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  1. #201
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    Feb. 16, 2010
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    Jacksonville, FL
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    Quote Originally Posted by FalseImpression View Post
    When you mention "catastrophic insurance", is it something like this
    http://www.sunlife.ca/Canada/sun+aff...gnLocale=en_CA ?

    What I see here is an insurance policy for a max. amount of $250K which kicks in after some conditions are met, but I don't see anywhere there is a deductible.
    Of course, the initial care is already covered by our universal health policy and this is an extra protection that people take to cover other expenses. But still... $100K deductible??? wow..
    No, it didn't have a $100k deductible. That's insane. I guess it's different in Florida. I think the deductible was high, but maybe around $8k?

    And yes I had that in my emergency savings just incase or available to me on a credit card.

    And you can negotiate a lower cash payment. I've done it. And I have a doctor in the family so I know how much resources doctors devote to dealing with insurance billing. This is why you can pay less when you are a cash payer. When they bill the insurance $1000 it often gets knocked down to $450 by the insurance company. The doctors inflate their charges knowing this. But if you're a cash payer they will give you the lower fee. You just have to ask. Again I've done this. I've done this even with insurance. I have a high deductible plan even now and I pay for the first $2000 out of pocket from my HSA. Just call the billing department and see what they're willing to do.



  2. #202
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    Aug. 28, 2006
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    Quote Originally Posted by showhorsegallery View Post
    No, it didn't have a $100k deductible. That's insane. I guess it's different in Florida. I think the deductible was high, but maybe around $8k?

    And yes I had that in my emergency savings just incase or available to me on a credit card.

    And you can negotiate a lower cash payment. I've done it. And I have a doctor in the family so I know how much resources doctors devote to dealing with insurance billing. This is why you can pay less when you are a cash payer. When they bill the insurance $1000 it often gets knocked down to $450 by the insurance company. The doctors inflate their charges knowing this. But if you're a cash payer they will give you the lower fee. You just have to ask. Again I've done this. I've done this even with insurance. I have a high deductible plan even now and I pay for the first $2000 out of pocket from my HSA. Just call the billing department and see what they're willing to do.
    We have a catastrophic major medical plan from AMA and it kicks in AFTER our regular health insurance plan is maxed out.

    Regarding the bold part of your post: Not always. I wouldn't count on it. Doctor's offices may not be making much from insurance payments (again, depending on what was done), and so they have to make it up elsewhere.

    When you have a high deductible you still only pay the amount the insurance company would have paid when you stay "in network" (the practice has a contract with the insurance company), until your deductible is paid off and the insurance kicks in. Or at least that's how Blue Cross/ Blue Shield works in NC.
    Last edited by grayarabpony; Nov. 6, 2012 at 12:59 PM.



  3. #203
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    Jan. 9, 2012
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    If I was trying to buy a free-market health insurance policy, I would not be able to get one no matter how much money I had, as I have a chronic, pre-existing health condition. Obamacare is NEEDED for people like me if they don't have employer-sponsored health insurance. If I didn't have a husband whose insurance I could go through, I would never be able to be out on my own as an entrepreneur or independent contractor, because I wouldn't be able to have health insurance. I'd be denied everywhere.

    For all the emphasis that Republicans put on small business, entrepreneurship, etc., they tend to forget the disconnect with people like me- we CAN'T do it without those changes to health care laws. And there are millions of people like me.


    7 members found this post helpful.

  4. #204
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    Jun. 19, 2001
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    Washington, D.C.
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    Quote Originally Posted by PaintedHunter View Post
    If I was trying to buy a free-market health insurance policy, I would not be able to get one no matter how much money I had, as I have a chronic, pre-existing health condition. Obamacare is NEEDED for people like me if they don't have employer-sponsored health insurance. If I didn't have a husband whose insurance I could go through, I would never be able to be out on my own as an entrepreneur or independent contractor, because I wouldn't be able to have health insurance. I'd be denied everywhere.

    For all the emphasis that Republicans put on small business, entrepreneurship, etc., they tend to forget the disconnect with people like me- we CAN'T do it without those changes to health care laws. And there are millions of people like me.
    This is huge--I've said this myself many times before, and agree with you 100%.

