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#61

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Posted 30 June 2012 - 06:58 PM

Every state's Medicaid program has different guidelines. I would be very surprised if Texas can help your friend, Casi. Oklahoma wouldn't. But it doesn't hurt to try. Oklahoma won't cover an able bodied adult ~ for any reason, no matter how low his/her income ~ unless that person has children.*

You know, along the lines of what Joanne said, if everyone had coverage, then we could eliminate financial ruin and bankruptcy from the horror stories about health care. We could then just stick to the regular awfuls of delayed appointments, missed diagnoses, indifference, incompetence, and the like. Having to fret about whether or not an illness is going to end in financial disaster makes the whole thing so much worse. Not knowing whether or not you'll be able to fill the prescription the doctor hands you can be terrifying. If we only improve that piece, it would be a good thing.


*last I looked at the guidelines, when I worked in the wretched system years ago

Here's a link to Oklahoma's guidelines if anyone wants to get an idea of what the program's like.



#62 loretad

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Posted 30 June 2012 - 06:59 PM

Is that true for even for people who have insurance? Interesting... I know they will sometimes - eventually - help someone with a long-term illness and no other coverage, but the rules are pretty hard to figure out.


I looked on the Social Security website to see if your friend's cancer is covered under their compassionate allowance section but it is not listed. Is anyone from any of the cancer support community helping him?

#63 loretad

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Posted 30 June 2012 - 07:03 PM

Casi mentioned above the fact that, in many cases, the uninsured can't even make an office appointment with a doctor. That is true, though hard to believe. I dealt with that for years with my clients, and I've seen it happen to friends and family members who are uninsured.

That leaves emergency room treatment, which is not the way to treat chronic ailments. It's ridiculously expensive, and when you walk out, you're told to "follow up with your doctor." Only you don't have a doctor. Because you don't have any insurance and no one will see you. So you just wait until another crisis occurs, and go back to the ER where you get your "follow up" to the tune of a couple thousand $$.

It's grotesquely inefficient and inhumane and wasteful, and people get sicker as a result of delayed treatment of manageable illnesses that turn into crises.

My best friend's son was laid off from his corporate job a year ago. The only thing he could find locally was with DirecTV. He was in management with DirecTV, but made less working than he was taking in for the few months he was on unemployment. And no benefits.

He got a sore on his leg and it got infected. He didn't have a doctor. It's just a bump, so hardly seems worthy of an ER visit. It got worse, and worse, until he was finally forced to go to the ER. His subsequent hospitalization with multiple surgeries and major high tech wound care, antibiotic therapy, pain management, probably cost at least $300,000. He had necrotizing fasciitis, and was sent home with a 2' open wound on his leg and a wound vac ~ because he had no insurance.

He's young and strong and he got well, returned to work, but he was unable to stand all day, had to sit for part of it. Fired.

THE SYSTEM IN THE US IS NOT WORKING!!! It is broken in such profound ways it's almost impossible to explain to people who haven't directly experienced it. If you think all this is just crazy talk, that you're doing fine and aren't having any problems, good for you. You've not encountered the horrors of this cobbled up, unfair, inequitable system first hand. Yet. Hope you never do.

We have to do something here. Passage of this bill, whatever its failings, at least got us off high center on an issue we've been trying to address since Jimmy Carter.

Harry Truman tried it before Jimmy Carter did. He couldn't get it here but he up the system in Germany after Hitle.



#64 CasiYucateco

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Posted 30 June 2012 - 07:30 PM

I looked on the Social Security website to see if your friend's cancer is covered under their compassionate allowance section but it is not listed. Is anyone from any of the cancer support community helping him?


His wife, son, parents (flew in from a northern state), and two brothers (alternately travel in from other states) are all helping. They've got resources with the Catholic Church, various help groups, etc. My understanding is pretty much what Lynette said: Texas is not a place to get sick, even if you have good insurance, because there is no other help. If you can afford your share, good. If you cannot afford your share, tough luck.

Get out of the hospital and figure out how to care for yourself in a hotel room while suffering from a collapsed lung, detached diaphragm, etc (tumor surgeries), changing wound dressings, suffering radiation after-effects and burns on the chest. It's just crazy. And another hotel room for the family, and this cost, and that cost.... Come on back for 1/2 a day while we pump you up with chemo then get out again. He's in no condition to be riding around in a car, let alone staying in a hotel. Even nice hotels are not very sanitary places.

People from outside the USA are rightfully horrified at our "healthcare" "system."

Even for uninsured people, the picture is not very good as far as Texas state funding. Few locations outside the major cities have public hospitals and people from surrounding counties show up there, but their home counties do not have to help by contributing to the cost.

So, strangely, blue (dem) counties are paying for the red (rep) counties poor folks' health care. Even wealthy red counties will not contribute to the public hospitals which mainly exist in blue counties. (The Collin County vs Dallas County long-standing battle comes to mind, but there are other examples.)

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#65

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Posted 30 June 2012 - 07:34 PM

I looked on the Social Security website to see if your friend's cancer is covered under their compassionate allowance section but it is not listed. Is anyone from any of the cancer support community helping him?


That's an interesting thought. Here's the list of illnesses that meet the Compassionate Allowance criteria for anyone else who might be facing something like that.

The other question would be this: once considered disabled under that listing criteria, would Medicare be given instantaneously? Because those who are found to be disabled under standard SSDI (for those who've been able to work most of their lives) have to wait 2 years for Medicare.

#66 CasiYucateco

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Posted 30 June 2012 - 09:38 PM

The thing isn't that he and his family are flat broke at the moment. But six months ago, they had a comfortable middle class life with appropriate savings, wise choices, insurance, good jobs, etc. One day, a pain in the chest led to the ER which led to good news - no heart attack - and bad news - the chest x-ray shows something odd.

