Vaccination Debate

[Slumba]

Google would know, yes?

http://lmgtfy.com/?q=referral+from+doctor+needed

http://lmgtfy.com/?q=referral+from+doctor+needed+for+cardiologist

Go ahead, click it, I know you want to!

Muzh, after looking at the two links above, would you not agree, that there must be some plans, or even some specialists, that require a referral before the person can go see a specialist?

[Muzh]

Google would know, yes?

http://lmgtfy.com/?q=referral+from+doctor+needed

http://lmgtfy.com/?q=referral+from+doctor+needed+for+cardiologist

Go ahead, click it, I know you want to!

Muzh, after looking at the two links above, would you not agree, that there must be some plans, or even some specialists, that require a referral before the person can go see a specialist?

That may very well be the case, but that is not what I was talking about.
 
You made an absolutist statement that in this country you need a referral to see a specialist.

[GQBlues]

PPO is the only way to go....

Referrals are NOT necessary. They would recommend it, but it is NOT a requirement.

http://www.cms.k12.nc.us/Jobs/benefits/EmplBenefits/Medical/Pages/PPOFrequentlyAskedQuestions.aspx#2


HMOs on the other hand aren't so...

So in the US, a person is NOT (necessarily) required to consult, or get referral from, his primary physician for a specialist referral.

[Slumba]

You made an absolutist statement that in this country you need a referral to see a specialist.

OK I retract my statement and you are correct, it is not accurate to say that "ALL" specialists in the USA require a referral from some other doctor. 

I can't find any hard and fast rules about what areas, or what cases, require or do not require doctor referrals.

[Muzh]

That took guts. 
 
Now, while we wait for Dougie...

[Faux Pas]

PPO is the only way to go....

Referrals are NOT necessary. They would recommend it, but it is NOT a requirement.

http://www.cms.k12.nc.us/Jobs/benefits/EmplBenefits/Medical/Pages/PPOFrequentlyAskedQuestions.aspx#2


HMOs on the other hand aren't so...

So in the US, a person is NOT (necessarily) required to consult, or get referral from, his primary physician for a specialist referral.

Agreed. My PPO's way of sticking it back is to make us pay double for the out of pocket expense. Not a bad plan or idea really. It insures that folks need to see a specialist rather than just want to. Curbing some element of fraud

[Anotherkiwi]

PPO is the only way to go....

HMOs on the other hand aren't so...

What do they stand for, and what's the difference?

[GQBlues]

What do they stand for, and what's the difference?

You can read it here.


It also addresses the current exchanges in this thread i.e. referrals. I like PPO for the simple reason I can go to any doctor I see fit. The premiums are higher but having the luxury to choose is vital to me. With HMO, you don't have this luxury. You're pretty much stuck with who they have in their system

:::just like Obamacare::::only with much higher premiums::::

[calmissile]

In fact, whether you need a referral to see a specialist depends on the state you live in and the plan you subscribe to.  An internet search shows that both conditions exist.  I am currently in a very good HMO which does require a referral.  No biggie, my GP gave me one last week for an MRI for an old shoulder injury.   I suspect that the reason it is required was mentioned earlier, the insurance companies don't want the expensive specialists clogged up with those that don't need them.

In any case, my original response was due to Muzh claiming that those policies that require a referrral are plans that 'suck'.  I am very happy with my policy I have had for many years and the referral issue is of no consequence.

Of course Muzh's buddy, Obama might screw it up but we will have to wait and see.     

[Muzh]

In fact, whether you need a referral to see a specialist depends on the state you live in and the plan you subscribe to.  An internet search shows that both conditions exist.  I am currently in a very good HMO which does require a referral.  No biggie, my GP gave me one last week for an MRI for an old shoulder injury.   I suspect that the reason it is required was mentioned earlier, the insurance companies don't want the expensive specialists clogged up with those that don't need them.

In any case, my original response was due to Muzh claiming that those policies that require a referrral are plans that 'suck'.  I am very happy with my policy I have had for many years and the referral issue is of no consequence.

Of course Muzh's buddy, Obama might screw it up but we will have to wait and see.     

Can't come out and admit you were wrong, won't you? 

[ML]

Back to the vaccination idea . . .

Ochka talked with friend on Skype yesterday who reported her 8 month old grandson just received his second Hepatitis B injection.

Don't know when those went on the recommended list, but anyway they are on the list for Ukraine now.

