Does Anyone Really LOVE Their Health Insurance?

Using it right now - for major surgery. We have a 3000 dollar max out of pocket. We don't have to get approval to see a specialist.

I would devastated, just devastated if I had to give up Cigna.

I loved the insurance I had when I had it through my employer. No referrals required, no deductible, minimal monthly cost.

Now I have to use the public option because I’m unemployed. $1,000/month, $6,000 deductible, need to deal with bitchy, nasty doctor secretary to get referrals - which usually takes at least 3 calls filled with her hostility. I want a job just to get good health insurance again.

I have terminal cancer, and had a major operation last year. Cigna, my insurance company, could not be better or more helpful. They have been fantastic.

The main people that want to keep their insurance are old or sick people. I know someone who has five or six doctors, probably takes at least ten pills a day, and had to wait for six months to get a first appointment with some of her specialists. She went through doctor after doctor.

In the case of one vital specialist, the insurance company kept referring new patients to a really shitty local doctor. She had that guy for about a year. He didn’t give a shit about her. It took several years before she was able to identify somebody who was actually good at the specialty and wait for an opening. Later, she found out a friend who was new in town got referred to the shitty guy, because she didn’t know any better. He was the only one you could get to see easily.

If you’ve gone through all that, you dread change. If you’re not rich, it’s worse, not better. Rich people can go anywhere.

Cigna is wonderful insurance. Loved them and Blue Cross and Travelers.

My insurance, Blue Cross Blue Shield, covers all my regular and specialized care. My copay? $15. My prescriptions which ran me $1200 a month on a different plan cost me $30 a month.

My regular HIV tests and Truvada - covered. When I need to find a doctor, I call and they send me a list of doctors in my area.

Blue Cross is one of the best. Others go through good years and bad - one year denting everything then correcting due to outrage. Blue Cross seems pretty consistent and decent.

I hated my Medicare Advantage until I had to go to the ER twice this yr. Once when I split my head opened and another when I thought I pinched a nerve at the gym....my whole body was numb but it turned out it was my heart rate that went down to 40. They took me right in as soon as the nurse got the 40 reading and hooked me up to adrenaline...no waiting for paperwork.

They gave me the best care both times..no scar with 5 sutures in my forehead and with the low heart rate, cat scans, and everything else they could do to see why it went so low. All that for $80 each ER visit......no hidden costs. I was really impressed with the professional care I had gotten...the rest of my plan...meh!

[quote]Using it right now - for major surgery. We have a 3000 dollar max out of pocket. We don't have to get approval to see a specialist.

For those of you who like it, like this poster and R6 and R7, etc., what's your monthly cost and who pays it? Are your plans through your employers or a union?

Does anyone who doesn't have an employer based plan and isn't independently wealthy love their insurance?

R9, Medicare and its various add-ons don't count. That's kind of the point. People are fighting to keep that level of care from other people.

I'd guess most people don't love their health insurance so much as they're afraid of the unknown, worried about losing it and getting stuck with something worse.

I love my coverage through Anthem. Minus the out of pocket max, my cancer treatment was all covered and no problems whatsoever with claims. All of the hospitals in town are in-network and every time I’ve had any kind of service set up for me, the providers are always in-network. I recently had to replace a doctor who moved away and it was after I made the appointment with the new doctor that I realized I should check if they are in network, and of course they were. I thought about people who buy crappy coverage online and how they always complain about doctors and hospitals not being in network. I’m getting closer to 65 and feeling scared about having to leave what I have for Medicare. The Medicare calculator shows that I will pay at least twice as much out of pocket per year as what I currently pay.

R10 I pay about $400 per month, which covers my partner as well. My employer pays more than this to buy down the cost for employees.

R10 - I’ve found I need to stick with Blue Cross on the public exchange In order to get access to good doctors. Expensive - $933. But the cheapest option on my exchange is $633 - but the deductible means you pay for everything.

