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unfair health care system hits home (Read 5656 times)
saxman
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Re: unfair health care system hits home
Reply #25 - Dec 30th, 2009 at 9:28pm
 
Callico, I think you and I really are on the same page! Believe me I kick myself now for not doing the Cobra!!!
What happens with me is that in between cycles(I actually skipped a year last year to boot) I go into denial and assume there gone forever.

I won't be making that mistake again.

Maybe someday
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Racer1_NC
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Re: unfair health care system hits home
Reply #26 - Dec 30th, 2009 at 9:38pm
 
saxman wrote on Dec 30th, 2009 at 9:28pm:
What happens with me is that in between cycles(I actually skipped a year last year to boot) I go into denial and assume there gone forever.

That means you are normal.
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saxman
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Re: unfair health care system hits home
Reply #27 - Dec 30th, 2009 at 10:02pm
 
no one ever called me normal before, I can't wait to tell my daughters the great news!!!
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Re: unfair health care system hits home
Reply #28 - Dec 30th, 2009 at 11:33pm
 
LMAO @ you Saxman.   Grin
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Hurt people.....hurt people.   Think about it.
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Callico
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Re: unfair health care system hits home
Reply #29 - Dec 31st, 2009 at 12:07am
 
I refuse to be normal!  Normal is only average!

I'll know mine are gone when the first shovelfull of dirt hits me in the face.  Till then, even if I go back to episodic I'll always be looking over my shoulder for the beast.

When you do get insurance back again and you get back onto the meds and the cycle ends I would suggest you stockpile for a while to be sure you don't get caught short again. 

Be proactive.  Educate yourself on other means of dealing with this stuff.  It can be done.  I went totally med free for several years.  Easy?  No, but doable.  In a lot of ways I think I was actually better off than when I was doing a lot of the meds.  I felt better overall.  Now I don't use any prescription meds other than oxygen, and if I didn't have that covered I'd get it on my own for less than copays on any of the other meds I used to be on. 

As my History prof always used to say just before an exam, "This, too, shall end."  You'll make it.  You are a clusterhead, and there is no tougher creature on this earth.  Sometimes we get knocked down and dusty, but as Ed Brown says in his motivational speeches, "When you get knocked down land on your back, cause if you can look up, you can get up."

Jerry
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Re: unfair health care system hits home
Reply #30 - Dec 31st, 2009 at 2:05am
 
thanks for the pep talk Callico. I came home from work, got hit on the drive home! a real k10!!!The first hit in several days out of the blue. I guess the pred taper is finally wearing off.
I hit the rockstar, and ice, Wow!!! I had the computer on and read your post as the hit lessened and it really did  help! It helped me fight back!! Somehow for me, as long as I keep mentally fighting back, not giving up, I can get through even the worst one. Tremendous help having allies on this site that I know are fighting there fight too!
Ahhh !! just about completely gone now
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saxman
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Re: unfair health care system hits home
Reply #31 - Dec 31st, 2009 at 7:26am
 
believe it or not? whats lmao?
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Re: unfair health care system hits home
Reply #32 - Dec 31st, 2009 at 8:40am
 
Laughing
My
A$$
Off

LMAO
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deltadarlin
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Re: unfair health care system hits home
Reply #33 - Dec 31st, 2009 at 10:30am
 
Charlie wrote on Dec 30th, 2009 at 8:03pm:
Quote:
Bob,
I agree wholeheartedly with you about the profit margins.   Most insurance companies are not showing that large of a profit margin, so they can't be as *ebil* as people paint them to be.


They're worse!

Charlie



Damn, Charlie!  What do *you* have against insurance companies?   

FWIW, our insurance thorugh the state is extremely good.  I've never had any problem with them denying any procedure, nor have they ever denied any form of treatment.   We're under a PPO, so I can pretty much go to any doctor I want.  When our neuro/headache specialist was located in Jackson MS, we were able to go there and the insurance picked up the costs with no problem.
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loopy
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Re: unfair health care system hits home
Reply #34 - Dec 31st, 2009 at 12:38pm
 
Charlie loathes the insurance companies because they are in business to make a profit.  They should not be allowed to profit from giving you such great service.

They use a shared risk model, where they hope that they collect enough in premiums to cover the charges they will get from their customers medical providers.

hmm...

- they don't control what doctors and hospitals charge
- they don't control what sicknesses or injuries you might sustain
- they do have enormous buying power, so they can negotiate rates down to save you money
- if they make a bad risk, they have to pay anyway
- if they make a profit, it goes to their shareholders
- nobody forces you to do business with them (oh wait...that is going to change, thank God for hope & change)

Such an evil system.  Thank God the government is going to fix all of this.

Last I remember, Charlie's income is entirely provided by insurance (disability).  Damn insurance companies.  Get a rope.
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Charlie
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Re: unfair health care system hits home
Reply #35 - Dec 31st, 2009 at 4:51pm
 
They kill people every day.

