American health insurance: This is more of a... - AF Association

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American health insurance

belindalore profile image
149 Replies

This is more of a rant. Sorry. This is an example of our wonderful (I mean that sarcastically) medical system here in the USA. My neighbor fell through a rotten place in her deck (which at the time was being rebuilt, don't know what she was thinking, but that's not the point I'm going to make). She was pretty bruised in one leg but in a few days she was flying back to her house in Wisconsin from her home here in Florida. When she got back to Wisconsin she went to her Dr there. She tries very hard to stay away from the Drs here in Florida. I've told you all Florida is 41st for bad healthcare out of all 50 states. 😱 Any way the Drs up there had her leg x-rayed, did blood work. She did have a small blood clot. (She is 84 and has no problems other than minor high blood pressure. Lucky her. Good genes too.) She spent almost an hour with the Dr. Dr explained everything they did. Gave her a med to dissolve the clot. She went back in a week later for follow up and everything was healing well. She is back here in Florida again for a couple weeks to see a very close friend who is in hospice. Okay the point of all this is my neighbor has better insurance than I can afford. She pays close to $500 for a supplemental policy that covers what Medicare doesn't. I'm on a very limited income. For me to pay $500 would put me in poverty. So she gets better care. (I am not begrudging her. She says she is blessed to be able to afford it.) Spends almost an hour with the Dr. I'm lucky to get part of the 15 minutes, which my insurance says the Dr can spend with me. I've never gotten the whole 15 minutes. She has time to have an actual discussion with her Drs. I am being pushed out of the exam room door while I'm still trying to ask questions. I kid you not. That has happened. Or the Dr stands right next to the door so he can get out before I do try to ask questions. This happens to so many people. And I see the same thing here in this forum from people from all over the world. We are all human beings. We should all have access to good healthcare. Anyone who thinks that healthcare is wonderful here in the USA is in la la land. It's wonderful if you can afford great insurance. If you can't, you're just in the way. You are expendable. You are nothing.

149 Replies
mjames1 profile image
mjames1

Sorry about your experience. And yes, the fact is that the medical system is unfair in the sense that if you have the money you can get better care. But it's not just in the US. I read here, for example, that many go "private" both in the UK and Canada, paying hundreds for a consult and thousands for an ablation, so they don't have to wait or so they can choose a doctor.

I have standard Medicare with a Supplemental plan that costs around $300 a month, for a total cost of $500 plus a separate prescription plan. With it, I see almost any doctor, including specialists, anywhere in the country, without having to go through a "gate keeper" gp for approval.

Wait time varies by doctor but is not restricted by the plan. Yes, I've had the 15 minute appointment when more was warranted, but I've also had doctors spend an hour with me.

The Medicare Advantage Plans are different in that you are restricted to a network of doctors in your own state although they do offer some perks my plan doesn't. Lots of different insurance plans in the US, so it can get confusing even to us! So much that every year, Medicare has a "Musical Chairs" window of a month or two where you can switch plans!

Jim

belindalore profile image
belindalore in reply to mjames1

Yes I do know how the insurances work. All I can afford is an HMO. Medicare advantage. And it's very limited. They pay for a very limited amount for their extra benefits they brag about. Dental, hearing, eyeglasses. And tell you what you can and cannot have. I am only allowed 15 minutes with the primary physician and 25 minutes with a specialist. Too little time.It's a money maker for Medicare advantage. I don't know if you notice the ads on TV for Medicare insurance plans but this year I've noticed that almost all of the ads are for Medicare advantage. That's because they can easily control what you as a patient will and will not get and what the Drs can and cannot do for the patient. I fear that is the future. And I don't see any of our wonderful (once again sarcastic) politicians doing anything about that. Nor will it change anywhere else in the world. I had to almost laugh at the aide in my Drs office who takes your vitals. She said she'd like to see universal health care like in other countries. She's too young to know any better. 🙄

Thanks for listening. You take care.

FlapJack profile image
FlapJack in reply to belindalore

It always interesting to hear other peoples opinions of healthcare provision as it applies to them and their country. Prior to the pandemic, generally but by no means always, people here in the UK were pleased with the level of care they received. Of course, care varied around the country and there has always been a bit of a postcode bias but that’s largely due to the people who provide medical services rather than services they provide . With an operation as huge as the NHS, it is obviously going vary but on the whole, if anyone was facing a life threatening condition and they didn’t live on top of a mountain, they were likely to get the level of care they needed.

The pandemic has changed all that but there are some very small but welcome signs of improvement but there is a long way to go. When you hear about procedures available in the USA being offered at eye watering prices and the suggestions that everyone there should almost demand to have one it almost gives the impression that they are available to all. Clearly from what you have said about your, and your neighbours recent experiences, this is far from the truth. Fortunately, cost effective treatments are available and for many, offer good levels of symptom relief from AF.

It’s interesting how this forum has grown and evolved over the year. When I joined back in 2014, there were only a couple or so thousand members and the vast majority came from the UK. As the AF Associated began to cast its net further, the membership grew and became more international which is great, because it made us all more aware of different treatment options. Unfortunately, unless we have a better understanding of how different healthcare systems work around the world, it’s going to make it more difficult to discuss treatment options which are genuinely available the masses rather than just a fortunate few. Of course, over time, these newer procedures may filter down to newly diagnosed patients living on a pension and nothing must stop the medical boffins from continuing to explore new ways of controlling AF. Hope your neighbours on the mend …..

belindalore profile image
belindalore in reply to FlapJack

Oh healthcare has been going downhill in the USA long long before the pandemic. When insurance started in this country it was a good thing. It was started by Drs and hospitals around the start of the great depression in 1929. To help people pay their bills. Then someone came along and saw insurance could become a money maker. So insurance companies formed to sell people insurance policies. It became privatized. Then came along Medicare for seniors and the disabled decades later and the government became involved. That's when things really started going downhill. So many different insurance plans it would make your head explode. A few years ago came along the Affordable Healthcare plans that we all call Obamacare. You could switch to it and keep your Dr you already had. Turned out to be a lie. And it's not affordable. If you let it lapse you are charged a huge penalty. A pharmacist I know told me she had a friend who didn't have much income but she found a plan with Obamacare for $15 a month. It had a huge deductible. Deductibles with some plans is money you have to pay out of your pocket before the plan starts to pay part of or all of your costs. Well she was diagnosed with stage 4 cancer and had to come up with $4000 to pay her deductible before she could even start any treatment. Deductible amounts can vary. That was in the month of October 3 or 4 years ago. She was able to come up with it somehow. Well the new year came in January and that meant another $4000 deductible. She didn't have it. She died. I could tell you lots of other horror stories about what really happens here in the states. It's not pretty. People can't get care because they can't afford the medicine they may need because their insurance either doesn't cover it or won't. It's awful what happens to so many people. Just awful. I've been arguing with my Dr because I've had pain in my gut for months. He keeps saying it's diverticulosis. It's not. I just can't go see another Dr. You have to fill out a request and it has to be someone in your plan. Then it takes a couple months to switch, if you find some other Dr who will take you. Also if you need to see specialist your primary Dr has to give you a referral with my insurance. People like my friend and mjames can go see whoever they want because they can afford better insurance than I. I don't begrudge either of them. But I get angry when I see our government spending millions and probably billions so all the illegals coming here can get FREE healthcare. While many of our own legal citizens can't get decent healthcare. What's also pointless is for our citizens to wear a mask when so many illegals are coming here and being let loose and bussed all over the country and VERY few have been tested for covid. That's crazy. Cases of covid are starting to go up again. No wonder when these illegals are carrying the virus and whatever else. This country is lost. Take care and be safe. Thanks for replying Flapjack.

Fulentium profile image
Fulentium in reply to belindalore

My GP is 70 years old and has said many times that Medigap is the supplemental insurance to get with Medicare. He has a retired plan that covered more, but told me Plan G is still good for current or later retirees. You have to choose Medigap when you're first eligible because they have the right to refuse you due to preexisting conditions if you choose it later. And it can also be more expensive later. Medicare Advantage looks better at first because it can cover more kinds of costs but if you have any health issues that are not superficial and have to see doctors regularly, Medigap will give you more coverage in the long run. Still, I believe that all Medicare plans involve outside decisions concerning which doctors you can see.

My concern is that Medigap might be gone by the time I become eligible. Plan G will probably be the next plan they retire.

belindalore profile image
belindalore in reply to Fulentium

I doubt that I could have gotten medigap. I had an irregular heartbeat already. I think there will be a lot of changes to Medicare in the future. Not necessarily good changes. I think it will be even more restrictive. Take care.

Fulentium profile image
Fulentium in reply to belindalore

belindalore:

Not to belabor the point, but since others read these threads, I need to say this:

My understanding is that every U.S. citizen who applies for Medicare within the six-month enrollment period can get Medigap. For that short time, insurance companies can't refuse you or raise prices because of preexisting conditions. But from the moment you select Medicare Advantage or some other plan, they are free to refuse you. It is a disgusting practice, since few apply for Medicare knowing the ins and outs, but people who are trying to decide what to do should know they can only choose Medigap once, and in the beginning.

I, too, will have had an irregular heartbeat and numerous other health problems before I am the correct age to enroll. I wish I could go back in time and post here whenever that happens, but the rules likely will have changed if politics in the U.S. continue to grind away at pensions, social security and healthcare.

All the best to you, and may any procedures you undergo (as well as the intervals before, between and after) be safe and yield the best results.

belindalore profile image
belindalore in reply to Fulentium

Yes I didn't know about Medigap when I applied 5 years ago. And the reps who sold me the plan never brought it up.🤔

mjames1 profile image
mjames1 in reply to FlapJack

The OP may or may not agree because her Medicare plan is different than mine, but specific to ablation, which you mentioned -- but here in the US, ablation is considered first-line treatment, promoted (perhaps overly IMO) by cardiologists, hospitalists and eps and is very easy to get, at no cost, with very little waiting, with most insurance plans, including Medicare, and it's been going on for some time. The last couple of times I was in the hospital for Cardioversion, while under the care then of only a cardiologist, an ep stopped and asked if I have considered an ablation. I'm sure if I took them up on it, they might have kept me in the hospital a few days longer an done it right then!

Jim

FlapJack profile image
FlapJack in reply to mjames1

It’s quite different here in the UK. Many GP’s do not see AF as being a serious health problem provided the patient is prescribed a beta blocker (nearly always Bisoprolol) and an anticoagulant if appropriate, depending on CHADs. The patient may be referred to a cardiologist (rarely an EP). This can take months and generally they also prefer that AF is controlled with medication. More informed patients can ask to be referred to an EP of their choice and if their GP resists, we suggest they consider a private consultation if it’s possible. This might cost around £250 but an ECG could add another £100 and an echocardiogram considerably more. For the age group of folk normally diagnosed with AF ie 55+, private insurance is rare, so any treatment suggested by an EP is generally carried out on the NHS and if an ablation is suggested, currently this could take a year. Here, patients attitudes towards having an ablation vary enormously. I know very many with AF both from within and outside this forum and many would not consider an ablation even it were offered.

Ironically, better informed medics and patients understand the if an ablation is considered as being suitable for someone with paroxysmal AF, the quicker it’s done, the more likely it will be successful. Unfortunately, because it tends to be a progressive condition, patients may need more than one ablation. If AF becomes a problem for a young professional athlete then they tend to have access to private healthcare and their situation is very different to the population as a whole.

So obviously, the situation varies enormously from country to country and all us poor mortals can do is try to help folk as best we can, given the differences which exist with health care provision in our respective countries……

FaberM profile image
FaberM in reply to FlapJack

Flapjack it varies - I insisted on a referral by GP to an EP - got appointment 4 weeks later - ablation offered 6 weeks after that (I panicked and waited another month). You are right that GPs are still thinking of AF as one of those chronic conditions managed in Primary Care.

