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SamTheButcher's Journal: [M,MH&I] Health Care broken - news at 11 126 126

This article details part of what's fucked about the current system and why I'd have a problem being a contractor or even freelancer. It's not that the costs are too high, but that I might not be able to get insurance *at all*.

Fuck your free-market medical health care system. It's broken, and if you can't see that then you're blind.

Am I offering solutions? Am I helping to fix the problem? No. Just pointing out the problems in America. Again. I must be a terrorist.

Healthy? Insurers don't buy it

Minor ailments can thwart applicants for individual policies.

By Lisa Girion, Times Staff Writer

December 31, 2006

Scott Svonkin joined the Los Angeles County Commission on Insurance 10 years ago because he was concerned about an emerging problem: people losing health coverage. Since then, the ranks of uninsured Americans have swelled to more than 46 million.

Svonkin almost became one of them.

It happened after he left a comfortable government job as a legislative chief of staff to start his own marketing and public affairs consulting business. Late last year he started shopping around for health insurance for himself, his expectant wife and his young daughter.

He knew he'd pay more without an employer picking up most of the tab. And he knew he'd have to fill out a medical questionnaire because, unlike job-based coverage, individual insurance in California is contingent on an applicant's health. But that didn't concern him because, he said, "I'm healthy as a horse, never smoked and have had no major surgery."

As it turned out, Svonkin was rejected by not just one but three of California's biggest health insurers, which cited his history of asthma, among other things.

"I couldn't buy it at any price," said Svonkin, 40, who lives in Sherman Oaks. "I remember thinking, 'This can't be happening to me.' "

Svonkin is part of what experts say is a largely hidden aspect of the nation's health insurance crisis: the uninsurables, people whom insurance companies won't touch, even though they can afford to pay high premiums. Some, such as Svonkin, pay steep rates for lean coverage from the state's high-risk insurance pool. Others simply go without.

Insurers have wide latitude to choose among applicants for individual coverage and set premiums based on medical conditions. Insurers say medical underwriting, as the selection process is known, is key to keeping premiums under control.

"Our goal is to extend affordable coverage to as many people as we can," said Cheryl Randolph, a spokeswoman for PacifiCare Health Systems Inc., a subsidiary of Minneapolis-based UnitedHealth Group Inc. "But because of the medical underwriting, we do not accept everybody."

Selective insurers

Consumer advocates see the practice as cherry-picking -- a legal form of discrimination that is no longer tolerated in schools, public accommodations or workplaces -- and a way to guarantee profits.

"The idea is to avoid all risk," said Bryan Liang, executive director of the Institute of Health Law Studies at California Western School of Law in San Diego.

Jerry Flanagan, an advocate with the Foundation for Consumer and Taxpayer Rights, said it wouldn't take much to be left out of the private-insurance market. "A minor asthma condition or a surgery 10 years ago that requires no further medical care is enough to get you blacklisted forever," he said.

As a result, some people forgo treatment so as not to tarnish their health records. Others withhold information from doctors or ask them to leave details out of their records. For those who are uninsurable, healthcare often is the chief reason they stay in or take a certain job.

Claudine Swartz enjoyed running her own consulting business but had been rejected for individual insurance. After a scare over a benign cyst in her breast, the San Francisco resident closed her business and got a job with the University of California's health system, where she enjoys guaranteed coverage.

The episode made her realize that without insurance, she would have been on the hook for catastrophic expenses if her diagnosis had been more serious.

"I wasn't willing to take that risk," said Swartz, 35. "It's a real problem for people trying to be entrepreneurial and work on their own."

Uninsurable individuals pose a significant challenge for the state, which expects to spend more than $10 billion this year on people who lack adequate coverage.

Gov. Arnold Schwarzenegger, preparing to announce a proposal for expanding coverage in his State of the State address, has said he favors a mandate on individuals to buy health insurance -- just as drivers must carry auto insurance.

Democrats, who control the Legislature, have favored expansion of employment-based insurance and have signaled their opposition to a mandate on individuals.

Consumer advocates say such a mandate is unworkable unless insurers are required to sell coverage to all comers, as they are in several states, including New York and Massachusetts.

No one knows how many Californians are uninsurable. Blue Cross of California, which dominates the market, declined to disclose its rejection rate, as did its chief competitors. A 2004 industry survey found that health plans said they turned away about 12% of all applicants. But the rejection rate rose with age to 30% for people 59 and older.

