Wow, Bwak, so sorry to hear that. I remember the (relatively) great treatment my mother used to get under BCBS in the '70s (two heart attacks and angina). She died soon after retiring to another state in the '90s where things were very different. The pills I was referring to above were actually a heart medication (inderol) but for a relatively minor condition not usually fatal. Still...

AA, thanks for the explanation. I think you’re right and though I don’t know any more about it than the average consumer (formerly known as patient), I know that Medicare A/B is managed care. It’s a problem, along with an enormous amount of fraud (it’s kind of like taxes, I think, drs. and other providers feel they have a right to pad their bills since the government is paying the tab). Then, too, regulators have been asleep at the wheel for too long now.

Anyway, when I talk about a Medicare-type government option, I’m including the government subsidies for additional coverage (Advantage) which fills in the gaps and allows more patient options. That, in fact is the part Obama is talking about cutting to pay for universal health insurance reform. I don’t want to take more from Grandma to give more to United or Humana. I can’t see a doctor holding a Medicare patient’s medication hostage to collect a fee. But, as someone was pointing out on another thread, the differences in quality and costs of care under Medicare is great between regions and cities. So, I’m guessing that local factors, state laws and regulations and even just regional practices play a part in how well that management works.

The point of my anecdote was that (many) Doctor’s attitudes towards patient care have changed with the HMO profit-centered evolution. At that time there was a lot of lip service paid to preventative health care (I was given dozens of colorful, smiling-faces brochures about this or that), but I know for a fact that in the case of not renewing my prescription, my doctor was just following a scheme which required him to fill quotas in his waiting room (I remember now that I was desperately trying to quit smoking (I believe, the number one factor in death and illnesses) back then and got absolutely no help from my doctor for that, though I just holed up and quit cold turkey a couple of years later). So much for "preventative health care."

I’ve seen more and more of this since then with different MDs and insurers, and I’ve seen the same shoulder-shrugging disregard for patients at the county hospital, which has become more and more “money-managed” too. I'm sure doctors don't like having their fees restricted and there are probably many who went into medicine just to get rich. But I bet there are more who went into medicine because they were interested in treating people and hate having their medical decisions made by accountants.

I don't think the public is really aware of how bad the system is. Costs are shuffled around and are escalating at a rate that will collapse on itself at some point. I spent about three hours in the ER last November with kidney stones, other than getting a CAT-scan and some pain medication at the end, I just lay in a corner in agony. I've had them before and knew that they were just stalling until I passed it to a certain point. The cost, not including the doctor's fees, was over $8,000.

A single-payer system would have to be nationally managed, including costs but people will demand that it is patient-centric. I'm willing to give up a lot for a universal low-cost HC non-profit system including ultimately unnecessary but feel good treatment.

Republicans and our other bought-and-paid-for representatives are trying to kill the public option (and even co-ops now) by saying it is just a Trojan horse to single payer. Damn right it is. But only if we do not allow the medical industry to hobble it with phase-ins, underfunding, limitations on collective bargaining, etc. (Sorry for rambling on).