Ducky2003 profile image
Ducky2003 in reply to FlapJack

This is the annoying thing, when AF is shrugged off as not serious as its effects can be .........I've got to have a mitral valve repair because of the atrium enlargement caused by the AF. To be fair, my GP just defers to the hospital and lets cardiology sort me out so I've not had to see him about cardiac stuff for a few years. Having read about the plight of belindalore it does make me grateful for the NHS. It may have its faults, huge at times but at least we turn up without having to worry about paying for it.

@

belindalore profile image
belindalore in reply to Ducky2003

I think that's a big problem here in the states, Ducky. Is what they are paid through these insurance plans. Drs look at what insurance you have. If you have crummy insurance that doesn't pay them well they don't seem to want to do much for you. With Medicare advantage plans, they discount what they will pay and the Drs have to accept that discount if they accept these advantage plans. They really don't like taking less money. A lot of Drs won't accept Medicare advantage plans. Some won't even accept Medicare at all. I wish some of you here could trade places with some of us in the states. Those of us who have to deal with bad healthcare. You would never step foot in the USA again. Okay. Some of my fellow citizens are going to tell me I'm unpatriotic. That's okay. I'm not. I just get crummy healthcare compared to what you get. That's a fact.

Ducky2003 profile image
Ducky2003 in reply to belindalore

So much for it being a vocation. I know we all want to earn a good living but putting money before peoples health is a bit mercenary. ☹

belindalore profile image
belindalore in reply to Ducky2003

Too many Drs go into the field to make money I think. It's like a 9 to 5 job to some of them. Very few Drs work on Saturday anymore. Some used to be in the office at least half a day on Saturday. Used to be you could get an appt within a couple days. Sometimes the same day. Now it's weeks or months. So if you're really in need to see a Dr you have to go to what they call urgent care centers or go to the emergency at the hospital. Medicine is not what it once was.

DawnTX profile image
DawnTX in reply to Ducky2003

I have completely different opinions from hers on our healthcare in the USA especially an HMO which I would kill for right now if I could have it but I can only have a PPO where I am living. My insurance also limits doctors on what they can charge they can see the bill is $4000 but just recently I had a test for that amount and they got a little over 300. When they sign up to work with the insurance companies they have to take what insurance pays them. They are also not allowed to than try to bill me. Most of my medicines are free some are three dollars and some odd cents. I have been extremely happy with every doctor including the one that did my cataracts. Don’t take the word of one person for the last two years I have dealt with a fib and just had my third surgery. The first two were ablation and they are still holding but this was in a completely different area. As I stated earlier I was spoiled but then again I appreciate the people that take care of me and if you don’t treat them right they will take care of you but that’s all they will do . They will do their job if you treat them like hired help. The last time I had a horrid roommate who I finally yelled at. She started screaming about 9 o’clock that we were having a party in my side of the room. They were checking on me because I had just returned from recovery. I blasted her and let her have it about everything she had done all day and the way that she is talking to my nurse. All I can say is take it from where it comes when somebody has so many complaints yes it can happen and yes nurses are burned out but they do their job because it matters to them not so they can miss treat people so in the mirror is what I tell. All I can say is take it from where it comes when somebody has so many complaints yes it can happen and yes nurses are burned out but they do their job because it matters to them not so they can mistreat people so If you have that many complaints maybe you should look in the mirror. There is a beautiful saying from Thailand it is if you sing a beautiful song you get a beautiful echo back. I had a sweet friend tell that to me one time and I think it’s a great thing to remember

mjames1 profile image
mjames1 in reply to FlapJack

Correct me if I'm wrong re your end, but I think the difference is that in the UK, you either go NIH or approach doctors privately.

In the US, we have so many different insurance plans it's mind boggling. And that's in part why you are getting so many different experiences reported here.

There are plans covered by your employer, plans partly covered by your employer, plans only for the self employed, Obamacare (if it still exists I do not know) and then there's Medicaid which provides free medical care if your income is below a certain amount. And lastly, Medicare and Medicare Advantage if you're over 65.

I have probably had all of the above, cept Obamacare, at certain junctions of my life. When younger, like many, I shopped for the cheapest plan possible, cause honestly not much wrong with me then. :) Of course, the less expensive plans cover less.

Now, I qualify for Medicare and am relatively happy with it. Covers about all I need, including an ablation, with almost any doctor, anywhere in the US, where I can self refer without worrying about gate keeper gps, etc. But in return I pay around $500 a month plus my drug plan. If I needed an ablation in the earlier days, with one of the other plans, I may well have had to pay out of pocket. There is a reason they call it the Wild West and the US is still a bit like that today, for better or worse!

Jim

FlapJack profile image
FlapJack in reply to mjames1

Almost right Jim. Like all things connected with tax, there are some variations but generally, everyone in work is required to pay a tax referred to as National Insurance. It’s based on a % of income and together with a contribution by your employer and amongst other things, it funds the National Health Service. This service includes GP local practice, hospital treatment and referrals, some special case prescriptions and prescriptions for pensioners, some dental work and eye tests for pensioners. Some companies might also provide private health insurance but this generally for senior management. There are various levels of cover available and the cover is provided by insurance companies. For want of a better word, it’s seen as a perk, a bit like company cars but I believe employees pay tax if this cover is provided. Please bear in mind I’ve been retired since 2004 so clearly I’m not an expert on this. Anyone can opt to have a private consultation or treatment but obviously if they are not insured, it has to be self funded. In practical terms I think it’s much simpler in the UK. Almost all Doctors are trained by the NHS and any private work is supposed to be monitored so I don’t think there are the same levels of competition or secrecy that may occur elsewhere.

belindalore profile image
belindalore in reply to FlapJack

It does sound a lot simpler than the USA. I like that the Drs are monitored there. There is much competition and secrecy here in the USA too. Like I posted that my friends in-law started a practice here in Florida years ago and closed it and went back to Wisconsin because the Drs here didn't communicate with each other when they shared the same patients. And Drs here still try to protect one another if one does something wrong. Not as bad as it used to be. But if a Dr does harm it should not be kept from the public. Do Drs over there have malpractice insurance in case they are sued for making a mistake? Maybe your private Drs do? What does the NHS do if one of the Drs causes harm to a patient? I ask a lot of questions but I'm like you. Curious about the workings of different medical systems in other countries. How do your Drs get paid? Does NHS pay them a salary of some sort? If so, Drs in the USA would all quit if they had to accept a set amount of money. The insurance companies pay them and they still have patients who private pay. But Drs make different amounts of money in that, once again, the insurance companies don't all pay the same. And it depends on how many patients they have. Less time the Dr spends with a patient the more patients he can squeeze in and make more. Do you have Drs in every town or just certain towns? In the USA it seems like there's a Drs office on every corner. Or there's an area that's nothing but a complex of Drs offices. Plenty of those too. And the Drs offices have multiple Drs. Wish I could at least show you pictures but my old cellphone is limited on one it can do. Like my medical insurance. 😒Take care and be safe.

FlapJack profile image
FlapJack in reply to belindalore

The situation varies around the country, in terms of area, the UK is probably the size of one of your bigger states and we have a population of around 65 million so it may seem crowded here. There are a number of densely populated towns/cities but there also remote and sparely populated areas. When I was young, most surgeries were one man bands, very often located within their house. Now they have developed into Medical Centres, accommodating a number of Doctors, nurses who administer blood tests etc and some even have pharmacies attached. As far as I know, all Doctors, nurses and support staff are funded from allowances the surgeries receive from the NHS. Similarly, in hospitals, Doctors, nurses, most of the support staff receive salaries via the NHS. Some support services such as cleaning, catering, building maintenance and patient transport are contracted out to private companies which are also funded by the NHS. Some Doctors carry out private work but they are contracted to provide services for the NHS for which they receive a salary. Almost all Doctors and medical staff are trained by the NHS so it’s only reasonable that the NHS have some control on earnings. Yes, of course things can go wrong and as far as I know all Doctors are insured against malpractice but it’s not unusual for medical staff to get struck off if things went horribly wrong and they were found to be negligent.

I may be painting what may seem like a perfect picture, perfect it is not, and the whole system is currently under great pressure. Not enough staff or funding is always a major issue but the pandemic has obviously put the whole system under immense pressure. Our current political difficulties are no secret either so we are in for a rocky ride!

Please understand, the NHS is a vast, complex organisation employing more than 1.3 million full time staff and it’s far from perfect but most of the population love it!

belindalore profile image
belindalore in reply to FlapJack

Thanks for the info. It's amazing that they are able to do what they can with the funding they receive. Things have suffered here too in the medical system since the pandemic. But troubles with poor care has been going on for a long time. The pandemic made it worse. It has been awful to see people here die because they couldn't get their care or surgery they needed because of not enough beds etc due to the pandemic. One military veteran need gall bladder removal but no one could find a bed for him so he died. In any other time an unnecessary death. But there have been other instances of similar things happening to people way before the pandemic. It's just not always in the news or very well hidden in the medical community. Yes I saw that Boris Johnson resigned. We are having trouble here too. As my friend used to say:The world is upside down.

Take care and be safe.

Fulentium profile image
Fulentium in reply to mjames1

mjames:

Obamacare -- which is really Romneycare, since Mitt Romney came up with that stopgap between insurance coverage and universal healthcare -- is still in effect. Huge efforts have taken the teeth out of Obama's stipulation that insurance companies not factor in preexisting conditions, but it is the major alternative for independent contractors and part-time employees who are not insured.

Also, you are the second person in this thread to reduce plans below D to Medicare Advantage or nothing. Do a survey of retired doctors in the U.S. and you will find that nearly all have a Medigap plan, not Medicare Advantage. Leaving Medigap out of the discussion seems to be part of an unspoken agreement between insurance companies and U.S. regulators. I'm not sure why that's so, but anyone who has major health issues that could incur considerable expense is better off with Medigap. At the very least, people should research Medigap before choosing any of the various Advantage plans, which cover more but pay for less.

in reply to mjames1

The Canadian health system is highly rated. Wouldn't something similar suit the US? What is the position of the different parties on healthcare? Is it a hot political issue?

mjames1 profile image
mjames1 in reply to

From what I read here, In Canada there are very long waits with gatekeepers to get to see specialists and/or an ablation. And even after the wait very little choice in who does the ablation.

