Upoming health care reform

a reply to: veracity

Here's one interesting story ..........

10 Statistics on Hospital Labor Costs as a Percentage of Operating Revenue

I just see all of those grinning politicians pushing Obamacare into existence and a snarl of hate forms on my lips.

Back a few years ago before I abandoned common sense as most call it. I was well employed as the network/systems admin for a mid sized company. Some investment company bought them up and this was just as Obamacare was kicking in. Everybody had to sign up for the new insurance (I wasn't one, I left the company around that time).

But I did hear a lot from the people I knew when I worked there about the new insurance. The coverage was much less and the costs were noticeably higher. This would cause most to not use their insurance unless it was absolutely necessary yet insurance companies were getting more money. That was when it was the cheapest it was going to be. Now it is more expensive.

Me, I had one well paying job since then for ta dee oh dee related company. A place I left for ethical reasons that have to do with conspiracy subjects often mentioned here. Buh bye insurance, hello penalty fine for being poor. Like I really need to pay my fine when I already don't have any money. I have zero insurance and I'm fine with that. If my body fails or is broken so be it. It's my choice. But to be fined for not keeping insurance on my body for the sake of the deep state because they spent all the tax money, they spent all of the social security money, the post 911 federal reserve vampire fest of financial rape. The have the audacity to say they want more...

There is something truly evil behind what we call Obamacare. I mentioned in the thread about taxing robot workers where Bill Gates thought it was a fine idea. Knowing more than I want to about Bill Gates I was suspect when I saw he was prying his way into the medical field. Bill would suck the devil's wee wee dry for more money.

F them and the F'ing horse they rode in on. Trump better get his head out of his ass and put this # down with prejudice. Use the people if he has to. Many of us would go and drag them from their offices. The reason he was elected was the growing desperation of the populace. He chose his method to be elected (populism) and he best perform. He grabbed the tiger by the tail. His choice.

Trump may just do the same ole same ole but people are getting real tired of hoping the politicians will act on the will of the people. Next, the people will act on their own.

a reply to: Aazadan

I'm sorry, but you have been fed too much bad information for me to give feedback in the 30 minutes that I have available.

a reply to: carewemust

Like what? Give me the cliff notes version and expand on it later. The information for both plans comes from the series of interviews Sean Hannity has been doing with members of Congress on the subject for a couple weeks now.

a reply to: Apollumi

For as bad as the ACA is, no one has come up with a better idea in the US since the 80's. It was the Heritage plan from 1988 until 2008 and it's what the ACA essentially compromised into. Even the current House leadership is offering the exact same thing, 9 years after 2008.

This has been basically the only thing anyone has been able to "agree" on for close to 30 years now. They've begged the people for better ideas, and they can't come up with anything despite the fact that physicians make up the second largest profession of anyone in Congress with 21 members (second only to lawyers), and almost all of them are currently Republicans who campaigned against the ACA.

Health care is complicated, go figure.

a reply to: Aazadan

The problem is that people like me cannot afford major medical issues.
After paying hundreds per month for a crap policy, people like me don't have over $6000 [deductible] to spend should something major happen.

They lied about the cap on medical spending for individuals.
They lied about costs going down.
They lied about keeping your doctor.

Drug prices are soaring.
Medical costs are soaring.
Premiums continue to go up, both by age and annual %.

They need to address tort reform, drug prices and do something to LOWER costs.

a reply to: DontTreadOnMe

I would disagree that they lied. I'll certainly not debate that things didn't work out the way they said they would, but I think it was an honest error.

One of the big problems when the ACA came out is that they assumed people that were already paying for health insurance, actually had proper health insurance. No one (except the insurance companies who had the data) thought they were going to get screwed when a minimum standard was created for procedures covered. In reality, most people didn't meet the new insurance requirements and saw massive increases because they were previously under insured.

I think that cost is here to stay, maybe there's a way we could get rid of it while still covering people, but I can't think of one. And I don't think one has been proposed either.

