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What happens to people who are disqualified because of pre-existing conditions? I mean, presumably they're the ones who need health care the most so there must be some way for them to get coverage?
No, not unless they find a job with an employer who offers a group health plan. Except in a couple of states, employers are not currently required to offer health insurance to their employees, and most uninsured people are employed. (note - in 13 states it is illegal for insurance companies to exclude people for pre-existing conditions, although of course there's nothing stopping them from charging them extremely high premiums and/or refusing to cover those specific conditions.)
Fortunately this will all change in 2014 when the Affordable Care Act (a.k.a. Obamacare) goes into effect.
And even if they do qualify for a group plan, they might not be able to receive care for their specific pre-existing condition until a certain period has passed, depending on the health plan. In most states, this is 6 to 12 months.
The only exceptions to all of this are certain cities (for example San Francisco) that have created city-run health care plans open to everyone earning less than a certain amount.
Granted Obamacare is better than what we had before, it is nothing like the Dutch or Swiss systems. The only thing they all have in common is private insurers, but Obamacare does nothing to change the basic employer based coverage. It remains to be seen what the exchanges will do, and with so many governors downright refusing to implement them, Obamacare's future is hardly a guaranteed success.
I personally think Canada's system is great, and have yet to meet a Canadian who doesn't like it.
I'm from Massachusetts. My state is the only US state that has mandatory Health Insurance. We have had it for 4 years now I think it is. Every Massachusetts resident is required to purchase Health Insurance for themself and thier family. If they cannot afford the insurance then it is subsidized by the state.
I have had Health Insurance most of my life. Fortunately I do not have a deductible but many do. So they are responsible for their bills, until the Insurance begins payment when the deductible is paid each year.
What can become a serious problem for people even with Health Insurance is the copayments. The amount of copayments can really add up and creep up on a person. Especially if one is having to see multiple doctors. I'm dealing with that right now. I had so many bills coming in from the copayments, that I called one of the doctors today. I asked about canx any appointments, if they were just to go over lab results. I felt if the lab results came back ok, then I don't need the appt just to be told they are good. The doctors office said that was fine and gave me my good results over the phone. It saves me the high cost of a doctors visit.
As everyone knows America has had a serious problem with health care for decades. It has caught up with us, and many suffer because they have not had it. Personally I think it has been a national disgrace for decades that so many haved died in the USA for lack of health care. Though many don't want to admit that. I can I worked in Health Care for several decades. I saw first hand what the lack of Health care, due to lack of Health Insurance can cause.
Hopefully Obamacare will be a success. I certainly hope so but I'm concerned, there are not nearly enough doctors for all these patients. I've wondered if the politicians even dealth with that fact when writing Obamacare.
It remains to be seen what the exchanges will do, and with so many governors downright refusing to implement them, Obamacare's future is hardly a guaranteed success.
Those governors may find that they've inadvertently hastened the day when the U.S. will finally have a single-payer system like Canada's.
Those governors may find that they've inadvertently hastened the day when the U.S. will finally have a single-payer system like Canada's.
I sincerely hope you are right! I'm sure I'm not the only one who realizes that Medicare For All is not just good for the country/people, but good for Medicare solvency as well - but thats another discussion.
Last edited by Captain_Fingers; 12-19-2012 at 09:51 PM..
Reason: typo
This is a good discussion, with no flaming, and polite points of view.
A bit more about my personal situation, here in Toronto. I'm 66 now, served for 30 years in the Canadian Forces, retiring at age 50. My wife is just about to retire from the University of Toronto, as a administrator. One of her retirement benefits is a comprehensive medical, dental, eye care, and prescription coverage, that costs her $80 a month. This is with a private insurance company, that covers all of the 14,000 employees of the U of T, both active and retired. It has an annual deductable of $100, and after that it pays between 80 and 100 percent of any covered service or equipment. I have sleep apnea, and use a CPAP machnbe every night to help me sleep without waking up every few minutes, struggling to breath.
The cost of that machine was covered by the Ontario Health Care Program, and the replacement filters, mask, hose, and humidifier, are all 100 percent covered by our private insurance, through the U of T.
