"Healthcare" in the US

[CRI]

I was thinking that was the case but was reluctant to say as the US health insurance system seems fiendishly complicated...

Sorry - lost the link to the dental care story, and can't find it now! It was cases of two people who couldn't afford dental care. One went to the ER (and Republicans keep saying because you can get emergency care there, that goes far enough in terms of "access to health care,") and was prescribed antibiotics he couldn't afford. Both ended up with dental abcesses that turned to septacaemia and they died.

 

[CRI]

House Democrats are up in arms over the Trump administration’s move to slash teen pregnancy programs, pressing officials to justify the decision.

The grants provided under the TPPP were slated to extend for five years, but in a quiet move earlier this month the Trump administration trimmed two years off of that window.

Adopted by Congress in 2010, the TPPP grants millions of dollars to local governments, universities, nonprofit organizations and other groups that provide education and other “evidence-based” services designed to rein in teen pregnancies. More than 80 groups currently receive funding, according to HHS — a list as diverse as Oklahoma’s Choctaw Nation, the Boys & Girls Clubs of Greater Milwaukee, Hawaii’s chapter of Planned Parenthood and the University of Texas.

The TPPP cut arrives as teenage pregnancy in the United States is at a record low. Reproductive health experts have attributed the decline in large part to the heightened education of today’s teens and the greater availability of better birth-control regimens.

 

[TomUS]

Can't understand Americans simmering hatred of 'single payer' or as most would call it, universal health coverage.
Why is it always portrayed as a 'commie or socialist plot'?
Bugger, I'm starting to believe the stereotype 'most Americans are as thick as pigshit'

It's all about a health insurance industry making tons of money off an antiquated inadequate system for patients and putting out propaganda to keep the gravy train going.

 

[Yuwipi Woman]

McCain wasn't the only one to leave a sick bed to vote:

She got no standing ovation. She got no mainstream media lauds for her heroism. She got no kudos for leaving home, a much longer journey than that other senator, the one from Arizona, to get to DC, and there are no mainstream media stories on it that I can find… I only found out from a friend who spotted it on Twitter.

She didn’t do it for publicity.

Senator Mazie Hirono of Hawaii was just doing her job as a good politician, voting not to repeal the ACA so as to protect her constituents. She has Stage Four kidney cancer — that means scarce chances of survival — is recovering from a second surgery to remove part of a rib, and made sure she got to her seat in the Senate Chamber to vote “no” to whatever Republican wealth-care crap was thrown at her.

The heroic Senator with severe cancer who interrupted treatment to vote... NO

 

[Yuwipi Woman]

A couple distraught over health care costs jumped to their deaths in Murray Hill early Friday — leaving suicide notes pleading for their children to be cared for, a law enforcement source told The Post....

The woman had a suicide note in her pocket that said, “in sum and substance, ‘Our kids are upstairs, please take care of them,’” the source said.

The man also had a note in his pocket saying, “’We both have medical issues, we just can’t afford the health care.

http://nypost.com/2017/07/28/couple-jumps-to-their-deaths-because-they-cant-afford-health-care/

 

[spring-peeper]

A pending court decision could force the Trump administration to pump billions of dollars into Obamacare insurers, even as the president threatens to let the health care law “implode.”

Health insurers have filed nearly two dozen lawsuits claiming the government owes them payments from a program meant to blunt their losses in the Obamacare marketplaces. That raises the prospect that the Trump administration will have to bankroll a program the GOP has pilloried as an insurer bailout.

Insurers are owed more than $8 billion in payments, and the tab is likely to grow. Insurers say spending restrictions Republicans forced on the “risk corridors” program during the Obama administration, aside from being illegal, are partly to blame for severe turbulence in some Obamacare marketplaces.

Lawsuits could force feds to pay Obamacare insurers

 

[Yuwipi Woman]

Here it comes:

Just a few hours ago, he threatened that, if a new bill is not quickly passed, he would end "bailouts" for insurance companies and members of Congress.

[Update: To clarify, as some readers don't seem to know, what Trump referred to are not the risk adjustment payments that were made legally through 2016. He's talking specifically about the payments the government makes to underwrite the co-pay and deductible reimbursements to insurance companies for low-income people so the insurance companies are not forced to directly subsidize these amounts.]

For insurance companies, that likely means the subsidy payments that reimburse the additional costs of coverage for lower-income citizens.

The results would be ugly and an intentional action to undermine the mechanisms that make the ACA work. And now, as Politico reported, Senate Republicans are considering another attempt at repeal.

