The Major Reason You Can't Afford Medical Insurance

a reply to: Christosterone

Then educate me.

a reply to: Kettu

True, if you have cancer or need a major surgery and you have no insurance, have fun.

A friend of mine needed a kidney transplant and even with average insurance, the hospital demanded a $5,000 certified check before they would cut, even with insurance.

We are hip deep in trouble. As a country we have allowed this medical "industry" to get way out of hand. Insurance costs so much because hospitals charge so much. It is that simple. Now the reasons are deep and complicated.

If corp America would have kept the rate of sharing productivity gains with the workers, a one person working household could be possible, with all the benefits that the baby boomers enjoyed. But trickle down econ is a fallacy.

a reply to: seasonal

Costs are higher here because they're lower everywhere else.

Profits have to be made up someplace...someplace that will just roll over and take it.

And that place? It happens to be America.

a reply to: Kettu

Are you talking about the cost of my carpal tunnel surgery costing $7500 becasue it is $2700 in Canada?

Or are you talking pharmaceutical drugs?

a reply to: Kettu

That is true, The US person pays for the drugs to be developed and sold to the rest of the world at a fraction of US cost.

Same with the US military functioning as the western worlds military.

a reply to: seasonal

You are right on point with your assessment, seasonal. It's really simple why medical care is so expensive here. It's because most physicians, hospitals, and pharmaceuticals, get paid what they want.

Americans are fighters and spoiled. We have a low tolerance for pain or sickness (spoiled). And we demand that the pain/sickness be eliminated ASAP...like RIGHT NOW! (Fighter).

One reason people on individual/family ObamaCare health plans are so pissed off is because those plans are not accepted by a growing number of physicians. Why? Because those plans pay physicians 20% to 30% less than what a Group/Employer health insurance plan pays. So, doctors who can afford to "cherry pick", don't accept "Obamacare" patients. There's nothing in the law that forces them to.

But, if the Trump administration allows health insurers to resurrect the "Grandfathered" (pre-2010) plans, the doctors will come flocking back. The less-healthy people who don't qualify for the newly resurrected plans will be moved to Medicare, along with the seniors. Physicians don't like Medicare pay either, but it's not as low as what Obamacare plans pay.

a reply to: carewemust

I agree with everything but the fighters and spoilers.

I have worked with guys that have torn ACL's, my mother inlaw has a benign tumor on one knee, and a torn something on the other, her husband has something seriously wrong with his back.
Most of the pain that people are going through is becasue it is so expensive to get treatment. So they limp, crack and just deal with it. I imagine some have seen different things, but my experience is kinda the opposite.

Americans are fighters and spoiled. We have a low tolerance for pain or sickness (spoiled). And we demand that the pain/sickness be eliminated ASAP...like RIGHT NOW! (Fighter).

a reply to: jellyrev

That maybe true, but that doesn't explain the cost of "simple" out patient surgeries. That seems to be charge what we want.

That is true, The US person pays for the drugs to be developed and sold to the rest of the world at a fraction of US cost.

a reply to: Aazadan

That I agree with.

The premium structure of insurance just doesn't work. The only part of it that does work, is the ability to negotiate lower rates due to purchasing services in bulk. The insurance system just isn't viable.

originally posted by: seasonal
a reply to: carewemust

I agree with everything but the fighters and spoilers.

I have worked with guys that have torn ACL's, my mother inlaw has a benign tumor on one knee, and a torn something on the other, her husband has something seriously wrong with his back.

Most of the pain that people are going through is becasue it is so expensive to get treatment. So they limp, crack and just deal with it. I imagine some have seen different things, but my experience is kinda the opposite.

Americans are fighters and spoiled. We have a low tolerance for pain or sickness (spoiled). And we demand that the pain/sickness be eliminated ASAP...like RIGHT NOW! (Fighter).

I went on a fishing trip in Canada 3 years ago. Our guide kept grabbing his groin in pain and pressing in. Stan had lifted a canoe, and got a hernia, 2 weeks earlier. Was on a "waiting list" for his FREE hernia surgery. The Canada Health Department (or whatever it's called) estimated that he'd be operated on 6 weeks after the injury. In the meantime, this poor bastard had to keep pressing a part of his lower intestines back into their cavity, if he moved the wrong way, or lifted something.

