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  1. #41
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    As long as health care is intertwined with a profit motive, this will be the result. Received any of those expensive "Donate to our nonprofit hospital" flyers lately?


    9 members found this post helpful.

  2. #42
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    Obamacare also isn't going to solve other problems we have. Last week I began looking for a new doctor since I had moved recently. Many were not accepting new patients. The ones who were had appointments in the middle of the day at the end of November/beginning of December. I really, really didn't want to take a full day off work so I kept calling. I finally found one who could get me in at the end of November in the late afternoon. I just have to hope I stay healthy until then or rely on urgicare.
    No hour of life is wasted that is spent in the saddle. ~Winston Churchill
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    5 members found this post helpful.

  3. #43
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    Quote Originally Posted by Daydream Believer View Post
    Was talking yesterday to a friend who is an MD and runs her own private practice in Newport News. The talk was about politics...she is Catholic and very conservative, and Obamacare came up. As we discussed it I mentioned that I had heard that originally Obamacare was going to eliminate mammograms for women under 50 and over 70 and that it caused an uproar and they "changed" it to fix the problem.. We talked about the A, B and C level issue where now the mammograms from 40 to 50 are considered "C" level procedures and will only be done if your doctor agrees that you need one. She said when that happens you get into an insurance company pissing contest over who will pay since it is a low priority procedure. She also said that even if a woman wants to pay for her own mammogram out of concerns for early cancer detection, she will be lucky to find a place to do it as there will be waiting lists and such preventative care will be rationed. Her comment (not mine) was that a woman will be able to get an abortion for nothing but not a mammogram in the US if this goes through.

    I found that a bit disturbing to say the least as my sister in law is alive now because her breast cancer was detected at age 44. Under Obamacare, she'd most likely be dead now..her cancer was invasive, fast spreading, and ended up in her brain and now is in her liver. 4 years later and she's still fighting but at least she has a chance.

    My doctor friend and I both agreed that health care reform is important and necessary but that Obamacare is not the right answer.

    Romney, if elected, says that he will replace Obamacare with state run health care similar to what Massachusetts had (and not it's not the same as Obamacare) so I don't think all is lost for those of you who are uninsured now. I certainly understand that it can be a big issue and it's one I may face one day myself.

    From my perspective, we are faced this year with a large premium increase for Tricare...covering military personnel and retirees. Every year it gets more and more expensive it seems. My husband is covered as a retiree and has insurance from his current job which is much better than Tricare which is our secondary insurance at the moment. If he dies before I do and I'm under 65, I'll be uninsured unless I can get my own insurance. It's a worry no doubt and as I said earlier, health care reform is necessary but there has to be a better way than socializing it. I experienced socialized medicine in the Army years ago and it sucked compared to what I have now.

    The ABC levels of coverage are not dictated by any govt entity but an outside committee that does an analysis of available data.

    A equals consistent, good quality evidence.

    B equals inconsistent or limited-quality patient-oriented evidence.

    C equals consensus, disease-oriented evidence, usual practice, expert opinion, or case series. In other words C is the standard care even if evidence doesn't necessarily back it up.


    4 members found this post helpful.

  4. #44
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    Quote Originally Posted by Daydream Believer View Post

    Romney, if elected, says that he will replace Obamacare with state run health care similar to what Massachusetts had (and no it's not the same as Obamacare) so I don't think all is lost for those of you who are uninsured now. I certainly understand that it can be a big issue and it's one I may face one day myself.
    Other than the obvious in that it will be paid for by federal taxes vs state taxes, what are the big differences?



  5. #45
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    Quote Originally Posted by RainyDayRide View Post
    but that is the way insurance works.. be glad you're not having medical problems costly enough to make insurance pay. Nobody wants to be in a collision or have a house fire, but that is when you need it. The best deal for a young, healthy person is often actually some kind of catastrophic health policy in which only major expenses are covered... but under those some people don't get preventative care.
    Why do you make that judgment? I have chronic pain and see a doctor several times a year. However, my insurance premiums ARE NOT GOING UP BECAUSE OF CLAIMS. My premiums are going up because the company I work for is being force to change the coverage they offer. Our premiums are linked to pay rates so the more you make, the more you pay. I'm sure that would put a smile on Obama's face.