As both my self and my wife are over 65 years of age, any prescriptions that we need are 100 percent covered by OHIP, with a two dollar fee to the pharmacy operator.
I have a long standing colitus condition, that is treated with an infusion, every two months with the drug remicaid. It has been amazingly effective, and now, after a year of treatments, I am symptom free. The annual cost of that drug is about nine thousand dollars, BUT it is provided to me, at NO COST, under a Ontario Government special plan, for "exceptional cost reduction ". I had to have my Doctor apply for a review, by a medical board, that considers such requests, and it was approved in 45 days.
I cannot understand the resistance in the USA, to a overhaul of the way in which medical care is delivered there. Having a system where millions are un-insured has to be a major drag on their economy.
As I said before on this thread, removing the profit motive from health care was the best thing that Canada has ever done. Of course our Doctors and nurses don't work for FREE, but they are well paid and medical research in Canada is first rate, with many advances being announced monthly.
I have the National Health Service in the UK. It's not free. It is paid for by taxes, but everyone is entitled to the same healthcare, even if they have never worked. Except for England there is no fee for prescriptions. My husband and I are both pleased with the care we receive. We live in a sparsely populated area though and doubt we'd be as pleased if we lived in a large city.
When I still lived in the US there were many years when I had no health insurance because I couldn't afford it. When I did have employer-provided health insurance I still had to pay large co-pays for doctor visits and prescriptions and 10% of my hospital bills.
When I moved to the UK I was eligible for NHS healthcare the moment I stepped off the plane with my visa. I'm very grateful I have the NHS in retirement.
As for me, I belong to an HMO ("health maintenance organization"), a not-for-profit healthcare provider that combines both insurance and patient care functions. My premium is about $400 per month, paid by my employer; I pay $35 for non-generic prescriptions and $20 for office visits and lab tests.
I have to visit a specific facility in a faraway neighborhood -- I can't choose a doctor or pharmacy near me, and it can sometimes take a couple of weeks to get a non-emergency appointment. On the other hand, it provides "one-stop shopping"; the doctor's offices, labs, and pharmacy are all in the same place, and if I didn't always wait until the last minute, I could have my prescription refills mailed to me. And whenever I have an urgent issue I've usually been able to get an appointment within a day or two.
Overall I'd say the quality of care is adequate for my needs. And the price is right.
Canadian Citizen: "I cannot understand the resistance in the USA, to a overhaul of the way in which medical care is delivered there. Having a system where millions are un-insured has to be a major drag on their economy."
I think the misconception is that Americans are resistant to universal health care - not true. I could be a little off in my statistics, but as Obama was beginning to propose his system, there was roughly 65% - 70% support for a single payer system. Yet, he not only chose to ignore that support, but also nixed the so-called public option from his system. So, the resistance is really from the insurers, pharmas and some doctors (not all), and Obama caved.
If I'm not mistaken, Canada had a similar uphill battle in the beginning, with only one province adopting your current system with others following later, am I right? So maybe Vermont will lead the way for us over here.
Ameriscot: The only people I have heard who vehemently criticize the NHS are American organizations with an axe to grind. Your experience is echoed by every Brit I have met.
pch1013: Are you sure your HMO is non-profit? I used to think Kaiser was at one point, until I was proved wrong. Besides, non-profits have a way of sucking up money just like for-profit organizations, using slick accounting techniques. This is one reason I prefer a government insured single payer system. After all, would you not prefer to be able to vote out the principals if you didn't like what they did? Of course, that calls for taking money out of politics, which is a whole nuther discussion. Still, I understand how some people viscerally distrust the government - no way you can satisfy them.
If I'm not mistaken, Canada had a similar uphill battle in the beginning, with only one province adopting your current system with others following later, am I right? So maybe Vermont will lead the way for us over here.
Canada-wide Medicare was established in 1966 with the federal government agreeing to pay 50% of provincial health care costs.
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And whenever I have an urgent issue I've usually been able to get an appointment within a day or two.
