Obamacare 2016

[MachineGhost]

I'm glad to see the goal of reducing the cost of health insurance is panning out. 

My plan now owned by those accounting beaners at Blue Cross Blue Shield is going from $0 copays to 20% on virtually everything and the out-of-pocket deductible is being raised from $1 (or something like that) to $6700.  Hows that for being fucked?  This is what they must do when they want to get people off plans they are losing money on.  Fortunately, there is plan competition unlike in Canada. 

[Pointedstick]

Blue Cross Blue Shield just dropped all their customers in New Mexico, saying that they lost 20 million dollars last year and could not come up with a way to offer coverage at a profit.

This whole Obamacare thing doesn't really seem to be working out for the vast majority of people who are employed and healthy. I guess it is better then what was there before for the I-must-imagine small number of people who are chronically ill, intermittently employed, and not poor enough for Medicaid.

[Libertarian666]

What, you mean socialized medicine doesn't work?
You would think someone would have noticed that before, like maybe Canadians?
Oh, that's right, Canadians could come here if they wanted any services...

[mathjak107]

we were informed our health republic aca plan here in ny will no longer be available in 2016 . they fell below the financial standards required in ny and they can't do business here anymore .

i am going with a new provider  for 2016 .

other then this i was very satisfied with the gold plan and it was a lot cheaper for us then the private company we had prior .

[barrett]

Self-employed here. So far, so good for me with my plan through Emblem Health in NY. It saved me a ton last year and this, though I also have been healthier than usual (not paying as much in premiums could have contributed to that).

But we need a system that everyone can count on for an extended time. People that are sick need care whether they have money or not. Those of us who have saved but are not wealthy need an insurance dollar number that adjusts for inflation, so that we can make some kind of reasonable prediction with regard to what the hell we are likely to have to spend on healthcare over the last 20-40 years of our lives.

Looking at just the smattering of posts on this thread makes it clear that what we have now is a mess. But the pre-ACA days were no picnic with premiums rising so fast that within another 20 years or so they would have eaten up the entire GDP. At least that's how it looked for someone on an individual plan. My premiums doubled in five years from 2008 to 2013.

[flyingpylon]

Gosh, it's so bad that maybe we should figure out why healthcare costs so much in the first place. 

[mathjak107]

Self-employed here. So far, so good for me with my plan through Emblem Health in NY. It saved me a ton last year and this, though I also have been healthier than usual (not paying as much in premiums could have contributed to that).

But we need a system that everyone can count on for an extended time. People that are sick need care whether they have money or not. Those of us who have saved but are not wealthy need an insurance dollar number that adjusts for inflation, so that we can make some kind of reasonable prediction with regard to what the hell we are likely to have to spend on healthcare over the last 20-40 years of our lives.

Looking at just the smattering of posts on this thread makes it clear that what we have now is a mess. But the pre-ACA days were no picnic with premiums rising so fast that within another 20 years or so they would have eaten up the entire GDP. At least that's how it looked for someone on an individual plan. My premiums doubled in five years from 2008 to 2013.

prior to my aca plan i had emblem health and was just as happy . we have very little in claims so far so i guess  we have very little in issues .

i am hoping that for 2017 my aca plan gets a subsidy since we are living of 3/4's cash the first 2 years ..

[flyingpylon]

1. Lawyers / malpractice insurance. So much of medicine is avoiding getting sued, i.e., running all kinds of tests to rule out everything.

2. Government. Regulations out the wazoo, electronic records, ICD-10, HIPAA, OSHA, etc.

3. R&D. New technologies are expensive to create and bring to market. Everyone wants the latest, best, most advanced care but wants someone else to pay for it.

4.  The government lets the healthcare industry screw us via monopolistic business practices.

[clacy]

4.  The government lets the healthcare industry screw us via monopolistic business practices.

Which areas are monopolistic?

[dragoncar]

What, you mean socialized medicine doesn't work?
You would think someone would have noticed that before, like maybe Canadians?
Oh, that's right, Canadians could come here if they wanted any services...

Uh, Canadians love their socialized healthcare.  The problem with Obamacare is it's not socialized enough.  Maybe that's the plan all along, to drive out people who "can't turn a profit" then we get single payer.

they also complain about long waits for things that we get on demand and consider basic care/necessary.. (and travel to the US to get them if they can afford it)

[MachineGhost]

And how's it working out for self-employed people who don't have access to a group policy through their employer? I'm healthy, but I still need insurance, just in case.

