US Healthcare in Big Mess !!

[honeyglue]

As the benefits enrollment period is going on, i wanted to share some thoughts on how the US healthcare system has gone from bad to worse. So many unwelcome changes, such as a surcharge for adding spouse through employer insurance, salary deduction for Short Term Disability (STD) rather than employer paid. Some new insurance term additions such as Accident Insurance, not sure how it kicks in and at what points. How is medical insurance different from Accident insurance..very confusing :emcrook:. I have seen the days when it used to be $5 co-payment, then they added a new plan and introduction of Health Re-imbursement Account (HRA) where money rolls over, and few years back Health Savings Account (HSA) was added where you never lose money unlike HRA. Medical procedures and equipments have become more advanced, but the healthcare plans have become more complicated, unpredictable and costly. :( If these healthcare companies are not done yet on acronyms, with HSA you can have LPFSA - Limited Purpose Flexible Spending Account.

Further there is a monetary value attached to your blood profile, $25 paid if your cholesterol is less than 200, $25 more if glucose is less than 100. I understand the consumer directed aspect of it, but attaching a $ value to my blood profile is beyond my imagination. Healthcare is a nightmare in US!! :o:o

[sophisticuss]

I have been crying on this forum for the past few years...Join the Queue...But worst is yet to come; many employers are withdrawing their insurance coverage completely since their their premium is growing double digits...PPO premium ( for both employees and employers) are now in thousands when it was close to $250 few years back...Only way to afford to go is now High Deductible plans..but you have to shell out $4000 first b4 you see any money...

And if you think it is bad, wait few more years,as real cost of Obamacare comes down through the channels...Cadiallac tax will kick in , 45+ employees will get laid off as their insurance risk is high...

[VS007]

After Nixon expanded insurance companies to health market, its actually becoming a racket with insurance companies using actuaries to calculate risk of insuring you . Private companies like Aetna, UHC all exist for profit just like Pharma cos, oil and gas companies! Not to serve people!
And without any regulation, its all freedom for profit insurance companies to discriminate!

No wonder even deep red state juries are putting fines on private insurance profit mongerers!
https://www.kansascity.com/news/article221348695.html

[greyfri]

I have been crying on this forum for the past few years...Join the Queue...But worst is yet to come; many employers are withdrawing their insurance coverage completely since their their premium is growing double digits...PPO premium ( for both employees and employers) are now in thousands when it was close to $250 few years back...Only way to afford to go is now High Deductible plans..but you have to shell out $4000 first b4 you see any money...

And if you think it is bad, wait few more years,as real cost of Obamacare comes down through the channels...Cadiallac tax will kick in , 45+ employees will get laid off as their insurance risk is high...

You've been making statements about the ACA that are factually inaccurate for several years, and ascribing everything negative health care related to the ACA, while ignoring everything positive about it, and this is no exception.

For one, the ACA makes it easier for 45+ people to get affordable care since it sets limits on how much older people can be charged. One of the main sticking points on the R replacement, the ACHA was that it couldn't decide on this rating.

The Cadillac care tax has been extended pretty much indefinitely each time it's come up, and it holds only for a subset of insurance plans. In any case, most companies are making good profits (and have had a tax cut), and the tax is levied on them.

I hear people ranting about the ACA, but what they seem to complain most about is the free market parts of the ACA -- the Cadillac tax is actually a small subset of what the Conservative Heritage Foundation wanted - removing tax benefits for all medical premiums. And the individual mandate was also a 'conservative' idea.

There are a lot of good things about the ACA -- no lifetime limits, portability, no pre-existing conditions. But you can't have portability and no pre-existing condition without the individual mandate because of adverse selection problem in insurance. Those who demonized (and still do the ACA) ignore it's positives and make counterfactual arguments against it. But more importantly, they don't suggest an alternative because it's much easier to just blame Obama than to recognize the tradeoffs that come with medical insurance.

[greyfri]

As the benefits enrollment period is going on, i wanted to share some thoughts on how the US healthcare system has gone from bad to worse. So many unwelcome changes, such as a surcharge for adding spouse through employer insurance, salary deduction for Short Term Disability (STD) rather than employer paid. Some new insurance term additions such as Accident Insurance, not sure how it kicks in and at what points. How is medical insurance different from Accident insurance..very confusing :emcrook:.

