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I know can be a hard job but

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

l would appreciate if one day some of you with time ,can explain me your healthcare system , assurances ,and so.It's difficult to me understand you
by not knowing your public and private system. HEre in Europe everything much easier, you choose your assurance ( if got it) or social security.
Then everything free in both cases no restrictions in SS. some but very little with prived assurances ,just small percentages in some test but very little ones ,and some hospital extras, like upgrading room , daily tv, or certain prothesis.
I chosen SS everything free of course but lately government sends you a kind of pro forma invoice just to let you be aware about your expenses , mine just arrived recently : 850000€ in 17 months, not bad ehh!
Thanks god to have an excellent SS here.
Thank you in advance.

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

Well, Pepe, would LOVE to explain our Insurance here, but CAN'T. It's all different.

Annabelle41415's picture
Annabelle41415
Posts: 6384
Joined: Feb 2009

We have been scewed. The Obama Administration has taken over GM and last year we didn't pay any deductibles and now because my husband is not a "union" worker he and I pay $7,000 a year plus a $250 montly fee for having health insurance. Obama only wants to secure Union jobs and union sourses. I have to pay for every test I have done. Obama is nothing but a big govenrment biggot that wants to take tax payers money and make commen people pay. He is not for the common pepole but just wants to get the money "RESDISTRIBUTED". I am tired of working so that people that don't work get my money. Sorry so harsh but Obama is a Fraud. Big time.

Kim

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

I know I'm on Medical, and I've worked all my life, (started at 14 at the Totem Drive In, in Homer, Alaska, and hadn't stopped until this year, but I AGREE with you about Obama.

greybeard64's picture
greybeard64
Posts: 254
Joined: Mar 2010

sorry to hear things have changed for you in regards to your health coverage. I guess I should blame by problems on the republicans who were in office when we went broke paying our medical bills. But see that is the problem. Democrats blame Republicans and vice versa and together they are screwing us all. The ones who have want to keep theirs, the ones who are losing everything want to change, and those who have nothing left cant get out from under the umbrella of govt. sponsered programs because the job they could get wouldnt began to pay the medical coverage they need. I dont pretend to know the answer, but I know this two party, right wing/ left wing civil war we have going now is trashing the middle class and no one is going to come out a head in the long run.....It seems to me a little give and take and A LOT LESS name calling and finger pointing would sure help....Sometimes I think we are still on a playground in 3rd grade. It is infuriating and makes all of us look simple minded and petty!
One day maybe we will get it right?

nudgie's picture
nudgie
Posts: 1483
Joined: Sep 2006

MY opinion, but I would rather have our screwed-up health care system then a "socialize" health care system that determines what services you can or cannot have. Medical treatments seem to be more fluent in the US than the UK.

I still prefer the "choice" of choosing which health care program(s) I (family) can use.

PGLGreg's picture
PGLGreg
Posts: 741
Joined: Jul 2006

Pepe, for me personally, our health insurance system works very much as you say yours does. I carry around a little collection of cards identifying myself as being insured, and I present them at a pharmacy, doctor's office, or hospital, and let a skilled secretary figure out what bills for what I need get sent where, and what leftovers to charge me for. Ordinarily, I don't have to pay anything, but when I do, the charges are quite small. I think the rules for how it all works and the associated billing systems are rather intricate, but there is no need for me to cope with the complexity. I let experts sort it out for me. I do get information statements from time to time saying what portions of what bills were paid by what insurer, but I stopped reading them.

I have an easier time of it than many, since I am a government worker, or I was, until I retired last summer. Now that I'm on a government pension, my retirement system pays all my health insurance premiums.

--Greg

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pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

I don't know what you understand as alternative treatments can you explain it ?
In other hand I honestly consider much better Spain system than German one which is considered here quite poor , (not only me but the WHO ,follow the link).We got here lots of Germans and British who come to be operated to avoid certain restrictions and waiting list of their countries,( as EU citizens they got the right to be treated in any EU country ).The bad thing is that you are paying the 20% of your incomes to social security With a maximum of 1800€ month, this is not considered as a tax but a direct payment to SS.Beside that you got normal tax which can go from 0 to the 48%.
The good thing is that once you are born you got SS for ever.
Cheers.

The World Health Organization's ranking of the world's health systems

www.photius.com/rankings/healthranks.html

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John23's picture
John23
Posts: 2140
Joined: Jan 2007

Would you like a free thinker's opinion?

