sophiegrace the costs are absurd, especially for small businesses. I forgot to mention that the part that pisses me off is that mine limits birth control acces because of religious reasons..
Eye update: I do not have pink eye. It's blepharitis. Not contagious & not an infection. Warm compresses & saline drops, unless it gets worse & then I'll get steroid drops.
Ugh, I'm sorry to hear that. I had chronic blepharitis for a large portion of my childhood, up through 8th grade. I got made fun of it all the time because I would always have crust around my eyelashes.
At one point the doctor had me washing under my eyelids with baby shampoo diluted in water twice a day. I also got this nice oily cream that I had to put on them overnight. It worked, though. I hope yours gets better soon!
Post by sophiegrace on May 9, 2016 20:34:38 GMT -5
I hope that didn't come off as nasty tallblonde!! I know that from the employee side seeing how shitty some benefits can be is just nauseating. I just wanted to throw in the 'other side' perspective. I'm sure big companies give zero shits, but it's things like this that my husband and I lose sleep over and I'm sure many companies are the same. Double those bad feelings when we started getting our J.ohns H.opkins bills from our loss last year. They were out of network and insurance was Therefore allowed to pay the legal minimum, H.opkins billed us the remaining amount.
The limiting of birth control access is a whole other topic that is just mind blowing to me this day and age. I'm truly sorry that you and your entire female staff have to deal with such stupid shit.
sophiegrace Agree with all of that, and I totally understand where you're coming from. My dad is a small business owner/self-employed and purchases his and my mom's insurance. Both in excellent health, no pre-existing conditions. Their costs skyrocketed b/c their previous policy wasn't in accordance with the ACA stipulations...my 60 y.o. mom apparently needs maternity coverage now. When my dad had employees (20 at his peak...he has scaled back to mostly consulting now), he paid 100% coverage for his employees AND their families. It was hundreds of thousands annually.
I wish I had the answer for controlling healthcare costs in our country. I'd sell it and retire on a beach in the south of France I think it has to be a combination of tort reform, allowing insurers to sell across state lines for a more competitive market, more transparency on behalf of providers in terms of cost/pricing. I also think people need to be smarter consumers, as well. So many Americans are used to employer-sponsored insurance, they really have no idea about the *actual* cost of health insurance and care. I know I didn't when I was single and working...I just saw $100-something taken out per pay period for my share, but I now realize just how much my employer was paying (spoiler: a lot more than $100/pay period).
Also, IMO, health insurance should be more like car insurance...for emergencies and not 'routine maintenance'. Hospitalization, treatment for major illness, etc.. A visit to urgent care for the flu or your GP for your annual physical to me is like an oil change...that's routine maintenance. Health savings accounts are perfect for that kind of thing. Everyone wants every little thing covered but that is what causes premiums to rise, and then it becomes an endless cycle. I don't know how to fix that, though, seems like a chicken/egg thing.
Ugh sophiegrace that sucks about jh - talk about compounding an awful situation. That's local to me and disappointing to hear it was a bad experience:( they are also not known for producing great politicians.
It is good to hear what it is like to have to pick the plans, since it is so confusing, and there isn't much visibility into it. The insurance industry is warped and it's scary - I felt bad that I forgot the main part of my complaint...so I was confusing in the first place!
Ugh, I'm sorry to hear that. I had chronic blepharitis for a large portion of my childhood, up through 8th grade. I got made fun of it all the time because I would always have crust around my eyelashes.
At one point the doctor had me washing under my eyelids with baby shampoo diluted in water twice a day. I also got this nice oily cream that I had to put on them overnight. It worked, though. I hope yours gets better soon!
Great. This does not sound reassuring. You don't have it anymore though?
I didn't mean to scare you! I haven't had it for 18+ years. Once they gave me the right cream it cleared up pretty quickly.
Yes I agree. Like I said ours has flaws. I admit but I 1000% think our medicine is better because it's not socialized. Not that the Dr's are better but the system isn't binding if anything we are excessively cautious. Said husband I referenced above didn't have complications because of medical oversight or missed diagnosis, he almost died because they wouldn't diagnose or treat him until it was almost to late that is a system flaw not a Dr flaw. His wife was also recently diagnosed with terminal colon cancer because the standard for screening is subpar. It could have and should have been caught much earlier when it was curable.
Wow. Thats a pretty skewed perception of a system you know nothing about. To each their own, keep on keeping on and all those saying I believe apply here.
