The "true" cost of healthcare?

[imported_Lothar]

Originally posted by: Genx87
Is this a true cost though? I mean this is a true cost of the insurance. But what were your true medical costs last year?

Medical: $20 copay for annual checkup. I have no idea what it costs to measure and test my blood/urine. The only thing I know is what came out of my pocket and that was $20 (besides my employee annual cost of $948.60).

 

[imported_Lothar]

Originally posted by: 0marTheZealot
What happens if you lose your job? Then you find out the true cost of healthcare, especially if you have a pre-existing condition. You could be looking at 1000 or more a month in that scenario. When the employer subsidizes your healthcare and you pay for it with pre-tax dollars, it seems pretty acceptable. When you have to pay out of pocket and don't have the bargaining chips a business has, you're fucked.

The current system works if you have an employer that has a decent health plan. It utterly sucks if you don't fall in that group.

If I lose my job, I find another job?

Requirements I had to do to be eligible:
Work for 90 days.

Lets see if anyone here knows how to read.
My insurance statement on pre-existing conditions:

The plan does not cover expenses connected to a disease, illness, sickness or condition which was diagnosed or treated by a provider within 90 days prior to your coverage date, or which produced symptoms during that 90 day period that would have caused an ordinary person to seek medical diagnosis or treatment.

The pre-existing condition limitations does not apply to:
1.) The employee after he or she has had 6 months of continuous participation;
2.) Dependents if either that have 12 months of continuous Plan participation or the employee that has enrolled the dependents has earned 9 months of continuous plan participation after completing 90 days of continuous, full-time employment;
3.) Pregnancies; or
4.) Children, if they are newborn, newly placed or adopted and have credible coverage within 30 days of their birth, adoption, or placement for adoption.

The 6 or 9 month exclusion period will be reduced for each month that a new participant had prior creditable health coverage. In other wordsm someone coming from a job where he or she had coverage for at least 9 months would have no pre-existing condition exclusion, as long as that earlier coverage had not been allowed to lapse for more than 63 days. For purposes of determining whether a 63 break in coverage has occurred, the 90 day waiting period for eligibility under this plan does not count as part of the break.

1.) Can they deny me coverage because they found out I had acne or malaria in 1994? No.
2.) Whatever happened to NOT getting fired in the first place? If you get fired, that means you're not performing. Do the people who don't get fired have two heads? When I was in school and I brought a B+ on my report card and explained the reason to my parents they always ask me "Do the people that get A's have two heads?" None of that "sweet" talk crap that parents seem to be doing to their kids nowadays. If fired, go work for your former employer's competitor. They all offer the best healthcare plans to keep talent at each of their firm. If you majored in something like medieval history, fine art, political science, liberal arts, psychology, film history, or basket weaving in college of course you'll have a hard time finding another job, and rightly so.

 

[imported_Lothar]

Originally posted by: piasabird
What about Dental and Glasses?

I have had to pay a lot of extra cash for Dental Work. That is fine as long as you dont want to eat. There is something to be said for happy teeth.

Does the plan being debated in congress mention anything about dental?

Dental: I only went for routine cleaning once last year. I have no idea of what the actual cost of a routine cleaning is. What I DO know is that my co-pay was $0 out of pocket. My medical and dental plan are separate. I didn't include it earlier in my post because none of the health care bills being debated in congress include dental coverage.

For reference...(not relevant to this thread or the UHC debate since congress hasn't included "dental" in any of the plans.)

Dental Plan:
Employer annual cost: $145.20
Employee annual cost: $79.56

Preventive services are covered at 100% with no deductible applied.
Fillings, root canals, and other minor dental work: 75% covered after $50 deductible.
Crowning, and other major dental work: 50% covered after $50 deductible.
Maximum annual deductible: $100 (You only have to pay $50 twice for 2 different procedures and never again...unless you reach the maximum annual benefit)
Maximum Dental annual benefit: $1,200

Vision? I have to look that one up. I won't even bother since I can see perfectly fine and don't wear glasses or contacts. I spent an hour finding and reading the documents so I could answer people's questions. I won't waste my time doing that for "vision" since I don't need it or use it.
Does the plan being debated in congress say anything about "vision" coverage?

