How to Reduce Health Care Costs
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Posted by Amorette Allison (+11757) 12 years ago
Anyone seen the front page of the August 8 Gazette? I assumed the ENORMOUS two story lobby, with the fancy floor and the walls of glass and the grand piano so dwarfed by the room it looked like a toy tucked in the corner was a posh new hotel.

It was the lobby to the Billings Clinic Cancer Center.

?!?!?!?!?!!?

HOW much was spent on that waste? No one needs a two story lobby with a grand piano to get quality medical care! I was APPALLED. Seriously. Want to reduce waste? Remind clinics and hospitals their job is to care for patients, not hire interior decorators and blow hundreds of thousands on a big fancy room unrelated to health care.

I wasn't a fan of the Billings Clinic before but they have managed to make me think even less of them. I didn't think they could drag my opinion any lower but they did.

STOP SPIRALING HEALTH CARE COSTS! SPEND LESS ON GRAND PIANOS!
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Posted by Donna Kingsley Coffeen (+398) 12 years ago
I agree with you on this sort of thing. In France, the hospitals were bare bones and very simple, but the care was good and it was inexpensive.
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Posted by Steve Craddock (+2743) 12 years ago
Excellent point. Grand pianos are for concert halls and Nordstrom's - grand entrances are - well, I can't really think where a grand entrance is really needed, but certainly the last place is a hospital or medical clinic.
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Posted by Kyle L. Varnell (+3745) 12 years ago
Isn't a calm soothing place also a part of patient care? Seems to me they were just trying to provide a nice environment to people with life-threatening cancer.

Do you expect they should have bare walls & steel bars for rooms?

but the care was good and it was inexpensive.

Donna, we've been down that "Pay now or pay later" shell game before. Should we revisit it yet again?

[This message has been edited by Kyle L. Varnell (8/8/2009)]
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Posted by Amorette Allison (+11757) 12 years ago
A calm soothing environment need not look like the lobby of an overpriced Vegas Hotel. You really have to see this place to believe it! Over the top barely begins to cover it.
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Posted by Bob L. (+5094) 12 years ago
Obama's "death panels" will kill a large swath of the population, thereby lowering health care costs.
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Posted by Rick Kuchynka (+4463) 12 years ago
One thing I'd say is don't make too many assumptions about how alot of that stuff gets paid for.

In many cases improvements like those are paid for by wealthy philantropists by private donation. I can't speak to this situation directly, but there are many people out there who make donations to hospitals for just this sort of thing.
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Posted by Donna Kingsley Coffeen (+398) 12 years ago
Donated or not, those in charge should have the sense to realize the impression they are making on their own clients. Over the top does not feel good to a person wondering if they can pay for the tests the doctor will advise.
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Posted by howdy (+4943) 12 years ago
Wonder how much Chemo the cost of that lobby would pay for?? Meanwhile thousands of Americans are slowly dying as they cannot afford to get chemo...Anyone who thinks that is ok is nuts IMO...and certainly not caring at all....As Americans, we are suppose to be famous as a caring and loving nation, what has happened to some of us??
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Posted by Rick Kuchynka (+4463) 12 years ago
So if a music-loving philanthropist donated a piano to the hospital, maybe because during a family member's recent hospitalization, they thought it would be a nice addition... you'd say the hospital should pawn it on ebay to pay for a few lab tests instead?

I'm pretty sure any donations would come to an end shortly after.
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Posted by howdy (+4943) 12 years ago
I am pretty sure that most people that donate would rather save a few lives instead of making the lobby prettier...Most people, that I know at least, want their donations to count for something...saving a life is certainly a lot more important than a piano...or using that money to hire more nurses etc. for someones care...
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Posted by Richard Bonine, Jr (+14950) 12 years ago
I am knowingly committing forum suicide here but... I think it is very ironic that the Miles City 501C3 crowd is up in arms over a grand piano in a hospital (which they have little idea how/who paid for) and yet they want to fix up a train depot that has been used as a pigeon rest are for the last 15 years.
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Posted by Kyle L. Varnell (+3745) 12 years ago
Let me ask you something Howdy, do you believe a persons own happiness and a general positive attitude contribute to their well-being?
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Posted by Rick Kuchynka (+4463) 12 years ago
Feel however you like about it Howdy, but the fact is that people donate all sorts of money earmarked for very specific things. It would be criminal to use it for other things.

