Only in America, the world's greatest country...

Aaaannnyyyywayyy, getting back to the cost of healthcare: @outlander, I'm assuming you had insurance to cover your 2 day stay and tests in the ER and hospital.

If so, the invoiced numbers are academic because hospitals have sweetheart deals, charging much lower than invoiced prices to insurance companies and Medicare.
 
There really is no cogent defense for the current US healthcare system, which isn't a system at all. It's like a garden with some good things totally choked by weeds.

I'm a very conservative person, but I don't see why we don't just scrap everything and copy a system that works. I hear Australia's is very good.
 
StarSong said:
Aaaannnyyyywayyy, getting back to the cost of healthcare: @outlander, I'm assuming you had insurance to cover your 2 day stay and tests in the ER and hospital.

If so, the invoiced numbers are academic because hospitals have sweetheart deals, charging much lower than invoiced prices to insurance companies and Medicare.
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I had a marketplace bronze plan which is worthless. Originally got it 5 years ago just to keep the government from penalizing my income tax. The premium was zero for my income. Started coverage in New Mexico 5 years ago and then cancelled and started a similar bronze plan when I moved back to Arizona. Seems New Mexico never cancelled my insurance and Arizona sent me a threatening letter saying I was illegally obtaining coverage. I immediately cancelled and contacted New Mexico marketplace to make sure I was cancelled.

I then reapplied but never got any confirmation from Arizona marketplace. So I paid the bill in full and got a 10% discount which came out to $9452 (self pay cost). That sounds horrible, but one must do the math to realize what the cost could have been. The Bronze plan has an $8400 deductible and then only covers 50% of emergency room costs after that. So $26,257 (insurance price)minus $8400 is $17,857, half of that is $8928 plus the deductible is $17,328. So like I said, any marketplace Bronze plan is worthless, actually costing more than just paying out of pocket.

A Silver plan would have cost me $272 a month with a $2500 deductible and 30% out of pocket costs after that. So same 60 month period at $272 is $16,320 plus $2500 deductible plus 30% of the remainder is ($9627) for at total cost of $25,947.

A lot of people who want good insurance coverage are paying $200 a month for medicare and an additional $400 for complete coverage (My mother does this). That is $7200 per year for true full coverage, Is it really worth it? It's another year before I'm old enough for medicare, but if I would have paid that coverage over the same 5 years it would have cost me $36,000 to pay a $9452 medical bill.

So if one has poor health and goes to the hospital several times a year than it might be worth it. It's a gamble, but if your health is relatively decent it might be better to avoid the outrageous premiums. I'm hoping to make it one more year and then just get a basic medicare plan B, or I have even considered moving abroad to a country with reasonable health costs.

So even if you are financially well off and pay the high premiums, you are getting ripped off and should question whether or not it is worth the cost. Like I said in the title of this thread, "only on America, the world's greatest country..."

A few weeks ago I got some New Mexico marketplace documents saying I still had coverage:ROFLMAO:
 
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@outlander, I had some difficulty following some of your logic because none of us knows what might happen ten minutes from now.

When my husband and I had the ACA, we bought bronze or silver (I forget which) it as hedges against catastrophic medical bills. The premiums plus possible copays were far less than what we'd been paying for private medical insurance.

If either of us had to pay the ACA dedutible of about $5000 in medical expenses over the course of a year, we could do so without breaking a sweat. $50K or more would have been been a whole different matter.

We have a Kaiser Advantage plan for which we pay nothing beyond our regular Medicare premiums. Have had a few copays since turning 65, but for the two it's come to under $1000. Total. Not per year. Total for 8 years.

For us, $4800 a year EACH in additional premiums would have been $76,800 poorly spent.

Did AZ or NM cover some of your bills?
 
@StarSong If one were to concur a catastrophic medical bill, the self pay discount might still be cheaper than a Bronze plan high deductible plus 50% copay. It was a 60% discount for self pay vs insurance cost not including an additional 10% for paying in full.

No financial help, I have too much money in my banking accounts to qualify. But I'm going to remedy that ;)
 
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This is one reason insurance is so expensive...

An analysis of the seven largest publicly traded U.S. health insurance companies (UnitedHealth, CVS/Aetna, Cigna, Elevance, Humana, Centene, and Molina) suggests they made a collective $71.3 billion in profits last year (2024).

If we got the profits out of health insurance, it would be a lot cheaper.
 
RambleTamble said:
This is one reason insurance is so expensive...

