Our health care system is crashing

[OzarkDem]

My day today taking care of my son who has ADD-

I pick him up at school to take him to an appointment with a psychologist who provides him with counseling to help him deal with a school system that doesn't like kids w/ ADD. Every time he forgets to take his medication, his teachers get angry and give him flunking grades. I have to pay out of $150 pocket for this counseling because our insurance company doesn't provide coverage.

His prescription needs to be refilled, so it was called into his doctor a week ago. They just got around to notifying me that it was ready to be picked up. We stop by to pick up the prescription (it can't be mailed or called in, and it has to be renewed every month). By now its time to go home and fix dinner, after which I call the pharmacy. They tell me they have been taken over by a large national chain which doesn't have an agreement with our health insurance company. I have to call the new prescriptions in to a pharmacy in the next town who has to call and get them verified at the old pharmacy. I drive to the next town to the new pharmacy, only to be told they are out of my son's medicine and I will have to come back the next day when the new shipment arrives. This now means my son has to go to school with no medicine tomorrow which means his teachers will get angry, give him bad grades and make me take half a day off work to come in for a teacher conference.

In the meantime, I've lost over half a day of work and have a backlog of cancer patients who need financial help. Five of them have already had their electricity, gas and phones turned off. Four of them that don't have health insurance have been told by their doctors that they will not treat them unless they make a cash payment. Social service agencies make them sit for 4 or 5 hours waiting to apply for food stamps, then send them home with nothing, telling them they'll have to come back another day. These are middle class, working people who've had the misfortune of getting a serious illness. They have bill collectors calling them all day threatening to take their homes and cars away. Their cancer care will cost them about $150,000 to $200,000 per year. The doctors who hound them for money campaigned for George Bush and our corrupt governor because they thought medical malpractice was a more important issue. The pharma companies regularly send them on nice paid vacations to the tropics.


This system is completely dysfunctional and, from where I sit, is rapidly deteriorating.

[mitchtv]

1. welcome to my world

transplant patient. I shudder every time I get a letter in the mail from certain companies. I got a $1500 bill last week for 1 month's supply of insured meds. After a lot of telephone time It got straightned out. I will save the bill for a few months now, wait and see if it comes back again.

[leesa]

30. Me too! Case Manager for transplant patients. Privatization and

managed care have turned healthcare into a nightmarish field of landmines. I deal with those same horrors every day except not for my kid but for hundreds of cancer patients...plus, as an RN, I have to monitor their clinical status. It IS collapsing and it ain't pretty.

[malmapus]

33. I recieved a bill from a collections agency the other day

For an insured visit I made last year. Never recieved a bill before, then out of the blue this.

Call up the collections agency and tell them they need to get their info and straighten it out. They tell me its my responsibility to do it, I tell them I charge $40 / hr and will be billing them directly.

[IndyOp]

2. I feel so sad and ANGRY reading your post --

ADD sucks. Cancer sucks. Health care in this nation is a cruel joke.

:grr:

[davekriss]

3. I have an adopted severely ill child

Early onset, rapid-cycling bipolar disorder, PDD, ADHD, and on an on. Her peak year her bills reached $859,000. We're over $300,000 this year and well over $1.5 million total. Health insurance? Ha! We've been thoroughly wiped out several times over. (However, we cope -- her sister, btw, her sibling and also adopted, is autistic ... she's the way easy one!)

[lildreamer316]

4. Bless you.

I know it is of little practical help,but people like you are surely the blessed among us. Thank you for having the courage to do what you do.

[davekriss]

5. Thanks, but in our way we are blessed...

...as there is no greater priviledge in life but to be a blessing to others. Our daughters give us that opportunity.

It's hard to paint optimism when thinking about my bipolar daughter's prognosis (one day at a time here), but just yesterday, her autistic sister, who is doing very well ... we were at a prayer meeting at our church and this shy 12 year old who didn't speak her first words until almost 7, started singing along with the music. Everyone else stopped and just listened. Her voice, angelic, with perfect pitch and preciousness proved more moving then the recorded music itself. All prayer stopped as we fell into silence, just listening adoringly to the sweet music emanating from this sweet kid. Our (small) church, more than a few moved to tears, enjoyed a very magic moment. Genuinely, our life is filled with such moments.

