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Post by millring on Dec 28, 2014 16:47:16 GMT -5
I don't think that accurately describes the ER-as-healthcare model as it is practiced. I think that's only part of the equation. I think the ER is many folks family doctor in the old "system". I'm not saying that's good, but neither is if filed under the "Americans have the worst health care in the industrial world". Turning them away (which is what is most often implied) would make us the worst. We don't. And I'm really surprised when we keep implying that we do. That's why I ask every time I see the suggestion crop up that that's something we do.
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Post by fauxmaha on Dec 28, 2014 17:07:55 GMT -5
There was a scene on The Simpsons once where a lady was checking out at the supermarket. She had a full cart. As the bag boy started to work, she barked at him "You! I want that all in one bag and don't make it heavy!"
Health care discussions always remind me of that scene.
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Post by brucemacneill on Dec 28, 2014 17:14:50 GMT -5
I wish there was someone on this board who could explain how healthcare versus healthcare insurance works in this country but I know better than to try.
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Post by Deleted on Dec 28, 2014 17:17:50 GMT -5
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Post by aquaduct on Dec 28, 2014 17:23:59 GMT -5
Hence Obama's brilliant master stroke of making it more expensive for so many people.
The man's a genius I tell you.
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Post by theevan on Dec 28, 2014 17:35:35 GMT -5
There was a scene on The Simpsons once where a lady was checking out at the supermarket. She had a full cart. As the bag boy started to work, she barked at him "You! I want that all in one bag and don't make it heavy!" Health care discussions always remind me of that scene. I laughed! Truth.
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Post by Hobson on Jan 27, 2015 11:50:57 GMT -5
To update, I've worked through all of the glitches and am enrolled in a bronze plan. Premiums of almost $500 per month with a $6,300 annual deductible. The deductible doesn't apply to preventive care. It does apply to prescriptions. With the health reimbursement account, the net premiums are about what I'm paying now with a $360 deductible and some copays. I'm looking forward to being old enough to get Medicare in about 3 years and hoping that the rules don't change for that.
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Post by PaulKay on Jan 27, 2015 15:43:50 GMT -5
My employer already dropped Medicare supplement coverage this year but still offer their coverage for those who retire before 65. Hopefully they continue to do that for a few more years until I reach 65. I don't feel confident I would find ACA coverage at the monthly premium or deductible they have. The problem with employer retirement plans is that they can pull the plug on stuff anytime they want to. That's why I'm taking the lump sum pension distribution. If I screw it up I have only myself to blame.
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Post by Fingerplucked on Jan 27, 2015 17:37:03 GMT -5
Yes he did, and as I recall it, he was brilliant. I don't know how to find the old threads either, but I don't think it matters. Everything I had came from the book Dr. Kennedy recommended, a book that I thought was going to be long and boring but turned out to be anything but. Anyone who wanted to read that book, anyone who was interested in facts about how other countries solved their healthcare problems, already has. The rest of the people, some of them anyway, just like the arguments approved by their political propagandists. If I'm wrong and somebody does want to read that book, I'll be happy to look up the title for you. (Can't remember it off the top of my head.) Renee, I'm sorry you guys got caught up in the elimination of benefits by your husband's former employer. Even if you can afford to pay, the situation sucks.
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Post by jdd2 on Jan 27, 2015 18:10:24 GMT -5
To update, I've worked through all of the glitches and am enrolled in a bronze plan. Premiums of almost $500 per month with a $6,300 annual deductible. The deductible doesn't apply to preventive care. It does apply to prescriptions. With the health reimbursement account, the net premiums are about what I'm paying now with a $360 deductible and some copays. I'm looking forward to being old enough to get Medicare in about 3 years and hoping that the rules don't change for that. I wonder what the costs for someone your age (and mine) would be if there were no Obamacare? That is, if you could even find coverage.
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Post by coachdoc on Jan 27, 2015 18:19:25 GMT -5
One payor and one payor only, paid through our taxes. Ya pay yer taxes, you gets your care. No more donut holes, every body gets the same start. Like Canuckistan. A better system than we have here.
