consumer-directed health care is a big fat joke

flowerchild

flowerchild

Member
Location
US - Michigan
Obamacare is high on my dislike agenda. Not only do we, the middle class, have 50% more out of pocket cost for deductibles and co-pays, we also have real majorly differences in costs for care. Seems to be a real mess.
Saw this in the paper today. Comparisons in some of the charges per hospital.
Surgery Costs vary widely <<<click here

US hospitals, you may or may not know, get fed. funding thru customer satisfaction ratings these days, via Press Ganey reports. This drives the cost of healthcare per hospital. So this may be the factor in the differences in cost. The higher the customer satisfaction % results in more money(reimbursements) they get in gov. funding. We as the customers end up paying the difference in charges from what's being paid by the Insurance co. and what the cost the hospital charges.
Health care pricing is "all driven by the reimbursement system," namely insurance companies and government Medicare and Medicaid
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Factors including the cost to operate a facility, the mix of public and private insurance and charity care, and the need for a wide network of providers affect the prices insurers pay
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This, to me, is part of the problem:
Some employer-provided plans reward workers for going to certain doctors and hospitals that have higher quality and lower prices, a practice BCBS supports.
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The HMO's limit people from finding healthcare somewhere they choose. In other words, sometimes your just stuck paying what they ask.
Spiraling health care costs, higher insurance plan deductibles and increased cost sharing have made procedure prices more important than ever to consumers. Insurers are also tired of paying ever-higher prices for treatments they say shouldn't change so much year to year — and certainly not hospital to hospital in the same region.
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I feel this a real problem and very unfair. Due to Obamacare's fine line rules that no one caught before the bill was iron penned, is a gut retching, money sucking problem for those of us on the brink of retirement and trying to save a few bucks to get there.

Anyone have anything good to say about Obamacare? So far I'm not having any good thoughts.
 

I LOVE the ACA.... because of it my son is finally receiving the care he needs that we could not previously afford. NO problems.... no red tape... just good care... I thank GOD every day that it was implemented.. I don't think my son would be alive if not for "ObamaCARE" Thank GOD Obama cared... I am forever grateful.

AND as more and more people enroll, the premium increases have been reduced to just 3% instead of the usual double digit increase seen before.. and it's costing the Feds a whole lot less than projected.. Not sure why some folks don't want fellow Americans to have healthcare... sad..

http://www.politico.com/story/2014/04/obamacare-premium-increase-2015-105685.html
 
That's good, and your son must fall into the class the gov. pays for. Like my sons as well. They can get healthcare assistance as well, this is good. But when I was that age I worked and found jobs that provided health insurance of some kind. Many businesses have dropped that coverage instead, allowing the gov. to take care of that.
It was a system that I thought worked. We may not have had BCBS, and maybe it was a limited Ins. but we had it.
Every time the gov. steps into things like this it costs the middle class some more. Wonder what the % of low income to high divide is now?
In the beginning, Obamacare, was supposed to be affordable to all. So far I'm seeing the increase in cost for everyone to have it in my lap, the middle class worker.
My out of pocket cost for healthcare went from an ave. $3000 to $8000 in 2 years. The costs have increase again this year by almost 50%. That's a big chunk of change. I'm on a budget, semi strick one and I know my fellow workers are in the same boat. I'll be lucky to afford groceries and the same luxuries I've worked to obtain. Pay scales have only increase 2% per year for many years. This does not hardly keep up with inflation, let alone have to pay the extra costs for healthcare.
 