The best scenario would be FREE (to the patient) and INSTANT medical treatment I suppose.

a reply to: carewemust

There was a guy I worked with that had to wait for 3 months for his hernia to be fixed. He had to save up for the co pay, oh ya he was paying $785 a month for insurance as well. Either way you can get to play the waiting game.

a reply to: seasonal

Right, so you're bringing up the worst-case scenario again, and using that to imply that we should be happy being forced to purchase insurance for the entirety of our adult life (unless parents let their children suckle at their insurance teat until they're 26).

That's what a health savings account is for--that is your back-up in case things happen. If I didn't have to shell out the $500+ each month for medical/dental/vision insurance, do you realize how quickly I would build up a health savings account? And that would be all my money, to use when I saw fit for medical issues and procedures.

Right now--like I've mentioned before--I'm paying slightly over $6,000/year just for insurance that I use maybe 1.5/year on average, dental coverage that I only have to use for semi-annual check ups, and vision where I go in once per year and MAYBE take advantage of the coverage on frames and lenses once every three years. And that annual total doesn't include co-pays.

You can disagree all that you want, but a federal mandate that forces me to purchase health insurance shouldn't exist. If my choice for my own well-being is to have only a health savings account that builds up over time--maybe coupled with a catastrophic insurance plan as I get older--then that should be me own choice.

And the costs keep going up because everyone is insured, to include people with pre-existing conditions. When you have people suddenly enter the pool of coverage that cost exponentially more than, say, a person like me at this moment in time, then of course the insurance rates are going to increase. The claim during the push for the PPACA that insurance rates would decrease AND all with pre-existing conditions would be covered was known to be a pipe dream to anyone with half a brain at the start of all of this, and now we're reaping the results of that stupidity.



a reply to: seasonal

I know a lot of people who need surgeries and get in within a few days, if not immediately when it is determined that surgery is required.

Again, we can always spout out these anecdotal stories to try and prove a point, but the extreme examples of stuff are not the general norm in the American healthcare system.

a reply to: carewemust

It's like that everywhere in America, although some states getting hit harder than others. It's a sad reality, and it's all because of the PPACA, I don't care what Obamacare apologists say to try and spin that reality.

a reply to: Kettu

That absolutely is a massive contributing factor to the cost of our prescription drugs, but it really doesn't bleed over very much into other things--at least, not to the same extent from the research that I've done.

The thing that hurts the total cost of hospital care (and it's still the same concept) is that there are many people who refuse to pay medical bills, thus transferring the cost to those of us who can/do (and don't believe that some who don't pay do so because they can't). That, plus the fact that we are one of the leaders in R&D in the medical field for the entire world, and all of that costs money that must be collected somehow--and again, it generally falls on those of us who pay medical bills (at least the amounts that aren't covered by investors...which in turn makes the cost of their products/services increase to recoup the initial investment amount, etc., etc.).

And yet, people who benefit the most from all of these medical advancements decide that the best thing to do is complain ad nauseam about the cost of their life-saving procedures. I get it--the cost to save your life can suck sometimes, but at least you're not dead.

originally posted by: carewemust
You are right on point with your assessment, seasonal. It's really simple why medical care is so expensive here. It's because most physicians, hospitals, and pharmaceuticals, get paid what they want.

Some do, sure--especially those who create monopolies in one area and have no competition. But more often than not, hospitals charge what they need to charge to stay in business, and many hospitals are bailing out water from their fiscal boats year in and year out.


My mom is an RN who has worked her way up to managing multiple departments in a hospital--they're not just raking in the dough because they can. Often times, they don't have enough funding to get necessary supplies.

Let's not make broad, generalized comments in an attempt to demonize hospitals as some money-hoarding monsters, because most of them are not.

One reason people on individual/family ObamaCare health plans are so pissed off is because those plans are not accepted by a growing number of physicians. Why? Because those plans pay physicians 20% to 30% less than what a Group/Employer health insurance plan pays. So, doctors who can afford to "cherry pick", don't accept "Obamacare" patients. There's nothing in the law that forces them to.