Here in the USA, we have become the land of the "Have's and the Have not's".

It's sad, Pepe', but over here, "pooling money" to provide things that can
benefit the majority is frowned upon, and deemed "socialistic".

"Socialism" here, is a "dirty word", and it's labeled to anything that
can provide equal services to all citizens, regardless of their social
standing, economic resources, or abilities.

Things like "Public Education", "Social Security Retirement Benefits",
"Unemployment Insurance", and even Government Provided Health Care
(our Medicare and Medicaid services), are denounced as "Socialistic
practices" capable of undermining our Capitalistic system.

People here Pepe', have what we call "TV Memory"; it's an attention
span lasting about 30 minutes, or as long as the average Television show.
History continually repeats itself, due to this short memory/attention span.

Our healthcare services were attempted to be revamped as far back
as I can remember! But the same old arguments against public healthcare
are repeated now as if they are new, valid arguments.
(Re: ‘Socialized Medicine’ )

So here, Pepe', partisan politics and greed are what control our
destiny. We try to have what other nations provide their citizens,
but are held back by ideology based on heretic and propaganda,
and far from reality and serious concern.

Our present President inherited a mess, and is denounced for what
he can't fix within that 30 minute time-span. It's been forgotten that
damage of 16 years of one party control had been reversed for 8 short
years, and then reversed again, to dig another 8 year hole from the same
16 year ideology.

And now? We can only fix just "so much" in less than two years,
but the critics prevail!

Someday Pepe', we'll see free universal healthcare for all our citizens,
just as public schooling, and a comprehensive retirement benefits program
manages to provide for all.

Someday, Pepe'...... someday.

Stay well.

John

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

I'm not American and I don't consider my self any body to criticize your health care system or talk about, l just try to understand how does it work as part of this board, some times is difficult to me to understand how some body is in stress because it's enssurance issues,that honestly don't understand .Any way just a suggestion to those who consider free universal healthcare as an "anathema ": Dont be afraid about, it works, and just notice that l never voted socialist in my life,LOL.
Big hug.

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

What John said is simply his opinion. Our public school system sucks, if you live in a rich area, you have the best, if you live in low income area, you usually have the worst.
Here in California, the system is being sued, as they let "teachers" that weren't qualified to be teachers, teach in the low income areas. The exception to the rule, if you are poor enough, (dirt poor), they will pay for your medical bills, but you can't be poor and still own a home, or a car over a certain value, you must be very poor and own NOTHING in order to get this insurance.
As for a wonderful retirement??? My husband is okay, he put as much as he could away, but a lot of seniors live in poverty here, relying on a democratic system that keeps taking away from Social Security for other needs, we all pay into the Social Security system for some type of retirement benefit.
Our NEWEST health care system would require that most people living on social security disability, low paying jobs etc., pay over half of their monthly income to pay for a universal insurance, then on top of that, have a few thousand dollars they must pay out first, and then co-pays for insurance and prescriptions. That means they go without food, sometimes housing, etc., in order to pay for insurance, so many die from cancer, etc., because they cannot afford our medical costs, this is including the "NEW and IMPROVED" system, which remains a joke. The democratic system here, is as close as you can get to socialism, which using Cuba as an example, doesn't and won't ever work.
The new insurance plan by Obama, is by no means FREE, very costly to the poor.

snommintj's picture
snommintj
Posts: 602
Joined: Mar 2009

Before being diagnosed with cancer I had what is now referred to as a "cadillac policy", meaning I had maximum coverage. It wasn't cheap but I was self employed and I just figured it would be better to have it and not need it, than to need it and not have it. I have never had any health issues, I was a non-smoker and a very light drinker. Quite simply, I was the ideal candidate for health insurance. I gave them roughly $7000/yr and they covered everything after I met a deductible of $5000. So I paid $12000/yr before they spent a penny. This went on for some time until I got diagnosed. I had a $1 million lifetime maximum policy. When I was diagnosed, the insurance company did everything they could to avoid paying. They spent thousands of dollars investigating my past hoping to catch me with a preexisting condition. Luckily for me, a woman had just recently received a very large settlement from my insurance company after they had denied her based on a preexisting condition where there had not been one. Once they agreed to pay they were awesome. They paid everything without question and I was happy. Unfortunately for me, they were too good. The hospital saw a nice juicy fruit on the vein and they sucked it dry very quickly. I reached my lifetime maximum pay out in less than 5 months. Now comes the tricky part. My wife had insurance through her work and it covered me but the lifetime maximum payout was only $25,000. Basically one round of chemo. After that, I qualified for social security which then qualified me for medicaid. I have compared the medicaid prices for treatment vs the "cadillac policy"
prices and noticed a huge difference. I have been on medicaid now for a little over a year. Medicaid has only paid out $200,000. I've received the exact same treatments and have had more surgeries on medicaid. Either there are two different prices for the same treatment or somebody was lying to me. I'm convinced my heath insurance paid the discounted rate while reporting to me that they paid full price.
I've discussed this with the hospital bill collector and they said they weren't allowed to discuss negotiated rates with me. Anyway, the poorest of the poor(if they qualify) receive excellent health benefits through medicaid or medicare. The process is difficult to complete but if there is no other option you do what they tell you to.
I would love to have my old insurance back. I should still have it had they calculated their payouts properly. If I live to 2014, big "if", you can bet I'm gonna hit them up again.