Trump Directs Threats Toward Poor People's Healthcare So He Can 'Win'

This is pretty much what I expected. They're going to make sure Obamacare fails by withholding its funding.

 

[Yuwipi Woman]

In a sign that the Democratic Party is embracing more progressive health care ideas, eight Democratic senators announced Thursday that they were co-sponsoring legislation that would allow people 55 and older to buy into Medicare.

Sen. Debbie Stabenow (D-Mich.) introduced the Medicare at 55 Act with the immediate support of Democratic Sens. Tammy Baldwin (Wis.), Sheldon Whitehouse (R.I.), Sherrod Brown (Ohio), Jeff Merkley (Ore.), Patrick Leahy (Vt.), Jack Reed (R.I.) and Al Franken (Minn.).

The bill, which would allow Americans aged 55 to 64 to purchase Medicare coverage, reflects the growing influence of progressive activists who are pushing for a single-payer health care system they dub “Medicare for all.”

Although the bill stops short of making Medicare universal, its embrace of expanded public health insurance, rather than the private model at the heart of the Affordable Care Act, or Obamacare, marks a distinct leftward shift for the party.

“People between the ages of 55 and 64 often have more health problems and face higher health care costs but aren’t yet eligible for Medicare,” Sen. Stabenow said in a statement. “If you live in Michigan, are 58 years old, and are having a hard time finding coverage that works for you, this bill will let you buy into Medicare before you turn 65.”

Senate Democrats Introduce Bill Allowing Medicare Buy-In At 55 | HuffPost

I'd love to see this. I'm 54 and would race to get out of the workforce, as would many people my age. One of the ongoing issues with the economy is that there's no jobs for younger people. How good would it be for the economy for people my age to be able to go out and start businesses? Or, feel comfortable taking other risks? That would open up a huge (Yuge!) numbers of jobs for younger people to move into "real" jobs, instead of the "mc"jobs, a lot of them are working just to survive.

The other benefit of this, is that once it was demonstrated to work, other age groups could be included as well. Start with 0-10, then 40-30, etc., until everyone is covered.

But, the reason this won't happen is very simple. Our politicians want people to be chained to their jobs. They want people to feel insecure, because its easier to control scared people and beholden people.

I also understand that Bernie Sanders is introducing a single payer bill soon. While I'd be happy to see that too, I don't think it would pass with the current Congress. It does, however, get the idea out there as a viable option for the future. Wasn't it Churchill who said that "you can count on the Americans to do the right thing, after they've tried everything else"?

 

[Yuwipi Woman]

No one should be surprised by this.

Diabetic man, 62, arrested for threatening Nevada senator over Obamacare with note reading 'If I'm going to die... I will take you with me'

A Las Vegas man has been taken into custody after police said he broke into a Republican senator's office and left him a threatening note about voting to repeal Obamacare.

The Las Vegas Metropolitan Police Department said in a statement that Richard Holley, 62, was arrested on Monday and is now facing charges of extortion, burglary and intimidating a public officer after allegedly leaving the threatening note outside Senator Dean Heller's office door.

Police: 'Threatening note' found near senator's office | Daily Mail Online

I've been to several town hall meeting with representatives and people are really angry, while their politicians have proven over and over that they aren't listening.

 

[Yuwipi Woman]

Just got next year's premium costs for health insurance this next year. It's not good. They've started to base our employer's plan premiums on the age of the enrollee. Since I'm now 54, that puts me in nearly the highest premium bracket. It looks like my portion of the premium will rise by $48.15 per pay period. If I were 55, it would rise by $56.94. If I were 64, the cost would rise by $128.20. We're told the rates go up again substantially on Oct. 1. So I get something else to look forward to next year.

The silly thing is that I still feel lucky. I still have health insurance, unlike millions of other people.

Sorry about the rant. I post this, in part, because I can't imagine I'm going to be the only one. All of the turmoil in American healthcare is going to bankrupt a lot of people. I used to say you can't afford to get sick. Now, you can't afford to be well either.

 

[StoneRoad]

That sucks, big time. IMO.
No idea how much this would be ... if not for the NHS.
My OH has had a gall bladder extraction in July (after three inpatient trips over the last two years, of between one and two weeks each time) and is now waiting for a "bionic hip" - as my niece describes it.

