What is a FAIR Health Insurance Premium for a 5700 Deductible.?

originally posted by: seasonal
a reply to: xuenchen

Would 18% be enough?

Could be.

If they "centralize" everything, Medicaid goes away, the VA goes away, employer paid insurance goes away, and Medicare "handles the whole thing etc. etc. and maybe dental and eyes get included.

google: " total medical spending "

then find what the total u.s. payroll is (if possible)

a reply to: xuenchen

Ok, I misunderstood. With some semblance of controlling and negotiation costs this is very possible.

I give your very good idea a 0% chance of even being considered.

originally posted by: peter_kandra

originally posted by: leolady
a reply to: carewemust

If a families monthly medical premium is $283/mo, they are already paying out $3,396 per year, should that not cover their regular routing doctor visits with no extra charges ?

If each individual's deductible is $5,700 on top of that, they are likely never going to be covered by the insurance plan if they are generally healthy and only need to goto the doctor for routine visits and occasional illnesses that come up through out the year. If a generally healthy individual goes to the doctor in this situation, they have been paying their monthly premium of $283.00 and when they goto the doctor insurance doesn't cover them, they get slapped with a bill for $100 to $200 on top of their mo premium and on top of a copay paid at time of doctor visit each time they goto the doctor. This is not affordable for avg/below avg folks. They are only going to get coverage if they get really sick and suddenly have bills that max $2396 + $5700 ...what is the likelihood of that ? If one individual in the family gets really "sick", they have to pay out $8,096 before anything is covered.

Why is it that the monthly premium doesn't get used to help pay for bills ? The money goes into the insurance system but there is zero value in it for the patient. It's just going into the abyss as soon as its paid out, it appears that it has no value at all in any way for the patient. I think $283.00 is plenty to cover one regular simple doctor visit...why on top of that does their have to be new bills and because a "deductible" has not been met the patient still has to pay money out of pocket.


The deductible should go back down to $100 to $200 for only certain types of services or nothing at all...the monthly premium should cover them and the insurance needs to do what it was intended to do, cover individual/family. Otherwise its becomes a money pit where we place a high percentage of our income but never get anything back from it.



leolady

As to whether or not regular doctor visits are covered, it depends on the plan. My current plan covers 3 or 4 doctor visits per year and 1 or 2 specialist visits for my wife (gyno visits). For this plan, I have the pleasure of paying close to $1,100 per month. Pre-ACA (as recently as 2014 I believe), the same policy was about $500 a month. Yes, I understand that health care costs have been rising for years, but each year, we price shopped and was easily able to find a policy with the coverages that we needed and wanted....affordable co-pays and deductibles, etc.

Even if rates had gone up 10% a year from 2014 to now, I'd be paying in the $665 to $675 per month range now. If rates had gone up 15% a year, I'd be paying in the $750 to $760 per month range. Both are more than I'd like to pay, but either would allow me to have more of my money each month...$300 to $400 more.

The government's own numbers (ignored by Democrats) indicate that ObamaCare health premiums have gone up a whopping 105% in just the past 3 years. So you're right in the middle of ObamaScrew hell, Peter.

If Congress can't repeal this horrible law, at the very least they should open up the free-market again, so healthier people can buy only what they need. Those plans would include all Doctors/Hospitals...just like most employer health plans.

If HHS Secretary Tom Price isn't a Swamp Creature on the inside, he can open up that market by himself...instantly.

originally posted by: WUNK22
Health care is a right according to the Bernie bots, a magic fairy will cover the bill. We see how good it worked in Vermont. I just want my old doctor back!

I heard Bernie Sanders speak about this and he says that if you model the programs after other countries where healthcare is a right and is working, then it will work. Right now (Bernie says) the only people benefiting are the drug and insurance companies. You are doing it all wrong.

a reply to: InTheLight

This is the same Bernie who wanted to figure out how to tax us all for an extra $18T every year, yes?

This is ignoring that we still don't tax enough to pay for everything we spend now and are over $18T in debt, right?

I'll trust Bernie on economics when my brain falls out of my skull.

originally posted by: ketsuko
a reply to: InTheLight

This is the same Bernie who wanted to figure out how to tax us all for an extra $18T every year, yes?

This is ignoring that we still don't tax enough to pay for everything we spend now and are over $18T in debt, right?

I'll trust Bernie on economics when my brain falls out of my skull.

It is not a matter of trusting Bernie's economics, it is a matter of copying healthcare programs and processes that work in other countries.

Also, is anyone looking at where that tax money is being spent? Probably on all the wrong things.

Take Canada's healthcare $ expenditures. It appears most of the expenditures go to hospitals and drugs.

How health care dollars are spent has changed significantly over the last three decades. On average, the share of total health expenditures paid to hospitals and physicians has declined, while spending on drugs has greatly increased. Though the share of health care expenditures accounted for by hospitals declined to 29% in 2010 from approximately 45% in the mid-1970s, hospitals continue to account for the largest share of health care spending. Spending on drugs has accounted for the second-largest share since 1997, making up 16% of spending in 2010. The third-largest share of health care expenditures is accounted for by spending on physicians, which made up 14% of spending in 2010.

www.canada.ca...