Jim

DawnTX profile image
DawnTX in reply to

We are spoiled here in the US. I can pick the phone up and have an appointment tomorrow. If it’s urgent my doctor can have me scheduled almost immediately for a procedure. I can call and speak to medical staff and they will call in a prescription for me. I know for a fact Canada‘s plan does not work like this. My dad was Canadian. I for one want nothing to do with socialized medicine. An HMO is different you look great to use the network of doctors you are not forced into it and you can take a PPO for the same amount of money. That gives you more options for doctors. I had no doctors anyway to speak of so I was grateful to be referred and because I really liked my GP I found I really liked those he sent me too as well because birds of a feather so to speak. You are not forced to do anything it’s a choice socialized medicine is not. Waiting two years for an ablation give your heart a chance to get more damage. They give you a total dollar amount a year mine is around $6000 after you have paid that much then you don’t pay co-pays. I have never had to reach the 6000 never been charged that much and things are capped. You all should know the truth and not a slanted view of our system for Medicare. Yes Medicare advantage is controlled so the doctors do not take advantage. As I said each of my first two were a quarter of $1 million US each that’s not what they got that’s what they tried to get. That did not include the Dr or any of the others that walk through the OR and send a bill. That nonsense is not allowed so tell me why our healthcare in the USA is so bad

belindalore profile image
belindalore in reply to DawnTX

I cannot just pick up the phone and have an appt tomorrow nor get in the same day. No one behind the desk in my Drs office even answers the phone. They have some service that answers their phones and they either say they will relay your message or you can leave a message. Which they seldom return an answer. My Dr ordered a mammogram and didn't even tell me. The imaging place I went to called me about scheduling an appt. I called the Drs office more than once to find out what it was for. No one ever called back. I had to call the imaging place to find out. The truth is that insurance is not equal for everyone in the states. Not state to state. And not all Drs or nurses are good. I guess you are pretty spoiled to not know that. I've never been hateful with a Dr or a nurse. But I've had them treat me pretty bad. And no I can't get a PPO for the same amount of money. Plans vary state to state and county. So do the costs. I am on a fixed income. If I could afford a PPO believe me I'd have one.

in reply to DawnTX

I didn't say your health service was bad. I have no first hand experience of it. Those who are from the US and have posted here seem to have varying perceptions. My impression, based on what has been said, is that those who have the more expensive insurance policies get very good healthcare, whereas those who do not do not get particularly good healthcare. This article by the Commonwealth fund (a US thinktank) discusses the merits/demerits of different national healthcare systems and provides a ranking:

commonwealthfund.org/public...

DawnTX profile image
DawnTX in reply to

Sorry it wasn’t directed at you just the one person who had so many complaints about it. We pay the same price pretty much unless you have a much higher income. The we meaning those of us retired.

Fulentium profile image
Fulentium in reply to mjames1

mjames:

You have to keep in mind that Medicare Advantage is the plan that insurance companies are trying to sell, and that even the OP has confirmed none of the "reps who sold" the OP on Advantage even mentioned options like Medigap Plan G.

It is understandable why the OP would not have known about alternatives. So I say to you new seniors who do have the luxury of reading this thread and knowing better before applying for Medicare:

Big mistake, new seniors, listening to reps from companies before reading about options on Social Security pages. Big mistake, heeding the mailings and calls of companies that contact you instead of researching in advance every company that offers Advantage and Medigap in your area. You should also check which states each company covers -- esp. if you think you might move at some point. If you choose Medigap, you aren't going to want to switch companies because of the loss of coverage if you move. So if you live in Chicago but fancy New Mexico, be sure that your Medigap or Advantage insurer covers both states.

Yes, it's better to read about options on Social Security pages and find links and insurance coverage ratings well before talking to reps. But not everyone knows they should do that and this is a serious problem in the U.S. It should be a part of healthcare law that every U.S. citizen reaching retirement age should hear about options like Medigap immediately from the government -- not have that kind of coverage buried in insurance company mailings from sharks masquerading as impartial helpers.

I also hope that seniors-to-be will research all of the different companies that offer services and where those services are active. If I'm in Oregon when I need Medicare and intend to stay there forever, I might choose Kaiser because it has the closest and coverage in that state, but I might not because you can't go outside that network of doctors. But if I'm still in New York, I'll choose whichever insurance company has the best rating for service and taking care of major medical events, and that also covers Oregon and possibly Vermont. I will be ready to pay a monthly premium even if that means living in a smaller place. Often, elderly people have to make choices that leave them less vulnerable to higher bills and added stress. I don't envy the person who has to declare bankruptcy in their 70s.

mjames1 profile image
mjames1 in reply to belindalore

Yeah, I see all those commercials with aging celebrities that they bring out during the switching period! I don't know how much less they charge than the $330 I pay for supplemental, but it might be worth it if not too much xtra since the other goodies they offer don't sound so great. It is too bad the disparity in health services but unfortunately a reality.

Jim

belindalore profile image
belindalore in reply to mjames1

It's not worth it because you don't get tests and good care like you do with supplemental. They make it sound like it's really good insurance when it's not. I read an article about lots of people switching to Medicare advantage in Texas. They found out they don't get as good of care.

mjames1 profile image
mjames1 in reply to belindalore

Maybe I misunderstood. I thought you had Advantage and your friend with the better coverage had standard Medicare with Supplemental? I pay $330 for supplemental not $500.

belindalore profile image
belindalore in reply to mjames1

Yes I have Medicare advantage. My friend has Medicare and supplemental. She pays $495 for her supplemental. Costs vary state to state. Her insurance is based in Wisconsin.

DawnTX profile image
DawnTX in reply to mjames1

Jim I have carried Humana HMO an advantage plan for the last 11 years and have never been unhappy with it. I have had plenty of choices for hospitals, doctors etc. it’s 170 a month that comes out of my check and they do not want you to have supplemental because you don’t need it. You can take extra for dental I found one for $15 a month that even pays for dentures not 100% of course but they make it affordable to have stuff done. They also cover the anesthesia if you need it at Cetera. Believe me I looked at everything before I decided on what I was going to use and I don’t have to renew each year but I do because I have been happy. I had both eyes done for cataracts it cost me $50 each eye. I recently had an echocardiogram that was $95 co-pay and my last surgery was 325 but then they just refunded me $60 I don’t know why. That’s all I had to pay. If I were admitted I believe it’s 125 a day for X number of days and then you’re covered 100%. ER is $95 but if you’re admit it they don’t charge you. I don’t know where you are because they do very state to state. My insurance in Florida was an HMO and wonderful unfortunately here in Texas I must have a PPO because of my location two hours away from Houston which is a major medical center. I don’t like the over paid people on TV but you really do get extras they even give you money each month for over-the-counter that you can buy from them and if you get your prescriptions mail order again most of it is no charge and you get 90 day supply I was on Multaq, Metropolol, Xarelto And I am on Jardiance all name brands and they cost me nothing. I would seriously look into a Medicare advantage plan if I were you and see if you can get one. Many doctors are under it so you can see if yours are part of it if it’s an HMO. I had to have all brand new doctors when I move to Texas. My EP/cardiologist is the pioneer of the procedure I had among other titles that he has. Houston is an amazing city for Medical and the majority of doctors are in my plan. My hospital is Houston Methodist and I would not trade the place for the world. Again maybe someone can explain what’s so bad about our healthcare.

belindalore profile image
belindalore in reply to DawnTX

Once again plans vary state to state and county to county. Especially here in Florida. Costs vary. Benefits vary. I have friends here in Florida who are snowbirds from up north. They all say the same thing. They would never get major care in this area. They wait and get their major care in their home states. So I guess they are all wrong too. We live in Volusia County. I've had two nurses tell me Volusia has the worst Drs. With my experience I have to agree with them. Why is Florida ranked 41st for bad healthcare out of all the 50 states?

Fulentium profile image
Fulentium in reply to DawnTX

DawnTX: Thanks tons for mentioning the exact name of your plan! I will research Humana HMO and compare it with other offerings in and out of Texas. Within each option, be it Advantage or Medigap, we have to navigate variations in the level of financial help and the degree of coverage, weighed against the expense of premiums and certain other parts of Medicare. Another plan in the Medigap range once covered Medicare B and other expenses, but that is a legacy plan available only to those who turned 65 within that now-closed window

belindalore profile image
belindalore in reply to Fulentium

A mechanic who did some work on my old car told me his mother here in Florida and where I live, has an HMO. He said she had to beg to get what care she got. She moved to Texas and moved in with another son. Kept the same insurance she had here but received better care. So it can matter where you live as to how good of care you get.

Poochmom profile image
Poochmom in reply to mjames1

I have exactly the same plan as you James. Before Medicare I had Kaiser which is an all inclusive HMO plan and I knew from the quagmire I experienced there not even being able to get referred to a cardiologist when I had AFib that when I got Medicare I’d be as far away from that as I could get. The surprising thing was the plan I have now is not any more expensive than if I had the advantage plan. I am happy to pay for the Plan G per month versus deductibles and co pays.

Peileen profile image
Peileen in reply to mjames1

Hi belindalore I wasn’t sure if the $500 was monthly or annually. In UK our National Insurance is a compulsory 15% of every earnings which comes to quite a lot. You stop paying that NatIns once you retire which at the moment is 67.

I recently paid £250 for a pain consultation of 40mins and £109 for the half hour follow up. New meds were suggested and one I keep using. This was while waiting for NHS consultation. A few years ago I paid £175 for heart specialist to discuss my electrocardiogram with me because GP hadn’t the time or rather expertise. Seeing a GP isn’t easy. I haven’t seen one for over two years. I will be getting routine blood tests this month that I should have had in March 2020. If you do see a GP here in Scotland or rest of UK the allotted time is 7mins. You can book a double appt but most appts seem to be by phone nowadays. I haven’t tried yet.

My sister pays a private insurance of £80 a month. That would be £960 a year. I can’t afford that. But itnwould have stopped me waiting 19 months for gall bladder removal. That would have cost £7,000 privately.

My intention in the future if I need surgery is to use my savings, but will probably need to use equity release on my house. I have to look into that. At least I own my house to be able to do that.

I think health services worldwide are feeling the strain of increased populations and high hospital admissions due to Covid. I am 75 and I believe the world population has doubled in that time. It was under 2billion in 1918 at the time of the Spanish flu and is nearly 8billion now. We desperately need a massive ampunt of more doctors trained.

Keep as well as you can mjames1.

Very best wishes. Peileen

belindalore profile image
belindalore in reply to Peileen

It would be $500 a month. That's the average cost for supplemental. It all depends where you live. Costs vary state to state as well as the coverage you can get with insurance. Yes the pandemic put a big dent in care here too. But this lack of care has been a problem here for a LONG time. Thanks for your best wishes. My gut hurts so bad this morning I cried.

Peileen profile image
Peileen in reply to belindalore

Wow belinaloer, that would be $6,000 a year or £4,900 in UK money. Many more people here are turning to private medicine so that increases the waiting time for NHS patients. The doctors here are usually the same. A more and more common practice is to pay tge £250 for a consultation and any suggested new meds is sent to the GP to prescribe. That’s what I have done. I do feel for you because the more people pay for private the longer you might have to wait. Make notes before seeing a doctor to refer to when you see one. Get as much prior knowledge too about your condition which you seem to do. And note times and severity of attacks. Get the most out of your consultations and take a seat.

I don’t envy anybody anything but when it comes to healthcare that’s the only exception I would make to having a lot of money. But as you say it should be a human right and like food and water that seems more and more to not be the case.

Again, best wishes.

Peileen

belindalore profile image
belindalore in reply to Peileen

It's hard to get any points across to the Dr when you get less than 15 minutes with him/her. Usually a lot less than 15 minutes. They book too many patients and rush you out.

Gtish profile image
Gtish in reply to mjames1

My experiences are exactly like yours, Jim. I have wonderful, caring, dedicated health care professionals at the University of Colorado Health Care System that take marvelous care of me. Those who think our system is second rate must not be reading all the horror stories (particularly GB and Canada - both with socialized medicine) on here of the incredibly long wait times they are experiencing. There is a reason people from around the world head here for care, despite what our government is doing to wreck a system not broken.

belindalore profile image
belindalore in reply to Gtish

Nice you get good care in Colorado. It's not the same everywhere.