 

[Uhtrinity]

Originally posted by: TheSkinsFan

Originally posted by: Uhtrinity

Originally posted by: TheSkinsFan

Originally posted by: Uhtrinity

Originally posted by: TheSkinsFan
Real questions:

How would you feel about losing said coverage as a result of an act of Congress?

If your personal payments stayed the same, roughly $948/yr, would you be willing to switch to Government care? What if your payments went up? What if they went down?

Are you personally satisfied with your coverage and care? If not, why not?

Losing said coverage and getting new coverage in turn vs. what we have now? If I lose my job I lose all my coverage unless I pay outrageous cobra payments.. I'll take the fed option!

Are you willing to give up your current plan even if you still have your job?

I can honestly say yes. I have seen both sides as I have been uninsured over half of my adult life, I have had good plans and bad plans. Long term security means more to me than having a good plan for 5 years.

fair enough. Would you support reform that simply offers you protection against high Cobra costs if it meant you could keep the same insurer and plan? Perhaps something simple that allows you to stick with one insurer through multiple employers, and in multiple States?

Simple yet effective reform FTW.

Not at current costs. The $800 my employer pays is honestly ridiculous.

Look at it this way, most countries with single payer spend about 7% GDP, we spend 15% and have more people who are not covered. That tells me we pay more than 2X what we should be paying.

 

[Uhtrinity]

Originally posted by: spidey07

Originally posted by: Marlin1975


Yea and 10 years farther back then that it probable be cheaper. That just proves the point that we have to do something as medical cost are just going through the roof. The only ones that are really happy are drug makers and insruance companies. There is a reason insurance compnaies are spending over a million dollars EVERYDAY to keep things the way they are.

The only ones that are really happy are Americans, 80 percent of whom say they are happy with their healthcare and insurance.

-edit-
WOW! Go to anthem and see what kind of plans you can get for 150 bucks. 1000 deductible and that's the OOPM

That is a bs question ... happy while they have it, unhappy when they lose their job and their coverage.

 

[Uhtrinity]

Originally posted by: Lothar

Originally posted by: Uhtrinity
Mine is a Blue Cross PPO for myself and my son. $500 deduct, $30 copay on Dr, $20 copay on meds. Roughly 15 insured individuals at our school / district.

$747 Medical
$7.50 Vision
$54.55 Dental

$9,708 a year paid by my employer. I'm lucky I even have benefits as I'm not full time, in turn I take a lower salary. IMHO that is far too expensive for a 39 yo male in excellent health, non smoker, not over weight and a healthy 7 yo boy. Even getting a median salary in my state; $800 a month for health insurance would be difficult if not impossible.

The op has cheap coverage and is lucky, btw, how old are you? That has a lot to do with it.

Age has nothing to do with it, and neither does salary. A 74 yr old coworker vs. a 24 yr old like me still pays for the same coverage.
All employees get the same coverage.
Hell, even if you smoke tobacco, all you have to do is sign a piece of paper saying you participated in a tobacco free program and you will still get the same rate as anyone else.

That isn't universal. Older teachers at our school pay more, younger one pay less. Cost goes up as they age.

 

[blackangst1]

Originally posted by: 0marTheZealot
What happens if you lose your job? Then you find out the true cost of healthcare, especially if you have a pre-existing condition. You could be looking at 1000 or more a month in that scenario. When the employer subsidizes your healthcare and you pay for it with pre-tax dollars, it seems pretty acceptable. When you have to pay out of pocket and don't have the bargaining chips a business has, you're fucked.

The current system works if you have an employer that has a decent health plan. It utterly sucks if you don't fall in that group.

Ive been in that position myself. I payed >$35/mo to be in the state insurance pool. Covered everything I needed. *shrug* anecdotal maybe.

