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No. 60
Old May 21, 2009, 08:15 PM
Updated May 21, 2009 at 08:46 PM by multicollinearity

Default Re: Talk of insurance mandate growing
Originally Posted by DrugReptoNurse View Post

My policy is a limited benefits plan. I just read the fine print a few hours ago for my own reference.

It covers everything you mentioned except doctors office visits.

Yep, I get MRIs, Chemo, physical therapy and PRESCRIPTION medications.

Do some more research as your statements are flawed. After my $2500 deductible BCBS covers at 80% whatever I am charged and I pay $47 a month for me and $47 per month for my son. My total annual out of pocket will not exceed $5000 a year. Your scare tactics of going on Medicaid and filing for bankruptcy are without merit.

I am happy
Read that "Limited benefit" policy again, especially regarding the passages I highlighted with bold emphasis above.

How can you make sure you don't end up with junk health insurance?
Consumer Reports says never buy a policy labeled "limited benefit" or "not major medical insurance."

"The policies are like Swiss cheese. And the way they're written, it's really hard to spot the gaps," said Nancy Metcalf, with Consumer Reports. "Even the insurance expert we hired to help us with this project had a hard time deciphering some of them."

Consumer Report said the buzz word on many junk policies is "affordable."
"Many big-name insurance companies are offering these. They look like a good deal because the premiums are low – but they're low for a reason," Metcalf said. "They are so riddled with loopholes, limits and exclusions that they will not come close to covering your expenses if you ever fall seriously ill."


http://www.wral.com/news/local/story/5190880/


...


Many people who believe they have adequate health insurance actually have coverage so riddled with loopholes, limits, exclusions, and gotchas that it won’t come close to covering their expenses if they fall seriously ill, a Consumer Reports investigation has found.

http://www.consumerreports.org/cro/m...view/index.htm
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No. 61
from Agrippa
Old May 21, 2009, 10:11 PM
Updated May 21, 2009 at 11:02 PM by Agrippa

Default Re: Talk of insurance mandate growing
Originally Posted by DrugReptoNurse View Post
What you may or may not realize is that those people you are calling "cubicle monkeys" are very often....REGISTERED NURSES!!!

I know, i've worked with them. I think the name calling needs to cease at this point.

Who's name calling? You're really take offense of me calling a hypothetical underwriter a cubicle monkey? C'mon now.

I know that many of them are nurses but am not quite sure what that has to do with anything. My point was that the person who is making the decision of whether you get a treatment or not is a third person who in all likelyhood works in a cubicle. This person makes the decision by entering into his/her computer the variables that pertain to your situation. The decision is made based upon how much the procedure costs - whether it will affect their profitability. They will take into consideration the possibility of you taking this to litigation or just eating it. If you do take it to litigation, they will take into consideration the state's particular civil laws for one to determine their chances of winning.

If the chances of you taking legal action and actually winning is great, they may pay for your procedure. If the price of your procedure costs well over a million dollars and they feel that they can weasel out of the policy, they'll risk you suing - it would be cheaper to litigate.

The key point here is that the problem with private healthcare is that it is systemically flawed. A private company's primary concern is that of it's principal shareholders - and rightfully so. Companies excel by maximizing profits and this works great for things like electronics, medicines, cars, computers, and other material things. But when this is applied to healthcare, there is a clear conflict of interest. The shareholders vs. the patient. In this model, paying out for procedures is inversely related to shareholder's interest.

I don't blame the companies, they're doing their job to make as much money as they can. They're playing the game as it has been set up. However, as consumers, we now see that the game is rigged - the rules favor the companies. We need to change the game.
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No. 62
Old May 21, 2009, 10:33 PM

Default Re: Talk of insurance mandate growing
I do take offense to "cubicle monkey"

As an African America the word monkey obviously is offensive to me when used in your context.

I would say about 1/4 of the insurance auditors I worked with at PacifiCare were African Americans. Yes, it does offend me as I am sure it would offend my prior coworkers.

I believe when you spiral down into name calling #1 It shows a lack of character and #2 It weakens your arguement.
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No. 63
from Agrippa
Old May 21, 2009, 10:38 PM

Default Re: Talk of insurance mandate growing
I'm sorry, but this is ridiculous. I think we both know that in no way does the use of cubicle monkey have any reference to race in any way in popular culture. I didn't even know you were African American so I have no idea how you made the connection of my use of "cubicle monkey" to AA. I have no way to know of everything you may take offense to, especially about something like "cubicle monkey" which there was no way for me to have known that you took offense to it in that way.

I'm sorry that you take offense, but don't you dare try to accuse or even imply that I used that term in a racial way. I even explained exactly what I meant by it.

If you like, I'll use the term "cubicle automaton" just so that you're not offended.

And I will also apologize to this hypothetical person - this said cubicle automaton, that you believe I've called a name.

