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Dusn

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  • Avatar Dusn 
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    Status: Physician
    Posts: 198
    Joined: 01/02/2018

    I would get the insurance while you’re healthy.  You never know when a medical problem may come up that increases the rates or makes it impossible to get insurance at all (and even well controlled medical problems can sometimes be major issues for these companies).

    I am not much older than you, have Principal with the “Super preferred non-tobacco” risk class and would be paying $1000 (if I adjusted by term insurance policy with them for a $2mil amount).  So the 771/year you got seems pretty good.

    in reply to: Help with Term Life #124839 Reply
    Avatar Dusn 
    Participant
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    Joined: 01/02/2018

    So one of those common causes of death seems somewhat avoidable. Do you think there would be a benefit in starting a low dose statin at a young-ish age (30-40s) to try to slow down atherosclerosis early on?

    in reply to: Life is short #122877 Reply
    Avatar Dusn 
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    Thank you all for the advice!

    in reply to: Options if you are denied term life insurance #121730 Reply
    Avatar Dusn 
    Participant
    Status: Physician
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    Joined: 01/02/2018

    Banner life is the company that denied, not me, but my wife.  We’re both physicians.  Diagnosis is inflammatory bowel disease, very well controlled for many years on just mesalamine.   Honestly, it seems completely ridiculous to me as she’s in her early 30s without other health issues or red flags. Everything normal on life insurance labs and physical.  I would consider myself to be far less healthy but I somehow had no trouble.   We were planning on shopping around but we just found out that she’s pregnant so if she did not get approved before I doubt she will now.  At the same time starting a family adds this new feeling of urgency to get all these things taken care of.

    Hank,  she does work at the VA so we’re looking into FEGLI.  Unfortunately I think we can only increase the rates to a max of 5x salary after a life changing event (ie after the baby is born) but I think it may also need a physical exam report and approval to make the increase?  In addition having life insurance tied to the job can be an issue if she wants to go part time or something after the baby is born… but we’re definitely looking into it.

    And yes, we’re living very frugally.  The major need would be over the next 10 years I think.

    in reply to: Options if you are denied term life insurance #121499 Reply
    Avatar Dusn 
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    what difference does it make? This man raped, tortured, killed, and terrorized countless people. I’m glad the DNA helped them catch this vile thug.

    And frankly I’d give a sample of my DNA if it helped them catch more criminals like this. What are they going to do with it to hurt you? And just think about how easy it is to get someone’s DNA already.

    Avatar Dusn 
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    Status: Physician
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    Joined: 01/02/2018

    I live in one of those areas and I sort of see what you’re saying but it doesn’t completely make sense to me.   There’s only one hospital in the area.  There’s no other option: all patients insured or not need to go to this hospital for emergency care, hospital admission, or in-patient surgery.   There’s no way to keep the insured patients and leave them with the patients with medicaid.  They end up trying to gobble up established practices by not allowing them to operate or admit there; then they treat their doctors and patients like crap because their overhead is too high from having too many administrators; then the doctors have no choice but to leave the area or switch to the VA.  It’s killing quality private healthcare in the area (the silver lining is that the VA now has excellent doctors and nurses, however).

    in reply to: Non-compete (restrictive covenant) clauses #119385 Reply
    Liked by Craigy, FIREshrink
    Avatar Dusn 
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    Contact your state legislators and present the case for them to be banned (like they have in Mass and California). It harms patient care and helps create hospital monopolies. I called mine about this two years ago and she said she would work on it… I think it’s about time to call again.

    in reply to: Non-compete (restrictive covenant) clauses #119258 Reply
    Liked by Craigy, ENT Doc
    Avatar Dusn 
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    Status: Physician
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    Joined: 01/02/2018

    You should get health insurance through your job (warning: a small part of your paycheck might get deducted for this).  In my residency we were told that the dental insurance probably isn’t worth it so we declined it (just remember to brush your teeth twice a day and floss! You don’t have time for the dentist intern year anyway) :).

    in reply to: New Intern, what happens to my paycheck? #117667 Reply
    Avatar Dusn 
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    Yes. I see the irony in it.   Except that if there are NO anecdotal experiences where a VA is better than a private hospital then maybe the anecdotal experiences have some meaning.  So I felt that I need to point out that I have absolutely seen VA hospitals and clinics where I believe the care is much better than the local private hospital.   It does not settle the debate; it just illustrates the mix of experiences and demonstrates that we need more objective measures.

    My wife quit the private hospital and switched to the VA.   She has not been working at the VA for very long but so far believes that the care she is able to provide is far better than at the private hospital.  I would agree that if physicians were still all self-employed and insurance companies did not reject treatments and need prior authorizations for everything than the private sector should be better; but that is no longer the case.  At the VA she has no need to worry about prior authorizations or billing.   There is zero psychiatry that accepts insurance available in our area in the private sector, at the VA there is a psychiatrist that works with each primary care team for a direct hand-off if needed.   Again, this is anecdotal.  But I find it funny that the VA gets blamed for failing to meet 30 day wait times when in the private sector no one is checking wait times and the wait for certain specialties like psychiatry in our area, with private insurance, would be never.

    The real question is: how would privatization of the VA work?   If they gave veterans a blank-check insurance with no co-pays and no deductibles and no denials of payment our private sector hospital would suck it dry of money in no time.   It would have to be like all other insurance: Negotiations with providers and hospital to determine the level of reimbursement.  In-network hospitals and doctors.   Prior authorizations. Denial of reimbursement for care that they deem unnecessary.  Co-pays and deductibles to deter overuse.

