Swine Flu and Britain's "Socialized" Approach

Wanna have a good cry all you Blue Cross/BlueShield/Aetna/Metlife/Unihealth or medically uninsured people? Take a look at Britain's National Health Service website.

Not only can you download 55 coherent pages on just Swine Flu symptoms and treatment, but the site itself is called "NHS Choices." It's full of simple, direct, taxpayer-funded ways to maintain good health and help you when you and yours fall ill, all at no charge beyond being a citizen and paying your fair share of taxes.

My nonprofit employer pays $2700 a month for my family after shopping around the above-mentioned insurance companies before deciding that Blue Shield made the most sense -- but not cents.

For just $33,000 a year from my employer, my wife, my 12 year old autistic son and my still-ticking 63 year-old body, "enjoy" the best of modern medicine for only an additional $20,000 out of pocket -- and that's without dental insurance! Blue Shield and all the rest are aping the banks and charging the maximum while paying out the minimum.

Tamiflu is free from the National Health Service in the UK as is the doctor visit and, if need be, your hospitalization. Here, Blue Shield let's you have just 10 Tamiflu pills every 6 months with a $40 co-pay at Walgreen's. If you want more, you can pay $121 to Walgreen's and they will fill your prescription without troubling Blue Shield for an exception to their invented rules. Since Tamiflu is only effective within 48 hours of the onset of any flu, do try and not get sick on a holiday or your physician's golfing day! By the time Blue Shield makes an exception "just for you" [I get that all the time from them because I'm not only a health lawyer but California's former Commissioner of Hospitals and don't fart around when need be].

Need Speech therapy for your autistic kid? Well, you can use their "network" therapists if you dare or have the patience to look high and low for the right match -- or you can find out who in town is regarded as the best for your child's diagnosis and pay $175 an hour -- "Out of Network" -- that little rule means you pay 30% of what Blue Shield (and to be fair, the rest of them) considers a reasonable fee. For West Los Angeles, that means $73 per hour not $175, and they cheerfully send me a reimbursement check (I have to pay upon receipt of each out of network service). Somehow, the 30% co-payment by me of Blue Shield's "discounted fee" of $73 always manages to come out not at $21.90 but $36 (insurance has its own way of calculating!). So, many weeks after laying out $175, I get a check for $37.

The Developmental Pediatrician skilled in autism charges over $200 a visit and the Blue Shield people do nearly an identical calculation as they do with the speech therapist. I get about $35 for that visit, weeks later.

Have I mentioned the $500 outpatient care deductibles for each of us? Or, the $500 pharmacy deductibles for each of us? Or, the uncovered services which somehow always equal 2/3 of whatever billing codes our doctors provide us on our bill for having paid up front. Uncovered services for Autism are nearly All services unless you go to an inventive provider like UCLA Medical Center which has "Day Hospitalizations" for your autistic kid, at which he gets what most people would deem services he could get in a doctor's office, schoolroom or gym but, being under the hospital roof, "look" medical not behavioral in nature.

We have a single payer: it's me!

Follow Richard Walden on Twitter: www.twitter.com/Rwalden63

Comments

[steppenwolfsayshi]

I spend half of pre-tax income in medical costs. My condolences.

Waiting for checks from the insurance company is all too common. What really gets me is that my FASA is run by a figgin insurance company. They deny my FASA claims all the time! I already have to pay for everything twice and listen to the Rethugs talk about how more tax credits will fix the problem. It won't! I can't guess at the beginning of the year if I'm going to spend 50,000 or 5,000 on medical costs. I don't have 100,000 to take 50 from my paycheck and pay 50 to the hospital. Who does? And I don't want to fight with an insurance company over money that is already mine.

If the Republicans are in league with the insurance companies, they sure have been drinking the Kool-Aid.

Single-Pay­er!!!!!!!!­!!!!!!!!!!­!!

[LMPE]

Anyone who thinks that the US has a better healthcare system than the UK is a plain old ignoramus.

[nowarpleez]

Good analysis. I'm self employed, so I pay for my own health insurance and it's a joke. I can only pray that the US catches up with the rest of the indutrialized world.

[lgillooly]

The sad thing is most Americans listen to the lies on talk radio, Fox news and other propaganda outlets and vote AGAINST their own self interests.
These over paid hosts represent corporate interests,but disguise themselves as being concerned for "freedom and individuality" when that really means your on your own and tough luck if you can't afford healthcare!
The best care in my family is Medicare (single payer with private sector delivery) for my 86 yr old mother.
I pay for private insurance and like you, have been nickel and dimed to death and who knows if I get really sick they will find a way NOT to pay. Singlr payer for all Americans is the way to go.

[schatsie]

And the preachers who have not stood up for the VICTIMS of Agent Orange,Love Canal, Asbestos poisoning and Autism....They have blamed the VICTIMS as Satans Poor and not worthy of good health....NEXT THING we will be burning witches....

[Steph55]

You know it's been ever present Americans vote against their own self interests whenthey are convinced they are the ones benefitting like the "priviledged few". They think cause they are white, (not all but those who are out there acting "afool" like my gram used to say), they beleive they have extra privileges. When in fact they don't, but the *feel* they do.

It's how the plantation owners got hillbillies and upcountry Southerners to fight and die in the Civil War when only 8% of the population of the South were slave owners. That made no sense, but they were convinced!

Just like now, they beleive they are better off and have "freedom", lord talk about an overused word, they beleive giving multi million dollar salaries to people who would spit on them, and who do cut their coverage every time they blink are on their side, cause that black man with the African father can't possibly be on thier side.

It's a failure of imagination. A failure to catch up with reality. And yes, there is always mental illness, and the two things that are magnetic to paranoia, are religion and politics.