I am the mob

[flintlock]

Re: I am the mob

In the few times when I went to the doctor, I just paid for it. Aside from treatment for an accident, in each case there was no medical treatment available for the problem . . . so I received no practical advantage from "professional" consultation.
.

Well that's basically what people used to do until late last century. Worked for them.

[ThePythonicCow]

Re: I am the mob

What if ...

One can only choose ones risks, not avoid any of them.

I don't know how old you guys are but I can guess probably younger than me(?) You may find out you are not as bullet proof as you think you are.

Well, I'm old enough that I won't be "nekkid" much longer, thanks to medicare kicking in at 65. I may be hesitant to even sign up for Medicare however; we'll see when I get there. What I'm doing now is working well.

As far as the affects of aging, I'm healthier now by a substantial margin than I was 20 years ago. My risks of the chronic illnesses such as cardivascular, cancers, diabetes, and such have been driven to essentially zero. The Standard American Junk Food Diet (SAJFD) leaves enormous "opportunity" for improvement.

And having kids makes a difference.

The kids (and wife) were the major thing that kept me on a normal medical insurance plan. Unless one is blessed with a like minded wife, going nekkid with the wife and kids is not really an option. Fortunately, the kids are grown now (barely) and fortunately for my wife, she's managed to get me divorced and out of her life.

[dummass]

Re: I am the mob

Have you considered getting different parents :rolleyes:?

They spelled it Damascus, but my fait accompli arrived on my first day of school. I no longer blame them. ;)

[thunderdownunder]

Re: I am the mob

I have been reluctant to enter any debate on your US health system as I have little knowledge of how it works. The only time I ever needed help was when on holidays in Aspen in 05. I tried out the "snowboard" thing and ended up with a dislocated left shoulder thanks to a tree and the inability to stop. It was fully covered by Travel insurance and I was treated well. My only additional cost was for copious pain killers at Nells bar. Note to skiers - two skis are much better at stopping as you have three times the edge.
A different view of what works

I do feel sorry for you because down here All People who pay tax are covered by "Medicare" and are given a little card with all dependents printed. You pay 2.5% of your taxable income and you pay nothing if you visit a "bulk billing" doctor.
These doctors work on volume and short consultations times of 15mins cycles the down side is that they are not good medical practitioners more like business men. They are Ok for cuts/bruises, suspected sprains and running noses but are totally impersonal and are usually a long wait time to see (2hrs not uncommon) They cost you nothing as they bill the Government for their time.
If you want to chose your doctor and pay the difference between what the government pays him and what he deems to be profitable you can. Typically I have my own Doctor (might I say he is the best of the best) I pay a cash co payment of $32 for each visit and he receives the balance from the government (called the schedule fee).
He is restricted from raising his prices higher because the market would tend to move to the bulk billed buffoon.
Private and competent doctors hate Medicare as all income is reported to the government and they can't hide the cash anymore.It also caps the income of good doctors because market forces restrict how much he can ask for co payment. Wait times are short and the consultation personal and expert.
Ok thats the Doctor side basically explained.

Medical testing

The government has this covered fully.Standard procedure Xrays, blood tests, scans, and all manner of investigative things are TENDERED by private practice and you tend to get them free (unsure about MRI's as never had one). This gives the government the whip hand. Specialized tests have a co payment but it is never much out of pocket. The competitive nature of tender keeps the costs down.

Public Hospitals- State government owned and run but funded by Fed Gov allowance. Out patient treatment (24hr service) is free - completely. As a result Waiting times can strain the patience of Job. 4-6 hrs wait is not uncommon but the treatments are first class. Patients are treated according to emergency at presentation. Amputations Car accidents , shootings and Heart attacks first then progressivly down to little jonnies splinter or Diarrhea. Never ever present at out patients on a full moon Friday or Saturday Night - it is given over to the drug F*%#Ked and the Bleeding Zombies of Youth. The waiting room will look like admission entrance to Hell.