A consumer survey this year found that 1 in 5 people who applied for individual coverage was turned away or charged a higher premium because of preexisting conditions. Experts say it is hard to know how many of California's more than 6 million uninsured residents are uninsurable because many people with medical problems don't even bother applying in the belief that they would be rejected.

Insurers tread carefully

The industry contends that individual coverage is widely available. But experts say a wave of consolidation has reduced the number of insurers offering individual coverage, leaving a marketplace that shuns all but the ostensibly healthiest consumers.

Insurers say they are picky because they have to be.

Kaiser Permanente's "fairly generous" benefits require that the health maintenance organization be restrictive to remain solvent, spokesman Jim Anderson said. "We have to be very careful to not enroll a bunch of people who are going to spend all the money on their care."

Insurers declined to disclose the underwriting guidelines that lead to rejection or higher premiums. But a review of public records, as well as rejection letters sent to individuals, shows that California carriers turn people away or charge them higher premiums for conditions that range from the catastrophic to the common. Cancer, epilepsy and AIDS make the list, along with breast implants, ear infections, varicose veins and sleep apnea.

Jeffrey Miles, a vice president of the California Assn. of Health Underwriters, a trade group for independent insurance agents, said one of his clients -- a 27-year-old woman "in perfect health with absolutely nothing wrong" -- was rejected because she had seen a psychologist for three months after breaking up with a boyfriend.

"I call it hangnail underwriting," Miles said. "If a person has taken virtually any medication, they are going to be turned down. If people have had any psychological counseling at any time in recent history, they are going to get turned down."

Swartz, the consultant, said the reason she couldn't get individual coverage was a condition in her records that she may never have actually had. Her physician had diagnosed ulcerative colitis. But after years without additional symptoms, Swartz said, her doctor decided the initial diagnosis was probably wrong.

Consumer advocates say out-of-date, ambiguous and even erroneous medical information can render people uninsurable. Sometimes the reasons can seem absurd. In a letter to an otherwise healthy recent college graduate, for instance, Blue Cross listed among the reasons it denied coverage a past bout of jock itch, "successfully treated with cream."

A last resort for people turned away by the private market is the state's high-risk pool, in which the state assumes the financial risk but pays private insurers to administer coverage. Enrollees spend as much as one-third of their income on monthly premiums that cost as much as $796. Yet annual benefits are capped at $75,000.

Still, demand perennially outstrips the high-risk pool's capacity, which has been reduced over the years as medical costs have risen and funding has remained largely limited to state tobacco tax revenue and enrollee premiums. Of 32 states with medical high-risk insurance pools, California's is one of the largest, covering 7,800 people.

"The best estimate is it's only serving about 10% of the people who are medically uninsurable," said Beth Capell, an advocate with the consumer group Health Access California.

Most people in the high-risk pool have been rejected by at least one private insurer. Yet many turn out to be a bargain, paying more in premiums than they cost in medical expenses. In fact, 19% of the enrollees submitted no medical claims at all in 2004, the last year figures were available, and about 80% submitted claims for less than the average annual premium.

Good health, poor risk

High-risk enrollees include people like Scott Svonkin, who makes time for at least one tennis match each week. On a Burbank court after more than an hour of play one recent evening, he scrambled for a ball so far out of reach that most people wouldn't have bothered. After the game, Svonkin's fair skin was ruddy and sweat dripped from his forehead, but he was not out of breath.

After suffering from debilitating bouts of asthma as a child, he clearly relishes the ability he now has to exercise. He credits medications that weren't around when he was growing up. But the very drugs that have allowed him to breathe freely for years may also have cost him his health coverage.

When Svonkin left his job, he picked up the premiums on the Blue Shield HMO his former employer had offered and extended his coverage for three years. That's the maximum allowed under a federal law known as COBRA and a matching state law, both designed to make health insurance portable. A couple of months before that coverage was to expire, he asked Blue Shield to sell him an individual plan just like the one he was on.

But Blue Shield declined to sell him anything like that HMO plan, which included prescription benefits, he said. Instead, the carrier offered him a plan that did not cover medication.