    Would this VA insurance keep paying for things like free yearly glasses and prosthetics, wheelchairs, magnifiers and monitors to enlarge print for veterans with low vision?  Multiple forms of therapy for PTSD?   Travel pay that pays for the cost of travel?  Lodging for patients the day before and the day of eye surgery because they can’t drive home?  (and having private insurance won’t decrease travel time for eye care in our area; there is one general ophthalmologist a 3 hour drive west of us and that’s it.  The rest all work in the same town as the VA).  It also wouldn’t dramatically increase choice for us at least — we have one private hospital monopoly in our area.   That’s it.  I’m sure there are many areas of country like that.

    in reply to: Thoughts on privatization of VA health care #114147 Reply
    Avatar Dusn 
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    Earnest refinancing bonus

    Quality of healthcare varies very widely between different VAs and even between different clinics and different doctors within the same VA.  But quality of care also varies widely amongst different private hospitals and amongst private physicians.   Its interesting that people seem to think their anecdotal experiences can be generalized to compare VAs and private hospitals across the entire US.    My anecdotal experience after having worked at 4 VAs and 16 private and university hospitals (during training and after) is that I would rather be treated at the VA than most of the private hospitals I’ve worked at (especially the hospitals in less wealthy rural or urban communities).

    I think the reason VA scandals get reported in the news is because 1) the media feels it is more newsworthy than what happens at a small private hospital, 2) there are federal laws protecting whistleblowers.  Physicians at the VA can presumably contact the press if they see a problem that they feel urgently needs to get fixed without as much fear of retribution as they would have in the private sector.  My wife, primary care at a private sector hospital, was recently told by administrators that patients were complaining that her practice was refusing the prescribe narcotics and that they needed to treat the patient’s pain because it was hurting their reviews and press gainey scores.  Do you think the news media would care if she reported this to them?  Especially if she has no written evidence?

    And what studies are you talking about ENT Doc?

    in reply to: Thoughts on privatization of VA health care #114081 Reply
    Avatar Dusn 
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    Joined: 01/02/2018

    The VA negotiates the price of meds. As a result the VA generally pays 1/10th -1/2 the price for meds that is costs Medicare and private insurers. So Durezol for the VA is $12; outside the VA it’s $120-200. Eylea and Lucentis cost the VA $1200; outside the VA they cost $2000.  My local VAs small eye clinic would spend $100,000 per week on retinal eye disease medication costs alone if the pts has to be sent outside VA; at the VA they get treated for half that cost.

    Every insurance company and Medicare have deductibles and copays to try to decrease excessive care. Many veterans can’t afford that. If they were given insurance with no deductible or copay and no “denials if payment,” I know my local for profit hospital system would suck that insurance dry of all it’s funding in no time at all.

    The VA does not charge the patients Medicare or Medicaid. Saving Medicare from going broke even faster.

    We should give our veterans the best care in the world. But make no mistake, the only reasons no administration has yet privatized the VA is because 1) large veterans groups are against privatization and 2) if they did it would take an endless pit of spending to keep it afloat or they would need deductibles/copays/denials of payment – effectively denying the less wealthy veterans of healthcare.

    in reply to: Thoughts on privatization of VA health care #113760 Reply
    Liked by Anne, StarTrekDoc
    Avatar Dusn 
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    Part of me does worry that the stock market is in essence a giant Ponzi scheme and once everyone around the world has maxed on their investments in it it will simply stop going up.

    But luckily we’re probably a long way from that point. And also I don’t really understand the stock market so my worries are most likely completely wrong.

    in reply to: What if everyone did the RIGHT THING financially? #109072 Reply
    Avatar Dusn 
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    I’ll admit that I have a hard time making close friends with non-physicians, unless I’ve known them since college.   It doesn’t take long before someone spouts off some anti-science or conspiracy theory nonsense and, while I know better than to confront them about it, it just pains me.

    in reply to: Income of your "inner circle" #107370 Reply
    Avatar Dusn 
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    Joined: 01/02/2018

    Universal health insurance does not mean that doctors will get paid less. In Canada many specialties get paid far more (Ophtho makes at least double what they do in the US, as does interventional rads I believe. Other doctors get a pretty equivalent salary I’ve heard).

    I think The difference is that pharma gets paid far less in Canada. They negotiate prices with pharma. But I agree that as long as the pharma lobby is so much stonger in the US then physicians, pharm will continue to drain all healthcare dollars and they will try to cut reimbursements to doctors to make up for it.

    in reply to: Universal health insurance #105836 Reply
    Liked by Zaphod
    Avatar Dusn 
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    One of the things that doesn’t seem to get factored into to “how much life insurance do I need?” calculations is what might happen to your savings during a prolonged illness (and with improving healthcare some of these terminal illnesses can take years before they finally do you in).  Suppose I get a terminal cancer… I’m personally not going to want to work and will want to spend as much of that time as possible with family.  So in fact, I would hope my wife wouldn’t have to work during my last few months or years to live as well and maybe she’ll need time to grieve and figure things out should I pass away.    And healthcare expenses might go up dramatically.  So I may have a good amount of savings now  but I don’t want to have to worry about that savings while dealing with a terminal illness.

    in reply to: How much term life insurance should I buy? #104918 Reply
    Liked by LizOB
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