    People also seem unable to understand just what sorts of "preexisting" conditions health insurers can use to deny you coverage (or charge you an insane rate for it). When I tried to buy insurance when I had a lapse in coverage coming out of college (aged out of my parents plan) they considered taking oral antibiotics for acne as a teen to be a "red flag". Then they denied me coverage flat out because I had an innocent heart murmur as a child (never caused any problems, nor did it have the potential to, and I outgrew it), and also because I had my spleen removed after falling off a horse years ago (also, has never caused any health problems nor is it likely to). Basically anything they can manage to dig up, however benign it may seem, can be used against you, to deny you coverage up front or revoke it down the line.

    So yeah, that free market man, it works super well...



    4 members found this post helpful.

  5. #205
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    Jul. 29, 2006
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    Colorado- Yee Haw!
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    Quote Originally Posted by grayarabpony View Post

    What you're saying about cash payments is just generally not true, not for family doctors, not for procedures, not for hospital stays. I'm married to a family doctor and he's been practicing 16 years.
    Where I live it is. In my childbirth class when asked the biggest fear of childbirth two couples said paying for it since they didn't have insurance. The teacher hooked them up to the billing department and they set up a VERY reduced rate on a pre-payment plan. It was like layaway. They paid a bit weekly ahead of the birth at a very reduced rate. The billing department even worked with on what supplies they could bring from home. Many places give a big discount for cash at time of service or ahead.
    I had to see a lactation consultant and when I booked my appointment she gave me the billing code and told me to call my insurance and see if it was covered b/c it was generally not and if it wasn't and I paid at time of service there was a 50% discount. It was not covered and I appreciated her telling me to call as I saved $70. She said I was one of a very small group of people who bothered to take her advice.



  6. #206
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    Aug. 21, 2011
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    Connecticut
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    To the OP: Sorry about your accident. I guess you're not aware that most of the changes to "Obamacare" won't even take effect until 2014, but you could have taken advantage of one before your accident, which is to be covered under your parent's healthcare.



  7. #207
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    May. 17, 2010
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    Where humidity isn't just a word, it's a way of life.
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    Quote Originally Posted by Tonkafriend View Post
    To the OP: Sorry about your accident. I guess you're not aware that most of the changes to "Obamacare" won't even take effect until 2014, but you could have taken advantage of one before your accident, which is to be covered under your parent's healthcare.
    I believe her parents were not covered, either, so that option was not available to her.



  8. #208
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    Sep. 21, 2010
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    Quote Originally Posted by Karosel View Post
    I don't pay income taxes at all (still in graduate school) and I love the fact I don't have to worry about holding down two jobs, while in school just to afford health care. Instead I devote my time to my research in biofuels.
    Ah, I wish! I'm an undergrad, and I have to pay income tax. I do hold down 3 jobs, but luckily they're to pay for the car and the horse, not basic rights like healthcare.

    ETA: I live in Canada and definitely do not pay 50% of my income in taxes - I think I pay something like 15%-20%. Definitely overall income based!


    1 members found this post helpful.

  9. #209
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    Aug. 28, 2006
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    Quote Originally Posted by 4Martini View Post
    Where I live it is. In my childbirth class when asked the biggest fear of childbirth two couples said paying for it since they didn't have insurance. The teacher hooked them up to the billing department and they set up a VERY reduced rate on a pre-payment plan. It was like layaway. They paid a bit weekly ahead of the birth at a very reduced rate. The billing department even worked with on what supplies they could bring from home. Many places give a big discount for cash at time of service or ahead.
    I had to see a lactation consultant and when I booked my appointment she gave me the billing code and told me to call my insurance and see if it was covered b/c it was generally not and if it wasn't and I paid at time of service there was a 50% discount. It was not covered and I appreciated her telling me to call as I saved $70. She said I was one of a very small group of people who bothered to take her advice.
    4Martini I deleted the part that you quoted from my original post. What I meant to say is that doctors will not always just charge what insurance would have paid, even with cash. For example, I've had haggles with a couple of doctor's offices when they charged me more than the insurance company had contracted for the visit, at the time of the visit. So they had to send me refunds.



