Drew99GT Likewise. I had my appendix removed at a cost of about $20 said:
Going without health insurance
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Originally Posted By: meep
you need insurance, at least catastrophic coverage, which is much less expensive - does not cover flu, earaches, and maybe even broken bones, but does cover the stuff that you HAVE to get taken care of, like appendix, liver, etc..
Maybe I didn't make my point clear.
I already have catastrophic coverage to the tune of a $5,000 deductible. It doesn't pay anything until we reach $5,000 in medical bills. I understand how my policy works and go over every EOB like a hawk when I reconcile bills from providers.
We're going to apply for every conceivable individual policy we can find but I doubt we'll have much luck. My wife had pre-eclampsia in her last pregnancy and even though it was "cured" with child birth and few policies cover maternity anyways, we were told it would make her ineligible for private coverage. Because we're eligible for a group plan through my employer, we're ineligible for the high risk pool. The only way around this paradox would be to get a divorce and just "live in sin".
you need insurance, at least catastrophic coverage, which is much less expensive - does not cover flu, earaches, and maybe even broken bones, but does cover the stuff that you HAVE to get taken care of, like appendix, liver, etc..
Maybe I didn't make my point clear.
I already have catastrophic coverage to the tune of a $5,000 deductible. It doesn't pay anything until we reach $5,000 in medical bills. I understand how my policy works and go over every EOB like a hawk when I reconcile bills from providers.
We're going to apply for every conceivable individual policy we can find but I doubt we'll have much luck. My wife had pre-eclampsia in her last pregnancy and even though it was "cured" with child birth and few policies cover maternity anyways, we were told it would make her ineligible for private coverage. Because we're eligible for a group plan through my employer, we're ineligible for the high risk pool. The only way around this paradox would be to get a divorce and just "live in sin".
Remember that all forms of insurance are priced to exceed the insurer's expected risk of a claim. If you're paying $50,000 in premiums over 4 years, that means the insurer believes you'll have less than $50,000 in claims over that time. So the majority of insurees will lose.
However, if you decline insurance you should be disciplined enough to save the money into an emergency fund and invest it prudently. If you don't trust yourself to do this, then keep the insurance. It acts like a forced savings plan.
Basically, either you save for the emergency or let the insurance company save for it. If you let them do it, they charge an extra amount (their profit margin).
However, if you decline insurance you should be disciplined enough to save the money into an emergency fund and invest it prudently. If you don't trust yourself to do this, then keep the insurance. It acts like a forced savings plan.
Basically, either you save for the emergency or let the insurance company save for it. If you let them do it, they charge an extra amount (their profit margin).
Originally Posted By: kb01
My wife had pre-eclampsia in her last pregnancy and even though it was "cured" with child birth and few policies cover maternity anyways, we were told it would make her ineligible for private coverage. Because we're eligible for a group plan through my employer, we're ineligible for the high risk pool. The only way around this paradox would be to get a divorce and just "live in sin".
This is the consequence of everyone trying to one up each other in isolating risk from their own pool, sort of a NIMBY thing to do when things go up in cost.
Is it possible to immigrate to Canada? In the end it might be more beneficial.
My wife had pre-eclampsia in her last pregnancy and even though it was "cured" with child birth and few policies cover maternity anyways, we were told it would make her ineligible for private coverage. Because we're eligible for a group plan through my employer, we're ineligible for the high risk pool. The only way around this paradox would be to get a divorce and just "live in sin".
This is the consequence of everyone trying to one up each other in isolating risk from their own pool, sort of a NIMBY thing to do when things go up in cost.
Is it possible to immigrate to Canada? In the end it might be more beneficial.
Originally Posted By: tonycarguy
Remember that all forms of insurance are priced to exceed the insurer's expected risk of a claim. If you're paying $50,000 in premiums over 4 years, that means the insurer believes you'll have less than $50,000 in claims over that time. So the majority of insurees will lose.
However, if you decline insurance you should be disciplined enough to save the money into an emergency fund and invest it prudently. If you don't trust yourself to do this, then keep the insurance. It acts like a forced savings plan.
Basically, either you save for the emergency or let the insurance company save for it. If you let them do it, they charge an extra amount (their profit margin).
