View Full Version : Obamacare insurance premium increase.
dpacrkk
09-26-2017, 07:18 AM
I think this says it all
https://cdn1-nyt-com.cdn.ampproject.org/ii/w1200/s/cdn1.nyt.com/images/2017/09/26/us/26dc-health1/26dc-health1-articleLarge.jpg
Zofia
09-26-2017, 04:11 PM
The problem with the current situation is the ACA makes healthcare more expensive and less available for those of us who have to pay for it. The people who were added to the system, for the most part, don't pay at all. And the rest of them get in at a substantial discount.
I am very well off, so I can afford private pay when my health insurance doesn't take care of a bill. In fact, for many things, I don't even use health insurance. For example, my child's pediatrician charges my insurance company about $400 and me a co-pay of $20 for my daughter's physical. When I self-pay, the charge is a straight $120. So, I opt for catastrophic coverage and I just self-pay for most other things. It's worse with lab tests. My daughter needed a hemoglobin test at her last physical. The lab would have charged my insurance company $375 for the test. The Insurance company has a pre-negotiated rate of $141 for the test. They would apply the $141 to my deductible and I am stuck with a bill for $141. Instead, I go self-pay for the test and the cash price from the lab is $112. I will admit I am a much better business person than anyone I have ever met who works for a health insurance company, but that's just ridiculous.
If we can find a way to expand medicare to working people at the current price. And, if the medicare expansion includes the ability to buy a supplement on the open market. I think I could support something like medicare for most. Otherwise, just expand medicaid to cover the poor people and repeal the ACA. The market, inefficient as it is for healthcare, works better than this government boondoggle.
Z
dpacrkk
09-27-2017, 06:54 AM
Otherwise, just expand medicaid to cover the poor people and repeal the ACA.
The ACA already expands Medicaid in the first place. If you repeal ACA, you're getting rid of the Medicaid expansion that comes along with it. And if Medicaid gets further funding, being funded by taxes, people would still complain "government entitlements, rabble rabble."
rickdugan
09-27-2017, 08:00 AM
The ACA already expands Medicaid in the first place. If you repeal ACA, you're getting rid of the Medicaid expansion that comes along with it. And if Medicaid gets further funding, being funded by taxes, people would still complain "government entitlements, rabble rabble."
This already is an entitlement, just one funded by way too few people. Indeed, the Supreme Court justified the existence of individual penalty by considering it a tax.
If we don't repeal ACA, then the entire individual market is going to collapse anyway. It already is and the upcoming rate hikes for 2018 will likely hasten its demise. The individual market dropped to just 17.6 million people in 2017, down 2.6 million people from a year prior, and is expected to drop even more next year with the upcomng rate hikes. Further this is not just unsubsidized people leaving the market, but also those who do receive subsidies yet still find it more cost effective to pay the penalty. I linked an article in one of my previous posts which covers all of this and was developed using insurance filings from all 50 states and the federal government.
So I suppose we will just have to wait for it to collapse more before something finally gets done. At this point the red party might just decide to just do nothing until the 2018 elections and let the tens of millions of people who are not covered by employer plans or medicare suffer for another year, caught between a rock and a hard place with even more expensive and mostly crappy insurance in 2018 on one side and an increasingly painful individual mandate on the other.
eagle2
09-27-2017, 09:06 AM
The problem with the current situation is the ACA makes healthcare more expensive and less available for those of us who have to pay for it. The people who were added to the system, for the most part, don't pay at all. And the rest of them get in at a substantial discount.
I am very well off, so I can afford private pay when my health insurance doesn't take care of a bill. In fact, for many things, I don't even use health insurance. For example, my child's pediatrician charges my insurance company about $400 and me a co-pay of $20 for my daughter's physical. When I self-pay, the charge is a straight $120. So, I opt for catastrophic coverage and I just self-pay for most other things. It's worse with lab tests. My daughter needed a hemoglobin test at her last physical. The lab would have charged my insurance company $375 for the test. The Insurance company has a pre-negotiated rate of $141 for the test. They would apply the $141 to my deductible and I am stuck with a bill for $141. Instead, I go self-pay for the test and the cash price from the lab is $112. I will admit I am a much better business person than anyone I have ever met who works for a health insurance company, but that's just ridiculous.
If we can find a way to expand medicare to working people at the current price. And, if the medicare expansion includes the ability to buy a supplement on the open market. I think I could support something like medicare for most. Otherwise, just expand medicaid to cover the poor people and repeal the ACA. The market, inefficient as it is for healthcare, works better than this government boondoggle.
Z
The original bill had a provision to allow Americans over 55 to be able to buy into Medicare, and there was also a public option, which might have been significantly lower priced than private insurance. but neither provision had the votes to pass.
RyanXO
09-27-2017, 10:25 AM
The ACA already expands Medicaid in the first place. If you repeal ACA, you're getting rid of the Medicaid expansion that comes along with it. And if Medicaid gets further funding, being funded by taxes, people would still complain "government entitlements, rabble rabble."
A lot of states chose not to expand Medicaid, making a large gap for the most vulnerable of populations: minimum wage workers who are too poor to get a subsidy on the exchange yet make too much money for Medicaid.
RyanXO
09-27-2017, 10:26 AM
The original bill had a provision to allow Americans over 55 to be able to buy into Medicare, and there was also a public option, which might have been significantly lower priced than private insurance. but neither provision had the votes to pass.
