Obamacare and rate increases - report your results here
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Sammas
Well-known member
rob_gould said:This thread is fascinating as a non- American.
Don't have anything else to say as it might be inflammatory to what is clearly a sore point
Likewise here. I have no idea how exactly the health system works in the USA.
If its not too much to explain, would anyone care to try?
This thread makes me take back all the bad things I have said about Australia's health system.
pucho812
Well-known member
Gold said:
wasn't that due to the fact it was delayed for unions for a year?
Spiritworks
Well-known member
I should mention that the Anthem Blue Cross/Blue Shield plan that I have, which is raising my rates - as stated in post #2 above, is an HSA ( Health Savings Account ) I'm told I can deposit up to $3500.00 per annum as a tax-deferred portion of my income. Not sure what happens to it if I don't spend it. However, I find making any savings deposits in this day & age difficult - outside of my SEP IRA - so the HSA portion of my insurance is going un-used.
As an aside, I recently got a letter from my local Hospital ( and related Health-care Provider Groups ) who were threatening to sever ties with Anthem BCBS because of contractual disputes over payments. Apparently they all reached an agreement to continue the Status Quo. Of course, that means for consumers ( at leat the legalized citizen consumers ) we'll continue to face more and more out-of-pocket expenditures and less & less care, while the illegals will continue to spawn un-checked and receive everything for free.
Flame suit on. Hope it works, 'cause my insurance probably won't cover it....................
As an aside, I recently got a letter from my local Hospital ( and related Health-care Provider Groups ) who were threatening to sever ties with Anthem BCBS because of contractual disputes over payments. Apparently they all reached an agreement to continue the Status Quo. Of course, that means for consumers ( at leat the legalized citizen consumers ) we'll continue to face more and more out-of-pocket expenditures and less & less care, while the illegals will continue to spawn un-checked and receive everything for free.
Flame suit on. Hope it works, 'cause my insurance probably won't cover it....................
pucho812 said:
The Freelancers Union is a cooperative not an actual union. Their members are individuals who are not exempt from the penalty. Most of the over 2000 exemptions by presidential fiat are good to 2018. Our family doctors did not take FU insurance, originally BCBS now proprietary, so I went with Oxford/UHC. Their self-employed plans went up 20% shortly after McCaincare was signed, and up another 15% over the next two years. When it went to $1,300 per month I formed a corp and got the same coverage for $958 per month. My recent increase was up 11% for the next 12 months.
Independent people do not have many choices. The system is rigged to get people into large businesses where everyone and everything can be controlled easier. When I first started working in NY I had very affordable major medical from Mutual of Omaha and paid cash when I went to the doc. The NYS Board of Insurance squeezed companies like MOO out of the biz with increasing regulation. Specifically they forced every company providing medical insurance to include prescription coverage. MOO is an insurance company not a healthcare provider so they left the state. All of this is about control anyway.
Its no wonder that my insurance costs are going up. As soon as the prez signed the law every mailing from UHC had an additional sheet of paper explaining my rights. Then last year they sent new cards that reflected prescription coverage, for my plan that has none, for free female birth control. Add in coverage for "children" up to 27 years old and can it be anything BUT ca-chingsville? A 25 year old should have a job in a vibrant economy and pay for their own insurance- not happening these days.
The problem with the business model of paying over 1K per month for "health insurance" is that the consumer will do everything possible to USE it. It was an easy decision not to pay an extra $120 per month for prescription coverage because I do not pay anywhere near that in actual purchases. I would rather have major medical. My family would not spend over 12K per year for doctor visits. A low cost MM policy is what healthy people ages 21-55 need. Negotiate everything else in cash. Big Ins and Big Gov legislated that away over a decade ago in NYS.
Supposedly McCaincare brings major medical back to NYS but I will have to wait for them to fix the website to investigate.
Mike
PS: nystateofhealth website still does not recognize my corp ID login and dumps me with a "timeout" if I try to create a personal login.
AMZ-FX
Well-known member
Spiritworks said:
It is $3250 per year (in 2013) for individuals and if you do not use all of it, the money stays in your HSA account, i.e. rolls over into the next year. If you are a geezer like me, you can put in extra money each year up to $1000 (I think).
