Going without health insurance

[eljefino]

The gov't has a "FAFSA" form for applying for financial aid and most colleges accept it.

Why can't they come out with a "health insurance contract" maybe with level A B C of quality? BC/[censored] could compete against company X Y and Z at open enrollment for level B for $X a month.

Then we aren't challenged with apples/oranges comparisons. And everyone will know the loopholes and either close them or take proper advantage.

They won't change billing codes every six months. They can buy off the shelf back-office software. Employees can move from one insurance company to another and be up to speed without retraining.

Doctors would negotiate to take the "standard contract" or miss a large chunk of potential business.

Noone would forbid non-standard contracts. I can't predict their market share.

Yea? Nay?

 

[3311]

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.

I fully understand your point and realize how it affects peoples lives. But I don't think you comprehend the fact that health insurance and health care are not rights but a service that companies and health care professionals choose to provide. One that I'm not able to afford right now.

I'm not sure what standard your speaking of that is worse than in other countries, but the fact remains, that by any objective measure we have the finest health care in the world here even with all of its flaws, as serious as those maybe.

People thought the world should be happy that they have our system to cherry pick. Where would they be without our medicines(thanks big pharma) to use, our universities to attend, and our hospitals to go.
Single payer is a failed idea and radical solution to our problems.

I think I'll be done with this topic I've already been warned about political commentary and I will try harder to respect rules of the site.
Goodnight everyone.

 

[65cuda]

By any objective measurement? I'd like to see them because I have yet to see one where the US rates as the best. But like you I'll drop this because I don't want to cause a problem. I just have a pet peeve about the health care system.

 

[Paulson]

I didn't have health insurance when I developed a hernia... flushed about 11K down the toilet on that one.

I've had insurance on and off and while it's crazy, so are visits to the ER (I just went... $3400 for 3 hours of ER time... fortunately with insurance all I have to pay is $500.

 

[crinkles]

Originally Posted By: 3311
Originally Posted By: 65cuda
I Bad things can happen when business meshes with medicine.
As already proven in many countries, much worse things will happen when government gets involved in health care.


I'd love for you to elaborate with some examples. sweden? canada? australia?

 

[finalyzd]

Huh. Never really thought about health insurance. I've never had a job that has offered it either. I will look into this................

 

[tonycarguy]

Originally Posted By: Vikas

The health insurance works when all individuals including healthy and non-healthy participate in it.


In other words, the healthy people should be in the pool to subsidize the unhealthy ones? Seems like the healthy ones are getting the short end of the stick here

 

[JustinH]

I feel for some of the guys on here. I may earn a lower paycheck but make it up in benefits. Full coverage with dental and a $500 annual deductible runs me 80 per month for a single.

For three prescriptions that I take, walgreens is telling me that the price without insurance is nearing $900 monthly. I pay $45. There is something wrong with the drug companies when a inhaled allergy medication is nearly $200 per month (nasonex).

 

[RTexasF]

I note some smugness here where folks with provided health insurance seem to feel those without it are absolute and total fools. Now if the opportunity is there and you can afford it then you are foolish not to have it.

There are situations where folks can't work, can't collect disability, and live month to month. Major medical/Health Insurance is just not possible so one's best hope is that the despised Obamacare or Medicare come into play.....that will take years. Even then it will be a financial hardship. In the meantime a constant prayer is that nothing happens requiring a hospital stay. I am in this situation and must wonder how many millions of seniors share it. I won't go into explaining why because it's no ones business but it does exist a lot more than folks realize.

Currently I am going through the long process of applying to the VA as my only hope. There is an outpatient clinic about 30 miles away and a VA hospital about 300 miles away. If accepted a great deal of stress will be relieved.

No sad songs or violin music required. My point is that some of us are in unique situations regarding health insurance/lack of same so don't look down your nose at those folks. We all have different crosses to bear and do the best we can with the cards we're dealt.

 

[TooManyWheels]

Originally Posted By: tonycarguy
Originally Posted By: Vikas

The health insurance works when all individuals including healthy and non-healthy participate in it.


In other words, the healthy people should be in the pool to subsidize the unhealthy ones? Seems like the healthy ones are getting the short end of the stick here


Yes. The logic being that when the healthy people become unhealthy, they will be covered also.

 

[eljefino]

Originally Posted By: tonycarguy
Originally Posted By: Vikas

The health insurance works when all individuals including healthy and non-healthy participate in it.


In other words, the healthy people should be in the pool to subsidize the unhealthy ones? Seems like the healthy ones are getting the short end of the stick here


When healthy people get dragged into paying into insurance, it suddenly starts mattering what doctors charge and what miracle cures keep octogenarians alive as vegetables for a few more weeks. Without everyone suffering their share, they aren't part of the debate.

 

[GROUCHO MARX]

Originally Posted By: Paulson
I didn't have health insurance when I developed a hernia... flushed about 11K down the toilet on that one.