(Of course I was aware of her singing as she sings all the time when she thinks others can't hear. I listen for hours at a time sometimes. But her voice and ability is suddenly maturing and she's become very very good.)

My wife is the angel, btw; she's the strongest person I know. You have to see her advocate for services (wherever they can be found, and however they get paid, she gets them for our kids). We get by.

My biggest fear is what happens to the first child (bipolar) when she's an adult and we can no longer care for her (she's spent the majority of time since 2001 in hospitals). Her bills prevent us from amassing any kind of nest egg to help her through when we're gone. My wife and I are honestly thinking about moving to Canada just so our daughters have a stronger safety net beneath them. We don't know what else to do. Shame, really, how we treat the least amongst us.

(Call us crazy too but there's a good chance we take on another troubled child. We'll know in December. This one a boy, 6, who through neglect does not read nor smile.)

[w8liftinglady]

7. words can't express the respect I have for you and yours

:grouphug:
I promise I'll continue to fight for universal healthcare for everyone-especially kids like yours...

[OzarkDem]

8. You're right, we get by

I feel incredibly lucky compared to others who are in much worse situations. These days I feel like the person carrying the cage of canaries in the coal mine.

At least I can open up a huge can of whup-ass on the doctors and American Cancer Society workers who are harrassing these cancer patients for money. There are some rewards to this job.

[Dem Agog]

6. I'm An ADD Adult...

Fortunately I have a doctor who writes me three prescriptions for a months' worth of Ritalin at a time...

Each month I must call the five nearby pharmacies. Who has 10mg of Ritalin x 120 count (I'm on 40mg a day x 30 days)? It's a gamble!

I can't take the generic version of methylphenidate because the generics have an additive that gives me a rash.

So each month I must call. Most months, Walgreens wins the "We have your drug in stock" lottery. And each month I must drop off a "new" prescription, written by the doc up to 3 months ago.

Don't even get me started on Celebrex. I have severe arthritis and BCBS and Caremark won't approve it for "knee pain" as they so sweetly put it. I wish they had "knee pain" the way I have "knee pain"... I tried everything, and documented it (Ibuprofen, Aleve, prescription strength of both) but they won't pay for my Celebrex.

In my experience, our health care system fucking sucks. It's all about deciding what they won't cover rather than what they do.

Hey, I'd love to be some random Ritalin addict, and Celebrex addict, who buys the shit for giggles and extra moolah. But the fact of the matter is that I need both. One to live a sane life. One to live a pain-free life. And if Bush gets his way, I'll have neither at a reasonable price.

[nashville_brook]

40. i know what you mean by "knee pain" in quotation marks

as if it's "elective pain."

severe arthritis is IMMOBILITY.

i have both osteo and rhuem in my back, hips, knees (missing a few discs, too). i'm completely immobile at least a week a month.

[Mr_Spock]

9. "Welcome to the real world" Similar issues here...

Concerta (Ritalin) is a controlled substance in our state, a NARCOTIC in the state where our company resides. So it's not possible to get the discount associated with mail-order...

only $140/therapist visit for us :(

The damn insurance co. hasn't gotten a claim right more than 50% of the time

If my company ships our jobs overseas as they are doing by the hundreds already, the shit is really gonna hit the fan.

[nadinbrzezinski]

10. This is why we NEED universal health care

no ifs, buts or any question in my mind

Many years ago, we used to see this lady, coming down to TJ for us to treat her diabetes... never mind she was an American citizen and all that

I always tried to get her to Social Services, but she never wanted to, her pride and all.

We treated her, until one month she no longer showed up... this is close to ten years ago... I finally managed to contact the daughter, and found some of the story, the part that did not embarrass them. Not that they had that much to donate to make up for some of the cost either...

Lucy Heinz was a Riveter, her husband served in the pacific during the War, and then staid in the Army and served at Ke Shan.. when he died, she lost her bearings.... and as they say, the rest is history... she felt very betrayed by her country.

