[Pesqueeb]

You might have missed this story back when it was going around in 2008. The short version is, Woman works for Wal-mart, woman gets plowed by truck driver, woman has crippling brain injury, womans family wins big law suit from said trucking company, Wal-mart sues family to get its medical insurance expenses back and wins.
You might not know it, but I guarantee if you look waaaaaaaayyyy in the back of the book you got from your health insurance provider, it has a clause about the "right to recoup expenses if an injury is caused by a third party" and also that if you fight the health insurance company you owe them for legal expenses.

I had a very similar experience after my accident. The insurance company for the 19 year old that hit me pretty much immediatly offered the max they were legaly obligated to pay (you can only sue an insurance company for whatever the coverages are, at least in colorado). However, my lawyer and I spent the next 3 months trying to convince my health care provider and my employer to let me keep any of it. They setteld for an amazingly small amout, but the point is, WTF am I paying health insurance for if I'm gonna get sued by my provider when an accident happens?

 

[RenegadeRick]

...WTF am I paying health insurance for if I'm gonna get sued by my provider when an accident happens?

Executive salaries, bonuses, and perks? Those mansions don't just build themselves you know.

 

[binary visions]

Uh, maybe I'm not remembering correctly, but wasn't the issue more that the woman got hurt, sued the trucker to pay for medical expenses, and thus Wal-mart (or their healthcare provider) demanded that they get back what they paid?

Essentially, the health insurance company paid for her expenses and then she was awarded money to pay for her expenses. Kinda like if I gave you ten bucks to pay for my half of dinner but the waiter screwed something up and comped the meal - I'd want my ten bucks back.

Of course, it was a royal PR nightmare and a cluster**** all around, but that was my understanding of the situation.

 

[ohio]

Uh, maybe I'm not remembering correctly, but wasn't the issue more that the woman got hurt, sued the trucker to pay for medical expenses, and thus Wal-mart (or their healthcare provider) demanded that they get back what they paid?

Essentially, the health insurance company paid for her expenses and then she was awarded money to pay for her expenses. Kinda like if I gave you ten bucks to pay for my half of dinner but the waiter screwed something up and comped the meal - I'd want my ten bucks back.

Of course, it was a royal PR nightmare and a cluster**** all around, but that was my understanding of the situation.

Sort of. It's more like you offered to take someone out for dinner, but when the waiter comped A DISH, and you demanded all of your money back, and left the girl at the restaurant with no cab fare.

WalMart should have been a co-claimant in the suit to ensure that they obtained enough to cover her remaining care/bills AND the money WalMart already spent. Not leaving her enough to care for herself is unconscionable.

 

[JohnE]

You dont get hurt to make money...it is just a fortunate side effect now and again...

 

[binary visions]

WalMart should have been a co-claimant in the suit to ensure that they obtained enough to cover her remaining care/bills AND the money WalMart already spent. Not leaving her enough to care for herself is unconscionable.

Ah, I misunderstood. The article(s) that I had read were not quite that clear on the subject, but this one spells it out.

Sort of. It's more like you offered to take someone out for dinner, but when the waiter comped A DISH, and you demanded all of your money back, and left the girl at the restaurant with no cab fare.

This is all getting very complicated. Did I at least get laid?

 

[ohio]

This is all getting very complicated. Did I at least get laid?

Only because after you took your money back, you went and spent on a hooker.

 

[valve bouncer]

Sort of. It's more like you offered to take someone out for dinner, but when the waiter comped A DISH, and you demanded all of your money back, and left the girl at the restaurant with no cab fare.

Sounds like an episode of the Dirt McGirk Chronicles.

 

[Pesqueeb]

You dont get hurt to make money...it is just a fortunate side effect now and again...

No actually and thats my point. The Wal-mart woman needs care for the rest of her life, and her family effectivly lost a wife and a mother. No amount of money will bring her back and the settlement that they got for her injuries and thier suffering was taken back by her health insurance provider. You don't think that family wouldn't happily exchange that money for there loved one?

In my case, I know for sure I'd give the money back that I got to regain full use of my arm, to not have the aches and pains I have on a daily basis, to not have all of the titainuim and stainless inserts and scaring. To not have to be a grown ass man who had to learn to walk again. Not to mention what my wife had to go through with being told to "prepare for the worst" and having to deal with me being in a coma and on a ventilator for 3 weeks.

