So we trade one crappy system for another? Why not wait until we can figure out a solution that actually is better for everyone? We had crappy insurance for a while while I was laid off. It sucked. Dd was sick, $40 copay, prescription, $40 copay. Allergic reaction to prescription cost us another $40 visit copay and another $40 presciption. All while I had no job and dh was working two. I get it. But everyone needing to wait hours at a clinic for a basic sick visit (similar to what we experience at the ER) sounds crappy too. It's not better it's just a different set of flawed rules.
I certainly don't see it that way (trading one crappy system for another) so I guess we'll have to agree to disagree.
Just because there isn't a PERFECT solution available doesn't mean we should continue plodding along in the pockets of insurance companies and big pharma.
hopefully if we do move to a universal healthcare system, we can do a good job with it. But I really don't think the systems in Canada and the UK are actually worse for people, as a whole, than here. Maybe worse for certain people, but overall I think the population of those countries as a whole, has a better healthcare system than we do.
25,000 a YEAR for a family healthcare plan that still has copays and deductibles. Thinking that isn't ludicrous, to me is ludicrous. It's LUDICRIOUS I SAY.
but I see we won't agree on this
We probably won't. I don't mind helping other people get what I have through my taxes I just don't want to lose what I have in the process. I realize that since I am employed again we have awesome healthcare. I would love a system that provides that for all Americans.
But the system here is only great for those of us who have enough money to pay for a good plan and choose their doctors and who can afford a copay every doctor visit and who, if they go to the pharmacy to pick up their RX and the pharmacist says “that’s $40 copay on that” they just say, oh ok and hand them the money. This is not everyone’s reality.
SERIOUSLY. We have semi decent insurance and it costs $30 for an office visit and we were at the doctor about a jillion times last fall. There was one week where we spent $90 just in copays. I had a prescription for nyastin last week for my DD and it cost me $20. Last month, her antibiotic she needed for an ear infection cost $30. And that is after insurance. And we have decent insurance! I can't imagine what its like for others who truly can't afford these things. I mean, what do you do?
it's pretty depressing. I've read many comments from people on facebook and such who can't even afford their medicines. They have to take less effective medicines or suffer side effects from a medicine that doesn't suit them because they have no choice. It's awful.
When I call in because one of my kids is sick and I take them to the pedi, it's a $25 copay. No problem because I have the money. They even have a big sign up at the pedi saying they will give vaccinations even if you don't have the money for a copay. Obviously people were/are skipping vaxes because they don't have the $25 or whatever their copay is.
Post by steamboat185 on Dec 30, 2015 11:49:04 GMT -5
A $40 dollar copay is not crappy insurance. It is amazing insurance. Try making 25k a year having a 4K deductible where you pay 100% of the negotiated rate up to 4K. One visit to the ER will run you 3K easy. A doctors visit can easily be over $100 and there is no copay on medication.
We have a HSA and love it, but it only works because we have had several healthy years where we have saved a ton on premiums, but it doesn't work for everyone.
Do we need to balance the budget? Honest question. Some economists (Paul Krugman, for example) would say that deficit spending isn't necessarily a bad thing.
I guess I was thinking that we can tax and tax and tax but eventually we will reach a tipping point and it would make more sense to cut spending and balance the budget.
That is pretty much the standard conservative line - that we need to balance the budget and cut the fat from government spending. Except their idea of "cutting the fat" = no skittles for poor people, IMO.
Here is an editorial from him from about a year ago about why a balanced budget fetish is hugely irresponsible and can do long term damage to your economy (using Europe as an example). The man has a Nobel Prize so pretty much I just nod in agreement with everything he writes.
Post by LoveTrains on Dec 30, 2015 11:51:14 GMT -5
The pharma thing with insurance is so wonky.
I was on this health care plan last year where I had to pay the full cost of prescription meds until I hit my deductible, which was $1500. I take meds 2x a day for a serious medical condition called idiopathic intracranial hyptertension.
The meds were like $175/month. Once I hit my deductible and insurance kicked in, they were then $10/month.
On my new insurance this year (through my H), the drugs are $0 copay every month.