 

[Carmen813]

Lifetime Maximum Benefit: $1.5 million per person.


That is your problem right there. $1.5 million is peanuts when dealing with a chronic condition. My wife went through that much money in 45 days after being diagnosed with leukemia. Hodgkin's Lymphoma was about $800,000 over 6 months for me, and I require CT scans every six months for the rest of my life (average of $4,000 a pop). Plus doctor and specialist visits, ect. My advice: don't get cancer.

 

[blackangst1]

Originally posted by: Carmen813
Lifetime Maximum Benefit: $1.5 million per person.


That is your problem right there. $1.5 million is peanuts when dealing with a chronic condition. My wife went through that much money in 45 days after being diagnosed with leukemia. Hodgkin's Lymphoma was about $800,000 over 6 months for me, and I require CT scans every six months for the rest of my life (average of $4,000 a pop). Plus doctor and specialist visits, ect. My advice: don't get cancer.

Thats a good point. Is there anything in the bill for tiered coverage as far as lifetime maximums go I wonder?

 

[Pens1566]

Originally posted by: blackangst1

Originally posted by: Carmen813
Lifetime Maximum Benefit: $1.5 million per person.


That is your problem right there. $1.5 million is peanuts when dealing with a chronic condition. My wife went through that much money in 45 days after being diagnosed with leukemia. Hodgkin's Lymphoma was about $800,000 over 6 months for me, and I require CT scans every six months for the rest of my life (average of $4,000 a pop). Plus doctor and specialist visits, ect. My advice: don't get cancer.

Thats a good point. Is there anything in the bill for tiered coverage as far as lifetime maximums go I wonder?

You're absolutely right. It's a very good point. I believe that removing lifetime caps was mentioned in a description of one of the bills currently being discussed.

1.5mil would be BLOWN through by any serious condition in short order. I've done 2mil in under a year at one point ... like the previous poster said, don't get cancer.

 

[spidey07]

Originally posted by: Pens1566

Originally posted by: blackangst1

Originally posted by: Carmen813
Lifetime Maximum Benefit: $1.5 million per person.


That is your problem right there. $1.5 million is peanuts when dealing with a chronic condition. My wife went through that much money in 45 days after being diagnosed with leukemia. Hodgkin's Lymphoma was about $800,000 over 6 months for me, and I require CT scans every six months for the rest of my life (average of $4,000 a pop). Plus doctor and specialist visits, ect. My advice: don't get cancer.

Thats a good point. Is there anything in the bill for tiered coverage as far as lifetime maximums go I wonder?

You're absolutely right. It's a very good point. I believe that removing lifetime caps was mentioned in a description of one of the bills currently being discussed.

1.5mil would be BLOWN through by any serious condition in short order. I've done 2mil in under a year at one point ... like the previous poster said, don't get cancer.

Or get better insurance. It really is that easy. 1.5 or 2 mill lifetime is normally only on the cheapest of plans.

I'm pretty sure you can get insurance with an unlimited lifetime maximum. That's what is so great, you get to choose the plan that is right for you.

 

[imported_Lothar]

Originally posted by: blackangst1

Originally posted by: 0marTheZealot
What happens if you lose your job? Then you find out the true cost of healthcare, especially if you have a pre-existing condition. You could be looking at 1000 or more a month in that scenario. When the employer subsidizes your healthcare and you pay for it with pre-tax dollars, it seems pretty acceptable. When you have to pay out of pocket and don't have the bargaining chips a business has, you're fucked.

The current system works if you have an employer that has a decent health plan. It utterly sucks if you don't fall in that group.

Ive been in that position myself. I payed >$35/mo to be in the state insurance pool. Covered everything I needed. *shrug* anecdotal maybe.

What state, and what did it cover?
Would you support creating a federal insurance pool since it worked just fine for you on your state level?
Not every state has a pool, or one that's as good as yours.

Would you support someone from Maine, Maryland, or Wyoming being able to buy into your state pool since it seems okay? If no, why not?