The way I see it, any form of insurance is gambling. Your provider is gambling that nothing bad is ever going to happen to you and that they will make money off you, and most times they do. I in turn spend lots of money every month hoping to never have to use my insurance. But in my case, and the case of the walmart woman, they lost, big time. Taking me and walmart woman to court is the equivilent of going to vegas, losing your shirt, then suing the casino because you lost.

The insurance you pay for is supposed to protect you, not screw you.

 

[valve bouncer]

Look fella, just be glad you didn't have that socialised medicine or else you'd be dead. In the UK they would have shot you by the side of the road. Actually you'd probably not even have been born and if you were born you'd probably be born a spastic or in Kenya.

 

[Pesqueeb]

*snip you'd probably be born a spastic or in Kenya.

But I don't want to be president.

 

[dante]

Yup. Totally true story, was riding with a friend in England when he was hit by a car. Since he was unemployed and presented zero worth to the community, this was the last I ever saw of him:

 

[valve bouncer]

In Australia (again socialised medicine) children born ginger are routinely euthanised.

 

[DaveW]

In Australia (again socialised medicine) children born ginger are routinely euthanised.

A sound policy.

 

[Silver]

The insurance you pay for is supposed to protect you, not screw you.

No, it's supposed to screw you. It's in there in the fine print.

 

[drkenan]

Wait...so what happened to you?

 

[Pesqueeb]

Back in 2007 I got hit and run over by a car while on my way to work on my scooter. Broke my right femur, pelvis in 3 places, tail bone, eight ribs, collar bone, shoulder blade in 2 places, and 2 teeth. The broken ribs punctured my right lung, severely lacerated my liver and my left lung collapsed in the ambulance. I bled out through my liver into my abdominal cavity and had 0 blood pressure and my heart stopped in the ER. I spent 3 weeks on a ventilator in ICU, then 4 more on the rehab floor learning to eat,wipe my own ass, and walk again and the following 3 months in near constant physical therapy. Not necessarily in that order. I have a titanium rod in my leg, I stainless filter in my inferior vena ceva (my heart essentially) for blood clots the was in too long to remove and a titanium insert in my upper jaw for a tooth that couldn't be saved. I also have a mesh lining holding my abdominal muscles together because the docs had to leave my open for 10 days to get my liver to stop bleeding.

I got a bitching collection of scars.

*edit, thats my brother in the beer costume, and I never really have gotten a good explanation about whats going on there.

 

[kidwoo]

Thank god we have the best health care in the world.

I'm sure you have no debt whatsoever.




















PS: HOLY ****ING HELL!

 

[drkenan]

Holy crap! Glad you're ok now man! Sounds like it could have been much worse.

 

[Jeremy R]

Pesqueeb,
What did your health insurance company pay out total for your accident, and how does that amount compare to your monthly premium?

Just curious.
When I was 19, I was in motorcycle accident where a car did a u turn in front of me and I flew over 100 feet over his car. I had a compound fracture in my right leg that stuck into my left calf muscle.
5 surgeries later I was healed up.
My monthly premium was under $100 a month and the insurance company payed out $70,000 for the claim.

 

[kidwoo]

My monthly premium was under $100 a month and the insurance company payed out $70,000 for the claim.

Man the early nineties were nice weren't they?

 

[Sghost]

Sounds like an episode of the Dirt McGirk Chronicles.

But if instead you copped a feel on the waitress, later crashed the girls car, and took off leaving her busted up in the passenger seat, then we would have The Red Rabbit Chronicles.

 

[Ciaran]

I have a 5 dollar co-pay no matter what. i broke my leg and had surgery. I made 12 bucks on the deal after all was said and done. My daughters birth cost us 5 dollars. Prescriptions? 5 bucks. Remove that tumor in my mother in laws brain? 5 dollars. MRI's, chemo, radiation? 5 dollars per visit. (They have the same insurance but not through me)

I have a crappy job that I don't like very much but I go in with a smile on my face and do the best job I can because of the health insurance my employer gives me. How much to I pay a month? For me, my wife and daughter. Medical AND dental... I pay appx 30 dollars a month.

So some of us really do have good health insurance. I just hope Obama doesn't ruin it.

 

[Inclag]

I have a 5 dollar co-pay no matter what. i broke my leg and had surgery. I made 12 bucks on the deal after all was said and done. My daughters birth cost us 5 dollars. Prescriptions? 5 bucks. Remove that tumor in my mother in laws brain? 5 dollars. MRI's, chemo, radiation? 5 dollars per visit. (They have the same insurance but not through me)

I have a crappy job that I don't like very much but I go in with a smile on my face and do the best job I can because of the health insurance my employer gives me. How much to I pay a month? For me, my wife and daughter. Medical AND dental... I pay appx 30 dollars a month.

