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Health Insurance

Discussion in 'Political Debate & Discussion' started by SolaSaint, Sep 14, 2010.

  1. Gold Dragon

    Gold Dragon Well-Known Member

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    Thanks! I didn't realize that the cost of these emergencies was completely unfunded by the federal government and carried entirely by the hospitals. How did hospitals allow that bill to pass as stated? I understand requiring hospitals to provide care in these situations, but to do so without any funding at all?
     
    #41 Gold Dragon, Sep 20, 2010
    Last edited by a moderator: Sep 20, 2010
  2. FR7 Baptist

    FR7 Baptist Active Member

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    I agree that it is a problem, which is part of why I support universal healthcare. What happens is if the patient has no insurance, he will be billed for the cost of the care. In theory, he is obligated to pay it, but if he has no money the hospital has to write off the cost.

    With that law, hospitals are in theory free to decline care on the basis of ability to pay, but they wouldn't get anymore Federal money which means that they couldn't take Medicare or Medicaid and then old and poor people would go to other hospitals which would cost them much of their business. Hospitals get anywhere from 40 to 60% of their revenue from Medicare, and that's not counting Medicaid and TriCare, which are also Federal.
     
  3. carpro

    carpro Well-Known Member
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    You've come close to identifying the problem, but like most liberals, your "solution" will make the problem worse by increasing the cost of healthcare and, at the same time, lowering the quality and availability, especially for the elderly.

    Government caused the problem and can't fix it. More government interference will only make it worse.
     
  4. billwald

    billwald New Member

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    >About 30% are for-profit and 70% non-profit.

    People who think "non-profit" means "less greedy management" are deluded. Consider the AARP, for example <G>
     
  5. carpro

    carpro Well-Known Member
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    AARP is now an insurance marketing firm, not an advocate for members.
     
  6. blackbird

    blackbird Active Member

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    I was born in '59---and can remember as a child my dad and his family talking about "So and so had to go to the Poor House"---or sent to the "Poor Farm"-----LBJ phased all of that out in '65

    I've heard of people actually escapeing from the "Funny" farm----but there was no escape from the Poor Farm!!!!
     
    #46 blackbird, Sep 21, 2010
    Last edited by a moderator: Sep 21, 2010
  7. FR7 Baptist

    FR7 Baptist Active Member

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    Gold Dragon, how does the healthcare delivery and payment system in Australia work?
     
  8. Don

    Don Well-Known Member
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    I'm interested in hearing first-hand experience with the Australian health care system.

    In the early 90's, I had the opportunity to live in England for a few years (military). My wife developed a problem that the base hospital couldn't deal with, so we were referred off-base. We were directed to make contact with the English medical system. It took 6 weeks to get the first appointment. At that appointment, we were told she needed a bone scan; the first available appointment for that was 6 months.

    She lived on Tylenol 3 for the remaining year we were in England. There were times that I literally carried her up and down the stairs, taking care of her and our two children (both under 6) while working 12-hour shifts. I don't write that to garner sympathy; I write that because I am not unique. There were many English citizens facing the same waiting times while dealing with the same type of situations.

    Upon returning to the US, we were still required to go off-base because the military didn't have doctors who could deal with her situation; but we were able to get a series of appointments and full treatment within 3 months.

    Granted, that was the early 90's.

    I'm interested in hearing about experiences in other countries.
     
  9. Salty

    Salty 20,000 Posts Club
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    and don't forget the extremely high amount of malpractice insurance that doctors must carry, due to the ridiculous amounts awarded by uninformed juries
     
  10. Gold Dragon

    Gold Dragon Well-Known Member

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    Australia has an interesting mix of public and private health.

    The public system (Medicare) for citizens and permanent residents is funded by a 1.5% Medicare levy for everyone who pays income tax. High income australians are encouraged to purchase additional private health insurance by being charged an additional 1% tax if they do not get coverage.

    Plans range from $30/month for basic single adult coverage to $500/month for comprehensive family coverage (dental, physio, etc). The government has set up a website to compare plans that is probably similar to what Obama wants in a Health Insurance Exchange.

    Federal funds are distributed to the states who run their own separate systems with their own policies, reimbursement rates and public hospitals. The states also fund about 20% of the cost of health care from their own budgets.

    3 different hospital scenarios with medicare
    1) public patient in public hospital: normal treatment, normal queue, no choice in doctor, no medical bill

    2) private patient in public hospital: normal treatment, normal queue, choice in doctor, 75% of medicare fee is covered by Medicare

    3) private patient in private hospital: better treatment?, faster queue?, choice in doctor, 75% of medicare fee is covered by Medicare

    Private hospitals can charge significantly more than the medicare fee and private insurance covers the gap. If you don't have Medicare then you pay out-of-pocket or through overseas visitor health insurance in either system.

    Most private hospitals are located near a major public hospital. Private hospitals are considered a luxury (single rooms nicely furnished, better food, shorter queues). But the best physicians and surgeons usually work in both systems so there isn't a talent drain away from the public system. While this isn't a requirement, there seems to be other factors I am not aware of that make this arrangement more attractive than simply working for the private system.
     
    #50 Gold Dragon, Sep 22, 2010
    Last edited by a moderator: Sep 22, 2010
  11. Gold Dragon

    Gold Dragon Well-Known Member

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    For out of hospital consultations, doctors are able to charge whatever rate they want. Patients pay out-of-pocket and are later reimbursed a fixed amount if they have medicare.

    Most doctors want to avoid chasing after patients who have difficulty paying so the option of "bulk-billing" exists. In this scenario, patients are not charged anything upfront but doctors only recieve 75% of the medicare fee. They normally get 85% plus whatever rate they charge on top of the medicare fee if they don't bulk-bill.

    The final significant cost is medications. Selected drugs (commonly used, cost effective ones) are covered under the PBS or Pharmaceutical Benefits Scheme for people with Medicare. When buying generics or drugs still under patent, the most you can be charged under the PBS is a copayment of $33.30 per drug. For concession holders like veterans and welfare recipients, the copayment is $5.40. There is also a "Safety Net threshhold" where if you have payed up to a certain amount in copayments for the year, you move to the concession rate. There is a surcharge for wanting brand name drugs when generics are available. Some particularly expensive drugs require special authorization by your doctor to confirm need before they can be filled.

    I am a visa student and do not have medicare. But my overseas health coverage plan is very reasonable. It doesn't cover everything but I can usually get 50-85% of the fees back. We have had to use a lot of services in the last year or so with my kids. Ability to pay has never factored into care. They just send us the bill which never has a late payment date. I've paid for medical bills 6 months later and not had any penalty.

    My daughter has had non-urgent elective surgery and had to wait a week which I would say is a fabulous wait time. Our specialist appointments can usually be made within the month if not within two weeks. Our GP appointments can usually be made the day of or the day before. Our biggest beef with the public system is waiting during out-patient clinics which has taken up entire days because of their terrible scheduling system. Emergency wait times for non-urgent cases have generally been good for us compared to our experiences in Canada, usually within the hour.

    Of course, we live in an affluent, well-serviced area of Sydney so the experience obviously varies for other places, particularly rural and remote Australia which makes up a significant portion of the country.
     
    #51 Gold Dragon, Sep 22, 2010
    Last edited by a moderator: Sep 22, 2010
  12. Don

    Don Well-Known Member
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    Very interesting. What about your experience(s) in Canada?
     
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