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08/11/2009 05:47:56 PM · #526 |
Originally posted by shamrock:
Originally posted by SDW:
Without insurance I would have to pay a little over $700/mo. for my medication. So I'm going to use that as a starting point.
Monthly Deductible : $14.95 (only one deductible no matter how many prescriptions per month)
Monthly Co-Insurance: $224.00 ($700 * 32%)
Monthly Contribution: $79.53
Yearly Premium: $585.00 or $48.75 monthly
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Total monthly cost: $367.23 (for prescription coverage per adult. NOTE: Co-Insurance will vary based on the amount of medication and cost)
Please let me know if I figured that correctly. If so that's more than I pay now for a PPO major medical insurance and prescriptions combined. |
Hmm... the way i read it, the monthly maximum contribution would be the total out of pocket contribution (79.53, possibly plus the 14.95 for a total of 94.48). In other words, you would pay 32% until you hit that limit, then nothing. You've got 32% of your cost, PLUS the maximum monthly contribution in your formula up there, which doesn't make sense to me.
Can someone in Quebec clarify?
Edit to add: My supposition seems to be upheld by the information found on this page, which states that the maximum annual out of pocket under a private plan is set at $954, which works out to $79.50 per month. |
You maybe right on that looking closely at what it says
Maximum monthly contribution
The maximum monthly contribution applies only to persons covered by the Public Prescription Drug Insurance Plan. Under the public plan, the maximum annual contribution is divided into maximum monthly contributions.
The maximum monthly contribution is the maximum monthly amount that a person covered by the public plan may be required to pay when purchasing insured drugs, and consists of a deductible and a co-insurance amount. Once the person has reached his or her maximum monthly contribution, the public plan generally covers all the person's drug costs from then until the end of the month.
With the word 'generally' added means that there are some cases where you may have to pay more. But I do believe your right about the MMC. Thanks for correcting me on that.
Message edited by author 2009-08-11 17:48:55. |
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08/11/2009 09:38:24 PM · #527 |
Another Canuck tossing in her couple pennies' worth;
First, keep in mind the details of what's covered vary provincially. For example, BC used to cover 12 chiropractor visits and 12 physiotherapy sessions annually, as well as eye exams every two years. They no longer do, though physio is covered if done at the hospital. Our dental, eyecare and prescriptions are covered by my husband's work insurance, 100% for basic dental down to 60% for orthodontics, new glasses every 2 years, and 80% of prescription costs, including dispensing fee. I'm sorry, I don't know how much this insurance would cost if we were to pay privately.
I have an incredible doctor. It does take anywhere up to 2 weeks to get an appointment, but he also keeps a few same-day openings for anyone calling between 9am and 10am, so if it's urgent I simply make sure to call as soon as they open. Otherwise I can go to the treatment center in the same building and wait a few minutes. At super-busy times it might take up to an hour, but not normally. This is staffed by a rotation of doctors in the building, so I could even end up with my own doctor. X-ray and lab are down the hall, so tests can be done immediately.
My other choice is a 10-minute drive to the hospital emergency room, but waits there are normally 2-3 hours so I only go there if it's middle of the night and the treatment center's closed.
On one trip to emergency it was decided that I needed surgery urgently but not immediately life-threatening. Midafternoon it was scheduled for 6pm but ended up being bumped to 11pm because of more critical arrivals but I still got it within about 8 hours of first being seen.
Non-urgent surgery definitely can take longer. When my GP referred me to an orthopedic surgeon it took about 3 months to get an appointment (including the surgeon's holidays) then another 8-month wait for surgery. I was still functioning, though. It probably would have been much quicker if it were more crippling than my rotator cuff.
My son was in hospital for 23 days, 5 of those in intensive care after surgery. The care was amazing, and on the day he was discharged at least 2 of the nurses were in tears. Our only worry was getting him well, not how we'd pay for it all.
My dad had his bladder removed due to cancer when he was 82 then another surgery soon after for adhesions on his intestines. He developed pneumonia and spent a week in intensive care. At no time was there any question of whether it was worth it because of his age. They did everything for him that they'd have done for a 20-year-old and maybe more. Again, the staff were incredible.
We do have a nursing shortage here but it's because there aren't enough training spaces available in local schools. I'm not sure the situation right now, but I know that 2 years ago there was a 2-year wait to get in.
Nope, our system is NOT perfect but I can think of a LOT that could be worse with it! |
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08/12/2009 10:42:35 AM · #528 |
Originally posted by Strikeslip:
Doctors-wise...
