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k.l.k


Nov 12, 2008, 10:56 PM
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Re: [yeahyeahyeah] Uninsured and need shoulder surgery. [In reply to]
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Sorry to hear about yr shoulder. I would 2nd the recommendation about saving cash for a visit to a good PT, preferably one who works a lot with athletes. Ask around and find out who has a good rep.

Some of the best PTs I've known could do a better shoulder exam than many of the orthos I've known.


k.l.k


Nov 12, 2008, 11:00 PM
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Re: [onceahardman] Uninsured and need shoulder surgery. [In reply to]
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onceahardman wrote:
In reply to:
As an asside, let me just say FUCK the insurance industry and everyone who works for it. Grow a conscience you fucking parasites.

WOW. I don't want to come off as an insurance company shill, as I'm not. Health insurance is a product one purchases, or chooses not to purchase. If you choose not to, well, that's really not the insurance company's fault. Had you saved the money, rather than paying the premiums, you'd likely have enough money to pay at least for your PT. Health care is not cheap. It is about to become MUCH more expensive, once the government is running it.

You chose not to purchase a product, and then blame the product you did not purchase.

And then, you call them "parasites"...check your definitions, YOU are the one who wants treatment, without paying for it.

If you are at a low income, their may be some medicare-type benefit you could get. I don't know, I've never personally applied for any social services.

What part of the country are you in?


EDITED:

Pretend, for a moment, that you owned an insurance company. Joe Blow doesn't buy any insurance, hurts his back, and pays a, say, $300 premium for the first month, then expects you to lay out $50,000 for a spinal fusion. Then he cancels his policy. You are out $49,700. How long can you afford to do that?

That's why the term "pre-existing condition" applies.

OAH: This seems unnecessary. We appreciate you chipping in with useful professional judgments, and it's tough to not get sucked into the rhythm of the flames, but would you have delivered this lecture to a patient?


dynoho


Nov 12, 2008, 11:00 PM
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Re: [Toast_in_the_Machine] Uninsured and need shoulder surgery. [In reply to]
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Toast_in_the_Machine wrote:

Should I buy this chick a beer and hope she gets drunker and I get lucky or should I save this money so I can send it to an insurance company and never see it again? It is a tough choice, but when you wake up with an incurable disease, you’ll know which one was the right choice.

First, buying a chick a beer to get laid is a sure fire way to get an incurable disease. Second hand knowledge, of course.

Second, those lucky enough to have insurance, have you read the fine print? I believe that many (certainly not all) policies will preclude you for an injury in our favorite activity. I don't have the patience to read mine, until, I become a patient, if you know what I mean.

Anyway, I wish you the best... I know how useful my shoulders are.


onceahardman


Nov 12, 2008, 11:08 PM
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Re: [aerili] Uninsured and need shoulder surgery. [In reply to]
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Thanks, yes that does help clarify some things.

Like I said above, I'm no shill for insurance companies. But I still think it's a bit much to expect a doctor to know about something so rare (1 in 40 million!) and to recognize it.

Failing to recognize it, to me, is not necessarily dumb. You can't know what you haven't learned. We all try to fit the world into our own existing framework of knowledge. Especially something like MS, which can have various presentations, and is probably not really one disease, but several.

Again, my heart goes out to your family. If the insurance company really denied coverage to which they were entitled, the only recourse in our society is legal. I'd consult a lawyer. Money can't make her whole, but it's the only means we have of trying.


onceahardman


Nov 12, 2008, 11:10 PM
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Re: [dynoho] Uninsured and need shoulder surgery. [In reply to]
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In reply to:
those lucky enough to have insurance

Luck has nothing to do with it. I started a business, and work it about 10 hours a week, solely to pay health insurance for my family.


dynoho


Nov 12, 2008, 11:20 PM
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Re: [onceahardman] Uninsured and need shoulder surgery. [In reply to]
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onceahardman wrote:
In reply to:
those lucky enough to have insurance

Luck has nothing to do with it. I started a business, and work it about 10 hours a week, solely to pay health insurance for my family.

