Sicko

[Leif]

Originally Posted by Karla523

What is the coverage like for mental health care in your areas? Is there a limit placed on the number of visits to therapists/psychiatrists? Is there a long wait to get mental therapy if needed? Can you decide on your own that you need it or do you have to be evaluated by a third party?

Karla -that has been discussed at a political level quite a lot over here lately, due to it seems to have been an area “not prioritised” or how to put it, not followed-up in the same way as the somatic health care area. But when I browse through our official national website (the same as above) it seems to be not too bad. The link here shows like for depressions etc. in adults (link) , -first column shows different hospitals when it comes to appointment waiting time for examinations, - second column is kind of “group discussions” (hope you know what I mean, cause don’t know what it is named in English), - third column is hospitalization waiting – and not emergencies again (btw, fourth column, is when the different hospitals and govern monitoring authorities last updated the database for the specific hospitals). Please also notice that this is for hospitals. And if having an emergency as for you’re question one can directly contact you’re permanent doc and he/she then can forward you to a specialist or a hospital. Or one could contact a practicing person in the field directly. But here again, the debate is if this is good enough, due to there seems to be some holes in the system. And from what I have read it seems like this is not good enough. As for third party, that is not an issue as such, not required, as I understand, but above that, in cases I have read, often a third party would have recommended it if the doc did not do it in the first place (but then it often is to late, I mean, when reading about it, not good). As I see it, this area you address over here has not been prioritized enough, this does not mean it is a bad system when it comes to this, but more in general that more focus should be given to this area as well, to make it better. But like we all know; typical somatic injuries/illnesses like broken bones, cancer, heart, brain etc. wins the budgets, -just imagine how difficult it is to push a SCI cure research project trough such systems, or any I guess (well, we have managed to push a couple of projects now, but then one has to push, push real hard, and one has to, because the expertise is whitin those systems “academia”, well enough of that). But as for you’re Q I can add that our gov has put down a committee among other things to evaluate the whole system when it comes to this, this due to public awareness and requirements (have never used this part of the health care system myself, but I understand the importance and the benefits of it, especially for the individual). Also, the fact that some self-employed (private operated) psychologists have been using the system for their own gains (scumbags), claiming gov money transfer for fictive patients, plus those self-employed jerks also have taken money from citizens that should not have paid them... But basically, one can decide on you’re own if needing some of this services. But then again???; if in such a situation, needing help for depressions, who really can decide on you’re own? That’s also one of my concerns which I have been addressing for some time over here when it comes to the health care system as a whole. Not for depressions as such, but say when being in a terrible situation say after cancer, an injury like SCI etc. Who will take care of you to guide you through the “system”? Like I see it, the ones with enough resources (and here I do not mean money) when it comes to self-propelled ways to find out of tings, or by having relatives cleaver to navigate the health care jungle will win. I managed fine by myself, but that is not a good system! Not at all… I think we need a system, for example say when one is prosecuted for violation of the law, the state if you cant yourself, will get you a lawyer to guide you through the legal fields when it comes to the violation of law one might have done – to me it seems like this should be equal when ending up in life altering situations when it comes to health issues. I think we need some board, designatet persons or whatever to follow some patients through the health care jungle. And by this I'm not concerned with resource strong people (they will manage, and not thinking about money again), but people who is not capable of fighting the health care systems by themselves. If I could have managed to help out getting a better system as for this in general, I would have been very happy.

[Leif]

Originally Posted by adi chicago

lol leif ...a big turban on his head after a brain surgery.

Turban in this case was a huge dressing, I guess the grumpy nurses there was afraid their cigarette smoke should enter his surgery wound

[Karla523]

I thank you all so much for the information. I am currently in an "insurance rut" until I *hopefully* get a teaching job in the fall with full coverage. I had a nasty sinus infection that required six weeks of Cefzil and the GENERIC cost me well over $300.00. I also had to pay $500.00 for two different CT scans of my sinuses because this infection was so persistent. Now they prescribed Nasacort AQ spray for my nose which is about $100.00 per month... I don't know how much longer I'll stay on that though as I think it is causing me headaches. Anyway, this coversation is very insightful.
Thank God my daughter has military medical insurance through TriCare Prime (my ex husband is active duty) so she has awesome insurance with no copays and only $3 generic drugs if needed. Her insurance is great so that puts my mind at ease. you know how it is... as a parent you can go without as long as your kids are OK.

[chick]

Interesting new study on the shortage of physicians, though this is one of many looking at the growing problem of the shortage of professionals in the field, much of it being cost related. Ironically, measures to contain costs invariably results in cost shifting, and often, increasing cost and putting greater burden on patients/consumers/taxpayers.

This study is more specifically about the shift in physician practice, from primary care to more specialty areas. Consequences trickle down to many other areas of healthcare, from access to services, quality of care, coverage, cost, etc. with many of these factors being driven by insurance companies.

Exodus of Men from Primary Care Drives Shift To Medical-Specialty Practice
Women and International Medical Graduates Mask Severity of Shift from Primary Care -- see News Release/Study Brief (incl. link to full report)

[adi chicago]

Originally Posted by Leif

Turban in this case was a huge dressing, I guess the grumpy nurses there was afraid their cigarette smoke should enter his surgery wound

lol leif you made my day ...i remember the dude that was my room mate in roswell nm[brain injury ]a big turban as well. total amnesia after his injury [he did not loose his locomotory functions],the nurses tide him to avoid him to escape [bed and wheelchair].the guy always escaped ..i called him houdini.
everybody in the rehab were laughing like crazy....he did not speak english [spanish only].you should see the nurses running to catch him ....hehe.

