McCain's Health Plan

[Skibo]

If the United States medical care were so great then why are there more and more US citizens traveling abroad to have elective surgery? Why are more and more US citizens traveling abroad for treatments for diseases?

I don't have a problem with people feeling they need to travel for elective surgery. It's their choice. The ones traveling abroad for diseases most likely are going to attempt experimental treatments that are not approved by the FDA. I haven't seen any data to support the argument that US citizens are traveling for insured care.

[SharkOnLand]

If the United States medical care were so great then why are there more and more US citizens traveling abroad to have elective surgery? Why are more and more US citizens traveling abroad for treatments for diseases?

I don't have a problem with people feeling they need to travel for elective surgery. It's their choice. The ones traveling abroad for diseases most likely are going to attempt experimental treatments that are not approved by the FDA. I haven't seen any data to support the argument that US citizens are traveling for insured care.

I've seen two reasons:
1. Insurance won't pay for whatever procedure, be it experimental, or "unnecessary" in the eyes of the insurer; or
2. It's cheaper to travel and have the procedure done, than to have to cover whatever copay/costs your insurer would require you to pay.

[Skibo]

If the United States medical care were so great then why are there more and more US citizens traveling abroad to have elective surgery? Why are more and more US citizens traveling abroad for treatments for diseases?

I don't have a problem with people feeling they need to travel for elective surgery. It's their choice. The ones traveling abroad for diseases most likely are going to attempt experimental treatments that are not approved by the FDA. I haven't seen any data to support the argument that US citizens are traveling for insured care.

I've seen two reasons:
1. Insurance won't pay for whatever procedure, be it experimental, or "unnecessary" in the eyes of the insurer; or
2. It's cheaper to travel and have the procedure done, than to have to cover whatever copay/costs your insurer would require you to pay.

I don't have a problem with my insurance refusing to pay for "experimental" or unnecessary procedures. That isn't why I have insurance. I am also familiar with my policy and know how to get a mole looked at by a specialist as a medical necessity instead of cosmetic.

If airfare to India or travel to Mexico is cheaper than a co-pay there is something wrong with the policy. Please cite and example of where it is cheaper to travel for medically necessary treatment where the insurance company even agreed to this. I have heard of people traveling for cosmetic surgery or the laser eye treatments. (My wife paid 100% for hers 10 years ago - it was elective she could have kept the glasses.)

This thread is interesting but I think it is getting cloudy because there isn't a clear theme as to whether we are hating on the insurance companies or the medical treatment field as a whole.

I think we can all agree that tort reform would help a lot in bring down the cost of care. It's tough to find a OB Gyn in the Philly area because of insurance costs. I would like to see the first step in any solution to be shoot the lawyers and stop all prescription drug advertising and then wait two years to see the effect. I have heard stories of OB Gyn's paying $500,000 per year for liability insurance. That's $2000 per day. Ummm..gotta see a lot of patients to cover that expense each day not to mention the other operational expenses including haz-mat disposal each day.

[ph4ever]

If the United States medical care were so great then why are there more and more US citizens traveling abroad to have elective surgery? Why are more and more US citizens traveling abroad for treatments for diseases?

I don't have a problem with people feeling they need to travel for elective surgery. It's their choice. The ones traveling abroad for diseases most likely are going to attempt experimental treatments that are not approved by the FDA. I haven't seen any data to support the argument that US citizens are traveling for insured care.

not necessarily. For example with HCV medicines one can expect in the neighborhood of $ 2300.00 a month for meds, in Costa Rica the same meds, same manufacturer cost $ 800.00 a month. I know of one guy here in the US that had to take out a loan for his treatment to cover his meds and he had insurance. I know someone that was treated in Costa Rica and his meds, necessary monthly labwork and doctors visits total were more than 1/2 the cost of meds here in the US.

Also more insurance companies are sending people to India for common yet medically necessary surgeries.

[ph4ever]

If the United States medical care were so great then why are there more and more US citizens traveling abroad to have elective surgery? Why are more and more US citizens traveling abroad for treatments for diseases?

I don't have a problem with people feeling they need to travel for elective surgery. It's their choice. The ones traveling abroad for diseases most likely are going to attempt experimental treatments that are not approved by the FDA. I haven't seen any data to support the argument that US citizens are traveling for insured care.

I've seen two reasons:
1. Insurance won't pay for whatever procedure, be it experimental, or "unnecessary" in the eyes of the insurer; or
2. It's cheaper to travel and have the procedure done, than to have to cover whatever copay/costs your insurer would require you to pay.

