Healthcare

[Vecha]

So, didn't see a "healthcare" topic. For people to rant and rave about the "system"(whether US or otherwise).

Recently, my wife had to renew our healthcare plans(we get insurance from her employer). 

What ticked me the fuck off was what they told her, and a whole group of employees, about saving money(of course saving THEM money).

Basically said, "healthcare costs continue to rise...we want you to go to the doctor, but don't go if you don't have to."

Ok....WTF? Who the FUCK wakes up one morning and goes, "Gee, you know. I don't HAVE to go to the doctor, but I feel like people poking and prodding me"...and ok, ok, yes I'm sure there are some hypochondriacs that have to see a doctor every  time the temperature changes, but last I checked, we have a major prevenative care issue in this country. People don't go to the fucking doctor until their left arm is rotting off from cancer, or their coughing up black blood(not red).

On top of that, they raised premiums and blamed it on Obama(told them all this). BUT BCBS has a fucking monopoly here in Alabama. Many, HATE Obamacare down here. It used to be that BCBS was supposed THE best insurance company in like the 70s and 80s I guess(per my mother/grandparents) but now...fucking assholes.


Now, I'm not a Obamacare "fan" per se. I won't defend, but Jesus H. Christ I fucking HATE insurance companies.

Still pissed because they fefused to help my wife's TMJ issue(had to pay 2K out of pocket to have her fitting for a special mouth guard that DID fix all her pain and issues.) Guess they wanted to wait til there was more apparent damage.

Good 'Ole insurance companies...save a few dollars now and wait to PAY OUT THE ASS later. 

Ok rant done.


 

[deanb]

[Mister Jack]

I truly cannot fathom why anyone would be against the single payer system except for insurance companies.

[Vecha]

Fear of "socialism/communism/facisms/insertismhere"

Don't want to pay "other lazy people."

 

[staySICK]

I'm looking at around $2,000 so far.  Which is down from the $6,000+ my first kid cost. But that's before this one's surgeries over the next year and a half.

 

#TeamSinglePayer

[TheRevanchist]

Man, is Obamacare not looking good.

 

First, I've heard that between 1.1 million (source SF newspaper) and 4 million (source AP) had been dropped by their insurance companies due to the ACA this year.  When contrasting that with the 2 million people estimated that signed up for ACA coverage, the net is not a positive number.

 

Second, of those that have signed up, only a small percentage of those people have paid their premiums.  This means only a small number of people are covered of the 2 million persons estimate (on the high side 300,000 people covered).

 

Third, think of the signups in terms of sales of a console.  First, you have a big wave of people signing up for a console/health coverage.  You get your first million consoles sold. Then, the numbers start to slowly decline.  So, it's important to start strong out of the gate.     Since this didn't happen this year, as they only reached about 60% of their goal for signups, 2014 is expected to have less signups?

 

Fourth, of those who will get affordable insurance, there are some catches that have not been outlined.  Deductibles is the most hidden, I guess you would say.  Deductibles are what you have to pay out of pocket before you insurance kicks in to cover the rest of your costs.  For me, with a wonderful health plan through her work, our deductible is super low.  But, her employer pays a lot.  For those without such luxuries, deductibles on some plans are HUGE.  I put in some fake data on the HealthCare.gov website, just to see for myself.  The deductible for 2 people, age 35 (the default that appeared), in Oklahoma, making 35k per year, on the Bronze package, were ranging from $3,750 to $6,300 per person per year.  The insurance payments estimate was $267 per month.  Mind you, this was something I just tried once, so their may be there are better options to choose from, but not from what I heard reported from the news.  This isn't really affordable healthcare.

 

Fifth, there is something called an EPO.  An EPO is an Exclusive Provider Organization.  Meaning, you do not have a choice of what doctor you go see.  You will only use the doctors we tell you, unless it's a visit to the ER.  Don't get sick away from your EPO provider.

 

Now, the pundits are too nitpicky for me to even bother anymore.  They keep going on about the website and the fact no one has their insurance cards yet, which are things that won't affect the ACA in the long run.  And the Dems are acting as positive as they can about anything, 'We have a 30% approval rating on our website!  That's more than zero!!', but, again, they aren't looking at the long run. 

 

Have a nice day.  And don't get sick.

