Health Insurance rant

[auschr]

so I don't have any blogs or any friends so i'll just rant here. I am an expat living in USA and one of the most frustrating things to deal with are the insurance people here.

My son developed a flat spot in the back of his head probably because he always slept on his back and he requires headgear to fix his head shape or he forever has a misshaped head, and in later life could develop into spinal problems, and a whole host of issues.

So anyways, last week, we go to his 4month check up, he gets a few shots, get told he is skinny (he has reflux too,spit up galore) but still at a good weight and hes taller than most babies. and the baby doctor told us that he needs to go to these people who deal with babies with flat spots on their heads.

so past friday i take off work, girlfriend takes off part of the day, drive about 3 hours to this place, they were nice, get some photos taken of his head and told of the treatment and they said they would contact his insurance to work something out. thanks to modern america i can't add my girlfriend or son to my insurance until i have 2 years of coverage for myself so my son is on state insurance, medicaid or w/e it is called and they won't cover the headgear he needs.

we write an appeal and they reject it. not something they cover. im told i can appeal two more times but what is the point? i have to cough up 4 grand which I don't have, well they offer payment plans, and since his case is severe he might require a second piece of headgear, so tot it up to $8k. Ridiculous. I'm fuming and so is my girlfriend. Times like these I really wish I lived back in broken Britain.

I'm pretty sure this flat head stuff is a new thing because none of the older people i talked to it have heard about it, it probably has to do with having kids sleep on their backs and not on their stomachs anymore. but whatever. we will just figure out how to pay for this, kind of makes sense when they talk about how so many americans are in debt, the vast majority are indebted to health insurance.

I could rant another 5 pages on health insurances and how difficult they are but whatever..

here is the little man

rant over

 

[deletebeepbeepbeep]

I've nothing useful to say but cute kid abd I hope it all works out

 

[auschr]

thanks we will be fine, i have a decent stash of money saved for when i was planning on taking us 3 to a falmer game next year, will just cancel that and get the headgear.

 

[Lyndhurst 14]

You have my sympathy mate - it’s one of the disadvantages of living in the States. The whole healthcare system in the States is a complete joke and it makes you realise how good the NHS is despite its problems. The insurance companies pretty much run the show and their whole purpose seems to be to deny or minimize legitimate claims. Everything seems to be a battle – you have to keep complaining until they cough up. The whole business of co-pay and in and out of network doctors and specialists is a real pain. I had a relatively minor ankle injury playing 5 a side – I went to the ER and they X rayed and said it looked like a hairline fracture and should be OK with some rest, but he still referred me to another orthopedic specialist. The specialist said an MRI scan should be done in case of any underling problems – nothing was found and the specialist, who was a Kiwi, pretty much admitted that because everyone is terrified of being sued they carry out a whole load of scans, tests etc. which are completely unnecessary to keep the insurance companies happy. My insurance covered most of it but I still ended up paying about a grand in out of pocket costs – absolute bloody joke and despite what Obama is trying to do I don’t see it changing as there are too many vested interests.

Don’t even mention dental insurance………..

Anyways – hope things work out OK for you and the little man.

 

[auschr]

You have my sympathy mate - it’s one of the disadvantages of living in the States. The whole healthcare system in the States is a complete joke and it makes you realise how good the NHS is despite its problems. The insurance companies pretty much run the show and their whole purpose seems to be to deny or minimize legitimate claims. Everything seems to be a battle – you have to keep complaining until they cough up. The whole business of co-pay and in and out of network doctors and specialists is a real pain. I had a relatively minor ankle injury playing 5 a side – I went to the ER and they X rayed and said it looked like a hairline fracture and should be OK with some rest, but he still referred me to another orthopedic specialist. The specialist said an MRI scan should be done in case of any underling problems – nothing was found and the specialist, who was a Kiwi, pretty much admitted that because everyone is terrified of being sued they carry out a whole load of scans, tests etc. which are completely unnecessary to keep the insurance companies happy. My insurance covered most of it but I still ended up paying about a grand in out of pocket costs – absolute bloody joke and despite what Obama is trying to do I don’t see it changing as there are too many vested interests.

