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Post by solinvictus on May 19, 2007 7:03:54 GMT -5
news.yahoo.com/s/ap/20070519/ap_on_en_mo/michael_moore_cuba;_ylt=Atael.JW2cE1BwXbQFUSVc_MWM0F"The Cuba trip actually accounts for just a small part of "Sicko," which aims its wrath at private insurance and pharmaceutical companies and HMOs, while praising socialized medicine in countries like France and Britain. Moore fills it with stories like that of a woman whose ambulance ride after a car crash wasn't covered — because it wasn't "pre-approved."" With all seriousness, this is the case. I worked in benefits administration in the health insurance industry and saw this happen every day. As an example; I used to work with Wal*Mart's group insurance in another state. In one case, a Wal*Mart insured was on a family trip out of state and was injured. She required an ambulance and an ER admission. A few weeks after returning home, her insurer (a Blue Cross/Blue Shield association franchise) sent a notice denying the ambulance claim. Why? Because she didn't call to have it pre-certified when she was admitted to the hospital. I've seen everyday middle and working class people (blue and white collar) stuck for thousands of $$ in liability because they didn't understand the Byzantine mechanics of their health insurance. I've seen cases where Wal*Mart workers had claims denied for services that were considered routine with any other health insurance plan. It's funny how the American mantra is "socialized medicine won't work" or "you'll have to wait in line for treatment". Have you ever fought with an insurance company over a pre-certification for a necessary procedure? It can take MONTHS. Here's something to consider: even as inefficient as Medicare is, the administrative costs are about $.02 on every dollar. For a private, for profit, insurer, those same costs (which include that value-added enterprise known as "advertising") raise this to nearly $.15 per dollar and climbing.
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Post by kevin on May 19, 2007 9:36:50 GMT -5
The 2nd part of your message I get, the first part...you aren't supporting Michael Moore are you?!? Anyway, it is estimated that 14% ($23 billion) of Medicare's budget comes from fraudulent claims. That was a figure from 2005 but you get the idea. I'm curious how many fraudulent claims insurance companies report? I don't have a figure for medicaid abuse but look it up on the net, you'll get plenty of links. My ex-wife (yes ex so here will come all the Christian bashers) used to work for a local doctor. The doctors ratio of surgeries covered by Medicaid/Medicare to insurance was staggering. She told me many of the patients really did not need the surgeries that were being performed. Here is a link that gives you an idea of the types of Medicaid abuse experienced: What's wrong with Medicaid and MedicareAnd as far a "Cuba's great healthcare system", here ya go: Health Care in Cuba: Myth Versus Reality Of course, not everyone in Cuba receives substandard health care. In fact, senior Cuban Communist Party officials and those who can pay in hard currency can get first-rate medical services any time they want.
This situation exists because the Cuban Government has chosen to develop a two-tiered medical system--the deliberate establishment of a kind of "medical apartheid"--that funnels money into services for a privileged few, while depriving the health care system used by the vast majority of Cubans of adequate funding. Moore is like a politician. He feeds misinformation to the uninformed so that their view of reality is skewed to his liking.
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Post by solomon on May 19, 2007 10:06:44 GMT -5
When I work security at the ER I see Yamika and her four kids with different dads come into the ER and treat the place like a family Doctor's office getting all of the kids checked out for non emergency complaints. Hector and his non english speaking wife come in and go straight to OB GYN to have a baby that we will pay for, all the while they never produce anything to prove they are legal in any way.
Then there are the Sally Jane pill heads that request their own prescriptions like they are at a drive thru. They all are leaches to this society. Ron Paul seems like the best answer to folks like these. No government health care period.
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Post by W.O.M.I on May 19, 2007 15:40:49 GMT -5
I >mostly< agree with solomon here.
I think that the hospital has a responsibility to treat true emergencies, but I have no problem at all with a doctor, upon certifying a condition isn't a true emergency, refusing treatment and to be protected from lawsuits being filed by people who think they were wronged.
And it really doesn't bother me that a hospital or hospitals in a town provide care for indigent patients and the costs for such treatment, subject to oversight, are paid via taxation.
But as regards true "socialized medicine". no. It's been an utter and abject failure everywhere it has been tried. I think I recall Neal Boortz relating a story where it took MONTHS to receive an MRI in Canada...assuming the powers that be decide you really need one at all. In the US, even if you have to deal with an HMO, the waiting time is measured in days- if not hours.
All socialized medicine will do is guarantee that everyone gets the least health care possible.
