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FelixDeCat

Lifer
Aug 4, 2000
29,294
2,095
126
Yeah, I remember the glory days before the ACA when insurance companies could drop cancer patients for any or no reason. Crazy how commie dems crammed it through when everything was totally fine. I assume because they wanted to take away our freedom.
A long time ago they had reasonsonble limits on coverage and didn't cover basket cases. Most importantly there was a $1m cap on losses they would sustain.

Now they ate required to bear unlimited losses as its illegal to put a max on policy coverage amounts. Which is why now you pay the first $3000 or more in losses before they pay a damn dime.

Thanks Obama! Hopefully we can fix this boondoggle one day.
 
Reactions: Pohemi

IronWing

No Lifer
Jul 20, 2001
69,474
27,748
136
A long time ago they had reasonsonble limits on coverage and didn't cover basket cases. Most importantly there was a $1m cap on losses they would sustain.

Now they ate required to bear unlimited losses as its illegal to put a max on policy coverage amounts. Which is why now you pay the first $3000 or more in losses before they pay a damn dime.

Thanks Obama! Hopefully we can fix this boondoggle one day.
Conservatives have had decades to fix health care. They ain’t done shit other than make it worse and block all attempts to address real solutions. Conservatives are horrible people.
 
Mar 28, 2008
41
90
91
A long time ago they had reasonsonble limits on coverage and didn't cover basket cases. Most importantly there was a $1m cap on losses they would sustain.

Now they ate required to bear unlimited losses as its illegal to put a max on policy coverage amounts. Which is why now you pay the first $3000 or more in losses before they pay a damn dime.

Thanks Obama! Hopefully we can fix this boondoggle one day.
I hope you get what you want and your insurance company gets to decide whether you deserve to have an expensive treatment or they just let you die. Since you care about the well-being of insurance companies so much.
 
Reactions: Pohemi

FelixDeCat

Lifer
Aug 4, 2000
29,294
2,095
126
I hope you get what you want and your insurance company gets to decide whether you deserve to have an expensive treatment or they just let you die. Since you care about the well-being of insurance companies so much.

If it costs more than $1m to save your life and you don't have it in assets or checking account, should we all have to pay for that?

That's more of a philosophical question since most would likely answer yes, they would push their medical costs onto others.

And I am asking this from a perspective of suffering from a current incurable ailment and a previous one that was life threatening.

I am here now because of a $300,000 surgery combined costs with follow up treatments, which was covered.

There really is no fair answer for everyone but I know one thing, I got to come up with $3000 each year and that is on top of the $3600 in premiums.
 

IronWing

No Lifer
Jul 20, 2001
69,474
27,748
136
If it costs more than $1m to save your life and you don't have it in assets or checking account, should we all have to pay for that?

That's more of a philosophical question since most would likely answer yes, they would push their medical costs onto others.

And I am asking this from a perspective of suffering from a current incurable ailment and a previous one that was life threatening.

I am here now because of a $300,000 surgery combined costs with follow up treatments, which was covered.

There really is no fair answer for everyone but I know one thing, I got to come up with $3000 each year and that is on top of the $3600 in premiums.
Then you have a better plan than most. Eat your free market vegetables, parasite.
 
Mar 28, 2008
41
90
91
If it costs more than $1m to save your life and you don't have it in assets or checking account, should we all have to pay for that?

That's more of a philosophical question since most would likely answer yes, they would push their medical costs onto others.

And I am asking this from a perspective of suffering from a current incurable ailment and a previous one that was life threatening.

I am here now because of a $300,000 surgery combined costs with follow up treatments, which was covered.

There really is no fair answer for everyone but I know one thing, I got to come up with $3000 each year and that is on top of the $3600 in premiums.
Very convenient that your arbitrary limit is $1,000,000 instead of say $250,000, so you get to claim you got the care you deserved, while depriving others in a similar situation. Without the ACA they could have simply denied you instead. After all, their profits are important, and they can't afford everything. I wonder how your opinion might have changed, assuming you were alive to whine about it.

If true socialized health care had passed, the total cost wouldn't have even been a concern for you, and you would be paying less overall since you'd only be paying for the health care rather than paying for the insurance middlemen who are maximally driving their profits through premiums and making decisions that should between you and your doctor. But Obama.
 

FelixDeCat

Lifer
Aug 4, 2000
29,294
2,095
126
Very convenient that your arbitrary limit is $1,000,000 instead of say $250,000, so you get to claim you got the care you deserved, while depriving others in a similar situation. Without the ACA they could have simply denied you instead. After all, their profits are important, and they can't afford everything. I wonder how your opinion might have changed, assuming you were alive to whine about it.

If true socialized health care had passed, the total cost wouldn't have even been a concern for you, and you would be paying less overall since you'd only be paying for the health care rather than paying for the insurance middlemen who are maximally driving their profits through premiums and making decisions that should between you and your doctor. But Obama.
My $1m limit was not arbitrary. If you were older than 30 (and assuming you had the desire to read the fine print) you would remember that was pretty much the universal limit on most individual plans. That amount was also cumulative for the life if the policy.

