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Journal bethanie's Journal: Denial: A Proud American Institution 62

Journal by bethanie
OK, this is why you don't let Bethanie get 10 hours of sleep AND have caffeine on the way to take Kiddo to preschool -- when she listens to the radio, she actually starts THINKING about the stories, and then she starts TALKING to the radio and making vehement arguments -- and sometimes, I have to warn you, she gesticulates. Umm... with BOTH hands.

So no, didn't get into any wrecks... but I didn't quite get it all out of my system. But that's what I have y'all for, isn't it? :-)

Issue of the day: Health care.

Story talks about how to manage healthcare costs and reform the system. Because folks, we can't keep going the way we have been. Something's gotta give, or else the whole thing is gonna break.

So the idea now, since nationalizing health care is SUCH a bad one, is to shift more of the cost to health care consumers. And of course, there's BIG resistance to this, because people don't LIKE to be aware of how much money they're spending on stuff like this. It's a whole denial thing.

It's like how stupid people are about paying income taxes. They get ALL fucking excited when they get a refund check. And getting excited about THAT is the stupidest thing EVAR because it means one of two things: either 1) you're fucking POOR or 2) you just gave the government a year-long interest-free loan of however much money you're getting back from them. Did you make an interest payment on any credit card balances? Did you pay interest on ANY debt you have? Well... you can consider that an additional donation. If you'd had that money you'd given the government, you could have eliminated part of that debt AND the interest you paid on it.

But you LIKE that big juicy check of a few $100 (PLEASE don't tell me you get more than that!) once a year? DUDE. Get a savings account! Better yet, buy yourself a CD! Don't make the government do your saving for you -- do it yourself! Sack up and have some discipline, for godssakes!!

But back to this whole healthcare thing: I got news for ya, folks -- we're ALREADY paying for it. Except for the very poorest among us, NOTHING that we are getting is "free." That private insurance that you have from work? Well, that's part of your compensation package. It's not something your company is giving to you out of the warmness of their hearts.

Those health insurance companies? Well, they have contracts with those providers (the doctors, labs, pharmacies, etc.) to give them discounts for the services you use. That's why it's advantageous to use them.

And I know that most of us don't use it (yet), but the biggies: Medicare and Medicaid? Fuuuuuuck. THOSE ain't free! That's coming out of our taxes, folks -- and it's the most inefficient system of all. And I can tell you how you can tell: Every health care plan, every hospital, EVERY program out there providing health care services, the FIRST order of business for them is to get "federally qualified" so they can start collecting those Medicare dollars. Yes, part of it's volume, but it's also the fact that there's just SO. MUCH. MONEY. coming out of those programs. Cash cow, all the way.

So... what if we reduce these programs? NOT eliminate, mind you -- there is DEFINITELY a place for health care "insurance," like when you get into a car wreck and have huge hospital bills, or when you get REALLY sick and need to subsidize the cost of long-term treatments. Insurance is for use in catastrophic cases. If your house burns down, you use your insurance. If you feel like retiling your bathroom, you save up and pay for it out of pocket.

So we reduce insurance coverage. Now, when you get a cold, you pay for that doctor's visit -- the whole kit and caboodle. You pay for the doctor's time, and you pay for the FULL cost of all those prescriptions you walk out with. So you are FACED with how much it costs when you decide to go that route.

And THAT's where the magic happens. You see, when we have to pay for shit, we get incredibly cheap. We start seriously considering the VALUE of what it is we're paying for. And you may say, what is more valuable than our health? Well... not much. BUT then again, how effective is that treatment that we're getting? Is that $60 bottle of cough syrup REALLY so much better than what we could pick up over the counter for $8? If we'd just been willing to gut it out for another week, do you think we could have lived without those $100 antibiotics?

When we begin to consider the value of the services we're getting from the health care industry, we'll begin to consider more alternatives. One that's REALLY cheap and amazingly effective is homeopathy. We have a VAST wealth of knowledge about homeopathic remedies that has been developed over hundreds of years... but because it's SO cheap there's no money to be made in researching it further to back up the effects with all of our "modern" science. (Kinda like breastfeeding -- it's free and supplied naturally so there's just not a MARKET to tap into; but they're doing their darnedest, I can tell ya!) Because, again, buying an $8 bottle of pellets that will last you for 5 years just doesn't make ANYONE near as much money as you'd be laying out for the doctor's visits and prescriptions.