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Post by solinvictus on May 19, 2007 16:01:23 GMT -5
But what is the definition of indigent? It's getting to a point that many American who are gainfully employed at full-time jobs aren't offered employer-sponsored health insurance. Because of the costs associated with securing individual health insurance (if they can get underwritten successfully, which is another story), they can't afford it anyway.
I knew this would come up; in Country X, where they have socialized medicine, why I heard of people waiting __ months for a procedure. Let me clue you in: with private insurance in the United States, you will have the same problem if your plan requires pre-certifications for diagnostics or procedures. Here's my own experience: I discovered I needed corrective surgery for obstructive sleep apnea last year. It was a congenital defect (too little throat space) and the apnea was such that I had over a hundred instances per hour of breathing cessation and my heart rate dropped below 30bpm (bradychardia). It took me a month of fighting with Blue Cross/Blue Shield of AL to get the sleep study, then another TWO MONTHS of fighting to obtain the needed precerts for the surgery. How does this translate? Well, it means I had a total of three months of wait time to obtain critical surgery WITH private health insurance purchased through a "reputable" company.
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Post by solinvictus on May 19, 2007 16:19:10 GMT -5
When I work security at the ER I see Yamika and her four kids with different dads come into the ER and treat the place like a family Doctor's office getting all of the kids checked out for non emergency complaints. Hector and his non english speaking wife come in and go straight to OB GYN to have a baby that we will pay for, all the while they never produce anything to prove they are legal in any way. Then there are the Sally Jane pill heads that request their own prescriptions like they are at a drive thru. They all are leaches to this society. Ron Paul seems like the best answer to folks like these. No government health care period. Yeah, I had to take my wife to UAB's ER years back and it was like that. Of course, we had to actually pay our bill for about $1500 or so for our ER visit. We should've tried to fake being an illegal Mexican or painted ourselves in blackface a la a minstrel show.
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Post by W.O.M.I on May 19, 2007 16:40:51 GMT -5
sol-
It might be worth seeing how Romney managed to implement free-market socialized medicine in Massachusetts if free health care for all is a desired goal. At least have private business run the program and not the Federal government.
As far as defining "indigent", I think I'd have to at least begin the discussion as an individual whose income is at the Federally-established "poverty line" or less- and who is a citizen of the United States of course.
I do hate to hear of your condition.
It's interesting that you had a bad experience with Blue Cross/Blue Shield.
My wife works for the Post Office and, several years ago, they phased out medical coverage from a company that was beyond excellent (our child cost us $0 from the hospital and she was a preemie) and phased in BC/BS, which I had heard was not a good insurer.
I hurt my back years and years ago and, from time to time, it flares up to the point that I can't move and even breathing isn't much fun.
Well, during one of these flare-ups, I went to my regular doctor who, upon poking and prodding my back, told me that he'd feel better handing me off to a specialist to see if anything serious wrong was going on. Of course, that requires the dreaded referral. BC/BS initially rejected the referral, saying that they believed diagnosis and treatment was within the skills of my regular doctor. This took a couple of days. Upon receiving the rejection, my doctor contacted me and told me of the decision and said that he had a telephone number by which we could contact BC/BS and appeal. We did so, my doctor argued strongly for reconsideration and the decision was revered that very afternoon and an appointment to the specialist secured for the very next day. Turned out that it was correctable thru some light exercise- thankfully.
I tend to think that my doctor, being a strong advocate for me to get the best reatment for my condition, made the difference, but I also state that BC/BS was open- very open- to reconsideration, and that's all you can ask for in today's managed care environment.
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Post by Twista on May 19, 2007 22:38:56 GMT -5
Well, time to hijack the thread a bit... Does anyone know of a reasonably priced health insurance policy?
The reason I ask is that I'm searching for something to help out an older couple in another state who aren't quite medicare age. The husband has bad knees and a hip that needs to be replaced, and the wife has a serious asthma condition. He is unable to work in construction, which is the only job he has ever had, and she is unable to work a steady job due to her asthma causing absences. I had them check into their state assisted health insurance plans, but they found their SS check of $1,154 a month made them ineligible (by $9) for a "free plan" (still paying a % and deductable) and the subsidized plans require they have less than $5K in assets to get a low price plan. Unfortunately they own a very old trailer on 5 acres, so they are above the limit on assets.
The plans they have looked at are in the $1,000 a month range to cover them both, but they obviously can't get by on $154 a month in living expenses...
Anyone know of a low priced plan that might be able to bridge the 3 year gap until they hit medicare age?
