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Re: The reality of universal health care [Re: grandbassslayer] #15381509 04/21/25 02:35 PM
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Originally Posted by grandbassslayer
Originally Posted by patriot07
Our pastor is in the middle of a fight with BCBS. They won't approve his heart surgery that his doctor says he needs. Socialized medicine sucks and private insurance sucks just as much. I wish we could just go to a system of catastrophic only coverage and you pay for everything else.

Aetna gave my co-worker a hard time for 2 years about covering a defibrillator and resuscitation when his wife bled out and flat-lined on the table after giving birth and the only MD in the area was an anesthesiologist...fortunately the anesthesiologist was able to save her, but insurance wouldn't pay him for over 2 years because they'd never seen an anesthesiologist code for a resuscitation.

But again, socialized medicine isn't any better. It all sucks

We have such systems- that’s what a high deductible tied to a HSA is.

It's not really. A 40 year old shouldn't be paying $7k per year for a policy that only covers catastrophic items. Maybe if I was 55 or 60...

Been paying for 20 years...never once have I gotten more out of insurance than I paid them in premiums


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Re: The reality of universal health care [Re: outfishdya] #15381518 04/21/25 02:56 PM
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Originally Posted by outfishdya
Originally Posted by grandbassslayer
Originally Posted by outfishdya
My wife was denied drugs this week by united Healthcare. Her doctor of 20 years prescribed them, and she was denied in 15 min from a "panel of doctors". She appealed the decision and got all the information of this panel. She lost her appeal and the only doctor on the panel is a dermatologist. The medication is for weight loss, not for skin care. The only way she can qualify is if she has a heart attack .
Our system sucks as bad as any other, probably more.

I won’t pretend to know what conditions your wife has, but weight loss is as much a function of how many calories you consume for 99.9 percent of the population

So you agree she should be denied coverage.
She is definitely in the .01 pct here, but they refused to allow her to debate the appeal.
They require proof of heart condition. No other options.


I'm probably wrong, but I thought these GLP1 drugs facilitated weight loss by suppressing appetite.


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Re: The reality of universal health care [Re: Ted Dyer] #15381524 04/21/25 03:11 PM
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Originally Posted by Ted Dyer


I'm probably wrong, but I thought these GLP1 drugs facilitated weight loss by suppressing appetite.


the problem is insurance doesn't want to pay for them if it's for weight loss. Now if your pre-diabetic or diabetic they will pay for them (most likely).


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Re: The reality of universal health care [Re: Bigbob_FTW] #15381565 04/21/25 04:17 PM
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Originally Posted by Bigbob_FTW
Originally Posted by Ted Dyer


I'm probably wrong, but I thought these GLP1 drugs facilitated weight loss by suppressing appetite.


the problem is insurance doesn't want to pay for them if it's for weight loss. Now if your pre-diabetic or diabetic they will pay for them (most likely).

If it works by suppression of appetite then it’s not technically needed if folks just have the willpower to eat less

Re: The reality of universal health care [Re: grandbassslayer] #15381568 04/21/25 04:28 PM
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Originally Posted by grandbassslayer
Originally Posted by Bigbob_FTW
Originally Posted by Ted Dyer


I'm probably wrong, but I thought these GLP1 drugs facilitated weight loss by suppressing appetite.


the problem is insurance doesn't want to pay for them if it's for weight loss. Now if your pre-diabetic or diabetic they will pay for them (most likely).

If it works by suppression of appetite then it’s not technically needed if folks just have the willpower to eat less


pretty sure it works differently, but don't quote me.


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Re: The reality of universal health care [Re: grandbassslayer] #15381712 04/21/25 07:14 PM
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Originally Posted by grandbassslayer
Originally Posted by Bigbob_FTW
Originally Posted by Ted Dyer


I'm probably wrong, but I thought these GLP1 drugs facilitated weight loss by suppressing appetite.


the problem is insurance doesn't want to pay for them if it's for weight loss. Now if your pre-diabetic or diabetic they will pay for them (most likely).

If it works by suppression of appetite then it’s not technically needed if folks just have the willpower to eat less

That was the point of the question. I could make an argument that weight loss is an immediate medical concern and should be treated the same as diabetes or heart disease, but I also understand the other side.
It's hard to call something a disease if the cure is to just stop doing the negative behavior.


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Re: The reality of universal health care [Re: patriot07] #15381753 04/21/25 08:29 PM
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Originally Posted by patriot07

It's not really. A 40 year old shouldn't be paying $7k per year for a policy that only covers catastrophic items. Maybe if I was 55 or 60...

