Health Insurance
- Thread starter TeamCaffee
- Start date
Even if those numbers are true (and I am skeptical about that), it does not tell the whole story. Obamacare made it impossible for us to buy the quality coverage we used to have. The plans available now are crap in comparison. As others mentioned above, it is insurance in name only. A major medical claim now subjects people to huge financial risks and likely bankruptcy that could have been avoided before by purchasing decent coverage.
I don't know why anyone would have to go bankrupt North and South Dakota both have subsidize programs administered by the hospitals aka and state if you have low income and not covered.. you qualify
And that would be your puddle of water to playing in for the day ...they are overcharging so much for the people that are insured they can afford on the other hand to give it away ...
ObamaCare is unsustainable in its present form and its demise is underway. Facts:
1. (Wall Street Journal) The majority of ObamaCare’s insurance co-ops—12 of 23—have now folded, and their $1.24 billion in federal loans has all but vaporized. More will fail, nearly a million Americans may lose coverage, and now the contagion from their failures is spreading....
... The co-ops aren’t merely jilting their displaced members or the taxpayers who supplied their “seed money.” Local regulators are defying the feds to close them because other insurers are liable for their toxic balance sheets ....
The greatest danger may be the 11 co-ops that remain in business, given that 10 have run deficits for as long as they’ve existed.
More about the CO-OP failures and their cascading effects
2. The largest health insurer in the country, United Healthcare, just announced that they are unlikely to participate in the ObamaCare health exchanges in 2017 and are limiting their marketing for customers through exchanges in 2016. The Wall Street Journal quotes UnitedHealth Group Chief Executive Stephen J. Hemsley as saying, "We can't sustain these losses," further explaining, "We can't subsidize a market that doesn't appear at this point to be sustaining itself."
3. A Wall Street Journal analysis of 2016 rates showed that premiums for individual health plans are going up, with double-digit increases more typical than not.
1. (Wall Street Journal) The majority of ObamaCare’s insurance co-ops—12 of 23—have now folded, and their $1.24 billion in federal loans has all but vaporized. More will fail, nearly a million Americans may lose coverage, and now the contagion from their failures is spreading....
... The co-ops aren’t merely jilting their displaced members or the taxpayers who supplied their “seed money.” Local regulators are defying the feds to close them because other insurers are liable for their toxic balance sheets ....
The greatest danger may be the 11 co-ops that remain in business, given that 10 have run deficits for as long as they’ve existed.
More about the CO-OP failures and their cascading effects
2. The largest health insurer in the country, United Healthcare, just announced that they are unlikely to participate in the ObamaCare health exchanges in 2017 and are limiting their marketing for customers through exchanges in 2016. The Wall Street Journal quotes UnitedHealth Group Chief Executive Stephen J. Hemsley as saying, "We can't sustain these losses," further explaining, "We can't subsidize a market that doesn't appear at this point to be sustaining itself."
3. A Wall Street Journal analysis of 2016 rates showed that premiums for individual health plans are going up, with double-digit increases more typical than not.
Actually insurance companies negotiate very discounted rates with health providers. They do not pay rates near those an uninsured person does. Medicare and Medicaid rates are not even negotiated they just say we pay x for y service. Obviously Healthcare is still big profits or we would not see the buildup we do of doctors offices etc. Being purchased by corporate run entities
wayneygogo
Seasoned Expediter
I would check this out I will have to check this out
Be wary of anyone who boasts he or she has a good deal on health insurance. The devil is in the details and a close look at any plan will likely flush out some surprises.
Diane and I are reviewing our options now. Each insurance company lists a host of features and prices. The thing to do is develop a spreadsheet that lists most if not all of the items covered and the amount you would pay for each of them under a given scenario. Then choose a plan based on what you learn and what is best for you.
Come up with a half-dozen scenarios for a full analysis. Examples:
1. We (married couple) we are healthy all year and each require only new eyeglasses, two routine trips to the dentist, a physical exam that includes blood work and a mammogram.
2. We are traveling out of network and are both injured in an accident that requires ambulance, ER and a week of hospitalization and six follow up appointments for physical therapy.
3. Scenario 1 above but also one of us is diagnosed with diabetes and goes on insulin.
4. One of us is diagnosed with cancer and chemotherapy and surgery is required.
Below is a partial list of items from our spreadsheet used to compare plans. Each item is given its own row on the spreadsheet. For each insurance company being considered, put its name at the top of a column. When the spreadsheet is complete, bring a scenario to mind and work your way down a column to total up what you would pay if that scenario played out in real life.
There is some overlap in the row titles because different companies describe their items in different ways. In such cases, create a row for each item. It's OK if two items overlap. Simply ignore the rows that do not fit a company and use the row that best matches the item as a given company describes it.
Monthly Premium
Deductible
Co-Insurance
Max Out of Pocket
ER Care
Generic Drugs
Preferred Brand Drugs
Non-Preferred Brand Drugs
Specialty Drugs
Preventative Care
Primary Care Dr. Visit
Specialist Visit
Specialist, Referral Required?
Physicals and Immunizations
Lab Tests and Blood Work
Mammogram
Colonoscopy
Mail Order Generic Drugs
Urgent Care
Depression, Diabetes, Asthma, High Blood Pressure, High Cholesterol
(Specific conditions if the insurance company lists them)
Hospital Co-Pay
Ambulatory Surgical
Outpatient Hospital
Provider/Surgeon Fee
Inpatient Hospital
Imaging
Ambulance
Diagnostic (Lab, etc)
Additional Feature
Out of Network Coverage
Diane and I are reviewing our options now. Each insurance company lists a host of features and prices. The thing to do is develop a spreadsheet that lists most if not all of the items covered and the amount you would pay for each of them under a given scenario. Then choose a plan based on what you learn and what is best for you.