    I would not have a problem paying increased premium if it were risk based. The increases I'm facing are not remotely risk based.


    5 members found this post helpful.

  6. #46
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    Quote Originally Posted by carolprudm View Post
    That's not exactly true. The insurance companies will have to pay out 80 or 85% of the premiums they collect or give a rebate to their customers.
    These stats are a few years old but health insurance isn't all that profitable
    http://money.cnn.com/magazines/fortu...tries/profits/

    I disagree, and so does the New York Times

    http://www.nytimes.com/2011/05/14/bu.../14health.html

    "Health Insurers Making Record Profits as Many Postpone Care

    The nation’s major health insurers are barreling into a third year of record profits, enriched in recent months by a lingering recessionary mind-set among Americans who are postponing or forgoing medical care."

    And, as many of them are publicly traded corporations, any one of us can go to http://www.sec.gov/ and look directly at all the many that was made on their annual filings (search 10-k, I would be happy to explain any questions on how to understand the different financial statements). In fact, I encourage everyone to see how various companies are doing.
    The Knotted Pony

    Proud and upstanding member of the Snort and Blow Clique.


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  7. #47
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    I oversee the employee health plan....we cover about 5000 people (employees and dependents) so we are a good sized self insured plan. The Obama care changes are going to cost us 3 to 5 million more per year which is a 15 to 25 percent increase. Because we are a school district there isn't really a way for us to increase revenue. So to pay for employee healthcare...we will most likely have to cut positions as well as increase premiums and deductibles while reducing coverage. By the way, my deductible is already $3000.

    My guess is that for profit companies will increase prices on all of their products and services to pay for their employees' healthcare.


    7 members found this post helpful.

  8. #48
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    Quote Originally Posted by Laurierace View Post
    It is true. I was injured slightly in a car accident that was not my fault and the urgent care place would not accept my health insurance and made me put it on my credit card. Luckily the bill was small but it would have been the same even if it was huge.
    That must be a state by state thing? Or even something with that urgent care place? Though I've never heard of such a thing. That has NEVER been the case here in Mass. If you have health insurance, they pay the bills for accident related injuries and then go after the responsible party to be repaid (a process called subrogation).



  9. #49
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    Quote Originally Posted by kb View Post
    I oversee the employee health plan....we cover about 5000 people (employees and dependents) so we are a good sized self insured plan. The Obama care changes are going to cost us 3 to 5 million more per year which is a 15 to 25 percent increase. Because we are a school district there isn't really a way for us to increase revenue. So to pay for employee healthcare...we will most likely have to cut positions as well as increase premiums and deductibles while reducing coverage. By the way, my deductible is already $3000.

    My guess is that for profit companies will increase prices on all of their products and services to pay for their employees' healthcare.
    What is driving the increasing? Covering adult children? Paying for preventative care? Could some of this reduce costs by catching stuff faster? I'm curious.


    1 members found this post helpful.

  10. #50
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    Quote Originally Posted by kb View Post
    I oversee the employee health plan....we cover about 5000 people (employees and dependents) so we are a good sized self insured plan. The Obama care changes are going to cost us 3 to 5 million more per year which is a 15 to 25 percent increase. Because we are a school district there isn't really a way for us to increase revenue. So to pay for employee healthcare...we will most likely have to cut positions as well as increase premiums and deductibles while reducing coverage. By the way, my deductible is already $3000.

    My guess is that for profit companies will increase prices on all of their products and services to pay for their employees' healthcare.
    Will you have to cover more employees?

    Insurance rates are going up an average of 15% year anyway at my husband's place of work (a doctor's office). The insurance has a 3k deductible.

    What people don't understand is that you're going to pay for healthcare one way or another.



  11. #51
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    Quote Originally Posted by Canaqua View Post
    That must be a state by state thing? Or even something with that urgent care place? Though I've never heard of such a thing. That has NEVER been the case here in Mass. If you have health insurance, they pay the bills for accident related injuries and then go after the responsible party to be repaid (a process called subrogation).
    Perhaps it is a state by state thing. In NC auto insurance and not health insurance covers injuries from car accidents.



