Monday, November 24, 2008

A Step in the Right Direction...

Two trade groups, America’s Health Insurance Plans and the Blue Cross and Blue Shield Association, announced their support last week for guaranteed coverage for people with pre-existing medical conditions, in conjunction with an enforceable mandate for individual coverage. In the absence of such a mandate, insurers said, many people will wait until they become sick before they buy insurance.

Members of Congress said Wednesday that they wanted to pass legislation next year, as proposed by Mr. Obama, to expand coverage and rein in health care costs.

The new position taken by the insurance industry — the industry that helped sink the Clinton's plan for universal health coverage in 1994 — could ease the way for passage of such legislation.
This news and that Senator Tom Daschle could be our new Secretary of Health and Human Services is a step in the right direction towards health care accessibility for all in the coming years.
In the October issue of Archives of Surgery, a study done by a John Hopkins trauma surgeon found that overall, uninsured patients were 50% more likely to die from their injuries than insured patients.
I find that to be an alarming statistic. So, now if you don't have insurance you #1) have to pay more if you go to the ER (because you don't get the I HAVE INSURANCE DISCOUNT) and #2) if you're a minority or don't have insurance at all, you're pushed to the back of the emergency treatment line, or worse you receive biased treatment.
I thought emergency care was the great equalizer in our health care system. Apparently not.


Jen said...

One fact you are not accurate about is the fact that people who don't have insurance pay more. If you tell your doctor that you are paying out of pocket because you don't have insurance, then they will give you a discount. If you tell your doctor, when having a surgery, that you are paying out of pocket, they will not only give you a disount, but in a lot of instances you will get more careful care. I have talked to my sister, who is a scrub nurse at a surgical center, AT LENGTH about this and have done some of my own personal researh--in addition to personally working for the an insurance company. My sister said that it's not that the doctors do a bad job on those who are insured, she just notices that they are more particular when they work on someone who is paying out of pocket. They are also not as wasteful in the supplies that they use. The key is letting them know before hand that you don't have insurance and that you will be paying on your own. They are also very good about putting you on a payment plan.

The exceptions are not everyday care, but the big diseases and illness.

Lula O said...

Jen, as someone who has been dealing with not having insurance in the family for almost a decade, I can honestly say, my husband almost always has to pay full price. Because I ask, EVERY TIME!!!!! If they do offer say a, 5% discount, it's if he pays the total amount due at the visit! You can't make payments and get the discount. In our case, this is true, 9 times out of 10. The hospitals have NEVER given us a discount based on us not having insurance. Never.
So in my own personal experience, it is very accurate. Because I live it, every single day of the week.

Ben and Christina said...

I hope this all works out!! I would LOVE to see universal health care in this country!!!!

okbushmans said...

First, I'm curious where you found that article. I would love to read more about the evil private health insurance companies actually listening to their market and implementing the people's will, instead of it being forced upon them by the government (which would eventually cause their collapse, look at the auto industry...) And what a great step forward, and hopefully will set the standard for the rest in the industry.
And I'm curious about that 50%, if it is caused by them not able to afford the necessary medication or follow-up appts instead of suggesting that the doctors willingly and intentionally open themselves up to justifiable lawsuits because they are getting their money in a different way. I would love to have the resources to read about it more in length.

Lula O said...

Also Jen, so what your sister is saying is that when someone DOES have insurance a doctor is not as careful on how much he or she wastes? No wonder the cost of health care is so out of control!!

This is exactly what that study was trying to figure out (found in Newsweek, Nov 10th issue, Health Matters. No Insurance? That's a killer by David Noonan) Were more people dying w/o insurance because they waited too long to go in, or because their doc failed to order an expensive necessary test?? Because they were trying to avoid waste and decrease the financial loss to the hospitals?? Good grief.

Lula O said...

The other article was in the October issue of Archives of Surgery. It chronicles a study led by Johns Hopkins trauma surgeon Adil Haider. Its findings are discussed in the NEWSWEEK article I cited.

The Bradfords said...

