View Full Version : Our "NEW" health care system....

09-15-2010, 01:27 PM
I think I have kept folks abreast of my physical condition pretty well......
I have carried a universal insurance plan for about 30 years...now I dare not let a simple mistake take it away, such as missing a payment because they will cancel my coverage in a heartbeat...they're looking for any reason whatsoever to drop my coverage.
While "employed" as an independent contractor, working primarily through offices around Washington, D.C. and certain places in California, I opted for a plan suggested by my employers. First it was an HMO called Kaiser Georgetown, then renamed Kaiser Permanente. I have always paid the premiums...through 25 years of no use of it...only in recent years.....
When I turned 65, they made Medicare my primary without any input from me...the only thing I noticed was a drop in my payments from $285 a month to $145 a month. After I had the car accident I became accutely aware of the limitations this placed on my prescription meds. Where before I had unlimited prescription meds on my policy, I was suddenly restricted to $2500 without going into the "donut hole".....normally this shouldn't be a problem...but now there is extensive "game playing".
I am on a drug called Renegel........which I was advised last week is no longer made by the company, the replacement is called Renvella.
Through the Kaiser insurance, my co-pay was $10. The receipt showed that the Renegel was actually billed through medicare at $240 for a 90 day supply.
I just went into the donut hole.....
Now, if I want to fill the prescription I must pay the full price from my pocket...but it's not $240...now the medicare billing is $540....so I must pay $540 to Kaiser or the pharmacy for the drug the rest of the year, and on top of that, I was advised that the price will go to $800 plus for the same number of tabs in about 60 days...
ain't the new plan nice?
The old med was made in Ireland, Ireland will not sell directly.......I just ordered it thru a Thai pharmacist, shipped from Germany, for the sum of $249 for 90 days supply. and it's getting worse, as I have 2 e-mails on other drugs...my "monthly tab" for the "required drugs" is now in excess of $3500 a month to purchase here in the U.S.

09-15-2010, 01:58 PM
At least you're still alive to bit$h about the costs ;)
Sorry to hear your troubles.

I watched a show on tv a while back, I think it was Dr.Oz or some such drivel, and on it they had Robert Kiyosaki and some fellow from a health insurance co. discussing catastrophic health crises (Kiyosaki was on the show to sell folks on the idea of taking care of one's financial situation so losing one's job due to health issues wouldn't put the whole family at risk). Anyway the message given by the insurance co. executive to one family who had been denied coverage was to keep pressing and 'negotiating' with their insurer. In other words, they'll deny deny deny until you place so much pressure on them that they'll pay. Wonderful news to all folks, I'm sure, who are dealing with 'catastrophic' medical issues - i.e. "Please take some of that extra energy you have from fighting your illness and use it to harass your insurer into paying the bills". It was quite an eye opener.

09-15-2010, 02:54 PM
I'm sorry to here your in this predicament. It's these exact situations that bankrupt family's. Its like your penalized for doing the right thing. Then,when your broke,they force you into subsidized housing,and Medicaid. Then you can't find a doctor that accepts it. It's horrible. How are you going to get by,if you can't get the scripts from over seas? Can you be sure there legitimate drugs? This is the last thing you should be having to deal with. Maybe you'd be eligible for scripts from the V.A.? (none of my business,just throwing a thought out there) Please keep us updated on this. Theres a whole forum here, who cares alot for you,and will do anything they can to help,I'm sure.

09-15-2010, 03:07 PM
That sucks! Sorry!
Just to cheer you up: I start a new experimental drug next week, another group of people to monitor me on top of my regular team. Blood work tomorrow. Collecting my new insoles for running shoes on monday, getting my cycling shoes modified at the same time. Got my regular physio assesment on wednesday. Looks like they can pick up my gym card costs - or at least some. This month, with drug costs, it might cost as much as 35USD ( 3 doctor visits, 4 blood tests, 1 physio, 4 massage, 1 set orthotics, 60 odd tablets and hopefully gym membership at 50USD a month).
Ditch the half-arsed Obamacare, shoot a few CEOs of Insurance companies and some lobbyists, never let anyone from a drugs company talk and impose a National Health Service - taxes WILL rise, but everyone will save money.

09-15-2010, 04:01 PM
Hey Chuck, with your expenses won't you emerge from the doughnut hole and get meds covered entirely soon?

Vince Brennan
09-15-2010, 09:46 PM
Hey, Bram... I understand where that comes from ( "Yeh, well... the alternative...."), but it's not the point. The point is that these (censored) drug companies gouge everyone for their drugs.... and that we AND Medicare, after that debacle of a drug-purchase agreement passed by both Dems AND Repubs, are getting slowly and steadily reamed into the realm of "food or Medicine".