So some of us really do have good health insurance. I just hope Obama doesn't ruin it.

I'm not sure why this gets looked over by so many people, but how much does your employer pay per month?

 

[ohio]

Back in 2007 I got hit and run over by a car

DAMN, that is intense. Glad you're still with us.

How the **** did they also run OVER you?

So it was a hit and run?

 

[ohio]

Man the early nineties were nice weren't they?

Also, let's not confuse auto insurance with health insurance.

My auto insurance is great. I couldn't be more satisfied with the private market. My health insurance is a bunch of scamming lying thieves.

 

[Silver]

I have a 5 dollar co-pay no matter what. i broke my leg and had surgery. I made 12 bucks on the deal after all was said and done. My daughters birth cost us 5 dollars. Prescriptions? 5 bucks. Remove that tumor in my mother in laws brain? 5 dollars. MRI's, chemo, radiation? 5 dollars per visit. (They have the same insurance but not through me)

I have a crappy job that I don't like very much but I go in with a smile on my face and do the best job I can because of the health insurance my employer gives me. How much to I pay a month? For me, my wife and daughter. Medical AND dental... I pay appx 30 dollars a month.

So some of us really do have good health insurance. I just hope Obama doesn't ruin it.

Canadians have all of that without the copay and they don't have to stay in a job they hate so that they can afford a checkup for their daughter...

 

[slein]

So some of us really do have good health insurance. I just hope Obama doesn't ruin it.

That's silliness.

 

[dante]

I have a crappy job that I don't like very much but I go in with a smile on my face and do the best job I can because of the health insurance my employer gives me. How much to I pay a month? For me, my wife and daughter. Medical AND dental... I pay appx 30 dollars a month.

So some of us really do have good health insurance. I just hope Obama doesn't ruin it.

Gee, imagine if you had a government supplied health plan that you could fall back on if you quit or got fired from your job. You might not have to stay at that crappy job you hate and go do something that you'd really love to do.

Oh, the horrors...

 

[kidwoo]

So some of us really do have good health insurance. I just hope Obama doesn't ruin it.

Have you heard about the death panels?

 

[Silver]

Gee, imagine if you had a government supplied health plan that you could fall back on if you quit or got fired from your job. You might not have to stay at that crappy job you hate and go do something that you'd really love to do.

Oh, the horrors...

Reminds me of the old story about how an American would be happy to live under a bridge and roast a sparrow for dinner on an old curtain rod as long as you guaranteed to him that the next guy over wouldn't get a sparrow...

 

[Westy]

Gee, imagine if you had a government supplied health plan that you could fall back on if you quit or got fired from your job. You might not have to stay at that crappy job you hate and go do something that you'd really love to do.

Oh, the horrors...

I take very good care of myself but I have psoriasis. Care is pretty cheap for me but there is a slim chance I could require very expensive medicine in the future. I would love to start my own business but one of the big things stopping me is health insurance would be very expensive. If I lose my job I have get a personal coverage plan because if I ever drop coverage for even a single day no insurance company will ever have to cover my pre-existing condition. I have a good job and live a simple live, I'm saving enough money to retire before I am 50. Of course because of health insurance I need to work for a large corporation and probably will have to work until medicare kicks in no matter what.

Oh yeah, the expensive medication I might need is also 33% cheaper in Canada.

 

[Ciaran]

Gee, imagine if you had a government supplied health plan that you could fall back on if you quit or got fired from your job. You might not have to stay at that crappy job you hate and go do something that you'd really love to do.

Oh, the horrors...

I could easily do something else and have insurance that is not as good. My wifes employer offers crappy insurance. I choose to stay at a crappy job (that's really not that crappy. I am not diging ditches in the heat or anything like that) because very few employers offer insurance like this. And I don't even have the highest level of coverage. I can go with a no co-pay option if I want.

I work for Kaiser Permanente so my employers costs are... weird.

As for government run health care... well I don't think the government can do it well. Look at almost anything the government runs. Look at medicare. Look at public schools. And how many vets have major complaints about the way the VA is run? I mean hell have you ever eaten government cheese and peanut butter? They can't even do that right, how the hell are they going to do something as massively complex as national healthcare correctly?

National/universal health care sounds great, but you mark my words, it is going to be a major fail. We will all end up with higher taxes and crappy care. And how much of the money will end up in the pockets of politicians and their cronies? Probably quite a bit. The only way it will work is if we got rid of all the politicians and lawyers.