I always supported these options. They make the most sense but for some reason nobody likes them.
eagle2
09-27-2017, 11:03 AM
I support them too.
dpacrkk
09-27-2017, 12:01 PM
This already is an entitlement, just one funded by way too few people. Indeed, the Supreme Court justified the existence of individual penalty by considering it a tax.
That's exactly my point, some view it as an entitlement, and are opposed to it and further funding on that principle. Others view it as a service from which we all pay into and all benefit, whether currently, previously, or in the future. That's the big difference between us, and honestly, there's no convincing either one of us of the other's viewpoint.
A lot of states chose not to expand Medicaid, making a large gap for the most vulnerable of populations: minimum wage workers who are too poor to get a subsidy on the exchange yet make too much money for Medicaid.
Then don't fault the law, fault the people in power for sabotaging it. I'll help you out, here's an alphabetized list by state name (not abbreviation): AL, FL, GA, ID, KS, ME, MS, MO, NE, NC, OK, SC, SD, TN, TX, UT, VA, WI, WY. It's a lot of red on that list...
I always supported these options. They make the most sense but for some reason nobody likes them.
The version with the public option passed 220-215 in the House and had 59 votes supporting it in the Senate. You can thank the holdout senator Joe Lieberman for threatening to filibuster until the public option was removed.
rickdugan
09-27-2017, 12:46 PM
That's exactly my point, some view it as an entitlement, and are opposed to it and further funding on that principle. Others view it as a service from which we all pay into and all benefit, whether currently, previously, or in the future. That's the big difference between us, and honestly, there's no convincing either one of us of the other's viewpoint.
So the thinking is that we shouldn't restructure a failing entitlement, which was obtained largely by deceit and is hurting at least as many people as it is helping, because passing a properly constructed one honestly might not be possible? That's an interesting viewpoint indeed. ;)
Then don't fault the law, fault the people in power for sabotaging it. I'll help you out, here's an alphabetized list by state name (not abbreviation): AL, FL, GA, ID, KS, ME, MS, MO, NE, NC, OK, SC, SD, TN, TX, UT, VA, WI, WY. It's a lot of red on that list...
What you call "sabotage" others might call fiscal prudence. These states see the federal government spending a whopping 25% of its entire budget just on healthcare and they don't want to get sucked into the same mess, especially once the medicaid cost sharing kicks in and states have to pony up part of the cost. Every dollar that a state spends on an open ended entitlement that they cannot control is one less dollar that can be spent on schools, other social programs, law enforcement, etc., etc.
dpacrkk
09-27-2017, 01:45 PM
So the thinking is that we shouldn't restructure a failing entitlement, which was obtained largely by deceit and is hurting at least as many people as it is helping, because passing a properly constructed one honestly might not be possible? That's an interesting viewpoint indeed. ;)
Are you capable of following a quote thread? The suggestion was the expansion of Medicaid and, using prounoun-antecedent agreement, is the "entitlement" we are discussing, not the ACA. Good job reading. /facepalm
Zofia
09-27-2017, 07:08 PM
^^^dpacrkk, one of the cardinal rules of this forum is no politics. I interpret that to mean no ad hominem arguments. That is no attacks on the person, only his or her ideas. I would thank you to refrain from posts such as the above. ^^^
Healthcare is both a political and economic matter. If we keep the discussion civil and directed at the ideas the mods will not close the thread.
HTH
Z
P.S. that applies to all, BTW.
rickdugan
09-27-2017, 07:40 PM
^ I refrained from responding because he was clearly getting a bit worked up. I had actually typed out a response indicating that he was the one who roped the entitlement concepts together in post #203 above, but then deleted it as it just didn't seem worth it at the time.
DP, if you believe that someone misunderstood the underlying meaning of your post and then responded based upon that misunderstanding, then by all means feel free to clarify, though it would be nice if you could do so sans the snark.
For example, I am fairly certain that you were defending ACA as the only way to keep the medicaid expansion and I was responding accordingly.
If I was wrong, I'm fine with you pointing that out. Simple.
dpacrkk
09-27-2017, 07:52 PM
^^^dpacrkk, one of the cardinal rules of this forum is no politics. I interpret that to mean no ad hominem arguments. That is no attacks on the person, only his or her ideas. I would thank you to refrain from posts such as the above. ^^^
He misread (at least twice in this thread, see here (https://www.stripperweb.com/forum/showthread.php?213893-Obamacare-insurance-premium-increase&p=3014286&viewfull=1#post3014286)) yet insulted me.
Also, it's not an ad hominem argument, here it is again:
Otherwise, just expand medicaid to cover the poor people and repeal the ACA. The market, inefficient as it is for healthcare, works better than this government boondoggle.
The ACA already expands Medicaid in the first place. If you repeal ACA, you're getting rid of the Medicaid expansion that comes along with it. And if Medicaid gets further funding, being funded by taxes, people would still complain "government entitlements, rabble rabble."
To reiterate: you suggest expanding Medicaid with repealing the ACA. That the ACA expanded Medicaid implies repealing the ACA also rolls back the very expansion that you suggest. Expanding Medicaid also does nothing to appease the people who are already against ACA on the basis of it being an entitlement (in their opinion), as these people would view Medicaid similarly.
rickdugan
09-27-2017, 08:31 PM
He misread (at least twice in this thread, see here (https://www.stripperweb.com/forum/showthread.php?213893-Obamacare-insurance-premium-increase&p=3014286&viewfull=1#post3014286)) yet insulted me.
