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  • Medical Costs

    Here's another example of why your insurance premiums are through the roof.

    I have a fistula (opening between multiple body layers) in an area previously affected by surgery and radiation. My multiple body layers are skin, throat, and everything in between. I leak onto my neck when I eat or drink. This is "not uncommon" following my procedure, but it happening 9 years later isn't expected. In areas affected by radiation, there is typically an inadequate blood supply resulting in loss of tissue viability, particularly in areas of surgical scars.

    Here's what the medical community wants to do:

    Surgery to insert a feeding tube - est. cost $4,000. I've previously had this done twice and I have a 50% survival rate with this surgery. 4 days in ICU and another week and a half in the hospital could happen again and run the cost through the roof.

    A minimum of 3 months of food for the feeding tube. This was $2,000 a month 9 years ago, so I'll use that number - est. cost $6,000

    A series of typically around 30 treatments in a hyperbaric chamber (over a period of about 3 months) at a total cost of about $10,000.

    Regular visits to a doctor to examine the wound, dress it and bandage it. - est. cost.$1,000. So we're at $20,000 and change to get the expected result of "it may or may not heal".

    About that food. I can use the generic version of Ensure and cut that cost down to just over $200 a month, but insurance won't cover that. With a 20% copay, that's still a savings of $200 a month, but I have to ignore what the doctor prescribes to save that money. Nutritional values are the same. The difference is that Ensure has flavorings. An even more economical approach is just run normal meals through a blender. Both Ensure and pureed "meals" work with a feeding tube.

    About those hyperbaric treatments. A good friend of mine had breast reduction surgery AFTER radiation for breast cancer (that's an incredibly risky procedure in a radiated area). She's been through two series of hyperbaric treatments with no noticeable results. She still has a hole in her chest. (She's also an RN, so I suspect she's getting a level of care that "normal" people might not expect.) If the first series of treatments doesn't work, they just order another, and another, and another. Insurance just keeps paying.

    There is an alternative called "do nothing".

    With this method you personally inspect the wound, clean it several times a day, dress it with anti-bacterials, and change bandages.

    Expected results: It may or may not heal. EXACTLY the same result as going through surgery and spending an hour and a half in a hyperbaric chamber 30 times over a period of 3 months.

    A very large number of people have survived for decades with holes in their throats. One example we're all familiar with is Stephen Hawking. The hole in his neck had nothing to do with his demise.

    If a doctor recommends taking care of the wound and seeing what it will do on its own over a period of a few months, it cuts into their billings and profit-sharing. There are some inherent problems with for-profit medical care. It makes the medical community less inclined to pursue strategies that minimize billings.
    Last edited by Aargh; March 19th, 2018, 01:18 AM.
    The future's so bright - I gotta wear shades.
    We like to cut down nets and get sized for championship rings.

  • #2
    my daughter has narcolepsy, developed as an adult. Without her meds she is almost 100% disabled, with her meds she can get 2 and a half to 3 decent weeks out of the month. Only one company makes the med and the cost is $7,000 per month.

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    • #3
      The cost to manufacture generic sterile injectables went up 150% in the last decade due to increased federal regulations.

      Livin the dream

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      • #4

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        • #5

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          • #6
            Keep crying Kalifornia you worthless haven of illegal sponges. I'm drunk with your tears...

            Fking 'BummerCare has cost me unbelievably. Thankfully I have acquired coverage through a religious cost-sharing organization and am back to paying what a healthy, responsible person should be paying. I also have unlimited coverage and a 500 deductible. The company's been in business for nearly 40 years.


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            • #7
              Originally posted by C0|dB|00ded View Post
              Thankfully I have acquired coverage through a religious cost-sharing organization and am back to paying what a healthy, responsible person should be paying. I also have unlimited coverage and a 500 deductible. The company's been in business for nearly 40 years.


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              How long have you been with them? I got too scared away by the fact that most of them call themselves a "cost-sharing" plan, like you said. Should they ever decide to deny coverage, there is no contractual remedy. What are you going to sue them for? You just have to trust that they will pay out. They also tell you to try to negotiate with the hospital since you're technically uninsured. They want you to knock at least 40% off the bill before forwarding it to them to pay.

              I've also heard that sometimes participants will get letters saying "another participant had exorbitant medical costs this last month. Can you chip in an extra $100?" or something like that. Have you had any similar experiences?

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              • #8
                Losing pre-existing conditions protections is a real problem.
                AMA announced its opposition to insurance plans being sold in individual, small group markets that do not guarantee critical patient protections under the ACA.