A $40 dollar copay is not crappy insurance. It is amazing insurance. Try making 25k a year an having a 4K deductible where you pay 100% of the negotiated rate up to 4K. One visit to the ER will run you 3K easy. A doctors visit can easily be over $100 and there is no copay on medication.
We have a HSA and love it, but it only works because we have had several healthy years and where we have saved a ton on premiums, but it doesn't work for everyone.
Well we went from my healthcare plan from work which had no premiums and a $5 copay to paying out of pocket premiums for three (and at the time we had to pay extra because pregnancy wasn't included in case we accidentally got pregnant) with a $40 copay. Like I said, I had been laid off, dh was underemployed, and dd was an infant who required formula since I couldn't breastfeed. It was a stressful time so I can only imagine how difficult it is for people who pay even more or have an even higher copay. Again, I'm not saying we shouldn't subsidize health care so everyone can have quality care. I just don't want to lose the awesome coverage I currently have.
I think the reason people do not want UHC is that many people are bad at statistics. Those against it tend to not have dealt with the costs associated with a chronic illness or a cancer diagnosis and feel like it will never be their problem.
That isn't why it makes me nervous. I've heard horror stories about health care in Canada. I think every person should have access to healthcare and I don't mind my tax dollars subsidizing for those who can't afford it. I don't trust that the government will manage it correctly (you know because they do such a stellar job with all the other programs that they run).
The government runs foodstamps, the post office, public libraries and schools. I suppose you think all of those are run inefficiently. Your complaint seems to be that change is slow, but this is true of any medium or larger sized company. In fact I would argue that some of the pRobles with education is that we shift from one solution to the next without allowing time for the programs to develop results.
Post by penguingrrl on Dec 30, 2015 12:32:43 GMT -5
After the year we spent $10K on insurance premiums and then another $7K due to one unexpected hospital stay (of a single night) I lost all faith in private insurance companies ever doing the right thing for anyone at any time. Our total HHI that year was $38,000 for a family of four in Manhattan. So just about half our gross income that year went to medical expenses and that's perfectly legal.The hospital gave us a small discount on their part so we only owed them several hundred, but each doctor cost over $1K OOP after insurance and I saw a ton of doctors because nobody could figure out what was going on. And even though the hospital was in network each doctor was in private practice through the hospital and out of network because they are allowed to be.
You will never convince me that private for profit medical care is in anyone's best interest except the CEO and board's. Not will you convince me that government will be necessarily less efficient than Aetna and BCBS and the insane network of private insurers.
I think the reason people do not want UHC is that many people are bad at statistics. Those against it tend to not have dealt with the costs associated with a chronic illness or a cancer diagnosis and feel like it will never be their problem.
That isn't why it makes me nervous. I've heard horror stories about health care in Canada. I think every person should have access to healthcare and I don't mind my tax dollars subsidizing for those who can't afford it. I don't trust that the government will manage it correctly (you know because they do such a stellar job with all the other programs that they run).
Well, the government already runs the VA, medicare, medicaid and tricare. It's not a huge leap to make everything socialized. Plus, you would eliminate multiple levels of bureaucracy, oddly enough, by eliminating private corporations from the industry. Have you ever had to wait for a doctor or pharmacist to run your insurance just to see what you owe? Or find an issue and need to call and spend 45 minutes on the phone sorting it out? Or gotten a bill that should have been paid by your insurance that was denied and spent the next 3 months trying to work it out so it doesn't end up in collections? All of that would be gone!
Plus, no one says we have to model our plan on Canada. We can model it on the UK. Or virtually any other country.
A $40 dollar copay is not crappy insurance. It is amazing insurance. Try making 25k a year an having a 4K deductible where you pay 100% of the negotiated rate up to 4K. One visit to the ER will run you 3K easy. A doctors visit can easily be over $100 and there is no copay on medication.
We have a HSA and love it, but it only works because we have had several healthy years and where we have saved a ton on premiums, but it doesn't work for everyone.
Well we went from my healthcare plan from work which had no premiums and a $5 copay to paying out of pocket premiums for three (and at the time we had to pay extra because pregnancy wasn't included in case we accidentally got pregnant) with a $40 copay. Like I said, I had been laid off, dh was underemployed, and dd was an infant who required formula since I couldn't breastfeed. It was a stressful time so I can only imagine how difficult it is for people who pay even more or have an even higher copay. Again, I'm not saying we shouldn't subsidize health care so everyone can have quality care. I just don't want to lose the awesome coverage I currently have.