Unfortunately, this approach does NOT work for health insurance. You can NOT be self-insured for health unless you think very lowly of your own life.
The health insurance works when all individuals including healthy and non-healthy participate in it.
Of course the fundamental question which nobody wants to even bring out is why we have to spend 18% of GDP on health care. One statistics is that a family of four is effectively charged $30,000 per year for its health care. Over twenty year period that family would have paid in (or used up) $600,000 towards health care. Does that sound reasonable?
- Vikas
Remember that all forms of insurance are priced to exceed the insurer's expected risk of a claim. If you're paying $50,000 in premiums over 4 years, that means the insurer believes you'll have less than $50,000 in claims over that time. So the majority of insurees will lose.
However, if you decline insurance you should be disciplined enough to save the money into an emergency fund and invest it prudently. If you don't trust yourself to do this, then keep the insurance. It acts like a forced savings plan.
Basically, either you save for the emergency or let the insurance company save for it. If you let them do it, they charge an extra amount (their profit margin).
Unfortunately, this approach does NOT work for health insurance. You can NOT be self-insured for health unless you think very lowly of your own life.
The health insurance works when all individuals including healthy and non-healthy participate in it.
Of course the fundamental question which nobody wants to even bring out is why we have to spend 18% of GDP on health care. One statistics is that a family of four is effectively charged $30,000 per year for its health care. Over twenty year period that family would have paid in (or used up) $600,000 towards health care. Does that sound reasonable?
- Vikas
the health insurance business over there seems like a "healthy" profiteering racket.
I pay 1.5% extra tax for public healthcare, and I am glad and proud to do so.
There is no way i'd be paying $12000 - $16000 for health insurance, the payoff just isn't there. And if I was stuck in that situation, I'd move to Canada, or Australia...
I pay 1.5% extra tax for public healthcare, and I am glad and proud to do so.
There is no way i'd be paying $12000 - $16000 for health insurance, the payoff just isn't there. And if I was stuck in that situation, I'd move to Canada, or Australia...
The key in this great nation is to have no money, no income, and live in a rent controlled apartment, only then will you get free health insurance and everything else for that matter. My whole working life I had to pay my own medical insurance and often dream of the vacation home and cars I could have bought with that money. The sad reality is one major illness can easily wipeout a lifetime worth of savings, and a house.
Originally Posted By: Vikas
Of course the fundamental question which nobody wants to even bring out is why we have to spend 18% of GDP on health care. One statistics is that a family of four is effectively charged $30,000 per year for its health care. Over twenty year period that family would have paid in (or used up) $600,000 towards health care. Does that sound reasonable?
- Vikas
A lot of effort is wasted in lawsuits, denied claim induced overhead, paperwork on negotiation between insurance and service provider, and of course, people who roll their dice and get sick then someone has to pay for the bill.
Socialized health care aren't all great and perfect, I know some places wouldn't cover expensive cancer drugs or would force you to wait for months for life threatening surgery. However care provider in the US and big pharmas know that they can charge all the want and insurance / medicare / medicaid have to pay because the patients are not directly paying for it, but indirectly via their insurance and when they need it, they want someone else to foot the bill. High deductible plan doesn't change that because you have no choice (other than to not seek care) when you are facing a monopoly. Unless you have another monopoly (socialized health care) countering against the big pharma / care provider monopoly, it is impossible to get a fair price and prevent someone else wasting your medical cost.
Of course the fundamental question which nobody wants to even bring out is why we have to spend 18% of GDP on health care. One statistics is that a family of four is effectively charged $30,000 per year for its health care. Over twenty year period that family would have paid in (or used up) $600,000 towards health care. Does that sound reasonable?
- Vikas
A lot of effort is wasted in lawsuits, denied claim induced overhead, paperwork on negotiation between insurance and service provider, and of course, people who roll their dice and get sick then someone has to pay for the bill.
Socialized health care aren't all great and perfect, I know some places wouldn't cover expensive cancer drugs or would force you to wait for months for life threatening surgery. However care provider in the US and big pharmas know that they can charge all the want and insurance / medicare / medicaid have to pay because the patients are not directly paying for it, but indirectly via their insurance and when they need it, they want someone else to foot the bill. High deductible plan doesn't change that because you have no choice (other than to not seek care) when you are facing a monopoly. Unless you have another monopoly (socialized health care) countering against the big pharma / care provider monopoly, it is impossible to get a fair price and prevent someone else wasting your medical cost.
