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(2,546 posts)
Mon Jan 18, 2016, 12:43 PM Jan 2016

I Am Getting An EGD (Esophogogastroduodenoscopy) Tomorrow While Many Others Who Need One Will Not

Because of costs despite The Affordable Care Act !

I told the clerk at the endoscopy center who called to tell me what time I needed to be there... and how much I needed to write the check for....

that I am A Nurse Practitioner and I have SHITTY INSURANCE. Going to cost me like $1,000 bucks!

I responded that WE can only hope for Bernie... and She replied I'm all for that!

Want to know why health care costs have slowed their growth?

In my view because I see and hear from my patients with cancer all of the time with distinctly similar stories, that people have looked at costs...They are taking the risk to forego needed tests, check ups and imaging because it costs them too much in an era of declining incomes among the middle class despite the ACA.

Premiums and cost continue to rise with the ACA. A lot of people do not have $1,000 bucks to shell out for a test. I would prefer not to either, but understand the need and value of the test and most importantly... I can write the check.

End result... People do NOT get their health care (Life Saving Tests such as Colonoscopies, EGD's CT Scans and "things" get missed and allowed to fester/grow and people end up very sick and then they die a whole lot sooner than they should have to.

The Affordable Care Act was an improvement for some, but remains inadequate for many.

Bernie is right and Hillary Clinton is wrong.

I can speak with authority on this issue not only because I see this stuff every day in the hospital where I work, (managing the care of Cancer patients), but also having significant credentials in the construction of Health Policy (MBA in Health Systems Management), that Hillary is siding with Corporate America not the American worker.

Bernie Sanders has it right and proved it once again last night to the consternation of Clinton Incorporated.
29 replies = new reply since forum marked as read
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I Am Getting An EGD (Esophogogastroduodenoscopy) Tomorrow While Many Others Who Need One Will Not (Original Post) CorporatistNation Jan 2016 OP
be well tomorrow...quick recovery and good results restorefreedom Jan 2016 #1
Thanks... CorporatistNation Jan 2016 #3
I wish you well. Your post is empathy personified. Take care and know you are loved. roguevalley Jan 2016 #18
What I Am Addressing IS Affordability AND ACCESS To Health Care CorporatistNation Jan 2016 #2
My 93-year-old mother underwent an LibDemAlways Jan 2016 #21
I sincerely wish you the best in dealing with your ailment Plucketeer Jan 2016 #24
Well Said... Medicare IS The Preferred Provider Among Physicians As Far As Ease of Billing And... CorporatistNation Jan 2016 #27
The ACA is going to become the CA in just a few years tularetom Jan 2016 #4
I have a relative who was unemployed and on COBRA LibDemAlways Jan 2016 #22
So many procedures are done at 'out patient facilities' and co pays don't apply. Your hospital plan ViseGrip Jan 2016 #5
Don't Depend On That... The Newest Scam Is Called "Obseervation" Status... CorporatistNation Jan 2016 #9
Wish you the UglyGreed Jan 2016 #6
I'm on Medicare now, but when I had the ACA (pre-existing condition pool) Vinca Jan 2016 #7
Indeed, we must. stage left Jan 2016 #13
This message was self-deleted by its author tularetom Jan 2016 #8
Eisenhower had to include "defense" in the interstate act before it could pass...? Lostnote Jan 2016 #10
WTF? Fuddnik Jan 2016 #12
Lol... My pt was how the labeling effects the outcome... WTF certainly labeled my post as obfuscaed Lostnote Jan 2016 #23
I was scheduled for a colonoscopy last year. Fuddnik Jan 2016 #11
You Are TOTALLY Validating What I Am Saying As Both Patient And Health Care Professional... Here's CorporatistNation Jan 2016 #14
I've been seeing this for the past 2 years........... mrmpa Jan 2016 #19
My dear dad (RIP) had it right Iwillnevergiveup Jan 2016 #15
There are plenty of procedures that have out-of-pocket costs to most everyone maxsolomon Jan 2016 #16
Insurance companies are in effect chapdrum Jan 2016 #17
YOU are a nurse practitioner? ismnotwasm Jan 2016 #20
I have a colonoscopy scheduled next month... StarzGuy Jan 2016 #25
Enjoy your evening! MuseRider Jan 2016 #26
EXCELLENT! We Need Much MORE Real World Input On Health Care In Order To Inform CorporatistNation Jan 2016 #28
Exactly! n/t MuseRider Jan 2016 #29


(2,546 posts)
2. What I Am Addressing IS Affordability AND ACCESS To Health Care
Mon Jan 18, 2016, 12:47 PM
Jan 2016

Cost remains a HUGE Barrier to ACCESS which are key components when discussing Health care Policy at the National and on down to the local level.


