A better way to do healthcare

[Flopper]

Free market principles work. I've read this whole thing and it sounds like a much better way for Americans to get good quality affordable health coverage.

Free market health care was unaffordable for tens of millions, leaving them with no coverage. Shitty policies and surprise cancellations drove millions into bankruptcy.

Your history rewrite is a failure.

Millions....

Biggest cause of personal bankruptcy: Medical bills - TODAY.com

Got it...

Now how about that family of four in California making $96k a year?

Having to pay out of pocket >$23k a year in premiums and meeting deductibles on the 'affordable' silver plan, before health insurance benefits kick in, how long will this family be able to sustain itself?

From the covered California Website, a family of 4 with income $96,000, and 2 adults ages 30 and 2 kids.
Premiums is $725 or $8700/yr for a Silver 70 plan

Silver 70
Individual Deductible $2,000
$250 brand drug deductible
Family Deductible $4,000 medical $500 brand drug deductible
Preventative Care Copay no cost
Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay
$45
X-Ray Copay
$65
Emergency Room Copay
$250
High cost and infrequent services (e.g. Hospital Stay)
20% of your plan’s negotiated rate
Preferred brand copay after Drug Deductible (if any) $50
Maximum Out-of-Pocket For One $6,350
Maximum Out-of-Pocket For Family $12,700

Insurance kicks in immediately. You pay the first $2,000 of the negotiate price with the provider. This is usually a very significant discount from the amount the provider charges. For example, I just received a bill for a trip to the ER. The billed amount was $3650, the negotiated amount; that is the insurance company's contracted amount with the hospital was $950. During the deductible period, I'm responsible for the whole $950. If my deductible was met, I would be responsible for only $150, my copay for ER service. If I had paid my maximum out of pocket expense, I would owe nothing. So even in the deductible period, your insurance is still benefiting you.

https://www.coveredca.com/shopandcompare/#calculator

 

[LoneLaugher]

That's Bobby Jindal and Jeb Bush. The NEW REPUBLICANS.

Cool.

 

[MeBelle]

Free market health care was unaffordable for tens of millions, leaving them with no coverage. Shitty policies and surprise cancellations drove millions into bankruptcy.

Your history rewrite is a failure.

Millions....

Biggest cause of personal bankruptcy: Medical bills - TODAY.com

Got it...

Now how about that family of four in California making $96k a year?

Having to pay out of pocket >$23k a year in premiums and meeting deductibles on the 'affordable' silver plan, before health insurance benefits kick in, how long will this family be able to sustain itself?

From the covered California Website, a family of 4 with income $96,000, and 2 adults ages 30 and 2 kids.
Premiums is $725 or $8700/yr for a Silver 70 plan

Silver 70
Individual Deductible $2,000
$250 brand drug deductible
Family Deductible $4,000 medical $500 brand drug deductible
Preventative Care Copay no cost
Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay
$45
X-Ray Copay
$65
Emergency Room Copay
$250
High cost and infrequent services (e.g. Hospital Stay)
20% of your plan’s negotiated rate
Preferred brand copay after Drug Deductible (if any) $50
Maximum Out-of-Pocket For One $6,350
Maximum Out-of-Pocket For Family $12,700

Insurance kicks in immediately. You pay the first $2,000 of the negotiate price with the provider. This is usually a very significant discount from the amount the provider charges. For example, I just received a bill for a trip to the ER. The billed amount was $3650, the negotiated amount; that is the insurance company's contracted amount with the hospital was $950. During the deductible period, I'm responsible for the whole $950. If my deductible was met, I would be responsible for only $150, my copay for ER service. If I had paid my maximum out of pocket expense, I would owe nothing. So even in the deductible period, your insurance is still benefiting you.

https://www.coveredca.com/shopandcompare/#calculator

Locked links don't work. I also don't know what county your quotes are from.

I stated family of four. You assumed ages. Below is also a Silver 70 plan

Premiums are 1900 a month.

I just checked again. The lowest premium available for this family is $991 per month, the lowest Bronze plan. Bronze 60. Anthem Blue Cross. Individual deductible $5k, Family deductible $10k. Still >$20k before insurance kicks in.

I understand what you are trying to say in your bolded paragraph, but your situation is not the norm,

Now how about that family of four in California making $96k a year?

Having to pay out of pocket >$23k a year in premiums and meeting deductibles on the 'affordable' silver plan, before health insurance benefits kick in, how long will this family be able to sustain itself?

Not sure how you figure anyone has to pay $23,000 before benefits kick in. Covered California has a standard benefit design in which silver plans have a $2,000 deductible/per family member. After which insurance is paying 80% or more of the tab.

