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I have been saying basically the same thing for years. The insurance and drug companies have been calling the shots in the health care industry for a long time. Medical research does not set the standards for blood values, drug companies do. They keep lowering acceptable standards, especially for blood glucose, cholesterol, blood pressure and triglycerides. This is so they can sell you more drugs, some that have as much risk associated with them as the condition itself.

Astra Zenaca has an ad that says even if your cholesterol is OK, taking Crestor may help reduce your chances of heart attacks. This is the drug I, my older brother and my sister were taking for elevated cholesterol. It put all three of us in the hospital within a three month period. Both of them had their gallbladders removed but I was to unstable to take to surgery. The drug almost killed me. My doctors told me I was lucky to be alive.

But my beef with insurance and drug companies came long before my personal experience. Watching them from a professional standpoint has soured my perspective greatly. Sandi is right. The government could not mess up health care any worse than private industry has. In my opinion it would be a case of going from the fire to the frying pan.

I too am a nurse, Yvonne. For years I felt the same way that you do. Then I went to work for one of the "dreaded insurance companies". It has been an eye-opening experience. I began in case management for Medicare patients., and was appalled at how much utter fraud is perpetuated by facilities. I can't begin to describe it in this forum, but suffice it to say that it is rampant. And this in a program that is monitored! I cannot begin to think of how traditional Medicare is abused, since it has no oversite.
I can also tell you that neither myself or any of my other nurse colleagues have ever been asked to do anything that isn't in the patient's best interests.
I am aware that the insurance industry has it's problems. But I don't believe they are the monsters that they are portrayed to be in the press.
I expect this response will draw a lot of ire, as it's fashionable to be opposed to businesses that make money. I suppose what is hard for me to understand is why anyone would bother to be in business if it were not to make money.

CL,

You have a perspective from being involved in a way I have only glimpsed. For a while I worked FT at Baptist Hosp and FT in home health. I did see much fraud in the home health job. Sometimes I would change dressings on wounds that had healed. Yet, because of the way we were taught to document, that patient would be recertified. I stayed in home health for less than a year because I felt it compromised my principles.

I have known of doctors, one inparticular, that abused the heck out of the system. He will lie regarding patient's conditions simply to admit and/or keep them in the hospital. So I know you are presenting an accurate picture also.

That being said, my own personal experiences have been a great teacher. I am not disputing your experiences. However, again in my opinion, the insurance industry has failed the American public. The cost of health care is greater than any other industrialized nation and is not available to millions of Americans.

Companies can make a profit and still be "good" companies. Unfortunately, we have too many greedy people running the health care industry. Look up the stats on insurance companies. They are some of the most wealthy companies in the world. To me, there is a big difference in making a decent profit and gouging (which is my beef with insurance and drug companies).

Consider this:
"The guvmints goal is to maximize wealth for their officeholders and moneymen behind them, not provide you excellent coverage. When they run the game, we lose."

It all depends on how you look at it.
Government run health care will be exactly like all government run programs. Think about that!

Yvonne and CL:

I too have seen rampant fraud in healthcare.

When I worked as an ER nurse in California, I would often see patients come at 6am to the ER for their gallbladder surgery. They weren't on the surgical schedule, and Admissions didn't open until 8am. The same doctor was always on call.

It didn't take a rocket scientist to figure out these were Medi-Cal patients who didn't have approval for non-emergency surgery who were being sent to the ER by the surgeon to 1) get around the system, and 2) pocket a fat fee for doing "emergency" surgery on these folks, who often weren't even in pain when they got to the ER.

What the system needs is oversight and penalties with real teeth to discourage the fraud.

It also needs transparent pricing. Patients would shop around if they knew how much health care really costs. Consumer groups like Consumer Reports would analyze pricing and tell us how much we are being over charged.

Example: did you know it costs $300 to get a dermatologist to remove varicose veins? Yet the procedure involves injecting the vein with a little normal saline solution (the stuff in IV's for the non-medical among us). Pennies for the needle, pennies for the syringe, and pennies for the saline. A fat fee for the dermatologist.

