Health Care in the USA question?

Middle class America is the bulk of the workers here, and we have medical, dental, and vision insurance through our employers that is affordable for most. Those who do not have insurance can still go to the emergency room where no one is turned away or to one of the county hospitals or clinics. Contrary to what some people want you to believe, the sick and diseased are not wandering the streets of the US.

Any Pre-existing condition instantly gives the insurance companies permission to deny you insurance. I have heard so many stories of people who had health insurance and when they went into hospital and made a claim, the claim was denied because the insurance company claimed that it was a pre-existing condition.

MOST people nowadays have some pre-existing health condition. This is why it is so hard.

Having worked in customer service positions for the past 10 years I can tell you most companies do not offer health benefits to their "peon" employees. Starbucks is not the norm. Also, my friend who works full-time for starbucks had to work for 6 months before be allowed to sign up for health benefits. She told me part-time employees have to work a year before being allowed to sign-up for health benefits. Health insurance costs employers money. Most companies want to make and keep their money. So they either opt not to offer health benefits at all OR because most employees in those positions don't last very long they put stipulations like working a whole year because they firgure most employees will leave before a year is up and therefore save money.

You can purchase an individual health care plan from insurance companies if your employer doesn't offer it. You pay a set monthly amount and you have insurance. Unfortunately you have to answer a ton of questions about your present health, past surgeries, past injuries, present and past prescibed medication, how many times you been to the doctor in the last year, etc. Health insurance companies want to make money so they only want to insure people who NEVER go to the doctor. If you have any pre-exisiting conditions, hospital stays, injuries, etc in the last 10 years they can refuse to cover you OR charge you insane monthly fees. I have depression and for me to be covered on an individual plan it's over $300 per month. Most people can't afford this. Especially families who need to cover more than one person. My dad owns a small business so he has to have the individual plans. For him, my mom, and my two sisters (minors) it's $1700 per month. The majority of families in the US do not have that money and the ones who do have employers who provide insurance anyway.

As far as the person who said you don't need insurance just go to the emergency room. I work in the healthcare field so I hear a lot of stories the general public doesn't hear. A hospital will most likely get it's money from an insurance company. However, if someone shows up who doesn't have insurance but doesn't have money either the hospital will likely have a hard time getting it's money. So patients with insurance are usually treated better and before patients without. Sometimes hospitals downright refuse to treat patients without insurance. There was a situation with a patient who was being cared for at a hospital in the US. He was paralized from the waist down. On the day he lost his insurance the hospial loaded him up in the hospital van and dumped him in an alley in the ghetto. Fortunately he had many witnesses to this AND some good samaritans stopped to help him. He sued the hospital and now is getting a large sum of money. Another instance a lady was taken to a hospital in California bleeding fairly severly. She had no insurance. The hospital refused to treat her and she bled to death. They even called the janitor to mop up the blood but just let her die. Last I heard that hospital had closed and the entire staff was being replaced. You can go to www.fiercehealth.net (I might have spelled that wrong, try switching the i and e if so) and sign up for their news letter if you want to read more about the people without insurance.

It breaks my heart. 40 million of us don't have it. many self employed can't afford it. There are long waits to get it when you do get a job which offers it and sometimes you must decline it because it takes such a big chunk out of your paycheck. Elderly and children must choose between buying food or buying medication. But people here are selfish and they won't vote for a plan that covers them AND their neighbor so they rather not have coverage for themselves OR their neighbor.

If you are a small private business owner, it is difficult. Also Starbucks is an exception to the norm rather than the norm.

extremely HARD MY SON HAS cROHNS DISEASE i have fought for two years for help I pray each day that a new person will understand and help those like my son- some day maybe some day when we realize we must help our own country instead of others

Like you said - most jobs actually HAVE insurance...........so those without insurance don't have JOBS!!!!!!!!!!!!

He!l, working 12 hours a week at a local grocery store - one can get full Union Benefits. Healthcare, disability, profitsharing, etc................

All you need to do is go to the emergency room. You don't need insurance.