Also, it's not an ad hominem argument, here it is again:
To reiterate: you suggest expanding Medicaid with repealing the ACA. That the ACA expanded Medicaid implies repealing the ACA also rolls back the very expansion that you suggest. Expanding Medicaid also does nothing to appease the people who are already against ACA on the basis of it being an entitlement (in their opinion), as these people would view Medicaid similarly.
Misreadings are bound to happen in a 200+ post thread. You responded to the first one and I agree that I misread it, which is why I let it go. But my more recent comment was perfectly valid given what you had previously posted in #203. Each post does not live in a vacuum separated from the points made by the same person in other posts.
But with that said, I agree that someone who is staunchly opposed to Obamacare purely from the standpoint of entitlement opposition will also view a standalone medicaid expansion in the same dim light. However, I also believe that some of the most fervent opposition to Obamacare has as much to do with the devastation it has wreaked upon the individual marketplace. if the reds do decide to go the bipartisan route instead of just letting this thing collapse even more, I could see a compromise involving an expansion of Medicaid in order to cover the poorest subsidized market participants, hopefully in exchange for a dissolution of the rest of this monstrosity.
dpacrkk
09-27-2017, 10:25 PM
Misreadings are bound to happen in a 200+ post thread. You responded to the first one and I agree that I misread it, which is why I let it go.
The common denominators in the two misinterpretations is you. And you "let it go" without any acknowledgement of being incorrect nor your condescending tone while, by your own admission, you were the person who made the mistake.
But my more recent comment was perfectly valid given what you had previously posted in #203. Each post does not live in a vacuum separated from the points made by the same person in other posts.
But with that said, I agree that someone who is staunchly opposed to Obamacare purely from the standpoint of entitlement opposition will also view a standalone medicaid expansion in the same dim light. However, I also believe that some of the most fervent opposition to Obamacare has as much to do with the devastation it has wreaked upon the individual marketplace. if the reds do decide to go the bipartisan route instead of just letting this thing collapse even more, I could see a compromise involving an expansion of Medicaid in order to cover the poorest subsidized market participants, hopefully in exchange for a dissolution of the rest of this monstrosity.
Your second paragraph is a reply to an equivalent rephrasing of post 203. If your previous replies to post 203 are relevant, then why reply to it again just now with a completely different response? It's a rhetorical question: because you replied to something that you didn't interpret correctly the first time.
Anyway, about health care policy: probably won't happen unless one party can get close to 60 members again. The latest attempt with 52 members didn't even hit the floor before 3 Republican senators said they would oppose it, with (according to aides) more that didn't announce their opposition.
rickdugan
09-28-2017, 04:46 AM
The common denominators in the two misinterpretations is you. And you "let it go" without any acknowledgement of being incorrect nor your condescending tone while, by your own admission, you were the person who made the mistake.
Your second paragraph is a reply to an equivalent rephrasing of post 203. If your previous replies to post 203 are relevant, then why reply to it again just now with a completely different response? It's a rhetorical question: because you replied to something that you didn't interpret correctly the first time.
Anyway, about health care policy: probably won't happen unless one party can get close to 60 members again. The latest attempt with 52 members didn't even hit the floor before 3 Republican senators said they would oppose it, with (according to aides) more that didn't announce their opposition.
Actually dp, with respect to my first misinterpretation, I showed great restraint in not responding to your counterpoint (or more accurately your restated original point, oopsie again, lol) that demand for healthcare is inelastic. While this is obviously true for treatment of injuries and life threatening illnesses, people forego a wide variety of routine and preventative services all the time. Many even forego visits when they are sick and/or showing signs of more serious issues, at least until they can no longer ignore those issues. In some respects, Obamacare has made these issues worse by eating up limited resources with premium payments and leaving little behind for folks to cover the high deductibles that must be cleared to actually pay for medical treatment.
But ok, I'm sorry if I hurt your feelings by injecting humor into two responses that were based upon misreadings of your underlying points. Better now? ;D
dpacrkk
09-28-2017, 05:57 AM
Actually dp, with respect to my first misinterpretation, I showed great restraint in not responding to your counterpoint (or more accurately your restated original point, oopsie again, lol) that demand for healthcare is inelastic. While this is obviously true for treatment of injuries and life threatening illnesses, people forego a wide variety of routine and preventative services all the time. Many even forego visits when they are sick and/or showing signs of more serious issues, at least until they can no longer ignore those issues. In some respects, Obamacare has made these issues worse by eating up limited resources with premium payments and leaving little behind for folks to cover the high deductibles that must be cleared to actually pay for medical treatment.
Except, a long list of preventative services costs no copay nor coinsurance with individual marketplace plans.
But ok, I'm sorry if I hurt your feelings by injecting humor into two responses that were based upon misreadings of your underlying points. Better now?
Your fake apology for condescension while being incorrect contains further condescension.
rickdugan
09-28-2017, 06:35 AM
Except, a long list of preventative services costs no copay nor coinsurance with individual marketplace plans.