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Post by solinvictus on May 20, 2007 5:22:56 GMT -5
Twista, it's not a hijack. Their case typifies the biggest problem with healthcare in America: it's treated like a commercial commodity rather than a necessity. Look at their case: you have two people with chronic health issues, living on a fixed income, unable to work, and unable to afford (or be underwritten) for private health insurance. Like you said, because of the threshold limit for public assisted healthcare, they fall short of the means test by $9 to qualify for assistance.
Honestly, Twista, I can't think of anything (private plan) that they could even be approved for because of their pre-existing health issues. Here's the way it works: if you apply for individual (or even some group) health plans, you usually aren't underwritten if you're able to produce a certificate of credible coverage (a letter from your prior plan that stipulates you've had health coverage for at least the past six months). Even with this letter, many group plans have a waiting period of a month to one year before they'll pay any claims related to pre-existing health issues and, during that time, they will often deny pre-certifications and claims related to any medical issues that could be considered chronic in nature. In this case, with one disabled from the construction industry (I can imagine the health issues there, orthopedic injuries?) and the other with chronic asthma, I doubt there's a private plan who would touch them at any price, let alone for something they could afford.
My dad's in the same boat: he was a lifetime skilled laborer (heavy equipment mechanic) and had to take disability because of a chronic and debilitating injury. Right now, he has no medical insurance for much of the same reason as he owns a modest home and wouldn't qualify for state or federal help. It's a screwed up system.
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Post by kevin on May 20, 2007 13:35:51 GMT -5
The biggest problem with socialized healthcare is that I believe it will cause a degradation of the quality of healthcare. Say what you will, but what government run entity runs proficiently? Plus, it would surely result in promising students turning to other job fields because they won't see 8 years of grueling upper education worth their time when better money can be made elsewhere. That is, doctors will eventually stop making the big $$. Pharmacists will as well, and nurses -- you get the picture.
There has got to be a better solution.
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Post by W.O.M.I on May 20, 2007 15:40:03 GMT -5
Step number one to reduce health care costs is to implement radical tort reform.
No more "jury shopping" where lawyers look for venues wherein the prospective jurors are prejudiced against corporations even before they hear a single fact on a specific case.
And yeah, Alabama is such a venue. Remember BMW being sued for a bad paint job and the jury awarding the plaintiff something like $15 million dollars?
But even more crucially, implement a "loser pays" system wherein the person filing the suit is responsible to pay ALL court and lawyer fees on BOTH sides if they lose the suit.
I think I've read studies that find something on the order of 40% of the costs of health care are factored in due to a fear of litigation. That's insanity.
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Post by kevin on May 20, 2007 16:20:22 GMT -5
Its interesting you brought up lawsuit abuse because I'm going to tie it into the TAM board's "Golden Boy", Ron Paul. Mr. Paul voted against these bills: Obesity Lawsuits bill – Vote to pass a bill that would prohibit lawsuits against food companies based on allegations concerning weight gain or obesity claims.
Cheeseburger bill – Vote to pass a bill that prohibits lawsuits against anyone engaged in the food industry on claims that the food caused obesity or weight gain to the plaintiff.
Protection of Lawful Commerce in Arms Act - Vote to pass a bill that would prohibit lawsuits to be filed against gun manufacturers or sellers, or ammunition manufacturers or sellers based on the criminal or unlawful misuse of the products.
Firearms Manufacturers Protection bill - Vote to pass a bill that provides liability protection for manufacturers, dealers or importers of firearms or ammunition products, as well as their trade associations, for harm caused by criminal or unlawful misuse.
Malpractice Liability bill - Vote to pass a bill that would limit the amount of money awarded to plaintiffs and attorneys for medical malpractice cases. But in fairness he did vote for the following Lawsuit Abuse Reduction Act of 2004 - Vote to pass a bill that would amend Rule 11 of the Federal Rules of Civil Procedure to improve attorney accountability, and for other purposes.
Lawsuit Abuse Reduction Act of 2005 - Vote to pass a bill that requires sanctions be imposed on lawyers, law firms or other parties that file pleadings, motions or official documents that are filed for an “improper purpose”, are not justified by existing laws, do not have the support of evidence and do not have a reasonable base for the lack of factual information. So Ron Paul believes that you have to have a good cause to sue, and if so, you can take 'em to the cleaners!! But wait, don't the two bills he voted for contradict the firearms and food manufacturers bills he voted against?
