Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
BTW my mom buys her insulin in cash from Walmart for $24 a vial for Novolin 70/30 which is cheaper than going through her insurance. Hope that can help.
At least you are getting something covered for your money. Unsubsidized families pay that amount in premiums and still have another 7K in deductibles before things are covered.
Good luck getting the 90% of people with health insurance to pay more in taxes than what they pay in premiums to get universal coverage for everyone. They wouldn't even pay the Cadillac tax to help pay for ACA.
Okay.. First.. why do you automatically assume that the cost in taxes would be more than the cost families are currently paying in premiums, deductibles and copays? Actually , it would cost less.
How do I know this.
Every country in the world, including France (ranked #1) provides health care for EVERY citizen and does it for less per capita than the U.S. As a matter of fact, the nation ranked #1 in health care by the WHO (the U.S is ranked 37th) is France. They spend $4118 per capita (I believe this was as of 2015) and the U.S spent nearly double that per capita $8508. There are many reasons why they do this, but a great example is the fact that their administrative costs are streamlined and more efficient, unlike the U.S that is not. I believe another contributor to this thread indicated just how much the U.S spends in billions on administrative costs as a reference. It is important to note that medicaid has a 5% overhead while private insurance company operates at a 20% overhead
(important side note: the ACA capped overhead for insurance companies to 20% so that at least 80% of your actual premiums went to your actual care. In the first year of the ACA - many received money BACK from insurance companies that exceeded that).
Another item; other countries are able to negotiate better drug prices from companies based on the large buying volume they have, which is why countries like Canada get drugs from American companies at steep discounted rates. That, and their are price controls that universal care governments enact in those nations.
Then there is the matter of how healthcare is funded. Many fund it through corporate taxes , as well as through income taxes (varying countries do it in various ways..Italy (ranked 2nd) for example has 35.6% of their healthcare funded through corporate taxes . Now you might say that corporate taxes might hurt corporations, but when you consider that approx 12% or more of total compensation per employee (benefits, etc) is contributions to health insurance premiums.. that expenditure could just be transferred to a tax paid to the government for a more streamlined health care system.
My point is.. to assume that a universal system would be more expensive to a family when you consider premium, deductibles and copyas combined is just not accurate. Streamlining, put in costs controls (limiting payouts for procedures and drugs) would actually work to reduce cost, reduce strain, end the problem of uninsured (which puts a huge strain on the rest of us - when prices need to be increased to make up for the losses in uncompensated care).
Our system is complex. I know a lot about it because I study it closely. I also look into other systems around the world.. The U.S COULD do it better and more efficient.. IF ONLY people would stop and think about it and really understand what it's all about rather than make the false assumption that moving to a universal system would cost you more. And THAT is part of the problem as to why we don't have that kind of system; false thinking and assumptions.
BTW my mom buys her insulin in cash from Walmart for $24 a vial for Novolin 70/30 which is cheaper than going through her insurance. Hope that can help.
Thanks.. and yes, there is "cheaper" insulin. But the insulin is a longer acting insulin. Switching to a longer acting insulin is an option i discussed with my doctor that could be used in the pump should my loss of insurance occur (I was unaware that humilin insulin - or longer acting insulin- could be used).
The issue with that, however, is that it makes it harder to control and manage blood sugars this way. It is not ideal. And why that matters is because the tigher your control the less chance of having major complications that become extremly costly later on, AND are life threatening.
Eventually, we might move to universal system. However, that "eventually" could be a very long time (decades if not more), and far too late to many who already lack health insurance, to many more who may soon lose it.
There are several actors in the U.S. health system whose interests condition them to oppose, or at least be indifferent to, implementing universal care.
(1) Health insurance companies have much more to lose than to gain by the U.S. switching to a govt based system. The truth is that there'd be much less work for them to do if everyone were covered by the same or similar plans (as in the case in Canada, where private health insurance is a pretty miniscule industry).
(2) People who already have excellent coverage through govt employers, through some high-end corporate plans (some of which provide retiree health insurance which is otherwise not common in the private sector). This population has a disproportionate level of access to health care resources now, and has little motivation to share those resources equally with the sweaty masses that they (the currently very well insured), in many cases, have disdain for.