 

[spring-peeper]

Just got next year's premium costs for health insurance this next year. It's not good. They've started to base our employer's plan premiums on the age of the enrollee. Since I'm now 54, that puts me in nearly the highest premium bracket. It looks like my portion of the premium will rise by $48.15 per pay period. If I were 55, it would rise by $56.94. If I were 64, the cost would rise by $128.20. We're told the rates go up again substantially on Oct. 1. So I get something else to look forward to next year.

The silly thing is that I still feel lucky. I still have health insurance, unlike millions of other people.

Sorry about the rant. I post this, in part, because I can't imagine I'm going to be the only one. All of the turmoil in American healthcare is going to bankrupt a lot of people. I used to say you can't afford to get sick. Now, you can't afford to be well either.

Read somewhere that some areas are putting a rape premium that females should get - scary stuff!!! If you don't take rape insurance and you get raped, does the insurance company deny women medical help?

 

[8ball]

Sorry about the rant. I post this, in part, because I can't imagine I'm going to be the only one. All of the turmoil in American healthcare is going to bankrupt a lot of people. I used to say you can't afford to get sick. Now, you can't afford to be well either.

Frightening. I'm a mixture of clockwork and cybernetics these days, got a bunch of machines at home and lots of consumables and drugs to keep me going (and in many ways I'm healthier and fitter than I've ever been because of them). More operations in the future too. I shudder to think what my premiums would be in the States.

 

[spring-peeper]

Frightening. I'm a mixture of clockwork and cybernetics these days, got a bunch of machines at home and lots of consumables and drugs to keep me going (and in many ways I'm healthier and fitter than I've ever been because of them). More operations in the future too. I shudder to think what my premiums would be in the States.

I agree - it was hard enough to be a stay-at-home mom and making ends meet.
I see the US premiums and wonder how anyone can make ends meet.
Hubby was well paid - but we could not make it if we had to pay the US health premiums,
There are people down there (USA) whose minimum wage is peanuts - how do they survive?

 

[existentialist]

I agree - it was hard enough to be a stay-at-home mom and making ends meet.
I see the US premiums and wonder how anyone can make ends meet.
Hubby was well paid - but we could not make it if we had to pay the US health premiums,
There are people down there (USA) whose minimum wage is peanuts - how do they survive?

Given that 13% of the US population (as of April 2017, from here: The number of Americans without health insurance rose in first quarter 2017) don't have health insurance, I guess that's one way they manage.

And I guess others will go short on other things, just to be able to meet the premiums - but as Yuwipi Woman illustrates, you're chasing a moving target all the time, and I guess some people will just keep falling further and further behind.

I imagine that there are plenty of figures to illustrate the relationship of morbidity/mortality to income in the US, and presumably they show wider disparities than we might see in countries with socialised medicine.

The crazy thing is that I imagine there's still a cost to society. The US does seem, by and large, rather good at marginalising those who drop below the line, but there's only so little you can do, even if it's just having to take on the care of children orphaned by prematurely-deceased parents, or picking up the bodies of homeless people who've died of preventable diseases.

 

[Streathamite]

Just got next year's premium costs for health insurance this next year. It's not good. They've started to base our employer's plan premiums on the age of the enrollee. Since I'm now 54, that puts me in nearly the highest premium bracket. It looks like my portion of the premium will rise by $48.15 per pay period. If I were 55, it would rise by $56.94. If I were 64, the cost would rise by $128.20. We're told the rates go up again substantially on Oct. 1. So I get something else to look forward to next year.

The silly thing is that I still feel lucky. I still have health insurance, unlike millions of other people.

Sorry about the rant. I post this, in part, because I can't imagine I'm going to be the only one. All of the turmoil in American healthcare is going to bankrupt a lot of people. I used to say you can't afford to get sick. Now, you can't afford to be well either.

christ, this is frightening. You have my every sympathy. I am currently 3 weeks away from a hip replacement operation and - although I've been dreadfully disappointed with the level of are I have received from my local hospital, all i can say still is 'thank fuck for the NHS!'

 

[Yuwipi Woman]

christ, this is frightening. You have my every sympathy. I am currently 3 weeks away from a hip replacement operation and - although I've been dreadfully disappointed with the level of are I have received from my local hospital, all i can say still is 'thank fuck for the NHS!'

Good luck with the hip replacement. Be sure to do the exercises. I've heard that doing them before the surgery is beneficial too.

 

[Yuwipi Woman]

Given that 13% of the US population (as of April 2017, from here: The number of Americans without health insurance rose in first quarter 2017) don't have health insurance, I guess that's one way they manage.