Originally Posted By: CivicFan
But if you cannot afford the insurance premiums then you might not have a choice but to stop your coverage, live safely and wait till 2014 when affordable health plans will become available to the public.
Hopefully you meant this as a joke, a twisted one, but a joke none the less.
Your not taking into how much coverage has increased in the last year and will continue to increase in the coming years until 2014 because of the price controls set motion by the Bill passed year. If you think prices will go down, no offense, but it's naive.
I don't blame insurers, if I was just told how much I would have to work for in a few years, I would jack my prices as well.
You will get absolutely less of everything with regard to health insurance and health care except a lower cost.
I sure hope I'm wrong, but I'm not. I'm self employed and had to drop health insurance for myself and my family last December. I was faced with a renewal price increase of over 100% and simply could not afford it.
We do need insurance reform, but reform that increases free market competition, not one that increases government regulation, compliance costs and decreases free market competition.
Just my rambling opinion on health insurance.
But if you cannot afford the insurance premiums then you might not have a choice but to stop your coverage, live safely and wait till 2014 when affordable health plans will become available to the public.
Hopefully you meant this as a joke, a twisted one, but a joke none the less.
Your not taking into how much coverage has increased in the last year and will continue to increase in the coming years until 2014 because of the price controls set motion by the Bill passed year. If you think prices will go down, no offense, but it's naive.
I don't blame insurers, if I was just told how much I would have to work for in a few years, I would jack my prices as well.
You will get absolutely less of everything with regard to health insurance and health care except a lower cost.
I sure hope I'm wrong, but I'm not. I'm self employed and had to drop health insurance for myself and my family last December. I was faced with a renewal price increase of over 100% and simply could not afford it.
We do need insurance reform, but reform that increases free market competition, not one that increases government regulation, compliance costs and decreases free market competition.
Just my rambling opinion on health insurance.
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I know of people that are without health insurance simply because they have lost jobs or the new job pays a lot less and they have to pay the bills. However many people do without health insurance simply because they want the money for other things like a nicer car, home and toys. Then when things happen they cry about the cost. Like some have said it only takes one illness and you can lose everything. The health care bill isn't the main reason for the cost going up. They have been going up for years at a far higher rate than inflation. At least now you aren't going to be dropped for some bogus reason. The insurance companies already weren't allowing different procedures. We have cases here even when the family has insurance but the company won't authorize the procedure, I've had friends that had to go through hoops to satisfy the insurance companies and it took months. To me anybody that says that less regulation and free market is being a little naive. The insurance companies can go into any state and apply to serve there, they chose not to. The big companies are already buying up the hospitals and the doctors are opening up their own little mini hospitals all the time. Funny thing is that their referring the people to tests go up when they just happen to get the machines in their place. Bad things can happen when business meshes with medicine.
Originally Posted By: onebigunion
Drew99GT Likewise. I had my appendix removed at a cost of about $20 said:
Do you think it may be Uninsured people (free medical)that are forcing up the cost of medical services for those that CAN pay, and the costs to the insurance companies are sky-rocketing to fill the void?
Sorry for the Dumb question, still trying to get my head around your system.
Sorry for the Dumb question, still trying to get my head around your system.
Originally Posted By: 65cuda
I know of people that are without health insurance simply because they have lost jobs or the new job pays a lot less and they have to pay the bills. However many people do without health insurance simply because they want the money for other things like a nicer car, home and toys. Then when things happen they cry about the cost. Like some have said it only takes one illness and you can lose everything. The health care bill isn't the main reason for the cost going up. They have been going up for years at a far higher rate than inflation. At least now you aren't going to be dropped for some bogus reason. The insurance companies already weren't allowing different procedures. We have cases here even when the family has insurance but the company won't authorize the procedure, I've had friends that had to go through hoops to satisfy the insurance companies and it took months. To me anybody that says that less regulation and free market is being a little naive. The insurance companies can go into any state and apply to serve there, they chose not to. The big companies are already buying up the hospitals and the doctors are opening up their own little mini hospitals all the time. Funny thing is that their referring the people to tests go up when they just happen to get the machines in their place. Bad things can happen when business meshes with medicine.
