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angela515
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« on: November 12, 2006, 08:01:46 AM »

(If I posted this in the wrong forum, I apologize, hopefully I got it right.)

Since I am not working, the only insurance I have is Medicare, and a Medicare Supplement. I also got Part D For prescriptions. Everyone knows that Medicare pays 80% and we are responsible for the remaining 20%. When I get bills from doctor's, hopitals, Fresnenius, and so on.. they get tossed in a drawer because I cannot afford to pay them. My supplies for dialysis each month cost's roughly 18,000-21,000 with my part due being in the 1000's... I don't understand how they think we can afford to pay these outrageous amounts, so theyend up going to collection, then on my credit report... where they will remain until they fall off after 7 years.

I have tried applying fo everything and anything out there that's supposed to help people who can't afford their medical bills but I am always denied because I make too much money they say. I get 1300/month from SSDi for me and my children together. That has to pay rent, power, gas, food, clothes, transportation, pull-ups, winter clothes for my kids... and so on and so on... not even close to enough to survive on for me and my 2 kids. So I don't know why thegoverment thinks so and denies any help.. now since I got sick my credit is ruined, I can't get anything because of it... it just sucks horribly. My credit was great until dialysis...  :banghead;
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« Reply #1 on: November 12, 2006, 08:10:24 AM »

I cannot imagine living on 1300 a month with 2 kids.  Good God!  It is poverty level.  Sucks that dilaysis had ruined your credit.  I think a letter to the credit card companies that explains the situation would go a little ways to helping restore your credit later on when and if you ever can get back onto your feet financially.  NKF used to have grants to give out but I do not know if they have it anymore.  Research the net and look around.  Sometimes money can be found.  I haven't found any yet, but that does not mean it is not there. 
     
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« Reply #2 on: November 12, 2006, 08:10:47 AM »

Doesn't the Medicare supplement pick up any of the 20%?  Do you get child support?  You should speak to your social worker about getting an "indigent waiver" filed at the center.  That may decrease or erase your debt from the dialysis center.  I thought PD supplies were much less that hemo.
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angela515
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« Reply #3 on: November 12, 2006, 08:25:29 AM »

Sorry, I should of clarified. I just moved to Iowa last December, and I got a Medicare Supplement here, so currently I have no out-of-pocket expenses for medical bills that are new bills acured here in Iowa. My bills are from Las Vegas and most of them are from emergency room visits and the doctor for the hospital since they bill seperate from the hospital. Unfortunately the hospital I went to in Vegas will not let anyone apply for indigent help if they had any type of insurance when seen at their hospital.. so since I had Medicare, I cannot apply.. even though I cannot financially afford 900.00 a pop hospital bill and I have like 20 of them for that amount alone... they tell me I was better off not having medicare, then I could of applied for the help and they would of wrote it off...  ::) Go Figure. 

Yah, 1300 is hard to live on, lucky for me my parents are helping me out until i get back on my feet. I am *supposed* t get 400/month child support, keyword being supposed to... I haven't seen a dime and currently e isn't even working.. all I can do is take it to the courts and wait. (Which I have.. so i am waiting the long wait.)
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« Reply #4 on: November 12, 2006, 08:31:29 AM »

If they accepted medicare assignment then you are only responsible for 20% of the assignment amount no matter what the actual bill or bills were. 

« Last Edit: November 12, 2006, 08:34:14 AM by BigSky » Logged
stauffenberg
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« Reply #5 on: November 12, 2006, 08:51:15 AM »

When I was a student in Germany, I spent a lot of time in a dialysis clinic, where I got to know the patients quite well, since I was doing a statistical study of patient outcomes.  Then when I developed kidney failure myself many years later, I was dialyzed in England, Canada, the Philippines, and the United States, and I got to know patients and their problems in all those countries as well.  The United States is the only developed country in the world which does not have a free healthcare system for its citizens, so only in the U.S., which is also the richest country in the world, is financial terror an integral part of the horror of dialysis.  All of this cruelty is needed 1) to keep taxes low on the wealthy, since by the American ideology, "freedom" is increased by low taxes on the rich, and 2) to guarantee that doctors can continue to charge outrageously high fees, so that they can afford a Jaguar before they are 30, because a public health system would dictate a much lower salary for them, and 3) finally, this cruelty is necessary so that the drug companies and the medical supply companies can make huge profits, since a public system would be in a strong enough bargaining position to keep their prices in line.

But I think it is obvious to every humane person looking at this system that the misery of the poverty for sick people which the American system generates causes infinitely more hurt than the freedom given to greed by this system causes pleasure among the rich who benefit from it.
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« Reply #6 on: November 12, 2006, 09:13:51 AM »

This is exactly one of the issues I want to address someday with an organization designed to help dialysis patients.