The current bronze plans shouldn't exist though IMO. The deductibles are utterly ridiculous and prevent people from actually using what they're paying for. The point is to give people health coverage without it financially ruining them, $6000 in your case or up to $15,000 in the case of some people before any benefits kick in just doesn't work.

They lied about keeping your doctor, but your doctor was always a function of what insurance plan you had, so it was pretty much unenforceable from the start.

The big one though has to do with cost increases. You may not remember this, but for several years leading up to 2008 health insurance premiums were going up annually, and they were projected to skyrocket a few years into the future. That's one of the big reasons health care was such a big issue in the campaign. Every study that has looked at the issue has concluded that the ACA reduced the speed premiums were increasing.

The ACA isn't perfect, but a large chunk of current people who don't have access to healthcare are those who fall into the medicaid gap which is a completely manufactured problem since the feds are subsidizing it for any state that wants the money. There are issues like yours where bronze plans completely screw over the customer which need to be fixed too but that's not going to happen without more rate hikes.

As far as drug prices go, what are they supposed to do? That's not something we can fix with health insurance legislation. We're effectively subsidizing the costs of the rest of the world right now. That's something we can only fix with patent legislation and convincing other nations to buy our drugs at full price rather than generics for a couple cents each. Needless to say, I don't think this is ever going to happen.

a reply to: Aazadan

Short answer.....many people like me HAD good insurance....but were kicked off for cost-savings by employers.
Those of us with these HUGE deductibles...the Bronze plans...have them because we CANNOT afford Silver plans....the premiums, even with subsidies are FAR too costly.


When drugs go up 100 to over 1000% ...and some have been rising for years.....that is because the drug industry has been monetized.
I don't buy the story we are paying for drugs in other countries.
And yes, unACA should have addressed the drug costs.

I worked for BlueCross. I spoke to sales executives, underwriters, actuaries, I have a good grip on the healthcare business.

Basically speaking, in rough numbers, health care premiums break down like this;

85% - directly paid to claims.
10% - overhead.
5% - profit.

Any attempt to stem the tide and reduce costs that looks at squeezing the 15% is a waste of time.

You have to attack the 85%.

There are only 2 components to the 85%, the patient and the provider.

We all know that asking Americans to put down the smartphone and Cheetos and work out is not going to happen so,

You have to get the costs down that the providers charge, and you can only do that from a leveraged position, and nothing is more leveraged that a monopoly.

Single payer is the only way out.

Single payer is not socialism, that is what the insurance lobby wants you to believe, single payer is a monopoly that would make Cornelius Vanderbilt blush.

It should be done in waves, and you should let people have private insurance if they want, but you can do it in 3-5 years.

It wouldn't be fair to the healthcare providers that just finished school and have $100,000 in debt, so I would take some of the savings from the system and offer those folks loan forgiveness over 10 years or so, not the full amount, just relief.

a reply to: DontTreadOnMe

What do you propose to fix that though? Premiums were going up, your employers would have kicked you off your insurance anyways. That's a story that had been replaying throughout the US through all of the Bush years. As soon as the baby boomers started hitting 50 that happened.

What do you consider to be too costly? According to the government, you should be expecting to spend 5% on health insurance. If you're above that right now, is it simply a case of the subsidy being too low? In which case we need tax increases to bring it up. Or is it a case of treatment being too expensive? In which case we need to start price fixing the market like Japan did.

a reply to: DontTreadOnMe

please watch the video I posted, tort reform does nothing

originally posted by: Aazadan
a reply to: Apollumi

For as bad as the ACA is, no one has come up with a better idea in the US since the 80's. It was the Heritage plan from 1988 until 2008 and it's what the ACA essentially compromised into. Even the current House leadership is offering the exact same thing, 9 years after 2008.

This has been basically the only thing anyone has been able to "agree" on for close to 30 years now. They've begged the people for better ideas, and they can't come up with anything despite the fact that physicians make up the second largest profession of anyone in Congress with 21 members (second only to lawyers), and almost all of them are currently Republicans who campaigned against the ACA.