People kick and scream when they're dragged into being personally accountable for shit. You know what? I have no pity for them. Waiting for someone else to do for you what you're not willing to do for yourself? That's soft. It's weak. And weakness deserves to be eliminated, or at the very least, taken SERIOUS advantage of.

OK... so that's my health care rant. For today. But I have one more nit to pick, which is this:

DICK CHENEY'S HUNTING ACCIDENT IS *NOT* A NEWSWORTHY EVENT!!!

I don't care how hard the media tries to make it into one, with the gun control spin and the hospital recovery spin and the ooooh.... another example of cronyism!! spin...

A couple of old guys were out quail hunting and there was a shooting accident. It happens. NOT a big deal. Get the fuck OVER it already.

Tell us more about all those WACKY Muslims shooting each other and shouting "Death to America" because some cartoons were printed in a country that most Americans can't even find on a fucking map. Now THAT's news, baby!!
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Denial: A Proud American Institution More

Denial: A Proud American Institution

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  • You go, girl.

    I too, want to throttle people who, when asked what they paid in taxes, say "Nothing - I got a refund this year."

    If more people knew how much of their money they were flushing down the Government Toilet of Inefficiency, more people would vote for tax-cutters.

    • A car. I bought the government a car. Not a really nice car, but certainly a new, American car. Sadly, it probably bought some damned Texas lawyer a few hours of intensive care. And THAT, my friends, is the ONLY reason why Whittington's wound is news.

    • How about this instead- I paid approximately $1900 Federal, $1800 State, and got back $3600 Federal, $1700 State. Unlike the other person below- I'm no liar cheating the government out of their withholding interest, I claim exactly the number of dependants I have on my W4. Part of this, though, is due to a huge capital loss I've taken since 2001- one that I blame the government entirely for.
    • Well, if you disregard social security, medicare, and the part of my rent that goes to property taxes, I didn't pay any taxes:

      (1) No taxable adjusted gross income.
      (2) No sales tax in Oregon.

      Chalk it up to being a dirt-poor university senior.
      • I should have been more specific - the Lexus driving executive who gets a refund and doesn't think he's paying any taxes because he gets a refund.... that's the archtype of who I was talking about.

        People who have no clue what it is they actually pay in taxes.

        • I should have been more specific - the Lexus driving executive who gets a refund and doesn't think he's paying any taxes because he gets a refund.... that's the archtype of who I was talking about.

          I've never met anyone with a hefty income who didn't know *exactly* how much taxes they paid.

          People who have no clue what it is they actually pay in taxes.

          I think that people who are just above the threshold of having taxable adjusted gross income and don't do their own taxes are more likely to not know how much

  • um... (Score:2)

    by ellem ( 147712 ) *
    8700USD Federal 1300USD State last year.
    • First things first:
      gesticulate \juh-STIK-yuh-layt\, intransitive verb:
      1. To make gestures or motions, especially while speaking or instead of speaking.

      (I'm no english major and figured someone else may need the definition)

      I'm around 3,800.00 federal.
      I'm a very undisciplined spender. If the government takes an interest free loan then pays a lump sum a year later, its money I woulda splurged on something stupid and, instead, am getting a new waterheater, fixing up my car, and paying off a couple credi
    • Dude, you can set your withholding exemptions on your W4 WAY higher than your actual family count, as long as you're sure you're not going to have to pay too much back at the end of the year. Mine is at 9, and I still get back >$1000. But nowhere near $10,000!
  • As a general rule of thumb prices for services are set at 1.5 times what Medicare allows. So if Medicare allows $100 it's billed at $150, with the assumption that private insurance will pay more than Medicare. Also knowing that depending on the contract with the insurance carrier a portion of the charges will have to be written off, the service provider has to make sure their charges are high enough that even with writing off that percentage they still get enough back to cover their costs.

    It's a stupid sys

    • I was just gonna say, I pay about $80 a month for my coverage.