Actually, it is a very short list of preventative services with specified ages and/or timeframes. Sick visits and a long list of other preventative services, including physicals and lab testing for a variety of potential issues, are not covered. Below is an article posted in the LA Times, which frankly mirrors my own experiences with how this plays out in practice when visiting a doctor's office to access the limited list of available screenings:
http://www.latimes.com/business/lazarus/la-fi-lazarus-obamacare-physicals-20160802-snap-story.html
So you can understand why folks with this crappy Obamacare insurance tend to avoid the doctor's office if at all possible. Sadly, this includes a lot of subsidized people. A $1,500 deductible may sound like a dream compared to what us un-subsidized people are forced to accept, but to someone living paycheck to paycheck, $1,500 might as well be $15,000, especially after we have already shaken this person down for premium payments.
dpacrkk
09-28-2017, 07:18 AM
Actually, it is a very short list of preventative services with specified ages and/or timeframes. Sick visits and a long list of other preventative services, including physicals and lab testing for a variety of potential issues, are not covered. Below is an article posted in the LA Times, which frankly mirrors my own experiences with how this plays out in practice when visiting a doctor's office to access the limited list of available screenings:
http://www.latimes.com/business/lazarus/la-fi-lazarus-obamacare-physicals-20160802-snap-story.html
Did you read the article in full? He was charged for the EKG, not the annual checkup. Blood work at annual checkups isn't covered under a lot of insurance either (blood cell counts, metabolic panels, tsh tests, etc). Maybe you're saying ACA didn't go far enough then? Also, the person in the article is 78, why isn't he eligible for Medicare?
RyanXO
09-28-2017, 09:16 AM
Then don't fault the law, fault the people in power for sabotaging it. I'll help you out, here's an alphabetized list by state name (not abbreviation): AL, FL, GA, ID, KS, ME, MS, MO, NE, NC, OK, SC, SD, TN, TX, UT, VA, WI, WY. It's a lot of red on that list...
You're not wrong on that point, but regardless, something needs to change so I can buy health insurance again. My vanilla job pays me well but it's a small business. It would cost them 1000k a month to insure me and I'm young and healthy. I lost my insurance because of Obamacare. The plans on the exchanges are still expensive plus I can't find any decent doctors who take them. The small business are really getting screwed. I'm feeling like I'm going to have to take a job I hate just so I can get benefits. I am an entrepreneur and independent contractor in addition to my regular job so I can't get anything as it stands (without moving to another state.)
I feel very fortunate that I am healthy except for migraines and I can just pay out of pocked cheaper than a plan would be. But At the very least I want to be able to buy a catastrophic plan again (under Obamacare these became illegal) so that I don't spend much on premiums, and even if the deductible is high, I only need it for an emergency. I am healthy, but all it takes is one crazy life event to completely ruin me financially and I don't like living that way. I'm not here to talk politics and point fingers at the Democrats Vs. Republicans or red vs. blue states because that is against the rules and I don't want to anyway. I just hope a compromise can be reached very soon. This whole system is already collapsing.
rickdugan
09-28-2017, 09:21 AM
Did you read the article in full? He was charged for the EKG, not the annual checkup. Blood work at annual checkups isn't covered under a lot of insurance either (blood cell counts, metabolic panels, tsh tests, etc). Maybe you're saying ACA didn't go far enough then? Also, the person in the article is 78, why isn't he eligible for Medicare?
I did indeed read it. Did you? Because if so, you seem to be getting caught up in the weeds with the first part of your response. Yes the one person in question was charged for an EKG, but the broader point made in the article (multiple times in multiple ways) is that almost any additional test performed or ordered by the doctor will be charged and may also completely changes the nature of the visit and triggers co-pays and deductibles (some policies waive deductibles for PCP visits and others don't). How many people will say no to a doctor who feels the need to check their heart, or test for xyz, or do some type of scanning procedure, or, etc.,etc? How many people will fail to disclose some ache or pain and/or refuse to let the doctor look at it? Not many, even assuming that they know exactly what is and is not covered to begin with. It is nearly impossible to go to a PCP without being rung up for the visit and non-covered services, which is understood all too well by those of us who are in the individual marketplace covered by one of these crappy Obamacare plans.
And I thoroughly disagree with your comments about the range of services covered and not covered by other insurance policies. I had a great policy that covered all of this stuff, for much less money, literally the year before the Obamacare mandates kicked in. So no, I'm not saying that Obamacare should go further, but rather I'm saying that it should be put down, for this and all of the other reasons noted in various posts. Obamacare has had more adverse behavioral and economic effects than can be easily counted and it needs to go away.
RyanXO
09-28-2017, 09:36 AM
Obamacare has had more adverse behavioral and economic effects than can be easily counted and it needs to go away.
This is the bottom line. For every one person it might have helped, it has screwed over several people like me and Rick and many other posters. This isn't an issue of believing in one political standpoint over another, this is a matter of THIS SHIT JUST DOESN'T WORK.
rickdugan
09-28-2017, 09:44 AM
You're not wrong on that point, but regardless, something needs to change so I can buy health insurance again. My vanilla job pays me well but it's a small business. It would cost them 1000k a month to insure me and I'm young and healthy. I lost my insurance because of Obamacare. The plans on the exchanges are still expensive plus I can't find any decent doctors who take them. The small business are really getting screwed. I'm feeling like I'm going to have to take a job I hate just so I can get benefits. I am an entrepreneur and independent contractor in addition to my regular job so I can't get anything as it stands (without moving to another state.)