ONLY use the HSA money to pay for valid medical expenses. Very important! You will have to answer questions about this on your following year's tax return, and it is much better to be able to confidently say that all of the expenses paid out of the HSA account were for approved purposes.
Best regards, Jack
I have a friend from Oz who was over here working as a consultant when his wife was diagnosed with cancer. He returned home so she could be treated there. She is still alive AFAIK so the treatment was adequate.Sammas said:rob_gould said:This thread is fascinating as a non- American.
Don't have anything else to say as it might be inflammatory to what is clearly a sore point
Likewise here. I have no idea how exactly the health system works in the USA.
If its not too much to explain, would anyone care to try?
This thread makes me take back all the bad things I have said about Australia's health system.
I am afraid a short explanation would not do this justice, and a long answer from me would include my bias, but I'll try to go short.
Explaining what US healthcare is or was is academic since we are in the middle of changing over to the ACA (affordable care act).
The poorly executed web site is getting a lot of attention but IMO that is just a symptom of government mismanagement and relatively easy to fix. It's a website not brain surgery. An amusing tidbit the consultant they just hired to fix the web problem worked for Bain in the past, the same company Romney worked for that was painted as evil capitalists.
On paper we are moving to a hybrid public/private system where the government is heavily regulating how the private insurance companies behave. with penalty fines for individuals or companies who do not participate. As with any undertaking this large (17% of our GDP) the devil is in the details. and I have been complaining about those details for the last few years. Now I am willing to wait and see how this plays out. I didn't expect the website to be a problem, I expect the next year or two to be very interesting when the reality of this is felt more strongly. We have seen changes in business and insurance company behavior in anticipation of this. Now we will feel the full effect.
I would truly love to be wrong in my judgement about this. I need to stop whining for now. It is not productive.
JR
Scodiddly
Well-known member
This is just stupid. My health insurance (through a small company group plan) has been going up every year for as long as I can remember. The Affordable Care Act has little to do with that, other than making the actual insurance more useful. The insurance companies used the pre-existing conditions thing to boot a lot of customers out as soon as they started actually using their insurance.
Sammas
Well-known member
JohnRoberts said:I have a friend from Oz who was over here working as a consultant when his wife was diagnosed with cancer. He returned home so she could be treated there. She is still alive AFAIK so the treatment was adequate.Sammas said:rob_gould said:This thread is fascinating as a non- American.
Don't have anything else to say as it might be inflammatory to what is clearly a sore point
Likewise here. I have no idea how exactly the health system works in the USA.
If its not too much to explain, would anyone care to try?
This thread makes me take back all the bad things I have said about Australia's health system.
I am afraid a short explanation would not do this justice, and a long answer from me would include my bias, but I'll try to go short.
Explaining what US healthcare is or was is academic since we are in the middle of changing over to the ACA (affordable care act).
The poorly executed web site is getting a lot of attention but IMO that is just a symptom of government mismanagement and relatively easy to fix. It's a website not brain surgery. An amusing tidbit the consultant they just hired to fix the web problem worked for Bain in the past, the same company Romney worked for that was painted as evil capitalists.
On paper we are moving to a hybrid public/private system where the government is heavily regulating how the private insurance companies behave. with penalty fines for individuals or companies who do not participate. As with any undertaking this large (17% of our GDP) the devil is in the details. and I have been complaining about those details for the last few years. Now I am willing to wait and see how this plays out. I didn't expect the website to be a problem, I expect the next year or two to be very interesting when the reality of this is felt more strongly. We have seen changes in business and insurance company behavior in anticipation of this. Now we will feel the full effect.
I would truly love to be wrong in my judgement about this. I need to stop whining for now. It is not productive.
JR
Thanks for the explanation. Is there any chance these are just teething problems?
Our public health system here in Australia is actually pretty damn good. Only some very specific treatments aren't covered. Dental is one of them... along with other more esoteric forms of cancer treatment, anything classed as "optional", etc.
