US Thanks, Obamacare

[Amy SF]

When I had medical insurance with my previous job, I started out with a premium of $250, which was just right for me. I had no problem paying it off early in the year, and I had good coverage for the rest of the year. After years of this premium, my plan suddenly eliminated the 250 premium and raised it to 500. It then became harder to pay it off and have full coverage for a good part of the year, but I managed. After a year or two at 500, my plan "suddenly" eliminated the 500 and raised my premium to $750. Which is fine if you have a spouse and/or dependents, but I don't have either. $750 became impossible to pay off early enough in the year and then have full coverage, which I think was the idea. I'd just keep paying out of pocket until the year was over. I didn't have that very long as I was fired very soon after this raise. And this BEFORE Obamacare. Obamacare had nothing to do with it.

 

[sleepydvdr]

When I had medical insurance with my previous job, I started out with a premium of $250, which was just right for me. I had no problem paying it off early in the year, and I had good coverage for the rest of the year. After years of this premium, my plan suddenly eliminated the 250 premium and raised it to 500. It then became harder to pay it off and have full coverage for a good part of the year, but I managed. After a year or two at 500, my plan "suddenly" eliminated the 500 and raised my premium to $750. Which is fine if you have a spouse and/or dependents, but I don't have either. $750 became impossible to pay off early enough in the year and then have full coverage, which I think was the idea. I'd just keep paying out of pocket until the year was over. I didn't have that very long as I was fired very soon after this raise. And this BEFORE Obamacare. Obamacare had nothing to do with it.

Starting in 2016, if you don't get insurance, the government will fine you between $695 to $2085, depending on your household income. You won't have a choice in the matter. That mandate comes directly from Obamacare. Isn't that kicking someone when they are down? If they can't afford insurance, they are financially punished for it.

 

[beancounter]

Well, also, depending on your income, you could receive fully or partially subsidized healthcare.

But the basic premise of the plan is that everyone will eventually need healthcare, so they should pay into the system that they will use at some point in their life.

 

[RabbitLuvr]

Your insurance company sucks. I can't believe they'd deny a PET scan. I mean I believe it, but it shouldn't happen. But who's to say that won't happen under Obamacare?

So Obamacare shouldn't be enacted because it might deny the same things that are already denied?
Idk if the PET scan would be approved under AHA or not, but I know in Canada the PET scan is covered, and standard care for those who need one.

When I had medical insurance with my previous job, I started out with a premium of $250, which was just right for me. I had no problem paying it off early in the year, and I had good coverage for the rest of the year. After years of this premium, my plan suddenly eliminated the 250 premium and raised it to 500. It then became harder to pay it off and have full coverage for a good part of the year, but I managed. After a year or two at 500, my plan "suddenly" eliminated the 500 and raised my premium to $750. Which is fine if you have a spouse and/or dependents, but I don't have either. $750 became impossible to pay off early enough in the year and then have full coverage, which I think was the idea. I'd just keep paying out of pocket until the year was over. I didn't have that very long as I was fired very soon after this raise. And this BEFORE Obamacare. Obamacare had nothing to do with it.

When you say you paid the premium, then had full coverage, do you mean after the $250/500/750 was paid off, you didn't pay any more out-of-pocket? If so, that's inexpensive for medical insurance. I also don't understand the "paying it off early in the year" part. My insurance premium is taken out of my paycheck throughout the year in 24 small payments.
My portion of my medical premium is $660/year AND I have a $4000 out-of-pocket. That OOP amount does not include office visit co-pays ($30 a pop), prescription drug co-pays ($4-30 each depending on the drug) anything the insurance company decides to deny, or anything they consider out-of-network.

Starting in 2016, if you don't get insurance, the government will fine you between $695 to $2085, depending on your household income. You won't have a choice in the matter. That mandate comes directly from Obamacare. Isn't that kicking someone when they are down? If they can't afford insurance, they are financially punished for it.

And if they can't afford the subsidized insurance premium, what will happen when they have a catastrophic health event that comes with a half-million dollar bill?

 

[rainforests1]

http://www.pbs.org/newshour/rundown/2010/09/health-spending-may-jump-new-report-says.html
According to this report, health care costs won't go up much or down because of Obamacare. If the Democrats and Republicans make claims that are opposite of each other, you should probably go in the middle. According to the report, this is the case. Neither side is telling the truth, as usual.

 

[RabbitLuvr]

Medical care simply costs too much in the U.S.

Something needs to be done to control and standardize medical costs.

After each chemo, I got a shot that boosts white blood cell production. I saw people online complaining that they were being billed anywhere from $400-$600 for each shot. My insurance was billed $12,000-$24,000 for each shot.* So not only does this thing cost way more here, I have no idea why the same shot, given in the same facility by the same nurse sometimes "cost" $12,000 and sometimes cost $24,000. And why does my injection cost so much when someone else's injection of the same exact thing only cost $600?


*It's literally just a shot. I checked in, sat down, got the injection in my arm, then left.

