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Simple summary of health care
Tweet Topic Started: Jun 18 2009, 01:26 PM (823 Views)
eelbor Jun 19 2009, 09:43 AM Post #16
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Cattman96
Jun 19 2009, 09:13 AM
eelbor
Jun 19 2009, 09:01 AM
Hey Cattman, glad to see you. Where you been hiding?
Hey Eel. Kind of a long story but I will make it short. It involved me, my nephew with a shotgun and me being about a half second to late to stop him. I lost my best friend in a mili second. So alot of hydrocordone on my part later to get rid of the images, and still having a hard time , I ma somwewhat coherent. Sorry if that is TMI man.
Seriously? Wow, that is rough. Makes me appreciate how the familar sameness and lack of excitement currently in my day to day life.
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"Liberal, shmiberal. That should be a new word. Shmiberal: one who is assumed liberal, just because he's a professional whiner in the newspaper. If you'll read the subtext for many of those old strips, you'll find the heart of an old-fashioned Libertarian. And I'd be a Libertarian, if they weren't all a bunch of tax-dodging professional whiners." - Berkeley Breathed


Meat is Murder. Sweet, delicious murder.
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Cattman96 Jun 19 2009, 09:54 AM Post #17
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eelbor
Jun 19 2009, 09:43 AM
Cattman96
Jun 19 2009, 09:13 AM
eelbor
Jun 19 2009, 09:01 AM
Hey Cattman, glad to see you. Where you been hiding?
Hey Eel. Kind of a long story but I will make it short. It involved me, my nephew with a shotgun and me being about a half second to late to stop him. I lost my best friend in a mili second. So alot of hydrocordone on my part later to get rid of the images, and still having a hard time , I ma somwewhat coherent. Sorry if that is TMI man.
Seriously? Wow, that is rough. Makes me appreciate how the familar sameness and lack of excitement currently in my day to day life.
Yeah it sucked. You know about 6 months ago the subject of guns came up and you had mentioned that you were robbed at gun point while going to college. My response to that was pretty cavalier and somewhat insensitve I believe. I apologize for that. Having a personal experience can change perspectives a bit... Sorry for dumping. still medicated a bit
The nine scariest words in the english language. " I'm with the government and I'm here to help" - Ronald Reagan
"When the people find they can vote themselves money, that will herald the end of the republic." -Benjamin Franklin
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HoosierLars Jun 19 2009, 11:29 AM Post #18
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Cattman96
Jun 19 2009, 09:13 AM
eelbor
Jun 19 2009, 09:01 AM
Hey Cattman, glad to see you. Where you been hiding?
Hey Eel. Kind of a long story but I will make it short. It involved me, my nephew with a shotgun and me being about a half second to late to stop him. I lost my best friend in a mili second. So alot of hydrocordone on my part later to get rid of the images, and still having a hard time , I ma somwewhat coherent. Sorry if that is TMI man.
I'm really sorry to hear that, Cattman. That's horrible...
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Cattman96 Jun 19 2009, 12:24 PM Post #19
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Thanks Lars.
The nine scariest words in the english language. " I'm with the government and I'm here to help" - Ronald Reagan
"When the people find they can vote themselves money, that will herald the end of the republic." -Benjamin Franklin
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Mr Gray Jun 22 2009, 10:19 AM Post #20
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brumdog44
Jun 19 2009, 12:34 AM
aaron, seriously, 90 days to find another policy? One that won't cover pre-existing conditions and that I'll have to pay 100% of instead of what the one that comes with work?

The school that I work at (as well as pretty much every school in the United States) has one year agreements with insurance companies, usually September to September. Yet the insurance companies regularly change what prescriptions that they cover during this time and there isn't a damn thing we can do about it. They simply bump a prescription from formulary to non-formulary and no longer cover it. The contract says they will cover formulary drugs..which is all well and good, but what is formulary in September isn't what necessarily what will be formulary in October, so how in the hell would knowing your policy help?
brum,
Do the drug companies or the insurance companies change teh prescription classification from formulary to non-formulary?

Do you think there is an alternative solution instead of allowing the government to force private companies to provide certain products/services? I realize that we already do that, but that doesn't make it right, and it certainly sets a precident that can lead down all sorts of roads.
Posted Image
The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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yawnzzz Jun 22 2009, 11:35 AM Post #21
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Jun 22 2009, 10:19 AM
I realize that we already do that, but that doesn't make it right, and it certainly sets a precident that can lead down all sorts of roads.
If we already do it... then a precedent has been set. :-/

I don't particular care for government getting involved in this or any area, but the way that insurance companies adjust what they cover on a constantly sliding scale is pretty shady.
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Mr Gray Jun 22 2009, 12:08 PM Post #22
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Jun 22 2009, 10:19 AM
I realize that we already do that, but that doesn't make it right, and it certainly sets a precident that can lead down all sorts of roads.
If we already do it... then a precedent has been set. :-/

I don't particular care for government getting involved in this or any area, but the way that insurance companies adjust what they cover on a constantly sliding scale is pretty shady.
I guess I meant that I don't want to further the precedent. A reversal would be nice, but I agree with you and Brum regarding the insurance company tactics, but they are also at the mercy of the health/drug providers for the most part, so they have to cover their risk.
Posted Image
The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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brumdog44 Jun 22 2009, 02:39 PM Post #23
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aaronk2727
Jun 22 2009, 10:19 AM
brumdog44
Jun 19 2009, 12:34 AM
aaron, seriously, 90 days to find another policy? One that won't cover pre-existing conditions and that I'll have to pay 100% of instead of what the one that comes with work?

