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Attacks mount on 'preexisting conditions'

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Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

most americans today get health coverage through group plans offered by employers. when workers receive insurance through their jobs, an insurer cannot exclude them from coverage, or charge more, because of a preexisting condition ....not so for individual coverage... thankfully, president obama plans to change that discrepancy.

attacks mount on 'preexisting conditions' | philadelphia inquirer ...

health care costs to top $8,000 per person

taxpayers set to pay half of us health care bill by 2016

...read more

Taxpayers already pay 60-80% of health care costs. See PNHP.org....

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

Watch this and then try to rationalize how for-profit healthcare has any moral right to do business.

RN., MSN, RN

Specializes in Perianesthesia. Has 30 years experience.

I couldn't get the player to work on my computer today because I'm a virus freak and have apparently overdone the virus protection, but I read a lot of the posts. Some of them were pretty interesting viewpoints, such as "whatever you've been drinking, share it." LOL

Something needs to change. We've got to start doing something differently.

Edited by RN.
clarification

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

Blue Cross refused to pay for cancer treatment.

HOW is THAT OK?

Adrian Campbell-Montgomery, a mother of two, described how Blue Cross in 2004 denied payment to a Southeast Michigan hospital where she was treated for cancer.

"I was 22-years-old and needed surgery. I got a bill for $8,000 that I couldn’t pay," Campbell-Montgomery said. "Blue Cross denied payment because there were recommendations you needed to be 26 years or older for that kind of surgery."

Two weeks ago, Campbell-Montgomery received more bad news. She was diagnosed with ovarian cancer.

"I already owe $10,000 for that. I am trying to get Medicaid. Where does this end? You have to stop denying people," she said.

http://www.crainsdetroit.com/article/20090312/FREE/903129971

Another article:

http://www.detnews.com/apps/pbcs.dll/article?AID=/20090313/POLITICS/903130349/1408/LOCAL

Honnête et Sérieux

Specializes in Flight Nurse, Pedi CICU, IR, Adult CTICU.

Watch this and then try to rationalize how for-profit healthcare has any moral right to do business.

They have just as much "right" as the gov't does to "do business."

I see lot's of criticism like this directed toward non-gov't payors, but I never see anyone present any evidence that a gov't program is somehow more eager to pick up the tab for these illnesses.

Fact; cervical cancer mortality in the United States is about HALF of what it is for the rest of the world...with some rare exceptions among some countries that don't host comparative numbers of minorities which experience higher rates of cervical cancer, the single-payor/nationalized/socialized/(insert your label here) nations suffer twice the mortality from cervical cancer than we do.

I'm not sure why anyone would want to expand that kind of suffering here.

The gov't denies 'coverage,' too.

Katie82, RN

Specializes in Med Surg, Tele, PH, CM. Has 39 years experience.

They have just as much "right" as the gov't does to "do business."

I see lot's of criticism like this directed toward non-gov't payors, but I never see anyone present any evidence that a gov't program is somehow more eager to pick up the tab for these illnesses.

I'm not sure why anyone would want to expand that kind of suffering here.

The gov't denies 'coverage,' too.

There is a program - called the Breast and Cervical Cancer Screening Program (BCCP). It is a federally funded program usually administered by local Health Departments. Every state has one. It is primarily focused on screening of uninsured (and underinsured) women, but it also pays for treatment. Adrienne would have been a perfect fit for this program. As I am watching this video, I ask myself why this young women developed Cervical Ca (and as a result of mets, Ovarian Ca) in the first place. As an old Women's Health nurse, I can tell you Cervical Ca is almost always preventable, and takes years of neglect to develop. As I listen to her, I am reminded of all the patients I had who either failed to get annual Pap Smears or ignored the recommendations for follow-up of an abnormal one. All these services are free to those who cannot afford them at any local Health Department under a Title X Program - also federally funded.

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

There is a program - called the Breast and Cervical Cancer Screening Program (BCCP). It is a federally funded program usually administered by local Health Departments. Every state has one. It is primarily focused on screening of uninsured (and underinsured) women, but it also pays for treatment. Adrienne would have been a perfect fit for this program. As I am watching this video, I ask myself why this young women developed Cervical Ca (and as a result of mets, Ovarian Ca) in the first place. As an old Women's Health nurse, I can tell you Cervical Ca is almost always preventable, and takes years of neglect to develop. As I listen to her, I am reminded of all the patients I had who either failed to get annual Pap Smears or ignored the recommendations for follow-up of an abnormal one. All these services are free to those who cannot afford them at any local Health Department under a Title X Program - also federally funded.