Six months later, they have spent down and are liquidating their assets. Why does our country literally "break people" - make them broke - due to a sudden serious illness? What is the freaking point of insurance anyway? Six months from today and they'll be broke. And he may be unable to work or worse.

The 'system' simply does not work. It is arranged for the profits of private insurance companies, not shelter from the financial ravages of serious illness. Not for the provision of appropriate health care such as Joanne and Bookworm report, but for the provision of minimally acceptable 'treatment' as long as that doesn't hurt the spreadsheets of insurance companies too much. It is barbaric and insane that the US continues with that non-system.

The USA is the only modern nation where families are routinely bankrupted and broken by illness. The only nation.
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#67 Bookworm

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Posted 30 June 2012 - 09:45 PM

Dear Lynette:
Thanks for your best wishes, but I am hale and hearty, long healed and well, thanks to a health care system that got right on the case from Day 1. I only included it as a personal example of how well things worked for us.
Chuburnaman --- I still fail to understand how divulging only enough details to make the case and absolutely no names would in turn reveal people's identities, but so be it. I'm with Joanne on this --- if two people waited 18 months to have serious cancers dealt with in Canada, that would not be a typical situation at all.
It just doesn't square with my experience. I suspect such situations are rare and unusual and hardly representative of how life-threatening cancers (which, frankly, at some point is all of them) are typically dealt with in the health care system.

#68 CasiYucateco

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Posted 30 June 2012 - 09:54 PM

Bookworm, I just want to say it is very good to hear you are well and were appropriately treated.
Perhaps the people who hate Obama-care in Chuck's original post will end up in Canada and learn how a civilized nation treats illness, if they are capable of perceiving reality.
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#69

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Posted 30 June 2012 - 10:05 PM

The USA is the only modern nation where families are routinely bankrupted and broken by illness. The only nation.


We're No. 1! :blink:

I not making light of your friend's situation. I completely understand. It is hideous that he is not only having to deal with these health issues, but has lost the life he made for himself and his family as well. I don't know why those opposed to universal health care don't get that. We "protect" the nation with the largest military in the world, but our citizens are subject to loss of health, untimely death, and financial chaos as a result of illness. It's inexplicable, I know, to many who live in saner countries. It is also inexplicable to a whole bunch of US citizens.

Bookworm: Yay!

#70 Dave_in_Ont

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Posted 30 June 2012 - 11:05 PM

I haven't weighed in on this topic because, as a Canadian I don't really understand the US medical care system.

My only experience with hospitalization in the USA was last summer in Wisconsin. Thankfully we had purchased medical insurance for our US trip and my experience was efficient and very satisfactory to me. $500 deductible was my cost for a 36 hr stay in the hospital.

As Bookworm points out, Canadian health care is not "universal" throught Canada, but is governed by individual provinces. Over my lifetime I have had a few situations that required hospital admittance for me and my family. ALL urgent situations were handled very quickly. My son requiered serious eye surgery at age 10 and he had it done, successfully, within 8 hours of the injury. He is now in his late 40's and that original surgery is still holding up well. I experienced a swelling and severe pain in my groin and was admitted to hospital within 2 hours of visiting my doctor. The next day a surgical autopsy was done and, thankfully it was a benign tumor.

In the last couple of years I have experienced discomfort walking for any long distance so, last June, my doctor sent me for a series of tests and decided to book an appointment with a vascular surgeon. Nothing life threatening, so it was going to be October 15 before I could get in. I said no, book me for sometime in May of this year. My choice, hang around Canada in the winter or go to Mexico!! (easy choice)

After the vascular surgeon checked me out he suggested it was a lower back problem...probably have to wait until next spring to see a back specialist. BUT that is my choice. I am not crippled and generally not overly in pain. Just not as comfortable walking as I was 5 years ago. Nothing life threatening.

I have one life long friend who went for his annual checkup with his family doctor. Doc determined he had something wrong with his bowel. One phone call, a 1 hour drive to the hospital and he was admitted and had surgery the following day. That was pretty quick response to something deemed life threatening. Friend is still alive and kicking and active as hell on the golf course.

I am a huge supporter of the Ontario Health care system. It seems to act quickly when the situation deserves fast action and lets the lesser needed wait. I am on the lesser needed list and happy to be there. (I hope I am making room for more critical situations to be taken care of)

BTW, here in Ontario, we pay zero dollars for a doctor visit and zero dollars for a hospital stay/surgery or anything else. No co-pay

Prescription drugs do need to be paid by the individual, a drug benefit plan thru work or, if over 65 there is a co-pay of either $6/per or $2/per prescription.

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Seven years snow free, and still counting on my luck!!!


#71

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Posted 30 June 2012 - 11:58 PM

BTW, here in Ontario, we pay zero dollars for a doctor visit and zero dollars for a hospital stay/surgery or anything else. No co-pay

Prescription drugs do need to be paid by the individual, a drug benefit plan thru work or, if over 65 there is a co-pay of either $6/per or $2/per prescription.


That would be pretty nice.

Here in the US, copays and deductibles have increased enormously, along with premiums, in the last 10-15 years especially. There were a couple of years running that our premiums increased almost 10% each year.

Our prescriptions run anywhere from $25 to $100 each. Mike takes 9 prescription meds each day, happily down from 12. Most of his run around $50, though one's $6 and another is $85.

A lot of people don't take their meds, or they skip days, or they never even get them filled because the costs are so high. Since Canada's life expectancy is greater than that of the US, maybe that has something to do with it? People can get the care they need and can put any recommendations into practice without going broke.




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