Awe shit, you know what I mean. Maybe I should have said "fortunate" enough for clarity. There are those who work 60 hours a week just to FEED & HOUSE their family. I suspect they would feel lucky to have insurance.


onceahardman


Nov 12, 2008, 11:55 PM
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Re: [k.l.k] Uninsured and need shoulder surgery. [In reply to]
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In reply to:
OAH: This seems unnecessary. We appreciate you chipping in with useful professional judgments, and it's tough to not get sucked into the rhythm of the flames, but would you have delivered this lecture to a patient?

Thanks, klk.

Aside from the "parasites" part, (which the OP actually started), Yes, I have defended insurance companies, when appropriate, to patients.

I have had MANY patients pissed off because there insurance wouldn't approve an MRI for back pain, neck pain, or shoulder pain, first, before referring for PT. I have specifically used a similar example to illustrate the "pre-existing condition" statement I made above..."pretend YOU owned an insurance company, what would YOU do?"

(Referral to PT is statistically a better option than MRI for back pain, in the absense of nerve root compression signs, and saves $800 per pt)

No one ever got better by having an MRI.

Granted, it's tough to communicate tone in this format. Maybe I could have used more smileys.Smile


onceahardman


Nov 13, 2008, 12:12 AM
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Re: [dynoho] Uninsured and need shoulder surgery. [In reply to]
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dynoho wrote:
onceahardman wrote:
In reply to:
those lucky enough to have insurance

Luck has nothing to do with it. I started a business, and work it about 10 hours a week, solely to pay health insurance for my family.

Awe shit, you know what I mean. Maybe I should have said "fortunate" enough for clarity. There are those who work 60 hours a week just to FEED & HOUSE their family. I suspect they would feel lucky to have insurance.

dynaho, this is getting kind of stale. In my personal case, a 45 hr work week was not sufficient to pay my medical insurance, so I creatively came up with a way to make it happen, by opening a small business.

Luck and good fortune don't pay the bills. They only take money. So I work harder and longer hours, and get it done. And I don't complain about it. I'm happy to provide for my family.


Toast_in_the_Machine


Nov 13, 2008, 12:46 AM
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Re: [yeahyeahyeah] Uninsured and need shoulder surgery. [In reply to]
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I’m not ignorant (about this), quite the contrary. If you will sit down, shut up, and listen, you might end your ignorance.

The $10,000 figure I quoted was based on a quick google search. This is the cost of the surgery. Tthis is the highest quality of care you can get, and the price shows it. There are lots of alternatives, down to doing nothing – which is free.

Buying insurance is not about free health care, it is about sharing risk between you and the other people who buy the same insurance policy. A heath care policy of RC.commers would be higher priced than one composed PartyPoker.com of because more of use are involved in activities that risk injury. A long term life insurance policy (excluding accidental death) would be lower because of our better general health. Insurance is about shared risk, not about free access to services. Insurance companies do buy in bulk, so they frequently negotiate discounts from health care providers, but you are free to negotiate with them as well.

You should be freaking grateful that a pro in the business (OAHM) deemed your story worth of his insight. He gave you for free an part of the knowledge that he uses to provide for his family. Your lack of obvious gratitude is insightful.

Oh yeah, and the most obvious incurable disease is children, and that is real responsibility.

You were right about me being a dick though.


nivlac


Nov 13, 2008, 12:47 AM
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Re: [yeahyeahyeah] Uninsured and need shoulder surgery. [In reply to]
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yeahyeahyeah wrote:
Let me reiterate my original intent.

I'm paying my own way here. If anyone has had a similar shoulder injury, please give me a number so I can start saving up.

We all know how insurance works and doesn't work, so lets not make it a disscussion about insurance.

YYY, I don't know how serious your injury is, but there is light at the end of the tunnel. I've similarly damaged my shoulders and had to go through rehab. I had those same problems you describe, although after visiting a doc, he told me it was probably a minor tear/damage of the rotator cuff and gave me a Thera-band.

It's about 5 years later, and while my shoulders still pop during full ROM exercises, they don't hurt and I'm climbing fine.