Blue Shield declined to discuss Svonkin's case, citing patient privacy laws, as did the other insurers that subsequently rejected him, Blue Cross and PacifiCare. Although the rejection notices pointed to various problems -- "expectant fatherhood" and swelling from a spider bite -- all three blamed his history of asthma, a condition that affects more than 4.5 million Californians.

Svonkin was able to enroll his wife, daughter and baby son in a private plan. But with nowhere else to turn, he reluctantly enrolled himself in the state's high-risk pool. In an ironic twist, the pool assigned him to a plan administered by Blue Shield. His premiums are $479 a month -- far more than he figures he has cost the plan. The only medical expenses he has submitted in his first year on the plan have been his prescriptions, which retail for about $100 a month.

Blue Shield "wouldn't take me at their risk, but they took me at the state's risk," he said. "The reasons they won't sell me insurance are ludicrous because they can still make a profit providing me with healthcare."

The ordeal has been an object lesson for Svonkin, who is now chairman of the county commission on insurance, an advisory panel to the Board of Supervisors. He uses his post to focus on the problems of the uninsured as well as the uninsurables. The county does not regulate insurers, but its clinics, hospitals and emergency rooms are overflowing with uninsured residents who have nowhere else to turn.

"Insurance companies are offloading sick people onto the county system," Svonkin said. "They want a guarantee that they are going to make money. That's why they won't take sick people. They are missing the whole point about assuming some risk."

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[M,MH&I] Health Care broken - news at 11

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  • nuff said. you wanna see broken? nationalize a sixth of the nation's economy. yeah because big huge government can do it so much better.
    • by rk (6314) *
      Part of the problem is that our system is neither free market nor socialized, but a nasty Frankenstein creation using parts of each. As a result, we have the disadvantages of both and the advantages of neither.

      I agree that healthcare in this country is fucked and absolutely broken, and I also believe the only thing more fucked is the federal government and that any attempt by them to fix it will only make it worse.
      • by ces (119879)
        I agree that healthcare in this country is fucked and absolutely broken, and I also believe the only thing more fucked is the federal government and that any attempt by them to fix it will only make it worse.

        I guarantee your prediction will come true if the insurance industry or pharmaceutical companies are allowed to write the legislation. Witness the Medicare prescription drug benefit (aka Medicare part D).

        On the other hand the rest of Medicare seems to work pretty well.
    • Am I offering solutions? Am I helping to fix the problem? No. Just pointing out the problems in America. Again. I must be a terrorist.

      yay for nationalized healthcare

      You said it, not me.
    • by ces (119879)
      I don't know, Medicare (other than part D) seems to work pretty well. You can't argue with the low administrative costs (3%) either.

      The insurance companies sure as fuck aren't doing a very good job (actually they are if you are a shareholder or an executive).
    • Whenever anyone dares point out that the existing health care system in America is borked, the response is invariably "yeah but socialized medicine yadda yadda yadda".

      As if "socialized medicine" (my goodness, what a bugbear that is) is the only possible alternative to the way things are done in the US health care system.

      May I remind the audience for the umpteenth time that not all health care systems in Europe (not even most) are socialized in any sense of the word, yet they provide essentially universa

      • And from an immigrant in the US, here's why:

        Every farking time the subject comes up in conversation, some enlightened (usually left wing) American will go off on how wonderful universal socialized health care is and how they wish America was as refined, educated, caring, and perfect as Europe, which they visited once backpacking through France in the 70's.

        Pointing out some of the downsides with existing universal systems in response only serves as a small reality check.

        A US version doesn't necessarily have
        • Pointing out some of the downsides with existing universal systems in response only serves as a small reality check.

          The point being, though, that the downsides of health care in Europe (which, as I may remind our dear readers, is mostly not socialized, though heavily regulated) pale in comparison to those of health care in America: Namely, that for a very substantial and growing number of Americans, there is no health care for them, either because they can't get or keep insurance at all (as the article

          • The point being, though, that the downsides of health care in Europe (which, as I may remind our dear readers, is mostly not socialized, though heavily regulated) pale in comparison to those of health care in America: Namely, that for a very substantial and growing number of Americans, there is no health care for them

            Those are two separate problems though. Availability of health care is one problem, quality (including timely treatment) is another. If there is a way to increase the availability while guarant
            • Those are two separate problems though. Availability of health care is one problem, quality (including timely treatment) is another.