When you leave out the word premiums. (VERY CRUCIAL btw)

and

When "Copays in Black are Not Subject to any Deductible."

Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay $45
X-Ray Copay $65

 

[MeBelle]

Not sure how you figure anyone has to pay $23,000 before benefits kick in. Covered California has a standard benefit design in which silver plans have a $2,000 deductible/per family member. After which insurance is paying 80% or more of the tab.

When you leave out the word premiums. (VERY CRUCIAL btw)

and

When "Copays in Black are Not Subject to any Deductible."

Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay $45
X-Ray Copay $65

You certainly don't have to have paid 12 months of premiums before you can access benefits. So I'm not sure what point you're trying to make.

You most certainly DO know what point I'm trying to make or can this family stop paying premiums if they hit their deductible and insurance picks up the rest?

I'm referring to an average health family that maybe visits a Dr two x a year, like mine.
Thinking back the last 20 or so years of me and my family's healthcare incidents, there have only been two times any of us landed in an ER or was hospitalized, besides childbirth.

Other healthcare incidents were taken care of @ a Doc in a Box if our Doc was not available.

 

[Flopper]

Millions....

Biggest cause of personal bankruptcy: Medical bills - TODAY.com

Got it...

Now how about that family of four in California making $96k a year?

Having to pay out of pocket >$23k a year in premiums and meeting deductibles on the 'affordable' silver plan, before health insurance benefits kick in, how long will this family be able to sustain itself?

From the covered California Website, a family of 4 with income $96,000, and 2 adults ages 30 and 2 kids.
Premiums is $725 or $8700/yr for a Silver 70 plan

Silver 70
Individual Deductible $2,000
$250 brand drug deductible
Family Deductible $4,000 medical $500 brand drug deductible
Preventative Care Copay no cost
Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay
$45
X-Ray Copay
$65
Emergency Room Copay
$250
High cost and infrequent services (e.g. Hospital Stay)
20% of your plan’s negotiated rate
Preferred brand copay after Drug Deductible (if any) $50
Maximum Out-of-Pocket For One $6,350
Maximum Out-of-Pocket For Family $12,700

Insurance kicks in immediately. You pay the first $2,000 of the negotiate price with the provider. This is usually a very significant discount from the amount the provider charges. For example, I just received a bill for a trip to the ER. The billed amount was $3650, the negotiated amount; that is the insurance company's contracted amount with the hospital was $950. During the deductible period, I'm responsible for the whole $950. If my deductible was met, I would be responsible for only $150, my copay for ER service. If I had paid my maximum out of pocket expense, I would owe nothing. So even in the deductible period, your insurance is still benefiting you.

https://www.coveredca.com/shopandcompare/#calculator

Locked links don't work. I also don't know what county your quotes are from.

I stated family of four. You assumed ages. Below is also a Silver 70 plan

Premiums are 1900 a month.

I just checked again. The lowest premium available for this family is $991 per month, the lowest Bronze plan. Bronze 60. Anthem Blue Cross. Individual deductible $5k, Family deductible $10k. Still >$20k before insurance kicks in.

I understand what you are trying to say in your bolded paragraph, but your situation is not the norm,

Not sure how you figure anyone has to pay $23,000 before benefits kick in. Covered California has a standard benefit design in which silver plans have a $2,000 deductible/per family member. After which insurance is paying 80% or more of the tab.

When you leave out the word premiums. (VERY CRUCIAL btw)

and

When "Copays in Black are Not Subject to any Deductible."

Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay $45
X-Ray Copay $65

I used a Los Angeles zip code, 90011
Not sure what you're keying in but if go to Covered California website:

1.www.coveredca.com/shopandcompare/#calculator

2. Enter 4 for the number of people in the household

3. 96,000 for a household income

4. 90011 for Los Angeles

5. Added 2 adults age 30

6. Click on 2 as the number of dependents (children)

7. Click See My Options

Scroll down and you will see 4 Silver 70 plans. I choose Anthem Blue Cross at $725/mo. Silver Plans run from $676 to $726 Clicking View Details gives a list of the benefits.

Even if you increase the adult ages to 59, the premiums only increase to $1369/mo well short of the $1900 you quoted.

Using the same data, I found a similar silver plan in Washington State except the deductible and maximum out of pocket was $5250 and copays were much lower with a premium of $625.

If you're looking at a different state, then the premiums could be quite different, however I could not find any state with a $1900/mo premium for this family premium.

I have a Blue Cross Plan and my daughter has an AETNA plan and in both plans the insurance company negotiated rates are significantly less than the billings rates.

