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I believe in fee for service. As long as the person paying the fee is the person receiving the service.

AdHominem says

I believe in fee for service. As long as the person paying the fee is the person receiving the service.

Which is not how it is today. I would like to go back to catastrophic insurance only and pay out of pocket for basic services and see what that does to health care. Would folks take responsibility for their own health. Maybe eat right and exercise to avoid diabetes and cardiovascular disease? It's been proven quite often that OTC ibuprofen works better than many name brand anti-inflammatories at a fraction of the cost.

Leigh says

AdHominem says

I believe in fee for service. As long as the person paying the fee is the person receiving the service.

Which is not how it is today. I would like to go back to catastrophic insurance only and pay out of pocket for basic services and see what that does to health care. Would folks take responsibility for their own health. Maybe eat right and exercise to avoid diabetes and cardiovascular disease? It’s been proven quite often that OTC ibuprofen works better than many name brand anti-inflammatories at a fraction of the cost.

Nah, that wouldn't work. What about R.A. or M.S. or any number of diseases or diagnoses that require treatment? They're not catastrophic, unless you have them.

Yes, sometimes Ibuprofen works well - but sometimes it's not enough. I do believe that lifestyle diseases, such as obesity or come cardiac dx, should be addressed somewhere...

elliemae says

Leigh says

AdHominem says

I believe in fee for service. As long as the person paying the fee is the person receiving the service.

Which is not how it is today. I would like to go back to catastrophic insurance only and pay out of pocket for basic services and see what that does to health care. Would folks take responsibility for their own health. Maybe eat right and exercise to avoid diabetes and cardiovascular disease? It’s been proven quite often that OTC ibuprofen works better than many name brand anti-inflammatories at a fraction of the cost.

Nah, that wouldn’t work. What about R.A. or M.S. or any number of diseases or diagnoses that require treatment? They’re not catastrophic, unless you have them.
Yes, sometimes Ibuprofen works well - but sometimes it’s not enough. I do believe that lifestyle diseases, such as obesity or come cardiac dx, should be addressed somewhere…

Yeah, I see your point. Besides, folks with chronic conditions rely on healthy folks as part of the insured mix, kind of like redistribution of health care dollars.

Yes - and I'd like to thank you for that. :)

Did I just hear you say what we need is more redistribution of health care dollars (wealth)? I'm OK with you having that opinion. Just wanted to clarify.

AdHominem says

I’m OK with you having that opinion. Just wanted to clarify.

I'm sure she lives & breathes for your approval. 'cause you're just so informed about everything & stuff. (thanks Nomo).

AdHominem says

Did I just hear you say what we need is more redistribution of health care dollars (wealth)? I’m OK with you having that opinion. Just wanted to clarify.

Private insurance relies on redistribution of health care dollars (and the stock market). How much money could a private insurance company make if they only took on those 65 and older, or only those with breast cancer, or only those with BMI's above 30. When I worked at a small company our premiums spiked one year and the company said that it was due to heavy usage, we had quite a few older nurses and that year two were diagnosed w/ breast cancer, one had a hysterectomy, and one had a quad bypass, and two of the younger RN's had babies. When you are only talking about 100 nurses in this insurance group that's very expensive stuff going on there.

Someone's gotta pay for it.

Which brings me to another point. I considered dropping to 24hrs per week which would mean I'd lose my health bennies. So I shopped around and discovered I could get the same coverage for half the price if I went with an individual/family plan via Lifewise. When I asked customer service why the big price difference he stated it was because of my family members' ages and overall general good health. When you are in a large company they take into consideration EVERYONE, all those old farts I work with and those overweight folks and the smokers, etc. So, yes, I am helping pay for those folks, too.

When my dad died after a very short battle with Multiple Myeloma, we were forced to flush all of his meds down the toilet in the presence of the hospice nurse. If I would have known this I would have denied that we had any left over. We flushed over a thousand dollars (out of pocket) worth of pain meds and anti-nausea meds. Complete waste. Why the hell did that have to be done.

How many other meds are sitting on people's shelves going to waste. I still have Percocet from my last delivery. What the heck am I gonna do with such a powerful pain killer.

Is there a redistribution center anywhere? Heck, I gave away gallons of my breast milk after discovering the long list of allergies my son was experiencing, why not prescription meds?

Leigh,

I am all for VOLUNTARY wealth redistribution. Where I have a problem is when people are FORCED to do so.

Leigh says

Is there a redistribution center anywhere?

It is illegal to re dispense medication in the US (Medical industrial complex hates competition). However I do believe there are missionary organizations that can take donations to the third world. Perhaps you could find one of them to take the meds.

So I guess I am not forced to get health insurance from my company but think about it. Throw Medicare out the door. Take all the money she had been contributing these past 40 years and put it toward private insurance after retirement. How much money do you think that would be? Would it be adequate to afford the premiums in the 'free market', imagine all of her pre-existing conditions. Would she have enough funds for 20 years of premiums, co-pays and deductibles, medications? And consider the premiums would be based on age and health.

In my mind, the 65 and older folks drain the health care dollars. Not only would their premiums be sky high but there will be much more scrutiny of where the dollars are going. Yes, private insurance has 'death panels' just ask any transplant doctor.

