Health Insurance?

[jono]

No man, I don’t always get paid, and there is no guarantee I will find them a plan. I will recommend they don’t put up with that bullshit and find a new doctor.

Yesterday I got a call from a clients sister who has cancer, lives off 700 a month in Ferguson and I will go see her next week and get her everything for free. I will get her extra help from the state and federal govt and I don’t get paid doing that. I also need a fucking Glock when I into those neighborhoods to help people for nothing.

You guys talk about freeing the doctors up from paperwork to allow them to see more patients but you don’t talk about what it costs.

If you want transparency, try having no insurance and paying cash, if you have it.

You have a business model; are you going bankrupt? Doctors don't always get paid, either. Unless they work the robosigner jobs, those apparently come pretty risk-free.

[Dantheman]

Yeah, we bitch about the unhealthy and the resources they take, but my "healthy" lifestyle has led to 6 ortho surgeries and all of the associated care. That wasn't cheap.

They way I understand it, end of life care trumps everything for most people. Average ortho stuff doesn't amount to much in the grand scheme of things.

[zion zig zag]

We spend an absurd amount of money in this country to prolong peoples misery for their last six months. Besides being inhumane, it doesn't seem sustainable.

[XXX-er]

Yes, stop skiing. There are two Americas, everyone be glad if you have some group plan and just fork over a plastic card at the time of appt and never have to see the bill.

actualy once yer in the system you don't even need the card they just ask your name and date of birth

asking that date of birth thing is really important, I had a yearly (free) check with a visiting resident in a teaching practise who didnt know me, even with an unusual last name he somehow got the wrong chart, didnt catch it until the lab tech at the hospitol (who always asks) figured out the chart was for a guy who was 8 yrs older

I had never heard the word "copay" until I started reading american paddling and skiiing forums

but it wasnt hard to guess

[Cono Este]

My model is to do the best I can for everyone who needs me. But not everyone needs me.

Doctors are in high demand, and for good reason, and yes they worked hard and probably made better decisions than a I did in choosing their profession.

But does that mean we can’t scrutinize them? Or hold them accountable for their work? In the current climate, that dates back to before Christ, we are supposed to kiss their ring, and never question them.

If my Ferguson lady went into a doctors office, or dentist, and told them she had no insurance they would laugh and call security.

Good thing I was never a doctor.

[Cono Este]

I know there are a lot of Dentists in here holding their breath, but last spring I visited this guy and had he just pulled out his own teeth.

Greatest healthcare in the world?


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[huckbucket]

Sweet. Is that a Jester toe piece lookers left?

[basinbeater]

We spend an absurd amount of money in this country to prolong peoples misery for their last six months. Besides being inhumane, it doesn't seem sustainable.

Obama care attempted to deal with this by listing different "options" for people at end of life stages, and this was politicized by the Republicans as government death panels. Anyone remember that?
There is some truth to it. If you are trying to do what is best for society in a systematic way, not every patient is going to be able to exhaust every last penny to keep them breathing as long as possible.

[Bunion 2020]

^^^, this. For me quality of life is everything. When it is my time I will go to the next phase with some trepidation and a lot of good memories as well as the knowledge that we all go sometime.

[Kinnikinnick]

My circumstance is one of keeping the costs down as I can afford it. But allowing people to go without fucking dental care in a 1st world country and have to go to the emergency room for any illness is cruel as well as financial madness.

If the repubelicans would actually try to improve Obamacare’s faults instead of go backwards we might actually get somewhere.


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[basinbeater]

If the repubelicans would actually try to improve Obamacare’s faults instead of go backwards we might actually get somewhere.


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You are right, but they can't. Doing so would mean admitting that they have been lying for years. Which of course they have been. They need to break it (because it was working, covering more people, bending the cost curve) to prove they were right.

[Dantheman]

I know there are a lot of Dentists in here holding their breath, but last spring I visited this guy and had he just pulled out his own teeth.

Greatest healthcare in the world?

I've spent quite a bit of time in SE Missouri. Various flavors of that pic repeat endlessly along every road.

If you are trying to do what is best for society in a systematic way, not every patient is going to be able to exhaust every last penny to keep them breathing as long as possible.

It's kind of sick and perverse that we even try. Like ZZZ said, it's usually just prolonging misery.

Dan Carlin's Common Sense podcast had a great episode in March about healthcare costs in the US vs. other developed countries.
http://www.dancarlin.com/product/com...althy-numbers/

[Kinnikinnick]

Well holy Jesus. Looks likeCobra for us. The plan on the exchange that I was looking at was only a catastrophic plan and therefore we don’t qualify (over 30).


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[Danno]

probably more appropriate for the shit that annoys you thread, but... I have medication I take every day, that used to be available in a 90 day supply for $10. Now, my insurance will not cover a 90 day supply from the pharmacy, they will only cover it through their own mail order. At, you guessed it, a higher price (but lower than the 30 day price through them). So, I am in a situation where I can pay less for the drug but not have it count toward my deductible or pay more and have it count. fuckers.