 

[Flopper]

When you leave out the word premiums. (VERY CRUCIAL btw)

and

When "Copays in Black are Not Subject to any Deductible."

Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay $45
X-Ray Copay $65

You certainly don't have to have paid 12 months of premiums before you can access benefits. So I'm not sure what point you're trying to make.

You most certainly DO know what point I'm trying to make or can this family stop paying premiums if they hit their deductible and insurance picks up the rest?

I'm referring to an average health family that maybe visits a Dr two x a year, like mine.
Thinking back the last 20 or so years of me and my family's healthcare incidents, there have only been two times any of us landed in an ER or was hospitalized, besides childbirth.

Other healthcare incidents were taken care of @ a Doc in a Box if our Doc was not available.

Sounds like a catastrophic or bronze plan might work well for you. My son 28 who lives in Florida got a $6350 deductible, $6350 max out of pocket for $123/mo with no subsidy.

 

[MeBelle]

From the covered California Website, a family of 4 with income $96,000, and 2 adults ages 30 and 2 kids.
Premiums is $725 or $8700/yr for a Silver 70 plan

Silver 70
Individual Deductible $2,000
$250 brand drug deductible
Family Deductible $4,000 medical $500 brand drug deductible
Preventative Care Copay no cost
Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay
$45
X-Ray Copay
$65
Emergency Room Copay
$250
High cost and infrequent services (e.g. Hospital Stay)
20% of your plan’s negotiated rate
Preferred brand copay after Drug Deductible (if any) $50
Maximum Out-of-Pocket For One $6,350
Maximum Out-of-Pocket For Family $12,700

Insurance kicks in immediately. You pay the first $2,000 of the negotiate price with the provider. This is usually a very significant discount from the amount the provider charges. For example, I just received a bill for a trip to the ER. The billed amount was $3650, the negotiated amount; that is the insurance company's contracted amount with the hospital was $950. During the deductible period, I'm responsible for the whole $950. If my deductible was met, I would be responsible for only $150, my copay for ER service. If I had paid my maximum out of pocket expense, I would owe nothing. So even in the deductible period, your insurance is still benefiting you.

https://www.coveredca.com/shopandcompare/#calculator

Locked links don't work. I also don't know what county your quotes are from.

I stated family of four. You assumed ages. Below is also a Silver 70 plan

Premiums are 1900 a month.

I just checked again. The lowest premium available for this family is $991 per month, the lowest Bronze plan. Bronze 60. Anthem Blue Cross. Individual deductible $5k, Family deductible $10k. Still >$20k before insurance kicks in.

I understand what you are trying to say in your bolded paragraph, but your situation is not the norm,

When you leave out the word premiums. (VERY CRUCIAL btw)

and

When "Copays in Black are Not Subject to any Deductible."

Primary Care Visit Copay $45
Specialty Care Visit Copay $65
Urgent Care Visit Copay $90
Generic Medication Copay $19
Lab Testing Copay $45
X-Ray Copay $65

I used a Los Angeles zip code, 90011
Not sure what you're keying in but if go to Covered California website:

1.www.coveredca.com/shopandcompare/#calculator

Thank you for providing the info you used.

I live in California.

LA has more providers and plans than other counties do.

Comparing where I live to LA is like comparing apples to lemons.

That's how ACA is!

 

[MeBelle]

Sounds like a catastrophic or bronze plan might work well for you. My son 28 who lives in Florida got a $6350 deductible, $6350 max out of pocket for $123/mo with no subsidy.

A Bronze or Minimum Plan would cost via CoveredCal about $750 per month/$9K per year with family deductible.

Now here's the funny part.

Several years ago, I covered our whole family with a Cat plan for approx $2K a year. Also had a HSA/Flex account where $$ was deposited to meet the deductible.
THAT is the plan, if needed, I would want back!

 

[Flopper]

Locked links don't work. I also don't know what county your quotes are from.

I stated family of four. You assumed ages. Below is also a Silver 70 plan

Premiums are 1900 a month.

I just checked again. The lowest premium available for this family is $991 per month, the lowest Bronze plan. Bronze 60. Anthem Blue Cross. Individual deductible $5k, Family deductible $10k. Still >$20k before insurance kicks in.

I understand what you are trying to say in your bolded paragraph, but your situation is not the norm,

I used a Los Angeles zip code, 90011
Not sure what you're keying in but if go to Covered California website:

1.www.coveredca.com/shopandcompare/#calculator

Thank you for providing the info you used.

I live in California.

LA has more providers and plans than other counties do.

Comparing where I live to LA is like comparing apples to lemons.