  12. #52
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    Quote Originally Posted by grayarabpony View Post
    Perhaps it is a state by state thing. In NC auto insurance and not health insurance covers injuries from car accidents.
    Ah, see we are allowed to waive the PIP (personal injury protection) coverage on our auto insurance if we have health insurance.



  13. #53
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    4Martini....the increase is for many things such as covering dependents up to the age of 26, having insurance for every single employee (in the past, many of our employees would opt of of it) and the way the plans have to be structured now. The big changes are coming up so you will see more impact in the future.

    Just saying that when companies cannot provide cost of living increases or must eliminate positions in order to pay for healthcare....that is going to be another huge blow to the economy.

    Our plan always had preventative care covered so that was no change for us.

    And yes...less plan utilization would decrease costs....losing weight, better diet, more exercise, less drinking, no smoking...those things would all help every benefits plan decrease expenses. But we have been preaching that for years.

    Health insurance as it stands now is dysfunctional for a gazillion reasons including the billing process as well as the expectations of the people. For every other type of insurance, it is only used for catastrophic events...but the expectation for healthcare is that it should cover every cost. Take home owner's insurance for example...if your air conditioning or heating unit dies...your insurance doesn't cover that...you do. But if your house burns...then they pay out (hopefully). Insurance is all about risk as related to a catastrophic event. General "maintenance, upkeep and repairs" don't factor into homeowners or auto insurance. Our current healthcare model doesn't really follow the same type risk model so the plans are extremely costly to an organization. My feeling is we need to rethink how we provide health insurance....and start from the ground up.


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  14. #54
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    Quote Originally Posted by grayarabpony View Post

    What people don't understand is that you're going to pay for healthcare one way or another.
    Amen! I say that all the time.
    I just wish I had some say so as to how I payed for it.


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  15. #55
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    We've been without insurance for a year and it's starting to make me very nervous. We were supposed to be covered under DH's job but they dropped insurance for their employees due to increased insurance costs, they said. It's supposed to be reinstated soon but I'm not holding my breath.



  16. #56
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    Quote Originally Posted by Daydream Believer View Post

    Romney, if elected, says that he will replace Obamacare with state run health care similar to what Massachusetts had (and no it's not the same as Obamacare) so I don't think all is lost for those of you who are uninsured now. I certainly understand that it can be a big issue and it's one I may face one day myself.
    1) That is not what Romney says. He says that he will let each state decide how to handle health care reform themselves, he won't be instituting state run plans. So, if you live in Massachusetts, you don't have too much to worry about. If you live in Texas, you are probably screwed.

    2) What is so different about the Massachusetts health care reform and Obamacare? I'm curious about the details, since I'm intimately familiar with the Massachusetts system.


    4 members found this post helpful.

  17. #57
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    Quote Originally Posted by mercedespony View Post
    Ummmm yeah.. I had to re-read your initial post two times, I wasn't sure why you hadn't yet been seen by an ortho and the wrist wasn't repaired within 2 days after your car accident..

    Then I realized, I'm Canadian. And I am quite happy paying in the 50% tax median so that my fellow citizens, regardless of their income, have full medical care..

    I'm sorry, Dazed, it really shouldn't come down to what country you live in, to have the ability to receive appropriate medical care.

    You are the next generation - get your butt out there and vote.

    eta: I just re-read for the 3rd time.. you sat there for 3 weeks with a displaced broken wrist? That is just so wrong, on so many levels.
    Sorry, I know it was very long/convoluted. You did read that correctly. It was 25 days from the day of the accident until I was able to receive surgery (But ONLY because I am lucky enough to have a relative that offered to loan me the money for the deposit. Doctors offices would not even speak to me once they discovered I didn't have insurance (I contacted four different orthopedic surgeons). Funnily enough I'm half canadian and was joking about seeking asylum just to get your awesome healthcare

    Quote Originally Posted by saje View Post
    I think she's saying the we NEED Obabmacare, and more. That she should go without medical care for a fracture because she couldn't pay is inexcuseable, but sadly not at all uncommon.
    Yes, exactly what I'm saying...I'm sorry that wasn't more clear in my OP.

    Quote Originally Posted by MoonoverMississippi View Post
    Where was your vehicle insurance in all of this? Is this a California thing?