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Post by billt on May 20, 2007 16:44:15 GMT -5
kevin those bills he voted against protect big business NOT the consumer....those bills would all DENY legitimate victims their rights to seek recovery of their damages.
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Post by kevin on May 20, 2007 16:48:12 GMT -5
Really? So you say it is OK to sue McDonald's for your lack of willpower to resist eating Big Macs? And should people be able to sue a gun dealer because he sold a gun that was used to kill people even if the person passed all background checks?
Next, you'll say it is OK to sue other drivers if one shoots a bird at another and the distraction causes an accident.
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Post by billt on May 20, 2007 16:53:00 GMT -5
NO, kevin it isnt all right to sue mcdonalds because you get fat, that would NOT be a "legitimate victim".
and NO, kevin a person shouldnt be able to sue the gun maker because of what someone did with it after purchase.
those suits should be rejected by the actual courts BECAUSE they have no merit!
kevin i said legitimate law suits NOTHING you posted was legitimate!
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Post by kevin on May 20, 2007 16:58:10 GMT -5
So you are saying Mr. Paul voted against them because he felt the courts should toss them out or take them based on their merit? Do you have anything that tells you that was his reasoning? On their face value, and based upon the highlights of the bills, the two obesity bills prevent people for suing for weight gain and the gun related ones prevent people from suing those who make/sell guns legally if they are used in a crime. If you can show me where Ron Paul voted against them because he felt it was up to judges to test their merit, I'll be convinced. Otherwise, based on a "no" vote, he is telling us he believes in the right of obese people and gun crime victims to sue the companies of origin.
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Post by billt on May 20, 2007 17:09:43 GMT -5
kevin are you sure the summation of the bills is accurate? or do the bills protect the makers FROM ANY lawsuits?
it is very RARE to have specific wording such as obesity in the actual bills.
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Post by kevin on May 20, 2007 18:11:59 GMT -5
The Library of CongressPersonal Responsibility in Food Consumption Act of 2005 (HR 554 PCS)
To prevent legislative and regulatory functions from being usurped by civil liability actions brought or continued against food manufacturers, marketers, distributors, advertisers, sellers, and trade associations for claims of injury relating to a person's weight gain, obesity, or any health condition associated with weight gain or obesity.
(a) Findings- Congress finds that--
(1) the food and beverage industries are a significant part of our national economy;
(2) the activities of manufacturers and sellers of foods and beverages substantially affect interstate and foreign commerce;
(3) a person's weight gain, obesity, or a health condition associated with a person's weight gain or obesity is based on a multitude of factors, including genetic factors and the lifestyle and physical fitness decisions of individuals, such that a person's weight gain, obesity, or a health condition associated with a person's weight gain or obesity cannot be attributed to the consumption of any specific food or beverage; and
(4) because fostering a culture of acceptance of personal responsibility is one of the most important ways to promote a healthier society, lawsuits seeking to blame individual food and beverage providers for a person's weight gain, obesity, or a health condition associated with a person's weight gain or obesity are not only legally frivolous and economically damaging, but also harmful to a healthy America.
(b) Purpose- The purpose of this Act is to allow Congress and regulatory agencies to determine appropriate laws, rules, and regulations to address the problems of weight gain, obesity, and health conditions associated with weight gain or obesity. Ron Paul may have had an issue with (b). Otherwise, where does he stand? The earlier obesity bill is similar, so no sense in repeating.
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Post by billt on May 20, 2007 18:36:41 GMT -5
(b) PURPOSE is worth repeating
b) Purpose- The purpose of this Act is to allow Congress and regulatory agencies to determine appropriate laws, rules, and regulations to address the problems of weight gain, obesity, and health conditions associated with weight gain or obesity.
YOU want to give congress the power to control how much people weigh? YOU want to give congress the power to have a say in health conditions?
take your BP medicine or go to jail?
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Post by W.O.M.I on May 20, 2007 18:37:12 GMT -5
kevin-
That'd be my guess as well, that Paul opposed the suits because he thinks that such decisions should be left to the Courts rather than Congress.
If all judges were as strict in their adherence to the Constitution as Paul is (or seems to be), that might be a sensible position to take.
It also utterly rejects the reality of the Court system we presently endure and the liberal activism that pervades it.
Read "Men In Black" by Mark Levin. He charts out the path from the smallest infringement on a given right to the ultimate wholesale dismantling of rights that do exist or the forced introduction of rights that do NOT exist by Courts, particularly over the past 50-100 years.......which just happens to coincide with the timeframe of SCOTUS' drift to the Left.