In patients - If you need a Knee or hip job its free in public system but you wait(2 years for non urgent) If you have a life threatening Coronary or Cancer you jump the line by rating and generally the treatment is World class as a public patient (Hospitals train and are overseen by the best specialists in the land)

Private Hospitals - Part funded by government and run for profit. You MUST have private insurance. The treatment is in my opinion less professional and inferior to the public system. The survival rate for say Leukemia in the public system is much higher than in the private system. It could be that follow ups are more intense in the public domain as it is not run for profit.
On the plus side the meals are better and the rooms are not austere.

Pharmacy - Pills for all ills - This is where our system shines brightly - It works like this. The Federal Gov has the Pharmaceutical Benefits scheme - PBS - and it asks the big Pharma manufactures around the World to tender on the pills that are "listed"
The result is that we get cut price pills due to competition. They act as bulk buyer (like Walmart) and distribute to private Drugstores called Chemists (that don't sell milkshakes just all manner of medical supplies). The public is made to subsidized in that you have to make a co payment.Varies up to $25/ prescription . If your chronic and have large prescriptions to fill you are protected buy a cap. Once you spend, I think, $1500 in one year the balance of that year is free.
If you are disadvantaged (poor or on social assistance) your co payment is about $2.50 for each prescription up to a cap of I think $250 annually. after that it is free.
No one begs for medication or goes bankrupt as in the US. Every taxpayer in Australia is protected. It does cost the government more than the Medicare levy brings in but it is a well loved safety net that uses competition and market forces to cap cost increases. It works and it is the best thing to happen in this country. (introduced by Labor under Gough Whitlam)
Wealthy people who can afford private insurance but opt out are penalized heavily with an additional tax surcharge (Thos earning $120,000/year) so no freeloaders are permitted and they pretty soon get themselves insured up as it is way cheaper than the fine. Full Family Private Costs about $4000/ year as some government payments are made to private health to keep costs down. (and encourage private investment in hospitals)

Personal Example of how it all works-
My ex wife contracted CML (chronic myaloid leukemia) diagnosed in late stage. It is incurable or was.
She had Private health cover
She could afford it with what she took from me She was treated by an oncologist and was in private care for 10 days until the bastards who had been taking our money for 20 years without much claim pulled the fine print out of the contract and explained that the insured limit of bed days was now exceeded and would she kindly go and die somewhere less expensive for them. Unless she paid full board and keep out of her pocket. At $560/ day it was not an option. Went and sought advise from Social security and as she was unable to work she was given care in a Public hospital under the best oncology professor in Australia.She was put on a course of tablets called Gleveec (Novartis) to stabilize her (this tablet was not on the PBS and cost $52,000 but she was given it free as a PBS trial) Her treatment of bone marrow extraction followed by a proper course of radiation to destroy what remained. Only a small dose of chemo was needed and the extracted bone marrow was "cleaned" of all traces of Leukemia then re injected. She has survived for 4 years and no trace can be seen in her blood. She is back working and is normal weight.
TOTAL COST (after we got out of the blood sucking private system) - NIL to HER
It works because it was designed to use market forces and big stick approach. It is fair to those who pay tax. Illegals and working visa holders are excluded. However in a Life threatening emergency they are treated. No one dies for lack of care.
The US treats its Pet animals better than its people and this must change. Put the Medical monied interest in competition with each other and let the Government buy in to see if it can make a profit (it never will) by competing. Leave the rest up to market forces.

Disclaimer: the above is a guide. The amounts are approximately correct as I am healthy and take no medications at all and am advised by my doctor that all medications will damage the liver or kidney/bladder in the end. Heal thyself with discipline. I am on single cheapest private @ $800/year and never use it.

However Mr Cow How much is the "Deductible" on divorce in the US. Down here they make men paraplegics when they take both the arm and the leg

[ThePythonicCow]

Re: I am the mob

However Mr Cow How much is the "Deductible" on divorce in the US. Down here they make men paraplegics when they take both the arm and the leg

Your Aussie medical system sounds quite a bit better than our U.S. system. Thanks for describing it. Now I can be even more depressed at how bad our system sucks, and even more grateful that I am sufficiently healthy to not care.

