I am curious as to whether people find the following normal, acceptable and such. Ever since I moved to the US, I have been going to a physician here. I don't have anything abnormal going on with me (thankfully), but I try and go see the doctor to get an annual check up. The kind where the guy makes you fast and takes your blood and urine and what not. He then calls me up later on and tells me I will die by age 35 if I don't control the cholesterol, lose weight etc and I go on a health binge.
Well, I liked that doctor. He met my requirements: close to work, I didn't have to pay anything more than the co-pay (which was $15 I think) and he seemed competent, compassionate and decent. He also used fear to motivate me well. I work well when fear is the motivating factor. Now, my employer decided to change health care insurance providers as of 2009. I tried to book an appointment with the guy yesterday, mentioned my change in insurance and viola, was told that they don't accept my new insurance plan. So I am out of luck. I have to find a new physician. Or pay for the whole thing myself. The last time I went there, I asked for a bill to see what it might cost if I didn't have insurance. It was greater than $1000. That's not a typo.
I understand that the healthcare 'industry' in the US is a business, i.e. participants make money off it. I am not entirely sure human health and suffering are things to be profited by, but lets leave that aside. Perhaps that has to do with the exposure to universal healthcare as is the norm in Canada and enshrined in the laws of land under the Canada Health Act. At any rate, in the US, I pay for a healthcare plan via deductions from my pay cheque. My employers pays a percentage of that as well I believe. So, as far as I am concerned, I _am_ paying for healthcare, whether it is via an insurance policy through company A or company B. The same is true of my employer. What I don't get is why I am not allowed to see the physician I want to see. And its not like the new policy costs me any less. I understand healthcare networks and what not, but I think its rather unfortunate that should you change insurance providers, you have a good chance of losing your physician. Is that normal? I've only seen this doctor a few times in the past couple of years, but what if he was my physician for the past 15 years? I would hate to change providers just because my insurance changed.
Is that even fair? I realise fair really has no place in this discussion, since we are talking about profit-making but still I wonder. This is after all an insurance policy... the insuring agency hedges a wager against me that I will not use services that add up to be greater than my premiums (I imagine that is how they make a profit). So it is not in their interests to pay for whatever this physician demands of his services.
Another thing I wonder about in the US is whether there are standards for procedures. Your run of the mill visit to the doctor for a nagging cold, does that cost the same for all doctors? Or are some doctors charging a premium? Does anyone regulate that? The reason I ask is because I recently went to my dentist (thankfully, they are still covered by the new insurance), and I got a break down of my benefits from my insurance provider. They covered a bunch of things, but only to a point. So, if my dentist billed $100 for a procedure, the insurer said that normally only costs $50 and chose to cover just that much. I assume I will get a bill from my dentist asking me to cover the rest. You may guess my anticipated reaction to such a bill. I don't like it.
For background, let me tell you how it works in the 2 places I have lived in for a while. In Canada, I book an appointment with my physician. I might have to wait a couple of days to see him or her unless I am coughing up a lung; in which case, I would probably see him the same day. I go there, I verify my address (they seem to want to know if I still live at the same place) along with my phone number. If I've been there before, they already have my provincial healthcare information at hand. In British Columbia, it is called MSP. Every province has its own version of it (that's because healthcare is a provincial responsibility in Canada's federal structure; certain things like defence, foreign policy are federal responsibilities, certain others like education and healthcare are provincial (really, they are both) and others are both, like immigration and marriage laws) but they are all roughly equivalent. Almost everything is covered by it. This isn't your basic bandages and ointment healthcare; this is the only healthcare you get in Canada and Canadians are pretty pre-occupied about their health. You can even claim certain procedures under certain situations (say you feel you're a woman trapped in a man's body, assuming you're mentally sound, you can get all the nips and tucks paid for). Something similar happens for certain folks who might want breast augmentation I believe (but I can't find a source to corroborate that; I have heard that on the news before). Anyway, the point of all this is to say that I don't have to switch doctors there.
But what about the doctors? Well, I worked with a whole bunch of them for 4 years, so here's what happens. They submit their claims to MSP, get re-imbursed for their patients (when I was there, it was $27 per cough-and-cold type of patient visit) and that was that. Lab fees were covered, even prescriptions (there were some limits you had to hit first if you earned a certain amount; but that varies by province). Aside from a national pharamacare program (where all prescriptions are covered by the MSP types), Canada's healthcare system pretty much covers it all. Dental care and vision care were slightly different; in British Columbia, you had to pay dentists (though nothing like in DC) but again, if you were not earning a lot, MSP covered that. Parts of vision care were covered as well (though glasses weren't). At any rate, most Canadians who worked had secondary insurance paid for by the employer that covered other things like massage therapy, acupuncture, physio visits etc. Every one of these service providers made money, they just billed MSP or the secondary insurance provider. Its socialised medicine, I am sure that is a term that worries the few remaining Communist-fearing American populace, but I think the majority wouldn't flinch (too badly) when they heard that.
In India where I grew up, healthcare was a different thing. I don't remember ever hearing about health insurance. You went, you paid and you got care. You could go to really great hospitals like Appollo and get fantastic treatment (and pay a lot too) or you could go to your local hospital and get decent enough care. You could even venture into the government run socialised healthcare institutions, though I have no idea if they charge anything or if you'll get decent care (because I never needed to go there, thankfully). But again, no need to change your physician. I probably saw the same 3 or 4 doctors all my life there. And if I had questions, I have a few cousins who are doctors...
