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vnatale
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Re: Gold's Time To Shine?

Post by vnatale » Thu Jan 30, 2020 10:43 pm

Smith1776 wrote:
Sun Dec 29, 2019 8:14 am
My perspective is that I'd still rather go with the Canadian health care system than the American one if given a binary choice. Though, obviously, there is bias in my perspective.

The waiting time issue is not as bad as portrayed in my humble opinion. We follow a triage system in Canada. If it's a medical emergency, you'll get in right away. If it's a bad knee that acts up when you do sports, then yeah, you'll wait a while for a surgery.
A few days ago I made reference to what Smith1776 wrote above. That the Canadian "wait" times are not as Americans seem to think that they are. That the Canadian system works on a triage system, which does seem sensible.

Vinny
"I only regret that I have but one lap to give to my cats."
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Re: Gold's Time To Shine?

Post by pugchief » Fri Jan 31, 2020 7:22 am

vnatale wrote:
Thu Jan 30, 2020 10:43 pm
Smith1776 wrote:
Sun Dec 29, 2019 8:14 am
My perspective is that I'd still rather go with the Canadian health care system than the American one if given a binary choice. Though, obviously, there is bias in my perspective.

The waiting time issue is not as bad as portrayed in my humble opinion. We follow a triage system in Canada. If it's a medical emergency, you'll get in right away. If it's a bad knee that acts up when you do sports, then yeah, you'll wait a while for a surgery.
A few days ago I made reference to what Smith1776 wrote above. That the Canadian "wait" times are not as Americans seem to think that they are. That the Canadian system works on a triage system, which does seem sensible.

Vinny
IDK about you, but I have lots of friends that have had various joints replaced, and from what I hear, you don't want the government deciding how much pain you are in or how you should walk 20 yards without a cane. I'd rather do the surgery when *I* think it's time, not some lackey with zero medical background. Ever been to the DMV? That's what government run anything will look like here. :'(
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Re: Gold's Time To Shine?

Post by technovelist » Tue Feb 04, 2020 8:12 pm

pugchief wrote:
Fri Jan 31, 2020 7:22 am
vnatale wrote:
Thu Jan 30, 2020 10:43 pm
Smith1776 wrote:
Sun Dec 29, 2019 8:14 am
My perspective is that I'd still rather go with the Canadian health care system than the American one if given a binary choice. Though, obviously, there is bias in my perspective.

The waiting time issue is not as bad as portrayed in my humble opinion. We follow a triage system in Canada. If it's a medical emergency, you'll get in right away. If it's a bad knee that acts up when you do sports, then yeah, you'll wait a while for a surgery.
A few days ago I made reference to what Smith1776 wrote above. That the Canadian "wait" times are not as Americans seem to think that they are. That the Canadian system works on a triage system, which does seem sensible.

Vinny
IDK about you, but I have lots of friends that have had various joints replaced, and from what I hear, you don't want the government deciding how much pain you are in or how you should walk 20 yards without a cane. I'd rather do the surgery when *I* think it's time, not some lackey with zero medical background. Ever been to the DMV? That's what government run anything will look like here. :'(
Don't worry, those rules are only for the "little people". High-level government employees will get the best of care.

Read Atlas Shrugged for details.
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Re: Gold's Time To Shine?

Post by Kbg » Wed Feb 05, 2020 6:51 am

Are you guys self-insuring? I don’t know too many Americans whose insurance company doesn’t determine that.
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Re: Gold's Time To Shine?

Post by sophie » Thu Feb 06, 2020 7:57 am

There are delays to get approved for procedures etc in the US, for sure...it's due to insurance companies. It's a lot more capricious than is the case in Canada. The average wait times are probably lower than in Canada - but yes, a bean counter with a high school diploma somewhere IS deciding how much pain and disability you have to have before you can have a knee surgery, in BOTH countries - if you want someone else to pay for it. You are free to bypass this by paying for the procedure yourself.

I don't think the Canadian delays are about socialized medicine per se, as about how much money Canada is willing to spend on health care. It's about half as much as the US currently, and the number of specialists (like orthopedic surgeons) as well as resources (e.g. MRI scanners) are strictly limited. It's a bit unfair to compare care in country A with country B, if country B spends half as much. Canada could make those delays vanish by increasing health care spending, but that's a matter for the taxpayers (whose taxes would go up) to decide.
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Re: Gold's Time To Shine?

Post by mathjak107 » Fri Feb 07, 2020 4:51 am

an important note:

when it comes to medicare there can be a huge difference in your treatment allowed between not for profit gov't medicare vs a for profit insurer in an advantage plan as your gate keeper ...

those cheaper advantage plans are only good until they aren't .

If you choose Advantage, know that you are divorcing yourself from Medicare and putting the decisions for treatments, benefits, and payment in the hands of the PRIVATE (this means for-profit) Advantage insurer. Some are good actors, others are not. Common bad behaviors by MA's are denials of mandated Medicare benefits, onerous oversight on long-term therapies and preapprovals, etc., slow pays, denials they've received the provider claims, customer-service run-around, and more.
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Re: Gold's Time To Shine?

Post by sophie » Fri Feb 07, 2020 7:17 am

Yup, otherwise known as the Laundry List of Nasty Private Insurer tricks. This is what everyone is faced with not just Advantage plan subscribers. Except you forgot to mention the out of network surprise trap.

Honestly, despite my otherwise Republican leanings I really would prefer a Canadian style system, both to work in and be a patient in. The Republican side of me would limit that to serious medical conditions (determined by ICD code not by a deductible system), and let routine stuff be handled by the free market on a cash basis. No insurers needed.
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Re: Gold's Time To Shine?