I've had insurance on and off and while it's crazy, so are visits to the ER (I just went... $3400 for 3 hours of ER time... fortunately with insurance all I have to pay is $500.


This just about summarizes it. I hope members (and all people) like RTexasF can get appropriate attention as the cost of insurance can be prohibitive for many people. Others, as was said here, prefer to buy cars, campers, etc. instead of health insurance. I have little sympathy for them when it hits the fan. If it comes down to universal coverage, I'll go for it if everyone, and I mean everyone, gets the same plan. No one jumps the line.

 

[Cujet]

I use a contract aircraft mechanic. He "self insures" his entire family. He has some expensive "tales of woe", but he is absolutely convinced he's doing it the right way.

That's because his overall yearly costs are lower than if paying insurance and out of pocket expenses.

In fact, he's found that the hospital will negotiate with him and significantly reduce his bill.

I'm not persuaded, so I continue to pay for my "Cadillac" plan. I've tried to convince Frank to get a catastrophic plan, but he feels that he has a better way. Who am I to argue?

 

[Cutehumor]

I'm 33 years old and I was perfectly healthy. I wasn't even on one medication. Back on 9/11, I woke up and starting coughing up blood. it got so bad that pure red blood was pouring out my nose when I coughed. After several bronchoscopies, blood tests, x-rays, ct scans, radiation, being on the ventilator in ICU for two weeks, hospital for a total of 25 days, three surgeries, I rang up almost $750k in medical bills and that was all IN NETWORK!!! I had a fungus mass the size of a fist in my right lung that was causing my pulmonary artery to bleed. So 60% of my right lung is gone. It's been six months now and I'm fully recovered, it feels like I was never sick, thanks to the Lord who has healed me.

But, as you can see, you don't want to go without health insurance. I gladly paid my $4800 out of pocket max for 2010 out of my health savings account. Even though my deductible is high, I only pay about $50/month for health insurance.

 

[Blaze]

In 2008 my wife went into cardiac arrest near Spokane. With the ER visit and pacemaker implant we racked up 180K in hospital bills. We did not have insurance since my wife was in between jobs and I am self employed at home farmer. We were going to file bankruptcy but our attorney advised to wait out the hospital and refuse to pay because of a future bankruptcy case. The hospital did end up lowering the bill to 20K and our attorney said that was not enough to file bankruptcy over since we owned our farm/house free and clear thus didn't meet the assest to hospital bill ratio. We are currently making monthly payments on that. We did get an itemized statement and the total doctor bill for the pacemaker implant was only 8K. Thge rest was the hospital bill. There was one drug they used to test the pacemaker which stops the heart and that was 4K. My stepson recently racked up about 10K in hospital bills and the hospital wrote the entire bill off. He has a low paying job and rents a house.

 

[Blaze]

My farrier was here this morning and we had just talked about this subject.... last month his fuel bill and health insurance monthly payment combined were $2100. Amazing paying over 24K a year for just two items.

 

[JHZR2]

Originally Posted By: Cutehumor
After several bronchoscopies, blood tests, x-rays, ct scans, radiation, being on the ventilator in ICU for two weeks, hospital for a total of 25 days, three surgeries, I rang up almost $750k in medical bills and that was all IN NETWORK!!!


What gets me is the $750k. Where I work, burdened rate for a professional engineering expert in a field is about $230k/man year. Its down to about $200k for a standard worker and $180k for a technician or equivalent. Let's take worst-case scenario, $4600 per man week. You were in the hospital the equivalent of five work weeks...Is the hospital really claiming that you had 32 full time equivalents working on you?

Of course there is some rental cost for the facilities. What can it really be? I can rent a nice hotel room in an big city for about $250/night. Sure there are other gadgets, so the cost of the room is say, $1000/night. So I guess youre paying $725k in labor? Maybe 30 full time equivalent people?

No hospital Ive ever been in dedicates one full time person to you, even in an ICU.

And there lies my dissatisfaction. Youre paying for the equivalent of 32 doctorate-level technical experts in any other field... working FULL time on a problem.

Something just doesnt align there, wrt costs, and that is where the discussion needs to be pointed, IMO.

At the same time, insurance for profit to me is a ridiculous thing. Why? Because if you are basing something upon probabilities and actuarial tables, then there should be zero variability from vendor to vendor unless one is taking more risk (bad) or less profit (good or bad depending upon the angle). But the probabilities and risk really dont change. I fear for profit insurance because they can allow/disallow payments based upon their profit structure, which is just a dirty way of doing things. Not advocating government care per se, just expressing my dislike of insurance systems in general.

Someone is making a LOT of money in this - a disproportionate amount. That may or may not be OK, but my gut is that not much of what is typically done is that advanced or comlex in the medical field that a trained monkey couldnt perform it... yet we are paying rates as if the world's top genius and only qualified individual are doing it.