I don't have a problem with my insurance refusing to pay for "experimental" or unnecessary procedures. That isn't why I have insurance. I am also familiar with my policy and know how to get a mole looked at by a specialist as a medical necessity instead of cosmetic.

If airfare to India or travel to Mexico is cheaper than a co-pay there is something wrong with the policy. Please cite and example of where it is cheaper to travel for medically necessary treatment where the insurance company even agreed to this. I have heard of people traveling for cosmetic surgery or the laser eye treatments. (My wife paid 100% for hers 10 years ago - it was elective she could have kept the glasses.)

This thread is interesting but I think it is getting cloudy because there isn't a clear theme as to whether we are hating on the insurance companies or the medical treatment field as a whole.

I think we can all agree that tort reform would help a lot in bring down the cost of care. It's tough to find a OB Gyn in the Philly area because of insurance costs. I would like to see the first step in any solution to be shoot the lawyers and stop all prescription drug advertising and then wait two years to see the effect. I have heard stories of OB Gyn's paying $500,000 per year for liability insurance. That's $2000 per day. Ummm..gotta see a lot of patients to cover that expense each day not to mention the other operational expenses including haz-mat disposal each day.

hip replacement, cardiac catheterization and gall bladder removal

right now I don't have the time to do a thorough research but here's one article http://www.msnbc.msn.com/id/25415614/

[SharkOnLand]

I don't have a problem with my insurance refusing to pay for "experimental" or unnecessary procedures.

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

If airfare to India or travel to Mexico is cheaper than a co-pay there is something wrong with the policy. Please cite and example of where it is cheaper to travel for medically necessary treatment where the insurance company even agreed to this. I have heard of people traveling for cosmetic surgery or the laser eye treatments. (My wife paid 100% for hers 10 years ago - it was elective she could have kept the glasses.)

"Medically necessary" is the problem. I know a woman who went to Mexico to get lap band surgery, as medical insurance wouldn't pay for it here in the US. It may not have been "necessary", but it definitely improved this woman's quality of life, and probably ended up saving her insurance company money in the long run, as she's much healthier now.

I don't agree that full-on government intervention is necessary, but something needs to be done.

Let the doctors play doctor, leave the insurance company out of the diagnosis/treatment phase.

[buffettbride]

I don't have a problem with my insurance refusing to pay for "experimental" or unnecessary procedures.

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

If airfare to India or travel to Mexico is cheaper than a co-pay there is something wrong with the policy. Please cite and example of where it is cheaper to travel for medically necessary treatment where the insurance company even agreed to this. I have heard of people traveling for cosmetic surgery or the laser eye treatments. (My wife paid 100% for hers 10 years ago - it was elective she could have kept the glasses.)

"Medically necessary" is the problem. I know a woman who went to Mexico to get lap band surgery, as medical insurance wouldn't pay for it here in the US. It may not have been "necessary", but it definitely improved this woman's quality of life, and probably ended up saving her insurance company money in the long run, as she's much healthier now.

I don't agree that full-on government intervention is necessary, but something needs to be done.

Let the doctors play doctor, leave the insurance company out of the diagnosis/treatment phase.

I'm glad someone else brought up the lap-band surgery. More and more it's a viable option and alternative to more dangerous surgery. I now know a handful of folks who have done it and are experiencing great success. If you have a solid screening process in place to ensure that lap band surgery isn't just a "quick fix" but part of a greater solution that has already been started (ahem...like someone who followed a steady diet and exercise plan for over a year with minimal results...), I take no issue with insurance covering the procedure.

Beats going to Mexico for it and facing the possibility of a doctor in the US refusing to see you for follow-up care because the surgery wasn't performed here.

I think both lap band and lasik/eye correction surgery are great examples of procedures that shouldn't be considered elective or cosmetic. I mean, heck, a vasectomy and a tubal ligation are both covered by most insurance plans yet there are alternatives such as abstinance and condoms and medication. Why should those medical procedures be covered by lap band and lasik are not?

[Skibo]

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

Its experimental and not approved by the FDA, that treatment isn't even available in the US unless you are in a study group. While I do agree the insurance companies are too involved in treatment, they are also pretty clear in what they don't cover. Yuh, I read my policy. It made my head hurt.