              Availability isn't the problem for the vast majority of Americans at all. There is abundant supply in most states and areas (OB-GYNs in Maryland being a glaring exception). It's access that is the problem. If you have the money, most anywhere in the US you can get care. The problem is that you need to have either insurance or cash to pay for it -- access.

              But just to let

              • But a largely market-based, yet regulated system can provide both high-quality care and low cost -- if the market is properly designed.

                Is this the case in Germany? What are the wait times like? Have you been happy with the system there? Since I believe the employer directly pays the cost of health care there, has it affected the unemployment rate?

                "Get it right"? Of course not. Nothing is perfect

                I'm not asking about perfect, but since you're in a picky mood when it comes to choice of words, let me then clari
                • Is this the case in Germany?

                  It gets much closer to the ideal, yes. It ain't perfect and it needs reforms as well, but nearly everyone's covered (including the unemployed) and the coverage is decent, without rationing or waiting lines. It is essentially a tightly-managed market. (Maybe too tightly, but whatever. It still works.)

                  What are the wait times like?

                  Well, I've been in the system now for 12 years (the first year I was here I used my American insurance, which I still had through my parents at t

                • Do you really believe, that the federal government of The United States of America, is capable of creating, maintaining, and sustaining a system that will provide universal access health care of similar or better quality and wait times as those of todays private system, at a cost similar to or lower than that which an insured person pays in todays system? Really? The U.S government can do this?

                  Yes I do- and the proof is in the mathematics. Today's private system wastes too much money on executive salarie
            • by elmegil (12001) *
              quality (including timely treatment) is another.

              The much vaunted quality of the US Healthcare system is bullshit, plain and simple.

              Let me give some examples from my own life. My wife and I have been treated for infertility over the course of the last two years. Everyone in Chicago raves about the quality of Northwestern, their hospital, their maternal fetal medicine unit, their infertility unit. From a purely technical standpoint, they're probably right. But from a quality of care standpoint, it's bull

              • Thanks for taking the time to relate your story. Sometimes I feel like I'm the only one that gets frustrated with the system as it is. :)
            • by elmegil (12001) *
              But just to let everyone add their name to a waiting list isn't really improving things.

              By the way, have you been to an emergency room recently? Unless you're out in the sticks, or are having heart attack symptoms, trust me, you get to wait a looong time.

              • Not for a few months, we have been to urgent care a few times and never saw more than about an hour of the waiting room.
              • Its actually *worse* out in the sticks. Nothing else is open. We don't have Urgent Care Centers, so if you get sick on Saturday or Sunday, you HAVE to go to the Hospital, or drive an hour to the closest Urgent Care.
        • A US version doesn't necessarily have to have the same flaws, but honestly, how much faith do you have in the federal government getting it right?

          More faith than I have in a bunch of con-artists on Wall Street. And that's what it comes down to for me- the federal government, with rule of law, in charge; or a bunch of butt pirates who earn their living off of investments instead of the sweat of their brows. It's a hard choice, a close race. But in the end, I trust government more than I trust business a
  • by nizo (81281) *
    Wouldn't insurance companies make more money if they didn't have to insure people who might get sick or need medical care?


    There are just some things that shouldn't be left up to the free market to take care of. Health care is one of them. Somehow having an insurance company, whose top priority is to make piles of money, in charge of my health care doesn't seem like such a great idea.

    • by RevMike (632002)

      Wouldn't insurance companies make more money if they didn't have to insure people who might get sick or need medical care?

      Not quite. They make money as long as the amount of money they take in as premium (less their overhead) exceeds the amount they pay out as benefits. They have the opportunity to be really choosy about individual plans. However, the balance between insurance provider and consumer is much more equitable in the world of group plans. A group plan represents a large amount of revenue, s

      • by TopShelf (92521)
        What you're discussing is a good option for many (certainly not all) people that is largely underreported, but it is really a work-around to compensate for a larger market failure under our current model. My in-laws are going through this situation right now, and it's a horrible situation. They're going to have to pay between $15-20,000 a year for basic health coverage, despite being basically healthy people. My mother-in-law was forced into leaving her job after nearly 30 years at a hospital due to "res
  • If you want to freelance, move to a European country - health care is free in most of them once you are a contributing member of society (i.e. pay tax). European taxes may be higher, but judging by those premiums - once you've added that premium in, you probably keep more of your own money under the European system.

