The system is broken, and that pretty much sums it up. Now I should just stop right there and leave the subject alone but being that I am who I am, that isn’t going to happen.
First I will tell you that health care and health insurance are two separate and distinct things that most people seem to confuse. One thing that really agitates the hell out me is the “news” reporting on the subject, these social actors that play the role of “reporter” on the nightly news are just reading a script that is written and prepared for them to read, no different than any other soap opera or weekly detective series actors that are on television.
If you think that is just my theory about it being “social actors” just ask yourself, “when was the last time you saw a physically unattractive reporter on TV that didn’t own a substantial portion of the TV station?” Ugly looking people don’t get television jobs unless they are operating the camera; they are never in front of it.
So, when the news tells you the health care system is broken they immediately go into medical insurance, Oboma Care , as it is referred to here by some in the USA. Insurance is not care and I wish the people writing the scripts would understand this, and then people might have a better grasp on just what the real issues are.
We have more health care facilities in this country than I could even begin to count and plenty of good doctors and nurses staffing them, at least “good” by our standards as a whole. Just in our little area alone there has been no less than 10 stand alone emergency care treatment centers pop up in the last four years or so. I can also tell you that they charge the same prices as the big hospitals so if you are in need of some emergency care and think you might be in a situation that will require a hospital stay, just go to the hospital emergency room and save yourself the ambulance ride that you’ll end up paying for if you go to a standalone emergency care, because they will summon an ambulance or take you in their own ambulance to the nearest hospital with beds for patients.
Medical insurance is a completely different subject than medical care. It is no different than any other type of insurance policy in that you pay an insurance company a “premium” at predetermined intervals so that you are covered in the event you have a medical situation. “Covered” means that the insurance company will pay the bill for your treatment or some percentage of the bill, less the deductible amount which you are responsible for paying. The insurance company can do this using the premiums you already paid and premiums from other folks like you with similar policies, the theory is that not all policy holders will incur a covered medical expense at the same time and so over a period of time things will equalize and they will still have enough money to make sure that the bills get paid and the insurance company can make a profit for their shareholders.
Think of the medical insurance companies like you would your local sports gambling bookie, when you want to bet on a football game. The bookie, or book maker, sets the odds and then he will take your bet, if your team you are betting on loses and you bet $5 on the team to win, you just lost $5. and the bookie keeps your money, that is now his profit from the bet.
But let’s say the bookie had set the odds at 2:1, and your team loses. The bookie still only gets the $5 you had bet. If team had won the game with the 2:1 odds the bookie would have to pay you $2 for every $1 you had bet so that $5 would now come back to you as $10 from the bookie.
Insurance companies are nothing more than bookies, and they have gotten pretty bad at figuring out the odds, so they are going broke left and right. Even with a rigged system like we have here in the USA where everyone is required by law to have medical insurance these companies are still going broke.
In an effort to help stop the bleeding these insurance companies have taken to really despicable tactics including this one my younger sister shared with me last week. Her medical insurance company has a condition in the policy that says before you go to an emergency room for treatment you must call the insurance company 24 hour hotline and talk to one of their employees and tell them what your condition is and why you believe you need to go to the emergency room. The employee on the phone will then determine what you need to do. In my sisters case, it was determined she needed to call 911 and get an ambulance, even though her husband was there and could have gotten her to the hospital in half the time it took the ambulance to get to their house and then transport her to the hospital.
Had she not called and just went to the hospital on her own the insurance would not have covered the portion of the expenses that the company did in fact have to pay as part of the policy coverage. Stop and think about that for a moment, you have a possible life or death situation and you have to call and discuss the situation with someone on the phone who may or may not even be a doctor before you can go to the hospital and have the insurance you are paying for cover you. That is insane in my opinion, luckily everything turned out okay for my sister, but I wonder how many people it doesn’t turn out okay for? So be real clear about what your policy covers and doesn’t cover and what the terms and conditions are. Having medical insurance isn’t like down loading an app and just agreeing to the terms and conditions like people do every day without reading them, her emergency room visit could have really cost her in the wallet if she had not called.
There are several factors that have lead up to the situation that we find ourselves in today with regard to medical insurance. I think that greed on the part of the part of the insurance companies is one factor. Medical insurance in the purest form was for catastrophic situations, like surgeries and prolonged hospital stays where 24 hour medical care was needed. You never heard of insurance companies going broke back in those days by the way.