PGLGreg's picture
PGLGreg
Posts: 741
Joined: Jul 2006

John writes: "So here, Pepe', partisan politics and greed are what control our
destiny."

True, but that's a rather negative way to put it. Say instead: "We have a democracy based on the party system, and our economic system is basically capitalist."

Think positive.

--Greg

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pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

sounds complicated to me! here is as easy as Free health care for every body from the moment you born, despite that many of us use to have a private enssurace.Those inssurances use to be quite affordable ( mine1200$ a year) which covers 100% expenses with a big choice of doctors and most of the best prived hospitals in Spain and no limits of money or time, as an example mine covers any expense at MD Andersons in Madrid. Despite that when something very grave happens most of us, prefer Public hospitals because their experience , ( my hospital has an average of 1 liver resection a day and 1 liver transplant a week), main problem: double bedded room,LOL. So hope it will help to make you understand how works free universal healthcare in Europe.
Hugs.

Kathryn_in_MN's picture
Kathryn_in_MN
Posts: 1258
Joined: Sep 2009

The thing is, nothing is free. You and everyone who works in your country pays taxes which cover your medical. I don't know your income tax rate in Spain, but in most European countries it is much higher than we pay here. And everyone here already complains about what they pay (myself included).

We pay taxes that cover medical for the poor - but not for middle income or rich. That is one of the big differences in our systems.

Another is that we allow crazy malpractice lawsuits which have driven up the cost of insurance for doctors - which drives up our cost of service.

Another is that medical is a capitalist system here, not regulated by the government. In most European countries that is not the case.

We live in a country where the majority want everything to be a free economic system where you get for yourself what you work for, and keep it. People do not want to "share the wealth." They feel if they worked hard for something it should be all theirs. Most do not want any sort of socialist system. But as soon as they are hit with unemployment, major health problems and costs, etc., many of those that screamed the loudest with complaints about any government programs all their lives, suddenly want to have a better system for themselves.

Greed. Our country is based on greed. It is not based on humanitarianism. We most often do NOT look for the common good, but "What's in it for me?" is our national motto.

Very, very sad.

PGLGreg's picture
PGLGreg
Posts: 741
Joined: Jul 2006

There is some question whether it is actually true that those "crazy malpractice lawsuits" drive up our cost of service. Here is a study
http://content.healthaffairs.org/cgi/content/abstract/29/9/1569
which concludes: "Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending."

A measly 2.4 percent. Even if we could devise some perfect remedy to what you (not I) see as the terrible problem caused by compensation to people injured through medical error, the impact on our overall healthcare system would hardly be noticeable.

--Greg

Kathryn_in_MN's picture
Kathryn_in_MN
Posts: 1258
Joined: Sep 2009

My OB/GYN's large practice totally folded. The reason - malpractice insurance. They were sued one too many times by families that lost babies that had major problems and wouldn't have stood any chance, and by those that tried fertility surgery and were not sucessful. This was a very good group of doctors - one internationally known for fertility research and success. Even when the doctors win the lawsuits the time and cost spent fighting them still hurts.

My doctor moved on to another practice, as did most of the other doctors. This is not the only clinic to close due to this issue in my area, but it is the one that really affected me. This doctor wss my OB/GYN from 1980 on. He treated my endometriosis, fertility problems, four successful pregnancies and one lost. He treated my cervical cancer and did my hysterectomy. Due to our history he shared with me what doctors wouldn't normally share about why the clinic had to close.

