Goodbye ObamaCare

[steamjam1]

I had such high hopes about Obama care when it first passed. Well. I'm a bit disappointed.

 

[slynne]

I had high hopes for Obamacare too but could see the flaws from the beginning too. I could write a whole paper on this and have!

I think someone has already mentioned it but there is a good chance that the whole thing is going to collapse and then what? If we are lucky, a true single payer system divorced from employment. I like my job but sometimes I think that the gig economy would suit me more even though it would mean a pay cut. I just like the idea of being able to work when I want to and not work when I want to take a break. Health insurance has me in a bit of job lock though. Oh well, maybe by the time I am ready to hit the road, this will be all sorted out?

 

[TrainChaser]

I have several friends who work for a West Coast health care system, in three different facilities, and one who deals with them from the outside (insurance).  They are in 5 states, they have 30 hospitals, 250 clinics, and more than 1,600 physicians.  They are also one of the most FU'd businesses on the planet.  Worse, they are probably just average in the industry.

When you go to a doctor, they have been instructed to give prescriptions for the newest,  most expensive meds, when the older and cheaper meds would do just fine.

Big Pharma takes govt grants from our taxes to create new drugs for which they charge a fortune -- well, in this country, anyway; the same drugs sell for much less in other countries, as you know if you've been to Los Algodones.

The industry has been made so complicated that it costs a fortune, and if you don't insist on getting an itemized bill (and scrutinizing it closely), you're very likely to be paying for things that you shouldn't be.
Eight out of ten hospital bills have errors, some of them in the 5-figure range.  And if you bother to check it, you will likely find that you have been charged for all kinds of things that weren't used, you didn't get, that you didn't need, and were double-charged for.  Heart attack patients are charged for baby bassinettes.  Dead people are charged for room occupation for two days after they died.  Appendectomy patients have their intestine accidentally knicked with a scalpel by the doctor, and the patient is charged for repair costs of the damage. Have a heart attack, and they may charge you about $15,000 for "medical supplies" when you're in Intensive Care, which consisted of oxygen, a ventilator, cardiac monitoring, etc;  but these are ALREADY included in the cost of being in the Intensive Care Unit (ICU).  Some medical supplies (like pacemakers) have warranties -- if a part has to be replaced, they shouldn't be charging you $35,000 for replacing a part.

My brother recently had triple bypass surgery.  By the fourth day, he was still having problems breathing, and the doctors were concerned.  They decided to send him home with an oxygen machine and oxygen tanks (for power outages).  He blew his nose on the fifth day, and felt a lump in one nostril, so he worked it out -- 'it' being a large blood clot from the tube they stuck in it.  The doctor came in for the daily exam, looked at his history, and said, "You've been having trouble breathing since the surgery, but you don't seem to be having any problem now".  My brother handed him the tissue with the clot in it.  It had never occurred to anyone to check his nose.

All of this crap, multipled millions of times, costs a huge fortune.  You pay for it out of your own pocket, through the rapidly-increasing insurance costs, or via your taxes.  There are no free lunches in health care, but we shouldn't be paying for stupidity, mistakes and outright theft.

 

[steamjam1]

What disappoints me so much about Obama-Care is what I got for paying just alittle more in premiums, which I was perfectly willing to do so that my fellow American could get quality health care.

My premiums didn't just go up, it went WAY UP. I pay 75% more in premiums then I did in 2011. For that 75% increase I now have a MUCH higher deductible, my prescription co-pay doubled, and my choice of doctor(s) went out the window. But I gotta pay it or face a penalty at the end of the year.

Obama-Care aint working. Thats for sure. He should have FOUGHT TOOTH AND NAIL for the Public Option.

But I'm glad Obama-Care passed. It set the US on the path to join the rest of the industrialized world. We are no where near there yet, but its a good start.

There is a saying accross the pond that goes: "Americans will always do the right thing. They just have to try everything else first!."