 

[beancounter]

Something needs to be done to control and standardize medical costs.

After each chemo, I got a shot that boosts white blood cell production. I saw people online complaining that they were being billed anywhere from $400-$600 for each shot. My insurance was billed $12,000-$24,000 for each shot.* So not only does this thing cost way more here, I have no idea why the same shot, given in the same facility by the same nurse sometimes "cost" $12,000 and sometimes cost $24,000. And why does my injection cost so much when someone else's injection of the same exact thing only cost $600?

I think I may understand what's going on. It's a combination of "two tier" pricing, and just plain old price gouging.

Earlier this year, I went to the hospital for a routine outpatient procedure. During the procedure, they took a biopsy which was sent to a lab for testing. For some reason, the lab didn't get my correct insurance info, so the claim was rejected, and they sent me the bill. They sent me a bill for $800. I called them up and gave them the right insurance info. A few weeks later, the bill passed through my insurance company. The charge to my insurance company was under $200. So, it's clear that insured people get charged one rate ($200), and the uninsured (what they assumed I was when the claim was rejected) a different, higher rate ($800).

But that's only one issue.

The second issue, is that a standardized/"mass produced" biopsy test shouldn't even cost $200....

 

[RabbitLuvr]

So, it's clear that insured people get charged one rate ($200), and the uninsured (what they assumed I was when the claim was rejected) a different, higher rate ($800).

But that's only one issue.

The second issue, is that a standardized/"mass produced" biopsy test shouldn't even cost $200....

And why would the uninsured patient be billed more than the insured patient?


I looked through my claims, and the total billed for six injections was $125,723. Insurance paid $25,228, the remainder was written off by the hospital.

Yeah, six injections should not cost $25k, much less $125k. I wonder how much I would have been billed if I didn't have insurance.

 

[beancounter]

And why would the uninsured patient be billed more than the insured patient?

Well, no doubt the biosy testing company would claim that the insured rate is based on a "volume discount" that's is, my insurance company said "we have X number of people in the plan who may potentially use your company, so we shouldn't have to pay full price". ..but that doesn't explain the difference between $200 and $800, so it's just blatent price gouging.

 

[RabbitLuvr]

..but that doesn't explain the difference between $200 and $800, so it's just blatent price gouging.

Yep.

 

[das_nut]

Really, I have a solution.

Most developed countries pay far less per person on healthcare. So, in the grand American tradition, I suggest we outsource all of our health insurance to some other country. I'm thinking Sweden has pretty good bang for the buck. Let them run a single-payer plan in the US.

 

[das_nut]

And why would the uninsured patient be billed more than the insured patient?

Because that uninsured patient is less likely to pay, thus the expense will be considered a loss. Now, if you're an accountant, wouldn't you want a bigger loss to file with your taxes to decrease your total tax burden?

 

[mlp]

Because that uninsured patient is less likely to pay, thus the expense will be considered a loss. Now, if you're an accountant, wouldn't you want a bigger loss to file with your taxes to decrease your total tax burden?

If that's part of the answer, it's an extremely small part. If that were true, someone who paid immediately would get some significant *cash discount*, and one certainly does not.

Those with insurance also get services that aren't covered by insurance at significant discounts over the uninsured. I remember being at the dentist's during one of the periods I had health insurance. As I was writing a check for the services, I was asked whether I had health insurance and I said that yes, I did, but the only dental services it covered were surgical ones. I was told it still made me eligible for a significant discount on my fillings and cleaning. Frankly it ****** me off.

 

[RabbitLuvr]

Because that uninsured patient is less likely to pay, thus the expense will be considered a loss. Now, if you're an accountant, wouldn't you want a bigger loss to file with your taxes to decrease your total tax burden?

An uninsured person might be able to afford to pay a lesser amount, but be unable to pay the higher amount they're billed just because they don't have insurance. And if the provider is only interested in a tax write off, why don't they also bill the uninsured person $200, and write off the remaining $600?

I just don't understand why, if a given procedure actually costs $200 to do, why they don't bill EVERYONE $200? Even if they're giving an insurance company a discount, they still need to be able to pay their employees, pay overhead, and report a profit to shareholders. There is no reason why any procedure, performed at the same facility by the same staff, should cost different prices, just because one person has insurance and the other person doesn't, or because one person has insurance a and the other has insurance b, or because one procedure was done on Monday and the other done on Tuesday.

 

[Wolfie]

Really, I have a solution.

Most developed countries pay far less per person on healthcare. So, in the grand American tradition, I suggest we outsource all of our health insurance to some other country. I'm thinking Sweden has pretty good bang for the buck. Let them run a single-payer plan in the US.

Might as well. We outsource everything else.

 

[Wolfie]

Sounds like you think our military is screwed up. And the interstate highway system is terrible. And it's dangerous to drink the water here. And polio is rampant.

Anyway, I have no idea how to get through to someone with this way of thinking. You say you don't want there to be some universal public insurance or healthcare system. Yet you say you don't want people to die in the streets.

