Disability and health insurance

Jewelry Discussion
21

Recent Federal laws do most of this as well. Your horror
stories will generally (but not always) be over two years old.
Basically, the federal laws require companies to keep you on even
if you’ve prior conditions, as well as requireing them to allow
you to continue coverage if you change employment, or become
unemployed. If you’ve never had insurance, and don’t qualify,
it can be difficult, but at least all those folks dropped for
little reason or because they changed jobs now have some
protection. One big kicker, though, is that if you’re changing
from a group policy to a private one, even if the companies
cannot deny you coverage, they CAN set their rates wherever they
like for the general class of private policies. They can no
longer discriminate against you individually, but they sure can
make a lot of money on private policies while at the same time
providing lesser benefits in those policies.

Peter Rowe

22

Greetings:

Thank you Mr. Mok for summarizing so effectively and accurately
the current status of health care in Canada.

Myself, being a senior, I am happy to say that we enjoy even
some financial support towards medical prescriptions not in
receiving funds, but rather in not having to pay them. In 90% of
cases the only expense we incur is a small dispensing fee paid to
the pharmacy, otherwise the prescribed medication is generally
free of cost. For me personally that an immediate saving of many
hundreds of dollars - being a type I diabetic I need constant
medication, glucose test strips, and rather expensive eyedrops,
every day!!. I calculated that the overall annual costs would be
in the vicinity of $1000.00 if I had to pay them from our
retirement income. My wife, for other illness, derived similar
benefits when she needed them.

If such be the “socialist” health care benefits, most peoples of
the world would be well served.

23

Dear Kevin - Thank you for your passionate description of the
Canadian health care system. not very dissimiliar to the British
system that my in-laws have. Mind you, they love to complain
about the waiting and all but when they realize what kind of
financial burdens that we have in the States, what to speak of
the inequities that we face with HMO’s, they quickly change their
tune. In Sweden too, the socialized form of medicine is receiving
some of criticism and because of economic duress is having to
curtail some of the minor benifits.But the heart of the system
will never be changed because the populace has been educated to
the equitable and humane benifits that EVERYONE has a right to. I
think that is the differance between the profit motivated system
in the USA and the more humane socialized health care programs of
Canada, Great Britain, Scandinavia, New Zealand and
Australia…an educated populace. If we continue to believe that
"We’re Number One!" then there’s no impetus to change. Who would
get elected today by broadcasting the statistics that the USofA
now has the greatest amount of medically un-insured people in
the developed nations, the greatest amount of children born of
teenaged mothers, the highest rate of early childhood deaths, the
greatest number of prisoners in the world (more than China,
even!) and the lowest scores in education? Of course we all love
to quote the maxim that in America everyone can become a
millionaire or rise from poverty and reach greater heights. And
yes, there are examples of that. But it’s like the lottery
(remember Orwell’s ‘1984’?) the reality is that the majority
suffer far greater under this system for there are no safety
nets. Unfortunately because of the cold war we have equated
socialism with communism and to create a nationalized/socialized
health care system is all but impossible with this black/white
mentallity,combined with the all-powerful medicine-for-profit
mentality. It won’t be fixed in my lifetime, that’s for sure.
Interestingly enough, the ONLY politician in America, who’s
openly discussing these issues is Jesse Jackson. A very
intelligent man, if you can bear the sermon-like delivery he
uses. But he doesn’t have much chance of getting elected to high
office. Anyway, I apoligize for the long-winded monologue…but I
wanted to share my view with you and others who find ourselves
with the same concerns. Up s…t creek, without a paddle…but
alot of hot air. Peace. Kim-Bob

24

G’day; everyone and his dog seems to have comments on medical
insurance v ‘socialist systems’. I thought I’d aquaint you with
the New Zealand situation as simply as I can so if you’re fed up
with it - delete now!

There is only a fraction over three million people in the whole
of New Zealand, so the government doesn’t have a lot of spare
taxes - although as it is we’re pretty heavily taxed directly
and indirectly , including 12.5% on EVERY transaction!

Everyone is covered for accidents by our Accident Compensation
system. (even including the bloke who fell through a skylight
when attempting a burglary!) If you have life-threatening
conditions you get whisked off to hospital (but you pay for the
ambulance unless you live in Wellington!) and discharged the
moment they reckon you might not just collapse. But for what
they call elective surgery, which includes cancers, heart bypass,
etc, you go on a long waiting list. (and hope you don’t die
before you get to the top!) If you have medical insurance
(prohibitive for most - it’s priced itself off the market) you
get to hospital inside a couple of weeks. Otherwise you pay for
elective surgery.

I had two bum knees, and could hardly walk; waiting list 2
years! Cant afford med insurance. Scraped up the necessary
$12,500 + $100 for physio after, and all was well, But. There was
the other one, just as bad and no more money! I went on the
list. Six months later, got hold of the phone number of the
person who handles the lists, and asked how long I had to go;
18 months she said. Didn’t they have cancellations? Well,
yes. Would I be prepared to go into hospital at short notice?
I said I’d pack my things as soon as I got off the line. Got
the letter three days later, was in 12 days later, out 9 days
later. No charge. Got 2 new knees which work fine. The private
hospital where I paid was like a 5 star hotel. You didn’t get a
cup of tea - you got teapot, hot water jug, milk, sugar plus fine
china and home-style cakes on a ‘silver’ tray, and real gourmet
cooking. In the Public Hospital you got air line meals and
cardboard food. but - and here I must shout it out loudly:
“THERE WAS ABSOLUTELY NO DIFFERENCE IN THE QUALITY OF THE
NURSING CARE!” I pay $30 for each visit to the doctor; children
under six are free. I pay a part charge for most medicines.
Full for others. The people of my village own the Mapua Medical
Centre - we built it with volunteer labour and donations of
materials. I pay full (damned heavily too!) for dental
treatment. Socialist? Don’t be daft!! Cheers now,

       / \
     /  /
   /  /                                
 /  /__| \      @John_Burgess2
(______)

At sunny Nelson NZ - and trying to stay well!

