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Rhesus Pieces posted:https://twitter.com/drewtoothpaste/status/1070701774095425541?s=21 Yah, giganto family deductibles are part of our new normal. What's worse, there are often individual deductibles within the family deductibles that must be fulfilled; e.g. if one family member has cancer, and reaches that $15k individually, another family member still has to meet a second deductible of $7,000 or so before the deductible is considered to be fulfilled for that year. And, of course, deductibles run per calendar year, so don't get hospitalized in December or you'll be facing $30,000 worth of deductibles if your illness spans the course of weeks. Oscar Health has nothing to do with absurd policies like this one, though--other than being your typical private insurer. All bronze-level plans are similarly priced; if anything those monthly premiums are actually fairly "low" compared to other family plans. The more absurd our healthcare system becomes, the sooner there will be even more popular demand for alternatives. (You'd think the fact that 50-60 percent of Republican voters support M4A/single-payer would have already ushered it in, but otoh: corporate donors.)
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Dec 6, 2018 23:49
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Hieronymous Alloy posted:Yeah I also want to get in on how wrong this post is, sorry dude Hmmm it turns out I was confusing medicare and disability fraud e.g. The LIRR scams. Well, I don't disagree with the conclusion
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Dec 7, 2018 14:43
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https://twitter.com/alexnpress/status/1071141578624909312
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Dec 8, 2018 01:44
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Rhesus Pieces posted:https://twitter.com/drewtoothpaste/status/1070701774095425541?s=21 Ehh, no charge after deductible is really, really good. This plan would work for families that tend to have consistently big healthcare costs that exceed the deductible. Maybe a family with lots of high schoolers who play sports and are liable to get injured.
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Dec 8, 2018 02:23
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qkkl posted:Ehh, no charge after deductible is really, really good. This plan would work for families that tend to have consistently big healthcare costs that exceed the deductible. Maybe a family with lots of high schoolers who play sports and are liable to get injured. I'm sure there are a lot of families that have $16000 lying around every year for big healthcare costs
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Dec 8, 2018 02:29
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CAPS LOCK BROKEN posted:I'm sure there are a lot of families that have $16000 lying around every year for big healthcare costs It doesn't have to appeal to lots of families, just enough families so the profit exceeds the administrative costs of having this plan on the menu.
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Dec 8, 2018 02:46
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CAPS LOCK BROKEN posted:I'm sure there are a lot of families that have $16000 lying around every year for big healthcare costs "obama gave us healthcare."
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Dec 8, 2018 02:52
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qkkl posted:Ehh, no charge after deductible is really, really good. This plan would work for families that tend to have consistently big healthcare costs that exceed the deductible. Maybe a family with lots of high schoolers who play sports and are liable to get injured. The reason there is "no charge after the deductible" is because the deductible is set to the out of pocket maximum, which is set by the HHS. Literally every plan has to abide by that. For 2019 can you guess what the out of pocket maximum is set to for family plans? That's right $15,800. So no, it isn't "really really good" in any way shape or form and is actually even a really lovely catastrophic plan. Keep in mind that all relates to in-network costs and doesn't touch on out-of-network. I am curious what families you think would actually benefit from having to spend $24k/year and see absolutely no benefit from their plan? That's almost half the gross income of the median American household; that's bankruptcy territory if they actually are hitting that point.
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Dec 8, 2018 03:09
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CAPS LOCK BROKEN posted:I'm sure there are a lot of families that have $16000 lying around every year for big healthcare costs $24500, can't forget the premiums
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Dec 8, 2018 04:29
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For-profit health insurance is inherently unsustainable because healthcare is inherently unprofitable. Healthcare needs to be provided a non-profit societal service because it is a) not a consumer good in any way shape or form and b) required by human beings to, you know, loving live.qkkl posted:Ehh, no charge after deductible is really, really good. This plan would work for families that tend to have consistently big healthcare costs that exceed the deductible. Maybe a family with lots of high schoolers who play sports and are liable to get injured. Most families in the US would be financially crippled by an unexpected 500$ expense thus a 16k deductible is loving laughably unaffordable, no matter how good the insurance coverage beyond may be.