The prices for many things have been going faster than the price of inflation. What about education for example, do we need a reform bill to reign in those evil, rich college professors? Energy? Milk? Tires? You get the point.
Your right companies can apply to any state they wish to yet choose not to why? Excessive regulation in large part. The cost of compliance is simply to great for many.
As already proven in many countries, much worse things will happen when government gets involved in health care.
Again, I mean no offense to anyone and I'm certainly not under any vision of grandeur when it comes the ethics of insurance companies but make no mistake we currently have the finest system in world even with its flaws and if anyone thinks that government will improve it, well that is a level of naivety that thankfully I'm not familiar with.
I know of people that are without health insurance simply because they have lost jobs or the new job pays a lot less and they have to pay the bills. However many people do without health insurance simply because they want the money for other things like a nicer car, home and toys. Then when things happen they cry about the cost. Like some have said it only takes one illness and you can lose everything. The health care bill isn't the main reason for the cost going up. They have been going up for years at a far higher rate than inflation. At least now you aren't going to be dropped for some bogus reason. The insurance companies already weren't allowing different procedures. We have cases here even when the family has insurance but the company won't authorize the procedure, I've had friends that had to go through hoops to satisfy the insurance companies and it took months. To me anybody that says that less regulation and free market is being a little naive. The insurance companies can go into any state and apply to serve there, they chose not to. The big companies are already buying up the hospitals and the doctors are opening up their own little mini hospitals all the time. Funny thing is that their referring the people to tests go up when they just happen to get the machines in their place. Bad things can happen when business meshes with medicine.
The prices for many things have been going faster than the price of inflation. What about education for example, do we need a reform bill to reign in those evil, rich college professors? Energy? Milk? Tires? You get the point.
Your right companies can apply to any state they wish to yet choose not to why? Excessive regulation in large part. The cost of compliance is simply to great for many.
As already proven in many countries, much worse things will happen when government gets involved in health care.
Again, I mean no offense to anyone and I'm certainly not under any vision of grandeur when it comes the ethics of insurance companies but make no mistake we currently have the finest system in world even with its flaws and if anyone thinks that government will improve it, well that is a level of naivety that thankfully I'm not familiar with.
Its sad that Americans that pay for health insurance get screwed and illegal immigrants that come to this country get better healthcare and don't pay a penny.
Suspected illegal immigrants arrive on Singer Island; woman goes into labor.
http://www.sun-sentinel.com/news/palm-be...0,5613105.story
Suspected illegal immigrants arrive on Singer Island; woman goes into labor.
http://www.sun-sentinel.com/news/palm-be...0,5613105.story
Originally Posted By: LT4 Vette
Its sad that Americans that pay for health insurance get screwed and illegal immigrants that come to this country get better healthcare and don't pay a penny.
Suspected illegal immigrants arrive on Singer Island; woman goes into labor.
http://www.sun-sentinel.com/news/palm-be...0,5613105.story
I don't blame people for trying to come here. If I was living in some third world country, like Canada for instance,(
) I would flock here as well. But what is really scary is that baby will be an American citizen.
Its sad that Americans that pay for health insurance get screwed and illegal immigrants that come to this country get better healthcare and don't pay a penny.
Suspected illegal immigrants arrive on Singer Island; woman goes into labor.
http://www.sun-sentinel.com/news/palm-be...0,5613105.story
I don't blame people for trying to come here. If I was living in some third world country, like Canada for instance,(
The problem with your examples is that we are talking about peoples lives, not their education, tires, milk well you get the point. Excessive regulation? You mean like the state not being able to decide what a minimun requirement is? It isn't any different than the auto insurance. It has been estimated that if the paperwork for each insurance company increases the cost of insurance by about 30%. Having standard policies or single payer could make a real difference in our costs. Also it doesn't help that these big companies are not only the insurance but also the hospital. I have a friend that used to work for a major hospital, but he had to buy his supplies through their network that they just happened to also own. He could buy the same product for much less outside, but wasn't allowed to. Also even though we spend much more than any other country our standard is worse than other major countries.
