No med insurance, how did people do it

[LiveMusic]

Forty years ago, I don't think people even had medical insurance. Not many, anyway. What the heck did people do?

 

My left knee is giving me trouble. It did this 20 years ago, went out on me one time. Hurt bad enough to make you cry. I finally jabbed at it and the pain went away immediately. Doc said that was cartilage sticking out from under the kneecap and that's why it hurt so bad. When I jabbed it, I stuck it back in there. Hasn't hurt me since until now.

 

So, if I were to have knee surgery, how much would that cost? I'd bet ten grand. I don't have ten grand. What the hell do you do? Seriously, what did people do way back when when knees needed surgery. I guess they didn't do knee surgery back then. You just developed a limp or something.

[Dak Lander]

Originally posted by LiveMusic:

So, if I were to have knee surgery, how much would that cost? I'd bet ten grand. I don't have ten grand. What the hell do you do? Seriously, what did people do way back when when knees needed surgery. I guess they didn't do knee surgery back then. You just developed a limp or something.

BWAAAAHAAAAHAAAAAHAAAAAA! 10k? BWAAAAHAAAAHAAAAAHAAAAAA!

 

I went in for what was, the doctor thought, a rotator cuff tear. I was in the hospital about a half a day, including prep time, time in OR and post op time. Nothing done except the prep, putting me under, xrays and bringing me back out and the bill was over 12K.

 

My stem cell transplant was in the neighborhood of a quarter of a million dollars, not counting the other surgery, chemo, pre and post transplant crap and ensuing charges.

[djwayne]

40 years ago, doctors used to make house calls. Now the only time they call is if you owe them money.

[Dak Lander]

Originally posted by djwayne:

40 years ago, doctors used to make house calls. Now the only time they call is if you owe them money.

Heh, not true. Dr's house calls are coming back in some areas, believe it or not...

 

Oh,and my doctors will call to check on me now and again, to enquire if the meds are doing what they are supposed to and if they notice anything amiss in regards to prescriptions or other things going on.

Maybe I'm lucky in having great doctors and staffs.

 

Well, actually, the doctors seldom call the but they do call. Someone on the staff is the usual caller in lieu of the doctor.

[djwayne]

Not in my neighborhood, try going to the VA hospital sometime, and you'll see hundreds of sick guys wearing veteran stuff, waiting around for hours just to see a doctor for a quick visit. It's unreal.

[Dak Lander]

Originally posted by djwayne:

Not in my neighborhood, try going to the VA hospital sometime, and you'll see hundreds of sick guys wearing veteran stuff, waiting around for hours just to see a doctor for a quick visit. It's unreal.

Well now, the VA thing is a whole 'nother ballgame.

I can talk about that lack of service for days. I've been had by the VA.

My service tenure is the reason I have the problems I have and they won't do squat.

[djwayne]

They'll give ya service, if you're a veteran, but you gotta go there, and wait, and wait, and wait for hours. They do NOT know how to schedule appointments. 4-8 hours is not unusual for a visit with one of their doctors.

[Billster]

Um, this is going to get bounced to the political forum...

 

The deal is, that 40 years ago, folks paid for their own medical treatment, and were aware of just what they were getting for the money. A catastrophic injury may have caused them real money problems, but they knew exactly what they received.

 

Nowadays, most people have insurance, and no one admits to what the medical services really cost. I see this at work frequently:

 

• The hospital says it costs $4000
  
• The insurer says it costs $2000
  
• The hospital and insurer eventually agree on a payment of $3000
  
• The hospital then claims they LOST $1000, and the insurer claims they overpaid by $1000
  
• The hospital and the insurer both cry poor, and seek to raise their rates
  

This way, no one knows what anything really costs, and there is no reason to try and contain costs. It doesn't really affect those who have insurance, but if you are uninsured, you are pretty cut off unless you are truly indigent. Nobody will turn you out of the emergency room in a true life or deeath situation, but the bill will be unrealistically inflated beyond all reason.

I'm just reporting the facts I know because of my day job, I can't really offer any solution, other than to suggest honesty in pricing.

 

And the VA hospitals are a sick joke.

[phaeton]

Back in the old country (that's Southern Oregon) I had a family doctor that I would go see all the time. The same guy.