And I guess others will go short on other things, just to be able to meet the premiums - but as Yuwipi Woman illustrates, you're chasing a moving target all the time, and I guess some people will just keep falling further and further behind.

Essentially, I just took a pay cut of around $1,200. That's all money that I would have spent in the local economy. I usually take a trip to Kansas to an environmental conference in the fall. I'm thinking that's $300 worth of hotel rooms, I won't be spending this year.

I imagine that there are plenty of figures to illustrate the relationship of morbidity/mortality to income in the US, and presumably they show wider disparities than we might see in countries with socialised medicine.

These are the official statistics for the place I live direct from the County Health Department. As you can see there's a clear difference in life expectancy by neighborhood. I live in Census tract 5. As you would expect, its a poorer neighborhood that houses a lot of refugees, recent immigrants, a number of half-way houses for drug treatment etc., and working class folks of all races. Census tract 37 is where all the higher income people live. It's also where all of the hospitals, supermarkets, and health clubs are. There's a difference of nearly 28 years in life expectancy between them.

Of the two, census tracts are closer to matching neighborhoods. The map above shows the dramatic differences in life expectancy in the county, especially the vast differences in life expectancy in Census tracts 5 (63.4 years) and 10.2 (67.3 years) versus Census tracts 37.13 (91.2 years) and 11.02 (94.7 years). While the wide variation in the computed life expectancies has drawn a great deal of attention, values aside, the differences in life expectancy across the City is shown by the shading and the actual values are less important. The Health Department and other City agencies produced a series of census tract maps for the Community Health Endowment’s “Place Matters” project. Some of the maps and the differences they display (e.g., differences in life expectancy and poverty among census tracts) are discussed in the profile and many more maps are included in Appendix

The full report is here and this bit above starts on page 21: http://lincoln.ne.gov/city/health/pde/pdf/CommunityHealthProfile.pdf

The crazy thing is that I imagine there's still a cost to society. The US does seem, by and large, rather good at marginalising those who drop below the line, but there's only so little you can do, even if it's just having to take on the care of children orphaned by prematurely-deceased parents, or picking up the bodies of homeless people who've died of preventable diseases.

Just the economic knock-on effect has to be quite large. From the amount of screaming I hear, I'm far from alone. If the same pay cut applies to 10 million people. That's a lot of economic activity that isn't happening on Main Street. I've heard that when someone gets a paycheck, the money bounces around 6 times before it leaves a community. That bit of money I won't see in my paycheck, barely passes through my hands, before it leaves the community again.

We should also not disregard the effect on business. I had to soak up some extra costs, but my employer did as well. He covers 70% of the cost of health insurance so his increase in costs was actually greater than mine. It has to be enough to put some businesses under.

I'd also guess that you're going to have higher policing costs. If you speak to homeless people, a lot of the time the reason they're living on the street is because of a major illness wiping them out. Since we've decided to criminalize homelessness rather than house people, that's going to add to policing costs. And this is the amount of "solidarity" they get from their fellow citizens:

Man's sign telling panhandlers to 'get a job' in Omaha | Daily Mail Online

 

[Streathamite]

Good luck with the hip replacement. Be sure to do the exercises. I've heard that doing them before the surgery is beneficial too.

Thank you! yup, arthritis UK's exercise bits (on their website) has been v helpful.

 

[Streathamite]

What baffles me is this; Practically every single person with healthy insurance in the US is absolutely robbed blind, by both providers (both primary and secondary) and insurers. Americans spend much, much more (as %age of GDP) on healthcare than any other advanced-economy nation (i.e. nations one can reasonably compare to) - a whopping, eye-watering 17% (UK- 9%, Germany, IIRC c.12%), and get poorer, and more erratic care, on the whole, in return.
Yet for republicans/conservatives, it seems an article of faith that this is a price worth paying, to ensure they don't contribute to anyone else's care.
it's utterly bizarre.

 

[Pickman's model]

christ, this is frightening. You have my every sympathy. I am currently 3 weeks away from a hip replacement operation and - although I've been dreadfully disappointed with the level of are I have received from my local hospital, all i can say still is 'thank fuck for the NHS!'

best wishes for a swift recovery, streathamite

 

[equationgirl]

Yuwipi Woman your situation sounds horrendous. I have chronic health problems requiring constant medication (7 separate meds each day), stopping one of them could trigger a relapse potentially requiring hospital treatment within 48 hours.