 

[Dandelion_Puff]

TrainChaser nailed the real problem, which is the cost of medical care and prescriptions. People love to blame the health insurance companies, but the truth is that health insurance has tighter profit margins than most other insurance despite the exorbitant premiums (my father sells all types of insurance and has for many years, so I'm going by what he's told me, including that some larger insurance companies have quit the health insurance game entirely because it's too low-profit compared to other insurance types). The normal operating procedures of the healthcare industry would be utterly unacceptable in any other industry. I mean, if your hairdresser refused to give you prices up front, then added a ton of extra services you didn't ask for or want, and finally presented you with a $500 bill at the end, would you even think about paying it, or would you walk out laughing before reporting her to every regulatory agency and review site in the world? But we let doctors do this very thing every single day. Truly, the amount of usury I've seen in the healthcare industry is beyond stunning. The only thing more shocking is how many otherwise-intelligent people are so brainwashed that they actually accept it without a second thought. Of course, they get away with it for the same reason criminal mafias got away with extortion: because you'll suffer or even die if you don't pay.

A related anecdote: back during the height of gas prices during the Bush administration, I saw an oil company executive interviewed on a news show. The interviewer demanded to know how he could justify the astronomical profit margins of his company when people all over the country were suffering for the inflated fuel prices. His response? "Our profit margins are far lower than those of pharmaceutical companies." He was telling the truth too, and the downright criminal profits of big drug companies have only increased in the decade since I saw that.

Anyway, right now I have health coverage through my husband's work, but once we're full-time on the road who knows how long that will last. I was without coverage of any kind for years and always have things arranged so I can pay for necessary medical expenses out-of-pocket (barring emergency, of course, but when hospitals will happily charge six-figures for whatever they please, there is simply no way to prepare for that, nor any way I could ever afford private coverage). My husband's meds are another issue, as they're a classic case of drug company extortion where paying out of pocket is not an option, but I try not to think about that. No point in buying future trouble when so much current trouble is available for free.

As for Obamacare, the only good part is the Medicaid expansion, which has literally saved the lives of several people I know and made massive differences for hundreds of thousands of others. It's such a fantastic thing, and I really hope many states maintain their Medicaid expansions even after the new administration repeals the Obamacare legislation. The rest of it is terrible, though. Like so many on this thread, my parents have seen their coverage go way down while premiums went way up, and I don't think that is even due to the Medicaid expansion which is actually helping people (as in, I don't think their increased expenses are being used to fund Medicaid). I wish I saw this as moving towards a single-payer system, mostly because that seems like the only way to stop the usury in the healthcare industry, since the government would have no choice but to really regulate them then. But with the current political climate I can't see that possibly happening any time soon. What I suspect will actually happen is that all the people saved by expanded Medicaid will be thrown back out into the cold to die, and people like my parents won't see their premiums drop one single penny as a result either.

 

[slynne]

I remember talking about this several years ago when I was in college. Health Economics admittedly was not a class I got an A in but I did learn some things about it as a market that makes it unique.

One thing is that the people who pay the bills and the consumers of the services are not usually the same people. Doctors are trained generally to provide the best care possible without regard to the costs of the treatment. As an example, I am on a drug that has a side effect a slight dry cough. It costs, even here in the USA, around $5 for a 90 day supply. I told my doctor about the cough and she prescribed me a different drug. One that cost $180 per 90 day supply. I had to go back to the doctor and get my old prescription back because while the cough is annoying, it isn't $175 annoying. This becomes even more of an issue at end of life and actually was one of the things the so called "death panels" were meant to help prevent. People often undergo treatments that don't have high rates of success and which are sometimes very painful and expensive just because they don't really know that there are other options. The panels were to help people by showing them ALL of the options, treatment and hospice. Also, when it is your mother or kid or whatever and you are making decisions for them that their insurance will have to pay, it is really easy to take a "do everything to save them" approach because of course most people will do anything to save someone they love. (It is very interesting to compare veterinary health markets to human ones too because the former is mostly private pay. You can see some interesting differences. Care is generally cheaper and much less is spent on end-of-life care.

Also, doctors are humans and like most humans they are incentivized by money. That means, that they do sometimes recommend more expensive treatments or more treatment. It isn't even always conscious on their parts but it happens. Large health care corporations like major hospitals usually are run by profit seeking MBA's who tend to make policies which maximize profits.

There is also a lot more expensive technology out there and people tend to want the latest and best. This is a trend that was happening without Obamacare and is one of the big reasons why health care insurance costs have been rising. There is a pretty good argument that Obamacare has actually kept costs down more than they otherwise would have been. Insurance is more expensive now but might have been even more expensive without Obamacare.

