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Post by Hobson on Dec 27, 2014 15:40:10 GMT -5
Warning: this really is a rant and probably more than most people want to know. My husband retired 13 years ago from a large company. Part of his retirement package was health insurance for him and me. Premiums have risen a lot since then. A couple of years ago, the company dropped its Medicare supplement for those 65 and over. On 3/1/2015, they're dropping retiree health insurance for those under 65. They say they're doing this because we can now purchase "affordable" health insurance through the Affordable Care Act (ACA) and have more choice. If I buy insurance through a particular private exchange, the company will set up a health reimbursement account for me of $3,500 per year. No guarantee that the HRA will continue beyond the first (prorated) year, but that's excellent. I was unsuccessful in setting up an online account with the exchange and got all sorts of wild ass guesses about why, including two people who wanted me to install Google Chrome. I am unimpressed and worried about the competence of the people who are now responsible for helping me make a health insurance choice and making sure that I actually get signed up. I have a phone appointment next month to get through the process. Fingers crossed. I was told to use healthcare.gov see the various plans and premiums. Holy crap! Individual premiums for the lowest level plans, "bronze," range from $500 to almost $600 per month for someone in her early 60s. Deductibles for bronze plans are $5,500 - $6,300 per year. Drug copays are ridiculously high. I generally only have preventive care, which will have no deductible, and one prescription. My friend who is my age and in the same situation has some chronic health issues that require treatment by several specialists. She will probably be getting one of the best plans, a gold plan, costing from over $800 to over $900 per month. Our current plan includes vision coverage and I have the dental plan that only costs $14 per month. There will be no affordable dental plans available in March and the benefits of the separate vision plan make it barely worth the cost. We can afford this. Don't like it, but can afford it. There are premium tax credits for those with lower incomes. There are also cost-sharing subsidies, but that only affects the out of pocket maximum and only if you buy a silver plan. Out of curiosity, I looked at how much help a person can get. It's not all that much unless you're really poor. Here's the best explanation that I found: kff.org/health-reform/issue-brief/explaining-health-care-reform-questions-about-health/I'm here to tell you that people in the U.S. really are losing their health insurance because of the ACA and that many of them really won't be able to afford individual policies. |
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Post by brucemacneill on Dec 27, 2014 17:16:04 GMT -5
we went through all that crap for Mary last year. I was really happy when she went on Medicare in November, However, even Medicare is getting expensive if you buy the AARP supplement plan F and some dental insurance that I can only get because I'm a Vietnam Vet. I'm not sure what the Medicare payments I made while working pay but above that it's about $600/mo for the 2 of us with a guaranteed increase of at least 6% every year as we get older until it's about $900(2014 dollars)/mo. for the 2 of us. That's only about 25% of our income so I'm sure glad I', rich and that Walmart still sells guns because that's my backup plan when I run out of money.
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Post by fauxmaha on Dec 27, 2014 17:20:19 GMT -5
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Post by aquaduct on Dec 27, 2014 19:12:16 GMT -5
I feel awful for you. And it's really hard to say anything more without being inappropriately asshole-ish. It's not like the country couldn't see this coming.
Sorry. Truly.
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Post by Shannon on Dec 27, 2014 21:30:13 GMT -5
My opinion of the ACA is so cynical (although likely correct) that I shouldn't even share it here. Let's just say that I'm not at all sure that all the aggravation is unintentional.
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Post by RickW on Dec 27, 2014 21:58:29 GMT -5
It'll be interesting to see what comes next, if the GOP yanks it completely, or it gets turned into single payer, or something else.
Whatever happens, it's a mess, from the sounds of it. Glad I don't have to participate.
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Post by millring on Dec 28, 2014 6:39:33 GMT -5
It'll be interesting to see what comes next, if the GOP yanks it completely, or it gets turned into single payer, 'twas always the plan. You have to break it beyond repair before you can move on. |
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Post by Deleted on Dec 28, 2014 7:44:05 GMT -5
The ACA isn't working? While I feel bad about your situation, using one or a few anecdotes to say the ACA "isn't working" is akin to saying that since the stock market is doing so well, ALL Americans are getting rich.