Eh I have a pretty good idea actually. Yes those are 2 very personal examples and I am by no means saying it's terrible or decrepit just incredibly flawed. I just prefer our actual practice of Medicine. Not perfect but or problems lie more with insurance and liability.
Post by sophiegrace on May 9, 2016 21:59:13 GMT -5
You have a nice soap box LizInFL, may I stand next to you on it? I could use some Florida weather! When insurance companies and the government get each their hands out of each other's pockets I think things will be able to go the right way, but until then it's going to be more of the same. And that's just causing a lot of mistrust between every side.
tallblonde, I live on the eastern shore! So we're close, yet a worlds away haha. I have to cross the bay bridge to get to my MFM. Talk about a quicker paced environment.
There isn't much visibility to the entire process on both sides. Even as a provider it's like both playing a game and walking a tightrope at the same time. They tell us what we are allowed to bill then only pay an average of 60%. Why not just tell us what we will get paid so we can just charge that? If we charge less? Federal audit. If we accidentally charge more? Federal audit. And yet neither controls how much we get paid because they already have internal set limits for what they'll pay for each code we send out. Like I said a damn game. And then the patient gets their EOB with the 'fake' charge and thinks we're stealing from them. It's getting harder and harder to be fulfilled when you spend more time dealing with politics and paperwork than you do with your patients.
sophiegrace ha! So close - I'm from Annapolis and am back there every other weekend lately - future g2g potential someday!
That's where my MFM is! I was actually considering AAMC to deliver in this time around, but it's just not a responsible idea if we get stuck in any type of traffic. There was an accident before the bridge the day of my NT and it took us 3.5 hours to get there. DNW if I'm in labor.
sophiegrace is wise and does a reeeaaallly good job of explaining this. I, too, am in the field. I am a Health and Welfare Insurance Consultant (health insurance broker). I work with employers who are providing health (and dental, life, disability, FSA, etc) benefits to their employees and the insurance companies to sell the policies, manage them, offer guidance on changing regulations including ACA, etc. I also work directly with the employees to teach them about the plans, how to be good healthcare consumers, and to assist with claim issues when they come up.
Our system is flawed, it most certainly is. However, I've also seen the good side of reform (not much but it's there). I've seen a 50 year old women with breast cancer be able to buy coverage despite her pre existing condition and finally get treatment. I've seen lower income families who couldn't previously afford it now be able to afford coverage and go to a primary care doc instead of driving up OUR healthcare costs by using the ER as their doc (since they can't be turned away).
With ACA, insurers are now required to meet MLR (minimum loss ratios) meaning 75 or 85% of the premium they take in must be paid out in claims or returned to the employers (and I've seen those premiums returned).
It still astounds me the amount of money an employer must pay to offer coverage to their employees for a crappy high deductible plan.
I think we do need a MAJOR overhaul on the prescription drug industry. There are non-generic drugs and specialty drugs costing upwards of $10k-$70k for one dose!!
Eta I know it's not entirely an ACA conversation but when we're addressing the fact that our system sucks we should also address the fact that there is reform occurring. I don't necessarily agree with that reform, but must point out the pros and cons.
aggiebug I really don't know where you're going with your comment of 'prefer actual practice of medicine' nor do I care, but do know that it comes off as completely arrogant. I love a good discussion here on the boards but you're hard to read here with your very personal experiences forming such an opinion and or preference for an entire health care system.
I apologize I know what I said and I do think it didn't come across completely clear and frankly rude. I admit. I shouldn't have posted in such a rush it clearly didn't help! If I didn't have to pay for medical care anywhere and could choose where I would go for help it would be the US. So money aside this is where I would seek help. That being said and this is the part I think became lost in my words, if the US wasn't an option Canadian Healthcare would be a top choice. There are a hell of a lot worse places to get medical care. I am not trying to say it is despicable or even terrible I just think there are some problems with it people don't quite realize are serious issues. The problem with socialized Healthcare is it becomes about saving money over the population vs the individual. It's just a fact and it changes the way medicine is practiced.
I think the thing is medical care comes up on here and it generally is man I wish I was in the Canadian system. And I think that is incredibly naive for most who say it. And the crux if why I said something. Our actual medical care is top notch, and people come around the world to pay for it if they can. Our problem is insurance and skyrocketing prices due to liability insurance not the medicine itself. And trust me I know how flawed our system is and how lucky I am to have descent coverage.
Eta
If I was in a terrible car accident and me and/ or my family had to be rushed to the er hanging on by a thread I would hands down have no issue with an er in either country if they were side by side. Both are excellent and my life would be in good hands.
