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Thread: Pay now, care later

  1. #61
    Moderator HCProf's Avatar
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    Quote Originally Posted by Amelia View Post
    I'm worried about the polyps. They found 3 in my colonoscopy. With zero, it would have been free. But with 3 ... I haven't heard yet if I'll be on the hook for the thousand dollar deductible ... plus the 20% of the rest. (Colonoscopies with my provider are over $4000 ... even though elsewhere in the nation they can be below $1000.)

    Because of the doubt after I talked to the financial person at the hospital, I almost cancelled the procedure, but I let hubby talk me into it. Glad to know ... and have polyps removed ... but waiting for the other shoe to drop.
    You did the right thing...I am just frugal and do not want to look for things that may or may not be there without experiencing symptoms. I never tell my husband about my medical stuff. I have had several basal cell carcinoma's removed and he knew nothing about it until I come home with the bandage. LOL My last one was under my eye in the corner of my nose and when I came home with the bandages and stitches, he was WTF!! This was when I had decent, usable insurance. Now, I just watch weird spots and luckily know the difference between Melanoma and Basal cell. My primary burns them off now with Histofreeze if she sees anything weird...instead of the MOH's procedure I used to have when my insurance was good.
    Thanks from Madeline and Amelia

  2. #62
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    Quote Originally Posted by Neomalthusian View Post
    You're assuming this is the case, but have ignored what I said about the double-edged sword when it comes to the pricing of medical care. They don't just rake it in. They incur huge risks of huge losses too.
    So can Wall Street bankers, and yet, somehow, it ain't happening. Fucking horseshit. Those risks are extraordinarily well understood and managed by the biggest data and the most powerful analysts money can buy.

    You can eliminate the profit motive from the insurance side of the equation but it won't actually go very far to address our problems because of reasons I've stated, which is that the net cost of private and government insurance administration are neither a large part of national health expenditure nor are they driving the cost growth. Your scapegoating of insurance companies is wrong.
    You are saying that. You are saying that a mega-billion-dollar industry with an interest in driving medical costs higher is for some reason not doing that. You are saying that. I think that beggars belief. They ARE driving cost growth. They dictate protocols and force hospitals to follow them, and patients as well. Try leaving a hospital sometime. Even if it's obvious to you and your doctor that you're okay, if you start some protocol, the insurance company won't cover the visit if you don't finish the WHOLE THING. Why? Your doc can say that the first 2 tests ruled out whatever the protocol is for, but the insurance company says you have to have 6 more, and an overnight stay, and if you leave, they won't pay. What does it cost for me to stay one night in a hospital? One night. Multiply that by millions of idiotic visits per year. DRIVING COSTS. Tip of the iceberg. And OF COURSE they're doing it. They're pouring money into Washington, into universities to fund the studies they choose, into SME's who "teach" docs and hospitals and lawyers about the right way shit has to be done, on and on and on, and I goddamn guarantee you that a health insurance CEO is going to think of ways to move that needle that I cannot even conceive of. That's his JOB. It's literally, actually, his job to do that. And he's paid handsomely to do it.

    No, not just "a few people." Tens of thousands of billing specialists have jobs because of this system. They're not getting "ungodly rich"...
    Yeah, and people working at McDonald's aren't getting "ungodly rich" either. Maybe that's why I wasn't talking about any of them. I was talking about insurance company C-levels and ownership.

    These are fundamental changes with respect to how health care is provided, not just how it's paid for and by whom.
    We don't need to argue too much about how it should work. There are lots and lots of examples of industrialized western nations that have implemented the single-payer system already. This is such old fucking news it's just embarrassing that we're still held hostage by these pirates.
    Thanks from labrea

  3. #63
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by HCProf View Post
    You did the right thing...I am just frugal and do not want to look for things that may or may not be there without experiencing symptoms. I never tell my husband about my medical stuff. I have had several basal cell carcinoma's removed and he knew nothing about it until I come home with the bandage. LOL My last one was under my eye in the corner of my nose and when I came home with the bandages and stitches, he was WTF!! This was when I had decent, usable insurance. Now, I just watch weird spots and luckily know the difference between Melanoma and Basal cell. My primary burns them off now with Histofreeze if she sees anything weird...instead of the MOH's procedure I used to have when my insurance was good.
    I had a lot of quality of life care, and so did my kid, when I was working. None of that would have been an option if we had not had great insurance.

