Healthcare

[Vanimal46]

This topic won't go away anytime soon, and there are many layers to this system that's faulty.

 

Example #1: https://www.wsj.com/articles/the-hidden-system-that-explains-how-your-doctor-makes-referrals-11545926166?mod=e2tw

[Craig Arko]

As long as it’s a for-profit service, none of those problems have incentives to be addressed.

[diehardtwinsfan]

 

As long as it’s a for-profit service, none of those problems have incentives to be addressed.

 

that's part of it. The system is essentially rigged too to prevent any sort of real competition or really anyone's ability to price shop. 

 

And no one seems interested in fixing it. 

 

Here's some more unenjoyable reading on the subject:

 

[Mike Sixel]

Try having two self employed people..... The system is anti entrepreneur. I have lots of experience and knowledge and opinions on this topic....

[Craig Arko]

 

Try having two self employed people..... The system is anti entrepreneur. I have lots of experience and knowledge and opinions on this topic....

Julie and I were there for 25 years. I sympathize deeply with the self-employed.

[Vanimal46]

The current landscape is very difficult to navigate. When I was unemployed for 4 months it was somehow cheaper to pay the COBRA rate than switching to ACA by a wide margin... The COBRA payments weren't cheap either: $400+ a month for a $10k deductible single plan. I'm fortunate to be healthy and not have to go to the doctor at that time.

[Squirrel]

I would retire sooner if not for health care costs. I can’t afford to. I have a colleague who is close to retirement age but can’t because his wife, non-employed is 8 yrs younger and, well, medical costs.

[Vanimal46]

that's part of it. The system is essentially rigged too to prevent any sort of real competition or really anyone's ability to price shop.

 

And no one seems interested in fixing it.

 

Here's some more unenjoyable reading on the subject:

Wow... This excerpt really hits home in the article. As many as 34% of ER visits lead to out-of-network bills in Texas. Way above the national average of 20%.

 

When we have our employer-provided healthcare meetings twice a year, the insurance reps certainly don't prepare you for that. All they say when they're on-site for assistance is to ensure the hospital you go to is in network. And ask questions whether the drug they're prescribing is necessary right now - or if we can obtain it as a generic drug later.

[diehardtwinsfan]

 

Wow... This excerpt really hits home in the article. As many as 34% of ER visits lead to out-of-network bills in Texas. Way above the national average of 20%.

When we have our employer-provided healthcare meetings twice a year, the insurance reps certainly don't prepare you for that. All they say when they're on-site for assistance is to ensure the hospital you go to is in network. And ask questions whether the drug they're prescribing is necessary right now - or if we can obtain it as a generic drug later.

 

There are tons more issues here. Doctors own privates practices and love to refer over those practices... that's a conflict of interest in most places, but it's allowed in healthcare. 

 

The entire system is gamed to make sure that prices are obscured. I agree with Craig that there's a for profit component to pretty much all of it, though what remains of the non-profits in the field aren't exactly cheaper either. I suppose at the end of the day, they charge what they can.

 

What to get more disgusted? Look how big pharma lobbied the government to effectively force generic albuterol inhalers off the market... It goes back to why I still think that Congress should actually have to pass an agreement with when federal regulators such as the FDA, SEC, etc. make changes... that and it limits the power of the presidency back to what the constitution intended. 

 

There's so much greed in this system right now. It has got to break at some point... Not that anyone wants to fix it... 

[TheLeviathan]

Not that anyone wants to fix it...

 

Most citizens do. And nearly everyone has been hit by the greed.

 

It's why I'm so adamant the Dems run on that issue front and center.

[Squirrel]

Most citizens do. And nearly everyone has been hit by the greed.

 

It's why I'm so adamant the Dems run on that issue front and center.

Yep. We saw turnovers in the suburbs here, where the Democratic candidates ran on healthcare as their primary issue, and they won in traditional republican strongholds because healthcare resonates with everyone across parties.

[diehardtwinsfan]

 

Most citizens do. And nearly everyone has been hit by the greed.