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Dec 8, 2018 04:51
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Raldikuk posted:The reason there is "no charge after the deductible" is because the deductible is set to the out of pocket maximum, which is set by the HHS. Literally every plan has to abide by that. For 2019 can you guess what the out of pocket maximum is set to for family plans? That's right $15,800. So no, it isn't "really really good" in any way shape or form and is actually even a really lovely catastrophic plan. Keep in mind that all relates to in-network costs and doesn't touch on out-of-network. I think a big family with libertarian parents that have a yearly household income in excess of $150k will benefit from this plan, because they can say they are paying for their own healthcare with the high deductible, while still being shielded from catastrophic health care expenses.
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Dec 8, 2018 05:02
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qkkl posted:I think a big family with libertarian parents that have a yearly household income in excess of $150k will benefit from this plan, because they can say they are paying for their own healthcare with the high deductible, while still being shielded from catastrophic health care expenses. Love spending 16% of my gross income with a "big family" for some hell world bragging rights. If that family were big such that they had 3 kids (total household of 5) they would qualify for tax credits and should get on a silver plan that would not only have cheaper premiums but a lower deductible and oop max. So no not even for a large family at the 90th percentile of household income.
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Dec 8, 2018 05:24
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https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215 nothing particularly new in this piece, but I loved this line. the most credulous, brain-dead neoliberal zombies on the face of the loving planet posted:Medicare for All skeptics point to the lengths the Obama administration went to secure industry support for the ACA prior to its passage in 2010, an effort that did little to insulate Democrats from eight years of political blowback. Yet another major government health care expansion could be even more painful, they say. hmmm. we gave them everything they asked for, and they hosed us anyway. but if we don't do that this time, maybe they'll gently caress us harder?
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Dec 11, 2018 17:04
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Rhesus Pieces posted:https://twitter.com/drewtoothpaste/status/1070701774095425541?s=21 This is cheaper than nearly every option I saw last year for family plans. 1k+ premiums for 14k deductible.
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Dec 11, 2018 18:09
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Yeowch!!! My Balls!!! posted:https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215 Hmmmm selling out to insurance company interests and crafting the wonkiest bill that ever wonked during a time of unprecedented levels of animus at the for profit health industry? Damnnnn why /didn't/ thst insulate them from political pressure  The best part though is they don't address what criticisms were largely lobbed to do so...which was calling ACA socialism etc etc, so the real takeaway should be that the right will do that no matter what. Best to create a bill with real beneficial changes most Americans will see and not want to give up easily.
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Dec 11, 2018 18:45
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I know there are some clear examples already, but I'm going to describe a scenario I currently find myself in, to illustrate the problem: ______________________ -Firstly, I'm self-employed, and thus have to purchase health insurance through the marketplace (Colorado's specifically). Because we have two kids and didn't make lots of money last year, after filling out the applications, me and the kids were assigned medicaid coverage. This is the closest form of UHC that America has, and works exactly like any form of American health insurance, in that you find a provider, go in to get service, and then pay. All of the care providers we've visited, including hospitals and dental surgeries, are nice clinics that also serve people covered with other insurances, so, all in all, the only difference is that, usually, when we leave, we pay little or nothing. Colorado medicaid provides $1000 of dental coverage for an adult per year, but the dentist has to seek approval from medicaid before they can authorize treatment. If medicaid denies coverage for treatment for something, you can still get it, you just pay more. ______________________ So, I haven't been to the dentist in a couple years because the last dental cleaning I had from a different dentist felt like coarse metal scraping against my soul, and I'm sure I looked like Arnold in Total Recall when he's flipping out in the machine. Also, with a new baby, time is a blur and days bleed into months. Stupid me. I go in for a check up recently and I need a root canal. Cost is ~$1100. Medicaid denies coverage (understandably because I should have gone in a year earlier at least and caught it then) so instead of paying $100 it will be full price. Well, our finances are definitely improving, and one must have all their teeth, so I can get this treatment. However, I'm visiting the UK at the end of January, so must schedule the appointment for the second week of February, 2019. It struck me yesterday that there are dentists in the UK, so I sent out a couple emails inquiring about the cost of a root canal without NHS coverage.. Turns out, the proceedure runs somewhere around ~£500....and the exchange rate is currently £0.80 - $1.00. Also, my round trip flights cost $300. In summary, I can potentially save myself about $300 by flying to England and having a private dentist perform my root canal. And technically, so can you!