If you are young and don’t use doctors, the cheap plan is fine. But I do regular checkups, heart doctor and cancer screenings every year. So far this year, my health care cost $21,000 according to my account - which means I saved $10,000. If I’m paying those obscene premiums, I’m going to make sure I use it. If I had paid for the cheaper monthly premium, I would have ended up paying for most of it myself because of deductible.

It’s worth spending a weekend reviewing each plan and doing the math for the annual cost. If you want decent care, stick with the big ones - Cigna, United, Blue Cross.

R13, who is subsidizing your insurance? Medicare Part B is a fixed cost of around $180 a month. Are you currently only paying $60 a month as a 64 year old? Something doesn't add up there unless someone else is paying a lot more for you to have great insurance.

Do any of you who like anything about their insurance who've posted on this thread pay for it 100% on your own with no employer or union or Medicare involved?

I did IT for financial companies. My insurance was United or MA-Blue Cross. They were essentially identical and great. I never had an argument over coverage for anything. United even covered something for $10000 that they simply did not need to - I had let it expire do to neglected premium payments when under COBRA after leaving work, but they covered me anyway.

I later worked for Coventry Healthcare who were self insured. Most of the employees got insurance through their spouse, because Coventry was so awful. I frequently heard my one-over manager arguing with them on the phone to cover his cancer medication. I actually quit so as to sign up for Obamacare and get decent medical coverage. They own a lot of smaller companies like Mutual of Omaha or “Moo”, and I wouldn’t wish them on anybody.

OP, I hardly know anyone who loves his or her health coverage. A minority of Americans have health insurance. Like many, I have managed care, which is not insurance.

If you have to obtain a referral or authorization to see a specialist, you do not have insurance.

Frau in Dallas here; my husband is an independent contractor and we have a six year old. I have autoimmune thyroid disease which only requires twice-yearly bloodwork and a very cheap monthly prescription, and I also took an antidepressant in the distant past. My husband is a smoker. Our son is healthy. We have had no major health incidents, ever. We pay $1,100/mo for a PPO with a $10K or $15k annual deductible EACH. We can't afford a dental plan here with such high insurance, so we negotiate checkups and cleanings. Any other dental work has to be put off until we can afford it.

Prior to living in Texas, we lived in a state that allowed small business owners to join a pool together, and we paid only $300 a month, and also had a cheap dental plan! But that was in the mid 00's. You're pretty well fucked in Texas if you're self-employed.

Frau in Dallas here; my husband is an independent contractor and we have a six year old. I have autoimmune thyroid disease which only requires twice-yearly bloodwork and a very cheap monthly prescription, and I also took an antidepressant in the distant past. My husband is a smoker. Our son is healthy. We have had no major health incidents, ever. We pay $1,100/mo for a PPO with a $10K or $15k annual deductible EACH. We can't afford a dental plan here with such high insurance, so we negotiate checkups and cleanings. Any other dental work has to be put off until we can afford it.

Prior to living in Texas, we lived in a state that allowed small business owners to join a pool together, and we paid only $300 a month, and also had a cheap dental plan! But that was in the mid 00's. You're pretty well fucked in Texas if you're self-employed.

Blue Cross as a civil servant is terrible so its akin to Medicaid. No idea what it covers and doesn't. I fill a scrip at Walmart and it's $70; I fill the same at CVS and it's $1. I fill the other at CVS and its $14, and at Walmart its $4. WTF.

My insurance is fine until you have to go into the hospital. Then there's a $5000 deductible.

R21 I'm sorry to hear your tale, but any "red state" is usually like that. Please search the internet for a company that offers actual dental insurance for a family for $60 monthly if you're under 50. I believe it's offered by Prudential or other company that begins with a P. I see it advertised often. What it doesn't pay is tax-deductible. Good luck!

