Discussion Our healthcare mess thanks to Obamacare

[manly]

This entire thread is yet another example where conservatives don't offer solutions just bitch and moan when others attempt solutions.

It's the same way they treat affirmative action.

The (not so) funny thing is that in the other thread, OP freely admitted he had some $300k worth of health care services covered by his plan. In other words, he's perfectly happy to leach off of others when it benefits him, but not when it benefits "the poors."

You can't blame Obamacare for healthcare expenses going through the roof. I wasn't a fan of Obamacare penciling in insurance companies because that is the problem....middlemen and bs corporate administration costs are stealing money from both the providers and the patients.

Prior to Obamacare, insurance expense were on the same trajectory. Pay more money for less coverage. Makes me sick when people are charged hundreds of dollars for Tylenol in the hospital.

If the Dems could have passed single-payer, they would have. ACA was a huge compromise to achieve what they could get through Congress. The ACA even tried some cost containment measures (because as pointed out throughout this thread, for-profit health care is the root of the cost problem) and Repugs foamed at the mouth and screamed "death panels." For a number of years after the ACA was implemented, the rate of growth in costs was actually moderated (you can see that in the chart that biostud posted).

 

[MrSquished]

This was an offshoot of another thread, which should be separate:

I mentioned that the cost of care is very high under the current regime. I have to pay $3,000 out of pocket before my insurance company pays anything, including doctor visits and medicine. This is thanks to Obamacare, which lifted the maximum a policy will pay during its lifetime. If you have a chronic condition or have a bad accident or problem that requires a lifetime of care, the maximum benefits you could claim in the past was $1,000,000 cumulative over how many years you have the policy. Now that cap is removed. Theoretically you could run up a bill over $1M - in just one year - and you only pay according to your plan, unusually 10% or $100,000 plus any deductibles.

Some have suggested a national healthcare scheme is the solution where costs are paid with higher income taxes ("healthcare tax") on top of marginal rates. However there are problems with this type of care as well including lower quality care, long wait times for appointments and assigned doctors within a zip code. If all your doctors are bad, too bad.

Here is someone describing a problems with the healthcare scheme in the UK:

Long wait times, short consultations, silly rules, etc

(Its only a brief part of a larger problem of poverty in the UK that I happened to be watching).

What do you think?

Can we make an exception so you can be denied any health insurance for having a pre-existing condition? And I'm not talking about your brain damage, but whatever it is you are whining about here.

I think we'd all be better off that way and it would free up resources for more deserving people.

 

[mikeymikec]

My father has had a relatively long, healthy life. There were blood pressure and glaucoma issues over the years but overall healthy. Then he had a series of problems that led to months in the hospital and rehabilitation centers back and forth, including time in the emergency room and ambulance rides. The total bill was over $750,000.

However, because he was on Medicare with co-insurance his total out of pocket was about $5,000, which was covered by an HSA from a retirement plan - from my mother paid by Siemens, a German company she retired from in the US.

Total cost? Zero.

So if you like the idea of not being on the hook for tonnes of medical expenses, why are you arguing against it?

 

[NWRMidnight]

Sorry, but no. Under my plan, I have to pay $3,000 before they pay anything thats not considered "preventative". Even worse, if they dont think your care or treatment was medically necessary, they wont pay jack shit or give you credit for your deductible.

Example - last year I got an intravenous iron injection that cost $4,000. The insurance company said they would not pay even though the primary and specialist doctors both said it was necessary. I got stuck with the bill! Thankfully after almost a year of haggling with the worthless insurance company and getting rejected, I negotiated with the hospital directly for $1,500 cash.

And no, I did not even get credit on my deductible. Thanks Obamacare!

So, it's not Obama care that is causing you problems, it's YOUR shitty insurance plan.

You said: "I have to pay $3000 before they pay anything that's not considered preventative" so you admit that you don't pay for everything, and what I told you is accurate, as that statement shows you do not pay everything up to the first $3000, as preventive care is paid in full by the insurance company as required by law (The ACA, aka Obama Care). You have made it clear you have no fucking idea how insurance plans work, as your plan dictates what it covered and what is not, it has nothing to do with Obama Care, other than what Obama requires them to cover per the law. What you are bitching about, having to pay out of pocket, solely has to do with the shitty plan you chose, or the plan your employer chose that they provide for you. Only medical care covered by your plan goes towards your deductible, and once again, you have shown that you don't have a clue about how deductibles work. Being medically necessary doesn't dictate if your plan covers it or not..