(3) The medical providers may be divided. However, I suspect that most medical providers would lose more than they'd gain by having the U.S. switch to a Canadian type system.
(4) People who work in health care administration and billing. Canada spends about $4600 per person on health care about 12% of which, thus $550 per person, is spent on administrative and billing costs. The U.S. spends about $10,000 per person on health care each year, about a third of which is accounted for by administrative costs (thus, three thousand and change per year, per person).
To be clear, the above means that the U.S. spends about a TRILLION dollars a year on health care administration and billing. This corresponds to millions of people with admin jobs who will not want to be made redundant by passing a universal health care bill. Unless something can be done to protect them against unemployment, this group of people will form a permanent, organized, and well-funded base of political opposition to the implementation of a less wasteful health care administrative system, whether the replacement system is public or private.
I agree with you whole heartedly. It is a difficult thing.
I do believe there is going to be a lot of pain and literal suffering before Americans will adapt a Universal system.
Sadly, there could be a smoother way IF Americans (in general) weren't so stubborn. BUT they are.. and they have a lot of misconceptions about a lot of different things regarding our own system AND other systems around the world that prevents them from really advocating FOR a smoother transition.
It's going to take a lot of people dying from access -and them loosing access to really push for a change. I just hope I can survive it..
Okay.. First.. why do you automatically assume that the cost in taxes would be more than the cost families are currently paying in premiums, deductibles and copays? Actually , it would cost less.
How do I know this.
Every country in the world, including France (ranked #1) provides health care for EVERY citizen and does it for less per capita than the U.S. As a matter of fact, the nation ranked #1 in health care by the WHO (the U.S is ranked 37th) is France. They spend $4118 per capita (I believe this was as of 2015) and the U.S spent nearly double that per capita $8508. There are many reasons why they do this, but a great example is the fact that their administrative costs are streamlined and more efficient, unlike the U.S that is not. I believe another contributor to this thread indicated just how much the U.S spends in billions on administrative costs as a reference. It is important to note that medicaid has a 5% overhead while private insurance company operates at a 20% overhead
(important side note: the ACA capped overhead for insurance companies to 20% so that at least 80% of your actual premiums went to your actual care. In the first year of the ACA - many received money BACK from insurance companies that exceeded that).
Another item; other countries are able to negotiate better drug prices from companies based on the large buying volume they have, which is why countries like Canada get drugs from American companies at steep discounted rates. That, and their are price controls that universal care governments enact in those nations.
Then there is the matter of how healthcare is funded. Many fund it through corporate taxes , as well as through income taxes (varying countries do it in various ways..Italy (ranked 2nd) for example has 35.6% of their healthcare funded through corporate taxes . Now you might say that corporate taxes might hurt corporations, but when you consider that approx 12% or more of total compensation per employee (benefits, etc) is contributions to health insurance premiums.. that expenditure could just be transferred to a tax paid to the government for a more streamlined health care system.
My point is.. to assume that a universal system would be more expensive to a family when you consider premium, deductibles and copyas combined is just not accurate. Streamlining, put in costs controls (limiting payouts for procedures and drugs) would actually work to reduce cost, reduce strain, end the problem of uninsured (which puts a huge strain on the rest of us - when prices need to be increased to make up for the losses in uncompensated care).
Our system is complex. I know a lot about it because I study it closely. I also look into other systems around the world.. The U.S COULD do it better and more efficient.. IF ONLY people would stop and think about it and really understand what it's all about rather than make the false assumption that moving to a universal system would cost you more. And THAT is part of the problem as to why we don't have that kind of system; false thinking and assumptions.
I base it on conversations with the 1 percent ers of healthcare coverage: govt and union folks. They are so far removed from the cost of healthcare there is no way they will ever agree to spending at least 15% of their income additional tax to pay for their insurance. Also there is limited appeal for this from those getting a sweet deal from ACA. They are doing great better being subsidized under ACA.
