IGX

My premiums jumped up 25% this year. You can say what you want about the PPACA and Obama and all that other shit, but I'm still paying through the nose for 7K deductible. There has to be a better way than Healthcare.gov. Also, there's no dental coverage with my plan, which is the one thing I really need.

Does anyone have any ideas here or are we (Americans) all fucked?

Insurance brokers probably won't help you with plans on the exchanges because CMS decided they shouldn't get paid for it. Check out a health care sharing ministry (seriously). They're not for everybody, but might work for you.

Old Mother wrote:My premiums jumped up 25% this year. You can say what you want about the PPACA and Obama and all that other shit, but I'm still paying through the nose for 7K deductible. There has to be a better way than Healthcare.gov. Also, there's no dental coverage with my plan, which is the one thing I really need.

Does anyone have any ideas here or are we (Americans) all fucked?

I lost my dental in 2014 and the premium jump this year was a mere 17%. Not sure how deductibles will change this year. It went way up last year and the year before. Lost my small business coverage last year and now we're forced into individual plans.

"If you like your insurance plan, you can keep your insurance plan" was a lie. "If you like your doctor, you can keep your doctor" was the truth. He just neglected to say that you have to pay a lot more money for a new insurance plan that your doctor will accept.

While the MSM is blaming Trump's win on Russian hacks, they're neglecting all the people who learned about their Obamacare rate hike around election time.

You might be better off negotiating with the dentist directly and paying cash.

Turdacious wrote:You might be better off negotiating with the dentist directly and paying cash.

I tried that and it was a no go for me. My present dentist doesn't do unnecessary work and my dental coverage was kind of shitty anyway. I've heard of things advertised that get you group rates with dentists but haven't looked into them yet.

Turdacious wrote:Insurance brokers probably won't help you with plans on the exchanges because CMS decided they shouldn't get paid for it. Check out a health care sharing ministry (seriously). They're not for everybody, but might work for you.

I've been using a health care sharing ministry for a couple years now. I pay $45 per month for coverage up to 120K. For each incident I must pay a 5k deductible. If I negotiate the price down due to being a "cash payer" the money saved goes toward the deductible. There are plans with much smaller deductibles.

I knew a guy who needed some expensive dental work. He didn't have dental insurance so his was work done in Thailand. His whole 2 week trip, airfare, hotel, food, dentistry costed less than what he would have paid here in the States for just the dentistry. He said the dentists are as good there as they are here.

Turdacious wrote:Insurance brokers probably won't help you with plans on the exchanges because CMS decided they shouldn't get paid for it. Check out a health care sharing ministry (seriously). They're not for everybody, but might work for you.

I'm an atheist, but I'll fake it to save on insurance.

So i guess the answer is to just suck it up and go somewhere else for dental work. Actually, my buddy went to Costa Rica for his chompers. It doesn't sound that bad.

Hookers.

Leave the US to buy foreign chompers and, on your return,Trump will slap you with a 45% Tariff.

Hookers.

My employer killed our PPO last year; now we have a choice between two HDHPs one 2500/5000, one 1500/3000 and the monthly premiums are pretty similar to what my ppo was (I think).

The problem with Obamacare is that you can't force a doctor to take shitty insurance coverage. Any doctor in a white collar area of LA just has a sign in the lobby saying "No Covered California".

Obama's flagship piece of legislation is a complete and utter failure. But we all knew it would be, you can't just add 30 million people to the system, many who aren't going to pay and many that are are going to use more care than the average payer. Of course everyone who was previously paying into the system was going to have to pay more. How else would these costs be funded?

I'm hoping Trump can kill this pos ACA, open a nationwide insurance exchange, figure out a better way to subsidize the people who need care and can't afford it. Maybe that's through a government sponsored entity insurance provider with limited doctor network, limited coverage, etc. Maybe that limited network allows young doctors with a shitload of education debt to have their loans reduced as they provide public service (similar to social workers). We could probably provide subsidized healthcare for the bottom 30% of our population if we stopped providing so much aid to the rest of the world. Alas, LOL @ Trump being able to do any of this.

Good dental is a unicorn. I've been very lucky with my union health plan but even that has shitty dental. I pay cash and don't even bother hoping for any kind of reimbursement.
My dentist is a friend and knows he's getting paid cash money so he discounts almost everything.

Fuzzy Dunlop wrote:My employer killed our PPO last year; now we have a choice between two HDHPs one 2500/5000, one 1500/3000 and the monthly premiums are pretty similar to what my ppo was (I think).

The problem with Obamacare is that you can't force a doctor to take shitty insurance coverage. Any doctor in a white collar area of LA just has a sign in the lobby saying "No Covered California".

Obama's flagship piece of legislation is a complete and utter failure. But we all knew it would be, you can't just add 30 million people to the system, many who aren't going to pay and many that are are going to use more care than the average payer. Of course everyone who was previously paying into the system was going to have to pay more. How else would these costs be funded?