Health care is complicated, go figure.

I understand your perspective. I only want to say that it is a trap. So many times government entices the people into a little more slavery by letting them think they are being done a favor. There is no good intent here and people may sing a hallelujah at the thought of it but the implementation should get the gears going.

Look at society these days. How do you think we got here, so hateful to one another and so judgmental. Go ahead, add one more burden. What could it hurt.

a reply to: Aazadan

Well, the premiums, with subsidy, were closer to 10% than 5%....and with the HUGE deductible....it was no insurance at all for having pneumonia and the like.
It covered nothing.

What I think should be done is something along the lines of, but TOTALLY separate from, Medicare.
Have a reasonable premium....say 5% of income. And have it cover 70-80% of your insurance. With a maximum out of pocket TBD....and a reasonable deductible....say $1500.
If you want anything else, you get a supplement package similar to Medicare Advantage.

Basically single payer.

And, drug prices rolled back and/or controlled.

Medical prices need to be controlled in some way as well.....especially hospital stays.
Something needs to be done with the horrendous bills for med school....and the outrageous incomes/salaries in medicine.

I wonder if we went to single payer and instituted a health-care tax on businesses to help cover the cost. Since businesses wouldn't be shouldering the burden of dealing with insurance and all the red tape that goes with it.Something needs to be done,I just don't know what it is.

a reply to: syrinx high priest

Your premium distribution is spot-on. 85 cents of every premium dollar paid, goes to pay claims. In fact, ObamaCare requires that insurance companies pay 85% of every premium dollar to medical claims, or they have to refund any excess back to the premium payers-insureds. (The ObamaCare rule/terminology is "Medical Loss Ratio" requirement)


You'll run into problems though if you allow PRIVATE insurance to co-exist with Single-Payer/Socialized healthcare. The BEST doctors won't accept patients who have "government" insurance, due to it paying them less than private insurance.

We're seeing that occur right now.

If you have Group, Non-Obamacare health insurance at work, almost every doctor will see you, and be glad to see you!

If you are one of the 9 million people who have an "ObamaCare" policy that you own and pay premiums for, roughly 40% of physicians and hospitals will not accept you, due to those plans paying physicians 20%-30% less money than Group Employer health insurance does.

If you are one of the 11 million people on ObamaCare Medicaid (it's FREE BTW), you're losing physician choices at an incredible pace. Here in Chicago, only 6 out of 100 physicians are accepting ObamaCare Medicaid. They are either brand new, or have a really big heart. Medicaid gives medical providers a 40% income cut, on average.

Those 20 million people are dwarfed by the 263 million who have health insurance by other means (Work, Veterans, Retired Military, etc..). The HEALTH INSURANCE aspect isn't that big of a deal, when looking at the overall population. I mention that, because when you see all the attention ObamaCare is getting, you'd think that most of country is directly affected by it. If that were the case, it would have been repealed/replaced in 2014/2015.

I can tell you about HSA's. They only apply in a high deductible plan. For a single person, you pay all medical costs each year for the first several thousand in costs, then get covered at 80% after you meet your deductible for the year. It works ok if you never get sick or you hardly ever visit the doctor and save the max each year if you can so that you can pay the deductible in a year you need to. Before Obamacare, I had a PPO plan and simply paid a deductible and roughly 20% of everything beyond a small deductible.

Some other problems I know of is that insurance companies can deny paying the full 80% they are supposed to pay. They can claim it was out of network or unfair and unreasonable. I once had a bicycle accident and was taken to a nearby hospital unconscious. The insurance company refused to pay the full 80% they were supposed to claiming a hospital 78 miles away had cheaper rates. I was unconscious and had hit my head. They denied my appeal.

