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Let's send some good thoughts over to a former member
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lexapro
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Nov 2, 2009, 11:43 PM
 
I posted this in the Political lounge thinking it would get some discussion, but it failed on that. So, instead, I was hoping to post it here in order to simply spread the word and hoping that you all could spend a moment or two thinking about him.

Some of you may recall a user named bstone. He has been banned from here for a while but he turned me onto Macs and this website when we were roommates years ago. I still keep up with him. He's been really sick for 2.5 years now with an incurable neurological disorder. He wrote the following, which he gave me permission to repost, in hopes of spreading awareness of his plight.

So, in keeping with forum rules let's keep this non-political but rather hoping to send bstone some good thoughts.

By Baruch Stone
September 2009

My name is Baruch Stone. I am 29 years old and I currently live in Cambridge, MA. I am also suffer from a chronic neurological condition and am officially classified as disabled by the United States Social Security Administration. I have a neurological condition that makes it very difficult for me to spent long periods of time sitting up or standing without suffering from extreme dizziness and extreme pain in my head. It is very debilitating. However, I was not always in this position.

In April 2007 I was sitting in the library at school studying for an exam when I suddenly felt very dizzy. I felt as if I was on a boat that was being tossed around in heavy waves. Thinking I was simply overtired I left and began to walk home. I called my doctor on the way and explain my symptoms. I was told to immediately go to the emergency room at the Cambridge Hospital, which I did. After several hours I was discharged with an “ear infection” and told to follow-up with an ear-nose and throat doctor.

It took until March 2008 before I was finally diagnosed and began treatment. In the interim I suffered, untreated, from extreme dizziness and extreme head pain. There is no cure for my condition. It is chronic.

Permit me for a minute to paint you a picture of my financial life, before and after.

In 2007 I was working for the Spherion Corporation as a full-time employee and going to school in the evening. I was a computer and systems engineer, with a contract to the Harvard University Art Museum. While there I was known for my high technical expertise, especially in the area of Macintosh computers. My boss at the museum, Esmond, liked me so much that he wanted to buy me out of my contract. We were in the last stages of salary negotiation when I got so sick to the point of being unable to work any longer. I was still a full-time employee of Spherion. At this time I was making over $50,000 a year and the negotiations were for quite a bit more.

Spherion provided me with an Aetna PPO and I had elected to pay into both Short Term and Long Term Disability policies. These premiums were faithfully deducted from my weekly paychecks and the money sent to Aetna and MetLife, the disability company.

When I still felt very sick in August 2007 I went to my Internist at the Harvard Vanguard Medical Associated. I was immediately referred for a brain MRI with contrast and to a neurologist. As the results of tests kept coming back with bad results my symptoms only got worse and worse. Then I had to stop working. I provided my disability forms to my internist, who filled them out.

I then went home to Chicago to live with my parents. This is around when the financial horror began.

I received a series of correspondences from MetLife, phone and letters, in which they indicated I had a “pre-existing condition” and thus my disability policy was void. After consulting with an attorney who specialized in disability law it turns out I went to my internist five days too early. I had not cleared the extremely long (and very unpublished) period of time between beginning to pay for the disability policies and actually being covered. Had I gone to my Internist five days later I would have cleared this time limit. As well, my condition began after I had begun working for this company and after I had started paying into the disability policies.

I simply assumed that since I was being given health insurance and that my premiums were paid on time and in full I would have nothing to worry about. The health insurance didn’t have a grace period, and it even covered pre-existing conditions. Of course this condition began AFTER I had begun paying into the disability policy. Somehow, using legalese and lawyers, MetLife still considered this pre-existing.

Due to losing the claim for disability I also lost my company health insurance. At that point I went from being someone with good health insurance and a monthly income to someone with no health insurance and no monthly income. If not for my parents I would have become completely homeless with no access to health care.

Just imagine for a minute the effect this would have on someone with a chronic, severe neurological condition.

My father, G-d bless him, had made a very wise choice back in 2004. He had purchased an individual PPO policy for me and had been faithfully paying my premiums since. I still had insurance- a PPO even. Thank G-d.