  10. #210
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    Nov. 16, 2001
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    Canada
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    Quote Originally Posted by Couture TB View Post
    ETA: OP I know people in Canada that have to wait months to get into an ortho. The brakes were set and then they got to wait on a list for having an ortho put pins etc in. A friend was visiting and she couldn't believe that since I was having certain symptoms etc that I could get in and get an MRI that same day. Unless it is a triage sort of thing she would have had to wait for it up in Canada. She also couldn't believe that I could just schedule surgery with my doctor for my ankle at any time and not have to wait. So what you got here, where you were seen by a doctor and then set up in a splint/cast, well that is what you would get a lot of places. People pay quite a bit in order to be seen by orthopidic docs.
    Know what? You can get bumped ahead IN CANADA if you're willing to pay, too.

    A few years back my mom injured her knee. They said it would need an MRI, but the wait time was about 8 months as it was non-urgent. Was there a way to speed it up? She asked..Yep.. if you pay. $600 got her that MRI within 2 weeks.

    Personally, I'd rather wait a few months with some discomfort for a free diagnostic procedure, if it means that someone with more urgent needs gets done first, and if neither of us loses the shirt off our back to obtain said health care.

    And my tax bracket, due to my income, is significantly less than 50%.

    Sometimes Canadians travel to the US for procedures we don't even have. Rare, oddball procedures. One child from Alberta went to NY for some very rare procedure ... but there was a LOT of fundraising going on to make it happen. Health care paid for some..but not all.

    I'll take our system any day. Even while I complain about the $230 bill I have for an ambulance trip I didn't even take (they came, I did not go to the hospital with them), I'm glad it's only $230. Just too used to EVERYTHING being covered by health care, and am still a bit shocked that ambulatory services aren't. But that's just a spoiled Canadian girl getting an unexpected bill. That my health insurance will re-imburse 100%. That really, I'm ok with, because as much as that's one month's groceries for me, it could be a LOT worse.

    Another thing we've learned from friends, family, etc's experiences over the years, is if you are having problems with our system, get a different doctor. Sometimes the push your family practitioner makes and the severity they assess/attribute to an ailment is the deciding factor in the time further diagnostics take.

    The system isn't perfect, but I'll take it and am unbelievably grateful for it.

    A good friend of mine in the US's facebook status the other day was "We're so excited ,we should have [our youngest child] paid off by his first birthday!"

    I am unbelievably grateful that if I ever am lucky enough to have children, I won't be saying the same. A full year mat leave to raise baby, and no stress about hospital bills. Sounds pretty good.

    And if someday I'm paying taxes in the 50% bracket, well, I'll gladly do so if it means free health care. Warts in the system and all.
    *&*&*&*&*&*&*&*&*&*&*&*&*&*&*&
    "Show me the back of a thoroughbred horse, and I will show you my wings."
    &*&*&*&*&*&*&*&*&*&*&*&*&*&*&*&


    4 members found this post helpful.

  11. #211
    Join Date
    Feb. 16, 2010
    Location
    Jacksonville, FL
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    814

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    Quote Originally Posted by PaintedHunter View Post
    If I was trying to buy a free-market health insurance policy, I would not be able to get one no matter how much money I had, as I have a chronic, pre-existing health condition. Obamacare is NEEDED for people like me if they don't have employer-sponsored health insurance. If I didn't have a husband whose insurance I could go through, I would never be able to be out on my own as an entrepreneur or independent contractor, because I wouldn't be able to have health insurance. I'd be denied everywhere.

    For all the emphasis that Republicans put on small business, entrepreneurship, etc., they tend to forget the disconnect with people like me- we CAN'T do it without those changes to health care laws. And there are millions of people like me.
    Have you looked into buying personal health insurance and shopped around? I can't tell from your post if you're speaking from personal experience or you are just assuming. When I was looking there was a two year wait period for pre-existing conditions but you could get pre-existing conditions. That's not too different from health insurance you get through employers. Similar to maternity coverage. You generally have to wait a year before that option is available. It prevents people from waiting to get health insurance right before they plan on getting pregnant just for the sake of the maternity coverage.

