So is someone else posting the explanation for you?
Have you ever attended one of my lectures on multi dimensional universes and layers of reality? Theyāre fun and educational and, at the same time, not.
1 Like
I had an eye test this morning. In the past, these have always consisted of a board with letters on. I am very short sighted so the first test is usually the optician making sure that i am pointing in the right direction.
This morning, I had a test board that was circles with a bit missing like this:
All i could see was a set of fuzzy dots. I honestly had no idea what I was being asked to comment on.
Eventually, there was a big reveal and I had some concept of what was going on. At that point a labrador retriever walked into the room.
I have another appointment with an eye clinic in April. At this rate, I should get a job with PGMOL.
12 Likes
Just had a nasty shock that we now have to navigate. Health insurance. Iāve commented in the past, but it is a disgrace in America. Way too much money, and the insurance companies seem hell-bent on denying coverage.
Subsidies from the Affordable Care Act were recently allowed to expire under the Republicans (one more thing to hate them for). I shopped the market for a plan for my family of four, and I switched to a new plan from last year and it costs me $2245 per month 
It more than doubled in price. How can they do that?
Anyway, just found out today that the new insurance company say they wonāt cover my sonās ongoing diabetes type one care. He has a Dexcom to monitor, and fills Omnipods with insulin, so itās all fairly automatic. Previously we paid $60 a month for the supplies he needs.
The poor lad went to the pharmacy today (heās in another State at college) and they said it was now $200. Heās a poor college student so it was a big hit, but we covered it.
Then Mrs ROTW got on the phone with the new insurance company and they said actually they are going to deny diabetic care for him, and it would now be an additional $2000 per month if we want to pay for the whole thing out of pocket (this is on top of the $2245 per month we are paying for insurance premiums).
We now have to get his endocrinologist to petition the insurance company to get coverage for his type 1 diabetes.
Itās a shit show of massive proportions. How can this even be allowed?
I grew up in the UK and lived there until age 37. Our kids were born there. The NHS has issues, but it is massively preferable to what I have over here. The ideal sweet spot is a bit more investment per capita into the NHS to make it truly world class, but Iām not sure there is the political will for that. But even an NHS with some flaws, mostly due to being underfunded, is better than this. Cherish it!
16 Likes
Thatās probably the most horrendous thing Iāve ever read on here. 
7 Likes
Yeah, but something something drag queens in sports.
Really sorry Redover, thatās appalling. So, you will have to pay $50,000 a year for health for your family?
4 Likes
The US are really terrible to workers especially everyday workers. In 2020, when COVID hits, I was laid off and I got a decent payoff a combination of the laws and the societal norms. My colleagues in the US was let go and when they described how it was done, I was in for a shock. Someone who had worked in the factory for years was first placed on a furlough with no pay but with basic health coverage and they were told if they did not hear back from the company after a month of furlough, they can consider themselves let go and can look for new employment but the company will āabove normsā cover their health coverage for an additional 2 weeks! Thatās it, nothing else!
2 Likes
For premiums alone, $26,940 per annum. Then my deductible, my out of pocket expenses each time I access health care, is supposed to be capped at $16,800. So depending on what happens in a year, I am expecting to pay up to $43,740 for health care for my family of four this year.
Then the fun begins, as Iām learning today, because my insurance company (Ambetter) is declining care for a 19 year old with type one diabetes, and saying thatās all on us. Which would be an additional $2000 per month for his dexcom and omnipod, to manage his diabetes.
The scary thing is he is a nine hour drive away, and while he has some supplies for 2 or maybe 3 weeks, without wishing to sound too dramatic, this needs to be sorted out or it will be life threatening for him.
Mrs ROTW has a call in with Riley Childrenās Hospital as he was a child when he was diagnosed. He was a really good footballer with good colleges scouting and so on, but then his energy fell off a cliff and he could barely run, and started to pass out ā¦ turned out he had diabetes type one.
We got him straightened out but it has been a journey. And now today all this. The childrenās hospital who cared for him has a specialist member of staff to petition insurance companies on your behalf, and thatās who Mrs ROTW has a call in with.
I fully expect to pay at least $43k for health care this year for my family of four, maybe even more. I donāt really understand why there isnāt a revolution over this singular issue in America.
As best as I can tell, and I have been here for 16 years, you either need to be very wealthy, or you need to work for a large organization with good health care as a benefit, or you need to be poor and have the government cover you.
If you work for a small sized employer, or have your own business, and you are doing well - to a point, not wealthy by standards over here - then you will be paying a LOT of money to health insurance companies, and they will be adept at giving you little health coverage in exchange for the money.
I feel like Iām moaning now, so apologies for that. I am pretty pissed off though.