Upon the advice of my disability lawyer, I filed for Social Security Disability. After 15 months and a denial that required a written appeal and two visits to SSD’s doctors, I was finally approved. I began receiving a monthly income 1/5 of my previous income.

My PPO, Blue Cross Blue Shield of Illinois, is highly ranked by Consumer Reports. However the plan has somewhat large deductibles, co-insurances, co-pays and don’t forget the monthly premiums. $1000 deductible, $1000 co-insurance, $20 co-pays (per office visit).

For someone who only has SSD as their only source of income paying all of this is a lot of money. I have calculated it to be between 3-4 months of income. Add to this the cost of my rent, food and the other basics in life.

To add insult to injury BCBS has been denying pre-approval for some medications. I am required to pay the hospital’s pharmacy up front and then I get to file this bill with BCBS. They then get to decide if and when they will reimburse me, and at what cost. This is a medication which my neurologist feels I may need to have for some time. It is an IV medication that takes 6 hours to infuse into my blood stream. I don’t understand why my doctor, a board-certified neurologist and the Chief of Neurology at his large university-based hospital, is being told “no” by my insurance company. This medication is fully FDA approved and the literature exists to demonstrate it helps people with my condition.

When I called BCBS to ask about setting up billing for this medication ahead of time I was told that this is not possible. I will only ever be allowed to pay for it out of pocket and then bill it to BCBS, hoping they reimburse me. This costs BCBS more money than simply paying the hospital directly. It’s a waste of time and money.

For someone who is officially classified disabled by the government (it was a long and lengthy process) it seems to me that I should be exempt from all co-pays, deductibles, co-insurances and out-of-pocket costs. I simply do not have the income to afford all of this. I have a very cheap rent and I never buy anything. I live very frugally and I buy food only with coupons.

So, to all the people out there who feel that there is no need for healthcare reform and the government needs to stay out of healthcare issues, I simply ask- is the status quo acceptable? I was a productive member of society who had every imaginable insurance. I did my utmost to ensure I would be covered if the worst happened. The worst happened and I was completely screwed over by a huge corporation.

Legislation needs to be put into place that would eliminate the co-pays, co-insurances, deductibles and out-of-pocked expenses for the disabled. As well, the legislation need to make certain that we cannot be dropped by our insurance companies and that there is no maximum dollar cap for treatment. Ever. In addition, the legislation needs to make certain that any treatments, tests or other medically necessary things ordered by our physicians cannot be denied by the insurance company. Especially FDA approved drugs.

This is not mind blowing or earth shattering in any way. It is sane, it is reasonable and it is the right thing to do.

None of this needs to be accomplished by the government setting up its own public-option. I am not opposed to this, but I’ll let the politicians work out setting up a parallel system.

As well we need to automatically be granted food stamps, rental vouchers and reduced fare for public transportation.

This is my personal situation and my personal thoughts of health care.


I am Baruch Stone. I am wishing you good health. May you have a blessed 5770 and a happy new year. Shana tovah umetukah.
     
Shaddim
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Nov 3, 2009, 12:58 AM
 
As much as I feel for his situation, this should probably be in the PL.
"Those who expect to reap the blessings of freedom must, like men, undergo the fatigue of supporting it."
- Thomas Paine
     
RAILhead
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Nov 3, 2009, 01:09 AM
 
Pre-existing condition. End of story. It sucks, but it is what it is — no reform will do anything about this.

The toe I had to have amputated because it contained a growing tumor? I'll end up paying about $25,000 out of pocket for the procedure that I pretty much had to have, otherwise, the tumor would end up taking over my foot and/or turning into cancer. Why? Pre-existing. Sucks.

I also have migraines, and have for years. Switched ins carriers because I retired, and now I pay for my meds out of pocket. Why? Pre-existing.

The problem is with the mindset of the vast majority of the people in this country, and reform can't do anything to help said people.

Lastly — and not trying to be a jackarse — he didn't do his due diligence, because nothing that happened was random or TEH BIG COMPANY purposefully trying to screw him around. He just didn't know what he was getting into, which isn't the ins company's fault.

Sucks, and I feel for him.

