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Thread: Pay now, care later

  1. #11
    Veteran Member bajisima's Avatar
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    Quote Originally Posted by Madeline View Post
    I had an HMO most of my working life. But I recall the bad, old days of copays and deductibles. As a new mom, worrying that if I take the baby in for her fever, it will mean we can't afford her baby food the rest of the month.

    There needs to be some disincentive to patients abusing any level of care. Doubtless, most GPs have treated a hypochondriac or two. We ALL know people without insurance use the ER for routine matters. And not every procedure anyone could have can be offered to all patients.

    But if you set the level of self-funding too high, people will delay care. This can easily lead to more expensive care on down the road. The serious illnesses that are preventable with a vaccine, for example.

    I'm not sure what the ideal solution is. A sliding scale might tweak the personal responsibility share more appropriately, but in the elderly, income is typically very low as compared to total wealth.

    Sadly, the UK's ongoing experience with trying to starve its NHS to death offers a lot of data that we can use in designing a sustainable universal health care system.
    That's been the cruel irony for my family over the last few years. We aren't offered insurance with our jobs so we went without insurance for a while. Now its great we have insurance and can get preventative care, but if anything goes bad, we cant afford it and probably wont bother. So its both better and worse I suppose.
    Thanks from Madeline and HCProf

  2. #12
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by bajisima View Post
    That's been the cruel irony for my family over the last few years. We aren't offered insurance with our jobs so we went without insurance for a while. Now its great we have insurance and can get preventative care, but if anything goes bad, we cant afford it and probably wont bother. So its both better and worse I suppose.
    Very sadly, this is a familiar story told by many middle class families. My brother has to pay 100% of the cost of his group health insurance policy, and can choose the lower-coverage option or simply go uninsured.

    And he works for one of the Big Five banks!
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  3. #13
    Veteran Member bajisima's Avatar
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    Quote Originally Posted by Madeline View Post
    Very sadly, this is a familiar story told by many middle class families. My brother has to pay 100% of the cost of his group health insurance policy, and can choose the lower-coverage option or simply go uninsured.

    And he works for one of the Big Five banks!
    My daughter works for a company that offers basic insurance at outrageous costs. Their ideas is that there are exchanges out there, go buy insurance there if you don't like ours. Its very costly and since many of the employees are young, many are paying the penalty and going without. One of the girls is pregnant and even planning on spending a couple weeks in Canada when she is due so she can have the baby there because its so much cheaper even in cash.
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  4. #14
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    Quote Originally Posted by HCProf View Post
    I think insurance companies are making up for the preventative care that now must be covered at 100% by raising the deductibles for care with a definitive diagnosis.
    I'm not sure the insurance companies are in the business of "making up for" anything. They're simply charging more every year because they can, because that's how the system is set up. Jacking up the costs of everything for everyone is in their financial interest.

    We have to tear down the whole system. There is no fixing it.
    Thanks from bajisima, Madeline and HCProf

  5. #15
    Veteran Member bajisima's Avatar
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    Quote Originally Posted by splansing View Post
    I'm not sure the insurance companies are in the business of "making up for" anything. They're simply charging more every year because they can, because that's how the system is set up. Jacking up the costs of everything for everyone is in their financial interest.

    We have to tear down the whole system. There is no fixing it.
    I think so too. Fixing it involves massive coordination with the insurers. Can we trust them now??? They could agree to anything and then find some tiny hole and screw us. Like they did with the ACA. I find it ironic that now Americans are mandated to carry health insurance but the insurers aren't mandated to stay, they can pull out anytime, anywhere. Really? No one thought of that? So basically here pay a fine for healthcare you wont have if all the insurers decide to pull out of your state.
    Thanks from Madeline

  6. #16
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by bajisima View Post
    My daughter works for a company that offers basic insurance at outrageous costs. Their ideas is that there are exchanges out there, go buy insurance there if you don't like ours. Its very costly and since many of the employees are young, many are paying the penalty and going without. One of the girls is pregnant and even planning on spending a couple weeks in Canada when she is due so she can have the baby there because its so much cheaper even in cash.
    Great. Where is she getting her prenatal care?

    What is her plan if the Canada thing is not an option?

    Jeeze Louise.
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  7. #17
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by bajisima View Post
    I think so too. Fixing it involves massive coordination with the insurers. Can we trust them now??? They could agree to anything and then find some tiny hole and screw us. Like they did with the ACA. I find it ironic that now Americans are mandated to carry health insurance but the insurers aren't mandated to stay, they can pull out anytime, anywhere. Really? No one thought of that? So basically here pay a fine for healthcare you wont have if all the insurers decide to pull out of your state.
    There is no way to drag profit out any system that covers everyone for some agreed-upon, rudimentary level of care. It cannot be done.

    Profit only occurs when insured people pay far more for their policies than they are worth, and most high-risk individuals are excluded.

    That's just reality.

  8. #18
    Veteran Member bajisima's Avatar
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    Quote Originally Posted by Madeline View Post
    Great. Where is she getting her prenatal care?

    What is her plan if the Canada thing is not an option?

    Jeeze Louise.
    I don't think she is getting prenatal care. She has no insurance. Thing is both she and her spouse have Masters degrees and decent jobs. But the costs between healthcare and their student loans is crushing. What world are we living in when this can happen? Am waiting for some genius to decide children of parents without health insurance should be taken away by child services or something..good grief.
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    Veteran Member TNVolunteer73's Avatar
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    obamacare 7500/year for insurance (least expensive plan) 6500/year deductible.

    so patient has to pay 14,000/year before Obamacare pays a dime.'

    Did you spend 14,000 on healthcare last year?

  10. #20
    Veteran Member bajisima's Avatar
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    Quote Originally Posted by TNVolunteer73 View Post
    obamacare 7500/year for insurance (least expensive plan) 6500/year deductible.

    so patient has to pay 14,000/year before Obamacare pays a dime.'

    Did you spend 14,000 on healthcare last year?
    Health insurance is a gamble, we are gambling we wont lose and get sick. But the problem is we are gambling with all our money so if we do get sick we cant afford it.
    Thanks from Madeline

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