And yes, America get used to death being a part of life. You can't treat you body like sh!t then expect medicine to fix it all after a few weeks in the ICU. And you might have a living will but if your relatives aren't on the same page as you they will keep that heart of yours beating until the ethics board steps in. And with all the advances in medicine we can keep dead people alive a very long time. Who's gonna pay for it?

Leigh says

When my dad died after a very short battle with Multiple Myeloma, we were forced to flush all of his meds down the toilet in the presence of the hospice nurse. If I would have known this I would have denied that we had any left over. We flushed over a thousand dollars (out of pocket) worth of pain meds and anti-nausea meds. Complete waste. Why the hell did that have to be done.
How many other meds are sitting on people’s shelves going to waste. I still have Percocet from my last delivery. What the heck am I gonna do with such a powerful pain killer.
Is there a redistribution center anywhere? Heck, I gave away gallons of my breast milk after discovering the long list of allergies my son was experiencing, why not prescription meds?

Actually, the medications belonged to your father and all that she legally could do is ask you to dispose of them. If you refused, you have that right. However, you can't share them with anyone legally. And no clinic can take them. They can't be redistributed. I've worked with many patients' families who kept the medications, had their own scripts for the meds but wanted to save the $$$.

Leigh says

And yes, America get used to death being a part of life. You can’t treat you body like sh!t then expect medicine to fix it all after a few weeks in the ICU. And you might have a living will but if your relatives aren’t on the same page as you they will keep that heart of yours beating until the ethics board steps in. And with all the advances in medicine we can keep dead people alive a very long time. Who’s gonna pay for it?

There's a medical ethicist in Salt Lake City who advocated DNR's and end-of-life decisions; her husband was in a bike accident and she's kept him alive at quite the cost. She said it changed her view completely.

That's the problem - people are all for ending life when there's no quality, in theory. When it's them or their family members, it's different. I've seen people keep family members alive at all costs, even when the family member wanted different. It just plain sucks.

Oh, I understand that it is illegal to use a prescription med that isn't in your name but I find it wasteful to toss them when you know folks are struggling and deciding between meds and food and the heating bill. My spouse just mentioned that he's heard of specific, very expensive cancer meds being redistributed.

I just googled some terms and so far came up with this

http://www.ncsl.org/IssuesResearch/Health/StatePrescriptionDrugReturnReuseandRecyclin/tabid/14425/Default.aspx

http://www.medicalnewstoday.com/articles/24729.php

I'll need to read up on the specifics as I'd like to pass this info on to my patients if Oregon has similar laws.

Leigh says

And with all the advances in medicine we can keep dead people alive a very long time. Who’s gonna pay for it?

Exactly. Who is going to pay for it? If we try to "save the world" it will bankrupt and kill us all.

But like I said, I am ALL FOR CHARITY. As long as it is optional.

Leigh says

Oh, I understand that it is illegal to use a prescription med that isn’t in your name but I find it wasteful to toss them when you know folks are struggling and deciding between meds and food and the heating bill. My spouse just mentioned that he’s heard of specific, very expensive cancer meds being redistributed.
I just googled some terms and so far came up with this
http://www.ncsl.org/IssuesResearch/Health/StatePrescriptionDrugReturnReuseandRecyclin/tabid/14425/Default.aspx
http://www.medicalnewstoday.com/articles/24729.php
I’ll need to read up on the specifics as I’d like to pass this info on to my patients if Oregon has similar laws.

I'm not sure it is illegal to use it, but it is illegal to transfer it. Not to get into semantics though. I'm just saying if the law were enforced, it would be the person who transferred the drug that would be prosecuted (I believe).

AdHominem says

I am all for VOLUNTARY wealth redistribution. Where I have a problem is when people are FORCED to do so

So, you're against car insurance then too?

tatupu70 says

AdHominem says

I am all for VOLUNTARY wealth redistribution. Where I have a problem is when people are FORCED to do so

So, you’re against car insurance then too?

Sure. Warren Buffet and Gieco don't need mandatory customers.

Leigh:
Just remember that some hospice nurse doesn't have the right to tell anyone what to do with the meds. They catch you in an emotional moment and demand that you waste the meds.

I've also seen hospice nurses take the meds, sell them or use them for themselves. It's their word against anyone else's.

AdHominem, can you address this previous comment. It's a crucial part of the debate3. What would folks 65 and old do for insurance w/out Medicare? What would the housewife who has never worked out of the home and now is widowed do for health care? WHat are your solutions?

"OK, say we throw Medicare out the door. Take all the money she had been contributing these past 40 years and put it toward private insurance after retirement. How much money do you think that would be? Would it be adequate to afford the premiums in the ‘free market’, imagine all of her pre-existing conditions. Would she have enough funds for 20 years of premiums, co-pays and deductibles, medications? And consider the premiums would be based on age and health.

In my mind, the 65 and older folks drain the health care dollars. Not only would their premiums be sky high but there will be much more scrutiny of where the dollars are going. Yes, private insurance has ‘death panels’ just ask any transplant doctor."

Do you realize how much health care is consumed by this age group? You really think charity can absorb half of it. You will see death panels if charity is what the majority of this age group is left with. DO you realize how much an MI can cost you especially if it involves bypass surgery, an ICU stay and meds, assuming you lived? Would the debt get passed on to your loved ones?

And should all of our veterans rely on charity?