Can we make the medical system more complicated?

[Tanj]

Was your biopsy done with the inter-rectum electric staple gun?

Pak! Oww! Pak! Oww! Pak! Oww! Pak! Oww! Pak! Oww!
"Doctor, how many of those do you have to do?"
"Oh, about nine."
"That was seven."
"Oh, about twelve."

Mine came back negative as well, thank God, although the urologist said he was surprised at that.

lol. I was told the twilight aesthetic would wipe that from your memory. At any rate, I went full aesthetic trans peritoneal with 20 biopsies, didn't feel a thing. My urologist was both surprised and little disappointed. at the negative result.

 

[CRAZY_CAT_WOMAN]

Think goodness I live in CA. And can get medical, if I had cancer. Because of Obama care , they stared allowing grownups to get medical.

 

[dogs4thewin]

Thank you for asking, I'm now feeling really foolish because I started thinking there was just Medicaid and Medicare, and that if I met the requirements I would get one or both, and not expecting anything complicated and my main energy went on getting a better job, yes after retirement. Retraining now that I had the time and doing something really interesting and profitable.

I'm also rather fearful, anxious, and with fear and trepidation finally filled in my Medicaid form once I had met the requirements and saw the word 'declined'.

I'm going to try to get SSI as that might work, or I might have to move, or there appear to be other loopholes. I've noticed four for women including two for cervical and breast cancer, but none for prostate cancer which is mine, but there may be updates I haven't seen either.

It was only yesterday I got rejection from the Health Marketplace by missing the 60 day limit after losing my health insurance, but any ideas at all would be very helpful.

You may be able to get SSI, but it would be best to get a lawyer. There is a special program called the TERI program that takes certain cancer cases for a fast approval. I am not certain, but it is my understanding that that program is easier if you have been declared terminal. That is to say not I will die within two years with no treatment, but more there is not treatment to give me ( unless you have relapsed in which case it may be easier to qualify for the TERI program even if you can be treated. I would talk to a disability lawyer though because I am not a lawyer and as such do not know this for certain. I know my father got disability with cancer quickly, but by the time he had to stop working and applied he was one on his second bout ( had relapsed) and two had been told he was terminal and that there was no more treatment they could give him other than just to maintain and keep him comfortable he passed within two months or so of getting benefits Talk to a lawyer, but depending on your situation the TERI program may get you benefits quickly.

 

[MorkandMindy]

TERI: I had medicaid two years ago and was given a 32% chance the cancer was aggressive, so it might be terminal now and so I can get TERI, but frankly if it is terminal and I get into a lot of pain I will ensure my will is in order, like the people in the Bible did, and if the pain is unendurable and there is no chance of recovery then I will use the Osterhagen Key.

If life is short, and it often is, then you just have to get things done faster.

 

[MorkandMindy]

As for complexity there is plenty. I applied twice in one week for medicaid and was rejected both times on grounds of age and a customer I know very well from work said she couldn't get medicaid because she is over 65.

I tried the Market place and through that Obamacare and Trumpcare and was rejected for both on the grounds that the enrollment period had closed and would not reopen until Oct 1. There were exceptions to that but unfortunately also exceptions to the exceptions, and I was warned I would face a 30% surcharge for having allowed my healthcare to lapse for more than 62 days.

I read some of the regulations myself and was totally amazed how long, convoluted and vague they are. That's when I got totally depressed and opened this thread about it.

Now I'm feeling more positive and taking comfort in the fact that after those bureaucrats die they will be ensnared in a huge strangling vine similar to the one they made on Earth. I think there is a good chance they enjoy that sort of thing.

 

[MorkandMindy]

A big thank you for support and advice, I've just reapplied and the form is now completely different. There is always hope even or especially when you really don't expect it!