    My family has a history of deadly skin cancer, and so every year, my kid was gone over by a dermatologist, who checked her scalp, between her toes, etc.

    She also inherited a tendency towards terrible acne from her dad, but never even had a single pimple, etc.

    Like any parent, I wanted my kid to be happy and healthy. How can middle class parents -- nevermind almost everyone else -- tolerate rationing that care? No scratch tests and injections, to reduce allergic suffering? No mental health care?

    It's Dickensian.

  4. #64
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    Quote Originally Posted by Madeline View Post
    This is concentration of risk,
    As it is when car insurance charges more to those driving new Land Rovers than it does to those who drive old Chevy Cavaliers.

    Obamacare lets insurers charge older people more. But then it gives out subsidies that let old people end up paying the same as young people.

  5. #65
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    Quote Originally Posted by Neomalthusian View Post
    ...government employees get ultra-platinum health benefits for virtually nothing...
    It's called compensation.

  6. #66
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    Quote Originally Posted by splansing View Post
    It's called compensation.
    Why are you making excuses for ultra-platinum special privileges for government employees?

  7. #67
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    Quote Originally Posted by splansing View Post
    So can Wall Street bankers, and yet, somehow, it ain't happening. Fucking horseshit.
    Settle down and learn to stay on topic.

    Those risks are extraordinarily well understood and managed by the biggest data and the most powerful analysts money can buy.
    So kill the private insurance market, I don't care. What I'm telling you is that the insurance companies are not causing all this shit. They are not the root of all evil here.

    You are saying that. You are saying that a mega-billion-dollar industry with an interest in driving medical costs higher is for some reason not doing that. You are saying that. I think that beggars belief. They ARE driving cost growth. They dictate protocols and force hospitals to follow them, and patients as well. Try leaving a hospital sometime. Even if it's obvious to you and your doctor that you're okay, if you start some protocol, the insurance company won't cover the visit if you don't finish the WHOLE THING. Why? Your doc can say that the first 2 tests ruled out whatever the protocol is for, but the insurance company says you have to have 6 more, and an overnight stay, and if you leave, they won't pay. What does it cost for me to stay one night in a hospital? One night. Multiply that by millions of idiotic visits per year. DRIVING COSTS. Tip of the iceberg. And OF COURSE they're doing it. They're pouring money into Washington, into universities to fund the studies they choose, into SME's who "teach" docs and hospitals and lawyers about the right way shit has to be done, on and on and on, and I goddamn guarantee you that a health insurance CEO is going to think of ways to move that needle that I cannot even conceive of. That's his JOB. It's literally, actually, his job to do that. And he's paid handsomely to do it.
    I hope we kill private insurance so that you wake up to the fact that insurance companies aren't the entire cause of our problems. Practically half the country does not interact with a private insurance company. Your conspiracy theories would have us believe the private health insurance company dictates what health care providers charge and dictates what the U.S. Government does and thus has all the power and it's all their fault because they're for-profit (even though they're not for profit anymore, they're subject to an 80/20 rule and explicitly told what to load into their policies).

  8. #68
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by Neomalthusian View Post
    As it is when car insurance charges more to those driving new Land Rovers than it does to those who drive old Chevy Cavaliers.

    Obamacare lets insurers charge older people more. But then it gives out subsidies that let old people end up paying the same as young people.
    For individual policies, yes. For group policies, the insured person is charged the group rate.

    Maybe insurance companies try to guesstimate the employees' average age, but this is not what you described.

    Most privately insured Americans are still covered by policies obtained at work. (Though there are probably fewer as time goes by.)

  9. #69
    Veteran Member Madeline's Avatar
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    Quote Originally Posted by Neomalthusian View Post
    Why are you making excuses for ultra-platinum special privileges for government employees?
    Traditionally, government employees were paid significantly less than private sector employees with similar jobs. Richer benefits were thought to offset this impact, attracting a more talented labor pool.

    That probably hasn't been true since the 1950's, but it is still true that it is cheaper for any level of government to promise benefits rather than to pay more salaries. Thanks to shitty government accounting rules, most government entities could avoid the fiscal impact of such benefits until they were used, if they ever were.

    E.g., 90% disability pay for cops and firefighters.

  10. #70
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    I bet the poor will present their own healthplan motto -- Die Now Pay Later!
    Thanks from Madeline

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