This is the same for Medicare/Medicaid, as well. Noticing a common link between all three?

But, if the Trump administration allows health insurers to resurrect the "Grandfathered" (pre-2010) plans, the doctors will come flocking back. The less-healthy people who don't qualify for the newly resurrected plans will be moved to Medicare, along with the seniors. Physicians don't like Medicare pay either, but it's not as low as what Obamacare plans pay.

Ah, so you already understand what I noted above.

This is the way that it should have been--Medicare and Medicaid should have been expanded in a way that allowed people with pre-existing conditions and other factors that kept them from getting "normal" plans before the PPACA--this would have been cheaper in the long run, and would have kept those who could afford to keep and were happy with their original plans happier as well...like my dad, who lost his doctor of >30 years because, once the PPACA kicked in, his doctor was no longer in his network. For someone who is in their 60s, it's pretty important to be able to retain a doctor that has decades of knowledge concerning your health. The PPACA destroyed that for many people.

And let's not forget the insurance companies who went out of business because of the PPACA and all of those jobs lost because of it. Resurrecting the pre-PPACA plans would be great, but some of those insurance companies don't exist anymore, and probably can't afford to resurrect their company if that happens, meaning we'll still be left with less competition in the marketplace.

I really hope that the Trump administration removes the inability for people to buy coverage outside of their state--to me, that's the most ridiculous limitation to competition in the insurance industry (or, at least, on of the biggest).

A comment about hospitals charging what they want:
9 years ago I got sick, very sick, and the doctors asked me "how long you want to live?" I replied "80".
They took out my stomach.
12 days in the hospital, various infections and treatments (which did not work, I had to sign myself out to get home to my herbal remedies). We were also charged for items we did not use (drugs, equipment, etc) to the tune of a couple thousand bucks.
The bill was staggering.
BUT my husband did some digging and discovered that the insurance company NEGOTIATED with the hospital to lower the charge.

It would have hit our savings hard, but we could have paid for the whole thing ourselves at the discounted rate.

If we could take the money we pour into insurance and just save it, we could afford any care we wanted. Husband's company won't allow that, though.

a reply to: SlapMonkey
The medical industry is a monopoly. It is so expensive that people are terrified of getting sick and are forced to get insurance or live your life with a possible chance of getting a huge bill. If you are the one to get sick and require a bit of help from a hospital , you very well could be working for the hospital literally for the rest of your life. Or pay what is the equal of a mortgage on a very nice house for insurance (+co-pays+deductions+......).

Medical is an inelastic product or need a definition below.

What is 'Inelastic'
Inelastic is an economic term used to describe the situation in which the quantity demanded or supplied of a good or service is unaffected when the price of that good or service changes. Inelastic means that when the price goes up, consumers’ buying habits stay about the same, and when the price goes down, consumers’ buying habits also remain unchanged. Read more: Inelastic Definition | Investopedia www.investopedia.com... Follow us: Investopedia on Facebook

Means they got you by the short hairs. Pay up or well you will die. Life isn't fair, and I know. But other countries are light years ahead of the US when it comes to how this life saving services regulated and dispensed. We need to figure this one out.

Some do, sure--especially those who create monopolies in one area and have no competition. But more often than not, hospitals charge what they need to charge to stay in business, and many hospitals are bailing out water from their fiscal boats year in and year out.

yes. thank you. a reply to: crayzeed

a reply to: TruthJava

Yep great points. If we can give our millionaire congressmen life time pensions and full benefits I think we can work this out for the regular "joes".
The medical monopoly is a racket, that I am thankful is there. I am well aware if you have cancer and no insurance, have fun, e-rooms don't do chemo.

originally posted by: Christosterone
My wife is a physician(MD, FACEP)...

The reason healthcare costs are through the roof is a direct effect of the affordable care act...

It's causality...

-Chris

you do realize that healthcare costs were "through the roof" before the ACA, right?...that's why millions of people didn't have coverage at all.....maybe your doctor wife can enlighten us on the "causality"