 

[Pens1566]

Originally posted by: spidey07

Originally posted by: Pens1566

Originally posted by: blackangst1

Originally posted by: Carmen813
Lifetime Maximum Benefit: $1.5 million per person.


That is your problem right there. $1.5 million is peanuts when dealing with a chronic condition. My wife went through that much money in 45 days after being diagnosed with leukemia. Hodgkin's Lymphoma was about $800,000 over 6 months for me, and I require CT scans every six months for the rest of my life (average of $4,000 a pop). Plus doctor and specialist visits, ect. My advice: don't get cancer.

Thats a good point. Is there anything in the bill for tiered coverage as far as lifetime maximums go I wonder?

You're absolutely right. It's a very good point. I believe that removing lifetime caps was mentioned in a description of one of the bills currently being discussed.

1.5mil would be BLOWN through by any serious condition in short order. I've done 2mil in under a year at one point ... like the previous poster said, don't get cancer.

Or get better insurance. It really is that easy. 1.5 or 2 mill lifetime is normally only on the cheapest of plans.

I'm pretty sure you can get insurance with an unlimited lifetime maximum. That's what is so great, you get to choose the plan that is right for you.

I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

 

[spidey07]

Originally posted by: Pens1566


I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

Are you missing where I already looked up a plan that you can go out and get on right now?

How is it dishonest? Want better insurance? Want less out of pocket maximum? Want higher or unlimited maximum? Then go out and buy it! Stop spreading lies and go out and get better insurance if one needs it or wants it. Even just quickly pricing plans right now you can generally increase lifetime maximum if you want to.

I'm reporting you and this thread to flag@whitehouse.gov.

 

[Pens1566]

Originally posted by: spidey07

Originally posted by: Pens1566


I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

Are you missing where I already looked up a plan that you can go out and get on right now?

How is it dishonest? Want better insurance? Want less out of pocket maximum? Want higher or unlimited maximum? Then go out and buy it! Stop spreading lies and go out and get better insurance if one needs it or wants it. Even just quickly pricing plans right now you can generally increase lifetime maximum if you want to.

I'm reporting you and this thread to flag@whitehouse.gov.

And if one can't afford that .... then what? Your problem is that you either don't realize, or choose to ignore, the fact that there are some people that just don't have means to pay for more than food/lodging/necessities and are living paycheck to paycheck and can't spare the ~$150 a month for shitty bottom of the barrel coverage.

 

[TheSkinsFan]

Originally posted by: Pens1566
I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

What if the Government takes away your bullet-proof plan tomorrow and forces you to accept the lowest common denominator -- something similar to the cheapest private plans, in terms of coverage?

You'd be cool with that?

 

[Pens1566]

Originally posted by: TheSkinsFan

Originally posted by: Pens1566
I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

What if the Government takes away your bullet-proof plan tomorrow and forces you to accept the lowest common denominator -- something similar to the cheapest private plans, in terms of coverage?

You'd be cool with that?

No I wouldn't be ok with it. But since that isn't in any of the proposed plans, I guess I don't have to worry.

 

[TruePaige]

Originally posted by: TheSkinsFan

Originally posted by: Pens1566
I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

What if the Government takes away your bullet-proof plan tomorrow and forces you to accept the lowest common denominator -- something similar to the cheapest private plans, in terms of coverage?

You'd be cool with that?

Name one UHC system that is equivalent to "bottom of the barrel" coverage.

You can't because it doesn't exist.

Why would you intentionally use a loaded example to try and start a pointless argument?

 

[Pens1566]

Originally posted by: TruePaige

Originally posted by: TheSkinsFan

Originally posted by: Pens1566
I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

What if the Government takes away your bullet-proof plan tomorrow and forces you to accept the lowest common denominator -- something similar to the cheapest private plans, in terms of coverage?

You'd be cool with that?

Name one UHC system that is equivalent to "bottom of the barrel" coverage.

You can't because it doesn't exist.

Why would you intentionally use a loaded example to try and start a pointless argument?

Thats his MO ...