[staySICK]

Did OK set up the exchanges?  I know that's hurting the law and people, the individual governors that refused to set up the exchanges and let the ACA succeed or fail on its own.  Our governor refused the money and set up his own harebrained idea called KanCare.  Costing us more money and providing lower benefits than if he had just accepted the medicare expansion.

[TheRevanchist]

OK didn't, from what I saw. A lot of states did, though. To me, that makes it more confusing and just adds more bureaucracy to the mix, increasing the costs of overhead to taxpayers and the insured.

[staySICK]

the expansion is pretty evenly split -- 26 no to  24 yes.

 

http://www.npr.org/2013/10/11/231104643/faq-where-medicaid-s-reach-has-expanded-and-where-it-hasn-t

[Faiblesse Des Sens]

Okay so I signed up in my state a while back and now I'm unemployed. There's a question about having the same status for 2 months and yeah I will be unemployed for about that long so whatever. So after trying several times and dealing with pages not loading and crap like that I finally get my data all done. But now I can't seem to change plans. Whoever designed and runs these sites sucks. I'll try again tomorrow.

[TheRevanchist]

Wife on phone with Medical: "So, since he brings in $1642 a month from his pension and social security, he has a co-pay of $1052? How do people even live like that."

 

Social Services worker: "I wish I could tell you."

[Vecha]

That is some grade A BS....god this world us a cold one.

[deanb]

I don't even know what a co-pay is.

[TheMightyEthan]

It's what you have to pay when you go to the doctor.

[TheFlyingGerbil]

The uk term is excess. Do Americans use the term co-pay for all insurances or is it just for medical?

Edited November 18, 2014 by TheFlyingGerbil

[TheMightyEthan]

I've only ever heard it used for medical. It's separate from the deductible, which is the amount you have to pay before the insurance kicks in.

 

*Edit - So basically on insurance you'll have certain services that have copays, typically doctor visits and prescriptions, and that's the amount you pay each time you use those services, with the insurance covering the rest. A deductible is the amount you have to pay for non-copay services before insurance starts covering them. So even before I hit my deductible a doctor visit only costs me my $20 copay, but other stuff, like tests or whatever, you have to pay the full cost of until you hit your deductible. Once you hit the deductible there's usually some amount of coinsurance, which is a percentage you have to pay (often 20-30%). Then on top of that most insurance has an out of pocket maximum, and once you hit that they cover everything 100%.

[deanb]

Doesn't insurance cover that?

[TheMightyEthan]

No, that's the part insurance makes you pay, they cover the rest. If you don't have insurance then you just have to pay whatever the doctor actually charges.

 

*Edit - Though $1052 is an order of magnitude higher than any copay I've ever heard of before.

[Pojodin]

That's about what my dad was paying for when he was doing the preliminary stuff for his prostate surgery a few weeks ago.

[TheMightyEthan]

But was that his copay, or was that coinsurance, or was it an uncovered service?

[Pojodin]

I'm pretty sure it was copay. But I didn't realize coinsurance was a thing.

[Mr. GOH!]

Single payer is the only moral and ethical solution.

[TheMightyEthan]

I'm pretty sure it was copay. But I didn't realize coinsurance was a thing.

 

Yeah, like on ours right now we have a $750 per person deductible, but even once we hit that we still have 20% coinsurance until we hit the out of pocket maximum (I believe $5000 per person).  So even if we'd already hit our deductible, a procedure that was billed at $5,000 we'd still have to pay $1,000 of.

[deanb]

See I'm just glad I have NHS to rely on purely cos nearly everything Ethan has posted so far just makes me go:

 

I kinda go "so that's free, that's free, and THE CAR PARKING IS HOW MUCH?!?" (okay, there is still the base fees for dentists, but it's on the NHS site so pretty simple to work out. Glasses aren't covered except for usual welfare cases (which strikes me as a bit unfair, not like I chose to have shit eyes), and you pay for prescriptions but I'm pretty sure that's a straight charge that mostly covers the "admin" rather than the pills (I'm rarely ill though to notice a pattern in that. Generally been like £7-8 a pop. Obviously it's paid for out of taxes, but my understanding is you guys still have medicare paid for out of taxes too anyway, on top of that I'm certainly not paying $1000 a month in taxes.

[TheMightyEthan]

Well all those numbers I gave are yearly, but you also have your monthly insurance premiums.

 

Medicare is tax supported, but it's only for people over retirement age. Medicaid is also tax supported, but it's only for low income people (welfare, basically).