My husband and several of his colleagues, with over 200 years of health insurance experience in a well-known national compny, have been saying for thirty years that the ONLY way to achieve successful and blanket coverage for the entire population was “single payer”–and their jobs would have been on the line!

I was at an eye specialist’s office late one Friday afternoon for a routine appointment. I could overhear the office manager getting horrible run-around from another patient’s insurance company over a surgery that had to be completed within 48 hours or permanent blindness would result.

My doctor didn’t have operating privileges at a hospital in her county, her county didn’t have any retina specialists, and her insurance wouldn’t cover her surgery outside of her own county. And anyone who had any approval authority to override this policy had already gone home for the weekend. This was the Bay Area, too!

I never did hear the end result of all the phone tag. I really hope she got her surgery…

I left the US in 1991 just before Penna Blue Cross and Blue Shield turned “for profit.” I’ve been able to observe the chaos from a distance.

I think a Federal public option could be joined by State Public option as different states have different needs. Did you read about how Hawaii’s state plan may exempt them from the fed. option? There are other good models in place.

BTW read this in the NYTimes and thought “That is SOOOO Alison.”
http://www.nytimes.com/2009/12/01/health/01well.html

More and more, insurance looks like it is not.

When I worked for a cardiologist (as his nurse) this was exactly our experience. Our insurance clerk spent HOURS on hold, just trying to get a pacemaker authorized, for instance. Hey, folks, cardiology is not always leisurely medicine. Somethings need to happen NOW!

The haggling is ridiculous. My son-in-law fractured his ankle last February, was brought to the emergency room and had to have surgery. Though the hospital was in the network, the covering emergency room doctor
at the same hospital wasn’t and the insurance company would only pay 60%
instead of the normal 80% for the entire bill including the surgery.

Something needs to be done in this country and I agree with you.

May I forward a link of this post to my father-in-law who is dead set against a public system?

I’m not saying it’s a perfect one – waiting times can be ridiculous for surgeries, for instance – but in my very humble opinion, I don’t believe it’s that discouraging either…

and yet, I can understand why my friends in the private sector have concerns. There is no question that we need a uniform pay system that focuses on providing needed care and services rather than always looking for a way to say no.
It would help if the current public funded programs paid more than 30% and that not for 6 months post care.
and then there is tort reform….
the list goes on and on and on

I spent yesterday going back and forth from gyno’s office and breast care center – prescription, referral, prescription, referral and on, and on and on.
I heard in both office clerks arguing with insurance companies. I felt so sorry for them

Oh by the way, I sent a big group of fruit flowers to the Breast Center today because they told me “see you next year.” Best 4 words you can ever hear – it means you back on the “average” range.

Afton

Ack. Just…ack. I can’t bear it.

I’m with all your commenters, and the single payer option doesn’t even affect me. I’m plenty .old enough to be on Medicare, plus AARP secondary, and while not perfect, it really isn’t bad.

After all that, we NEED some humor –

WHAT A DIFFERENCE A  COMMA MAKES
 
An English professor wrote the words: “A woman without her man is nothing” on the chalkboard and asked the students to punctuate it correctly.
 
All of the males in the class wrote: “A woman, without her man, is nothing.”
 
All the females in the class wrote: “A woman: without her, man is nothing.”

Our Canadian system isn’t perfect, but it has always worked for me. If I’m in need of hospital care – I get it. If I need to see a doctor – I see him/her. I’m sure many of my countrypeople have had horrible experiences, but knock wood, I have not.
I just wishe there was a way to have universal health care universally. Those that need it, get it. period.

Absolutely.
No one says EVERYONE needs to go the public route but it MUST be available.
No one should die because treatment was out of their price range.

Heh, I was going to post the same link as LynnM. Great minds!

And I’m with you on the single-payer system.

Go register. Be sure everyone you know is registered. Go vote when you can. Be sure everyone you know goes and votes. Go.Vote. And write your Senators daily if possible. They need to know we want a public plan more than we want them if they don’t pass a robust one.

Oh, most definitely YES! How do we not know this yet?

I know, know, know that we need a reform; I just get all trembly thinkin’ about any, any, any government official havin’ a hand in it.
After all, they’ve just been so thrifty with our Social Security funds. _rolls eyes around and around_

It’s taking so long. I am so discouraged. I’ve worked in a pediatric clinic. The largest department was people just handling the insurance issues. One thing to know is that often times there is a person that “specializes” in dealing with each particular insurance. You can ask about that person if you need help. They can also tell you which insurance they have the most trouble with. Once upon a time I had an insurance card and upon presenting it, the receptionist said, “Oh, you have GOOD insurance!” Sadly, that is no more. Another good thing to ask if you are having trouble is, “do you have any suggestions?”
Once on being told “no, that is not covered”, asking the question told me what hoops to jump through to get it covered.
However as this new deductable starts with this new year, I am at the point that I simply can’t pay any more. And since I can’t pay, I can’t have the care or medicine I need. I’ll have insurance, I just won’t be able to use it.
So, this waiting till they get it right, is too long for me.

Amen, sister.

We’ve just been told that our Cobra medical coverage for October was not valid, that we didn’t pay. We did, but due to administrative snafus of various sorts, they are claiming that our payment was for the previous month and October wasn’t covered. Paul had quite a number of doctor visits, a minor surgery, an MRI and various other things happen in the month of October. It’s got to add up to thousands of dollars.

It’s crazy, and we will of course appeal it but I have very little hope that they will change their tune. I’m just really praying for a miracle.

It shouldn’t take a miracle to be covered for decent health care. God knows we need a public option.

A single risk pool/single payer option would allow everyone to focus on what is best for the patient. Now, despite paying premiums out of pocket costs are rising. Unless you have unlimited free time, fighting with your insurance company becomes impossible. I work in an FQHC (federally qualified health center) – most of our patients are uninsured or underinsured(high deductible plans for example). Our staff spends countless hours haggling with the insurance companies of our insured clients – prior authorizations – often for medications that were covered a month ago.

What a waste of resources!

I do not hold out great hope for the current plan. I fear by the time it makes it through both the house and senate it will be so full of compromises and amendments that doing nothing would be better. I say do it right the first time or do not do it at all. But then again, my days are spent caring for people who have not been able to access health care in years, or can not afford life sustaining medications (or food, or housing).

I could not agree with you more — as of Dec 15 I will be totally uninsured — just wingin’ it here, hoping I don’t get sick anytime in the next 6.5 years, until medicare kicks in