 

[TheSkinsFan]

Originally posted by: Pens1566
And if one can't afford that .... then what? Your problem is that you either don't realize, or choose to ignore, the fact that there are some people that just don't have means to pay for more than food/lodging/necessities and are living paycheck to paycheck and can't spare the ~$150 a month for shitty bottom of the barrel coverage.

So how about you and I sponsor a short and specific reform bill that simply gives those people coverage?

Six months from now, we can draft another short and specific bill to regulate rising costs.

Then, six months after that, we can draft yet another short and specific bill to stop the practice of denying coverage or treatments.

etc. etc.

Baby steps to rational and reasonable healthcare reform FTW.

 

[TheSkinsFan]

Originally posted by: Pens1566

Originally posted by: TheSkinsFan

Originally posted by: Pens1566
I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

What if the Government takes away your bullet-proof plan tomorrow and forces you to accept the lowest common denominator -- something similar to the cheapest private plans, in terms of coverage?

You'd be cool with that?

No I wouldn't be ok with it. But since that isn't in any of the proposed plans, I guess I don't have to worry.

actually, it might be. Your old bullet-proof plan will instantly become "grandfathered," and then it may or may not remain on the Government's list of approved plans after five years.

Then what?

Welcome to the LCD brutha!

 

[TheSkinsFan]

Originally posted by: TruePaige

Originally posted by: TheSkinsFan

Originally posted by: Pens1566
I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

What if the Government takes away your bullet-proof plan tomorrow and forces you to accept the lowest common denominator -- something similar to the cheapest private plans, in terms of coverage?

You'd be cool with that?

Name one UHC system that is equivalent to "bottom of the barrel" coverage.

You can't because it doesn't exist.

Why would you intentionally use a loaded example to try and start a pointless argument?

UHC is NOT currently on the table in Congress.

next...

 

[Pens1566]

Originally posted by: TheSkinsFan

Originally posted by: TruePaige

Originally posted by: TheSkinsFan

Originally posted by: Pens1566
I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

What if the Government takes away your bullet-proof plan tomorrow and forces you to accept the lowest common denominator -- something similar to the cheapest private plans, in terms of coverage?

You'd be cool with that?

Name one UHC system that is equivalent to "bottom of the barrel" coverage.

You can't because it doesn't exist.

Why would you intentionally use a loaded example to try and start a pointless argument?

UHC is NOT currently on the table in Congress.

next...

No, but the federal "exchange" program is ...

And your question was extremely loaded. So what if his response was as well? Next.

 

[Pens1566]

Originally posted by: TheSkinsFan

Originally posted by: Pens1566

Originally posted by: TheSkinsFan

Originally posted by: Pens1566
I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

What if the Government takes away your bullet-proof plan tomorrow and forces you to accept the lowest common denominator -- something similar to the cheapest private plans, in terms of coverage?

You'd be cool with that?

No I wouldn't be ok with it. But since that isn't in any of the proposed plans, I guess I don't have to worry.

actually, it might be. Your old bullet-proof plan will instantly become "grandfathered," and then it may or may not remain on the Government's list of approved plans after five years.

Then what?

Welcome to the LCD brutha!

I'm quite positive my plan will be just fine. Thanks for your concern though.

 

[spidey07]

Originally posted by: Pens1566

And if one can't afford that .... then what? Your problem is that you either don't realize, or choose to ignore, the fact that there are some people that just don't have means to pay for more than food/lodging/necessities and are living paycheck to paycheck and can't spare the ~$150 a month for shitty bottom of the barrel coverage.

The coverage you can get for 150/month is pretty good. Go look up plans.

And if they can't afford health insurance, how the hell can they afford to get car insurance or put a roof over their head? It's part of your cost of living, you don't just skimp and not get it (well some people do, but very few are because they can't afford it).

How are they paying electric bills? Water? Cell phone, cable TV, eating out if they can't pay or refuse to pay for insurance?

I am not nor will I ever condone being responsible for people making poor decisions.