Obamacare... 'Affordable'???

@chai2,

From what I'm seeing in the media, it makes a huge difference if you're in a state that's part of the exchanges. Alabama and FL friends are screaming. OR and WA friends are reasonably happy with their numbers.

http://www.fbnstatic.com/static/managed/img/fb2/news/MAP_HEALTH_DECISIONS_BY_STATE.jpg

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All of these issues with deductibles existed before Obamacare. HMOs and PPOs have beed in place for at least 20 years. Our deductibles have continued to go up year after year. We've had some of the biggest insurers, Blue Cross, Cigna. The basic problem with healthcare is cost. The cost of major illness. My wife was in hospital for 12 days a couple years ago and the cost was over $200k. We paid $20k. Doctors were another $50k. If we had no insurance, who would pay that? Obamacare doesn't fix the whole health care problem, but getting everyone insured is a start.

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@IRFRANK,

Here in Germany, you just pay about $200 maximum for a hospital stay (per year, regardless how long you're there), if you're in the mandatory health insurance.

In any private health insurance, the deductibles are limited to 5,000 Euros per year. (usually, people have programs with deductibles not more than between 600 and 1,000 Euros/year).

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@Walter Hinteler,

Here in the UK it's zilch, with nada deductables and zero exclusions whether you earn a million a year or are unemployed.
Those who are lucky enough to have a job and get paid, get roughly 9 or 10% (I think...haven't checked lately) taken at source, whether they use the NHS constantly, or never use it at all. A sort of Government insurance scheme, really.

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@Lordyaswas,

We (= those who earn money) pay a bit less than 15%. And you don't see that, too. (Opposite to those living in the USA, here we are only interested about what we get, net = if someone earns 2,000 Euros per months, that's the sum she/he gets = taxes, social security, health insurances [be it mandatory or private] already paid.)

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@Walter Hinteler,

That's govt ran, single payer which is what we should have. The right refuses to consider that. It gets in the way of insurance making their money.

Is that 15 percent only for health care?

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@IRFRANK,

IRFRANK wrote:

Is that 15 percent only for health care?

And long-term care insurance (but that only up to 1,550 Euros/month)

As of this year, employers pay 7.3%, employees 8.2%. The maximum an employee has to pay is 630 Euros per month.

Opposite what is often told, with our mandatory health insurance you get medical and dental treatment, free choice of physicians and hospitals,
resort therapy (prevention or rehabilitation), prevention and/or rehabilition sports, other psycho- and physio-therapies, cash benefits (sickness benefit for those unable to work, maternity benefit) ...

There are about 140 insurance companies offering the mandatory health insurance. For the same fee, they offer about 95% the same - 5% difference, because some pay any acupuncture, others only for a few illnesses; some pay training at the gym, most don't; ... ... ...

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@Walter Hinteler,

So you buy the insurance from 1 of 140 companies? What are the costs for a retiree?

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@IRFRANK,

Yes, there are still about 140 companies (several smaller companies formed a new company with others - we had had more than 600 companies a few years ago) which we can join.

Retirees pay 8.2% like anyone else, the pension fund pays 7.3%.

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@chai2,

chai2 wrote:

As far as having a $10,000 dollar bill......assuming you meant all at once, one bill....what difference does it make if your out of pocket max is $6000?

I meant all within one year.

If you have a bronze plan with a $6,000 deductible, $10,000 within a single year will result in you paying $6,000.

But say you have a silver plan with a $1,500 deductible and then it's 30/70 until you've paid the $6,000 out of pocket maximum.

You would pay the $1,500 deductible, and then 30% of the remaining $8,500. Your total bill would be $4,050, a savings of about $2,000 for that year compared to if you had the bronze plan.

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@IRFRANK,

IRFRANK wrote:

My wife was in hospital for 12 days a couple years ago and the cost was over $200k. We paid $20k.

Ouch! In your case a $6,000 out of pocket maximum will be a massive improvement.