While I agree that our current system is flawed and needs an overhaul, I don't think that the government taking over even a little bit is the answer.

My opinions, YMMV.

 

[stevew]

Have you heard about the death panels?

they throw you down a well and make you listen to Attack Attack! until you bludgeon yourself to death.

scary sh*t.

 

[Silver]

While I agree that our current system is flawed and needs an overhaul, I don't think that the government taking over even a little bit is the answer.

So, basically, the system needs an overhaul, but you don't bother to offer any ideas because FYIGM?

 

[kidwoo]

As for government run health care... well I don't think the government can do it well. Look at almost anything the government runs..

Why do you hate our military?

Or the CDC?

And how much of the money will end up in the pockets of politicians and their cronies?

Are you kidding me? The answer to that question is a hell of a lot less than what happens NOW. With a baseline plan provided by the government, there's LESS reason to grease palms to get favors that benefit an industry.

 

[Ciaran]

So, basically, the system needs an overhaul, but you don't bother to offer any ideas because FYIGM?

Just because you don't have the answers doesn't mean that you should not point out the problem. And how the hell would I or anyone here for that matter be able to come up with a viable solution. The answer is WAY beyond anyone who posts here.

"...because FYIGM"? You're reading comprehension sucks. I never said that. I never even implied that. I really should just keep you on ignore.

Why do you hate our military?

Or the CDC?

Are you kidding me? The answer to that question is a hell of a lot less than what happens NOW. With a baseline plan provided by the government, there's LESS reason to grease palms to get favors that benefit an industry.

I said ALMOST everything the gov't runs. And I never said anything about hating the military or the CDC. You sharing Silvers brain or something?

And do you really thing that the politicians are going to be behind something or put effort into something that isn't going to make them money? I don't believe that for a second. Government contracts for drug companies, medical equipment, computer software, etc. Did you know that the head if the IT department for KP met with Obama? Met directly with him and talked to him about how awesome the KP model is and how KP could sell it/contract out to the government. No, I think that gov't run health care will increase the reasons to grease palms.

 

[Silver]

Just because you don't have the answers doesn't mean that you should not point out the problem. And how the hell would I or anyone here for that matter be able to come up with a viable solution. The answer is WAY beyond anyone who posts here.

No, it's not. It doesn't take a genius to point out that markets don't work in an industry that is a classic Econ 101 example of a market failure. What does that leave you with? Basically, it leaves you with the conclusion that every other first world country has come up with. The same one you dismiss out of hand, and then offer no alternate solutions. I'd call you a concern troll, but I don't know if you're that clever...

We've actually come up with some damn good ideas here, btw. The Ridemonkey Immigration Reform Plan was top notch work, I thought.

 

[kidwoo]

I said ALMOST everything the gov't runs. And I never said anything about hating the military or the CDC. You sharing Silvers brain or something?.

Nah I deliberately picked those because

1. Most of the people that generally share the 'incompetent government' mindset are also some of the most ravenously pro military..a government run entity.

2. Working in the insurance/health care biz, I figure you actually use the CDC's services from time to time.

And do you really thing that the politicians are going to be behind something or put effort into something that isn't going to make them money? I don't believe that for a second. Government contracts for drug companies, medical equipment, computer software, etc. Did you know that the head if the IT department for KP met with Obama? Met directly with him and talked to him about how awesome the KP model is and how KP could sell it/contract out to the government. No, I think that gov't run health care will increase the reasons to grease palms.

So a president concerned with changing a system talks with someone involved in the current system. Oh the horror.

There are a few reps out there who actually do give a shlt about what the electorate wants. Talking congress here, not necessarily obama.

For such a staunch hater of greased palms, you do happen to be making the exact arguments put forth by those holding the most butter in theirs. You do know that right?

And don't forget: Don't want gov't run healthcare? Don't choose it. That is the option being put forward after all.

 

[Westy]

I think a good model/analogy for healthcare should be education.

-At certain ages everyone is required to attend(covered), for pretty much free. Anyone can pay for and get a better education(insurance).
-After a certain age you can choose to buy relatively cheaply a basic education(insurance) (tax funded community college) or take a step further, (tax funded State University) or even further with a fully private University. Basically anyone responsible enough to scrape a few cents together can get basic coverage and those who want really good coverage can pay more for it.
-The system is still funded from both private and public funds and society and the economy as a whole benefits with a stable and secure workforce (healthwise).