Lack of education regarding the need to get a test.

Or not knowing about the program?

Or when she was insured maybe her primary care practicioner didn't do one?

Regardless doesn't she deserve treatment now?

truern

Specializes in Telemetry & Obs.

I can't complain about my BCBS thru WakeMed. Every surgery I had this past year cost me $50...even the one that was over $16,000. They've been great to me.

Insurance is a major concern for me as a cancer survivor. I hate to think what I'd have to pay with a private policy IF I could get one.

WildcatFanRN, BSN, RN

Has 25 years experience.

I'll be glad when I'm working again so I can get insurance. I don't qualify for government assistance as I have no kids. So, I'm unemployed, uninsured and very glad I will be starting a job soon so I can finally have insurance again to afford to actually see a Dr to care for a few things.

Most of the people who I hear or read about who are totally against any kind of universal healthcare are usually people who actually have healthcare. When I was in AZ I tried to apply for the State healthcare program, only to be told I made too much money. I would have only been allowed to make $780/month which meant I would have only been able to work about 2 shifts a month since I was working agency nursing at the time. If I had kids, I would have been able to get coverage. Actually, I could get coverage right now if I were to get myself pregnant....not a good reason to do so IMO.

When I worked agency several years ago, I tried to get individual coverage but would have had to pay $500/month at least and my HBP would not have been covered for 12 months since I had been treated for it before. $500/month doesn't sound bad, unless you take into consideration that agency isn't guaranteed shifts.

All, I hear are reason why NOT to do something. "it costs too much", "taxpayers pay too much already for underinsured/uninsured", "the govenment shouldn't be in the business of insurance coverage", etc ad nauseam. I haven't heard anyone give any real consideration that something needs to be done. I personally would like all those against covering people who can't otherwise get healthcare come up with an idea themselves instead of blasting those actually trying. No, not every idea or system works well for everyone.

Oh, btw there is a free clinic. Too bad its first come, first served. I went once with a knee injury but because I made a certain amount the year before I didn't qualify to be seen. Wasted 4 hours waiting in line outside only to be told I had made to much money the year prior to be seen. Funny isn't it?

I just want someone to fix the problem and stop arguing on what to call it, who will pay for it, or whatever. I am just tired of hearing about how American's won't pay for a universal system....ok will American's pay for something that everyone can afford?

BTW, I have preexisting conditions that IF I had the money to get individual coverage would not be covered for at least 12 months. For this reason alone, I doubt I'll ever bother attempting to get individual coverage even when I'll be able to afford to.

Edited by WildcatFanRN
needed to add more

Honnête et Sérieux

Specializes in Flight Nurse, Pedi CICU, IR, Adult CTICU.

All of these issues sound challenging and unfortunate, but there is no guarantee that a universalized program will fix them.

We have presented ideas. There are specific actions we can take which will make a big difference in improving delivery and reducing cost without pursuing a complete makeover of the industry just to make our problems look like everyone else's problems worldwide.

flightnurse2b, LPN

Specializes in EMS, ER, GI, PCU/Telemetry.

i can't even really comment on this without getting mad.

it brings tears to my eyes.

you guys know about my current struggle.

pregnancy is "pre-exisiting". gag me with a spoon.

you know, maybe the rate of abortion would go down for under/uninsured mothers if universal health care was available for all pregnant women. just a thought to throw out there. medicaid is not available to everyone in need, you know.

the struggle i went through just to get TWO MONTHS of supplemental coverage makes me so mad i want to spit nails and the only reason i was able to even get that policy is because i know the damn rules... otherwise i would have just said "oh, ok, thanks anyways" when the first clown i talked to told me i wasn't allowed to get an individual policy until my waiting period at the hospital is over so i don't have the 60 days coverage lapse causing me to wait 12 months.

my dad, the 9/11 survivor, who is on disability since about 2 years after the attacks (and he was a stock broker) due to severe PTSD and severe respiratory problems for which he remains oxygen dependent has actually gone to canada (and continues to go a few times a yr) to get health care because his COBRA ran out and my mom's plan will not accept him. his out of pocket costs for care on an individual plan for just one year ran him tens of thousands of dollars here in the wonderful united states of america.

my mom is a cancer survivor--got diagnosed @ age 35 with a sarcoma with mets to the ovaries, cervix and uterus. the "in-network" oncologist told her she had 3 months to live. so with 4 children, my mom got another opinion at a specialist who was out of network. the surgery to save her life cost over half a million dollars out of pocket. my parents were fortunate enough to be able to sell their home and move to a condo and cash in their retirement to pay for it, or else my mom would be in the ground right now.

and my bronchoscopy last year was deemed "medically unnecessary" last year by my insurance company, regardless of the 3cm lesion observed on CT Scan. the doctor was ruling out malignancy but because i was only 23 @ the time, i paid out of pocket for that too.

whatever. carry on.

challenging and unfortunate my tail.

unnecessary and sickening is more like it.