    I ask because we have had accidents where the other party was at fault, but our vehicle insurance made it clear that we were covered regardless of fault.
    I been involved in 3 injury accidents (none my fault) and have never had to show proof of health insurance to be treated. I did have to show my vehicle insurance paperwork and fill out extra forms on the accident that caused the injury, but that was it.
    I had full coverage, including medical payment coverage. Not one out of five total orthopedic surgeons would accept third party billing (ie my auto insurance). I am in California, so I'm sure the laws differ by state.

    Quote Originally Posted by HighFlyinBey++ View Post
    It's not just you who's been screwed with. My 30 y/o coworker was in San Diego for a work conference last year and broke his hip while running. Only he didn't know it was broken because the x-rays at the CA clinic showed nothing wrong. It took him a MONTH of arguing with both doctors and CIGNA about the serious pain he was in before someone finally ordered an MRI and saw the break. My coworker was ordered to stay off the leg and return for surgery the next day. To add insult to injury, he was told he needed $800 for the copay up front or the surgeon wouldn't look at him. The surgeon's policy is for the patient to pay and then be reimbursed by their provider. He's lucky he had that much available. Not many people do--and we have good insurance.
    Yes, this is exactly the problem. They can't refuse to treat you at the ER. But that essentially serves as palliative, short term care and diagnosis. No more, no less. Any specialist I talked to would not even make an appointment to see me.

    Quote Originally Posted by danceronice View Post
    Nope, not gonna change my vote. If YOU don't want to pay for your health care, I'm certainly not going to do it.

    Unless we pay for socialized medicine by instituting a 10+% federal sales tax. ESPECIALLY on groceries and other things everyone has to buy so it hits the people getting the care the hardest. The non-payers of federal income tax need to start ponying up big time before I support any more of my money getting taken away for their benefit.

    I have to pay my own way with health care. Find a way to pay yours. I'm sick of being a cash cow because I'm single and plan and other people don't. If you want charity, see the Salvation Army.
    I WANT to pay for my healthcare. If I could afford it, I would. Why should I be stuck in a splint, with immense amounts of pain, unable to work, with everyone refusing to treat me?? I can't imagine why you don't have a huge problem with this. Take a walk in someone else's shoes.

    Quote Originally Posted by Frizzle View Post
    JanM, I did get quotes from several companies and they were all extremely expensive. And, no, I have never had any bad accidents or workman's comp issues or anything like that. My one "accident" that caused injury was when I slipped on ice and broke my ankle, which required seven screws and a plate. So, really, not exactly major.
    Ditto

    Quote Originally Posted by Ajierene View Post
    This story is interesting because when I broke my anke and needed surgery, I had to wait from a Sat (day of break) to the next Tue for surgery. When asked if I had medical insurance I told them I had none, hence the wait for the next Tue, when the Drs did their pro bono orthopedic surgeries. I still had to pay for the room, anesthesiologist and other expenses. I called up the hospital and told them my situation, the knocked the bill down by at least 40% and I spent the next year or two paying it off. As long as I kept current, I could pay $5/month to each bill. There were 4 bills, or so. So tops, I paid $20/month. It was annoying to pay 4 bills, but I paid off the smallest first and worked my way up from there.
    I would have done this as well but it was not offered to me by the four orthos/hospitals I spoke to before I got the attorney. I know none of that stuff is free and they should be paid fairly for their skills and education. But again, I didn't do anything wrong.

    Quote Originally Posted by RainyDayRide View Post
    dazed, have you checked to see if your income level makes you eligible for Medicaid in your state?

    As an earlier poster said, in a couple of years there should be insurance exchanges in each state that will make insurance available to all - with a subsidy in some cases. I think that is scheduled to take effect in 2014.

    Hope your nasty break heals well now. (and how do your parents cover their health needs?)

    Count me as someone who would be willing to pay more for all to have health care - on pragmatic as well as on moral grounds.
    From what I researched, I was ineligible for Medical for the same reasons as being ineligible for my county's medical services pool - there is an at fault party that is responsible for my medical costs (eventually).