"Medically necessary" is the problem. I know a woman who went to Mexico to get lap band surgery, as medical insurance wouldn't pay for it here in the US. It may not have been "necessary", but it definitely improved this woman's quality of life, and probably ended up saving her insurance company money in the long run, as she's much healthier now.

I don't agree that full-on government intervention is necessary, but something needs to be done.

Let the doctors play doctor, leave the insurance company out of the diagnosis/treatment phase.

Medically necessary is the current benchmark. While I would benefit from that lap band surgery myself and it does improve quality of life. It really isn't necessary. A proper diet and perhaps portion control would be just as effective. The lasix surgery is another that glasses solve. (Yeah, I agree over time glasses are more expensive but logic doesn't always apply in the insurance industry.) Unfortunately as long as the insurance companies are footing the bill they will do what they can to control costs. Perhaps if the consumer got more involved in the actual billing process maybe that would help. My wife had a 3 night stay two years ago over $28k. The itemized bill was sick. She found over $5000 in excessive charges, reported it to the insurance company but unfortunately nothing ever came of it.

[The Lost Manatee]

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

Its experimental and not approved by the FDA, that treatment isn't even available in the US unless you are in a study group. While I do agree the insurance companies are too involved in treatment, they are also pretty clear in what they don't cover. Yuh, I read my policy. It made my head hurt.

"Medically necessary" is the problem. I know a woman who went to Mexico to get lap band surgery, as medical insurance wouldn't pay for it here in the US. It may not have been "necessary", but it definitely improved this woman's quality of life, and probably ended up saving her insurance company money in the long run, as she's much healthier now.

I don't agree that full-on government intervention is necessary, but something needs to be done.

Let the doctors play doctor, leave the insurance company out of the diagnosis/treatment phase.

Medically necessary is the current benchmark. While I would benefit from that lap band surgery myself and it does improve quality of life. It really isn't necessary. A proper diet and perhaps portion control would be just as effective. The lasix surgery is another that glasses solve. (Yeah, I agree over time glasses are more expensive but logic doesn't always apply in the insurance industry.) Unfortunately as long as the insurance companies are footing the bill they will do what they can to control costs. Perhaps if the consumer got more involved in the actual billing process maybe that would help. My wife had a 3 night stay two years ago over $28k. The itemized bill was sick. She found over $5000 in excessive charges, reported it to the insurance company but unfortunately nothing ever came of it.

You know it is really sad that the insurance companies don't take a tougher stance about excessive or fraudulent charges on bills. In your wife's case 18% of her bill was either excessive or fraudulent. If they could cut 18% of their costs by reducing that waste, they could slow the rate of increases however they don't have any real incentive to do so since they just pass those costs through to the consumer. Something about a lack of competition in too many markets.

As a percentage, that is worse than Medicare/Medicad's numbers, which I thought were pretty appalling.

[ph4ever]

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

Its experimental and not approved by the FDA, that treatment isn't even available in the US unless you are in a study group. While I do agree the insurance companies are too involved in treatment, they are also pretty clear in what they don't cover. Yuh, I read my policy. It made my head hurt.

"Medically necessary" is the problem. I know a woman who went to Mexico to get lap band surgery, as medical insurance wouldn't pay for it here in the US. It may not have been "necessary", but it definitely improved this woman's quality of life, and probably ended up saving her insurance company money in the long run, as she's much healthier now.

I don't agree that full-on government intervention is necessary, but something needs to be done.

Let the doctors play doctor, leave the insurance company out of the diagnosis/treatment phase.

Medically necessary is the current benchmark. While I would benefit from that lap band surgery myself and it does improve quality of life. It really isn't necessary. A proper diet and perhaps portion control would be just as effective. The lasix surgery is another that glasses solve. (Yeah, I agree over time glasses are more expensive but logic doesn't always apply in the insurance industry.) Unfortunately as long as the insurance companies are footing the bill they will do what they can to control costs. Perhaps if the consumer got more involved in the actual billing process maybe that would help. My wife had a 3 night stay two years ago over $28k. The itemized bill was sick. She found over $5000 in excessive charges, reported it to the insurance company but unfortunately nothing ever came of it.

You know it is really sad that the insurance companies don't take a tougher stance about excessive or fraudulent charges on bills. In your wife's case 18% of her bill was either excessive or fraudulent. If they could cut 18% of their costs by reducing that waste, they could slow the rate of increases however they don't have any real incentive to do so since they just pass those costs through to the consumer. Something about a lack of competition in too many markets.

