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Old 04-17-2008, 09:36 AM   #1
sarah
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Americans paying more for drugs

Read this editorial in the IHT/Times. It's sad when people have to have money to stay healthy, glad to live in a country with universal health.



Krugman: Health care horrors
By Paul Krugman

Friday, April 11, 2008
PRINCETON, New Jersey:
Not long ago, a young Ohio woman named Trina Bachtel, who was having health problems while pregnant, tried to get help at a local clinic. Unfortunately, she had previously sought care at the same clinic while uninsured and had a large unpaid balance. The clinic wouldn't see her again unless she paid $100 per visit - which she didn't have.
Eventually, she sought care at a hospital 30 miles away. By then, however, it was too late. Both she and the baby died.
You may think that this was an extreme case, but stories like this are common in America.
Back in 2006, The Wall Street Journal told another such story: that of a young woman named Monique White, who failed to get regular care for lupus because she lacked insurance. Then, one night, "as skin lesions spread over her body and her stomach swelled, she couldn't sleep."
The Journal's report goes on: "Mama, please help me! Please take me to the ER," she howled, according to her mother, Gail Deal. "OK, let's go," Deal recalls saying. "No, I can't," the daughter replied. "I don't have insurance."
She was rushed to the hospital the next day after suffering a seizure - and the hospital spared no expense on her treatment. But it all came too late; she was dead a few months later.
How can such things happen? "I mean, people have access to health care in America," President George W. Bush once declared. "After all, you just go to an emergency room." Not quite.
First of all, visits to the emergency room are no substitute for regular care, which can identify and treat health problems before they get acute. And more than 40 percent of uninsured adults have no regular source of care.
Second, uninsured Americans often postpone medical care, even when they know they need it, because of expense.
Finally, while it's true that hospitals will treat anyone who arrives in an emergency room with an acute problem - and it's wonderful that they will - it's also true that hospitals bill patients for emergency-room treatment. And fear of those bills often causes uninsured Americans to hesitate before seeking medical help, even in emergencies, as the Monique White story illustrates.
The end result is that the uninsured receive a lot less care than the insured. And sometimes this lack of care kills them. According to a recent estimate by the Urban Institute, the lack of health insurance leads to 27,000 preventable deaths in America each year.
But are they really preventable? Yes. Stories like those of Trina Bachtel and Monique White are common in America, but don't happen in any other rich country - because every other advanced nation has some form of universal health insurance. We Americans should, too.
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Old 04-17-2008, 02:11 PM   #2
StephN
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Very timely, Sarah.

At the conference this week an Italian researcher stopped at our table to see what we were all about. Some of the people thought we were there to raise funds.

We explained we were non-profit, run by volunteers. That is a novel concept to many! We are only trying to raise awareness and educate.

The Italian woman told us that when a drug such as Herceptin becomes a standard of care there, it is mandatory that a patient is offered it no matter who they are or where they live. The government pays and for Herceptin the cost is about $1,200 (but she may have meant Euros).

My insurance is billed about $6,000 for my Herceptin alone each treatment. Some of you pay more.

An interesting woman from Argentina talked to us about the HER2 testing also being standard in that country now. Joe and I were recalling that in 2003 in San Antonio the oncologists from other countries (such as Mexico, India) were telling us that there was NO MONEY to pay for tumor testing. No wonder a cancer diagnosis was a death sentence.

Nice to see that turning around.
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 04-17-2008, 02:50 PM   #3
PinkGirl
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I inquired about the cost of my year of Herceptin.
It was $47,000.
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Dx Aug/05 at age 51
2cm. Stage 2A, Grade 3
ER+/PR-
Her2 +++

Sept 7/05 Mastectomy
4 FAC, 4 Taxol, no radiation
1 year of Herceptin
Tamoxifen for approx. 4 months,
Arimidex for 5 years
Prophylactic mastectomy June 22/09