      I haven't been to a doctor since...well, I had an exam before I could come here (They don't want no sick Swedes covered in germs to come here and mooch off of your free healthcare system I suppose). That was 4 years ago. Before that...well, a friend did make an honest effort at popping my shoulder back in after it was dislocated, but in the end I decided that going to the hospital would probably be necessary after all.

      When I get sick I buy Dayqui
      • When I get sick I buy Dayquil or Nyquil (mmm, Nyquil, if only they'd carbonate it and sell it chilled by the registers in convenient 20oz bottles).

        Denis Leary calls NyQuil the 13th step. :-)

        That stuff works wonders on colds, though. It (and DayQuil...or the store-brand equivalents that cost only about half as much (if that) at Costco or Sam's Club) works at least as well as the high-dollar stuff that I've been prescribed in the past.

      • Nyquil (mmm, Nyquil, if only they'd carbonate it and sell it chilled by the registers in convenient 20oz bottles).

        Look at the list of Active Ingredients sometime- if they did that they'd have to put it in with the wine and beer (it's got more alcohol than some wines- but then again, so does Lysterine).

        I just don't understand why healthy people choose to pay several hundered dollars a month for their health insurance.

        2 reasons. 1. I'm not that healthy- and doubt rather that I'll ever be. In fact I'
        • Uhm, so in fact, your first reason doesn't apply to my statement since you're not a healthy person. Reason two doesn't really fill me with pity since I said choose to pay. If you Choose to not get insurance and are hit by a bus, well, you gambled and lost. Tough.

          The debate on universal coverage is very much a different disucssion from the one on over-insuring yourself needlessly.

          But out of curiosity, how much would a $5000 deductible/hospitalization only insurance cost you? My insurance co starts under $50
          • The $300/month is for a $10,000 deductible. It's mainly due to the migraines associated with the Asperger's syndrome, the indicators for future lack of health due to that, and the expense of the two most immediate treatments (getting my dental fillings removed and replaced with something that doesn't contain mercury, and the fact that Imitrex is still patented and I'd require a hell of a lot of it to handle the mercury poisoning for getting the dental fillings removed). It sucks to be over 30...and have s
  • It even works fractionally.

    When I started at my current employer, I had a choice of about 8 HMOs (No co-pays -other than for Rx, see our doctor, If you need to see a specialist, get a referral. on our schedule) or 1 PPO (You can see whatever doctor you want. Depending, you will pay either 20% or 40% copays).

    Of course, HMOs were "the way to go to keep costs low. managed care! Woo-Hoo!".
    I went with the PPO, due to my deep and abiding hatred of HMOs. I was willing to pay more for the joy of not being in a HMO.
    • I wonder how much of the current cost difference is due to a difference in administrative overhead?

      PPO plans generally have much lower administrative costs since they don't try as much to be gatekeepers on service.

      As many of you know administrative costs have been one of the largest components of health care cost inflation. (even more so than prescripton drug costs)
      • Not that much, I would expect. Besides, that whole "gatekeeper" function is what was supposed to allow HMOs to be more cost effective...

        Except for the part where divorcing patients from the costs and divorcing doctors from profits warps the system out of all rationality. I would still go with the PPO if it were more expensive - as it was when I started.

        Oh, and I remembered it wrong. I pay just over 1/4 of the cost of the cheapest HMO. :-)
  • First and foremost, is complete coverage for pre-natal and delivery expenses for all pregnant women. It may seem like a big outlay but compared to government covering NICU expenses because the mom-to-be didn't go to the Ob-Gyn to save a few dollars will easily be higher.

    Second is, as others pointed out, pay some of the freight. Not a flat co-pay but a percentage.

    Third is, if your ailment is related to bad lifestyle choices then your percent pay goes up. Or percent goes down if you do certain good things
    • Actually, I disagree. I think that OB/GYN care offers one of the most exciting prospects for reforming *care* by reforming the way it's paid for.

      You see, there's absolutely NO reason for the vast majority of women to be hospitalized to give birth. Hospitals are HORRIBLE places to be giving birth. There's also no reason in the WORLD why every woman should be seeing a physician EVERY month (and later, every WEEK) of her pregnancy. That's excessive.