STD and Accident insurance are most definitely not medical insurance. They should not be conflated.

Further there is a monetary value attached to your blood profile, $25 paid if your cholesterol is less than 200, $25 more if glucose is less than 100. I understand the consumer directed aspect of it, but attaching a $ value to my blood profile is beyond my imagination. Healthcare is a nightmare in US!! :o:o

Realistically, it's not any different from auto insurance companies charging you more based on your record. And it provides an incentive for people to control their cholestrol and glucose. $25 isn't large enough to be a problem, but is enough to provide an incentive.

[greyfri]

I've been on HDHP plans for 2 years now, and here are my suggestions for people who don't use that much care and will likely not reach their deductible.

1) For prescriptions, ask for the cash price. Places like Costco and Wal Mart can give you cash prices that are sometimes better than co-pays.

2) Since you aren't paying a flat fee for doctor's visits, try and bundle up non-urgent health issues and bring them up at one meeting with your PCP. That way, you don't have to pay separate for multiple visits. Also save as many as you can for your annual visit, since that should be largely free.

3) For any blood or other test, ask the doctor's office if it can be coded as preventive, since it that case it will be covered by the ACA.

4) You can get some non urgent health care and blood tests done in India and show results to your PCP.

5) Avoid emergency rooms unless absolutely necessary.

6) Ask labs and offices for prices on routine tests and shop around. I know it's not easy to get straight answers on costs, but insist. Even ask for cash prices, although it may not be as good as the insurance negotiated price. Note that if you pay cash, it will not count towards your deductible.


7) Finally, Max out your HSA and make NO withdrawals from it. Use it as the only triple tax free investment vehicle available in the US.

[VS007]

I've been on HDHP plans for 2 years now, and here are my suggestions for people who don't use that much care and will likely not reach their deductible.
[/quote]
Good suggestions
Instead of ER, go to urgent care.
When going to specialists tell them you have no insurance. That?s many times cheaper than deductible on HDP. Even for some tests like xrays , they charge lower for no insurance! I paid 30 bucks for X-ray saying no insurance!
Plus you pay with HSA card.

Sad part is HDP is not economical as you age and have to visit doctors more often!

[sophisticuss]

Why stop going back only till@ Nixon...why not blame Adam and Eve ?

[sophisticuss]

You've been making statements about the ACA that are factually inaccurate for several years,....

If the premiums going up by 100% ( 600% in case of PPO) than few years back is factually inaccurate, then you and me are living in different world..
If you wakeup with a debilitating neck/back pain stenosis and you run few gamuts of tests , your cost will cross $4500 minimum...If this is factually inaccurate , then we are living in seperate world.


All are good points but will only scratch the surface .I will give you an experience I had last year...3 of 4 family members got Flu in 2-3 weeks time. Since children were involved , we went to doctor...They prescvribed Tamiflu to couple of us..Doctor's visit $135*3 ..TamiFlu - even with insurance - $135*2....total bill close to $600-700 for a small fever...Thanks Obama.

[sophisticuss]

I've been on HDHP plans for 2 years now, and here are my suggestions for people who don't use that much care and will likely not reach their deductible.

1) For prescriptions, ask for the cash price. Places like Costco and Wal Mart can give you cash prices that are sometimes better than co-pays.

2) Since you aren't paying a flat fee for doctor's visits, try and bundle up non-urgent health issues and bring them up at one meeting with your PCP. That way, you don't have to pay separate for multiple visits. Also save as many as you can for your annual visit, since that should be largely free.

3) For any blood or other test, ask the doctor's office if it can be coded as preventive, since it that case it will be covered by the ACA.

4) You can get some non urgent health care and blood tests done in India and show results to your PCP.

5) Avoid emergency rooms unless absolutely necessary.

6) Ask labs and offices for prices on routine tests and shop around. I know it's not easy to get straight answers on costs, but insist. Even ask for cash prices, although it may not be as good as the insurance negotiated price. Note that if you pay cash, it will not count towards your deductible.


7) Finally, Max out your HSA and make NO withdrawals from it. Use it as the only triple tax free investment vehicle available in the US.

Another important point:

#8)Use Telehealth option . You get a flat bill of $40.00 and doctor will send prescription to your pharmacy.