Remember that no matter what the PT or doc tells you, you have to be diligent about following through. And it'll take (significant) time to get your shoulders stronger using whatever regimen you follow.

Best of luck.


dynoho


Nov 13, 2008, 12:51 AM
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Re: [onceahardman] Uninsured and need shoulder surgery. [In reply to]
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I'm not missing your point; however, I think you have missed mine. Consider yourself lucky, fortunate or creative. I don't care to argue it.

I hope you have read the fine print and are covered if/when you should happen to get hurt climbing.


Toast_in_the_Machine


Nov 13, 2008, 1:13 AM
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Re: [dynoho] Uninsured and need shoulder surgery. [In reply to]
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dynoho wrote:
I'm not missing your point; however, I think you have missed mine. Consider yourself lucky, fortunate or creative. I don't care to argue it.

I hope you have read the fine print and are covered if/when you should happen to get hurt climbing.
Oh, I get your point. Having had injuries (with still outstanding bills) and knowing that certain activities and how they are deemed in insurance contracts.

May I throw the “you missed my point” back????

My point was, insurance is a form of fiscal safety protection to be trusted as much as a single piece of climbing protection. We are sympathetic to the friends and loved ones of people who get seriously hurt while understanding that the person could have seriously f’ed up. Whining about “I f’ed up, someone else should set better pro” should be no more acceptable than “I f’ed up, someone else should pay for my medical bills”/


lunabruandabby


Nov 13, 2008, 1:23 AM
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Re: [yeahyeahyeah] Uninsured and need shoulder surgery. [In reply to]
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Surgery costs will run you from $4000.00 min to $30,000 +....have fun with that.


glytch


Nov 13, 2008, 3:39 AM
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Re: [yeahyeahyeah] Uninsured and need shoulder surgery. [In reply to]
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yeahyeahyeah wrote:
You know, I could afford super cheap insurance but for the kind of care I would get it wouldn't be worth it. I know from my own experiences. Everyone agrees that insurance-for-profit is a huge problem but they keep throwing their money at it for some false sense of security and in doing so they are perpetuating the problem(s) with our healthcare system. By not paying for insurance I'm choosing to take more responsibility for my own health than you are. You pay for insurance to cover your ass, you want them to take the responsibility when you bust it.

Go back to your "secure" little suburb and continue to live your "secure" but ignorant life. If you wake up with an incurable disease I hope you realize that your insurance would find a way to bail on you and you'd be SOL. So do yourself a favor and take some fucking responsibility and don't rely on insurance to go through with their end of the deal.

Oh btw, congratulations. You are the new dick of this thread.

so, uhh, let me get this straight: you're taking responsibility for your own healthcare by asking a bunch of people on the internet (some of which, lucky for you, are willing to share substantial expertise) for medical advice because you can't afford - and haven't gotten insurance for - a visit to the doctor. How is that in any way responsible?

Who do you think should pay for your medical costs?


onceahardman


Nov 13, 2008, 4:27 AM
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Re: [Toast_in_the_Machine] Uninsured and need shoulder surgery. [In reply to]
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In reply to:
Buying insurance is not about free health care, it is about sharing risk between you and the other people who buy the same insurance policy.

That might be the smartest thing anyone has said in this thread. Kudos.

If I pay $4800./yr for my family policy, but we use $15,000 of the policy's money, the $10,200 shortfall must be made up by others within the pool, or by me, next year, when we hopefully enjoy better health. There are not usually "massive" profits in health insurance. They compete with other companies for the same dollars.

When the government is in control, the competition goes away. They'll just pay MDs less if they want. The brightest minds will seek employment elsewhere. Quality will decrease.


aerili


Nov 13, 2008, 5:56 AM
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Re: [onceahardman] Uninsured and need shoulder surgery. [In reply to]
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onceahardman wrote:
But I still think it's a bit much to expect a doctor to know about something so rare (1 in 40 million!) and to recognize it.

Failing to recognize it, to me, is not necessarily dumb. You can't know what you haven't learned. We all try to fit the world into our own existing framework of knowledge. Especially something like MS, which can have various presentations, and is probably not really one disease, but several.

Somehow I'm not explaining myself well, I guess.