If I get an ear infection or whatever, I'm usually too lazy to make an appointment with my family doctor. Heck, I'm too impatient to make an appointment to have my hair cut, so I sometimes do it myself.
So...
I usually just go to one of the clinics nearby, walk in, and see a doctor within about 15 minutes. He checks me out and writes me a prescription, if needed. I walk across the hall to the pharmacy and buy it. Done
To see the doctor is [FREE], but I pay for my prescription, which is pretty cheap anyway, $20-$30 for ear infection, for example. |
he he, I do the same... And a good thing my sister is a hair dresser, so she cuts my hair between two customer whenever I come to her salon, or else, I would also do like you. |
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08/12/2009 12:34:32 PM · #529 |
Originally posted by BeeCee:
I have an incredible doctor. It does take anywhere up to 2 weeks to get an appointment...
When my GP referred me to an orthopedic surgeon it took about 3 months to get an appointment (including the surgeon's holidays) then another 8-month wait for surgery. |
Exactly. I can call my doc anytime today and be seen today, without fail. I can usually get a specialist appointment within 2 weeks, more often even quicker. I have very reasonable copays and monthly premiums. Guess what...my insurer works for profits and I am still completely cared for in a very timely manner. Government take over, or even interference, is not the answer. Sure, changed need to be made, but nothing involving more government subsidies. Nothing in the healthcare realm that the government touches has worked thus far. With a plan that absolutely cannot support itself long-term, why the hell would we even think of giving them yet another chance? |
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08/12/2009 01:30:58 PM · #530 |
Originally posted by ericwoo:
Originally posted by BeeCee:
I have an incredible doctor. It does take anywhere up to 2 weeks to get an appointment...
When my GP referred me to an orthopedic surgeon it took about 3 months to get an appointment (including the surgeon's holidays) then another 8-month wait for surgery. |
Exactly. I can call my doc anytime today and be seen today, without fail. I can usually get a specialist appointment within 2 weeks, more often even quicker. I have very reasonable copays and monthly premiums. Guess what...my insurer works for profits and I am still completely cared for in a very timely manner. Government take over, or even interference, is not the answer. Sure, changed need to be made, but nothing involving more government subsidies. Nothing in the healthcare realm that the government touches has worked thus far. With a plan that absolutely cannot support itself long-term, why the hell would we even think of giving them yet another chance? |
Well, I'm glad it's working so well for you, Eric, but I deal with an entity called Cape Cod Health Care, and it doesn't work that way. They are a very good group, affiliated with Cape Cod Hospital, but if I want an app't with my GP it takes 2-4 weeks to get one. If I have a need that can't wait that loing, I have to go to the walk-in clinic (in the same bldg) and sign in and wait for an available physician to see me; sort of a wannabe emergency room for non-urgent care, I guess. I'm not complaining, it works OK, but I don't think anything like *most* Americans share your experience. For most of us, getting in to see "our" doctor on a same-day need is an unfulfillable dream.
R. |
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08/12/2009 02:24:53 PM · #531 |
Originally posted by Bear_Music:
... For most of us, getting in to see "our" doctor on a same-day need is an unfulfillable dream.
R. |
That is not only unfulfillable, but unrealistic, and if we're still talking about the proposed gov't healthcare plan, I can't see this changing. If anything, I think the waits will get longer, much longer, if we end up with the government running our healthcare system.
Most of the time, if someone in our family REALLY needs to see a doctor about some concern that is not an emergency, we usually can get in that day or the next. If we're trying to setup a scheduled kind of checkup, then that can be 2-4 weeks out. For the most part, what we have seems to work pretty darn well overall. |
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08/12/2009 03:30:56 PM · #532 |
Originally posted by Bear_Music:
Originally posted by ericwoo:
Originally posted by BeeCee:
I have an incredible doctor. It does take anywhere up to 2 weeks to get an appointment...