As a percentage, that is worse than Medicare/Medicad's numbers, which I thought were pretty appalling.

I know in the past whenever I've been overcharged the insurance company said it was my responsibility to challenge the charges.

[pbans]

I don't have a problem with my insurance refusing to pay for "experimental" or unnecessary procedures.

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

If airfare to India or travel to Mexico is cheaper than a co-pay there is something wrong with the policy. Please cite and example of where it is cheaper to travel for medically necessary treatment where the insurance company even agreed to this. I have heard of people traveling for cosmetic surgery or the laser eye treatments. (My wife paid 100% for hers 10 years ago - it was elective she could have kept the glasses.)

"Medically necessary" is the problem. I know a woman who went to Mexico to get lap band surgery, as medical insurance wouldn't pay for it here in the US. It may not have been "necessary", but it definitely improved this woman's quality of life, and probably ended up saving her insurance company money in the long run, as she's much healthier now.

I don't agree that full-on government intervention is necessary, but something needs to be done.

Let the doctors play doctor, leave the insurance company out of the diagnosis/treatment phase.

The lapband surgery that I PAID FOR....is now saving my insurance company $150 a month in prescriptions that they are NOT having to pay for anymore......not to mention benefits down the road.

Statistically, if you are more than 50 pounds overweight...you have less than a 10% chance of losing and keeping it off in more traditional methods.....which means insurance companies will continue to pay for the cost of the disease instead of helping with the cure.

Hot button for me, that's for sure......and yes, I know I have strayed from the original discussion......but it still IRKS me that my insurance company is benefiting from what I paid out of pocket......of course, I'm benefiting, too......but we're b*tching about insurance companies right ow.

[pbans]

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

Its experimental and not approved by the FDA, that treatment isn't even available in the US unless you are in a study group. While I do agree the insurance companies are too involved in treatment, they are also pretty clear in what they don't cover. Yuh, I read my policy. It made my head hurt.

"Medically necessary" is the problem. I know a woman who went to Mexico to get lap band surgery, as medical insurance wouldn't pay for it here in the US. It may not have been "necessary", but it definitely improved this woman's quality of life, and probably ended up saving her insurance company money in the long run, as she's much healthier now.

I don't agree that full-on government intervention is necessary, but something needs to be done.

Let the doctors play doctor, leave the insurance company out of the diagnosis/treatment phase.

Medically necessary is the current benchmark. While I would benefit from that lap band surgery myself and it does improve quality of life. It really isn't necessary. A proper diet and perhaps portion control would be just as effective. The lasix surgery is another that glasses solve. (Yeah, I agree over time glasses are more expensive but logic doesn't always apply in the insurance industry.) Unfortunately as long as the insurance companies are footing the bill they will do what they can to control costs. Perhaps if the consumer got more involved in the actual billing process maybe that would help. My wife had a 3 night stay two years ago over $28k. The itemized bill was sick. She found over $5000 in excessive charges, reported it to the insurance company but unfortunately nothing ever came of it.

You know it is really sad that the insurance companies don't take a tougher stance about excessive or fraudulent charges on bills. In your wife's case 18% of her bill was either excessive or fraudulent. If they could cut 18% of their costs by reducing that waste, they could slow the rate of increases however they don't have any real incentive to do so since they just pass those costs through to the consumer. Something about a lack of competition in too many markets.

As a percentage, that is worse than Medicare/Medicad's numbers, which I thought were pretty appalling.

When my Dad had his stroke and subsequently died.....on the hospital bill there was a charge for $1200 for a treadmill test....HE WAS IN A COMA FOR HELL'S SAKE. The insurance company paid it.....I refused to pay our portion of it....it took me six months to get them to take it off the bill. I'm quite confident the insurance company never got reimbursed nor even tried although I did report it to them too.

[SharkOnLand]

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

Its experimental and not approved by the FDA, that treatment isn't even available in the US unless you are in a study group. While I do agree the insurance companies are too involved in treatment, they are also pretty clear in what they don't cover. Yuh, I read my policy. It made my head hurt.

What the FDA considers experimental and what insurance companies consider experimental aren't always the same thing.

When my brother had leukemia, for example, there were certain so-called "experimental" treatments that the insurance company refused to pay for, even though they were fully available to anyone willing to pay for it.

[buffettbride]

What if an experimental treatment is the best chance a person has of beating cancer? Why should an insurance company play doctor and say "nah, you don't need that"? Insurance companies are TOO involved in the actual treatment and diagnosis these days.