Peacefulneedshelp profile image
Peacefulneedshelp in reply to mjames1

My understanding is the advantage plans actually take you out of Medicare and Medicare pays the premium to the insurance company you go with so you’re really not in Medicare anymore you’re in a private insurance company and I don’t think I wanna go that route because like someone mentioned you’re at the mercy of that plan and that company and who takes that insurance.

belindalore profile image
belindalore in reply to Peacefulneedshelp

No. It's still Medicare. Some costs are combined with Medicare advantage. They all pay differently but all are still Medicare. Almost every insurance company that sells Medicare sells whatever Medicare plan you want or can afford.

belindalore profile image
belindalore

One thing I do know. I'm so happy I found this forum. I've told a couple Drs a little about it but of course they think it's a waste of time. What do they know anyway. 🙄 I know at times I can sound like a tyrant in some of my posts. But my bark is worse than my bite. I just want everyone on here to be as well as they can. Sometimes it's not so easy. It's a struggle. But being in this forum helps people so much. I really think a higher power guided me to find it. I'm so glad. You all take care. 💖

mjames1 profile image
mjames1 in reply to belindalore

Most docs don't think much of forums like this and the internet as a whole. Partly because they like to be the sole authorities. To their credit, some are coming around to the shared decision making concept, but it's still in its infancy.

Ppiman profile image
Ppiman

Your story made your point, beautifully. Thank you for writing it. And your conclusion is spot on. The world, even in its richest countries, is geared to satisfying only its wealthiest inhabitants. A more equitable system. one that ensures effective healthcare to all, free at the point of need, would always get my vote.

The problem with such a system, as I see it, is that there is no easy definition of fairness; allied to this, there seems no way to determine or prevent what is misuse or overuse.

Steve

oscarfox49 profile image
oscarfox49

Shocking! And even more amazing that people think there is something wrong with 'social medicine'. Of course we should all contribute to the health care of the sick no matter who they are; good health is not an entitlement for the rich only. Any civilised society should have caring for the sick as its top priority.

FaberM profile image
FaberM

I went to High school in USA and had a young friend die of a rare cancer, his family were bankrupted by his medical bills, their insurance would only cover part of the overall cost. Years later (also USA) a friend’s wife developed aggressive melanoma, they had two small children, he gave up work to care for them (all family were in UK), he too was bankrupted, returned to UK a widower. I am on another health site for a condition which requires regular venesection, and some participants in USA bleed themselves in the shower, because their insurance has run out, they are between jobs, they can’t get the insurance to work.

The NHS is being starved of people - the Kings Fund research shows that the problems are mainly to do with lack of staff - Brexit, too few trainees in all specialities and many drop out or work in related less scary fields. It is also true that modern medicine can do so much that the costs spiral. I have very good GP, but she took educating about AF, and hospital care has been ok to good but not enough nurses and equipment breaking as needs replacing.

Tony Blair criticised those of us who regard NHS as our religion but to me help to those in need and pain without payment and without adding up the £ advantages to the clinician is a boon.

Ugh.

Richos profile image
Richos

Actually here in the UK the USA has a reputation for really awful health care which can cost a fortune and few people can afford. It’s certainly not thought of as “wonderful”

Gtish profile image
Gtish in reply to Richos

How many Americans go to the UK for treatment? Or Canada? If anything, they’re traveling here from around the planet to see our world-class health care professionals.

belindalore profile image
belindalore in reply to Gtish

Yes if they can afford it. Do you think everyone gets to see these world class professionals? No only if they have great insurance that covers them or deep pockets. Too many people fall between the cracks because they don't have great insurance or lots of money. My friends brother had cancer of the tongue and she was helping him. Tried to get him into the Mayo clinic. They turned him down because his insurance wasn't good enough. Terrible. That proves your life is only worth what kind of insurance you have or if you have deep pockets. Is that something the USA should be proud of?

FlapJack profile image
FlapJack

It all seems very confusing to me. Just as a matter of interest, how many ordinary US folk, as a percentage of the population would actually be able to access a Wolf MiniMaze procedure which we are told costs $150,000…….

belindalore profile image
belindalore in reply to FlapJack

I don't think very many.

mjames1 profile image
mjames1 in reply to belindalore

My plan covers it and your plan may also cover it.

belindalore profile image
belindalore in reply to mjames1

No my plan would not cover it. My plan only covers out of state if it's an emergency.

mjames1 profile image
mjames1 in reply to FlapJack

I know that Wolf Mini Maze (WMM) is covered by Medicare and I assume it's covered by many major insurance companies as well, but you would have to call the office for specifics.

But to put things in context, WMM is not a well known procedure in the US and therefore accounts for a very small percentage of all ablations, the vast majority of which are catheter ablations, like in the UK. The $150K is a cash price and I just assume most here would either have it reimbursed by insurance or look for other alternatives, there are so many.

Jim

FlapJack profile image
FlapJack in reply to mjames1

It’s OK Jim, I’m under no illusions about the WMM but appreciate and fully understand your comments. Thanks

frazeej profile image
frazeej

Personally, I am very satisfied with Medicare and the U.S health services in general. To the best of my recollection, I have never paid more than ~$200 "out of pocket" for several echocardiograms, treadmill stress test, adenosine "nuclear" stress test, successful GI surgery, successful cataract surgery, oral surgery for removal of precancerous lesion and coronary angioplasty-all done in timely manner with no "waiting lists", all done by specialists of my choice. It would be a cold day in hell before I would go to UK or Canada for medical care!

I am sorry that you are having issues with the presumed diagnosis of diverticulitis, which you apparently disagree with. Why don't you see another doctor-one of your choice? That is your right with Medicare.

belindalore profile image
belindalore in reply to frazeej

I have Medicare advantage. You can only use the Drs within that type of insurance. To go to a Dr outside of the plan you have to pay yourself. You need to learn the difference in insurance. I don't have a lot of money to find another Dr. You don't realize that healthcare is not equal for everyone in the USA.

frazeej profile image
frazeej in reply to belindalore

Your primary Medicare plan will cover 80% of the cost of a visit to ANY doctor, irregardless of what your Advantage Plan may or may not cover-the restrictions in the Advantage plan do not abrogate the benefits you are entitled to under Medicare Part B. A visit to my cardiologist (specialist of my choice) costs me $28 out of pocket. Medicare pays the rest. As you are suffering from diverticulitis (I know, I've been there), and your HMO type doctor is unsatisfactory, I would be anxious to see someone else and pay the 20% out of pocket.

belindalore profile image
belindalore in reply to frazeej

20% out of pocket to see a Dr would be manageable. But 20% for surgery or any other high costs would not be for me on a fixed income.

And you either have original Medicare which pays 80% and you have to pay the 20%. Or you have original Medicare with supplemental insurance to pay the other costs. Or you have Medicare advantage. Medicare advantage is supposed to pay for everything original Medicare covers plus cover all or part of costs for meds. They cover Dr and hospital costs but at discounts which the Drs and hospitals have to accept if they accept Medicare advantage. Some Drs and hospitals won't accept advantage because they want to be paid the full amounts. You have one type of Medicare insurance or the other and that's it.

Fulentium profile image
Fulentium in reply to frazeej

A practice that seems odd on this thread is when people post that Medicare is terrific because they're satisfied with their coverage, and suggest that anyone who isn't happy has done something wrong. That can be true in a way, but in truth, it should never be true. Empirical evidence can be persuasive; universal conclusions drawn from it, less so.

A person who turns 65, is mentally challenged and can't know the repercussions of signing up for the wrong plan should suffer no worse coverage than anyone else. Healthcare in the U.S. is far more complex to navigate than its tax laws, and the proof is those who have terrible coverage despite doing whatever research they did, and those who are bankrupted by things like grotesque increases in the cost of drugs in the U.S. -- increases that are often caused by vultures exploiting and abusing the patent system.

The reason for the complexity is that Romney and then Obama wanted to cover as many U.S. citizens as possible without affecting the profits of insurance companies or rendering them moot. Universal healthcare terrifies insurance companies, so it should not seem a coincidence that a republican designed the initial plan and a moderate democrat implemented it. They wanted to address inequalities in healthcare in the U.S. while guaranteeing continued business to corporate insurers at the same time. That is the reason for the complexity, but it should not be an excuse for insurance companies to exploit the complexity by hoodwinking people who can't navigate it and burying plans that might do them the most good.

belindalore profile image
belindalore in reply to Fulentium

Why I feel like a nothing. Because I wasn't able to make a zillion dollars in my lifetime to afford better insurance I feel like I really don't matter. And most of the Drs I've seen make me feel that way too. That I'm wasting their time. Since I've been on Medicare I've never been treated so poorly. But occasionally I do hear about someone who has good insurance who gets poor treatment once in awhile. Some of these Drs really do act like robots. No compassion or caring whatsoever. I do believe that the system is broken in that regard. Remember the old movie "Soylent Green" with Charlton Heston? Sometimes I wonder if things will be like that in the future. Kind of feels like that now. Obamacare turned out to be a joke. So many lies were told about the coverage. Politicians only care about themselves. Take care.

irene75359 profile image
irene75359

In the UK, my experience in cancer care has been first-class. I do have private medical insurance but most people I have spoken to found treatment is quicker on the NHS and I have found no reason to change. I shudder to think what the past 15 months’ intensive treatment I have had would have cost in the USA. I have had two ops in the past few months and both times stayed in a private room. Also, all cancer drugs are free, regardless of age. I feel very strongly that free treatment should continue to be available to all and wouldn’t have minded paying far more during my contributory years, providing it was ring-fenced specifically for the NHS. My heart goes out to people in the USA who cannot afford treatment, for whatever reason.

belindalore profile image
belindalore in reply to irene75359

Meds here cost more than anywhere else in the world. Too many people die because they can't afford the meds. The USA is supposed to be a great country but people won't admit our system is broken. I can't imagine what your cancer treatment would have cost here. Just the meds put people in poverty. We have teaching hospitals here. Where Drs go to intern and they do research and whatnot in these hospitals. There is a hospital in Kansas called KU MED Center. It's a big place. They do everything there. I had a friend in Kansas, Colleen, who didn't have much. No insurance. In her late 40's. Her sisters paid for her to get a mammogram because these sisters had had breast cancer. Colleen had the mammogram. She had stage 4 breast cancer. KU med center took her in. They have funds for people who don't have insurance. And I'm sure it's funds from the government. But they also get private donations. They did everything possible to save her life. It did go into remission for a short time. But it came back and spread to her bones. The last thing they tried was stem cell treatment. Another of her sisters was a perfect match. It didn't work. But she was never charged a penny. People like her know that the hospital uses them as a human guinea pig. And she was okay with that. It must have been in the millions for the cost of care she received. Had she survived she would not have had to pay anything. And yet hers is just one story. And this is just one of a very few hospitals that will do this. Others like her would not have been able to get the care she received. Because they can't take everyone. So happy you received good care. May you stay well.

Zora1 profile image
Zora1

I am sorry to hear of your troubles. Unfortunately, here in the USA healthcare quality and cost varies considerably from state to state. I have read that healthcare quality in Florida is 41st out of 50 in the country. I am in the Chicago suburbs and have a Medicare Advantage plan that has no additional monthly fee over the basic Medicare charge and also includes drug coverage. There is no copay for my PCP and the copay for a specialist visit is $20. I use a large hospital group that is top rated in the whole country. I was in my Cardiologist’s office when I was first diagnosed with Afib and she took me herself to the ER to be admitted to the hospital. While there I was visited by an EP and offered an evaluation (all of this during the pandemic). My hospital group offers me a no interest payment plan (copays add up if you’re in the hospital 4 times and have 7 different specialists). My only rant is against Big Pharma. Drugs cost much more in this country than anywhere else in the world.

belindalore profile image
belindalore in reply to Zora1

Healthcare varies state to state. Texas seems to have better care under Medicare advantage. My home state of Kansas is ranked 20th. If I could get back there I would. Too sick now and not enough finances to get back. Glad you are getting good care.