It's the preventative medicine where things are most restrictive and some middle of the road issues are slow to be diagnosed and managed appropriately. My first example did live and miraculously didn't lose his leg because of the treatment he received I acknowledge that it's was just to reactive and not proactive.
sophiegrace I wouldn't trust bay bridge traffic either! November would be better than the summer, but you really just never know when it will be a mess.
Post by sophiegrace on May 10, 2016 6:26:50 GMT -5
Ahh thank you thank you kleigh!! That's a story I needed to hear. Like so often the case I hear the negative outcomes of people trying to get themselves insured. I'm glad we have you, yet another side of this super confusing coin to chime in with your knowledge. Especially since you do get to see some of the good.
I feel like this is such an important conversation to have and wish it happened more often IRL. I'm in the midst of it and still barely understand the system.
ETA: and I also agree 100% with your ETA. I'm glad there is finally movement SOMEWHERE to get changes made to the system. It was always obvious that there are no easy fixes and it's going to take many tries and many years to get it right.
Those are some good points kleigh . I used to work for a national payroll company and I loved talking to our guy who essentially did your job for our clients; he was such a wealth of knowledge about the entire system.
In general I'm not an ACA fan, but I do think there are some good things about it...allowing those with preexisting conditions to finally get insurance is a huge one. (I can remember my parents wanting to switch insurance when my sister was in high school and she was temporarily on an expensive acne medication, and they were turned down b/c of that! Craziness.)
In general, though, I do not want the government overly involved in my healthcare. Democrat or Republican, I really don't trust either, lol. I see the issues, corruption, long wait times, etc. we have here with the Veterans Administration, which is essentially government-sponsored care for just a small segment of our population. I imagine if we rolled that out on a mass scale for the rest of the population, it would be 1000x worse. Maybe it works better in other countries, I don't know enough to judge.
kleigh Yeah the thing about those drugs is it costs tens of thousands of dollars to do the research for a drug and tens of thousands more to prove it is safe and to get its approval to be released to the market and only a small percentage of drugs actually make it to market. So those costs suck, but they are entirely so the company can recover costs and fund more research for more drugs. If we didn't have patents and the ability to price drugs that high we wouldn't have any companies available to do research and produce new drugs.
Now the ones that make me angry are the people who monopolize old drugs (doxycycline for one, hiv drug for another) and charge a huge profit per pill. With no competition they can do as they please. Unfortunately that is the downside of the free market system.
Good morning ladies! I've got an OB appointment today, I'm sick with something, and I think I have a UTI!?! I'm with starbuck27, and my MS has gotten worse! danib, I'm sorry about your wait, I'm hoping today is your day!
Post by sophiegrace on May 10, 2016 7:11:58 GMT -5
danib come down here and I'll get you set up with your injection and then we'll work together to fix the insurance woe's of North America. I do love the medical care available to me, but you're right about how it can absolutely put patients with chronic conditions into devastating life situations.
I agree LizInFL , it's such a tough thing. In an ideal world we would all just be smart healthcare consumers (take care of ourselves, get annual checkups, seek more cost effective treatments, etc)... I don't necessarily like the gov't involvement but also don't know how else to "encourage" poor healthcare consumers from affecting an otherwise decently run system. I'm glad I'm not the President or Congress that's all :-)
If we all do our own little part then maybe one day we'll see real change.
Post by ClassyMrsA on May 10, 2016 10:20:12 GMT -5
Re healthcare: I'm not sure how many of you have had to get heath insurance through the "marketplace." Since DH works, of course he has insurance, but he's a teacher and much like how teachers don't get paid nearly what they're worth, his insurance options are terrible. For him to add me and L to his insurance, we would pay $500 a month for the lowest level with a high deductible and out of pocket max. Why? So I have my lovely marketplace insurance. While it's very hard to find something decent these days (my individual insurance with L was amazing and I paid less than $3000 total for my entire pregnancy, labor, and all the hospital stuff but you can't get anything even close now) it's not as bad as DH's and much less expensive. So that's what I do and I'm glad I don't have to jump through hoops to get it. Plus, it covers the stuff I need it to. The system is far from perfect, though, and I wish it wasn't so insanely expensive. Even when I go back to work it's going to be tight money wise (I'm a teacher too). I'm lucky to have parents who can help us when we need it. Most people who are at our income level don't. No real position here, just my experience and thoughts.
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