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Dec 14, 2018 17:27
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i am harry posted:I know there are some clear examples already, but I'm going to describe a scenario I currently find myself in, to illustrate the problem: Mexico is probably cheaper and easier for a lot of people to be honest. But yeah going abroad is almost always cheaper, especially if you can get a cheaper flight
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Dec 14, 2018 17:35
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i am harry posted:I know there are some clear examples already, but I'm going to describe a scenario I currently find myself in, to illustrate the problem: Not to bury the lead, but how the bloody hell did you find a return ticket from Colorado to Britain for $300?!?
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Dec 14, 2018 20:53
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So now that "Texas v US v California" says that the ACA is unconstitutional - which will obviously go to appeal - are we now taking odds on this? Because I'm hoping to gently caress that it dies on appeal and SCOTUS just refuses certiorari.
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Dec 15, 2018 13:17
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Crashrat posted:So now that "Texas v US v California" says that the ACA is unconstitutional - which will obviously go to appeal - are we now taking odds on this? The 5 justice group in NFIB v Sebelius (Roberts, Ginsburg, Breyer, Sotomayor, Kagan) are still on the court and unlikely to decide "no, actually I was wrong that first time, this dipshit judge got it right with his stupid reasoning and the ACA is unconsitutional." At the Supreme Court level this is almost certain to be overturned, assuming it even gets that far.
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Dec 15, 2018 14:51
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Interesting NYT piece on how contract law might be used in lawsuits against balance billing:quote:While consumers are obligated to pay something, the question is how much? Hospitals generally bill out-of-network care at list prices, their highest charges. (emph. added)
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Dec 19, 2018 23:35
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So they could hypothetically make it so uninsured costs are equivalent to Medicare, and then presumably some other stuff to basically do medicare/Medicaid for all?
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Dec 19, 2018 23:51
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I don't think it would go that far, the providers would just have to start providing an estimate and get assent from the patients. The average or market price is only used when a price was not agreed upon beforehand by both parties.
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Dec 19, 2018 23:53
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Hospital Ghouls posted:Hospitals say yes, that signed admission forms, which include a promise to pay, constitute mutual assent, even if there was no price disclosed. Lmao, stealing a check from someone's checkbook if it was already signed constitutes mutual assent because
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Dec 19, 2018 23:54
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I mean, many companies are starting to grouse about healthcare costs, so it isn't impossible they might stab insurance companies in the back.
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Dec 19, 2018 23:54
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Reik posted:I don't think it would go that far, the providers would just have to start providing an estimate and get assent from the patients. People knowing upfront what a medical procedure would cost them out-of-pocket would be a huge change from the status quo--and likely lead to less care than even $7,000 annual deductibles do. (So be ready for private insurers to back such disclosures.)
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Dec 19, 2018 23:59
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thechosenone posted:I mean, many companies are starting to grouse about healthcare costs, so it isn't impossible they might stab insurance companies in the back. If the company is big enough and self insure, they serve as the insurance company.
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Dec 19, 2018 23:59
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https://twitter.com/markpopham/status/1076320029271044097?s=21 https://twitter.com/markpopham/status/1076320510999494656?s=21 https://twitter.com/markpopham/status/1076321473722310656?s=21 https://twitter.com/markpopham/status/1076322221864435712?s=21 What a totally cool and ethical health insurance system we have in this country No reason at all to burn this poo poo down and adopt what the rest of the civilized world already has, this is just fine as it is
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Dec 22, 2018 05:37
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  Radical idea: Stop having gofundme campaigns for your one person, start buying congressmen. David Scott's corporate owners will never let Medicare for All happen, so let's buy him and end these horror stories.