(15,139 posts)
21. My 93-year-old mother underwent an
Mon Jan 18, 2016, 02:46 PM
Jan 2016

endoscopy at an outpatient center recently. She was in at 9 and having lunch with me at a restaurant by 11:30. Medicare and her supplemental insurance covered the whole thing. The sticker price charged by the clinic was $12,000.

You can bet uninsured and underinsured people would likely have gone without and would continue to suffer from whatever condition was necessitating the procedure in the first place.

Access and the cost of premiums, co-pays, and deductibles continue to be extremely problematic under the ACA.



(12,882 posts)
24. I sincerely wish you the best in dealing with your ailment
Mon Jan 18, 2016, 03:10 PM
Jan 2016

I'm currently dealing with a kidney stone. It started with a trip to the emergency room - then trips to my GP and ultimately to a specialist - several trips to said specialist and the problem is yet to be totally resolved. But I'm happy with the care I've been getting and even HAPPIER that at not ONE of the places I've gone to has asked for a dime out of my pocket. At age 71, I'm on Medicare. But the real blessing is that I have lingering medical insurance via that provided by my wife's past place of work. That coverage is my secondary insurer and picks up everything that Medicare might not.

The point I'm aiming to make here is that while the affliction is painful in and of itself, the fact that I walk in and out of these places without having to consult with the offices thereof as to how much I owe is truly liberating. And if we DID HAVE Medicare for all, everyone could experience the same feeling of freedom that I've been enjoying of late.
The wife and I DO have a monthly premium for the healthcare thru her old workplace (she was a public school teacher), but it's almost incidental in it's amount - sorta like the "tax" that Bernie's proposing for the single payer he wants to establish for us.

It's liberating folks! It really is. And all we have to do is demand it. All we have to do is elect folks to office that do OUR bidding - not the bidding of the monied interests.


(2,546 posts)
27. Well Said... Medicare IS The Preferred Provider Among Physicians As Far As Ease of Billing And...
Mon Jan 18, 2016, 07:09 PM
Jan 2016

getting paid in a timely fashion. Insurance companies make money by charging exorbitant premiums and restricting access to health care. Making $$$$ at the expense of people.


(23,664 posts)
4. The ACA is going to become the CA in just a few years
Mon Jan 18, 2016, 01:07 PM
Jan 2016

It's turning out to not be very affordable. The 15% administrative limit is either not being enforced or the insurance companies have come up with new ways to lie with numbers. At any rate, increasing numbers of Americans, especially younger people, are optin to pay the penalty and roll the dice on medical care, rather than pay the exorbitant and ever increasing insurance premium. Soon, this will lead to an upward spiral in premiums, and we'll see a mass exodus from Obamacare.

Whether this leads to a single payer health care delivery system depends heavily on who is in control of the executive and legislative branches of government.


(15,139 posts)
22. I have a relative who was unemployed and on COBRA
Mon Jan 18, 2016, 02:52 PM
Jan 2016

to the tune of over $700 a month when the ACA kicked in. When his COBRA eligibility finally ended, he found a crappy "silver" plan through Covered California which was $675 a month and covered practically nothing. A few hours in a hospital ER ended up costing him 6K even with so-called "insurance."

This is unsustainable.



(3,133 posts)
5. So many procedures are done at 'out patient facilities' and co pays don't apply. Your hospital plan
Mon Jan 18, 2016, 01:09 PM
Jan 2016

goes into affect. This is where nothing is affordable. So glad you have the money.

It's clear, many will not have the procedure.

Why does a cancer nurse practitioner have shitty insurance?

Why do people not have the same insurance?

Talk about your inequality!!!!!!!!!


(2,546 posts)
9. Don't Depend On That... The Newest Scam Is Called "Obseervation" Status...
Mon Jan 18, 2016, 01:21 PM
Jan 2016

You're admitted... but by Insurance parameters... You're NOT... Therefor the hospital bills YOU and the Insurance Industry Skates! The entire system of financing is a Rube Goldberg contraption engineered to ensure that risk and cost is transferred to the patient thus resulting in people avoiding health expenditures that they should have but choose to avoid because of COST!