Well, what's your answer? Seriously. What's your solution?

Because we don't have a universal basic healthcare system now. And we don't (for the most part) let people die in the streets.

So what we inevitably have is an emergency care system, which in fact everyone ends up paying for, and is the most expensive and least effective way to deliver and pay for healthcare. You're already paying for the "deadbeats" you don't want to pay for, you just pay for them when they show up in the emergency room. If you don't want them to die in the streets, and you don't want your tax dollars to contribute in any way to their healthcare, then what is your solution? A realistic solution that can actually be implemented, given the skills and limitations of real humans? Meaning, aliens don't get to come down and perform free healthcare for deadbeats. Fraud doesn't suddenly disappear from humankind - not going to happen. Angels don't come and sort through those who are deserving of healthcare and disappear those who don't so you don't have to see them dying in the streets. There will always be people whom you don't feel are deserving. But it doesn't seem like you want to see them dying in the streets either (or do you?). Please follow your thinking through to some logical conclusion! How do you reconcile not wanting to see people die in the streets with not wanting your tax dollars to go to anyone else's healthcare? And do you not realize you're already subsidizing them in the most inefficient and expensive way?

Well I'm still trying to figure out where I said some people aren't deserving. I said the waste needs to be stopped. If I visit an ER for something that's not an emergency my insurance won't cover it. I get the bill. Why should taxpayer-funded coverage be any different? I don't know what it's like where you live but here there is NO REASON to use the ER as a walk-in clinic. There are several clinics just for Medicaid. They will also take the uninsured and charge based on what the person can afford to pay. There is simply no reason to go to the ER for a paper cut (yes, they do that, among other trivial reasons) just because the taxpayers are paying your way. If someone has a true emergency, of course they belong in the ER whether they can afford to pay or not.

I see nothing wrong with wanting waste trimmed from other taxpayer-funded programs before raising taxes yet again to cover Obamacare. Again, I have to budget when I shop for groceries, but I guess I should be okay with people on foodstamps with carts full of stuff I couldn't afford if I wanted to. My budget doesn't allow for a giant screen TV. Why should someone in taxpayer-funded housing be having one delivered? Why should someone living off the taxpayers have cable TV? That's not a necessity.

I realize it's not possible to stop all fraud and abuse and misuse but does that mean we shouldn't try to stop part of it? Then those tax dollars would be free for other things, like maybe funding Obamacare in part. For those that think entitlement abuse isn't that common, I invite you to my place and I can show you what I see/hear all the time. It's more common than you think. I know people who have made living off others a way of life for years. Yet I should be happy my taxes will be going up again. (I don't buy for second he's only raising taxes on the super wealthy.)

Maybe I seem a bit sour. But I have paid into all these supposed safety net programs for YEARS. Almost a year ago I lost my job due to outsourcing and found I wasn't eligible for any kind of help, even for a short time, because I didn't have kids. So my money is good enough to take all those years yet I can't benefit from the safety net it was supposed to fund. No food stamps, no grants for school, nothing, because I failed to reproduce. It's all reserved for the single moms. So yes, let me keep my money and fund my own dang future, thanks. I am not saying single moms and their kids should starve, like some of you will read into my rant. But why they can live better off taxpayer money than some taxpayers can live themselves is beyond me.

I did find another job. I don't make quite as much as before but I get by. And I make sure any money I donate to the less fortunate goes to those that fall through the cracks. But go ahead, add one more tax-funded program for the government to mismanage. Let's hope when the money starts running out, and it will, they don't start picking and choosing who deserves care more.

 

[Wolfie]

I can't edit for some reason. I just was going to add, I have to meet certain standards or I pay more for health insurance. Is Obamacare going to be that way too, or should we all chip in for the smokers and those who eat terrible diets and just happily pay our increased taxes?

 

[beancounter]

Maybe I seem a bit sour. But I have paid into all these supposed safety net programs for YEARS. Almost a year ago I lost my job due to outsourcing and found I wasn't eligible for any kind of help, even for a short time, because I didn't have kids.

You weren't eligible to collect unemployment?

 

[Digger]

Maybe I seem a bit sour. But I have paid into all these supposed safety net programs for YEARS. Almost a year ago I lost my job due to outsourcing and found I wasn't eligible for any kind of help, even for a short time, because I didn't have kids.

I know how you feel. I've worked hard my entire life and paid into these programs for over three decades but when I lost my job as a result of a rare congenital heart defect I found that I wasn't eligible for most assistance programs in my state because: a) I chose to go back to school rather than collect disability, and b) I am single. Single persons are no longer eligible for assistance in PA regardless of disability, which has put many folks out onto the street. You pretty much only get help here now if you pop out babies and don't do anything to improve your circumstances.

 

[mlp]

The fact that adults who don't have children are left out of what social safety net we have is almost always overlooked by those who insist we are already doing right by people. I think the answer is to make things more equitable for everyone, not to get rid of benefits.