" I yam what I yam." - Popeye

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Old 04-17-2008, 06:55 PM   #4
KelliD.
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Being newly dx, this is a HUGE concern for me, as I do not have health ins & don't qualify for assistance of any kind, due to income level...
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Old 04-18-2008, 01:07 AM   #5
sarah
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Hello all,
My herceptin costs 1200 euro every 3 weeks (per shot) including the hospital, nurse, etc. that's $1911!!! how is it you pay so much more in the US? Since I pay into a universal health system, it is covered by that. Frankly it is the health insurance companies in the US that are getting away with murder. Someone should do an investigative reportage on them. I highly recommend universal coverage - like democracy it may not be perfect but it's better than the alternative and personally I don't like to think of people dying because they don't have enough money. As for screening, we get constant and thorough screening. Again I am so grateful that my recurrence happened while I'm living in France.
I hope Americans won't be persuaded by the cynical advertising of the insurance companies to be afraid of universal coverage.
My father was a doctor and worked in Canada, England and the US and we all loved Americans and living in the US but my father liked universal health care because he felt it was fair to everyone. Don't forget that the US gov't pays twice as much per person for health care - I suppose because the desperate get treatment only when they need everything or all the emergency room visits. who pays for that? on top of paying large sums to the insurance industry.
But it's not a question of cost, it's a question of humanity. As a deeply religious country, the US should appreciate that.
I wish good health and happiness to all of you,
sarah

Last edited by sarah; 04-18-2008 at 01:08 AM.. Reason: spelling
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Old 04-18-2008, 06:42 AM   #6
hutchibk
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A universal health system won't be 'FREE' as it is often perceived - we will have to pay with a much higher tax rate on our income - as our taxes are much much lower than in the UK or other european countries. And, the costs of the universal health systems in other countries are becoming a financial burden on the governments and some are in danger of imploding in coming years as the cost outweighs what the taxes bring in to support the programs. They are currently grappling with this potential in many countries. Most countries also have individual insurance situations that supplement the universal systems. Also, is the UK one of the countries where it depend on what health district you live in as to whether certain drugs or treatments are approved?

I know our system is complicated and certainly not perfect, but there is not a health system in the world that is perfect, fair and totally free, no matter what the perception of it is. It is a complicated situation for which there are not easy answers.
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Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."

Last edited by hutchibk; 04-18-2008 at 06:48 AM..
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Old 04-18-2008, 07:06 AM   #7
PinkGirl
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I just got out my calculator and did some math. The $47,000 total for my Herceptin is 903.85 weekly for 52 weeks, or
2711.54 every 3 weeks for a year.

StephN, what does the $6000 you quoted refer to, weekly
or every 3 weeks?

Someone would have to wrestle me to the ground and
hit me over the head with a 2X4 to take away my
Canuck health card. Or you could try hitting me over
the head with the big, heavy brown envelope where I
keep all my income tax files!
__________________
PinkGirl

Dx Aug/05 at age 51
2cm. Stage 2A, Grade 3
ER+/PR-
Her2 +++

Sept 7/05 Mastectomy
4 FAC, 4 Taxol, no radiation
1 year of Herceptin
Tamoxifen for approx. 4 months,
Arimidex for 5 years
Prophylactic mastectomy June 22/09



" I yam what I yam." - Popeye

My Photo Album

Last edited by PinkGirl; 04-18-2008 at 07:12 AM..
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Old 04-18-2008, 10:34 AM   #8
StephN
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Wink

Hi Pink -
That number of $6000 was for a 3-week dose of Herceptin. The other lab and nursing services are on top of that.

When I had weekly along with Taxol and Navelbine, the Herceptin cost a lot more than the other two drugs combined, but don't recall the exact number at the moment. But it was close to $3,000 each week.

We had a thread started by Sheila about how much everyone paid for their Herceptin. Her clinic was charging by FAR the most, at something like over $10,000. She got it reduced based on all the info the rest of us gave on our much lower charges.
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 04-18-2008, 02:26 PM   #9
caya
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We have visited this subject before, and I will say it once again - I agree with Pink and sarahdalton. You would have to pull me screaming and yelling from my home before I would give up our Canadian universal health care. It's not perfect, and we do pay higher taxes - but Americans pay high insurance premiums, so what's the difference? The difference is that everyone is covered equally.
You get diagnosed, you can see any doctor you want (no HMOs or "sorry, that doctor is not in your network" stuff), you get your treatment and do not have to fill out any forms or worry about how much the treatment is. No one is mortgaging their home to pay for Herceptin, or wondering if they have to choose between putting food on the table or take their child in to the pediatrician...

Yes, we pay for supplemental insurance, for stuff like semi-private hospital rooms, dental services... but most medical expenses are covered. If your child is born and has to go to the NICU, it is covered. If you need Herceptin, it is covered. Yes there are some longer waits for some surgeries, but the majority of the system is working, and working well.

