Doctor co-pays

[all]

[quote=njtosd][quote=ocrenter]

it’s just a way to try to manage “overusers” of the system.[/quote]

Yup. If there was no cost to going to the doctor, people would be there everyday.[/quote]

Maybe few. But people mostly avoid doctors. Waiting in the waiting room followed by some more waiting in the cubicle combined with increased chances of leaving sick is not appealing to everyone.

IMO there should be few no-copay visits/year in addition to the one annual well-check, especially for kids. Once I was forced to bring 3rd kid to see the doctor a couple of days after the other two were diagnosed with stomach flu and given some anti-nausea medicine. I had to leave the office, drag the sick kid around for a 30 second chat with the doctor and pay $50 for the pleasure. She got the same medicine the other two got.

[flyer]

With our coverage, we have very small co-pays, regardless of which medical group we choose–UCSD, Sharp, or Scripps (which is our favorite), or other.

Even if we choose a doctor or facility elsewhere, we’re still covered, and it has been our experience that all will bill you if you don’t pay the required co-pay up front. We’re so glad to have such great coverage, that we’re more than happy to meet that requirement.

[Hobie]

Not to beat a non-issue, but I think the co-pay will keep some of the non-urgent doctor visits down.

Ever notice how some elderly folks seem to treat their trip to the post office, bank, market, doctor office as a personal visit. These are their only friends. Annoying as it can be, I give them a pass and wait quietly. We might me in their shoes someday.

[ocrenter]

[quote=all][quote=njtosd][quote=ocrenter]

it’s just a way to try to manage “overusers” of the system.[/quote]

Yup. If there was no cost to going to the doctor, people would be there everyday.[/quote]

Maybe few. But people mostly avoid doctors. Waiting in the waiting room followed by some more waiting in the cubicle combined with increased chances of leaving sick is not appealing to everyone.

IMO there should be few no-copay visits/year in addition to the one annual well-check, especially for kids. Once I was forced to bring 3rd kid to see the doctor a couple of days after the other two were diagnosed with stomach flu and given some anti-nausea medicine. I had to leave the office, drag the sick kid around for a 30 second chat with the doctor and pay $50 for the pleasure. She got the same medicine the other two got.[/quote]

you are right, just a few, but that few soaks up a lot of resources from the rest of us.

agree, stomach flu and cold and flu, you are WAY better off just staying home, doctors can’t do anything for you anyway.

[scaredyclassic]

if you paid 10,000 a year for hair insurance, and then had to pay $20 to go get it cut, it dwould seem sort of like a scam.

seems like the copay should be way higher to discourage people from coming to the dr. like $300.00. maybe $500.00. if you really need to see the doc, it’d be cheap, right?

would that bring insurance costs down.?

[earlyretirement]

[quote=flyer]With our coverage, we have very small co-pays, regardless of which medical group we choose–UCSD, Sharp, or Scripps (which is our favorite), or other.

Even if we choose a doctor or facility elsewhere, we’re still covered, and it has been our experience that all will bill you if you don’t pay the required co-pay up front. We’re so glad to have such great coverage, that we’re more than happy to meet that requirement.[/quote]

Which begs the question flyer, which provider/company do you use?

I didn’t know what to expect with Kaiser Permanente because I’ve never used an HMO before but I have to say so far in the past several years I’ve been happy. What I really like is how everything is so organized and they utilize the latest technology.

I like going online and being able to email my primary care physician (or even specialists that I’ve seen) and they typically email me back the same day. My primary care physician is AWESOME where he typically emails me back within minutes of when I email him.

Anytime I need a prescription, he just calls it in for me without me having to visit him first. If I have a question, I just email him and he answers. All my visit information is right there online. All my results from tests are right there.

When I get blood work it’s pretty amazing how they will send you an email as each result comes in. Seeing a specialist is typically pretty easy as well. I do have to drive out to San Marcos typically for specialist visits/MRI but that center there is nice and the physicians have all been friendly.

Don’t let my post give you the wrong idea. I’ve always been super healthy and spent decades paying for medical premiums and never used it. I’ve pretty much always owned my own companies so I essentially paid for my own insurance coverage for myself and my family which typically was/is expensive.

But I never used it myself until I moved to San Diego and used Kaiser.

One example is last year I had severe stomach pains. To the point where it would be daily. My primary care physician tried a few things but they never could solve it or figure it out. They had me do stool samples that nothing ever picked up.

