So, a patient just called me...

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  • _
    _ Posts: 6,657
    So, I just denied Medicaid to a pregnant patient. I just looked a human being in the eye and said, "Of course we'll care for you and your unborn child... but we're going to charge you up the ass for it!" (Self-pay patients pay more than insurance companies do, ya know.) She doesn't qualify for Medicaid because you have to have had a green card for 5 years. She's only had hers for 4 and 1/2 years.

    So now she'll likely not get the prenatal care she needs because she'll have to pay for it out-of-pocket. Of course, by the time she delivers she'll qualify for Medicaid. (Even if she still didn't meet the 5-year bar, her delivery would still be covered by EMSA - Emergency Medical Services for Aliens.) Ultimately we'll pay for her childbirth and pay for the healthcare of her child, but it may be more costly to us since she won't get good prenatal care.

    Her boyfriend is with her and he's from Massachusetts. He pointed out that she'd be covered under their healthcare system.

    Jlew... no need to take this as a value statement. I'm just pointing out yet another crack in the current system through which human beings fall.
  • jlew24asu
    jlew24asu Posts: 10,118
    why can't she pay for the prenatal care she wants? does she work? is her BF (the father?) willing to help pay? why doesnt she have insurance?

    she doesnt have to pay for it all upfront. and it wouldnt be millions of dollars. she can even set up a payment plan.

    how much would the services you denied her for cost?
  • polaris_x
    polaris_x Posts: 13,559
    jlew24asu wrote:
    thats a really big exception wouldn't ya say?

    if you require it - absolutely however, if you're a garage - it's better to be able to service most makes of cars as opposed to a few specialty cars.
    jlew24asu wrote:
    this is an interesting report, thanks for posting.

    in regards to access, its only bad for those who have no insurance. which should go as no surprise right? but....

    "insured patients in the U.S. have rapid access to specialized health care services. In other countries, like the U.K and Canada, patients have little to no financial burden, but experience long wait times for such specialized services"

    so you tell me, who has better access ?

    I'm all for the current system being improved. I've never said otherwise.

    again - that's for specialized care again ... for the majority of illnesses the wait times are manageable ... i would much prefer to have my system than yours easily as a person who could probably afford to pay for insurance ...

    really tho - i don't think there is much of an argument as to which health care system is better especially if you believe that everyone should have at least some basic coverage ... the only real argument here is whether - given the funds and mandate: can the us gov't manage a program like this without fucking it up like they do a lot of programs ... that to me is the main debate ...
  • _
    _ Posts: 6,657
    jlew24asu wrote:
    in regards to access, its only bad for those who have no insurance.

    Wow. Do you really not see the inhumanity of this statement? Here's how it reads: "As long as I and those like me have access to healthcare, other people don't matter." It's kinda like saying, "Of course we're a free nation; it's only the slaves who aren't free," or "Of course we're a representative government; it's only the women, people of color, and those who don't own land who can't vote."
    jlew24asu wrote:
    "insured patients in the U.S. have rapid access to specialized health care services. In other countries, like the U.K and Canada, patients have little to no financial burden, but experience long wait times for such specialized services"


    so you tell me, who has better access ?


    I'm all for the current system being improved. I've never said otherwise but if you want to talk about access, you should tell the whole story.

    YOU are the one who should be telling the whole story about access. If the statement I bolded is true, how come it just took me - an insured person - over 3 months to be seen by a specialist? How come I have to wait 2 months just for a regular check-up with my primary care physician? How come my friend with cancer is having to wait over a month for surgery? Where are these stories in your account of our healthcare system; why are they not represented?
  • jlew24asu
    jlew24asu Posts: 10,118
    polaris_x wrote:

    again - that's for specialized care again ... for the majority of illnesses the wait times are manageable ... i would much prefer to have my system than yours easily as a person who could probably afford to pay for insurance ...

    really tho - i don't think there is much of an argument as to which health care system is better especially if you believe that everyone should have at least some basic coverage ... the only real argument here is whether - given the funds and mandate: can the us gov't manage a program like this without fucking it up like they do a lot of programs ... that to me is the main debate ...

    you are just brushing off specialized care as if its not important. it is.

    and there is a very big argument which better. UHC is not better by any means. its only better in the sense that eliminates uninsured people. thats something that needs fixing.....and it can be fixed without going to UHC.
  • jlew24asu
    jlew24asu Posts: 10,118
    scb wrote:

    Wow. Do you really not see the inhumanity of this statement? Here's how it reads: "As long as I and those like me have access to healthcare, other people don't matter." It's kinda like saying, "Of course we're a free nation; it's only the slaves who aren't free," or "Of course we're a representative government; it's only the women, people of color, and those who don't own land who can't vote."

