Our screwed-up heath care system

I think you can spin things however you like. My mom waited 95 days for a cancer specialist and she had cancer. It’s not like we don’t also wait while paying 20x more.

My best friend’s family holds degrees from Harvard/Stanford and has citizenship in the US and Taiwan splitting time in both nations. They get absolutely nothing done here despite having good insurance but go to doctors and dentists when they are in Taiwan, faster and something like 97% cheaper to do there, they love it.

My office has people in the US, Hong Kong, and Toronto. The non US employees are horrified of the realities of our “system” when we review “plans”.

I've been told Mexico is a good place for dental work, just curious if you've heard that also?
 
I worked in health care for 8 years in the imaging department (X-ray and CT). It's been almost 11 years since I left it.

My advice to family & friends (based on personal experiences and working in healthcare): You have to advocate and stay on top of things for yourself and family members. If possible, stay with a family member that's in the hospital or spend as much time as you can with them. Obtain your medical records and review results yourself. You can google search the terms you don't understand. But don't try reading more into things - let your doctor interpret it. Ask questions. Make sure they explain so you understand. If they don't/won't - find another doctor. Remember, you have the right to make your own decisions for what to do with your health.

Doctors and those working in healthcare are not gods. Like all humans, they are fallible. And, as in all jobs on this earth, some people are good at what they do, some are mediocre and some just suck at it. Sometimes doctors (or anyone else talking with the patient) do not pass along enough history for those scheduling/doing/reading the exam or those making a decision to pre-authorize it. Sometimes an incorrect exam protocol is ordered or done. And - sometimes results are not read properly or just not reviewed right away.

I've had my own personal battles with doctors not listening to me. I've found male doctors don't listen to female patients as well as they do with men. (Believe there are studies backing up the same) Years ago my son fell and it took almost a week before we found out his shoulder was fractured (BTW fractured, broke & cracked all mean the same thing). Another time I took a son in, thinking he had bronchitis or pneumonia. Doctor didn't think he had either or needed a chest x-ray. I insisted. They did it - I was right - he had pneumonia. My Grandma had a colonoscopy at her local rural hospital with a general surgeon and afterwards was told she had colon cancer and needed to schedule colon removal/resegmentation surgery immediately. She got a second opinion & went to a gastroenterologist, was told she had suspicious polyps which were removed and sent for testing. Results came back showing pre-cancerous and just monitoring was needed afterwards. (Still trying to figure out WHY those polyps weren't removed & tested during the first colonoscopy).

How can it all be fixed (including costs, etc)? No clue. IMO - it's a very complicated mess on all sides and not just one thing will remedy it. But there are good people in healthcare doing what they can to give their patients the best.
I’m commenting on your first 3 paragraphs; I agree and feel you are spot on!

I’m sorry for your personal experiences.
 
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#fakenews. We don't have a health care SYSTEM. There's health care out there but there's no system. The business model of insurance companies is to put as many obstacles in the way of paying claims as possible.

Sorry about your wife. I hope she recovers quickly.
Just like the rainmaker movie
 
At one time Medicaid was used to help Medicare seniors for things like nursing home care. I believe Medicaid also used to help middle-class families who had children with disabilities.


will cover things like preemies as well. 40% of US births are actually covered by Medicaid.
 
This one takes the cake. Got a statement in the mail today from McFarland Clinic here in Ames. Statement date says 4/19/22. Today is 4/28/22. I live like a mile from there. Pony Express might have been faster.

The issue here is I had some orthotics made on 7/20/21. I always kinda wondered why I never got billed for it and basically just forgot about it. Today is the first statement I have ever gotten on it. So around 9 month later they send me a bill. Here is the real kick in the pants, the due date is 5/17/22. So in less than three weeks they want me to pay a bill for services that happened 9 months ago. Plus the small print says partial payments will not stop there collection process, unless I call to make arrangements. Wonder what they would say if I made $40 payments to them for the next 9 months. :)

I called billing and they told me that United Healthcare finally said they wouldn't cover it on 4/18. I did tell them about my payment plan and the gal got a chuckle out of it.
 
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This one takes the cake. Got a statement in the mail today from McFarland Clinic here in Ames. Statement date says 4/19/22. Today is 4/28/22. I live like a mile from there. Pony Express might have been faster.

The issue here is I had some orthotics made on 7/20/21. I always kinda wondered why I never got billed for it and basically just forgot about it. Today is the first statement I have ever gotten on it. So around 9 month later they send me a bill. Here is the real kick in the pants, the due date is 5/17/22. So in less than three weeks they want me to pay a bill for services that happened 9 months ago. Plus the small print says partial payments will not stop there collection process, unless I call to make arrangements. Wonder what they would say if I made $40 payments to them for the next 9 months. :)

I called billing and they told me that United Healthcare finally said they wouldn't cover it on 4/18. I did tell them about my payment plan and the gal got a chuckle out of it.
My mom passed away in October 19. In august 20 I got a bill from the hospital for her. Nothing like making me juggle things as executor.
 
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On Monday, my wife while at work, collapsed while walking, her right knee popped, and she could not but any weight on her knee. They had to wheel her out to a coworker's car in an office chair and took her to the ER. Do an X-ray and put her in a brace and send her home with crutches, telling her to set up an appointment with her doctor in a few days. Last few days she is struggling to walk around, brace is too small for her and keeps sliding down, holding it up with an ace bandage.