I'll be honest that I have goals in this area but I'm not sure if it will ever materialize. I'm doing research on these issues.
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« Reply #7 on: November 12, 2006, 10:30:44 AM »

When I was a student in Germany, I spent a lot of time in a dialysis clinic, where I got to know the patients quite well, since I was doing a statistical study of patient outcomes.  Then when I developed kidney failure myself many years later, I was dialyzed in England, Canada, the Philippines, and the United States, and I got to know patients and their problems in all those countries as well.  The United States is the only developed country in the world which does not have a free healthcare system for its citizens, so only in the U.S., which is also the richest country in the world, is financial terror an integral part of the horror of dialysis.  All of this cruelty is needed 1) to keep taxes low on the wealthy, since by the American ideology, "freedom" is increased by low taxes on the rich, and 2) to guarantee that doctors can continue to charge outrageously high fees, so that they can afford a Jaguar before they are 30, because a public health system would dictate a much lower salary for them, and 3) finally, this cruelty is necessary so that the drug companies and the medical supply companies can make huge profits, since a public system would be in a strong enough bargaining position to keep their prices in line.

But I think it is obvious to every humane person looking at this system that the misery of the poverty for sick people which the American system generates causes infinitely more hurt than the freedom given to greed by this system causes pleasure among the rich who benefit from it.

Please point us to the "gold standard" of health care.  Which country has the best?  How do they do it?
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« Reply #8 on: November 12, 2006, 02:16:52 PM »

Angela, I wouldn't worry about it.  There is no one who can afford even 20% of what medical bills cost.  I don't know why they even bill you.  They should be ashamed to charge that much but they aren't.  I think they know they are on their last years of absurd charging so they are getting all they can now.
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stauffenberg
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« Reply #9 on: November 12, 2006, 02:23:29 PM »

There are many problems with comparing systems.  Generally, the Canadian system is best, since all medical care is provided by the government for free out of general taxation, where the rich pay a larger share than the poor. This means that instead of financing health care by burdening people according to how sick they are, which is cruel, since they may also be poor as well, and since they already have enough to contend with just from their illness, Canada finances healthcare according to how well people can afford to contribute to it.  The end result is that millionaires have fewer Mercendes in the driveway because they are paying for free healthcare through their taxes, but no one suffers financially because of illness.  In the U.S. the solution is the opposite: keep taxes on the rich low, but handle the problem of healthcare costs by leaving 48  million poor people to die in the gutter with no health insurance at all.

But the problem with Canada is that the taxes are still too low, so the amount of money spent on healthcare is inadequate, with the result that there can be long waiting times for treatment, given the shortage in supply of doctors, hospital beds, diagnostic equipment, etc.  The U.S. pays 15% of its gross natioinal product on healthcare to cover only 86% of the population, but Canada spends only 9% of its gross national product on healthcare to cover 100% of the population.
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« Reply #10 on: November 12, 2006, 03:02:02 PM »

Hang in there Angela, that is all that we can do at the moment, i should know cuz i am in the same boat (but with no kids)  just wanted you to know you are not alone girlfriend  :grouphug;
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« Reply #11 on: November 12, 2006, 04:00:29 PM »

I have had the same problems.  I pay what I can, when I can and don't worry about it.  They can't get blood from a turnip.

I agree that the system sucks.  The problem with the social security disability system is, even though they give you enough to survive on, you will always stay poor.    It's cruel.  >:(
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« Reply #12 on: November 12, 2006, 07:57:40 PM »

I have always been astounded by the medical costs in the States.  In my home country, Barbados, a small developing island nation, health care is free to all residents of our country.  We pay a 1% health levy on our salaries.  However, we still have private doctors, clinics, and hospitals.  But that is your choice.  The only difference in the care is that you usually have to wait longer for the free service, and you do not get to choose your doctors, but sometimes you get the best doctors (the luck of the draw).
I have asked this question many times, and up to now, no one has answered me.  How come we buy our dialysis machines, equipment, supplies and medication from the US and a dialysis session in the Caribbean only costs between $300 and $500?
I had the misfortune to have had my graft done in the US Virgin Islands and for just a few hours in the hospital there (no overnight stay) my bill was over $9000 (my insurance paid a little over 5000 and I am left with over $3000).
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Zach
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« Reply #13 on: November 12, 2006, 09:19:11 PM »

I'd like to learn more about how other countries provide health care to their citizens.  (I mean general health care, not just dialysis.)
« Last Edit: November 13, 2006, 04:56:48 AM by Zach » Logged

Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
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« Reply #14 on: November 12, 2006, 11:14:58 PM »

All medical care as a public patient involving dialysis is free here. You only pay for medications which arent too expensive if you are on a pension. Most dialysis patients can get on a pension pretty easily. You can go private if you wish, but it will cost you.
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angela515
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« Reply #15 on: November 13, 2006, 08:32:43 AM »

If they accepted medicare assignment then you are only responsible for 20% of the assignment amount no matter what the actual bill or bills were. 