I mean none of that to be dismissive of your situation. It is obviously painful. But why no vitriol towards the company that changed its policy to drop its Medicare supplement to those over 65 -- and doing so before the fallout from the ACA was even known?
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Post by theevan on Dec 28, 2014 8:20:46 GMT -5
Hmmm.
Somewhat related, I just read that the ACA Medicare expansion expires after Wednesday. The effect will differ by state, but for most states the result is a big cut rate doctors receive. The result will be finding a primary care doctor will become more difficult.
Our governor was (and still is) heavily criticized for refusing the Medicare expansion dollars offered the state with ACA. He predicted the trouble I just described. I think the idea was when the boost expires, the states would step in to cover the cuts. State budgets being what they are, that won't happen.
So here we are.
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Post by millring on Dec 28, 2014 8:22:27 GMT -5
The ACA isn't working? While I feel bad about your situation, using one or a few anecdotes to say the ACA "isn't working" is akin to saying that since the stock market is doing so well, ALL Americans are getting rich. I mean none of that to be dismissive of your situation. It is obviously painful. But why no vitriol towards the company that changed its policy to drop its Medicare supplement to those over 65 -- and doing so before the fallout from the ACA was even known? Good point. If the goal was the providence of health insurance for everyone instead of only for those who could afford it, "the system" was already broken. Before the ACA I was a healthy guy already paying >$1,000 a month for insurance with a $10,000 deductible while at the same time I was paying my share of the tax base from which the money used to pay for all the uninsured -- the young and/or cavalier who simply didn't want to pay for it, the poor who couldn't afford it, the immigrant who weren't part of "the system" --- were all going to be getting free health care. Additionally, my $1,000 premium already inflated to reflect the cost shifting necessary in health care to make the actuary tables seem even somewhat reasonable. Now we're finally coming to the conclusion that we don't really want health insurance. It's a tough pill to swallow because, ironically, we're one of the only countries left in the world who still believes that we can have free health care. Those who already have single payer understand that it's not free (right Rick?). But that's how it's been sold to the US because it's now a political issue being demagogued to a supremely undereducated and ignorant populace (Gruber). |
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Post by millring on Dec 28, 2014 8:25:42 GMT -5
Hmmm. Somewhat related, I just read that the ACA Medicare expansion expires after Wednesday. The effect will differ by state, but for most states the result is a big cut rate doctors receive. The result will be finding a primary care doctor will become more difficult. Our governor was (and still is) heavily criticized for refusing the Medicare expansion dollars offered the state with ACA. He predicted the trouble I just described. I think the idea was when the boost expires, the states would step in to cover the cuts. State budgets being what they are, that won't happen. So here we are. That was my understanding as well. I think it was an additional cynical calculation that Governors like yours and mine who understood that would pay a political price -- an important calculation in a changing political landscape in which the State governments are the ONLY thing holding the line thwarting a total Democratic Party federal hegemony. |
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Post by dickt on Dec 28, 2014 8:41:36 GMT -5
Hmmm. Somewhat related, I just read that the ACA Medicare expansion expires after Wednesday. The effect will differ by state, but for most states the result is a big cut rate doctors receive. The result will be finding a primary care doctor will become more difficult. Our governor was (and still is) heavily criticized for refusing the Medicare expansion dollars offered the state with ACA. He predicted the trouble I just described. I think the idea was when the boost expires, the states would step in to cover the cuts. State budgets being what they are, that won't happen. So here we are. It is Medcaid not Medicare expansion and by 2020 states will pay only 10 percent so please get your facts straight |
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Post by millring on Dec 28, 2014 8:46:25 GMT -5
