This is crazy! Health Care Insurance!

[sahtt]

Car insurance is obligatory here in Europe and it's a good thing to have. If you ever get in a crash you're not bankrupt or don't have to sue anyone's money. We also have a long-during driving school education and don't just drive around a few blocks for a license like other continents do.

Which point? After you got seriously ill you don't have any choice or is it the choice between the illness and the bullet?

Car insurance is mandatory in the inferior U.S. as well for similar reasons. It's a totally different subject. If you get a heart attack from eating too much cake sitting on your couch, that can't crash my BMW. If you get diabetes from being obese, that doesn't effect me or somehow cause me to get diabetes. As far as the driving school goes, I'm pretty sure you are not in charge of what Europe does and I'm certainly not in charge of what the U.S. does so I won't take any credit/responsibility.

The bottom line is there is a large segment of the population who are net tax receivers. Many of these people and some who do pay some taxes are a major burden on everyone else because they get free healthcare (exlcluding those who pay out of pocket obviously). The reason they do not pay is either because they don't have to or they don't have the ability to. These various propositions do NOTHING to fix that problem or the related externalities. If a private insurer can't make profit off them there is Z_E_R_O doubt the government is going to suffer catastrophic losses in attempting to do so. Given the government does not exist, the tax payers who aren't broke yet will foot the bill. The problem has been moved around and generated a lot of votes for the save the poor party, but the problem is not solved. Changing who pays the bill at dinner doesn't make it cheaper.

 

[tosugrad]

Car insurance is mandatory in the inferior U.S. as well for similar reasons.

Auto insurance is mandatory but liability (which is easily more important) is still not required in WI and NH. Idiots.

Here's what someone from WI actually says:

"I live in Wisconsin where nothing is required but I want to move to another state where insurance isn't mandated and am very disappointed to find out that we are 1 of 2 states that don't mandate. Why should I pay insurance when I know I will never be in a car accident that is my fault. I think it is a stupid rule and will never go to another state that has this policy. Since when has the government taken so much control, I thought this was a democracy."

 

[Sig]

The US Govt is THE worst capital allocator we have in this nation. Giving them another kingdom of control to build is like appointing Barney Gumble CEO of construction and operation of a new bar in Springfield. To willingly putting the US govt in control of a brand new entitlement program that is charged with our nation's well being is not only frightening, it dramatically compounds the disasterous state of the existing entitlement programs in the US. As a nation, our politicians (both parties) kick the proverbial bucket down the road year after year because it is a career limiting move to make the tough decisions necessary to keep these programs solvent in the years to come without a 70% tax rate on those evil 1%'ers who can 'afford it'. The funniest part of the 1% myth is that taxes on 'earned' income are completely irrelevant to the wealthy. The truly rich among us count on trust funds and other protected forms of wealth for their financial well-being. The majority of the 1%'ers are busting their humps to make ends meet. This primarily to due to the fact that they maintain a higher cost of living... but without their spending power, every economic marker would suffer greatly.

Governement run healthcare will have the following effects:
-Artificially lower costs (at least on paper) in some areas
-Much higher costs in others.. many of these will not be able to be directly tied back to the care (that's the genious of it)
-American innovation in the healthcare field will suffer significantly in time as the best and brightest pursue non-medical careers in greater numbers
-Efficiency of the care itself will drop off a cliff withing 10 years of implementation
-Quality of care will suffer significantly in time as the best and brightest pursue non-medical careers in greater numbers

The most effective vote getting strategy of all time is to create a highly dependent population so they can never vote you out to preserve their benefits. The current situation in this country reminds me of a friend that fell head over heals for a beautiful girl that paid him romantic attention he was unaccustomed to receiving. This friend agreed and even championed some of the most ridiculous things she put to him in the first months of their relationship despite the glaring flaws in said things. He was so desperate for her to live up to the dreams he had for her that he set himself up for a horrific fall that took 5 years to occur. Mr. Obama is currently a popular president and even more popular with the media. At this point, he could develop a headache medicine that caused cancer and 90% of the national media would laud him as hero for helping all the headache sufferers, while simultaneously ignoring the cancer deaths. Ultimately, you have to respect his political prowess in developing this level of emotional equity in his own political success. It is downright impressive. He is also bright enough that this level of blind support is not sustainable... which is why we see him exert so much pressure for quick passage.

