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Topic: Healthcare Debate (was: Quesada apologizes) (Topic Closed Topic Closed) Post ReplyPost New Topic
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William McCormick
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Posted: 15 March 2010 at 9:00pm | IP Logged | 1  

But Mike, their profits are only 3%. They're suffering man.

In our quarterly meeting where I used to work, the CEO would tell us that if their annual profit was at least seven cents left of every dollar of sales before taxes, they were having a good year. A fantastic year was having profits of ten cents of every dollar of sales left. And this was a manufacturing plant where the overhead was a much greater percentage than in the insurance industry.

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Mike O'Brien
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Posted: 15 March 2010 at 9:09pm | IP Logged | 2  

William - I know, right? Where did that 3% come from? It sure went viral fast. Health Insurance makes a killing, by killing. It's a vile industry.
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Monte Gruhlke
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Posted: 15 March 2010 at 10:09pm | IP Logged | 3  

So what they're saing is that they only have a 3% profit margin... and it's ben reported that apparently the industry nets many, many billions in profit per year?  That sounds like a healthy 3% to me. What do they want? 4%?

AND Quesada doesn't need to apologise for anything... except for his role in the last three big cross-over M***** events...
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Joseph Gauthier
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Posted: 16 March 2010 at 8:20am | IP Logged | 4  

So can I safely assume that the insurance you provide for yourself and your wife is free? Because if it's not then there is no way you walk out $200 richer. Tell me how much ahead you are after figuring in your premium.

I'm not sure I understand the question.  Payments made toward insurance coverage are standard expenditures, whether made in the form of taxation or monthly premiums; in many cases it doesn't even figure into net pay.  Of course I don't receive a check from my primary insurance coverage, but in cases such as the one under discussion, I do receive a check from my supplemental.  And in those cases, those checks not only cover remaining co-pays, but also leave a tidy sum for me to pocket.
I suppose, however, moneys received from the supplemental could be looked upon as moneys received to down pay against the monthly premiums of the primary.  And if I do look at it that way, I have no idea where I'm at in regard to money paid out vs. money received, but if taken in isolation, I'm way ahead on my supplemental.
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Brad Krawchuk
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Posted: 16 March 2010 at 9:58am | IP Logged | 5  

So this supplemental insurance... they're made of money? How the hell does it work if they're giving you MORE than what you spend?

There's seriously a way I could have walked out of the hospital with an EXTRA 200 bucks that came from NOWHERE?
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Matthew McCallum
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Posted: 17 March 2010 at 12:55pm | IP Logged | 6  


 INVISO TEXT (Click or highlight to reveal):
I’ve missed the last couple of days of back-and-forth on this, but to help stir the pot on the discussion, I’d like to share some experiences with the Canadian Medicare System, both personal and professional. (For those who don’t know, I lived the first 30 years of my life in Edmonton, Alberta and return regularly to visit family. For the last decade-plus, I’ve lived in California. My wife, a doctor, has practiced under both systems.)


 INVISO TEXT (Click or highlight to reveal):
 


 INVISO TEXT (Click or highlight to reveal):
I not going to dump everything into one post or a series of back-to-back posts, but I’ll work some of these thoughts up over the next couple of days.

 


 INVISO TEXT (Click or highlight to reveal):
The Personal Story


 INVISO TEXT (Click or highlight to reveal):
Back in 1991 I broke my collar bone and separated my shoulder -- ripping all the ligaments -- in a ball hockey accident. Ball hockey is essentially organized street hockey played during the summer in an ice-less rink. And I know, you’re supposed to either break your collar bone OR rip your ligaments. Doing both is rare. What can I say: I’m an over-achiever when it comes to self-harm.

 


 INVISO TEXT (Click or highlight to reveal):
Not to be overly dramatic, but in retrospect it was a Chris Reeve-like accident. After being taken out at the knees (in a non-contact game, no less!), I launched into the air at speed and came down hard on my helmet (breaking it), neck and shoulder. Landing an inch to the right, I likely would have got up with little more than a bruise and either chased after the puck or pounded the guy who tripped me. Landing an inch to the left, I likely would have broken my neck. Life truly is a game of inches at times…

 


 INVISO TEXT (Click or highlight to reveal):
I held my arm in place for the remainder of the game – we came back from being down 4-1 to tie the game 4-4 – and then elected to head off to the emergency room at the nearby University of Alberta Hospital. At that time U of A was the best and most up-to-date facility in Edmonton, if not the whole province. A chum went off to fetch my medical resident girlfriend (now wife) and she met me at ER.

