15
   

Damn Healthcare kills me every year

 
 
oralloy
 
  1  
Reply Tue 19 Jan, 2016 10:31 pm
@puzzledperson,
puzzledperson wrote:
oralloy wrote:
And then when they die the state gets to seize their house instead of ownership passing to their children.

This is laughable, preposterous, and false.

Unfortunately not. People on Medicaid end up losing their homes to the state when they die.


puzzledperson wrote:
Signing up for Medicaid does not give the federal government any equity in, lien on, or claim upon, a recipient's house.

Sort of true. It is the state government which seizes your home when you die if you are signed up for Medicaid.


puzzledperson wrote:
I see no need to reply to the rest of your comment, since you've discredited yourself.

It is always interesting to see the various ways that the Left comes up with to avoid confronting the truth.

I'm curious, do you react to truth the way a vampire reacts to sunlight?

Here's another dose of truth to hide from:

"Actually Obamacare resulted in many high quality plans being pulled from the market.

Before Obamacare my insurance had an out-of-pocket maximum of $250 per year and I could see any doctor without worrying about networks.

The best plan I can get from the Obamacare marketplace has an out-of-pocket maximum of $3,000 per year, and I have to stay within a network to get full coverage."
McGentrix
 
  4  
Reply Tue 19 Jan, 2016 10:39 pm
@oralloy,
oralloy wrote:

puzzledperson wrote:
Signing up for Medicaid does not give the federal government any equity in, lien on, or claim upon, a recipient's house.

Sort of true. It is the state government which seizes your home when you die if you are signed up for Medicaid.



Hadn't heard that.

Little-known aspect of Medicaid now causing people to avoid coverage

Can Medicaid Really Come After Your House When You Die? Yes.

Quote:
In 1993, concerned about rising Medicaid costs, Congress made it mandatory for states to try to recover money from the estates of people who used Medicaid for long-term care, which can cost taxpayers hundreds of thousands of dollars per person. They included exceptions in cases in which there is a surviving spouse, a minor child and other situations.

Congress also gave states the option to go further — to target the estates of all Medicaid recipients for any benefits they received after age 55, including routine medical care.


Huh.
puzzledperson
 
  1  
Reply Wed 20 Jan, 2016 02:15 am
@McGentrix,
I guess I have to eat crow on this one. Here it is straight from the horse's mouth:

https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Estate-Recovery.html

I gave McGentrix a thumb's up too.

Apology to oralloy also. No intent to avoid the truth, it just sounded like something from a right-wing phone-in caller to a talk-radio program.
puzzledperson
 
  2  
Reply Wed 20 Jan, 2016 02:37 am
@oralloy,
Well, here it is from that supposed bastion of liberalism, the New York Times:

"In many states, more than half the plans offered for sale through HealthCare.gov, the federal online marketplace, have a deductible of $3,000 or more, a New York Times review has found."

http://nytimes.com/2015/11/15/us/politics/many-say-high-deductibles-make-their-health-law-insurance-all-but-useless.html?referer=

Well, doesn't that mean that nearly but somewhat less than half of the plans offered in those states have smaller deductibles? Is this a case where diligent buyer research is the answer? You can find a lot of expensive coffee brands, too, but does that imply that all coffee is expensive? I'm not trying to be facile or evasive, just asking a serious question. I also found this in the same article:

"In employer-sponsored health plans, deductibles have also been rising as companies shift costs to workers. Still, the average annual deductible in employer plans, $1,320 for individual coverage according to the Kaiser Family Foundation, is considerably less than the deductibles in many marketplace plans."

What percentage is "many" and what is the typical or average minimum? The article doesn't say.

puzzledperson
 
  1  
Reply Wed 20 Jan, 2016 03:14 am
@puzzledperson,
Many of these articles cite a Kaiser Family study. Excerpts:

"Looking at the dollar amounts that workers contribute, the average annual premium contributions in 2015 are $1,071 for single coverage and $4,955 for family coverage. Covered workers’ average dollar contribution to family coverage has increased 83% since 2005 and 24% since 2010 (Exhibit A). Workers in small firms have lower average contributions for single coverage than workers in large firms ($899 vs. $1,146), but higher average contributions for family coverage ($5,904 vs. $4,549). Workers in firms with a higher percentage of lower-wage workers have higher average contributions for family coverage ($6,382 vs. $4,829) than workers in firms with lower percentages of lower-wage workers."