With the actual loss limit known, insurance companies could price a relatively affordable plan

.But now they could be on the hook for millions for just one person. How do price a plan with that kind of liability? Exclude the cost of most services up to the first $3000 to $5000 annually, charge a hefty monthly premium and keep a 10% overriding OOP cost on care up to the full amount of the claim.

Here is a $300,000 bill:

$300,000 less $3,000 is $297,000. The is an extra $2000 OOP expensive on certain claims, so now the remaining amount is $295,000. Once you hit your maxes, there is an overriding balance due of 10% of the remaining amount of $29,500.00

Of $300,000 you owe $34,500 plus $300 monthly in premiums.

Any future claims for the current year is 10% of the amount due.....AND that's assuming they cover it (deemed medically necessary). Next year everything resets to zero and you have to pay $3000 before they pay dollar one.

Last year I had a $4000 procedure they rejected and I got stuck with the bill. Thankfully I negotiated it down to $1500 on my own.

And the bastards did not give me credit on my $3000 deductible!

Obamacare. Pffft.
 

IronWing

No Lifer
Jul 20, 2001
69,474
27,748
136
My $1m limit was not arbitrary. If you were older than 30 (and assuming you had the desire to read the fine print) you would remember that was pretty much the universal limit on most individual plans. That amount was also cumulative for the life if the policy.

With the actual loss limit known, insurance companies could price a relatively affordable plan

.But now they could be on the hook for millions for just one person. How do price a plan with that kind of liability? Exclude the cost of most services up to the first $3000 to $5000 annually, charge a hefty monthly premium and keep a 10% overriding OOP cost on care up to the full amount of the claim.

Here is a $300,000 bill:

$300,000 less $3,000 is $297,000. The is an extra $2000 OOP expensive on certain claims, so now the remaining amount is $295,000. Once you hit your maxes, there is an overriding balance due of 10% of the remaining amount of $29,500.00

Of $300,000 you owe $34,500 plus $300 monthly in premiums.

Any future claims for the current year is 10% of the amount due.....AND that's assuming they cover it (deemed medically necessary). Next year everything resets to zero and you have to pay $3000 before they pay dollar one.

Last year I had a $4000 procedure they rejected and I got stuck with the bill. Thankfully I negotiated it down to $1500 on my own.

And the bastards did not give me credit on my $3000 deductible!

Obamacare. Pffft.
Sounds like you were stealing the hard won money of the insurance company's investors. Shame on you.
 

MrSquished

Lifer
Jan 14, 2013
21,860
20,182
136
Conservatives have had decades to fix health care. They ain’t done shit other than make it worse and block all attempts to address real solutions. Conservatives are horrible people.
Look. Someone gets it. Conservatives are horrible people. That's pretty much it. The shittiest of the shitty. Nothing more to it.
 
Reactions: dank69

HomerJS

Lifer
Feb 6, 2002
36,277
28,135
136
A long time ago they had reasonsonble limits on coverage and didn't cover basket cases. Most importantly there was a $1m cap on losses they would sustain.

Now they ate required to bear unlimited losses as its illegal to put a max on policy coverage amounts. Which is why now you pay the first $3000 or more in losses before they pay a damn dime.

Thanks Obama! Hopefully we can fix this boondoggle one day.
From the author of "billions" of people illegally crossing the border under Biden, why should anyone believe anything you say?
 

FelixDeCat

Lifer
Aug 4, 2000
29,294
2,095
126
From the author of "billions" of people illegally crossing the border under Biden, why should anyone believe anything you say?

Since you are humorless and devoid of detecting obvious devices to emphasize it, here is something even you can understand:

Why would it be unreasonable to put a cap on losses on any insurance policy to be able to sell affordable policies?

There are limits on auto and home policies and a long time ago there were coverage limits on health policies that were cumulative. So if you have a $50,000 claim one year it reduces the max your policy will pay in the future by that amount.

Can you imagine if the government removed caps on those policies?

You have to balance cost of care and overall coverage amounts.
 

outriding

Diamond Member
Feb 20, 2002
3,213
2,330
136
Since you are humorless and devoid of detecting obvious devices to emphasize it, here is something even you can understand:

Why would it be unreasonable to put a cap on losses on any insurance policy to be able to sell affordable policies?

There are limits on auto and home policies and a long time ago there were coverage limits on health policies that were cumulative. So if you have a $50,000 claim one year it reduces the max your policy will pay in the future by that amount.

Can you imagine if the government removed caps on those policies?

Where are you getting this information???


Lifetime Limits​


Insurance companies can no longer set a dollar limit on what they spend on essential health benefits for your care during the entire time you’re enrolled in that plan. Previously, health plans set a lifetime limit — a dollar limit on what they would spend for your covered benefits during the entire time you were enrolled in that plan. You were required to pay the cost of all care exceeding those limits.


Annual Limits​


Insurance companies can no longer set yearly dollar limits on what they spend for your coverage. Previously, health plans set an annual limit — a dollar limit on their yearly spending for your covered benefits. You were required to pay the cost of all care exceeding those limits.