9 Likes
Ridiculous premiums. Some people donāt even earn that much in a year.
3 Likes
I am astounded at what ROTW has stated above.
Our system is Australia is therefore magnificent compared to that debacle and believe me I have found out over the last year.
Head over here mate - get out of that shithole.
But good luck to your family health.
3 Likes
I know you really donāt need it pointing out just how bad it is there. But , a couple of years ago I had two stents put in and the cost to the insurance company was around 3,000 euros which was covered in full. Out of curiosity I decided to check just how much that would be in the US. It came in at around $20,000 , thatās 700% more than in France. There can be no other explanation for that other than it is a scam.
4 Likes
ā¦ and they wonder why the owners of these companies get shot.
2 Likes
I think the high spot for the NHS came around the late 2000s. There was a decent amount of funding coming in and they hadnāt gone too far into the hell of outsourcing.
Iām just comparing the health insurance that I pay in Germany. In total is is ā¬1020 per month, of which half is paid by my employer. Itās compulsory insurance but you get a choice of insurer (which I frankly find confusing). We just ended up with the AOK which is the original one that went all the way back to the Bismarck government. I think some of the others can be cheaper or offer additional services (usually crap like homoeopathy). That figure is also (theoretically) supplemented, so someone on a lower wage would pay significantly less. There are also private insurers that can work out cheaper for high earners, but that really is taking a risk at both oneās future earning capacity and health. (I remember Klopp mentioning this in an interview. He always kept the public insurance, even though his earnings would have made it worth his while to go private.)
One thing I do like is that they issue you with a health identification card which you present when accessing services. This really speeds up registration. It also doubles as a EHIC card so it is valid if you need emergency care in other EU countries and the UK.
One thing I hate about it is how fragmented it is. The NHS is largely integrated and the ease of access and lack of administration tends to be regarded as a major plus point compared to other health systems. Just as an example, if you get an eye test in a UK optician, they will also perform standard monitoring for things like glaucoma. In Germany, I have to make separate appointments at a different clinic. I suspect that a lot of people fall through the system in Germany because they donāt get screened until it is too late.
But it definitely comes down to money, and I think the lack of clarity in the UK as to where the funding comes from means people are less inclined to pay more in general taxation to cover it.
2 Likes
Thanks for the insight into the German system.
We left the UK in the late 2000s so perhaps we experienced the NHS at a higher point, as I donāt have personal experience since then. Our kids were born there, and everything with the NHS was great, including the actual birth experience and pre and post-natal care. Mrs ROTW was impressed that they had a midwife come round to the house for follow up visits too.
Apologies to all if my post above came across as having a bit of a pity-party.
The costs here are ridiculous, and finding out yesterday that the insurance company said they arenāt going to cover type one diabetes care for our son was a real shock. The whole set up and industry feels like a scam, but now I suppose we roll up our sleeves and battle to contend for a better outcome ā¦
3 Likes
That is just awful. And what exactly do they do for $2k a month exactly? Not a bloody lot I expect.
If itās not too personal. How much do you make a year?
Iām speaking because a substantial amount of my relatives (who are us citizens) are choosing to spend their last years back in India. Even if it means paying out of pocket for emergencies
This is right but just as an example. My father broke his leg Christmas Day. Ambulance job, straight in and operation on the following Monday.
What followed was a bit of a mare. Post operation dilerium on top of his dementia was tough going for all concerned. Followed by an infection that nearly killed him.
He appears to be over the dilerium and the infection but isnāt eating. The morphine and antibiotics they pumped him full of has destroyed his sense of taste such that everything tastes awful. Trying to get someone with dementia that eating and drinking is really important is not easy.
Weāre currently waiting for him to get transferred to a smaller more local hospital where we hope heāll get some more personal care. The main hospital heās at is basically a high level triage unit where you get the basic treatment before being moved on.
Christmas was āgreatā this year. Eating a microwaved Christmas dinner at 10pm on my own was not expected.
7 Likes
Im actually interested in thatā¦
As for the NHS, Iād be dead with the initial heart issue I had a summer or so back. My mum would also be dead considering without treatment they said 6 months at most.
So yeah 
2 Likes
Mrs ROTW has invested several hours of advocacy, and we are down to $1000 per month for diabetes meds for our son - on top of the $2245 monthly health insurance premium.
She has halved it, but the sums are ridiculous, and the fact that you have to dance a dance and fight to get anything, even after ridiculous premiums, is a joke.
This is one of the worst parts of living in America, imo. The actual health care is great. But the cost, and the system around it, is a joke. The whole thing needs massive reform.
1 Like
Next time you do something pretty staunch and think to yourself, āIām hardcore, meā¦ā, you should punch yourself in the face.
10 Likes