Now, Please go educate yourself, starting with reading your insurance plan, and what coverage you have, so you know what is covered and what is not. Then, go learn how deductibles work, and lastly, educate yourself about Obama care, so you don't keep looking like an idiot, because everything you are claiming is due to Obama care, has nothing to do with Obama Care.

 

[FelixDeCat]

So, it's not Obama care that is causing you problems, it's YOUR shitty insurance plan.

You said: "I have to pay $3000 before they pay anything that's not considered preventative" so you admit that you don't pay for everything, and what I told you is accurate, as that statement shows you do not pay everything up to the first $3000, as preventive care is paid in full by the insurance company as required by law (The ACA, aka Obama Care). You have made it clear you have no fucking idea how insurance plans work, as your plan dictates what it covered and what is not, it has nothing to do with Obama Care, other than what Obama requires them to cover per the law. What you are bitching about, having to pay out of pocket, solely has to do with the shitty plan you chose, or the plan your employer chose that they provide for you. Only medical care covered by your plan goes towards your deductible, and once again, you have shown that you don't have a clue about how deductibles work. Being medically necessary doesn't dictate if your plan covers it or not..

Now, Please go educate yourself, starting with reading your insurance plan, and what coverage you have, so you know what is covered and what is not. Then, go learn how deductibles work, and lastly, educate yourself about Obama care, so you don't keep looking like an idiot, because everything you are claiming is due to Obama care, has nothing to do with Obama Care.

Well, lets hear about your marvelous Obamacare plan. Im betting you pay more than you think you do, assuming you need to access it all year long like I do.

 

[IronWing]

Well, lets hear about your marvelous Obamacare plan. Im betting you pay more than you think you do, assuming you need to access it all year long like I do.

Another pathetic diversion on the part of Felix. Private health insurance is sucking the life blood out of the American economy and Felix wants more of it, disgraceful.

 

[Pohemi]

Felix is blaming Obama for his own poor choices? What a whiny little bitch.

Felix, did you lose your HSA contributions in bad investments? That money should have been more than enough to cover your deductible and you should have factored it and the accompanying tax savings into your health plan choice. Are you just bad at handling your finances?

So, it's not Obama care that is causing you problems, it's YOUR shitty insurance plan.

....What you are bitching about, having to pay out of pocket, solely has to do with the shitty plan you chose, or the plan your employer chose that they provide for you...

Sounds to me like FDC needs to get some training to find a better job with better insurance options.

Bootstraps, bitch.

 

[FelixDeCat]

Another pathetic diversion on the part of Felix. Private health insurance is sucking the life blood out of the American economy and Felix wants more of it, disgraceful.

Sounds to me like FDC needs to get some training to find a better job with better insurance options.

Bootstraps, bitch.

Ive already successfully argued against single payer, so the only remaining option is affordable private healthcare.

 

[biostud]

Well, lets hear about your marvelous Obamacare plan. Im betting you pay more than you think you do, assuming you need to access it all year long like I do.

If you look at the graph I posted, you will recognize that US is spending way more on healthcare than any other western nation, and it started way before Obamacare. I don’t know enough about the different aspects of your healthcare system to say why it is so, but the major difference between the US system and the rest of the western countries is that you have one based on insurance, while the rest have one based on taxation.

 

[Pohemi]

Ive already successfully argued against single payer, so the only remaining option is affordable private healthcare.

No, no you haven't. You still haven't learned that simply saying something doesn't make it true.

And lying continually does not equate to "successfully arguing".

 

[sportage]

So, it's not Obama care that is causing you problems, it's YOUR shitty insurance plan.

And correct me if I am wrong, but did not Donald Trump and his Trump republicans pass some law that once again ALLOWED shitty insurance companies to bid for your service?
Did not Obamacare put a stop to shitty insurance where people BELIEVED they were getting insurance AND getting a good deal, that was UNTIL the insured individual actually needed to USE their insurance? Then.... that insured individual painfully discovered their policy was in deed CRAP!!!!
Crap, because the insurance they thought they could depend on refused to pay FOR ANYTHING. Obamacare stopped that fraudulent practice. Under Obamacare only REAL insurance companies could sell insurance.