"... Almost all (98%) covered workers are in plans with an out-of-pocket maximum for single coverage, significantly more than the 88% in 2013. While almost all workers have an out-of-pocket limit, the actual dollar limits differ considerably. For example, among covered workers in plans that have an out-of-pocket maximum for single coverage, 13% are in plans with an annual out-of-pocket maximum of $6,000 or more, and 9% are in plans with an out-of-pocket maximum of less than $1,500."

http://kff.org/report-section/ehbs-2015-summary-of-finding/
0 Replies
 
oralloy
 
  0  
Reply Wed 20 Jan, 2016 03:58 am
@puzzledperson,
puzzledperson wrote:
Apology to oralloy also.

Apology accepted. I look forward to our next vigorous debate (I'm recalling our earlier one about the war on terror).
0 Replies
 
oralloy
 
  0  
Reply Wed 20 Jan, 2016 04:00 am
@puzzledperson,
puzzledperson wrote:
Well, doesn't that mean that nearly but somewhat less than half of the plans offered in those states have smaller deductibles? Is this a case where diligent buyer research is the answer? You can find a lot of expensive coffee brands, too, but does that imply that all coffee is expensive? I'm not trying to be facile or evasive, just asking a serious question.

My plan last year and this coming year has a $750 deductible, then I pay a 20% co-pay until I've paid an additional $2,250, for an out-of-pocket maximum of $3,000 per year.

A similar plan has a $150 deductible, then you pay a 20% co-pay until you've paid an additional $4,950, for an out-of-pocket maximum of $5,100. This was my plan the first year of Obamacare (my current plan wasn't available the first year).

I don't pay much attention to the deductible. I figure if I end up in a hospital I'll max out the deductible and maximum co-pay regardless of the plan, so I focus on the out-of-pocket maximum.
McGentrix
 
  1  
Reply Wed 20 Jan, 2016 07:45 am
I have a $3600 deductible which then becomes a 10% co-pay til $7200 max out of pocket. My company picks up $2700 through 3 payments over the year.

Still the absolute worse health insurance I have ever had and I hate it.
George
 
  3  
Reply Wed 20 Jan, 2016 08:18 am
@McGentrix,
The company I work for also offers a crappy High-Deductible Health Plan.
There are options to pay less every pay period, but take higher deductibles
and out-of-pocket. Nevertheless, you have virtually no insurance until the
bills get very high.
puzzledperson
 
  1  
Reply Wed 20 Jan, 2016 02:36 pm
@oralloy,
oralloy wrote: "My plan last year and this coming year has a $750 deductible, then I pay a 20% co-pay until I've paid an additional $2,250, for an out-of-pocket maximum of $3,000 per year."

The 20% sounds more like co-insurance than co-pay: the latter is a fixed fee (dollar amount) rather than a percentages. This makes it very clear:

http://www.bcbsm.com/index/health-insurance-help/faqs/topics/how-health-insurance-works/deductibles-coinsurance-copays.html

According to the link, some plans with deductibles pay for some services without applying the deductible. Sounds like something I'd want to research if I were insurance shopping.

Apparently the lower the co-insurance, the higher the monthly premium.

I have to admit that all of this is a lot worse than I thought and that I've learned something in this thread.

Here's my take on the big picture:

Any service that is a universal necessity of life, requires highly specialized skills to practice, and has large investment costs to practitioners (hospitals, drug companies, doctors), will tend to have a limited number of practitioners; and because of the essential nature of the services, they will thus be in a position to gouge users of those services without worrying about competition by new entrants to the field undercutting profits (i.e., oligopoly). This is also true for gatekeeper organizations like physician networks that function as a agents for practitioners.

The medical oligopoly then drives insurance costs, which in turn are passed through to the consumer of the services.

Requiring insurers to provide universal coverage while imposing price ceilings on insurance costs while simultaneously allowing medical service providers to price their services at what the market will bear, will cut into insurance companies' profits. In response, they will use cost shifting loopholes to maintain profits: for example, in response to caps on annual growth in premium costs to consumers, they will increase deductibles, co-insurance, and copay costs to consumers.

Effective closure of the loopholes used by insurance companies would either drive them out of business or else force them to negotiate lower prices with medical service providers (which, however, they already do through managed provider networks).

The conclusion seems to be that since costs are ultimately driven by medical service providers (hospitals, pharmaceutical companies, and doctors), that is where effective price controls must be implemented.

That said, costs could be reduced by putting health insurance on a non-profit basis so that premiums pay only the cost of benefits plus basic administration; also by streamlining administration to eliminate duplication in organizational overhead (e.g. only one insurance company instead of many, billing only service providers and not consumers, and standardizing/simplifying the claims filing procedure so that all claims involve a single, simple format submitted electronically to a single company).

In addition, by combining all medical service consumers into a single insurance pool, cost sharing is spread over a wider population and thus is less of a burden to any single consumer household. Access to such a large pool of potential customers would also be very attractive to medical service providers, which would make it easier to negotiate lower costs.

Finally, if the one insurance company is the only game in town, medical service providers don't have any choice but to play ball.

Of course, this is single-payer. In the Canadian system, the government is the payer, but medical service providers are not government employees.

https://en.m.wikipedia.org/wiki/Single-payer_healthcare

0 Replies
 
Kolyo
 
  2  
Reply Wed 20 Jan, 2016 05:23 pm
@puzzledperson,
puzzledperson wrote:

That said, if someone doesn't qualify for Medicaid, they still qualify for the Marketplace subsidies under Obamacare. There is no class of persons who make too much to qualify for Medicaid but too little to qualify for Obamacare.