Don’t even mention dental insurance………..

Anyways – hope things work out OK for you and the little man.

yikes a grand for that. i agree about obama, too many people making money from the current system. i mean they had old people convincced of death panels.. only in america would any sucker believe something as ludcaris as that.

my son was born in California and on my Californian insurance called kaiser, they were the best insurance company ive had in the usa. everything was covered, pregnancy, check ups, the babies, all ob/gyn was free, no co pay!! prescriptions were really cheap.

moved to dallas because its much cheaper [to live] but the insurances out here are awful. My girlfriend handles the medicaid stuff, she has to renew his paperwork every month and only give you 5 days to return it or he gets instantly cut off. id like to add him to my insurance but i can't. and the public transportation around here is nonexistent or the parts that do exist completely inefficient. haha.

 

[RexCathedra]

The idiots with whom I share my republic seem to think that there's some enormous loss of Freeeeeeeeeedom in any system besides what we've got, and whatever we're spending in premiums, and not seeing in actual health care, goes to pay for that sweet, sweet Freeeeeeeeeedom. That, and Canadians all drag themselves through the mean and empty streets of, say, Monckton, all initiative destroyed, all free will gone, like zombies after brains, because they don't have a privately held company skimming off 30% of whatever passes through the system.

NHS always made sense to me. It's how every country in the world does defense -- and defense is supposed to be the one thing you don't dick around with. The Department of the Navy doesn't lease aircraft carriers on a turnkey basis on annual contract with Northrop/Grumman -- at least not yet. It owns them. It staffs them with naval personnel. And then it goes and blows shit up. Health care could be done that way, I guess.

(Freeeeeeeeedom is a registered trademark of the Republican National Committee. All rights reserved. Used with permission)

 

[Kalimantan Gull]

Will the new healthcare law help you when it comes in? Admittedly half-arsed, but I remember hearing you could now buy insurance across state lines and it might reduce the coverage limits for your son. Plus when he does get insurance they can't exclude it as a 'pre-existing condition'?

 

[adrian29uk]

I suppose having to pay for car parking is not an issue after what you have just told us. That stinks having to get health insurance. We need to protect the NHS, because I could see the same thing happening in this country one day if this goverment does not start saving money. I hope everything works out for you.

My wifes nan has been in hospital over in France for the last 2 months. Apparently the health care has been fantastic, and its not first time I have heard is.

 

[withdeanwombat]

I lived in Australia when they first introduced the Medibank system.You paid the docs bill,got a receipt,sent it to the Medibank office and got a cheque back to cover your costs.Sounds good.I was ill.Went to a doctor who set a timer clock on the table.It went for a couple of minutes and dinged,was reset,etc.I was billed by the second.He told me I was either diabetic or had TB.It's an exact science.He sent me to a colleague who was an expert in diabetes(ding) who asked for a urine sample.After the bucket overflowed you'd think maybe there was a clue(ding),but I did have pains in my leg,but then I had had a double fracture courtesy of Patcham Athletic,but obviously another specialist had to investigate(ding,ding).Eventually I got recalled to the first doctor (ding,ding)who sent me to the hospital(dingfree,not in the system)where a half minute urine test showed that I was diabetic.Course,I got refunds for the dings,but I was just doing the circuit to boost private medicines coffers.

Oh,and I'm still diabetic.

Hope things go well for you all,but I loathe health insurance schemes which put health behind profit.

 

[Finch]

I am completely biased, but people in New Zealand do not appreciate what an amazing system we have over here. Everything including workers compensation (for both work and non work related injuries), medical bills, surgery, home help, travel for treatment, counselling for sexual abuse, compensation for survivors of accidental deaths. All covered under a very efficient scheme, run by a state owned enterprise (i.e. not for profit).

The system never receives good press. No journalist is interested in a system working as it should.

Sorry to hear you had a bad experience in the States however, I would not want to have to deal with their system at all.

Edit: I missed an important part of our system. You cannot sue someone in New Zealand over an injury, its a no fault scheme, we simply look after you. Its very important in avoiding all of the jumping through hoops to cover your ass when its not needed.