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Why should I make health decisions based on insurance coverage?

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burythehatchet Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 10:52 AM
Original message
Why should I make health decisions based on insurance coverage?
Edited on Mon Dec-13-04 11:00 AM by burythehatchet
I suspect that during the past decade we have all had to deal with COBRA, continuation of benefits, certificates of continuity, pre-existing conditions, in netwrok, out of network, blah..blah..blah.

It's probably reasonable to assume that you have had to, at least once, make a decision about when to procure health services based upon one, more or all of the above. You didn't think you needed a law degree to analyze your coverage did you?

I am not conversant with the history of why the public policy decision was made to tie health to employment. At its very core is that not a moral speed bump? Tying your health to whether you're employed? But we digress....

This topic has been discussed for many years by many qualified individuals. So the question is why don't we have a solution as yet?

:(est 45MM un-inisured
:(embarassing infant mortality rate
:(highest cost
:(most elective procedures
:(pitiful legal governance
:(etc...etc...etc...


Do you think that unting the Employment/Healthcare link is critical to reform?



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madrchsod Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 11:00 AM
Response to Original message
1. because it`s the american way !
untying the employment link will never happen although it would be cheaper for companies to back government backed health care. america will never see universal health care.
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Not_Giving_Up Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 11:00 AM
Response to Original message
2. I know that I have, many times
I broke two bones in my right hand...When I went to the ER they told me that I needed to see an orthopedist...I explained that I had no insurance, and asked if there was a doctor who could work with me a little. They fixed me up in a nice little splint thingy and told me that I'd be fine. (This was four and a half years ago.)

I need to go to the doctor right now, but can't. I have asthma, but have no rescue inhaler because my refills ran out, and I can't afford a trip to the doctor ($70 minimum!)...I thought I was going to have insurance on 12/1, turns out my boss didn't know what she was talking about, I won't be covered until 1/15/05.

I don't know that the connection between employment and healthcare is the problem. I think that the cost of healthcare period is the problem.
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elehhhhna Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 11:05 AM
Response to Reply #2
4. Call the Doctor's office NOW:
explain the situaton. They should phone in a scrip...maybe offer a freebie sample. Call now, please.
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burythehatchet Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 11:07 AM
Response to Reply #2
5. I invite you to consider your statement
"I don't know that the connection between employment and healthcare is the problem. I think that the cost of healthcare period is the problem."

What I am theorizing is that the employment connection is the root of the problem. One symptom of which is high cost.
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mdhunter Donating Member (373 posts) Send PM | Profile | Ignore Mon Dec-13-04 11:02 AM
Response to Original message
3. Because you're thinking like a democrat
Only a democrat would whine about having to "make health decisions based on insurance coverage."

That's just the wrong way to think about it. Join the conservative chorus. It's not insurance coverage, you're basing it on your "ability to pay." Health care isn't a right, it's a commodity - so of course people should be concerned about whether or not the can purchase the services, right?

Right?
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Lydia Leftcoast Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 12:31 PM
Response to Reply #3
9. actually, you're acting exactly according to the Republican script
See, according to the Republicanites, the problem with the U.S. health care system is that people are accessing it when they need it instead of shopping around for the best price or just grinning and bearing whatever ails them.

So by putting off your health care needs until you can afford them, you're being "an informed health care consumer" in Republican eyes. :eyes:
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leftofthedial Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 11:10 AM
Response to Original message
6. money wins in Murka
them that's got, gets more

why should healthcare have ANYTHING AT ALL to do with employment? You might as well tie healthcare to owning a car or to belonging to the jelly of the month club.

People do not matter at al in our culture anymore. Period. Life, death, suffering . . . irrelevant. We have only two purposes that are valued in our society: cannon fodder for necon wars of conquest; consumers for the capitalist machine.
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kuozzman Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 11:29 AM
Response to Reply #6
7. Have you ever dealt with companies that use the "AWP"
It may just be used with Medicaid, I'm not sure. But I was recently watching some 3am congressional hearing and saw some red flags. This is not the first time I've watch pharma companies finally admit some serious wrongdoings on CSPAN, though I'm pretty sure nobody cares (in Congress). Anyway, this AWP price, is apparently completely misleading and unfair to consumers and 100% unnecessary. He admitted that it's basically a way to increase profits for the pharmacy and the supplier at the expense of the consumer and the government. Was wondering if anybody has dealt with it? This admission is nothing compared to another I saw.