Originally Posted By: 3311
As already proven in many countries, much worse things will happen when government gets involved in health care.
What metric are you using? We have been proven time and time again that we got the worst health care if you are poor and affordability is the lowest among industrialized nation.
Unless if you want to compare against 3rd world like China and Cuba.
As already proven in many countries, much worse things will happen when government gets involved in health care.
What metric are you using? We have been proven time and time again that we got the worst health care if you are poor and affordability is the lowest among industrialized nation.
Unless if you want to compare against 3rd world like China and Cuba.
Originally Posted By: CivicFan
Doctors do not have an obligation to treat a patient they think will not be able to pay the bill. Or they may not recommend tests thinking that the patient cannot pay for them. Health care in the US is de-facto rationed by the ability to pay.
Doctors may not but the hospital near me does, and they have a big plaque in the admissions area saying they'll treat you regardless of ability to pay. I suspect it's part of their charter, and part of how they maintain their non-profit status. I'm confident many hospitals are like this, but the threshold for charity care would mean only paupers would get out for free.
Doctors do not have an obligation to treat a patient they think will not be able to pay the bill. Or they may not recommend tests thinking that the patient cannot pay for them. Health care in the US is de-facto rationed by the ability to pay.
Doctors may not but the hospital near me does, and they have a big plaque in the admissions area saying they'll treat you regardless of ability to pay. I suspect it's part of their charter, and part of how they maintain their non-profit status. I'm confident many hospitals are like this, but the threshold for charity care would mean only paupers would get out for free.
Originally Posted By: 65cuda
The problem with your examples is that we are talking about peoples lives, not their education, tires, milk well you get the point. Excessive regulation? You mean like the state not being able to decide what a minimun requirement is? It isn't any different than the auto insurance. It has been estimated that if the paperwork for each insurance company increases the cost of insurance by about 30%. Having standard policies or single payer could make a real difference in our costs. Also it doesn't help that these big companies are not only the insurance but also the hospital. I have a friend that used to work for a major hospital, but he had to buy his supplies through their network that they just happened to also own. He could buy the same product for much less outside, but wasn't allowed to. Also even though we spend much more than any other country our standard is worse than other major countries.
There are good and bad in vertical integration. It reduces overhead like how Kaiser does and increase income stability for the group / company. The conflict of interest is the downside, you can't pick your own doctor and they may decline things that you want to do and may be necessary in low probability, which, indirectly write off your life.
But having each layer of supplier / payer be in conflict of each other can be bad too, look at how much paper work and delay there is, people can die while they sort out who gets paid how much with you on the operating table.
The worst IMO is the horizontal integration. Sutter group bought up so many small hospital they are now monopoly in the east bay area, that they started shutting down emergency room and increases rate so much, that even insurance companies can't do anything about (because they are the only game in town within a 20 sq miles area). By the way, they are non profit that pay huge salary to the CEO too.
The problem with your examples is that we are talking about peoples lives, not their education, tires, milk well you get the point. Excessive regulation? You mean like the state not being able to decide what a minimun requirement is? It isn't any different than the auto insurance. It has been estimated that if the paperwork for each insurance company increases the cost of insurance by about 30%. Having standard policies or single payer could make a real difference in our costs. Also it doesn't help that these big companies are not only the insurance but also the hospital. I have a friend that used to work for a major hospital, but he had to buy his supplies through their network that they just happened to also own. He could buy the same product for much less outside, but wasn't allowed to. Also even though we spend much more than any other country our standard is worse than other major countries.
There are good and bad in vertical integration. It reduces overhead like how Kaiser does and increase income stability for the group / company. The conflict of interest is the downside, you can't pick your own doctor and they may decline things that you want to do and may be necessary in low probability, which, indirectly write off your life.
But having each layer of supplier / payer be in conflict of each other can be bad too, look at how much paper work and delay there is, people can die while they sort out who gets paid how much with you on the operating table.
The worst IMO is the horizontal integration. Sutter group bought up so many small hospital they are now monopoly in the east bay area, that they started shutting down emergency room and increases rate so much, that even insurance companies can't do anything about (because they are the only game in town within a 20 sq miles area). By the way, they are non profit that pay huge salary to the CEO too.
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