Health Insurance?

[liv2ski]

To the clueless individuals that think Universal Health Care sucks, you obviously have not educated yourself on the topic and what other countries offer around the world and the results given to patient or the society as a whole.
My extended family are all in Canada, except my mom and I. My father over a 35 year span had 3-4 heart attacks. His care was fantastic (I mean he did live for an extra 35 years with only 50% of his heart working).
My sister, was treated for breast cancer last year. Again, her treatment was stellar and did not bankrupt her.
Universal Health Care is the first leg a decent society is built upon IMO.

[TheSilverSurfer]

So much wrong here with your presumptions here that I simply don't have time to engage, but I'll just say that you're incorrect on just about every point. Conservative =/= Republican. Nor does it mean anti-safety net. Nor does it mean pro-Trump. Nor... ... ...

And no. $1000 is NOT a good deal. How rich are you?!

$1000 is a great deal when viewed through the lens of the actual cost of healthcare and medication.

In 4 years we've paid out about 60k for health insurance.

Insurance has paid for one child birth, all the office visits associated with that, ambulance call for pay birth complications, emergency room visit for post birth complications, miscarriages the following year, one knee surgery, psychiatrist, ADHD medication, pre birth care, anti nausea pregnancy medications, and more.

Insurance has easily paid out 100k.

[bagtagley]

I was talking with a friend about this recently. She has MS and is covered by her employer. The company was recently bought out, and the new folks are doing everything they can to push long-time employees out, making them completely miserable. Friend looked seriously at going independent, but ran into insurance costs. She was looking at over $3000/month for a family of four, which eliminates the possibility of her working for herself. I thought the numbers sounded a little exaggerated, but I've heard and read of similar situations since.

https://www.nytimes.com/2017/11/16/u...dle-class.html

[MontuckyFried]

Austin, I am sorry that you're going through rough times. But what you think of all the poor folks just sitting back getting their govt bennies is not reality. It may look like some people have it easy because they don't seem to be struggling from your vantage point, but your vantage point isn't theirs (ie, they may not be struggling with the stuff you are, but they may be struggling with all sorts if stuff that you are not). As someone who used to administer the govt bennies system (food stamps, cash assistance, medicaid), let me tell you a few things. It isn't easy to qualify for benefits, it's extremely difficult to live on whatever benefits you do qualify for, and it's difficult to stay qualified for those benefits. It may look like a better option for you right now, but I am virtually certain -- without knowing a single detail -- that trying to qualify for benefits, or being in a situation where you do qualify for benefits, is worse than being in a situation where you don't.

ETA: You're a good mag and if there is some way that the community could help you, speak up.

Thanks, man. Appreciate that.

And I know, I know. I really do NOT want to get on the system for anything. I'm honestly (mostly) just being facetious. It's just tough right now, so I'm just venting a bit. Working a menial job does sound kind of awesome, though. Haha.

[XXX-er]

To the clueless individuals that think Universal Health Care sucks, you obviously have not educated yourself on the topic and what other countries offer around the world and the results given to patient or the society as a whole.
My extended family are all in Canada, except my mom and I. My father over a 35 year span had 3-4 heart attacks. His care was fantastic (I mean he did live for an extra 35 years with only 50% of his heart working).
My sister, was treated for breast cancer last year. Again, her treatment was stellar and did not bankrupt her.
Universal Health Care is the first leg a decent society is built upon IMO.

well yes but actualy I thot " unfathomable " was kinder/gentler nomenclature than " clueless " and thats the point eh?

[liv2ski]

well yes but actualy I thot " unfathomable " was kinder/gentler nomenclature than " clueless " and thats the point eh?

Yep, this topic just really pisses me off as does 4matic's defense of all things Capitalistic and deplorable. I am off to go surf, as this conversation is pissing me off.