25

This is true, Pete, but, and it’s a very very large but: they
can and do make it prohibitively expensive so the effect is the
same. Try being a 20 year who’s had a CVA for no known reason:
no drugs, no smoking, no coffee, no family history, no pill.
Or even someone without a “history” who simply is still trying to
cobble together a career out of part time opportunities and
can’t afford much… Ryr

26

Hi, I am truly happy that many of my Canadian friends and
neighbors are so pleased with mediocrity!:o) I have worked in
the Health Care industry for 30+ years. It is difficult to put
a label such as “Craftsman” or “Mechanic” on a Dental Tech
because our ‘duties’ involve not only the fabrication skills to
make the restoration, but metallurgy, bio-mechanics, case
planning and sequencing, and just plain engineering. When a
person commits to a profession, he/she should strive for
excellence in that given undertaking. I have seen over the
years, the results of Dentistry performed in these ‘health care
utopias’, and I highly suspect that the medical care is on a
par. This out and out scares me.

Altruism is a wonderful thing, unfortunately not enough of us
have it. As distasteful as it may seem, profit is the motivator
that fuels a free economy. When you have a 'one size fits all’
program in anything, health care, business, baseball bat or
hockey stick making, you have a program that, at best, fits most
of the people in varying degrees of success, and the rest of the
people not at all. It’s kinda like getting your uniform when in
boot camp, you always wondered who they were averaging. These
cost cutting measures used by HMO’s by and large, border on
criminality. Their success is predicated on giving the patient
the least amount of treatment to keep him alive or in my end of
things, keep him chewing, as is possible. This is 'penny wise’
in the short run, but, pound foolish in the long run. It is
akin to treating the symptoms of the disease and not the disease
itself.

New and wondrous discoveries in medicine, or most things for
that matter, are not found by people who are trying to plug
different numbers into a formula and hoping to get the same
answer, but are nonetheless willing to accept whatever answer
they get. These discoveries are made by people for both
altruistic and remunerative reasons, with a heavy emphasis on
remunerative. How many people of exceptional ability do you
think you would be drawn to a career as a doctor, with all of
its expense, study, and just plain hard work, if the
remuneration was not substantial. Cynic that I am, I doubt that
there would be a very long line, and we really need those
people. I may be wrong but the Canadian Health Care system
seems to be on the same road as the U.S. Education system which
tried to make everybody ‘feel accepted’ by lowering the average
so all would be equal. This has been a marvelous success
, just look at the test standings vis-a-vis the rest of th
world :o).

Please don’t bring up the Clintons "attempt’ to revamp our
health care. The First Criminals had only their own self
interest and the furthering of the Democratic parties strangle
hold on the uneducated masses as their goals. (Whoops, I guess
I may have alienated another whole segment of society, oh
well…) Hillary is reported to have made big money by bashing
the drug companies in public to effectively driving down their
stock prices and then investing heavily in the undervalued
stock.

Is something wrong with our system? You betcha, just as there
is a ‘ton’ wrong with HMO’s. Can it be fixed? Maybe if we can
find Solomon or someone with that degree of wisdom but one thing
that I do know for sure is that ‘averaging’ the health care is
reducing the health care and as a person who strives for
excellence, I find this unacceptable. I tend to lean to a tiered
health plan, where no one is denied health care ( here in the
U.S., it seems the people getting screwed are the middle class,
precisely the people who pay the bills!). This needs to be
worked out. Are the insurance companies at fault? Is Northern
Siberia cold? Their actions are unconscionable. I could never
understand why there is not a health care pool consisting of
everyone in the country, so no one goes without. There could
then be several levels of increased (or luxury to my northern
neighbors) coverage paid for by the person being insured with
all insurance companies having to accept every one and the rates
would stay the same no matter what happens because the group
would be big enough. Elitest? Of course, but ya pays yer money
and ya takes yer chances. But at least you have the option.

I am not usually this contentious, at least not in public. It
must have something to do with the ageing process.:wink: There are
merits for both systems and I suspect that the ‘ideal’ is
somewhere in the middle.

Regards,
Skip

Skip Meister
@Skip_Meister

27

This is a little bit off the topic of jewelry, but I have to
respond. Recent Federal legislation has precluded group insurers
from declining to extend coverage to an individual based on
his/her medical condition. If the coverage is individual rather
than group, as is the case with most self-employed, the Insurer
is with few exceptions free to decline coverage, and to issue
"riders" excluding coverage of charges related to specific
conditions and/or specific body parts. A favorite trick of
Insurers issuing these individual policies is this; When an
insured is faced with a catastrophic illness or injury, the
Insurer investigates the insured’s medical history going back
several years prior to the application, hoping to find an
inconsistency between the medical record and the on
the application. If/when an inconsistency is found, the Insurer
either rescinds coverage retroactive to the initial date of
coverage, issues a rider excluding the condition, or jacks up the
rates retroactive to the initial date of coverage. While the
investigation is in progress, the Insurer commonly suspends the
processing of bills for the insured, and the investigation often
takes several months to complete, during which time the Insureds’
medical providers often turn the Insured’s account over to a
collection agency.

I am a third party reimbursement specialist for a national Home
Health Agency and I deal with scenarios like this on a regular
basis. Believe me, the horror stories continue unabated.

Lee