Here is the thing though. One of the big reasons why insurance costs are so high is bargaining power. We have a system with many different insurance companies and only a few of the big ones have much bargaining power. You can really see this if you see Medicare prices. In fact, sometimes I have heard about private pay people seriously reducing their bills by demanding to be charged the Medicare price. It is often very much reduced. Even a large insurance company can have an impact. I have Blue Cross/Blue Shield of Michigan which is Michigan's largest insurer. I broke my wrist a few months ago. The bill I got from the hospital for the ER was around $13000 but BC/BS negotiated it down to around $2000 (which they paid minus my deductible). That is a *huge* difference and Medicare has even more bargaining power as they account for about 1/3 of all health care spending in the USA. Now imagine what a true single payer health system could do in terms of bargaining power? Well, you don't have to imagine it. It is proven to result in the lowest cost health care you can find. I know a lot of capitalists don't like to hear this but there actually are things which are more efficient when socialized and health care is one of them.

I am not sure that the present political climate means that we can never have a single payer system. It is true that a lot of people will be hurt if the medicaid expansion is killed and I truly hope that doesn't happen. However, Trump is talking about keeping things like the law requiring health insurance companies to accept people with pre-existing conditions while getting rid of the individual mandate. That won't just end Obamacare, it has the potential to kill the entire individual health care market. If that happens, we will have to rebuild the whole health care system from scratch and a single payer system is really the way to go. I still am hoping that this doesn't happen though as without an individual health care system, a lot of people will go uninsured and they will suffer for it. It will also result in a lot of 'job lock' which can hurt the economy as a whole as it discourages entrepreneurship.

 

[steamjam1]

I m hopeful that in my lifetime the US will get to either the public option, or single payer.

 

[SternWake]

Today was the last day to sign up for coverage in CAlifornia.

Oh well, gee, I guess I missed another deadline.

A childhood friend of mine is employed by one of the Big Pharma companies. He was a salesman, and then moved up to head of sales as of a decade ago. Not sure his position since.

He explained how they would go to doctors, inform them how such and such a drug could be prescribed for a condition well outside that of which the drug is designed for, and how the doctors would then receive kickbacks for every prescription they wrote.

The whole for 'For maximum profit' aspect of healthcare, has kept me from visiting a doctor for well over a decade, and will continue to do so. I am so thoroughly disgusted with the whole system.

If/when my obstinate nature kills me, so Be it.

Giant middle finger to the whole medical establishment.

 

[flying kurbmaster]

I don't think anyone should make any decisions based on healthcare as it exists now.  In a years time, we'll all have a much better idea of the way healthcare will work after the new administration comes into power.

you will likely not need any health care in a years time and if you need it you probably wont want it, if this new administration ever comes to power.

 

[akrvbob]

you will likely not need any health care in a years time and if you need it you probably wont want it, if this new administration ever comes to power.

I've had Obamacare for the last two years and did NOT sign up again for exactly this reason. I just went to the doc and got a clean bill of health in nearly every way, so it's highly unlikely I 'll need it this year. My premiums jumped dramatically so why pay anything at all? My deductible is so high they will never pay a penny unless I have a truly bad accident or illness. 

I did it before because it saved me money instead of paying the penalty--so why wouldn't I take it!!!!!?

But not this year, I'll save by paying the penalty so I will.

 

[TrainChaser]

Another big expense in health care are the drug addicts. A friend of mine has one adult son. He's been a junkie for at least twenty years, and for the last several years he's been on meth. He uses his SS to buy it, making the deal on his taxpayer-paid cell phone. A couple of years ago, he had to have his intestines removed. (How much did that cost?) After that, he had to have a medical person come to the house and give him a daily nutritional feed (cost?) Then he disappeared from home and went back to his junkie friends; after a while, they drove him to the ER and dropped him off outside the door.

Apparently, he can only stay in a hospital for a certain amount of time, and then he's shifted to another hospital, and then to another hospital. His weight is down from 175 to 110. Yes, he's dying. And yes, the hospitals keep treating him and billing someone, or they're eating it. (I don't know how that works.) How much has this guy cost everyone else for the last 20 years? And then multiply that by another million or so meth junkies. Then add in those who are on cocaine, heroin, ecstacy, etc. We pay for both their illegal drugs and their medical care until they die. And then we likely pay for the funeral or cremation. And they keep on a-comin'.