 


 INVISO TEXT (Click or highlight to reveal):
It was your typical busy night at ER, but thanks to professional courtesy extended to my sweetheart I got moved up the food chain a little faster. Although I’d been in pain for a few hours by that point, I didn’t cry until they had to cut the hockey sweater off me. (My dear girlfriend cut it down the seam and later stitched it back together. That’s when I knew she was the one!)

 


 INVISO TEXT (Click or highlight to reveal):
We got x-rays and reading the film the ER doctor concluded there wasn’t much to be done, that I should wear a sling and let everything knit itself back together. How long would that take, I asked. About 18 months would do the trick, he opined. And he wasn’t joking.

 


 INVISO TEXT (Click or highlight to reveal):
My girlfriend, looking at the same film, drew a different conclusion.

 


 INVISO TEXT (Click or highlight to reveal):
The next day, as I spent the morning trying to get used to my sling and learning how to use my left hand for daily living, she called in some favours and squeezed me in for an end-of-day appointment with Dr. Boucher, the U of A orthopedic surgeon who worked on the Edmonton Oilers. Boucher looked me over, looked at the film and decided I wasn’t going home that night. I was going to surgery. He got me a bed at the U and the procedure was scheduled for the next day, Saturday. I didn’t have the surgery until Sunday – got bumped by a bad highway accident – which involved stitching all my ligaments back together and putting a bolt in my shoulder so the collar bone would heal. I was released Monday, and went back to work on Tuesday. (Why? I was young and stupid. I’d had my first major injury and wanted to prove I wasn’t a cripple.)

 


 INVISO TEXT (Click or highlight to reveal):
So, what lesson do we draw from my story? Well, I got great treatment for my tax dollars, operated on by one of the best surgeons available just three days after my injury, enjoyed a full recovery after only six weeks in a sling, and do not suffer from frozen shoulder today two decades later. The system works fine, right?

 


 INVISO TEXT (Click or highlight to reveal):
But if I hadn’t had an advocate looking over the ER doctor’s shoulder, the system would have been happy for me to wear a sling for a year and a half and then endure limited mobility in my right shoulder for the rest of my days. And, of course, being right-handed, 18 months in a sling would have made work and school somewhat difficult. The system is broken, right?

 


 INVISO TEXT (Click or highlight to reveal):
Personally, I consider myself very fortunate to have been dating a woman with the right talents and the right connections in my time of need. However, I don’t think that’s a workable solution for resolving the healthcare crisis in both countries.

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Joseph Gauthier
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Posted: 17 March 2010 at 1:38pm | IP Logged | 7  

So this supplemental insurance... they're made of money? How the hell does it work if they're giving you MORE than what you spend?

Unlike the primary provider, the supplemental provider sends checks directly to the subscriber rather than to the health care provider.  The reason I often receive more from the supplemental than I pay out in the form of primary co-pays is because the supplemental does not act in concert with the primary.  For some subscribers, it may be the only form of health insurance coverage they carry, in which case they would be left with a sizable balance owed to the health care provider.  But for those subscribers who do use it as a supplemental, they may each carry a different primary, with each separate provider requiring different co-pays from their subscribers.
The fact that I'm way ahead in regard to money paid in the the supplemental vs. money received from the supplemental is due to two serious car accidents; one involving my step-son, the other involving my wife, our son and me.  In both cases, my family and I were faultless victims, but please, let me stress that this is good luck I would not wish upon anyone.  At this point, as I said, I'm way ahead of the supplemental insurance, and it will take a number of years worth of premiums to even things out.  Of course I plan to keep the supplemental for a number of years...


Edited to clarify and expand.