      Lay midwives are perfectly suitable for most pregnancies,
      • OK maybe we don't need as much care as we give to pregnant women (though I'm not going to be the one to tell that to a woman in labor...), but I really feel we should ensure that pregnant women are going without care because of budgetary issues. This is preventative spending in the best sense as a little extra spent now could mean the difference between a life-long state ward in the future or a healthy child.

        Beyond that we can get into the minefield of people who already can't afford the kids they have hav
        • I think that "prenatal care" really ends up being like any other preventative care- eat right, get enough nutrients, make up for deficiencies, get enough exercise, don't smoke, don't do drugs. All of these things can be done on your own to prevent future medical problems, without the expense of a doctor. Most people don't do everything they can prevention-wise, either out of ignorance or laziness. If you're pregnant, however, your decisions affect another potential person, which means more future medical
        • Well, how about this (and SW can speak to this, if she bothers to look in on this thread any more): How about reduced rates for women who are willing to FOREGO maternity coverage? That is, women who WILL NOT be having any children, and are going to do whatever it takes to see that that happens? They certainly lower health care costs!

          I do think that if people had to pay the full price of having a baby (and I do mean PRICE in the financial sense), they might be more careful about planning it. And if they do
          • Given the current worries about declining birthrates in Western countries (including the US), I think any policymaker who suggested encouraging people to not have babies would be considered a bit daft.

            Most countries I know of are quite happy to have health care systems pay for a bit of testing if it means catching potential problems down the road. Ounce of prevention and pound of cure and all that. That doesn't mean all testing is paid for, but certainly certain tests should be paid for, others perhaps pa

          • I would be all for that. Maybe the premium savings would make up for the fact that I have to pay for my birth control out-of-pocket. (Yes, Viagra is covered. Thanks for asking.)
          • If you have private coverage you save about $125-$175 a month by not having maternity coverage (at least with the plans available in SC).
      • Unfortunately, unless a pregnant woman is seeing a medical professional, she's not going to get tested or diagnosed for many of the pregnancy complications that would preclude being delivered by a midwife. I'm guessing that you had normal pregnancies with your kiddos - not all of us are so lucky. I think that unless someone has had a pregnancy with medical complications, it's easy to write off the frequent doctor's appointments and tests that detect problems like IUGR, placenta previa, preeclampsia, GBS,
        • I didn't say women shouldn't be seeing healthcare professionals. But a lay midwife (that's very different from the kind of midwife who works for an OB/GYN practice, by the way) is COMPLETELY capable of screening for all of those complications, and can refer women to a physician if the need exists.

          And I *am* one of those women who declined tests for "complications," particularly the AFP. I also would have declined the glucose test if they'd offered it with my 2nd pregnancy, because there were NO other indi
          • I don't think people, pregnant or not, should have to be in any more pain than is necessary, especially when the pain relief can speed things along. (Long story, let's just say that labor for me without pain relief of any kind is very slow, the progress of labor is unpredictable, and Stadol is very very bad for a baby.) The cost of having an epidural is under/around $1000, not $5000, and it's a cost I would gladly pay if my insurance didn't cover it, given the options.

            I dunno why your docs wanted to run s
            • I'm not questioning individual procedures and practices in specific cases. What I am saying is that if we were responsible for paying for them out of pocket, we could more carefully consider their value and effectiveness.

              You, for example, would be willing to pay the price for pain relief during labor and birth. I, on the other hand, would have been willing to pay (and did!) out of pocket for an ultrasound to know if I was going to need a D&C, or should be on immediate bedrest to try to save my pregnan

      • You see, there's absolutely NO reason for the vast majority of women to be hospitalized to give birth.

        Unfortunately, there is a reason -- CYA. Have you seen the malpractice insurance costs for any facility/hx which has an OB section? What Dr's pay?

        Birth has been and always will be "risky" for women. Modern technology has virtually eliminated the deaths of mother and/or child -- but complications still occur -- accidents do happen. And the lawsuits are HUGE. You are right that the vast MAJORITY these

        • Not disagreeing with you about the tort reform. But about childbirth being inherently "risky" -- that's a misconception (ha ha ha).