Universities build swanky new facilities all the time, often with the help of alumni and benefactors. It's common for new facilities or 'wings' to be named after generous contributors. You can always ask 'couldn't that have been better spent on books or tuition?' But the decision belongs to the person donating the money, not the one looking the gift horse in the mouth.
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Posted by howdy (+4943) 12 years ago
I believe that good health generally depends on good genes (in my case at least)...I was born with a very debilitating illness thus no matter my state of mind I have to deal with it and I do...but I also believe that if it doesn't kill ya it will make ya stronger..thus by the end of my life I should be the female equivalent of Hercules...

[This message has been edited by howdy (8/8/2009)]
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Posted by Donna Kingsley Coffeen (+398) 12 years ago
I don't believe a fancy piano or a chandelier makes a person suffering from a brain tumor headache and nausea, makes them feel one bit better, particularly if they cannot pay for the chemo that could save their life. I think they probably find the whole thing at the least ironic, and at the worst, disgusting.
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Posted by Bart Freese (+926) 12 years ago
Mighty impressive and sure does look expensive.



Not sure how long this link will work.
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Posted by Kyle L. Varnell (+3745) 12 years ago
I don't believe a fancy piano or a chandelier makes a person suffering from a brain tumor headache and nausea, makes them feel one bit better

Why don't you ask somebody about that Donna?

I guess by your logic all those sports athletes that visit children in the hospital aren't worth sh*t either right?

[This message has been edited by Kyle L. Varnell (8/8/2009)]
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Posted by Steve Craddock (+2743) 12 years ago
I think Rick has brought up the specific issue of the piano because some very nice and generous people donated a beautiful and perfectly-in-tune baby grand to Holy Rosary not long ago, and one of the nurses there is a concert-quality pianist. The music she creates is definitely soothing and probably speeds healing - at the very least it makes the time it takes to heal much more enjoyable.

I'm all for donations and gifts of this kind. But all you have to do is look at the photo that Bart posted to realize that Amorette has identified a valid and serious issue.

Executives that run health insurance companies, medical clinics and hospitals realize need that far from glittering, their gold-plated fixtures have tarnished the trust Americans have in their ability to manage health care. Period.

And that's a THREE story lobby. One can only imagine how many free or reduced-cost examinations and treatments could be provided each month with the money they spend on heating and cooling that ostentatious atrium. As the great Daffy Duck used to say: REEE-dic-a-LUSSS.

[This message has been edited by Steve Craddock (8/8/2009)]
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Posted by Gunnar Emilsson (+17321) 12 years ago
Slightly off-topic.....but still.......it is the same vein......

If you want to talk about grand mansions and the like, lets look at the State of Montana government.

I live in Helena, and for the most part, state government workers work in relative squalor. Some of those old buildings are downright scary.

There is one obvious exception. Obvious to everyone.

Montana Department of Fish, Wildlife, & Parks.

This is probably no news to any Miles Citian who has driven past Region 7 Headquarters on the way out to the interstate towards Billings.

Why is this department treated different than the rest of the state?

The answer: FWP is not part of the general fund that we taxpayers pay, relying solely on fees they collect from users.

Still, this begs the question: Why do they spend this money on these fine buildings, instead of securing more block management access and fishing access, etc.?

I now return you to your regularly scheduled health care debate.
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Posted by Donna Kingsley Coffeen (+398) 12 years ago
Kyle, I wish you would not twist my words!

A fancy hospital would not have made my husband's brain surgery any more pleasant, and I DID just ask him.

I think the picture says a thousand words. Wonder what that costs to heat in January in Montana? I bet some patients would much rather have cheaper care.

[This message has been edited by Donna Kingsley Coffeen (8/8/2009)]
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Posted by Kyle L. Varnell (+3745) 12 years ago
I don't believe a fancy piano or a chandelier makes a person suffering from a brain tumor headache and nausea, makes them feel one bit better

How did I twist your words? Is that not what you wrote?

I would argue that the overall atmosphere of a hospital has as much to do with patient care as anything else. I don't think a bare-bones hospital that offers great care helps as much as one with both great care and a calm & soothing atmosphere does.
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Posted by howdy (+4943) 12 years ago
Cheaper costs would make a patient feel a great deal better than a pretty lobby...The constant worry about how to pay for the procedures is very debilitating to a lot of patients...
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Posted by Donna Kingsley Coffeen (+398) 12 years ago
Kyle--sports celebrities visiting sick children?

I could get just as well in a simple hospital rather than the one pictured, particularly if my bills were cheaper. In fact, the worry over medical bills kills some faster.

[This message has been edited by Donna Kingsley Coffeen (8/8/2009)]
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Posted by Rick Kuchynka (+4463) 12 years ago
I think alot of what you're seeing is that same "I'm insured" disconnect you see in other places in the health care system.

