Hearing care should also be included along with

[shraby]

eye, teeth and mental health! Everyone leaves that out and hearing aids are small but expensive buggers.

[donco]

1. Hell might as well throw a Podiatrists or two in as well.

Never know when a toenail might start... up,eh,er in.

[Lars39]

4. Diabetics need their toe nails cut by pros.

[dflprincess]

6. Many of the current plans cover podiatrists

or vision care - there is no reason a public program shouldn't cover those things. And certainly dental should be covered as your dental hygene can affect your heart. And it was just a year or so ago that a 14 year old died in Baltimore because he had an infected tooth and his mother couldn't find a dentist who'd help without cash up front.

[Oregone]

8. Here is a better idea...

Let the private insurance companies cover those things and forget about it publicly. Then ban them from covering what the public option covers. Case close, great health system as a result. :)

[dflprincess]

11. And what other specialities would you leave out of the public health plan?

Cardiologists? Oncologists? Ob-Gyn? What happens if you can't afford a policy that covers a specialist in whatever area you need one?

As another poster noted in this thread, diabetics often need to have their feet cared for by a professional. And as I noted, dental hygene does affect your overall health. It is (or should be) unacceptable that anyone in the U.S. should die because they have an infected tooth or develop heart problems because they can't afford to get their teeth cleaned or get access periodontal care.

[Oregone]

13. Look, Im not going to re-invent the wheel here...

And congrats to that other poster for their mention, but I hope you realize the idea I suggested is effectively a single-payer health plan (specifically, a Canadian model). What would I leave out? Anything that is unnecssary and not administrered by a professional enrolled in the program. Is a cardiologist unnessary? No. Oncologists? No. Ob-Gyn? No. Everyone will be covered with the public plan, which would pay for any services *required*.

As I said, Im not going to re-invent the wheel. Here is what my very current single-payer plan covers:

medically required services provided by a physician enrolled with MSP;
maternity care provided by a physician or a midwife (see the BC Midwifery Program);
medically required eye examinations provided by an ophthalmologist or optometrist;
diagnostic services, including x-rays and laboratory services, provided at approved diagnostic facilities, when ordered by a registered physician, midwife, podiatrist, dental surgeon or oral surgeon;
dental and oral surgery, when medically required to be performed in hospital*;
orthodontic services related to severe congenital facial abnormalities.

* Surgical removal of an impacted third molar (wisdom tooth) is an MSP insured service only when hospitalization is medically required, due to the extreme complexity of the extraction and where there is associated pathology. The removal of healthy wisdom teeth, even if impacted, is not a benefit.

Supplementary Health Care Benefits

Eye Exams - Medically required eye examinations are a benefit for all MSP beneficiaries when there is a medical necessity (for example, eye disease, trauma or injury, or health conditions associated with significant risk to the eyes, such as diabetes). Routine eye examinations are a benefit only for those 18 years of age and under and 65 years of age and over.

Surgical Podiatry - Surgical podiatry services are a benefit for all beneficiaries.

For MSP beneficiaries receiving premium assistance, MSP pays $23 per visit for a combined annual limit of 10 visits each calendar year for the following services: chiropractic, massage therapy, naturopathy, physical therapy and non-surgical podiatry.

That good enough for a plan that will cover your ENTIRE family for $108 a month? Again, look at the price tag to ensure you will never lose your home and life. $108 dollars a damn month. Yes, it doesn't cover the following:

services that are deemed to be not medically required, such as cosmetic surgery;
dental services, except as outlined under benefits;
routine eye examinations for persons 19 to 64 years of age;
eyeglasses, hearing aids, and other equipment or appliances;
prescription drugs (see PharmaCare);
chiropractic, massage therapy, naturopathy, physical therapy and non-surgical podiatry services (except for MSP beneficiaries with premium assistance status);
preventive services and screening tests not supported by evidence of medical effectiveness (for example, routine annual "complete" physical examinations, whole body CT scans, prostate specific antigen (PSA) tests);
services of counsellors or psychologists;
medical examinations, certificates or tests required for:
driving a motor vehicle
employment
life insurance
school or university
recreational and sporting activities
immigration purposes

You want that stuff, pick up a private plan for your ENTIRE family for another $100 a month. Yeah, thats right, everything, drugs, eyecare, mental health, etc for an easy $200 a month. You dont like this model? Not ideal enough for you or something?

If you can use single-payer to eliminate the main financial insurance risk in covering people, the goodies cost next to nothing on the private market, and the public premium subsidies remain minimal for those in need since the premiums are so small. Not everyone, especially those who dont need it, get the "goodies", which still introduces a mechanism of personal rationing against these private market provided services (which can be a good thing if you look at what it costs).

The reason I bring this all up is because this is what Ive lived with for about a year. It works, quite well.

[dflprincess]

15. Goodies?

Everybody needs dental and eye exams regardless of their age. And, contrary to what it says above, dental services are required for good health.

You're right, $200/month wouldn't be a bad price and I'm lucky enough to be able to afford it (4 years ago when I was unemployed I would not have been so lucky). I imagine there are a lot of families who couldn't squeeze another $100 out of their budgets to cover "goodies" - like a root canal.