I think Bob has the best idea. Before I got ObamaCare (when they forced me), I went to the local poor-people's clinic. They billed Medicare and gave me a bill for $35. I don't have a doctor of my own, because many doctors don't do that, anymore. I went to the poor-people's clinic for an infection (w/ObamaCare), and they billed Medicare and sent me a bill for $35.

I don't know how all of this is going to play out, but I hope someone finds a solution.

 

[Cammalu]

The thing about turning down the Medicare is that for each year you are eligible and don't take it there is a hefty penalty. Last I checked you had to pay 10% more for every year. That can be a substantial amount in a very short time.


Sent from my iPad using Tapatalk

 

[One Awesome Inch]

Just FYI as a Canadian I pay $35 per month and I'm fully covered. Yes it's a perfect system but I'll never be thousands in debt for needed health care.

 

[One Awesome Inch]

* not* a perfect system. ...

 

[Gunny]

I have priced what the costs would be for my meds I get from the VA, average runs about 1200 a month. That's just the online prices, I'm sure they get them for less.

When they were trying to get my heart back in rhythm they were using some very expensive ( with three pages of side effects) drugs. Didn't work and one damn near killed me.

I'm just parroting what others have said, the system is broke. People are dying for lack of basic care and we, as a nation, deserve better. Rob

 

[ArtW]

Part of the problem is the way we USE insurance
Do you ask you auto insurer to pay for your car's yearly checkup (inspection)? do you ask him to pay for that new headlight bulb? oil changes? Alignments? no, you pay out of pocket, unless a Bad Thing happens, like a wreck, theft, etc
Now look at the way we all use health insurance
would you drop a C note to hit the Dr's orifice for a mere sniffle out of your own pocket? A checkup? a small, shallow cut? Nope, but many will, if it's picked up by their insurer, and the Dr's know they can charge those high per-visit prices and still have to turn patients away, thanks to 'am not payin fer it' itis
yes, you are payin fer it, and probably more than if we all handled minor problems out of pocket
I went literally for decades with no medical expenses at all, because I had to pay out of pocket and it wasn't worth the cost for minor things i could handle myself, at home
of course, at 50, i want that insurance for a fall back option, but I sure wish it was cheaper

 

[Almost There]

Just FYI as a Canadian I pay $35 per month and I'm fully covered. Yes it's a perfect system but I'll never be thousands in debt for needed health care.

You're in BC which has different fee structures for their health care systems than I do in Ontario.

I'm moving to BC this coming spring so I'm really interested in what changes I'll find.

What exactly is it that you're paying $35. a month for?

 

[slynne]

I know a lot of people who have decided not to sign up again for Obamacare next year because the premiums have risen so much. It really scares me to be honest but I have resigned myself to the notion that folks will essentially be using fund raising web sites as insurance. I have already contributed hundreds of dollars just to help people cover their large deductibles and I don't mind that but worry about people who don't have social networks of people who have a few extra bucks they can spare to help out.

 

[Optimistic Paranoid]

I've had Obamacare for the last two years and did NOT sign up again for exactly this reason. I just went to the doc and got a clean bill of health in nearly every way, so it's highly unlikely I 'll need it this year. My premiums jumped dramatically so why pay anything at all? My deductible is so high they will never pay a penny unless I have a truly bad accident or illness.

I ran across this info while researching types of RV insurance:

_*Medical Payments (aka MedPay)*_
 
This is an optional coverage* which pays for the costs of medical care
for you, your family, and any passengers resulting from a
covered accident.  It may be used regardless of fault.
 
This coverage is fairly inexpensive and may be a great supplement to
your health insurance especially if you have a high deductible health
insurance policy.  If you have medical costs resulting from an accident,
this coverage pays quickly and may save you paying for a high
out-of-pocket deductible.
 
It may also be worthwhile if you have no health insurance.  It's
certainly not a substitute for health insurance and only kicks in if you
are injured in a covered accident, but it may be worth the premium.
 
* - Some states require insurers to include a minimum amount of this
coverage.



http://www.rv-dreams.com/rv-insurance-coverages.html#Medical

 

[DannyB1954]

Our politicians have socialized medicine, but apparently it is not good enough for the rest of us. Or something like that. Another gripe of mine is VA medical. Why have a separate system? just issue them medicare with the provision that the VA will pay the copay. That way a Vet can go to any doctor that takes medicare.