THANK GOD for PRIVATE HEALTH INSURANCE

[Keystone Phil]

Isn't it hilarious how EVERY single republicanconservativelibwrtarian or whatever the duck they call themselves this week opposes every democratic position that makes sense... Or all of them brainwashed or sth?

Intelligent post

Wait...doesn't every "Democratic position" make sense, Democrat?

[Sam Spade]

Bingo.

I'd rather have a bureaucrat I can vote out of office than have some profit-seeking selfish pig blowhard in an office somewhere trying to kill people for a living in order to increase his margin.

KP already said this but it deserves repeating - You can't vote bureaucrats out of office.  Simple fact.

What most people fail to understand here is that the present health-care model is merely an unrationed version of what is being proposed (well, those who are proposing it may say it's not unrationed, but it will be) AND that certain types of bureaucratic/private functions will work differently in the new system (some will be more or less efficient - I'd bet on it being generally less efficient than today's horribly inefficient model, but I am not beholden to the assumption)

If folks want to continue to avoid reality, it's your business, but as we keep heading off that cliff, I'll be here to remind y'all of some sanity (which btw, is not the present system, don't get me wrong - then again, people don't really want to change the present system, I wonder why...)

[True Federalist (진정한 연방 주의자)]

My point with the second sentence is that I don't think the government insurance would give a damn about whether or not my asthma med cost $289 or $45.  They'd pay for whatever the doctor prescribed me.

What BC/BS obviously tried to do was keep me on the cheaper Proventil, despite it being ineffective, just because it was cheaper.

Let's see here.  The entity actually paying the bill wants proof the doctor had determined that a much cheaper medication was ineffective instead of simply being swayed by a pretty ex-cheerleader salesrep to start prescribing it with no idea of the cost.  Sadly, far too many doctors are clueless about prescription costs.  I don't see the problem, especially at a difference of $244/month. ($2,928/year)  Frankly, that's the sort of hoop an insurance program, whether private or public, should make doctors go through.

If you don't want a third party having any say concerning the medical decisions of you and your doctor, pay the damn medical bills yourself!

Plus there is the fact that you changed from one class of asthma drugs to another.  You went from using a β₂-agonist to a combination β₂-agonist / glucocorticoid, so it wasn't as simple as simply trying a different medication to produce the same effects.

[Sbane]

Well the current system isn't working so shouldn't we try something else, something we have a model for from every other developed nation. I don't see what's the harm in giving the insurance companies more competition with the option of a public plan. The level of service provided by them is horsesh**t as proven by the OP's example and countless others. Perhaps private insurance itself will improve as a result of competition.

I don't care that the insurance companies have competition. I love competition and I'm certainly not some insurance company hack but we're talking about a program that would cost so much money that it's just not feasible. Pointing to "every other developed nation" only goes so far, by the way. There are reasons why we can't implement such a system even though "every other developed nation" has done so.

Why can't America do it when every other developed nation can?  

[Franzl]

Just to provide an example of government insurance causing problems:

My aunt (German hospital doctor) has, more than once, paid for certain medications that her patients needed out of her own wallet.

Just saying.

[Marokai Backbeat]

My point with the second sentence is that I don't think the government insurance would give a damn about whether or not my asthma med cost $289 or $45.  They'd pay for whatever the doctor prescribed me.

What BC/BS obviously tried to do was keep me on the cheaper Proventil, despite it being ineffective, just because it was cheaper.

Let's see here.  The entity actually paying the bill wants proof the doctor had determined that a much cheaper medication was ineffective instead of simply being swayed by a pretty ex-cheerleader salesrep to start prescribing it with no idea of the cost.  Sadly, far too many doctors are clueless about prescription costs.  I don't see the problem, especially at a difference of $244/month. ($2,928/year)  Frankly, that's the sort of hoop an insurance program, whether private or public, should make doctors go through.

If you don't want a third party having any say concerning the medical decisions of you and your doctor, pay the damn medical bills yourself!

Plus there is the fact that you changed from one class of asthma drugs to another.  You went from using a β₂-agonist to a combination β₂-agonist / glucocorticoid, so it wasn't as simple as simply trying a different medication to produce the same effects.

Your arguments are your arguments and I'm sure you have plenty of perfectly fine reasons for all the positions you hold, but:

Please, for the love of god, stop pretending to be an independent.

[True Federalist (진정한 연방 주의자)]

Please, for the love of god, stop pretending to be an independent.

Let's see:  In the past decade I've voted for Republicans, Democrats, Libertarians, and a Socialist.  So which party is it I'm a member of?  (And don't invoke love of god in trying to force me into a party.  There's no way I'd ever vote for the Constitution Party.)