Victims, aren't we all?
"Everything's so clear to me now: I'm the keeper of the cheese and you're the lemon merchant. Get it? And he knows it.
That's why he's gonna kill us. So we got to beat it. Yeah. Before he let's loose the marmosets on us."
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lexapro  (op)
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Nov 3, 2009, 01:33 AM
 
RAILhead, is it still a pre-existing if it only started months after he began paying for the insurance?

I think his point, however, is that he is unable to work and can barely walk. Yet his medical expenses are really high. He was telling me he had to figure out how to make 8 months of income last for 12 months. This includes rent, utilities and food. All because of the huge medical bills that his insurance company doesn't cover.

Meaning to say, our dear former member is in pretty bad shape. And I feel bad for him.
( Last edited by lexapro; Nov 3, 2009 at 01:41 AM. )
     
besson3c
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Nov 3, 2009, 01:50 AM
 
It just really puzzles me that as Americans we have such a competitive spirit and the desire to be the best at everything, yet this doesn't seem to include having the most accessible health care system. Say what you want about Canada and their system, I know that many have and many will, and I don't mean to open up that can of worms, but bstone would be fine if he just happened to live there and Railhead would be $25,000 USD richer.

There are so many bstones that go into bankruptcy because of health care expenses, and so many of them even have health insurance. Is this really the best we can do as Americans, the same country that many patriotic Americans would assert is the "best country in the world"? Shouldn't this be "the best country in the world, so long as you don't get sick or else have very comprehensive health insurance and aren't stuck with the label of having a pre-existing condition"?

Whatever our future holds, public option or none, whatever happens, I hope that someday there are fewer bstones.


...I don't mean that literally
( Last edited by besson3c; Nov 3, 2009 at 03:13 AM. )
     
RAILhead
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Nov 3, 2009, 02:14 AM
 
The time coverage begins has nothing to do with pre-existing status.
"Everything's so clear to me now: I'm the keeper of the cheese and you're the lemon merchant. Get it? And he knows it.
That's why he's gonna kill us. So we got to beat it. Yeah. Before he let's loose the marmosets on us."
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lexapro  (op)
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Nov 3, 2009, 02:14 AM
 
besson, you make many important and very true statements!

Just so you know, bstone had comprehensive insurance through his employer. But when he got too sick to work he lost it. That just doesn't seem right....
     
CharlesS
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Nov 3, 2009, 05:04 AM
 
Originally Posted by RAILhead View Post
Pre-existing condition. End of story. It sucks, but it is what it is — no reform will do anything about this.
HR3200 has a provision in it making that pre-existing condition crap illegal.

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Paco500
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Nov 3, 2009, 05:35 AM
 
It's got it's issues. Big issues. But sometimes I like the NHS.
     
besson3c
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Nov 3, 2009, 05:46 AM
 
Originally Posted by CharlesS View Post
HR3200 has a provision in it making that pre-existing condition crap illegal.
Good catch.. Section 111 from this bill:

A qualified health benefits plan may not impose any pre-existing condition exclusion (as defined in section 2701(b)(1)(A) of the Public Health Service Act) or otherwise impose any limit or condition on the coverage under the plan with respect to an individual or dependent based on any health status-related factors (as defined in section 2791(d)(9) of the Public Health Service Act) in relation to the individual or dependent.
     
ebuddy
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Nov 3, 2009, 07:31 AM
 
Has bstone applied for Medicaid? Medicaid is designed specifically for aged, blind, and disabled people in the US.

He was deemed disabled and went through the lengthy process of getting affirmed disabled, why no mention of Medicaid? This is part of the 46% of our healthcare system managed by the government. The problem here is that everything bstone outlines above costs money. Lots of money. I believe the insurance industry on the whole made some... 2.2% profit? The government continues to operate at substantial losses and the ideals bstone proposes to help himself and others in his situation is not a sustainable solution.

