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        New Message Board Archives >> 2007 General Board Posts >> American Health Service
        
(Message started by: michael on Jun 6^th, 2007, 1:37pm)

Title: American Health Service
Post by michael on Jun 6^th, 2007, 1:37pm

Hi all

I've read many posts from you guys in the States complaining about Insurance, nurses, PCP (what is a PCP) scripts etc.

Being a Brit who has never travelled to America I am very interested in how your system works.

Would any of you please be kind enough to explain to me.

Mike

Title: Re: American Health Service
Post by Charlie on Jun 6^th, 2007, 7:20pm

Hi Mike:

PCP is Primary Care Physician.....yeah, I know: It sounds as dumb to me as it probably sounds to you.

Thanks to the evil insurance companies: HMO or Health Maintenance Organizations.....They now call our GPs or general practiconers: PCPs. I have no idea why.

Here, it's a matter money to get decent health care if you don't have it at work or other place. For the most part, if you have a decent job, you likely will get health care paid for through an insurance company at work. You may have to pay some but it won't kill you. If you are not working or are at someplace like Walmart; you're screwed. I was paying about $3,000 a year for awhile. Not every business is required to provide insurance. It's a crime that it has to be done that way at all but insurance company lobbiests make sure it stays that way. Way too much money is being made by them. They are as I say: evil. It's why nearly 50,000,000 people in the U. S. have no insurance at all.

However...hospital emergeny rooms have to treat you....at least in New York State. The care will be basic stuff unless life and death...however, you will get a bill that has to be paid by someone and it can be tens of thousands of dollars for serious stuff. The medical professionals for the most part here are usually sympathic...up to a point.

I have epilepsy and have applied for disability and now
have help from New York State...not Medicaid...as so many have, but a system provided for people that make a few dollars more than eligibility for it. It's essentially for those making something a little over $500 a month or so...I was told. It's a great thing for me. Non-generic drugs are $6 each and most doctors accept Fidelis insurance, which is what I have. New York State is pretty good if you really pursue it. The thing is that you have to be very serious about it and spend some time working on it. I must have looked helpless as they accepted this old Swede and it's a lifesaver as basically, my insurance is paid for by the state.

I don't know if that makes much sense to you but it's a start.....Oh...when you reach 65, you are put on Medicare which essentially is not too bad care for retirees. It costs some money but is much easier on the pocketbook....so they say. People still have to pay for a lot of drugs though and often get them from Canadian online pharmacies.....I get one from Canada that is considered a cosmetic and Fidelis won't pay. For me, it's not just a cosmetic. Here it costs $172; In Canada: $51....Anyway: get this:
The cream is manufactured in Canada, the on line pharmacy is in British Columbia on the Pacific coast about 3,000 miles from me.......however, the drug..... that is made only in Canada...... is being sent from Calcutta. God help when I reach 65!

That isn't unusual for our wonderful health care system.

Kill me now.

Charlie

Title: Re: American Health Service
Post by Brewcrew on Jun 6^th, 2007, 9:35pm

I thought PCP stood for Primary Care Physician. Could it have more than one definition? Either way, people know what it means.

Believe it or not, my PCP is the team physician for the Milwaukee Bucks.

Title: Re: American Health Service
Post by BlueMeanie on Jun 7^th, 2007, 5:58pm

Basically its' the cost. If you can afford decent highly skilled docs, then you get better treatment/facilites.

We have what is called HMO's, which is doctors that are contracted with insurance companys for a set rate to be paid. Those docs are usually, not as versed in the medical field and are way over-worked to handle all the people who cannot afford better insurance (better docs and facilites). Also with HMO's they are limited as to what types of exams they can perform on you.

I'm not sure about across the board for the U.S., but I would say it cost around $800 month for a good medical program. Those that work for decent companies usually only have to pay 1/2 the cost, as the company pays the other half. I guess you can say I am one of the lucky ones as I only pay 1/2 which is $450 month out of pocket medical insurance. Plus I pay an extra co-pay cost for doc visits, exams, xrays and meds.