 

I made an appt to see him, and in 2 or 3 days i'd go see him. He was an Osteopath and a general doc. I went to see him once for a mild case of prostatitis. $120 for an hour of his time (out of my pocket) and a $26 prescription (out of my pocket), and I was on my way to recovery.

 

Problem resurfaces again last summer. Went to see a doc here in the Federated Republic Of Mercy Health System. $1200 for 20 minutes, $370 for lab work and $600 for 8 weeks of medication.

 

Nothing I can do can get them to report it to my insurance company (Employer says I alone am $900 of the total insurance payment per month). Bills get sent to collections, but the medical office still sends me invoices and hounds me on the phone.

 

Sometimes, you just feel like ppl are out to get ya.

 

Sorry If i grossed anyone out.

[offramp]

Don't even get me started on knee problems. Thanks to ITT Hartford, we are in much worse financial picture than we could have been.

[Dr Nursers]

Without venturing into political territory, you have two options down here as far as a knee replacement:

 

1. Done in public hospital, costs nothing. Can be a significant waiting time though (18 months plus).

 

2. pay into health insurance (around $1500 US per year for whole family) and pay around another $500-$700 excess for a knee replacement.

 

Either way you get a good standard of care (and usually the standard is better in public hospital). And our income tax rates are no worse than US

[Ed A.]

Originally posted by DakLander:

 

I went in for what was, the doctor thought, a rotator cuff tear. I was in the hospital about a half a day, including prep time, time in OR and post op time. Nothing done except the prep, putting me under, xrays and bringing me back out and the bill was over 12K.

[/QB]

I had surgury for a torn tendon in my right rotator cuff and it came to about $20K. The actual procedure took about an hour.

I fortunately had a Golden Rule high deductible ($3000) medical policy that covered the surgery expense beyond the deductible.

 

I was thinking what I would do if medical insurance got to the point where it was too expensive and I needed some major surgery, like $100K+. I'd probably go vacation in Canada and check into a local hospital there, or stay here and declare bankruptcy. From what I understand, I'd would at least be able to keep my house and car in that case.

It's kind of disgusting what our medical options are in the US.

[Veracohr]

Perhaps forty years ago medical costs weren't artificially inflated.

[Harald F. Metzner]

Hi,

 

here in Germany the first law about med insurance is from 1883 (no typo: Das Krankenversicherungsgesetz von 1883 führte die Versicherungspflicht für gewerbliche Arbeiter ein.) That means, from 1883 on in Germany every worker has to have a med insurance, today between 10 and 12 % of your monthly income (before tax) is going to the insurance.

 

So 40 years ago: no problem here.

[YourMotherShouldKnow]

This is a toughy because 40 years ago the medical technology was far less than it is today. The doc 40 years ago would've said, "Your knee looks like it'd hurt." Today, they have a lot more options.

 

With major, life-saving surgery what can you say? Is there too high a price you can put on that?

 

When it comes down to it, no one owes it to you to save your life or your knee. You have to pay whatever price they demand.

[LiveMusic]

by Harald:That means, from 1883 on in Germany every worker has to have a med insurance, today between 10 and 12 % of your monthly income (before tax) is going to the insurance.

Is the care "good" in Germany?

 

Originally posted by YourMotherShouldKnow:

This is a toughy because 40 years ago the medical technology was far less than it is today. The doc 40 years ago would've said, "Your knee looks like it'd hurt." Today, they have a lot more options.

Yep, no doubt, you're right. A long time ago, arthroscopic knee surgery didn't even exist.

 

By the way, Dak, my out patient rotator cuff surgery, three years ago, was $10,000. That's the reason I said knee surgery, at least ten grand.

[RABid]

40 years ago doctors provided the care they thought you really needed and a visit might have been $20. Today, doctors own clinics and labs. The goal is to do all procedures allowable by insurance or Medicaid. The first question among staff is always "Can we bill for this?" As my parents get older I see more and more of this. My parents are lucky enough to have good insurance. Doctors abuse it by scheduling tests over and over.

 

Until fiscal responsibility is separated from those in the role of caregiver it will only get worse.