(50,354 posts)
7. I'm on Medicare now, but when I had the ACA (pre-existing condition pool)
Mon Jan 18, 2016, 01:15 PM
Jan 2016

I had a routine colonoscopy. Much to my surprise the insurance claim was denied. When I made inquiries, they said the gastroenterologist coded it as a "follow-up" procedure rather than routine screening so the deductible applied. "Follow-up" because I had been paying out of pocket for routine screenings since there is a strong history of colon cancer in my family. We went round and round and round and after 6 months I finally paid the hospital and informed the ACA person I would be filing a complaint with the state insurance commissioner. That got their attention and within a couple of weeks they had reimbursed the hospital and the hospital reimbursed me. It was a worse pain in the ass than the colonoscopy. We MUST get to single-payer at some point.

stage left

(2,967 posts)
13. Indeed, we must.
Mon Jan 18, 2016, 02:09 PM
Jan 2016

My adult daughter, who suffers from chronic depression and an anxiety disorder, should be able to get medicaid under the ACA, but cannot do so, due to our Republican Governor, Nikki Hayley, who refuses to expand medicaid. She is only able to get insurance she can't afford which pays for nothing. She gets piecemeal care through County Mental Health. Patients see a psychiatrist once every three months. This is one of the reasons I'm making calls for Bernie. And one of the major issues with many people, I've found, is health care.

Response to CorporatistNation (Original post)


(8,846 posts)
11. I was scheduled for a colonoscopy last year.
Mon Jan 18, 2016, 01:33 PM
Jan 2016

The only reason my wife is still working, is for my health insurance. The colonoscopy was scheduled, and supposedly the insurance company was covering it. The night before, they called and said I needed to have $900, my co-pay, the next morning. I said "Fuck You", and canceled the appointment.

5 years ago, I had my last colonoscopy, and the insurance refused to cover anything (different ins. company) and my bill was $1,000. but the doctor said since I was self insured for the procedure, they cut the fee in half.

Hillary talks about a tax increase on the middle class, a typical Republican talking point, but tries to obscure the facts. Under single payer, my medical bills, and premium costs, would be much less than anything I'm paying now. Or anybody else is paying now.

The present system is rigged for Rick Scott, Bill Frist, CEO's and corrupt politicians get wealthy, and we get screwed to death by the "greatest health care system on earth".

And, as an afterthought, see those nice cute Hep C drug commercials on TV? $1,000 per pill, and not an insurance company in the world covers it.

The working class is being reduced to plant food under capitalism.


(2,546 posts)
14. You Are TOTALLY Validating What I Am Saying As Both Patient And Health Care Professional... Here's
Mon Jan 18, 2016, 02:11 PM
Jan 2016



Gary Thompson pays $550 a month for a health insurance plan that covers him and his wife.
The monthly bill strains the Tampa couple's finances. He works in cabinet design and sales. She is a hair stylist. Together, they make about $65,000.

But here's what really gets him: With the exception of a few basic services, the plan won't pay any of Thompson's claims until he has spent at least $6,500 on health care. His wife also has a $6,500 deductible.

That IS $13,000 TOTAL before the" insurance" kicks in!

"You spend thousands of dollars a year on insurance," Thompson said, "and you can't afford to go to the doctor." SNIP

But for middle-income consumers, premiums can cost hundreds of dollars for each member of their household. A paper published in December by the nonprofit Robert Wood Johnson Foundation reported consumers with incomes around the $47,080 cutoff spent nearly 10 percent of their annual earnings on health insurance premiums — a larger share than lower-earning consumers.

In addition to the premiums, most mid-level silver plans require some level of cost sharing from the insured. SNIP

Wally Blackburn, a 60-year-old retired medical administrator from Tampa, recently found out the cheapest coverage for himself, his wife and his 23-year-old daughter would cost $2,100 a month — a "huge chunk" of the family's monthly income, he said.

He opted to buy an $800-a-month plan for his wife, who may need back surgery later this year.

But Blackburn and his daughter are sticking with the so-called catastrophic plan they had before the Affordable Care Act. The plan, which has a $6,500 deductible and will only cover them in case of serious injury or illness, was grandfathered in under the health law.

