We rented the movie 'Sicko' this weekend

[Dad_of_4]

All I know is that I am an uninsured American. Well more like under insured. We pay 30 dollars a week to have a major medical only plan. The next option up was going to be 160 a week. At 640 a month we would be homeless if I tried to pay that.

Even with my pitiful insurance plan I still had to pay over 700 dollars to get my daughters broken arm treated last month. And I am not talking bill in the mail. I had to pay cash on the spot. NOW I can't pay my morgage payment this month.

Maybe if you were in my place you would see things differently.

I am very saddened by the attitudes of some of you .

If the hospital demanded $700 on the spot you could refuse and they would still have to treat her. There is a federal law that requires an ER to treat anyone that walks in their doors. The illegeals have figured this out and use ER's like doctor offices because they cannot be refused service.

[Dad_of_4]

Coding refers to billing, compliance refers to regulations.

Pay for performance is payment based upon performance in certain key QUALITY Indicators as demonstrated by MDS reporting.

Please, you really don't know what you're talking about.

Ok, I'm going to try to go through this step by step so you will understand the link between coding and billing.

A person on Medicaid or Medicare goes to the doctor with an medical issue. The doctor examines the person, orders lab tests A, B and C, and schedules a follow up appointment. The doctors office then codes the visit and passes the information on to the billing department. However, there is an error in the coding that is not caught by the office staff or the billing department.

Time passes and the goverment asks for 10 charts to audit. One of the charts happens to be the fore mentioned person. The auditor find this error. The auditor then decides a more in depth audit is needed and schedules a full audit of the hospital. During the full audit, it is discovered that this same coding error and others had occured numerous times. The hospital is then found to be in non-compliance and fined $20,000.

For the next 3 months the hospital spends tens of thousands of dollars training staff and doctors on the errors and hire consultants to review their system to try to prevent future errors.

By the way this is not a hypothetical example. It happened at the hospital that my mom works at last summer. So do you now see how coding and regulations are linked? If not, I consider it a hopeless cause.

[Michelle68]

Working in home health care, I have to agree that Medicare and Medicaid rules and regs do not change "3-4 times a day". That would be simply ridiculous. Also, I kind of hope that while you were at your mother's desk you weren't made privy to any patient charts or billing. That would be a MAJOR patient privacy violation (HIPAA). In our office, we are not even allowed to leave any patient info out in the open and visitors do not have access to the room which holds patient files.

Also, our home health company has gone to seeing strictly Medicare and Medicaid patients because of the difficulty the company had getting the private insurance companies to pay for care.

--Michelle

[MommyJess]

I work for a rather large health insurance company and I will be the first to say it...the system is screwed up horribly. Perhaps national healthcare won't work, but what we have now isn't either. I work at this company JUST for the health care. In pocket I might make $200/month that does not go to health care or daycare. I am very lucky that my company will cover pre-existing, because I have high blood pressure (because of genetics, not from my taking poor care of myself). I work for providers and deal with their frustrations over not getting paid because my company finds the most ridiculous reasons not to. Private health care is not working. I have been on medicaid, my children were on medicaid and WIC, while I was working and while I was paying taxes. It makes me so angry that people assume those getting assisted by the government are all low lifes. I am an educated, hard working woman, but I wanted to make sure my children were given the best care possible and that I would never have to choose between their care and paying the power bill. Dad of 4, you might change your tune had you ever had to walk in someone else's shoes.

[Dad_of_4]

Working in home health care, I have to agree that Medicare and Medicaid rules and regs do not change "3-4 times a day". That would be simply ridiculous. Also, I kind of hope that while you were at your mother's desk you weren't made privy to any patient charts or billing. That would be a MAJOR patient privacy violation (HIPAA). In our office, we are not even allowed to leave any patient info out in the open and visitors do not have access to the room which holds patient files.


--Michelle

She does not work directly with patients record except during audits. Then she is set up in a secure area so she does not have to constantly check out and return the records. She does get 3 to 4 e-mails a day from the goverment on coding, procedure, and regulation changes. Most of them are minor but they are a constant headache for her to review and communicate to the right people. Working in Home Health, most of these changes probably do to effect you. If they do affect you they may or may not be communicated to you that they are due to the government.

Reguardless, the only reason for coding in the first place is because of the goverment. Remove coding and you remove a lot of the indirect costs of health care.

[Dancing Lotus]

If the hospital demanded $700 on the spot you could refuse and they would still have to treat her. There is a federal law that requires an ER to treat anyone that walks in their doors. The illegeals have figured this out and use ER's like doctor offices because they cannot be refused service.