Big government programs such as Medicare and Medicaid are likely only purchasing prescription aspirin in rare scenarios, experts said. Aspirin doesn’t get a mention on a list of high 2015 drug spending released by Medicaid and Medicare. But the gist of what Trump said is correct: Consumers can get better prices for some drugs on their own than they could through their private insurer or a government insurance program, said Michael Rea, founder and chief executive officer of Rx Savings Solutions.

www.marketwatch.com...

By studying ways to improve and/or streamline processes, such as improving home care, finding ways to bring the cost of drugs down by perhaps buying in bulk, having doctors/specialists diagnose in more efficient ways etc. we can start putting those dollars to work for the 99%.

a reply to: ketsuko

This is ignoring that we still don't tax enough to pay for everything we spend now and are over $18T in debt, right?

Perhaps our health care system is helping put us in debt?

originally posted by: seasonal
a reply to: ketsuko

This is ignoring that we still don't tax enough to pay for everything we spend now and are over $18T in debt, right?

Perhaps our health care system is helping put us in debt?

That's where the banker complex comes in .....

Get a personal loan to help pay off debt from medical expenses

Rates range from 6.99% to 23.99% APR and loan terms range from 36 to 72 months. Only the most creditworthy applicants qualify for the lowest rates, longest loan terms and largest loan amounts. Rates will generally be higher for longer-term loans.Learn more


No fees. Ever.

Truly, we make money on interest, not fees.

originally posted by: seasonal
a reply to: WUNK22

There is no mechanism to keep costs down. The evidence that costs can be contained is evident in other industrialized countries.

Or is it the other way around?

The insurance system as it stands (combined with medical tort issues and the abomination that is the ACA) is the most likely candidate for pushing prices up. For a significant proportion of people, direct pay medical services are likely to be much cheaper and better quality. Not in all cases, but trying to make a system one-size-fits-all will end up with a system that only truly fits the worst case scenarios.

When the doctor has to ask the patient directly for the money, this tends to level the costs closer to what the market will bear, especially when combined with competition against similar service providers.

Also, getting a smaller amount paid immediately can still work out better financially and stress-wise than paying a small army of admin staff to spend months fighting with an insurance company and still only getting half of the claim paid.

Other nations may have systems that constrain costs, but often the first thing to be sacrificed is availability of care. Note that I don't say quality of care - the NHS staff here are well trained and very dedicated people who want to give the best quality they can. It's just hard to do that when every medical problem has to be squeezed into a 10 minute slot with a queue of people waiting behind you. Availability of care becomes the issue because time is money.

Even in the UK, with it's single payer system, people still use concierge or direct-pay packages from private providers. Not as a common thing, but it's available.

a reply to: EvillerBob

Maybe, if I remember correctly the cost were way out of control before the ACA. The ACA just accelerated the coming crash.
It is impossible to know what the prices would look like with out the ACA, but double digit real increases in costs werre common.

For profit HAS to increase profits every quarter. That is a fact.

a reply to: carewemust

Fair is either having a deductible or a premium.....not both.

Who says I can afford to pay 7% of my hard-earned income for a premium that covers nothing...considering the $6500 deductible.
Why should I be penalized for being debt-free ???

ETA
Before unACA, I had reasonable insurance with a reasonable deductible...until my employer kicked us off.

If it was fair you wouldn't be paying for illegals and freeloaders. Obamacare is not for most Americans it is for the liberals voter base period.a reply to: carewemust

a reply to: xuenchen

There are also a lot of TV commercials by lawyers, declaring that if you had any one of a hundred illnesses, you can SUE somebody, and pay your outstanding medical bills.

August 1, 2017

Today, my state of Illinois released the ObamaCare premium changes for 2018.

Health Alliance = +43% - HMO (Only Central and Southern Illinois)

Blue Cross = +38% - PPO and HMO (Every County in Illinois)

Cigna = +37% - HMO (Only Cook County - Chicago)

Ambetter = +15% - HMO (Only Cook County - Chicago)

Source Article: www.chicagotribune.com...

This is insane! Just the premium increases from 2017 to 2018 across the country will milk taxpayers for an additional $5 billion dollars. That's in addition to the $38 billion dollars this year!
Source: www.kff.org...:%22Locat ion%22,%22sort%22:%22asc%22%7D

The already distressed individuals and families who earn above 300% of the Federal Poverty Level (see thread post #1) will have to pay almost the entire increase. Little/No government subsidy for them.


Want to see how much premiums are going up where you live?

Go To: ratereview.healthcare.gov...

Gosh I'm so glad we in the UK don't have this worry and stress.

