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I already stated my surgeon had been using the material for years for my condition. It was not new, it was just expensive and they didn't want to pay for it. They have no vested interest in whether I got better, or not.
An MRI is not a new procedure, they just don't want to pay for it. They have no vested interest if I blow through my savings and go into debt based on a doctor guessing incorrectly what was wrong with me.
Again, you are forgetting what this thread is about. I am telling you I was forced to lose and spend thousands and thousands of dollars because of these decisions that were made for me, and that is caused a hardship in my life. For many, it results in bankruptcy, losing their home and other financial (as well as health) disasters they never recover from.
All so some CEO can get a bigger bonus and the stock shares rise. In the meantime, my premiums rise and rise. Last year the bump was so high I had to downgrade to the lowest tier plan (which is $700 a month), this year the price hikes are expected to be massive. This is a nightmare situation for many Americans, and the solutions are not going to come from the corporate world.
Go read some threads on Health and Wellness, and see how the state of health insurance and healthcare in this country is devastating people, forcing them to go without insurance, and without health care period.
My surgeon had been doing my desired procedure for years also.
I've been a general internist caring for patients and working in their best interest for over 40 years. My training and HC delivery has been focused on quality and cost savings where sensible. I'm not forgetting about the topic. I've participated on HC delivery panels and blogs/discussion groups and other general medical panels for decades.
If you can tell me more about your personal medical/surgical issues, diagnosis, surgical procedure, type of MRI desired, I might be able to shed more light on the background decision making that may have occurred with your case.
All so some CEO can get a bigger bonus and the stock shares rise. In the meantime, my premiums rise and rise. Last year the bump was so high I had to downgrade to the lowest tier plan (which is $700 a month), this year the price hikes are expected to be massive. This is a nightmare situation for many Americans, and the solutions are not going to come from the corporate world.
Really? All this is happening so a CEO can get a bigger bonus? If only your CEO had been paid $500k instead of $15M he would have ordered admin to grant all claims without question.
It does sound like you got a raw deal and decisions were made by administrators not doctors, but it seems the inherent problem is large scale management. We are talking about policy decisions based on huge aggregate numbers not individual cases. And that is the essence of government. Why do you think these problems will go away under UHC?
Strong Economy just means that those who own it are going strong. And hint: its not the poor and never will be.
Our problem is that the middle class is being demoted to working poor and poor (sadly, they all think they're still middle class ---- chuckles). Another hint: There's only room in the top 20% for..... wait for it..... 20 percent! The bottom 80 will always be the bottom 80.
So your $89K pay is probably in the top 10%, or above the other 90%. Now if the other 90% went from $89K to a low of $70K, it wouldn't be so bad, would it? Then they too, could buy a $1600 car for cash, and borrow one year's pay for a home. But here's the problem: the floor isn't $70K, IT'S ZERO OR LESS. And that fall from $89K/yr to less than $30K/yr is FAST! I'm making a number up, but probably the bottom 40% earn $30K or LESS per year.
As the income inequality gap continues to increase, the bottom 40% will become the bottom 70%. Ouch.
So, since you're doing great @ your $89K job, HOW MANY OF THOSE JOBS ARE AVAILABLE?? Hint: not that many... About the same number that we have now. However, you need to continue to save. Technology continues to enable employers to CUT those jobs and re-introduce them at lower paying levels like $49K/yr (with 10 yrs exp).
90k here is like 40k in a rural area. I chose to live on the outskirts to have a cost-of-living advantage with a 35 min commute instead of stretching to buy a 400k house 5-10 mins from work.
Been there done that at my $11/hr job, the $17/hr job after that, and the $25/hr job after that. Got to stay ahead of what software developers can automate. So long as there are so many different companies and new, emerging technologies, there will always be a delay in how fast different systems can be automated. It's my job to provide the manpower and during those gaps. I would be foolish to think I'd be doing the same job at the same company for 30 years in my industry.
My surgeon had been doing my desired procedure for years also.
I've been a general internist caring for patients and working in their best interest for over 40 years. My training and HC delivery has been focused on quality and cost savings where sensible. I'm not forgetting about the topic. I've participated on HC delivery panels and blogs/discussion groups and other general medical panels for decades.
If you can tell me more about your personal medical/surgical issues, diagnosis, surgical procedure, type of MRI desired, I might be able to shed more light on the background decision making that may have occurred with your case.
My injury was due to herniations at L4-L5, stenosis and a cyst in the same area. It was misdiagnosed as right hip tendonitis based on an X-Ray and nothing else. Again I think I’ve already said all this. The doctor sent me for several months of active release treatment at a chiropractor, and when that didn’t work sent me to several months of physical therapy. Again all based on that x-ray. Even though on every follow up visit the pain was getting worse. Again when I finally asked for an MRI he yelled at me and screamed I dint need an MRI. It was only when I called and complained about him yelling at me, that they sent me for an MRI. Any kind of MRI. this is one of the things I am angry about. Everyone of those active release and physical therapy treatments I had to pay $50 for every one of them there were dozens of them. Based on a wrong diagnosis. That is what makes me angry they don’t care that people are spending all this money and order to for them to avoid “unnecessary test“. Shouldn’t be prescribing treatment based on diagnosis that you’re just guessing about.
Same thing with the epidurals. If the first two didn’t work then why do I have to pay $500 for two more as well as remain in pain and out of work for more months?
I cannot remember the name of the material the surgeon uses. I tried to Google it but was unsuccessful in getting what I was looking for. In any case it’s the only thing he uses. He says it should last at least 10 years were older materials often failed much sooner than that.