I know, I know I tell her story every time I can... but for me the fact that an old lady felt far more confident to go to a public Emergency Room in Tijuana spoke volumes.

[nashville_brook]

41. healthcare shouldn't be tied to employment

it's like saying only the healthy and young can be covered.

[davsand]

11. It is a mess--no doubt. It is also changing.

Yep, it is really F*&ked up. No arguments from me about that one. What I do want to point out is that you are all talking about several different aspects of the health care crisis...

Prices for prescriptions are going sky high. There is not a thing that is gonna change about that as long as the drug companies contribute so much cash to the politicos--on BOTH sides of the aisle. The big pharma companies made a huge windfall off the Prescription drug coverage for medicare patients farce that the GOP jammed thru, and it is only gonna get worse.

Private docs are allowed to do business pretty much any way they want to. If they want to shut people off from access to health care, they can do it because, oddly enough, there are no real laws to prohibit it. The special interest groups that protect Docs are doing a "great job" of keeping any reform laws off the books in the individual states and at the federal level.

I live in a county where 90% of all the Docs are associated with two private clinics that both refuse to treat Medical Card people. When we broached the idea to one of the hospital CEOs that the hospital should be REQUIRING a certain amount of free or reduced fee service in order to practice in that hospital, the CEO just about laughed out loud.

We FUND those hospitals with property tax subsidies (well, we used to, anyhow--more on that in the next paragraph...) because they claim to be non-profits and, thus, tax exempt, and they refuse to even consider forcing Docs to do the right thing.

We have stripped local hospitals of property tax exemptions because they charge uninsured people higher rates (for the SAME procedures!) than they do people with insurance. Additionally, we nailed them for not following the charity care requirements--or even their own stated charity care policies. Currently, that case is awaiting a decision on the appeal, and we expect the hospitals to appeal that new decision to a higher court unless they get that exemption back...

The CEOs of both our local hospitals are completely unrepentant for what they have done. They claim that we are too radical because we are demanding they follow the laws that already are in place to protect consumers. While they protest and complain, they have also re-vamped stated policies to make them cover more people.

On a national level, there have been settlements in several locations that have made charity care more accessible and collection procedures less draconian. Minnesota is one state where they have done a LOT to help the consumers. (That AG is awesome, BTW. Read up on that man--he's a hero.)

There was just a multi-hospital settlement to a Class Action suit brought on behalf of consumers at Providence Health System, in Portland, Ore. I just saw that announcement yesterday...

Read online at the Health care Finance Journal to learn a lot more:

http://www.healthbusinessandpolicy.com/ExemptHospitals.htm


Early next year I will be speaking in front of an organization of Health Care Finance guys (CEOs and CFOs primarily) about what they need to do to clean up their hospitals and comply with existing laws about charity care and collection practices. This was at their request--they are scared of where this is all headed.

The House Ways and Means Committee has held several hearings about hospital tax exemptions. One of my fellow board members was asked to speak...

It is a mess, absolutely, but it is showing some signs of improvement.




Laura

[nadinbrzezinski]

12. To quote DK

we need to take the profit out of health care...

I know radical, but that is where this is going

[davsand]

15. Most docs would probably benefit from Universal Health Care.

Just ask your doc sometime if he'd be willing to take a bit less for his time if he was guaranteed payment for every person he saw and every procedure he does.

He'd jump on it in a heartbeat.


People are literally sitting at home in pain--possibly dying--forced to decide if they want to face a lifetime of debt and harassment in order to stay alive. My husband and I lost an old friend for exactly that reason earlier this year.

He sat at home for five day with chest pains waiting to see if it'd get better. It didn't. His brother literally forced him to go to the local ER where he died in the waiting room. He worked retail all his life, paid his bills and was one of those "disposable" people--a gay man over the age of thirty five. He also had no insurance--either provided by his employer or paid for out of his own pocket.