[GQBlues]

More on current vaccination news:

http://abcnews.go.com/Health/wireStory/princeton-university-considers-meningitis-vaccine-20921420

[JayH]

Can't come out and admit you were wrong, won't you? 

Well now--he was not wrong-you were. You quoted the exception as being the rule.

To extend your question to Aus-- yes you could go straight to a specialist--but health insurance would not pay in that case. It would have pave with a referral.

Muzh-- you will not admit or concede when you are plain outright wrong-- so what is the deal with expecting anything from others?  No reply here required.

[Anotherkiwi]

You can read it here.


It also addresses the current exchanges in this thread i.e. referrals. I like PPO for the simple reason I can go to any doctor I see fit. The premiums are higher but having the luxury to choose is vital to me. With HMO, you don't have this luxury. You're pretty much stuck with who they have in their system

:::just like Obamacare::::only with much higher premiums::::

Thanks.  I'm glad our system is simpler - you get sick, you go to the doctor (or straight to A & E [your ER] for something major).  You pay the doctor, but you don't pay the hospital.  I have no idea how health insurance payments or refunds work in these cases, because I don't have any (and nor do about 70% of New Zealanders).  The health cover provided by one of the insurance companies I worked for (years ago) simply provided flat rate benefits for various events, rather than being true health insurance.

[GQBlues]

Actually, it is simple. Especially PPOs. The text I gave you to explain this is actually shorter in context than your daily post-game wrap-up news.

You have the coverage and see the doctor of your choosing, whether it be a gen. practioner or specialist, and get treated. No waiting, no referrals, and certainly no (re)scheduling.

Understand what your annual deductible, coverages, etc...and that's pretty much it. Most of the time, people get full time jobs, they're generally afforded insurance coverage of their choosing by their employer. They even have a choice between HMO & PPO. Sometimes people don't even pay a dime into it. You want to increase the degree of your exposure/coverage, you pay a prorated amount additionally.  This way your total financial exposure in the event of catastrophic event is 'limited'.

[Boethius]

Well now--he was not wrong-you were. You quoted the exception as being the rule.

No he didn't.  The assertions were that (a) one cannot see a specialist without a referral; and (b) most plans require a referral.  Others have posted that they can, indeed, see a specialist without a referral.  So, Muzh's position was not the exception.

[TS]

The cheaper the plan the more likely you have to get a referral.  You pay less money and insurance needs to control your spending.  You also tend to have less of the best doctors in your network as they go with younger doctors or doctors who have lower fees.  A real good experienced doctor is not going to cut their fees with certain insurance carriers.  You find them in the higher end insurance plans.
The more expensive the plan is the insurance company usually has less control over you as your paying a larger monthly premium.  You have a larger in net work doctor base.
Now with the affordable health care act it does tax the more premium plans. 
Tens of millions of people in the USA have health insurance where they don't need a referral.  But a brain surgeon is not going to operate on someone who just shows up in the hospital.  Your going to have to see other doctors first.  But this has nothing to do with referrals. 
 
 
 

[The Natural]

A number of years ago, most dentists in the U.S. that wasn't an oral surgeon wouldn't perform a root canal in one visit. Whether they would or not they would depended on the infection of the patient. Often root canal patients would be put on antibiotics and scheduled a week or so later. Perhaps the technology has changed?

This is pertinent to my wife's case. She went to a certified dentist who decided for a root canal. He explained the procedure for us, but can't remember all the spesifics. But it was (as I can recall) about on the first procedure to remove the nerves and fill up and then let 3 months go past. She was just recently the second time and he told us to come for a Third and final time in yet another 3 months. Something about not risking infection and starting all over again. The first appointment cost 300 dollars but fortunately the second was brief and only cost 140.

A little about vaccines. There was this hysteria here (and in the rest of western Europe) about the swine flu back in 2009. I had a blog back then and wrote about it and wrote that this mass vaccination would be a scandal. It's not often that I'm spot on, but in this case I was as I was in saying before it happened that there would be a financial crisis in 2008. Mind you, I'm not saying I'm particularly smart, but reading other things besides the mainstream media can give oneself a clue.

Back in 2009 we were on a seminar at work when a collegue of mine received a sms from our boss if we wanted the vaccine. I told him "no" from me and he opted out also. I talked about this at work and elsewhere and "scared" at least a few out of taking the shot.

Nowadays, even on mainstream media, they report this mass vaccination as a scandal. Hundreds of people are hurt by it and many has received damages claims. Even the ones in charge of ordering millions of doses have admitted to it. One major side effect was narcolepsy but there were others. Most affected are young people. The vaccine was approved and recommended by the "experts".