Chuck is fairly well off (Sorry if I [mis]speak for you, Chuck) compared to many in our society, but even he feels the pinch when something suddenly jumps from $10 to $800... Hell, even a Rockefeller would gripe about that sort of an increase!

I have several friends (well, at last count ONE of them still thought of himself as a 'friend' .... andTHAT may change after this post...) in the drug business and it is both heart-breaking and hilarious (at the same moment) to watch them try to defend the exorbitant (IM {not-so-feckin'-humble}O) prices charged for drug protocols:

"It's the R&D Costs!"
"It's the cost-to-market!"
"It's the Government constraining our profit margins on a substance that wouldn't have existed without us!" (This one gets a HUGE belly-laff outta me!)

What's the real reason?


How many of us hold stocks in McNeil, Pfizer, or any of the other major companies? I know I did.

How many of us are willing to see our dividends drop even a little bit? If these Giants dropped their prices to a reasonable level, thus reducing OUR dividends, how many, I ask, would continue to hold those stocks?

Damn few.

The outrageous prices charged for drugs fuel our retirements... the retirements of many, MANY people and if those dividends and revenues drop, how many of us will stick with a suddenly 'less-than-formerly' producing investment?

G R E E D. Pure and simple.

Gecko was right.

It reaches right down to US.

What are YOU gonna do about it?

I know what I've done. I've divested, and it cost me a bundle.

I'll be living under an overpass in Philly... probably under I-95 in South Philly.... got a nice cardboard box all set up for me.... but damned if I'll continue to profit off the misfortunes of my fellows.

GREED. That's it, lads. GREED.

09-15-2010, 10:21 PM
Tristan...I don't know/am not aware of any situation that would change the "donut hole" status.....what are you referring to.
I realized that in my business I would not have a conventional retirement so I planned accordingly. I made a good estimation based on 10 years figures at about how fast the cost of living would increase, and how fast other parameters changed, and then targeted what I thought was a good target and added 25% for long term health.......all that went out the window 3-4 years ago, and what I had planned for an extremely comfortable life left about the same time. I'm a long way from starving but at the rate things are changing....I may be growing my own alfalfa pretty soon. At least I don't have to buy meat and I have a load of canned fruits/pecans etc every year, But again today I was told by our lovely U.S. Government that I am not allowed to sell part of my retirement plan, in fact, I have to leave it for the grandkids to dispose of.
The drugs are legit....but they will allow me only 90 days supply at a time. The sad part...if I go to the hospital, the drugs are paid for by insurance, so if I'm feeling bad, I let them check me in for a free week of evaluations and it's all paid for.....about $18K for the week......it's rather screwy.

09-16-2010, 01:26 AM
Sorry to hear of your circumstances Mr P. A real pity you didn't emigrate here or Unzud when you had the chance.


09-16-2010, 02:01 AM
Hi there Chuck. I echo Purri's comment. I had to buy a couple of Ventolin plus another type of inhaler yesterday and it cost me $AU5.00. The other inhaler sells for $AU78.00 normally but I have a health care card.

09-16-2010, 11:40 AM
Hey, Bram... I understand where that comes from ( "Yeh, well... the alternative...."), but it's not the point. The point is that these (censored) drug companies gouge everyone for their drugs.... and that we AND Medicare, after that debacle of a drug-purchase agreement passed by both Dems AND Repubs, are getting slowly and steadily reamed into the realm of "food or Medicine".
I think you misread me - I meant to illustrate how utterly out of tune some folks are, and how brazen they are going on national tv with their tripe: this insurance executive was sitting in front of people who were going through a catastrophic medical issue and his only advice was for them to keep harassing the insurance provider (it was his own insurance co. IIRC). It seems to me that folks who are dealing with a catastrophic illness, and their family, have a lot better things to do than sit around trying to convince one toneless twit after another that they need their insurance to pay the bills - including drugs.
And the 'alive to bit$h' was entirely an attempt at humour...thus the ;)

I wish you both well.

Vince Brennan
09-16-2010, 11:49 AM
No problem, O Northern Brother! I did indeed miss the telltale!

09-16-2010, 03:23 PM
I want to be the next American Dictator. First order of the day, new stocks and guillotines in every town with a population over 1500, and double the number where the populace has a high number of former politicians.

09-16-2010, 10:19 PM
I'm so sorry to say,I can't vote for you,being a dictator and all,but I'm in. Your the most competent person qualified to do this. When is the coup? So,can I have the nuclear curling iron,attached to my nuclear powered boat?? You the man..I have faith.Some ones gota do it! While you at it,can you make all the appliances,furniture,and other things the USA developed be from HERE? The list is too long.:(