You just need to join one of those groups for self-employeds to get the group rate.  NASE?  It's people that are employed but with no access to group that are screwed the worst by ObamaCare.

Group isn't true insurance anyway.  It's a co-op and previous years medical expenses are pro-rated among all participants for the current year's premium.  That was a large reason for the huge increases we saw last decade.  I can't recall off the top of my head the exact differences between a co-op and true insurance though.

[MachineGhost]

What, you mean socialized medicine doesn't work?
You would think someone would have noticed that before, like maybe Canadians?
Oh, that's right, Canadians could come here if they wanted any services...

Uh, Canadians love their socialized healthcare.  The problem with Obamacare is it's not socialized enough.  Maybe that's the plan all along, to drive out people who "can't turn a profit" then we get single payer.

I wouldn't call Canada socialized sickcare.  They are like Medicare where you have competition and free choice to choose the provider you want from the marketplace.  Since it is universal, all providers are included/covered, which you can't say for the USA with its ridiculous hodgepodge of networks up the wazoo.  But since the government controls the prices paid providers to below market rates, there is a chronic shortage of providers interested in hanging up a shingle, hence why there are short-term waiting lists and citizens coming to the USA for immediate treatment via out of pocket.  The same problem exists for Medicare here.

Now, true socialized medicine is like the Veterans Administration or the UK's National Health Service where the government in true Orwellian fashion is literally controlling the means of production and there is no choice or competition, like a HMO plan except you don't even have a sad sack network to pick your sorry few choices from.  This is good as a price control but literally bad at everything else, especially physician quality.  Who you get would be the random luck of the draw with no recourse if they're an incompetent nincompoop as many are.

Due to the chronic budget shortfalls, Canada's provinces has had to relent and legally allow private sickcare insurance to take some of the pressure off of their Medicare.

I see the future as Medicare-For-All for basic sickcare with private insurance covering more exotic things like life extension.  It is the only way the economics is ever going to work.

[Libertarian666]

4.  The government lets the healthcare industry screw us via monopolistic business practices.

Which areas are monopolistic?

I can think of a few:
1. You can't buy health insurance from a company in another state.
2. You can't go to a doctor who doesn't have a medical license.
3. The government FORCES people to buy health insurance even if they don't need it.
4. You can't buy whatever medicines you want, only those that are prescribed by a licensed doctor and are "legal" according to insane laws that have nothing to do with medical facts.

[clacy]

I can think of a few:
1. You can't buy health insurance from a company in another state.
2. You can't go to a doctor who doesn't have a medical license.
3. The government FORCES people to buy health insurance even if they don't need it.
4. You can't buy whatever medicines you want, only those that are prescribed by a licensed doctor and are "legal" according to insane laws that have nothing to do with medical facts.

1. Yes I agree, the government definitely created that monopolistic factor, and I agree it's beyond stupid that those laws exist.

2. I'm not sure what to say to this.  A "doctor" which we generally consider to be MD's, have to be degreed and licensed.  You can chose to seek healthcare from non-MD's, but I don't think our government should pay for non-MD supervised care in most instances beyond home health care, PT, etc.  And I can't fault insurance companies for not wanting to pay some holistic non-MD type either.  If you want to seek that kind of treatment, you certainly can at your own expense.

3. Agreed.  I am not a fan of the current system in the least. 

4. YOU can buy any legal, OTC medicine, herb, supplement, etc that is available.  You just have to accept that no one else wants to pay for most of that stuff.  That goes back to point 2 essentially.  As for illegal drugs, well that's a whole other ball of wax that isn't really related to our medical system.

[ochotona]

Same exact thing happened to me with BCBS of Texas. They withdrew from the private marketplace. This is creating sheer havoc. Fortunately, I got full-time work with benefits in September    I stopped paying my friggin' BCBS bill after September.

[Cortopassi]

I work at a <50 people small business.  Last year I changed to HSA style BCBS plan vs. previously being on regular PPO $20 copays, etc.

I never spent so little on healthcare as last year, and fingers crossed, same this coming year.  And using the pre-tax money from the HSA account to pay for things is nice.

Not saying we are typical, but so far so good.  We've been told things will change next year.

[MachineGhost]

LOL!!!!!!!!!!!!!!!!

Sadly, degreed and licensed physicians do kill about 150K patients a year just through sheer incompetence (remember, half of all physicians graduated in the BOTTOM of their class).  People (mostly old) have such a naive expectation that they're all cum laude graduates and have the time to be experts at anything other than pushing drugs and performing hack, slash and burn.

[ochotona]

Aren't all doctors above average?

