(no subject)

[hnpcc]

OK, this is just ridiculous. How on earth can someone who is on a good salary fall through the cracks like that? What happens to the people who aren't on good salaries?

Richest country on earth.

Comments

[jamaisneutral.livejournal.com]

That's a disgrace...
The whole point of insurance is that you have it IN CASE you get sick. You don't need it when you're healthy! Of course insurance companies are going to lose some money when they're faced with people who are actually sick, that's what the millions they get from people who are healthy are for!
Thank god for the Belgian health system...

[dalmeny]

What happens to the people who aren't on good salaries?

The very poorest are often covered by a state scheme or by a minimalist federal scheme for emergency care. Otherwise you have to sell your belongings, go into debt (perhaps later declaring bankruptcy) or rely on friends and family. Eventually you may be poor enough to qualify for the emergency care.

It's barbaric.

[ang-grrr.livejournal.com]

I'm horrified. That poor woman.

God bless the good old NHS. At least you know exactly where you stand.

[valamelmeo.livejournal.com]

And the solution is to make everyone, even the healthy, pay for the care of the ill? No, thank you. I've been without health insurance most of my life, and I can tell you that there's always a way to get what you need.

The problem is that middle-class folks like her are used to having insurance at their jobs, and now that the market is such that they generally don't, they don't know what to do. Having grown up poor, I know that no hospital or doctor will force you to pay the whole bill up front, and as long as you send them a little bit of money every month, will not bother you. (the pharmacy is a different matter, though...)

I also know that there are lots of charity organizations who help people like her with treatments and such. The fact that she doesn't seem to have even looked for help speaks volumes.

[damienw]

You might, um, "like" to read Uninsured in America, by Sered and Fernandopulle (Uni. California Press, 2005).

[epideme.livejournal.com]

I was fairly sure that my Health Insurance could not lapse like that and part of having the insurance for years when I'm healthy means that I'll be able to renew for the same amount if I get ill. That's the whole point of being insured.

I'm going to have to read the small print now.

[hnpcc]

And the solution is to make everyone, even the healthy, pay for the care of the ill?

Well that's basically what happens in most of Europe, Australia and New Zealand so from my perspective that's totally normal. Hospitals are funded by tax. Doctors are partially funded by tax. For my GP I pay a set amount up front, which would be less/none if I were on a health care (low income) card. The hospital costs vary according to what's going on but are mostly covered by Medicare (Australian system funded by tax). There are costs associated with treatment - it's very rare if you have a taxable income to have the entire thing covered by Medicare - but there is a safety net provision so that if your costs blow out past a certain level you are covered for anything above that. Ambulance you pay an annual subscription fee for ($35) which then covers you for any treatment (if you don't pay then you're up for the actual costs, which are quite high).

Medicines - some are partially funded through the Pharmaceutical Benefits Sceheme, whereby the government subsidises the cost of some drugs. There is also a huge push by pharmacies and doctors (and the government, heh) to encourage people to use cheaper generic rather than brand name drugs.

Having said all that, there is still a reasonably high rate of private health insurance take up here. Partly this is because if you earn over $50,000/year you are charged a 1% levy if you haven't taken out private health insurance, partly it's because if you need a non-urgent operation it allows you more choice as to where to go and also means you can bypass the waiting lists for surgery (some elective surgeries e.g. knee reconstruction have a lists of several months/years). I don't currently have private health insurance (never had the need), but given my income and a few other variables I'll probably take it out at some some stage in the nearish future.

The problem is that middle-class folks like her are used to having insurance at their jobs, and now that the market is such that they generally don't, they don't know what to do.

You're probably right with that. You know where to ask for help and that doctors won't push you for bill payment necessarily, but if you've always paid on time and paid the full amount you probably aren't aware of that.

There's also a status thing involved I think - the last part of the article where she's wondering about the standard of care is more I think that she's wondering whether people think she's poor and are boxing her in a category she's unhappy with. It also means that she's less likely to ask for help as that puts her more firmly into that category and that's not how she sees herself - surely that kind of help is only for "poor" people who actually need it.

Having said all that though, it still amazes me that someone on what is a pretty decent income cannot afford treatment.

[hnpcc]

It's not the first case I've read where someone who's paid insurance for years suddenly finds themselves unable to get coverage once they get sick. Most of the cases I've read have been US insurers, but there is some bias there because the public health group I read has a predominantly US membership.

[vestalvagrant.livejournal.com]

Another insurer suggested she remarry her former husband to get back on his insurance plan.

I'd love to know how that insurer decides on his (couldn't be a woman making that suggestion) priorities in life. "I'd divorce my wife, but then she'd make me move out and I'd lose my off-street parking space."

[valamelmeo.livejournal.com]

They're only required to renew you at the same group rate if you actually still belong to the group (as in, work for the company). She no longer worked for the company she had bought the insurance as an employee of, and so they could tell her to pay a higher rate or shove off.

[valamelmeo.livejournal.com]

At least where it comes to name-brand pharmaceuticals, I know that prices in the US are artificially high because of mandated artificially low prices in Europe and Canada... Laws require drugs to be below a certain price in those countries, which doesn't actually cover the costs incurred by the pharmaceutical companies to produce them. Since these costs have to be covered somewhere, pharmaceutical prices are absurdly high in the US. I think that adding a drug price ceiling here as well would only slow the pace at which new drugs are developed and available for sale, but that's really neither here nor there, just something that irritates me a bit.

I remember one year my dad and I both needed ambulance rides and hospital stays, for unrelated sudden illnesses (he thought he was having a heart attack that turned out to be pneumonia, and I had a case of heat stroke). We didn't have insurance, and paid on those bills a few dollars every month, more when we could spare it, until they were paid off. One of the ambulance providers actually called to thank us for paying them, saying that even though we were only sending them about $5 per month, that was better than all those people who just don't pay!

Also, I've found that some doctors have a separate fee schedule for uninsured patients, and charge slightly less. If you're looking for a doctor, it's worthwhile to tell them up front that you're uninsured and ask what the average visit will cost... But yes, these are tricks I've learned from growing up with no insurance most of the time. It's a status thing, I know, that middle-class people generally have insurance, and to not have insurance makes some people feel poor. But to allow yourself to become a victim of circumstance is unacceptable, as far as I'm concerned. There's always a way if you're willing to find it.

[kirstenfleur.livejournal.com]

Yeah, I wasn't taken with that last insurer's suggestions either.

I did wonder what would happen if she didn't disclose that she'd been diagnosed with cancer until she got her policy sorted out- because yeah, I'd have been lying all the way.

[hnpcc]

They'd cancel her policy if she didn't disclose and refuse to cover her.

Same as here, really.

[valamelmeo.livejournal.com]

Yeah, but most insurance companies define a preexisting condition as a chronic illness you've been treated for in the previous 6 months. If you can manage to forgo treatment for 6 months to a year, you can become insurable again, but as an independent contractor who isn't entitled to insurance from her job, that'd be shaky ground as well...