Edited by Joseph Gauthier on 17 March 2010 at 2:35pm
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William McCormick
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Posted: 17 March 2010 at 5:30pm | IP Logged | 8  

I'm not sure I understand the question.  Payments made toward insurancecoverage are standard expenditures, whether made in the form oftaxation or monthly premiums; in many cases it doesn't even figure intonet pay.

********

How does the premium you pay not figure into net pay? Where do the monthly premiums you pay come from? Even if you pay them pretax, they still come out of your gross wages, which lowers your net pay. You stated above that you and your wife provide your own insurance. Do you pay for it out of pocket? Does a portion come out of your check and your employer pick up the rest? Does your employer cover all of it? Because only under the third option do you walk out of the hospital $200 richer. In both of the other two it only offsets the premiums you pay. In my above post I stated that I paid in $230 a month towards my insurance at my previous employer. So even if I had no copays and received a check for $200 from a supplemental insurance, I'm still $30 in the hole. Figure in copays and it's even more. Now you may not be in the hole as much as you would be if you had no insurance, but you sure as hell aren't making money.

Payments made toward insurance are not standard expenditures. They are a luxury too many Americans can no longer afford. My local state representative Matt Baker recently sent out a newsletter touting how 92% of Pennsylvanians have health insurance. He included CHIP, Medicare, Medicaid and Adult Basic under that 92%. Since all 4 of them are government run programs, it's kind of a lie to include those people as having insurance when your writing your constituents about how your fighting the good fight against Obama's plan to overhaul health care and trying to put a stop to government run health care. All those people are under government run health care.

Just one more example of how Repubs fudge the numbers to make things look better than are. Hypocrites, all of them. It must be easy to sit on Capitol Hill and rail against government run health care, while being enrolled in government run health care at our expense. If they were serious about what they say they are fighting for, every single one of them would drop the Congressional insurance and pay for it out of their own damn pockets.
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William McCormick
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Posted: 17 March 2010 at 5:38pm | IP Logged | 9  

So,what lesson do we draw from my story? Well, I got great treatment formy tax dollars, operated on by one of the best surgeons available justthree days after my injury, enjoyed a full recovery after only sixweeks in a sling, and do not suffer from frozen shoulder today twodecades later. The system works fine, right?

 

Butif I hadn’t had an advocate looking over the ER doctor’s shoulder, thesystem would have been happy for me to wear a sling for a year and ahalf and then endure limited mobility in my right shoulder for the restof my days. And, of course, being right-handed, 18 months in a slingwould have made work and school somewhat difficult. The system isbroken, right?

*********

We have the same problems in America. It's just that here people go broke trying to pay for the same lousy treatment you almost got. My wife suffers from psoriasis. Severely. It was starting to give her psoriatic arthritis and she was having trouble moving her hands. The only thin g they hadn't tried was Humira. Problem was my insurance didn't cover the cost of Humira unless you could have a doctor prove medical necessity. After 2 years of back and forth with the insurance company and getting nowhere, I lost my job. She immediately sent a letter to the company that makes Humira  and they enrolled her in a program for people with no health insurance and she's been on the shot ever since. Her skin is completely clear and she has no more problems with her hand. But, I had to lose my health insurance and my job to get the medicine she needed. How sad is that.
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James Malone
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Posted: 17 March 2010 at 7:20pm | IP Logged | 10  

its more sad that we live in a country where people pay their cellphone, internet, cable bills before their medical bills.

Prioritze

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Mike O'Brien
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Posted: 17 March 2010 at 9:38pm | IP Logged | 11  

Context? Source?
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Brad Krawchuk
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Posted: 17 March 2010 at 9:58pm | IP Logged | 12  

its more sad that we live in a country where people pay their cellphone, internet, cable bills before their medical bills.

Prioritze

---

Yeah! Prioritize! Goodness knows you can afford NOT to pay for the stuff you use DAILY, and instead pay outrageous fees for medical expenses already incurred. 

I couldn't hold my job without a phone and the internet. I could let you slide with the cable comment, but most people need to keep in touch with the outside world through some technological means, so going without a phone or email would be stupid. Since having a cellphone or a landline is almost the same cost for me, I opted to keep just a cell last year. Why should I have to give up my phone to pay medical bills?

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