Be well.
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No. 64
Old May 21, 2009, 10:42 PM

Default Re: Talk of insurance mandate growing
Here is a California Nurse's Association article about insurance mandates and "limited benefit" health insurance policies.


http://www.calnurse.org/media-center...temID=29182756
Just a few days before gallbladder surgery, she found out from a hospital that the little-known kind of policy she bought 2½ years ago would cover only a small portion of the bills. She will pay thousands of dollars out of her own pocket because the policy caps payouts for various services at very low amounts.


"I cried for two days because I didn't know what I was going to do," said White, an instrumentation technologist in Lake Jackson, Texas, who had to have her gallbladder removed before it ruptured. "I was just devastated. I was angry."
White, 34, has a "limited benefit plan," which employers increasingly offer hourly, part-time and temporary workers, and insurers such as Aetna and CIGNA see as a growing opportunity.


In a nation of 46.6 million uninsured, including 407,000 in Connecticut, the plans have spurred impassioned debate about the question "Is something better than nothing?" and whether they're a good step toward universal health care.

The plans' premiums are thousands of dollars cheaper than regular health insurance, sometimes costing less than $1,000 a year for an individual...

Not all buyers may understand that limited benefit plans, unlike high-deductible health insurance or home and auto coverage, aren't meant to cover life's catastrophes. Insurers insist their marketing doesn't try to portray the plans as comprehensive coverage for serious illness.

It seems many people don't understand what limited benefit plans are, and how they aren't the answer to those lacking coverage.
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No. 65
from blue note
Old May 21, 2009, 10:55 PM

Default Re: Talk of insurance mandate growing
Originally Posted by DrugReptoNurse View Post
I do take offense to "cubicle monkey"

As an African America the word monkey obviously is offensive to me when used in your context.
I think that if you had noted the reason for your objection to the term in the first place, it would have been respected. I certainly hope you aren't implying that anyone using the term was being racist to you since no one would have had any idea you were African American until you said you were. I would not be tossing out "lack of character" accusations over something like this.

And while you may be offended, the term itself does not have any racial connotation whatsoever.

As defined by the urban dictionary, it means, "An anonymous, soulless white-collar cubicle dweller." Personally, I've always preferred calling them bean counters.
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No. 66
Old May 21, 2009, 10:57 PM

Default Re: Talk of insurance mandate growing
Originally Posted by DrugReptoNurse View Post
I do take offense to "cubicle monkey"

As an African America the word monkey obviously is offensive to me when used in your context.

I would say about 1/4 of the insurance auditors I worked with at PacifiCare were African Americans. Yes, it does offend me as I am sure it would offend my prior coworkers.

I believe when you spiral down into name calling #1 It shows a lack of character and #2 It weakens your arguement.
I don't think anyone here wants to offend you. Here's my understanding of what a cubicle monkey is:

http://www.urbandictionary.com/defin...bicle%20monkey

An anonymous, soulless white-collar cubicle dweller.
Bob is a cubicle monkey. He works from nine to five doing God-knows-what under fluorescent lights in a moveable three-walled office.
However, we aren't going to let you change the subject and get away with hawking a $50 a month junk insurance plan as the solution to our nation's health insurance problem.
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No. 67
from blue note
Old May 21, 2009, 10:58 PM

Default Re: Talk of insurance mandate growing
Originally Posted by multicollinearity View Post
It seems many people don't understand what limited benefit plans are, and how they aren't the answer to those lacking coverage.
I am sure that when they really need to use the plan for a major illness, they will understand the small print all too well, and then, it'd be too late.
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No. 68
Old May 21, 2009, 11:06 PM

Default Re: Talk of insurance mandate growing
Apology accepted and I can see the merits of the misunderstanding.

With that being said....yes I have health insurance. Yes, my son had a major hospitalization and it was covered. Yes, I pay less than $50 a month for what I need. It doesn't cover everything, but it meets my needs.

Obama and the rest of the Democratic party have it wrong when it comes to single payor coverage. It won't work in America and I believe the majority of Americans wont' go for it once they realize the true costs.

Obama is a great orator and the Democrats are going to have the power in the Congress for at least another 22 months. They may just pass socialist health policies. I hope not. America was not built upon socialism. It was built upon capitalism.

I would respond more to this topic but it is taking away from my anesthesia studies.
Finally, I still believe and will always believe, if you can't pay for it, you can't have it.
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No. 69
from blue note
Old May 21, 2009, 11:08 PM

Default Re: Talk of insurance mandate growing
Originally Posted by multicollinearity View Post
I don't think anyone here wants to offend you. Here's my understanding of what a cubicle monkey is:

http://www.urbandictionary.com/defin...bicle%20monkey
Hah! Snap!

However, we aren't going to let you change the subject and get away with hawking a $50 a month junk insurance plan as the solution to our nation's health insurance problem.
Why, that would be playing the race card, wouldn't it?
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