I'm hoping Trump can kill this pos ACA, open a nationwide insurance exchange, figure out a better way to subsidize the people who need care and can't afford it. Maybe that's through a government sponsored entity insurance provider with limited doctor network, limited coverage, etc. Maybe that limited network allows young doctors with a shitload of education debt to have their loans reduced as they provide public service (similar to social workers). We could probably provide subsidized healthcare for the bottom 30% of our population if we stopped providing so much aid to the rest of the world. Alas, LOL @ Trump being able to do any of this.

http://www.factcheck.org/2014/02/aca-im ... alth-care/

Grandpa's Spells wrote:

Fuzzy Dunlop wrote:My employer killed our PPO last year; now we have a choice between two HDHPs one 2500/5000, one 1500/3000 and the monthly premiums are pretty similar to what my ppo was (I think).

The problem with Obamacare is that you can't force a doctor to take shitty insurance coverage. Any doctor in a white collar area of LA just has a sign in the lobby saying "No Covered California".

Obama's flagship piece of legislation is a complete and utter failure. But we all knew it would be, you can't just add 30 million people to the system, many who aren't going to pay and many that are are going to use more care than the average payer. Of course everyone who was previously paying into the system was going to have to pay more. How else would these costs be funded?

I'm hoping Trump can kill this pos ACA, open a nationwide insurance exchange, figure out a better way to subsidize the people who need care and can't afford it. Maybe that's through a government sponsored entity insurance provider with limited doctor network, limited coverage, etc. Maybe that limited network allows young doctors with a shitload of education debt to have their loans reduced as they provide public service (similar to social workers). We could probably provide subsidized healthcare for the bottom 30% of our population if we stopped providing so much aid to the rest of the world. Alas, LOL @ Trump being able to do any of this.

http://www.factcheck.org/2014/02/aca-im ... alth-care/

I wouldn't put too much stock in that article from factcheck.org. It was put out before the CBO revised cost projections (especially long term Medicare costs) back to pre-ACA projections, assumes that high deductibles would bring down spending in the mid term (it didn't, it rose in 2015-6), assumes that Medicare cost saving programs were sustainable (the GAO says it isn't), doesn't account for US specific drug inflation or out of network costs, and doesn't account for doc-fix/MACRA.

Turdacious wrote:

Grandpa's Spells wrote:

Fuzzy Dunlop wrote:My employer killed our PPO last year; now we have a choice between two HDHPs one 2500/5000, one 1500/3000 and the monthly premiums are pretty similar to what my ppo was (I think).

The problem with Obamacare is that you can't force a doctor to take shitty insurance coverage. Any doctor in a white collar area of LA just has a sign in the lobby saying "No Covered California".

Obama's flagship piece of legislation is a complete and utter failure. But we all knew it would be, you can't just add 30 million people to the system, many who aren't going to pay and many that are are going to use more care than the average payer. Of course everyone who was previously paying into the system was going to have to pay more. How else would these costs be funded?

I'm hoping Trump can kill this pos ACA, open a nationwide insurance exchange, figure out a better way to subsidize the people who need care and can't afford it. Maybe that's through a government sponsored entity insurance provider with limited doctor network, limited coverage, etc. Maybe that limited network allows young doctors with a shitload of education debt to have their loans reduced as they provide public service (similar to social workers). We could probably provide subsidized healthcare for the bottom 30% of our population if we stopped providing so much aid to the rest of the world. Alas, LOL @ Trump being able to do any of this.

http://www.factcheck.org/2014/02/aca-im ... alth-care/

I wouldn't put too much stock in that article from factcheck.org. It was put out before the CBO revised cost projections (especially long term Medicare costs) back to pre-ACA projections, assumes that high deductibles would bring down spending in the mid term (it didn't, it rose in 2015-6), assumes that Medicare cost saving programs were sustainable (the GAO says it isn't), doesn't account for US specific drug inflation or out of network costs, and doesn't account for doc-fix/MACRA.

SRS question: what's your proposal for a practical healthcare solution in this country?

Grandpa's Spells wrote:SRS question: what's your proposal for a practical healthcare solution in this country?

From a practical (something that could actually pass) perspective-- keep insurance segregated by state rather than allowing interstate health insurance sales (state insurance commissions are the only competent regulatory body); simplify Medicare reimbursement rates (rates determined by procedure and local rent only with a 10-15% pay bump for rural providers); replace the health care portion of Indian Health Service and Medicaid with the individual market with guaranteed access provisions (minimum # providers per # insured); increase roles of LPNs and retail clinics for insured receiving subsidies; set insurance subsidies at a rate that maximizes participation and hospital profitability; and import the primary care shortage.

Bottom line-- subsidized care should give you everything you need but not everything you want. Only people who pay for insurance out of pocket or through an employer should get certain things like short lines for non emergency procedures, individual rooms at hospitals, direct access to specialists, etc... That allows the free market to determine prices for things that improve quality of life but not necessarily life expectancy.

Realistically we'd have to do something about the real cost drivers in American medicine too-- morbid obesity, hypertension, and diabetes. Limiting what people can buy on food stamps and taxing sugar are probably necessary. All of that is probably the easy part-- getting the federal health care bureaucracies to function effectively is probably the biggest challenge. Getting to the point where we can measure the effectiveness of what we're doing and what we're paying for requires a big investment in primary care that the AMA will resist every step of the way.