The school that I work at (as well as pretty much every school in the United States) has one year agreements with insurance companies, usually September to September. Yet the insurance companies regularly change what prescriptions that they cover during this time and there isn't a damn thing we can do about it. They simply bump a prescription from formulary to non-formulary and no longer cover it. The contract says they will cover formulary drugs..which is all well and good, but what is formulary in September isn't what necessarily what will be formulary in October, so how in the hell would knowing your policy help?
brum,
Do the drug companies or the insurance companies change teh prescription classification from formulary to non-formulary?

Do you think there is an alternative solution instead of allowing the government to force private companies to provide certain products/services? I realize that we already do that, but that doesn't make it right, and it certainly sets a precident that can lead down all sorts of roads.
The insurance companies are generally changing the classification.

Blue Shield's formulary/non-formulary decisions are made by the Blue Shield Pharmaceutical and Therapy Committee. What do you think their bottom line is on their decisions?
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eelbor Jun 22 2009, 03:06 PM Post #24
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Jun 22 2009, 02:39 PM
Blue Shield's formulary/non-formulary decisions are made by the Blue Shield Pharmaceutical and Therapy Committee. What do you think their bottom line is on their decisions?
Money.
Posted Image

"Liberal, shmiberal. That should be a new word. Shmiberal: one who is assumed liberal, just because he's a professional whiner in the newspaper. If you'll read the subtext for many of those old strips, you'll find the heart of an old-fashioned Libertarian. And I'd be a Libertarian, if they weren't all a bunch of tax-dodging professional whiners." - Berkeley Breathed


Meat is Murder. Sweet, delicious murder.
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Mr Gray Jun 22 2009, 09:47 PM Post #25
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brumdog44
Jun 22 2009, 02:39 PM
aaronk2727
Jun 22 2009, 10:19 AM
brumdog44
Jun 19 2009, 12:34 AM
aaron, seriously, 90 days to find another policy? One that won't cover pre-existing conditions and that I'll have to pay 100% of instead of what the one that comes with work?

The school that I work at (as well as pretty much every school in the United States) has one year agreements with insurance companies, usually September to September. Yet the insurance companies regularly change what prescriptions that they cover during this time and there isn't a damn thing we can do about it. They simply bump a prescription from formulary to non-formulary and no longer cover it. The contract says they will cover formulary drugs..which is all well and good, but what is formulary in September isn't what necessarily what will be formulary in October, so how in the hell would knowing your policy help?
brum,
Do the drug companies or the insurance companies change teh prescription classification from formulary to non-formulary?

Do you think there is an alternative solution instead of allowing the government to force private companies to provide certain products/services? I realize that we already do that, but that doesn't make it right, and it certainly sets a precident that can lead down all sorts of roads.
The insurance companies are generally changing the classification.

Blue Shield's formulary/non-formulary decisions are made by the Blue Shield Pharmaceutical and Therapy Committee. What do you think their bottom line is on their decisions?
for sure it's money....their not a charitable organization or an NFP, so they can't provide something that they are going to lose money on, nor should they be forced to...however they also shouldn't really just have open reign on what they provide/don't provide. It sounds like we need MORE competition as opposed to less capitalistic influence (government intervention) in order to create a service that the public really wants. If they are forced by the government to provide certain items/services that aren't provided right now, they aren't going to do it for free, and I don't want to pay the bill for you if I'm not using those services.
Posted Image
The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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brumdog44 Jun 22 2009, 10:29 PM Post #26
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aaronk2727
Jun 22 2009, 09:47 PM
brumdog44
Jun 22 2009, 02:39 PM
aaronk2727
Jun 22 2009, 10:19 AM
brumdog44
Jun 19 2009, 12:34 AM
aaron, seriously, 90 days to find another policy? One that won't cover pre-existing conditions and that I'll have to pay 100% of instead of what the one that comes with work?

The school that I work at (as well as pretty much every school in the United States) has one year agreements with insurance companies, usually September to September. Yet the insurance companies regularly change what prescriptions that they cover during this time and there isn't a damn thing we can do about it. They simply bump a prescription from formulary to non-formulary and no longer cover it. The contract says they will cover formulary drugs..which is all well and good, but what is formulary in September isn't what necessarily what will be formulary in October, so how in the hell would knowing your policy help?
brum,
Do the drug companies or the insurance companies change teh prescription classification from formulary to non-formulary?