    I'm not really in contact with my father. My mom is currently going without (though she has two interviews coming up, both at jobs in her chosen field with great benefits, at which point I could get on her plan for next year....fingers crossed furiously!).

    I'm still in a lot of pain, but on my way to mending up.

    Quote Originally Posted by horsefaerie View Post
    I am sorry you find yourself in this situation. However, many years ago, I decided to go to college at the urging of my teachers. My parents could afford to pay my way but chose not to. It made it impossible to get work on campus because I wasn't "needy". I was also young, 17, so I couldn't do the good stuff that paid well like bartend. I sold my clothes etc and made it through the first two years. THe school had health insurance. I

    I switched schools and they did NOT have health insurance. I had to find my own. I got one job as a barmaid to pay expenses like tuition and rent and another at a hospital to get benefits, i.e. health insurance.

    I understand what you want to do for a living and how important that is to you. However, you also found out you NEED health insurance. You need at least a part time job that will provide it. OR start a horsemen's group to buy it as a group or find one that already exists.
    I work six days a week, 8 hours a day, and technically am always on call should I have a sick horse or other crisis. I am also going to school part time, or was until I was laid off and then hurt. When do you propose I find the time to get another job? And who the hell would hire me in my current state?? Why should I have to hold down two jobs just to get my health taken care of??? Are you people f^&*^ng crazy??!!

    Quote Originally Posted by red mares View Post
    The people I know who complained the loudest about their healthcare costs or premiums have plenty of funds, they just don't want to spend it there. The folks with a huge house, and spend $200 a week on doggy day care, $itching about the cost of care for their child. Guess what, if you would rather spend $$ on your dog and too big house, I'm really not inclined to pay for your kid's health care. If it's not your priority, why should it be mine?

    I had socialized medicine when I was in the service. It was one of the reasons I got out. I certainly DO NOT want higher taxes for it.

    For the last 5 years I've lived next to a woman on Section 8 and welfare. She finally got evicted this summer. After supporting (through my taxes) her efforts to devalue my property, trash the neighborhood and keep the locals in drugs, my outlook toward those on government assistance isn't as charitable as it was when I moved in.
    I live extremely modestly on a strict budget. I don't own any horses of my own, have a fancy car, or take vacations. I make enough to get by and save a little, and pay for a couple of classes worth of tuition/books. I'm not in debt. I've worked all of my adult life with no gaps in my employment until now. I've never been on any kind of gov't assistance, welfare, unemployment or disability. I most certainly don't do drugs or devalue anyone's property. I have no idea what this idiotic comparison is playing at.

    Quote Originally Posted by LauraKY View Post
    OP, even if you had health insurance, it wouldn't have covered you because it was a car accident. Lesson here is to hire a lawyer in a situation like that ASAP. Otherwise, the auto insurance companies will jerk you around. No question.
    Read my post, I did have to hire an attorney.

    Quote Originally Posted by RainyDayRide View Post
    I don't believe that is true. In case of an accident such as that, you'd get care. Your insurance company might well go after the responsible driver's insurance for reimbursement - or your own carrier if you were at fault. (it would make no sense for your health insurance carrier to deny immediate treatment, since to do so would likely increase the costs later in your life)
    Precisely. My takeaway from dealing with so many doctor's offices and hospitals over the past month is that they just want some proof they're going to get paid, and health insurance is pretty much the only thing they look at. If you have it and it doesn't cover something, that's fine. They'll still see you and treat your problem, but bill you later. No insurance? They just want a pile of cash upfront. Which, if I had that, then I WOULD HAVE HEALTH INSURANCE.

    Quote Originally Posted by prairiewind2 View Post
    You will need to pay for Obamacare. It won't be free, though it will probably be subsidized for you.

    And yes. I find $250 to be reasonable. DH and I have a $10,000 deductible each and still pay close to $1200 a month. We are in excellent health and have had no major claims in 35-40 years. My wrist/hand was my last claim of any size (a thousand or two, back in the day). So absolutely - I would kill for a policy that cost $250!

    As far as not affording it. You say you were socking away some money. Well, there's your payment. DH and I don't get cable, we drive a very old car and truck, we eat out rarely and I'm counting fast food here, and do only a couple movies a year. We don't buy lots of clothes. We don't have expensive smart phones.