I am just curious about the whole healthcare experience in the US and people's take on it. I find it strange to give up my doctor and to move onto a new one because my insurance changed. Frankly, I think its a terrible idea. But, those are the rules we have to live by. But is that normal or acceptable? Do people change doctors when their insurance changes, or do they bite the bullet, pay the insurance and then pay the doctor potentially thousands of dollars of their income?
Well, I liked that doctor. He met my requirements: close to work, I didn't have to pay anything more than the co-pay (which was $15 I think) and he seemed competent, compassionate and decent. He also used fear to motivate me well. I work well when fear is the motivating factor. Now, my employer decided to change health care insurance providers as of 2009. I tried to book an appointment with the guy yesterday, mentioned my change in insurance and viola, was told that they don't accept my new insurance plan. So I am out of luck. I have to find a new physician. Or pay for the whole thing myself. The last time I went there, I asked for a bill to see what it might cost if I didn't have insurance. It was greater than $1000. That's not a typo.
I understand that the healthcare 'industry' in the US is a business, i.e. participants make money off it. I am not entirely sure human health and suffering are things to be profited by, but lets leave that aside. Perhaps that has to do with the exposure to universal healthcare as is the norm in Canada and enshrined in the laws of land under the Canada Health Act. At any rate, in the US, I pay for a healthcare plan via deductions from my pay cheque. My employers pays a percentage of that as well I believe. So, as far as I am concerned, I _am_ paying for healthcare, whether it is via an insurance policy through company A or company B. The same is true of my employer. What I don't get is why I am not allowed to see the physician I want to see. And its not like the new policy costs me any less. I understand healthcare networks and what not, but I think its rather unfortunate that should you change insurance providers, you have a good chance of losing your physician. Is that normal? I've only seen this doctor a few times in the past couple of years, but what if he was my physician for the past 15 years? I would hate to change providers just because my insurance changed.
Is that even fair? I realise fair really has no place in this discussion, since we are talking about profit-making but still I wonder. This is after all an insurance policy... the insuring agency hedges a wager against me that I will not use services that add up to be greater than my premiums (I imagine that is how they make a profit). So it is not in their interests to pay for whatever this physician demands of his services.
Another thing I wonder about in the US is whether there are standards for procedures. Your run of the mill visit to the doctor for a nagging cold, does that cost the same for all doctors? Or are some doctors charging a premium? Does anyone regulate that? The reason I ask is because I recently went to my dentist (thankfully, they are still covered by the new insurance), and I got a break down of my benefits from my insurance provider. They covered a bunch of things, but only to a point. So, if my dentist billed $100 for a procedure, the insurer said that normally only costs $50 and chose to cover just that much. I assume I will get a bill from my dentist asking me to cover the rest. You may guess my anticipated reaction to such a bill. I don't like it.
For background, let me tell you how it works in the 2 places I have lived in for a while. In Canada, I book an appointment with my physician. I might have to wait a couple of days to see him or her unless I am coughing up a lung; in which case, I would probably see him the same day. I go there, I verify my address (they seem to want to know if I still live at the same place) along with my phone number. If I've been there before, they already have my provincial healthcare information at hand. In British Columbia, it is called MSP. Every province has its own version of it (that's because healthcare is a provincial responsibility in Canada's federal structure; certain things like defence, foreign policy are federal responsibilities, certain others like education and healthcare are provincial (really, they are both) and others are both, like immigration and marriage laws) but they are all roughly equivalent. Almost everything is covered by it. This isn't your basic bandages and ointment healthcare; this is the only healthcare you get in Canada and Canadians are pretty pre-occupied about their health. You can even claim certain procedures under certain situations (say you feel you're a woman trapped in a man's body, assuming you're mentally sound, you can get all the nips and tucks paid for). Something similar happens for certain folks who might want breast augmentation I believe (but I can't find a source to corroborate that; I have heard that on the news before). Anyway, the point of all this is to say that I don't have to switch doctors there.
But what about the doctors? Well, I worked with a whole bunch of them for 4 years, so here's what happens. They submit their claims to MSP, get re-imbursed for their patients (when I was there, it was $27 per cough-and-cold type of patient visit) and that was that. Lab fees were covered, even prescriptions (there were some limits you had to hit first if you earned a certain amount; but that varies by province). Aside from a national pharamacare program (where all prescriptions are covered by the MSP types), Canada's healthcare system pretty much covers it all. Dental care and vision care were slightly different; in British Columbia, you had to pay dentists (though nothing like in DC) but again, if you were not earning a lot, MSP covered that. Parts of vision care were covered as well (though glasses weren't). At any rate, most Canadians who worked had secondary insurance paid for by the employer that covered other things like massage therapy, acupuncture, physio visits etc. Every one of these service providers made money, they just billed MSP or the secondary insurance provider. Its socialised medicine, I am sure that is a term that worries the few remaining Communist-fearing American populace, but I think the majority wouldn't flinch (too badly) when they heard that.
In India where I grew up, healthcare was a different thing. I don't remember ever hearing about health insurance. You went, you paid and you got care. You could go to really great hospitals like Appollo and get fantastic treatment (and pay a lot too) or you could go to your local hospital and get decent enough care. You could even venture into the government run socialised healthcare institutions, though I have no idea if they charge anything or if you'll get decent care (because I never needed to go there, thankfully). But again, no need to change your physician. I probably saw the same 3 or 4 doctors all my life there. And if I had questions, I have a few cousins who are doctors...
I am just curious about the whole healthcare experience in the US and people's take on it. I find it strange to give up my doctor and to move onto a new one because my insurance changed. Frankly, I think its a terrible idea. But, those are the rules we have to live by. But is that normal or acceptable? Do people change doctors when their insurance changes, or do they bite the bullet, pay the insurance and then pay the doctor potentially thousands of dollars of their income?
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