Local "non-profit" hospitals have not done anything to help the medically indigent in our community. They PREY on the poor, charging them higher rates for the same services. The hospitals claim that price difference is because the insurance companies have "negotiated" discounts. This is not peculiar to my local area, but it really is galling given the fact that those same hospitals used to be subsidized by the local community with property tax exemptions.

WE are ALL paying for those hospitals to victimize poor people.

Something that makes it even more ugly is the fact that, very often, Hospital Executives (CEOs, CFOs, and other higher ups) are usually making salaries in the six figure range. The Docs and the Nurses aren't making it--the policy wonks are. A lot of times they even use sleazy "deferred compensation" plans to beat the income tax system a little bit more.

CEOs are frequently compensated based on economic performance, and THOSE are the guys making decisions about how much "charity care" is "given" to the local community...

What is particularly "amusing" in all of this mess is the fact that the hospitals frequently don't collect much more than about five percent on any bill to an uninsured person. They put you thru a living hell, hand you off to a predatory collection agency, and you sit at home as long as possible before you seek care--and they still only get about five percent of what is owed when it is all said and done.

Hospital execs know this. They know full well that the PR for doing charity care is WAY bigger than any money they are gonna make off of it--but they persist in doing the harassment dance just so they can write it off as "uncollected debt."

They know people are dying, and the bottom line is they are unwilling to do anything about discounting services--in spite of information that shows they would collect MORE if they would only work out payment plans and give people a chance to pay over time.

We need single payer in the worst sort of way, and I seriously wonder if any politico currently in office will have the fortitude and the political skill to make it happen.



Laura

[nadinbrzezinski]

19. We will have to lead

Hell as an ambulance worker more than once I ended up on this side of the border and the docts got PO'ed when I refused to play the dance... I knew how to play it in Mexico... but let me tell you, will not identify chain... they were worst than even the General Hospital down in Tijuana... and those boys were at times sleezy as can be.

[KT2000]

22. CEO's - interesting

what other incentives are there for CEO's?
I live in a rural community that is geared for the retired people. We have many uninsured in the younger ages - they must use the charity clinic that is open 2 evenings a week.

The hospital is VERY agressive in seizing property from people who cannot pay their bills. Believe me - they get the house even when people are paying off their bills in a timely manner.

Anyway, the hospital - public - is in a constant state of remodeling. They are constantly acquiring land and building new facilities. The improvements are beyond necessity and well into elegance.

What would a CEO get out of this type of behavior? What could he be getting out of this? I am just wondering where to start looking and I am sure it is with him. He had the previous CEO fired when he was his assistant. He got the job and abolished the job of assistant.

[davsand]

29. I sent you a PM, KT2000.

Get hold of me if you need more info, I'll be happy to help in any way I can.


Laura

[Burried News]

32. You need to focus more on the Board of Directors and the

businessmen the renovations are contracted out to. The CEO may be more visible but is not 'the Power'.

I suggest it is similar to kickbacks on road construction, state lotteries etc.

[IndyOp]

25. Most docs would benefit from Universal Health Care --

In spades! My chiropracter practiced in Canada before coming to the states. There was one form to fill out for each patient, submit them all to the same place, get the reimbursment check in one nice lump sum. The amount of money wasted, wasted on time to fill out forms and arguments with for-profit health insurance companies is enough to fund doctor services and drugs for so, so many people who have none right now.

:kick:

[nashville_brook]

36. i had an unexpected $240,000 hospital bill -- never been sick

never a broken bone. and have rarely in my life had insurance -- sometimes went without when i was working professional gigs. for the last 4 years my husband's co has paid for my insurance -- a benefit that's largely unheard of.

we still had more than 12,000 in bills on the basic hospitalization. drugs, home care and tests were another 7,500. we had to borrow against the house just to pay bills. so, almost 20,000 aside from insurance.

luckily we had something to mortgage.
luckily we even had insurance.

and now no bankruptcy. i want to punch something.

[eridani]

24. Another very relevant Kucinich quote

We are already paying for universal health care, we just aren't getting it.

[JJackFlash]

13. But the alternative is communism

sorry, had a Fox moment.