flowerchild said:
That's good, and your son must fall into the class the gov. pays for. Like my sons as well. They can get healthcare assistance as well, this is good. But when I was that age I worked and found jobs that provided health insurance of some kind. Many businesses have dropped that coverage instead, allowing the gov. to take care of that.
It was a system that I thought worked. We may not have had BCBS, and maybe it was a limited Ins. but we had it.
Every time the gov. steps into things like this it costs the middle class some more. Wonder what the % of low income to high divide is now?
In the beginning, Obamacare, was supposed to be affordable to all. So far I'm seeing the increase in cost for everyone to have it in my lap, the middle class worker.
My out of pocket cost for healthcare went from an ave. $3000 to $8000 in 2 years. The costs have increase again this year by almost 50%. That's a big chunk of change. I'm on a budget, semi strick one and I know my fellow workers are in the same boat. I'll be lucky to afford groceries and the same luxuries I've worked to obtain. Pay scales have only increase 2% per year for many years. This does not hardly keep up with inflation, let alone have to pay the extra costs for healthcare.
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Supplemental Insurance.Medicare and Drug Premiums for Seniors is killing us!! No help there..crybaby.gif

Cost of Living raises are a joke!!!!
 
Ken N Tx said:
Supplemental Insurance.Medicare and Drug Premiums for Seniors is killing us!! No help there..View attachment 13405

Cost of Living raises are a joke!!!!
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Medicare part A is free... Part B is what?.. $104 a month and a decent supplemental costs around $300-$400 every six months? (that's what my SIL pays) or $50 a month. I am not familiar with the premium for Part D Medicare.. It depends I guess on what drugs you need.

I have group insurance through my employer and I pay $350 a month for that. I have copays and deductibles to meet.
 
QuickSilver said:
Medicare part A is free... Part B is what?.. $104 a month and a decent supplemental costs around $300-$400 every six months? (that's what my SIL pays) or $50 a month. I am not familiar with the premium for Part D Medicare.. It depends I guess on what drugs you need.

I have group insurance through my employer and I pay $350 a month for that. I have copays and deductibles to meet.
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I hope and pray your SIL never needs to go into the hospital!!!!
 
Ken N Tx said:
Supplemental Insurance.Medicare and Drug Premiums for Seniors is killing us!! No help there..View attachment 13405

Cost of Living raises are a joke!!!!
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Oh ya I forgot to mention the limited pharmaceuticals available this year on top of the increase in costs.
I was wondering if this was strapping the Medicare folks too. Guess it would be.
So again, who's enjoying the new benefits?
 
QuickSilver said:
Medicare part A is free... Part B is what?.. $104 a month and a decent supplemental costs around $300-$400 every six months? (that's what my SIL pays) or $50 a month. I am not familiar with the premium for Part D Medicare.. It depends I guess on what drugs you need.

I have group insurance through my employer and I pay $350 a month for that. I have copays and deductibles to meet.
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My hubs gets Medicare part D. It does help some since he'd disabled. But every month he play the roulette game thru the Pharmacies to find the cheaper drug costs and who got the meds he needs.
I pay before tax and % of my premium, my employer pays the better half. Medical, Dental, and eyecare are paid all separately. About $350 a month. This cost I cannot claim for any reimbursement on taxes. Flat out of my pocket and increased 50% this year. The rest is costs for co-pays and deductibles.
I don't believe we got a raise this year at all either. At 2%, that's just mo money for uncle sam....anyway. doesn't even begin to make a difference. Hubs got a whopping $10 raise this year, whoa, was I impressed!!!! That'll just about pay for a gal. of milk and bottle of soda.
 
Ken N Tx said:
I hope and pray your SIL never needs to go into the hospital!!!!
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Hospital stays are covered under Medicare part A.. and are paid in full, except the $1200 deductible that is covered by the Supplement. Unfortunately there is a lot of misinformation out there about part A and the Supplement. Medicare part A pays your entire hospital bill.. you are not responsible to pay anything other than your deductible... If you are re-hospitalized within 60 days, you are not responsible for another deductible.. (or rather your supplemental isn't)

Part B covers outpatient services by 80% and the balance of 20% is picked up by the supplement.