Starbucks apparently does offer insurance even to part-timers--may help explain what I hear they charge for their coffee (I can't afford them).

We have a VERY uneven and unfair health insurance system in the US. Approximately 60% of employers offer some manner of insurance--but the costs are rising so more and more of the cost of the insurance IS being passed on to employees. It is hard to get insurance on your own BECAUSE too many folks wait until they NEED insurance, thus resulting in higher rates IF they can get insurance. If they have an active medical problem at the time, they'll not be able to get coverage for it through individual insurance anyway.

The REAL problems, however, are these:

government MEDDLES in insurance. When they violated the Constitution during WWII and put wage and price controls in place, employers decided to offer health insurance (and other perks) to keep or attract the better workers as they couldn't do it via wages as they should. That association unfortunately stuck. Since that time, the feds unconstitutionally created Medicare (early '60s). They have NO jurisdiction to do that--see Amendments IX and X of the Constitution--STATES could do it, but not feds. Then LIARS came along and claimed that doctors were "getting rich" and "overcharging" people for health care and if only we'd trust LAWYERS and BUSINESSMEN to MEDIATE we'd all save bundles of money! Since pols saw a way to get their hand in the till and have more power over life and death, they jumped on this lie and repeated it constantly. "Managed care" was born and the health care field was hijacked. Now docs get very little of what they SHOULD get and HUGE sums are wasted going into the pockets of CEOs and insurance companies that do this with the aid of an idiotic government that refuses to enforce antitrust laws or contract law. Thus, the taxpayer takes it in the pocketbook constantly, some people are bankrupted, and doctors can even be driven into bankruptcy dealing with these THIEVES aka insurance companies.

Documentation follows because I'm telling the truth which people don't want to accept because it's scary to realize what's been done and it's easier to participate in the mud wrestling over UHC instead of addressing the REAL issues.

First, see Medicare (the "ideal" to a lot of UHC folks who either are ignorant or disingenuous):

In the US, Medicare is going bankrupt. In 1998, Medicare premiums were $43.80 and in 2008 will be $96.40--up 120%. "Medigap" insurance is common because of the 20% co-pay required for service. Medicare HMOs are common because they reduce that burden without an extra charge in many cases. HOWEVER, many procedures which used to have no or a low co-pay NOW cost the full 20% for the HMO Medicare patient. ALSO the prescription coverage they tended to offer has been REDUCED in many cases to conform to the insane "donut hole" coverage of the feds. Doctors are leaving Medicare because of the low and slow pay AND because the crazy government wants to "balance" their Ponzi scheme on the backs of doctors.

"That dark cloud lurking over the shoulder of every Massachusetts physician is Medicare. If Congress does not act, doctors' payments from Medicare will be cut by about 5 percent annually, beginning next year through 2012, creating a financial hailstorm that would wreak havoc with already strained practices.

Cumulatively, the proposed cuts represent a 31 percent reduction in Medicare reimbursement. If the cuts are adjusted for practice-cost inflation, the American Medical Association says Medicare payment rates to physicians in 2013 would be less than half of what they were in 1991."

http://www.massmed.org/AM/Template.cfm?Section=vs_...

Only IDIOTS want to NOT pay the ESSENTIAL personnel in health care, which is the PHYSICIANS, most definitely not the bureaucrats. It's getting harder and harder to find docs who will put up with Medicare and anyone who's intelligent can see why.

Antitrust violations:

A 2006 article, “U.S. Health Insurance: More Market Domination, More CEO Compensation”

(hcrenewal.blogspot.com) notes that in 56 percent of 294 metropolitan areas one insurer “controls more than half the business in health maintenance organization and preferred provider networks underwriting." In addition to having the most enrollees, they also are the biggest purchasers of health care and set the price and coverage terms. “’The results is double-digit premium increases from 2001 and 2004—peaking with a 13.9 percent jump in 2003—soaring well above inflation and wages increases.’" Where is all that money going? The article quotes a Wall Street Journal article looking at the compensation of the CEO of UnitedHealth Group. His salary and bonus is $8 million annually. He has benefits such as the use of a private jet. He has stock-option fortunes worth $1.6 billion."