    Like a poster before, I also have a minor heart murmur that is no big deal. I've not had an issue with my health insurance because of it.



  12. #212
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    Jan. 9, 2012
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    Alright then- for the person giving me a thumbs down: what's YOUR solution for those who can't get private health insurance, don't have access to employer insurance, and make too much for Medicaid? What are they to do, or do you just not care? My medications alone WITH insurance cost me $150. I can't imagine what they plus doctors appointments plus potential hospitalization a would cost me annually without insurance.


    1 members found this post helpful.

  13. #213
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    Jan. 9, 2012
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    Quote Originally Posted by showhorsegallery View Post
    Have you looked into buying personal health insurance and shopped around? I can't tell from your post if you're speaking from personal experience or you are just assuming. When I was looking there was a two year wait period for pre-existing conditions but you could get pre-existing conditions. That's not too different from health insurance you get through employers. Similar to maternity coverage. You generally have to wait a year before that option is available. It prevents people from waiting to get health insurance right before they plan on getting pregnant just for the sake of the maternity coverage.

    Like a poster before, I also have a minor heart murmur that is no big deal. I've not had an issue with my health insurance because of it.
    Personal experience when in between jobs, plus knowing of others like me. Insurers don't want to insure someone with an autoimmune disease in so many cases. Through no fault of our own, we are very expensive.


    3 members found this post helpful.

  14. #214
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    Oct. 20, 2009
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    979

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    I could only get through 4 pages of this garbage. You people, pointing fingers at the OP claiming that she wants YOU to pay for HER "choice" not to have health insurance are clearly not reading for comprehension. The POINT of her post was that it took THREE EFFING WEEKS to be seen by a specialist. This. Is. Just. Wrong!!!
    She wasn't trying to not pay for things- she even went so far as to say if there was a payment plan available for her to use, she would have taken it. She said that she believed that people should be paid for their services. She just didn't want to (and shouldn't have had to!!!) wait three weeks to get an operation, that could have left her permanently disabled (and, ironically, eligible for some sort of disability).
    EVERY TAX PAYING CITIZEN is paying for someone else's health care at the moment, whether you like it or not. It's been this way for a long time, and most likely always will be this way. The problem is that there are people who fall between the cracks (like the OP) who are suffering because of the Archaic and frankly predatory nature of health insurance companies. I don't care if you want Obamacare, Romney Care, Full on socialized healthcare, or some other kind of crazy health insurance legislation, the fact that so many of you told the OP "tough titty, you took a risk now you suffer the consequences, don't come looking for any help from me" makes me ill.
    what a bunch of selfishness. I hope you "fend-for-yourselfers" never find yourself in a situation where life does not go as planned and you need help.
    Shame on you.


    10 members found this post helpful.

  15. #215
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    Aug. 20, 2006
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    wyoming
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    Quote Originally Posted by pinkpony321 View Post
    I could only get through 4 pages of this garbage. You people, pointing fingers at the OP claiming that she wants YOU to pay for HER "choice" not to have health insurance are clearly not reading for comprehension. The POINT of her post was that it took THREE EFFING WEEKS to be seen by a specialist. This. Is. Just. Wrong!!!
    She wasn't trying to not pay for things- she even went so far as to say if there was a payment plan available for her to use, she would have taken it. She said that she believed that people should be paid for their services. She just didn't want to (and shouldn't have had to!!!) wait three weeks to get an operation, that could have left her permanently disabled (and, ironically, eligible for some sort of disability).
    EVERY TAX PAYING CITIZEN is paying for someone else's health care at the moment, whether you like it or not. It's been this way for a long time, and most likely always will be this way. The problem is that there are people who fall between the cracks (like the OP) who are suffering because of the Archaic and frankly predatory nature of health insurance companies. I don't care if you want Obamacare, Romney Care, Full on socialized healthcare, or some other kind of crazy health insurance legislation, the fact that so many of you told the OP "tough titty, you took a risk now you suffer the consequences, don't come looking for any help from me" makes me ill.
    what a bunch of selfishness. I hope you "fend-for-yourselfers" never find yourself in a situation where life does not go as planned and you need help.
    Shame on you.
    But, you see, unlike with a classroom discussion, when you post on a BB people don't have to stick to the subject you want them to. Don't like that, then don't post.