I am self employed and un subsidized. I figure I will paying about the same no matter what. I just do not see those who have good insurance sacrificing one penny to get universal care for everyone. Hell, the unions got the Cadillac tax delayed, and Hillary wanted to do away with it complately, despite the fact it was needed to help pay for ACA.
Maybe we need campaigning and marching against the 1 percenters of healthcare similar to the Occupy Wall Street movement a few years back, but those protesters are doing fine under ACA.
^ I corrected for you. I don't listen to a stubborn idealistic man. He has destroyed jobs in this country by redirecting income to the insurance companies. The poor people always had insurance they just need to go to the state's own HMO.
Yeah.. no .. I'm sorry .. I have to disagree with you there. He hasn't destroyed jobs. As a matter of fact, jobs are up in this country (unemployment is down). It's just false. Facts do not support what you are saying. Forbes Welcome
Quote:
ACA gave poor people open access to insurance companies that normally would not accept people with low income.
I'm sorry.. but wrong again. The ACA DID NOT give poor people with low income open access to insurance companies. Not sure where you are getting this information.
First.. poor people .. low income people already had access through medicaid - which is distributed, by the way, through private insurance companies (not by the government itself). In other words, if you have a child or you are on medicaid you choose your medicaid plans that are offered through a private company. In Pennsylvania, for example, I believe there are ones issued through Geisinger, United Healthcare and Aetna for example. So even in fully funded government "plans" they are not really administered BY the government.
Secondly - when you apply for a plan through the marketplace and you put in your income, IF your income falls BELOW the ACA guidelines you are kicked to medicaid. Your income is TOO LOW to qualify for an ACA - or marketplace plan. Where the ACA left off - medicaid is supposed to kick in. And, the ACA expanded medicaid (meaning the states needed to raise their income requirements to meet the incomre requirement number that was "too low" for aCA) This expansion, by the way, was going to be picked up for the states BY the federal government, so that it wouldn't cost the states additional money. Sadly, out of pure stubborness, Republican controlled states refused to expand medicaid (they could opt out - added because the GOP raised a stink). In those states, if your income was too low to receive subsidies making an ACA plan affordable to you, BUT your state did not raise medicaid requirements , that person fell into a hole (which is why we still have uninsured people despite the ACA). They made too little for an ACA plan but too much for their state medicaid plan and remain uninsured.
It is important to note that these individuals that fall into this "hole" are exempt from paying fines for being uninsured, by the way.
Quote:
But now insurance companies pulling out and many doctors refusing to accept certain insurances and not accepting new patients altogether.
The ACA is not perfect. and has many kinks to work out. One of the many things that could alleviate the issue of insurance company profitability - particularly in more sparsely populated states - would be to allow insurance to sell across state lines. This was, ironically , first proposed by Lieberman (I think that is who it was) - an independent that caucuses a lot with Republicans at one point, but when it came time to vote on it it was rejected by the GOP and even the man who first proposed the idea.
I have to correct you , however, on doctors refusing to accept certain insurances. NOPE.. sorry.. doctors don't "refuse". THAT has NOTHING to do with the ACA.. and everything to do with the insurance companies. Many insurance companies decided to limit their networks. I'm not exactly sure why, but again , this has nothing to do with ACA requirements or lack thereof - but rather decisions between the insurance company and the doctors. Probably has more to do with the pressure insurance companies put on doctors for pricing than anything else. Remember; their goal is to take YOUR money for healthcare, but pay little if nothing for your actual care. (which is why the ACA limits overhead to 20%, by the way).
Quote:
This is the worst scenario resulted from government interfering with commerce without being directly involved to ensure that rates aren't skyrocketing for everyone.
On this point I will agree. There is not enough price control within the system of our health care from a central location to effectively reduce costs. Prices are negotiated between the individual insurance companies in varying states (even regions) and caregivers, with different rates negotiated in different areas. All very convoluted. And no government to step in and tell a company that a $335 for a vial of insulin is insane.
Quote:
Obama tells liberal media to issue fact checks that insurance premiums aren't going up as high as before. Then just before the election he tells everyone that it's going up. What a way to hurt Hillary indirectly.
