Obamacare/Trumpcare Horror Stories

[Blarg]

Red, the options are simple, you are fucked. Maybe you are not involved in the getting ass fucked by a phony socialist Ponzi scheme called Obmacare but when that day comes you are going to be posting more in this thread with an entirely different viewpoint.

[fan_since79]

Red, since you're a liberal, what do you think of the idea of interstate competition in the health insurance business? I don't believe the ACA allows for it.

 

[red321]

The last thing we want is a race to the bottom when it comes to health insurance. At that point you allow a state, let's say Texas, to become incredibly pro payer and you end up with all sorts of loopholes in coverage. It would allow companies to head off to a state that has stripped out most regulations and then start selling junk insurance in other states, like California, which provide more consumer protection.

You think insurance companies get away with murder now, institute selling insurance across state lines and watch what happens.

[Adam]

Why would anyone buy junk insurance?

[halobob]

5 hours ago, red321 said:

The last thing we want is a race to the bottom when it comes to health insurance. At that point you allow a state, let's say Texas, to become incredibly pro payer and you end up with all sorts of loopholes in coverage. It would allow companies to head off to a state that has stripped out most regulations and then start selling junk insurance in other states, like California, which provide more consumer protection.

You think insurance companies get away with murder now, institute selling insurance across state lines and watch what happens.

#feelthebern

[Lhalo]

1 hour ago, Adam said:

Why would anyone buy junk insurance?

In case you receive a kick to the nuts?

[arch stanton]

2 hours ago, Adam said:

Why would anyone buy junk insurance?

Because junk insurance companies will send reps out to give swag to all the financial advisors to make sure they emphasize the importance of insuring your junk and the catostrophic consequences of failing to do so. 

[nate]

14 hours ago, red321 said:

The last thing we want is a race to the bottom when it comes to health insurance. At that point you allow a state, let's say Texas, to become incredibly pro payer and you end up with all sorts of loopholes in coverage. It would allow companies to head off to a state that has stripped out most regulations and then start selling junk insurance in other states, like California, which provide more consumer protection.

You think insurance companies get away with murder now, institute selling insurance across state lines and watch what happens.

God forbid that consumers have a choice.

Your statement about insurers getting away with murder is the biggest problem with all of this.  People still don't understand their insurance and think having it means they can go to any doctor at any time and not pay a penny.  When they can't they call it insurance companies getting away with murder.

What part of most regulated industry in America doesn't get through to people?

[red321]

Healthcare is not like buying a car, or groceries, or speakers.

There is a reason healthcare is heavily regulated, once you institute selling across state lines though...a good portion of that goes away and you'll see states competing on who can set the lowest bar.

[nate]

As it should be.

Or you could live in NJ and pay the highest rates in the country because the state insists on mandating every last bit of coverage since the people obviously can't choose what is best for themselves.

[red321]

Hold on doc...let me pull out Kayak for healthcare before you start on that emergency triple bypass to make sure I'm getting the best price

[nate]

What does that have to do with it?  All plans cover emergency services.

They also cover viagra, mental health, durable medical equipment, etc.

 

If you are 22 without mental health issues, do you need that?

[Adam]

Because progress, dude. Get with it

[Blarg]

I can't wait until the H1-B doctors start arriving to offset the costs of Obamacare. Think of it as NAFTA for Health Care. Same great smocks but with cheaper people that don't speak your language and have a two year certificate from an online school.

[Lhalo]

... or India.

[Blarg]

So you have had an appointment with Dr. Patel.

[red321]

Different plans cover emergency services at different levels. Go put yourself in a high deductible HSA and let them pitch you on how awesome their app is...because that's where things are headed...consumer choice...exactly what you want to do when you are sick or injured...cost shop for services.

You understand how insurance works...overall costs are cheaper and risks are mitigated if you are spreading costs across larger pools. Younger people are cheaper to cover (for the most part) than older people and by having a larger pool including both younger and older (i.e. more expensive) lives you spread out the risk lowering the overall cost for everyone. Is that necessarily fair to younger people? Maybe not today, but as they get older and start using the system more it evens out.

 

[nate]

The government is not there to be our dad.  If someone chooses the cheapest plan knowing that it has a high deductible then they know the risk they are taking.  These are adults making the choice, the same people we let buy booze and cigarettes.  Meanwhile you are adding a huge burden to the entire system and country by mandating so much coverage.  There is a reason it is so expensive here.

All plans have a maximum out of pocket of $7250 per year so worst case is they have a big hospital bill that takes them a couple years to pay back.

[red321]

No, but in some cases we all get together and decide that we can better manage something together than individually.