I feel very fortunate that I am healthy except for migraines and I can just pay out of pocked cheaper than a plan would be. But At the very least I want to be able to buy a catastrophic plan again (under Obamacare these became illegal) so that I don't spend much on premiums, and even if the deductible is high, I only need it for an emergency. I am healthy, but all it takes is one crazy life event to completely ruin me financially and I don't like living that way. I'm not here to talk politics and point fingers at the Democrats Vs. Republicans or red vs. blue states because that is against the rules and I don't want to anyway. I just hope a compromise can be reached very soon. This whole system is already collapsing.
Ryan, thanks for sharing that. It's hard to make people who aren't in the individual insurance market understand just how bad things are right now, especially with all of the politically motivated media spin in support of this broken system. Zofia also shared good information about how she actually has to pay her doctors outside of her insurance company in order to access them for a reasonable price. I've more than overshared myself, but I think that it is important for people to understand what is going on.
I previously mentioned two people in offices near mine who completely dropped their coverage for 2017 largely for the same reasons that you have declined coverage. For one, it was simply too expensive. For the other, whose premiums were in fact subsidized, it was because she felt like she was paying for nothing since it covered almost nothing before deductibles and the doctors that she had used for years wouldn't take it anymore. She limped along in 2016 by seeing the local medicaid doctor, who was slammed because they were the only ones taking most of the obamacare policies, and finally decide that it was worth it to pay the penalty and pay her preffered doctor in cash. I only hope that neither of these two, who are substantially older than you, run into serious health issues, but these are the horrible choices that Obamacare has forced upon almost all of us.
dpacrkk
09-28-2017, 11:04 AM
But At the very least I want to be able to buy a catastrophic plan again (under Obamacare these became illegal) so that I don't spend much on premiums, and even if the deductible is high, I only need it for an emergency.
Catastrophic plans are not illegal. A poster in this thread even said they have one. Do you mean you don't qualify for one?
I did indeed read it. Did you? Because if so, you seem to be getting caught up in the weeds with the first part of your response. Yes the one person in question was charged for an EKG, but the broader point made in the article (multiple times in multiple ways) is that almost any additional test performed or ordered by the doctor will be charged and may also completely changes the nature of the visit and triggers co-pays and deductibles (some policies waive deductibles for PCP visits and others don't).
So you admit that the physical is free. That's contradicts your original claim:
Sick visits and a long list of other preventative services, including physicals and lab testing for a variety of potential issues, are not covered.
Also is an EKG preventative? If not (and it's not, it's diagnostic), then it does not refute the original point: "a long list of preventative services costs no copay nor coinsurance with individual marketplace plans." The semantic difference is incredibly important.
This is the bottom line. For every one person it might have helped, it has screwed over several people like me and Rick and many other posters. This isn't an issue of believing in one political standpoint over another, this is a matter of THIS SHIT JUST DOESN'T WORK.
This sounds like it's from anecdotal evidence or intentionally misleading echo chambers. In 2010, 10.7 million people were on the individual market. Let's take the absolutely worst case scenario and assume all 10.7 million were screwed over. The ACA added coverage to more than 20 million people. That ratio (20m:10.7m) isn't even close to "for every one person helped, it screwed over several." In fact, it's closer to the converse, i.e. "for every one person hurt, it helped several." Obviously, the ideal is it just helps people, and for that maybe you're saying the ACA didn't go far enough.
RyanXO
09-28-2017, 11:41 AM
Allow me to correct myself: When I meant illegal, I meant that all insurance plans are priced to cover EVERYTHING for EVERYONE. For example, even though I can't get pregnant, my insurance cost includes pregnancy care. Same with mental illness. I don't have mental illness, but the shared cost is still spread to me. Per Obamacare, insurance Companies aren't allowed to not cover certain things. True, a catastrophic plan I could buy would only cover certain things for, but the costs of them still cover everything for everyone else. My catastrophic plan would still be priced out to pay for things I would never use. That was the point of Obamacare: to try to lower prices by everyone buying into the same pool, to cover everything. But that hasn't happened and that's the point.
And not everyone can qualify for one:
From healthcare.gov
Catastrophic health plans: For people under 30 or with certain exemptions
Catastrophic health insurance plans have low monthly premiums and very high deductibles. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself.
Who can buy a Catastrophic plan
Only the following people are eligible:
People under 30
People of any age with a hardship exemption or affordability exemption (based on Marketplace or job-based insurance being unaffordable)
If you’re eligible to buy a Catastrophic plan, you’ll see them displayed when you compare plans in the Marketplace.
I make too much money to get this.
dpacrkk
09-28-2017, 12:02 PM
Allow me to correct myself: When I meant illegal, I meant that all insurance plans are priced to cover EVERYTHING for EVERYONE. For example, even though I can't get pregnant, my insurance cost includes pregnancy care. Same with mental illness. I don't have mental illness, but the shared cost is still spread to me. Per Obamacare, insurance Companies aren't allowed to not cover certain things. True, a catastrophic plan I could buy would only cover certain things for, but the costs of them still cover everything for everyone else. My catastrophic plan would still be priced out to pay for things I would never use. That was the point of Obamacare: to try to lower prices by everyone buying into the same pool, to cover everything. But that hasn't happened and that's the point.
Still relevant, though I made some edits:
[R]isk is shared and it's not different from any other insurance...I have to ask: if you received a higher cost of health care than your premium, would you do the "noble" thing and pay the difference? I've never received more than the value of my health insurance premium in health care, but I know it's part of risk sharing..