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Jan 2, 2019 16:19
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Easy Diff posted:
ooh, I like it.
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Jan 3, 2019 04:18
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In more, "You don't go to an American hospital to get better," news, a woman in a decade-long vegetative state just gave birth.
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Jan 6, 2019 01:45
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i am harry posted:In more, "You don't go to an American hospital to get better," news, a woman in a decade-long vegetative state just gave birth. OK so an orderly or whoever took advantage of her, and that's sad, but how does the family let that pregnancy continue? Also,  
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Jan 6, 2019 01:50
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Easy Diff posted:OK so an orderly or whoever took advantage of her, and that's sad, but how does the family let that pregnancy continue? Also, The article said that the people at the facility didn't know she was pregnant until she pretty much started labor.
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Jan 6, 2019 01:52
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Well folks, I'm finally able to tell my healthcare story through the exchange. In December I applied pre deadline for me, wife, kid, plugged in income, stuck with same plan as last two years (the only one on exchange my hospital takes). This year, unlike the last two, the exchange said my kid "might" qualify for chip/Medicaid and his info would be routed to the state to determine. Redid app a few times to make sure this was on purpose, submitted and also called and chatted with the healthcare reps. They said I had to wait for a denial and could reapply retroactively for coverage. Kid of course has seen the doctor a few times because toddlers are germy. This week I've been between temp jobs and finally had time to sit on hold and find out what's up. After 3 hours of hold, got through to the state (was #113 in line today). They found the application and said a letter went out mid January and would resend. So it took 3-4 weeks for the denial of chip/Medicaid to even happen, which was needed to be eligible for the exchange. I asked for a way to check online which they gave me a login for, but it didn't have the denial letter despite them saying it would, but did have a denial notice. Of course I couldn't do this checking while on the phone, because the rep said I couldn't be on the computer when she gave me instructions on how to access the website and I had to write it down by hand. Now I got to redo the entire healthcare exchange application and it looks like we are all enrolled! Yay! Except I have no idea if retroactive coverage is going to work or if the premium will get hosed up or whatever. It's a hell of a hoop to jump through and nerve wracking to have no coverage and no control over the application wandering through federal and state bureaucracies.
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Jan 24, 2019 23:02
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The best thing to come out of the navy breaking my body and mind is I don't ever have to put up with that kind of bullshit. Everyone's healthcare access should be at least as good as mine. It's me - I'm the one guy in the nation saying they like the VA.
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Jan 24, 2019 23:12
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Mr. Nice! posted:The best thing to come out of the navy breaking my body and mind is I don't ever have to put up with that kind of bullshit. Everyone's healthcare access should be at least as good as mine. I have heard alternating stories that are wonderful and miserable, in regards to the VA, but I don't form opinions based on anecdotes regardless. However, I am sure that all of the republicans and a good number of the democrats, prodded by private health care interests and libertarian "think" tanks (spot the oxymoron here), are working hammer and tongs to dismantle health care for veterans and active service alike while endlessly repeating "We support our troops
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Jan 24, 2019 23:26
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JustJeff88 posted:I have heard alternating stories that are wonderful and miserable, in regards to the VA, but I don't form opinions based on anecdotes regardless. However, I am sure that all of the republicans and a good number of the democrats, prodded by private health care interests and libertarian "think" tanks (spot the oxymoron here), are working hammer and tongs to dismantle health care for veterans and active service alike while endlessly repeating "We support our troops They want to privatize it, but I say gently caress that. Some things, yeah, it would be nice to see private practice. There are some speciality clinics that I have to drive to see. That part sucks. Primary care/labwork/mental health/urgent care? Like hell would I want to deal with the local healthcare scene. VA lab wait times are shorter than any of the local labs plus they're in the same building as my doctor. The pharmacy is there, too. The phlebotomists are great and I have yet to be mangled by one. Primary care can get booked sometimes, but that's universally true. In the same building, though, is an urgent care clinic that can do literally anything. My copay for all of this is zero. I can go to the ER, too, after hours if the clinic is not open at no cost to me. I get to see my friends struggle with finding good doctors, changing health plans, meeting deductibles, etc. It's miserable. I'm glad I don't have that headache. It's absurd that we haven't fixed this yet, but 