          I'm not going to go into ALL the data out there about the fact that UNDER NORMAL CIRCUMSTANCES homebirths ARE safer for women than hospital births -- but it's the truth. And I'm not going to argue that maternal mortality rates have NOT dropped since the introduction of "modern medicine" into the process -- but that's got more to do with more knowledge of germs and antibiotics

          • I'm not going to go into ALL the data out there about the fact that UNDER NORMAL CIRCUMSTANCES homebirths ARE safer for women than hospital births -- but it's the truth.

            Yes... UNDER NORMAL CIRCUMSTANCES . I'd suggest that the cost of dealing with complications which arise from home-birth are greater than those from HX births. Further, all the studies of which I've had access to the methodologies were skewed -- some showed home-births which ended up at the HX due to complications were counted as HX bir

            • As I said, I'm not going to get into an argument over the studies. But I've read about this EXTENSIVELY, and even considering the statistical flaws that you mention, homebirths are still safer than hospital births. You won't convince me otherwise; I've done my research.

              ....Bethanie....

              • even considering the statistical flaws that you mention, homebirths are still safer than hospital births. You won't convince me otherwise

                What's the title of this JE again? heh.

                I'd just suggest you go back and read the methodologies and make sure you aren't reading someone's SUMMARY of a given study -- but the study itself.

                That said, you may be right -- but I've yet to see a study which truely showed this. And if home-births for low-risk pregnancies ARE riskier than HX births for the same risk-rate, I do

          • But about childbirth being inherently "risky" -- that's a misconception (ha ha ha).
            I guess we just differ on the definition of "risk". There's about a 1 or 2 per 2000 infant mortality rate in the US, iirc. Add to that JUST the preeclampsia statistics -- something like 5%-10% of all pregnancies. I don't know... but rolling a "1" or a "2" on a D20 to see if your pregnancy will result in high-blood pressure seems "risky" to me.

            • Preclampsia happens even with good medical care- and a good at-home midwife will, in her pre-birth examinations, catch Preclampsia. What I'm mad about is that even with the hospital (my wife had this with Christopher, that's what caused inducement instead of waiting for natural labor) the following happened:

              1. got put on hold for 12 hours because the hospital ran out of beds.

              2. Inducement medicine for the next 18 hours.

              3. Water finally broke at midnight, pain was so bad that they had to give her an e
              • Preclampsia happens even with good medical care
                My point exactly. I stated the risks of PERGNANCY -- not of "pregnancy with good medical care".

                Preeclampsia can have some nasty effects on both mother and child -- besides just toxemia
        • Lemme just say 'Amen'. And while OB's are doing okay, they aren't raking in the bucks like surgeons.
      • One- I completely agree in most cases that birth in the hospital does not improve chances- I actualy blame our hospital for Christopher's CP because they WITHHELD services and dinked about for 7 hours when it was clear that inducing labor hadn't worked and the baby was stuck in the birth canal. Chances are his brain damage came from that time.

        But beyond that- I want ultrasound *required* for every woman's prenatal care- even if she's going to get an abortion. It is my belief that we'd have a lot fewer ab
  • even interest free.

    At least we have the choice.

    So you choose to have less taken out during the year, good for you.

    I don't. I don't get back absurd amounts, but I'm also not tracking it down to the penny like some apparently are.

    Whatever, different strokes for different folks.
  • From CNN [yahoo.com]:

    The failure to disclose the accident touched off a political furor as the press complained that the White House had tried to hide the incident and Democrats charged it showed the secretiveness of the Bush administration.

    On Wednesday, Senate Minority Leader Harry Reid, a Nevada Democrat, and California Rep. Nancy Pelosi (news, bio, voting record), the top-ranking Democrat in the House of Representatives, emerged from a White House breakfast meeting with
    President George W. Bush and Cheney to say the

    • Well, actually, it's more like he was drunk and forgot one of the basic rules of hunter safety. Oh yeah, and apparently so was the VICTIM, same story! I agree though it's not a political story unless you think getting drunk socially to shoot tame quail in a party is bad judgement- and even if you do, it's not like we haven't had plenty of other warnings of bad judgement from this man.