CDreamer profile image
CDreamer

You are so right in what you express. It seems to me that UK is going in exactly the same direction, very, very sad days when in so called ‘rich’ countries cannot afford to offer basic care or no care to the poor, yet very high tech pricey procedures to those able to pay both in the UK and US.

In UK private health also has many, many exclusions and does not offer cover monitoring for chronic conditions. AF is a chronic condition so all monitoring and drugs etc has to be through NHS registered doctors. If you PAY for private consultations, you will have to also pay for private prescriptions and you will pay a LOT more than the NHS pays.

Most doctors I have come across however, are very helpful about how you can navigate between the two systems and Private Insurance is NOTHING like the level you pay in US or Ireland. My husband thought he was on a good deal with private insurance in the UK after Ireland - he isn’t so much nowadays as each decade the prices rise and he pays about £500/month but then he is 88, for a comprehensive cover with £200 decuctables. I pay much less but it’s heading in that direction unfortunately.

I fear it’s going to get a lot worse before it begins to improve.

belindalore profile image
belindalore in reply to CDreamer

I think I'm going to just be another statistic soon if I don't get help. I haven't said much about it but it's been almost a year since I 've had this gut pain. I know it's not diverticulosis. That's just easy for the Dr to peddle rather than send me to a specialist. At this point the way I've been treated by these Drs I'm afraid.

belindalore profile image
belindalore in reply to belindalore

When my pain started the USA hospitals were full of covid patients. I did go to the emergency room. And the Drs told me I didn't want to check into the hospital and get tests with all the covid patients there. Actually there were no rooms for anything else then. Then when I saw my primary Dr for a follow up he decided I had diverticulosis and still does now without any testing to rule out anything else.

dmjtanner profile image
dmjtanner in reply to belindalore

Sounds like you should see a GI doc regarding stomach issues. (Gastroenterologist)

belindalore profile image
belindalore in reply to dmjtanner

If my primary will refer me to one. I have to get a referral. Quite frankly with the shoddy treatment I've received from the Drs I've seen that scares to have a procedure done.

dmjtanner profile image
dmjtanner in reply to belindalore

Hopefully he will give you a referral. What part of the country do you live in?

belindalore profile image
belindalore in reply to dmjtanner

Florida. 41st for bad healthcare out of all the 50 states..

in reply to belindalore

A friend who was diagnosed with diverticular disease told me the standard test to diagnose that condition is a colonoscopy (or a CT scan as a second best option) which rules out other conditions. I would press your doctor for a referral. There is no way he can *know* that you have diverticular disease without testing in this way. I have found that a good way to deal with this stubborn sort of doctor is to write or email them, asking them to explain their diagnosis also in writing. Your doctor, knowing that he could be held accountable (everything is there in writing) is less likely to fob you off with excuses. Worth a try at least.

irene75359 profile image
irene75359 in reply to CDreamer

When I enquired on a cancer forum about using my private medical insurance one person answered ‘Check the small print’. I found out that there was a very low limit to visits with a consultant (I think it was about two/three a year) and drugs for six months only. We took out this scheme in our early 40s and are now paying just shy of £700 for the two of us. I hate to think how much we have paid in over the years with very little taken out.

CDreamer profile image
CDreamer in reply to irene75359

Completely agree. Our old GP told us that we would be better off putting the money in the bank to use to pay for private health, should we need it. I did a quick calculation on what I would have spent for all of my claims and it well exceeded £300,000 so I think in my case, that wouldn’t have worked!

Age has the big influence and the costs rise every decade. I think if we had any confidence in the NHS surviving we would be happy to drop health insurance now but unfortunately we seem to be using the private cover more rather than less at the moment.

My husband had really good cancer treatment with no restrictions on his policy and was able to have Brachytherapy for Prostrate Cancer which would have been iffy to get on the NHS because of the long waiting time to get an Urology Appointment in the first place so we went private. I can’t remember if he actually had it at a private clinic or NHS hospital? But certainly it went through his insurance. Absolutely brilliant technology.

irene75359 profile image
irene75359 in reply to CDreamer

Really interesting. When I went a few years ago to my GP with a small sore on my face she wasn’t sure about it and asked if I had private medical insurance. I replied that I did, but was keeping it for ‘the big things’. She replied that for the big things, ie heart, cancer etc she could refer me to the absolute best in London, and I would be seen very quickly, but to see a dermatologist could take months of waiting. My husband always maintains we should have self-insured by putting the money away every month, but what has happened to you is a prime example of where that would not have worked.

belindalore profile image
belindalore in reply to irene75359

That's another conundrum I have with my insurance here in the states. They limit the number of visits with the specialists. The ones that are more important.

CDreamer profile image
CDreamer in reply to belindalore

They limit here as well Belindalore. We are attempting (not very successfully) to get an appointment to check pacemakers, we moved out of area of our previous clinics. My husband has authorisation for x2 appointments with specialist, diagnostics and replacement, if required. After that all regular follow ups are down to us. 🤷‍♀️

belindalore profile image
belindalore in reply to CDreamer

It's a crime to do people this way. It makes me wonder why have insurance at all if you can't see the Dr when you really need to. They don't limit the visits to the primary Dr but the insurance frowns if they think you make too many. Maybe if we were allowed more time per visit there wouldn't be so many visits. But then I have to remember it's profit over patient.🙄 My insurance will call me and ask to call back. It's a survey they do wanting to know how your recent visit was. It's all a robo call Not ever a real person. I never give a positive review. Don't think it matters much. Nothing changes.....

Shmediac profile image
Shmediac

I’m in the US, had my ablation this past April. I’m covered with employer medical insurance, but paid $8000 out of pocket😳

I believe the healthcare system is good in Canada. I'm not clear why there isn't more political pressure in the US to introduce a similar system. Also, I wasn't aware that there was wide divergence in standards between different states. Shouldn't this be addressed at federal level to ensure there is good provision all round?

belindalore profile image
belindalore in reply to

We have too much corruption within our government and our politicians to get anything done about healthcare in the USA. I learned long ago that our politicians are all lip service. As long as they have what they need the rest of us are prone. Look at Nancy Pelosi. Her husband was recently arrested for drunk driving. And they are ultra wealthy. They went on vacation to Italy while the citizens are battling high prices and being evicted because their rent keeps going up. Our politicians are not for the people. If they were things wouldn't be so bad.

NYCgal22 profile image
NYCgal22

I had the opposite experience when I had an ablation this year in Florida. I have a Medicare Advantage plan and I only paid 250 for my entire ablation. That was 125 per night of hospital stay since I had to stay 2 nights because I was put on a new drug called Tikosyn and had to have some ekgs done for observation first. I pay nothing to see my primary Dr. and 20 to see a specialist. Once I got up my courage to have the ablation I was able to arrange a date for the procedure within 3 weeks. I also don't feel rushed when I see my drs. Previously before I was 65 and able to get Medicare all I could afford was a high deductible plan which if I was still on that I would be out of pocket 6,000. Are there things wrong with our American insurance companies there sure are but overall I was pleased with my experience and so glad I had an ablation as so far no AFIB, though I am aware it can return.

belindalore profile image
belindalore in reply to NYCgal22

Glad to hear you had a good experience. It's not the same for all of us. And there are some good Drs in Florida. Where I'm at not so much. I had a nurse tell me not long ago that the county we live in has the worst Drs. My neighbor and some of her friends who are snowbirds say the same thing. They will get minor care down here but they all say they will never get anything major done here. That if something happens if they have to they will crawl back to their home states up north to get care. My neighbor has an in-law who's a retired Dr. He came to practice from Wisconsin to Florida years ago. He didn't stay long. He said the Drs down here don't want to communicate with each other when they have the same patients. And I've had that happen. Drs didn't tell my primary care Dr anything. One was the 1st cardio Dr I had. He didn't tell my primary care Dr anything he found and I called him on it. Then I switched to a better cardio Dr in the same practice. I've found the Drs I've seen as arrogant. Don't listen and think they are good as God. I don't think God would agree with them.

Snowgirl65 profile image
Snowgirl65

I'm so sorry for your friend's bad experience, and yours too. I'm in the US and have had absolutely priceless care from my doctors, both before I retired and while I'm now on Medicare.

belindalore profile image
belindalore in reply to Snowgirl65

You are fortunate and blessed. I am happy for those of you who do get good care. But shouldn't it be the same for everyone?

Snowgirl65 profile image
Snowgirl65 in reply to belindalore

Well I guess it has to do with the health care rules of each State, and which plan you choose. I hate having to choose a plan each year. I live in Ohio and my chosen plan kept my rates cheap again this year, but the prescription plan isn't as efficient as last year's. Perhaps you'll have better choices next year, and your friend too. Best wishes.

belindalore profile image
belindalore

I think we can all agree healthcare is not equal no matter where we live. Sometimes those who can afford to pay for better insurance do get better care. Sometimes good care depends on where you live. Medicare advantage is supposed to offer the same coverage as regular Medicare. But if that's the case why do I see so many articles about people NOT getting tests and such that they need? Why can't I get what I need? I believe a lot of times it's as I've always said, profit over patient. Yes I know that's not the case everywhere. But I think it's much more so than people know. And yes I do believe our healthcare system is broken. When someone is denied testing. When someone is denied any care. Then the system is broken. I see a future where when you reach old age you will be euthanized. Strange thing is it happens all the time.

SeanJax profile image
SeanJax

Change your doctor If he does not give you enough time. It is so simple and there are so many good doctors in any US cities. You have your choice here. In France patients are stuck to their GP who act as their master. No referral you cannot see any specialist. I don’t know enough about UK or Canada systems and I guess in US we are better off than other countries. I did not say it is better but it is acceptable. And you can sue the doctors if they mess you up. Good luck with that in France. Can we sue practitioners in Canada and Uk or Australia?

belindalore profile image
belindalore in reply to SeanJax

Sean all I can afford is the HMO I have. You have to use Drs within the plan. If you see one outside your plan you have to pay yourself. Believe me if I had the money I'd have much better insurance and other Drs. I don't have a lot of money. So I'm one who gets not so good care. The point I keep making is that it shouldn't be that way. There's a good article by John Steele Gordon about the history of the American insurance industry. Google it and read it. It's why our system is breaking down.

in reply to SeanJax

You can sue doctors anywhere!

belindalore profile image
belindalore in reply to

Yes but you don't always get anywhere. My brother and his wife sued the Drs and hospital where their baby was born. They bungled it. My sister in law was in distress. Had to wait for the Dr to get to the hospital so he told the nurses to give her whatever to delay the birth. My sister in law the whole time was saying something was wrong. When they finally delivered the baby the umbilical cord was around the baby's neck and she was deprived of oxygen. She survived but ended up severely handicapped because of it. My brother and his wife sued. It went on for 8 years and they finally gave up. In the end their lawyer said he found missing information in the hospital and Drs files about what happened. Yeah you can sue Drs. But some have shady lawyers to cover their mistakes.

Keta1 profile image
Keta1

I also live in Florida. It depends on what county you live in, but I have my regular Medicare plus the part B so I can get the supplemental insurance that covers everything Medicare doesn’t plus many extras and it doesn’t cost me a dime more. For my last ablation the bill was all most two hundred thousand dollars , I paid one hundred dollars co-pay at the hospital. That was it. I got hearing aids that would have been three thousand dollars without the insurance, I paid zero dollars. I get allergy shots and my co-pay when I see the Dr. is ten dollars. I pay zero when I get my weekly shots. When I see my PCP I never have to pay for anything including lab work. I have one of best Electrophysiologists in South Florida. I pay a ten dollar co-pay when I have to see him. I would recommend you check out what supplemental Medicare insurance is available for you where you live. It’s very simple, just go to the Medicare website.