Post by Xan » Fri Feb 07, 2020 9:07 am

Kbg wrote:
Wed Feb 05, 2020 6:51 am
Are you guys self-insuring? I don’t know too many Americans whose insurance company doesn’t determine that.
I've mentioned here before how happy I am to be a member of Christian Healthcare Ministries, or CHM, a cost-sharing ministry for healthcare.

It isn't technically insurance, although it counts as being "insured" for purposes of the Obamacare mandate. Our family of 5 pays well under $6000 a year for unlimited reimbursement after with a $500-per-event deductible. And they cover maternity which even before Obamacare obliterated choices in the health insurance market was hard to find. I'm pretty sure that accounting for the three pregnancies they've paid us more than we've paid them, but we're happy to keep the service long-term.

We're completely free to negotiate with any provider of any service, with CHM there to reimburse us. It's a great system. (There are some caveats: they won't cover problems that are the result of substance abuse, for example.)
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Re: Gold's Time To Shine?

Post by Kbg » Fri Feb 07, 2020 9:56 am

I know some people who go this route and it seems to work well. The questions I’ve heard raised about CHMs is that they don’t really help if you have major (really expensive) healthcare issues...so if this is a reality, I would then say it is a restriction and your “choice” is circumscribed.

To me the whole choice issue is a gigantic red herring argument and an utter and total lie. Anyone who has commercial insurance knows they are restricted in their choices. They are restricted in how they are treated, they are restricted as to when they will be treated and they will follow the insurance companies’ policies for medical care and associated reimbursements and claims. Google searches will indicate doctors are widely dissatisfied with the system as they are for the most part completely controlled in how they do their jobs by insurance companies unless they are in the high end concierge business.

We have several friends who are Canadian (and formerly American) and from everything I’ve heard from them is that healthcare is really contingent on where you live. In some areas it is as good and rivals anything in the US and in other areas it can be overcrowded and old...kinda like rural healthcare in America which is quickly disappearing.

This whole topic is very complex and I would not pretend for a moment to have a solution for ...but pretty much all studies done on comparative healthcare systems indicate the following:

- The US pretty much leads the world when it comes to healthcare innovation and technology
- The US pays vastly more for worse healthcare results than other first world countries

My personal view is that we have the worst of both worlds...lots of government involvement with lots of corporate profit motive and the end result is a highly expensive mess. I also believe healthcare is fundamentally different than buying a pair of socks. There are things that do not function well in a completely free economy due to other factors involved and there is a public aspect to healthcare similar to utilities and other public infrastructure. I’m also confident that sometime in the future the whole thing is going to implode due to costs. It won’t go on like it is, it can’t.
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Re: Gold's Time To Shine?

Post by Xan » Fri Feb 07, 2020 11:41 am

Kbg wrote:
Fri Feb 07, 2020 9:56 am
I know some people who go this route and it seems to work well. The questions I’ve heard raised about CHMs is that they don’t really help if you have major (really expensive) healthcare issues...so if this is a reality, I would then say it is a restriction and your “choice” is circumscribed.
I haven't heard this, nor had problems with them paying, but I haven't had a "really" expensive event. It's possible that people who have had this might have paid for a weaker plan than they need.

Without the "Brother's Keeper" program, all the plans max out at $125,000 per illness. With Brother's Keeper, Bronze and Silver can have their maxes increase over time up to $1 million. Gold plus Brother's Keeper has no max, ever.

Gold plus Brother's Keeper is certainly the way to go. But the other options are much cheaper, and maybe that's how people get in a pickle. We pay less than $6,000/year for Gold plus Brother's Keeper for the whole family of 5.
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Re: Gold's Time To Shine?

Post by vnatale » Fri Feb 07, 2020 11:51 am

mathjak107 wrote:
Fri Feb 07, 2020 4:51 am
an important note:

when it comes to medicare there can be a huge difference in your treatment allowed between not for profit gov't medicare vs a for profit insurer in an advantage plan as your gate keeper ...

those cheaper advantage plans are only good until they aren't .

If you choose Advantage, know that you are divorcing yourself from Medicare and putting the decisions for treatments, benefits, and payment in the hands of the PRIVATE (this means for-profit) Advantage insurer. Some are good actors, others are not. Common bad behaviors by MA's are denials of mandated Medicare benefits, onerous oversight on long-term therapies and preapprovals, etc., slow pays, denials they've received the provider claims, customer-service run-around, and more.
Am I to infer from what you state above that I made the better choice choosing a Medigap plan over an Advantage plan?

Vinny
"I only regret that I have but one lap to give to my cats."
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Re: Gold's Time To Shine?

Post by Kbg » Fri Feb 07, 2020 3:07 pm

This is wholly anecdotal...

I spent 20+ years under a government medical system (military) and have been in the private system for coming up on 5 years. Some quick observations...

I can't really tell a difference for the most part...some small/key differences

+ Didn't have to hassle with insurance and bill tracking
+ Emergency room visits were MUCH faster
+ Way more attention paid to preventative healthcare issues (immunization notifications, annual check up notifications etc.)

- No doctor consistency (either you moved or they moved frequently)
- You were being treated by someone in training oftentimes
- You were kinda stuck with whatever doctor you were issued (at least for a while but it wasn't hard to switch)
- Extensive use of PAs and LPNs for primary care

Issues over getting a treatment or not getting one that wasn't "by the book"...haven't noticed a difference really. Some nameless face was going to review what the doctor proposed/you wanted and you could appeal a decision you didn't like to a different higher nameless face

Friends indicate their VA experience is quite variable. Some places not good, other places amazingly good which sounds a lot like my Canadian friends. Supposedly where I live it is pretty good; however, the VA is too far away from where I live so I never use it.

For me I'd say the biggest difference is that I have the same doctor going on 4 years now which I like a lot.
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