So, she missed work this entire week, sitting on the couch, struggling to get up the stairs at night and the rest of it. Today, I have to take a day off work to take her to the doctor, she cannot drive and hell, cannot get in and out of the car without help. Get right in to see the doctor, she says she should not be in a brace, promotes swelling in the knee, and since the X-ray showed no broken bones, it's a tendon or ligament that was damaged and we need an MRI to determine that. They can do the MRI today, if Blue Cross OKs it, so they send us back out in the waiting room, we hang around another 30 minutes, and the nurse comes out and tells us that "BC wants her to do physical therapy first, and then if there is still a problem, we will do an MRI."

So now she will be doing PT for a couple of weeks to determine if there is a problem in the knee, instead of just having the MRI, and then determining a treatment plan off the data from the MRI.
Welcome to the American Healthcare system.
This happened to me last week. I go to Dr. He says I need an MRI on my neck. United Health Care cubicle doctor denied it. So i have to suffer for 6 more weeks. Its a fricken joke.
 
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There are people who play games. I know couples who have divorced (FAFSA works this way also) and they pick the parent who doesn’t make as much and just list their income to get them on it. I know couples who wouldn’t marry (advice from one of the families) while they had a kid or one was going to college, in order to obtain government subsidies, although they were living with their fiancé and has a kid or two.

That is where the talk of the marriage tax happens. If one makes 150k/year and their SO stays home and watched the kids. (They would be considered high middle income combined), it would be max grants, free lunch, qualify for Medicaid, everything available through the government. If they get married, they would get none of it, college kid wouldn’t even be offered a subsidized loan.

So yes, there are many working the system.

Don’t get me started on how the care center game the system. Wow!!
Hopefully your loved ones avoid the care center in BC.
 
Hopefully your loved ones avoid the care center in BC.
There are issue people at all of them. Ironically I had a grandparent there several years ago and was wonderful for them. Heard they had some lawsuits lately, not sure the details. Probably hasn’t been a care center that’s not been sued.
 
My oldest son has a genetic condition that requires seeing specialists on an annual basis; however, there literally isn't a specialist in network for him. Wherever we go, we have to get pre-authorization unless we're going to pay cash, and the pre-authorization process from insurance is a pain in the ass every single time. Because they always initially deny it, despite the fact that they know he has this genetic condition, and they don't have anyone in network. Even just making an appointment is almost impossible, because we're making appointments up to a year ahead of time, with no guarantee that the pre-authorization will actually go through prior to the appointment. Fun stuff, the American health Care system, no notes whatsoever, obviously couldn't be improved.
 
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You just want to discuss access? Look at the MRI wait times that I posted earlier, are you fine with those?

Those times you posted are misleading. In Canada, if you have life threatening condiion and you need n MRI the same day, you get one. If you have a bad knee or something that you can easily live with, you wait. You try to make it seem like everyone waits the entire 11 weeks and that's not the case.
 
Those times you posted are misleading. In Canada, if you have life threatening condiion and you need n MRI the same day, you get one. If you have a bad knee or something that you can easily live with, you wait. You try to make it seem like everyone waits the entire 11 weeks and that's not the case.
No I didn’t. The whole discussion was around non life threatening situations. That is what the comparisons were to.
 
Too many healthcare providers say things like "We can't do that," when they really mean "Insurance won't cover it."

In my wife's case, there were instances when a few hundred dollars made a huge difference. I had to ask clarifying questions to find out that they could do those things, just that I had to pay for them.
 
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My oldest son has a genetic condition that requires seeing specialists on an annual basis; however, there literally isn't a specialist in network for him. Wherever we go, we have to get pre-authorization unless we're going to pay cash, and the pre-authorization process from insurance is a pain in the ass every single time. Because they always initially deny it, despite the fact that they know he has this genetic condition, and they don't have anyone in network. Even just making an appointment is almost impossible, because we're making appointments up to a year ahead of time, with no guarantee that the pre-authorization will actually go through prior to the appointment. Fun stuff, the American health Care system, no notes whatsoever, obviously couldn't be improved.
Yeah, we have run into issues with mental health visits. My son needs special pediatric counseling. There are counselors in my area but none of them are in network. And we have the most expensive open network plan my employer offers. So in order to get counseling he has to go to in network counseling which will be nearly an hour away - under an hour only if not during rush hour. And getting an appointment that isn't during school hours or within an hour of school is impossible. I'm trying to remember the distance but I think they only pay for out of network if there is not an in network provider within 80 or 100 miles. So he is supposed to miss school once a week or once every other week for counseling simply because the insurance company doesn't want to pay a counselor that is within a reasonable distance of where my son lives and goes to school? He is already missing too much school for appointments for his other medical issues despite our best efforts to schedule around the school day.
 
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Fairly convinced when my dad died that at some point they just want people on Medicare to die so they can quit paying. Fought them tooth and nail to keep him in real hospital and got him an extra week. They insisted on moving him to skilled nursing where a doctor was supposed to see him upon admittance and once a week. He was moved there on a Friday and never seen by a doctor there. He was life flighted back to Mercy after developing sepsis from the clot thrown by his pacemaker and was dead by Thursday.
 
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