I don't think you are correct. I was able to find evidence to the contrary, but I'm on my phone and can't post the link. There is a small gap of people who earn too much for Medicaid but not enough to get subsidies. Obama's planned Medicaid expansion would have insured those people. The supreme court said states didn't have to go along with expansion. Many states were glad to implement it, since the federal government picked up most of the tab. However, many states did not.

Edit -- yeah just google: can't get Medicaid or subsidy
puzzledperson
 
  1  
Reply Wed 20 Jan, 2016 05:53 pm
@Kolyo,
Looks like I was wrong on this one too: there is a coverage gap of about three million individuals:

http://kff.org/health-reform/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid-an-update/

There are tables by state at the end.
Kolyo
 
  1  
Reply Wed 20 Jan, 2016 10:50 pm
@puzzledperson,
I used to be involved in state politics. Otherwise I wouldn't have known about the coverage gap either.
0 Replies
 
Miller
 
  1  
Reply Thu 21 Jan, 2016 02:56 am
@Linkat,
LINKAT QUOTE:
Quote:
Not sure what I am going to be paying soon as just this weekend we were in the emergency room with concussion - I gave over my insurance card just waiting for the bill now. If it is high, I am going to have to negotiate a payment plan as it will be difficult to pay.


I hope your situation with the concussion is improving. As for payment plans, I'm sure that Boston's Children Hospital has several, excellent payment plans to offer you.

As far as adult care ( for yourself), in the Boston area, all of the Harvard-based hospitals offer payment plans, in one form or the other . Don't worry, I know you'll be just fine.
Miller
 
  0  
Reply Thu 21 Jan, 2016 03:10 am
@Kolyo,
Kolyo wrote:

The reason your rates have gone up probably has to do with how insurers have to cover sick people now.

There's no free lunch.


In the Commonwealth of Massachusetts, insurance rates for a specific plan are determined in part by the region inMassachusetts, in which you reside.

Another factor in determining a rate in Massachusetts , is the number of people enrolled in your plan. This fact is nicely printed on your BC/BS bill for insurance.

And yes, there is "no free lunch". If only Obama and Sanders knew that!

The more welfare that is offered the Public, the greater the number of individuals seeking a "free lunch" and a " free ride"....till the welfare train runs out of steam...
0 Replies
 
Linkat
 
  2  
Reply Thu 21 Jan, 2016 09:43 am
@Miller,
I have a HSA - so an amount comes out of my pay before taxes to pay for medical expenses. Of course, I prefer to use this to pay the bills. I should have enough to pay for the bills, just I might not have it yet - you are only entitled to the amount they have taken out of your pay. The plan I had before the total amount you set aside for this account was available on day 1.

Where it is the beginning of the calendar year, I have less accumulated in the account so if they could wait a few months or perhaps take payment monthly it should not be a problem. I planned for something like this just in case (being a responsible person I want to make sure I can pay for what I use). It is more the timing.

And thank you - she went to school yesterday - could tell it took a toll on her - she had a follow up yesterday, and took an impact test - she did terrible on it. So the doctor gave her instructions on what she could and could not do. We have another follow up next week.

As far as pay at the doctor's they said you don't pay now - they send it to the insurance company and then they send a bill. They did caution me to read my policy closely and make sure I am charged correctly.
One Eyed Mind
 
  0  
Reply Thu 21 Jan, 2016 01:41 pm
It's not the healthcare that's killing you.

It's the stupidity of the people voting in stupid leaders that create stupid systems that kills you.
0 Replies
 
september
 
  0  
Reply Thu 21 Jan, 2016 08:59 pm
@Linkat,
Why not look at this health care from the long-term vision ,it does have cons and pros ,but actually the pros much more than cons .
0 Replies
 
cicerone imposter
 
  1  
Reply Thu 21 Jan, 2016 09:21 pm
For all you Americans on this thread. You're gonna love Medicare when you retire, and that's when you really need medical care (as we age). Most doctor visits are $35, annuals are free, and prescription drugs are subsidized so much, your out of pocket is rarely over $10. Last year, my kidney completely stopped on me, and I was in the hospital for over two weeks. The out of pocket cost was under $2,000. I had the best doctors, nurses, technicians, and support staff that one can only dream about. Now that I've lived it, I'm proud of the medical care I received. When I needed X-rays, biopsies, electrocardiogram, or other tests done, they came to my room. I can't image what the true cost of my care was, but I know that any illness I may have in the future will be handled by caring professionals. I couldn't ask for more.
JPB
 
  1  
Reply Fri 22 Jan, 2016 05:37 am
@George,
Except all of your annual checkups are included at no cost. That's not "no insurance" if you make those appointments. The idea is to keep you healthy through preventative care so that you don't need much coverage other than catastrophic events.



0 Replies
 
 

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