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Man denied life-saving surgery over 26-cents

new jersey insurance dispute myelogenous leukemia bone-marrow transplant cobra program

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#16 adrynalyne

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Posted 14 August 2013 - 14:33

Soon there will be people in here complaining that Europeans are derailing the thread to talk about how bad US healthcare is compared to Europe again. ;)

Never mind the fact the guy needed to have two expensive insurances to have a life saving surgery.had to fight for one of them because the payment system didn't inform hi of minor error and the insurance company didn't inform him he wasn't insured... So to getthesurgery he would need to get a loan he could never pay and thus would never get...


Wake up. Your health system if broken beyond repair. Patching it with forced insurance isn't good enough.

Two?

 

No, one.

 

COBRA extends employee coverage for some time after being laid off.




#17 adrynalyne

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Posted 14 August 2013 - 14:36

You take the employer out of the equation and your health insurance cost alone would kill your paycheck.  The employer is paying nearly 50% of your insurance premium. So, they have a say.  Unfortunately, that say entitles them to try and save every nickel and dime, such as this case.

 

The problem will never go away until health care becomes a service, not a business.  But, to do that hospitals, ambulances, and drug companies would all need to convert to a government service.  It just isn't going to happen with the greedy 1%.

Been paying for health insurance without employer for several years.  Its about 200 a month for my entire family.

 

So it doesn't have to eat your paycheck although in most cases it does.



#18 B0mberman

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Posted 14 August 2013 - 14:40

It's not broken, you are dying wrong.  :/



#19 Rohdekill

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Posted 14 August 2013 - 14:51

Been paying for health insurance without employer for several years.  Its about 200 a month for my entire family.

 

So it doesn't have to eat your paycheck although in most cases it does.

I pay $185 a month, just for me, on the cheapest plan out there where I have to pay $100 out of pocket for ER visit, $20 just to see a doctor.  That's with my employer paying in.

 

And, the insurance only covers certain items.  Plus, if I see a doctor outside of plan, those out of pocket expenses double.  None of this is uncommon with most insurance plans, unless you opt for the highest price selection.

 

Take this, add into account cost for prescriptions and you could go broke in no time.  



#20 Lord Method Man

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Posted 14 August 2013 - 14:53

Insurance companies should be taken out of the health care equation.

 

All legal citizens go on Medicare.

 

You know that Medicare is an insurance company? And that they deny a greater percentage of claims than any other insurance provider in the US?



#21 Spartan Erik

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Posted 14 August 2013 - 14:57

We're all awake and are aware the health system here is shoddy.  Having the government step in is going to make it a hundred times worse.

There's way too many people in this country for any sort of system to work, but the worst problem is that the costs of healthcare are out of control.

 

But good luck telling multi-billion dollar companies to settle for less money.  It basically won't ever happen, and we all just have to deal with it.  Capitalist America at it's finest...

 

Medicare and Medicaid works fairly well, and the government has been cracking down on fraud to the tune of hundreds of billions already which is nice to see.

 

I see Obamacare as a step towards a single-payer system.  Right now, we're starting to see a separation of insurance from employment, because businesses can no longer afford to provide insurance to employees.  It's a bit of a gamble, but the hope is by separating insurance from employment, that gives workers more freedom to change (or, forces them to change [depending on your view :p]) work and find better paying occupations.  Plenty people I know who graduated college only work the jobs they were given because of the benefits available to them.  If they lost those benefits, they would be searching for a better paying job immediately.  Whether they find better paying jobs though, that will be a different story..

 

When you finally separate insurance from employment, and everyone is forced to have insurance (or pay a fine), the government could then theoretically step in and offer an insurance plan of its own to compete with private insurance companies.  The government doesn't need to profit, it just needs to break even; after all, the government serves the people.  Private insurance companies serve their CEOs, stockholders, creditors, employees, then the people.

 

It will essentially be Medicare for all, which is what we should've had from the start.  Everyone has "skin in the game" so to speak, and every taxpayer has a responsibility to be healthy since they and everyone else are paying for it (rather than a faceless insurance company).  Heck, maybe even refund a bit of the monthly premium if you pick up healthy habits that reduce the healthcare costs for the government in the future.



