Thu
Feb 14 2008
11:00:am
By: Dumping Ground  shortURL

This from another thread yesterday; (link...)

So I am working to pay health services for people making more money than me when I cannot afford insurance for myself?

I felt strongly Ms. Blevins's question needs its own thread. Yesterday, I asked government officials to chime in to see if sense could made of this situation, but at this point, I'm willing to hear anyone try to explain it.

regarding PPOs

Allow me to add one more bit to this whole equation and its effect on the uninsured / under insured.

The county, like many employers, uses a 'network of providers' which means those providers charge the Plan ( county ) less for those services. This means a person who is insured and uses a preferred provider gets the discount rate and those without insurance pay more. Just how much more?

Here are a couple of examples I am pulling from our family EOBs these past few years. Keep in mind we don't have BC insurance, but do have the PPO option via a major insurance carrier.

The Provider Bill is what those without insurance or not on the PPO plan are charged. The Discount Rate is the amount the Providers accept as full payment from my insurance company for those same services.

In other words, on the left is AB's price and the right my price.

Provider Bill Discount Rate
$1,684.53 $777.30
$ 229.98 $ 57.26
$ 540.00 $145.49
$4,923.00 $636.30
$1,287.00 $473.96

I have always felt that just because we are privileged enough to have insurance we get a discount while those without get screwed with what almost seems to be part of my bill.

Just a note, at many medical

Just a note, at many medical facilities, if you don't have insurance and do pay cash (credit card, etc.) they do give a discount, some times substantial.

Yes there are discounts or

Yes there are discounts or reductions of costs for uninsured. After a gall bladder removal in 2006 I recieved a hospital bill for $36,000. It was reduced to $18,000. I am paying on this monthly. To me that's alot of money. I have never purchased anything worth $18,000 in my life and never cared to.
We, as a nation need to really look at universal coverage for all Americans. Why we are on the subject what about the costs of medical care?? The $18,000 dollar hospital bill was topped off with bills from various doctors and x-ray clinics.
I laughed when I asked the worker at BMH how much they wanted amonth for the rest of my life... It's laugh or cry in this situation and I prefer to laugh.....

Injustice anywhere is a threat to justice everywhere.
Martin Luther King, Jr.

You probably already know

You probably already know about this, but check out CoverTN to see if you can qualify:

(link...)

Hospital bill

Health care costs are high. Did you ask for an itemized bill from your surgery? Most of these high costs are from the hospital side. My child was in the newborn intensive care after birth and had a pacifier that the hospital charged $13.00! Those of us who pay our bills have to pay for those who don't. So many people do not pay their medical bills because no one is going to repossess anything. I am sorry for your large hospital bill, but I commend you for being person enough to pay your bills.

I have to pay.. the last

I have to pay.. the last thing I want is to end up in Judge Young's court for not paying!! LMAO
Oh now wait a minute.. I'm local, white, Baptist.. I could do well in that court, but I am a woman and there was that Calixto business..

Injustice anywhere is a threat to justice everywhere.
Martin Luther King, Jr.

You're not going to like the answer.....

So I am working to pay health services for people making more money than me when I cannot afford insurance for myself?

Yes...

Blount County's program is a good self insured program. Long before the clinic was opened it was planned to cover everyone who is covered by the insurance program whether employee, dependent, or retiree. The one catch is they must be covered by Blount County's program.

It should be noted:

All employees unless they opt out of the program are covered by the Blount County Insurance program, this is cases where their spouses maybe covered by another program where they could be dependents. All dependents and all retirees are not covered by the program. There is a cost to the employee for dependents, and retirees would depend on other contractual agreements.

Blount County's program is a

Blount County's program is a good self insured program

For those that get it, apparently not for those who are paying for it.

it goes to the larger picture

That is simply that health care should not be a privilege, but a right enjoyed by all.

Question....

For those that get it, apparently not for those who are paying for it.

Are you saying that Blount County should not provide insurance to their employees?

If so, should it simply be taken away?

Should they be compensated through their pay structure when it is taken away?

What benefits should BCG provide to its employees?

Just curious...Thanks!

I don't think supplementing

I don't think supplementing government insurance with a government run clinic for government employees is decent in face of individuals in the private sector having neither while paying for both.

The key word is decent. I know it's legal, I know it will done - but it just feels unseemly.

Should they be compensated through their pay structure when it is taken away?

Yes.

What benefits should BCG provide to its employees?

An good to better wage based on performance.

Our government is for all us. If government is going to be in the business of providing healthcare, do you think it's right to be selective?

Thanks ...

Thanks for the clarification.

From the previous thread....

I am ok with government employees having benefits. We must have these things so that we can maintain quality people working for us in government jobs. I have no problem with that.
As many must do, government workers should pay their part in their own health care.
There should not be insurance and also a public funded free clinic payed for by citizens for only government workers. There should be insurance for government workers and also health care for uninsured workers.

Injustice anywhere is a threat to justice everywhere.
Martin Luther King, Jr.

I don't see anything wrong with it

In fact, having a clinic for employees goes along with the whole self- insured concept of coverage. This can also be called 'we can do it better than any old insurance company can!"

Few notes- only about one third of all group insurance in the US is in self insured policies.

(link...)

Q. Why do employers self fund their health plans?

The employer maintains control over the health plan reserves, enabling maximization of interest income - income that would be otherwise generated by an insurance carrier through the investment of premium dollars.

The employer is not subject to conflicting state health insurance regulations/benefit mandates, as self-insured health plans are regulated under federal law (ERISA).

use of government clinic

Commissioner Walker says that only those family members of employees who are covered by Blount County insurance can use the clinic. I am aware of someone who has used the clinic, but has insurance other than Blount County. The individual has a family member who works for the county. How is this issue monitored? Are they supposed to show their insurance card? Just how many people use this clinic? How much money does the government pay the hospital? Is the contract monthly based on number of people who use the clinic or is there a yearly contract? Mayor Cunningham wants transparency, so this is your chance to let everyone know just how much money is going to the hospital. Now that there is another nurse practitioner, is the hospital wanting more money?