 

[JHZR2]

Originally Posted By: Blaze
My stepson recently racked up about 10K in hospital bills and the hospital wrote the entire bill off. He has a low paying job and rents a house.


Though I just ranted the other way, and though this may come across as cold, he should not have used the hospital if he could not pay.

Though I don't agree with the cost structure of the medical industry, at the same time, using it without the ability to pay is really not much beyond stealing. Not keen on that either. And it is a lousy thing to say - I get that. But what else is it? What would the situation have been 150 years ago? Low paying job and home rental arent really an excuse. Does he have a cellphone? Cable TV? stuff like that means that people can afford to pay at least based upon their ability. I do hope he at least made some good faith payments versus taking and giving nothing back.

Again, seems cold reading it, but Im trying to look at both sides of the situation.

 

[eljefino]

Originally Posted By: JHZR2

At the same time, insurance for profit to me is a ridiculous thing. Why? Because if you are basing something upon probabilities and actuarial tables, then there should be zero variability from vendor to vendor unless one is taking more risk (bad) or less profit (good or bad depending upon the angle). But the probabilities and risk really dont change. I fear for profit insurance because they can allow/disallow payments based upon their profit structure, which is just a dirty way of doing things. Not advocating government care per se, just expressing my dislike of insurance systems in general.


To hear them say it, they have a better filter. If not a healthier-than-average lot of subscribers, they are better at filtering "fraud".

But then who'll insure the sickos? Sometimes they get lumped into an assigned risk pool and shoved back into the hands of the insurers who initially balked at covering them. Other times they dump the lame for-profit coverage and go with a spouse's state-employee plan, which is, from my anecdotal overhearings, very fair. The actual cost of course just gets moved around on the books, never goes away.

Since we've deindustrialized, insurance and pushing paper is what we do as a country. We're even trying to get other countries hooked on our being middlemen!

 

[Cutehumor]

Originally Posted By: JHZR2
Originally Posted By: Cutehumor
After several bronchoscopies, blood tests, x-rays, ct scans, radiation, being on the ventilator in ICU for two weeks, hospital for a total of 25 days, three surgeries, I rang up almost $750k in medical bills and that was all IN NETWORK!!!


What gets me is the $750k. Where I work, burdened rate for a professional engineering expert in a field is about $230k/man year. Its down to about $200k for a standard worker and $180k for a technician or equivalent. Let's take worst-case scenario, $4600 per man week. You were in the hospital the equivalent of five work weeks...Is the hospital really claiming that you had 32 full time equivalents working on you?



I was looking at the breakdown of my 138 EOB's.

check out their breakdown below. The hospital billed $325,234.50 for me to stay as a patient in the hospital from 9/16-10/10. The insurance paid $95,584.80. the difference was wrote off since it was an in network facility, if it was out of network, the hospital could have came after me for the $230kish difference. I'm glad I looked up in network hospitals when I was coughing up blood. some fool would have just went to an ER at any hospital and not knowing if that hospital was out of network or not to their insurance plan. These charges were just from the hospital. I didn't include the two surgeons, oncologist, infections disease MD, diagnostic tests, pulmonary MD, anesthesia MD, or Nurse Anesthesia charges that bring the total to $750K charged to my insurance. I'm pretty sure I'm forgetting more folks.

Date of Service: 09/16/2010 - 10/10/2010
Status: Processed 10/19/2010
Date Received: 10/15/2010
Download Explanation of Benefits (EOB)
View Claim History


Services and Charges
Remark Code
Description
Date of Service Billed Amount Network Discount Applied to Deductible Paid by Plan Patient Responsibility
Room And Board
09/16/2010 - 09/24/2010 $19,206.00 -$70,074.00 $0.00 $89,280.00
D2*
Room And Board
09/25/2010 - 10/10/2010 $39,105.00 $39,105.00 $0.00 $0.00
D2*
Ih Misc. Services
09/16/2010 - 10/10/2010 $86,016.00 $86,016.00 $0.00 $0.00
D2*
Ih Misc. Services
09/16/2010 - 10/10/2010 $93,161.00 $93,161.00 $0.00 $0.00
D2*
Ih Misc. Services
09/16/2010 - 10/10/2010 $87,746.50 $81,441.70 $0.00 $6,304.80
Totals $325,234.50 $229,649.70 $0.00 $95,584.80 $0.00

Paid at Visit
$0.00
Already Paid
$0.00
Amount You May Owe
$0.00










Claim Notes
*Remark Code D2: Thank You For Using A Network Physician Or Other Health Care Professional. We Have Applied The Contracted Fee. The Patient Is Not Responsible For The Difference Between The Amount Charged By The Physician Or Health Care Professional And The Amount Allowed By The Contract, Except In Situations Where There Is An Annual Benefit Maximum For This Service. The Patient Is Also Responsible For Any Copay, Deductible And Coinsurance Amounts.