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Post by jdd2 on Dec 28, 2014 8:56:19 GMT -5
Among other things, I guess Jeb Bush is distancing himself from Tenet Healthcare: www.latimes.com/nation/la-na-jeb-bush-money-20141225-story.html#page=1*** If anyone's familiar with it, I recently got 90 days of zetia for about $60. On the other hand, something simple like aspirin is rather expensive here (so I buy online). My wife had some added skin removed last week (connected to last May's colorectal surgery) and was in a large private room, with kitchenette (3 days). Total bill, calculated and final on checkout was about $900, half of which was the room (all the paperwork was done/complete on checkout--nothing else will be arriving in the mail). Some of the non-room cost may be reimbursed in a month or two, since there's a monthly cap on the max you have to pay. This past May, she had surgery for colorectal cancer (lost about 20cm of colon & has a colostomy), and besides that was in a basic private room for 25 days. Bill on checkout was about $2100, including the room, and again, all the costs/billing were finalized at checkout time. That was all within the month of May, and she got some money back on the monthly cap. Most all of the costs/billings for medical procedures here are gov't controlled. E.g., an appendectomy is an appendectomy, regardless of the hospital or location, and any given drug or test costs what the gov't says it does. I think this may be similar to the medicare-for-everyone that has been discussed. That said, we pay a lot into the system. One quirk is that since we both earn over a certain minimum threshold, neither of us can claim the other as a dependent (no joint, or head of household filing status here, and our health/pension coverages are assessed separately), and for healthcare purposes we are also viewed as two singles. So we pay proportionally more than most. It's strictly salary based, and since health deductions are also blended with pension (SS equivalent), it's difficult to tease out exactly how much is healthcare-specific. But it's a lot, and I don't even "see" that part where my school is matching my contribution every month... At this point, with that match, I probably pay around 14k/yr for health, and my wife pays maybe 11-12k (lower salary). Ripoff? Probably so, but on the other hand, the safety net is there, and you are never ever going to be bankrupted by the medical system. Also, when my income flatlines in retirement, I'll be paying much less. *** Anyway, if you're getting good care, Ms Hobson, those fees/deductibles kind of look like a gift to me. ((Incidentally, the japan counterpart of the US state is prefecture, and they have nothing to do with the medical system, its assessments, who can operate (or not) within their borders, and on down the list. 'State' (prefecture) regulation of medicine does not exist here, the system is national. Also, while there are research hospitals that you're better off getting a referral for, there are no for-profits, nothing like going to one hospital vs another is ever in-plan or out-of-plan, since there are no such plans/groups. Will this system survive the tsunami of aging Japanese? Who knows. At least the US has all those immigrants bolstering its population. on edit: auto-correct is worse than any health care system in the world. |
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Post by Marshall on Dec 28, 2014 10:09:30 GMT -5
The real crime here is that your husband's company used the ACA as an excuse to drop their contractual commitment to provide free health insurance to retired employees. They did that, because healthcare insurance costs are escalating almost exponentially. and they wanted an excuse to get out from underneath that obligation. They likely would have found a different excuse had the ACA not been enacted (or at least found ways to shift a significant portion of the cost to the individual).
Health insurance is a sticky wicket. There's no way around the fact that it costs a LOT. The government is only picking up the tab on those that don't have the means to pay themselves. That, plus the fact that they are supposedly forcing the insurance companies to provide a policy for everyone and not letting them categorically drop people. Of course the premiums are going to try to cover the risks. That's the insurance biz.
Supposedly the rates for everyone will go down, because now more people will be covered and the health care system won't have to spread the cost of uninsured care to those with insurance. But in this crazy life, nothing ever goes down.