When people are removed from the real cost of their care, they start to make decisions based on some pretty frivolous things, even subconsciously. Bigger and more swanky lobbies get built because people choose facilities with bigger, swankier lobbies. In most (insured) peoples' minds, they're going to pay the same amount of money whether they go to the brand-spanking new marble-floored palace, or the dimly-lit community clinic basement labyrinth.

It's nice to think that people'd try to save their insurance company some cash and go to the hole in the ground. But subconsciously, a better facility makes people think better care, whether true or not. And since the real price is hidden, most aren't thinking about efficiency.
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Posted by Amorette Allison (+11757) 12 years ago
Rick has a very good point. If you are one of those folk with flashy insurance (say, a Congressman) you probably want a flashy hospital because, heck, you think you aren't paying for it. If you are someone like me, with lousy insurance, the sight of that much waste makes you queasy because you know you are paying for it.

Sadly, EVERYONE who goes to the Billings Clinic is paying for that Las Vegas lobby, whether they can afford it or not.

Hey, Gunnar, friend of mine is a state bank auditor. She is in a building the Feds moved out of because it was unsafe. The whole building leans to one side. Everyone has to shim their desks. First earthquake and your bank gets a "get out of jail free" card 'cause the auditors are toast.


Say, I just went back to the Billings Gazette site and discovered the negative comment--a polite statement, nothing nasty, just saying that the lobby was a waste of money--wasn't approved. Three positive comments saying how it will be a "special events center" and it is wonderful were. Great. Cancer patients paying for a special events center. Makes all the sense in the world.

[This message has been edited by Amorette Allison (8/8/2009)]
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Posted by Amoo Daboo Dabutsu (+110) 12 years ago
To this point in time the Billings Clinic is a "for profit" operation and how they choose to spend that profit is not any of my business. Until Obama and the Donna turn this into France lets let them spend their profits as they see fit.

For me the lobby gives the impression of a sucessful operation, an operation where I would feel comfortable having my operation. Not to mention sometimes listening to music in that elegant lobby wouldn't harm in the recoperation of ill people.

To the bleeding hearts this is wastefull, they may be right, but in a country of waste this is some of the least offensive I have seen in a while. Much lesss offensive that the waste of 750,000 "clunkers" some poor folks would love to be driving as their main sorce of transportation not to mention the 3 billion in aid to help "able" and credit worthy people buy a new car.

I guess waste is in the eye of the critic.
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Posted by Richard Bonine, Jr (+14950) 12 years ago
There maybe another reason to have a facility like this... namely recruiting highly qualified medical staff to a rural setting.

I am sure we could construct a hospital out of abandoned Milwaukee Railroad boxcars. If we clean, paint, and sterilize them we could have a hospital that wouldn't have to charge very much. But it would be really difficult to attract top-notch doctors to such an environment. If as a private business you are trying to build a regional medical facility so your clients don't have to go "back east", you build the necessary facilities to recruit the necessary medical staff.

[This message has been edited by Richard Bonine, Jr (8/9/2009)]
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Posted by howdy (+4943) 12 years ago
Most of Mayo Clinic is bare bones...the only fancy part is the older part...Mayo Clinic has top doctors as I am sure you will agree, and their costs are far cheaper than Billings Clinic...(I have experienced both)
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Posted by dcjdinmn (+332) 12 years ago
My son was diagnosed with scoliosis recently and was in a position to observe practices between to totally different medical institutions. After an unsuccessful attempt at creating a back brace at the traditional institution, our doctor referred us to the Shriners Hospital as they had higher skilled artisans in that department.

Having the opportunity to compare the differences, it was refreshing as well as encouraging to see what a medical institution can do while being budget minded. Though the Shriners facility was pleasing to the eye and great ephamsis put forth to comfort the children with a pleasing/entertaining enviroment, you quickly realize the common sense approach they take. In many cases one could observe the work of a 'Handy Man' on site, creating fixtures of common hardware store materials. Such fabrications (one for example) made of galvanized pipe and assorted 45 & 90 degree fittings with the addtion of some common handy work, performed as well or better than the comparable aluminum contraption that one could easily assume cost the traditional hospital thousands of dollars (the proverbial $900 hammer).

I'm not proposing this as a solution to our health care costs, but would definetly be one piece to the puzzle.

We left the Shriners with a back brace that is providing our son the correction he needs. The only costs we now bear is for the MRI prior to being referred to the Shriners. My insurance company (United Health Care)who has reported record profits, managed to stick us with a good share of that bill. Considering how much of my paycheck goes to UHC, I find them somewhat (if not greatly more than...)unethical.