That's how ACA is!

Rural counties have always had limited choices in individual plans with higher premiums than urban areas, because the cost of delivering healthcare is higher and the market is much smaller. This was the case before Obamacare as it is now. The only way to avoid this is for the state to adopt state rating zones which would equalize costs across the state.

Humboldt County in northern California has a size of over 4,000 sq miles and a population of 135,000. Using the same family as above and zip code 95556, a very rural area in the north county, there is only one silver plan available on the exchange, Anthem Blue Cross Silver 70 PPO with a premium of $866/mo. or $10,332/yr. Also there is an Anthem Bronze plan at $652 or $7824/yr.

The Kaiser Foundation surveyed all counties across the nation and determine the highest premium for a silver plan in the country. They found the most expensive place was Carbondale in Garfield County, Colorado. For the above family the premium for a silver plan was $1503/mo. Last year, before Obamacare that plan was $1425, a 9.5% increase.

 

[Greenbeard]

You most certainly DO know what point I'm trying to make or can this family stop paying premiums if they hit their deductible and insurance picks up the rest?

I'm referring to an average health family that maybe visits a Dr two x a year, like mine.
Thinking back the last 20 or so years of me and my family's healthcare incidents, there have only been two times any of us landed in an ER or was hospitalized, besides childbirth.

Other healthcare incidents were taken care of @ a Doc in a Box if our Doc was not available.

I'm not sure where "Having to pay out of pocket >$23k a year ... before health insurance benefits kick in" fits into whatever scenario you're coming up with.

I was just responding to the (false) implication that someone has to pay 12 months of premiums + their entire out-of-pocket maximum "before health insurance benefits kick in."

 

[Listening]

are you saying Obama care is a government plan ???

Yes.

obama care has nothing to do with government selling you insurance ... all insurance bought is bought from private companies ... there aren't any government health care plan ... I challenge you to show us one government run health care plan that is paid for by the consumer ... I dare you to show us one ... by your statement alone show us all how ignorant you really are ...

Most states have an insurance commissioner. In many states they set the level of coverage....defacto making it a government plan.

 

[Grandma]

Originally Posted by BobPlumb

We had to pass the bill to find out what was in the bill (now it's law).

More fail.

There was a phony bill that originated from a wingnut in Tulsa, Oklahoma. That phony bill, with all of its obvious errors, was believed to be the real bill by people too stupid to know how real bills are written.

Nancy Pelosi was informing the idiots that until the REAL bill was passed it, like every other bill, would not be available for public viewing.

Negged for trying to revive a long-debunked wingnut lie.

What phony bill?

Remember before the bill was passed how some were saying "this" is in it, or "that," and they'd provide a page number, and sometimes provide a link to "the bill?"

It was a phony that had been traced back to a website in Tulsa, Oklahoma. One of the dead giveaways was that it was written in common english, not legalese. All government bills are written in legalese. Also, no bill is presented or quoted to the general public until it's signed, so "...on page 43 it says..." or whatever passages were being quoted were clearly disinformation.

Everything, and I mean EVERYTHING your heard quoted about the bill before it was passed was completely fabricated.

 

[Listening]

More fail.

There was a phony bill that originated from a wingnut in Tulsa, Oklahoma. That phony bill, with all of its obvious errors, was believed to be the real bill by people too stupid to know how real bills are written.

Nancy Pelosi was informing the idiots that until the REAL bill was passed it, like every other bill, would not be available for public viewing.

Negged for trying to revive a long-debunked wingnut lie.

What phony bill?

Remember before the bill was passed how some were saying "this" is in it, or "that," and they'd provide a page number, and sometimes provide a link to "the bill?"

It was a phony that had been traced back to a website in Tulsa, Oklahoma. One of the dead giveaways was that it was written in common english, not legalese. All government bills are written in legalese. Also, no bill is presented or quoted to the general public until it's signed, so "...on page 43 it says..." or whatever passages were being quoted were clearly disinformation.

Everything, and I mean EVERYTHING your heard quoted about the bill before it was passed was completely fabricated.

I am sure you can supply some documentation for your claim.....

 

[MeBelle]

More fail.

There was a phony bill that originated from a wingnut in Tulsa, Oklahoma. That phony bill, with all of its obvious errors, was believed to be the real bill by people too stupid to know how real bills are written.

Nancy Pelosi was informing the idiots that until the REAL bill was passed it, like every other bill, would not be available for public viewing.

Negged for trying to revive a long-debunked wingnut lie.

What phony bill?

Remember before the bill was passed how some were saying "this" is in it, or "that," and they'd provide a page number, and sometimes provide a link to "the bill?"