[Conundrum]

I work in the health insurance industry. I read a lot of misconceptions here but it would take far too long to engage all of them. Remember under ACA, insurance company profits are capped. Depending on the market segment, either 80% or 85% of the premium dollars paid in have to go out in claims. Insurance companies are merely premium aggregators anymore. Are there profitable insurance companies? Hell yes. But it's not like it was pre-ACA. There is a hospital two blocks from my house. They just pulled the trigger on a $400 million dollar expansion. I urge you to google the cost of every prescription advertised during the Super Bowl. My wager is you won't find one that the retail cost is less than $400 per month or $4,800 per year. Health insurance copays for these are going to be in the $50-$100 range for the patient. I can pay in my $5,000 per year premium with no claims so someone can have a $500/month drug for $50 when there is a 96% chance an $8/month generic will give the same result. But "I saw my drug on TV so it must be better".

Where do you think that money is coming from? I'm certainly not trying to defend the insurance companies. I quit working for them for a reason. But, we need to wake up and look at where the money is going. And times have changed. It's probably time to evolve. I look at hikesalot's situation. She says her kids hit the out of pocket every year. An insurance company knows that her family is a financial loser every year but they have to take them. Yeah, there's going to be denied claims. No insurance company, then it's up to the government to build her in with the national risk and tell hospitals what they are going to get paid to treat her kids. Sad situation all around. I don't have much sympathy for her not being able to live the van life though. I bet a majority of us would love to jump ship and cruise around in an RV the rest of our lives but can't due to one reason or another.

I will tell you is that the only fix to our system is a single payor, Medicare for all program. If you doubt me, remember that I am supporting getting rid of the job I've had for almost 20 years. I used to work on the company side and couldn't morally take it anymore. Now I'm on the client side. I still don't like it but turns out I'm decent at it and make a fair income doing it and write my own schedule.

Now, you'll have to overcome the hospital, physician, and pharma lobbies to get there. Good luck.

[huckbucket]

Now, you'll have to overcome the hospital, physician, and pharma lobbies to get there. Good luck.

How about the insurance co lobby? I can already hear the stat of how many people will be out of a job.

I found some of the reasons why docs are against single payer to be pretty interesting:
http://www.benefitspro.com/2017/09/0...ngle-payer-med

- increased rationing (87 percent)
- unaffordable (75 percent)
- harm to patient privacy (66 percent)
- unconstitutional (58 percent)

[panchosdad]

I was talking with a friend about this recently. She has MS and is covered by her employer. The company was recently bought out, and the new folks are doing everything they can to push long-time employees out, making them completely miserable. Friend looked seriously at going independent, but ran into insurance costs. She was looking at over $3000/month for a family of four, which eliminates the possibility of her working for herself. I thought the numbers sounded a little exaggerated, but I've heard and read of similar situations since.

https://www.nytimes.com/2017/11/16/u...dle-class.html

This to me why I think the current system is terrible for the economy. I've heard to many stories of people afraid to leave their jobs, or abandoning their small businesses to go work for the government or large corporations, simply because of access to affordable health insurance. I'm hardly a socialist, but I've come around to the idea that single payer is the way to go (everything else we've tried obviously isn't working) and that it would actually encourage entrepreneurship. Which is precisely why the Republicans and their corporate overlords oppose it.

[uglymoney]

Austin, I am sorry that you're going through rough times. But what you think of all the poor folks just sitting back getting their govt bennies is not reality. It may look like some people have it easy because they don't seem to be struggling from your vantage point, but your vantage point isn't theirs (ie, they may not be struggling with the stuff you are, but they may be struggling with all sorts if stuff that you are not). As someone who used to administer the govt bennies system (food stamps, cash assistance, medicaid), let me tell you a few things. It isn't easy to qualify for benefits, it's extremely difficult to live on whatever benefits you do qualify for, and it's difficult to stay qualified for those benefits. It may look like a better option for you right now, but I am virtually certain -- without knowing a single detail -- that trying to qualify for benefits, or being in a situation where you do qualify for benefits, is worse than being in a situation where you don't.

ETA: You're a good mag and if there is some way that the community could help you, speak up.