 

[NSX-Tuner]

Is this proposed health care reform about "Health" and "Care" or is it all about "Power" and "Control"?

 

[robr]

I suspect I may now have a somewhat unique perspective about health insurance among prime members. I'm thankful but at the same time, I'm kind of disgusted.

I was laid off in July. I have two little kids so I need health insurance, and the state of MA requires everyone to have it. I could not afford the $1200+ for COBRA, so I applied for unemployment insurance health insurance. This is one of those things you apply for along with your unemployment benefits. The standard is the state will pay 70% of COBRA but if you can't afford that, they will pay up to 100%. They are paying 100% of mine. It's Blue Cross, deductibles are $20 at your PCP, prescriptions are 10/20/50. Basically identical coverage that I received from my work with similar deductibles. No dental however.

Now, I'm OK with that since my kids need it, the state mandates it and the deductibles are reasonable. However I also applied for the state insurance program for the poor as my only income is uninsurance benefits (which is capped at $629/week + $25/child). I was told this is an umbrella policy that will cover things the unemployment insurance will not. I was granted this for my children (but not us adults, not sure why yet, but that's OK for now). Office visit deductibles. $0. No referrals needed for in-network specialists. Prescription costs, $1/2/3. This is through Neighborhood Health. Damn.

BTW, I wasn't eligible for food stamps, I make too much from unemployment. Ha!

I need a friggin job, I'm going out of my tree here. I'm working on upping my certifications in the meantime. Sigh....... It truly is bad out there.

 

[EdinKali]

I signed up for a family plan with Blue Shield of CA for $477/month. $3500/yr deductible.

Much less than the $1300+/month for COBRA. No subsidized health in CA AFAIK. The plan I had a couple years ago went up to almost $700/month so I opted for this one instead.

Going to work on getting some more certs myself but it is pretty tough out there. I wish you luck on your search.

 

[steveny]

New rates are out for NY. $1547.66 a month. Here is the part I think all you guys might find interesting... this will be the nationwide family rate when the new health care plan takes effect nation wide. It's not going to be an average of what the 52 states now charge. It's not going to be multiple plans to choose from, it's going to be 1500 for a family plan no matter where you go and this is straight from the BCBS guy that was here at my house for 2 hours last night. So get your check books ready to start paying for all those who won't pay for themselves.

 

[EdinKali]

New rates are out for NY. $1547.66 a month. Here is the part I think all you guys might find interesting... this will be the nationwide family rate when the new health care plan takes effect nation wide. It's not going to be an average of what the 52 states now charge. It's not going to be multiple plans to choose from, it's going to be 1500 for a family plan no matter where you go and this is straight from the BCBS guy that was here at my house for 2 hours last night. So get your check books ready to start paying for all those who won't pay for themselves.

I already got my note about a rate increase from BS of CA starting 1/1/2011 in response to the new "Health Plan". Sigh..

 

[Hasdrubal]

So the yearly fine for not having health insurance is less than two months of insurance premium? They either want the public to demand more government regulation to drive the rates down, or demand for the government to directly provide a cheaper plan and drive the companies out of business.

How many small companies will lay off employees just to lower health care overhead?

 

[druby]

What the BCBS guy said is not correct. Rates will vary from State to State since the cost of care varies in each State. What will happen is that everyone in one location will pay approximately the same cost. There can only be a 3 to 1 ratio in premium based on age so if the cost for a 64 year old is $900 the cost for a 18 year old can not be less than $300 and that happens in 2014. Overall the problem is that the penalty is much less than the premium that will charged and there is no real reason to buy coverage until you need after 2014. I know the bill well now and can answer questions if anyone has them.

 

[steveny]

What the BCBS guy said is not correct. Rates will vary from State to State since the cost of care varies in each State. What will happen is that everyone in one location will pay approximately the same cost. There can only be a 3 to 1 ratio in premium based on age so if the cost for a 64 year old is $900 the cost for a 18 year old can not be less than $300 and that happens in 2014. Overall the problem is that the penalty is much less than the premium that will charged and there is no real reason to buy coverage until you need after 2014. I know the bill well now and can answer questions if anyone has them.