Title: Re: American Health Service
Post by john_d on Jun 7^th, 2007, 6:19pm

My employer offers a few different plan choices, HMO's, EPO's and PPO's. EPO's are basically the new name for HMO's because of the stigma HMO has gotten. PPO's are prefered provider plans where you can pick your physicians and are not required to have a specific physician that refers all the other doctors for you. The cost is different for each and it depends if you have a family. I think the highest cost is maybe $250 a month for a you, wife and kids. It's a good plan, BCBS of Alabama. Then there is a separate dental plan which costs maybe $20 a month. If you don't have a job that offers medical, which is alot of people. You have to pay a fortune for medical, I worry alot about how I am going to pay for it when I retire when i will actually need it the most. Then we are now facing the baby boomers start retiring and reaching the age of more medical needs, all the many folks born after ww2, it's gonna strain our system bigtime. I will be retiring right after the baby boomers. It's gonna be interesting to see how it all plays out.

Title: Re: American Health Service
Post by Linda_Howell on Jun 7^th, 2007, 7:00pm

It IS Primary Bill. Charlie is just such a nice guy and his Dr. likes him, so he prefers to call it his personal care Physician. ;)

Michael, I think most of Americans would also like to know how our system works. Whoever has money gets good treatment. Whoever is just a working stiff gets less care. It's all in the amount of Premiums one pays.

Most hard-working people cannot afford Insurance these days.

Title: Re: American Health Service
Post by Charlie on Jun 7^th, 2007, 7:57pm

Yuz is all right: It's Primary Care Physician.

Mike: After reading this thread you have an idea of the complexity and stupidity of our health care. If this sounds bad to you, you are not alone. It get worse every day. Early in the Bush Administration, a bunch of Senators and Congressmen got together to amend Medicare. (the 65 and older plan in place since the 1960s) Their idea was to make some drugs cheaper for older people because there are lots of them that have to choose between heat or drugs and lot are not taking full doses....I kid you not. Anyway, this new system is so complicated that drugstores, some doctors and clinics have mountains of paperwork trying to explain the various plans this stupid thing has created. It's so complex that few people understand the thing without help and a lot of work. True to Washington, there is a time limit as well and it may have already passed. If you didn't sign on for what is called "Part D" I think, you will have to wait to get this silly thing.

It's not some panacea in any case and still misses the mark by a wide margin. Of course one of the reasons that it is such a mess is that it's really to benefit the evil drug companies. It would never have passed in Congress or been signed if it didn't prevent the government from negotiating with drug companies for cheaper drugs by buying in bulk. That's a no no over here. It's criminal what we do to our older and sick relatives. Only in America.

Not to worry John. Health care will be national in a few years. We boomers and the next generation will see to that. No one will have a shot at getting elected in a few years without supporting big time changes in medical care and eventually a national health system. Contrary to the politicians' ranting, it will not break the bank. If it's done right, it will cost less. The same is said about social security. It just ain't so. It's politics dating back to the New Deal of the 1930s.

I'm convinced that one could win big in elections now if all they ran on was health care. It's going to be the third rail in American politics soon. About time.

Whew....

Charlie

Title: Re: American Health Service
Post by Mosaicwench on Jun 7^th, 2007, 9:32pm

Not to worry John. Health care will be national in a few years. We boomers and the next generation will see to that.

Sorry Charlie, but that makes me shudder.

It's not that I don't think people should have access to medical care, it's the notion that GOVERNMENT (ANY government) will make something cheaper and less complicated. It's just not true.

Government is bureaucracy and bureaucracy is never efficient, cheap, and is almost always self-serving.

Title: Re: American Health Service
Post by BlueMeanie on Jun 7^th, 2007, 9:36pm

Michael,

Just wanted to let you know so you understand our system a little better. We have two different medical insurance programs here in the U.S. The one I was refering to is PRIVATE health insurance in which if you work, you pay for out of your check each payday.

The one Charlie is talking about is a Government sponsored medical insurance that is used by disabled and retired people. On top of paying for private insurance, it is mandated by law that people who work pay into that program also. It is suppose to still be available to us when we either become disabled, or retire.

I believe part of the problem with the Government sponsored program is that it was not manditory to pay into that program until the early 80's. No-one looked into the future soon enough to realize it would be underfunded and that medical cost was going to skyrocket. It will get worse before it gets better if they don't do something soon to keep cost down as our largest population (baby boomers) will all be retiring soon.