During the course of my job I deal with a lot of people who have qualified for care under the medicare expansion. One such hard working gal who I visit with twice a week (an Eastern European immigrant) had gastric bypass surgery yesterday. She was at work this morning at 5 fucking am! THIS MORNING (:

I am sure she was making what she thought was a rational decision based on her lack of sick pay, and probable lack of compassion from her employer. I don't know the details.

It made me sick to my stomach and I urged her to go home. She is one tough bitch I'll tell you that.

WTF is wrong with us? The majority of these supposed poor lazy people work themselves to the bone because they have to and they are good people. A lot of them are smart as well. This girl is trying to better herself and is always trying to get ahead. Yet we kick her in the nuts.

Austin...sorry to hear about your situation. Seemed like you had the world by the balls when we met. I really hope things turn around for you and your family.

[Conundrum]

How about the insurance co lobby?

Yes but look at the dollars spent by each group. Insurance is a blip compared to pharma. The US is currently subsidizing drug prices in other countries. We're the profit center for global pharma. The insurance co lobby group is going to fight but they are not going to be the drivers of keeping the insurance industry around. And no, I don't contribute to the insurance PACs. At every industry group meeting, I get the stink eye from the person passing out the envelopes.

[Ted Striker]

Going back to this for a second...

These stories are tragic. I’ve always lived in societies (Australia and Canada) that provide universal free health care, and it seems to me that of all the injustices perpetrated in the US, exploiting people facing sickness, injury and aging (ie. all of us) for profit is the most perverse. It’s a testament to how completely the elites control your politics and media that there is no meaningful dissent against a system that makes the lives of everybody else significantly and demonstrably worse.

There is no "universal free health care". You guys pre-pay in the form of higher taxes, employer paid (very low) premiums, and government run lotteries (the poor and stupid tax). And you have one fewer layers between patient and provider: the insurance companies. Like any corporation, their goal is to maximize profit. That's why the Canadian government has fought so hard to keep "for profit" providers out of the system.

Aside from that, I agree with everything you've said. With the exception of wait times - which are partly a by-product of low population density - your system is better than the US in every way. When I lived up there I never once gave a single thought to the 'what ifs' of health care.

Really it's a question of what kind of society do people want to live in. Canada has gone for more of a collective, whereas the US has gone for more individualism (except that individualism tends to vanish when convenient).

We can't have nice things here in the US, including universal health care. We would ruin it.

I'm sort of not kidding. We're so fucking fat that it might just bankrupt our country if we gave it all away.

The US spends more money per capita on healthcare than any other country in the world. It's reasonable to expect universal healthcare would positively impact that figure even with a population of fat fucks.

Both of those posts are true. It would also be reasonable to expect that universal healthcare would reduce the number of fat fucks.

Sadly, America is home to the smartest and dumbest motherfuckers on the planet. And that's a bad combo.

[MontuckyFried]

Now, you'll have to overcome the hospital, physician, and pharma lobbies to get there. Good luck.

Lol, that ain't happening any time soon. And honestly the "system" isn't the sole thing to blame either. A HUGE part of the problem is cultural and how we approach medicine and health in general as a society. You'd be shocked to learn how many people clog up the ERs with stupid stuff that they should be going to a walk-in clinic for. My mom used to be an ER nurse at a county hospital and she would get so mad when people would come in for a hang nail or a minor cough. Total waste of resources.

As a society, we tend to over-medicate everything. We over-complicate things. We have (expensive) pills for EVERYTHING. And people are happily lining up for them. We could solve SO many of our problems through proper nutrition, exercise, self-control, and general lifestyle choices.

At the same time, we also punish those who make decisions that are fiscally much more beneficial to the system, through higher costs and/or zero reward for being responsible. I'm a great example of that. We chose to use a midwife and pay out of pocket for the births of both of our kids. $5000 each time. Cost to health insurance? Zero. We had pre-birth complications. We also paid out of pocket to the tune of thousands of dollars for a procedure that would help us to continue to use the midwife as opposed to the C-Section that the law would have required had we not done it. Cost to health insurance? Zero. Cost of a C-Section? Like 50K average these days. It is asinine that a regular vaginal birth costs like $30K to deliver in the US.