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                • #9
                  Originally posted by jdshock View Post

                  How long have you been with them? I got too scared away by the fact that most of them call themselves a "cost-sharing" plan, like you said. Should they ever decide to deny coverage, there is no contractual remedy. What are you going to sue them for? You just have to trust that they will pay out. They also tell you to try to negotiate with the hospital since you're technically uninsured. They want you to knock at least 40% off the bill before forwarding it to them to pay.

                  I've also heard that sometimes participants will get letters saying "another participant had exorbitant medical costs this last month. Can you chip in an extra $100?" or something like that. Have you had any similar experiences?
                  http://www.chministries.org/

                  A monthly newsletter details all the donations that come in above and beyond the normal "premiums" that help pay a surprising amount of member pre-existing conditions. The program, concept, and company are legit. Limitless testimonials of people drawing $1M+ out of the pool for medical bills. I've been with them about 9 months. They even help/encourage price haggling with your provider. It's the magic of free markets in action. CB approved!


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                  • #10
                    Originally posted by Anthroshock View Post
                    Losing pre-existing conditions protections is a real problem.
                    Drop all preexisting condition protections except for newborns otherwise we need preexisting condition protection for auto, home, and business insurance too. I'd like to buy insurance after I wreck my car, burn my house or business down. I can REALLY save me some money!!!!!!!!!!11111

                    Oops! That doesn't make sense...

                    Libtards... *sigh*


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                    • #11
                      Originally posted by Anthroshock View Post
                      Losing pre-existing conditions protections is a real problem.
                      https://www.ama-assn.org/ama-backs-s...a-marketplaces

                      We need to take steps to ensure that healthy individuals stay enrolled in coverage offered in the ACA marketplaces and are not siphoned off into coverage that does not guarantee critical patient protections, leaving behind a sicker population facing higher premiums in ACA-compliant coverage..
                      Translated: We need to fleece responsible, working citizens who've planned ahead by maintaining a disciplined budget that includes insurance protection to pay for the X-Box superstars who stumble into the ER following a major Call of Duty ass-pounding triggered heart attack.

                      AMA President David O. Barbe: Joseph Stalin would be impressed sir!!!

                      Libby-LoLz!


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                      • #12
                        Originally posted by Anthroshock View Post
                        Losing pre-existing conditions protections is a real problem.
                        I'm obviously all for covering pre-existing conditions, and I'm one of the biggest proponents of the ACA on this board. But I just don't know how we can cover pre-existing conditions without also keeping the mandate.

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                        • #13
                          Originally posted by jdshock View Post

                          I'm obviously all for covering pre-existing conditions, and I'm one of the biggest proponents of the ACA on this board. But I just don't know how we can cover pre-existing conditions without also keeping the mandate.
                          So you must not be aware of one of the largest abuses of BO-Care which is signing up for "insurance" the moment you are diagnosed with a condition. A semester of economics with an exit exam requiring mastery of the incentives section should be compulsory for all Americans and those aspiring to be one.

                          I have an idea... those who sign up for this Utopian no-holds-barred health coverage immediately after being diagnosed with a serious condition are required to serve 2 years on a humanitarian expedition. I figure since I saved your life, you can donate yours for two years and pay back the free-riding you enjoyed while not paying for my healthcare needs.

                          Deal?


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                          • #14
                            Originally posted by C0|dB|00ded View Post

                            So you must not be aware of one of the largest abuses of BO-Care which is signing up for "insurance" the moment you are diagnosed with a condition. A semester of economics with an exit exam requiring mastery of the incentives section should be compulsory for all Americans and those aspiring to be one.

                            I have an idea... those who sign up for this Utopian no-holds-barred health coverage immediately after being diagnosed with a serious condition are required to serve 2 years on a humanitarian expedition. I figure since I saved your life, you can donate yours for two years and pay back the free-riding you enjoyed while not paying for my healthcare needs.

                            Deal?


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                            My post was about why the economics don't work if you don't mandate coverage. I was literally making the same point you are, just with less vitriol.

                            What did you think I meant when I said "I just don't know how we can cover pre-existing conditions without also keeping the mandate"?

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                            • #15
                              Originally posted by jdshock View Post

                              My post was about why the economics don't work if you don't mandate coverage. I was literally making the same point you are, just with less vitriol.

                              What did you think I meant when I said "I just don't know how we can cover pre-existing conditions without also keeping the mandate"?
                              I'm obviously all for covering pre-existing conditions, and I'm one of the biggest proponents of the ACA on this board.
                              Sir, we are certainly not making the same point. En garde!


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