I spent 5 days in hospital a few years back - my own room, MRI's, regular blood tests, skin biopsies, ultrasounds. It didn't cost me a cent directly.
Indirectly though, every tax paying Australian who earns beyond a "low income wage" either pays 1.5% of their annual earnings in tax towards public health... or you can spend the money on private health insurance and be exempt from the tax. That is literally where the line is drawn. It doesn't matter if you pay for private health insurance... you can still use the government health system, government hospitals and not actually ever claim anything through your private insurer at all.
From my stint in the UK, its quite similar. Each paycheck had an additional "national insurance" tax on it in exchange for public health and dental.
That is largely the reason I chimed into this thread. I am not a vocal person when it comes to politics, but our health care system is one thing that would take me to the streets in protest if anyone ever tried to remove it. While the government shut down and the reasoning behind it were reported regularly here in Australia, nothing much was mentioned about what ObamaCare actually is.
That would be nice...Sammas said:
For the record I am not complaining about the website... that is readily fixable.
One issue many western nations are struggling with is end of life care. We can spend remarkable amounts of money buying extra months of life. A rather tough decision to have made for us by others.
Um, That is good and bad. Good because people should not postpone needed healthcare that they really need, but bad because it doesn't make us very thrifty about consuming healthcare. We do actually pay for this and that is why newer experimental cancer treatments are considered optional. Cancer is worthy of a whole topic by itself. We spend incredible amounts of money developing new cancer treatments that just postpone the inevitable for many (like two of my siblings no longer among us). While some actual cures come from throwing all this money against the wall, and these once proved get shared elsewhere.
1.5% seems modest. but, add another 1% tax on the wealthy, and according to wiki "but mostly out of general revenue" so you are paying more than 1.5% of your income for it whether you realize or not.
I have written a great deal about this over recent years and I can't repeat everything. Short version is I agree the healthcare system is broken, but I don't believe they have fixed it with ACA. And I certainly don't agree with Pres Obama's characterization that this is a "good deal". Good deal for somebody, just not most of the public. The public will figure that out eventually.
I expect reform from here to be even harder, trying to put flesh on the skeleton of ACA , but I am getting ahead of myself. For now I need to just let this play out.
JR
I would echo Sammas comments.
It used to be like the US in the UK before WW2, getting sick was a disaster financially for ordinary people.
The voters even dumped Churchill in '45 in order to get a National Health Service. It has had its ups and downs in the last 68 years but on the whole it has served us well and no-one would do without it.
Listening to the infinite complications of your system I don't know how you stand it. There must be so many people stuck in jobs they hate because they dare not lose their company's health plan.
My country may be "piss-ridden" as one member put it, but I think we got you beat on this one.
best
DaveP
It used to be like the US in the UK before WW2, getting sick was a disaster financially for ordinary people.
The voters even dumped Churchill in '45 in order to get a National Health Service. It has had its ups and downs in the last 68 years but on the whole it has served us well and no-one would do without it.
Listening to the infinite complications of your system I don't know how you stand it. There must be so many people stuck in jobs they hate because they dare not lose their company's health plan.
My country may be "piss-ridden" as one member put it, but I think we got you beat on this one.
best
DaveP
My state didn't expand Medicaid, so there's a hole between the poverty line and the bottom of the discount line, in which one qualifies for neither discount option. That's clearly broken. My income has been known to swing the extreme of poverty line to top of the discount line from one year to the next; not normal but it has happened enough times to expect it again, and I can imagine landing in the no-fly zone. And I am supposed to predict my income for the next year? And then chose to pay full rate and get a rebate at the end, or take the rebate in advance and pay a large lump sum at the end if I earn more than predicted? Like I said earlier, my rate for 'most similar service' is to go up 300% if I don't make a lesser selection. My rate has never gone up more than 10% a year.
Lots more to learn.
Lots more to learn.
At one time employer health care was considered a really good deal, and may have still been for some, but going into the late 80s or so the pendulum started swinging back. There was an increasing trend towards companies using temp service employees to avoid adding full time people to the payroll which also meant none of the health insurance benefits that full time employees would receive. Add to that yearly increases in deductibles for those few who still had full time status and a decent health care policy and eventually nobody really had a good plan, full time or not. The private plans had always been more expensive. And all this well before Obama was in office.