I am in California. I have Kaiser and I pay $800 a month for me and daughter. ER visits are $100 on my plan I think, and $1000 if I'm admitted. It is convenient, they have labs, X-ray, everything right in one place. Prescriptions are cheap. My 90 year old father is on it and they asked him to come in and discuss his end-of-life wishes. I went with him and we decided to have him be DNR. He's in very good shape for his age and he loves Kaiser and his MD. I think it's one of the cost-cutting measures they are taking, and I think it's a great idea. I left the medical field because of the awful things I was expected to do to elderly people who should be allowed to die in peace. My only concern is that I eventually want to leave my area and move to another part of California which may not have Kaiser, as they need a large population base to support it.

I had a $35,000 hospital bill for a 5-day stay and I payed nothing OOP. Blue Cross.

r16, the big difference is in the drug coverage. Almost all of my prescriptions have $0 or $15 copay. I have eye drops that have a $50 copay, but that’s it. The Medicare calculator shows I will have to pay thousands of dollars per year for what I get now for practically nothing. For those of you who have never had name brand employer sponsored health insurance, you have no idea what you’re missing and how good it is.

R26 you lucky biotch. That what my parents and I had growing up, Blue Cross & Blue Shield.

R20 - I’ve heard Texas is one of the worst for insurance because so many uninsured means those who are insured get charged more for everything, I once went to a doctor there with a sinus infection, in NY, my doctor wouldn’t even give me antibiotic pills. In Texas, not only did I get antibiotic pills - they have me a shot in the office of antibiotics. Totally crazy and excess - but I realized after, it was so they could charge me more for the visit.

Have you looked at HMO option? PPO is the most expensive. In NY, you can’t even get PPO independently - only through an employer. All individual plans require referrals - effectively HMO.

R29 I might be able to shed some light. I suffered from chronic sinus infections until I moved to a different part of the country. My old internist typically gave me antibiotics and other medications. Other doctors will say "No!" to antibiotics for even the worst sinusitis unless the patient has a high fever and green or yellow discharge. So your problem may not have been financial, insurance, or location, it may have been that modern doctors are taught/trained to not prescribe antibiotics for sinus infections unless the symptoms are extremely severe and acute.

8150 deductible. Cost 576. Per month. Ga. Age 55 total be Wrong

I hate ALL insurance. Healthcare should be a basic fucking human right. And it should be free for all Americans.

Who are you OP, and who do you work for?

I gave BCBS bronze plan with a deductible that is so high that the amount that comes out of my pocket surprised me. I guess the benefit is that my out of pocket is capped. So at least I am protected that way. That said is they keep canceling plans and moving me to the closest other plan they have. Anyone else?

My plan is $15k per year for family coverage. My employer pays more than I do - around $18k, I think. Vision and Dental are also employer-sponsored, and purchased separately.

I don’t think many people realize exactly what healthcare currently costs, or how many of those costs are related to overhead (25% of healthcare spending is administrative) that could be eliminated if we moved to single-payer healthcare. Having lived in a European country with a socialized healthcare system, we paid less and it was hassle free.

R35, I agree, but as others have said, most Americans oppose a single-payer system because they don't want anyone they oppose to get coverage. Americans are so lazy and/or stupid, most don't know that since 1921, the USA has maintained the strictest anti-immigration policies in the world. However, that's not the real opposition to a single-payer system. That comes from the American Medical Association, hospitals and physicians. For example, I see a specialist regularly who drives a car that cost as much or more than than the homes in which most Americans live! Doctors will not permit those lifestyles and privileges to be lost without the biggest fight of their lives.

Kaiser California is nonprofit and I’ve found it to be excellent.

Me! I love it so much I would volunteer to be their spokesperson.

From what I've read, I was right. The only people happy with their insurance and its costs to them are those who get it subsidized or in whole from their employer or have Medicare (except the drug plan). Does that sound about right?