But in their effort to make more money they started covering things that insurance wasn’t intended for like regular doctors visits, vaccination shots, physicals and such. The problem with that is most everyone needs those things and then throws in the minor illnesses like colds, flu and poison ivy and you have a whole bunch of claims against the insurance policies.
The fact is that the more people you insure and for more things the more you are going to have to pay in claims if you are an insurance company. The problem is the insurance companies suck when it comes to being bookies, and so they have given ridiculous odds to the customers and now they are paying the price for being greedy. Government interference has compounded the problem, they know less than the insurance companies when it comes to running a business yet the government has their noses and fingers in it like a kid stealing frosting from his mom’s bowl when she is baking a cake.
There is nothing wrong with plain cake, not all cakes need icing or frosting, and we don’t need insurance paying every time we need to go to the doctor, we need to go back to paying as we go for routine medical care and have insurance do what it was designed for, the unexpected medical expenses. Only one portion of the American Medical Health System is really broken, that is the insurance portion and the only way to fix it is to go back to what has been proven to work for decades before all the greed set in.
I know there are other factors, and most of those are related to greed as well with doctors being sued left and right by lawyers who work on a percentage basis of what they can settle the lawsuit for. I’m not going to go into all of that right now, this has gotten pretty lengthy already. The main point is that health care and insurance are two separate issues and needed to be addressed as such, combining them does nothing but cloud the water up so you can’t see what is in the water. Also I wanted to point out that we need to know what exactly the insurance policies we have say as to the terms and conditions before we have an emergency.
Alright this concludes my thoughts for the moment. I probably should have just done a “happy mother’s day” daily dose and slid on out but this is important and there is not a better time to bring it up then when it is on the mind.
Until next time,
@sultnpapper
Photos: property of @sultnpapper
At least as important as separating the ideas of medical care and health insurance is the desperate need for medical care not to be so expensive.
When I was younger, I didn't have to stop and think about making a doctor's appointment -- or ask myself whether I was sick enough and whether I could afford this. Now I do. And the answer is almost always , "No."
I wound up in the hospital about 7 years ago and more than one doctor asked me, "Why did you wait so long?" Stupidest question I'd heard in a long time. Because I wasn't sick enough -- or too sick ... take your choice -- to sit in an emergency room for 7 hours waiting for someone to see me because "I didn't feel good." But when I turned glow-in-the-dark yellow from liver failure, finally I had something we could talk about -- at which point they were willing to see me right away.
The health care system in this country is far more broken than equating health care with medical insurance. There's a lot more to it than that.
True the system is far more broken than just equating health care with medical insurance but people need to understand the basics before you can move on to the complexities and explain in more detail. The news has it programmed in peoples minds that the two are one in the same and they are not.
A person can get treated without any money or insurance at the county hospital here at Ben Taub Hospital, the wait in the emergency room is quite lengthy, but that is because people use it as their "family doctor" in some cases rather than the free clinics in the different community areas of the city.
There is medical care available for sure, even for the most financially challenged person, and good care at that.
The expense is the real issue that needs to be addressed, both on the care side and the insurance side. The explaining of that will come in a future daily dose.
Congratulations! This post has been chosen as one of the daily Whistle Stops for The STEEM Engine!
You can see your post's place along the track here: The Daily Whistle Stops, Issue #135 (5/15/18)
The STEEM Engine is an initiative dedicated to promoting meaningful engagement across Steemit. Find out more about us and join us today.
Thank you for the inclusion in this edition.
I hope that's not your leg in the picture.
I remember paying for medical insurance was mandatory when I lived in the USA (Mid 90's). We don't have such problems here as basic medical is covered by the NHS, which In turn is payed from taxes.
That saying, the general level of care here is not good in my opinion, the doctors are pressed for time, they make guesses at what your condition is, you buy the drugs at a basic prescription charge (£8.45 I think currently) and if they guessed wrong, you paid for something useless.
That saying, as far as care goes, I would prefer to be here than there. The expertise level is greater in the US, but at a huge cost to your pocket.