Really? All this is happening so a CEO can get a bigger bonus? If only your CEO had been paid $500k instead of $15M he would have ordered admin to grant all claims without question.
It does sound like you got a raw deal and decisions were made by administrators not doctors, but it seems the inherent problem is large scale management. We are talking about policy decisions based on huge aggregate numbers not individual cases. And that is the essence of government. Why do you think these problems will go away under UHC?
You took my post completely out of the context of the post that I was responding to. Hoonose claimed a CEO he knew saved his heath care company money by implementing policies denying “unnecessary” tests and procedures, and so was a hero who deserved his millions.
My post was stating that his huge “success” bonuses came on the backs of people like me, who spent thousands and lost tens of thousands in income because I couldn’t get the MRI I needed to diagnose me correctly until i had already spent thousands in useless treatments based on a wrong diagnoses.
I spent an extra two months out of work and in pain because my surgery was denied the first time and had to be appealed. The people that Hoonose thinks are great businessman saving their companies money cost me dearly.
You took my post completely out of the context of the post that I was responding to. Hoonose claimed a CEO he knew saved his heath care company money by implementing policies denying “unnecessary” tests and procedures, and so was a hero who deserved his millions.
My post was stating that his huge “success” bonuses came on the backs of people like me, who spent thousands and lost tens of thousands in income because I couldn’t get the MRI I needed to diagnose me correctly until i had already spent thousands in useless treatments based on a wrong diagnoses.
How did I take anything out of context? I repeat, what makes you think that without these bonuses that you would have received an MRI and been correctly diagnosed? Can you show companies with lower-compensated CEOs have more generous consumer policies?
If your issues stem from faulty initial diagnosis and arrogant doctors who didn't want their initial diagnosis second-guessed, how do you see UHC solving this?
I fear that UHC will result in an enormous increase in healthcare costs. The medical care industry will play the inefficient government and may result in even more unnecessary tests than now. Right now we have a sort of checks-and-balances where the medical industry has an incentive to increase amount of care and billing charges while the insurance industry has an incentive to decrease amount of care and billing charges.
How did I take anything out of context? I repeat, what makes you think that without these bonuses that you would have received an MRI and been correctly diagnosed? Can you show companies with lower-compensated CEOs have more generous consumer policies?
If your issues stem from faulty initial diagnosis and arrogant doctors who didn't want their initial diagnosis second-guessed, how do you see UHC solving this?
I fear that UHC will result in an enormous increase in healthcare costs. The medical care industry will play the inefficient government and may result in even more unnecessary tests than now. Right now we have a sort of checks-and-balances where the medical industry has an incentive to increase amount of care and billing charges while the insurance industry has an incentive to decrease amount of care and billing charges.
It is not the bonus itself, it is the reason given by Hoonose as to why he deserved that bonus. I do however think this relatively new phenomenon hurts us all. Money that went into companies used to trickle down to everyone from workers to customers. Now it all goes to shareholders and execs. My premiuims should not go up 30% a year if a company is so profitable it can give out $50,000,000 in bonuses.
Per CNBC, In 1978 the average CEO's salary was 30 times the average worker in his company. Today it is 271 times more. In a thread that is really about the struggle of millions to remain middle class in this country and losing the battle, this is a problem IMO.
How did I take anything out of context? I repeat, what makes you think that without these bonuses that you would have received an MRI and been correctly diagnosed? Can you show companies with lower-compensated CEOs have more generous consumer policies?
If your issues stem from faulty initial diagnosis and arrogant doctors who didn't want their initial diagnosis second-guessed, how do you see UHC solving this?
I fear that UHC will result in an enormous increase in healthcare costs. The medical care industry will play the inefficient government and may result in even more unnecessary tests than now. Right now we have a sort of checks-and-balances where the medical industry has an incentive to increase amount of care and billing charges while the insurance industry has an incentive to decrease amount of care and billing charges.
As someone who works in healthcare, I can safely say Medicare is a pretty good system that both patients and providers are happy with. Sure it can be tweaked, but it should be evident that your fears are unwarranted.
My injury was due to herniations at L4-L5, stenosis and a cyst in the same area. It was misdiagnosed as right hip tendonitis based on an X-Ray and nothing else. Again I think I’ve already said all this. The doctor sent me for several months of active release treatment at a chiropractor, and when that didn’t work sent me to several months of physical therapy. Again all based on that x-ray. Even though on every follow up visit the pain was getting worse. Again when I finally asked for an MRI he yelled at me and screamed I dint need an MRI. It was only when I called and complained about him yelling at me, that they sent me for an MRI. Any kind of MRI. this is one of the things I am angry about. Everyone of those active release and physical therapy treatments I had to pay $50 for every one of them there were dozens of them. Based on a wrong diagnosis. That is what makes me angry they don’t care that people are spending all this money and order to for them to avoid “unnecessary test“. Shouldn’t be prescribing treatment based on diagnosis that you’re just guessing about.
Same thing with the epidurals. If the first two didn’t work then why do I have to pay $500 for two more as well as remain in pain and out of work for more months?
I cannot remember the name of the material the surgeon uses. I tried to Google it but was unsuccessful in getting what I was looking for. In any case it’s the only thing he uses. He says it should last at least 10 years were older materials often failed much sooner than that.
Sounds to me like you need another opinion. Either different a pain management specialist or spine institute/surgeon. The doc may not want another MRI if there are no substantial clinical changes since the last one. Or if no other or new intervention planned. Seems to me another MRI would be helpful at the very least to let you know things are stable. Assuming not recently done. Many spine places will take a copy of your MRI over the internet, review it, and then let you know of their opinions on intervention.
Repeated epidurals if not successful makes no sense.
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