Most docs who practice relevant medicine are aware what neurosarcoidosis is, esp. neurologists, internists, and rheumatologists. However, my family is not of the view that these docs SHOULD have concluded it was, in fact, this.

What we feel is that they should have owned up to the fact that they were at the end of their abilities/knowledge when it became clearer and clearer that they were not diagnosing her symptoms properly. I know MS has various and vague presentations, but from what I remember my uncle saying, it eventually seemed fairly conclusive she did NOT have MS. I mean, how can one justify docs taking 2 years to "figure out" symptoms that keep confounding them when a dude at Mayo dx'd it in 2 hours? What's the reasonable cut-off time before the best in-network specialists in town just say, "Clearly we are not getting anywhere so we recommend you go a step higher."

I don't believe the Mayo docs diagnosed the other 3 U.S. cases in existence, so they had never officially seen this either but were smart enough to pursue the right method of inquiry anyhow.

My aunt and uncle aren't your average people who criticize how things operate in healthcare without the slightest clue as to how it all works firsthand. They have their reasons for feeling how they do in this situation. I can only hope they at least get the reimbursement they deserve from the insurance company that cheated them; money can hardly change the past but at least it can cover other, uninsured medical bills.

Okay, that is the end of my off-topic rant.
Attachments: onoffrant.gif (25.6 KB)


jt512


Nov 13, 2008, 6:07 AM
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Re: [glytch] Uninsured and need shoulder surgery. [In reply to]
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glytch wrote:
Who do you think should pay for your medical costs?

Society.

Jay


onceahardman


Nov 13, 2008, 1:33 PM
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Re: [aerili] Uninsured and need shoulder surgery. [In reply to]
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Again, I sympathize with your aunt and uncle, and I'm not trying to make a strong defense of a tragic missed diagnosis, but I have looked around a little .

From NIH:

In reply to:
Because neurosarcoidosis manifests in many different ways, a diagnosis may be difficult and delayed

http://www.ninds.nih.gov/...neurosarcoidosis.htm


Unfortunately, the dx doesn't bode well:

In reply to:
There is no known cure for the disorder. Treatment is indicated if symptoms are severe or progressive. The goal of treatment is to reduce symptoms.

I couldn't find anything about it's extreme rarity.

As usual you have explained yourself well. I simply disagree. I'm sorry for your family's difficulty.


dynosore


Nov 13, 2008, 2:17 PM
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Re: [yeahyeahyeah] Uninsured and need shoulder surgery. [In reply to]
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yeahyeahyeah wrote:
Toast_in_the_Machine wrote:
It is your responsibility to be fiscally responsible. We can replay the whole “take some f!@king responsibility” thread and replace the word “safety” with “finances” and you can get the drift of this. You, not the g’ment, not some company, not some community, are responsible for your finances. This includes planning for bad things. Before beginning climbing, why didn’t you make sure you had a $10,000 injury safety net in place? You made sure you placed protection on the climb, buying insurance is the same thing; it is a form of protection. Does every piece of pro hold in every situation? No, that is why you shouldn’t bank on only one form of fiscal safety net.

Look, it is very, very difficult to make the right fiscal choices. Should I buy this chick a beer and hope she gets drunker and I get lucky or should I save this money so I can send it to an insurance company and never see it again? It is a tough choice, but when you wake up with an incurable disease, you’ll know which one was the right choice.

Even if I saved everything I had after paying my minimum expenses, it would take years to save that kind of money. Some people don't have the luxury of having money to save, like my parents who can't even pay for necessities even though they are both working. They don't live in a nice neighborhood or have new cars or waste money on shit either. My mom works for the gov't and makes minimum wage. She had to go to mexico to get an operation done because the same operation with her gov't funded insurance would have cost her 3 times as much as the trip to mexico and the operation combined.

You know, I could afford super cheap insurance but for the kind of care I would get it wouldn't be worth it. I know from my own experiences. Everyone agrees that insurance-for-profit is a huge problem but they keep throwing their money at it for some false sense of security and in doing so they are perpetuating the problem(s) with our healthcare system. By not paying for insurance I'm choosing to take more responsibility for my own health than you are. You pay for insurance to cover your ass, you want them to take the responsibility when you bust it.