Basic health care/insurance should be a human right. The for-profit insurance companies can move to being boutique providers like they are in most other civilized countries where they even exist. You can buy all the extras you want but everyone should have access to affordable, competent health care with only their ID as a citizen of this country. It should no longer be attached to employment. The employer can go back to what offering health benefits originally was...an enticement. They can offer all kinds of bells and whistles onto the basic plan that everyone already had.

And, though I'm not sure why it matters, to the person who asked, I work in a non-profit organization and they make sure to keep me just under 30 hours a week so I don't get health insurance. I have to buy mine through the Marketplace where my subsidy is getting lower every year due to crap plans being allowed to artificially lower the cost by filling the market with horrible plans from crap companies that are there to simply undercut the market and make profits for themselves...namely, Ambetter.

So, I'll end up with a BCBS Bronze plan with a $6000 deductible and almost nothing covered before hitting that mark. There aren't even copays for doctor's visits. You just pay for everything until you hit $6000. It's fucking ridiculous. Basically it's not health insurance, it's death insurance because I'll have to be dying before I get any kind of healthcare under this plan.

I have great insurance through work, but that has its own problems where I live.

Has anyone felt that doctors are ordering unnecessary tests just to bill the insurance? I went through a harrowing 5 months of tests including an EKG at the Cleveland Clinic b/c I asked my internist to refill a prescription I've had since 1997. They billed in the $10-20K range. I didn't pay for it, so I didn't care. But, waiting for the results of all those tests! I was terrified; I googling symptoms I didn't have. Needless to say, the tests came back negative.

It's bad here in FL, with so many retirees with nothing to do. And so much to check.

R39 I feel for you because only in America. I'll give you a tidbit. Before the late 1970s, our healthcare system was basically non-profit or not-for-profit. There were private hospitals, but they were few and far-between. Most hospitals were owned by religious or charitable organizations. Then Corporate America stepped in and decided to make our healthcare system for-profit. That's when we starting getting managed care. People talk about their insurance. Managed care is not insurance. If you have to get a referral or authorization, have massive deductibles or limited coverage, that's NOT insurance. The person who said he was hospitalized with Blue Cross and didn't pay anything out-of-pocket, that is insurance. That's what my parents had which covered me as a minor and what I had during my corporate career, but those days are gone for most Americans. Even my position immediately below management at a Fortune 25 converted us from point-of-service insurance to managed care.

R36

R34 - same here. They change plans - and cost and coverage - every year. Bu they it’s a “new entity” So “you will need to pick a new plan”. Some BS to get around regulations probably.

But I did the math - and if you end up using it heavily and paying the deductible, it ends up being a better deal than the Gold plan. It also allows you to avoid using it altogether and pay nothing. But I need some prescriptions - dirt cheap generics - and a few specialist visits a year. It still ends up being cheaper than paying for Gold.

R21 Also self-employed in Texas and I agree with you— it sucks big time and it doesn’t seem like there’s a good option even available. It makes me frustrated to hear that in other states you can join a pool because I’d definitely be into that!

Someone above said health care should be a right, (a statement with which I agree), and then said it should be free. Hmmm. Ok - So either that means that NO ONE in the health care industry should be paid (doctors, nurses, orderlies, lab technicians, janitors, architects, holders of mortgages on medical buildings and hospitals), or it means that the government should pay for everything.......which means that either the government will have to raise taxes considerably on all of us, or it will have to print money until other nations stop accepting its currency. I THINK what that poster might have meant is that health care should be free for the very very poor, moderate cost for those of modest means, and expensive for the super wealthy. Although I'm not opposed to that idea, it's very possible that the super wealthy might push back on that idea. They are not famous for their concern for the poor.

The reality is that medical care costs money, and actually a lot of money in our high tech medical age - but it would be generally affordable if every person was required to either buy insurance or pay a regular and significant government deduction from paychecks to pay for medical care. I also think that all insurance should provide the same benefits to all instead of the current piecemeal system we have.