Transparency in pricing. That is crucial to any meaningful health care reform.

Chiropractors use only their hands, but how much did it cost to train them?

"However, again in my opinion, the insurance industry has failed the American public."

My 80 year old dad just spent 10 days in the hospital. He had a potentially serious but correctable illness that was fixed with surgery and proper care afterward. I went to see him almost everyday (was out of town for 2) and saw the excellent quality of care he was provided.

He told me the total bill was around $110K when all was said and done. I asked him how much he would have to pay out of pocket. Answer: nothing.

I knew he was on Medicare, which he paid into during his working years, but thought surely he would pay for something. Nope, he and my mom enrolled in Medicare Part B and all the other available supplemental insurance that they pay out of pocket to the tune of $600/month for both of them.

$600/month to cover such an expensive stay, sounds like a bargain to me.

Dan, glad your dad is doing better.

My dad had a quadruple bypass a year ago. I don't think he paid much if anything either. But he had Medicare and the Federal BCBS plan.

I had my gallbladder out last October, and owed about $2500 of the 10k bill. I'm still paying it off (5 more payments to go!).

Laproscopic gallbladder surgery is so commonly done it is routine. I don't begrudge my surgeon his fee. He did a great job, and I got great care at the hospital. However, it helped that after surgery, I was admitted to the maternity floor (they take post op cases when their post partum census is down). If I'd been on a busy med surg unit, I know I would have had more trouble getting pain medication in a timely manner. I know this because I do my clinics at that hospital.

It's a good hospital, with good nurses, who are terribly overworked--and care suffers. And when care suffers, patient's don't get good value for their dollar.

And truth to be told, I really don't know if I paid a fair price for my surgery and care because I have no idea how much it should cost. I was told the cost of my hospital stay, but not what the surgeon or anesthesiologist would charge, upfront. I said, "OK."

I am truly grateful not to suffer the pain I was in last fall.

That doesn't mean I wasn't overcharged. And that's where healthcare really needs to reform: transparent pricing. If the price I paid was fair, then it was worth every penny.

But if I was overcharged in any way, then the argument, "but your pain is gone" is insufficient to meet the smell test.

Glad you are doing well too Panacea and your dad. I oft wonder if my dad lived in a country of socialized medicine if he would have had delayed, or worse denied treatment because of his age. Eighty years is getting old, yet he is on the mend and otherwise a very healthy person.

My wife had surgery last Dec. and the copay was around $2500, same as you. I've got about $1000 left to pay and the Mose Cone Health System had been more than gracious with the payment plan. They suggested $60/month with no interest and I've been paying more than that.

I'll be the first to admit that health care is very expensive here and yes, the fees are oft unknown prior. My dad couldn't eat and had to have a special IV nutrient for 3 days that costs $2000/day. Six grand for a life sustaining nutrient. Expensive yes, but imo the best in the world.

If he lived in a third world country he'd likely be dead, and again I still wonder about a country with socialized medicine. Not sure.

At any rate, he and my mom came to a Mothers Day party at my sister's house. Dad looked great and it was good to see him up on his feet again. Well worth the money to his family, especially my mom. They have been happily married for 53 years.

People should check their Explanation of Benefits from medical service providers. In my dealings with Moses Cone, my insurance company was billed for services not rendered, medications not received, and charges for services above the capitated fees to increase co-pays EVERY time. Until, that is, I call them out on it. It would seem there are people employed by Moses Cone whose job function includes padding medical bills. To be fair, I have no doubt that every comparable service provider engages in the same practice.

The true reason why we don't have universal health care is large medical providers don't want it. Health care companies engage in over-billing to increase their profits in a manner that would make the Mafia proud. I am not talking about your neighborhood clinic, I am talking about the large corporations whose executives continue to rake in obscene compensation no matter how the overall economy is doing. More government control means less opportunity to skim. So they throw out all kinds nonsense, telling us how universal health care would be horrible for patients, and the anti-government people lap it up.

yvonne, i too am taking crestor. i have been taking it for approximately one year. what were the symptoms the three of you had? now i'm scared.

brenda,

Many people take Crestor without ever having any problem. Unfortunately, my family is not amongst those people.