    I didn't say this shouldn't be fixed. calm down. those without any access should get it. its the how is the debate.
    scb wrote:

    YOU are the one who should be telling the whole story about access. If the statement I bolded is true, how come it just took me - an insured person - over 3 months to be seen by a specialist?

    I don't know. you tell me. what specialist did you need to see? how many doctors specialize in this in the country?
    scb wrote:
    How come I have to wait 2 months just for a regular check-up with my primary care physician?


    because he is good? find a new one if you don't want to wait. or maybe you think your wait time to see him would drop under UHC?
    scb wrote:
    How come my friend with cancer is having to wait over a month for surgery?

    again, you think this wait time would be LESS under UHC? thats impossible.
  • polaris_x
    polaris_x Posts: 13,559
    jlew24asu wrote:
    you are just brushing off specialized care as if its not important. it is.

    and there is a very big argument which better. UHC is not better by any means. its only better in the sense that eliminates uninsured people. thats something that needs fixing.....and it can be fixed without going to UHC.

    how is that? if you feel like the priorities in a health care system is micro-brain surgery ... fine ... but to me most people die from heart disease and trauma and cancer, etc ... for the most part everyone in canada can get treated for the major illnesses ..

    UHC is better for the entire population as a whole - it has been shown in numerous health care analysis ... the sad part is that in the US - you guys pay more than countries with UHC and the overall care is worse ...

    sure, if you are loaded - everything is top notch ... but if you're going to evaluate a system - makes more sense to evaluate over the whole population than a segment no?
  • jlew24asu
    jlew24asu Posts: 10,118
    scb wrote:

    YOU are the one who should be telling the whole story about access. If the statement I bolded is true, how come it just took me - an insured person - over 3 months to be seen by a specialist? How come I have to wait 2 months just for a regular check-up with my primary care physician? How come my friend with cancer is having to wait over a month for surgery? Where are these stories in your account of our healthcare system; why are they not represented?

    furthermore, I didnt post the source but these authors seemed much more qualified then you.

    Authors: Karen Davis, Ph.D., Cathy Schoen, M.S., Stephen C. Schoenbaum, M.D., M.P.H., Michelle M. Doty, Ph.D., M.P.H., Alyssa L. Holmgren, M.P.A., Jennifer L. Kriss, and Katherine K. Shea
    Editor(s): Deborah Lorber


    and I'd love to know your theory on how UHC will bring down your wait times for the specialized care you claim to need. and thats IF that type of specialized care even exists anymore under a government plan.
  • _
    _ Posts: 6,657
    jlew24asu wrote:
    why can't she pay for the prenatal care she wants? does she work? is her BF (the father?) willing to help pay? why doesnt she have insurance?

    she doesnt have to pay for it all upfront. and it wouldnt be millions of dollars. she can even set up a payment plan.

    how much would the services you denied her for cost?

    Yes, she works, but she barely gets paid enough to live on and her employer doesn't provide health insurance. Same with her boyfriend. They need to save any extra money they can to provide for the baby.

    She still has to pay at least $50 up front per visit (that's a lot for some people, ya know), and even payment plans have minimum payments that are often too much for people to afford.

    I don't have the exact numbers in front of me and can't know every test or whatever she might need, but the visit today will cost about $1000. There should be a minimum of 15 prenatal visits, if everything goes well and no extra testing is needed. I'm not entirely sure about the cost of delivery off hand, but I'm pretty sure it's several thousand dollars.
  • jlew24asu
    jlew24asu Posts: 10,118
    polaris_x wrote:

    how is that? if you feel like the priorities in a health care system is micro-brain surgery ... fine ... but to me most people die from heart disease and trauma and cancer, etc ... for the most part everyone in canada can get treated for the major illnesses ..