Best wishes, Janice

belindalore profile image
belindalore in reply to Keta1

I know about supplemental insurance. But I cannot afford it. Being on a fixed low income it's just not attainable for me.

Keta1 profile image
Keta1 in reply to belindalore

If you can afford the part B Medicare coverage you probably can get the supplement insurance with out spending any more money. If you can’t even cover the part B you might qualify for assistance programs.

belindalore profile image
belindalore in reply to Keta1

No in Florida I don't qualify for assistance. I live with my ex and they consider me as his dependent. It's very hard for anyone to get any type of assistance here in Florida.

belindalore profile image
belindalore

Yes some people can self refer if they have insurance that allows you to.

Jajarunner profile image
Jajarunner

The British system is free but underfunded. I listened to a whole podcast about different systems. Basically, France and Germany spend more (a public/private insurance mix) and theirs is better. We spent middle amounts, like Italy, and our system is middling like Italy's. The USA spends huge amounts on admin and orders needless tests partly because of fear of litigation and partly to get business for their fellow doctors (my words, not the podcast's).The trouble in the UK that we want to pay low taxes like US but have top quality services like the Nordic countries. And actual funding to our system has been cut in real terms for last 12 years. But I don't envy the us system. Thanks for sharing,Belinda

belindalore profile image
belindalore in reply to Jajarunner

You are mostly right. But sometimes Drs won't order tests if you don't have the better insurance. Medicare advantage is supposed to cover everything that original Medicare covers but because Medicare advantage discounts what they pay Drs and hospitals, and they don't like that, many times the Drs won't order tests you may need. It's profit over patient. Once again it's not like that everywhere around the country but it should not be happening anywhere. Like you said huge sums of money go to administration costs here. The costs of meds are more than anywhere in the world. And sometimes people still can't afford the meds even if the insurance they have covers part of the cost. Some people die because they can't afford their meds. To me that's a broken system. Thanks for listening. Take care.

Gumbie_Cat profile image
Gumbie_Cat in reply to Jajarunner

A big agree on that underfunding! Then watching the latest leadership contests, tax is the main thing that most of them want to cut. After a pandemic, I’m not sure how they’re proposing to fund the NHS while still lowering taxation. I have to think that we are still better to have the NHS - and very glad for free Apixaban. Plus the Dronedarone that I’ve just been told to stop - but feel bad about the remainder of the box being unused, when I realise what others have to pay for meds.

Jajarunner profile image
Jajarunner in reply to Gumbie_Cat

Yes, isn't that a waste. The amount of drugs I've had to stop after using just one or two tablets.... Such a shame. I suppose it's to prevent tampering but....

belindalore profile image
belindalore in reply to Jajarunner

But the drug companies are still making money.😒

Kingst profile image
Kingst

Wow, you are preaching to the choir!! There are three huge problems with medicine in the US, especially Florida (!). The first is sheer greed. Most doctors overbook to keep the money coming in, and that means that (a) you are in their waiting room for an hour and (2) they "stand by the door" claiming they are way behind and can't talk. This has reached an almost comical point. There really isn't much point in seeing a doctor unless you have an emergency or need a prescription drug. And (3), most doctors are so poorly educated or so unintelligent that they are either no help or dangerous. Most doctors now it seems get their medical degrees from terrible schools in the Caribbean or Mexico. It's a sorry state of affairs.

belindalore profile image
belindalore in reply to Kingst

Yes those are all good points I didn't bring up. I was in the ER not long ago because my BP went too high (realized later it was because I'd taken too much Tylenol because my gut hurt so bad, yes Tylenol will raise some people's BP even though they advertise on TV it doesn't🙄. Drs at the hospital of course rolled their eyes at that. Dr was foreign. Couldn't understand a word he said. Then he said we'll do a stress test. The nuclear one which I declined because of the chemicals they use and I don't tolerate most pharma meds. I explained all that to him. I could see it made him mad. Next thing I know I'm discharged. Oh they never even told me I was going to have any tests to begin with. Nurse just poked her head in the door and said you'll be going for a test soon and she was gone before I could ask what test. What the heck is that??? What happened to a Dr coming to you and discussing what he'd like to do and also get your okay to do it?? When I had a follow up with my cardio Dr I told her what happened. She said be careful with Tylenol. Then she asked me what the Dr wanted to do a stress test for. Said there was no reason for one. She was a little miffed. Right now she's the best Dr I have. Florida seems to attract a lot of foreign Drs. And the ones who want to make lots of money. I have a friend back in Kansas whose brother is a Dr there. Henry. I asked Henry once did he ever think of going to Florida to practice. He said why, I have a good practice here. He does very well. So yes it is a sorry state of affairs. You take care. Thanks for listening. Too bad some of these Drs can't listen as well as you all on this forum.😊😌

Kingst profile image
Kingst in reply to belindalore

Thanks for your response. You are right, the doctors are mostly foreign, and the ones I have had to unfortunately deal with all have the same attitude: THEY DON'T CARE! They come from places that are far less affluent and they look at us Americans and think we are over-privileged and expect more of them. It's a sorry state of affairs. I hope you find better care!!

belindalore profile image
belindalore in reply to Kingst

Yes they don't care. I've been treated like I'm a complete bother to some of these Drs. I'd like to find better care but not holding my breath. I'd need to move out of this area and that's not something I'm able to do. Thanks.

Aoxomoxoa profile image
Aoxomoxoa

I have really good health insurance, and they definitely try to push me to get MORE surgeries and more expensive tests. All the time. I was offered a hysterectomy at 35 for a 2cm fibroid and heavy bleeding. NOT kidding. I was also offered an ablation very early with paroxysmal afib that is months apart with most episodes lasting <1 hour. The first time I went to the hospital with AF, they basically told me nothing was wrong with me, but kept delaying my release. They took me up to a PRIVATE single person fancy room in the middle of the night and then kept me until 6pm the next day (my echo was complete at like 8am, including them telling me it came out fine before noon), I assume so they could charge more to the insurance for the room. I had to continually poke the nurse because I wanted to leave. Excuse after excuse. Same thing happened in January when I went - I had an appointment at 2pm with my EP the next day, so early in the morning I told them, I really need to get to this appointment. They kept trying to say the Dr. didn't sign the discharge yet, so finally around noon I told them I was going to do a discharge against medical advice, then the doc signed it within 10 minutes.

That said, I wish we would have had universal healthcare from the start. I never understood how so many in the US would push all this stuff about "this is the greatest country in the world", exceptionalism BS all that, how great our military is etc - and then those same people would turn around and say we couldn't possibly do universal healthcare right. What do you mean?! lol

The fact is that prices are ridiculous because everyone has their hand in the profit bin. Most of the issues you talk about would not exist if health care would have been universal from the beginning. Profit will never work for healthcare in my eyes for really what is the simplest reason possible. Healthcare cannot be a free market, because your choice is "buy or die" - this isn't should I get an iPhone or a Pixel. You pay what your local hospital charges in an emergency, or you die. There's no true choice. They can charge what ever they want for a large number of emergency procedures. Like a monopoly. They also make it that it is impossible to compare prices at multiple hospitals when you have a less emergency situation. Though last year when I had to get a pelvic ultrasound, my insurance company actually called me to see if I would consider getting it done at a different facility to save them money, apparently they have a price list somewhere. That was a first. We've made a huge blunder thinking capitalism works for healthcare.

belindalore profile image
belindalore in reply to Aoxomoxoa

Wow you hit it on the nail. What I call, profit over patient. If you can only afford the crummy insurance like I have they kick you out as fast as possible. They want insurances they can make money off of. I have Humana HMO and they advertise on TV they have the human touch. I laugh at that ad. They might have a touch but it's not human. At least not in my experience. Yes if universal healthcare had been started in the beginning it may have worked. But not now. There's too much corruption within our government, our politicians, the insurance industry and big pharma for things to ever change to universal health care. They'd have to kill off all of the population and start from scratch in the USA. 😱😂 Actually there kind of was universal healthcare at one time. In the 1920's Drs and hospitals started financial plans to help people pay for their medical bills. I believe that was when the great depression started in 1929 and people were struggling. But someone came along and saw that money could be made from these people and that's when medical insurance came about. Then Pres Johnson came up with Medicare. And because of those two things healthcare has gone downhill in this country. If you want to Google it and read it there's a good article by John Steele Gordon about the history of the American medical insurance industry. It explains how medical insurance started and why it's the mess it is today. A real eye opener. Everyone should read it. You've had your share of what goes on in these hospitals and with Drs. It's shameful.

Take care.

DawnTX profile image
DawnTX

I am in the states and very happy with my coverage. I just moved from Florida and my first two surgeries were there with one of the best doctor you could ask for. Delray MEdical center besides being a top trauma hospital is also moving up the ladder for stroke and heart treatment. I have a Medicare advantage plan and yes I pay out of my SSA disability check. I have no need for supplemental nor do they allow you to have it. The most I have paid was 325 for my copayment entering the hospital for a quarter of $1 million surgery and that’s just the surgery not the doctors etc. Oh and I got $60 back from that 325 for whatever reason. In Florida I only had to pay $50 copayment maybe a little bit more for some very expensive test. As soon as I was diagnosed with a need, I was scheduled for the following week. Have you read how long people have to wait in the UK? What they have to go through to get anything taken care of? You should readjust your thinking I don’t know what part of Florida you’re in but you don’t know how lucky you are. Many of the doctors in Florida especially South Florida where I was originally were in New York City or Boston and the best of the best. I was spoiled rotten but maybe then it’s because I appreciated the people taking care of me. Attitude makes a big difference and though they will take care of you anyway if you put a smile on your face instead of ranting you might be surprised at what you get.

Anyone using basic Medicare should consider a Medicare advantage plan I’ve had it for the 11 years since going on it. My medical treatment in Florida was over a quarter of 1 million for each surgery just for the surgery. I never got a bill. That’s for the HMO if you can get it and in Florida you can unfortunately I am in Texas now and I cannot get it because I am two hours from Houston where the hospitals are. I still go to those and I wish I had the HMO. You may not like my statements here but I speak from experience and as I said I was spoiled, had incredible treatment and have no complaints. Don’t want them all together I don’t know where you are as I said but Florida has Cleveland clinic and just about every other hospital you can think of I can’t believe you don’t like anything

belindalore profile image
belindalore in reply to DawnTX

Yes it depends on where you live. Glad you are getting good care. Not my experience. Not everyone's experience. I've always had good rapport with Drs. Never ranted about anything to them. But I live in central Florida and this area does not have the best Drs. And that's not just my opinion. I've not thrived since I've been on the Medicare advantage I have. Not given time to discuss anything with the Drs. They act like they know how you feel. Don't know of any Drs who can crawl inside the patients body and know how it feels. Stare at their computers and don't even look at you. It's certainly not the care I'm used to. Glad it's better where you are. People need to understand healthcare is NOT the same everywhere.

DawnTX profile image
DawnTX in reply to belindalore

I also lived in Central Florida however did not have the health issue I have now with a fib. I also was not retired at the time. If you have not tried Humana maybe you’ll consider especially the HMO if you can get it unless you have doctors who are extremely fond of. Again I can’t speak for central as much as I can south Florida after retirement. I did have a fabulous Dr. Anthony Douglas depending on where you are in central. He listens

belindalore profile image
belindalore in reply to DawnTX

I do have Humana. It's crap. Glad it works for you. You have to remember not all areas in the state offer the same level of care. Nor do all areas have good Drs. It's the way it is. So no you can't speak for central Florida where I've lived for 36 years.

Aoxomoxoa profile image
Aoxomoxoa in reply to DawnTX

" Have you read how long people have to wait in the UK? What they have to go through to get anything taken care of? You should readjust your thinking I don’t know what part of Florida you’re in but you don’t know how lucky you are."