There are other solutions that do not involve bankrupting the public sector and private industry, but they are nowhere on the table.
ebuddy
     
OldManMac
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Nov 3, 2009, 07:41 AM
 
What a tragic story, and a great illustration of the lack of morals and empathy on those who run the insurance industry. Just to brush it of by saying, "it sucks" is sad.
     
ghporter
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Nov 3, 2009, 08:40 AM
 
When the insurance company calls something a "preexisting condition," it's up to the patient to show otherwise. This is inherently unfair, as it usually only comes up when the patient NEEDS medical care. Funny how so many expensive preexisting conditions get denied but most relatively minor ones get ignored... Sure sounds like a double standard to me.

I feel sorry for bstone, I really do. I can't help but think that some advocacy organization (think ACLU for people who get dumped by insurance companies) could change this practice without or before any legislation.

Glenn -----OTR/L, MOT, Tx
     
-Q-
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Nov 3, 2009, 08:50 AM
 
Pre-existing conditions are complete bullshit. If someone is sick and covered by insurance, they should get treatment. No hoops to jump through.

Human health should not be a farking profit center.
     
ghporter
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Nov 3, 2009, 10:24 AM
 
Originally Posted by -Q- View Post
Pre-existing conditions are complete bullshit. If someone is sick and covered by insurance, they should get treatment. No hoops to jump through.

Human health should not be a farking profit center.
I completely agree that health should not be something that's handled "with the needs of the stockholders in mind." Far from it. However, there is a particularly troubling issue with preexisting conditions; a very few individuals max out their benefits under one policy and then attempt to get another company to cover them for more benefits. That's the ONLY thing that should prevent someone from getting insurance for a preexisting condition. Maybe one should have to pay more for the higher likelihood of needing more services, but it's not like those services are going anywhere.

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paul w
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Nov 3, 2009, 10:37 AM
 
Originally Posted by -Q- View Post
Pre-existing conditions are complete bullshit. If someone is sick and covered by insurance, they should get treatment. No hoops to jump through.

Human health should not be a farking profit center.
Indeed. In theory it makes sense, but in practice it has been shown over and over that the previous condition clause has been manipulated with plenty of bogus refusals, apparently for profit. Enough.

(This is coming from someone that had to pay for a tonsilectomy out of pocket because of previous condition refusal that came 6 months afterwards that was argued against by my very own doctor, in vain. )
     
turtle777
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Nov 3, 2009, 10:40 AM
 
Originally Posted by -Q- View Post
Pre-existing conditions are complete bullshit. If someone is sick and covered by insurance, they should get treatment. No hoops to jump through.

Human health should not be a farking profit center.
What you're saying is this: pre-existing conditions should be a burden on the general society and paid by EVERYONE.

I'm not sure if I agree.
Yes, it's very unfortunate that people have conditions, and that their medical cost will be higher than others. I still fail to see why this should be paid solely by society, and why the individual should not pay a dime more than someone with superior health.

Part of the problem is that many pre-existing conditions are the result of poor choices of an individual. Why would you make the society pay for this ?

-t
     
ShortcutToMoncton
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Nov 3, 2009, 11:25 AM
 
Originally Posted by turtle777 View Post
Yes, it's very unfortunate that people have conditions, and that their medical cost will be higher than others. I still fail to see why this should be paid solely by society, and why the individual should not pay a dime more than someone with superior health.
Layman's translation: "I've had good health my entire life and haven't been unfortunate enough to have anything bad happen to me, so sucks to them who've been unfortunate."

I mean, that's not very nice, but it is what it is.

Part of the problem is that many pre-existing conditions are the result of poor choices of an individual. Why would you make the society pay for this ?
...and many aren't the result of poor choices of an individual. Some people, for whatever reason, just have bad, bad luck. I've known a few. We all have.

Why not better over-inclusive, than under-inclusive? That's what I don't get with this whole thing. Some people seem so outraged at the thought that "the system" might be taken advantage of. Well, yeah. It will. You minimize that as best you can, but isn't that option better than screwing over people like bstone, who was damned by luck/statistics/genetics?

greg
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Atheist
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Nov 3, 2009, 11:35 AM
 
I definitely feel sorry for bstone. His life has been turned upside down and will never be the same. I have a cousin going through the a similar experience (Ménière's disease). It's a real tragedy.
     
lexapro  (op)
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Nov 3, 2009, 11:41 AM
 
Regarding those who wonder about Medicare- it only goes into effect *two years* after you've been affirmed as disabled by the Social Security Administration.