Good, if you're "taking responsibility for your health care", WHY are you whining here? Sounds like now that you're hurt, you want SOMEONE ELSE to pay for your surgery.

Your mom makes minimum wage working for the gov? What gov job pays minimum wage Crazy

Look, my wife and I chose to finish college and work a few years before we even considered kids. We paid our own way through and I worked midnights for a while to get it done. We BOTH have good insurance now. If others chose to not get a good education, breed like hamsters, and live paycheck to paycheck, guess what, there's a consequence. I take it your parents are both at least in their 40's, how in the world does neither of them have a decent job? Choices we make, and it seems you're following in their footsteps. Wake up before it's too late, or you'll be in their shoes before you know it....


banketh


Nov 13, 2008, 3:40 PM
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Re: [dynosore] Uninsured and need shoulder surgery. [In reply to]
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It's sad to see so many people defending a predatory and corrupt system like the insurance/health care system. But i guess we do the same with our political system as well.

Also kind of amusing to see how many people think we have 'quality health care' in any sense of the word.


(This post was edited by banketh on Nov 13, 2008, 3:43 PM)


onceahardman


Nov 13, 2008, 6:03 PM
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Re: [dynosore] Uninsured and need shoulder surgery. [In reply to]
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dynosore wrote:
yeahyeahyeah wrote:
Toast_in_the_Machine wrote:
It is your responsibility to be fiscally responsible. We can replay the whole “take some f!@king responsibility” thread and replace the word “safety” with “finances” and you can get the drift of this. You, not the g’ment, not some company, not some community, are responsible for your finances. This includes planning for bad things. Before beginning climbing, why didn’t you make sure you had a $10,000 injury safety net in place? You made sure you placed protection on the climb, buying insurance is the same thing; it is a form of protection. Does every piece of pro hold in every situation? No, that is why you shouldn’t bank on only one form of fiscal safety net.

Look, it is very, very difficult to make the right fiscal choices. Should I buy this chick a beer and hope she gets drunker and I get lucky or should I save this money so I can send it to an insurance company and never see it again? It is a tough choice, but when you wake up with an incurable disease, you’ll know which one was the right choice.

Even if I saved everything I had after paying my minimum expenses, it would take years to save that kind of money. Some people don't have the luxury of having money to save, like my parents who can't even pay for necessities even though they are both working. They don't live in a nice neighborhood or have new cars or waste money on shit either. My mom works for the gov't and makes minimum wage. She had to go to mexico to get an operation done because the same operation with her gov't funded insurance would have cost her 3 times as much as the trip to mexico and the operation combined.

You know, I could afford super cheap insurance but for the kind of care I would get it wouldn't be worth it. I know from my own experiences. Everyone agrees that insurance-for-profit is a huge problem but they keep throwing their money at it for some false sense of security and in doing so they are perpetuating the problem(s) with our healthcare system. By not paying for insurance I'm choosing to take more responsibility for my own health than you are. You pay for insurance to cover your ass, you want them to take the responsibility when you bust it.

Good, if you're "taking responsibility for your health care", WHY are you whining here? Sounds like now that you're hurt, you want SOMEONE ELSE to pay for your surgery.

Your mom makes minimum wage working for the gov? What gov job pays minimum wage Crazy

Look, my wife and I chose to finish college and work a few years before we even considered kids. We paid our own way through and I worked midnights for a while to get it done. We BOTH have good insurance now. If others chose to not get a good education, breed like hamsters, and live paycheck to paycheck, guess what, there's a consequence. I take it your parents are both at least in their 40's, how in the world does neither of them have a decent job? Choices we make, and it seems you're following in their footsteps. Wake up before it's too late, or you'll be in their shoes before you know it....

Or, as I heard an economist say once, "Poverty is the default condition of mankind".

If you don't want to be poor, you need to take action. You don't get rich by tearing down the rich.