You Americans that can afford healthcare insurance are paying high premiums to compensate for those who cant afford it. And much of what you are paying doesn't go into healthcare at all, it goes into the pockets and personal bank accounts of those individuals that own the insurance companies. Every month you are paying thousands for nothing.

And look how many people have been forced into bankruptcy just because insurance companies are allowed to quibble and wriggle out of their obligations.

Universal healthcare peeps, it's the way forward. It belongs to the taxpayer. No non-medically qualified insurance company CEO to rob the pot of half the revenues.

Funding? Don't want to pay a universal health tax? Easy. Legalise marijuana and tax it. It would raise billions in revenues. Use half this revenue (or more or less) to fund UHC, and possibly many other projects.

The bonus is that drug dealers will be out of business, jails will be echo-chambers, drug-related petty crimes down, etc.

The American healthcare system isn't about delivering healthcare, its primary obligation is making profits. Everything and anything else is a cost, a loss, and these must and will be minimised.

UHC is a win-win. Unless you own an insurance company, that is.

All governmental healthcare entities need to become the middleman and buy drugs in bulk for distribution to hospitals, nursing homes, etc. to keep the prices down. Although there are also pharmaceutical middlemen, which also hike up the prices, so perhaps governments need to look at becoming pharmaceutical distributors. But, how would this affect jobs within that industry and the economy; complex repercussions abound?

AmerisourceBergen’s Columbus, Ohio–based American Health Packaging buys drugs in bulk and repackages them for use in places like hospitals, including the 14 drugs in question. The idea is that patients in a hospital, who could be discharged at any time, are provided a daily dose of a drug. It’s convenient for a hospital to buy drugs packaged that way, in unit doses, like an individually packaged cookie, handy to grab quickly, as compared with, say, a box of 100.

www.marketwatch.com... 06-21

a reply to: doobydoll


Your method of keeping the "pork" out of healthcare sounds logical. Is the U.K. system doing well, despite the negative stuff we're hearing about it here in America this year?

a reply to: carewemust

The negative stuff you are hearing about it this year, comes down to one singular feature.

The deliberate underfunding and hobbling of the service by center right, and fully right wing governments, going back to the Thatcher era. This was done to make selling parts of it off look like a reasonable plan, despite the reasons for the failures in the service which have occurred, ALL being directly related to the deliberate scuppering of the NHS over successive governments.

Its also worth pointing out that although the healthcare system in the US is better FOR THOSE WHO CAN AFFORD IT, the system being as it is prevents huge amounts of people from accessing ANY care. In Britain, although the care quality is not as it used to be when the NHS was being properly funded (i.e. before the penny pinching, skinflint centrists and right wingers got at it), it still looks after a greater percentage of our population. No one here has ever been turned away from a British hospital because their insurance was wrong, or because they were not in the right area code, or because they did not have enough money on their credit card to get the surgery they needed.

Although it may not be perfect, our NHS is, despite the activity of the Conservatives and other right or center right groups, still offering EVERYONE in the country life saving care, and paying for it via taxation. An ambulance ride? No charge. Saved your life by shocking your heart back into steady rhythm? No charge (save the voltage itself). Yanked your appendix before it flooded your lower abdomen with toxic filth? No charge, no bills, no credit cards required or insurance premiums to rise or anything of the sort.

You get treated, you go home, you carry on with your life.

originally posted by: carewemust
a reply to: doobydoll


Your method of keeping the "pork" out of healthcare sounds logical. Is the U.K. system doing well, despite the negative stuff we're hearing about it here in America this year?

See TrueBrit's reply, everything he says is bang on the proverbial nail.

We in the UK don't have worries and stresses about how we'll pay for healthcare if we get sick, it's already taken care of with our National Insurance tax.

You Americans are already forking out hundreds a month for your health insurance and you still have a deductible to pay on top of premiums, and after all that your insurance company might not agree to pay all or part of your medical bill. You'd all be better off healthwise and financially to pay into a UHC system like we do instead of giving it to insurance companies. No deductible, no quibbling over what you're not covered for, just get your treatment and convalesce instead of stressing.

What is so bad about UHC? I don't get you yanks.

a reply to: carewemust

Here's the proposed hikes for MI...from 6 weeks ago
www.crainsdetroit.com...

Blue Cross Blue Shield of Michigan is asking for a 26.9 percent average rate increase and 13.8 percent hike for Blue Care Network HMO plans.

At least if you opt for the HMO, the increases are not so bad.
I never liked HMOs because I feel they act as if I am not intelligent enough to know when I need a specialist, nothing but gatekeepers IMHO, but to save money........I would have to bite that bullet.

When is it all going to collapse....

Besides premium increases caused partially by uncertainty in the individual market, U.S. Department of Health and Human Services said last month that about 16 percent of consumers who signed up for coverage this year through public health insurance markets had canceled their plans by early spring.

Last year about 13 percent canceled their policies. As of April, 10.3 million people, including about 350,000 in Michigan, were paying for their individual policies, about 2 million less than in 2016