Here's an article on it:
For disabled, two-year wait for Medicare 'devastating' | News for Dallas, Texas | Dallas Morning News | Latest News

So because of this super long wait, he is forced to pay obscenely high rates for both his private insurance and the huge out-of-pocket expenses.
     
Laminar
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Nov 3, 2009, 11:49 AM
 
Originally Posted by ebuddy View Post
Has bstone applied for Medicaid? Medicaid is designed specifically for aged, blind, and disabled people in the US.
...

Originally Posted by lexapro View Post
Regarding those who wonder about Medicare- it only goes into effect *two years* after you've been affirmed as disabled by the Social Security Administration.
     
turtle777
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Nov 3, 2009, 11:56 AM
 
Originally Posted by ShortcutToMoncton View Post
Some people, for whatever reason, just have bad, bad luck. I've known a few. We all have.
Well sh!t. We should shift ALL BAD LUCK as a burden to general society.

Isn't that socialism pure ?

Look at it this way: if you shift all bad luck to society, you are (by definition) also shifting all GOOD LUCK to society. Those with GOOD LUCK pay for those with BAD LUCK.

It boils down to total equalization. Socialism.

-t
     
The Final Dakar
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Nov 3, 2009, 11:59 AM
 
Is LUCK a zero sum game?
     
CharlesS
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Nov 3, 2009, 02:18 PM
 
Question: How many in this thread have actually read the HR3200 bill?

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ShortcutToMoncton
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Nov 3, 2009, 02:22 PM
 
Originally Posted by The Final Dakar View Post
Is LUCK a zero sum game?
Hah
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besson3c
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Nov 3, 2009, 02:33 PM
 
Somehow there are numerous other countries with a public option of some sort that are not socialist countries, yet if the US goes this same route it will be branded socialist overnight.

What is with the socialist boogieman? I didn't live here during the Cold War, is socialism the new communist scare?
     
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Nov 3, 2009, 02:36 PM
 
Originally Posted by CharlesS View Post
Question: How many in this thread have actually read the HR3200 bill?
It dwarfs the Bible, and it's written in an even less accessible dialect of English. I question how many people in the world have read the whole thing.
Chuck
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turtle777
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Nov 3, 2009, 02:44 PM
 
Originally Posted by besson3c View Post
Somehow there are numerous other countries with a public option of some sort that are not socialist countries, yet if the US goes this same route it will be branded socialist overnight.

What is with the socialist boogieman? I didn't live here during the Cold War, is socialism the new communist scare?
Can you read ?

I said *IF* you equalize all good and bad luck, then it would be pure socialism.

And no, I don't know a single country that has a health care system that is as f*cked up as what Nancy Pelosi is proposing.

-t
     
Chuckit
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Nov 3, 2009, 02:46 PM
 
Originally Posted by besson3c View Post
Somehow there are numerous other countries with a public option of some sort that are not socialist countries, yet if the US goes this same route it will be branded socialist overnight.

What is with the socialist boogieman? I didn't live here during the Cold War, is socialism the new communist scare?
Socialism scares people who don't believe theft is OK and might makes right.
Chuck
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The Final Dakar
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Nov 3, 2009, 02:47 PM
 
Edit: Nvm, brain fart
     
RAILhead
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Nov 3, 2009, 02:53 PM
 
No sympathy for me and my $25,000 plus out-of-pocket expense due to my pre-existing condition?

"Everything's so clear to me now: I'm the keeper of the cheese and you're the lemon merchant. Get it? And he knows it.
That's why he's gonna kill us. So we got to beat it. Yeah. Before he let's loose the marmosets on us."
my bandmy web sitemy guitar effectsmy photosfacebookbrightpoint
     
lexapro  (op)
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Nov 3, 2009, 02:57 PM
 
Originally Posted by RAILhead View Post
No sympathy for me and my $25,000 plus out-of-pocket expense due to my pre-existing condition?

I think bstone would be right there with you. I think he feels your pain.
     
