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Re: Amy - Cost of Medical in the US - My Story - VERY LONG!From: tanya (anonymous@obgyn.net)Thu Jan 30 22:13:40 2003
At Wed, 19 May 1999, yenta wrote: > >China Rose, >In my dreams -- I wish my insurance premium were $160 a month -- that is >why I need to get my endo under control for at least 2-5 yrs in the >future -- no new insurance will cover the endo for at least that period >of time - "pre-existing condition":0( >Amy, >Insurance, especially individual insurance , is very expensive and they >hike it every 6 months! >Amy, the bottom line is, it sucks! It truly is absolutely horrible that >people who are ill and in need of medical care are denied that care if >they don't have the money to pay for it. I think it is a heartless >system -- after all, medical treatment is or should be considered a >"necessity", not a luxury -- and yet, it is only those who can afford to >seek out the medical assistance required, who get the necessary >treatment. >As you said, in Canada, although I'm sure your system also must have its >problems, at least you are permitted to get treatment from a specialist. >In America, (and I do love my country but I hate this part of it), only >those who have the insurance or the cash can gain access to the >specialists necessary for quality medical treatment. >I can only imagine how miserable it must be for someone with a severe >medical ailment who is suffering with chronic pain, to be left to the >mercy of those less qualified. >I've heard of so many endo sisters who have been misdiagnosed or who >have been subjected to "poor surgical expertise" who have ended up worse >as a result. >You see, even with medical insurance and money, many of our drs are not >of the caliber they should be and yet they are more than willing to >"treat" you (I'm trying to be subtle here because I don't want to get >into trouble with the forum). I've learned this from my own experience >as well as from the experience of others. >I had a lap a couple of years ago in which my gyn literally misdiagnosed >me with PID rather than Endo. My complaints/symptoms were dismissed -- >he had already decided on my diagnosis. Had he diagnosed me correctly, >my endo could have been caught before its rapid progression to Stage 3. >Instead, my endo flared out of control and rapidly progressed, engulfing >my sacral/back region, etc.. I was living a life of PAIN and misery -- >a living Hell. On one of the particularly bad endo "attacks", I went to >him, groveling in pain, begging for help. He suggested a laparotomy in >which he would cut and shorten the ligaments to suspend the uterus, cut >the nerve bundles and the presacral nerve, lyse any adhesions, and guess >what -- I would have still have had endo! I didn't understand how his >recommended surgery would keep the pain from recurring and asked him >about possible causes of the inflammation I was experiencing, about >"interceed" since he contended it was the adhesions and chronic PID >responsible for my pain, etc. @Three days after that appt, I received >from him a "Dear John" letter! Had I not had the good fortune to speak >with a specialist, Dr. R, on the phone who accurately dx'd me via >telephone!!! and sent me to a local specialist, Dr. J, to have my last >lap, G-d only knows where I would be now. >I still have sacral pain and my specialist has suggested additional >treatment to check out possible bowel endo:0(. >Endo is truly a nasty disease, one that requires a specialist. >I'm more than happy to share names but only through personal email -- I >don't want the forum to get upset -- although I really feel it is in our >best interest to know which drs are "good" and which are "bad" -- I hope >the forum agrees and understands. > >Very long, I know, >Yen > >At Tue, 18 May 1999, ChinaRose wrote: >> >>--=====================_78678160==_.ALT >>Content-Type: text/plain; charset="us-ascii" >> >>Hello Amy, >> >>Yes, you are very fortunate and I'm glad you are! :o) I hope that >>you get great care. >> >>I will give you my take (My opinion & experience ONLY!) >> >>The US is very capitalistic and doctors that are under HMO/PPO >>or some kinda of health plan, do not make much money unless >>they schedule enough patients for the day to earn the fee's the >>Health Plan deems is resonable. So doctors schedule alot of >>patients, therefore no one really gets the time needed with the >>doctor for the doctor to consider all the ailments of one patient. >>Unless of course, a patient is paying out of his/her own pocket. >>Now if you go out of network, the plan will only pay a percentage >>of what they deem is a resonable fee, for example; my second >>surgery the surgeon cost $3,500 (just the surgeon) the Health >>Plan said $368 was a resonable fee and they only pay 70% of the >>$368. >> >>Well, after being so mistreated by the Health Plan system of >>America, I had to go out of pocket or I would've ended up on >>welfare. Needless to say, I'm in debt. 1-surgery under medical >>plan and 3 surgeries out of network. As long as I make some kind >>of payment ($20 a month to each hospital, surgeon, lab, etc.) every >>month, they cannot turn it over to collections and there is no >>interest charge (well not yet anyways). >> >>Insurance can cost anywhere from $60 - $160 a month for single >>women between the age 21-30. Or some business will pay for 100% >>of medical benefit. And then one has to consider too, some plans >>if you're new and have had pre-existing conditions, will not accept you >>at all. It's all a scam!! Only the heatlh insurance and lawyers make >>money out here!! While we suffer. Oh, here in Los Angeles, CA, >>it's the plastic surgeons that make money.... LOL (please excuse the >>sarcasim), gotta laugh otherwise I'll cry. >> >>In some instances, I have written letters to the labs, hospitals, surgeons, >>doctors..etc. to plead my financial plight and some have actually either >>taken a percentage off or written the bill off. I have had one doctor also >>make arrangements with the hospital to accept whatever payment the >>Plan pays as payment in full. I still owe $ XX,XXX in medical