Then, as I said, then along came the Trumpies passing laws that once again ALLOWED those shitty insurance companies to bid for your money.
Seems to me that actually happened.
But time goes by so fast under republican leadership with so many things totally screwed up under republicans..... who can keep track???

 

[IronWing]

Ive already successfully argued against single payer, so the only remaining option is affordable private healthcare.

Liar.

 

[pete6032]

Then please, feel free to share your thoughts on the plusses and minuses. I think what we had before Obamacare was more affordable since most things were partially paid up to your deductible. I used to have a $1,700 ded, now its $3000-4,000 + 10%.

Also, they used to limit copays on doctor visists, medicine, etc. Now you pay 100% until you reach $3,000, excluding certain situations like preventive care, etc. Most people do not go to the doctor if there is nothing wrong, so thats usually a waste of time.

Really need more information than just deductible and co-pay to properly understand why costs are different. What is the monthly premium? What is the coinsurance amount? What services were covered etc? It's not just as simple as "what was your deductible under your old vs new plan."

 

[Stokely]

Nothing has stopped the Republicans from fixing things since Obama, except that there is a lot of money at stake. How did you feel about the replacement plan torpedoed by John "I'm dying and so finally can show some spine" McCain? That plan seemed pretty crappy to me, but the GOP had the power to put something in if they had really wanted to.

Let's face it, there's no perfect health care system, but I look around the world and ours seem worse than many in most ways. My buddy an ex-pat American in Japan just underwent heart surgery with several weeks before and after staying in the hospital and didn't pay a dime. I can only imagine how much that would cost here. But of course we can't have the evil S-word pop up so instead we have this hyper-capitalist for-profit medical industry with layers and layers of companies trying to get their cut, and someone is paying for all of it.

Far as I'm concerned, Obama's big failing with health care and in general was continuing to try to compromise with Republicans. He kept holding out a hand and it just kept getting bit. Our system needs to be gutted but you can bet there's a lot of lobbying behind those industries making a killing, so I don't expect this to ever happen.

 

[kitkat22]

I would have to change jobs every 8 months with a 1 million dollar cap. My options for treatment for hemophilia are benefix, Alprolix, idelvion or rebinyn. Each one is about 1.25 million/year. Doesn't include hospital visits or surgeries.

My other option is bleeding to death or becoming disabled from frequent joint bleeds. Look up hemarthrosis and look at a few pictures.

Obama care completely allows me to have a life. No lifetime caps. No preexisting conditions. No having to ensure there is no lapse in insurance.

BTW, the most expensive drug on the planet is gene therapy for hemophilia B. $3.5 million.

 

[mikeymikec]

Ive already successfully argued against single payer

The Dunning-Kruger poster child strikes again

 

[FelixDeCat]

I would have to change jobs every 8 months with a 1 million dollar cap. My options for treatment for hemophilia are benefix, Alprolix, idelvion or rebinyn. Each one is about 1.25 million/year. Doesn't include hospital visits or surgeries.

My other option is bleeding to death or becoming disabled from frequent joint bleeds. Look up hemarthrosis and look at a few pictures.

Obama care completely allows me to have a life. No lifetime caps. No preexisting conditions. No having to ensure there is no lapse in insurance.

BTW, the most expensive drug on the planet is gene therapy for hemophilia B. $3.5 million.

Wow, that is pricey. I am taking a drug that has a $750 per month deductible. The sticker price is $6500.

My niece has hemophilia, it seems to have moderated as an adult but it never goes away.

 

[FelixDeCat]

Really need more information than just deductible and co-pay to properly understand why costs are different. What is the monthly premium? What is the coinsurance amount? What services were covered etc? It's not just as simple as "what was your deductible under your old vs new plan."

The difference is the premium payment. Higher deductible, lower premium. Lower deductible, higher premium. The difference remains the same, about $3000 annually.

The difference is made up in premium payments so no matter what, the ins company gets that money or doesn’t pay your expenses. Both are the same in the end.