Funding the ACA was simple. Make the fine for no coverage exceed the cost of coverage. Couldn't sell it

Turdacious wrote:Realistically we'd have to do something about the real cost drivers in American medicine too-- morbid obesity, hypertension, and diabetes.

isn't care for old people on the brink of the hereafter expensive and, let's be honest, fruitless? we've got so much technology that if we don't ration health care for old folks, medical costs will continue to rise. good palliative care, but forget a cure.

we're too clever by half. doctors can replace half your body, and they'll happily do it, and you think you deserve it, but goddammit, my premiums are too high.

get real.

dead man walking wrote:

Turdacious wrote:Realistically we'd have to do something about the real cost drivers in American medicine too-- morbid obesity, hypertension, and diabetes.

isn't care for old people on the brink of the hereafter expensive and, let's be honest, fruitless? we've got so much technology that if we don't ration health care for old folks, medical costs will continue to rise. good palliative care, but forget a cure.

we're too clever by half. doctors can replace half your body, and they'll happily do it, and you think you deserve it, but goddammit, my premiums are too high.

get real.

People with those conditions make up a large share of Medicaid costs and all three comorbid conditions are heavily lifestyle related. Keep in mind that merely needing dialysis makes a lot of people Medicaid eligible. Regardless of age.

Fuzzy Dunlop wrote: Maybe that's through a government sponsored entity insurance provider with limited doctor network, limited coverage, etc. Maybe that limited network allows young doctors with a shitload of education debt to have their loans reduced as they provide public service (similar to social workers). We could probably provide subsidized healthcare for the bottom 30% of our population if we stopped providing so much aid to the rest of the world. Alas, LOL @ Trump being able to do any of this.

So... the public option that had the GOP and jackwagons like Lieberman up in arms?

While I wouldn't put it past the political class of the party to embrace something like this now that the nigra is out of office, I suspect there are too many true believers in the House to let it happen.

Practical solutions went out the window when the President tried to reform everything at once by negotiating a massive deal with one side of Congress. There was simply too much for Congress to screw up.

Smaller steps would have been more practical, like funding a Medicare expansion by killing the tax credit for employer-provided insurance. Unfortunately, that particular small step would have required working with both parties, but it also would have given both parties something they wanted.

milosz wrote:

Fuzzy Dunlop wrote: Maybe that's through a government sponsored entity insurance provider with limited doctor network, limited coverage, etc. Maybe that limited network allows young doctors with a shitload of education debt to have their loans reduced as they provide public service (similar to social workers). We could probably provide subsidized healthcare for the bottom 30% of our population if we stopped providing so much aid to the rest of the world. Alas, LOL @ Trump being able to do any of this.

So... the public option that had the GOP and jackwagons like Lieberman up in arms?

Anyone who thinks our government can competently setup and manage a public option hasn't been paying attention the last six years.

Pinky wrote:Practical solutions went out the window when the President tried to reform everything at once by negotiating a massive deal with one side of Congress. There was simply too much for Congress to screw up.

Smaller steps would have been more practical, like funding a Medicare expansion by killing the tax credit for employer-provided insurance. Unfortunately, that particular small step would have required working with both parties, but it also would have given both parties something they wanted.

That assumes that Medicare isn't broken. It was, and is.

Turdacious wrote:

Grandpa's Spells wrote:SRS question: what's your proposal for a practical healthcare solution in this country?

From a practical (something that could actually pass) perspective-- keep insurance segregated by state rather than allowing interstate health insurance sales (state insurance commissions are the only competent regulatory body); simplify Medicare reimbursement rates (rates determined by procedure and local rent only with a 10-15% pay bump for rural providers); replace the health care portion of Indian Health Service and Medicaid with the individual market with guaranteed access provisions (minimum # providers per # insured); increase roles of LPNs and retail clinics for insured receiving subsidies; set insurance subsidies at a rate that maximizes participation and hospital profitability; and import the primary care shortage.

Bottom line-- subsidized care should give you everything you need but not everything you want. Only people who pay for insurance out of pocket or through an employer should get certain things like short lines for non emergency procedures, individual rooms at hospitals, direct access to specialists, etc... That allows the free market to determine prices for things that improve quality of life but not necessarily life expectancy.

Realistically we'd have to do something about the real cost drivers in American medicine too-- morbid obesity, hypertension, and diabetes. Limiting what people can buy on food stamps and taxing sugar are probably necessary. All of that is probably the easy part-- getting the federal health care bureaucracies to function effectively is probably the biggest challenge. Getting to the point where we can measure the effectiveness of what we're doing and what we're paying for requires a big investment in primary care that the AMA will resist every step of the way.

Your version is more way more expensive.

Either everybody pays for single payer via taxes, or
Everybody pays via mandated insurance coverage, or
Healthy people opt out, driving insurance costs up for errybody else (and bankrupting themselves when they get sick or have to go to ER).

There is no way around it.