#22 Spartan Erik

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Posted 14 August 2013 - 14:59

You know that Medicare is an insurance company? And that they deny a greater percentage of claims than any other insurance provider in the US?

 

Keep in mind that (up until recently) private health insurance companies would drop your coverage if you had a pre-existing condition.  Dropping coverage /= denying a claim when it comes to those statistics. If you are dropped, how can you be denied? Had those people not lost their coverage, who knows how many claims would have been denied.

 

Also, keep in mind you can appeal a denied claim with Medicare and bring it up with a judge.  Can't do the same with private insurers.. their word is the final word.



#23 adrynalyne

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Posted 14 August 2013 - 15:02

I pay $185 a month, just for me, on the cheapest plan out there where I have to pay $100 out of pocket for ER visit, $20 just to see a doctor.  That's with my employer paying in.

 

And, the insurance only covers certain items.  Plus, if I see a doctor outside of plan, those out of pocket expenses double.  None of this is uncommon with most insurance plans, unless you opt for the highest price selection.

 

Take this, add into account cost for prescriptions and you could go broke in no time.  

I'm not disagreeing with you.  I am just saying, it doesn't have to be that way and illustrated it with my own insurance.  Granted, mine isn't great, but its better than what I have had employers offer.

 

The problem is, affordable insurance companies are few and far between.



#24 adrynalyne

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Posted 14 August 2013 - 15:03

Keep in mind that (up until recently) private health insurance companies would drop your coverage if you had a pre-existing condition.  Dropping coverage /= denying a claim when it comes to those statistics. If you are dropped, how can you be denied? Had those people not lost their coverage, who knows how many claims would have been denied.

 

Also, keep in mind you can appeal a denied claim with Medicare and bring it up with a judge.  Can't do the same with private insurers.. their word is the final word.

I've appealed to private insurance companies before.

 

It didn't help, but they do have an appeal process.



#25 vetSkyyPunk

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Posted 14 August 2013 - 15:09

I've appealed to private insurance companies before.

 

It didn't help, but they do have an appeal process.

I had to once before as well. It was a weird situation though...I have had allergy issues since I was a kid. I got my own insurance after college and I was working as a contractor. They covered allergy related stuff for about a year, then stopped covering it suddenly since it was a 'pre existing condition'. After a quick chat with them they covered it again. Luckily I switched jobs and had insurance through my employer after, no more worries on that stuff!



#26 +LogicalApex

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Posted 14 August 2013 - 15:17

You take the employer out of the equation and your health insurance cost alone would kill your paycheck.  The employer is paying nearly 50% of your insurance premium. So, they have a say.  Unfortunately, that say entitles them to try and save every nickel and dime, such as this case.

 

The problem will never go away until health care becomes a service, not a business.  But, to do that hospitals, ambulances, and drug companies would all need to convert to a government service.  It just isn't going to happen with the greedy 1%.

Then my job can offer to pay me more so I can afford the coverage. There is no reason to couple the two together.

 

It also has nothing to do with Hospitals or the others you mentioned.



#27 Growled

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Posted 14 August 2013 - 18:38

I truly despise insurance companies. They are all greedy bastards.



#28 Ph1b3r0pt1c

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Posted 14 August 2013 - 21:29

I truly despise insurance companies. They are all greedy *******.

And the reason that 'health care' is broken in this country. Funny thing is, I dont see ILikeTobacco defaming that dudes wife for missing out on the .26 cents, and that it was ultimatly her fault that he almost died. Where are youuuu?



#29 astropheed

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Posted 14 August 2013 - 21:38

God, am I glad I'm Canadian/Australian. I can't believe Americans don't start a revolution on Healthcare, it's so incredibly sad.



#30 watkinsx2

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Posted 15 August 2013 - 11:01

I know some people may disagree but I think state funded healthcare free for all at the point of service is a must for any forward thinking progressive society.