When my GP referred me to an orthopedic surgeon it took about 3 months to get an appointment (including the surgeon's holidays) then another 8-month wait for surgery. |
Exactly. I can call my doc anytime today and be seen today, without fail. I can usually get a specialist appointment within 2 weeks, more often even quicker. I have very reasonable copays and monthly premiums. Guess what...my insurer works for profits and I am still completely cared for in a very timely manner. Government take over, or even interference, is not the answer. Sure, changed need to be made, but nothing involving more government subsidies. Nothing in the healthcare realm that the government touches has worked thus far. With a plan that absolutely cannot support itself long-term, why the hell would we even think of giving them yet another chance? |
Well, I'm glad it's working so well for you, Eric, but I deal with an entity called Cape Cod Health Care, and it doesn't work that way. They are a very good group, affiliated with Cape Cod Hospital, but if I want an app't with my GP it takes 2-4 weeks to get one. If I have a need that can't wait that loing, I have to go to the walk-in clinic (in the same bldg) and sign in and wait for an available physician to see me; sort of a wannabe emergency room for non-urgent care, I guess. I'm not complaining, it works OK, but I don't think anything like *most* Americans share your experience. For most of us, getting in to see "our" doctor on a same-day need is an unfulfillable dream.
R. |
Robert, sorry to hear it takes so long to be seen by your GP. I usually can get an appointment the same day if I call early in the a.m. and if I call later in the day it maybe the following day before I can be seen.
You say you have Cape Cod Health Care. Is that a private insurance provider or that part of Massachusetts health care system?
Is that the only only hospital you can go to or do you have access to other hospitals with your plan?
Message edited by author 2009-08-12 15:32:52. |
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08/14/2009 10:37:43 AM · #533 |
As U.S. Health Row Rages, Many Seek Care in Mexico:
"The total number making the trip is unclear. But a recent study by the UCLA Center for Health Policy Research estimated that nearly 1 million people from California alone seek medical, dental or prescription services in Mexico each year." [emphasis added] |
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08/17/2009 09:07:17 PM · #534 |
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08/17/2009 10:27:43 PM · #535 |
Originally posted by Judith Polakoff:
As U.S. Health Row Rages, Many Seek Care in Mexico:
"The total number making the trip is unclear. But a recent study by the UCLA Center for Health Policy Research estimated that nearly 1 million people from California alone seek medical, dental or prescription services in Mexico each year." [emphasis added] |
Well good for them!! It really pleases me to see a group of individuals make a stand and decide to take personal responsibility for finding health care that works for them and fits into their budgets. If only the rest of the whining liberals who want everything for free would follow that lead.
Do you normally cite Comedy Central as one of your reliable news sources? Did the Enquirer and Star also have similar, supporting articles?
You guys just need to let it go until you can find a solution for health care reform that is financially feasible, fiscally responsible, and keeps the government, who have only demonstrated the ability to administer programs that FAIL, out of the mix. |
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08/17/2009 10:57:19 PM · #536 |
Originally posted by ericwoo:
You guys just need to let it go until you can find a solution for health care reform that is financially feasible, fiscally responsible, and keeps the government, who have only demonstrated the ability to administer programs that FAIL, out of the mix. |
That'd be the Republican guv'mint, though, wouldn't it?
The same one that allowed health care costs to go screaming out of the reach of most self-employed small businessmen.
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08/17/2009 11:46:29 PM · #537 |
Originally posted by NikonJeb:
Originally posted by ericwoo:
You guys just need to let it go until you can find a solution for health care reform that is financially feasible, fiscally responsible, and keeps the government, who have only demonstrated the ability to administer programs that FAIL, out of the mix. |
That'd be the Republican guv'mint, though, wouldn't it?
The same one that allowed health care costs to go screaming out of the reach of most self-employed small businessmen. |
Its always easier to point fingers, and maybe a quick fact check would be in order. Many believe, including me, that a great deal of the health care cost issues stem from the ridiculous amount of litigation that hits doctors, clinics, hospitals, ambulance services, etc, etc, etc. Which president was it that, just recently, stated that he is opposed to capping payouts for medical malpractice suits? Yep, Obama. At last check, he wasn't republican. However, I agree with you. Republicans are just as guilty for as much of the damage as democrats. Who's fault it is really isn't the issue, finding an affordable solution is, or at least it should be. |
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08/18/2009 01:42:48 AM · #538 |
Originally posted by ericwoo:
Originally posted by Judith Polakoff:
As U.S. Health Row Rages, Many Seek Care in Mexico:
"The total number making the trip is unclear. But a recent study by the UCLA Center for Health Policy Research estimated that nearly 1 million people from California alone seek medical, dental or prescription services in Mexico each year." [emphasis added] |
Well good for them!! It really pleases me to see a group of individuals make a stand and decide to take personal responsibility for finding health care that works for them and fits into their budgets. If only the rest of the whining liberals who want everything for free would follow that lead. |
You can always be counted on to respond in the most disgusting manner possible. Thank you for not disappointing! |
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08/18/2009 01:59:30 AM · #539 |
Originally posted by Judith Polakoff:
Originally posted by ericwoo:
Originally posted by Judith Polakoff:
As U.S. Health Row Rages, Many Seek Care in Mexico:
"The total number making the trip is unclear. But a recent study by the UCLA Center for Health Policy Research estimated that nearly 1 million people from California alone seek medical, dental or prescription services in Mexico each year." [emphasis added] |
Well good for them!! It really pleases me to see a group of individuals make a stand and decide to take personal responsibility for finding health care that works for them and fits into their budgets. If only the rest of the whining liberals who want everything for free would follow that lead. |
You can always be counted on to respond in the most disgusting manner possible. Thank you for not disappointing! |
Oh, my bad...I thought you were pointing out the fact that some had decided to stop whining and find a system that was working for them. Were you saying that this is a 'bad' thing? |
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08/18/2009 02:40:47 AM · #540 |
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08/18/2009 03:15:02 AM · #541 |
Does this Krugman character manage to write anything that isn't idiotic?