The hospital didn't demand anything because I didn't take her to a hospital. It was a minor fracture I didn't really think anything was wrong so I took her to the pediatrician who then referred me to the otho. The ortho demanded the money or no treatment. It was friday afternoon and he was the only one who could even see her untill next week.

I'm sorry but I have a strong moral objection to using the ER as a Dr.'s office and refuse to go unless its that important. I believe in doing whats morally right even if it is the hardest thing to do. I will be getting a 300 refund but in the mean time I have to sit and wait while my other bills are paid late.

[Dad_of_4]

Private health care is not working. I have been on medicaid, my children were on medicaid and WIC, while I was working and while I was paying taxes. It makes me so angry that people assume those getting assisted by the government are all low lifes. I am an educated, hard working woman, but I wanted to make sure my children were given the best care possible and that I would never have to choose between their care and paying the power bill. Dad of 4, you might change your tune had you ever had to walk in someone else's shoes.

Private Health care works great for my family and I. Granted I look at it as insurance and not contract health care. Most years we do not reach our deductible, but it provides us piece of mind just like life and home insurance.

I also find it hard to believe that you were eligible for Medicaid and WIC and paying taxes. Social Security Insurance is not a tax, it is INSURANCE run by the goverment.

No where have I said getting assistance makes one a low-life. Living for years on that assistance, however, does make one a low-life.

Now as far as walking in someone else's shoes. What makes you think you have even a clue of the hardships I have lived through. But, i will educate you some. I was born the son of a Navy Sailor. After paying rent and utilities they had $35 for the month for food. How did we survive? Well, my mom would cook meals for Dad's fellow shipmates if they brought the groceries. She would also do their laundry and press their uniforms at the local laundry mat and they would give her enough change to wash our too.

I have been constantly employeed since I was 14 yrs old. Mowing yards, delivering newspaper, washing windows, you name it I'd do it. At 16, I got a job at McD's working as many hours as the law allowed. By 17 I found a way around the max of 20 hours a week. I got a second job at Subway. After graduating HS, I joined the Navy and went into Special Forces. I got married and we had our first daughter. I was deployed over 60% of the time, much like the armed forces now. I have fought for our country and am proud that I did.

After almost ten years of services, we decided to to leave the Navy. I was immediately recruited by several companies. I choose a job in Oklahoma. During the next five years, I worked 50+ hours a week, went to school for my Engineering Degree fulltime, had our first son and second daughter and remodeled our first home. I then took a job at a company in Indiana were our parents live. After buying a house and expecting our fourth the company was bought and they immediately closed the plant. What did we do? I immediately went looking for another job and found one in Arkansas. So for the second time in 15 months we moved over 700 miles.

If you are poor and not working 2 or more jobs, I have sympathy for you. If there no jobs in your area, move. If you can't find a job that pays enough, you over value your labor. If people worked as hard as they whine, they would be able to pay for medical care.

[POOTERSMOMMY]

I know OUR Dr's will charge less if you pay cash, as they hate to deal with red tape of insurance - I can't blame them.

Our Dr's also give us many options of labs we can use (actually you can use any lab, our doctor does not dictate that) They also give us "many" free samples of script medication.

I'm not much for welfare, food stamps, WIC ect, unless it's for a very short time. It's not free - we all pay for it with our tax money. The churches in our area will help anyone! Not just members. Many also have classes for updating skills, and they help with job hunting. They also have food banks and clothes closets - no questions asked. There are also many not-for-profit agencies in our city that will help.

I guess that I believe that everyone should be responsible for themselves - the govt. should not be responsible for us. In the past we have both had to work multiple jobs to pay insurance and living in general.
We all complain that taxes are too high now, when you start adding services from the govt. - they will only go up higher.

I don't have the answer - I just know that I don't want to pay more taxes. They are high enough. This country has the best technology in the world, and to utilize it, there must be some cost to us.

[Dad_of_4]

I know OUR Dr's will charge less if you pay cash, as they hate to deal with red tape of insurance - I can't blame them.

Our Dr's also give us many options of labs we can use (actually you can use any lab, our doctor does not dictate that) They also give us "many" free samples of script medication.

I'm not much for welfare, food stamps, WIC ect, unless it's for a very short time. It's not free - we all pay for it with our tax money. The churches in our area will help anyone! Not just members. Many also have classes for updating skills, and they help with job hunting. They also have food banks and clothes closets - no questions asked. There are also many not-for-profit agencies in our city that will help.