I still say that this is PART of our problem. With the crazy rising costs of everything else medically related, in percentages maybe it isn't as big of a problem as it was even in 2005 when the clinic closed. But it is still an issue. We sue here for crazy ridiculous things quite often.

John23's picture
John23
Posts: 2140
Joined: Jan 2007

It seems your innocent question about our health care has managed
to start a political debate! That's a good thing, since it's the way
some of us learn new things.

By the way, the United States isn't a "Democracy", it is a "Constitutional Republic".

In a Democracy, the majority rules; in a Constitutional Republic, the Constitution rules.

What that means very simply, is that in a "Democracy", the majority
can tell you that you have to sit in the back of a bus.

In a Constitutional Republic, the Constitution guarantees you the
right to sit wherever anyone else can sit, regardless of any
"Majority's preference".

Re:
"We pay taxes that cover medical for the poor - but not for middle income or rich. "

Actually, (some of) our taxes go to paying for "Medicare", and that is for everyone,
that reaches the age of retirement, or is unemployable for reason of health, regardless
of economic abilities.

Our taxes also supports "Medicaid", a health care subsidy for the very poor,
and for those unable to get any other type of commercial health insurance.

And...... Our taxes go to providing health care for -any and all- government
employees, regardless of their economic abilities.

As a Nation, we are divided by political ideology, although the ideologies
have become quite muddled and confused........

The "Conservative" approach is to let free enterprise set it's own standards,
and to prevent the government for regulating free enterprise.

The "other" approach is to allow the government to regulate free enterprise,
keeping corporate empires from monopolizing the marketplace, and setting
unreasonable standards.

It would be great to settle on something between the two, but it's a
difficult task made more difficult by those wishing to remain stubborn with
their perceived ideology.

Health care costs have become exorbitant due to a lack of regulation.
There is absolutely no reason for the ridiculously high cost of one dose
of a chemical that can save a life. But if the political ideology of a party
in power refuses to allow any regulation, that corporate empire can
and will charge whatever it deems "fair".

In many other nations.. well, Norway for instance, the government owns
and sells oil products, and that revenue pays for their government supplied
health care. It sounds great! But here in USA, the government was never
designed to own and operate businesses. (It does, but it was not a
constitutionally designed thing....) So our costs for "free services" are paid
by our taxation. It was originally designed to be from Import fees (tariff),
but somewhere along the line, some political party felt that tariffs hurt
our corporate empires..... and tariffs were set aside.

So Pepe', the USA has in many ways "morphed" into a country of
many ill-designed paths to governmental management. If our two major
political parties ever managed to decide to do things based on Constitutional
requirements, and work together rather than fight every decision, perhaps
we can "morph" into something very viable for all our citizens.

We deserve universal health care, good public schools, and a
financially guaranteed retirement for all.

We could have all that.... if only we could get enough people to agree
to the same goals.

But alas..... if we can't manage to do that here on this forum.....
How could we possibly do that in the real world?

(all my opinion, of cuz)

Stay well Pepe'!

John

Nana b's picture
Nana b
Posts: 3045
Joined: May 2009

By the time employees paying minimum wage pay for daycare and medical they are broke, they instead stay home and collect welfare, in wick, food stamps, cash, and medical insurance. Heck, I could live off that! :-)

Kathryn_in_MN's picture
Kathryn_in_MN
Posts: 1258
Joined: Sep 2009

Thank you John. You've stated it all very well (including correcting me about some of our taxes covering health care for those that are not poor).

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

Medicaid system which as per I see is the closest to social security!

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

debate , what a paradox Not been American LOL.

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

Medicaid is free medical care, medicare is costly medical care. My mother, goes without her injections for arthritis, because her co-pay is 500.00 a month, and on social security, she cannot afford it. Her only income is social security, but because she owns her home, she doesn't qualify for medicaid.

PGLGreg's picture
PGLGreg
Posts: 741
Joined: Jul 2006

Yes, Medicaid is free (to the indigent), while Medicare (part B) has a monthly premium, and various limits and copays. But it's more complicated than that, for many of us, because of supplemental insurance of various sorts. My mother had Medicare together with a package of supplementary insurance plans that was offered through her retirement system (and so, with low rates negotiated by her retirement system with an insurance company for a large group of retirees). Even if Medicare didn't cover the cost of a certain treatment or medication, it would often turn out that the cost was covered by her supplementary insurance.

I just started on Medicare, myself, in August, when I retired, but it is free for me, since my retirement system reimburses me for the Medicare premiums ($110 per month), and also pays my premiums for supplemental insurance coverage of several different sorts (medical, drugs, dental, vision).