"In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured."
But hey, what's cost really matter when the liberals just want to take all the money and redistribute it anyway, right? Sheesh. |
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08/18/2009 03:40:23 AM · #542 |
Originally posted by ericwoo:
Does this Krugman character manage to write anything that isn't idiotic?
"In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured."
But hey, what's cost really matter when the liberals just want to take all the money and redistribute it anyway, right? Sheesh. |
Maybe you should apply for Krugman's job? You could write about how that liberal Mitt Romney practiced wealth redistribution when he was governor of Massachusetts and signed the healthcare reform bill into law.
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08/18/2009 07:36:55 AM · #543 |
Originally posted by ericwoo:
Does this Krugman character manage to write anything that isn't idiotic?
"In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured."
But hey, what's cost really matter when the liberals just want to take all the money and redistribute it anyway, right? Sheesh. |
That Nobel Prize Winning Bastard....dont'cha hate those guys...? <<
I kinda see how this works...
Eric's Health Care Plan is fine it works for him so we should all pipe down and relax...All's good with the world.
If anyone's been whining I think you'd get 1st, 2nd and 3rd Prize in that category. Good try on the turn around, though.
Is Medicare a "FAILED" system? Again...IS Medicare a "FAILED" system? And I did some more VA care research with my dads Marine buddies and they're all happy with their service. You can always find people to bitch about something so, go ahead if you must but generally they get a good report card.
It's interesting how so many people are proud to be American...proud of American "can do"...ingenuity. We are the best...we are the best BUT we aren't smart enough or competent enough to provide healthcare like every single one of our peer nations. Why do they and why can't we? Primarily they have a more compassionate view on this topic. It's also easy to point fingers at a group of folks that were in a deep slumber for 8 freakin years only to wake up in a frothing rage and claim to be defenders of the Constitution and champions of fiscal responsibility. It smells.
As for using Comedy Central or The Daily Show to cite practically anything we're discussing, they ARE probably the absolute best at dispelling myths and calling a spade a spade. If you've noticed every single news program including FOX, CNN and the major networks use The Daily Show and Colbert clips in their newscasts and not simply for the sake of humor. They do an amazing job and showing Glen Beck in multiple clips excoriating the healthcare system, painfully bitching and moaning calling it "the nightmare that IS our Health Care system" or stating that "getting well in this country can almost kill you" to Ummmmmmmm "having the best health care system in the world" an incredible turn around in a years time is a miracle. They hit exactly where every other news agency fails. You should watch more of it...it'll straighten you out a bit.
eta: I wonder if Glen Becks insurance covers head from ass removal?