She has been just fine with her supplement
 
flowerchild said:
My hubs gets Medicare part D. It does help some since he'd disabled. But every month he play the roulette game thru the Pharmacies to find the cheaper drug costs and who got the meds he needs.
I pay before tax and % of my premium, my employer pays the better half. Medical, Dental, and eyecare are paid all separately. About $350 a month. This cost I cannot claim for any reimbursement on taxes. Flat out of my pocket and increased 50% this year. The rest is costs for co-pays and deductibles.
I don't believe we got a raise this year at all either. At 2%, that's just mo money for uncle sam....anyway. doesn't even begin to make a difference. Hubs got a whopping $10 raise this year, whoa, was I impressed!!!! That'll just about pay for a gal. of milk and bottle of soda.
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Have you ever had a year where health premiums did NOT go up? Even before Obama care.. My out of pocket and deductables and copays stayed the same for 2015. BUT the premiums increased slightly by about $350 dollars a year. That's not a whole lot.. and I'm not complaining..
 
What we can be THANKFUL for is.......my wife's salary is descent! Not really what she'd like to get, but more than some folks her age get who are still working.

Currently we are paying $254 a month for my medical insurance......which is, Medicare, Florida Blue and Humana Rx. Also have the VA, if needed, but not as reliable for me as the other three.

Depending on a person's health, medical and Rx insurance can be pretty high. Thank God our health isn't in that bad of shape.
 
ClassicRockr said:
What we can be THANKFUL for is.......my wife's salary is descent! Not really what she'd like to get, but more than some folks her age get who are still working.

Currently we are paying $254 a month for my medical insurance......which is, Medicare, Florida Blue and Humana Rx. Also have the VA, if needed, but not as reliable for me as the other three.

Depending on a person's health, medical and Rx insurance can be pretty high. Thank God our health isn't in that bad of shape.
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So that $254 a month covers your part B premium, your supplemental AND your Drugs.. That's not bad...
 
QuickSilver said:
Have you ever had a year where health premiums did NOT go up? Even before Obama care.. My out of pocket and deductables and copays stayed the same for 2015. BUT the premiums increased slightly by about $350 dollars a year. That's not a whole lot.. and I'm not complaining..
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When you are a senior on a fixed income it does mean a lot!! OBC does not affect us..Supplements vary a whole lot and the old saying "you get what you pay for" applies..
 
Ken N Tx said:
When you are a senior on a fixed income it does mean a lot!! OBC does not affect us..Supplements vary a whole lot and the old saying "you get what you pay for" applies..
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Let me put this another way..... ALL supplements cover your Medicare Part A deductible for inpatient hospitalization.... that's standard.

Part B Medicare pays 80% of outpatient services.. So it is hoped your supplemental will pick up the 20% not paid by Part B..

I suppose you can find a substandard plan that won't cover much of your part B.. BUT my SIL has never had to pay anything for her doctor visits or other outpatient services like blood work or Xrays.. So I don't think her plan is all that bad. That's all I expect from it.

I cannot speak for Part D as I have not looked into a plan. But CR has... he seems pretty satisfied.
 
I have medicare part A, B and D and a Supplement policy, the Supplement picks up any deductibles. I have had all of these since I have been on Medicare, the premiums go up about 2% every year. I am happy with all of them.

My daughter has an ACA policy that she is able to afford and happy to get.
 
I also want to add that some of the increases that people see with their group insurance premiums and out of pocket have NOTHING to do with Obamacare... It's the company pulling a fast one and BLAMING Obamacare.. It happens all the time. How convenient of a scape goat for them to pad their bottom line at the expense of their employees.. Not surprising though.. Corporations will always try to keep more of their money and shift the cost on to employees and consumers.


http://money.cnn.com/2013/08/29/news/economy/employers-obamacare-benefits/index.html

http://www.examiner.com/article/blame-for-obamacare-price-gouging-misguided
 
I concur with that one!!! Yup. Insurance companies are the biggest scammers around. Our Pres. gave them permission, so to speak. Obama opened that can of worms.
 
flowerchild said:
I concur with that one!!! Yup. Insurance companies are the biggest scammers around. Our Pres. gave them permission, so to speak. Obama opened that can of worms.
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I don't believe that to be true at all... They are gouging because that's what they have always done.. Yet mention "Regulations" and see what happens.. Corporations are looking for any excuse to save money and really don't care how they do it or at whose expense.