[Mr_Spock]

14. lol

:rofl:

I first though - "Freeper"? :rofl:

[nadinbrzezinski]

20. GET ME THE SMELLING SALTS< STAT

Get me teh paddles

WWWHOOOOOOZZZZZZ

Clear

WHOMP

Feel better now?

[lovuian]

16. Now let me add my voice in this Add ilegal immigrants

coming in the millions getting services and if they can't pay try finding them in Mexico???

Plus add Insurance companies charging huge premiums and even still you pay 10 % or 20% if you have insurance!!!

if you don't well welcome to the rest of America...

you have the haves and the not haves

but in this system we have nobody!!!

[nadinbrzezinski]

21. This about the aliens is kind of a broken record and

a could be solved easy

b.- it is over stated.

Most of these people AVOID having any contact with any of the authorities out of fear of the Migra... and at times the migra takes them in their vans to the border and calls us.

Did I mention they were run over and a crime had been committed?

The point is, far more complex than people think and if you live in the Border area you surely have seen US Insurance companies who now insure people for services IN MEXICO... check it out... I saw it last sunday and I went WTF?

[leftofthedial]

17. Over the past 6 weeks, I've been trying to get care for my mother

She's elderly, sick and was getting worse. She has great insurance that covers everything. She had a good doctor, who had her feeling good and healthy. Then, she started feeling kind of bad and contacted him for an appointment. Long story short, after two weeks of cancelled appointments (by him!), she felt very bad.

I took her back to her old doctor (not as competent, IMHO). We visited the old doctor 2 or 3 times a week for four weeks, each time, I had to take 3 to 6 hours off to transport her. On the "off" days, my sister and I took turns caring for her (cooking, helping her to the bathroom, cleaning up, etc.). She really needed someone to visit and care for her, but the doctor wouldn't okay it. They slightly tweaked her medication (she takes LOTS of drugs for various things) each time, but she kept getting worse. Finally, three weeks ago on Saturday, we called an ambulance to take her to the emergency room. She was seriously sick. Turns out she had pneumonia! Two or three visits to the doctor each week and they couldn't frigging diagnose pneumonia!

She's somewhat on the mend now and we found her a better doctor. She can get up and around and even drove herself to the doctor and the store a couple of days ago. Still, this is grossly inadequate care.

And she HAS insurance.

[Ladyhawk]

18. People shouldn't have to pay exorbitant prices just to stay alive.

Jesus, I thought I'd had issues with health care (waiting over a year for an MRI), but this is disgusting. Those cancer patients are going to freeze this winter. They can't afford to not have heating. I mean, being cold has to affect one's health, right?

What the hell are we going to do, folks? Even if we all banded together, we can't pay the bills for these people. Are we going to have to take down the corporations? Is that even possible? What will it cost us to do so?

This is unconscionable. I don't want to be a member of a society that would treat people this way. This is the same America that left the Katrina victims without food, water or sanitary living conditions. My Republican family members keep saying, "Well, it's my money...it's my money!" and complain about the little people. Fools. Their tax money is going to make people like Cheney very rich.

[snot]

23. Pls put this in an LTTE to LOTS o' media via the DU blaster. nt

[progressoid]

26. Yes, this needs to become a national outrage. Yell it from the rooftops.

[europegirl4jfk]

27. All your accounts are really shocking

And to think that there are people here in Europe (I'm German and live in France) who complain that they have to pay 10 Euros now for there former totally free prescription drugs and doctors consultations. We are still very blessed with our universal health-care system.

My only personal experience with the health-care situation in the USA was eye-opening for me. My daughter spent a school year in the USA last year and had an accident during a ski-trip with her school. Nothing really very bad but they took her to the local hospital to make sure that it wasn't something serious. My daughter just spent one hour in the hospital and I thought that could cost a few hundred dollars but when I got the bills I was shocked: not a few hundred but a few thousand dollars with different bills for different doctors, different treatments etc. Fortunately we had an international health insurance for my daughter just for this year in the US and after several months, bills, reminders and more letters later, the situation was finally settled. But it showed my how fast you can end up with this kind of exorbitant bills in the USA.