Its experimental and not approved by the FDA, that treatment isn't even available in the US unless you are in a study group. While I do agree the insurance companies are too involved in treatment, they are also pretty clear in what they don't cover. Yuh, I read my policy. It made my head hurt.

"Medically necessary" is the problem. I know a woman who went to Mexico to get lap band surgery, as medical insurance wouldn't pay for it here in the US. It may not have been "necessary", but it definitely improved this woman's quality of life, and probably ended up saving her insurance company money in the long run, as she's much healthier now.

I don't agree that full-on government intervention is necessary, but something needs to be done.

Let the doctors play doctor, leave the insurance company out of the diagnosis/treatment phase.

Medically necessary is the current benchmark. While I would benefit from that lap band surgery myself and it does improve quality of life. It really isn't necessary. A proper diet and perhaps portion control would be just as effective. The lasix surgery is another that glasses solve. (Yeah, I agree over time glasses are more expensive but logic doesn't always apply in the insurance industry.) Unfortunately as long as the insurance companies are footing the bill they will do what they can to control costs. Perhaps if the consumer got more involved in the actual billing process maybe that would help. My wife had a 3 night stay two years ago over $28k. The itemized bill was sick. She found over $5000 in excessive charges, reported it to the insurance company but unfortunately nothing ever came of it.

Most tubal ligations and vasectomies are not medically necessary and they are covered by insurance. People can avoid pregnancy by other means, just as I can wear glasses to improve my eyesight rather than "elective" eye surgery.

[krusin1]

If the United States medical care were so great then why are there more and more US citizens traveling abroad to have elective surgery? Why are more and more US citizens traveling abroad for treatments for diseases?

I don't have a problem with people feeling they need to travel for elective surgery. It's their choice. The ones traveling abroad for diseases most likely are going to attempt experimental treatments that are not approved by the FDA. I haven't seen any data to support the argument that US citizens are traveling for insured care.

not necessarily. For example with HCV medicines one can expect in the neighborhood of $ 2300.00 a month for meds, in Costa Rica the same meds, same manufacturer cost $ 800.00 a month. I know of one guy here in the US that had to take out a loan for his treatment to cover his meds and he had insurance. I know someone that was treated in Costa Rica and his meds, necessary monthly labwork and doctors visits total were more than 1/2 the cost of meds here in the US.

Also more insurance companies are sending people to India for common yet medically necessary surgeries.

What you mention above is a great argument to make tort reform the first step in fixing our healthcare system.

It ain't that the drug costs more here - it's paying all the ^@#%^@#!@#!@#$ lawyers.

[Frank4]

I work in the healthcare industry. I can tell you in all honesty the system is messed up in this country and it's not likely to change anytime soon. As long as these "Special interest groups" are around and leading congress by their noses nothing is going to change. No matter who you stick in the Oval Office.

[LIPH]

You mean if Barack Obama gets elected he's not going to make everything all better on January 21? I'll give him one day to have his inauguration party.

[SharkOnLand]

I bet Chuck Norris could fix it.

[ph4ever]

If the United States medical care were so great then why are there more and more US citizens traveling abroad to have elective surgery? Why are more and more US citizens traveling abroad for treatments for diseases?

I don't have a problem with people feeling they need to travel for elective surgery. It's their choice. The ones traveling abroad for diseases most likely are going to attempt experimental treatments that are not approved by the FDA. I haven't seen any data to support the argument that US citizens are traveling for insured care.

not necessarily. For example with HCV medicines one can expect in the neighborhood of $ 2300.00 a month for meds, in Costa Rica the same meds, same manufacturer cost $ 800.00 a month. I know of one guy here in the US that had to take out a loan for his treatment to cover his meds and he had insurance. I know someone that was treated in Costa Rica and his meds, necessary monthly labwork and doctors visits total were more than 1/2 the cost of meds here in the US.

Also more insurance companies are sending people to India for common yet medically necessary surgeries.

What you mention above is a great argument to make tort reform the first step in fixing our healthcare system.

It ain't that the drug costs more here - it's paying all the ^@#%^@#!@#!@#$ lawyers.

how about the cost of television commercials?

[ph4ever]

I work in the healthcare industry. I can tell you in all honesty the system is messed up in this country and it's not likely to change anytime soon. As long as these "Special interest groups" are around and leading congress by their noses nothing is going to change. No matter who you stick in the Oval Office.

agreed