    No system is perfect - but the US health care system in many states is far more broken than any European so-called 'socialistic' health system. Having lived on both sides of the Atlantic, I far p
    • by ces (119879)
      Cannukistan also has a nice health care system.

      Probably easier to relocate there as an American due to NAFTA.

      You'll still be paying more in taxes but between health care and retirement benefits it probably is a wash at worst and you'll come out somewhat ahead at best.
      • by RevMike (632002)

        Cannukistan also has a nice health care system.

        Probably easier to relocate there as an American due to NAFTA.

        You'll still be paying more in taxes but between health care and retirement benefits it probably is a wash at worst and you'll come out somewhat ahead at best.

        It all depends on how you measure it. My wife participates in several pregnancy related message boards that have an audience worldwide. Several expectant mothers were showing signs of miscarriage. In Canada, they were examined in the

        • The US health system provides a truly excellent level of care to 75% and a virtually nothing but emergency care to 15%. In Canada and Western Europe, the medical system provides good care to almost everyone. Pick your poison. The Canadian and European systems look great until you disagree with the system about the urgency of your particular case.

          Sorry, Mike, it ain't that simple.

          The US manages to blow through far higher sums of money on health care -- in terms of GDP, absolute terms and per capita --

        • by elmegil (12001) *
          The US health system provides a truly excellent level of care to 75%

          I said elsewhere in this JE that excellent is all dependent on the eye of the beholder. We've had huge waits for certain specialists (I believe the longest was two months to finally get to the doctor who was able to stop the benign but still concerning growth on my son's nose, after the GP and the local recommended dermatologist). We've had prompt but unsympathetic and at times downright stupid care from many others (by stupid I mean ha

    • It's not actually true that most of Europe has "free" health care (by which you presumably mean "paid for from the general tax fund, free at the point of service"). While that is the case in the UK, Sweden and Ireland (and IIRC Norway), most European countries have a system more like Germany's, where health insurance is paid for by employers and employees and insurance is provided by either a single insurer or by a host of private or semi-private insurers. The Germans, Swiss, Dutch, French and Austrians all

  • ... to find some sort of organization that offers a group plan. For instance, in NY a group called the Freelancer's Union [freelancersunion.org] has groups plans available to members. The Freelancer's Union is an organization specifically designed for NY's population of independent IT workers, graphics designers, marketers, etc. My wife is an attorney. Lots of attorneys have very small practices or are independent. So the Bar Associations in the area all offer group plans as well. Basically any profession that has lots of s

  • That will give you no-history health insurance at a premium- $600/month for my family, $800/month for my parents. This issue chased me into government service- nobody would employ me with my health care history and I couldn't afford this on my own.
  • We already have a nationalized healthcare finance system, socialist to the core, in this country which currently provides the best health insurance available to any American--Medicare.

    The solution? Make everyone eligible.

    That takes care of the financing.

    The real problem is infrastructure. There are about 60 million people in this country currently not using the health care system. The system has adjusted to this. If those 60 million were to come back in and seek regular preventative care, screenings, an
    • by ces (119879)
      DING! We have a winnah!

      The beauty of extending Medicare to everyone is you don't have to change anything other than the eligibility requirements and the amount of Medicare taxes collected.

      Insurance companies would still be free to offer their own plans, employers and individuals would still be free to purchase those plans. Of course private insurance would likely morph into "Medigap" style plans where the private insurance is only paying for some of the things that Medicare doesn't cover.

      There seem to be a
      • The beauty of extending Medicare to everyone is you don't have to change anything other than the eligibility requirements and the amount of Medicare taxes collected.

        Where do you get that money from? More taxes? Robin Hood doesn't work in the real world. Steal from the rich enough, and they leave the poor all alone.
        • by ces (119879)
          Where do you get that money from? More taxes? Robin Hood doesn't work in the real world. Steal from the rich enough, and they leave the poor all alone.

          Who's "stealing from the rich"? No more so than the current Social Security and Medicare payroll taxes do.

          To be clear I would fund expanding Medicare eligibility by raising the existing Medicare payroll tax.

          I suspect for most people the amount involved will be either less than their employer pays for health insurance coverage or less than their total out of p
        • by elmegil (12001) *
          Steal from the rich enough, and they leave the poor all alone.