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Jan 24, 2019 23:46
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Mr. Nice! posted:They want to privatize it, but I say gently caress that. Some things, yeah, it would be nice to see private practice. There are some speciality clinics that I have to drive to see. That part sucks. I'm with you mate. I'm a veteran myself, but not of the US armed forces and I served domestically in peace time, so I wouldn't begin to compare myself to servicemen who were in combat or dangerous postings. That said, the Medicaid expansion saved my life last month when I spent a week at the hospital with two sizeable pulmonary embolisms - cost to me was $0 and I pay $1 a month for my coverage. Without it, they either stabilise me and send me out with a large bill and the distinct possibility of dying or they care for me as they did and my cost would have been surely six figures. On a slightly different note, I realise that Medicare-for-All is a big issue right now and, while it would be a massive improvement for huge numbers of people, I'm not that chuffed with it. I fully understand that it's the only politically feasible idea for comprehensive health care in this joke of a country, but Medicare is very limited in a lot of ways and a nation as wealthy as the US can do better. I'm probably "spoiled" by functional health care systems like the NHS and la Sécu in France, but one thing that I really don't like about Medicare are the high co-pays due for services such as seeing doctors and the 300-some dollars for any surgery. Again, I'm not saying that it's worse than the status quo, but fees like that really disincentivise people seeking care and this hesitation can lead to things getting worse, and more costly. Given the masses of people in America who have no savings and are living meagre paycheck-to-paycheck, even a $30 co-pay to see a generalist is a huge expense and can lead to a triviality becoming serious. Nobody with half a brain believes that masses of people are going to see doctors for no reason or have scans done with no reason, and I feel strongly about that aspect of Medicare. Again, I'm probably biased in favour of the NHSs no-fee at the point of service model, but that doesn't mean that I'm wrong either.
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Jan 25, 2019 02:05
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Again: Bernie's plan for improved and expanded medicare for all is more like an improved & expanded medicaid for all: there are no premiums, no copays and no deductibles. The ACA did incentivize states to use private managed care plans for medicaid, but even so, there are way more options for plans & providers under my state's medicaid system than there are in the same area for marketplace plans. I remember getting my provider directory last year when I was on medicaid and nearly crying in relief that I could go to the two hospitals within a mile, instead of the one 10 miles away that came with the only private marketplace plan I could afford for several years, and that I wouldn't be bankrupted through out-of-pocket costs, as I would under the private plans, if I needed to seek care. Best of all, as with for people under Medicare, people under Medicaid don't face surprise or balance billing for out-of-network costs (which under private plans don't apply toward deductibles, and for which there are no caps) when some rando practitioner sees them in an in-network facility. And you know why hospitals don't directly bill Medicare/Medicaid patients for costs not covered by the government? Because there are federal laws that ban that practice. Medical costs from providers and for patients can be regulated, but that doesn't happen under legislation created under regulatory capture like the ACA, nor does that happen when private insurers are incentivized to not rein in provider costs. Willa Rogers fucked around with this message at 02:44 on Jan 25, 2019 |
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Jan 25, 2019 02:41
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Willa Rogers posted:The ACA did incentivize states to use private managed care plans for medicaid, but even so, there are way more options for plans & providers under my state's medicaid system than there are in the same area for marketplace plans. I remember getting my provider directory last year when I was on medicaid and nearly crying in relief that I could go to the two hospitals within a mile, instead of the one 10 miles away that came with the only private marketplace plan I could afford for several years, and that I wouldn't be bankrupted through out-of-pocket costs, as I would under the private plans, if I needed to seek care. Are you a countycare patient? So far I've heard nothing but good things about the medicaid plan that cook county runs, which I'm assuming is why Pritzker promised people that he will support medicaid buy in.
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Jan 25, 2019 03:28
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