If you let the court decide the result of a contested divorce, then it depends much on the biases of the judge and the skills of your attorneys versus your spouse's. Decades ago, the men usually held the strong position. The last couple of decades, especially in liberal states such as California (where I lived at the time,) the women have held an equal or favorable position in the courts.

But that didn't matter in my case, as my wife and I arrived at a consensual agreement. The details don't matter here; suffice it to say the deal was fair and I did fine.

[flintlock]

Re: I am the mob

One can only choose ones risks, not avoid any of them.


Well, I'm old enough that I won't be "nekkid" much longer, thanks to medicare kicking in at 65. I may be hesitant to even sign up for Medicare however; we'll see when I get there. What I'm doing now is working well.

As far as the affects of aging, I'm healthier now by a substantial margin than I was 20 years ago. My risks of the chronic illnesses such as cardivascular, cancers, diabetes, and such have been driven to essentially zero. The Standard American Junk Food Diet (SAJFD) leaves enormous "opportunity" for improvement.

The kids (and wife) were the major thing that kept me on a normal medical insurance plan. Unless one is blessed with a like minded wife, going nekkid with the wife and kids is not really an option. Fortunately, the kids are grown now (barely) and fortunately for my wife, she's managed to get me divorced and out of her life.

I find some people tend to be generally healthy and some are not. Its not always lifestyle though. Good genes play a big part. Otherwise how do we account for childhood cancers and heart defects? Or my 46 year old tennis fanatic neighbor dropping dead at 46? :eek: I'd say that if you have almost made it to 65 being very healthy the odds are good you will continue to be so for a long time. Taking good care of yourself improves your odds vastly no doubt.

When I think about it, I've probably pretty much broken even on health insurance so far. But only because a of a few larger claims.( wife's hip replacement, two pregnancies, etc) I may even be ahead. I think some people are too fixated on the small stuff and want insurance to become a replacement for savings and prudent living, which it was never intended to be.

Pregnancy is one of those things that should not be covered under insurance, but is. So we all end up paying for other people's kids in that regard.

[Thailandnotes]

Re: I am the mob

"This leaves about 15.5 million who actually are uninsured" Raz

I've seen several claims that 100 million Americans have insurance policies that won't pay up. And then there are the situations where even the co-pay will bankrupt them.

My wife fainted in LAX a couple of years ago and was forced to take an ambulance ride to the emergency room. The bill was over 10,000 $. We had insurance. I kept getting a bill for 1,000 $ and arguing that according to our policy I only owed a 10 % co-pay. Finally the penny dropped. 1,000 was my co-pay.

"A google search for "high-deductible health plans" should provide you a start on this. There are plans with for example $5000 deductibles. You pay the first $5000, they pay the rest, up to some large cap." Cow

Yes, but how can you trust one? My brother (American) got in a car wreck in Canada. A month in ICU, over $1,000,000. The plane ride home was over $ 20,000 (medical plane owned by Pizza Hut (YUMS) not kidding). The Canadian government paid all expenses including lost wages for years. No way that would happened if the wreck had occurred south of the boarder.

"I figure I've saved over $80,000 by not having insurance over my lifetime."
That will buy you a lot in Thailand.

Colonoscopy $500, root canal $50, back surgery or knee replacement $2-3,000….ultra modern facilities, computerized medical records, easy referrals, walk-in service. And oh yeah, exact same medicine sold in the US at 10 % the cost.

[ThePythonicCow]

Re: I am the mob

"A google search for "high-deductible health plans" should provide you a start on this. There are plans with for example $5000 deductibles. You pay the first $5000, they pay the rest, up to some large cap." Cow

Yes, but how can you trust one?

I don't know if you can trust one. If they go bankrupt before you need them, or if they dishonestly cancel your policy if you start charging too much, then you wasted your insurance premium.

"I figure I've saved over $80,000 by not having insurance over my lifetime."

That will buy you a lot in Thailand.

