Our Health Care System – An Insider’s View

After completing college or university back in the early 1970s, My spouse and i worked for a sizable office store in NY in the accounting office. Doing work full time, naturally, I used to be afforded a company group insurance policies which included health benefits, along with dental care, and life insurance. During that time there were no HMOs, nor were there any physicians that did not accept any legitimate health insurance plan. During my childhood, my parents always maintained coverage on both me and my sis through Blue Cross/Blue Safeguard of NY. The insurance proposed by my employer was also through Blue Cross/Blue Shield of NY. This was touted to be the best health insurance plan around in those days, and cost me personally not enroll. The employer paid the complete premium in my behalf, and although it did have an each year deductible, and then paid 80% up to a specified amount before paying 100%, being relatively healthy it posed no real economical hardship on me personally, and i also was easily able to cover my deductible, and small out of pocket costs for any tests or prescriptions I may have needed. read more

It wasn’t until I relocated to the southern area of California in the the middle of 1970s, that initially, I actually realized just how much our country needed to revamp its health treatment system. Perhaps revamp is a poor term so that I observed in the beginning, but eventually it would become a well suited term for what would be needed. Of course today what is needed is a total overhaul of our health care system, and a program that will allow everyone affordable and good quality health health care. However, intiially, the programs in place were very good, and very affordable to prospects who worked full time. There obviously are not as many small enterprises away there, and your ones that were, could at least afford some type of medical care coverage for their families. When i was surviving in southern Washington dc I met and wedded a new woman who acquired been afflicted with an unusual form of Muscle Dystrophy, and was on Social Security Disability and State Supplemental Income. In addition she had Medicare health insurance and Medi-Cal to help pay for her medical fees and services which she desperately had to keep her alive, and performing.

Even back then, it was a little while until almost an work of Congress to be eligible for those programs, and you had to have a redetermination every two years to verify that your conditions had improved. Every two years my wife was subjected to an impartial medical exam with a Medicare approved physician who reviewed all her medical records for the previous two years, and reviewed her, and then reported their findings to the Social Security Administration for review with his or her recommendations. Although my wife’s condition was only getting worse, and other than short periods of remission where her disease was in check, your woman was basically declining, and it was clear it will would never be healed, still she would continue to be subjected to these exams every two years until her fatality in 1988. In was during this time frame that we personally became involved in the healthcare field, and saw quality just how insurance companies worked, at least when it came up to health care.

In 1981, I obtained a situation at a very well known Hospital and Well being Care center in the southern area of California. My job is that of a Person Financial Counselor, which required the discussion with patients and/or their families either prior to admission, during admission or at put out, in order to work out arrangements for repayment of the unpaid section of their hospital expenses. In most cases the balance owing was everywhere from a few hundred or so dollars to couple of thousand dollars depending after the procedure done and the amount of time actually spent in the hospital. In case the patient was covered by a good private insurance carrier, it was usually only a few hundred dollars. In the case where these people were covered by Medicare of Medi-Cal, they ofter due nothing. If they were indigent, together no insurance at all, there were a social worker on staff who would look at to get them some form of emergency medical assistance to help pay their debt in full. However, that would soon all change with the cut backs in Treatment, and other social programs during the course of the Regan Administration. By simply the mid to later 1980s, insurance carriers were demanding second opinions on certain procedures, and PPOs and HMOs started out to spring up all over the country. It was quick managed health health care, which has its advantages and cons. The biggest advantage to the organisations who provided these programs to their employees of course was the costs. Costs for PPOs and HMOs were much less expensive than the traditional health care plans, and saved the employer hundreds of dollars per yr in costs. It had been the biggest selling point for them, but left many employees with less than enough coverage.