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Post by majorminor on Jan 27, 2015 18:22:30 GMT -5
To update, I've worked through all of the glitches and am enrolled in a bronze plan. Premiums of almost $500 per month with a $6,300 annual deductible. The deductible doesn't apply to preventive care. It does apply to prescriptions. With the health reimbursement account, the net premiums are about what I'm paying now with a $360 deductible and some copays. I'm looking forward to being old enough to get Medicare in about 3 years and hoping that the rules don't change for that. I wonder what the costs for someone your age (and mine) would be if there were no Obamacare? That is, if you could even find coverage. Since I'm grandfathered in I opted to keep my private plan this year as I wanted to wait and see how Obamacare plays out before joining the exchange. Going with either option my monthly premium is still up over last year - something like $370 to now $410 a month for a basic high deductible catastrophic type plan. I'll be pleasantly amazed if insurance premiums ever actually go down, but I definitely am a fan of the nobody can be denied aspect of the ACA.
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Post by coachdoc on Jan 27, 2015 18:28:15 GMT -5
""Since I'm grandfathered in I opted to keep my private plan this year as I wanted to wait and see how Obamacare plays out before joining the exchange. Going with either option my monthly premium is still up over last year - something like $370 to now $410 a month for a basic high deductible catastrophic type plan. I'll be pleasantly amazed if insurance premiums ever actually go down, but I definitely am a fan of the nobody can be denied aspect of the ACA.""
And that's it. Prices keep going up, access to care keeps going down. The AMA, AHA, insurances and Big Pharma stick it to us and take HUGE profits off the top. It has to go single payor, or it will never change. We pay more and more, get less and less.
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Post by millring on Jan 27, 2015 18:41:39 GMT -5
""Since I'm grandfathered in I opted to keep my private plan this year as I wanted to wait and see how Obamacare plays out before joining the exchange. Going with either option my monthly premium is still up over last year - something like $370 to now $410 a month for a basic high deductible catastrophic type plan. I'll be pleasantly amazed if insurance premiums ever actually go down, but I definitely am a fan of the nobody can be denied aspect of the ACA."" And that's it. Prices keep going up, access to care keeps going down. The AMA, AHA, insurances and Big Pharma stick it to us and take HUGE profits off the top. It has to go single payor, or it will never change. We pay more and more, get less and less. My brother, the periodontist, is so conservative, I'M the family leftist. But my conservative brother, president of his dental association, doer of good deeds and a bright guy wrote his Republican congressman during the wrangling over ACA and BEGGED him to leapfrog the debate and propose a single payer expansion of medicare for basic care.
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Post by Doug on Jan 27, 2015 18:55:08 GMT -5
I can't see anyway that quality of care (in general) won't go down no matter what system. Cutting edge technology will keep being more and more expensive. And no matter what you call them/it some where cost comes into limiting care.
So where do you draw the line with 90% of your labor going to health care, or 40% or 10%. Do you do it on an individual basis, or through insurance companies, or through the government. But there will be a limit to what people are willing to pay.
I'd like to see it on an individual basis with paying the doctor when you see him/her with cash, chickens or goats. But you would have to roll up a lot of history to do that.
But I agree if we are going to have government do it, it needs to be single payer. And for it to work you need to socialize the medical field. Any mixed system is something that can be worked, bent, got around, scammed. And you have to do the whole medical field from janitors up to brain surgeons and all the way out to the pharmaceutical companies. Any where there is a link between government and private there will be someone ripping off the government. And every rip off adds to the cost.
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Post by brucemacneill on Jan 27, 2015 19:26:36 GMT -5
I don't believe that Socialism is a good thing and I think the Socialist countries are going to hit a wall pretty soon. What I do know is that a fairly decent group coverage plan here was costing us $370/mo in 2013 for Mary and that was supposedly the COBRA rate which is the full cost, no employer contribution. When her COBRA ran out we had to look for an individual plan for her and the company she had been with quoted $2000/mo for the same coverage she was getting for $370 so we had to take a higher deductible higher co-pay plan that at least had the same doctors and meds covered for $922/mo. Then came the ACA so I looked into it to see if it was cheaper and it appeared to be somewhat cheaper and we could get a subsidy and it was theoretically the same insurance company she had so I took the "Silver, multi-state plan for $680/mo less the $240 subsidy. It looked like less nut it was way worse.