I have such respect for the Shriners and their Hospitals for Children. You can count on me for your support Shriners, Thank You!
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Posted by Steve Allison (+981) 12 years ago
I have a feeling doctors would be more drawn to facilities with latest equipment and treatment options not by three story walls of glass that are going to cost the place thousands of dollars every month in heating and cooling costs, which will wait the money that could have been spent upgrading year after year. No one said there should not be a piano to help entertain patients, comfortable seating to make waiting less stressful and pleasant decorations to help cheer an ailing body. You are all complaining about how there will be government waist in any new health care system, well here is corporate waist that we have now thumbing it's nose at you. And try to remember as you walk in, you not only paid for the over-priced setting, you paying for it's upkeep in the bill you pay and pourer service from upgrades not done to meet rising expenses.
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Posted by Bob Netherton (+1893) 12 years ago
I've been to the University of Washington Medical Center many times. The UWMC is a top rated cancer center, is one of the major transplant centers in the region, has agreements with Children's Hospital and also operates Harborview(a major burn center and the place where a most victims of major accidents from our region are airlifted for treatment). None of these places exhibit the pseudo-opulence of the Billings Clinic. In my opinion, treatment from caring, competent doctors and staff goes a lot farther than some damn grand piano and a big pretty atrium, donated or otherwise.
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Posted by Donna Kingsley Coffeen (+398) 12 years ago
I agree. I am treated at least every 6 months at U of WA Med. Ctr and there is nothing fancy about the place, but the care is excellent. My husband is treated at Virginia Mason and again, very basic, but his brain surgery there was cheaper than anywhere else in the NW and yet the place is ranked number 1 in the NW for good and safe care.

I spend my time checking out the infection rates, how many complications/failures the surgeon has had etc. ---not whether the lobby has crystal chandeliers. In fact, if they do, it tells me something about their priorities that I find off putting.
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Posted by howdy (+4943) 12 years ago
What most people don't realize is that they are all one catastrophic illness away from bankruptcy....A lot of folks have that 80%/20% split and believe me the 20% can be crippling...My last operation was $125,000....so figure 20% of that is $25,000...Anyone out there got an extra 25 grand lying around?? Fortunately my insurance isn't that way, but a lot of folks are...My hubby is a retired steel worker and we fortunately have great insurance..Only 2 grand a year out of pocket thankfully...but combine these costs on top of the horrid medicine costs and you are in trouble...but most folks don't realize it until it is too late...
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Posted by Bart Freese (+926) 12 years ago
You hit the steel nail on the head, Howdy.
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Posted by Kyle L. Varnell (+3745) 12 years ago
The U.W. Med School is great for cancer treatment and such. My whole argument is that the overall experience counts just as much as great care. Like Rick said there's a good chance the Billings clinic was built with private donations.

As far as Harborview goes I think they serve Washington (obviously), Oregon, Alaska, Idaho, Western Montana, British Columbia and possibly Alberta.
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Posted by James (+94) 12 years ago
I know this is a bit off topic, but in 1990 I was working as a deputy for the San luis Obispo Sheriff's dept. when I was diagnosed with a brain tumor. We had a great HMO at the time (rather expensive though). My surgery was performed at Sierra Vista hospital, nice, but not overly fancy, great doctor's and nursing staff. I found the care there for the insured and not insured to be equal treatment.Top of the line for all. I think all facilities could learn somthing from them, from patient treatment to administration and operations.
(IMO).
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Posted by Bob Netherton (+1893) 12 years ago
Even if the "fancy stuff" was donated, it represents money that could have been spent on any number of things - from salaries to equipment to quality assurance to etc.
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Posted by Kyle L. Varnell (+3745) 12 years ago
So like a spoiled child that didn't get the Birthday/Christmas gift they wanted Bob, should they've just said "Take it back. We want the cash equvilant."?

[This message has been edited by Kyle L. Varnell (8/9/2009)]
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Posted by howdy (+4943) 12 years ago
More like a group of people that are terminally ill that are reading the Gazette and saying wow I wonder how much treatment that lobby would have paid for if it were available...Just wishful thinking on their part...certainly not spoiled...
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Posted by Kyle L. Varnell (+3745) 12 years ago
I was talking about the hospital.
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Posted by howdy (+4943) 12 years ago
so was I....
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Posted by Chuck Schott (+1284) 12 years ago
Fortunately you had good insurance Howdy, and there wasn't some third party telling you it wasn't piratical for you to have that kind of operation. I have insurance of a comparable nature and I would sure like to keep it that way. That is why I am so dead set against any government take over of my health care decisions. And if they think the debate is getting heated they have yet to meet me at a "town hall meeting", I will give them an ear full and the outright lies Obama has been telling won't get it for me. Oh, and I don't belong to a mob......YET!
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Posted by howdy (+4943) 12 years ago
Next year, I am old enough to go with medicare...will be interesting to see the difference in costs and care...and interestingly the supplemental is just as expensive as the whole policy now, but there will no longer be any out of pocket costs which will be wonderful..