It's why I'm so adamant the Dems run on that issue front and center.

yeah, the problem is that they keep running on a single payer platform. That won't fix the issues. As a matter of fact, it will make them worse. If they actually had a good plan, that would be the type of thing that would get someone like me vote Dem at least temporarily... it has to get fixed. The problem is that the plan will be rather lacking in specifics and ultimately costly to the tax payer (or in this case, our children). They are just as bought and sold as the Republicans are. I don't see them fixing the system.

 

[TheLeviathan]

yeah, the problem is that they keep running on a single payer platform. That won't fix the issues. As a matter of fact, it will make them worse. If they actually had a good plan, that would be the type of thing that would get someone like me vote Dem at least temporarily... it has to get fixed. The problem is that the plan will be rather lacking in specifics and ultimately costly to the tax payer (or in this case, our children). They are just as bought and sold as the Republicans are. I don't see them fixing the system.

Single payer is the only answer left. The market is too far gone for tweaks.

 

Taxes will have to go up, but for the vast majority of people and companies, those increases will be more than offset by saving on health care costs.

[Mike Sixel]

 

yeah, the problem is that they keep running on a single payer platform. That won't fix the issues. As a matter of fact, it will make them worse. If they actually had a good plan, that would be the type of thing that would get someone like me vote Dem at least temporarily... it has to get fixed. The problem is that the plan will be rather lacking in specifics and ultimately costly to the tax payer (or in this case, our children). They are just as bought and sold as the Republicans are. I don't see them fixing the system.

 

Every other civilized nation other than Israel has single payer, and has better outcomes, for less money, than the US. why won't single payer work? How will it make things worse?

[PseudoSABR]

Those that admire the market's ability to develop competition for production of a particular commodity need to accept that the nature of producing this commodity--healthcare--does not create competition among providers no matter how much the market is unfettered.  The reasons for this are manifold, but here's a few things that jump to mind: 1) there is no bargaining power for emergency procedures 2) providers have exclusive information about the quality, necessity and cost of a product/service, again denying consumers bargaining power 3) the results of any service/product is often far removed from the first purchase of that product/service (i.e. how long before you realize your surgeon was crappy (if ever), or that the medicine your taking isn't working?) 4) hospitals function as regional monopolies 5) the private insurance model makes it virtually impossible to even shop around for a pcp, what with a closed network of doctors for any given plan 6) patent laws 7) organizations like the AMA create parallel conduct and under cut competition among doctors.  

 

Not to mention that for-profit model creates something of a paradox for healthcare providers, as providing an expensive, life-long treatment is almost always more profitable than a one-time cure; whether it's the executives of a hospital or a pharmaceutical, they have an fiduciary duty to pursue the more profitable route. 

 

Single-payer won't solve all these problems or all of the cost inflating problems in healthcare generally, but it will prevent multiple layers of companies and individuals from skimming as much profit as possible at every level of each medical transaction, and it will take away some of the horrible incentives to not pursue inexpensive quick remedies.  

[Doomtints]

I was between projects last year so I bought some insurance on the exchange. I won't name the company.

 

I knew it was not a great plan when I bought it, but I am completely surprised by how bad it really was.

 

It was pricey ($600+/mo for me and my daughter).

 

I was sick a couple of times, so there were doctors visits and tests run. Nothing major.

 

Much to my surprise, this company paid absolutely nothing on my behalf. Zip. Zero. Nada. They took my monthly payments and provided zero to me.

 

So what did this insurance company do for me? They allowed me access to their negotiated rates with healthcare providers. Yes, this knocked down what I owed considerably, but it got incredibly annoying seeing statement after statement that read like this:

 

- Amount billed:  $437

- Negotiated amount:  $187

- We paid for you: $0

- You owe:  $187

 

This is how EVERY statement read.

 

Now, we hear a lot of politics about how insurance companies cannot afford to stay in the exchanges. HOW? This company literally spent NOTHING on me, I was pure profit to them!

[TheLeviathan]

The system is broken, that's for damn sure.

 

Well, not for the insurance companies.

[PseudoSABR]

Imagine if the pool of people negotiating was all of the Americans, do you think that kind of leverage would get us a better deal in terms of health costs? 

[Badsmerf]

Imagine if healthcare wasn't for profit? I'm fine with doctors getting paid well, and even some pharmaceutical phd chemists that save lives. I'm not fine with multi million dollar salaries for hospital/pharmaceutical/insurance executives, numerous unneeded test/drugs/procedures, being at the mercy of others with barely any protection. Big health-care is failing.