 

[Brainonska511]

The difference is the premium payment. Higher deductible, lower premium. Lower deductible, higher premium. The difference remains the same, about $3000 annually.

The difference is made up in premium payments so no matter what, the ins company gets that money or doesn’t pay your expenses. Both are the same in the end.

Except it isn't the same in the end. It really depends on other factors like OOP maximums, cost sharing before you hit that maximum, what are the copays, how much you need to routinely spend on healthcare, etc.

If your healthcare expense are low, you can easily come out way ahead with the HDHP. If you're expenses are high, it could potentially be the opposite: you come out ahead using the traditional style plan.

Regardless, the plans and coverage offered today far exceeds many of the crap plans of old.

 

[Homerboy]

Maybe "for [SIGNIFICANT FUCKING] profit" middle men carry some of the responsibility?

UnitedHealth Group Reports $5.6 Billion Profit As 2023 Starts Strong For Optum And Health Plans

UnitedHealth Group reported a $5.6 billion first quarter profit as the healthcare giant’s UnitedHealthcare insurance plans and Optum medical provider businesses grew by double-digits.

www.forbes.com

 

[Leeea]

I love my Obamacare plan.

I made sure to buy a silver plan though. Costs me about $240-$280 a month if I remember right depending on which year. I have had this plan for many years.

Of course it is a commie plan. Covered California. PPO. $35 copay Dr visit. $35 copay urgent care. $45 copay specialist. $45 copay mental health.

I use the mental health part weekly. Things broke last winter when I took some pills for ADHD and things have not been the same since. I discovered the hard way my ADHD was a side effect of DID, and well the first ADHD treatment had a profoundly negative effect on my DID symptoms as reality and me went our separate ways.

I have no idea what your talking about having to spend thousands of dollars out of pocket though.

My wegovy prescription for weight loss is covered also. $27 per pack. I feel like I am robbing the bank every time I walk out of the pharmacy with that. ( without insurance it is like $1500 ). Most of my meds are between $1 to $3 per month per prescription.


Honestly, it all seems fine to me? I paid in for years on this silver plan, and now that I am using it everything is fine. It is paying out a staggering amount of $$$$ this year.


edit:
without it, I would be another homeless crazy person. The only thing that is attaching me to reality these days are powerful prescription psychiatric medications.

 

[hal2kilo]

I love my Obamacare plan.

I made sure to buy a silver plan though. Costs me about $240-$280 a month if I remember right depending on which year. I have had this plan for many years.

Of course it is a commie plan. Covered California. PPO. $35 copay Dr visit. $35 copay urgent care. $45 copay specialist. $45 copay mental health.

I use the mental health part weekly. Things broke last winter when I took some pills for ADHD and things have not been the same since. I discovered the hard way my ADHD was a side effect of DID, and well the first ADHD treatment had a profoundly negative effect on my DID symptoms as reality and me went our separate ways.

I have no idea what your talking about having to spend thousands of dollars out of pocket though.

My wegovy prescription for weight loss is covered also. $27 per pack. I feel like I am robbing the bank every time I walk out of the pharmacy with that. ( without insurance it is like $1500 ). Most of my meds are between $1 to $3 per month per prescription.


Honestly, it all seems fine to me? I paid in for years on this silver plan, and now that I am using it everything is fine. It is paying out a staggering amount of $$$$ this year.

I don't think I've begun to use medical services compared to what I've paid in. But, now I'm on Medicare and I expect sometime in the next few years I'm going to have to have at least one knee replaced. That's like a minimum of 35k. Who knows, I may get cancer that can be anywhere from 100k to 500k. I won't sweat a wink, if I have to use it, and actually it would be wonderful if I never had to use any of it.

 

[FelixDeCat]

I love my Obamacare plan.

I made sure to buy a silver plan though. Costs me about $240-$280 a month if I remember right depending on which year. I have had this plan for many years.

Of course it is a commie plan. Covered California. PPO. $35 copay Dr visit. $35 copay urgent care. $45 copay specialist. $45 copay mental health.

I use the mental health part weekly. Things broke last winter when I took some pills for ADHD and things have not been the same since. I discovered the hard way my ADHD was a side effect of DID, and well the first ADHD treatment had a profoundly negative effect on my DID symptoms as reality and me went our separate ways.

