen View Post
Claiming that only liposuction, plastic surgery patients go to the US in also not true. There is many examples of stories where parents have taken their children - often at own expenses - to child clinics in the US - for extensive and more advanced treatment than available in Norway. Other stories are also frequently in the media, and in most cases the problem is that the government is reluctant to pay the costs of these treatments.
No, they are not frequently in the media. I do know how to read the language, you know. Also...

Articles in the media do not represent average performance. They represent exceptional cases.

Articles in the media do not represent average performance. They represent exceptional cases.


That is so important that I had to write it twice. And what would be considered exceptionally bad performance in Norway would often not make the news in the US. Also, media attention is part of the corrective process.
Further, I did not claim that only people go to the US only for plastic surgery and liposuction. I said that was the biggest reason, by a wide margin. The US does keep statistics on the number of people that come from medical treatment every year. Its 80 000 form all countries. (Between 1-1,5 million leave for medical treatment each year, not counting drug purchases) Norway treated 820 000 patients in 2006.

Quote:
Originally Posted by Vikingen View Post
My point is that socialized health care system is not as perfect as the ones that advocate this system will try to make you beleive. Even in the countries that has socialized medicine there is major discussions of the system, and its shortcomings.
No, it is not perfect. And yes, there are major discussions about the shortcomings. For example while you are guaranteed immediate treatment for life-threatening conditions, and within a certain time frame for progressive or painful conditions, no-one has actually defined which conditions are progressive or painful and which are not. A lot of the media articles are generated when there is disagreement on this.

Also, there are problems with hospitals protecting their budgets by not informing the patients about all their rights and choices.

However, like most of the European systems, it does perform at a level the surgeon-general in the US would give his eyeteeth for.

Also, if you desire, you can get insurance or out of pocket health care in Norway, considerably cheaper than in the US. The fraction of your taxes that go to government health care is pretty much the same (less in therms of % of GDP, more in terms of number of $ per person, because Norways GDP per person is larger).

So all the health care you get from the government is above and beyond what you'd get in the US, unless you qualify for Medicare, Medicaid, or VHA.

I am sorry to be blunt, but you should at least get some fundamental information about the system before engaging your mouth here. Urban legends and newspaper headlines is not sufficient. Newspaper headlines are not going to give you a realistic impression of the day-to.day level functioning of anything.
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Old 09-17-2012, 11:13 AM
 
Location: Vik
392 posts, read 413,798 times
Reputation: 396
Quote:
Originally Posted by Grim Reader View Post
Right? Highest level of taxation? I pay less taxes than I would in New York. Seriously, taxes in Norway are rather better than many other countries. Taxation level is not the same as personal income taxes. Sweden, the UK, Denmark...I'd pay higher taxes in all of them.

And yes, the 7,9 % does cover all the benefits. From the individuals viewpoint. The total expense is greater, but your membership fee in Folketrygden is 7,9 %. The rest is made up from other sources.



No, that is not how we do it in the Norwegian health care system.

First off, yes you can use Fritt Sykehusvalg, if you disagree with your local hospital, or change your physician.
Now, you may have a problem if all the hospitals and physicians disagree with you, for example if you are an 80-year old man with prostrate cancer. But if your opinion diverges from that of all the physicians and hospitals, that goes beyond what pretty much any insurance and system will cover. And there are lines, but there are also triage. There is a line for surgery for light snoring, but none for third-degree burns.

Second, no, there is no per capita value.
There is a guideline that you do not spend more than roughly 150 000 $ per year on new or unproven drugs for a patient. Above that, there should normally be a relation between the cost and a demonstrably better effect than that of cheaper treatments. (Nasjonalt råd for kvalitet og prioritering i helse- og omsorgstjenesten ) For example, Nexavar, which cost 210 000 $ per year was not approved, because there were considerable uncertainty whether it had a measurable positive effect. (Drugs and health care treatments are generally far cheaper in Norway than the USA, so that money does go a lot further.)

Also, this is only a guideline and frequently broken.



Quite, quite true. But the results produced are worse by quite a significant degree.



No, they are not frequently in the media. I do know how to read the language, you know. Also...

Articles in the media do not represent average performance. They represent exceptional cases.

Articles in the media do not represent average performance. They represent exceptional cases.

That is so important that I had to write it twice. And what would be considered exceptionally bad performance in Norway would often not make the news in the US. Also, media attention is part of the corrective process.
Further, I did not claim that only people go to the US only for plastic surgery and liposuction. I said that was the biggest reason, by a wide margin. The US does keep statistics on the number of people that come from medical treatment every year. Its 80 000 form all countries. (Between 1-1,5 million leave for medical treatment each year, not counting drug purchases) Norway treated 820 000 patients in 2006.



No, it is not perfect. And yes, there are major discussions about the shortcomings. For example while you are guaranteed immediate treatment for life-threatening conditions, and within a certain time frame for progressive or painful conditions, no-one has actually defined which conditions are progressive or painful and which are not. A lot of the media articles are generated when there is disagreement on this.

Also, there are problems with hospitals protecting their budgets by not informing the patients about all their rights and choices.

However, like most of the European systems, it does perform at a level the surgeon-general in the US would give his eyeteeth for.

Also, if you desire, you can get insurance or out of pocket health care in Norway, considerably cheaper than in the US. The fraction of your taxes that go to government health care is pretty much the same (less in therms of % of GDP, more in terms of number of $ per person, because Norways GDP per person is larger).

So all the health care you get from the government is above and beyond what you'd get in the US, unless you qualify for Medicare, Medicaid, or VHA.

I am sorry to be blunt, but you should at least get some fundamental information about the system before engaging your mouth here. Urban legends and newspaper headlines is not sufficient. Newspaper headlines are not going to give you a realistic impression of the day-to.day level functioning of anything.

If comparing your tax level in NYC and finding it higher than Norway, I do suggest than you must have had a pretty lofty penthouse suite on Manhattan, with property taxes to match.

Facts are that Norway with 45% average income tax, 25% sales tax, property tax, inheritance tax, road tax, high fuel tax, toll charges...the list goes on... in total has an extremely high tax level - and many feel they are taxed more than they ever bargained for.

Taxation in Norway - Wikipedia, the free encyclopedia

My MAIN question is: if the a government driven socialized health care system is so successful in protecting it`s citizens, how come more and more are getting private coverage? How come more and more are getting treatment overseas? Shouldn`t there be some redundancy here?

More and more citizens are not buying the hype that they and their families are well protected. Of course anyone within the system will try to make you believe the opposite. The whole idea of socialized medicine is that everyone MUST contribute.

We are not talking about 80 year olds with prostate cancer, we are talking 50 year olds with prostate cancer. That are not satisfied with the operate and burn procedure in Norway, that are not satisfied waiting 8 months for treatment. Anyone with internet - and an interest for saving his own life - will find superior treatment else where. Even doctors admit it, but not officially of course.

Even IMS Health, an US based health information provider has concluded that Norway is spending less and less per year on for instance cancer medicine. Norway is spending 20% less costwise on cancer medicine than in 2002???? This country is also according to their studies among the countries in the Western hemisphere than has the LOWEST increase in medicine usage. All other comparable countries have increased their usage. How does one explain that? Is cancer medicine fast becoming too expensive for the government program?

Now of what interest is all of this for people in Florida? Well, Obamacare wants to have government run health care. I am sure that the US system has many flaws, why don`t fix those flaws, instead of producing a massive government run program.

As health care becomes more and more expensive, the population becomes older and older - anyone with the funds and interest is going to buy themselves out of the government system.
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