[Doomtints]

Healthcare wasn't for profit until Nixon. The law was changed to allow health entities to make a profit so long as they offered HMOs for the masses too. I believe the HMO stipulation has long since expired, however, so companies no longer have to offer them as an option (though they seem to be coming back since Obamacare).

[Vanimal46]

St. Jude Children's Hospital, and children's healthcare in general is something I care deeply about. With Valentine's Day around the corner, please take a minute to send a virtual card to a child at the hospital. It only takes a minute to put a smile on a child's face!

 

https://www.stjude.org/get-involved/other-ways/valentines-day.html

[Craig Arko]

 

St. Jude Children's Hospital, and children's healthcare in general is something I care deeply about. With Valentine's Day around the corner, please take a minute to send a virtual card to a child at the hospital. It only takes a minute to put a smile on a child's face!

https://www.stjude.org/get-involved/other-ways/valentines-day.html

Done. Thanks for posting this.

[Mike Sixel]

Trying to abolish the ACA. If they do, how will I find insurance, given that but my wife am I are self employed? How will my soon to graduate soon be covered until he finds a job?

 

Putting aside my issues, millions, tens of millions, will lose coverage.

 

The lack of understanding and empathy in this issue is appalling.

[PseudoSABR]

 

Trying to abolish the ACA. If they do, how will I find insurance, given that but my wife am I are self employed? How will my soon to graduate soon be covered until he finds a job?

Putting aside my issues, millions, tens of millions, will lose coverage.

The lack of understanding and empathy in this issue is appalling.

I know so many twenty-somethings who benefited from the ACA allowing them to stay on the parents insurance until 26, and many panicked after they turned 27.  So many young people work in retail, restaurants, etc. jobs before they find their careers or while they continue their education; and with insurance they actually will go the doctor instead of the alternative of going to the emergency room or urgent care when they can't suffer any more. 

 

I don't even think Republican voters are really behind repeal anymore. The politicians still want their pound of flesh though.  

[MMMordabito]

 

Trying to abolish the ACA. If they do, how will I find insurance, given that but my wife am I are self employed? How will my soon to graduate soon be covered until he finds a job?

Putting aside my issues, millions, tens of millions, will lose coverage.

The lack of understanding and empathy in this issue is appalling.

 

The ACA shouldn't be abolished.  It just needs to be improved and tightened up.  There are situations where you could go in the black, and that shouldn't be possible at the expense of taxpayers.

[Mike Sixel]

 

Trying to abolish the ACA. If they do, how will I find insurance, given that but my wife am I are self employed? How will my soon to graduate soon be covered until he finds a job?

Putting aside my issues, millions, tens of millions, will lose coverage.

The lack of understanding and empathy in this issue is appalling.

 

Lots of typos. sigh. My phone's auto correct, sigh.....sorry about that.

[TheLeviathan]

Politically speaking, I encourage the Republicans to undertake more stupid campaigns like this.

[Brock Beauchamp]

 

I know so many twenty-somethings who benefited from the ACA allowing them to stay on the parents insurance until 26, and many panicked after they turned 27.  So many young people work in retail, restaurants, etc. jobs before they find their careers or while they continue their education; and with insurance they actually will go the doctor instead of the alternative of going to the emergency room or urgent care when they can't suffer any more. 

 

I don't even think Republican voters are really behind repeal anymore. The politicians still want their pound of flesh though.  

Bolded: They're obviously not, as Trump couldn't do jack to repeal it under a completely GOP-controlled federal government. This law is here to stay, despite GOP dumb****ery.

 

As for the rest, I'm 42 and still under an ACA program, despite my wife having a good job. To add me, she needs to drop an extra $700/mo to add an entire family (our kids are still fosters, so under government plans). 

 

It's not just 20-somethings. The ACA protects loads of us, even though I'm pretty unhappy that my bill has gone from $100/mo to $200/mo to $300/mo over the course of five-ish years without me tapping into a single dime of usage. The system is broken and needs to be fixed but the ACA is a hell of a lot better than what came before it.