BTW, as far as health insurance is concerned, I'm in favor of something like the system the Dutch have.

[Sbane]

My point with the second sentence is that I don't think the government insurance would give a damn about whether or not my asthma med cost $289 or $45.  They'd pay for whatever the doctor prescribed me.

What BC/BS obviously tried to do was keep me on the cheaper Proventil, despite it being ineffective, just because it was cheaper.

Plus there is the fact that you changed from one class of asthma drugs to another.  You went from using a β₂-agonist to a combination β₂-agonist / glucocorticoid, so it wasn't as simple as simply trying a different medication to produce the same effects.

But it was producing the same effects. The budesonide (glucocorticoid) reduces inflammation which helps alleviate the symptoms of asthma and it works in conjunction with the sympathomimetic formoterol, which is a bronchiodilator. This combination of drugs has the same effect as albuterol (proventil) so I don't see anything wrong with the doctor prescribing it. It's not as if he was being switched to a BP drug or anything like that. The doctor was just seeing if reducing inflammation in conjunction with stimulating the SNS would produce a more desired effect than the sympathomimetic alone.

[True Federalist (진정한 연방 주의자)]

My point with the second sentence is that I don't think the government insurance would give a damn about whether or not my asthma med cost $289 or $45.  They'd pay for whatever the doctor prescribed me.

What BC/BS obviously tried to do was keep me on the cheaper Proventil, despite it being ineffective, just because it was cheaper.

Plus there is the fact that you changed from one class of asthma drugs to another.  You went from using a β₂-agonist to a combination β₂-agonist / glucocorticoid, so it wasn't as simple as simply trying a different medication to produce the same effects.

But it was producing the same effects. The budesonide (glucocorticoid) reduces inflammation which helps alleviate the symptoms of asthma and it works in conjunction with the sympathomimetic formoterol, which is a bronchiodilator. This combination of drugs has the same effect as albuterol (proventil) so I don't see anything wrong with the doctor prescribing it. It's not as if he was being switched to a BP drug or anything like that. The doctor was just seeing if reducing inflammation in conjunction with stimulating the SNS would produce a more desired effect than the sympathomimetic alone.

Similar effects, but not the same effects.  Keep in mind that in medical billing they go to some seemingly absurd lengths at times to specify conditions.  There are some 14 different diagnosis codes that apply to asthma under ICD-9, which is the system most U.S. doctors and insurers use to communicate with each other.

I don't know the specifics, but it is entirely possible that for him that the insurance company had in their files on him a prior diagnosis code from the doctor for which a combination medicine is not indicated as bring more effective than a bronchodilator alone and thus were refusing to pay for the combination product.  Since his medicine had been working, but was ceasing to work as desired, it is possible that his diagnosis code changed to one for which a combination inhaler was appropriate, but the doctor's office failed to get that code to the insurance company in a timely fashion.

I'm not disputing that he suffered from a bureaucratic failure, but in this case I don't see a problem with the bureaucratic system he was dealing with per se, just its implementation.  His reaction would be as if in light of FEMA's failures during Katrina, the proposed solution was to eliminate FEMA.

[Keystone Phil]

Well the current system isn't working so shouldn't we try something else, something we have a model for from every other developed nation. I don't see what's the harm in giving the insurance companies more competition with the option of a public plan. The level of service provided by them is horsesh**t as proven by the OP's example and countless others. Perhaps private insurance itself will improve as a result of competition.

I don't care that the insurance companies have competition. I love competition and I'm certainly not some insurance company hack but we're talking about a program that would cost so much money that it's just not feasible. Pointing to "every other developed nation" only goes so far, by the way. There are reasons why we can't implement such a system even though "every other developed nation" has done so.

Why can't America do it when every other developed nation can?  

These other developed nations are much, much smaller countries. We have enough problems with other enormous entitlement programs in this country so it's best to avoid another.

[Ban my account ffs!]

Well the current system isn't working so shouldn't we try something else, something we have a model for from every other developed nation. I don't see what's the harm in giving the insurance companies more competition with the option of a public plan. The level of service provided by them is horsesh**t as proven by the OP's example and countless others. Perhaps private insurance itself will improve as a result of competition.

I don't care that the insurance companies have competition. I love competition and I'm certainly not some insurance company hack but we're talking about a program that would cost so much money that it's just not feasible. Pointing to "every other developed nation" only goes so far, by the way. There are reasons why we can't implement such a system even though "every other developed nation" has done so.

Why can't America do it when every other developed nation can?  

These other developed nations are much, much smaller countries. We have enough problems with other enormous entitlement programs in this country so it's best to avoid another.