It was a phony that had been traced back to a website in Tulsa, Oklahoma. One of the dead giveaways was that it was written in common english, not legalese. All government bills are written in legalese. Also, no bill is presented or quoted to the general public until it's signed, so "...on page 43 it says..." or whatever passages were being quoted were clearly disinformation.

Everything, and I mean EVERYTHING your heard quoted about the bill before it was passed was completely fabricated.

Never heard of the phony bill.
Have any links? This is really intriguing to me!

 

[MeBelle]

I used a Los Angeles zip code, 90011
Not sure what you're keying in but if go to Covered California website:

1.www.coveredca.com/shopandcompare/#calculator

Thank you for providing the info you used.

I live in California.

LA has more providers and plans than other counties do.

Comparing where I live to LA is like comparing apples to lemons.

That's how ACA is!

Rural counties have always had limited choices in individual plans with higher premiums than urban areas, because the cost of delivering healthcare is higher and the market is much smaller. This was the case before Obamacare as it is now. The only way to avoid this is for the state to adopt state rating zones which would equalize costs across the state.

Humboldt County in northern California has a size of over 4,000 sq miles and a population of 135,000. Using the same family as above and zip code 95556, a very rural area in the north county, there is only one silver plan available on the exchange, Anthem Blue Cross Silver 70 PPO with a premium of $866/mo. or $10,332/yr. Also there is an Anthem Bronze plan at $652 or $7824/yr.

The Kaiser Foundation surveyed all counties across the nation and determine the highest premium for a silver plan in the country. They found the most expensive place was Carbondale in Garfield County, Colorado. For the above family the premium for a silver plan was $1503/mo. Last year, before Obamacare that plan was $1425, a 9.5% increase.

I agree with the bolded portion.

The county I live in had eight plans for both bronze and silver (if I recall correctly).

 

[MeBelle]

You most certainly DO know what point I'm trying to make or can this family stop paying premiums if they hit their deductible and insurance picks up the rest?

I'm referring to an average health family that maybe visits a Dr two x a year, like mine.
Thinking back the last 20 or so years of me and my family's healthcare incidents, there have only been two times any of us landed in an ER or was hospitalized, besides childbirth.

Other healthcare incidents were taken care of @ a Doc in a Box if our Doc was not available.

I'm not sure where "Having to pay out of pocket >$23k a year ... before health insurance benefits kick in" fits into whatever scenario you're coming up with.

I was just responding to the (false) implication that someone has to pay 12 months of premiums + their entire out-of-pocket maximum "before health insurance benefits kick in."

Semantics...keep trying.
The 'implication' is not false.

Premiums + deductibles (if reached) = >$23K before HI 'benefits' kick in.

Go back to your echo chamber.

 

[Flopper]

Yes.

obama care has nothing to do with government selling you insurance ... all insurance bought is bought from private companies ... there aren't any government health care plan ... I challenge you to show us one government run health care plan that is paid for by the consumer ... I dare you to show us one ... by your statement alone show us all how ignorant you really are ...

Most states have an insurance commissioner. In many states they set the level of coverage....defacto making it a government plan.

State Insurance Commissions rarely get involve in detail levels of service. They enforce state insurance laws, licenses insurers and brokers, and investigate complaints of insurance fraud. Many states establish some required benefits. For example if you market a policy as a comprehensive healthcare plan, you must include physician and hospital services. Some states have passed laws that specific benefits must be included such as maternity or drug treatment. They also specify factors that can be used to determine rates such as smoking, age, etc. They often specify how rates can be determined. The one thing they don't do is create insurance plans with the exception of Medicaid in some states.

 

[JakeStarkey]

Yep. Not often I agree with you, Jake, but you've nailed it. Let's get to correcting these problems!

To have a real free market in healthcare, you would have to deregulate and take government out of the picture, Medicare, Medicaid, FDA, EMTALA, etc. The amount of healthcare services available to you would depend on your ability to pay. There's no way that you can sell that to the public.

I dunno. Freedom is more popular with the public, than with the powers that be.

If they are on these programs it is not.

 

[dblack]

To have a real free market in healthcare, you would have to deregulate and take government out of the picture, Medicare, Medicaid, FDA, EMTALA, etc. The amount of healthcare services available to you would depend on your ability to pay. There's no way that you can sell that to the public.

I dunno. Freedom is more popular with the public, than with the powers that be.

If they are on these programs it is not.

Heh... right. This is the very issue that confounds so many statists - how can the people who are 'benefiting' from these programs vote against them? Yet they are, and they do.