Do you think there is an alternative solution instead of allowing the government to force private companies to provide certain products/services? I realize that we already do that, but that doesn't make it right, and it certainly sets a precident that can lead down all sorts of roads.
The insurance companies are generally changing the classification.

Blue Shield's formulary/non-formulary decisions are made by the Blue Shield Pharmaceutical and Therapy Committee. What do you think their bottom line is on their decisions?
for sure it's money....their not a charitable organization or an NFP, so they can't provide something that they are going to lose money on, nor should they be forced to...however they also shouldn't really just have open reign on what they provide/don't provide. It sounds like we need MORE competition as opposed to less capitalistic influence (government intervention) in order to create a service that the public really wants. If they are forced by the government to provide certain items/services that aren't provided right now, they aren't going to do it for free, and I don't want to pay the bill for you if I'm not using those services.
That's fine, but I don't want to have to foot the bill for a drug that was approved when the contract was signed. As I said, our insurance contract is September to September....so medication that is approved on the signing date should have to be approved through the cycle.
Edited by brumdog44, Jun 22 2009, 10:31 PM.
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Mr Gray Jun 22 2009, 10:43 PM Post #27
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brumdog44
Jun 22 2009, 10:29 PM
aaronk2727
Jun 22 2009, 09:47 PM
brumdog44
Jun 22 2009, 02:39 PM
aaronk2727
Jun 22 2009, 10:19 AM
brumdog44
Jun 19 2009, 12:34 AM
aaron, seriously, 90 days to find another policy? One that won't cover pre-existing conditions and that I'll have to pay 100% of instead of what the one that comes with work?

The school that I work at (as well as pretty much every school in the United States) has one year agreements with insurance companies, usually September to September. Yet the insurance companies regularly change what prescriptions that they cover during this time and there isn't a damn thing we can do about it. They simply bump a prescription from formulary to non-formulary and no longer cover it. The contract says they will cover formulary drugs..which is all well and good, but what is formulary in September isn't what necessarily what will be formulary in October, so how in the hell would knowing your policy help?
brum,
Do the drug companies or the insurance companies change teh prescription classification from formulary to non-formulary?

Do you think there is an alternative solution instead of allowing the government to force private companies to provide certain products/services? I realize that we already do that, but that doesn't make it right, and it certainly sets a precident that can lead down all sorts of roads.
The insurance companies are generally changing the classification.

Blue Shield's formulary/non-formulary decisions are made by the Blue Shield Pharmaceutical and Therapy Committee. What do you think their bottom line is on their decisions?
for sure it's money....their not a charitable organization or an NFP, so they can't provide something that they are going to lose money on, nor should they be forced to...however they also shouldn't really just have open reign on what they provide/don't provide. It sounds like we need MORE competition as opposed to less capitalistic influence (government intervention) in order to create a service that the public really wants. If they are forced by the government to provide certain items/services that aren't provided right now, they aren't going to do it for free, and I don't want to pay the bill for you if I'm not using those services.
That's fine, but I don't want to have to foot the bill for a drug that was approved when the contract was signed. As I said, our insurance contract is September to September....so medication that is approved on the signing date should have to be approved through the cycle.
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
Posted Image
The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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eelbor Jun 23 2009, 08:14 AM Post #28
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aaronk2727
Jun 22 2009, 10:43 PM
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
They already do this. I am sure your insurance premiums rise annually just like mine do. I know it is a hugely unpopular idea, but if there were a law that required adults to carry insurance, the price of health care (per visit) in the US would shrink, as would your insurance premiums. Right now all the uncompensated heathcare provided to the nation's indigent population is being passed back on to taxpayers and your insurance premiums.
Posted Image

"Liberal, shmiberal. That should be a new word. Shmiberal: one who is assumed liberal, just because he's a professional whiner in the newspaper. If you'll read the subtext for many of those old strips, you'll find the heart of an old-fashioned Libertarian. And I'd be a Libertarian, if they weren't all a bunch of tax-dodging professional whiners." - Berkeley Breathed


Meat is Murder. Sweet, delicious murder.
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yawnzzz Jun 23 2009, 12:01 PM Post #29
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My personal opinion is just that there should be a grandfather clause. If an insurance company wants to change the services/products they provide, that's fine except for clients that have already made claims against these products. If I've had cancer for 2 years, and my current medicine was covered, then it should continue to be covered as long as I keep paying my premiums. In this way, it helps protect those who would be denied due to pre-existing conditions. Those who do not currently have a condition should read the fine print and decide what insurance company provides the most options for their dollar like any other business.
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Mr Gray Jun 23 2009, 03:00 PM Post #30
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Jun 23 2009, 12:01 PM
My personal opinion is just that there should be a grandfather clause. If an insurance company wants to change the services/products they provide, that's fine except for clients that have already made claims against these products. If I've had cancer for 2 years, and my current medicine was covered, then it should continue to be covered as long as I keep paying my premiums. In this way, it helps protect those who would be denied due to pre-existing conditions. Those who do not currently have a condition should read the fine print and decide what insurance company provides the most options for their dollar like any other business.
2nd
Posted Image
The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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