I had been on Crestor for 3-4 years prior to my episode. My brother and sister had been taking it a little over two years. All three of us had switched to Crestor due to non-life threatening side effects from another statin drug, Lipitor. At the time, none of us knew what the other was taking. About six to eight weeks after I got out of the hospital, my brother called to say he was in the same room in the same hospital with the same diagnosis. I immediately asked if he was taking Crestor. He had to ask his wife but she confirmed he was. My sis, who had been having milder intermittent symptoms for a long time, told me she was on Crestor when she visited me in the hospital.

At any rate, I was visiting a friend at Badin and was feeling great. We were preparing dinner when a pain in my chest and stomach made me break out in a cold sweat. Not wanting to call attention to myself, I went out on the porch to take a Nitro (coronary artery spasms). After that, I started vomiting. The chest pain and stomach pain worsened to the point I was having difficulty breathing. And I could not stop vomiting. I was still sitting on the bathroom floor hugging the commode when the ambulance arrived. (Anyone who knows me knew it was serious for me to agree to an ambulance. However, I could not make myself stop vomiting.)

Now I rarely get scared about my health. However, I truly thought I was going to die. I thought I had a perforated bowel because my belly, from my breasts to my pelvis, hurt worse than one can imagine.

They did all the usual blood work and x-rays/scans in the ED. I would never have guessed the final diagnosis..acute febrile pancreatitis. (It can cause multi-systems failure rather quickly due to the rapid breakdown of cells, especially muscle.)

Alcohol is the number one cause of acute pancreatitis. Gallstones or gallbladder disease is number two. My younger brother is the only one in the family that drinks alcohol and he is the only one who has not had acute pancreatitis (but he does not and never has taken Crestor).

My older brother and I had the same GI doctor. I asked if the fact that we all are diabetic had anything to do with us having the same reaction to Crestor (He and the hospitalist who admitted each of us determined it was the Crestor). His opinion was they were unrelated.

As a result of almost dying from my reaction to Crestor, all doctors included in my care have advised me to refrain from taking any statin drug. Even red yeast rice capsules are off-limits since statins are derived in part from it. And, naturally I cannot drink any alcohol. Not even that rare (about every six months) glass of red wine I used to enjoy at special occasions. But after a two week stay in the hospital, almost dying and losing over 50 lbs (mostly muscle), my restrictions are inconsequential in comparison.

What people do not know is drug companies put fillers in their drugs. Sometimes it is the fillers that people react to, not the drug itself. Since red yeast rice is pure, as without fillers, I thought it would be worth a shot. Then my doc says "But what if it was not the filler you reacted to. Are you willing to risk possibly your life on the gamble?"

An important fact I left out and the reason my case was so life-threatening is I had been bitten by a snake a couple of weeks before my attack. Snake and scorpion bites can cause and/or exacerbate acute pancreatitis. My brother and sister had no such accelerator.

Yes, the gummint is the one I want taking care of my health. The same gummint that just buzzed NYC with AF1, a couple of fighters jets in tow. That same incredibly clued-in government, I want them and only them to take care of my health.

Before you run down the street screaming "Affordable healthcare for all!", I suggest you read Thomas Sowell's column at NRO today. It's about what happened after a bunch of idiots ran down the street screaming "Affordable housing for all!". You might want to think about that.

The problem with leftists is that they never stop to think about the results of their do-good and feel-good projects, and the law of unintended consequences bites them in the ass every time.

"I knew he was on Medicare, which he paid into during his working years, but thought surely he would pay for something. Nope, he and my mom enrolled in Medicare Part B and all the other available supplemental insurance that they pay out of pocket to the tune of $600/month for both of them."

Dan, under Obamacare, there's an excellent chance that he will not have that type of surgery available to him again.

In addition, his other supplemental insurance could well disappear.

http://bubbanear.blogspot.com/2009/05/obama-claims-he-can-save-trillions-on.html