[DeepModem Mom]

28. Thanks for this post, OzarkDem -- another recommendation. nt

[callady]

31. It's broken

We should not try to fix it

We need different modes

New ways of living based on community

New ways of medical distribution based on community

New ways of healing based on ecology

New ways of caregiving based on solidarity

New ways of education based on wisdom and knowledge not information and commercialism

New ways of politicking based on organic inter-relations not representative voting

Nominated

[CitySky]

34. 75%

Sorry I have no link, but didn't a recent poll show that SEVENTY-FIVE PERCENT of Americans think we should have some version of universal health care? Hey, the only people that leaves out are (1) the insurance company executives who benefit from the current system, and (2) a handful of selfish greedy people who are not sick, don't love anybody who's sick, and don't think they'll ever get sick. So some of them are likely to be "converts" soon.

What I told the receptionist at my doctor's last week: "75% percent of Americans think we should have some form of government-provided health care for everybody! Seventy-five percent! So why haven't we made it happen? Here's what we need to do: we gotta round up all of the insurance company executives and their lobbyists and lock 'em all up in a cellar somewhere for a few days, maybe a week, while we hammer out a plan. Then, when we let 'em out, we say, 'So sorry! You're out of a job! But you're smart people; we're sure you'll find something else to do."

She smiled, and agreed of course. Almost EVERYONE agrees on this one. We just need to keep hammering it home. Thanks, OzarkDem and the others who've posted personal stories on this thread, for reminding us what it looks like when the system just isn't working.

[cosmicdot]

35. consider sending your post to Rep. Nancy Pelosi ...

as the Democratic leader in the House ... it was reported fairly recently that Pelosi and 'House Democrats' (along with 'key Democratic strategists, advisers, outside interest groups') were "privately" devising a party platform to promote on the 2006 campaign trail, including a call for "affordable life insurance" to address health care ...

they seem to have a co-dependency problem with corporations, and can't lead outside the corporate box ...

http://www.house.gov/pelosi/contact/contact.html

I often visit opensecrets.org to look at individual congress member's personal finance statements, PAC donors, etc. Some of Pelosi's PAC contributors: Cargill Inc., Time Warner, AT&T, SBC, Lucent, Nextel, Loral, Siemens, Microsoft, EDS, Lockheed Martin, Raytheon, PG&E, Bank of America, Bank One, Citigroup, JP Morgan & Chase, Wells Fargo, MetLife, Johnson & Johnson, Vinson & Elkins, etc.

[Cleita]

37. It's terrible what is happening and this deterioration of

the system started more than twenty years ago. So many of us realized this would be the end result, yet we couldn't fight the special interests because we couldn't get anyone interested into looking at the future, the way things were going. Most people felt if they had coverage from their jobs they were fine. They didn't realize the system sucked from the bottom up.

I hope we can finally get this fixed with everyone participating in a real health system that covers everyone and keeps the health care providers happy and compensated like they should be.

[nashville_brook]

38. pharm sales incentives -- let me tell you!

a friend of ours "represented" Aderal (sp?) -- a Ritalin-type drug. at the end of her first year her co sent her to a tony Hawaii resort for TWO WEEKS. when she got there -- there was an envelop on the bed with something like 8,000 cash for shopping, golf, whatnot. she figured it was a $20,000 trip if it were all full price with airfare.

and lets not forget all the lunches, breakfasts and jee-jaw schwag that's given to physician groups.

we live in a Brazil-like dystopia healthcare-wise.

[Corgigal]

39. Along your lines

I tried to buy some Tamiflu online, just because I would feel better if I had a prescription or two. I go to the VA and they won't write it.

SO, as of yesterday I thought I could purchase at least one script online when I received the following email tonight.


Please note that we are currently out of stock of Tamiflu and Relenza, and the US Government has taken possession of all of the remaining Tamiflu and Relenza at all of the drug wholesalers throughout the country. In the event that we get more in, orders will be processed in the order in which they are received. We have no way of knowing when this will be however. Please accept our sincere apologies.


Thank you for your business,


Damn, damn and double damn.