I heard many others get treated for emergency treatments or even standard procedures and the hospital system does not watch out for consumers. Insurance companies deny paying if doctors are out of network and many times hospitals arrange several doctors to see a patient. It's like highway robbery getting treated at a hospital. If they do pay, it might only be 40% or less. If you had a procedure that cost $250,000 or had a heart attack or something else, you could lose your house unless you are well off or lucked out and only owe 20% or only 25% if they don't deny too many charges. Well maybe not lose your house unless it was a really big procedure.

Routine preventative care was covered if the doctors code everything correctly and file it correctly with the insurance. Things like one physical a year. Doctor visits still cost 100 bucks a visit. I've only seen the doctor 2 or 3 times in the last several years as a result.

originally posted by: orionthehunter
I can tell you about HSA's. They only apply in a high deductible plan. For a single person, you pay all medical costs each year for the first several thousand in costs, then get covered at 80% after you meet your deductible for the year. It works ok if you never get sick or you hardly ever visit the doctor and save the max each year if you can so that you can pay the deductible in a year you need to. Before Obamacare, I had a PPO plan and simply paid a deductible and roughly 20% of everything beyond a small deductible.

Some other problems I know of is that insurance companies can deny paying the full 80% they are supposed to pay. They can claim it was out of network or unfair and unreasonable. I once had a bicycle accident and was taken to a nearby hospital unconscious. The insurance company refused to pay the full 80% they were supposed to claiming a hospital 78 miles away had cheaper rates. I was unconscious and had hit my head. They denied my appeal.

I heard many others get treated for emergency treatments or even standard procedures and the hospital system does not watch out for consumers. Insurance companies deny paying if doctors are out of network and many times hospitals arrange several doctors to see a patient. It's like highway robbery getting treated at a hospital. If they do pay, it might only be 40% or less. If you had a procedure that cost $250,000 or had a heart attack or something else, you could lose your house unless you are well off or lucked out and only owe 20% or only 25% if they don't deny too many charges. Well maybe not lose your house unless it was a really big procedure.

Before ObamaCare changed the rules for the worse, you could get an HSA with a $1500 deductible. Once that deductible was met, the health insurance paid 100% of all medicals costs. If you didn't use the money put into the HSA account every year for medical care, it accumulated, and would build up a nice nest-egg that could be used for ANY purpose at age 65. I hope the freedom to do that, along with the $1500 deductible returns. Young people loved them, because the monthly premium was so low... about $170 a month.

My deductible with an HSA was somewhere around $4600 or $5500, very high. I originally signed up for a 90% plan after that but my company dropped it. Then I only had 80% after the deductible if I have something major. HSA's accumulate but only for medical expenses and they penalize you extra in addition to taxes if you withdraw funds for other purposes I thought I read.

Our health care costs are very high. Most people have no way to compare costs. There isn't much competition. A single aspirin pill in the hospital can cost $25 a pop, same for every other pill. A bunch of doctors have to approve medication while in the hospital. Everything costs an arm and a leg buying through a hospital.

My monthly premium with an HSA plan was only about $142 a month as a single person but I hoped I never got sick. If I did $100 for the doctor, plus I paid for medicine out of pocket usually $50 to $100 for an antibiotic or whatever. I did get mailed some kind of prescription discount card that saved me money for those without insurance. It worked because I never reported $75 to $100 in medicine once a year or every few years.

a reply to: orionthehunter

I seriously thought about doing the HSA plan, its a nice option, but for just about $60 more a month I could do the other plan.

Question:

Did you find at the end of the year that you saved up lots of money? Could you use it on what you wanted?


I always thought the monthly contributions to HSAs should be a little lower to be more appealing.

originally posted by: carewemust
You'll run into problems though if you allow PRIVATE insurance to co-exist with Single-Payer/Socialized healthcare. The BEST doctors won't accept patients who have "government" insurance, due to it paying them less than private insurance.

It already does coexist with Medicare, though.
And it has been working for decades.

Which is why I think a separate system for non-Medicare citizens could work...as long as it was totally separate from Medicare.