So IOW it's a tax every year of X-k every year plus the cost to see a doctor every few months if you need to then if you get really sick buy the coverage and you can't be denied service? I bet the monthly cost will be astronomical too. Sounds like that would work for a single person but not so well for a family that needs to keep coverage in place because kids go to the doctor a lot.

 

[druby]

Pretty much except the cost for a family will much higher so it will be less expensive for most folks even families to just pay for their care unless they have a large medical expense. Get diagnosed with cancer or heart condition then buy the insurance otherwise just pay your doctor for the occassional office visit and pay the penalty. The insurance carriers really can't price for that and will go out of business with the way the law works. Look at what is happening now. The law said this has to happen this year for children under age of 19 so the insurance companies just said they won't write policies on kids 19 and under and in most states that is the case. I know in GA and SC no carrier offer a policy to a child of that age even if they are perfectly healthy as if they write a healthy person they have to write the child with conditions.

 

[Hrant]

So IOW it's a tax every year of X-k every year plus the cost to see a doctor every few months if you need to then if you get really sick buy the coverage and you can't be denied service? I bet the monthly cost will be astronomical too. Sounds like that would work for a single person but not so well for a family that needs to keep coverage in place because kids go to the doctor a lot.

Not even for a single person that gets in sudden unexpected serious illness/hospitalization. Take the following example.

You [genericallly speaking] paid the penalty, and assumed the risk of paying from your own pocket regular preventative and minor illness related visits to the doctor. As long as you remain totally healthy this is great.

What if you were suddenly hospitalized due to an unforseen stroke, or heart attack, felll down from a ladder, or any other serious accident? You will be admitted through the emergency to the hospital where your first 2-3 days will be in the ICU/CCU with battery of tests, MRIs/X-Rays, and specialists making their rounds to capitalize on their billing opportunities. This is the highest cost period - assuming the fourth day you were awake enough to buy your insurance policy. And assuming such policy is available year around and not based on calendar year or federal fiscal year, or the "open enrollment" period [I don't know what the law says on this.]

Since you are on your own the first 2-3 days, the hospital will bill you at their arbitrary and totally bogus full charges (insurance companies get a significant discount from such charges). Can you afford the $40K-$70K out of pocket for those 2-3 days? And of course the ambulance company will bill you separately for some $800, and so will the Fire Department for showing up. And who knows who else ........

YMMV

 

[Hasdrubal]

That's worst case, but if you get diagnosed with cancer and go buy the insurance the next day, you save a bundle.

 

[steveny]

Not even for a single person that gets in sudden unexpected serious illness/hospitalization. Take the following example.

You [genericallly speaking] paid the penalty, and assumed the risk of paying from your own pocket regular preventative and minor illness related visits to the doctor. As long as you remain totally healthy this is great.

What if you were suddenly hospitalized due to an unforseen stroke, or heart attack, felll down from a ladder, or any other serious accident? You will be admitted through the emergency to the hospital where your first 2-3 days will be in the ICU/CCU with battery of tests, MRIs/X-Rays, and specialists making their rounds to capitalize on their billing opportunities. This is the highest cost period - assuming the fourth day you were awake enough to buy your insurance policy. And assuming such policy is available year around and not based on calendar year or federal fiscal year, or the "open enrollment" period [I don't know what the law says on this.]

Since you are on your own the first 2-3 days, the hospital will bill you at their arbitrary and totally bogus full charges (insurance companies get a significant discount from such charges). Can you afford the $40K-$70K out of pocket for those 2-3 days? And of course the ambulance company will bill you separately for some $800, and so will the Fire Department for showing up. And who knows who else ........

YMMV

Yes.... that I could handle, 40 to 70 k is 2 to 3 years of premiums in the bank. Problem is I don't think a 2 to 3 day stay in ICU is 70k in NY it's more around 300k at best. Renee spent a few hours in the ER and we were billed almost 9 grand of shit that wasn't covered and or went towards the deductible.

 

[SilverStone05]

My company used to pay 100% of my premiums.

Completed my benefits renewal a couple months back and now i'm on the hook for $20/m.