    I guess we have different definitions of specialized care then. but for me certain cancer and trauma treatments qualify.
    polaris_x wrote:
    UHC is better for the entire population as a whole - it has been shown in numerous health care analysis ... the sad part is that in the US - you guys pay more than countries with UHC and the overall care is worse ...

    :roll: the system can be improved for the entire population without going to UHC.
    polaris_x wrote:
    sure, if you are loaded - everything is top notch ... but if you're going to evaluate a system - makes more sense to evaluate over the whole population than a segment no?

    I agree.
  • _
    _ Posts: 6,657
    jlew24asu wrote:
    polaris_x wrote:

    again - that's for specialized care again ... for the majority of illnesses the wait times are manageable ... i would much prefer to have my system than yours easily as a person who could probably afford to pay for insurance ...

    really tho - i don't think there is much of an argument as to which health care system is better especially if you believe that everyone should have at least some basic coverage ... the only real argument here is whether - given the funds and mandate: can the us gov't manage a program like this without fucking it up like they do a lot of programs ... that to me is the main debate ...

    you are just brushing off specialized care as if its not important. it is.

    If everyone had good primary care though, there would be much less need for specialists.
  • polaris_x
    polaris_x Posts: 13,559
    jlew24asu wrote:
    :roll: the system can be improved for the entire population without going to UHC.

    can you point to any other country's health care system that is better that is not socialized?
  • _
    _ Posts: 6,657
    jlew24asu wrote:
    scb wrote:

    Wow. Do you really not see the inhumanity of this statement? Here's how it reads: "As long as I and those like me have access to healthcare, other people don't matter." It's kinda like saying, "Of course we're a free nation; it's only the slaves who aren't free," or "Of course we're a representative government; it's only the women, people of color, and those who don't own land who can't vote."

    I didn't say this shouldn't be fixed. calm down. those without any access should get it. its the how is the debate.
    scb wrote:

    YOU are the one who should be telling the whole story about access. If the statement I bolded is true, how come it just took me - an insured person - over 3 months to be seen by a specialist?

    I don't know. you tell me. what specialist did you need to see? how many doctors specialize in this in the country?
    scb wrote:
    How come I have to wait 2 months just for a regular check-up with my primary care physician?


    because he is good? find a new one if you don't want to wait. or maybe you think your wait time to see him would drop under UHC?
    scb wrote:
    How come my friend with cancer is having to wait over a month for surgery?

    again, you think this wait time would be LESS under UHC? thats impossible.

    I never said my wait time would be LESS under UHC. It may or may not. (I think it's possible that it would, because then patients could be more spread around amongst the docs and not have to be limited in who they see.) But if I'm going to wait this long anyway, I would definitely prefer that it's because everyone is receiving care.
  • _
    _ Posts: 6,657
    jlew24asu wrote:
    scb wrote:

    YOU are the one who should be telling the whole story about access. If the statement I bolded is true, how come it just took me - an insured person - over 3 months to be seen by a specialist? How come I have to wait 2 months just for a regular check-up with my primary care physician? How come my friend with cancer is having to wait over a month for surgery? Where are these stories in your account of our healthcare system; why are they not represented?

    furthermore, I didnt post the source but these authors seemed much more qualified then you.

    Authors: Karen Davis, Ph.D., Cathy Schoen, M.S., Stephen C. Schoenbaum, M.D., M.P.H., Michelle M. Doty, Ph.D., M.P.H., Alyssa L. Holmgren, M.P.A., Jennifer L. Kriss, and Katherine K. Shea
    Editor(s): Deborah Lorber


    and I'd love to know your theory on how UHC will bring down your wait times for the specialized care you claim to need. and thats IF that type of specialized care even exists anymore under a government plan.

    It's simple... I am more qualified than anyone as a source for my experiences.