ShortcutToMoncton
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Nov 3, 2009, 02:58 PM
 
Originally Posted by RAILhead View Post
No sympathy for me and my $25,000 plus out-of-pocket expense due to my pre-existing condition?
Sorry, you made your poor choices, it's a tough world out there

Just kidding.... that really sucks like you wouldn't believe
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paul w
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Nov 3, 2009, 03:00 PM
 
Sk tsk... for $25,000 he could have gone to a country with cheaper socialized medicine and spent the difference on an epic prostitutes-and-drugs spree, legally, in Amsterdam.
     
besson3c
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Nov 3, 2009, 04:12 PM
 
Originally Posted by Chuckit View Post
Socialism scares people who don't believe theft is OK and might makes right.
Pulleze, now your larger-than-life rhetoric is sounding very Doofyesque. It's okay to oppose health care reform, but resorting to this sort of language when we've long accepted government programs that spread out these expenses among the tax payers even where it is not always "fair" is not cool. We don't have a flat tax, and our tax dollars pay for prisons even to lock up criminals that don't live in your area. Is this theft too?

We are a damn pack of wolves. Most of us could literally not live if we were unplugged from the "system" orchestrated in large part by our government. All of this is about is finding the best balance and the most effective systems that scale to meet the needs of our entire population.

I still can't wrap my heads around why we can't have these sorts of conversations without all of the usual socialist/communism/Stalin/theft/marxism/etc. sort of incredibly over-inflated philosophical drama. I really do think that there are many problems that would be best addressed taking philosophy out of the equation entirely in a sort of freakonomics style, and I do think that health care might be one of those things. All of the philosophy and moral stuff makes it nearly impossible to examine these sorts of issues in any sort of practical manner, especially since this is frequently inflated even more with complete FUD.

Sorry Chuckit, I don't mean to direct all of this at you, I'm just venting a little.
     
besson3c
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Nov 3, 2009, 04:17 PM
 
Originally Posted by RAILhead View Post
No sympathy for me and my $25,000 plus out-of-pocket expense due to my pre-existing condition?

I feel your pain, brother. I know your political leanings to some extent based on your past postings, and I'm not trying to ask a leading question here to put you on the spot for the purpose of proving a point or anything like that, but tell me, if you care to answer did the thought ever cross your mind that if you were Canadian you wouldn't have a $25,000 bill?

You don't have to answer that, but feel free to if you care...

The way I look at it, whatever you think about the Canadian system and that whole worm can, the purpose of insurance is to spread risk, and in this case it failed you since you had to absorb your own costs single-handedly even though you have been paying for an insurance plan that is supposed to do just this.
     
turtle777
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Nov 3, 2009, 04:19 PM
 
You damn socialists have still not answered the question how all this crap is going to be funded ?

The current proposals are like killing the goose that lays the golden eggs. And continue to killing it on a daily basis. Awesome plan

-t
     
turtle777
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Nov 3, 2009, 04:22 PM
 
Originally Posted by besson3c View Post
I feel your pain, brother.
Ok, so put your money where your mouth is.

All you pro-socialist health-care proponents should send bstone and Maury a check for $100 each to help him out.

And you shouldn't care if others are doing it or not, since you are SOOOOO convinced that this is the right thing, you surely would do it out of the goodness of your heart.

-t
     
besson3c
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Nov 3, 2009, 04:37 PM
 
Originally Posted by turtle777 View Post
You damn socialists have still not answered the question how all this crap is going to be funded ?

The current proposals are like killing the goose that lays the golden eggs. And continue to killing it on a daily basis. Awesome plan

-t

The current proposal, AFAIK, calls for a deficit neutral not-for-profit version of existing insurance options, but where the government is able to theoretically leverage lower prices. This is a compromise of a compromise of another compromise, since some projections say that only 2% of Americans would be eligible to buy into this program (where they pay for this out of their pocket like anybody else). There are also some provisions to provide for the poor, which is not all-too-different from what we currently do with Medicare.

If you believe that the current proposal is not deficit neutral or will be funded from tax dollars despite what we are being told, make this case, but until then can we try to dispense with the FUD?
     
besson3c
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Nov 3, 2009, 04:39 PM
 
Originally Posted by turtle777 View Post
Ok, so put your money where your mouth is.