Now, as I said before, I don't believe in vaccines. They may prevent outbreaks of otherwise natural and oftentimes harmless childhood diseases (which I went through as a child) but they also offer possible fatal or lifelong side effects, particularly autoimmune disorders. Welcome diabetes type 1, asthma, allergies and friends.

Remember my ex-wife's son? He's now 15 and hasn't been vaccinated since he came to Norway 9 years ago and has no asthma or allergies and is in very good health. So is my 10 month old son. He's so smart (we give him cod liver oil, omega 3), he has a giant appetite and, lo and behold, we so-called tin foil hat people, take him regularly to the health station and doctor and he is, and have always been, well within the normal parametres of head size, height and weight.

Who needs them added risk of vaccines then, huh?

[SANDRO43]

we give him cod liver oil

Doesn't he cringe when subjected to it? I did, some 65+ years ago, the stuff tasted terrible . If he likes it, give him a stokkfisk to play with .

[alex330]

Why bother to vaccinate?
Two children have been paralysed in the first polio outbreak in Europe for five years, according to the World Health Organization (WHO). 
Both cases were in Ukraine where only half the children are fully immunised.
It is likely large numbers of other children have also been infected without developing symptoms.
The WHO said the risk of the virus spreading further in the country was "high" and that the outbreak needed to be rapidly controlled. http://www.bbc.com/news/health-34130620

[jone]

I remember the Oral Polio vaccination I received.  They must have put sugar in it, because I do not remember that it tasted so bad.

[ML]

I remember the Oral Polio vaccination I received.  They must have put sugar in it, because I do not remember that it tasted so bad.

No you were part of the control group that got the placebo.  The real pill tasted bitter.

[Anotherkiwi]

Why bother to vaccinate?
Two children have been paralysed in the first polio outbreak in Europe for five years, according to the World Health Organization (WHO). 
Both cases were in Ukraine where only half the children are fully immunised.
It is likely large numbers of other children have also been infected without developing symptoms.

Why bother?  Because people extrapolate all sorts of negative connotations from headlines like this without knowing the full facts.

First question: had these two children been vaccinated against polio?  If they hadn't, how vulnerable were they before they came into contact with such a dangerous disease?  By that I mean - what was the general state of their health?  Are these children who were robustly healthy, with no medical issues at all, or did they suffer regular bouts of mild illness (e.g. multiple colds in a short space of time), or were they in fact already chronically ill with some other disease?

Second question: if they had been vaccinated, did they complete the full course of vaccination, or were they prevented because their parents couldn't afford it (that's if the state didn't supply free vaccine)?  If they became ill AFTER vaccination, and therefore the vaccine itself is potentially indicated as the vector, that would suggest to me that they would already be vulnerable to SOMETHING serious (not necessarily polio), even if they had not already suffered a chronic illness.

Third question: there are two children who have reportedly been paralysed.  How many have NOT been, simply because they DID get vaccinated and didn't suffer any side effects?  Fifty thousand?  Five million?

You shouldn't jump to any conclusions before you know ALL the facts.

[Boethius]

Kiwi, vaccination rates in Ukraine dropped dramatically, because people did not believe the vaccinations they were being given were "pure".  This was reported on a couple of years ago -


http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61469-5/fulltext?rss=yes




Since the collapse of the USSR, many diseases have returned not only to Ukraine, but to Russia as well, which had minor cholera outbreaks in the 1990's.  In Soviet times, vaccinations were mandatory.  If people did not bring children in, or come in for boosters, health authorities would appear at the door at give you a vaccination at home.

[Anotherkiwi]

Kiwi, vaccination rates in Ukraine dropped dramatically, because people did not believe the vaccinations they were being given were "pure".  This was reported on a couple of years ago -

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61469-5/fulltext?rss=yes

Since the collapse of the USSR, many diseases have returned not only to Ukraine, but to Russia as well, which had minor cholera outbreaks in the 1990's.  In Soviet times, vaccinations were mandatory.  If people did not bring children in, or come in for boosters, health authorities would appear at the door to give you a vaccination at home.

That's pretty worrying, especially as it appears that the major cause of such mistrust was a widely-reported, but incorrect, story about the death of a child.  It's like the report of so many "scandals" - huge story and pictures on the front page, with the retraction (and maybe an apology) buried away on page 43 a week later.