If I was a US citizen I would live in constant fear of not getting the healthcare needed, plus the financial strain of an insurance policy. I don't know how you do it

 

[FridgeMagnet]

What baffles me is this; Practically every single person with healthy insurance in the US is absolutely robbed blind, by both providers (both primary and secondary) and insurers. Americans spend much, much more (as %age of GDP) on healthcare than any other advanced-economy nation (i.e. nations one can reasonably compare to) - a whopping, eye-watering 17% (UK- 9%, Germany, IIRC c.12%), and get poorer, and more erratic care, on the whole, in return.
Yet for republicans/conservatives, it seems an article of faith that this is a price worth paying, to ensure they don't contribute to anyone else's care.
it's utterly bizarre.

When I lived in the US I was working for big pharma (yeah yeah I know, we've all done some bad stuff when we were younger right). As you may imagine they get pretty good deals on health insurance for their employees, second only to if you actually work for an insurance company I suspect, plus free drugs if they're made by the pharma corp concerned.

Yet even then when I needed to use this it was massively shit and also expensive. The "network" thing was incredibly awkward and everything came with an extra price tag; not only drugs but you pay for every consultation, and it's not like things are any faster or more efficient. I must have racked up thousands of dollars in fees, over and above the insurance premiums, for worse care than I've got on the NHS.

Of course nowadays the problem with the NHS is getting seen at all due to cuts and overloading. That's the only way they can sell private health, the opportunity to jump the queue.

 

[NoXion]

Why not just fuck off the insurance and start a savings account? That way you can pay into the account whatever you feel like you can, and when you do need the money for something, you won't have the additional hassle of having to get blood out of the stone that is health insurance.

I'm guessing that there's good reasons why people don't do this, but what?

 

[TheHoodedClaw]

Why not just fuck off the insurance and start a savings account? That way you can pay into the account whatever you feel like you can, and when you do need the money for something, you won't have the additional hassle of having to get blood out of the stone that is health insurance.

I'm guessing that there's good reasons why people don't do this, but what?

Pooled risk*. You're unlikely to be able to save up enough to pay for multi-year cancer treatment out-of-pocket.

*notwithstanding the shitness of the US system of course

 

[FridgeMagnet]

Why not just fuck off the insurance and start a savings account? That way you can pay into the account whatever you feel like you can, and when you do need the money for something, you won't have the additional hassle of having to get blood out of the stone that is health insurance.

I'm guessing that there's good reasons why people don't do this, but what?

The prices charged are insane, massively inflated—no individual is expected to cover them out of their own pocket, or could without being super rich. The principle of Breaking Bad was someone trying to cover their cancer treatment without insurance and it wasn't unrealistic.

 

[NoXion]

I've heard that medical prices in the US are so absurdly inflated because hospitals etc charge insurance companies who of course have deeper pockets than the average US consumer. Price controls sound like they might start to fix this mess but of course that seems unlikely to happen and in any case an American Health Service would be better anyway.

 

[equationgirl]

Why not just fuck off the insurance and start a savings account? That way you can pay into the account whatever you feel like you can, and when you do need the money for something, you won't have the additional hassle of having to get blood out of the stone that is health insurance.

I'm guessing that there's good reasons why people don't do this, but what?

There's charges for every piece of medical equipment and tests. So, say for example you need blood tests, there's a charge for the butterfly kit, blood vials and the cotton ball and tape, the costs of each test run and then whatever treatment is prescribed, so for example IV fluids (charges for each bag and line and the venflon connection) and painkillers. A trip to the emergency room for even a few stitches can be a few thousand dollars.

Saving to offset the costs just isn't feasible. The costs for minor injuries is already extortionate, anything requiring extensive investigation, treatment or operations will be prohibitive for all but the wealthiest.

 

[Streathamite]

best wishes for a swift recovery, streathamite

Cheers mate!

 

[Yuwipi Woman]

Why not just fuck off the insurance and start a savings account? That way you can pay into the account whatever you feel like you can, and when you do need the money for something, you won't have the additional hassle of having to get blood out of the stone that is health insurance.

I'm guessing that there's good reasons why people don't do this, but what?

That's nearly impossible for the average person. Streathmite's hip replacement could run $100,000 at last check. I know people with bills that exceed a million dollars. Most people have all they can do to pay their health insurance's deductibles. Mine is currently $4,500 for in network services, and $9,000 for out of network care. If you're in the hospital, there's no way to tell, when you doctor walks into the room, if he/she is in network or out of network. All of that has to be paid before the insurance kicks in. If you're sick a while and the illness goes over into the next fiscal year, you have to pay all that again. I have a health savings account in place just to pay the deductibles.