    The OP didn't fall through the cracks with her choice not to get health insurance. She chose not to get it. She's already said that she uses a smart phone because it costs "only" $29 a month more than a regular cell. That tells me that she doesn't recognize wishes from needs, and that there are likely other places she could cut - if she really wanted to get insurance.

    There are definitely people who can't afford insurance, in spite of their very best efforts. For them, I have the deepest sympathy.

    I can't get all fashed about someone whose choices helped to create their current troubles. I can be very sorry they were hurt in the first place, and I am.

    Liz, heartless beyatch


    4 members found this post helpful.

  16. #216
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    Feb. 4, 2006
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    Quote Originally Posted by Tonkafriend View Post
    To the OP: Sorry about your accident. I guess you're not aware that most of the changes to "Obamacare" won't even take effect until 2014, but you could have taken advantage of one before your accident, which is to be covered under your parent's healthcare.
    Neither of my parents are insured, so thanks, but no, that wouldn't have helped me (I was covered under my mom's plan in 2009-2010, but she's no longer at that job).

    ETA: I actually am aware of the 2014 implementation. I know it wouldn't have necessarily helped me in 2012, but if someone else can be prevented from going through what I have, either by lowering the cost of plans to choose from, subsidizing those who cannot afford it, or preventing insurance companies from holding pre existing conditions against you...all of those things can at least help people like me get insurance. See, I don't just care about what happens to me and that I get fixed, but also other people who may be in a similar situation.
    Last edited by Dazednconfused; Nov. 6, 2012 at 02:57 PM.


    3 members found this post helpful.

  17. #217
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    I too was confused by the title of this thread. I was thinking at first that OP didn't want obamacare and was blaming it for her problems.

    I've had health insurance from the first time I got a job through to retirement and beyond. My pension plan from Fulton County has health insurance, which is deducted every month from my pension. But all policies have limits. What people do not realize is that when you do max out, say if you have a wreck or cancer, and require millions in treatments, you are done.

    I am a firm believer that everyone in this country should have free health care. Paid for by our taxes. (And if we'd legalize and tax marijuana, we'd have some more money for health care.) It's ridiculous that people suffer and sometimes die because people don't want to pay hospitals and doctors to take care of those who cannot afford healthcare. It's a shameful thing for a country where so many people define themselves as 'good Christians."

    We are lucky in my state that if you need care, you can go to the emergency room at Grady (in Atlanta) or Memorial here in Savannah, and get some of the best doctors/surgeons from our med schools who work there. You'll be billed, but if you cannot afford to pay, you will still be treated. But politicians are constantly trying to limit funding to Grady and Memorial for treating any and everyone.

    It's ok to give Georgia Power $$$ incentives to build a new nuclear power plant, but apparently the politicians don't think that people have the right to live with good medical treatment.


    3 members found this post helpful.

  18. #218
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    Feb. 4, 2006
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    Quote Originally Posted by prairiewind2 View Post
    But, you see, unlike with a classroom discussion, when you post on a BB people don't have to stick to the subject you want them to. Don't like that, then don't post.

    The OP didn't fall through the cracks with her choice not to get health insurance. She chose not to get it. She's already said that she uses a smart phone because it costs "only" $29 a month more than a regular cell. That tells me that she doesn't recognize wishes from needs, and that there are likely other places she could cut - if she really wanted to get insurance.

    There are definitely people who can't afford insurance, in spite of their very best efforts. For them, I have the deepest sympathy.

    I can't get all fashed about someone whose choices helped to create their current troubles. I can be very sorry they were hurt in the first place, and I am.

    Liz, heartless beyatch
    $29 doesn't buy any health insurance in any state I am aware of. It is the only 'luxury' I have, and would not make any difference as to whether I could purchase insurance or not.

    As for "I can be very sorry they were hurt in the first place, and I am". It's an exercise in absurdity, and a distinction without a difference.

