[Copernicus]

[ QUOTE ]
Come my son, and listen.

Since you've been healthy enough not to find out on your own, here's what to expect, from my own family's experience.

You are charged $800 for a $200 procedure. You haven't met your yearly deductible yet, so the anesthesiologist bills you instead of your insurance company. Insurance company is charged only $200 for that particular procedure, but you get stuck with an $800 bill for being you.

Children's health insurance is canceled without notice. When queried, the company claims that photocopied forms you sent were illegible. You know this isn't true because this is the second time they've pulled this. Repeat three times with more inventive excuses.

You wait 3 months for an appointment with what turns out to be a nurse who is screening things for a doctor. You persuade her you have something that really needs to be seen. NOW you make an appointment with the doctor -- in three months.

A doctor you finally develop rapport with gets transferred to another county. Medical conglomerates do that sort of thing.

Your father (a retired physician) waits in an emergency room for 6 hours with chest pains before being closely examined. By this time, the heart muscle is badly damaged. He dies.

A prescription you've been taking for years is rejected by the new insurance company. Why? That drug is not in the list in their manual. (Real issue: no generic version available.) You must pay a monthly $50 CO-payment. This is name-brand insurance, Blue Cross!

Insurance refuses to pay for a surgical procedure. You spend TWO DAYS on the phone attempting to reach higher ups, who eventually confirm that yes, it's supposed to be covered.

A doctor charges a friend $800 for a five minute visual/hand examination of a child's arm. No lab work or x-rays or casts of any kind are involved. You need to see a doctor of that same specialization. You beg the insurance company not to send you to a proven crook. Sorry, only in-network doctors will be paid for.

A doctor under pressure to shorten his per patient time informs you of a new condition that you have. He gives 30 seconds of generic boilerplate explanation, then vanishes. You ask a nurse if you are supposed to leave now, or wait for something else.

Your sister is a doctor at Mayo. One after another, her colleagues are driven out of the company -- replaced in one case by a doctor who had not worked in a year due to substance abuse problems. Why? The new hires would not challenge the corporate bean counters.

And we are a basically healthy, highly educated Caucasian family adept at pressing bureaucrats. Imagine what it is like for everyone else.

Here is the underlying problem with our HMO/ private insurance system. The way the companies cut costs and boost profits is by denying coverage, not through efficiencies or expanded services. A large portion of every health care dollar (30% is what comes to mind, Paul Krugman wrote about this) is spent on the bureaucracy whose job it is to invent regulations that deny coverage. As one outfit's profits go up, its competitors must develop more byzantine ways of restricting coverage.

Years ago, the complaint was that arrogant, unapproachable doctors thought they're god. Now we find out that an overbearing individual is far preferable to a corporate bureaucracy, which offers no face to challenge. The doctors are degraded by corporate even more than the patients.

Your grandparent's life skills included learning to fix farm machinery. You will learn to pour through coverage manuals like a lawyer, in order to force action out of institutions whose job is to not do their job.

But at least we don't have a single-payer health system. I hear that destroys freedom.

[/ QUOTE ]

What you are describing fits Canada to a T...a single payer health system that is failing. Read the above linked article about Canada if you think single payers is the answer.