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Post by kevin on May 20, 2007 18:59:14 GMT -5
(b) PURPOSE is worth repeating b) Purpose- The purpose of this Act is to allow Congress and regulatory agencies to determine appropriate laws, rules, and regulations to address the problems of weight gain, obesity, and health conditions associated with weight gain or obesity. YOU want to give congress the power to control how much people weigh? YOU want to give congress the power to have a say in health conditions? take your BP medicine or go to jail? Yes, and I pointed that out. Judging by what I've seen of RP since I've been looking into his voting record, I surmised that he had an issue with the (b) part. Just can't be sure, but most people won't look that in-depth to be informed.
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Post by solinvictus on May 20, 2007 22:57:33 GMT -5
Really? So you say it is OK to sue McDonald's for your lack of willpower to resist eating Big Macs? And should people be able to sue a gun dealer because he sold a gun that was used to kill people even if the person passed all background checks? Next, you'll say it is OK to sue other drivers if one shoots a bird at another and the distraction causes an accident. Here's where the media takes things out of context: the biggest reason for the McDonald's lawsuits was disclosure. Imagine, those idiots actually want to KNOW the nutritional content of the food they purchase at these restaurants and these same restaurants who promote their food as being part of a moderate diet consistently stonewalled consumer organizations who wanted contents and nutritional values to be openly and reasonably disclosed.
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Post by solomon on May 21, 2007 10:14:26 GMT -5
Its interesting you brought up lawsuit abuse because I'm going to tie it into the TAM board's "Golden Boy", Ron Paul. Mr. Paul voted against these bills: Obesity Lawsuits bill – Vote to pass a bill that would prohibit lawsuits against food companies based on allegations concerning weight gain or obesity claims.
Cheeseburger bill – Vote to pass a bill that prohibits lawsuits against anyone engaged in the food industry on claims that the food caused obesity or weight gain to the plaintiff.
Protection of Lawful Commerce in Arms Act - Vote to pass a bill that would prohibit lawsuits to be filed against gun manufacturers or sellers, or ammunition manufacturers or sellers based on the criminal or unlawful misuse of the products.
Firearms Manufacturers Protection bill - Vote to pass a bill that provides liability protection for manufacturers, dealers or importers of firearms or ammunition products, as well as their trade associations, for harm caused by criminal or unlawful misuse.
Malpractice Liability bill - Vote to pass a bill that would limit the amount of money awarded to plaintiffs and attorneys for medical malpractice cases. But in fairness he did vote for the following Lawsuit Abuse Reduction Act of 2004 - Vote to pass a bill that would amend Rule 11 of the Federal Rules of Civil Procedure to improve attorney accountability, and for other purposes.
Lawsuit Abuse Reduction Act of 2005 - Vote to pass a bill that requires sanctions be imposed on lawyers, law firms or other parties that file pleadings, motions or official documents that are filed for an “improper purpose”, are not justified by existing laws, do not have the support of evidence and do not have a reasonable base for the lack of factual information. So Ron Paul believes that you have to have a good cause to sue, and if so, you can take 'em to the cleaners!! But wait, don't the two bills he voted for contradict the firearms and food manufacturers bills he voted against? The democrats added tons of Gun Control to the Firearms Manufacturers Protection Bill in amendments. I believe in automatic weapons and I would not have passed it after they contaminated it. The same thing probably applies to the rest of the seemingly good bills he voted against. I remember reading Gun Owners of America updates on the Firearms Bill.
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Post by W.O.M.I on May 21, 2007 15:19:19 GMT -5
I'd say that, if you think that eating fast food is part of a healthy lifestyle, you're an example of Darwinism at its finest.
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Post by billt on May 21, 2007 15:55:53 GMT -5
ANYONE that thinks you cant get decent food as some fast foods is out of touch with reality.....what is wrong with a salad please? what is wrong with bacon, eggs, and a buscuit? what is wrong with eating a taco? how is the milk they sell different from other sources? same for the OJ?
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Post by phinehas on May 21, 2007 16:26:40 GMT -5
W.O.M.I. Did you see the movie, "Super Size This"? That's what the documentary was about...that fast food, ie. McDonalds was not good for you, minus milk, juice and other obvious things they don't actually "make".
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Post by billt on May 21, 2007 16:35:30 GMT -5
that movis was SILLY.....NOT exercising and OVEReating ANYPLACE is UNhealthy.
where the food was purchased had NOTHING to do with why that fella gained weight.....he STOPPED his daily exercise and OVERate....WOW he gained weight, what a shocker!
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