I have no idea what your talking about having to spend thousands of dollars out of pocket though.

My wegovy prescription for weight loss is covered also. $27 per pack. I feel like I am robbing the bank every time I walk out of the pharmacy with that. ( without insurance it is like $1500 ). Most of my meds are between $1 to $3 per month per prescription.


Honestly, it all seems fine to me? I paid in for years on this silver plan, and now that I am using it everything is fine. It is paying out a staggering amount of $$$$ this year.


edit:
without it, I would be another homeless crazy person. The only thing that is attaching me to reality these days are powerful prescription psychiatric medications.

I actually like crazy homeless people so long as they stay nonviolent.

But seriously I'm glad it worked out for you, but I have a HDHP and it ducks.

 

[NWRMidnight]

Well, lets hear about your marvelous Obamacare plan. Im betting you pay more than you think you do, assuming you need to access it all year long like I do.

Oh, what a big mistake. I hope you like feeling stupid. I have one of the best plans available.. Let me give you an example of my "Obamacare" plan (all plans have to follow Obamacare laws/guidelines/requirements, no matter if you purchase it yourself or get it thru your employer.. I pay NOTHING for my Medical insurance for me or my family, employer pays it 100% (same for dental/vision, but that isn't what we are talking about here).

Who pays for the plan isn't really relevant, it's about the coverage: I pay $15 co-pay for all regular doctor visits that are not covered under preventive care, and zero copays for most specialty care services. I pay $150 co-pay for ER (use to be $50 but stupid assholes who work for the same employer, abused the ER, rather than going to their primary doctor, so it was changed). I have a $750 deductible that ONLY kicks in when I am hospitalized, and my room costs ($75 per day) is the ONLY thing that goes towards my deductible. Now, my family as a whole, has a maximum of $3000 deductible per year. in 7 years, I have yet to ever have anything applied to that family deductible.

Let me give you an example of the difference between shitty health plan and a good health plan. 1) before Obama care, in 2013, I had kidney stones, which I had to have surgically removed. The bill was about $30K. I had to pay around $6k out of pocket ($4500 deductible) , as well as $350 per month premium costs. United Health. 2) In 2017 (different employer), I had some heart issues, total bill was about $40K, out of pocket was $250 which was co pays only. ZERO monthly premium costs. (It's also the most I have ever paid in a year for any health care needs since Obama care) United Health 3) Today, I have monthly medical needs that are covered 100%, no copays. been that way since 2017 (related to my heart issues) United Health, until we switched to Blue Cross.. same coverage no premium costs to me. I also just had carpal tunnel surgery 8 weeks ago.. out of pocket, $15.

Do you feel a little stupid now?

so.. you ready to take responsibility for your stupidly and bad choices, or are you going to continue to blame Obama Care?

(edit) I forgot about prescriptions, I have to spend some money for most of my prescriptions when needed ( I am not on any medications currently).. Maximum cost is $12, but most only cost $6. (express scripts plan thru my employer), however that was getting them from Walgreens.. I switched to Costco pharmacy, and that $6 dropped to $0.88. (88 Cents), but that may be a fluke, as I only have purchased the pain killers I need after my carpal tunnel surgery.. so time will tell, but maximum cost is $12 , no matter the pharmacy.

(2nd edit), correction on prescription costs, I had to check my prescription plan, as I remembered there is a $12 tear of prescriptions that I never have purchased.

 

[IronWing]

I actually like crazy homeless people so long as they stay nonviolent.

But seriously I'm glad it worked out for you, but I have a HDHP and it ducks.

I have an HDHP as well as it works out to be the most cost effective option for me. It's fine if one doesn't skimp on the HSA portion of the plan. They go together you know; lower premiums, higher deductible, tax free HSA contributions and earnings. I'm surprised you aren't liking the very plan the Heritage Foundation crafted and pushed for. HDHPs are the pinnacle of conservative thought wrt health plans. I'd trade it for single payer or nationalized healthcare in a heartbeat but spectacularly stupid conservatives keep voting against their self interests and then have the gall to bitch when they have to live with the consequences of their shitty votes.