And not everyone can qualify for one
I'm well aware. After all I typed this:
Do you mean you don't qualify for one?
Ask the aforementioned previous poster how they got theirs.
rickdugan
09-28-2017, 01:28 PM
^ I don't think Zofia was referring to a true catastrophic plan as defined under the Obamacare regs. Someone who is 30 and over only qualifies for a catastrophic plan if that person would have been exempted from the personal penalty anyway for hardship reasons, which I'm sure is not the case for Zofia. I'm guessing that she purchased the cheapest (relatively since even the garbage plans are pricey) crappiest plan available and is just working around it, which is a sad testament indeed to the real value of the purported benefits offered by these policies.
dpacrkk
09-28-2017, 01:51 PM
I'm guessing that she purchased the cheapest (relatively since even the garbage plans are pricey) crappiest plan available and is just working around it, which is a sad testament indeed to the real value of the purported benefits offered by these policies.
It's a sad testament that people are ok with middle men (health insurance companies) profiting billions from people needing health care. The insurance companies are the only ones that never lose because their actuaries figure out risk and basically guarantee that they never pay more in care than they take in, while not even being the ones that actually provide health services.
rickdugan
09-28-2017, 02:56 PM
It's a sad testament that people are ok with middle men (health insurance companies) profiting billions from people needing health care. The insurance companies are the only ones that never lose because their actuaries figure out risk and basically guarantee that they never pay more in care than they take in, while not even being the ones that actually provide health services.
Did we miss something? Was the CEO of Aetna voting in the House of Representatives when the Obamacare takeover of the individual market was passed? Was the CEO of United Healthcare one of the 60 Senators who thought that this was a great idea? Was the CEO of Blue Cross responsible for signing this oh-so-wonderful legislation into law? ::)
dpacrkk
09-28-2017, 03:29 PM
It's a sad testament that people are ok with middle men (health insurance companies) profiting billions from people needing health care. The insurance companies are the only ones that never lose because their actuaries figure out risk and basically guarantee that they never pay more in care than they take in, while not even being the ones that actually provide health services.
Did we miss something? Was the CEO of Aetna voting in the House of Representatives when the Obamacare takeover of the individual market was passed? Was the CEO of United Healthcare one of the 60 Senators who thought that this was a great idea? Was the CEO of Blue Cross responsible for signing this oh-so-wonderful legislation into law? ::)
The nested comment has absolutely nothing to do with the passage of ACA, nor any given value of premiums. As long as insurance companies are around, no matter what happens in legislation, they are guaranteed to take in more than they pay out to the real healthcare providers (and currently the difference is in the billions). And despite you insulting me yet again, I don't want to seem insulting: but I don't see how you could possibly make the link between the nested post and the ACA. For the scoreboard: that's misinterpretation #3.
rickdugan
09-28-2017, 03:56 PM
The nested comment has absolutely nothing to do with the passage of ACA, nor any given value of premiums. As long as insurance companies are around, no matter what happens in legislation, they are guaranteed to take in more than they pay out to the real healthcare providers (and currently the difference is in the billions). And despite you insulting me yet again, I don't want to seem insulting: but I don't see how you could possibly make the link between the nested post and the ACA. For the scoreboard: that's misinterpretation #3.
Well, we were talking about Obamacare right before that, which in fact is the subject of this entire thread. If you were having a more general moment, it might have been helpful to qualify it as such. Yet again dp, our comments don't live in a vaccuum.
But ok, if I misinterpreted then where is this going? What's the next logical step in your train of thought? Who are you suggesting replace the insurers as administrative consolidators and group negotiators, if anyone? Should we remove all middle men from the equation, including the federal government? Inquiring minds want to know. :)
dpacrkk
09-28-2017, 05:40 PM
Well, we were talking about Obamacare right before that, which in fact is the subject of this entire thread. If you were having a more general moment, it might have been helpful to qualify it as such. Yet again dp, our comments don't live in a vaccuum.
Come on, man. It's like following a conversation. When a reply follows a quote of a previous post, that reply is relevant to that quote (i.e. _replying_ to it), and not likely anything else.
But ok, if I misinterpreted then where is this going? What's the next logical step in your train of thought? Who are you suggesting replace the insurers as administrative consolidators and group negotiators, if anyone? Should we remove all middle men from the equation, including the federal government? Inquiring minds want to know. :)
It's a complex issue, but here's three:
* centralized negotiation for leverage
* price transparency and signaling
* all-payer rates when possible for routine and planned services
rickdugan
09-28-2017, 06:41 PM
It's a complex issue, but here's three:
* centralized negotiation for leverage
* price transparency and signaling
* all-payer rates when possible for routine and planned services
Ah huh. And who do you suppose would, or even could, be responsible for this "central negotiation?" It's ok dp, spit it out, you know you want to. ;)
dpacrkk
09-28-2017, 08:22 PM
Ah huh. And who do you suppose would, or even could, be responsible for this "central negotiation?" It's ok dp, spit it out, you know you want to. ;)
If you're anticipating me to say "the government" then:
First of all, the government already does this with Medicare in medical procedures (not drugs) and, not surprisingly, it gets the lowest rates. And nobody's claiming "Medicare is collapsing under its own weight!"
