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7136. wonkers2 - 5/30/2007 4:07:37 PM Health care pricing is a bit strange. The prices allowed by Medicare or Blue Cross are a small fraction of those for the uninsured man on the street. A friend of mine was able to buy a prescription item at Costco for $15 dollars that his Blue-Cross Blue Shield/Medco was charging, as I recall, something like $160 against his minimum/co-pay. He had the prescription filled at Costco and paid cash. He called Medco to find out what they were charging and got the run-around. They told him to call BC-BC where he also got the run-around. Finally, somebody at BC-BS told him what the price would be--ten times more than Costco's price. 7137. thoughtful - 5/30/2007 7:05:56 PM For those of you with pets...do the same thing with the vets.
I've gotten Rx slips from my vet instead of the drugs they like to dispense and have saved big bucks by going to cvs or walgreens with it. 7138. judithathome - 5/30/2007 11:42:49 PM Yeah, except my vet won't erite scripts. He fills them himself so he "knows what they're getting." Riiiight. 7139. wonkers2 - 5/31/2007 1:09:16 AM Seems to me that's unethical. I have to pry the prescription for eyeglasses out of the optometrist who checks my prescription, but he does give me a copy. Of course he wants me to buy new glasses from the selection in the store where he does the exams. 7140. thoughtful - 5/31/2007 1:39:42 PM I'm very open with my vets about what they charge. When the cat needed surgery, i price shopped it with other vets in the neighborhood, came back to them and asked them to justify their cost....which they did. But it was a wake-up call to them that there is competition out there and they need to charge accordingly. 7141. wonkers2 - 5/31/2007 3:12:04 PM Opinion All NYT
Opinion
The Obama Health Plan
Save
By ATUL GAWANDE
Published: May 31, 2007
As a surgeon, I’ve worked with the veterans’ health system, Medicare, Medicaid and private insurance companies. I’ve seen health care in Canada, Britain, Switzerland and the Netherlands. And I was in the Clinton administration when our plan for universal coverage failed. So, with a new health reform debate under way, what I want to tell you in my last guest column is this:
First, there is not a place in this world that is not struggling to control health costs while providing high-quality, easily accessible care. No one — no one — has a great solution.
But second, whether as a doctor or as a citizen, I would take almost any system — from Medicare-for-all to a private insurance voucher system — over the one we now have. Job-based insurance is bleeding away the viability of American businesses — even doctors complain about the cost of insuring employees. And it has left large numbers of patients without adequate coverage when they need it. In the last two years, for example, 51 percent of Americans surveyed did not fill a prescription or visit a doctor for a known medical issue because of cost.
My worry is less about what happens if we change than what happens if we don’t.
This week, Barack Obama released his health reform plan. It’s a puzzle how you are supposed to regard presidential candidates’ proposals. They are treated, by campaigns and media alike, as some kind of political G.P.S. device — gadgets primarily for political positioning. So this was how Mr. Obama’s plan was reported: it is a lot like John Edwards’s plan and the Massachusetts plan signed into law by Mitt Romney last year; and it has elements of John Kerry’s proposal from four years ago. In other words — ho hum — another centrist plan. No one except policy wonks will tell the proposals apart from one another.
Well, all this may be true. And if what you care about is which candidate can one-up the others, it is rather disappointing. But if what you care about is whether, after the 2008 election, we’ll be in a position to finally stop the health systems’ downward spiral, the similarity of the emerging proposals is exactly what’s interesting. I don’t think you can call it a consensus, but there is nonetheless a road forward being paved and a growing number of people from across the political spectrum are on it — not just presidential candidates, but governors from California to Pennsylvania, unions and businesses like Safeway, ATT and Pepsi.
This is what that road looks like. It is not single-payer. It instead follows the lead of European countries ranging from the Netherlands to Switzerland to Germany that provide universal coverage (and more doctors, hospitals and access to primary care) through multiple private insurers while spending less money than we do. The proposals all define basic benefits that insurers must offer without penalty for pre-existing conditions. They cover not just expensive sickness care, but also preventive care and cost-saving programs to give patients better control of chronic illnesses like diabetes and asthma.
We’d have a choice of competing private plans, and, with Edwards and Obama, a Medicare-like public option, too. An income-related federal subsidy or voucher would help individuals pay for that coverage. And the proposals also embrace what’s been called shared responsibility — requiring that individuals buy health insurance (at minimum for their children) and that employers bigger than 10 or 15 employees either provide health benefits or pay into a subsidy fund.
It is a coherent approach. And it seems to be our one politically viable approach, too. No question, proponents have crucial differences — like what the individual versus employer payments should be. And attacks are certain to label this as tax-and-spend liberalism and government-controlled health care. But these are not what will sabotage success.
Instead, the crucial matter is our reaction as a country when the attacks come. If we as consumers, health professionals and business leaders sit on our hands, unwilling to compromise and defend change, we will be doomed to our sliding global competitiveness and self-defeating system. Avoiding this will take extraordinary political leadership. So we should not even consider a candidate without a plan capable of producing agreement.
The ultimate measure of leadership, however, is not the plan. It is the capacity to take that plan and persuade people to find common ground in it. The politician who can is the one we want.
Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston and a New Yorker staff writer, is the author of the new book “Better.” He has been a guest columnist this month
7142. thoughtful - 6/1/2007 2:20:30 PM Arky, on the thyroid board, someone posted an article suggesting that T4 supplement is more effective when taken at night than in the morning, in case that helps you at all.
7143. arkymalarky - 6/1/2007 6:16:58 PM Thanks! I'll ask my doctor about it when I go in the 11th. I wondered why they have you take it in the morning--whether they think it might affect sleep, or what. My parents take theirs once a day whenever they think about it, without regard to whether they have eaten recently or not (their doses are very different from each other).