It is an intricate system, and it changes every year; so far as I can tell from my very limited perspective, it's getting better, and providing more insurance coverage to more people. For instance, you might check the current limitations on Medicaid to see if it is still true that your mother cannot get on that, even though she owns her home. Medicaid generally requires that a recipient must have exhausted all personal resources before Medicaid will start paying the bills; however, there are some special exceptions to permit a home to be retained.

Kerry S's picture
Kerry S
Posts: 607
Joined: Dec 2009

$0.24 milage amount allowed From 1/07 $90,421 per day $65.60

5% 1% 12% 16% 1% 65% Total for 2010
3,411 $819 $262 $2,101 $2,736 $242 $11,333 $17,491
Per Day $62
Miles Deduction Doctor Hospital Drugs Other Insurance

Above are the medical “out of pocket cost” for 2010. I am on Medicare and the scary old woman has 1.3 years to go before she will be there. She has crohns. That will save us about $900 per month.

This medical expense represents 57% of our cost of living. We have always lived below our means. We have no debt. The upper right shows what our cost has been from Jan of 07.

This makes me mad, but I will take our system over what the other countries have.

Kerry

tanstaafl's picture
tanstaafl
Posts: 1292
Joined: Oct 2010

Thanks, all those figures are enlightening. You may find this interesting, or jarring.

The insurance companies tend toward less current, less personalized treatments. Often less effective too with lots of delay, stress and bs. For us in the US, across two generations, they've been milked by standard medicine, bilked by bad medicine paraded as standard, and skipped out on the good that actually worked. hmmmm.

I detest the inflated and fake billing practices. Adding government may tie valuable middle class taxpayers down to local practices, with limited choices. Obamacare does't pay outside the US, and I would not want it to, too many strings would still be attached.

So dumped all that rather than choose more expensive, less useful policies. After prior assignments across the years, recently moved back to Asia about 5 months before disaster struck, stage IIIC++. We paid all cash, for colonoscopy, consultations, CT, surgery, 4 days total hospital stay, pre-op to walking out. Under $5000, tourists will pay more. VEGF/EGF inhibitor, infusions, supplements and oral chemo, 6 months various regimes, under $3000 total so far, *with lots of footwork and independent research*. Declined less effective $10-$25,000/month offers with more burdensome effects. Good QoL, biomarkers going to ground, minor treatment challenges, swinging for a home run.

Not for the mentally unprepared or faint hearted. Hard cash required for all bills, in envelopes, just to get out of the hospital. Credit cards, ~5% more.

Aud's picture
Aud
Posts: 480
Joined: Oct 2009

Pepe, it is indeed complicated. As a young woman, I've been in the so-called lower class, receiving Medicaid when I was a single mother with 3 children to raise and currently, in the so-called middle class, with private commercial insurance through my employer.
On Medicaid, though one doesn't have out-of-pocket costs, it can sometimes be difficult to find a doctor who will take you. And for anyone who wouldn't mind being poor enough to receive Medicaid, let me just say that it is much better to have the option of working and paying for insurance rather than live in poverty.
With my current insurance, (I will not bore anyone with all the medical insurance jargon of bridges, co-insurance,deductibles, and such.), I pay $400 before it goes into the 80/20 plan where the insurance pays 80% and I pay 20%, with a maximum out-of-pocket cost of $5000 annually. To be smart about it, I should be putting away approximately $400 a month away to prepare. This, of course, doesn't include the $125 per month paid for insurance premiums. I am currently able to take care of myself, but if I were to lose my job, I don't know what I'd do, not to mention the problem of pre-existing condition.
Needless to say, we all make choices, including choices on how we spend our money. Hmmm...pay medical bills or buy a house?...pay medical bills or go see the grandchildren in Germany...sometimes it has to come down to that.
But I am fortunate, for now. And there should be no "fortunate" for anyone here. Medical insurance/care should be included for all, without putting people in the poorhouse.
Enough said.
In the Light,
Aud

greybeard64's picture
greybeard64
Posts: 254
Joined: Mar 2010

"And for anyone who wouldn't mind being poor enough to receive Medicaid, let me just say that it is much better to have the option of working and paying for insurance rather than live in poverty."

I agree, speaking as someone who has been there also, it amazes me that others would think that. If you really believe it, by all means quit that job and take the "easy" way by living on what the government gives you....hmmmm no takers??

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