OBAMA/TRUMPCARE MEGATHREAD

[Jenksismyhero]

Serious question. I know a lot of people without health insurance. They can't afford it or are unemployed.

Let's say you have no health insurance and have the start of a heart attack and call 911. Take me through what happens to you in terms of getting treated then charged for services.

 

Thank u

 

 

p.s. read another good op/ed story today that said Obama flat out made his plan incomprehensible to get it passed and lied about certain things in Obamacare knowing full well they were lies to the public.

 

You call an ambulance, they pick you up, they take you to a hospital, normally one that is known to cater to uninsured people, you get to the ER, you get treated with everything you need and told to follow-up with your doctor. If you're medicare eligible, they bill medicare. If you're medicaid eligible, you go see the employee at the hospital that deals with medicaid and they set you up. If you're anyone else, they bill you and do a half-assed job trying to collect (if they do anything). Even if you're billed $5000, you can offer them $1500 and they'll probably take it.

Edited November 17, 2014 by Jenksismybitch

[Jenksismyhero]

The problem isn't that simple. People currently complain about the quality and time it takes to see a physician. If you make it less attractive for people to become physicians, it will make the quality and shortage even worse.

 

the best way IMHO is to go to an HSA system. Hospitals charge up to 60% less when paid in cash. Use insurance only for the catastrophic injuries. Everything else, cash. Much of the cost the hospitals and physicians trump up is due to insurance companies taking 180 days to pay.

 

By the way even though hospitals and physicians may charge 117,000 or whatever, they know they aren't going to get it. They charge that and the insurance company says it will only pay 30,000. They hospital gets 30,000 and ingores the rest. It's mostly just monopoly money.

 

Yeah, this is the big problem. And it has to do with agreements between the provider and the insurance company they're willing to work with. I just had a case come in where a lady got hit by a car as she was walking across a cross walk. $30k initial hospital bill for an overnight stay with monitoring/scans. Guess how much the insurance actually paid... $3,300 bucks.

[StrangeSox]

Right, since 1986 hospitals that accept Medicare patients (which has to be close to every hospital) are required to provide emergency health care treatment to anyone who comes in the door.

 

http://en.wikipedia.org/wiki/Emergency_Med...ctive_Labor_Act

[Chisoxfn]

The total cost of my plan has only gone up 1-2% per year. My in-laws are not on an employer sponsored plan and theirs went up 15% because they had to add a bunch of coverages required by the ACA that they didn't already have. My plan already had all those things.

A lot of employer plans were above and beyond the ACA so what happened was they either cut the costs or brought their plans down for various reasons. That didn't happen to be the case with my company but it also comes down to people's use, etc. If costs of care are up, then insurance costs will be up too.

[Balta1701]

A lot of employer plans were above and beyond the ACA so what happened was they either cut the costs or brought their plans down for various reasons. That didn't happen to be the case with my company but it also comes down to people's use, etc. If costs of care are up, then insurance costs will be up too.

Also an important addition...a cut in benefits from a company like you've described is basically a company wide paycut. If there is a strong economy where wages are rising, a company wouldn't be able to afford to do that without knowing it would be susceptible to losing workers to better paying jobs. The crappy, high profit/low wage economy we're developing plays into this conversation through that important mechanism.

[bigruss]

My low cose-high deductible plan was removed, they offered 2 new plans instead:

Silver plan - lower cost, high deductible, HSA

Gold plan - lower cost, high deductible, company would match $500 into your HSA

 

However, it costs you an extra $550 for the upgrade to the Gold plan, I think the only other difference was that there was a reduced cost for generic drugs which doesn't matter much to me (and it's an extra like $400 if you are covering a family).

 

I ended up switching to the more expensive but lower deductible plan, it was about a $100 total difference over the year. I'll miss my $17 payments but the cost for the "new" plans was too high to justify. Plus, we now have a new HSA for dental/vision so having an HSA option from my healthcare plan wasn't necessary anymore.

[Chisoxfn]

A Towers Watson survey showed that by 2017, 63% of employers will add surcharges or exclude spouses from coverage when employer-sponsored health coverage is available elsewhere, according to a Nov. 13 new release.

The survey noted that the shift in subsidy in health care coverage for employees' spouses and dependents aims to better control rising health care costs and minimize the risk of triggering the Affordable Care Act's excise tax.

In addition, an earlier Towers Watson survey revealed that in 2014, 49% of employers increased employee contributions for spouse and dependent coverage at a faster rate than for individual employee coverage. Of those surveyed, 24% implemented spouse coverage surcharges in 2014 of about $100 per month or more when other coverage was available to the spouse. The surcharges increased the cost of spouse coverage for employees by $1,200 a year, on average, and at the high end, by more than $2,000 a year.

 

[jasonxctf]

my personal plan only went up 4% this year. I think that's the lowest its ever gone up. Blue Cross plan.

[NorthSideSox72]

You call an ambulance, they pick you up, they take you to a hospital, normally one that is known to cater to uninsured people, you get to the ER, you get treated with everything you need and told to follow-up with your doctor. If you're medicare eligible, they bill medicare. If you're medicaid eligible, you go see the employee at the hospital that deals with medicaid and they set you up. If you're anyone else, they bill you and do a half-assed job trying to collect (if they do anything). Even if you're billed $5000, you can offer them $1500 and they'll probably take it.

True except the part where they pick a hospital based on insurance. Paramedics don't ask for insurance cards - they treat and street, or pick up and go to the ER, and drop you off at the ER they are assigned to by a central triage dispatch (in a multi-hospital environment) or just the nearest one with the right level of trauma care available for the injury or illness at hand. This I know is the way it is done.