I guess that I believe that everyone should be responsible for themselves - the govt. should not be responsible for us. In the past we have both had to work multiple jobs to pay insurance and living in general.
We all complain that taxes are too high now, when you start adding services from the govt. - they will only go up higher.

I don't have the answer - I just know that I don't want to pay more taxes. They are high enough. This country has the best technology in the world, and to utilize it, there must be some cost to us.

I could not agree more

[Dancing Lotus]

Dad- now I get it! YOu are an engineer. And before you take offense to that My father is one and my Dh is studying engineerning
at UCF.

We are poor because dh is a student and yes he does work two jobs.

[Dad_of_4]

Dad- now I get it! YOu are an engineer. And before you take offense to that My father is one and my Dh is studying engineerning
at UCF.

We are poor because dh is a student and yes he does work two jobs.

I hope the best for him it is a hard work and seems endless at the time. It is the best thing I have done for myself and my family. I survived on barely 4 hours a night of sleep during the school year including weekends. But I would do it agian in a heartbeat.

We were living paycheck to paycheck until the degree brought in the money.

[momof42003]

My sister is uninsured. She has a degree, yes, but in the past 10 years she has had three beautiful boys. The boys are insured on the state health plan. Her DH is insured by the employer and has VA as a place to go. It would cost my sister 70.00 a week, 1000.00 deductable, and she would have to do this all while her husband is going to school and working as an apprentice as an electrician. Even if she were to pay the 280.00 a month in insurance, she would, in the event of a major medical problem, still come up with 1000.00 for the deductable. ??????? Other wise she is paying 280.00 a month in insurance and if she has to go to the doctor, she still has to pay the full amount of the visit to go towards her dedcutable....?????? Don't get it... So, she sits here with NO insurance, hoping that she is not ever put in a hospital. My Brother in law works his but off.... And his wife is not insured. That is not ok with me. We definately need someone to come in with a GREAT way to over haul the insurance system. As it is now, it kind of "sucks"...

By the way Cuba has a lower infant mortality rate that the US(5.93vs6.9 out of 1000 births) and they live to be 77 years old (US 77.8 years). They live longer than either of my parents did, who died from cancer... So I think Dadof4, some of your "facts" about Cuba may be a little exagerated.... At least from what I have read.

[Palooka]

I also find it hard to believe that you were eligible for Medicaid and WIC and paying taxes. Social Security Insurance is not a tax, it is INSURANCE run by the goverment.

I was working full time and taking care of my kids and still needed WIC and Medicade because my job did not offer insurance back then. I had 0 debt and lived from check to check in a very small house. Glad WIC was there to take care of the health for me and my child then. You seem to not understand the cost of daycare verses what jobs pay. Let along a mother wanting to spend time with her child and give them the best she can.

If you are poor and not working 2 or more jobs, I have sympathy for you. If there no jobs in your area, move. If you can't find a job that pays enough, you over value your labor. If people worked as hard as they whine, they would be able to pay for medical care.

I find this statment, uhh, so unrealistic and just plain nonsense. Gotta have money to move and also people usually stay where family is.

You are over looking so many things and this is just a big generalization. You even said in another one of your post that you never had to meet your deductible. To me that is saying that nothing 'tragic' has ever happened to you or your family. When you get slammed with thousands and thousands of dollars of something that you had no control over, get back to me and say that a working person would be able to pay for medical care. This is after insurance has payed their part of course.

Did you even watch that film? I see you worked hard for where you are in life now. So many here have. You have no idea what can happen in a split second to take all the years of hard work away from you.

Only in American this can happen just simply through being struck with cancer or some freak car wreck.

[fernykins]

You know I'm 51 and I have state medical............ I do not work not because I don't want to but because I am ill . Not because of my life style but others.......... I thank God daily I have it. I do not think the US would do well with socalized medicine. If they studied different places that have it and come up with a plan that would work here I'm all for it. But unless you have walked in my shoes or anyone elses. Don't put us down for using what is availible for us. As far a people using WIC its for the babys to make sure they have enough to eat so they have a fighting chance to grow strong..........
Fern

[VanVivCam]

we have individual health insurance for my hubby, daughter, and myself. we only pay 225 per month and my medicine is 15 unless it is something new, and the doctor visit is only 25. er visit is 75 unless we are hospitialized and the deduction is at 1000 if hospitialized. I think this is a VERY fair policy and have been pleased with this for going on 3 years now. not sure why everyone whines about the cost of health insurance. get online and find a policy that suits you and your family needs, it is out there if you just look. people need to think of health insurance as they do cars and homes...it is something you need to work into your budget and just get it. Stop wanting ME to pay for YOUR insurance.