Vaflier
Pre-takeoff checklist
My insurance is doubling for next year and with a much higher deductible. Thank you very much Obama for shafting us all.
Health Insurance cluster
- Thread starter Let'sgoflying!
- Start date
RalphInCA
Cleared for Takeoff
He didn't "shaft us all".
There are many people (including people with preexisting conditions - like me) who can now get affordable insurance when they could not get it previously.
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EppyGA
Touchdown! Greaser!
That's all that matters, right.
Jthamilton
Line Up and Wait
Most hospitals know exactly how much the cost is to do a given procedure. They also know to the dollar how much each payor source will reimburse them. The costs fluctuate significantly based on agreements or group purchasing contracts with suppliers. Unfortunately there has to be some form of inflation with billing to compensate for plans that do not cover costs. Geographically this plays a large role. Rent and utilities may be significantly higher in downtown Austin as opposed to Ada, Oklahoma.
A good business/physician owner knows exactly how many tests will need to be performed to payoff any given piece of equipment. Or what the exact cost is per click with a MRI. If they don't they won't survive, hence many don't. With yearly changes in reimbursement and no telling WTF the idiots in Washington will do from year to year private medicine will continue to be a dying breed. Thus leading to a single payor system. Just my 2 cents, raising cows sounds like such a good second profession!
RalphInCA
Cleared for Takeoff
Jthamilton
Line Up and Wait
I respectfully agree that he did shaft us, when most of the tax increases take place in 2015 after the election how can that be viewed any differently then getting shafted?
When an insurance company is forced to cover all pre-existing conditions that only increases the insurance payouts hence requiring higher premiums. Simple economics. When the 20 year old can't pay his higher than in the past health premium due to shift of burden from the older clients to younger clients what are they going to do? There's no way when I was 20 or even 25 I could afford $150 a month for insurance, not while going to college and working 2 jobs.
I would ask myself what kind of coverage you can now get. Most of the millions that are being now thrown into the insurance pool are getting nothing more than Medicaid. Better accessibility to providers with Medicaid, not gonna happen. Tell a grocer he has to sell milk at $2.50 a gallon when it costs him $3.00 and see what he says.
When I sold my practices 3 years ago I was told I was only one of three organizations they had reviewed that actually made money that year. I didn't accept Medicaid at all in my 9 years and had 3-4 percent Medicare population and I wasn't accepting any new Medicare patients. That is the reality of private practice medicine.
We are only seeing the tip of the iceberg for the ACA and it's impact on our health system and every part of our economy.
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FormerHangie
En-Route
We have plain old company sponsored medical insurance. Every year the premiums go up and the coverage declines. Now they're getting to get picky about what they cover. My wife went in to the GP's office for some minor ailment, and also mentioned that her ears were buzzing. The doc looked in her ear and saw some wax buildup, and pulled out the syringe and tray, and lavaged her ear canals. You'd think that would be covered as part of a normal office visit, but no, the insurance company refused to cover that, and the office charged us $58 for a syringe, a plastic tray, and three minutes of the doctor's time, on top of the standard $30 copay.
It is that way because congress wrote a law and HCFA (now CMS) wrote regulations.
Get congress to write another law, get the president to sign it and you can have all the pricing flexibility you want.
EdFred
Taxi to Parking
So as long as you don't get ****ed over, the screw the rest of us, right? Got it.
Sorry, pre-existing conditions is like wrecking your car, then buying insurance, and expecting
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RalphInCA
Cleared for Takeoff
Wrong.
Pre existing conditions means that you cannot get insurance because of some condition you had in the past. It's not fair that the insurance companies get to exclude you because of a past condition.
And yes, we all have to contribute to make this work.
You would see how important this is if you were ever denied coverage because of a PEC. Especially if you faithfully paid insurance premiums for YEARS prior to this.
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EdFred
Taxi to Parking
Yeah, and that's the way it should be.
When my house burned down, I had insurance BEFORE it happened. I didn't wait until after it burned down, and said, "hey I need insurance for my house that's destroyed." No effin way.
You have a PEC, you should be uninsurable. Why? becuase you're a house that has burned down.
At this point in my life I don't even WANT insurance of any kind. But do I have that option? Noooooooooooo. I have to pay for a bunch of burned down houses.
When my house burned down, I had insurance BEFORE it happened. I didn't wait until after it burned down, and said, "hey I need insurance for my house that's destroyed." No effin way.
You have a PEC, you should be uninsurable. Why? becuase you're a house that has burned down.
At this point in my life I don't even WANT insurance of any kind. But do I have that option? Noooooooooooo. I have to pay for a bunch of burned down houses.
1600vw
Pattern Altitude
Problem is most people had insurance at one time. Then they loose their job then loose their insurance. Then they try to get insurance again and told no go for its a PEC.
That fire department is a NOT for Profit. Our health care should be ran the same way.
Having our health care for profit is a conflict of interest.