[cheesecake]

These are popping up at pharmacies here in the states:
minuteclinic.com There are set fees but if you look they charge and then send you back to your primary doctor. They are also offering camp physicals,they take 5 minutes vs a good physical with your doctor (she spent an hr with my 14 yr old)

[Leif]

Originally Posted by cheesecake

Our insurance companies spend more time trying not to cover you than covering you.

Cake – I think you nailed it pretty good ("most have a car I guess"), of course you did, and there is a deep logic there. Private in general is for moneymaking machines as such (but not necessarily bad). Thus to balance it, a socialised (universal) health care system run by gov can be a good thing, to make sure one has a safety net if shit happens when one is not prepared, say by not singing on all those fancy health care life insurance papers, who ever think about that anyway when being healthy and going strong? Nothing against any of those systems, but a balance that will gain the most people should be stressed. Say like here, if some dumb politician should go for privatisation to make our entire health care system a corp. system, the politician whom suggested it would go politically dead instantly. Not even our progress party has suggested such things. I know of course there are differences say when it comes to the history of the US and over here, but one of our fights (the unions, well some over there at you’re place refer to all of those as communists?) was the unison fight for equal health care, this was on the top agenda back then when we got industrialized, this stay strong also now, these days, even when we have become one of the most capitalized countries in the world. I’m not saying that our system is the best, but it is pretty good, and as for taxes I gladly pay for health, this is neither something I discovered post SCI. And again, you are right. If not the ones that can’t navigate or does not have the means to navigate through the health care jungle will fall short, and I don’t think that is fair, right nor good.

[adi chicago]

here in romania i cannot find [nitrofurantoin]macrobid.
regarding antibiotics like [an example]levaquin ,vanco etc. they are like dinosaurus ...do not exist ..market and politics issue.

[TheRainman]

Originally Posted by SCI-Nurse

Since it appears that you work in the insurance industry, I think you have been brain-washed into believing all that you write above, Rainman, but I don't think you are correct.

Nurses are leaving Canada, Brazil and South Africa for the USA because of the salaries available in the USA, which are paid because our cost of living (including health care) is so high. They are aggressively recruited by the hospital industry because they can hire them more cheaply than USA trained nurses. It is not because our healthcare system is better. Nurses are leaving nursing in DROVES in the USA because they are unhappy with their working conditions and yes, having to say NO to patients all the time. I know that is what drove me out of the private sector and into the VA 18 years ago. I like to say 'yes, we can help you with that' without the insurance company telling me that I cannot do things for my patients that I know they need, which happened to me daily in my previous job in a supposedly non-profit hospital/rehab center.

Do you honestly think that Medicare provides the coverage that elderly and disabled people need? I see people all the time who don't buy food because they need to use the money to buy drugs not covered by Medicare, or dressings, or bathroom equipment or catheters. They are not taking drugs because they cannot afford them, even at the risk of their health. The co-payments alone (20% and more) under Medicare will quickly bankrupt anyone who has a catastrophic illness like cancer, serious heart disease or a spinal cord injury. I see these patients often, because if they they are also veterans we are often their safety net, and they only come to the VA when they run through their other insurance or declare bankrupcy because they now have run through all the money they were saving for their retirement.

I would gladly pay much higher taxes to fix our system. I don't want to pay higher taxes to fight a war, but health care should be a right, just like (as described in the movie) we have free public education, free libraries and free fire and police protection. Of course we pay taxes for all of that, but so far you don't have the fire department telling you that they won't put out your house fire without a 20% co-pay, or that the fire is not serious enough, or that you really don't have a fire, you only think you see flames shooting out of the windows....

(KLD)

KLD

No i'm not brain washed. I think it's because we see people from two differant perspectives. You see the people when their in need and hurting and willing to do anything to ease the pain. I see the people when their feeling good and don't have a care in the world.

Now I don't sell healthcare plans but I got a good idea why they might get turned down for some coverages. Insurance agents job is to explain the coverages and the cost to each coverage. Its up to the insured if they want to be covered on certain illnessses. Cancer would be one that would raise the premium.

Now cancer is one that can ruin you financailly if you don't have the right coverages. For an example, I write a lot of home policies. I have insures ask me all the time if they can drop hurricane coverage from their policy because that portion is so high. If they have a mortgage they must carry it. But a lot of the ones with their homes paid for will drop the insurance totally. I ask them what if a hurricane comes and takes your home. Some will say i'll take my chances and others say I collect it from FEMA. So you can't expect insurance companies to pay for coverages that they did not collect a premium on.

People when their feeling good they will take the cheapest plan posible. And when something happens they'll swear up and down that they did not know that coverage wasn't on the policy. I have been called a crook more than once because the insured turned down a certain coverage. And i'm a guy that goes way out of my way to explain what their turning down and what it will cost them if something happens.

See it's just that we see these people in different perspectives.

And as far as providing healthcare for everyone. I would be all for it if it was feasible. But economically its not. And I bet in your life time you will see other countries moving more towards our system.

[alan]

If our government wasn't subsidizing corporations, and some wealthy Americans, as well as funding wars of choice (Iraq, the War on Drugs, etc.), there would be sufficient funds to provide quality healthcare for all along with more medical research.