While I'm here, an update (I know everyone's been dying of curiosity wrt my "program progress"):
I'm able to do a lot more already than I was, and I'm wrapping up the last project of a hellacious school year today (as I lurk in here), so I'll be focusing much better on my diet/exercise, with a lot more fruit and veggies than I eat during the school year. I'm also eating out way less and keeping better tabs on a food journal.
The basketball goal has been great, along with the other exercise I'm doing--more regularly now. With the allergy shots back on and being very careful about my antihistimine and controlling exposure, I hope to enjoy more outside stuff than I have in the past. If it bothers me too much I have plenty of stuff to work out with inside, including a nice treadmill and a stepper. I can also swim in my parents' pool. The town has a great paved walking/biking trail, too, and a nice recreation center with an inside walking track and exercise equipment. Since I have a class in town five days a week during June I can do any of those things before or after class whenever I want.
I'm sort of eyeing the end of June to see where I am in relation to where I was when I posted a few weeks ago, which was before I knew I had a thyroid problem, but at a point where I knew I had to do something to lose some weight and get some energy. At the end of June I'll post where I am healthwise. July 1 we're leaving for CO for at least two weeks (YEAH!!!). 7144. wonkers2 - 6/11/2007 1:36:29 PM A conversation with Dr. Death 7145. jexster - 6/14/2007 3:48:15 PM Do Not Get Sick in Los Angeles
Tragic Catch-911 for dying woman
June 13, 2007
In the 40 minutes before a woman's death last month at Martin Luther King Jr.-Harbor Hospital, two separate callers pleaded with 911 dispatchers to send help because the hospital staff was ignoring her as she writhed on the floor, according to audio recordings of the calls.
...
An LA Supe says the janitors did a fine job of cleaning up the vomit of the woman dying on the floor 7146. thoughtful - 6/14/2007 4:51:58 PM and to think we're spending 16% of our GDP for this top notch health care system! 7147. arkymalarky - 7/14/2007 3:28:07 AM Well, I did 2 miles of mt. Walking at 8800ft, and now we're walking in Pearl Street Mall in Boulder. I'll post more at home, but since getting my thyroid straightened out I've lost 11 lbs and I'm getting more able to exercise. I've taken a lot of the advice here, especially keeping an eating journal. I'm trying to stay at 1500-1600 calories a day and staying out of restaurants. I'd like to lose 25-30 more, but mostly I'm ready to stop feeling like crap all the time. It's pretty bad when both your 70+ parents can run circles around you, to say nothing of Bob, who's 8 years older. 7148. thoughtful - 7/16/2007 5:30:12 PM good news on the 11 lbs. Keep up the good work. 7149. arkymalarky - 7/16/2007 10:10:01 PM Thanks!
We're on our way home now and I'm going to the doc Wed to talk about thyroid, hormones, etc, and I hope to have a diet/exercise/supplement regimen in full swing by the time school starts. The isolation of the cabin makes it easier to establish a routine and I'm hopeful I will stick with it.
I have another question for y'all along that line. I'm trying to decide what supplements to take besides a multivitamin. I'm thinking ginseng and flaxseed, and maybe D. I'm probably about to go back on hormones, at least for a while. Any suggestions would be very helpful. 7150. thoughtful - 7/17/2007 2:12:31 PM IMO ginseng is not worth it. Flaxseed oil definitely is but make sure the oil is refrigerated when you buy it and keep it refrigerated. The good omega-3s deteriorate rapidly when heated, thus you can't cook with it and expect it to stay beneficial. Vit D would be ok, depending on how much sun you get as your body will make its own. Also check how much is in your multivit. You should also consider adding a calcium supplement and most of those have added vit d as it's necessary to properly utilize the calcium. Along with calcium, it doesn't hurt to supplement magnesium. 7151. arkymalarky - 7/17/2007 3:47:24 PM Thanks! Bob takes ginseng and I have noted positive effects from drinking ginseng tea in the past wrt feeling. As a daily supplement, you're probably right, tho Bob's best friend swears by it and it's had good results in some major study, I think I read about in Newsweek. I'd as soon drink the tea, but it's hard to find here. Bob got a huge box of ginseng tea from a Korean exchange student, but that was a few years ago; he takes a supplement or the real root, which grows in parts of AR, when he can get it. 7152. judithathome - 7/17/2007 11:28:46 PM Arky, I'll bring you a box of the tea...Keoni drinks it and gets a good brand from Korea. It keeps really well, too. 7153. arkymalarky - 7/18/2007 12:33:53 AM Oh cool! Thanks Judith! 7154. arkymalarky - 7/18/2007 7:48:13 PM Well, went to the doctor, have meds in order and a plan lined out, and I'm done. I will check back with her wrt meds in 2 months and with my allergist at the end of Sept. I'll either stick with my plan or not, but my meds, supplements, diet, and exercise are all in place. Thanks for all the good advice and support! I feel I can take control of my routine for the first time in several years, and if it doesn't work it's all on me. 7155. thoughtful - 7/18/2007 8:07:42 PM Or, if it doesn't work, there's always more adjustments.
I've found I do much better with gradual adjustments than drastic changes.
I'm amazed at how I used to never drink coffee without sweetener/sugar, and now just the smell of is such a turnoff.
I'm amazed at how I used to mainline diet soda and now regular soda smells like sugar syrup and the diet smells flat. BLECCH!
But if someone told me I had to give them up all up at once, I'd've never done it. I would've felt deprived and craved it, and gone back.
And just as bad habits can be a problem, good habits can also be your friend. I miss veggies if I don't have them at breakfast and I go nuts if I miss more than a day or two of my walk. A few years ago, if you asked me if i'd ever eat broccoli at breakfast, I'd have told you you were nuts!
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