All you pro-socialist health-care proponents should send bstone and Maury a check for $100 each to help him out.

And you shouldn't care if others are doing it or not, since you are SOOOOO convinced that this is the right thing, you surely would do it out of the goodness of your heart.

-t

You must be a ton of fun to be around in real life. It seems like over 90% of the stuff you post on these sorts of subjects is combative and hostile, hence my genuine curiosity whether you are like this in real life?
     
turtle777
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Nov 3, 2009, 04:42 PM
 
Originally Posted by besson3c View Post
You must be a ton of fun to be around in real life. It seems like over 90% of the stuff you post on these sorts of subjects is combative and hostile, hence my genuine curiosity whether you are like this in real life?
In knew it. It was all cheap talk. Way to go, "Socialists"

-t
     
besson3c
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Nov 3, 2009, 04:52 PM
 
Okay, moving right along then...
     
downinflames68
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Nov 3, 2009, 05:07 PM
 
Originally Posted by paul w View Post
Sk tsk... for $25,000 he could have gone to a country with cheaper socialized medicine and spent the difference on an epic prostitutes-and-drugs spree, legally, in Amsterdam.
I like the way this guy thinks.
     
lexapro  (op)
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Nov 3, 2009, 05:49 PM
 
So in a further chat today with bstone, he told me of a $5000+ from Tufts Medical Center for surgery that the insurance company refused to pay for. All the doctors and surgeons agree it was medically necessary, the insurance company (BCBS PPO) agreed to pay for it and then reneged. So now he's getting bills for $5k surgery while appealing the decision.

He says BCBS is rejecting it as "not medically necessary". Nothing to do with pre-existing whatevers.
     
Trygve
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Nov 3, 2009, 05:49 PM
 
I am in a similar situation, though not disabled (touch wood). I have a pre-existing condition (since I was born) and all told have had two very minor surgeries related to it in the last 30 years. Still, I was declined by every insurance company in my state.

Solution: Leave the USA.

More than 7 years ago, I sold most everything, and moved my family and business out of the country. Now I spend and keep my money outside of the USA (well over a million dollars since I left). I have private insurance from a UK company valid everywhere in the world except the USA. For a $1500 deductible it costs me about $200/mo for my wife and I.

The total amount my insurance company has paid in claims is: ZERO.

Rest-of-World 1, USA 0
     
ShortcutToMoncton
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Nov 3, 2009, 05:51 PM
 
Originally Posted by turtle777 View Post
Ok, so put your money where your mouth is.

All you pro-socialist health-care proponents should send bstone and Maury a check for $100 each to help him out.

And you shouldn't care if others are doing it or not, since you are SOOOOO convinced that this is the right thing, you surely would do it out of the goodness of your heart.

-t
Don't you have it backwards?

Shouldn't you be doing that? You know, as part of the less-taxes-because-I'll-give-to-who-I-feel-should-get-it-and-not-let-the-government-waste-it crowd?

Why should I give them money directly? Any taxes I pay go towards paying the doctor last week when I pinched nerves in my back. Didn't cost me anything to visit her. And then my insurance helped pay for my physio and massage therapy....

greg
Mankind's only chance is to harness the power of stupid.
     
Laminar
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Nov 3, 2009, 05:53 PM
 
Originally Posted by Trygve View Post
I am in a similar situation, though not disabled (touch wood).
     
turtle777
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Nov 3, 2009, 05:53 PM
 
Originally Posted by Trygve View Post
The total amount my insurance company has paid in claims is: ZERO.
Do you mean denied ?

-t
     
ShortcutToMoncton
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Nov 3, 2009, 06:05 PM
 
Sounds like he means: haven't had to pay because he hasn't made any
Mankind's only chance is to harness the power of stupid.
     
turtle777
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Nov 3, 2009, 06:20 PM
 
Originally Posted by ShortcutToMoncton View Post
Don't you have it backwards?

Shouldn't you be doing that? You know, as part of the less-taxes-because-I'll-give-to-who-I-feel-should-get-it-and-not-let-the-government-waste-it crowd?
Huh ?

-t
     
 
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