I think if anything Insurance companies are not able to do as MUCH gouging as before. No more denials or higher premiums for pre-existing conditions. No more charging women more then men... Mandated to spend at least 90% of their premium money on ACTUAL care.. not CEO bonuses. I think that Corporations are doing most of the scapegoating against obamacare..
 
I can't really contribute much to this thread, as being in England , everything medical is covered by the NHS[National Health Service] which has been in place since 1947. Money is paid in to NI [National Insurance] along with tax, directly from a persons pay. However, those not working [ retired, on benefits for various reasons] still can use all the services of the NHS.So retired people like ourselves, get ALL medical services free of charge, including prescriptions for medication , sight tests and hearing tests, operations and all hospital stays and visits.
The huge amount of immigration here has put the NHS under great pressure, so things are not as good as they once were, but still, all healthcare both from the doctor locally and the hospitals are free when you need them.The Obama Care seems very good for the population of the US in general, it must be awful to think you can't afford to have care when you need it.So, what are the main objections?
 
Personally, I Like the ACA (Obamacare)....not because of any provisions in that legislation...but, rather I think it will be the impetus that Finally brings this nation to the same conclusion that most of the rest of the civilized world knows. That being, the passage of a SP-UHC plan for our people. Our "For Profit" system is Raping this nation, and it is quickly becoming unsustainable. We already pay twice as much for Health Care, as most other nations, and the last ranking of the WHO (World Health Organization) places the U.S. at about number 34, in terms of quality of care, and value received. If you look up the top 10 highest paid careers in the U.S., 7 out of 10 are in the Health Care field...doctors, dentists, anethesiologists, etc. Our Medical Profession has been replaced by the Health Care Industry...and the primary objective of Any Industry is to Make Money. Over 17% of our nations Entire GDP is spent on Health Care, as opposed to 7 or 8% in most other nations. The Health and Human Services budget is the single largest item in the Federal budget...far outstripping things like Defense.

Health Care, in most other nations, is based upon Prevention...here it is based upon Treatment. Treatment is far more profitable than Prevention, so our Health Care Industry continues to resist any movement towards a Universal System...or "Socialized Medicine", as they would prefer to call it.

I'll go out on a limb here, and predict that somewhere around 2020, our present system is going to collapse inwards on itself, due to rising costs. About that time frame, health care costs will become so ridiculous in this nation that the bulk of our people will be in dire straits trying to afford decent care, and the government will be going deeply in debt trying to support this bloated system. Perhaps THEN, our people will wake up, and tell these corrupt politicians that we need to look at the rest of the world, and demand here what is working quite well for Europe, etc. The quality of their care/life, etc., exceeds that in this nation, at half the costs.

That, then, is why I like Obamacare. It does NOTHING to address the root causes of these runaway costs, and just shifts the burden around so as to continue to pad the pockets of our Medical system, the Insurance Companies, and the Drug manufacturers, etc. After all, it was written mostly by the Health Care Industry Lobbyists, and most of those in Congress never read more than a few pages of the bill, and had no idea of what was in it...remember Nancy Pelosi's statement..."We need to Pass this Bill, so we can find out what is in it?" Eventually, we will reach a breaking point, where our people realize just how much we are being Scammed, and Hopefully Then, we will see some real progress towards a sensible system.
 
So, Don, you are not objecting to Obama Care, because you hope it will bring about changes [ simply because it ISN'T very good and is unsustainable?] It would be better to have a system that helps 'everybody' wouldn't it?
 
Don M. said:
Personally,
Health Care, in most other nations, is based upon Prevention...here it is based upon Treatment. Treatment is far more profitable than Prevention, so our Health Care Industry continues to resist any movement towards a Universal System...or "Socialized Medicine", as they would prefer to call it.