YOU don't know how lucky you are. YOU should readjust your thinking. Just because things go well for you doesn't mean they do for others.

My mom waited months to get a diagnosis for her ovarian cancer because they kept blaming her symptoms on her IBS and that she needed to lose weight. (She looked 9 months pregnant) Then the doctor who did her cancer surgery in MAY, the doctor consulted with my dad and I while my mom was in recovery, and he gave us hope, that it was bad but he removed as much as he could. He did not tell us how bad it truly was. He waited until September to tell me and my mom at an appointment "I knew since I did the surgery that it was incurable, but I was afraid you would give up to soon because of your history of depression" WHAT - excuse me, that should be my mom's decision, not yours so you can make more money off her treatment. It was a complete shock to all of us, a literal bomb drop. He gave her the choice whether to get a few more months of life out of more treatments. I was so angry and distraught at the same time, he turned to me to ask what I thought. I was seething but I managed to get out "We'll talk about it". She was 47 when she died on my birthday in October. They waited until after midnight to call me, and a family "friend" even went so far as to have them set her time of death as after midnight even though it was 30 minutes before, just so it wouldn't be on my birthday. (My dad told me this a year or so after my mom died) I also don't know why the hospice weren't clear enough to my dad that she was going to go soon, or I would have been there.

My dad 5 years later went into congestive heart failure, in part because after what my mom's doctors did, between dismissing her symptoms for months and then not being straightforward to her, he turned into a cynic and didn't trust them anymore. Unknown to me he had been having heart symptoms (probably Afib!) for years and didn't go to a doctor until his body was filled with fluid. At the time he had just started a new job, and his health coverage had not kicked in yet. My dad died a month after going to the hospital for CHF at age 57. I should have did a request for his medical records. IF they offered him a pacemaker or anything of that sort, it was probably denied due to inability to pay. I thought his hospital bill was going to be taken out of his estate, but medicaid actually covered it due to the fact that he would have been eligible for it.

I lost both of my parents by age 28.

In July of 2019, a doctor prescribed me a drug called Rizatriptan when I went in talking about having headaches of unknown origin for months, that most of the time were not even relieved by Advil etc. We specifically had a conversation about the fact that I had had migraines in the past, and I knew these were not migraines. I took the medication that evening, I woke up in the middle of the night with chest tightness and pain in my upper legs. I called the office the next day and they acted like I was annoying them , Then they didn't call me back for 5 days, I had to call them back - "just don't take it then" is literally what she said to me. No kidding, I didn't after the first time, I told her. I read the information about the drug closer, it specifically states this should not be prescribed if your headaches are not like your usual migraines. Welp. A week later I went into hospital the first time with Afib, I had NO IDEA what was happening to me. To this day I am almost certain it was that medication - I had not had a single blip from my heart before it. The afib was over by the time I got to hospital. So then I was subjected to the way they treat women when their tests won't tell them anything. They don't listen to the answers you give to their questions. They asked me about caffeine consumption no less than 6 times that first visit (and probably 6 more the 2nd). They kept asking if I was under stress, had I ever had panic attacks. No to all these. I had a short run of tachycardia while there. The doctor came in later and said "I don't know why it didn't print out" - I didn't know what she meant until the next day when I told another doctor that I had had an issue while on monitoring - she went and checked and told me the ER said they LOST it. Both of these episodes I had strong sense of doom, and thought I was going to die. And since no one was telling me quite literally anything at all, I went to the ER again. Again, must just be panic attacks.

Then I saw my first cardiologist, he did his tests, including stress test, and told me I just "need more stamina". They all acted like I was making things up.

So this had me running around trying to find answers. I ended up at an endocrinologist, and I did a test for the rare Pheochromocytoma. The lab (LabCorp which is pretty much the main one in the US) sent back my results as high, and the endocrinologist prepared to run more tests to look for the pheo. I looked closer at the lab test result sheet, and did the math and recognized that they had incorrectly processed the test and doubled the result. I called my endocrinologist as she hadn't noticed, and she reordered me to take the test (which is a pain as you have to pee in a jug for 24 hours). I contacted LabCorp, threatened to do what I had to do to report their negligence, so got them to refund the money I had paid for the test from our HSA.

Meanwhile I had another episode, this time with my heart rate hitting runs of ~250bpm for about 40 minutes. By this time I had an Apple watch so they couldn't dismiss me anymore. My GP prescribed me atenolol, and I emailed my cardiologist to demand a referral to an EP. My diagnosis of vagal mediated paroxysmal afib was finally made in November, from Apple watch recordings, by the EP. I finally got an official EKG in January of this year from the paramedics showing Afib with RVR, two and a half years after my first episode.

The notes from those first ER visits are infuriating. I saw multiple notes about how they thought it was panic attacks. For both the first visit, and my 2nd one a week later. During the first visit at the hospital here are the other mistakes that happened: the doctor came in and asked me if I could be pregnant because the urine test came back positive, I told her my husband had a vasectomy, no. So she does the blood test and it comes back negative and she goes "they must've wrote it down wrong" - um, how about they don't do things like that? I mean REALLY.

By far the most infuriating thing is on those records, I saw a note from the ER staff that a nurse "took a picture of the monitor and it could possibly be atrial fibrillation" during that episode I had while on monitoring. SO after that my cardiologist never bothered to read those notes, the doctor who "checked on" the ER record of the episode I told her I had on monitoring, never mentioned afib or noted it again anywhere, and the ER staff during my 2nd ER visit a week after the first did not read that note either and continued to ask me about panic attacks. So I ran around being told I was having panic attacks and just needed more stamina, or had a rare pheochromocytoma for months for no reason. Talk about terrible.

" I was spoiled rotten but maybe then it’s because I appreciated the people taking care of me. Attitude makes a big difference and though they will take care of you anyway if you put a smile on your face instead of ranting you might be surprised at what you get."

Excuse you, I had a perfectly good attitude those first ER and doctor visits, under the circumstance, other than being understandably scared after the sense of doom, near blacking out, and no one telling me anything. Take your victim blaming elsewhere. 🙄

Also here, get out of your “just world” bubble and get an education:

mentalhealthathome.org/2020...

belindalore profile image
belindalore in reply to Aoxomoxoa

Thank you. I am so sorry for the loss of your parents. And I'm sorry for everything you have gone through. I've found that too many Drs don't treat us women like human beings. We are either hysterical, hostile, lazy, anxious and we are ignored by these stupid arrogant Drs. No matter how nice of an attitude I have this is what I've been getting. This is the year 2022 and this kind of ignorance is still being practiced by these Drs. I had moved my mother down here to Florida in the late 80' s. She had to go on Medicaid and received poor care then. I have medical problems and really have lost hope finding out what is wrong with me. The 1st cardio Dr I had found out I had mitral valve regurgitation. Didn't tell me or my primary Dr. Didn't send her the test results. I had to go to the hospital and get copies. That's when I found out I had mitral valve regurgitation. I told him off which he deserved and changed to another cardio Dr in the same office. She's better and at least listens. That's a real problem with these Drs. They don't listen. It's happened to male friends of mine. But more to us females. I tend to see some ( I say some) people who have their great insurance and get good care don't have a clue how some of the rest of us are treated so badly. It really sucks. Take care and thanks for sharing.

Aoxomoxoa profile image
Aoxomoxoa in reply to belindalore

What's worse, is I have had excellent insurance ( I have United Healthcare with a $250 deductible and a 2k out of pocket yearly max and they cover quite literally everything, without any referrals needed, pretty much everything is "in network" and even if it wasn't they would cover most of it) - through ALL of this, and still got jerked around a lot. Thank you. Take care as well.

belindalore profile image
belindalore in reply to Aoxomoxoa

Yes I know a couple people who have great insurance and still got crummy care. Go figure.

DawnTX profile image
DawnTX in reply to Aoxomoxoa

Perhaps you should get out of being a victim and do something for yourself. If you don’t like the way you’re being treated speak up and change your doctor if you must. There is good and bad medical care everywhere FYI I have an education and also I’m from Boston originally I know good medical care and when I first moved to Florida I was concerned. It has changed quite a bit over the last 20 years maybe you should open your eyes and find a place that specializes in your issues. I lost both of my parents within a year from cancer and again no complaints with the way they were treated. Dad beat it the first time 25 years mom was gone five weeks after it was diagnosed it sounds like yours and my and sounded the same one of the cancers she had was adrenal I pretty much had the same staff for both of my parents.

I don’t know where you are but I would move from Hillbilly Junction if I were you. Meaning if your hospital is that bad and your doctors are that bad why are you going to them? You can disagree with what I said I as you are irrelevant to me. Pour me just doesn’t carry any weight with me. Spout your venom and cry your river with someone else and make a change for yourself. You deserve to be treated as I was and if you settle for less that’s your fault

Aoxomoxoa profile image
Aoxomoxoa in reply to DawnTX

You obviously didn’t click on the link. I’m telling you to get an education on cognitive biases, just world fallacy and victim blaming - all of which you continued to use in your new post. I’m not going to even grace any of the new BS you posted with a response. 👋

belindalore profile image
belindalore in reply to DawnTX

Wow talk about spewing venom. Wow. Depending on where you live in Florida it has not gotten better everywhere in the last 20 years. I've lived here for 36 years.

Aoxomoxoa profile image
Aoxomoxoa in reply to belindalore

The funniest part is I’ve avoided that hospital since and have switched Drs multiple times. Doesn’t change the fact of what I experienced. This hospital is located in Gig Harbor which is considered one of the best areas to live in WA. I spend hours more now commuting to Seattle to get better care as I have to take a ferry there. I’m privileged to have the resources and good insurance to do that.

Some people just need to think like this because they can’t handle the thought that they too “could” be a victim just as much as the next person. So they do anything they can to tell themselves the other person must have brought it on themselves. So they save their egos and quell their insecurities by being cruel to others 🙃

belindalore profile image
belindalore in reply to Aoxomoxoa

Yes. No empathy for others. Glad you are getting good care now.

belindalore profile image
belindalore in reply to Aoxomoxoa

My main problem is I'm sensitive to prescription meds. My body has a hard time tolerating them. I had a Dr years ago who understood that. He'd prescribed me a med once when I was having problems with menopause. I had a bad reaction and it almost killed me. He was so sorry that happened. He told me I was going to be one of those people who don't tolerate pharma meds well. Why I don't know. There's a test called pharmacogenomics that may have given me a clue. And Medicare used to cover it. But they quit covering it in June 2020. Saying it was inconclusive. My friend has a granddaughter who's a Dr in California who uses the test for many of her patients. She says it's a big help to see what meds they can and cannot tolerate. The Drs I've seen since being on Medicare have all poo pooed this pharmacogenomics test. And they treat me like some kind of leper when I explain to them I have bad problems with with pharma drugs. They want to be able to push the pills and say we'll see you in 3 months. When they diagnosed me with Afib it was Eliquis and metoprolol. No explanation whatsoever. Just take them and we'll see you in 3 months. I'd never had a Dr do me that way. I asked the Dr (cardio Dr) about testing my nutrients to see if I might be lacking in something that could be causing me problems. He shook his finger at my face and said all us Drs are trying to help you. I tried taking the pharma meds and after awhile I could barely function. Was losing weight. My irregular heartbeat was way worse. I told the cardio Dr what was happening and he got mad and said you have to take them. He didn't know I'd already quit. I switched to a different cardio Dr in the same office. A woman. She is much better. Still not getting the test I want but she does listen. Understands my problem with prescription meds. And is okay that I watch my diet and take supplements that help me. I live with my ex and he was put on the same meds a few months before me. He goes to a VA clinic. He couldn't take them either. The VA tried two other blood thinners on him and he ended up in the hospital with a swollen prostate because of the meds. The VA told him well it looks like you can't tolerate pharma meds well. It's a problem for lots of people other than my ex and me. But these Drs don't want to acknowledge it. Just take the pills even if they kill you.

