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Mass Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-09-11 11:54 AM
Original message
Why we need socialized medicine
Edited on Fri Dec-09-11 12:30 PM by Mass
Getting nuts with my son's insurance. Remember we live in MA, one of the states that is the most favorable for insurance's customers, and that has a mandate and cannot refuse people due to preexisting conditions.

My oldest son is in college and is on the insurance college plan through Aetna, He pays about $2700 a year, and increase of 25 % from the previous year (He is a 22 year old student with very limited revenue, and health insurance is mandatory in MA).

Up to last year, it was very worthwhile. Aside from a $200 deductible, nearly everything was covered 100 % for their preferred network, which is very extensive. At the beginning of the year, they changed their policy and there is now a 15 % copay for their preferred network, 25 % for their non preferred network (aside from a deductible that is now $250).
As his university is in a very rural town, he usually does the medical checkup he needs to do during recess (aside an emergency). So, now, we have to go through various hospital department to get the codes for each department in order to get the appropriate referral from the college doctor (he has a very rare medical condition, so all the primary care doctor does is to give the referrals, but the insurance will not accept a referral from the specialist that has been following him since he was 12). Let's just say that it is a pain and even after all that, we will still pay about $400 just for preventive care. Sorry, but I want socialized medicine. In addition, he cannot really change doctor because he will have to educate his doctor about his medical condition (last new doctor he saw had to read about it from the internet).

Just venting, but for those who do not get why ACA, while a progress, still leaves so much to fix, this is a good example.
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karynnj Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-09-11 12:23 PM
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1. I"m with you 100%
All three of my kids have long standing medical problems and it has always been time consuming as well as occasionally expensive to deal with.

My middle daughter just got a glimpse of how things are under socialized medicine. She is doing an intensive masters at the University of London, so she is eligible for the National Health. She asked for and got a copy of her US records and took them with her when she saw a regular doctor. In the US, as she has moved to various areas, she has always had to visit the doctor, get a recommendation to a specialist, and then go to the specialist to get the prescriptions that have worked well for about a decade. She was pleasantly surprised that in London, the first doctor reviewed her records, spoke to her, and gave her the needed prescriptions - which were cheaper than what we paid on our drug plan.
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karynnj Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-09-11 03:48 PM
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2. Slightly off topic, but I found this interview with Jeffery Lewis, who
was the Senator Heinz's Chief of Staff, then worked for Teresa for 20 years in her foundation. Imagine if more Republicans had his values and his solutions to healthcare problems. From the article, he worked for Kerry's Presidential run. It is really a shame that the Kerry campaign did not get out information on the type of things Teresa"s foundation did.

http://www.healthcarefinancenews.com/news/newsmaker-int...
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Blaukraut Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-09-11 06:50 PM
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3. Yes!
It's a manyfold problem, too. We have 'government insurance'. Tricare Prime. It used to be called CHAMPUS, when the government really was in charge of it. Since it was handed over to a private entity to manage, Tricare has gone to the dogs. We used to be able to see any doctor we wanted to and CHAMPUS would naturally pay the bill. There was no 'preferred network' like there is now, with Tricare.

Our 'preferred network' is pretty much limited to the Lahey Clinic employed physicians unless there is an emergency, and heaven help you if there is, because at that point we need to jump through hoops to get our bill paid.

The insurance system in the US sucks, that's all there is to it. Being from Germany, I'm used to going to see a doctor without ever getting any bills or statements mailed to my house. That said - Germany has gone the partial privatization route with their public insurance and lo and behold, rates are going up and coverage is going down. I'd like to know what it takes for any country to realize that health care is a basic right, not a privilege.
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