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        New Message Board Archives >> 2002 Posts >> Med. Insurance / OUCH?
        
(Message started by: marty on Oct 16^th, 2002, 3:19am)

Title: Med. Insurance / OUCH?
Post by marty on Oct 16^th, 2002, 3:19am

I the back of my mind, a voice is telling me: "Don't post this!" - but I am going to do it anyway :o

I have been reading many posts that deal with the cost of medication and that some (many?) do not have insurance that will cover the cost - leaving some CH'rs to suffer by decreasing doses etc, in order to make the medication last.

The latest incident that really bothered me was a college girl in MD that could not afford to see a Doctor that knew (hopefully) atleast the basics about CH.

Now, what if OUCH (as a non-profit Org) would re-instate the membership fee and use this money for a limited coverage with a Nation Wide Healt Provider and by doing so, supplement the monthly cost to the participants and thereby making it affordable.

I am aware that this would be a great undertaking, it would be a tremendous responsibility but the reward could be just awsome :)

Most likely, this have already been discussed and I do not mean to start something, but just imagine what we could do...

I am new here and mayby it is not my place to bring this up, but if I get some of you "old-timers" (on this board that is) with me on this, I am willing to do some research and put myself at your disposal.

Marty

Title: Re: Med. Insurance / OUCH?
Post by Bob P on Oct 16^th, 2002, 9:23am

Marty,

You're right, it is a huge undertaking, which is why I think we've shyed away from it.

I'm pretty sure the cost is out of OUCH's reach, even if we reinstated the membership dues.

My full medical coverage here at work costs my employer somewhere around $400 a month. No way for OUCH.

My #1 daughter, who is too old to be on my med, has a basic policy with Blue Cross. Cost $36/month. Of course this has huge deductables. So for basic Dr. visits and scripts it does nothing. It's only for really major hospital stays. So even at this amount it probably wouldn't do a clusterhead any good.

Feel free to look into it but my gut feeling is that it's something OUCH can't help with.

Now, the college girl. I think she went about it the wrong way - looking for a Dr. that knows CH. The trick is for the patient to learn everything there is to know about CH and teach the doctor. I had a new HMO doc last year during my cycle. He never heard of CH so I told him what it was, that I had it, and what treatment I wanted (backed up with articles from the experts). I got whatever I wanted because the doc didn't know any better. Being a college student, she probably gets medical care at the campus Health Center as part of her student fees. She needs to teach them what CH is all about.

Just my thoughts.

Title: Re: Med. Insurance / OUCH?
Post by Ueli on Oct 16^th, 2002, 11:41am

Marty, your idea looks great, but it has a very big flaw: The way insurance companies work.

Insurance companies are a kind of bookmakers, they take a bet that you stay healthy and need no doctor nor medications. But unlike the bookies, who pay off without hesitation when they lost a bet on a horses or dog, the insurance companies try every trick to avoid paying on a lost bet.
A bookie adjusts the odds he offers for every horse in a way that, regardless which one wins, he makes an overall profit.
An insurance company tries to offer, in order to be competitive, a low premium (your stake). In order to make the required profit, they subsequently try to lower the odds, like saying our bet was for only 6 imitrex shots a month.
When an insurance takes on a group of people, like all employees of a company, they make a risk assessment of this group to get the price.
Risk assessment for a group of clusterheads: Lets say $1000 a month for medications. Add to this $1000 for overheads and another $1000 for taxes and profit. That gives $3000 per month per head (or 1440 OUCH members at $25 a year). So it's out of question to take a separate insurance on a high risk group as we are.

PFNADs
Ueli

Title: Re: Med. Insurance / OUCH?
Post by oringkid on Oct 16^th, 2002, 12:23pm

Your right Ueli, and add onto that the amount they up the premium for smokers (and they look at it as a group) and look how many of us are smokers.

Good idea, but unfortunately, unworkable.

Sherry

Title: Re: Med. Insurance / OUCH?
Post by marty on Oct 16^th, 2002, 7:07pm

OK, my feet are once again firmly placed on the ground...

Thanks guys

Marty

Title: Re: Med. Insurance / OUCH?
Post by Charlie on Oct 16^th, 2002, 8:43pm

Very nice guys. Our hearts are in the right place and as Bob and Ueli so rightly point out, insurance companies have none to worry about.

I think Bob is right that it's best to find a good doctor, educate him on CH and that she needs some help with costs. Nothing to lose anyway.

Oh, and I found some of Marty's heart right here. I'm worried that he spreads it too much around.

Charlie