Been paying for 20 years...never once have I gotten more out of insurance than I paid them in premiums

This was true for me until I turned 62.
Last year I paid $4,744 for insurance that paid out $19,183.


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Re: The reality of universal health care [Re: Bigbob_FTW] #15381878 04/22/25 12:21 AM
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Could not get quote to work:

("Veterans are quick to slam the VA for being terrible, but the truth is, no healthcare system could keep up with what’s been thrown at it. The wars in the Middle East left a massive number of veterans seeking care for real or imagined health issues. That kind of demand would stretch any system to the breaking point. It’s not just about bad management, it’s about a level of need that’s way bigger than the system was built to handle.

Ignoring combat arms veterans, it’s mind-boggling to me that someone can serve just 2-4 years in the military and walk away with lifetime healthcare coverage. The amount of money to keep that promise is enormous.")

You wouldn't feel that way if you raised your hand and pledged everything you had, including your life to this country. Then they sent you to Vietnam twice and gave you a big damn dose of agent orange so monsanto, dow, and all the neocons, war-hawks, and warmongers could get rich by poisoning and killing off the younger generation. Yeah, I got my dose of OA and now I am terminally ill because of it. It flipped my immune system and my immune system started attacking my lungs. Now I have pulmonary fibrosis and an 18% breathing capacity and am on high flow oxygen 24/7 just to stay alive. The VA refused to give me a lung transplant even though my interstitial lung disease Pulmonologist recommended and requested it. Bean counters didn't want to spend the money. Needed it for their next promotions and raises.

And yes the VA is horrible and I find that they care about the VA far more than the servicemen they are supposed to take care of. I don't give a damn about the system and its breaking point. If we can find billions for other countries and illegals, then we can damn sure give our veterans FIRST CLASS MEDICAL CARE!! The govt made the promise and I don't give a damn what it costs to keep it!!! No excuses are aceptable now after the fact!!!

By the way just so you will know. I was a reservist and ONLY SERVED ON ACTIVE DUTY FOR 2, THAT'S RIGHT - 2 YEARS!!!!!!!

Last edited by bluesman; 04/22/25 12:31 AM. Reason: add something
Re: The reality of universal health care [Re: Bigbob_FTW] #15381881 04/22/25 12:26 AM
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Again, can't get the quote button to work.

('So many people are scamming the VA now. Example- how the heck can you get a disability rating for appendicitis? Did the military really cause that? You wouldn’t believe the number of folks that live and think every minute trying to get that next 10-20%. It’s designed for true disability that was caused by military service. The system is broken.")

TWO DIFFERENT VA SYSTEMS. One is medical side and other is disability side. They do not connect with each other at all. In fact the dont eve share records. I am talking about the medical side, NOT the disability side. I will say however that I have seen things denied on the disability side that should not have been denied.

Re: The reality of universal health care [Re: Bigbob_FTW] #15381882 04/22/25 12:28 AM
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I believe Scagnetti made that pledge, sir.

Re: The reality of universal health care [Re: Bigbob_FTW] #15381883 04/22/25 12:34 AM
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I have no idea and never said he didnt. I was stating my experiences. Everyone's experiences are different.

Re: The reality of universal health care [Re: Bigbob_FTW] #15381884 04/22/25 12:37 AM
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Oh no, I get it. Hoping the best for you sir.

Re: The reality of universal health care [Re: bluesman] #15381885 04/22/25 12:39 AM
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Originally Posted by bluesman
Again, can't get the quote button to work.

('So many people are scamming the VA now. Example- how the heck can you get a disability rating for appendicitis? Did the military really cause that? You wouldn’t believe the number of folks that live and think every minute trying to get that next 10-20%. It’s designed for true disability that was caused by military service. The system is broken.")

TWO DIFFERENT VA SYSTEMS. One is medical side and other is disability side. They do not connect with each other at all. In fact the dont eve share records. I am talking about the medical side, NOT the disability side. I will say however that I have seen things denied on the disability side that should not have been denied.

Maybe try this button.

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Re: The reality of universal health care [Re: Bigbob_FTW] #15381886 04/22/25 12:40 AM
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Wife is type 2 diabetic
Dr prescribed ozympic
It’s not for appetite suppressant. It blocks sugar somehow. Blue cross is losing bad on this stuff.


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Re: The reality of universal health care [Re: Bigbob_FTW] #15381889 04/22/25 12:45 AM
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medacaid and medicare are basically socialized medicine

medicade, CHIP and medicare have 146M out 330M people in the USA enrolled


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