You didn't have good insurance, you had a good employer. Your plan still had premiums but the employer paid them, you didn't.
Post by penguingrrl on Dec 30, 2015 13:34:17 GMT -5
I will add that now we have absolutely amazing insurance and it doesn't come out of the stated salary H is paid. so now that he's paid well he also gets great insurance at no stated cost (although absent that cost he likely would have a higher stated salary) to us as a family.
It's rather perverse that H makes nearly three times what my sister does and she ate $1K a month out of her lower salary for a less comprehensive plan. Another way those who are well off stay well off and we punish those who earn less money.
Post by StrawberryBlondie on Dec 30, 2015 13:44:55 GMT -5
We have really good insurance. After my daughter was born, the insurance company kept denying claims saying I hadn't told them if she's also covered under any other policy, because if so, that would make them have to pay less!! Even though I'd checked "no other insurance" on the form and followed their instructions 3 times to tell them that she had no other insurance.
And then after her 1 year check up they sent us a letter sanding to know the reason for the visit,because if it's the result of an on-the-job accident, someone else would have to pay!!!
I'm sure there would be plusses and minuses to a uhc system, bit I'm confident neither of those headaches would've ever happened.
That is pretty much the standard conservative line - that we need to balance the budget and cut the fat from government spending. Except their idea of "cutting the fat" = no skittles for poor people, IMO.
Here is an editorial from him from about a year ago about why a balanced budget fetish is hugely irresponsible and can do long term damage to your economy (using Europe as an example). The man has a Nobel Prize so pretty much I just nod in agreement with everything he writes.
I'm not advocating for reducing or eliminating social safety nets, but we can't tax our way out of trouble, I don't think that plan is sustainable. I will read this Krugman (I follow Robert Reich) though.
I like Robert Reich, too! I have been meaning to read Aftershock but still haven't yet. I don't know what he says about deficit spending but I do know that he is all in favor of expanding the social safety net. I think I get nervous whenever I hear someone talk about the deficit because it often goes hand in hand with reducing the social the safety net. That's when I bust out Krugman.
How can a country full of so much money and smart people be so scared of innovation?
Exactly. Why is it that we must either choose a system where insurance and pharmaceutical companies continue to rake in the $ while many people can't afford basic health care and those who can afford it pay $25,000 a year for it. OR we can choose a system with long wait lists for procedures and hours waiting in offices for basic health visits
Why is it we live in supposedly the greatest country in the world and we can't just get out shit together and create our own better plan.
Well we went from my healthcare plan from work which had no premiums and a $5 copay to paying out of pocket premiums for three (and at the time we had to pay extra because pregnancy wasn't included in case we accidentally got pregnant) with a $40 copay. Like I said, I had been laid off, dh was underemployed, and dd was an infant who required formula since I couldn't breastfeed. It was a stressful time so I can only imagine how difficult it is for people who pay even more or have an even higher copay. Again, I'm not saying we shouldn't subsidize health care so everyone can have quality care. I just don't want to lose the awesome coverage I currently have.
You didn't have good insurance, you had a good employer. Your plan still had premiums but the employer paid them, you didn't.
Agreed ... as a childless single my former firm's health insurance was AMAZING ! The firm paid the full cost of the premium and co-pays were in the $10-20 range. Married with a spouse who was self employed and a child it was the pits ! If had chosen to cover both under the offered plan at my firm, I would have been paying upwards of $1k/month out of my salary (65k gross at the time) for health ins. !!! Now xh went without ins and dd had her own policy that was FAR cheaper than the $495 one my firm offered. Nonetheless, even having $200/month on a policy for bare bones ins was a hit.
Well we went from my healthcare plan from work which had no premiums and a $5 copay to paying out of pocket premiums for three (and at the time we had to pay extra because pregnancy wasn't included in case we accidentally got pregnant) with a $40 copay. Like I said, I had been laid off, dh was underemployed, and dd was an infant who required formula since I couldn't breastfeed. It was a stressful time so I can only imagine how difficult it is for people who pay even more or have an even higher copay. Again, I'm not saying we shouldn't subsidize health care so everyone can have quality care. I just don't want to lose the awesome coverage I currently have.