All plans have a maximum out of pocket...now...why is that...should we send a thank you note to dad?

Yes, there are many reasons coverage is expensive here...mandates being a very small part of it. Just like overuse of services, lack of coverage resulting in people utilizing emergency services rather than basic wellness screening, poor health maintenance and managing of chronic diseases, excessive drug costs, etc. etc. etc.

ps. in some cases that high deductible plan is all people are offered because the system is setup to use employer based coverage

[nate]

People have the option of waiving employer coverage and getting an individual plan.  Or they have the option of getting a supplemental individual plan.

They also can put pre-tax $ toward the HSA to offset emergency costs.

Mandates are the biggest reason health costs are expensive.  Doctors know it will be covered so why not do it?  Doctors can charge whatever they want because the insurers are forced to pay it.  Plus thanks to Obama and ACA we have to pay for the health costs of chronic smokers and fat people since he got rid of underwriting.

[red321]

You are right, they do...and then they lose the employer portion of the coverage (in essence agreeing to take a pay cut) plus I'm pretty sure that means they don't qualify for subsidies (and if they are gainfully employed, they probably don't qualify anyways). Sounds good in the perfect world scenario...though sad to say most people don't live in that world.

Can you please reference something that shows mandates are the reason why healthcare costs are so expensive? Doctors over subscribing care is not mandates, it's "defensive medicine" that results in unneeded tests and services. A doctor subscribing the latest brand name drug that Billy Joe saw advertised on TV is not a mandate. Utilization of specialists when a GP could provide the same care in some cases is not mandated. Doctors cannot charge whatever they want, providers and payers have contracts that set rates for services and payers routinely reject costs submitted by the provider...who in turn then goes after the patient in some cases.

The administrative costs of running our healthcare system are crazy, something like a quarter of the costs. And yes...I would agree that some of that is due to government regulation. It's friggen ridiculous that providers hire people (which are then built in to the cost of their services...so we are paying for them) to scan through codes to identify how to maximize billing. I recently received a bill from a specialist because they audited their records and recoded my visit from over a year ago. I now have to spend my time arguing with them on the phone unless I just want to fork over another $100 bucks on top of the $300 my 10 minute visit already cost. None of that is mandated.

 

[NJHalo]

1 hour ago, nate said:

People have the option of waiving employer coverage and getting an individual plan.  Or they have the option of getting a supplemental individual plan.

They also can put pre-tax $ toward the HSA to offset emergency costs.

Mandates are the biggest reason health costs are expensive.  Doctors know it will be covered so why not do it?  Doctors can charge whatever they want because the insurers are forced to pay it.  Plus thanks to Obama and ACA we have to pay for the health costs of chronic smokers and fat people since he got rid of underwriting.

I agree with most of this, other than the MDs charging whatever they want. Not true. You work in the insurance industry, so you know there are fee schedules and contracted rates. These rates usually stay the same, or go lower despite continued increase in costs to the provider. That is why office managers and doctors need to be careful when they decide which networks to participate in. It's a tug of war between insurance companies trying to contain their costs, vs. providers trying to cover theirs.

[nate]

4 hours ago, NJHalo said:

I agree with most of this, other than the MDs charging whatever they want. Not true. You work in the insurance industry, so you know there are fee schedules and contracted rates. These rates usually stay the same, or go lower despite continued increase in costs to the provider. That is why office managers and doctors need to be careful when they decide which networks to participate in. It's a tug of war between insurance companies trying to contain their costs, vs. providers trying to cover theirs.

This is true for doctors that are in network with the insurance company.  For insurance that doesn't have a LCN or narrow network they will charge higher prices.  That is why those HDHP plans exist, it keeps people within a LCN but with a high deductible which penalizes them if they leave the network.

[halobob]

6 hours ago, red321 said:

No, but in some cases we all get together and decide that we can better manage something together than individually.

All plans have a maximum out of pocket...now...why is that...should we send a thank you note to dad?

Yes, there are many reasons coverage is expensive here...mandates being a very small part of it. Just like overuse of services, lack of coverage resulting in people utilizing emergency services rather than basic wellness screening, poor health maintenance and managing of chronic diseases, excessive drug costs, etc. etc. etc.

ps. in some cases that high deductible plan is all people are offered because the system is setup to use employer based coverage

I don't want anyone managing my affairs other than me because I know what I want.  If I fuck up, it's on me and no one else.  

[red321]

19 minutes ago, halobob said:

I don't want anyone managing my affairs other than me because I know what I want.  If I fuck up, it's on me and no one else.  

 

My bad...apparently halobo is a fucking bad ass who builds and manages everything himself