[Conundrum]

probably more appropriate for the shit that annoys you thread, but... I have medication I take every day, that used to be available in a 90 day supply for $10. Now, my insurance will not cover a 90 day supply from the pharmacy, they will only cover it through their own mail order. At, you guessed it, a higher price (but lower than the 30 day price through them). So, I am in a situation where I can pay less for the drug but not have it count toward my deductible or pay more and have it count. fuckers.

Try www.goodrx.com for your med. If it isn't going to apply to your deductible, might as well get it as cheap as you can.

[Conundrum]

Well holy Jesus. Looks likeCobra for us. The plan on the exchange that I was looking at was only a catastrophic plan and therefore we don’t qualify (over 30).


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Got your PM. Sorry, haven't responded yet. Bummer. I would look at HSA compatibles but if there isn't much savings, might be time to accept COBRA.

[old goat]

I know there are a lot of Dentists in here holding their breath, but last spring I visited this guy and had he just pulled out his own teeth.

Greatest healthcare in the world?


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when homeless people were surveyed about health care their first priority was dental care, before medical care. Maybe we should start with universal single payer dental care and move on from there.

we can argue endlessly about who pays for health care--employers, the feds, the states, the counties (most indigent emergency care is paid for by the counties), individuals. The fact remains that regardless of who pays, ultimately the cost comes from our individual pockets--in the form of taxes, higher costs for goods, or individual payments for services. We can spread that cost evenly amongst all of us by providing universal coverage or we can charge individuals who are unlucky enough to get sick or injured. Or we can get the cost down to a reasonable number and the solution of who pays will become more obtainable.

[Danno]

Try www.goodrx.com for your med. If it isn't going to apply to your deductible, might as well get it as cheap as you can.

thanks. that info isn't updated, it shows Walmart at a $4 price for 30 but they upped their pricing.

[Kinnikinnick]

Got your PM. Sorry, haven't responded yet. Bummer. I would look at HSA compatibles but if there isn't much savings, might be time to accept COBRA.

Thanks for the $.02

The guy you recommended was on vacation but I go ahold of someone else and she said in the last year in CO everyone she’s worked with in my situation has gone to CoBRA as the prices in the exchange went up such that there is t much savings.

$1615 for an exchange plan with $5800 ind deductible/$11500 family max vs $1707 for CoBRA w $2500 deductible/$6000 family max.

$90 savings isn’t worth the extra deductible iMO


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[Mazderati]

HealthCare.gov does not list income as a factor in premium setting. For people who fall into lower income brackets and obtain insurance through the ACA, is the expectation to pay insurance premiums up front and be reimbursed through tax credits at the end of the year?

[Sirshredalot]

HealthCare.gov does not list income as a factor in premium setting. For people who fall into lower income brackets and obtain insurance through the ACA, is the expectation to pay insurance premiums up front and be reimbursed through tax credits at the end of the year?

That is correct. Or if you are sufficiently low-income, you qualify for Medicaid. Unless you live in a state with a Republican governor, in which case they likely spat back the federal money for Medicaid expansion and there is now a donut hole where you can make too much for Medicaid but not enough to afford insurance through the exchange. But you still get to pay the federal taxes for the Medicaid expansion, so you are getting full on double penetrated by your lovely Republican politicians.

[Dantheman]

HealthCare.gov does not list income as a factor in premium setting. For people who fall into lower income brackets and obtain insurance through the ACA, is the expectation to pay insurance premiums up front and be reimbursed through tax credits at the end of the year?

Premiums are independent of income, but premium subsidies are very dependent on income. Towards the end of the application process you can elect to have all of your subsidies paid directly to your insurance co., receive them all as an end-of-year tax credit, or a mix of both that you select. Also, "income" is AGI, not gross. You can bring down your AGI via HSA or IRA contributions in order to stay below the "subsidy cliff" or increase your subsidy amount.

[Talisman]

when homeless people were surveyed about health care their first priority was dental care, before medical care. Maybe we should start with universal single payer dental care and move on from there.

we can argue endlessly about who pays for health care--employers, the feds, the states, the counties (most indigent emergency care is paid for by the counties), individuals. The fact remains that regardless of who pays, ultimately the cost comes from our individual pockets--in the form of taxes, higher costs for goods, or individual payments for services. We can spread that cost evenly amongst all of us by providing universal coverage or we can charge individuals who are unlucky enough to get sick or injured. Or we can get the cost down to a reasonable number and the solution of who pays will become more obtainable.

Using single payer dental care is a clever beta test for an expanded system. Dental care has less passion and far fewer deeply invested special interest groups than health care which increases the chances for success with fewer well funded foes.

[LightRanger]

^^^ Interesting thoughts.

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[evdog]

Don't we already have single-payer healthcare, AKA Medicare?

Dental care isn't a good beta test because it doesn't have all the special interest drama that healthcare does. Dentists just aren't as good at raping and pillaging...not enough money to be sucked out of us when all you can sell is teeth-whitening, gum massages and unnecessary fillings.