[Oregone]

16. But do remember...

The premiums for the public plan are subsidized for those below the poverty line, and some of the extras have partial coverage for those people. So the real draw back is the affordability of the private plan ($50 to $150 depending on what you want, which is HIGHLY customizable)....

But, this is also in a bit of a different society. One that gives you $100 per child per month for daycare and a child tax benefit that can be quite a lot monthly if you are below the poverty line. A single mom of two kids with a part time job would get $550 a month in addition to $200 for the childcare benefit (I get under $100).

So, in an more "ideal" society, I have beyond no qualms about this. Families can and do make it work. Further....employers cover the private and public premiums for full time workers. Clearly, that isn't the US, so how applicable is it all? Who knows. I don't think covering the basics should theoretically cost more per capita if the agency is funded sufficiently on the back end (via progressive taxation). The private plans can cost as little as $16 too BTW. I guess it depends on what you want. I don't find this to be so horrible. Its the dental that fucks everything up and makes the prices so high (and it pays out the worst)

Dental remains a pre-paid service with limited coverage and high deductibles, which induces self-rationing. I don't even know how a public model would be affordable enough (or funded enough) to make it feasible, especially if it was unlimited, as in the single-payer model

[dflprincess]

17. One of the problems in the U.S. with programs that have a means test

for subsidies is that what they set the income limits at rarely have anything to do with realty.

These are the current poverty guidelines for the U.S.:

The 2009 Poverty Guidelines for the 48 Contiguous States and the District of Columbia

Persons in family Poverty guideline
1 $10,830
2 14,570
3 18,310
4 22,050
5 25,790
6 29,530
7 33,270
8 37,010
For families with more than 8 persons, add $3,740 for each additional person
(the limits are slightly higher for Alaska & Hawaii).

Usually a program will say it's for people earning less than the poverty level times X but, with the exception of SCHIP, the income limits for being eligible for medical programs have been especially out of whack.

I would prefer a program that was fully funded by a tax (like Social Security) and covered everyone. I doubt if the tax would cost more than what I'm currently paying for the premium, copays and deductibles.

[Lars39]

2. I agree.

I've got some pretty expensive durable medical goods that insurance mostly covers.

[Rosa Luxemburg]

3. people have ears

[rwheeler31]

5. I agree, the money boys will

never consider anything good.

[frazzled]

7. Especially for children

I sensed my daughter was not hearing right when she was only 3 months old. When I brought it up with the pediatrician (one of the partners in the practice; my pediatrician was out on maternity leave) he laughed at me. He had clapped near her ear and she startled. Not exactly a hearing test, but I was properly chastised. She began saying words at 8 months, so I really thought perhaps I was just a worry wort.

It wasn't until she was three and a half that the gnawing sense that something was still greatly amiss led us to take action. We bypassed the pediatrician and went to an ear specialist. The doctor was perplexed that the tests showed she had a moderate to severe bilateral sensorineural hearing loss, meaning in both ears she was missing out totally on higher-pitched sounds (half the alphabet really), receiving distorted input. The doctor couldn't understand why her language was so well-developed, given such a marked hearing loss. Since we were about to move to another state, she gave us the name of one of the country's best hearing specialists and we continued the testing there. After extensive testing, the hearing loss was confirmed, and hearing aids and regular tests and exams became the norm. She's fine, just hearing impaired.

I should say that with all the top-notch insurance we had over the years, none paid a single penny for the hearing aids, which are quite expensive. I've never understood this. Given that a child's entire education hinges on being able to see and hear adequately, I think it is imperative that at least children be covered for eyeglasses and hearing instruments.

Lastly, I must say that the biggest problem is that young children are almost never tested in any serious way for hearing loss, and pediatricians receive next to no training in this area. I now know that there are many cues in infancy and early childhood that we experienced which are easy signs. No baby book or pediatrician covers them: early and excessive babbling (to self-stimulate the hearing), twirling around (we thought it was cute, but it's often a sign of trying to address ear imbalances), the child always needing to look directly at you, etc.

So get your young children tested as you would test for eyes, and don't laugh about hearing aids: they aren't just for grandpa.

[Maccagirl]

10. I've paid thousands for hearing aids in the last 20 years

I lost most of my hearing at age 30 due to growths on my mastoids, and you are correct-insurance doesn't pay a penny. I'm used to being screwed, and hope that your daughter has a good life.

[dflprincess]

12. And grandpa has a right to hear as well

It's a quality of life issue for anyone of any age with a hearing problem.

My mother's hearing is getting bad and she's stalling on getting checked because she can't afford hearing aids. I've told her I'll put it on a card if we have to, but that gives her the vapors. A friend did give some info that she might be able to get some help with the cost but I have to get her moving before all the state funds for this sort of thing are gone.

Given how much frames can cost I understand why glasses aren't completely covered, but I don't understand why the lens are not and they could give an allowance toward frames.

[cherokeeprogressive]

9. WHAT?

[Fire1]

14. LMAO!!! Good one!

:rofl: