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Space Kablooey posted:Living in the US and having to min max all this bullshit sounds exhausting If your plan includes a Flexible Savings Account you have to guess what you’ll spend on healthcare that year because they take all the unused money in the account away at the end of the year, and you can’t take the money out directly so people will just buy random poo poo from Walgreens because it technically counts as a healthcare expense.
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Oct 10, 2023 08:06
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Foxfire_ posted:$100 ER fee You missed a couple 0s for anyone without insurance, which is part of the whole problem
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Oct 10, 2023 08:07
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Philthy posted:when I was in the hospital, and i was able to start eating again, they began with giving me ensure. basically like a thick milkshake loaded with proteins n stuff. anyway, every 2 hours they'd leave one on my side table. i must have had 10 at one point before i told them to stop, im not drinking those. A lot of health insurance systems will cost more for basic poo poo. There's quite a few cases were people will run a prescription with their health insurance and it's $60, but they run it without and out of pocket, and it's $30. Health insurance is a middleman markup on literally everything healthcare-related now. Also, fun fact, those Ensure are probably covered by your American health insurance policy, so you can buy them at a "discount" from the pharmacy. It's not really a discount, but the money you spend goes toward the deductible on your policy, so you nickel-and-dime your way toward that annual initial OOP requirement. I did a stint explaining all this poo poo. It's easy to understand if you're like, 30 and mentally all there, but having to explain all this to people who are 60+ and just now trying to wrap their heads around it all is  Mr Lanternfly posted:Where the hell does all this insurance money go??? Shareholders first, then C-suite, then sales reps holding some wild loving junkets for hospital system administration to sell them on the network system. Pretty sure the sales rep slush fund budget across the health insurance companies hits well above $100 million annually. pencilhands posted:I’m looking over my claims and i saw the same doctor 2 weeks apart. The first visit it shows him as “in network” and the second as “out of network” can the same loving doctor shift in and out of network somehow? And yes the second visit cost hundreds of dollars more If the first visit was "just a visit" then it was a "preventative doctor visit" but if you went back with a specific problem, then it's a "diagnostic visit" then they will gouge the poo poo out of it. Decedent posted:You saw them at a "different clinic". You (hopefully) walk down a hospital hall, turn left, walk more and BAM out of network. Or this. Charles Ford posted:One time I was hit by a car while riding a bicycle home from work. After I managed to call the police/an ambulance (the driver and her parents were very insistent we "just sort it out amongst ourselves") the paramedic himself told me I shouldn't go with them in the ambulance, and instead get a friend to do it, because I didn't know if the woman who hit me had insurance and so whether or not I myself would be billed. A good guy, that guy. There's a whole "medical transportation" service that's less than an ambulance, but more than a taxi, and they're making fat stacks because they're billing insurance at something like double a standard established taxi fare simply because they use the van with the sliding door and help them into and out of the vehicle. And it works out for everyone because that's cheaper than an ambulance service. aniviron posted:This is good but I also suspect that the retail price is a bunch of bullshit. Unless you are taking antimatter pills it should not cost that much. There's a number of specialty medications for poo poo, particularly for cancer and other rare diseases, and they run $10k for a 30-day scrip fill, and these are medications that are necessary for a long-term treatment, so minimum six months. great big cardboard tube posted:I'm a poor working/living in MA and get free state health insurance and paid $3.65 for a prescription with a retail price of $15906.89 Medicaid has a flat rate for any prescription(and it is cheaper than 80% of just about anything), but you need some fulltime-working poverty-level qualifications federally. Can't speak for MA state qualifications, though, they might have a better safety net than federal. great big cardboard tube posted:You missed a couple 0s for anyone without insurance, which is part of the whole problem I went to the ER after work one day(night, it was 1am when I got there after a half hour drive), and the out of pocket was like, $400. The total billed to the insurance was drat near $4,000. No, I couldn't wait some 8 hours until the urgent care clinic was opened. 
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Oct 10, 2023 09:49
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hey at least Kaiser Permanente employees are striking so that's cool
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Oct 10, 2023 19:37
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My wife lost her Medicaid for like a month a few years ago. Cut to get having to go to the ER for health issues (t1 diabetic) One night in the ER, and a couple bags of saline drip later and her bill was nearly 20k. She literally has to stay poor, because with all of her medical needs/prescriptions/specialists no normal insurance will ever be affordable. And I just lost my insurance because of job change. Tldr America is a gently caress.
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Oct 10, 2023 20:40
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Sophy Wackles posted:Are you sure that $800 isn’t the annual cost OP? This wasn't answered, but either way, lmao there may be a long wait for specialists with socialized medicine, but I'll take it over the confusing and expensive mess of US healthcare. The peace of mind alone is worth it. Jesus loving Christ.
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Oct 10, 2023 21:29
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mom and dad fight a lot posted:This wasn't answered, but either way, lmao there may be a long wait for specialists with socialized medicine, but I'll take it over the confusing and expensive mess of US healthcare. The peace of mind alone is worth it. Jesus loving Christ. I called for an appt with an allergist in May, and they gave me a date for September. They called in July to tell me the doctor has better things to do that day I guess, and the appointment is now in December. I work for this place too. 
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Oct 10, 2023 21:46
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Roundup Ready posted:My wife lost her Medicaid for like a month a few years ago. Cut to get having to go to the ER for health issues (t1 diabetic) you were supposed to get divorced to protect your assets BEFORE she got in the ambulance, c’mon, it’s your own fault if you skipped that step
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Oct 10, 2023 22:12
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Bad Purchase posted:you were supposed to get divorced to protect your assets BEFORE she got in the ambulance, c’mon, it’s your own fault if you skipped that step We weren't married at the time, so ptttttfffff
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Oct 10, 2023 22:48
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mom and dad fight a lot posted:This wasn't answered, but either way, lmao there may be a long wait for specialists with socialized medicine, but I'll take it over the confusing and expensive mess of US healthcare. The peace of mind alone is worth it. Jesus loving Christ. Buddy, for most of us the wait is the same or longer in the US. If I call my doc I'm 6+ weeks out for an appointment, and I have to go through him for any specialist appointment. Which is then 3-6 months after he agrees
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Oct 10, 2023 23:02
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The thing that US healthcare defenders like to tout is that it gets better results, but that's simply not true. We get the same incredible wait times and botched surgeries as anywhere else. The only place that it's true is for the truly wealthy who can afford to pay absurd amounts to get the best medical care, but if you're not a millionaire that's probably not you.
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Oct 11, 2023 01:10
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Why does anyone think that if you had public healthcare that the rich won't pay to skip all the fuss anyway? They literally do that here, and you know what, fine, I still don't go into terminal debt from a cold.
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Oct 11, 2023 02:20
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syntaxfunction posted:Why does anyone think that if you had public healthcare that the rich won't pay to skip all the fuss anyway? They literally do that here, and you know what, fine, I still don't go into terminal debt from a cold. People are naive loving morons
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Oct 11, 2023 02:26
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The fun part of all that medical debt is it doesn't actually get paid, it is just used to torture poor sick people to drive up administrative costs. Another fun fact: There is something called the Medical Loss Ratio, it states that the maximum profit an insurance company can make is 20 percent of what they spend on medical care, anything over that has to be returned, thus, forcing insurance companies to be focused on patient care costs and not profits. OK, think about this for a second.... 20% of what the SPEND... So, say they spend $1,000 on your MRI, they can only make $200 in profit. What they spend... Oh, also you have co-insurance, so they more they spend, the more you spend... Think about that for a minute if you still aren't getting it... Their profit is capped at what they spend, not how efficiently they spend it, if they spend more they are allowed to keep more in absolute dollars...
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Oct 11, 2023 02:39
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Three Olives posted:The fun part of all that medical debt is it doesn't actually get paid, it is just used to torture poor sick people to drive up administrative costs. gotta spend money to make money
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Oct 11, 2023 02:43
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mom and dad fight a lot posted:This wasn't answered, but either way, lmao there may be a long wait for specialists with socialized medicine, but I'll take it over the confusing and expensive mess of US healthcare. The peace of mind alone is worth it. Jesus loving Christ. Also, it's not like you can be seen whenever you want in America's "better," "faster" system. I need to see a specialist, and the soonest I can have the procedure done is over a month from now. My uncle is going to have to wait like 2 months to get a catheter removed. You're not even paying for speed or convenience in the American healthcare system. The best thing you can say is that many of the best medical professionals in the world live in the United States, and that might be advantageous in some circumstances (you're rich and afraid of airplanes).
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Oct 12, 2023 19:04
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Time_pants posted:The best thing you can say is that many of the best medical professionals in the world live in the United States, and that might be advantageous in some circumstances (you're rich and afraid of airplanes). i wonder what the big draw could be... certainly all of these doctors arent purely concerned about profit.
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Oct 12, 2023 19:08
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Another fun thing about the US healthcare system are PBMs, which are yet another middleman extracting profit from the system: https://en.wikipedia.org/wiki/Pharmacy_benefit_management Tangential to that, the entire system of generic drugs is fairly bullshit. The official line is that all generics of a given medication are equivalent, but in practice that is often clearly not the case. My easiest personal example of that is caffeine tablets. I rely on caffeine tablets, which are generally pretty standardized at 200mg per pill. Even between the two biggest brands, Vivarin and NoDoz, the actual effects are different. Vivarin hits faster and I'm guessing hits a higher peak concentration in the bloodstream whereas NoDoz ramps up a little more slowly and likely hits a lower peak blood concentration. Getting into other brands, like store-branded versions, and there is even more variation. I mean, I don't doubt they all have 200mg of caffeine, but the actual effects and how that 200mg of caffeine hits varies a surprising amount. Extrapolate the same thing to prescription drugs and the FDA assertion that all generics are bio-equivalent looks pretty disingenuous.
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Oct 15, 2023 22:27
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Just finished my taxes: This stupid loving country. edit: Non-Americans: This means my employer paid over 16,000 for my health insurance last year. For context, that is more than someone working full time making minimum wage makes, total. I went to the doctor once last year. Three Olives fucked around with this message at 23:39 on Oct 15, 2023 |
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Oct 15, 2023 23:34
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you file your taxes in october?
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Oct 16, 2023 00:05
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Three Olives posted:Just finished my taxes:
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Oct 16, 2023 00:11
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A friend's husband had a kidney stone. Got admitted, had to stay over night, emergency surgery for it's removal in the morning. They pay ~1600 a month in insurance. The insurance company told them today that the single over night stay was "medically unnecessary" and provided them with a bill. $61,000.
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Oct 16, 2023 00:12
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Bad Purchase posted:you file your taxes in october? It's called not procrastinating.
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Oct 16, 2023 00:12
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Bad Purchase posted:you file your taxes in october? Extension, I didn't owe money but had to deal with how to report some things. Vegetable posted:You going to the doctor once — or many times — isn’t really a factor in how much your employer pays for insurance. I am aware, I am also aware that we live in a system where me having healthcare costs my employer as much as employing a person full-time to like, make burgers at McDonalds, who doesn't have healthcare. Three Olives fucked around with this message at 00:20 on Oct 16, 2023 |
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Oct 16, 2023 00:17
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$16k is a lot, even for the US. Average US spend for working age people (not-medicare) is like $9.5k/year. For comparison, western europe ranges around $5-10k/year/person (across the whole population, including old people). In sensible systems, it's not /that/* much more money total, it's just funded from progressive tax revenue instead of being a flat cost attached to your job. *US pays a ~30% premium in admin costs dealing with paperwork for many insurance systems, then the rest is better salaries, higher drugs costs, and fancier equipment.
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Oct 16, 2023 00:58
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That seems insanely high op. I got laid off a few months ago and have been on cobra while I look for another job and even my inflated rear end cobra insurance isn't that high a month
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Oct 16, 2023 00:59
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I would support domestic terrorism against insurance companies, no holds barred
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Oct 16, 2023 01:02
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CaptainSarcastic posted:Another fun thing about the US healthcare system are PBMs, which are yet another middleman extracting profit from the system: https://en.wikipedia.org/wiki/Pharmacy_benefit_management Talk to the prescribing doctor and complain that the generic is having adverse effects, and if the doc agrees and signs off, you might be able to qualify for an exception/waiver, but that's all on you to submit paperwork and complain a lot, and then they may deign to give you a covered copay/coinsurance on it. But you absolutely need to try the generic first and have a doc write a loving note about "this poo poo's not working for the patient." interwhat posted:I would support domestic terrorism against insurance companies, no holds barred 
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Oct 16, 2023 01:22
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Every time I've had my medical covered by an employer, the story goes as thus: I pay into that poo poo time after time. Something happens and oh no, I need to go to the hospital! Maybe it's an injury, or maybe it's that one time my gallbladder exploded; who knows! Suddenly my medical is cut off and I don't have medical now. It's really dog poo poo, American medical basically exists so you pay but they'll take it away if you ever actually need it for anything. Anyway I'm self employed now so that's been fun. My current care providers are terrible! My doctor has been MIA for like a year, I've spoken to her once and just can not get ahold of her for anything. Sometimes my medications are just delisted on the website I'm forced to use to ask for refills so I have to wait and hope I don't run out until it says I can request them again. Currently, one medication has been delisted for months, I have no way to contact my doctor because I call and she's just loving gone. Maybe she doesn't exist. She's my third doctor. She took over after the guy before her, who I also talked to literally once then never again, quit without any warning to anyone and no one bothered to tell his patients until like a year after. So maybe that happened again, who knows. I sure do love the american medical system.
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Oct 16, 2023 01:29
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Threw my back out at the gym deadlifting. I like how I have to ask the same questions every time I do anything because I’m not wealthy. Schedule an an appointment to talk to a doctor? “Is this in my insurance network? Is there an out of pocket or copay?” Doctor orders an X-ray? “Is this in my insurance network? Is there an out of pocket or copay?” Doctor recommends a PT to teach me some stretches? “Is this in my insurance network? Is there an out of pocket or copay?” Same questions every time because they will bleed me dry instantly if I don’t check Shitass country. In Asia I could just walk into any random clinic or hospital and an hour later I’d have all this done and it would cost $20, or maybe less or even free.
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Oct 16, 2023 20:08
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how much were u deadlifting
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Oct 16, 2023 20:11
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315 / 3 plates I was also learning sumo deadlifts specifically because it’s supposed to be safer for the back too lmao What a scam
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Oct 16, 2023 20:12
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Toxic Mental posted:Threw my back out at the gym deadlifting. I like how I have to ask the same questions every time I do anything because I’m not wealthy. And then it turns out the information was wrong anyway and you're actually out of network. Or someone who was out of network got involved behind the scenes without your input or knowledge (if you were even conscious at the time). Or the insurance company just feels like playing games and tries something. 
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Oct 16, 2023 20:18
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skooma512 posted:And then it turns out the information was wrong anyway and you're actually out of network. Or someone who was out of network got involved behind the scenes without your input or knowledge (if you were even conscious at the time). Or the insurance company just feels like playing games and tries something. I want to point out, and this is actually just illustrating how truly hosed the US healthcare system is, that most practices and hospitals contract with 3rd parties for the massive amount of paperwork that needs to be done for authorization or claims filing. Those companies are usually located in other countries. Those companies also do not have any clue what the gently caress they are doing and train their employees to also not have any clue what they are doing. So when filing authorizations or claims, they must fill in a National Provider Number, Tax ID (if required, which apparently varies by insurance company which is loving stupid), mostly correct name of provider or facility. The NPI and TID must match what the insurance has as in-network, but the 3rd party companies either receive the information wrong from the practice or hospital and the alternate numbers they received and are using on all forms are from an out-of-network account for the same provider and/or same hospital. Sometimes they pull a little mix and match, so insurance companies that use both sets of numbers to confirm the account requesting payment or authorization show that the request is invalid because those 2 numbers are not together in their system. I’m pretty sure the required information for prior authorization and claims is also different for different insurance lines offered by the same company. I know that the case between Medicaid, Medicare, and Marketplace plans for one of the companies that handles multiple versions of all of those for the state in which I used to live. And that same company handles those plans and many prison healthcare plans all over the US. So basically, it’s a super confusing system that is just a bloated waste of money at this point and the companies that are like,”We can totally handle these frustrating administrative tasks for you!” are also wasting the tons of money being filtered over to them because they do not give a poo poo about actually doing the job well. Edit: I really wish more health insurance companies and health insurance administrative middleman companies would get sued for gross incompetence, cause both have a massive problem with incompetence that management is aware of, but since management also does not understand any of the minutiae of health insurance or anything about human biology or what it’s like to practice medicine, they just ignore it and keep cashing that paycheck (which is probably not even that much for the level of management that should be bringing it up to their superiors but is too afraid to because it doesn’t fit into any metrics boxes). Bored fucked around with this message at 06:16 on Oct 17, 2023 |
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Oct 17, 2023 06:08
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Toxic Mental posted:315 / 3 plates tried a hex bar? heard that's the real answer for people with low back issues. been really thinkin to cop one for the ol' home gym this year. it does change the movement a bit to be somewhere between a squat and a deadlift, but unless you really care about competing in powerlifting, probably not enough to matter
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Oct 17, 2023 06:28
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Bored posted:So basically, it’s a super confusing system that is just a bloated waste of money at this point and the companies that are like,”We can totally handle these frustrating administrative tasks for you!” are also wasting the tons of money being filtered over to them because they do not give a poo poo about actually doing the job well. idk maybe I am veering into conspiracy theories here but I feel like all of the middleman companies prefer a massive convoluted system. Sure it costs them more money, but ensuring that the healthcare system is unnavigable by anyone except them locks in their place as a guaranteed profit skimmer.
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Oct 17, 2023 07:27
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aniviron posted:idk maybe I am veering into conspiracy theories here but I feel like all of the middleman companies prefer a massive convoluted system. Sure it costs them more money, but ensuring that the healthcare system is unnavigable by anyone except them locks in their place as a guaranteed profit skimmer. I think that is likely true. Nvm, corporate lobbying. Like, I’m not for a terrorist attack on insurance company buildings because that is not going to effect most of the people responsible for this bullshit. Those people don’t have to work from the office. Edit: like, the only thing they can really charge them with corruption for is double billing the governments they have contracts with and it is a shame that it takes so loving long to find proof of something so goddamned obvious. https://californiahealthline.org/ne...verbilling/amp/ (Centene has had to settle with multiple states regarding double billing for pharmacy services, but since they settled, the states continue to use them) Also, somehow (lobbying) United Healthcare is being permitted to bill providers an extra fee for processing their claims. Bored fucked around with this message at 08:11 on Oct 17, 2023 |
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Oct 17, 2023 07:57
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Philthy posted:You would think it would be a no brainer type of decision to make. I honestly don't understand how anyone can argue against it. Nearly everyone has had someone in their family get sent to the hospital at some point, even if it's just from being old and your body begins to give out in one way or another. Even Republicans in the highest offices know how awful our healthcare is, and that they're extremely lucky to have fantastic coverage while the rest of their family doesn't and has to deal with the bullshit. It's infuriating. It really is a terrible system but there are reasons it lingers. One of those reasons is that there is an entire, enormous industry and related supporting industries who's existence depends on this bad system. The health insurance industry are leeches. They market their product to companies as a way to reduce turn over and any attempt to nationalize or even provide a public option will be met with one of the biggest war chests of lobbying dollars and PR machine that exists short of the defense industry. During the Obama administration, "Obamacare" as the affordable care act was branded met with fierce opposition, not just from Republican elected but a PR machine that convinced regular people that a public option would mean "death panels." It led to dumb dumbs showing up at congressional townhalls with tricorn hats and assault rifles. The ACA passed but the public option was stripped out and we got this feckless half-measure that did make things better but not nearly enough. Republican state legislatures poked holes in the plan by not expanding medicaid, but were also successful in misdirecting the voters the blame for Obamacare being bad to Obama. It was presented to them that people in blue states got medicaid expanded and they got nothing because its a handout for Black people and Illegals. The phenomenon is called "Manufacturing Consent." There's another, even more depressing reason that this persists even when if you ask the public if we should have universal healthcare, they tend to agree, provided you don't bring up divisive framing or public figures that PR firms have poisoned the well against. https://www.vox.com/2014/4/18/5624310/martin-gilens-testing-theories-of-american-politics-explained The short version is that electeds, essentially, do not give a flying gently caress about any of us, at all. Literally nothing we do or say on this or any other forum, on twitter, to any pollster, or anything else matters at all. They only care about their donor base, and millionaires and billionaires prefer the system as it is. They prefer it as it is because they either parasitically make money off of it directly or they do so indirectly because the threat of losing health insurance keeps us going to our jobs. The media is largely on the side of the wealthy. There's no suit that comes in to tell journalists what to write. There never needs to be because journalists with heterodox views that don't align with the owners who are likely to rock the boat, the never get hired in the first place.
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Oct 17, 2023 09:14
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Bad Purchase posted:tried a hex bar? heard that's the real answer for people with low back issues. been really thinkin to cop one for the ol' home gym this year. it does change the movement a bit to be somewhere between a squat and a deadlift, but unless you really care about competing in powerlifting, probably not enough to matter I mean I think I'm just done with deadlifting period. I threw my back out two times in my early 20s doing it, but never a spinal hernia like I did this time.
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Oct 17, 2023 09:20
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I just went to see my PCP about my blood pressure. They told me I should eat less sodium and more vegetables. I was charged $300 In addition to my $800 monthly premium. But wait! There's good news.... I got a $25 discount! LMFAO
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Oct 17, 2023 16:07
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