Midwife assisted births in the US = 4%. In Europe? 75%. See the difference? Yet here in the states, when you decide to use a midwife for any variety of reasons, people act like you're some sort of hippy or even that you're being "irresponsible." Again, something needs to change CULTURALLY for universal health care to even remotely have a shot of working here, let alone the health care system that we already have (which obviously doesn't work either).

[skaredshtles]

<snip> I'm hardly a socialist, but I've come around to the idea that single payer is the way to go (everything else we've tried obviously isn't working) and that it would actually encourage entrepreneurship.

Yup. I'd wager there would be a HUGE explosion of small-business growth if single-payer could be sorted out.

Which would be good - 'cause there would be a LOT of healthcare paper-pushers out of a job.

[XXX-er]

and oddly enough you don't live longer than Canadians cuz USA is like 30th in the world compared to 12th for Canadians, historicaly you just barely stay ahead of Cuba

that wait time thing is bad for some procedures but IME of breaking legs, falling off ladders, some colonoscopies its pretty quick and the care is great

BTW drugs are not covered by universal HC neither is dental those items are usually covered by an extended plan thru insurance provided by an employer

[MontuckyFried]

Austin...sorry to hear about your situation. Seemed like you had the world by the balls when we met. I really hope things turn around for you and your family.

Thanks. My, how quickly things can change. If nothing else, it's certainly teaching me massive compassion for those in need (which believe it or not I already had), but now I'M on that side of things. Before I may have had some level of compassion, but now I can truly sympathize since I'm there. It's also made me scared out of my mind to ever want to bother going into business for myself again, especially with ever-rising operating costs. I shall get back up on my skis once again, my friend.

The US is currently subsidizing drug prices in other countries. We're the profit center for global pharma.

I've always wondered about that. Are the massive amounts of money that we spend on pharmaceutical drugs the REASON that Rx drugs are so cheap in other countries? I would assume that the US is also spending the lion's share on R&D and the leader in medical innovations.

That said, I've heard so much screaming on all sides that I'm not sure entirely where the truth lies any more.

[TheSilverSurfer]

I was talking with a friend about this recently. She has MS and is covered by her employer. The company was recently bought out, and the new folks are doing everything they can to push long-time employees out, making them completely miserable. Friend looked seriously at going independent, but ran into insurance costs. She was looking at over $3000/month for a family of four, which eliminates the possibility of her working for herself. I thought the numbers sounded a little exaggerated, but I've heard and read of similar situations since.

https://www.nytimes.com/2017/11/16/u...dle-class.html

A lot of this is because of the sabotaging of Obamacare by the same people that are now bitching about not being able to afford health insurance.

Such a bunch of hypocritical assholes and idiots.

"Let's ruin the system and then bitch about it as if we didn't ruin it".

[GeezerSteve]

You'd be shocked to learn how many people clog up the ERs with stupid stuff that they should be going to a walk-in clinic for. My mom used to be an ER nurse at a county hospital and she would get so mad when people would come in for a hang nail or a minor cough. Total waste of resources.

ERs clogged with non-emergencies wouldn't happen if the U.S. had free or cheap walk-in clinics for basic health issues. Complaining about the problem is meaningless unless you identify the solution present in every other developed nation.

Yup. I'd wager there would be a HUGE explosion of small-business growth if single-payer could be sorted out.

Universal HC can be achieved without single payer, e.g., Germany's system, which uses highly regulated private insurers w/ govt cost controls on procedures, drug prices, profit caps, etc., similar to large U.S. utilities. In theory, ACA could be amended to get close to that.

[basinbeater]

A lot of this is because of the sabotaging of Obamacare by the same people that are now bitching about not being able to afford health insurance.

Such a bunch of hypocritical assholes and idiots.

"Let's ruin the system and then bitch about it as if we didn't ruin it".