debt. >> >>If I could do it all over again, I would have gone to seen Dr. Redwine the >>first time around, I think I would have saved myself ALLOT of money, >>frustration and my health may be better, as some of the treatment feels >>as it's taken some years off my life, not to mention the quality of life is not >>as full as it use to be... perhaps in time. >> >>Anyhow, this has been my experience in the last several years. $$ denotes >>your quality of care here. I hope this answers some of your questions. Again, >>this is only my experience and opinion. >> >>Hope you are welll. >> >>Peace, Love and Light >>~ ChinaRose >> >>Educate yourself. Endometriosis Awareness: >>http://members.xoom.com/China_Rose/endohome.htm >>My personal experience with Endometriosis: >>http://members.xoom.com/China_Rose/endohome2.htm >> >>At 08:20 PM 5/18/99 , you wrote: >>>Hi ladies >>>I feel very fortunate that I live in Canada where I don't have to pay >>>for medical procedures, and I don't say that to be insensitive, but I >>>just wonder, how do you pay for all this stuff??!! If just baffles me, >>>honestly, and I mean that sincerely. That's a LOT of money!!!! Sorry >>>for being so dense, but HOW? Do you like have to pay over years, do >>>they charge interest too? I just think that is sooooo awful that you >>>have to pay for this stuff!!! How much do you pay for insurance, and >>>does that cover all the expenses of surgery? Hope you don't mind all my >>>questions. Can someone enlighten me? please and thks >>>luv, Amy >> >>--=====================_78678160==_.ALT >>Content-Type: text/html; charset="us-ascii" >> >>Hello Amy, >> >>Yes, you are very fortunate and I'm glad you are! :o) I hope >>that >>you get great care. >> >>I will give you my take (My opinion & experience ONLY!) >> >>The US is very capitalistic and doctors that are under HMO/PPO >>or some kinda of health plan, do not make much money unless >>they schedule enough patients for the day to earn the fee's the >>Health Plan deems is resonable. So doctors schedule alot of >>patients, therefore no one really gets the time needed with the >>doctor for the doctor to consider all the ailments of one patient. >>Unless of course, a patient is paying out of his/her own pocket. >>Now if you go out of network, the plan will only pay a percentage >>of what they deem is a resonable fee, for example; my second >>surgery the surgeon cost $3,500 (just the surgeon) the Health >>Plan said $368 was a resonable fee and they only pay 70% of the >>$368. >> >>Well, after being so mistreated by the Health Plan system of >>America, I had to go out of pocket or I would've ended up on >>welfare. Needless to say, I'm in debt. 1-surgery under >>medical >>plan and 3 surgeries out of network. As long as I make some >>kind >>of payment ($20 a month to each hospital, surgeon, lab, etc.) every >>month, they cannot turn it over to collections and there is no >>interest charge (well not yet anyways). >> >>Insurance can cost anywhere from $60 - $160 a month for single >>women between the age 21-30. Or some business will pay for >>100% >>of medical benefit. And then one has to consider too, some >>plans >>if you're new and have had pre-existing conditions, will not accept >>you >>at all. It's all a scam!! Only the heatlh insurance and >>lawyers make >>money out here!! While we suffer. Oh, here in Los >>Angeles, CA, >>it's the plastic surgeons that make money.... LOL (please excuse >>the >>sarcasim), gotta laugh otherwise I'll cry. >> >>In some instances, I have written letters to the labs, hospitals, >>surgeons, >>doctors..etc. to plead my financial plight and some have actually >>either >>taken a percentage off or written the bill off. I have had one >>doctor also >>make arrangements with the hospital to accept whatever payment the >>Plan pays as payment in full. I still owe $ XX,XXX in medical >>debt. >> >>If I could do it all over again, I would have gone to seen Dr. Redwine >>the >>first time around, I think I would have saved myself ALLOT of money, >> >>frustration and my health may be better, as some of the treatment >>feels >>as it's taken some years off my life, not to mention the quality of life >>is not >>as full as it use to be... perhaps in time. >> >>Anyhow, this has been my experience in the last several years. $$ >>denotes >>your quality of care here. I hope this answers some of your >>questions. Again, >>this is only my experience and opinion. >> >>Hope you are welll. >> >>Peace, Love and Light >>~ ChinaRose >> >>Educate >>yourself. Endometriosis Awareness: >>http://members.xoom.com/China_Rose/endohome.htm >>My >>personal experience with Endometriosis: >>http://members.xoom.com/China_Rose/endohome2.htm >> >>At 08:20 PM 5/18/99 , you wrote: >>>Hi ladies >>>I feel very fortunate that I live in Canada where I don't have to >>pay >>>for medical procedures, and I don't say that to be insensitive, but >>I >>>just wonder, how do you pay for all this stuff??!! If just >>baffles me, >>>honestly, and I mean that sincerely. That's a LOT of >>money!!!! Sorry >>>for being so dense, but HOW? Do you like have to pay over >>years, do >>>they charge interest too? I just think that is sooooo awful >>that you i have dealt with my endometriosis for 2-3 years now and i am 22 years old i had my baby 3 months ago prior to this i have tried birth control and lupron and 2 surgeries to help control it now i just recently had a surgery scheduled on the 28th and my insurance company calls and says they refuse to cover it until i tried the birth control or lupron above again since i had my baby they think it is going to work this time i am so mad why should i have to go through the pain all over again and have to take something that i know is not going to work? my insurance comp is medical assistance badger care please give me some answers! thank you >>>have to pay for this stuff!!! How much do you pay for >>insurance, and >>>does that cover all the expenses of surgery? Hope you don't >>mind all my >>>questions. Can someone enlighten me? please and thks >>>luv, Amy >> >>--=====================_78678160==_.ALT--
-- tanya
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