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@IRFRANK,

IRFRANK wrote:

That's govt ran, single payer which is what we should have. The right refuses to consider that. It gets in the way of insurance making their money.
Is that 15 percent only for health care?

Germany and the UK are not single payer.

Germany has something like our new Obamacare exchanges, but with much greater regulation and oversight of the insurance companies. Also, I believe the companies have to be not-for-profit so that there is no diversion of funds to a CEO's paycheck.

The UK has a system where the government owns the hospitals outright, and the doctors and nurses are government employees. There are no bills to insurance companies (single payer or otherwise) because the doctors and nurses just receive an ordinary salary from the government for their work.

For examples of a single payer system, look at Canada or our own Medicare system.

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@oralloy,

oralloy wrote:

Germany has something like our new Obamacare exchanges, but with much greater regulation and oversight of the insurance companies. Also, I believe the companies have to be not-for-profit so that there is no diversion of funds to a CEO's paycheck.

If it was so, it would be that 'Obamacare' is something similar to our German system, since we've got this system from 1883 onwards.

But it is just slightly similar. The German health system is more complex than it seems, and it is a multi-payer system

And since the very beginning (= before 1883 already) those companies always have been non-profit companies - that was and is one of the major ideas behind this system.

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@Walter Hinteler,

Walter Hinteler wrote:

oralloy wrote:
Germany has something like our new Obamacare exchanges, but with much greater regulation and oversight of the insurance companies. Also, I believe the companies have to be not-for-profit so that there is no diversion of funds to a CEO's paycheck.

If it was so, it would be that 'Obamacare' is something similar to our German system, since we've got this system from 1883 onwards.

If "A" is similar to "B", then "B" is similar to "A".

Walter Hinteler wrote:

But it is just slightly similar. The German health system is more complex than it seems, and it is a multi-payer system
And since the very beginning (= before 1883 already) those companies always have been non-profit companies - that was and is one of the major ideas behind this system.

The Obamacare exchanges are also a complicated multi-payer system.

The main difference the Obamacare exchanges have with German health insurance is that the companies on the Obamacare exchanges are for profit. Also there is a lot less regulation and oversight of the companies on the Obamacare exchanges.

The idea is that competition between the companies will keep the prices low and the service decent. There will also be a handful of government-sponsored policies that will set a baseline for everyone to compete against, so that the companies do not decide to all simultaneously raise prices to unreasonable levels. If they were to do so, everyone would just switch to the government-sponsored policies.

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@oralloy,

oralloy wrote:

If "A" is similar to "B", then "B" is similar to "A".

Which in this case certainly is a quite common historian's fallacy.

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@oralloy,

oralloy wrote:

The Obamacare exchanges are also a complicated multi-payer system.

Our health insurance system isn't complicated.

I wrote:

The German health system is more complex than it seems

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@oralloy,

oralloy wrote:

a savings of about $2,000 for that year compared to if you had the bronze plan.

Minus the $1600 extra in premiums you pay for the silver plan, bringing the savings down to $400.

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@oralloy,

Yes, you are correct. I see that now. But it looks to me like both are stronger and better than obamacare and much better than nothing. We had a serious health care problem back in 2005 and in all this talk about how bad obamacare is I see no alternative offered. Just the unfair chaotic situation we had before.

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@IRFRANK,

IRFRANK wrote:

But it looks to me like both are stronger and better than obamacare

Once it gets going, Obamacare might turn out to be just as good as the others.

I do see a big problem related to the Medicaid aspect of the program. But if people can manage to avoid Medicaid, I believe Obamacare will work out OK for them.

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Obamacare is incredibly affordable. You do not need to be insured during the 3 month open enrollment period. You do not need to pay premiums during the 90 days before the open enrollment period because if you get sick you just pay the delinquent premiums. So, you only have to pay premiums for 6 months of the year because if you get sick 3 months prior to open enrollment or during open enrollment you just pay the delinquent premiums or enroll. So anyone can effectively cut their premiums in half.

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Obamacare... 'Affordable'???

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