An analysis of the seven largest publicly traded U.S. health insurance companies (UnitedHealth, CVS/Aetna, Cigna, Elevance, Humana, Centene, and Molina) suggests they made a collective $71.3 billion in profits last year (2024).

If we got the profits out of health insurance, it would be a lot cheaper.
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I'm wondering if I should be encouraged that Kaiser is not on that list, or if it matters, ultimately. I'm happy enough with my health care; I see doctors when I need them, my meds. are free. But I know that I am fortunate in this and certainly that health care as a business doesn't work.
 
I've said it before, I have no problem with capitalism and making money.

But health care, basic shelter, basic groceries, education, and basic transportation should be affordable for everybody. Making obscene profits off of these things while working people suffer is just plain wrong and downright evil. These should be basic human rights that are available to anyone that is willing to try. No, it should not be a hand out to people who do not want to try, with exception for truly disabled people.
 
Medusa said:
I'm wondering if I should be encouraged that Kaiser is not on that list, or if it matters, ultimately. I'm happy enough with my health care; I see doctors when I need them, my meds. are free. But I know that I am fortunate in this and certainly that health care as a business doesn't work.
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Kaiser is non-profit.
 
For those interested a Straw Man arugument is this:

Straw man​


Form of argument and an informal fallacy based on giving the impression of refuting an opponent's argument, while actually refuting an argument that was not presented by that opponent.​

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For example, you are arguing against an increase in your property tax. Your opponent then says ā€œthis will give all the billionaires another tax break for the very richā€. See the straw man? The discussion is a general increase in the property tax on all property owners, not how billionaires should be taxed. People with weak arguments often setup straw men that they can easily knock them down and look victorious/righteous/smart etc.

Now back to the discussion.
 
Medusa said:
I'm wondering if I should be encouraged that Kaiser is not on that list, or if it matters, ultimately. I'm happy enough with my health care; I see doctors when I need them, my meds. are free. But I know that I am fortunate in this and certainly that health care as a business doesn't work.
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Ooh, choose your words carefully, someone might pounce on the F word...
 
RambleTamble said:
This is one reason insurance is so expensive...

An analysis of the seven largest publicly traded U.S. health insurance companies (UnitedHealth, CVS/Aetna, Cigna, Elevance, Humana, Centene, and Molina) suggests they made a collective $71.3 billion in profits last year (2024).

If we got the profits out of health insurance, it would be a lot cheaper.
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Yes, but the total health care expenditure is close to $5 trillion. Insurance profits are a drop in that bucket.
Pepper said:
Free Luigi.
Someone had to say it.
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Why? Do you think murdering health care executives is the way out of this mess? Why not start executing defense contractors, grocery store executives, pharmaceutical company executives, members of Congress?
 
Brookswood said:
For those interested a Straw Man arugument is this:



For example, you are arguing against an increase in your property tax. Your opponent then says ā€œthis will give all the billionaires another tax break for the very richā€. See the straw man? The discussion is a general increase in the property tax on all property owners, not how billionaires should be taxed. People with weak arguments often setup straw men that they can easily knock them down and look victorious/righteous/smart etc.

Now back to the discussion.
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That was interesting. I admit to having been a bit hazy on this and was prompted by this post to look up the difference between a Straw Man argument and a red herring. Useful information.
 
Irishdude said:
Yes, but the total health care expenditure is close to $5 trillion. Insurance profits are a drop in that bucket.

Why? Do you think murdering health care executives is the way out of this mess? Why not start executing defense contractors, grocery store executives, pharmaceutical company executives, members of Congress?
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.. and lawyers?
 
StarSong said:
Kaiser is non-profit.
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Kaiser, as a "non-profit" reported a net income (profit) of $12.9 billion for the full year of 2024. How exactly does a "non-profit" make $12.9 billion in profits? And with their "non-profit" status, they're exempt from paying corporate income tax.

Many states exempt "non-profits" from paying property tax, which means the rest of the taxpayers have to pick up the slack.
 
RambleTamble said:
Kaiser, as a "non-profit" reported a net income (profit) of $12.9 billion for the full year of 2024. How exactly does a "non-profit" make $12.9 billion in profits? And with their "non-profit" status, they're exempt from paying corporate income tax.

Many states exempt "non-profits" from paying property tax, which means the rest of the taxpayers have to pick up the slack.
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The "profits" are reinvested in expanded services, facilities improvements, and so forth, rather than being distributed to shareholders.
 

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