Toast_in_the_Machine


Nov 14, 2008, 3:43 AM
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Re: [banketh] Uninsured and need shoulder surgery. [In reply to]
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banketh wrote:
It's sad to see so many people defending a predatory and corrupt system like the insurance/health care system. But i guess we do the same with our political system as well.

Also kind of amusing to see how many people think we have 'quality health care' in any sense of the word.

Your sadness is exceeded by my sadness. Frown I'm sad because you missed the entire point of "take responsibility".Frown

You also assumed that we are happy that we are forced to keep our medical tricorders away from those people who don't belong to The ###### of the #####.Frown

However, the cherry on my sadness is your lack of ability to get a really good troll shot going.Frown Be specific man. You might have well as typed:

-1 thread

and saved some time.


rmsusa


Nov 14, 2008, 11:57 PM
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Re: [yeahyeahyeah] Uninsured and need shoulder surgery. [In reply to]
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I had something similar (constant dislocations/subluxations due to an accident) fixed on an outpatient surgery basis, by an orthopedic surgeon for about $2500 (cheap). The last straw was coming out of joint about 3 times on a 10 pitch alpine trad climb.

Ask for a discount for cash or credit card. They probably won't even argue. Then try to talk them down a bit more, but don't feel bad if you can't.

As an aside, I'd like to say to people who don't find a way to insure themselves: Grow a conscience you fucking parasites.

After you get it fixed, get some insurance. If you get in a car wreck, you're passing a major bill off on the rest of us. I'll bet you've got auto insurance.


bmapple


Nov 15, 2008, 3:32 AM
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Nationalized healthcare would be better... [In reply to]
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I'd like join the "Fuck the health insurance industry" side of the debate.

For the OP- Go to Canada. Or Europe, or Japan, or anywhere else. It seems like the entire rest of the world has figured out that a system of private for-profit insurance and for-profit hospitals doesn't work for everyone. Oh wait, the rest of the world did figure it out! The US is the only industrialized country on the globe that hasn't provided a base layer of nationalized health care (in one form or another) for all their citizens. Had this shoulder injury happened in any other first or second world country then the OP probably would have been treated by now on his road to recovery.

No country's system is perfect, but then again what's your opinion of ours? Research data shows that the US spends more per capita for health care then any other nation, AND we have one of the lowest satisfaction ratings of our health care services. We pay more and get less because of the profiteering middle man.

And let's not forget that the government already controls over half the health care spending in the US. Lets not be so naive to think the government is about to get into health care- they're already the biggest player around. Oh my, and I heard bureaucrats will start getting involved with health care, too. Who do you think is running the show now? It aint just you and your doctor.

Me, I'd rather have bureaucrats that are answerable as governments servants then bureaucrats who are only answerable to the shareholders. The problem with the current system is that everyone wants a piece of the pie- profiteering bureaucratic excess only rewards itself.

As much as we bitch about "the government" it does do a heck of a lot for us. The roads we drive on, the parks and places we climb at, the schools our kids go to, the food that is kept safe, the actual research that furthers the medical profession... Imagine if that was all private and run to make maximum profit?

I think we'd all be better off if there existed a nationalized health system that provided a basic range of services with high end doctors and special premium services available to those who want to pay/insure for more. That system seems to work OK for the rest of the real world.

If all it took was hard work to be fully covered for health care costs then we wouldn't be in this mess. And for the 45 million without health insurance? They must just be lazy.

And before you start taking cheap shots I do pay out of pocket for my health insurance, though the best insurance of all is having the luck to not get sick or injured.


USnavy


Nov 15, 2008, 12:34 PM
Post #50 of 209 (8004 views)
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Registered: Nov 6, 2007
Posts: 2667

Re: [angry] Uninsured and need shoulder surgery. [In reply to]
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angry wrote:
So um, through Aetna, I buy insurance.

It's $92 a month, has a $3000 deductible and after that everything is totally covered.

One thing that I should bring up is that very few insurance companies cover injuries sustained well participating in a high-risk activity or from gross negligence. Meaning, if you get hurt well climbing you are likely to get your claim denied. Almost every insurance company specifically states they don’t cover this in their policy. Generally you have to buy special high-risk insurance to get this covered.

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