The so called "Catastrophic" coverage is a scam.... and keeps people from getting the preventative services that they need which results in worse health care outcomes = shorter lives among those affected.

Medicare for ALL... Yes We Can... With Bernie NOT Hillary!


(4,033 posts)
19. I've been seeing this for the past 2 years...........
Mon Jan 18, 2016, 02:38 PM
Jan 2016

in 2014 insurance would cost me (single) $300 a month, with a deductible of $6500, so this was $9500 a year before insurance would pay anything, more than 2/3 rds of my income.

in 2015 insurance was about $150 a month with a $7500 deductible so this was $9300 a year before insurance now that was nearly 50% of my gross income.

I had no coverage those 2 years and neither did I have it in 20012 or 20013. The funny thing was that in 2014 I was eligible for medical assistance under federal guidelines, but we had an f'ing republican governor who did not expand medical assistance.

In the past 2 weeks I became eligible for medical assistance (we have a democrat governor, who expanded medicare) and have insurance for the first time in 4 years.

It's not the cost of insurance premiums, but what the consumer has to pay in deductibles that makes it unaffordable.


(9,298 posts)
15. My dear dad (RIP) had it right
Mon Jan 18, 2016, 02:16 PM
Jan 2016

He said when a baby is born, on the very first day, she/he needs 4 things:

*A social security number
*A Medicare enrollment card
*A free college education card
*A voter registration card



(33,497 posts)
16. There are plenty of procedures that have out-of-pocket costs to most everyone
Mon Jan 18, 2016, 02:23 PM
Jan 2016

and Deductables are common in most insurance policies. I have to pay $2500 before my insurance kicks in this year - up from $1000 last year. I have the Alan Grayson plan - don't get sick.

This is the way Health Insurance works. This is the way America works. And we decided, DEMOCRATS decided, to continue with for-profit Health Insurance. Hillary is correct in that in her assessment of the politics of the Congress is accurate. I didn't watch the debate; did she say she LIKED this situation?



(930 posts)
17. Insurance companies are in effect
Mon Jan 18, 2016, 02:27 PM
Jan 2016


Like most mega-corporations, we are evidently helpless before them.

Bernie is not mincing any words. If we don't stop the asteroids, they will take us out.


(254 posts)
25. I have a colonoscopy scheduled next month...
Mon Jan 18, 2016, 03:50 PM
Jan 2016

...fortunately, I'm on Medicare and it is a needed test. I've had these done before so I a mentally prepared to go through the "cleansing" procedure. (great way to describe what happens). I also have secondary insurance that will hopefully cover anything Medicare doesn't. So, I feel pretty good about that. But, I want people to know that even though you pay into Medicare throughout your working life when you finally retire on Medicare they do not pay for the entire bill for such procedures. To top that off you still have to pay premiums every month out of your Social Security and you also still have a deductible you pay out of pocket before Medicare kicks in.

Becoming disabled after a working life of 40 years I retired and qualified for Medicare. Now I am expected to pay the above healthcare costs and also try to live on SSDI and a small pension. I have to rely on free food boxes from St Mary's food bank every month (worth it) to supplement my food budget as I become broke before the end of the month.

I am a Sanders supporter. I can only dream of a time when great healthcare becomes an equal right (not just for the privileged). I can only dream of a time when single payer would become the law of the land. But, alas, unless we turn out enough Republicans from Congress that's all it will ever be, just a dream. In the mean time my health continues to deteriorate because I can't afford the same healthcare the 1%'ers can. So it's a crap shoot (pun intended) as to the quality of the care I receive.

Let's elect Sanders and enough democrats that will allow for single payer to become law.


(34,151 posts)
26. Enjoy your evening!
Mon Jan 18, 2016, 04:26 PM
Jan 2016

I had that combined with a colonoscopy this last summer. It did not find a thing so we had to move on to other means of investigation.

I found that I think Propofol is perhaps the coolest drug around. BOOM, done. Nothing after at all. Just awake and home.

Good luck. Find a good book to read tonight, you will be awake for a good deal of it.

EDIT to add: I am also a nurse. I adore my nurse practitioner. She is the one who finally figured out what was wrong with me.


(2,546 posts)
28. EXCELLENT! We Need Much MORE Real World Input On Health Care In Order To Inform
Mon Jan 18, 2016, 07:14 PM
Jan 2016

everyone who is not in health care WTF is really going on! ALL In for Bernie!

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