Charlie
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Re: unfair health care system hits home
Reply #36 - Dec 31st, 2009 at 5:57pm
 
Compared to how many who continue to live with their assistance?

Weak argument.
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« Last Edit: Dec 31st, 2009 at 5:58pm by Brew »  

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deltadarlin
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Re: unfair health care system hits home
Reply #37 - Dec 31st, 2009 at 7:43pm
 
Charlie wrote on Dec 31st, 2009 at 4:51pm:
They kill people every day.

Charlie


So, do you hate doctors, hospitals, cars, guns, natural disasters, and humankind in general?
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loopy
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Re: unfair health care system hits home
Reply #38 - Dec 31st, 2009 at 8:32pm
 
deltadarlin wrote on Dec 31st, 2009 at 7:43pm:
Charlie wrote on Dec 31st, 2009 at 4:51pm:
They kill people every day.

Charlie


So, do you hate doctors, hospitals, cars, guns, natural disasters, and humankind in general?


Don't forget Oxygen, Imitrex and most triptans.  All have killed.  Oxygen kills every day (you can't have fires without it).


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jon019
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Re: unfair health care system hits home
Reply #39 - Dec 31st, 2009 at 10:51pm
 
I'll let you deduce what I think of health insurance companies:

For 25 years, mine (2 different co) would not cover O2. Me: why not? Them:...we don't approve it for THAT condition. Me: But why not? Them: BECAUSE we don't. Me: DON'T you have a reason?.....Them: click......

For 25 years, they would only approve "6" triptan doses per month. Me: why? Them: You can't be having that many MIGRAINES. Me: It's clusterheadache...not migraine. Them: Huh? Me: It's different! Them: We only cover 6 for migraines. Me: Haven't you been listening? Them: Yeah, migraines. Me: NO....clusterheadache! Them: ....click....

I no longer bother to call "them"...it's too stressful. I have been LIED to...given WRONG information...blown off...or just ignored. I now go through the broker....used to work great....the current one couldn't care less....he WILL regret that.

Will they eventually cover darn near anything?..yup...but reluctantly...and ONLY IF you know how to play the game. I learned...mostly HERE (ch.com)....and THAT is friggin SAD. I despair at the thought of those who have given up....and I FIRMLY believe that is the strategy...make it SO hard....most WILL give up. Give up on what they NEED...because ya can't fight city hall, right? WRONG! Not this cowboy.

So, that all is ch...enough of a battle as you all know. But now, I am dealing with cancer....frightfully common...you'd figure well, they can't mess with you on that, right? Wrong! I'm currently in a fight for coverage of a procedure that is ABSOLUTELY state of the care....I know...have researched it...and they are refusing to cover (nearly $4000). ANOTHER battle...and I grow weary...

During this I was offered "managed care"...for FREE... for those with chronic conditions. Initially I thought....GREAT....my own nurse contact with promises to manage my care for the best outcome...lead me throught the maze of treatment options...hold my friggin hand (we're ALL little boys when we're sick doncha know). Great...just great! ONLY, I read the fine print....seems if I signed up...THEY would decide what is the apppropriate treatment (not the doc)...they would decide who I could see and when...they would decide EVERYTHING.....If I chose a path, a doc, a treatment, a whatever they didn't approve of...well then...NO coverage for ANY costs. I couldn't wait NOT to sign up..........

If you are healthy...the health insurance companies love you...my best advice.... DON'T get sick (yeah, right). I ONCE made the mistake of feeling sorry for my insurance company....it won't happen again.

Are health insurance companies the ultimate evil empire? Nope...they are just eating at the same banquet (with sauce smeared on the face). My personal belief is that they build those profits on the backs and bodies of their "clients" (that's a joke son) rather than working to correct the disfunctional system...which is...the medical service costs which are just friggin STAGGERING...and I consider the MAJOR problem....

I live in DAILY fear of losing my job...with my condition(s) it could happen any day, as I am not performing to past practice after all....and I KNOW, with PRE-EXISTING conditions, I will NOT be able to get coverage...and the savings I have so diligently accumulated...so I would NOT be a "burden" on society, will be gone, gone, gone...and crying won't bring them back.....

The new "Health Care Bill" is so confusing I cannot begin to comprehend....what I do percieve is that it goes into effect 3-5 years from now....I don't expect to be here then.....

Jon

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Charlie
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Re: unfair health care system hits home
Reply #40 - Jan 1st, 2010 at 11:56am
 
Quote:
Compared to how many who continue to live with their assistance?


Reminds me of the old argument that because the percentage of murders in a small country is higher than in a large country means something other than percentage. There are still a lot of dead people no matter the statistic.

Denying treatment to their own insured customers when it starts hurting balance sheets is inhumane and it happens all the time. Shame on us for allowing it. Fine, make money but do it with a conscience. Using health care to demonstrate the American self reliance ethic is ugly.