[MachineGhost]

Not saying we are typical, but so far so good.  We've been told things will change next year.

ObamaCare tried to kill the HSA but it managed to survive due to some minor grassroots uproar, but the deductible got markedly reduced to near uselessness and no longer covers sensible things.  The powers that be want to eliminate HSA's completely because its forces trifle competition upon the cartel.  Heaven forbid if we got any real competition...

[MachineGhost]

Aren't all doctors above average?

Maybe in Lake Wobegon, Minnesota?  Maybe moda lives there!

[WiseOne]

These reports of insurance costs going up are more than a bit frightening!

Where are you guys getting the idea that doctors run the health care scene, though?  Is that because it used to be the case?  Well, no longer. Doctors are basically the janitors of the health care world.  Your health care dollars are mainly paying for legions of administrators and management systems as well as pharmaceuticals & medical devices.  The portion that goes to physicians is very, very, tiny.  Probably less than 10% of your dollar.

Still, there are other countries who follow mostly the same health practices as the U.S. and still manage to spend only half as much on health care.  These overhead costs are rather unique to the U.S.

[Benko]

Doctors are basically the janitors of the health care world.

Agree.  I usually put it, docs are 3rd class citizens way way behind administrators. 

[Libertarian666]

I can think of a few:
1. You can't buy health insurance from a company in another state.
2. You can't go to a doctor who doesn't have a medical license.
3. The government FORCES people to buy health insurance even if they don't need it.
4. You can't buy whatever medicines you want, only those that are prescribed by a licensed doctor and are "legal" according to insane laws that have nothing to do with medical facts.

1. Yes I agree, the government definitely created that monopolistic factor, and I agree it's beyond stupid that those laws exist.

2. I'm not sure what to say to this.  A "doctor" which we generally consider to be MD's, have to be degreed and licensed.  You can chose to seek healthcare from non-MD's, but I don't think our government should pay for non-MD supervised care in most instances beyond home health care, PT, etc.  And I can't fault insurance companies for not wanting to pay some holistic non-MD type either.  If you want to seek that kind of treatment, you certainly can at your own expense.

3. Agreed.  I am not a fan of the current system in the least. 

4. YOU can buy any legal, OTC medicine, herb, supplement, etc that is available.  You just have to accept that no one else wants to pay for most of that stuff.  That goes back to point 2 essentially.  As for illegal drugs, well that's a whole other ball of wax that isn't really related to our medical system.

2. I find it hard to believe that you haven't heard of "practicing medicine without a license", which is against the law. I'm not asking the government to pay for anything. I just want to be able to go to anyone I want for medical advice and treatment, which I can't do due to the medical licensing laws, which were enacted to restrict competition.

4. The exact point I was making is that there should be no such thing as "legal" and "illegal" drugs, and that I should be able to buy anything I want without needing a prescription, which is again required due to medical licensing laws.

Hope that helps.

[Mountaineer]

For what it's worth to the health care professionals on the forum:

I really like and respect the physicians, nurses, technologists, and dentists that I go to.  To the best of my knowledge, I've been blessed with competent and caring people.  I trust them and I'm very good at sniffing out shady behaviors and ethics (learned via decades of working with mostly really good and a few really bad excuses for humans).  Perhaps I've been hoodwinked, but I don't think so ... and, I'm still alive!  I have a far greater respect for the healthcare professionals than I do the insurance companies and their administrators, although I'm sure many of them are honest too.

... M

[MachineGhost]

Where are you guys getting the idea that doctors run the health care scene, though?  Is that because it used to be the case?  Well, no longer. Doctors are basically the janitors of the health care world.  Your health care dollars are mainly paying for legions of administrators and management systems as well as pharmaceuticals & medical devices.  The portion that goes to physicians is very, very, tiny.  Probably less than 10% of your dollar.

Still, there are other countries who follow mostly the same health practices as the U.S. and still manage to spend only half as much on health care.  These overhead costs are rather unique to the U.S.

So don't shoot the messenger?  Well, someone's got to be the public face.  It's a little hard to get upset at a nameless, faceless bureaucrat that a patient does not have day-to-day contact with.  They're so insular from the general public in their tony enclaves, just like politicians.

I don't think other countries have such a mess of 50 states and 1 federal government implementing a cockamamie of endless sickcare schemes that goes all the way back to Medicare and Kennedy's HMO.  I think someone on the Republican debate mentioned there were like 750 federal agencies.  If that don't take the cake!

I'll make another prediction that Medicare-For-All basic sickcare is going to be robot driven.  Like in Star Wars.