 

[Cimorene]

I don't understand the American medical system at all. My family is American but we moved to Canada yrs ago. My sister has Asperger's & T1D. She gets super amazing care & it's not at a cost. I don't have any big expenses but when I thought I might have broken my ankle it was super simple to get the x-rays and all that done and it doesn't cost anything. It's not complicated. My vaccines were free too. I got most when I was little but some as a teen, they were free. That really stinks the OP has had such a rough time, I really hope that gets straightened out!

 

[MorkandMindy]

Hi Cimorene!

The motive behind the US medical system is pretty simple, it's to make as much money as possible for those who run it.

Like chess a few simple rules can produce a totally bewildering plethora of different game plays.

Or perhaps it is better to think of a few parameters in a formula producing a complex fractal, or a formula such as for pi producing an infinitely long non repeating string of digits.

 

[MorkandMindy]

It really is a lot like this fractal, there is a rule for everything, cover provided for every eventuality,

but there is a gap in every part of every piece of cover, exceptions, with exceptions to each exception, and exceptions also to those.

Following the Social Security Act as embodied in SSA 1902, 1905, 1925, 1931, and 42 CFR 435.120 etc, 1634 and so on, the part most relevant to me was SSA 1902(a)(10)(A)(i)(II)(aa) and the various regulations referenced from that regulation. It's easy to look it up now there's an Internet, you should, it only takes seconds.

I am entitled by reason of lack of income and assets but according to New Mexico medicaid (called 'centenial care') I'm not because I have passed my 65th birthday though I have been unable to find any such rule. I would be entitled under the cancer initiative if I had breast or cervical cancer but being male I have prostate cancer therefore I am not covered as far as I'm able to find out. Despite being white (boo) and male (boo) I would be covered if I was an opioid addict or in prison. If it first spreads down to my legs and I become disabled I will be covered, but I will be very terminal by then.

The areas covered and the areas not covered looks like this fractal:

 

[MorkandMindy]

Remember these things when you vote. I am not being flippant. You have done an amazing job of making an argument for universal coverage.

I'm not so sure. In a genuine free market medical care would cost a lot less, the problem is the US health care system is a government-enforced monopoly, as well as an insane bureaucracy.

 

[MorkandMindy]

I looked up how to buy medication for a competitive price. The same medication in another country often costs a fraction as much as in the US. If it was made in the US the pharma got the money and profit but not as much as if it had been bought in the US, so re-importation is normally a crime.

YOU MAY: To bring more than 50 dosage units across the border you need a prescription from an FDA-approved U.S. physician. A prescription from a Mexican doctor is no longer acceptable. However, U.S. Customs agents may prohibit a supply that is for more than 60 to 90 days.

Explanation: the drug lobby in the U.S. is strong and that many of these laws are in place to protect the interests of pharmaceutical companies. It is why certain U.S.-manufactured HIV drugs, for example, cost over $2,000 per month here and less than $100 for consumers in Africa and India.

No, the communists and their cronies in the US have been doing a great job of destroying our medical system and enriching themselves.

 

[cow451]

I'm not so sure. In a genuine free market medical care would cost a lot less, the problem is the US health care system is a government-enforced monopoly, as well as an insane bureaucracy.

You are correct theoretically about a true single payer. I advocate universal care by a combination of approaches including expanding Medicaid, Medicare and fixing the individual market with a Medicare type approach.

It would provide incentives for small business entrepreneurs to start new businesses and force employers to compete better for skilled workers through better benefits. It would allow some parents to Stay at Home and Homeschool rather than take a job solely to access health insurance.

There never has been and never will be a “genuine free market” for healthcare. Most countries that have national healthcare don’t have single payer.

 

[cow451]

I looked up how to buy medication for a competitive price. The same medication in another country often costs a fraction as much as in the US. If it was made in the US the pharma got the money and profit but not as much as if it had been bought in the US, so re-importation is normally a crime.

YOU MAY: To bring more than 50 dosage units across the border you need a prescription from an FDA-approved U.S. physician. A prescription from a Mexican doctor is no longer acceptable. However, U.S. Customs agents may prohibit a supply that is for more than 60 to 90 days.