 

The EMS who picked you up (local Fire or EMS, or whatever it is) will get info later from the hospital and/or information they have (like your name and address), to send a bill and/or bill insurance, sometimes via the hospital's systems.

 

The hospital then does exactly what you described.

[Jenksismyhero]

True except the part where they pick a hospital based on insurance. Paramedics don't ask for insurance cards - they treat and street, or pick up and go to the ER, and drop you off at the ER they are assigned to by a central triage dispatch (in a multi-hospital environment) or just the nearest one with the right level of trauma care available for the injury or illness at hand. This I know is the way it is done.

 

The EMS who picked you up (local Fire or EMS, or whatever it is) will get info later from the hospital and/or information they have (like your name and address), to send a bill and/or bill insurance, sometimes via the hospital's systems.

 

The hospital then does exactly what you described.

 

They certainly aren't going out of their way to take you to a hospital known for un-insureds, but there's a reason a lot of west side folks end up at Stroger over UIC or Rush, hospitals a stones throw away with better equipment/doctors/services. And you're right, they're assigned, but I think there's assumptions being made when the dispatch center gets an address.

 

edit: I shouldn't phrase it like i know this as absolute fact. However, i've prosecuted and defended hundreds of PI cases and it always seems that a particular brand of person is getting treatment at Stroger over the other hospitals. I don't think that's mere coincidence.

Edited November 20, 2014 by Jenksismybitch

[Y2HH]

They certainly aren't going out of their way to take you to a hospital known for un-insureds, but there's a reason a lot of west side folks end up at Stroger over UIC or Rush, hospitals a stones throw away with better equipment/doctors/services. And you're right, they're assigned, but I think there's assumptions being made when the dispatch center gets an address.

 

edit: I shouldn't phrase it like i know this as absolute fact. However, I've prosecuted and defended hundreds of PI cases and it always seems that a particular brand of person is getting treatment at Stroger over the other hospitals. I don't think that's mere coincidence.

 

Glen Lerner?!

Edited November 20, 2014 by Y2HH

[cabiness42]

Not really political but relating to this topic, beginning in February my family will once again be a two-income family and we need to figure out how to get the best value in health insurance between our two employers. Anybody have experience/insight with this that they'd like to share. How much value is there in both people paying for insurance?

[SnB]

Not really political but relating to this topic, beginning in February my family will once again be a two-income family and we need to figure out how to get the best value in health insurance between our two employers. Anybody have experience/insight with this that they'd like to share. How much value is there in both people paying for insurance?

It will all depend on the individual programs. Honestly, take a night, get all the paperwork out and crunch the #s. Just make sure you include any penalty that one program may have for spouses that have their own coverage available.

[pettie4sox]

Is this thread to discuss the healthcare market place? I am signing up for insurance and wanted to know if anyone else had used the get cover illinois website to do so.

[Cknolls]

http://www.nationalreview.com/corner/39456...e-it-ian-tuttle

 

 

 

Expect nothing less from the lying assholes n the White House.

 

 

Disgraceful....WORST EVER

 

 

 

Do they tell the truth about anything?

 

 

Waiting to get my copy of the NY Times tomorrow, I'm sure this will be Page one, right? Or should i just watch the network news tonight? They'll surely be all over it...Hmmmmm....decisions decisions.....

[StrangeSox]

This is clearly worse than torturing people for years.

[Jake]

In the context of a hundreds of pages long bill, "I helped write it" could mean so many different things as to make it nearly meaningless. Since he definitely was involved in Romneycare, is this claim made based on portions of Romneycare being carried over to the new bill? Did he write it all himself? Did he answer questions from legislators about what should be in it?

[StrangeSox]

Pelosi has definitely looked silly in her denials about knowing or having worked with Gruber, but I have no idea why anyone would think that this would be worthy of the front page in any newspaper or worthy of a mention on a national news broadcast.

[StrangeSox]

How Vermont's single-payer health care dream fell apart

[Y2HH]

How Vermont's single-payer health care dream fell apart

 

An appendectomy, for example, can cost anywhere from $1,529 to $186,955, depending on how good of a deal an insurer can get from a hospital.

 

And people blame insurance companies when it's doctors/hospitals making up arbitrary values ranging from 1,529$ to 186,955$. That's what this law needed to put a stop too, and did nothing of the sort.

[Balta1701]

An appendectomy, for example, can cost anywhere from $1,529 to $186,955, depending on how good of a deal an insurer can get from a hospital.

 

And people blame insurance companies when it's doctors/hospitals making up arbitrary values ranging from 1,529$ to 186,955$. That's what this law needed to put a stop too, and did nothing of the sort.

And of course, the reason why those charges are now public is this law.

[StrangeSox]

Single-payer would also eliminate that spread, and many people's heads would have exploded if they had tried to pass explicit price controls.

[bmags]

I feel like the law did everything politically possible to address price controls through billing and pricing transparency changes.

[Y2HH]

I feel like the law did everything politically possible to address price controls through billing and pricing transparency changes.

 

But it didn't, because you don't get the prices until after you've had the service performed, and it's not like a profession where you can "shop around" most of the time.

 

If I go into Jiffy Lube, I see the prices on the wall, and if they're too high, I leave. Medical prices are more like, have your oil changed and then we'll tell you how much it costs...great, now I'll know for next time if I have the exact same ailment.

 

The law did some good, but it didn't really do much to curb costs in any way...insurance companies/hospitals and doctors are making more than ever.

[StrangeSox]