Aoxomoxoa profile image
Aoxomoxoa in reply to belindalore

Yeah, I don't like to take them - nor do I usually do well on any of them. I've been afib free for months now, after choosing to lower the amount of atenolol I was taking myself after I had read that beta blockers can actually irritate vagal mediated afib. I long ago connected my afib to my digestive system (which is why I am in search of a new EP, he completely dismissed me in that regard) - I did a lot of research on my own and have been getting acid reflux and constipation under control, adding more potassium to my diet, taking magnesium taurate. It's working. I have even only had ectopics when something is changed (like I recently was given PPI and miralax by a GI doc, neither of which went over well) - the ectopics used to be a near daily occurrence. There are alternative ways to treat things sometimes. My new GP is a naturopath, though I have only had one appointment with her and there wasn't much discussed at the time except that I needed my prescription for the atenolol renewed. She did suggest I get a digestive test, and after the test, I am also on a custom made for me blend of pre/probiotics.

I've always had bad or strong reactions to pharmaceuticals. They gave me tylenol with codeine once when I was a teenager, and I could not even function at all on it. I was just out. Same with a migraine drug I was given back when I used to get hormone induced migraines. It had a "mild sedative" in it - that would absolutely knock me out way harder than it was supposed to.

The thing of it is, they don't know everything. And they definitely don't know everything about our individual cases, they don't spend nearly enough time with us to do so. They simply don't have the time to do a "case study" on everyone. Sometimes you have to do some of it yourself. And I get why they don't have the time, and I don't fault them for it, it's clearly the system we have. I do fault them, though, when they dismiss me like my EP did. Or when they scoff the moment I mention I read any sort of information on my own. It is insulting, especially when I know how to do research - I am educated and could have been a doctor if I had decided to do so.

belindalore profile image
belindalore in reply to Aoxomoxoa

Yes. I've had the same problems being dismissed. And scorn from the Drs when I tell them I did some research. They really hate that. Maybe if they listened to us and we had more time to discuss our concerns with them, we wouldn't have to do our own research. They really leave us no choice. It's really a problem with the insurance companies ruling over everything. And the Drs won't go up against them. Drs have become puppets of the insurance companies. I envy my friend who does get up to 45 minutes with her Dr in Wisconsin. Of course she has the better insurance. But even for something minor she gets a lot of time. My sister's youngest son always wanted to be a Dr. And he would have been a good one. And he did start college to study to become a Dr. But the more he probed and found what it was like to have to deal with the insurance companies, he said no way. And his mother told him if he was going into it to make money she would disown him. He told her no, that he wanted to help people, but he wasn't about to let insurance tell him what to do. In the end he studied to be an electrician. He's happy and he makes pretty good money. 😊

Take care and be safe.

lovetogarden profile image
lovetogarden

I agree that US insurance plans, particular Medicare, are incredibly confusing, with uneven coverage and often hugely expensive. Some of us are fortunate to have really amazing coverage and others have terrible coverage. It’s simply not fair. Very difficult to move the country forward on this, ObamaCare was a step in the right direction, but there’s a long way to go.

belindalore profile image
belindalore

Yes. That's the problem with so many insurances. Vary state to state. Vary plan to plan. Costs vary. Benefits vary. 😵 I have to admit that I feel a little sorry for the gals in the Drs office who have to muddle through all the different insurances. I think I would have nightmares. 😳😂

GuyDora profile image
GuyDora

My sister has Medicare and Medicaid. She never receives a bill and gets the same care that I do. I have Medicare and Aetna, that I pay close to $460, for a supplement, medication coverage, as well as dental and minimal vision plan. Her dental bills are all paid for and just had her free eye exam. She pays nothing for her many prescriptions. I pay $99/month, plus an $780 yearly deductible , just for my Eliquis, after my very, expensive Medicare part D (medication insurance) pays their share. When I heard her whining about receiving a $23 bill, I almost lost it. She is scheduled for a knee replacement and a gastric bypass, by some of her specialists, at a top notch hospital, here in IL. This is not an unusual scenario, and I still feel we have the best healthcare system. I may not like paying a lot more, for the same care, but at least I know everyone does get healthcare, here.

belindalore profile image
belindalore in reply to GuyDora

Not true. Not everyone gets healthcare here. If you don't have insurance at all you can be ignored by the healthcare system. It happened to a friend of mine who fell on hard times and could no longer afford insurance. She died from a severe infection she had because Drs refused to help her. She was a nurse for part of her life too. I hope the Drs who refused to help her end up with the devil.

GuyDora profile image
GuyDora in reply to belindalore

I’m sorry for your friend, but I cannot understand how anyone, with a serious condition, did not get medical help. My 42 yr. old nephew, who hasn’t worked in the last three years and carries no insurance, developed heart failure after Covid, and was treated and put on public insurance. He was taken care of, by the same Cardiologist, that both my mother and another close friend, are patients of. They live on the Coastal AL/FL border. I have been a licensed nurse, for over 30 years, and I never knew of anyone turned away from a serious condition. The hospitals generally help those who qualify for Public medical assistance. Sometimes, people have to be persistent in dealing with governmental agencies. I have never worked with an emergency physician, who refused to treat someone with a serious condition, based off their insurance.

belindalore profile image
belindalore in reply to GuyDora

Well it happens. It certainly did to my friend.

GuyDora profile image
GuyDora in reply to belindalore

As I before mentioned, I am terribly sorry that this happened to your friend. I can certainly understand why you are upset.

belindalore profile image
belindalore in reply to GuyDora

Thank you. She was a good person. She worked hard until her health turned bad. She was a nurse for a long time but finally quit because she didn't like some of the nasty attitudes of Drs she had to deal with. She raised two great kids on her own. She was only 56 when she died. Sad thing is she did find a Dr finally who said he'd help her. She never made her next appt with him. Her sister went to pick her up to take her and she didn't answer her door. The manager of the apartment where she lived had to get a key and open her door. She was on the floor unconscious. She died at the hospital with sepsis. It was all unnecessary for her to die. Things like this happen in this country. We just don't hear about it all.

Janith profile image
Janith

Typical … European socialized medicine is the same. If you can afford to pay … superior care. Otherwise, forget it. Fortunately, we are well off and can afford just about anything. However if you are less fortunate, then all healthcare is poor pretty much throughout the world. I wish you the best! Find a wealthy husband sweetie!

Aoxomoxoa profile image
Aoxomoxoa in reply to Janith

We are well off and have excellent insurance, and still run into substandard care too often. There aren’t enough wealthy husbands in the world for everyone 🙄 🙄🙄

Janith profile image
Janith in reply to Aoxomoxoa

I hope that you realize that I was joking ... Good luck with your healthcare ...

belindalore profile image
belindalore in reply to Janith

I think we were all joking..

Aoxomoxoa profile image
Aoxomoxoa in reply to Janith

I do, I was too lol

belindalore profile image
belindalore in reply to Janith

Yeah. Right. 🙄

Clarrisa profile image
Clarrisa

I live in Northern California. Reading these comments reminded me of a young dental hygienist I once had who suffered very bad diabetes. She had to move to Oregon in order to receive the healthcare she required. That state was more generous to patients in such situations.

When I was working with private insurance I received care at the Mayo Clinic for many years but after I retired & went on Medicare I was dropped as a regular patient. I read awhile back their CEO did not want Medicare patients travelling to there from out of the area (Unless of course you are referred there by a challenging situation). I have been dropped by several long time doctors in California too since retiring from private insurance. Numerous seasoned doctors where I reside do not accept Medicare patients period. I pay completely out of pocket to still see one. I pay out of pocket for more complete labs with consultations as well.

One problem here is even doctors (Specialists included) can no longer afford to purchase a house in the area so once a doctor retires, replacing them is very iffy. During the pandemic schools closed and some professionals that were left to teach their children as well, asked what they were still doing here in this expensive location, then moved away.

I agree with a earlier post or two that this country should not be footing the bill for patients who sneak into here for treatments like ongoing dialysis, giving birth to "anchor babies" etc. It is adversely affecting the safety net of many who some politicians have even branded as "deplorables" (and Trump gained a following with no surprise, to their dismay). Judging from all the comments, patients in the U.S. have a real need to process what they go through here to receive healthcare.

jeanjeannie50 profile image
jeanjeannie50

I'm in Devon, U.K. and I think my NHS care is excellent. We call the GP's surgery in the morning and book a telephone call back from a GP. That GP when he talks to us (mostly within an hour or two) will then decide if we need to be seen by them that day or not. If you have something they think needs urgent hospital attention they arrange for you to have an appointment with a consultant asap, usually within a few weeks. Once I had a small but sore spot on my leg, was seen by GP and skin consultant and had the cancerous spot removed within about 10 days.

Jean

belindalore profile image
belindalore in reply to jeanjeannie50

Wow. If I received that kind of care I'd be on cloud nine. Here it's very seldom to be able to pick up the phone and talk to the Dr directly. Some Dr offices have the nurses do that and that is becoming rare. My office has a separate agency from the office that only books appts for them. If I do need to call the office I get a taped list of things to ask about and then you still don't talk to anyone in the office. You can leave a message and maybe in a few days you might get a reply. Then if you do they sound put off like you're a bother. Medicine is in a sad state of affairs for too many people in the U.S. I recently had a mammogram. You go to an imaging center of which there are several, usually the one your Dr wants you to use. I kept getting a call from an imaging center I had never used and had no idea what it was for. The Dr I see apparently had ordered a mammogram and didn't even tell me. !!!???? I tried to callthe Drs office to find out. No luck. No call back from them. I finally called the imaging place and found out what was going on. Okay. A mammogram. So I made the appt. Then after all that the Drs office finally called me back. I said never mind. I took care of it..😬🙄 But I know I'm not the only one this happens to. But it's still annoying. Before anyone else who reads this has a hissy fit. This is my experience. Not everyone's. But I did read some comments on Quora about why people are moving out of Florida. Like California and New York it's getting too expensive and the healthcare system is not great.

You are fortunate in being able to get good care where you are jean. But others in the UK and other countries I've seen in this forum are not so fortunate. It's sad it can't be good for everyone. Sad 😥.

Storyjo1 profile image
Storyjo1

I totally agree, Belinda. After being on the good, expensive insurance and supplement where I never paid a co-pay for anything, we fell on hard times and had to go to a Medicare advantage plan. The plan is not bad for someone who does not have chronic conditions (Afib, spinal issues, Parkinson’s, etc) and just needs minimal care, but for us it has affected our Quality of Life.

belindalore profile image
belindalore in reply to Storyjo1

So true. It's basically preventive care and not even really good for that. Take care.

jwsonoma profile image
jwsonoma

My 1st experience with afib was a stroke at work. I lost my ability to read. I knew what was going on and had a coworker drive me to the nearest ER. Our company had switched health insurance from Blue Cross PPO to Kaiser HMO to reduce the annual cost from $18,000 to $11,000 per employee. The ER was not part of Kaiser. I got a cat scan, a bag of fluids and 2 aspirin over the 2 hours I was there. The bill was $16,000. $14,000 was the walk-in charge. Luckily, because I was deemed an emergency Kaiser paid for the amount over my $2,100 deductible. There are still milions of Americans with no insurance. You can always get emergency care but not ongoing treatment with no insurance..

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