 

Robert

[Dak Lander]

Ed A & Duke. The thing is, there was no surgery. A mis-diagnosis and a missed diagnosis. Upshot of it was the later surgery to remove the tumor where my arm broke & then the ongoing treatments, transplant & etc.

 

That bill was over $10K and essentially, nothing was done.

[ptuzer]

Get a Canadian Health Card! They are FREE! ... There are thousands of Americans who have Canaidan Medical insurance.

Many Americans who live close to the Canadian border are dicovering how easy it is to get a Canadian Health Card. This fact is even being hidden by many Canadian officials.

[Kendrix]

Originally posted by nursers:

Without venturing into political territory, you have two options down here as far as a knee replacement:

 

1. Done in public hospital, costs nothing. Can be a significant waiting time though (18 months plus).

 

2. pay into health insurance (around $1500 US per year for whole family) and pay around another $500-$700 excess for a knee replacement.

 

Either way you get a good standard of care (and usually the standard is better in public hospital). And our income tax rates are no worse than US

Wow- 1500/year for family coverage. Where i am its closer to 1000/month.

 

On a related topic: one thing Al Gore had right was the push to equalize coverage for mental and physical ailments. As a result of my daughters serious head injury 5 year ago, and subsequent subjective judgments by our insurer/doctors about what is a phyical versus emotional issue, I'm much much poorer today than i was then. Im tallkin over $150K -much of what had been my retirement fund at the time.

 

FWIW- She could not walk for 6 months and also had issues of emotional stability following the accident. However, since they could not detect any physical brain damage ( micro damage, firmware issues dont show up on scans)I was screwed. I hired a very good lawyer- but lost my appeal to the final arbiter.

 

What id like to see is catastophic coverage for whatever treatment you may need - not just listed proceedures. Not covering the rehab/treament that, Im conmvinced, saved my daughters life was absurd. This was not optional /discretionary.

 

Of course, the flip side of this argument is that new technolgy is being created that could end up having us spend all the worlds wealth keeping very sick people alive for an additional period of time. It really is a moral/financial dillema how you draw the line.

 

For example: My daughter, now largely recovered, volunteered at a transplant ward at the local hospital. Its filled with longtime herion addicts and alcoholoics who have no ability to manage their lives. Somehow these folks get $250,000 + operations funded by tax dollars/the hospital. Then they just go out and resume their destrucitve behaviors. This doesnt seem like the the right use of public resources to me.

 

I actually think the government workers have the best health benefits available today. Most big/small companies have been forced to cut back significantly over the past several years. With the unions and related politics the public sector has not made the same changes. So, almost everyone paying taxes these days has less coverage than the government employees they are funding. Thats crazy.

 

Do you think you hit a nerve with me?...

 

The only viable option seems to be to live a happy healthy life and to die very quickly without being hospitalized. Good Luck.

[Duddits]

How did they do it?

 

They didn't get sick.

 

They lead healthy lives, and then one day, they just dropped dead.

[shniggens]

Can't you just poke the tendon back in for free?

[whitefang]

For me, 40 years ago means I was 13. And my step father was a UAW member. We had medical insurance. In many cases, you'd have to go back more than 50 years for this not to be so.

 

Comprehensive hospitalization insurance was both a boon, and a boondoggle. People who couldn't afford medical treatment before now could. Being laid up in the hospital no longer meant paying for it the rest of your life, or foregoing needed hospital stays because the cost was prohibitive. But no sooner did the money for hospital stays move from the blue collar pocket to the insurance company that many in the medical field find ways to fleece them. To compensate, the premiums went up, more fleecing took place, and on and on...

 

So, medical insurance helped a lot of people to be able to get needed treatment, but it also moved the medical profession to become more impersonal and distant.

 

Double edged sword, so to speak.

 

whitefang

[Dr Nursers]

So I'm wondering why it works relatively well down here? Taxes aren't particularly higher, and mortality rates are better than the US.

 

So what is going wring in the US?

[Dak Lander]

Originally posted by nursers:

So I'm wondering why it works relatively well down here? Taxes aren't particularly higher, and mortality rates are better than the US.

 

So what is going wring in the US?

That's a great question and I certainly can't answer it.

A very good friend, living here, is from Australia and she is a nurse. Her mother, in the last couple of years, went through some extreme issues and has since passed on. The care was exemplary by any standards.