Colonoscopy $500, root canal $50, back surgery or knee replacement $2-3,000….ultra modern facilities, computerized medical records, easy referrals, walk-in service. And oh yeah, exact same medicine sold in the US at 10 % the cost.

How would an American contact such services? I have a lasting affection for Thailand, from the 18 months I spent there back in the early 1970's. Heck, I can probably still speak two or three words of Thai well enough that you could guess what I am trying to say . Do some of the more reliable Thai medical services have representatives in the U.S., or does one fly over first and expect to stay for a few weeks while one locates services? How does one avoid the less honest or less capable services?

[Thailandnotes]

Re: I am the mob

For major stuff you can google Bumrungrad Hospital. It was on 60 Minutes. You can google Bumrungrad Hospital 60 minutes. If you were saving up for lots of minor stuff, there are great hospitals in many other locations. If you are seriously considering coming here, send me a pm and I'll give you more information.

[ThePythonicCow]

Re: I am the mob

For major stuff you can google Bumrungrad Hospital. It was on 60 Minutes. You can google Bumrungrad Hospital 60 minutes. If you were saving up for lots of minor stuff, there are great hospitals in many other locations. If you are seriously considering coming here, send me a pm and I'll give you more information.

Thanks. I have no plans at present to come. My current plans are to remain in perfect health for another 30 years at least.

If that doesn't work, and you and I are still both on iTulip, I'll look you up.

Thank-you much, sir.

P.S. -- I see this hospital has a fine web site, suitable for any major nationality to view, at http://www.bumrungrad.com/. The World Wide Web continues to support a dramatic increase in the variety of economic goods and services that can be profitably delivered. This is a form of wealth that I see routinely when I order some strange good that takes my fancy, from the various corners of the world, to be delivered at quite modest cost to my door step by my friendly UPS driver. Such was not possible even just a decade ago. Life is good.

[BigLandbaron]

Re: I am the mob

I agree with this bovine philosophy and practice it as well. Over the past ten-years, I've needed to visit the doctor once: after smacking myself in the face with a large pair of pliers (doing something stupid of course). With all the money saved on insurance premiums over the years, I could afford the very best plastic surgeon.

It would be more accurate to say that I am self insured. I keep funds available for emergencies and I make my own decisions on how the funds are spent.

This MOB appears to be real. I've seen very little in the MSM reporting to convince me that these town hall protests are not "real". There may be paid protesters at some of the town hall meetings, but I think they are outnumbered by the really pissed off / fearful constituents.

I have the same insurance philosophy as Dummass and The Cow; I can afford the insurance but choose not to participate. I was fully insured (via corporate group insurance) from age 22-45 ... and I never made a claim. I'm uninsured now because I feel I have sufficient funds to fend off anything short of a black swan - big-time cancer or a long term debilitation. I'm 50, divorced, no kids, working girlfriend with her own mandatory insurance. I considered high-deductible insurance options in 2004 but decided to play the odds; take the risk / self insure. I've saved ~$50K in premium payments over the last 5 years (calculated with the cost of low-deductible coverage offered to me in 2004), and have had no issues ... as usual. I'm healthier now than I was then. Asprin is my medication of choice for most ailments (an occasional headache, muscle ache, a rare pounded thumb or other miscalculation).

This is the last "free market" vote we have against the current US health insurance industry; to choose to be healthy and not participate!. I wish to pay only for what I need. I do not wish to support fraud, bureaucracy, incredible bonuses and a litany of additional procedures/referals. I hope to stay healthy and remain self insured as long as I have that option and it makes good financial sense to me.

BLB

[flintlock]

Re: I am the mob

My brother (American) got in a car wreck in Canada. A month in ICU, over $1,000,000. The plane ride home was over $ 20,000 (medical plane owned by Pizza Hut (YUMS) not kidding). The Canadian government paid all expenses including lost wages for years. No way that would happened if the wreck had occurred south of the boarder.

Yeah, I guess healthy living and good genes were not much help in his case.
This kind of story is why I still reluctantly pay for insurance.