I'll go out on a limb here, and predict that somewhere around 2020, our present system is going to collapse inwards on itself, due to rising costs. About that time frame, health care costs will become so ridiculous in this nation that the bulk of our people will be in dire straits trying to afford decent care, and the government will be going deeply in debt trying to support this bloated system. Perhaps THEN, our people will wake up, and tell these corrupt politicians that we need to look at the rest of the world, and demand here what is working quite well for Europe, etc. The quality of their care/life, etc., exceeds that in this nation, at half the costs.

That, then, is why I like Obamacare. It does NOTHING to address the root causes of these runaway costs, and just shifts the burden around so as to continue to pad the pockets of our Medical system, the Insurance Companies, and the Drug manufacturers, etc. After all, it was written mostly by the Health Care Industry Lobbyists, and most of those in Congress never read more than a few pages of the bill, and had no idea of what was in it...remember Nancy Pelosi's statement..."We need to Pass this Bill, so we can find out what is in it?" Eventually, we will reach a breaking point, where our people realize just how much we are being Scammed, and Hopefully Then, we will see some real progress towards a sensible system.
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Very well said and I think, good prediction. So what happens when people finally realize what's in it, what's it's doing to our economy, healthcare, and incomes?
We just can't yank it off the law books now.
As for healthcare being the top of industry and jobs, why yes it is at the moment. They do not compensate small business very much, so there aren't any small trade school jobs going around in this country. Another story for another day tho.
 
I think I remember reading that there is a clause in the ACA that limits Insurance companies profits.

Also here is a list of preventable health care the ACA covers...

[h=2]Free preventive services[/h][h=2]All Marketplace plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.[/h]This applies only when these services are delivered by a network provider.

  1. Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  2. Alcohol Misuse screening and counseling
  3. Aspirin use to prevent cardiovascular disease for men and women of certain ages
  4. Blood Pressure screening for all adults
  5. Cholesterol screening for adults of certain ages or at higher risk
  6. Colorectal Cancer screening for adults over 50
  7. Depression screening for adults
  8. Diabetes (Type 2) screening for adults with high blood pressure
  9. Diet counseling for adults at higher risk for chronic disease
  10. HIV screening for everyone ages 15 to 65, and other ages at increased risk
  11. Immunization vaccines for adults--doses, recommended ages, and recommended populations vary:
  12. Obesity screening and counseling for all adults
  13. Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  14. Syphilis screening for all adults at higher risk
  15. Tobacco Use screening for all adults and cessation interventions for tobacco users
[FONT=Open Sans, sans-serif]https://www.healthcare.gov/preventive-care-benefits/[/FONT]
 
DON.... I think this is what most Progressives had and have against the ACA.. It should have been Single Payor... BUT... Obama took that off the table early on in order to show the spirit of compromise to the GOP... Lot of good that did him. AND it created a lot of distrust in him from his Base.
 
Jackie22 said:
I think I remember reading that there is a clause in the ACA that limits Insurance companies profits.

Also here is a list of preventable health care the ACA covers...

Free preventive services

All Marketplace plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

This applies only when these services are delivered by a network provider.

  1. Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  2. Alcohol Misuse screening and counseling
  3. Aspirin use to prevent cardiovascular disease for men and women of certain ages
  4. Blood Pressure screening for all adults
  5. Cholesterol screening for adults of certain ages or at higher risk
  6. Colorectal Cancer screening for adults over 50
  7. Depression screening for adults
  8. Diabetes (Type 2) screening for adults with high blood pressure
  9. Diet counseling for adults at higher risk for chronic disease
  10. HIV screening for everyone ages 15 to 65, and other ages at increased risk
  11. Immunization vaccines for adults--doses, recommended ages, and recommended populations vary:
  12. Obesity screening and counseling for all adults
  13. Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  14. Syphilis screening for all adults at higher risk
  15. Tobacco Use screening for all adults and cessation interventions for tobacco users
https://www.healthcare.gov/preventive-care-benefits/
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I just got my Shingles vaccine free of charge.. Normally it would have cost me over $200
 

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