Charlie

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« Last Edit: Jan 1st, 2010 at 12:12pm by Charlie »  

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Callico
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Re: unfair health care system hits home
Reply #41 - Jan 1st, 2010 at 4:05pm
 
When dealing with ins companies about denial of coverage always go to a supervisor at the very beginning, and then on to a manager if necessary.  Those answering the phones are given a very rudimentary training on the different types of policies, and rarely know enough to make an educated guess let alone analysis of your situation.  They also are held responsible for anything they approve without proper authority, hence it is easier to say "no" and not dig deeper into YOUR situation unless you read the specific verbiage from your own policy.  The fault lies at the feet of the insurance company's lack of training of those representing them much more than on the policies of the companies.  The turnover rate of those answering the phones is so high it is virtually impossible to keep the training at a high enough level.

Jerry
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Re: unfair health care system hits home
Reply #42 - Jan 1st, 2010 at 5:28pm
 
Callico wrote on Jan 1st, 2010 at 4:05pm:
When dealing with ins companies about denial of coverage always go to a supervisor at the very beginning, and then on to a manager if necessary.  Those answering the phones are given a very rudimentary training on the different types of policies, and rarely know enough to make an educated guess let alone analysis of your situation.  They also are held responsible for anything they approve without proper authority, hence it is easier to say "no" and not dig deeper into YOUR situation unless you read the specific verbiage from your own policy.  The fault lies at the feet of the insurance company's lack of training of those representing them much more than on the policies of the companies.  The turnover rate of those answering the phones is so high it is virtually impossible to keep the training at a high enough level.

Jerry


Yup....ABSOLUTELY golden advice...I now know how to play the "game". Without a full rehash (see archives) this is what I've learned. Hope your experiences are better...I'm bitter.....

I work in a service industry. If we treated people like I have been treated...we wouldn't be in business....and I'm not just talking about drones on the phone...

Don't consider yourself a customer...you are not...you are an adversary...act accordingly.

Move up the chain of command at every opportunity...take names and numbers of everyone you talk to...make notes on what is said to you....keep a log.

Put everything in writing...collect every piece of paper. Denials? Fine....dispute them...get a written reply.

Get your doc in your corner. Don't leave interpretation up to the insurance company. In my case, the doc got pissed and wrote a VERY specific letter...with unequivocal statements, demands, and instructions to call if they STILL didn't understand. The insurance company HATES this because it creates a paper trail...one not open to interpretation..one that would bury them in front of a judge.

If your insurance is purchased for your company through a broker...get them on your side too. The broker IS the insurance company customer (you aint)...and they can get stuff done that will put your mind in a spin. If the broker won't respond to you...get the HR dept involved...no HR...get the owner to hammer on them. He who pays the money gets the voice.

NEVER NEVER NEVER give up...that's the strategy...they want you to....dogged determination frustrates their strategy...it can only help when they just want you off ther backs.

SIGH...I don't like being bitter...it's not me...and they did that. I'm not expecting altruism...I don't begrudge profits...but I detect no conscience or soul...it's ALL about money....and in this business...with health and lives at stake...it's GOTTA be more than that.

jon
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saxman
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Re: unfair health care system hits home
Reply #43 - Jan 1st, 2010 at 9:10pm
 
someone told me once that at Dental school the future dentists practice that God awful novacaine shot to the roof of the mouth on each other.

I wish Drs. and ins co mgmt types could suffer a 5 min K10 as part of there training
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Re: unfair health care system hits home
Reply #44 - Jan 2nd, 2010 at 1:16pm
 
Some good posts kids!

Time for another rant topic....

Charlie
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Re: unfair health care system hits home
Reply #45 - Jan 2nd, 2010 at 1:48pm
 
saxman wrote on Jan 1st, 2010 at 9:10pm:
I wish Drs. and ins co mgmt types could suffer a 5 min K10 as part of there training

That's just cruel.
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Re: unfair health care system hits home
Reply #46 - Jan 2nd, 2010 at 9:05pm
 
Quote:
That's just cruel.


It sure is but..................

Charlie
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Re: unfair health care system hits home
Reply #47 - Jan 3rd, 2010 at 12:30am
 
But what? It's cruel.
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Re: unfair health care system hits home
Reply #48 - Jan 3rd, 2010 at 6:37pm
 
Charlie wrote on Jan 2nd, 2010 at 9:05pm:
Quote:
That's just cruel.


It sure is but..................

Charlie


   But nothing, it is cruel.
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Re: unfair health care system hits home
Reply #49 - Jan 23rd, 2010 at 3:45am
 
I don't think my thought was cruel. Ithink that if my wish was for the Drs to suffer gratuitously then perhaps. I do not wishthem any pain but rather to be educated and to understand.

I'm in sales and very sensitive to what isn't said. I've (we've all) sensed Drs trivializing our condition. Even when being hit, many of these professionals are still categorizing us  headache (migraine/tension) people.

The result: They under prescribe, they under everything!! They wouldn't if they had felt the pain themselves.

I hate cruel.
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