Yah, my bills are correct... I only pay 20%... I still cannot afford the 20%.. like i said the 20% is still around 900.00 a pop.. i dont have that kind of money... lol
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angela515
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« Reply #16 on: November 13, 2006, 08:36:22 AM »

I have had the same problems.  I pay what I can, when I can and don't worry about it.  They can't get blood from a turnip.

I agree that the system sucks.  The problem with the social security disability system is, even though they give you enough to survive on, you will always stay poor.    It's cruel.  >:(

True, they can't get blood from a turnip.. but they can ruin you so you can't get anything either. Since our country everything is based off your credit... your pretty much screwed.
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« Reply #17 on: November 13, 2006, 10:05:11 AM »

All of this cruelty is needed 1) to keep taxes low on the wealthy, since by the American ideology, "freedom" is increased by low taxes on the rich, and


How do you figure the taxes are low on the rich when the top 5% of taxpayers account for 54% of the taxes paid?

Granted that the system needs to be much better and maybe indeed that the rich should pay more as when the bottom of society lives better all of society will live better,  but to say taxes on the rich are low is a bit disingenuous IMO. :twocents;
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« Reply #18 on: November 13, 2006, 03:14:15 PM »

You have to put those tax percentages in context.  In a ruthlessly cruel, capitalist system such as the United States has, half of all the wealth in the country is controlled by the top 10% of the population, while 95% of the wealth in the country is owned by the upper 50%, leaving the lower 50% to struggle to keep warm under just 5% of the blanket!  This would be rejected by everyone as unfair if two people were sleeping in bed together on a cold night, so why is it praised as American 'freedom' when it is the way the entire political system operates?

Keeping dialysis patients at a degree of anemia which is not medically necessary, making people out of work because of dialysis and struggling to cope with the tragedy of renal failure endure co-payments for wildly overpriced medical services and supplies, and all of this being done 1) to keep taxes lower on the rich, 2) to allow general practitioners to earn an average income five times higher than normal, and specialists often ten times higher than normal, 3) and to allow drug companies to charge vastly higher rates for their medicines than anywhere else in the world, is inconsistent with the theory that the American government democratically values what the majority of its population needs rather than what the tiny minority of the wealthy want.  As former Attorney General Ramsay Clark once said, "America is not a democracy but a plutocracy" (i.e., rule not by the majority but by the rich).
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« Reply #19 on: November 13, 2006, 03:44:34 PM »

You have to put those tax percentages in context.  In a ruthlessly cruel, capitalist system such as the United States has, half of all the wealth in the country is controlled by the top 10% of the population, while 95% of the wealth in the country is owned by the upper 50%, leaving the lower 50% to struggle to keep warm under just 5% of the blanket! 

So if the US system is so cruel what's your solution??  Be a Socialist country? Take a look at countries who have Socialism.  There is still the rich and the poor. It's not the cure all for all the problems.  Communism doesn't work.  Look at North Korea.  The leader eats lobster flown in from Maine and 1000$ bottles of wine yet the people starve. They have no chance of bettering themselves.  Everyone in a free society can better themselves through education. You sound just like Cesar Chevez, BTW.  We have it so bad in the US, we have a horrible system, blah blah blah.....but everyone wants to come here to live legally or illegally.  You never hear of anyone wanting to LEAVE the US because of bad medical care.

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« Reply #20 on: November 13, 2006, 08:07:05 PM »

If anyone is interested...in Australia we have Medicare, we pay a compulsory 1.5% Medicare Levy with our tax and this covers all medical treatment at public hospitals. If you see a GP they may bulk bill, where they only charge you what Medicare will pay, otherwise you may have to pay the "gap" which, depending on how long you see the GP for is usually around $10-$20.

My partner (who is on dialysis) had private health insurance but we found the only difference in his treatment at the hospital was who paid the bill, Medicare or our health insurance company. In Victoria the Royal Melbourne Hospital has a large renal department and he was pretty much told he had to have all his treatment through this hospital.

So far my partner spent a couple of weeks in hospital last year having a fistula created (and then the fistula got infected!) and had a few dialysis treatments whilst in hospital. Then he went to the dialysis ward 3 times a week for dialysis before starting home training. His home training went for 4-5 weeks 3 times a week. Then we had a plumber sent to our home to install the plumbing, the dialysis machine was delivered a few days later and then the first 3 month supply of dialysis consumables was delivered. This was back in January and he has been dialysing 3 times a week nocturnally since then. All of this has been covered by Medicare or the hospital. Our only expense is Heparin for the machine (only $30 every 3 months), iron infusions ($30 every 5 months), caltrate (maybe $20 month) aranesp ($30 month) and a few things when we set up like a trolley and floor coverings.