          And you don't think they've been trying to leave the poor all alone anyway? Quadrupling the gap in salaries between the top and the bottom not enough? Give me a break. Corporations, "the wealthy" and corporate lawyers in judicial positions have been fucking this country since the civil war, and the only time they've given any back has been when the alternative was likely to be outright armed rebellion (e.g. the Union movement in the early par

          • The problem though is that the 'rich' in the eyes of those who make up tax code is anyone who makes more than $50k single or $120k married. In a good chunk of the US, that's barely scraping by (especially if you have kids). The 'haves' are having a hard time until you're in the $200k+ range (again, varying by region). I'd love to only have to pay for my own health care concerns, but unfortunately, the way the system is now, that's not possible.

            The only reason I'd be willing to switch to a more socialized
        • Where do you get that money from? More taxes? Robin Hood doesn't work in the real world. Steal from the rich enough, and they leave the poor all alone.

          Ah, but you see, the neat thing about this is that the rich are taxed ALREADY- this money can either go to private insurance companies to be wasted on profits and corporate jets and the like, or it can go to government to insure more people.
          • How is building wealth a waste? My honest goal is to make enough money to not ever have to deal with the US (or any other nation's) government once I retire.
            • How is building wealth a waste? My honest goal is to make enough money to not ever have to deal with the US (or any other nation's) government once I retire.

              Well, for that matter, retirement is a waste of resources keeping somebody alive who isn't contributing to society. There is no reason to think you should "own" anything outside of your own body. Where social myths allow you to have a mythical ownership, it's always for the express purpose of paying your own way or taking care of others.

              Wealth is j
    • You don't need "choice" in health care, you need *access.*

      Access to a waiting list isn't access to health care.

      Having lived in a country with socialized medicine, where I waited insanely long for treatment of shoulder problems, I have less faith in universal systems than many Americans who have never experienced it firsthand. Perhaps you also have more faith in government than I do, but I doubt the US federal government will execute reform well. I think there are a lot of things that can be done to improve
      • by rdewald (229443) *
        There's no need that I can see for the government to take over anything other than collecting the premiums and paying the bills. Medicare does this adequately well. Now, it is true that if 60 million people can suddenly get health care there will be a run on services, but that's because there hasn't been anyone to pay for the care of the 60 million Americans, probably only about 300,000 or so of these are sick enough right now to desire an appotinment somewhere. So, yes, we would have to deal with an extr
        • There's no need that I can see for the government to take over anything other than collecting the premiums and paying the bills.

          Hah, you're a funny man.

          If that's all, then yes, I don't have much of a problem with it. I seriously doubt it'd stop there though. There's too much of an opportunity to expand government, something politicians on both sides love to do.

          But if you have any links or other recommended reading on expanding the availability of Medicare without creating a huge waste of resources health ca
          • by ces (119879)
            But if you have any links or other recommended reading on expanding the availability of Medicare without creating a huge waste of resources health care behemoth, please do share.

            Current overhead for Medicare is roughly 3%, I believe the average for private health insurance plans is something on the order of 12%. Medicare would have to become 4 times as inefficient as it is now in order to become as bloated as private insurance.

            Oh and for those of you who think 'Socialized medicine' would be horrible and kil
          • by rdewald (229443) *
            The government actually already exercises a great deal of control over health care right now, and has for many years, by virtue of the details of the Medicare benefit. In my area of practice, hospice, the services one receives , no matter who pays for them, is dictated by what Medicare (our biggest payor, about 85% of our revenue) pays for.

            With the exception of reproductive services for women (and Terry Schiavo's case), the government has not ventured into private healthcare decisions. If someone wants to
      • by ces (119879)
        Why don't you ask someone who is covered by Medicare what their experience has been?

        AFAIK patients on Medicare are no more subject to 'waiting lists' than those covered by private insurance. And trust me unless you are willing to pay 100% out of pocket you are going to have to wait in the US to receive non-emergency surgery or to see a specialist. A friend had to schedule his hernia operation 4 weeks in advance and the only reason he got in so soon is he was willing to go in on the 26th of December.

        We just
        • Four whole weeks? Ouch.

          Looking at a Swedish site for wait times in Stockholm, one hospital shows a wait of hernia surgery of 4 weeks or less, five show 5-8 weeks, five show 9-13 weeks, three show over 13 weeks.