Second of all, it doesn't have to be. There are many two tier systems in the world (New Zealand, France, Denmark, etc), and they all spend less than the US for much lower healthcare spending:
http://www-tc.pbs.org/prod-media/newshour/photos/2012/10/02/US_spends_much_more_on_health_than_what_might_be_e xpected_1_slideshow.jpg
And if you were anticipating me to type "the government" and you were going to follow up with "government is never more efficient than private business," then yet again:
Here's the first "barking cat" (is this common parlance?) for you then: Medicare overhead is ~6% while private insurance industry average is 11-12% and as high as 20%, individually.
Look. Just drop your insurance, pay your penalty, and wait for the next attempt at ACA repeal. Maybe the 116th Congress will have more senators in favor. The fifth time's the charm?
baer45
10-02-2017, 10:34 PM
single payer healthcare system...It's better than the mess we have right now.
baer45
10-04-2017, 05:59 PM
http://www.cavemancircus.com/wp-content/uploads/images/2017/october/dumping_grounds/10_4/funny_pictures_7.jpg
ZeroSugarMonster
10-05-2017, 04:19 PM
Health insurance in this country is a failure, period. What the Obama Care did was legally mandate the public subsidization of private health insurance companies. This means you and I, and any able-bodies, none-broke young-ish person pays a premium for those who need it more. That's all well and good, in my opinion but the administrative costs need to go. Administrative costs in the health insurance companies have always made health care more expensive than it needs to be, such that it's no different than an elaborate pyramid scheme. The health care in this country makes me absolutely ill (thank god, it's not to the point where I'll need to go to the doctor), but I have no idea where else to go or how to get out of this crap whole. Single-payer system is what we need.
Ifyouseekamy
11-08-2017, 11:46 PM
Lol...I’m old enough I had an insurance company tell me that being an adult entertainer was a preexsiting condition. Tragic. I assume they thought I was sucking and fucking random guys.
I got Obamacare, but then I had to file taxes and now my job is on paper (facepalm).
I’ll probably just get a day job with benefits and work part time. After my bills and taxes were paid, I had hardly an extra income. I also got sexually transmitted debt which Should be paid off this year. So I should actually have extra money next year as long as nothing goes wrong (but if Murphy keeps knocking I don’t know what I’m gonna do). I know I can’t afford to date anymore.
eagle2
01-30-2018, 08:21 AM
Amazon, Berkshire Hathaway, and JPMorgan are creating a new healthcare company to tackle rising costs
http://www.businessinsider.com/amazon-berkshire-hathaway-jpmorgan-teaming-up-on-healthcare-2018-1
Zofia
01-30-2018, 03:37 PM
Amazon, Berkshire Hathaway, and JPMorgan are creating a new healthcare company to tackle rising costs
http://www.businessinsider.com/amazon-berkshire-hathaway-jpmorgan-teaming-up-on-healthcare-2018-1
For themselves, not anyone else. There are plenty of companies that have, from time to time, gone it alone or in industry groups with mixed success. Ford and GM still do it, along with the UAW. Their industry plans are good enough that Ford and GM are willing to continue them with the UAW. But, the costs are not that much better controlled than the bigger plans from BCBS, Kaiser and the other big carriers. However, industry/labor plans are the norm in the German health care system. It's a model that does work in some places. I think the real savings though can only come from controlling costs on the provider side and that means wages, medicines and liability claims.
Z
eagle2
01-30-2018, 04:28 PM
Maybe if Amazon, Berkshire Hathaway, and JPMorgan are more successful, other large corporations will do the same thing. I've also heard of large hospitals forming their own insurance companies or merging with insurance companies, to reduce overhead. A lot of money paid to insurers goes to overhead that doesn't do anything to help the patients or providers.
KatyBoleyn
01-30-2018, 04:36 PM
There's a few little things that might help make a dent in costs, but we're looking at a 40% jump in our employer/employee health plan this year. Nobody is getting silver now, that's for sure. We were already paying for basically junk insurance just to avoid the penalty. $1700 a month to be charged $300+ per doctor visit anyways is just stupid. Its cheaper for any of us to get on an airplane to Romania and get the same visits and procedures done for under $1000 out of pocket, and thats for the intense things. A pediatrician visit is $20, and that's paying the "spaga" for better service.
What kills me is that I have no idea what it will cost before I go get anything done anywhere in the US. There's no price chart they'll tell you about. Its completely against every libertarian/free market principle. If consumers could compare healthcare quality and prices between competing institutions in larger markets, you would see prices come down quite a bit. Saying "they just don't know" is a BS excuse. They do know. They code and bill for everything...MC&B is a major industry unto itself. Consumers are completely blind until they get the bill, and there's no guarantee their neighbor will get the same bill for an identical procedure.
And the cool part about the Trump taxes is that the discount on my income tax goes entirely toward my employees' insurance rate hikes and state taxes we can no longer write off. As a small business owner, it was a net loss. We certainly went through our business expenses and started trimming - so much for "stimulus".
eagle2
01-30-2018, 07:54 PM
$1700 a month for an individual? That sounds extremely high to me.
KatyBoleyn
01-30-2018, 09:04 PM
$1700 a month for an individual? That sounds extremely high to me.