Jesus says an amount of faith even as small as a mustard seed makes all things possible
Message edited by author 2009-08-19 10:36:43. |
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08/18/2009 09:50:36 AM · #544 |
Originally posted by ericwoo:
Its always easier to point fingers, and maybe a quick fact check would be in order. Many believe, including me, that a great deal of the health care cost issues stem from the ridiculous amount of litigation that hits doctors, clinics, hospitals, ambulance services, etc, etc, etc. Which president was it that, just recently, stated that he is opposed to capping payouts for medical malpractice suits? Yep, Obama. At last check, he wasn't republican. However, I agree with you. Republicans are just as guilty for as much of the damage as democrats. Who's fault it is really isn't the issue, finding an affordable solution is, or at least it should be. |
This is the stupidest argument ever. You think taking all power away from the little guy is the going to improve health care? Your party is screaming about death squads out to kill grandma. This idea would give health care providers the ability to just keep people sick while they line their own pockets with cash. |
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08/18/2009 12:45:25 PM · #545 |
Originally posted by pawdrix:
Originally posted by ericwoo:
Does this Krugman character manage to write anything that isn't idiotic? |
That Pulitzer Prize Winning Bastard....dont'cha hate those guys...? |
That'd be Nobel Prize-winning economist Krugman ... |
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08/18/2009 03:41:48 PM · #546 |
Originally posted by pawdrix:
Jesus says an amount of faith even as small as a mustard seed makes all things possible |
Well, since you brought it up, I don't buy into that bullshit, either. And Nobel, Pulitzer, whatever, the guy is writing like a moron right now. He wants us to do what Massachusetts did?!? WTF? Sure, it really isn't working for them, but we could probably make it work for us. Seriously? AND, the Noble Prize argument may have retained some strength, but don't they just toss those out to everyone? Hell, even Jimmy Carter, Georgia's great embarrassment, got one for peace. Nobel Prize?!
Originally posted by Niten:
This is the stupidest argument ever. You think taking all power away from the little guy is the going to improve health care? Your party is screaming about death squads out to kill grandma. This idea would give health care providers the ability to just keep people sick while they line their own pockets with cash. |
Really...stupidest argument ever? Fraudulent litigation is the sole reason why docs and hospitals have to pay such ridiculous premiums for malpractice insurance. Do you think those guys should just absorb those costs and still give you fair prices? That sounds like the same dumb-ass argument that says tax the rich and the corporations. Surely they'll just absorb the taxes, keep paying their employees the same and spending the same. There is an argument you should label 'stupidest' way ahead of mine. |
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08/18/2009 11:01:52 PM · #547 |
Originally posted by ericwoo:
If only the rest of the whining liberals who want everything for free would follow that lead. |
I know that you're factually challenged, but listen up and try to learn something for a change. There happens to be a mandate in the House bill that all Americans purchase insurance. This means that virtually everyone will be contributing some amount and virtually no one will get "everything for free."
I was going to post on another topic in addition, but I think I'd better go real slow here so you have a chance to absorb that information first. |
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08/18/2009 11:16:46 PM · #548 |
Originally posted by Judith Polakoff:
Originally posted by ericwoo:
If only the rest of the whining liberals who want everything for free would follow that lead. |
I know that you're factually challenged, but listen up and try to learn something for a change. There happens to be a mandate in the House bill that all Americans purchase insurance. This means that virtually everyone will be contributing some amount and virtually no one will get "everything for free."
I was going to post on another topic in addition, but I think I'd better go real slow here so you have a chance to absorb that information first. |
Yeah, slow down and make sure you look over the entire bill before you post your liberal bullshit. I have no problem with everyone being required to buy insurance. But what to do with those that can't F*CKING REFUSE to work? Hmm, let's all build a big campfire, sing Kumbaya while feeling sorry for them. Since you have deemed yourself so intellectually superior than the rest of the group, please, with all your glorious knowledge, share with us exactly how these parasites contribute? Is it just the fact that they grace our presence with breathing and walking the earth as a human being? There is my problem. Not everyone contributes. You jerks want the wealthy to cover the social parasites and anyone else who can't work for whatever reason. I work. I don't necessarily like it, but I do it. Every freaking day. I'd much rather sit on my ass and have you provide me with every means I need for daily life. Can I send you my address? Virtually everyone contributing is not enough for me. Please, grace me with more of your abundant liberal hogwash. |
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08/18/2009 11:18:47 PM · #549 |
Originally posted by Judith Polakoff:
Originally posted by ericwoo:
If only the rest of the whining liberals who want everything for free would follow that lead. |
I know that you're factually challenged, but listen up and try to learn something for a change. There happens to be a mandate in the House bill that all Americans purchase insurance. This means that virtually everyone will be contributing some amount and virtually no one will get "everything for free." |
Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America
"Mandatory insurance is a thinly veiled system of welfare. Politicians rarely admit this fact, but ordinary citizens understand it all too well." |
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08/18/2009 11:31:33 PM · #550 |
| Let me see if I have this right; at least one of the contributors to this thread feels that certain systems shouldn't be in place because some people find ways to abuse the systems? |
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