      I see it politically as important as Dan Quayle misspelling Potato by giving it a British e on the end. Absolutely worthl
  • Especially in the case where you're poor, it's very exciting to be able to pay next month's rent.

    In the cases where I receive a refund check (every year except this one), I look at it as forced responsibility. If I'd had that extra $50/month, I'd probably fritter it away on burritos. But in a lump sum, it looks like a lot more money, so it goes straight to savings. That's what happened to the $600 property tax refund that I received last year.
    • And a thought regarding health insurance...

      I fucking hate when people go to the doctor for a freaking cold. The doctor cannot do shit for you; you have a minor viral infection. Take some freaking Sudafed and stay in bed. (Exceptions for people who have underlying medical conditions that might result in complications.)
      • Unfortunately there is sometimes a reason for that. Some employers insist on a note from the doctor to prove you were actually sick if you want to stay home.

        As for reforming the American health care system, considering that one of its major problems is that a lot of people (not just companies, but individual people) are going under trying to pay for care, it strikes me as odd to say the solution is for people to pay more. Americans also by and large have far less coverage than people in other developed co

      • There's also the slight little point that if everybody did this, we might miss an important viral epidemic which proceeds to kill all of the people who work with the people who can't afford to stay home in bed ever. Sometimes, there's more at stake than mere money.
      • I fucking hate when people go to the doctor for a freaking cold.

        So do doctors who are worth a damn. It's a waste of time and resources for a 35 yo to go to the doc for a cold. Even worse are when they demand an antibiotic. Those are the genius actions that take place when people can make their own healthcare decisions.
    • Comment removed based on user account deletion
  • "Medicare and Medicaid? [...] it's the most inefficient system of all."

    As it happens, they do not appear to be less dollar-efficient than private health insurance.

    "According to the World Health Organization, in the United States administrative expenses eat up about 15 percent of the money paid in premiums to private health insurance companies, but only 4 percent of the budgets of public insurance programs, which consist mainly of Medicare and Medicaid. The numbers for both public and private insurance are s
  • Homeopathy=horseshit. Or, if I'm feeling generous, it just about equals a placebo.

    As far as the other stuff: just pray you never have any catastrophic healthcare needs. The killer isn't the needless antibiotics; it's the required insulin and heart meds, among others.

    • Agreed. Bethany, if you're talking about homeopathic stuff that's been diluted 10 times until there's only a few molecules of active ingredient in the whole bottle, that's the placebo effect in action. You don't believe in God, but you believe homeopathic dilutions contain some sort of healing essence?
      • You know what -- if it's the placebo effect that got my baby to quit screaming from gut-wrenching gas pains, then I'm all for it.

        The mind is a powerful force. If all it takes to get well is *thinking* that you're taking something to get well, then what the hell -- why spend money on medicine and physicians?

        In any case, I have a feeling IHBT (was it the misspelling of my name that gave it away? Who knows....) Can't help but just give you a nibble, though, George. You are just too tempting. :-)

        ....Betha

        • You know what -- if it's the placebo effect that got my baby to quit screaming from gut-wrenching gas pains, then I'm all for it.

          Excellent point. If it works, go with it.

          Example: Airborne

          I seriously doubt the claims made by it or it's fanatical followers (some of them can be quite annoying).

          Yet I tried it... and found that while I don't believe it's "doing much of anything", I seemed to fight off on-coming colds. Why? My GUESS is that I'm "drinking fluids" and taking "vitamins" regularly rather than t

  • But a system where insurance companies rule all is flawed. They shouldn't decide whether someone lives or dies.

    Unless the Cheney target jumped up right in front of him dressed as a quail screaming BOO and pulled the trigger himself it's Cheney's fault. But admitting mistakes is something this administration cannot do regardless what they be.

  • 2) you just gave the government a year-long interest-free loan of however much money you're getting back from them. Did you make an interest payment on any credit card balances? Did you pay interest on ANY debt you have? Well... you can consider that an additional donation. If you'd had that money you'd given the government, you could have eliminated part of that debt AND the interest you paid on it

    And thanks to my layoff- I've made a $39,000 multi-year loan to the government merely by selling inherited s

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