          Splitting the ranges gives an average of 9 weeks if I got my middle school math right.

          This is of course after you visit primary care, get referred to a specialist, get examined, and then finally scheduled for surgery. All the previous steps take weeks by themselves. To see a specialist ~ 5 weeks, he s
          • by ces (119879)
            Yep 4 weeks, and it would have been longer if he hadn't gotten it done last week (after Christmas is a bit slow for elective surgery).

            Depending on where you are in the US and what providers are covered by your insurance you can see similar wait times here with private insurance. The only exception is likely the MRI. But even then you will probably have a short (~1 week) wait for a non-emergency MRI appointment.

            Funny thing is those covered by Medicare can actually have more choice since most places will take
            • Depending on where you are in the US and what providers are covered by your insurance you can see similar wait times here with private insurance

              Do you have a reference for this? I'd like to compare some US numbers, but funnily enough pretty much all wait time articles are about waits in Canada :-)

              And there's a difference between making an appointment and being put on a wait list. "We can see you on Thursday at 4" is an appointment, "We'll call you in June to schedule your surgery" is being put on a wait lis
              • by ces (119879)
                Do you have a reference for this? I'd like to compare some US numbers, but funnily enough pretty much all wait time articles are about waits in Canada

                Unfortunately most of what I have is anecdotal. I know there have been at least some surveys but I wouldn't know where to find them.

                And there's a difference between making an appointment and being put on a wait list. "We can see you on Thursday at 4" is an appointment, "We'll call you in June to schedule your surgery" is being put on a wait list.

                From where I s
              • by elmegil (12001) *
                Do you have a reference for this?

                Got one right here. My son had a growth on his nose, kinda wart like, but not your stereotypical hard, hairy red thing. More of a skin tab with aspirations.

                GP froze it off. Came back 3 months later. GP burned it off with some standard chemical treatment. Came back 3 months later. Referred us to a local dermatologist, took about 3-4 weeks to see him. He froze it off a slightly different way...it still came back. Went through about 4 cycles with him until he referred

            • My son waited 6 months for an "emergency" MRI on private insurance in the United States. Good thing it was just Cerebral Palsy and not Hydrocephalous, which was the fear that prompted the MRI.
              • by ces (119879)
                My son waited 6 months for an "emergency" MRI on private insurance in the United States. Good thing it was just Cerebral Palsy and not Hydrocephalous, which was the fear that prompted the MRI.

                So that can happen here too.

                I was basing the possible exception on the fact that the US has a larger number of MRI and other high-tech diagnostic machines per-capita than say Canada or Sweden.
      • My last tumor, in your wonderfull America- I had to wait 18 months to see a doctor for. It wasn't that I wanted to stay away- it's that I couldn't afford to see him when I was unemployed and without insurance. So fuck you.
        • How charming.

          What does that have to do with my post? I simply said that I have chosen to not see a doctor.
          • Well, you claimed that wait times were small in the United States- and that the 60 million were just "choosing" not to see a doctor.
            • I said nothing about waits in the US, I commented on the wait in Sweden, let me repost it in bold so that you can read it again:

              Having lived in a country with socialized medicine, where I waited insanely long for treatment of shoulder problems

              Secondly, I never said that all the 60 million chose to not see a doctor, again, I said I, as a member of that 60 million, chose not to. Here's what I said:

              Also, not all of those 60 million are staying away because they can't afford it.

              You may rant and rave as muc
              • You're not a member of the 60 million. You choose not to go to a doctor. The 60 million (of which I was one for a time) can't afford to see a doctor, and are uninsured. Those are totaly separate groups- and I find it insulting that you would merge them.

                In addition to that- it isn't as much that I trust government as that I don't trust contract law and business even more. I've been burned by the health care industry enough in my 36 years that I simply can't trust a man who is only interested in his own
                • The 60 million (of which I was one for a time) can't afford to see a doctor, and are uninsured.

                  Find a solid reference that says that the reason every single one of the 60 million did not have insurance was because they were too poor. Show me that not a single one of those 60 million was uninsured because they were briefly between jobs. Show me that not a single one of those 60 million elected to not have insurance.

                  Knock yourself out, and get back to me when you've done your homework.