Come up with a half-dozen scenarios for a full analysis. Examples:
1. We (married couple) we are healthy all year and each require only new eyeglasses, two routine trips to the dentist, a physical exam that includes blood work and a mammogram.
2. We are traveling out of network and are both injured in an accident that requires ambulance, ER and a week of hospitalization and six follow up appointments for physical therapy.
3. Scenario 1 above but also one of us is diagnosed with diabetes and goes on insulin.
4. One of us is diagnosed with cancer and chemotherapy and surgery is required.
Below is a partial list of items from our spreadsheet used to compare plans. Each item is given its own row on the spreadsheet. For each insurance company being considered, put its name at the top of a column. When the spreadsheet is complete, bring a scenario to mind and work your way down a column to total up what you would pay if that scenario played out in real life.
There is some overlap in the row titles because different companies describe their items in different ways. In such cases, create a row for each item. It's OK if two items overlap. Simply ignore the rows that do not fit a company and use the row that best matches the item as a given company describes it.
Monthly Premium
Deductible
Co-Insurance
Max Out of Pocket
ER Care
Generic Drugs
Preferred Brand Drugs
Non-Preferred Brand Drugs
Specialty Drugs
Preventative Care
Primary Care Dr. Visit
Specialist Visit
Specialist, Referral Required?
Physicals and Immunizations
Lab Tests and Blood Work
Mammogram
Colonoscopy
Mail Order Generic Drugs
Urgent Care
Depression, Diabetes, Asthma, High Blood Pressure, High Cholesterol
(Specific conditions if the insurance company lists them)
Hospital Co-Pay
Ambulatory Surgical
Outpatient Hospital
Provider/Surgeon Fee
Inpatient Hospital
Imaging
Ambulance
Diagnostic (Lab, etc)
Additional Feature
Out of Network Coverage
It was mentioned above that this Obamacare is not insurance at all since it does not protect people from significant financial impacts if care is needed. This story is a case in point.
"Research by Families USA this year found that nearly 30 percent of adults with deductibles of at least $1,500 per person decided to forgo needed medical care because they could not afford it."
Obama happily includes this 30 percent in his "success" statistics but that's a crock. There is nothing successful in insurance plans that prompt people to delay medical care instead of seek it.
"Research by Families USA this year found that nearly 30 percent of adults with deductibles of at least $1,500 per person decided to forgo needed medical care because they could not afford it."
Obama happily includes this 30 percent in his "success" statistics but that's a crock. There is nothing successful in insurance plans that prompt people to delay medical care instead of seek it.
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wayneygogo
Seasoned Expediter
I've delayed buying health insurance for the last 12 years because it was $600 a month for one person. I now pay $240 per month for one person. Me. I have had Obamacare for 5 months. 0 payment for prescriptions. I was just prescribed a 12-week regimen. The cost is $90,000 for a 12 week supply. My out of pocket is 0 deductible for prescription
wayneygogo
Seasoned Expediter
By the way that is one hell of a list and a lot of good points that you had made. Very good idea, we should buy insurance 4 our immediate needs and perhaps an accident, in addition our age in what required tests in physicals are needed should be looked at
wayneygogo
Seasoned Expediter
What is nurses make $30 per hour from the folks of McDonald's make $9 an hour there will always be a deficit whether ran by the government or private entiny. In 2008 Obama tried to increase our Medicare Medicaid yes it would have perhaps put the healthcare industry speaking of wages in jeopardy certainly but the healthcare industry would not be willing to take a 20 or 30% pay cut across the board to reduce the health care costs
If you pay zero for the prescription drugs, who pays the $90,000 and to whom does the money go?
I think he will not have that insurance next year due to a very high monthly payment.
The above is a case in point. Good grief. A man who goes without insurance for 12 years (and presumably without treatment) now gets Obamacare and gets on a med that costs $90,000 for 12 weeks. What kind of drug is worth $90,000 and is needed now that insurance is available? Are there no other drugs that cost less? What doctor prescribes such a thing? On what planet does a $90,000/12 week prescription make any sense at all? How many healthy people must pay premiums for a year to cover this $90,000 expense for 12 weeks? Even if the cost is negotiated down by an insurance company to $40,000 or even $10,000, the same questions apply.
I'm not saying to deny the man treatment. I am saying the money in the Obamacare system has gone totally insane. Drug companies are protected from foreign competition. They sell the same drugs overseas for a fraction of what they sell them for here. Congress specifically prohibits the government from negotiating better drug prices, and everyone seems just fine with paying $90,000 for a 12 week prescription.
Medical tourism here I come!
As one person put it, "The average hip replacement in the USA costs $40,364. In Spain, it costs $7,371. That means I can literally fly to Spain, live in Madrid for 2 years, learn Spanish, run with the bulls, get trampled, get my hip replaced again, and fly home for less than the cost of a hip replacement in the US."
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wayneygogo
Seasoned Expediter
Was your insurance cancelled because of competition he calls those taking part in Obamacare could offer a better rate and these companies are just going bust? Why are we seeing a cost in increased private health care coverage? These companies have to continue to try to make a profit and a good showing to their shareholders. it sounds like to me they're putting the cost on the taxpayer, I think that's what the government is doing haven't we heard that the taxpayer will bear the cost whether its private for government ran. The US has always been a market driver when it comes to wages. Remember what certain Union had done when they continued to drive wages up.
your wages down here actually suck for the unskilled division but then again if the minimum wage was higher you'd be paying $6.00 for a Wendy's burger with no fries.......IMO....
those very same shareholders you mentioned also have to payout premiums....
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