We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
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Saturday, January 5. 2013
The Mrs. recently reported a conversation she had had with a tennis friend who had a rotator cuff repair, and had prematurely discontinued her physical therapy because the insurance coverage cut off after the predetermined number of sessions for that surgery.
This friend of hers drives a new Mercedes every year, owns three houses in various vacation spots, and spends three months/year traveling around the world. However, the notion of actually paying (pocket change) for her own physical well-being eluded her imagination. And her shoulder still hurts.
People have been well-trained to expect to get what they need "for free." And somehow have been trained to imagine that, if insurance doesn't cover it, it must not matter very much. A childlike, entitlement culture.
Who wants a statistician for a doctor?
As I have mentioned before, I have inexpensive major medical insurance with a $10,000 two-year deductible for my family. (Some other Maggie's folks have similar.) After that, it's unlimited. If anybody (God forbid) gets very ill or injured, I will keep my humble abode.
When I see a doctor, I enjoy the look of surprise on the faces of the office staff when I pull out my checkbook. I like to pay doctors. What better use of money is there (other than buying cigars)?
A word to the wise: If you tell them you are paying out of pocket, most docs will give you a discount because it's no staff time, it's instant payment, and because it just seems right to pay for a service - same as an electrician or plumber or lawyer.
If you are on Medicare or Medicaid, or if some insurance pays your bills, what do you do personally for your doctor to let him or her know that you appreciate their care for you?
PS: My Internist tells me that a couple of wines and two or three cigars daily is just about right for a guy like me. Like most Americans of my middle age, I take Lipitor and BP meds, and I always take care to use extra salt. The occasional Viagra? I'm not saying. He is a good, sane, practical doc who individualizes things, and thinks it's narcissistic for people to obsess about their health. "Get the most out of life, while you have it" is his motto. "You can't save life for later because 'later' is just a theory."
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One of my pet peeves, Barrister. People don't blink at regularly handing out ridiculous amounts of money for their hair treatments, manicures, pedicures, Lexus or Acura rather than Toyota or Honda, gourmet everything, will scream bloody murder over the notion of handing a doctor more than $30 or their own cash.
The logic of it escapes me. But then, I never was very bright and I'm getting dimmer with each passing year.
I like your doctor, Barrister. He sounds like our doctor, who tells my 85 year old husband that if he loves his bacon and eggs, and eats them multiple times a week, it seems to be working just fine for him. Dr. Lent has a nice, "gather ye rosebuds" approach to doctoring, which is not careless, but rather fully aware that high cholesterol works just fine for some people who live to a great age, and not so well for others.
Downs' mother lived to be 98, by the way, and told Downs a month before she died that she'd like ten more years.
Not a problem if the patients want to continue exercises on their own.
A few years back I suffered from torn labrum and bicep on left side. Left the arm/shoulder so weak that I couldn't raise my hand enough to signal a right turn while riding a motorcycle.
Went to my VA provider in Chico, was referred to a surgeon at VA hospital at Mather. She told me that MRI and X-rays indicated surgery would repair the damage but I wouldn't have the full range of motion after the operation. If I wanted to try physical therapy first I could do that. I figured that I'd end up doin' the PT after they sliced on me anyway, I'd give exercise a try. Went to the VA Physical Therapist (another 200 mile round trip) and was shown necessary exercises and told I only needed to come in 3 times a week. When I let her know that I'd rather pass on making the drive and would rather not miss 3 of my 6 work days, she told me I could try exercising on my own and gave me the necessary rubber tubing with increasing degrees of resistance. I went back once to let her see that I was slowly progressing, then kept at it at home.
After 10 months, I was back in the same shape as before the injury, in fact I just tested it and can lift my left arm, reach over my head, and scratch my right shoulder.
Was it easy? No. Did I slack off a few times? Yes. If I hadn't followed through I wouldn't have been able to blame the doctors for not fixin' me, only myself.
Granted, the VA billed my insurance for the visits, but I didn't go unnecessarily, didn't use sick leave and avoided subjecting my body to surgery. I'd say we all won.
My father, a retired surgeon, talks about how people routinely avoid having to "pay" for health care or insurance. He, personally, has a very high deductible insurance policy which allows him to incur substantial expense in event of catastrophic or chronic problems, but limits his actual out of pocket, thus keeping himself from bankruptcy.
He does this along with a MSA, which he started while he was still working. The MSA, as a result, more than covers his deductibles...and is growing (unlike flex spending, which I think is an unreasonable solution to a very big problem, and Obamacare has completely ruined the basic raison d'etre for flex spending anyway).
He was the first to say to me, when I lost my job "drop COBRA - you can find less expensive insurance available, anything basic will do for you at this age" and indeed I found something similar for $500 less per month.
He also said, when I was young and felt the $150 a month extra I'd be paid by NOT having insurance was "worth it" - "Don't do that. You'll suddenly find yourself in the hospital with no means of payment." Sure enough, I blew out my knee and I had THANKFULLY TAKEN HIS ADVICE. I paid $500 and was set. Overall, the extra $150 a month would have wound up costing me far more than I'd have made!
We are very poorly informed about health care. We are very poorly informed about what our options are. The politicians like things this way, because (no offense, barrister), they are lawyers and I have long noticed deep seated antagonism between lawyers and doctors.
Not all, mind you. But many and most. Politicians being those with the worst impression of how doctors work...insane jealousy and dislike for their ethic.
Are you saying that if you pay your own health insurance premimum you are not paying your doctor?
Won't you folks who have high deductible health insurance plans be breaking the law in a few years or rather won't you be wishing you could break the law (if nothing changes)?
I tell you, you have to love living in the land of the FREE and the home of the brave in this brave new world!
Define "a couple of wines"....we talking bottles? I like your doc.
My doctor said she would write me an RX for massage or acupuncture. I told her that I didn't think insurance should cover such items and I would pay myself.
When I was in grad school, I knew plenty of students who had cable TV but no health insurance. Ticked me off, because I paid my insurance bill first, then the rent and food.
So Barrister, does yall call her when the Viagra is long last or have yall to pay her with cigars?
Before the Israeli health system was reformed, some elderly folks treated the clinic as a social club - show up, kvetch and complain, get an aspirin.
Minimum out-of-pocket charges for visits and medication ended that - saving millions if not billions.
This is in reply to I like to pay doctors. Can you post the name of your insurer? I've been looking at high deductible plans and among other things, have read that the health care "reform" law has taken them off the table.
I have a big deductible as well, though not as big as The B.
However, I am self-employed and resist going to the doctor. I don't like spending money on myself plus I don't want anything diagnosed that would result in a pre-existing condition. That would likely send my insurance rates through the roof and make it completely unaffordable.
I hope the blood on the toilet paper ends by itself...
Glad your doc has a means of calculating charges for service. Tried to pay a specialist after service and the price was double the negotiated rate from my High Deductible carrier (BCBS for those looking for one). bottom line we need more transparency for costs for the ill informed like the woman with fancy cars and homes and those riding the bus
My doctor here in CA charges $50 cash for an office visit. You can hardly get your oil changed on your car for less out here. High deductible is the way to go.