                  You can play insulted an
  • First on my list are the lawyer scum. The ones who help people squeeze money out of medical systems for treatments that were the best there were to offer at the time. They directly cause the insurance rates of Doctors to go up (they're more likely to get sued than say, a mechanic), they have to raise their rates to cover their malpractice insurance. Doctors in fields like Obstetrics are in greater risk, because they are being sued for Medical Malpractice with GENETIC ILLNESSES they had no control over sh
    • by ces (119879)
      First on my list are the lawyer scum. The ones who help people squeeze money out of medical systems for treatments that were the best there were to offer at the time. They directly cause the insurance rates of Doctors to go up (they're more likely to get sued than say, a mechanic), they have to raise their rates to cover their malpractice insurance. Doctors in fields like Obstetrics are in greater risk, because they are being sued for Medical Malpractice with GENETIC ILLNESSES they had no control over short
      • Two things here. One is that in a majority of medical malpractice cases the care provider fucked up and in a fairly major way. Things like leaving surgical retractors in a patient's abdomen after surgery, or giving someone a drug the patient had a known allergy to.

        I have no problem with LEGITIMATE suits. I do have a problem with the "Medical Malpractice" lawyers that troll the airwaves during offpeak hours with an 800 number to call if you happen to have suffered any pain when your doctor, in attempting to
        • by ces (119879)
          FDA (under Clinton) approved it, and it was highly effective. With the baby boomers aging, there's more pressure to get more drugs on the market faster. What if this was an AIDS treatment that was 95% effective, but raised your risk of a stroke by 15%? Would it be worth the risk?

          The company withheld information about possible side-effects because they were afraid the FDA wouldn't approve the drug. All of the possible risks weren't disclosed to the patients.

          On the other hand I will say that the FDA is often
    • If you want to freelance, what's your wife doing? The rule of thumb my wife and I've worked with is at least one of us has to have a 'real' job with benefits.

      She's working two part-time jobs and taking care of the kids. :) It's nice to have the flexibility of part-time work (one of her jobs is at my kids' school). If she had more hours at the school, we'd qualify for a discount on our current medical coverage.

      I don't know that I want to freelance, but insurance is one of the things that holds me back somewh
      • by ces (119879)
        I don't know that I want to freelance, but insurance is one of the things that holds me back somewhat careerwise. Even working for a startup would be dicey, as they typically don't have good (much? any?) coverage plans. not that I'm even at that level, but it'd be nice to have it as an option, ya know?

        Not sure what it is like in Colorado but here in Seattle the vast majority of people freelance/contract via an agency of some sort. Most agencies offer some form of health insurance though typically they will
        • I think living in Seattle has something to do with it, like living in the Bay Area. A more affluent place coupled with higher awareness of the benefits of employee wellness. When I lived in the Bay Area previously (and then working for Apple), our health care was *awesome*. Since I've been in Colorado, it's been hit-and-miss. I worked for a startup (touchscreens for home control, 14 people) when I tried to get personal coverage and was denied by BCBS/Anthem. I bought that coverage for my family @ $300/month
          • by ces (119879)
            I think living in Seattle has something to do with it, like living in the Bay Area. A more affluent place coupled with higher awareness of the benefits of employee wellness.

            Perhaps, there is also the need to compete with established companies with gold-plated coverage, the fact that it is seen as a "standard" benefit at tech companies, and the relative ease of getting coverage for small companies via the trade association.

            I worked for a startup (touchscreens for home control, 14 people) when I tried to get
          • by ces (119879)
            I'll cross that bridge when I get to it (I keep optimistically thinking I'm ready to be a programmer, which is more dreaming than optimism). I guess I do have more options than I think, but my previous experiences aren't/weren't too heartening, and that was 3 years ago. The climate has only gotten worse (and more expensive) since then.

            BTW you'll likely need at least 1 year of experience before you are terribly marketable as a freelancer.

            For that matter you'll probably find it somewhat difficult to find prog

            • BTW you'll likely need at least 1 year of experience before you are terribly marketable as a freelancer.

              For that matter you'll probably find it somewhat difficult to find programming jobs until you have a years experience as well.
              :( Yeah, that's what I was thinking. I'm trying to find ways to get experience now, looking on Craigslist and sourceforge but not finding terribly much.

              Any tips that way? :)
              • by ces (119879)
                Any tips that way?

                No, not really other than maybe taking a job where you might be able to weasel into some programming. Another thought would be to start or get involved with an open source project.

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