As a side note I found an article discussing a similar version of an "Affordable Health Care Act" written by the Republicans way back in '89. Interesting to see that, for whatever reason the beliefs and attitudes towards the US adopting tax based Nationalized Health Care were largely the same as they have been in recent years. Note the arguments listed under the section titled "Solutions That Will Not Work" in the original document from '89. (maybe best interpreted as "Things We Are Not Willing To Do").
http://www.thedailybeast.com/articles/2012/03/27/why-the-right-turned-its-back-on-the-individual-mandate.html
I need to correct a comment I made about the ACA driven expansion of state medicaid programs. Indeed it is only 100% funded by federal grants through 2016, but CBO (congressional budget office) predicts that it will be federally funded at no less than 90% after 2016. So increase to state budget responsibility will only be $73 billion of this $931 billion expansion thru 2022. The CBO also predicts that 1/3 to 2/3 of that $73 billion state paid fraction will be offset by local savings elsewhere. So only $25 to $50 billion state cost (note: the CBO does not predict with complete certainty, just based on how legislation is currently written and best guess predictions. )
But this is just one part of the ACA.
The SCOTUS ruled that this could not be forced on the states (because of state's rights).
A state refusing federal money seems stupid in the short term. but this free money comes with expanded future liability.
This is apparently a matter of principal and long term budget prudence by each state. The Gov of Ohio over ruled his own legislature to take this money. I think my state may have refused it, to be honest I haven't been playing close attention.
JR
But this is just one part of the ACA.
The SCOTUS ruled that this could not be forced on the states (because of state's rights).
A state refusing federal money seems stupid in the short term. but this free money comes with expanded future liability.
This is apparently a matter of principal and long term budget prudence by each state. The Gov of Ohio over ruled his own legislature to take this money. I think my state may have refused it, to be honest I haven't been playing close attention.
JR
DaveP said:
I don't read a local newspaper, and don't watch the local TV stations. I used to read the local paper on Sundays but found myself writing letters to the editor defending the "theory if evolution" and such fanciful notions.
I think I saw MS mentioned in a national news story as one of the states that declined.
I do not currently have health insurance or medica-whatever.. but I am getting old. I suspect I will find out my local situation soon enough.
JR
Sammas
Well-known member
JohnRoberts said:
I pay about 3 point something percent for private health insurance, as I get optional extras like optical, dental & gym membership coverage.
1.5%... 4%... either way, I see the real advantage of the system being the declaration of "low income earner". Students studying at university, people who physically are unable to work, single mothers with dependent children, etc still get the same access to health care.
The problem I see with the USA's hospital system is not health insurance, but rather the financial administration.
Health costs in Australia are lower, and health care is cheaper simply because the vast majority of hospitals are publicly owned and operated.
When that is the case, tendering to the private sector for maintenance, supplies, cleaning, etc on a state and national level results in much better prices.
Its cheaper per unit to buy wima caps when you get 100 rather than 10. When you start tendering the private sector for the purchase of 5 million syringes rather than 50000, it gets a whole lot cheaper too.
I have to pay for my gym membership out of pocket, but I pay for everything out of my pocket.Sammas said:
ding ding ding... Yes we have an unholy alliance between hospitals and insurance companies that perpetuate bad management and poor allocation of resources (concealing/distorting price discovery from consumer decision making). That said adding government to the mix, without fixing the underlying problems just makes it all bigger (more expensive), not better.
That would seem logical if the cost of the syringes was the only issue, and the government was the single prime contractor, but that is not what we have.
I concede that the government was not allowed to take over the entire healthcare industry and run it themselves (thankfully). So we get this bride of Frankenstein monster mix of the former system and a nice on paper hit list of how they want it to turn out.
The path I've advocated is not simple and easy either,,, they got their shot, let see how it goes. I'm afraid we can't put this one back in the bottle , so now we need to make it work eventually.
JR
Sammas
Well-known member
Yeah.. it definitely looks less like a mole hill... and more like a mountain. :-\