You didn't have good insurance, you had a good employer. Your plan still had premiums but the employer paid them, you didn't.
I'm a CA teacher! At the time I was getting a pink slip (a notice that I was being laid off) for three years until I actually was laid off. Of course, that was the year I was pregnant and dd was born in the middle of June, our awesome healthcare expired at the end of that month. I know it could have been a lot worse. They did get stuck with the bill for our emergency c-section even if we did have to pay for healthcare while I was on unemployment.
I guess seeing my husband work for a Fortune 100 company and seeing the asshattery that goes on with health insurance companies, I don't know why I should trust a private company to do any better. Anyone who thinks private enterprise is inherently more efficient than government has clearly never been on hold with Comcast. Yes, there are inefficiencies in government, but really, not every program is run terribly. And having a third party like an insurance company make decisions about what care a patient can and cannot receive is horribly inefficient. The fact that medical practices have to employ people whose sole job is to code procedures for insurance and deal with insurance reimbursements is kind of insane.
At least my vote is my voice in government (unless you live in the District, then sucks to be you).
I think I'm just really tired of the "government is terrible!" attitude. ANY operation - private enterprise or government - that gets to a certain size is going to have inefficiencies.
I'm a teacher in a large school district. Change is slow and the real experts are never consulted about what needs to occur. How would Government run healthcare be any better than our broken education system? With private companies I can at least have options and decide what is best for my family instead of letting the government do it.
It's worked out so well for our prison system, amiright? I mean, privatizating that has lead to a ton of money being made and so what if people suffer for it, they're prisoners and deserve subhuman treatment anyway.
Government isn't perfect but believing that private enterprise will always be better is foolish.
I mean, I recognize that that's not going to happen, but that's what *should* happen. Also, it will be easier to balance the budget once the boomers die.
I think with respect to health care, we really need to just change our perspective. We keep trying to look at health care (and education for that matter) from a business perspective. But those things shouldn't be run like businesses. Their purpose should not be to make money. Efficiency, I can see people wrangling over, although usually "efficiency" is just a euphemism for "There HAS to be a way for this to make money." I think we should be looking for a model that makes people productive and healthy. And cost shouldn't necessarily be what we focus on. Not that we should be reckless, but this whole thing of saying, "We can't have universal health care because it costs too much," that's just not very persuasive to me.
I teach a class on health care access and here are some of the costs of health care in the US:
50% of personal BKs in the year 2000 were due to medical expenses An uninsured family will only be able to afford about 12% of the costs of an in-patient hospitalization By 2012, 17 cents of every dollar spent in the US went to healthcare costs In 2009, before the implementation of the affordable care act, 33% of American had attempted to curb health care costs by relying on OTC meds rather than going to a doctor, 31% had skipped dental visits; 28% had postponed a well-person appointment; 25% had cancelled a Rx that they had placed after being told the cost; 17% had cut pills or skipped meds to make Rxes last longer; 11% of people who sought mental health services, were delayed in or entirely unable to access them.
71% of families who were uninsured pre-ACA had one or more full time worker in the family. And the number one reasons people give for not being insured is that they cannot afford the premiums.
The question is not really "can we afford it." It's 6 of one, half dozen of the other. The question is really just what do we prioritize? Is it a priority for all Americans to have access? It is to me. I am not a fan of the Canadian system. My husband has had trouble getting patients seen for non-emergent things there. But I don't think it would take much for us to tweak that system to make it work in the US.
Post by cookiemdough on Dec 30, 2015 17:16:48 GMT -5
Yes I am not sure why the narrative stops with all that is wrong with UHC in other countries. Can we not learn the dos and donts to implement a workable system here? We don't model anything other countries do EXACTLY so why this?
lexus - what are the horror stories you've heard about Canada? I can tell you if they're legit or not.
I've had great experiences in Canada and the U.S. Others haven't. I don't think Canada should be your role model either but I also don't think you should discredit it solely because you've "heard things".