[This message has been edited by howdy (8/9/2009)]
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Posted by Bob Netherton (+1893) 12 years ago
Kyle. You are really, really stupid.
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Posted by Donna Kingsley Coffeen (+398) 12 years ago
howdy, we are the people Michael Moore did Sicko about. 6 years ago we owned several businesses, I had a good job with health care, we own land, properties, etc. I could have EASILY retired 10 years ago EVEN with 2 children in college. Then suddenly I lost my hearing. 2 surgeries at U of WA to try to save it and it failed. A third surgery for an implant. We had 26 trips to Seattle in one winter. Had I not had the surgery I would have lost my job due to being unable to function. Every 5 years I have to buy 2 devices that are $10,000 and my insurance won't cover a cent of it. Then my husband got Parkinson's a few months later at the young age of 49. Thousands and thousands of dollars in medications that the insurance paid only part of. He had brain surgery in March and bills are still coming in. I think we are around $150,000 total on that. We also did not plan that he would be unable to work the last 10 years before retirement from a self-employed business. Then my son got a neurological disorder. $70,000 worth of treatment and we still spend $300 a month out of pocket and we pay $400 a month for his insurance coverage on to top of that.

In the last 6 years we figure we have racked up about $400,000 in medical costs for illnesses that could not have been predicted or prevented in any way. Thank the Lord, my insurance paid enough that we did not lose everything. I probably won't be able to retire until I am 92 thanks to our pre-existing conditions.

One illness away for SURE. We, healthy people that we were, ended up with 3 illnesses--any of which would have put us totally under without good insurance and even then---well, watch Sicko--Michael Moore was talking about us, the insured with GOOD insurance.

Now, for any of us to get private insurance? Well, it would be astronomical. I have to keep my job for the insurance alone. If I get laid off we are in a world of hurt.

I am a very hard working person, as was my husband until he became disabled. My sons both work very hard. In this country you should not be one illness away from losing everything.
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Posted by Kyle L. Varnell (+3745) 12 years ago
I've been called worse Bob, so can you at least put a little creativity in your insults?
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Posted by Amorette Allison (+11757) 12 years ago
Chuck, you obviously haven't had an argument with your insurance provider.
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Posted by howdy (+4943) 12 years ago
You are right Donna, your family could be the poster children for what I was referring to...so sorry about your troubles but I totally understand what you have been fighting...if this nation doesn't implement some sort of help universally, we as Americans will just fall deeper and deeper into debt and destruction...it is totally a roll of the dice as to whether or not you make it till retirement without illnesses...we need a safety net before it gets worse...
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Posted by Bob Netherton (+1893) 12 years ago
Sometimes the basics are the best fit, Kyle.
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Posted by Chuck Schott (+1284) 12 years ago
No, I've been very lucky. They have paid everything up @ 80% with a maximum 2K out of pocket in one year. That's about to change when I go in for my preventive stints and knee/hip replacements in anticipation of coming changes.
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Posted by howdy (+4943) 12 years ago
Hope you can get it all fixed before the changes, Chuck...Unfortunately, stints and joint replacements have a shelf life....With any luck, you will have medicare when that occurs...
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Posted by Bob Netherton (+1893) 12 years ago
I think you'll find stents work better than stints.
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Posted by Richard Bonine, Jr (+14950) 12 years ago
Make sure they are medicated.
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Posted by Bob Netherton (+1893) 12 years ago
I think Chuck is medicated....oh....you mean the stents.
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Posted by Gail Finch Shipek (+94) 12 years ago
And pray you can still buy supplemental insurance. Without it my parents would be beggars on the street.
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Posted by Gail Finch Shipek (+94) 12 years ago
Donna,
I am sorry about your sudden hearing loss. I also have a hearing loss that requires me to wear hearing aids. They are not covered by my insurance either. I asked why and found out that the coverage I have is negotiated by my employer. If I want insurance coverage then I need to convince my company to have hearing aid coverage added to the plan. I have not decided to take on that battle. Maybe you can talk to your company and see if they will change their coverage so you get better coverage.
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