Ask the beneficiaries

I think the question Alice posed may be a good question for our local reporters to ask Blount Clounty employee's. How do they feel about getting their health services paid for by people who can't afford insurance? We can't continue avoiding this issue as if it's not a problem.

The real problem is that

The real problem is that this country, unlike all other major industrialized countries, does not have universal healthcare. Everybody ought to have access to good health care. I hope this "progressive" blog does not deteriorate to a place where we discuss who should not have healthcare. As long as we rely on "the market" and insurance and drug companies, we will be pointing fingers at each other and not noticing the bigger picture.

The answer is simple ...

... Socialize Medicine & Healthcare. Ooooh, I said a dirty word--Socialized.

viva Evo Morales

A dirty word

..but I agree with you. That we see bottles and boxes in convenience stores with "Please help Billy's mom pay for his life or death operation" is a disgrace to the richest country on the earth.
I have told my children not to sign anything if I become gravely ill so they will not be held responsable for debts I may incur. I have told them to cremate my remains as now we must have insurance to be buried or pay out the ying yang for that.. Insanity!!!

Injustice anywhere is a threat to justice everywhere.
Martin Luther King, Jr.

The simpler answer is HR676,

The simpler answer is HR676, which is NOT socialized medicine or health care, but instead is single-payer universal health insurance based on Medicare.

All the systems are in place, it works, and all it would take is a vote in Congress and the stroke of a pen by a President who won't veto it.

on seeing children at the clinic

The other aspect of this original thread was the fact that children over 6 will be seen there since they are hiring another nurse. That issue still needs more discussion.

Clinic seeing kids

In the blog news, there is an article about a young girl from Nashville who died from meningitis just this week. If the clinic doesn't give shots and kids don't go to their peds because peds can't give free care, how many kids are going to be at risk? Is the clinic seeing people at night when the doctors offices are closed? Is the clinic praticitoner going to be available for the kids after they are seen at the clinic or will the child have to go to the ER because no one is available? That doesn't seem like a way to save money.

Why would a county employee go to the clinic instead

Why would a county employee go to the clinic instead of going to their regular doctor? It is only because they don't have a co-pay with a county clinic visit?

One word: "FREE"

One word: "FREE"

Socialized Medicine has arrived....

SeeJaneRide
...ushered in by the GOB network in Blount County. Oh, but it's only available to a select few. Is this classic? The power brokers created another perk for themselves!

And, to top it off, it will now expose the county to a huge legal risk. Give just one child a bad diagnosis at that clinic, and mom and dad will head straight to an attorney. Any guesses who would pay for a legal settlement? The power brokers who created the perk? No, YOU get to pay for it!

Smarter heads would advise telling employees to take their children to a trained pediatrician like the rest of us. Our county employees have better insurance than many people in Blount. Remember, YOU pay for their insurance. And, that insurance will cover those office visits. Even with a deductible, it's well worth the price of admission.

deterrence

What is the major number one deterrent to People in this country, from going out and starting a business of their own, on their own?

Healthcare

For if Healthcare were free, then folks would be more encouraged to become entrepreneurs, and this would threaten Mega-Corporations' strangleholds on our wallets. Time is drawing neigh on Corporate Prostitution, and they KNOW it. When President Obama swears in, there will be one Heck-Of-A Long Drawn-Out Battle, for K-Street will stop at nothing, to ensure their indentured servants stay shackled to the current system.

viva Evo Morales

what sends

What sends farm wives to work in the city? Health care!

What sends farmers to work in correctional facilities? Health care!

Healthcare costs

For some backgroud and stuff you probably already know: After World War II, enticing workers meant providing benefits along with pay. With medical discoveries, health care costs increased. It costs over $700 million dollars to do research on a drug and start selling it. As a nation, we don't exactly take care of ourselves which increases healthcare costs. We also live longer, so that costs more. Premature babies are saved and stay in the hospital for months. For every car produced in the US, $1800 goes toward healthcare. One way to decrease costs, would be to stop Tenncare on people who have insurance. Companies are trying to make people healthier by helping them stop smoking and lose weight. Many people think this is taking away rights, but it really is a move to make them healthier. There is no easy answer, but duplicating services does not seem cost effective. A free clinic for insured people or Tenncare for people who have good insurance costs tax payers money. Teach people when to go to the Emergency Room. It is so expensive to go to the Emergency Room. What keeps people from seeing their own doctors? Many people fear taking time off work to see the doctor. That is too bad, but at least there are after hours clinics in the county. After hours clinics are less expensive than the emergency room. The emergency room won't turn anyone away, but it might help if they tell people that the problem they have can be seen by their primary doctor. Volumes can be written on ways to solve the problem. Insurance companies do make money, though. Insurance companies usually are housed in beautiful buildings. The guy who is in charge of United Healtcare made a HUGE amount of money in salary and bonuses. Does anyone really need that much money? Many employers can't afford to pay health insurance costs. So where does that leave the employee? Sometimes, it may be less expensive to just pay as you go if you are healthy. The problem is that if something bad happens, the cost is outrageous. Something will have to give at some point. Socialized medicine is not really the answer. In countries with socialized medicine, there are long waits to get anything done. People from Canada go to the US to get medical care because they can't wait. I don't see the general population accepting not being able to get healthcare. I realize that those without insurance have to wait now, but it won't fly when it hits widespread. Maybe Blount Views can solve the problem! Brainstorming helps!

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