You have the option to self insure. You must have the money in the bank to cover most costs. So if you have say a million in a bank account set aside for this insurance, you can self insure. No law against it.
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EdFred
Taxi to Parking
The ACA, from what I read, prevents me from going uninsured. Well, that's not entirely true. I can go uninsured, but I get to pay a hefty fine if I do.
I also disagree on health care being for profit. I think it can be if it so chooses. The federal government should not be able to mandate that any industry be for or not for profit. What if they decide restaurants should be not for profit? Or the construction industry, or car dealerships, or any other sector?
I also disagree on health care being for profit. I think it can be if it so chooses. The federal government should not be able to mandate that any industry be for or not for profit. What if they decide restaurants should be not for profit? Or the construction industry, or car dealerships, or any other sector?
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JOhnH
Touchdown! Greaser!
Why would you think that would be covered as part of a normal office visit. I have had hundreds of office visits, and only once did I need an ear cleaning. Why should an ear cleaning be built into the cost of an office visit when it is rarely performed?
I do agree that it would seem like insurance should cover at least part of this cost. Although it could be argued that cleaning your ears is as much your personal responsibility as washing your face. They don't cover washing your face either.
JOhnH
Touchdown! Greaser!
I'm pretty sure you are going to lose your "plain old company sponsored" insurance program soon. That is what offer my staff and my CPA recently asked me why? Right after the ACA came out, I received a $2,000 tax credit for offering an insurance policy. That credit wen away last year unless you shift your insurance to an ACA "SHOP" plan (exchange for small business). But the SHOP plans are as bad as the personal EXCHANGE plans. They have higher premiums, higher co-pays and higher deductibles with less coverage.
My wife's employer continues to provide health insurance to its employees. At the last renewal, they conducted the usual "new insurance" meeting and gave a few tidbits about the process.
Bottom-line, the company could have simply declined to offer health insurance, and the penalties they would have paid would have been a fraction (and yes, with the numerator smaller than the denominator) of the cost of providing the coverage. And, not a single person in the company (not the lowest-paid phone-answerer) qualifies for a subsidy.
The whole schmere is apparently calculated to fail spectacularly (and it will - indeed, it is); or, it is merely incompetence and corruption on an epic scale.
Bottom-line, the company could have simply declined to offer health insurance, and the penalties they would have paid would have been a fraction (and yes, with the numerator smaller than the denominator) of the cost of providing the coverage. And, not a single person in the company (not the lowest-paid phone-answerer) qualifies for a subsidy.
The whole schmere is apparently calculated to fail spectacularly (and it will - indeed, it is); or, it is merely incompetence and corruption on an epic scale.
wsuffa
Touchdown! Greaser!
One of the whisper-rumors around Washington has been that this was calculated to fail, with the replacement being government single-payer (aka "Medicare for all").
Hard to verify whether true or not, but it would make sense that failure was an option early on - the far left would like nothing better than to have govt single payer, the far right would love this to fail with "I told you so". The citizens, however, are stuck in the middle as usual.
FormerHangie
En-Route
I would have expected the insurance to cover that and have reimbursed the physician as part of the office visit. Our copay is supposed to cover normal office visits, and an ear lavage is one of those things that are routinely done at a general practitioner's office.
Having impacted earwax removed by a doctor is commonly done. It is not analogous to washing your face any more than having a badly ingrown toenail surgically removed is the same as trimming your toenails.
FormerHangie
En-Route
I wouldn't be surprised. One of the reasons they wouldn't do this (yet) is that no one has gotten so much as a cost of living increase in the last six years.
FormerHangie
En-Route
Having seen what my in law's experience with Medicare was, I'd gladly take it. We had an AARP supplemental policy, and between the two it was better than what I have now.
JB1842
En-Route
I believe it. I'm getting an upper gi endoscopy tomorrow. Yesterday I got a call from the hospitals finance office asking me if I wanted to set up a payment plan for the $1800 I would have to pay out of pocket. She had no idea how they came up with that number, considering my out of pocket expenses for shoulder surgery earlier this year was less than $600. After I called my insurance company, they laughed and said that if they try to bill me that $1800, they will look into it. I only have a $100 co-pay for surgery and have to pay for 30% of supplies and stuff used during the procedure. So I called the hospital back, told her that if they plan on charging me, I will cancel the procedure, and give a friend $50 and a case of beer to stick a camera down my throat. She admitted she read the insurance policy wrong and would make a note in my file. We'll see what happens.
gkainz
Final Approach
When my kids were little, their pediatrician was, I kid you not, Dr. Payne. That went over REAL well...
JB1842
En-Route
I have an ex-girlfriend who is a Dr. Payne. She's a pathologist. It was either that or become a stripper with her first name....Misty.
Coulda used both names and worked in window sales.
JB1842
En-Route
Good one. And she was a pilot, too. Still wondering why I let her go, but don't let my wife know that.