Hey after you have been bitching about how it is going to break, and doesn't work, you gotta make sure it breaks so everyone can see how right you are. The shameful part of it is, the ACA was basically the republican plan for years, and then it finally got implemented by a democrat, so now it is the devil. They never had a better plan, they were the dog that never thought it would catch the car, well now they did, and they have NO plan to improve care for people whatsoever. They have to break it to keep their year after year after year promises, and when their voters see their bad healthcare get even worse, Fox news will spin it so the dumb people never know what happened. Down is up. I get so pissed off thinking about this stuff.

Even with the fucking tax cut, eliminate the mandate, drive up healthcare costs that will eat up everyone's tax cut, meanwhile the rich carry the money bags away and put it on the fucking credit card. GRRRRRRR!

[basinbeater]

Oh, and health care insurance companies need to go, and the care system needs to move to paying providers on outcome based metrics rather than by services rendered. Your patients routinely coming in with better and better health, you get paid more. Not, you did x, get $1000, then you did x for $500, then you did x for $3000.

[4matic]

up here the MD's are averaging narth of 200K

In loonies? That’s not much. Entry level wage in USA.

Don’t mistake my concise view of the marketplace with lack of compassion. Shoulda, woulda, and coulda is a fools errand.

I believe in a two tiered system like Hong Kong. A private and a public option.

[GeezerSteve]

Hey after you have been bitching about how it is going to break, and doesn't work, you gotta make sure it breaks so everyone can see how right you are. The shameful part of it is, the ACA was basically the republican plan for years, and then it finally got implemented by a democrat, so now it is the devil. They never had a better plan, they were the dog that never thought it would catch the car, well now they did, and they have NO plan to improve care for people whatsoever. They have to break it to keep their year after year after year promises, and when their voters see their bad healthcare get even worse, Fox news will spin it so the dumb people never know what happened. Down is up. I get so pissed off thinking about this stuff.

Even with the fucking tax cut, eliminate the mandate, drive up healthcare costs that will eat up everyone's tax cut, meanwhile the rich carry the money bags away and put it on the fucking credit card. GRRRRRRR!

For all but Fox News watchers (<10% of registered voters), GOP now owns HC policy

[fastfred]

ERs clogged with non-emergencies wouldn't happen if the U.S. had free or cheap walk-in clinics for basic health issues. Complaining about the problem is meaningless unless you identify the solution present in every other developed nation.

.

I've heard some pretty fucked up stories from people who work in the ER, people show up to the ER with some big problems health and drug related and they usually have waited till things are really out of hand to show up

I once sat around with missing appendages (long story) waiting to get cared for dripping blood all over the ER, I finally threw a fit, and someone apolgized because they whole staff was trying to figure out what was wrong with some fat fuck old lady who came in with all kinds of health issues and no one could figure anything, they can't tell her to leave and go see a doctor or they'll get sued when she passes out half way home

[fastfred]

I was a corporate manager and have been a landlord. Hate both. Being accountable for people with adult problems blows. They’re not my friends.

this just needs repeating that's all

[fastfred]

Thank you. We'll get through it. Wife just got a job waiting tables at night. I'm working two jobs. It's tough as hell right now, especially with two babies, but once the house sells, our situation will (hopefully) drastically improve. These past few years have been a HUGE learning experience in why you don't try to make something of yourself in a ski town when you're up against a bunch of billionaires who don't like competition from plebes like us. Woops!

I think ski towns amplify everything by 10. Best of luck man. My two cents though, I showed up in a ski town with nothing. Had the time of my life. Got my shit together one day and started a business, my insurance costs will be over 30k a year next year and that doesn't include health insurance for anyone unless you count WC. Anything is possible, having a trust fund helps dearly, but you can easily make it, it just takes lots and lots of sacrifice and willing to deal with an ungodly amount of bullshit.

My medical costs and insurance could be cut in half if I moved an hour towards denver. But who the fuck wants to do that. That sounds like misery to me. If you've never been to the vail valley surgery center, well that's the gold standard. I'd rather walk into what looks like a hotel for some work than some industrial looking surgery center.