So they referred me to a specialist in San Marcos where I had to do an endoscopy and colonoscopy (YUCK..my first time ever). They did a biopsy of my stomach and found I had something called H. Pylori. I guess something like 50% of the world has it but they don’t have symptoms. Mostly in underdeveloped or developing countries.

I do so much darn traveling that I picked it up on one of my travels. I was so happy once they got it figured out and solved it!

Another example is I have chronic neck pain from an accident when I was a kid. Constant migraines and about every 6 or 7 years for the past 2 decades I’ve been asking my doctors if there is anything that can solve it. Typically the answer is no.

Well, I met with a specialist and they had me do an MRI and they will do this surgery called Radio Frequency Ablation (RFA). Essentially burning the nerves. So I’ll do that here soon.

Hopefully all goes well. It was funny as I’m going in next week for a procedure and someone from Kaiser called me yesterday and was going through this list of questions including, “do you have a will, do you have advanced directives, etc. LOL. Needless to say I got a bit nervous after that list of questions…

But totally happy with Kaiser and it’s good to have the feeling of people that really care about you.

Any hoo….. if you don’t see any more posts from me after next week…. you know what happened… I’m just saying…

[spdrun]

H. Pylori is 30-40% prevalent in Americans — no need to have picked it up while traveling.

Susceptibility is likely more down to genetics and diet than location. Good that you got rid of it; it’s reputed to cause ulcers, at least in some people.

[earlyretirement]

[quote=spdrun]H. Pylori is 30-40% prevalent in Americans — no need to have picked it up while traveling.

Susceptibility is likely more down to genetics and diet than location. Good that you got rid of it; it’s reputed to cause ulcers, at least in some people.[/quote]

Ah.. I didn’t realize it was so prevalent in Americans as well. They said they rarely see it here. I guess because most people are asymptomatic? I’m not sure.

All I know is I’m darn glad they diagnosed it and I can go back to eating In-N-Out burgers and other junk food that I love so much! LOL.

For a while there I didn’t want to eat as there was so much pain all the time. All I know is now I’m back in FULL force clogging up my arteries. It feels good.

[ocrenter]

[quote=earlyretirement][quote=spdrun]H. Pylori is 30-40% prevalent in Americans — no need to have picked it up while traveling.

Susceptibility is likely more down to genetics and diet than location. Good that you got rid of it; it’s reputed to cause ulcers, at least in some people.[/quote]

Ah.. I didn’t realize it was so prevalent in Americans as well. They said they rarely see it here. I guess because most people are asymptomatic? I’m not sure.

All I know is I’m darn glad they diagnosed it and I can go back to eating In-N-Out burgers and other junk food that I love so much! LOL.

For a while there I didn’t want to eat as there was so much pain all the time. All I know is now I’m back in FULL force clogging up my arteries. It feels good.[/quote]

That peaked my interest so I looked up prevalence rate per the world GI organization (WGO). Yes US and Western Europe are at 30-40%, Asia is at 60-70%, Latin America and Africa are more like 80-90%. So while it is possible to simply just get Hpylori in the US, if a native born US citizen was in Latin America or Africa for a few years, came back and got diagnosed, I’ll put my money on him getting the bacteria from the travel instead of from the US.

[SK in CV]

[quote=ocrenter]
That peaked my interest so I looked up prevalence rate per the world GI organization (WGO). Yes US and Western Europe are at 30-40%, Asia is at 60-70%, Latin America and Africa are more like 80-90%. So while it is possible to simply just get Hpylori in the US, if a native born US citizen was in Latin America or Africa for a few years, came back and got diagnosed, I’ll put my money on him getting the bacteria from the travel instead of from the US.[/quote]

I wouldn’t be so sure of that, nor is it of much significance. It’s very common in the US. A 30 to 40% colonization rate is extraordinarily high. The most common human bacterial colonization known. It was only discovered about 30 years ago and its precise method of transmission is still unknown.

[earlyretirement]

[quote=ocrenter][quote=earlyretirement][quote=spdrun]H. Pylori is 30-40% prevalent in Americans — no need to have picked it up while traveling.

Susceptibility is likely more down to genetics and diet than location. Good that you got rid of it; it’s reputed to cause ulcers, at least in some people.[/quote]

Ah.. I didn’t realize it was so prevalent in Americans as well. They said they rarely see it here. I guess because most people are asymptomatic? I’m not sure.

All I know is I’m darn glad they diagnosed it and I can go back to eating In-N-Out burgers and other junk food that I love so much! LOL.