I dont' mind paying for my insurance benefits and understand that I've got it pretty darn good concerning health insurance.

Just offering further evidence of how this bill is already increasing costs at an astronomical rate....which ironically, the administration claimed /asserted/promised the exact opposite. As if the American people were complete idiots.

My opinion on this health care bill has changed over the last year or so.

I dislike it even more. :frown:

 

[druby]

the real problem is the normal person doesn't think the way we do, we (prime members) are a bit more reliable and responsible. But think of the normal young person that already feels invincible or the family struggling to make it. They will drop coverage not caring and figuring if they need just buy it then.

 

[Hrant]

That's worst case, but if you get diagnosed with cancer and go buy the insurance the next day, you save a bundle.

This is what is called "moral hazard" in the industry. What is worst case is a matter of opinion depending on your age and lifestyle.

When I was young, and fresh out of college, I too took the gamble that I was "invincible" fortunately the Russian roulette turned out in my favor. To do so in this environment and my age would be utter folly :wink:

 

[Hrant]

Yes.... that I could handle, 40 to 70 k is 2 to 3 years of premiums in the bank. Problem is I don't think a 2 to 3 day stay in ICU is 70k in NY it's more around 300k at best. Renee spent a few hours in the ER and we were billed almost 9 grand of shit that wasn't covered and or went towards the deductible.

As much as we know NY is expensive, and unlike California where managed care has a very strong business stronghold, even at full charges if gets to $300K for 2-3 days somebody in the hospital's accounting department is "really" padding or triple counting, and probably including items/services not rendered ..... I know enough to question such "charges" :wink:

 

[Hasdrubal]

I've got coverage through work, and have had it through several jobs going back more than 10 years now. I think that the changes coming down the pipe are actually going to cause more people to decide to not be covered, or simply not be able to afford it.

If they really wanted to lower costs, they would have done something to limit frivolous lawsuits and improper use of the ER.

 

[Hrant]

If they really wanted to lower costs, they would have done something to limit frivolous lawsuits and improper use of the ER.

I am with you with the former. But as for the latter, the ER use is by default the access or portal for all those who can't afford (fall outside welfare coverage such as Medicaid - and even some who are eligible still don't get it!) or choose not to have insurance as a matter of gambling with risk. Its a circular thing :wink:

 

[steveny]

As much as we know NY is expensive, and unlike California where managed care has a very strong business stronghold, even at full charges if gets to $300K for 2-3 days somebody in the hospital's accounting department is "really" padding or triple counting, and probably including items/services not rendered ..... I know enough to question such "charges" :wink:

I know of several people who have ended up in the hospital for less than a week and ended up with a bill over 200k. I also know that not one of them paid it. In fact the last person I know of was my mother friend who had a stroke. About 15 years ago her husband died and she got 250k life insurance payout. The money was gone in less than a month. The 250k should have been held by a lawyer and used to pay for her living expenses. Instead she blew it and went on welfare which paid her rent and her heat/ electric/ food..etc... While she was a nice lady (dead now) she should have been forced to pay her own bills. I have seen the same deal with many of my tenants. They get a one time large payout and they blow it so they can get back on the gravy train.

With 1547 dollars a month I could lease TWO Range Rovers. Someone tell me that 1547 is not an asinine amount to pay for health insurance. I detest paying for something that someone else gets for free. Worse yet is they aren't actually getting it for free I am the one paying for it.

Shame is what is missing from current society. No one has any shame anymore. From the big wigs stealing to the able bodied people collecting benefits because they are lazy.

 

[NSXLNT]

Any opinions on HSA ( Health Savings Account ) ?

 

[SFNSXguy]

Those of you lucky enough to live in the right part(s) of the country to be served by either Mayo Clinic, Cleveland Clinic or Kaiser Permanente (and maybe one or two others) can get the kind of care the rest of the country can only dream about.

 

[druby]

H.S.A. qualified plans are great if priced right. My feeling is that there needs to be spread of at least 20% or more in the premium to make that change. If you are an employer then H.S.A plans can make great sense as they do real in utilization. I have seen it where people start to care about the cost of care when they spend their own money. I have also done it myself and made changes in how I used my health care using more over the counter drugs instead of prescription drugs.