 
Reactions: soundforbjt

compcons

Platinum Member
Oct 22, 2004
2,155
1,166
136
Since you are humorless and devoid of detecting obvious devices to emphasize it, here is something even you can understand:

Why would it be unreasonable to put a cap on losses on any insurance policy to be able to sell affordable policies?

There are limits on auto and home policies and a long time ago there were coverage limits on health policies that were cumulative. So if you have a $50,000 claim one year it reduces the max your policy will pay in the future by that amount.

Can you imagine if the government removed caps on those policies?

You have to balance cost of care and overall coverage amounts.
ummmm.. because homes and autos are property and have definite values associated with them. I guess you assign value to a human life but most people do not.

It is so sad that you value insurance profits over your fellow humans. It is very telling as to what kind of person you are.
 

HomerJS

Lifer
Feb 6, 2002
36,277
28,135
136
Since you are humorless and devoid of detecting obvious devices to emphasize it, here is something even you can understand:

Why would it be unreasonable to put a cap on losses on any insurance policy to be able to sell affordable policies?

There are limits on auto and home policies and a long time ago there were coverage limits on health policies that were cumulative. So if you have a $50,000 claim one year it reduces the max your policy will pay in the future by that amount.

Can you imagine if the government removed caps on those policies?

You have to balance cost of care and overall coverage amounts.
You are lying. You always lie
 
Reactions: Meghan54 and Indus

FelixDeCat

Lifer
Aug 4, 2000
29,294
2,095
126
ummmm.. because homes and autos are property and have definite values associated with them. I guess you assign value to a human life but most people do not.

It is so sad that you value insurance profits over your fellow humans. It is very telling as to what kind of person you are.
Do you want an affordable plan with a limit or do you want an unaffordable plan with high premiums and deductibles and no limit?
 

FelixDeCat

Lifer
Aug 4, 2000
29,294
2,095
126

Lifetime Limits​


Insurance companies can no longer set a dollar limit on what they spend on essential health benefits for your care during the entire time you’re enrolled in that plan. Previously, health plans set a lifetime limit — a dollar limit on what they would spend for your covered benefits during the entire time you were enrolled in that plan. You were required to pay the cost of all care exceeding those limits.


Annual Limits​


Insurance companies can no longer set yearly dollar limits on what they spend for your coverage. Previously, health plans set an annual limit — a dollar limit on their yearly spending for your covered benefits. You were required to pay the cost of all care exceeding those limits.
Read the first sentence of the first paragraph. Keep reading it. Now imagine you are an insurance company trying to make a profit. How do you make money without charging so much the government has to subsidize premiums? Because that is what is happening now.

As a result, health insurance companies are making RECORD profits (see United Health recent report) because we are footing most bills out of pocket these days.
 

Paratus

Lifer
Jun 4, 2004
16,840
13,765
146
Do you want an affordable plan with a limit or do you want an unaffordable plan with high premiums and deductibles and no limit?
Maybe if you weren’t mooching off your betters you could afford a good insurance plan with lower deductibles.
 
Reactions: Meghan54

outriding

Diamond Member
Feb 20, 2002
3,213
2,330
136
Read the first sentence of the first paragraph. Keep reading it. Now imagine you are an insurance company trying to make a profit. How do you make money without charging so much the government has to subsidize premiums? Because that is what is happening now.

As a result, health insurance companies are making RECORD profits (see United Health recent report) because we are footing most bills out of pocket these days.

Did you read the article????

Because essential health benefits covers alot of stuff


What Marketplace health insurance plans cover​

All plans offered in the Marketplace cover these 10 essential health benefits:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

Additional benefits​


Plans must also include the following benefits:



Pretty much everything but eye and dental..





You might have read the quoted part but you did not bother to understand the coverage..

BTW you were complaing about caps in health care as an issues

and now you are worried about profits from the health care insurance companies... I am not following you ..
 
Last edited:

nakedfrog

No Lifer
Apr 3, 2001
58,521
12,816
136
ummmm.. because homes and autos are property and have definite values associated with them. I guess you assign value to a human life but most people do not.

It is so sad that you value insurance profits over your fellow humans. It is very telling as to what kind of person you are.
To be fair, it's not just insurance profits he values over fellow humans, there's all kinds of other profits that he values more than fellow humans.

Won't someone think of the poor insurance companies?!?
For the full year 2022, Cigna earned $180.5 billion in revenue and $6.7 billion in profit. By comparison, the insurer reported $174.1 billion in revenue and $5.4 billion in profit for 2021.
 

sportage

Lifer
Feb 1, 2008
11,493
3,159
136
I wish Joe would avoid these situations and back off these kind of interactions
Old people don't think that way. They think they are being playful. And usually the average old grandpa would never try to be too playful to a strange child. That is.... unless he is running for president. Then you have to act friendly, to everyone. So... what else was Joe to do??? I bet 99% of all grandpas running for president would have done something questionable too when a kid is stuck up in their face. Or I guess Joe could do what WC Fields would have done, just say "GO AWAY KID, YA BOTHER ME". And how do you think Fox News would have reacted to Joe saying THAT????

It's a real bitch to be old. Damned if you do and damned if you don't.
 
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