I also think people should get discounts if they A. maintain a healthy weight , B. don't smoke and drink or use drugs very moderately, (as in one or two whatevers a month) and C. exercise regularly. Why? Because there's a great deal of evidence that the driver for rapidly rising medical costs are obesity, smoking, drug and alcohol abuse, and sedentary lifestyles.

10 years ago you COULD NOT GET insurance in most states if you had any pre existing condition or even over a certain age - at ANY cost. Scarily this is an improvement. When I was out of work, I could not get insurance. Scary times. At least now there is an option - even if most can’t afford, it’s cheaper than the $100,000+ that you can easily rack up if you get sick. It was the major cause of bankruptcy. Now for $500/month you can avoid that risk.

R45 I'm glad you mentioned the word bankruptcy. The leading cause of personal chapter 7 bankruptcies in the USA has always been major medical expenses. Everyone please think about that!

I don't love my insurance, but I know it could be worse. My insurance got noticeably worse after the ACA passed. The number of doctors in-network shrank, and I'm relatively lucky to be healthy so it's not a huge deal when/if I lose my regular doctor and have to choose another one. I have a friend who's been battling cancer for years, and every November she struggles to find a plan that will let her keep the doctors she relies on.

American health care is the most expensive in the world, and it's not just the fault of insurance companies. Doctor choice/shopping and Americans expecting the best health care (no matter if it bankrupts them) are also significant reasons why health care is so expensive, and any Medicare for All plan that's serious about providing care without bankrupting the country would have to limit choice and draw back some of the absurd expectations Americans have. If you have cancer, you'll go to your local oncologist and only your local oncologist; you will not be going to MD Anderson, not if your only option is M4A.

People expecting better care than a nationalized health care system can provide is why most national systems allow private insureds to bypass rationing and waitlists.

“Health Insurance”? Why would I need that?

We have universal health care in my country.

I used to pay an exorbitant amount for private health care but the ROI couldn’t justify it so I gave it up, like the majority of my countrymen. As a consequence private premiums keep going up so more people drop out. It’s a dying industry here.

I’ve had major surgery twice in my adult life, once with and once without private health insurance. The only difference was that I didn’t get a private room, instead I was in a room for two.

I don’t understand the fear in America of universal health care.

R48 thanks for sharing. You sound like my friends in Europe with national health plans. There are two fears of American universal health care. Bigoted, greedy Americans fear that minorities and others they hate will get free coverage. Hospitals, doctors and other medical providers who realize huge profits and lavish lifestyles know those shall end if the USA converts to universal health care or a single-payer system, so they shall fight those with their final breaths.

Maybe other countries can fund universal healthcare out of general taxation - without necessarily having much higher rates than the US - because they allocate their national budget differently.

r50, most countries that have universal health care have personal tax rates in the 45-55% of income range, vs. the 33% that is the US rate. (I think that must include SS and Medicare insurance). So it will cost, there's no doubt about it. Needless to say, I'm in favor of repealing the corporate tax break and increasing the tax rates for the wealthy, but you can only push those so far - corporations and the wealthy have much more clout with congresspeople than the average citizen of the US, and they won't willingly give up a penny to help those less fortunate - at least the majority of them won't.

r11 one still has to pay for it and it's not cheap. I had to buy an advantage plan....besides the great $80 ER visits, the rest costs me a fortune

Simple repealing the 40% tax cut Republicans / Trump gave to corporations would go a long way. Of course, that is being funded by borrowing via deficit - but who said income needs any correlation with expenses? America borrows for everything - yet Medicare for All has to be “funded”. While huge tax cuts for corporations and the rich are funded by borrowing, American democracy is dead.

No further proof that DL has become a troll farm than this thread full of health insurance shills singing the praises of American health insurance corporations bu name. Complete fucking bullshit.