Lula, our family has had a few (nothing compared to your's) experiences with not being insured for various reasons and every time we've explained that to the doctors or hospitals they have given us a substantial discount on their services. So that leads to a new question: what the heck is going on? Why do some people get that treatment and others don't? Is it because of the type of visit or the type of illness? What's going on?
Another thing: We get bills/statements from the insurance company that are wrong all the time. We are forever calling and straightening things out. If we didn't do this we would be paying so much more than necessary. We wonder all the time that there are people who don't take the time to deal with it and are grossly overpaying. I won't bore you with my root canal story but in short one dentist told me I needed to pay $382 and my insurance would cover the rest. Another dentist told me I needed to pay $120 and my insurance would pay the rest. Guess where I went?

okbushmans said...

Lula, also my experience pales in comparison, but I have also had many doctors/offices/hospitals give cash-customer discounts. Especially in the past 8 months of being uninsured (Monday's the big day! woo-freakin'-hoo!) I even had a doctor barter for piano lessons for his kids (of course, LDS!) I'm sure you've exhausted all your resources and options, but it sounds like you are in an exceptionally non-generous part of the country or something!
There is one thing we can agree on is the coverage for pre-existing conditions. I've had some many health concerns while we're uninsured, but I feared getting checked out, in case it would be something dramatic that would consider me a 'pre-existing condition'.

Lula O said...

To be fair, in the past I have been given discounts before - a doc once gave me 50 bucks off my daughters ear tubes when we didn't have insurance.
It's mainly Eric, the one with the pre-existing condition who is never given one. Just last month he went to the eye doctor, I asked - no discount and I could only make payments if we paid the first half up front.
His endocrinologists have never given discounts, only allowed payments which I believe they think is just as good.
What frustrates me is Eric is the one that needs it the most! Not when my daughter has an ear infection once a year.
And therein lies the problem. Those that need it the most, can't get it, no matter how much they earn, etc. If that's not extremely back-ass-wards, then I don't know what is.

Bryce and Mandy said...

I think it is great that insurance companies might actually cover those with pre-existing conditions. Did they say anything about cost? I'm just wondering how expensive it might be... although it would still be cheaper then w/o insurance, I suppose.

And I am glad to hear that because I have insurance doctors tend to be more wasteful when they treat me. Even though insurance pays for the majority, I still have to cover part of the costs. I wish they would be as frugal with everyone, regardless if they have insurance or not (although I get why they give those w/o insurance a break).

"It's not that the doctors do a bad job on those who are insured, she just notices that they are more particular when they work on someone who is paying out of pocket." Does that make anyone else who does have insurance feel uneasy? What exactly does that mean?

Jen said...

Lula, you're getting WAY ahead of yourself. When I say "waste" I am referring to the tools or labs they use, some are more expensive then others but insurance companies require them to use certain ones that they have negotiated contracts with ie. Blue Cross Blue Shield requires to send patients to Lab Corp for testing, however Qwest labs is JUST AS GOOD, some of the tests at Qwest are less and some of the tests at Lab Corp are less, so if the tests are equally good but one charges less than the other, the doctor can use discretion as to where to send to patient as opposed to HAVING to send them to the one that the insurance requires. This is same for tools and instruments that they use in surgery.

Every time I ask for a discount I get one. I'm sorry you have crappy doctors that don't help, no wonder you are frustrated. Also, sometimes you can negotiate after the fact. You can let them know you are having a financial hardship and ask if they can lower the costs. My friend Tammy has awful health insurance, she may as well be self-insured. Her friend happens to be a finance person at the hospital who works with families to help lower bills and put them on payment plans, and also write off the expenses when they have to. According to him they help people ALL THE TIME.

Lula, I told you where you can get a great deal on supplies, my brother in law gets customers all the time who say they haven't found anyone as reasonable as them. AND he's a small business owner, just the kind you like to work with :) No big businesses here. Go to

Christina, what do you mean by Universal Health Care? I would like to know how you specifically see that working ie. Completely run by govt, more assistant programs, etc. I'm just trying to understand your particular definition.