It was the hearings about the use of depression drugs by adolescents and possible increased risk of suicide. Amid the questioning, these 4 of 5 pharma companies, Pfizer and the other main ones, (I'm not awake yet) all admitted that they weren't even sure that it was EFFECTIVE on adolescents! Which is why it wasn't FDA approved!, which is apparently quite common these days (75% of prescriptions for adolescents). At the time, (couple months ago) the drug was the leading revenue creating drug at each company.
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leftofthedial Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-04 11:32 AM
Response to Reply #7
8. self regulation, deregulation
unfettered capitalism is always a disaster.
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Blue Wally Donating Member (974 posts) Send PM | Profile | Ignore Mon Dec-13-04 12:39 PM
Response to Original message
10. Only since World War II
Prior to WWII, there was no health insurance as we understand it today. Doctors individually administered a "rough socialism" where they billed patients on a sliding sacale based on the doctor's own estimates of a patient's "ability to pay". Most communities established public hospitals which also had sliding scales.

During WWII, the Wage and Price Administration put a damper on large sacale wage increases. The United Auto Workers in their contract talks with the "Big Three" were hampered in their ability to negotiate the wage increases which they sought. Bcause benefits were not considered to be a part of the wage package, the UAW negotiated and won health and life insurance benefits from the auto companies. Postwar, this became a pattern of fringe benefits which extended to most large businesses and government entities during the forties, fifties, and sixties.
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pnb Donating Member (959 posts) Send PM | Profile | Ignore Mon Dec-13-04 12:47 PM
Response to Original message
11. Started happening mostly around and after WWII
"I am not conversant with the history of why the public policy decision was made to tie health to employment. At its very core is that not a moral speed bump? Tying your health to whether you're employed?"

Employee benefit plans became a widespread source of health insurance in the 1940s and 1950s. Increased union membership at U.S. factories enabled union leaders to bargain for better benefit packages, including tax-free, employer-sponsored health insurance. Wage freezes imposed during World War II (1939-1945) also drove the growth of employee benefit plans. Unable by law to attract scarce workers by increasing wages, employers instead enhanced their benefit packages to include health care coverage.

http://encarta.msn.com/encyclopedia_761576408_5/Health_Insurance.html

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ivolsky Donating Member (61 posts) Send PM | Profile | Ignore Mon Dec-13-04 01:36 PM
Response to Original message
12. Language and Social Security
In the spirit of Lakoff, lets inspect the framing Bush uses when talking about his yet-to be-proposed Social Security privatization plan:

From his weekly radio address: "A crisis in Social Security can be averted, if we in government take our responsibilities seriously, and work together today. I came to Washington to solve problems, not to pass them on to future Presidents and future generations. I campaigned on a promise to reform and preserve Social Security, and I intend to keep that promise. "

Here, Bush elicits fear-- the same tool used to whip the population into a frenzy for the Iraqi war.

And he is painting himself as the savior, (in Lakoff's terms), a strong leader, the strict father who can lead the nation out of its "crisis," the omniscient father figure.

The fact that the crisis is fabricated is irrelevant; the language he uses urges change, it overtly identifies a crisis. And in a crisis, something must be done!

The framework: Bush is showing strength in a time of crisis!
Translation: How can you not support this brave and heroic president! He is willing to stand up to the problem.

As long as Democrats work in this framework they will loose the Social Security debate.

Progressives should frame social security in terms of responsibility to our elderly. Democrats are the party of responsibility. The Republicans/Reactionaries/Conservatives are the party of weakness: they are weakening the financial security of senior citizens.

more thoughts here:http://www.politicalthought.net">www.politicalthought.net
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