Mail Call

[rolanni]

Remember that MRI scheduled for this evening? Today's snail brings News! from Anthem Blue Cross. After due consideration, they agree that an MRI is reasonable in the case and will allow the appointment to stand.

WTF? Anthem gets to decide if my knee hurts bad enough for me to Do Something About It?

Ghod, we need a health care system in this country. Please.

Comments

Re: this completely disgusts me.

[keristor.livejournal.com]

Try Britain, where the government take the money anyway and still make you wait months and/or deny treatment on the grounds that it is too expensive. And where a lot of our best people have left (either the National Health Service or in some cases the country) because they weren't paid decently (and had to work long hours -- do you want a person operating on you who has only had 6 hours sleep in the last 48 hours?). And where they have pledged to make waiting times shorter, but all they've done is shorten the maximum (and therefore the mean) but the median (most likely) time has stayed the same or gone up.

I'm not sure if I could get an MRI for a non-life-threatening condition here within 6 months. I do know that when I was in Germany (another national heath system) my knee (cartilage abrasion, it turned out) only got seen quickly because my private insurance paid for it and it would have taken months to get an appointment otherwise...

Nationalised health scemes aren't utopia either...

Re: this completely disgusts me.

[ligeia-bm.livejournal.com]

No, they are not, true. But they are far better than the system in the US. I'm from a Third World country, with a public system (free for all: public hospitals, for example), then the semi-public (a health insurance paid from your income, but the cost is ten times lower than any private company) and private health care. There are great problems in public hospitals. However, they can't deny any kind of procedure to patients (be MRI, surgeries, etc), OR medication (contraceptives are freely given in public hospitals, as well as antibiotics, or other treatments for people who otherwise would not have the chance to buy them). However, you depend on the fact that the machines are working, the surgery rooms are ready and fully provided, and the hospital pharmacies have the drugs required. Sometimes, you do have to wait months for a surgery or a procedure like your MRI. However, these services are entirely free.

Within this category also falls treatments like those for cancer or HIV, or insulin for diabetics. You can apply for them at the Health Ministry, and they'll give these for free.

Then those who have a job in any branch of public administration (in town, province or federal administrations) has a sort of health care on their own. They don't ask if you want to belong to it, you just do. They take a small amount from your paycheck, and you are included on it. It's compulsory for all public employees.

(However, anyone can join it for a slightly more than the public employees, and the cost is really not much, compared to the private companies).

This one is much, much, much better than the free, public system. You might still have to wait for procedures but never as long as in the public system, and sometimes, not at all.

I had hernia surgery and hysterectomy a couple of years ago. I paid nothing, except a plus the surgeon and then to the anesthetist, a plus that was absolutely within my budget (husband is a public employee, and the second job is veterinarian). The health care system covered the costs of the surgery, and the stay at the private clinic where I had it, plus medication.

I am diabetic and have thyroids problems, and my daughter has asthma. The health care system pays 70% of the cost of our medications. The voluntary second health insurance we have with the Union of public employees covers more than 20% of what's left. So, we end paying almost nothing.

I have had all kind of procedures and tests (including mammographies and ultrasounds). All they require is an authorization, which is never denied if the doctor attaches a report explaining why you need it. And you don't have to wait weeks to get the authorization. You go to the Health Care office closer to your home and present your papers there, and they approve it (they have a doctor there).

Now, there are procedures that require a deeper review. They can take months, and sometimes, but MRI's or CAT scans aren't among them. We are talking about meds that need to be imported, or experimental treatments here. Everything outside this category, that's considered normal, you get almost without incident, always.

I wear glasses (severe myopia), and I do have to get authorization from them, but they basically cover half the cost of my glasses and 60 to 70 % of contacts, so it's worth the wait, and all the paperwork.

Health is a Constitutional right. You can sue the State here and get compensation if they don't cover your medical needs if you can't pay for them, so they cover themselves.

It might be not perfect, but sure as hell it beats the alternative. I wouldn't have been able to my surgeries, my glasses or my meds if some sort of public system had not been in place. So, considering the alternatives, I would still take this system over nothing at all.

Re: this completely disgusts me.

[keristor.livejournal.com]

I'm willing to believe that a "third world" country does better than Britain. Here we often do have to fight to get the correct drugs (if the NHS decides that the drug or treatment "isn't worth the cost" you're out of luck, and they often substitute cheaper versions which contain different ingredients). Adults here don't get glasses or eye surgery discounts at all (children may, I'm not sure whether that's means-tested) unless they are on 'benefits' (i.e. below minimum wage) except when the (private) shops do offers; we do get free eye tests (again done privately, NHS subsidised to the testers) at intervals (and employers are required to provide them as as well).

Prescribed medicines are subsidised, being fixed price per item (I take enough that I buy a fixed-price prepayment certificate, it works out cheaper if you have more than 2 items per month), or again free to those on benefits. But anything else you buy from a pharmacist (but they compete and for common drugs like Ibuprofen the "own brand" ones are cheap).

Better than the US system? For emergencies, certainly, there's no checking of insurance on admission. For 'elective' and non-urgent surgery I'm not so sure...

Re: this completely disgusts me.

[jl-johnson.livejournal.com]

I know, and don't get me wrong, I'm not trying to tote that socialized medicine is perfect, but living so close to the States, I hear so much complaint about people not getting the treatment they need because some unknown person says it isn't needed.

It may not be the fastest, but at least you know you're going to get the treatment you need and not have to argue and fight to have your voice heard. Especially when you've paid your premiums.

Sorry, I know I sound argumentive, and I don't mean to be. It just makes me so angry, and I'm not even American. But the thing that burns me the most, is that all those polititicans who are against any kind of government plan, would get the treatment they need without a second thought. Why can't it be lik that for every American?

Re: this completely disgusts me.

[keristor.livejournal.com]

From what I've heard Canada is better than the UK for health service (and social services in general), it doesn't surprise me that yours works. Emergency care is one area where I agree that there should be an automatic system, I've been appalled by reports of Americans being not treated because they don't have insurance (or don't have it with them when they are injured), but non-urgent and 'elective' treatment is another matter, at least the UK system is slow and a "postcode lottery" (i.e. it depends where you live and what your GP is like).

Why isn't it like that for every American? Because a lot of them don't want it. A lot of non-politicians strongly oppose a 'tax' or forcing people to pay for it (some of them on my f-list), many on principle, some because they (think they) can't afford it, and others because it's "someone else's problem". The same for education.