Then perhaps we should divide ourselves into several smaller regional nations.. if it is so difficult for a nation of our size to run entitlement programs, then perhaps we are too big.

Or you just make the states run the programs with certain rules and guidelines and minimums set forth by the federal government.

[Nym90]

Yeah but I think you're forgetting LONG WAITS, RATIONING, SOCIALISM.

lol

scare game works.  you and I will go to our grave(s) without a US 'public option' in place

Well there already is one for seniors of course, has been since 1965. It's a single payer plan, too. Yet somehow the Republic has survived.

[Lief 🗽]

Yeah but I think you're forgetting LONG WAITS, RATIONING, SOCIALISM.

lol

scare game works.  you and I will go to our grave(s) without a US 'public option' in place

Well there already is one for seniors of course, has been since 1965. It's a single payer plan, too. Yet somehow the Republic has survived.

Also the Veteran's Health Administration, which is socialized medicine, similar to the British model, as both the insurance and the hospitals are run by the government.

[Sbane]

Well the current system isn't working so shouldn't we try something else, something we have a model for from every other developed nation. I don't see what's the harm in giving the insurance companies more competition with the option of a public plan. The level of service provided by them is horsesh**t as proven by the OP's example and countless others. Perhaps private insurance itself will improve as a result of competition.

I don't care that the insurance companies have competition. I love competition and I'm certainly not some insurance company hack but we're talking about a program that would cost so much money that it's just not feasible. Pointing to "every other developed nation" only goes so far, by the way. There are reasons why we can't implement such a system even though "every other developed nation" has done so.

Why can't America do it when every other developed nation can?  

These other developed nations are much, much smaller countries. We have enough problems with other enormous entitlement programs in this country so it's best to avoid another.

I like Snowguy's idea of making states provide universal care. A smaller system will certainly be better than one huge national one, although a national healthcare system could probably push down costs more effectively.

[Hatman 🍁]

Prescriptions aren't covered here in Canada either. But, it's so rare that I need a prescription, that I just pay out of pocket. Some people have insurance.

Of course, visits to the doctor are free.

[mgrossbe]

hey bud,

Not trying to get into the debate on what a health care provider should or should not cover but i went through the same problem with my asthma medication.  I found that maxair in combination with singuliar works much better than any other option. Also, you not your doctor decides which medication you take.  If your doctor says otherwise he is either lying to you or in cahoots with the pharmaceutical company.  Next time you go in tell him what you want prescribed and if he doesn't give it to you tell him you will find a doctor who will. It work for me and since i did my asthma is completely under control.  Oh maxair is 15 dollars copay with blue cross/blueshield and singuliar is 20 dollars under the same plan.  Asthma sucks but it can be overcome good luck man.  Plus add over the counter claritin during the season changes and you will be golden.  This has worked for me for the last five years.

[Starbucks Union Thug HokeyPuck]

Last week, I went to my doctor because of problems I've been having with my current asthma medication Proventil.  After examining me, he gave me a prescription for a different asthma medication: Symbicort.

After the appointment with the doctor, I stopped by my local CVS/pharmacy to fill the prescription and handed them my nice little Blue Cross/Blue Shield (which happily paid for my Proventil refills over and over and over and over again) card.  And within 15 seconds of entering my info into the computer, the BC/BS notifies CVS that I do not need Symbicort because, suddenly, it has been determined that I no longer have asthma.

The pharmacist contacts my doctor, who is a Blue Cross/Blue Shield licensed care physician, who then contacts Blue Cross/Blue Shield, who then contacts the pharmacist, and once again rejects the prescription.  My doctor then faxed a complete medical report and chest x-ray to BC/BS to prove that I in fact needed Symbicort.

Today, I received a call from my BC/BS representative saying something a long the lines of "after reviewing your case, we find you are eligible to receive Symbicort."  Woo-hoo! So, I finally got it filled.

Before leaving, I asked the pharmacist what the price for both my new prescription Symbicort and my old prescription Proventil would be if I didn't have insurance.

Symbicort is $289 a refill.
Proventil is $45 a refill.

I can see why BC/BS no longer wanted me to have asthma.

So, thank you, PRIVATE INSURANCE.  Thank you for being around so the DECISIONS are between ME and MY DOCTOR and not BUREAUCRATS in WASHINGTON.

I'll quote Bill Maher from his show a few weeks ago. 

Yea, I want things to run like the Post Office, which the government runs... they get a piece of paper from New Jersey to California in 2 days flat.

We ELECT our government... they are not the bad guys. 

The bad guys are the greedy f  *cks who would let our forum friends here die if it meant spending less on ONE prescription plan.