    It's all a matter of priorities. Keeping our policy has caused us some real hardship at times, but it has always been a priority. I've seen too many people bankrupted by health care bills to do without our health insurance.

    So yes, I still say it's a valuable lesson. I wish it didn't have to be - I certainly wish our health care and health insurance systems weren't broken, but they are what they are. You have to deal with life the way it is, not the way you'd wish it to be. I am truly very sorry you were hurt, but fairly unsympathetic to your lack of insurance. Makes me a creep, I know.

    Any vehicle such as a motorcycle or Vespa is a hazardous vehicle. Drivers can't see you well, so they are more dangerous to drive than cars. (I am remembering right, aren't I? You did say Vespa? If you didn't, never mind!)

    Liz
    I was socking money away because I found myself UNEMPLOYED! Not just because I had piles of cash I should have been spending on health insurance! Had I had the money, I would have health insurance...but again, apparently you think I have a money tree in my backyard. I guess blowing $250 this month on health insurance should have been more important than, oh, I dunno...EATING???

    I had a vespa because I was in a head on collision with a 90 year old woman driving 65mph in the wrong lane back in April (also not my fault. luckily was not hurt or killed in that one). The money leftover from the insurance was not enough to buy another car. I also got 60-70mpg, so spent half as much on gas, and half as much on insurance costs. I don't believe in payments or debt, so no, I could not afford a car. Again, if you'll read, she would have hit me regardless. This was a sunny day, late morning on a flat, straight road. She was an idiot and it would not have mattered had I been on a camel...not that it should matter. I should not have to suffer an untreated broken wrist for three weeks, be in a huge amount of pain, have to borrow money from my family, and hire a freaking attorney to get treated. Or I guess I should, because I can just start shitting out gold bricks...

    I am trying to go to school and eventually do better for myself, get a job with benefits, but it's not really possible the way I see it right now.

    Quote Originally Posted by Canaqua View Post
    That must be a state by state thing? Or even something with that urgent care place? Though I've never heard of such a thing. That has NEVER been the case here in Mass. If you have health insurance, they pay the bills for accident related injuries and then go after the responsible party to be repaid (a process called subrogation).
    Wish that were the case here in CA, but it isn't apparently...?


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  18. #58
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    I'm sorry you have been hurt and have not had proper care.
    But I am not sure what Obamacare has to do with anything?

    You are un-insured. Because it's expensive, and you opted to take your chances rather than find an insurance plan.
    Then you get hurt. Who should pay for your care?
    Me??? I have worked all my life. And struggled to kep insurance, though NEVER needed it till recently. I know I have paid out, over the years, WAY more than my recent broken leg has cost my insurance company.
    But that's what insurance is. A legal gamble really. You chose not to be insured. And now, you are thinking its unfair that you are not getting the same care for next to nothing, as those of us who pay out our hind ends are getting?
    I\'m not crazy. I\'m just a little unwell.


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  19. #59
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    Quote Originally Posted by kookicat View Post
    That is totally crazy. Hope your wrist heals well.

    I'm never been so glad to live where I do.
    Me too... and I pay nowhere in the 50% bracket in taxes.
    I broke my ankle between Christmas and New Year in 2008. I signed in at the ER at 1 10 pm, was on the operating table at 3 pm... home by 8 pm. had follow up appointments with the ortho surgeon at the hospital several weeks, change of cast, etc. Total cost out of my pocket? $0. My insurance paid for my physio.

    I really don't understand what is so great about a country who can't take care of its citizens and would rather they go broke and suffer than share the "wealth". So sad and so selfish.


    10 members found this post helpful.

  20. #60
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    Quote Originally Posted by Dazednconfused View Post

    I had full coverage, including medical payment coverage. Not one out of five total orthopedic surgeons would accept third party billing (ie my auto insurance). I am in California, so I'm sure the laws differ by state.
    Interesting... my earlier comment was based on the experience my cousin had - also in California - who relied on her auto insurance to cover the cost of shoulder repair she needed following an auto accident. (she was rear-ended - not her fault.) I wonder now if she paid for the surgery and was reimbursed later or if she found a surgeon who was willing to accept third party. This was five - six years ago.



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