Explanation: the drug lobby in the U.S. is strong and that many of these laws are in place to protect the interests of pharmaceutical companies. It is why certain U.S.-manufactured HIV drugs, for example, cost over $2,000 per month here and less than $100 for consumers in Africa and India.

No, the communists and their cronies in the US have been doing a great job of destroying our medical system and enriching themselves.

The capitalists have been the problem. Big pharma isn’t run by communists. The big hospital systems and suppliers are not communists.
I’ve been in healthcare four decades and have yet to meet any big wig that was anything close to a communist. I am puzzled at how you have come to that conclusion.

 

[coffee4u]

I am so sorry you are going through this. The American health care system seems like a right mess to me. You would never get treated like that here.

 

[Ana the Ist]

And there are a lot of documents covering eligibility though many are not specific as these vary from state to state and time to time.

SOOO, what are these administrators authorized to do? Allocate health care to the needy. And what are they actually doing? Deciding who is not eligible on grounds not of income or savings but on various complex rules and enrollment periods and between a whole bunch of different types of eligibility, different plans: PPO, HMO, POS, EPOS, Indemnity, HSA, which under stress along with the other government documents 42CFR435.116 etc it is enough to give anyone a mental health problem.

Our heathcare system is designed to make money....not provide healthcare.

 

[MorkandMindy]

Well I just got phoned and told my application had been denied again. Medicaid stops at 65 because you are then eligible for Medicare. I explained I have only 34 credits and need 40 to get Medicare so I've been told I'm not eligible for Medicare.

She explained I'm not eligible for Medicaid because I am eligible for for Medicare, but I sort of repeated her back to herself and explained if I'm not eligible for Medicare then I should be eligible for Medicaid, no she said I'm not because I'm over 65 so I'm eligible for Medicare and therefore I'm not eligible for medicaid.

Around it goes. I will soon need blood pressure medicine, I can't buy any without the very expensive signature of an American doctor, it's a monopoly, no other nationality will do. If I go to Mexico and buy it then it is strictly illegal to bring it into the country and it is illegal to fail to declare it.

Forget the nation's future, I'm going to vote communist.

 

[cow451]

Well I just got phoned and told my application had been denied again. Medicaid stops at 65 because you are then eligible for Medicare. I explained I have only 34 credits and need 40 to get Medicare so I've been told I'm not eligible for Medicare.

She explained I'm not eligible for Medicaid because I am eligible for for Medicare, but I sort of repeated her back to herself and explained if I'm not eligible for Medicare then I should be eligible for Medicaid, no she said I'm not because I'm over 65 so I'm eligible for Medicare and therefore I'm not eligible for medicaid.

Around it goes. I will soon need blood pressure medicine, I can't buy any without the very expensive signature of an American doctor, it's a monopoly, no other nationality will do. If I go to Mexico and buy it then it is strictly illegal to bring it into the country and it is illegal to fail to declare it.

Forget the nation's future, I'm going to vote communist.

Universal healthcare. I keep repeating the obvious......

 

[MorkandMindy]

Universal healthcare. I keep repeating the obvious......

Too true, they spend more money picking out the few who are not entitled than it would cost to cover all, and they should also cover the ones they pick out according to the overall plan of Medicaid.

 

[Tanj]

Well I just got phoned and told my application had been denied again. Medicaid stops at 65 because you are then eligible for Medicare. I explained I have only 34 credits and need 40 to get Medicare so I've been told I'm not eligible for Medicare.

Whats a credit and how do you get one?

 

[Speedwell]

Whats a credit and how do you get one?

He's talking about Social Security credits. You need 40 "credits" earned by a certain number of years of work subject to Social Security withholding in order to qualify for Social Security benefits. You need to qualify for Social Security (with some exceptions) in order to qualify for Medicare. M&M worked out of the country for a number of years and so does not have the credits for Social Security.