We also get a $450 rebate from the hospital every year to cover out of pocket expenses such as water and electricity. However, electricity is only costing us around $120 extra per year and I rang our water company, explained why our water usage was so high and found out they offer rebates for consumers who need to use excessive amounts of water for health reasons. So, the water company pays for any usage in excess of our normal use before the machine was installed, so our water is also paid for.

I am so grateful for the great healthcare system Australia has.
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« Reply #21 on: November 14, 2006, 08:51:47 AM »

I am interested in this thread as it is still a possiblity that Sandman and I will live in PA in a few years (where he lives now) but first he will come to Canada because I have FULL health care here. No I don't have private care. I just live in Ontario where anyone who's been here at least 6 months as a resident gets OHIP (Ontario Health Insurance Plan). Plus I am on ODSP (Ontario Disability Supplimental Program I think it stands for) so the $2 co-pay is paid for as well through that per medication. Also my taxi cab fare to dialysis is also paid for.

Is it any wonder why I want to stay in Canada?


But as for what brought me to this thread .. the title: For me dialysis=bad credit..

You see .. I was working for years toward a promotion I was trying to hard to get. Then with having to go back on dialysis I lost the job completely (forget the promotion! lol) and had to claim bankruptcy a few months later as I just couldn't keep afloat!

So now I have very bad credit. Credit cards were all chopped up by the Bankruptcy Lawyer even though one of them I had just paid off  .. oh well no choice :(

I literally felt like everything I had worked so hard for went down the stinky toilet! All my hopes and dreams and goals .. gone!

Now it's been a few years and I have adjusted .. but sometimes it just hits me and really makes me so depressed. I hope it is okay to talk about this here since the subject got me thinking about this.

I know they say the USA is the land of opportunity and they say the transplant list is shorter in the USA than in Canada .. but really .. the things I have heard related to anyone on dialysis or even after a transplant in the States is very discouraging.
« Last Edit: November 14, 2006, 08:55:38 AM by angieskidney » Logged

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« Reply #22 on: November 14, 2006, 09:11:18 AM »

So sorry about your job and promotion. I was working my way up slowly in my job doing wonderful, next thing I know I am back on dialysis. I went out on long-term disability through FMLA and for awhile I got disability payments, then I started getting SSDI so i wasn't eligible for disability pay from my job anymore, but I still had my job title and position. After a little over a year of being out on long term disability my job said I either need to come back to work, or they would have to fill my position. So, I was let go,but formaly, so I wasn't fired.. if i wanna work there again, I can.

As for my credit.... after transplant, my credit was fine, I had no problems, my problems started when I got on dialysis, and I started having co-pays for hemo, and you know the rest.. lol.. I went thru chapter 7 bankruptcy also.... but i guess i did that for no reason cuz im in more debt then before lol.

Lots of places like car dealerships and apartments... say its ok if your credit is bad, we dont really look at medical anyways... then when they see my redit report, which is 99% medial and 2 cell phones... they say, oh, well... thats just too much medical we have to look at it.. LOL..  ::)

One thing I do not agree with, and no matter what anyone says, i never will agree... I dont believe dialysis patients should have co-pays on there dialysis treatments. Thats like... hey, you wanna live? Pay up. Stupid... makes me mad.
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« Reply #23 on: November 14, 2006, 11:04:39 AM »

I dont believe dialysis patients should have co-pays on there dialysis treatments. Thats like... hey, you wanna live? Pay up. Stupid... makes me mad.
I agree! See where I live in Canada they don't make you pay co-pay because yes that is stupid. I mean, especially that would piss me off considering it was a doctor's fault that I lost my kidneys in the first place.
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« Reply #24 on: November 14, 2006, 12:25:12 PM »

I want to be as sensitive as possible here and realize that every patient's situation is different.  If at all possible it makes good sense to hang on to a job if you have to start dialysis.  That was the choice I made and it worked out very well.  Employers are required by law to accommodate medical disabilities so that can mean schedule adjustments or a private room in which to do pd exchanges.

Back when I started dialysis the situation looked like a train wreck.  Without an income it is as this thread illustrates.  It is hard to maintain a full time work schedule and dialysis but it can be done and it is worth it.  When the time comes that a person gets transplanted and after healing everything is completely back to normal.

Like I said, I want to be sensitive.  Work is not an option for many patients but it can be continued on a trial basis to see if work and dialysis will work out.  Leaves of absence when needed can be part of the plan so a person doesn't actually have to quit while things are rough.  My personal decision was not to let this disease mess up my life permanently and it didn't.
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