[MikeT156]

The mortality rate is higher in the US because there are more murders here than in Australia.

 

I had health care coverage to get my big toe operated on it the bill was almost 8k. God. The medical care prices are SO high. From what I hear they can't turn you away from emergency room care in the US, its the law. However, if you SIGN the paperwork they give you, you're liable. Just don't sign the financial responsibility form and insist on treatment. Someone correct me if I'm wrong, but I think they still have to treat you.

 

Mike T.

[Base]

I haven't followed ER for a couple of years so my knowledge of the US health services is a bit limited

 

Seriously, I don't get why you don't have a national health service. Ours may be a bit shaky in places but at least we have one...

 

We get all the stories of you having 'ambulance chasers' over there, are they exagerated or is that serious?? That can't help the costs...

[djwayne]

I was recently turned down at a ER. I had gone there for a terrible, painful earache on a Sunday, I saw the doctor for 3 minutes, he looked at my ear, wrote a prescription, and I left, a week later I still had the earache and went back to tell the doctor the prescription he gave me wasn't working...the receptionist refused to let me see the doctor. So I am now refusing to pay my share of the $200 bill. Their collection agency has threatened to ruin my credit rating unless I pay. Absolutely no concern about my earache. I went to go see an ear specialist, he cleaned it out gave me a $100 prescription, a $100 bill, and some over the counter ear drops, and the over the counter stuff is what worked the best..$7-8.00. So now I use the over the counter stuff, and no more earaches !! The specialist got paid.

[Billster]

Originally posted by nursers:

So I'm wondering why it works relatively well down here? Taxes aren't particularly higher, and mortality rates are better than the US.

 

So what is going wring in the US?

More oversimplified analysis from Billster:

 

I try to stay out of hospitals, that's where all those sick people are. Seriously, the information given by the pediatrician at our son's birth said essentially "Try to avoid the emergency room. Unless the situation is truly life-threatening, it is better to have your child seen in our office as soon as possible" That makes perfect sense, but you have to have a personal physician and be able to understand your symptoms.

 

For many people in this country they have no primary doctor. The "medicaid" system for people without private health insurance is funded federally and administered by the states. As far as I can tell, there is no incentive to have a doctor. It looks like you are steered towards doing nothing until you can't take it anymore, and then go to the hospital, which is the least personal, most expensive treatment.

 

Another problem I have seen first hand is immigrants from impoverished countries where there is no such thing as a private physician's office. So you "go to hospital" for all problems; if you are a poor immigrant, you probably live in an urban area where the hospital is a mega-expensive teaching hospital of some world renowned medical school.

 

End rant.

 

Like I said before, the disconnect between who is paying and who is getting service creates a situation where the consumer has no incentive to be discerning - "someone else" (though in the end it's really you) is paying.

[philbo_Tangent]

Originally posted by phaeton:

Back in the old country (that's Southern Oregon) I had a family doctor that I would go see all the time. The same guy.

 

I made an appt to see him, and in 2 or 3 days i'd go see him. He was an Osteopath and a general doc. I went to see him once for a mild case of prostatitis. $120 for an hour of his time (out of my pocket) and a $26 prescription (out of my pocket), and I was on my way to recovery.

 

Problem resurfaces again last summer. Went to see a doc here in the Federated Republic Of Mercy Health System. $1200 for 20 minutes, $370 for lab work and $600 for 8 weeks of medication.

 

Nothing I can do can get them to report it to my insurance company (Employer says I alone am $900 of the total insurance payment per month). Bills get sent to collections, but the medical office still sends me invoices and hounds me on the phone.

 

Sometimes, you just feel like ppl are out to get ya.

 

Sorry If i grossed anyone out.

When our 2nd son was born, the hospital billed us for about $10K, and the insurance would only pay $2K, which they said was a reasonable charge. So I called the hospital billing dept and said I intend to pay them the $8000 in installments of $10/month for the next 667 years, but would not consider paying any more than that each month. They ended up going back to the insurance company and renegotiating the whole thing, and I ended up paying them nothing.

 

The moral: Every thing is negotiable in medical costs, all you have to be is as unreasonable as they are.