Insurance premiums, overall, have increased at a slower rate than prior to the ACA. There are certain areas, however, where this isn't true. Again.. the ACA is no perfect.. and needs tweaking.
For example.. I would have liked to have removed health insurance being tied to employment all together, and rather, allowed families and individuals to ALL shop on the marketplace for a plan that best works for them (as opposed to whatever plans their companies limit them to). The reason this is important is because one plan does not fit all with regard to the market. For example, I shop very carefully for my marketplace plan by looking at the numbers closely. I could choose a plan that, in premiums, would cost me less, but when I look at out of pocket, etc. the lower premium plans actually cost me more by thousands. Rather, taking the higher premium plans, over the long run, costs me less. This is because I know my usage of healthcare. And every family situation varies. Employees limit your options to plans that may cost them less money premium wise, but transfers more of the cost to the family in high deductibles and higher copays, etc. Those that got premiums through work also didn't qualify for subsidies on the exchange that reduces not only the premiums, but through cost sharing (based on income) reduces the deductible and even the max out of pocket before the 100% coverage kicks in. For example, rather than meet a deductible ofa few thousand on the plan I selected, the cost sharing through my qualifications, reduces my deductible to a couple of hundred. Employees don't get that benefit.
At the same time, I would have liked to have seen the law state that employers who previously provided health care plans (prior to the ACA) transfer the amount they spent on insurance the previous year to actual take home compensation to the employee . Leaving the employee free to purchase (or not) their own insurance and having the additional funds from their previous benefit awarded to them in compensation. The company doesn't loose anything, the employee doesn't loose anything. Long term, the burden of health insurance is removed from the employer and the freedom of choice is given to the employee.
Quote:
Well good for his party because they've enriched their elite friends in the Insurance cartels and now have Trump going after them soon.
Ultimately, insurance should be supplemental, like in France or Italy where coverage is taken care of by a national plan but insurance could be purchased to cover what the government won't (in some countries elective surgery, in others the coinsurance amount - usually around 20% or 30% of the cost).
Our current insurance system is not sustainable no matter how many "reforms" you do.. The entire concept of paying a profit company for your care - with their goal of not paying for your care to pocket the money you give them is insane.
I base it on conversations with the 1 percent ers of healthcare coverage: govt and union folks. They are so far removed from the cost of healthcare there is no way they will ever agree to spending at least 15% of their income additional tax to pay for their insurance. Also there is limited appeal for this from those getting a sweet deal from ACA. They are doing great better being subsidized under ACA.
I am self employed and un subsidized. I figure I will paying about the same no matter what. I just do not see those who have good insurance sacrificing one penny to get universal care for everyone. Hell, the unions got the Cadillac tax delayed, and Hillary wanted to do away with it complately, despite the fact it was needed to help pay for ACA.
Maybe we need campaigning and marching against the 1 percenters of healthcare similar to the Occupy Wall Street movement a few years back, but those protesters are doing fine under ACA.
Ah.. indeed.
Well unions are quickly being killed - so eventually that gravy train will stop.
I am self employed and have great insurance through the ACA (I am most grateful) but I do advocate for a universal system. The ACA sets out that no more than 20% of your income goes to healthcare. I spend about 15% with my cost sharing and subsidies.. as the ACA is set out to do. So those of us that have a sweet deal through the ACA would "break even" if 15% of our income was taxed. Additionally, as i mentioned, corporations would need to chip in a percentage.
Indeed.. universal care is ways off - and for the reasons you stated and many more. Sadly, there will be lots of pain before we actually make the moves we need to toward it.
What we have now is unsustainable.. ACA or not.. and the killing of the ACA will accelerate the pain that is coming for sure.
The election of Trump has certainly changed my ability to retire early. Obamacare would have provided a bridge to Medicare age; although expensive, at least I could have gotten myself and my wife insured, since we both have pre-existing conditions. Now with the distinct possibility that ACA will be gutted, and beyond that, the possibility that Medicare and Social Security may be rolled back - there's no way I'm going to take the risk of leaving my current job. I dare say there are a whole lot of people in similar circumstances.