Honnête et Sérieux

Specializes in Flight Nurse, Pedi CICU, IR, Adult CTICU.

you know, maybe the rate of abortion would go down for under/uninsured mothers if universal health care was available for all pregnant women. just a thought to throw out there. medicaid is not available to everyone in need, you know.

This data is available.

Although it is variable, it doesn't speak well for universalized systems like Sweden, the UK, or N. Zealand...and if you believe Cuba's stats, their abortion doctors are some of the busiest in the world.

Our abortion rates are dropping without changing the system.

flightnurse2b, LPN

Specializes in EMS, ER, GI, PCU/Telemetry.

This data is available.

Although it is variable, it doesn't speak well for universalized systems like Sweden, the UK, or N. Zealand...and if you believe Cuba's stats, their abortion doctors are some of the busiest in the world.

Our abortion rates are dropping without changing the system.

do you have an article i can look @ with these rates?

i believe in the countries you have mentioned, sweden especially, that abortion is not as "taboo" as it is here in the united states.

Honnête et Sérieux

Specializes in Flight Nurse, Pedi CICU, IR, Adult CTICU.

do you have an article i can look @ with these rates?

i believe in the countries you have mentioned, sweden especially, that abortion is not as "taboo" as it is here in the united states.

That's quite possible, but I didn't think we were discussing the morality or ethics of abortion (that is a black hole of bandspace), but rather I saw the idea introduced that abortions would decrease in a UHC system...to me it seemed like an epidemiological statement, not a moral one.

I was just pointing out that abortions are decreasing in the US, but were more common in places like Sweden and N. Zealand, and were escalating in places like the UK.

That was all.

WildcatFanRN, BSN, RN

Has 25 years experience.

I find it amazing how one can be against any form of universilized healthcare. There are ways of doing it where its a single payor system where EVERYONE can actually afford care, and the doctors not the for profit insurance companies, make decisions on care for patients.

My finance is on social security disability. He has medicaide. Guess what, it covers absolutely nothing unless he's admitted to the hospital. No doctor takes it, nor can he afford the so called perscription coverage. He had a brain tumor removed several years ago and is supposed to have MRI's every year. Guess what, his neurologist dropped him since he no longer had insurance. Hasn't had any of his follow up MRI's and won't until we get married and I have group insurance that I can add him too. Of course with our luck, it will be considered preexisting and it won't be covered.

But I guess this too is challenging and unfortunate. No, there is no guarantee that a universilized system will fix anything. But the status quo fixes I've read about from those against a universilized system just seems to be the same old nothing. Btw, why do we have to look to other countries systems. I am sure we can come up with our own unique system that works well for us. Take the best of what works, and throw out what doesn't. A system where doctors are trusted to do what is right by their patients, not what some pencil pusher at an insurance company wants them to do. Will a universilized system do this, probably not. But it might. At the rate things are going, we may never know. Too many people are afraid to try.

flightnurse2b, LPN

Specializes in EMS, ER, GI, PCU/Telemetry.

That's quite possible, but I didn't think we were discussing the morality or ethics of abortion (that is a black hole of bandspace), but rather I saw the idea introduced that abortions would decrease in a UHC system...to me it seemed like an epidemiological statement, not a moral one.

I was just pointing out that abortions are decreasing in the US, but were more common in places like Sweden and N. Zealand, and were escalating in places like the UK.

That was all.

believe me when i tell you if anyone on this board doesn't wanna debate the ethics of abortion, it's me.

i was just saying that possibly the statistics there are higher because it's a more widely accepted practice in those areas, as opposed to here.

i just wonder if the expenses of having a baby were covered for EVERYONE, if people would feel better about keeping their baby since their prenatal care and delivery would not cost them thousands of dollars.

Most of the people who I hear or read about who are totally against any kind of universal healthcare are usually people who actually have healthcare.

Careful with this, or the anti-generalization/judgmental team will come out and attack! :uhoh3:

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