Well, it wasn't my leg , it belongs to my oldest boy. That happened last July when his younger brother was chopping some wood. The younger boy got the ax for his 15th birthday and I trained him how to use it and he is real good with it. The older brother said, "I'll show you ..." and the end result you see. The older boy wasn't trained and the younger one told him he didn't think it was a good idea for the older to use it, but the older brother "won" the argument and the preceded to prove his little brother correct.
We in the USA did not have it where it was mandatory you had to have medical insurance in the 90's that didn't come about until Oboma was president just about 6 years ago or so.
Plenty of companies have used providing medical insurance as benefit of employment with the company and most people took advantage of it because the group rates were lower than having an individual policy. So if you got it through your job that might make it seem like it was required by the government but it wasn't back then.
I have never had medical care in a country other than the USA so I can't say as too quality where is better, I do know that the USA has plenty of foreign dignitaries and royalty come here for treatments and operations so the care must be better than a lot of places.
The cost is the big issue, and prescriptions are a prime example, there are plenty of people who will go down to Mexico and have their prescriptions filled down there for the exact same brand and dosage at 1/5 or less cost than here in Texas. Some are even more savings than that, and the drugs are exported to Mexico from the USA to begin with. There is something wrong in the system when things like that can happen. I'm told that people go to Canada as well for prescriptions to save on the cost.
One big problem here is we are a very litigious society, people will sue each other for anything and everything and what ever falls between those two things. The costs of malpractice insurance and product liability insurance is astronomical and that is a big reason the care is so expensive, no the only reason, but a major contributing factor.
Ill have to stand corrected on the mandatory medical care. It was when I was working, and it did appear to be non-optional.
I never used it during my work tenure, as I was younger then and didn't get sick, except for a bout of chicken-pox that was very unpleasant.
The border prescription thing you mentioned sounds totally ridiculous. I don't know where you live in Texas but I do know it borders Mexico. Have you done this border trip to buy yours?
I do not take any medicines so I have no need too. I regularly travel down to south Texas on business and meet several people in the hotels that are there for that expressed purpose. I have met people from Oklahoma and Arkansas as well that will drive down to cross and get their meds.
I live in a small town on the outskirts of Houston, just to the north of Htown.
Insurance companies are big gambling outfits. They are gambling you won't need it and you the policyholder is gambling you will. That's a no-win situation in my book. They are out to make money but in their greed, they messed up. Now it is costing money due to their greed and stupidity.
Yes, the greed is just over powering in a lot of cases. Insurance was never intended to pay each and every time you needed to go to the doctor.
Medical care in the US is possibly the best on earth. Doctors are incredibly well trained in most every discipline as are nurses and administrators. It is also unbelievably expensive.
Insurance is an entire separate subject, and so distasteful I think I'll not poison the remainder of my Sunday with discussing it.
It is Mother's Day, my first without one so I'm a little 'out of sorts' anyway.
I just said no right after the election of 2016. To TV News. The only news I've seen since has been in doctor's waiting rooms. What's wrong with Animal Planet or Nat Geo? I guess they want to pre stress my blood pressure readings in order to sell more prescriptions.
So. No you have it. My dog is gone and it seems I may have a cantaloupe dog hanging around here. You know, a melon collie. Means it's a good time to quit :)
I'll do better tomorrow.
All the "first days" after losing someone are especially tough so I feel for you.
Our health care is among the best I'm pretty sure, we have the people and the knowledge, also the facilities.
Hadn't given much thought to what the doctors offices have on in their waiting rooms, they might very well be contributing to some elevated readings, good for their business model I guess.
Make the best of your day, go for a ride and enjoy the outdoors.
Your are very correct when you say:
these social actors that play the role of “reporter” on the nightly news are just reading a script that is written and prepared for them to read, no different than any other soap opera or weekly detective series actors that are on television.
Yes, it is true.
May as well call them what they really are, they sure aren't news reporters.
Thanks for dropping in, and making your presence known here, hope to see you back again soon..
I think having a financial incentive for people to be sick is a bad idea.
I agree with you on that for sure.
Your Post Has Been Featured on @Resteemable!
Feature any Steemit post using resteemit.com!
How It Works:
1. Take Any Steemit URL
2. Erase
https://3. Type
reGet Featured Instantly & Featured Posts are voted every 2.4hrs
Join the Curation Team Here | Vote Resteemable for Witness