--Save America, Save the World by Cassandra Nathan pp. 127-128

Contract law violations:

Linda Peeno, MD testified that SHE had often denied treatment JUST to save the insurance company money (http://www.thenationalcoalition.org/DrPeenotestimo...

Furthermore:

"the vast majority of health insurance policies are through for-profit stock companies. They are in the process of “shedding lives” as some term it when “undesirable” customers are lost through various means, including raising premiums and co-pays and decreasing benefits (Britt, “Health insurers getting bigger cut of medical dollars,” 15 October 2004, investors.com). That same Investors Business Daily article from 2004 noted the example of Anthem, another insurance company. They said the top five executives (not just the CEO) received an average of an 817 percent increase in compensation between 2000 and 2003. The CEO, for example, had his compensation go from $2.5 million to $25 million during that time period. About $21 million of that was in stock payouts, the article noted.

"While growing into a colossus, UnitedHealth has repeatedly failed to perform its basic job of paying medical bills. UnitedHealth, which covers 70 million Americans, has been sanctioned in nine states for paying claims slowly; shortchanging doctors, hospitals, or patients; or poorly handling complaints and appeals.

One Nebraska woman complained to state regulators that UnitedHealth's computers had incorrectly rejected claims related to her son's surgery six times.

At one point, UnitedHealth owed Dr. George Schroedinger, an orthopedic surgeon, $600,000. He and his clinic sued UnitedHealth of the Midwest in 2004.

Deciding for the clinic, U.S. District Judge Stephen Limbaugh of Missouri declared that the company's claims processing systems were "flawed in many ways, denying, reducing, and improperly processing claims on a regular basis. And despite innumerable requests, United was unwilling to remedy the underlying errors in its systems" (Star-Tribune Dec. 12, 2007).

Payment troubles continued after the verdict, and Dr. Schroedinger filed a second lawsuit. "These people can never get it right, which says to me that they just plain lie," he said in an interview.

Failure to pay isn't the only complaint. The insurer also gives incorrect information on which physicians are in its network, creating enormous problems for physicians' staff.

The AMA said that no other insurer has prompted as many complaints as UnitedHealth about abusive and unfair payment practices. AMA officials have met with UnitedHealth executives 16 times since 2000, with little to show for it.

"They have always got a new plan to fix it," said Dr. William G. Plested III, past president of the AMA. But "nothing ever happens."

It seems to us that this case is just the tip of the insurance iceberg. More and more stories are appearing daily in the news media about how insurance company are instructing employees their jobs are to deny claims and/or delay payments.

With such a high percentage of medical premiums and other costs going to the legal profession, to maintain compliance with endless government rules/regulations and being hoarded by the insurance companies and executives — is it any wonder medical costs are increasing so dramatically?

It's time to take a closer look at the medical insurance companies.

UnitedHealth Group is not the first medical insurance company to rob patients, hospitals and clinics to pay obscene salaries to their executives.

It's a modern day robbing patients to pay pimps.

Michael Arnold Glueck, M.D., comments on medical-legal issues and is a visiting fellow in economics and citizenship at the International Trade Education Foundation of the Washington International Trade Council.

Robert J. Cihak, M.D., is a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons.

http://www.newsmax.com/medicine_men/medical_insura...

Further evidence that the hijacked system is seen as a fertile ground for the predatory:

Hospitals especially and some docs have become so aggressive about medical bills that that bankruptcy issue is likely to get worse http://www.businessweek.com/bwdaily/dnflash/conten...

BTW, in the US bankruptcies more than 50% of the time are over medical bills AND in 75% of the cases, the people have insurance. The public refuses to listen to these FACTS, but you can see one such case (with those figures included) here:

http://www.msnbc.msn.com/id/20201807/

NONE of our candidates have anything remotely like a solution to the ACTUAL problems in the field--none have even admitted to what the problems are or how to fix them. T