The American insurance companies will continue to use their scare tactics - the American health care system would somehow fall to its knees if universal health care would be brought it ... Uh no, I think their profit margins would be plummeting. As I have said before, our system is not perfect, but it is equitable for all citizens.
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ER90%+/PR 50%+/HER 2+
1.7 cm and 1.0 cm.
Stage 1, grade 2, Node Negative (16 nodes tested)
MRM Dec.18/06
3 x FEC, 3 x Taxotere
Herceptin - every 3 weeks for a year, finished May 8/08

Tamoxifen - 2 1/2 years
Femara - Jan. 1, 2010 - July 18, 2012
BRCA1/BRCA2 Negative
Dignosed 10/16/06, age 48 , premenopausal
Mild lymphedema diagnosed June 2009 - breast surgeon and lymph. therapist think it's completely reversible - hope so.
Reclast infusion January 2012
Oopherectomy October 2013
15 Years NED!!

Last edited by caya; 04-20-2008 at 10:52 AM..
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Old 04-18-2008, 02:50 PM   #10
Mary Anne in TX
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Ok, Pink and Caya, stop that bragging right now and shed a tear or two for those of us fighting our insurance companies to keep our Herceptin going! No, really, I haven't got a clue what is best. I just know I'm willing to do battle to keep getting herceptin. My doctor went to bat for me with the director of the insurance co. last month to get me 3 more months. Not sure what will happen after June 28, but I'm praying someone far wiser than I will figure this all out and go to battle for us all! There are too many who don't have the care they deserve. I'm blessed and I'm grateful! Luv to all of you warriors, ma
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MA in TX.
Grateful for each and every day....

Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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Old 04-18-2008, 05:14 PM   #11
Bill
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Hi everybody! I hope you're all doing well. I'm not a very good computer person, so I thought it would be better for me to ask you guys. I wasn't involved with cancer when Herceptin and alot of the chemo. drugs came out. Where did herceptin come from, and who funded the research?
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Old 04-18-2008, 06:31 PM   #12
Sheila
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Steph you are right...my Herceptin ran about 12,000 every 3 weeks, I did get them to reduce it, not I am getting it every 2 weeks to coincide with the Taxol and it is 8000.00.....which is really cheap I guess compared to the 20,000 a pop when I was getting Avastin....with the Taxol figured in, the blood counts , the premeds and the infusion and supply charges, my chemo bill was running 65,000 every 2weeks!!! I remember the bill for November included installing the port, and my November hospital bill was 150,000....my hubby always says that port is the most expensive jewelry i will ever be wearing around my neck!
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is fighting some kind of battle."



Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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Old 04-18-2008, 07:03 PM   #13
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If we didn't have our system, would anyone be interested in doing research? BB
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Old 04-18-2008, 08:38 PM   #14
Gerri
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Hi Bill,

Read "HER2, The Story of Herceptin, a Revolutionary Treatment for Breast Cancer", by Robert Bazell. Very interesting book that tells how Herceptin came to be and where the funding came from. I found it at the library but it can be ordered from Amazon.com

All my best,
__________________
Gerri
Dx: 11/23/05, Lumpectomy 12/12/05
Tumor 2.2 cm, Stage II, Grade 3, Sentinel Node biopsy negative
ER+ (30%) /PR+ (50%), HER2+++
AC X 4 dose dense, Taxol X 4 dose dense
Herceptin started with 2nd Taxol, given weekly until chemo done
then given every 3 weeks for one year ending on March 16, 2007
Radiation 30 treatments
Tamoxifen - 2 yrs (pre-menopausal)
May 2008 - Feb 2012 Femara
Aug 2008 - Feb 2012 Zometa every 6 months
March 2012 - Stop Femara, now Evista for bone strengthening
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Old 04-20-2008, 10:35 AM   #15
sarah
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I agree with Caya, I really like my universal coverage and I've been through the US private insurance method and universal and I'll take universal. I'd like to ask some questions and hope they won't seem rude:
1. what is the cost you pay plus what your employer pays for your insurance?
2. Can you see anyone anywhere in the US or do you have to chose for a list? (with my PPO in the US I had to chose from a list and the surgeon who did my biopsy quit the system before the next surgery!)
3. Does your conscience bother you that others with less money have problems getting medical insurance?
4. What about the fact that the US gov't pays twice per person what gov't with universal health pay person? Isn't that a kind of tax?
Also our taxes go to good roads, hospitals, schools, the police and fire dept. etc and here where I live we have 6 canadair fire plances - in LA that yearly went up smoke, they borrowed one from Canada one year!
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