That was for our family of 4 on a silver plan. New rates are around $2200 for a Silver, or if we downgrade to bronze the cost stays the same. The cool part is that every doctor visit I've been to we've paid entirely out of pocket, so I'm not really clear what we pay for exactly. I think its $25,000 a year or so just in case someone gets cancer or a car accident. This is entirely unsustainable.
rickdugan
01-31-2018, 07:49 AM
That was for our family of 4 on a silver plan. New rates are around $2200 for a Silver, or if we downgrade to bronze the cost stays the same. The cool part is that every doctor visit I've been to we've paid entirely out of pocket, so I'm not really clear what we pay for exactly. I think its $25,000 a year or so just in case someone gets cancer or a car accident. This is entirely unsustainable.
Sadly, all of that sounds about right to me. I'm paying almost the same this year for a shitty Bronze plan for 5 where almost nothing is covered before a 7,500 per person/14k family deductible is paid. And you're right, it is unsustainable. Read my earlier posts to see what you are paying for, which is other people's healthcare. You don't get to use your own money to take care of yourself and your own family until certain favored classes are taken care of first.
But that is changing. This is the last year of the atrocious individual mandate. Next year, you will not be penalized if you ditch the $24k per year plan and just pay cash directly. To be perfectly honest, I am within a hair of doing that myself, even with the penalty this year. On top of the 24k per year I am now paying, a hospital now has its hand out for another 2k because one of our kids was referred there for further testing and IV treatment due to a bad case of the flu. But hey, at least that 2k comes off of my deductible, right? SMH.
Zofia
02-01-2018, 06:17 AM
Maybe if Amazon, Berkshire Hathaway, and JPMorgan are more successful, other large corporations will do the same thing. I've also heard of large hospitals forming their own insurance companies or merging with insurance companies, to reduce overhead. A lot of money paid to insurers goes to overhead that doesn't do anything to help the patients or providers.
As I wrote above, company/union insurance plans have worked and do work. It's not clear that they save great amounts of money, but they do save some. There are also examples of these plans that have failed or just not delivered.
As to overhead, no matter what kind of plan, private, company, or government, there is overhead. Someone has to review claims to see if they are covered, someone has to review claims to see if the amount is reasonable, someone has to write the checks to the providers. Even a single provider plan like the VA in the U.S. or the National Health Service in the U.K. has overhead. Every business has overhead. It's just a fact of life. The only real ways to cut health care costs are to reduce the services available, reduce what is paid for medicines and equipment, and/or cut the pay of the providers. In the U.S. system, there is certainly room for all three. But, I'm not willing to bet on anyone's willingness to really do it.
Z
eagle2
02-01-2018, 08:41 PM
That would be true about the claims with a fee-for-service system. With a managed-care system where providers were paid a set amount of money to provided all necessary medical care for the insured, there is a lot less overhead and there is a lot less incentive for providers to perform unnecessary procedures so they could bill more money. This would also be the case where insurance companies merged or bought providers, and there wouldn't be billing to the insurance company. There will most likely always be some overhead in healthcare, but the more overhead is reduced, the less money will be wasted. Doctors and hospitals spend a significant amount of time and money on billing.
KatyBoleyn
02-01-2018, 10:26 PM
As I wrote above, company/union insurance plans have worked and do work. It's not clear that they save great amounts of money, but they do save some. There are also examples of these plans that have failed or just not delivered.
As to overhead, no matter what kind of plan, private, company, or government, there is overhead. Someone has to review claims to see if they are covered, someone has to review claims to see if the amount is reasonable, someone has to write the checks to the providers. Even a single provider plan like the VA in the U.S. or the National Health Service in the U.K. has overhead. Every business has overhead. It's just a fact of life. The only real ways to cut health care costs are to reduce the services available, reduce what is paid for medicines and equipment, and/or cut the pay of the providers. In the U.S. system, there is certainly room for all three. But, I'm not willing to bet on anyone's willingness to really do it.
Z
Only in America are doctors' salaries some kind of sacred cow that can't even be discussed. European doctors are living the high life, driving the best car, having a beach house on the Riviera and a cabin in the Alps, and they make a fraction what US doctors make. They whine only because they have US doctor salaries to compare with to sometimes, but they still live head and shoulders above their neighbors.
I think one issue is that in Europe, medical education is highly subsidized or free in most countries. If you are capable of being a doctor, you will be a doctor if you want. The social contract is understood that you will owe some service to the state for this, possibly throughout your life. In the US, becoming a doctor is a long, expensive, and elitist process. This is understood by the public to mean doctors are justified in drawing 7 figure salaries in some markets and specialties.
Likewise with equipment. US hospitals (happily) pay absurd markups for their machinery.
Don't even get me started on Medicare abuse. Hubby had to wheel a patient into surgery who was 96 years old, in a coma for the last 2 months, on hospice care...to get his knees replaced. We can't say no to that because we'd be doing a "death panel" if we rationed care reasonably. In Europe, you would not hear anything like this, at least in Germany or Romania.
To fix our healthcare system in the US would require a fundamental shift in how we view and value healthcare providers. So long as their lobbying groups remain strong, I don't see that happening.
magicgembliss
02-01-2018, 11:46 PM
Don't even get me started on Medicare abuse. Hubby had to wheel a patient into surgery who was 96 years old, in a coma for the last 2 months, on hospice care...to get his knees replaced. We can't say no to that because we'd be doing a "death panel" if we rationed care reasonably. In Europe, you would not hear anything like this, at least in Germany or Romania.
Older white males are those who are making and maintaining the laws. They care more about "the best" :/ healthcare for the elderly and less about lower tuition costs for their grandchildren.