    Again, I'm glad for you that you could make enough money, go to school, etc and have good benefits or make enough money to purchase your own. Not everyone is that lucky (especially when they've just experienced a layoff). I too, hope one day that I will make that kind of money and have good benefits. I could sort of understand your specious, idiotic argument if I was off gallivanting on vacation, eating out at all, buying expensive clothes, or doing drugs. I could even understand being irritated if I got hurt by a horse/at work. But I'm not. Not that I should justify to ANYONE why I shouldn't have to live with a permanent deformity and subsequent arthritis because someone else wasn't paying attention and made a horrible, stupid mistake.

    It doesn't matter whether I bag groceries, wait tables, or muck stalls for a living. There is absolutely no reason why someone as hard working as me should be in this situation.

    (Oh, just to add - the job I was hired for full time two days before the accident, in addition to the other two farmettes I service would have probably provided me with enough extra income that I could have bought one of those high deductible plans, with some shifting of my budget. But guess what, I never got the opportunity because of the idiot who hit me! Awesome.)

    Apparently logic fails people (Particularly Americans, which is especially funny.) on this subject. Sad. I hope the intelligent and empathetic will prevail, someday.


    4 members found this post helpful.

  19. #219
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    Jun. 19, 2001
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    Quote Originally Posted by cloudyandcallie View Post
    I too was confused by the title of this thread. I was thinking at first that OP didn't want obamacare and was blaming it for her problems.

    I've had health insurance from the first time I got a job through to retirement and beyond. My pension plan from Fulton County has health insurance, which is deducted every month from my pension. But all policies have limits. What people do not realize is that when you do max out, say if you have a wreck or cancer, and require millions in treatments, you are done.

    I am a firm believer that everyone in this country should have free health care. Paid for by our taxes. (And if we'd legalize and tax marijuana, we'd have some more money for health care.) It's ridiculous that people suffer and sometimes die because people don't want to pay hospitals and doctors to take care of those who cannot afford healthcare. It's a shameful thing for a country where so many people define themselves as 'good Christians."

    We are lucky in my state that if you need care, you can go to the emergency room at Grady (in Atlanta) or Memorial here in Savannah, and get some of the best doctors/surgeons from our med schools who work there. You'll be billed, but if you cannot afford to pay, you will still be treated. But politicians are constantly trying to limit funding to Grady and Memorial for treating any and everyone.

    It's ok to give Georgia Power $$$ incentives to build a new nuclear power plant, but apparently the politicians don't think that people have the right to live with good medical treatment.
    This is a really important thing to note as well. A friend of mine was diagnosed with Chrohn's disease a few years ago, and after just 2-3 years of treatment (test, medicine, procedures, and yes, a few emergency room trips) she was already nearing her lifetime cap. All this well before the age of 30, with a chronic, incurable medical condition.

    Thanks to the Affordable Care Act, she won't be $hit out of luck in just a few years. If not for the new restrictions, what do you propose she should have done (or will have to do if Obamacare gets overturned), those of you who so believe in the free market's ability to regulate health care?


    2 members found this post helpful.

  20. #220
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    Quote Originally Posted by prairiewind2 View Post
    The OP didn't fall through the cracks with her choice not to get health insurance. She chose not to get it. She's already said that she uses a smart phone because it costs "only" $29 a month more than a regular cell. That tells me that she doesn't recognize wishes from needs, and that there are likely other places she could cut - if she really wanted to get insurance.

    There are definitely people who can't afford insurance, in spite of their very best efforts. For them, I have the deepest sympathy.


    Liz, heartless beyatch

    Do you see the OP's monthly budget here? How do you determine she fits in first category and not the second?

    If the best plan available for the OP, as she mentioned, is $250/ a month with a 3K deductible, where should she cut the other $221 from? Food? Rent? Gas to get to work? Emergency fund? Op already said she doesn't eat out and budgets carefully.

    Even then, she would need to save up an additional $3K just to meet that deductible before she would be given any treatment anyway - she would be in the same spot she's already in.

    I certainly hope if anything should happen to you, others would treat you with a little more empathy and a little less judgement than you show here.

    For those asking where our American sense of community is - it's right next to our sense of empathy for others - kicked to the curb to make way for greed and selfishness.
    It's not having what you want, it's wanting what you've got.

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