For a while there I didn’t want to eat as there was so much pain all the time. All I know is now I’m back in FULL force clogging up my arteries. It feels good.[/quote]

That peaked my interest so I looked up prevalence rate per the world GI organization (WGO). Yes US and Western Europe are at 30-40%, Asia is at 60-70%, Latin America and Africa are more like 80-90%. So while it is possible to simply just get Hpylori in the US, if a native born US citizen was in Latin America or Africa for a few years, came back and got diagnosed, I’ll put my money on him getting the bacteria from the travel instead of from the US.[/quote]

Yes, that is what the doctors that I saw said. They said almost definitely I picked this up abroad. Again, know nothing about this. Just going off what the doctors I saw said.

I’d rather trust my docs info vs. some random posts from armchair docs on Piggington. LOL.

Fortunately, none of my family had it. I got paranoid for a while after I was diagnosed with it. Every time my kids said their stomach hurt, I would take them to Kaiser for an H. Pylori test! LOL. (Well, exaggeration…just the one time for each kid…LOL).

But none of them had it. Just pops.

Maybe my immune system is getting weak in my advanced old age! I hate getting old. It sucks.

[flyer]

ER–Sorry to hear about your medical issues, but I’m sure everything will be taken care of, and you’ll be good as new.

We have United Healthcare, which has been great, but, I don’t believe they are writing policies in CA anymore–not sure. Since the airline I fly for is not based in CA, it’s a nonissue for us. I’ll probably stop flying commercially in a few years, and, even then, my wife and I will be able to keep this coverage until we’re 65–which is quite a few years away.

No one wants to be ill, but what I like about it is the fact that, if necessary, we can go to MD Anderson, Sloan, Mayo, Hopkins, as well as local providers. From what I understand, this is a special policy negotiated by the union for the pilot group, since they have to insure us, no matter where we live.

If things are working out well for you at Kaiser, you should be all set, and I wish you the best.

[ocrenter]

[quote=SK in CV]

I wouldn’t be so sure of that, nor is it of much significance. It’s very common in the US. A 30 to 40% colonization rate is extraordinarily high. The most common human bacterial colonization known. It was only discovered about 30 years ago and its precise method of transmission is still unknown.[/quote]

The only place on earth with a lower rate is Australia at 15%.

we know transmission is food borne. And in the US food sanitation still beats other areas on earth.

you go from an area with 1/3 prevalence rate to an area where 90% of the population has the bacteria and we are debating whether the bacteria is picked up here within the US or overseas?

[SK in CV]

[quote=ocrenter]
The only place on earth with a lower rate is Australia at 15%.

we know transmission is food borne. And in the US food sanitation still beats other areas on earth.

you go from an area with 1/3 prevalence rate to an area where 90% of the population has the bacteria and we are debating whether the bacteria is picked up here within the US or overseas?[/quote]

I don’t think there is a reason to debate it. The actual transmission locale is not knowable at this point.

Unless there’s some really recent stuff, I don’t know that it’s food borne. There’s been some studies showing an association with yeast, and probably not drinking water, but the most recent stuff I’ve seen indicate that the method of transmission remains a mystery. And if someone has spent most of their life in an area with a 1/3 prevalence rate, acquiring the bacteria is hardly unlikely. It is not a 3rd world issue.

[ocrenter]

[quote=SK in CV][quote=ocrenter]
The only place on earth with a lower rate is Australia at 15%.

we know transmission is food borne. And in the US food sanitation still beats other areas on earth.

you go from an area with 1/3 prevalence rate to an area where 90% of the population has the bacteria and we are debating whether the bacteria is picked up here within the US or overseas?[/quote]

I don’t think there is a reason to debate it. The actual transmission locale is not knowable at this point.

Unless there’s some really recent stuff, I don’t know that it’s food borne. There’s been some studies showing an association with yeast, and probably not drinking water, but the most recent stuff I’ve seen indicate that the method of transmission remains a mystery. And if someone has spent most of their life in an area with a 1/3 prevalence rate, acquiring the bacteria is hardly unlikely. It is not a 3rd world issue.[/quote]

never said this is a 3rd world issue. Germany has a much higher rate of colonization compared to rest of western Europe and I would not say it is a 3rd world country. Western Japan has a higher rate compared to the eastern part, western Japan is not more 3rd world. Australia is not more 1st world compared to the US.

I’m not saying there’s zero chance of getting H.pylori with a native born in the US who does zero foreign travel. Simply saying in this single case, chances that ER’s travel to a country with close to 90% prevalence rate is the more likely explanation for the infection.

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