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I get that premiums are age rated. My point is that these events (which are not going to happen to me in any way, shape or form) are "covered" by my insurance premiums. And yes, of course I realize that I'm paying for them to happen to someone else.
Prior to the ACA I could have lowered my premium by opting out of some options, such as maternity care. And I did that. Now I can't do that.
The actuarial value of a maternity benefit for someone in their 50- 60’s is likely $0.00
Prior to ACA you were 10 years younger. Me too.
Prior to ACA , one’s current health status and medical history mattered in the Individual Plan market. It includes accidents. You could be denied insurance or charged a higher premium based on these factors.
ACA mandated Guarantee Issue. Your current health status and medical history were no longer rating factors in determining a premium.
The Guarantee Issue thing is likely one of the single greatest factors impacting premiums in addition to age and geo rating.
The Guarantee Issue thing is one area where Obama, Trump, Democrats and Republicans are now in lock step.
USA has fantastic health care coverage for those able to afford it, for the upper middle class and the wealthy. If you are middle class or poor your future is dark indeed, because no amount of financial planning will be able to overcome the burden of future health care costs in our current system.
So who is stupid? It's not the health care providers and insurance companies that are harvesting trillions of dollars in a "market" that is almost completely free of regulation or oversight. These corporations are doing what any unregulated corporation will do; chase any and every dollar of profit regardless of the consequences to the society.
Interesting.
I view insurance and hospitals as two highly regulated markets.
I am a staunch conservative, and also a physician.
I think we really need a two tiered health system in which a basic "single payer" system is offered to every citizen (partially funded by a VAT tax and personal income tax) and the option of a "Cadillac" private insurance supplemental program for those who want "luxuries" beyond nuts and bolts care, like transplants, total joints, bariatric surgery, cardiac surgery on the elderly, ect……….
Hey, something we agree on!
I am not sure on the VAT tax but I am in favor of a basic, single-payer plan + private "gap" plans like Medicare has.
Only the free market will EVER solve this f***ing boondoggle known as the American health care system.
Starting right from the get-go: The cost of medical school MUST COME DOWN !!!
There is no evidence of free market healthcare anywhere.
Forcing the cost of medical school down does not sound particularly “ free market”, does it?
The Federal Government forgives student loans when one is employed by any government body, including schools, or 501 (c) 3 organizations which includes most hospitals and increasingly hospital- owned medical practices.
It can be a serious consideration for healthcare professionals in terms of employment. They is no cap on this benefit.
Yes to the free market.
The only way it can be effective is the complete removal of govt from every layer of health care.
No licensure, no FDA, no certificates of need, no limits on residencies or teaching schools...
However it looks like it will get much worse based on the utterance of magic words by the latest and greatest politicians.
As always; dont get sick
I am prepared to performed open heart surgery on you, just as soon as I finish my used copy “ Surgery for Dummies.
There is no example of a successful free market healthcare system anywhere.
I am not sure on the VAT tax but I am in favor of a basic, single-payer plan + private "gap" plans like Medicare has.
Is there a single system in the developed world where the national health care system does not perform transplants and is only reserved for people with lots of money? Sounds crazy.
I said on the forum I was hanging out on in 2009/2010 that past all the obvious bad of ObamaCare, one of its most glaringly cynical, almost Machiavellian aspects was how the real damage of it would be felt long after Obama himself wasn't around to catch any hell for it, and would most likely land on some future president's shoulders. Heck, most of the awful provisions were specifically built to not even go into effect until Obama was lame duck.
And I was calling out that iceberg ahead well before that law even got out of committee. So were a few hundred thousand other people.
Trump campaigned on the promise of repeal/ replace....” something wonderful that would take care of everybody and the government ness going to pay for it”
Not much daylight between Trump and Bernie promises.
Trump enjoyed 2 years of a Republican majority. Nothing “ wonderful” was proposed. Nothing that would “ take care of everybody” was proposed. Nothing about “ government paying for it” was proposed.
There’s nothing particularly awful about the ACA, beyond the cost of premiums.
There was an option like that? All the options I ever saw was a choice between 2-4 plans, and the coverage was either included or not included. There was no menu for specific treatment where you can choose YES/NO etc.
Yep, there was most DEFINITELY that option. I opted for various things not to be covered, and thus lowered my premium, every single year.
Is there a single system in the developed world where the national health care system does not perform transplants and is only reserved for people with lots of money? Sounds crazy.
It does sound crazy but after thinking about our healthcare dilemma over the years I am no longer convinced that it must be a system that is predicated on providing unlimited, perfect care for everyone. Doing so has created a positive feedback loop with providers who know that anything they cook up to sell the public will automatically be paid for by insurance. It motivates them to develop expensive treatments rather than affordable treatments. This is readily seen in the pharmaceutical biz, which no longer researches antibiotics because they don't make much money off of them, so they spend their time on $400,000 cancer cures, even though infections are far more common.
So, my view is that the government's role is to provide guaranteed coverage to say the 95% level which will serve most people for most things and be affordable. If you want more, you will have to contribute to it at a higher level, like with a private insurance policy.
Yes this means poor people will go without a heart transplant but on the other hand it will mean that all poor people will have good prenatal care, healthy kids, and healthy adults without needing to go to the ER for the flu.
Most “ family” plans have both an individual and family deductible. The individual deductible in your case would be $6,125 per year.
If however, either you or your husband incurred more than $13,200 in a given year, the “ healthy” one would not have any deductible.
A few weeks ago my Primary Care told me to proceed to the ER as one knee could not bear any weight- no injury. The concern was that I might have a DVT.
Long story short, the visit was billed at $4400, including xrays and ultra sound. I have a $1000 deductible. After the PPO discount, my cost was $300 out of pocket, applied towards my deductible.
I will never understand why providers bill $x when they contractually agreed to accept $y, but that’s how it works.
My point here is to consider the value of the PPO Discount in relation to all costs.
I can and do appreciate PPO Discounts are highly variable depending on insurer, plan and provider.
Our individual deductible is $6750, not $6125.
Whatever - it's still $13,500 PLUS the $13,200 in premiums we are spending if either or both of us maxes out our plan (one outpatient surgery will max out our deductible).
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