I don't understand for the life of me why the us can't come up with a better system. It's probably not rocket science. Lol.
lexus - what are the horror stories you've heard about Canada? I can tell you if they're legit or not.
I've had great experiences in Canada and the U.S. Others haven't. I don't think Canada should be your role model either but I also don't think you should discredit it solely because you've "heard things".
I don't understand for the life of me why the us can't come up with a better system. It's probably not rocket science. Lol.
Here's my horror story:
DH was the team doctor for a professional team in a major US city. One of the payers injured his knee and was a Canadian citizen. DH tried to coordinate with his PCP to get an MRI of the knee to see whether he needed sx or not. The wait for the MRI in Canada was six months. The wait in the US was three weeks. The player paid out of pocket in the US because A) he could afford to; but B) his job required that his knee get back to 100% ASAP and six months would not work. The wait times for non-urgent care in Canada are a problem. The US loses productivity of its workforce due to people not being able to afford care and treatment; Canada loses it because care and treatment is not timely. That's not a good trade in my opinion.
lexus - what are the horror stories you've heard about Canada? I can tell you if they're legit or not.
I've had great experiences in Canada and the U.S. Others haven't. I don't think Canada should be your role model either but I also don't think you should discredit it solely because you've "heard things".
I don't understand for the life of me why the us can't come up with a better system. It's probably not rocket science. Lol.
Similar to PP that people who need wait a ridiculously long time for procedures that aren't deemed urgent. I've also heard from a Canadian fried that wait times at clinics are similar to the ER here. I don't know anything about other systems.
lexus - what are the horror stories you've heard about Canada? I can tell you if they're legit or not.
I've had great experiences in Canada and the U.S. Others haven't. I don't think Canada should be your role model either but I also don't think you should discredit it solely because you've "heard things".
I don't understand for the life of me why the us can't come up with a better system. It's probably not rocket science. Lol.
Here's my horror story:
DH was the team doctor for a professional team in a major US city. One of the payers injured his knee and was a Canadian citizen. DH tried to coordinate with his PCP to get an MRI of the knee to see whether he needed sx or not. The wait for the MRI in Canada was six months. The wait in the US was three weeks. The player paid out of pocket in the US because A) he could afford to; but B) his job required that his knee get back to 100% ASAP and six months would not work. The wait times for non-urgent care in Canada are a problem. The US loses productivity of its workforce due to people not being able to afford care and treatment; Canada loses it because care and treatment is not timely. That's not a good trade in my opinion.
That's a legit issue here for sure. there was an interesting article I read recently from a US doc who now practices in Canada and her observations. She said it's easier to see your GP in Canada, but anything requiring a specialist is longer in Canada.
For some reason, apparently dermatology is a wait in both countries.
I don't have a solution other than in Canada we need More $$$ into the system. My h would support a partial privatization (ie you can pay for elective or perhaps some private clinics) in order to fund everything better, but I worry that would just eventually push us towards full privatization.
I will never forget the first words when I took my DD (who was having trouble breathing) to urgent care in the Us last month.
"Hello. How will you be paying for today?" Not "how can we help?" - which is typical in Canada. That stuck with me. Our care was outstanding, I have no complaints about the actual care, but the fact that their #1 concern was payment was haunting.
A $40 dollar copay is not crappy insurance. It is amazing insurance. Try making 25k a year an having a 4K deductible where you pay 100% of the negotiated rate up to 4K. One visit to the ER will run you 3K easy. A doctors visit can easily be over $100 and there is no copay on medication.
We have a HSA and love it, but it only works because we have had several healthy years and where we have saved a ton on premiums, but it doesn't work for everyone.
Well we went from my healthcare plan from work which had no premiums and a $5 copay to paying out of pocket premiums for three (and at the time we had to pay extra because pregnancy wasn't included in case we accidentally got pregnant) with a $40 copay. Like I said, I had been laid off, dh was underemployed, and dd was an infant who required formula since I couldn't breastfeed. It was a stressful time so I can only imagine how difficult it is for people who pay even more or have an even higher copay. Again, I'm not saying we shouldn't subsidize health care so everyone can have quality care. I just don't want to lose the awesome coverage I currently have.
