Hmo Minnesota: Fill & Download for Free

I think I have a petty unique and useful take on this.Because unlike most people, I am chronically ill and have been ever since childhood. I have been a patient in a couple dozen hospitals at various times in both countries and have had major surgery in both.I grew up in Virginia and later lived in Minnesota. In Virginia, my parents had Blue Cross-Blue Shield; in Minnesota, we had an HMO.And the care was…patchy. And a constant battle, particularly in Minnesota with the HMO, over just about everything.With the HMO, we had to use in-house doctors and clinics for everything. When we first moved there, we went through something like six or seven pediatricians to correctly diagnose the problem, and some of them were frankly borderline quacks. We eventually found one that got it right, and he repeatedly went to bat with the HMO to get me the treatment I needed, including sending me to an expert pediatric gastroenterologist outside the HMO.Ultimately he was forced to leave the HMO and start his own practice (which was booming, as many of his patients all went with him).And of course I was in a constant panic about how to keep even that insurance. I ended up staying in college longer than I originally intended just to keep my parents’ insurance.—Then in 1993 I went to Germany as an exchange student. The contrast was astonishing.In Germany, everyone is covered. While it is universal health care, it is not socialized. Instead, it is run as a system of two tiers — statutory health insurance companies (most of which are non-profit and privately run) and for-profit private insurers in parallel. Everyone is required to have the same package of coverage. And no one can be refused coverage. Premiums in the statutory system are set based on income, in the private system as a flat fee. No risk-based premiums.And the best part? No limitations on what doctors or clinics I use. I can see any doctor I want nationwide. No more having to fight with the insurance company about what is covered, either — there is a standard catalog of coverage that all companies have to follow. (Many cover more than that — since premiums are uniform, they attract customers by offering more coverage.)There are some co-payments, but they are a joke compared to what Americans are accustomed to. In the statutory system, there are no deductibles or similar, just a few token co-payments for prescriptions and some treatments. I pay a maximum of 10 Euros per prescription, no matter how much it costs — including a regime of TNF-alpha shots that cost the insurer around €20,000 per year.Last year my total co-payments were about €250 for the entire year. And I am a very heavy user of the system, being legally handicapped and on a full disability pension. I average at least three or four doctors’ visits a month, plus rehab sports, various weekly or biweekly therapies, and so on.—What’s the quality of care like? Overall, while there are a few things I find better in America, generally the quality has been much better in Germany. Besides the fact that some care is better than no care at all (which would have been the case had I tried to stay in America!), the hospitals, clinics, doctors, and so on have had a similar level of equipment and training.Waiting times vary quite a bit depending on where you live and what type of doctor or clinic you need, but generally waiting times have been as good or better in Germany for me. There have been a few crass exceptions, like recently I had to wait a couple months for an MRI in Berlin, but that is balanced out by the lack of problems I had in the greater Hannover region. There I generally got an MRI appointment within a week, sometimes less. And the CAT scan I had just before the MRI took less than a week, too. And X-rays are so easy to get that most radiologists do it on a walk-in basis. In my experience I have had to wait maybe an hour without an appointment for an X-ray.A few things irk me about German hospitals, such as their propensity to have multi-bed rooms with no curtains or privacy. But you can get supplemental insurance to cover private or double rooms (which I now have).—The truly bizarre part is that if you ask many Germans, they will complain loudly about how terrible their system is. (And indeed it does have its wonky sides.) Yet invariably if I ask them to name an example of a country where it is better, they get very quiet.It was instituted by Bismarck (a notorious anti-socialist!) in the 1880s, and the system is still essentially unchanged since then.If any country gets health care right, it’s Germany. In fact it was one of the biggest reasons I chose to stay.

What bothers me the most, is common misinformation about Canada from the United States.Canada is not that cold. We do not have winter for 6 months of the year. Almost no one in Canada actually lives in igloos anymore. The majority of Canadians live south of Minnesota, Washington State, Maine. The southern point of Canada divides California in half.Generally my accent isn’t that strong, so please don’t ask me to say “About”. From what I am to understand, my speech pattern is very similar to Californian. Unfortunately I am known to say “Eh” occasionally.We are not a backward people. We have as many or more modern conveniences as any American and lead in some areas of Medical Research and Computer Animation.I am not burden by taxes. What i pay in taxes is mostly covered by what I don’t pay in HMO costs or medical costs.I am not a “Wannabe” American.And finally I am not polite. I am passive/aggressive. If you do not understand I am calling you an asshole seven ways to Sunday that just makes you an idiot too.

Every patient with Crohn’s is different, which is why it is so hard to diagnose. Hence experiences will vary widely.In my case, in my childhood in the 1970s, it sucked doubly because few had ever heard of it — even doctors. I went through a lot of different doctors and got all sorts of (in hindsight bizarre) diagnoses. Worse, people who knew me, including family members, often thought I was faking it or that it was all in my head. With no visible outward signs of illness, often my gutaches and diarrhea were chalked up to nerves, and my aversion to certain foods was seen as me just not wanting to eat them (like beans).When I was eight, my pediatrician diagnosed ulcerative colitis. (Which is close, almost the same thing.) At last, my illness had a name and people around me began to take it more seriously.Unfortunately, that was only a small step. My doctor quickly deduced I had trouble with milk products and suggested yogurt. Except in those days where I lived, yogurt just wasn't available. My mother ended up ordering a yogurt machine in the mail. My parents also gradually began to give me more leeway in eating, rather than force me to eat whatever was on the table. I taught myself to cook and began cooking for myself.Still, one pattern quickly became clear: Emotional stress made it much worse. So when we moved from Virginia to Minnesota, my health went completely downhill. I developed an anal abscess and fistula that was leaking pus everywhere, and my joints started to seize up. Yet more tests from numerous clueless doctors at our HMO got nowhere.Eventually we finally found a doctor there who probably saved my life (and definitely my sanity). Dr. Rigatuso, who I believe is still practicing (for those of you in Minneapolis-St. Paul), immediately diagnosed Crohn’s and sent me to the hospital, and from then on, my care dramatically improved. He in turn sent me to a pediatric gastrointestinal specialist outside the HMO (much to their anger), Dr. Kibort, as well to a great Australian surgeon, Dr. Buls, both of whom are still doing their thing.They took good care of me and helped enormously with my family and school. Still, the ongoing stress of the change to living in Minnesota (where I had a lot of trouble with classmates) made my health worse. Eventually they recommended an ileostomy, which I did, celebrating my 16th birthday in the hospital with a good dozen tubes sticking out of me.The good news is that since the ostomy, the Crohn’s has been fairly quiet. Apart from a couple operations for adhesions and an abdominal fistula right when I got married the first time (my wedding suit was stuffed full of gauze to soak up pus, and the day afterwards I went in for surgery), it has been pretty manageable in the almost exactly 30 years since the ostomy.These days I manage it mostly through diet (avoiding fiber and roughage or anything that causes gas, avoiding NSAIDs like ibuprofen) and psychotherapy (to manage stress). For a time I took TNF-alpha shots for the ankylosing spondylitis (another disease closely related to Crohn’s), which also kept inflammation in check.The hardest part for me, though, was less the actual symptoms than the way others around me reacted — classmates, colleagues, family members, etc. Few if any understood what I was going through (even doctors!) and that was very lonely at times.Thankfully, my current wife is also chronically ill, so she and I understand and take care of each other. So in the end, it worked out OK. But the road getting here was extremely difficult.