(Except maybe gas prices. Though I'm not convinced that that won't jump up and bite us in the ass somehow.}
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Post by Doug on Dec 28, 2014 10:11:33 GMT -5
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Post by millring on Dec 28, 2014 10:18:36 GMT -5
The real crime here is that your husband's company used the ACA as an excuse to drop their contractual commitment to provide free health insurance to retired employees. They did that, because healthcare insurance costs are escalating almost exponentially. and they wanted an excuse to get out from underneath that obligation. They likely would have found a different excuse had the ACA not been enacted (or at least found ways to shift a significant portion of the cost to the individual). Health insurance is a sticky wicket. There's no way around the fact that it costs a LOT. The government is only picking up the tab on those that don't have the means to pay themselves. That, plus the fact that they are supposedly forcing the insurance companies to provide a policy for everyone and not letting them categorically drop people. Of course the premiums are going to try to cover the risks. That's the insurance biz. Supposedly the rates for everyone will go down, because now more people will be covered and the health care system won't have to spread the cost of uninsured care to those with insurance. But in this crazy life, nothing ever goes down. (Except maybe gas prices. Though I'm not convinced that that won't jump up and bite us in the ass somehow.} Additionally, the cost will continue to go up because the US health care is the most expensive in the world for a good reason -- it's the best in the world. And now we're expecting to keep the Cadillac that the old system of paying for it built....but we're doing so while operating with the public's delusion that we can do so while only paying the price of a small Subaru to keep it. The reality is that that is not possible. "If you think health care is expensive now, just wait until it's free" |
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Post by Doug on Dec 28, 2014 10:28:54 GMT -5
I'm against government being involved in health care at all. But if government is going to be involved that only way it will work in the long run is nationalize the entire health care industry. And everyone goes to something similar to the VA system and all healthcare providers are government employees.
Remember the whole health care mess we are in now was caused by the government freezing wages in WW2.
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Post by RickW on Dec 28, 2014 10:45:08 GMT -5
It is expensive. But we have not gone bankrupt doing it. And no, the workers do not have to be government employees. I think it's better if it's left private, with the government contacting it out. That is one of the mistakes we made. But yes, everyone having their own room, everyone having whatever they want at the drop of a hat, was never affordable or intelligent.
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Post by Deleted on Dec 28, 2014 11:58:57 GMT -5
...the US health care is the most expensive in the world for a good reason -- it's the best in the world.... At the risk of sounding like I don't believe in American exceptionalism, I'd posit that the U.S. healthcare system isn't the best in the world. Two things you have to include in any definition of "best" have to be affordability and access. By those measures, the U.S. healthcare system is lacking. What's the use of a great healthcare system if it is effectively closed to most people? After living for a few months in a foreign country that has fine universal healthcare, I can tell you there are different ways to skin the cat. I've talked to a lot of locals about a lot of different subjects over the months, but I have yet to hear one complain about their inability to see a doctor, the cost of their healthcare or the quality of that healthcare. I posted this on Facebook on Dec. 1: Had my first brush with the evils of socialized medicine tonight. Sharon's had a bad cough for a couple of days, so we went to the doctor. Headed to her assigned clinic and went to the front desk. She was told to take a number and pointed towards the doctors' office down the hall. She went right in to see the doctor. Total wait time: Zero minutes. I sat in the waiting room, reading the direction signs in the hallway, trying to find the one that said "Death Panel," but I didn't see it. Sharon described her symptoms and the doctor listened to her cough and gave her a couple of prescriptions. Went down the hallway to the pharmacy, where she walked up to the window and the pharmacist filled her prescription right away and threw in some pain reliever for good measure. Wait time to fill the prescription: A couple of minutes. Total time spent in the clinic: 15 minutes. Total out-of-pocket expenses: Zero. Total Sharon will be billed: Zero. Oh, the horrors of socialized By way of update, the medicine took care of Sharon's cough. Earlier this month, I had to have a root canal. Since I don't have my civil ID yet, I had to go to a private dental clinic. It is about a 10-minute walk from where I live. I'm no expert but from all appearances, it was modern and clean and professional. Took two visits to deal with it. Total cost: 150 KD, or $525. No complications, no problems. When my son had to have a root canal in St. Paul last year, it was $1,200. |
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