Up until life got messed up and I could get medicade, I went without with a known auto immune disease since I could not get insurence period. It didn't matter how much or little I had. I was okay here in OK until they decided to save the state money and lowered the income limit on medicade, meaning that most on disability didn't qualify. I never used my ACA policy, but it didn't charge me anything. As things are under control, the cost wasn't going to go near the limit for paying premiums. But should something bad happen it was there.
At least I turn 65 mid next year and am hoping this doesn't turn into a mess since I'm only barely managing things and eventually the problem will have to be dealt with. The stated premiums worry me too since I have expenses with my house which I own as well.
If some sort of coverage had been there years ago for pre-existing conditions I would never have gotten as sick as I did, and I wouldn't have the degree of problems I do now either. I only got treatment than when it was proven that the condition existed while I was covered and as such my dad's navy insurence had to cover it. The doctor also said if we sued the doctor for malpractice since he was clueless but wouldn't admit it, he'd back us up but my parents didn't. I really wish they had now.
I don't think people without preexiting conditions can even imagine the worry and fear about this problem those of us who have them deal with and how sometimes things get neglected because it costs too much. I worked for a few years but the stress woresended the condition and only qualify for the lowest disability amount, and its just enough to clear the month, no extra for things like premiums and no eligability for things like food stamps either. If I moved, I might get more, but then the cost of housing is minimal since all I owe are property taxes, which are small. Moving somewhere I'd qualify for food stamps and such would just be eaten by housing costs.
I don't think the joker who won has any idea what anyone who isn't fjush with cash deals with and more to the point, It doesn't care.
How are you paying 15% of your income? If you are eligible for CSR you need to be between 150 and 250% of FPL which should mean about 7% of income going to premiums. What is your max OOP with the CSR?
Lower income folks in NY can qualify for an essential plan. Premiums are under $75 a month.
A side question as a fellow self employed person: if your income is so low that you qualify for low income subsidies, is your business viable? Are you able to contribute to an IRA? This should be when you are maxing out retirement savings.
Up until life got messed up and I could get medicade, I went without with a known auto immune disease since I could not get insurence period. It didn't matter how much or little I had. I was okay here in OK until they decided to save the state money and lowered the income limit on medicade, meaning that most on disability didn't qualify. I never used my ACA policy, but it didn't charge me anything. As things are under control, the cost wasn't going to go near the limit for paying premiums. But should something bad happen it was there.
At least I turn 65 mid next year and am hoping this doesn't turn into a mess since I'm only barely managing things and eventually the problem will have to be dealt with. The stated premiums worry me too since I have expenses with my house which I own as well.
If some sort of coverage had been there years ago for pre-existing conditions I would never have gotten as sick as I did, and I wouldn't have the degree of problems I do now either. I only got treatment than when it was proven that the condition existed while I was covered and as such my dad's navy insurence had to cover it. The doctor also said if we sued the doctor for malpractice since he was clueless but wouldn't admit it, he'd back us up but my parents didn't. I really wish they had now.
I don't think people without preexiting conditions can even imagine the worry and fear about this problem those of us who have them deal with and how sometimes things get neglected because it costs too much. I worked for a few years but the stress woresended the condition and only qualify for the lowest disability amount, and its just enough to clear the month, no extra for things like premiums and no eligability for things like food stamps either. If I moved, I might get more, but then the cost of housing is minimal since all I owe are property taxes, which are small. Moving somewhere I'd qualify for food stamps and such would just be eaten by housing costs.
I don't think the joker who won has any idea what anyone who isn't fjush with cash deals with and more to the point, It doesn't care.
OR it could also be that the Joker lives in a state that provides a safety net that made insurance available for those with previous existing conditions purchase insurance on a sliding scale pre ACA. Medicaid expansion beyond what the Feds required too. That is the reality of where he lives.
As a NYer, it amazes me how little other states do for their citizens, but I guess that is what you get when you want to live in low tax state.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