The bolded is what it all boils down to. I know that that is what I consider when reading all of these health care threads. Unlike a lot of political threads where debate is somewhat of an intellectual exercise, the cost of an error or a change in policy in this arena is death. (post-heart transplant husband) There's no "welp, he can't get his treatment and medicine anymore because the government doesn't want to fund it, so let's just go overseas and do it."
He can't even get life insurance of any kind except whole life. Why would a government official think it worthwhile to sanction spending for visits, medicine, and so forth? Why not just ration him out completely? We're already seeing fewer doctor visits and increases of 20% in premiums for our good health care coverage as a result of the ACA, which in turn squeezes out other benefits in negotiations because we place health care coverage above wages and maybe even sound evaluation language.
No one said it, so I will. There will obviously be less research and development if drug prices were set artificially low.
Well we went from my healthcare plan from work which had no premiums and a $5 copay to paying out of pocket premiums for three (and at the time we had to pay extra because pregnancy wasn't included in case we accidentally got pregnant) with a $40 copay. Like I said, I had been laid off, dh was underemployed, and dd was an infant who required formula since I couldn't breastfeed. It was a stressful time so I can only imagine how difficult it is for people who pay even more or have an even higher copay. Again, I'm not saying we shouldn't subsidize health care so everyone can have quality care. I just don't want to lose the awesome coverage I currently have.
The bolded is what it all boils down to. I know that that is what I consider when reading all of these health care threads. Unlike a lot of political threads where debate is somewhat of an intellectual exercise, the cost of an error or a change in policy in this arena is death. (post-heart transplant husband) There's no "welp, he can't get his treatment and medicine anymore because the government doesn't want to fund it, so let's just go overseas and do it."
He can't even get life insurance of any kind except whole life. Why would a government official think it worthwhile to sanction spending for visits, medicine, and so forth? Why not just ration him out completely? We're already seeing fewer doctor visits and increases of 20% in premiums for our good health care coverage as a result of the ACA, which in turn squeezes out other benefits in negotiations because we place health care coverage above wages and maybe even sound evaluation language.
No one said it, so I will. There will obviously be less research and development if drug prices were set artificially low.
We are self insured so I see the costs. How is the ACA raising your premium's? Is your place of business self insured? Were you told the reason for the increases?
Do we generally actually have better outcomes here? I'm sure that's measurable. Compared to Canada and the United Kingdom and other countries with universal healthcare do we have better medical outcomes?
I know I remember reading that we have worse outcomes than much of the developed world in terms of maternal and infant mortality. If that's the case, if you aren't even getting a better statistical outcome why are we supporting a system where childbirth costs 20k or more.
And for other things- so there is less wait for an mri here. But do we have better outcomes overall for sports medicine injuries?
I mean I don't know the answers but I feel like those are the things we should look at, medical outcomes as a whole looking at the country not anecdotes about wait times.
Well we went from my healthcare plan from work which had no premiums and a $5 copay to paying out of pocket premiums for three (and at the time we had to pay extra because pregnancy wasn't included in case we accidentally got pregnant) with a $40 copay. Like I said, I had been laid off, dh was underemployed, and dd was an infant who required formula since I couldn't breastfeed. It was a stressful time so I can only imagine how difficult it is for people who pay even more or have an even higher copay. Again, I'm not saying we shouldn't subsidize health care so everyone can have quality care. I just don't want to lose the awesome coverage I currently have.
The bolded is what it all boils down to. I know that that is what I consider when reading all of these health care threads. Unlike a lot of political threads where debate is somewhat of an intellectual exercise, the cost of an error or a change in policy in this arena is death. (post-heart transplant husband) There's no "welp, he can't get his treatment and medicine anymore because the government doesn't want to fund it, so let's just go overseas and do it."
He can't even get life insurance of any kind except whole life. Why would a government official think it worthwhile to sanction spending for visits, medicine, and so forth? Why not just ration him out completely? We're already seeing fewer doctor visits and increases of 20% in premiums for our good health care coverage as a result of the ACA, which in turn squeezes out other benefits in negotiations because we place health care coverage above wages and maybe even sound evaluation language.
No one said it, so I will. There will obviously be less research and development if drug prices were set artificially low.
Is this an actual issue in other countries? I mean, people have heart transplant in Canada, UK, France, etc, right?