    Again, I never said UHC would necessarily decrease wait times.
  • jlew24asu
    jlew24asu Posts: 10,118
    edited July 2009
    scb wrote:

    Yes, she works, but she barely gets paid enough to live on and her employer doesn't provide health insurance. Same with her boyfriend. They need to save any extra money they can to provide for the baby.

    maybe they should have put more thought into having a baby then no? I make plenty of money to live and having a baby is still a few years away because I don't have enough money saved to comfortable provide for a child.

    and just because neither employers provide insurance, doesnt mean that cant have any. why can't she buy her own insurance plan?
    scb wrote:
    She still has to pay at least $50 up front per visit (that's a lot for some people, ya know), and even payment plans have minimum payments that are often too much for people to afford.

    from what I've seen, payment plans always exist. and even if they do, providers are always willing to set one up that is doable.
    scb wrote:
    I don't have the exact numbers in front of me and can't know every test or whatever she might need, but the visit today will cost about $1000. There should be a minimum of 15 prenatal visits, if everything goes well and no extra testing is needed. I'm not entirely sure about the cost of delivery off hand, but I'm pretty sure it's several thousand dollars.

    if prenatal care was important to her and her bf, they should do. several thousand dollars is doable
    Post edited by jlew24asu on
  • jlew24asu
    jlew24asu Posts: 10,118
    scb wrote:

    It's simple... I am more qualified than anyone as a source for my experiences.


    are you a Doctor?
  • _
    _ Posts: 6,657
    jlew24asu wrote:
    scb wrote:

    Yes, she works, but she barely gets paid enough to live on and her employer doesn't provide health insurance. Same with her boyfriend. They need to save any extra money they can to provide for the baby.

    maybe they should have put more thought into having a baby then no? I make plenty of money to live and having a baby is still a few years away because I don't have enough money saved to comfortable provide for a child.

    and just because neither employers provide insurance, doesnt mean that cant have any. why can't she buy her own insurance plan?
    scb wrote:
    She still has to pay at least $50 up front per visit (that's a lot for some people, ya know), and even payment plans have minimum payments that are often too much for people to afford.

    from what I've seen, payment plans rarely exist. and even if they do, providers are always willing to set one up that is doable.
    scb wrote:
    I don't have the exact numbers in front of me and can't know every test or whatever she might need, but the visit today will cost about $1000. There should be a minimum of 15 prenatal visits, if everything goes well and no extra testing is needed. I'm not entirely sure about the cost of delivery off hand, but I'm pretty sure it's several thousand dollars.

    if prenatal care was important to her and her bf, they should do. several thousand dollars is doable

    "Several thousand dollars is doable"?? Again, what an elitist statement! It seems that you don't have a great understanding of the plight of some people in this country/world.

    And with regard to your suggestion that they should have put more thought into having a baby, they are right now in clinic deciding whethre or not to have an abortion because they can't afford a baby right now. (She was on the pill, by the way.)
  • _
    _ Posts: 6,657
    jlew24asu wrote:
    scb wrote:

    It's simple... I am more qualified than anyone as a source for my experiences.


    are you a Doctor?

    Do I have to be a doctor to know how long it took to get an appointment?
  • soulsinging
    soulsinging Posts: 13,202
    jlew24asu wrote:
    scb wrote:
    I don't have the exact numbers in front of me and can't know every test or whatever she might need, but the visit today will cost about $1000. There should be a minimum of 15 prenatal visits, if everything goes well and no extra testing is needed. I'm not entirely sure about the cost of delivery off hand, but I'm pretty sure it's several thousand dollars.

    if prenatal care was important to her and her bf, they should do. several thousand dollars is doable

    It's very clear here that you work for the big guns in the financial industry, if you think several thousand dollars is no big deal. Not everyone is as lucky as you and I in their income. You sound like McCain when he said a million dollars is middle class or whatever nonsense it was. Holy out of touch batman.
  • jlew24asu
    jlew24asu Posts: 10,118
    scb wrote:

    "Several thousand dollars is doable"?? Again, what an elitist statement! It seems that you don't have a great understanding of the plight of some people in this country/world.

    :roll: yes, even for low income people, several thousand dollars is doable. especially when it comes to the health of a their child and low interest free payment plans are the norm.
    scb wrote:
    And with regard to your suggestion that they should have put more thought into having a baby, they are right now in clinic deciding whethre or not to have an abortion because they can't afford a baby right now. (She was on the pill, by the way.)

    I have a feeling you make up all this shit just for debating purposes. funny how this story seems to progress right along with your arguments.

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