Multi-state turned out to mean coverage if you got hurt out of state but not that you could just go see a doctor out of your state. We live closer to Maryland than to the rest of Virginia so we have doctors in Maryland which was never a problen before but now they wouldn't pay. Routine tests Mary has a couple of times a year due to pre-existing conditions which had been covered for the past 8 years weren't covered just applied to deductible, a deductible we'd never get past unless she got hit by a bus and lived. Meds that were on the company's formulary and that they had been covering for 8 years all of a sudden weren't covered. Her doctor sent appeal letters but they were denied. The Meds in the policy weren't done acording to the companiy's formulary, they'd been outsourced to another company that only covered generics. The company whose name was on the insurance card was real slow to explain that but there was no winning the argument. The policy started in March and by June we had figured out we'd been scammed and just paid out of pocket until Mary went on Medicare in November. I wish y'all luck if you get caught up in the ACA scam. As I said in another thread, when I add up what we paid in medical last year for tax purposes it will be right around 25% of gross income. We got about $150 in benefits from the ACA policy but had to go 300 miles and $40 i tolls to get to a doctor they'd pay 70% of. As I also mentioned in another thread, when we tried to cancel that ACA policy the company that it was supposedly through didn't know Mary at all and we had to talk to the exchange. 3 months later it appears the policy was finally cancelled. I'm waiting for the revised tax form but I'm not holding my breath.
Renee, you have my sympathies. So far, the AARP United HealthCare plan seems to work well despite the expense. It's still more than the group plan but less than the ACA plan. Hope you get to 65 OK.
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Post by RickW on Jan 27, 2015 22:00:04 GMT -5
Single payer, not single provider. You end up with very large, strong unions, which is what happened to use here. I'm all for paying a livable wage, but $25 per hour to do laundrey was a bit much.
Haven't hit any walls yet, Bruce.
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Post by epaul on Jan 27, 2015 23:37:12 GMT -5
Each year, drop the 'eligible for Medicare' age by three years. Give the process a ten-year transition period. The goal would be to eventually get to single payer without throwing 30% of the economy (which means real people with jobs they depend on) into shock and disruption. The writing would be on the wall, but it would be a slow writing with some time to adjust and re-position.
There is no reason to work out the bugs on a whole new from scratch complex and expensive bureaucracy when Medicare can be expanded slowly but surely over a ten or fifteen year period.
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Post by brucemacneill on Jan 28, 2015 5:59:31 GMT -5
Each year, drop the 'eligible for Medicare' age by three years. Give the process a ten-year transition period. The goal would be to eventually get to single payer without throwing 30% of the economy (which means real people with jobs they depend on) into shock and disruption. The writing would be on the wall, but it would be a slow writing with some time to adjust and re-position. There is no reason to work out the bugs on a whole new from scratch complex and expensive bureaucracy when Medicare can be expanded slowly but surely over a ten or fifteen year period. I think y'all forget that Medicare costs money if you actually need healthcare, money above and beyond what you get from the government for the taxes you paid if you worked all your life. Each of us, that's Mary and me, pay about $300/mo for supplemental plans to Medicare to cover what it doesn't cover, drugs, dental, eyes, co-pays and deductibles. To make Medicare cover healthcare in total and for people who didn't work would bankrupt the country in a month. Beyond that, not many people who didn't work or worked minimum wage jobs can afford the extra $300/mo per person. The math doesn't work. Who pays for everyone's healthcare isn't as important as how much healthcare costs. We need to cut the pay for all those greedy doctors and pharmacies and hospitals. Then we can figure out how to pay what's left. That's Socialized Medicine at work.
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Post by jdd2 on Jan 28, 2015 7:06:05 GMT -5
Each year, drop the 'eligible for Medicare' age by three years. Give the process a ten-year transition period. The goal would be to eventually get to single payer without throwing 30% of the economy (which means real people with jobs they depend on) into shock and disruption. The writing would be on the wall, but it would be a slow writing with some time to adjust and re-position. There is no reason to work out the bugs on a whole new from scratch complex and expensive bureaucracy when Medicare can be expanded slowly but surely over a ten or fifteen year period. Excellent idea, tho I'd propose that it be done a little more slowly, but only if you could keep special interests from eviscerating it. My pay gets deducted about $600/month for healthcare, and my employer matches that, so make that 1200 (that also covers one remaining dependent, but it's salary-based so that doesn't matter). And then my wife, who is also a full time worker, and because of that is necessarily independent of me (tax/employment rules here), pays a little less, since she doesn't make as much as I do. And there is some co-pay if something happens. But costs/payments are universally controlled in what I think is a universal-medicare kind of way. So yes, it's expensive, but no, I'm not whining and complaining. It works (tho the aging population here will be a huge strain in coming years, they're making changes (adding death panels, if you will!)). *** I'll be hospitalized for maybe four days, starting on Feb 3rd. Cubital tunnel syndrome (ulnar nerve entrapment), and they're going to take some bone off my elbow and re-route the nerve. Maybe I'll post what out-of-pocket costs are, etc.
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