I was in charge of managing my parents' business when they were too sick to do it themselves and what I went through with crooked/incompetent medical billing and Blue Cross stonewalling me on payments made me realize why so many people go bankrupt during a major illness. Those people are ruthlessly greedy and they genuinely do not give a fuck. Getting rid of those vultures would be the best thing to happen to this country since getting rid of the King.

R44 Smokers are quite a good risk for insurers, they die younger and relatively quickly and cheaply. They should probably get the discount.

Yeah, I don't think people should have to go through all the underwriting medical questions you know? Especially elderly people, 85 and so, getting denied for that 20 percent medigap plan the 80 percent of Medicare doesn't cover. It's just sad, but at least they get the 80 percent from the government.

Still it's just sad when people have declinable conditions. Like major depression. Say you have major depression or bipolar or schizophrenia and you're declined? So what happens then? They get disability and go on Medicaid anyway! 😂 The cost is shifted to everyone ANYWAY because those major companies decline those high risk patients!

All because people envision socialized medicine like a trip through a TSA screening.

R51 Your 45 -55% estimate I assume includes VAT (sales tax) which raises the most of the revenue.

Given how complex the US tax system is a form of National Sales Tax (VAT) is probably the easiest and fairest way to fund Universal Healthcare. It averages 15-20% in most of Europe though, so would be a bit of a shock initially.

Though unlike local sales tax the price you see is the price you pay and basic food items are excluded.

ALL US Insurance companies are pieces of shit. I come from South Africa. No co-pays, 100% coverage for a fraction of the cost here. You have NO idea what private health insurance should be. No idea.

r10 - Ours is Aetna - it costs me 600 dollars a month for myself and my husband, through my work.

I work for Anthem. No, I hate them. They treat us like shit, and have undermined every positive we used to offer. We used to be considered 'the good guys' . Ten years ago, maybe we were. But not now. I'm ashamed of the company for which I work. I do the very best I can to serve our members: seriously. You have no idea how much I struggle with some of the medical cases I have to review. I make every single effort to pay claims, but I get turned down, a lot. And I worry, a lot, about the patients. I've already admitted to DL, on other threads, that I've sometimes ended up in tears, reading medical records.

I have Medicare A, B and D(PPO) with Aetna. I had a knee replacement this year. The retail price on the insurance summary was $110,000 and I paid a total of $1,300. My monthly deduction on my Social Security benefits for insurance is $160 monthly.

R39, to make you feel better about your situation, I'd offer a couple of observations.

First of all, even with a $6,000 deductible, you do have some things that are first dollar coverage because the ACA law requires preventive services to be covered with no member cost-sharing, even with plans such as yours that have a high deductible. That includes an annual preventive visit with your doctor, some testing such as a colonoscopy, some drugs, etc. Second, remember that even when you are having to pay out-of-pocket, you are at least still paying based on the usually greatly discounted pricing that your insurance company has negotiated with their contracting network providers. If you didn't have insurance, you'd be subject to the exorbitant charges that doctors and hospitals charge. Lastly, if you think you'd have to be dying to burn through $6,000, you are mistaken. That wouldn't touch a single night in a hospital. It's even close to that for a trip to the emergency room with some tests and imaging.

R57, with all due respect, you're mistaken. In the USA, nobody gets Medicaid unless he or she is below the federal poverty level, has no assets and no life insurance. The majority of doctors in my state refuse to treat patients with Medicaid. My docs do not accept Medicaid. The Affordable Care Act does not permit insurers to deny coverage based on a pre-existing condition. I don't know if that was reversed by President Trump's plan that went into effect this. About 80% of homeless Americans have a mental condition. At least 20% of all Americans suffer from a mental disorder. I'm fortunate that I don't. I've been a mental health advocate since college. Proper mental health services are not available in the USA and few people care.

Good point R63. I was trying to get an X-ray and it was only $300 under insurance. Because insurance wouldn’t cover it, I wanted pay to pay myself - they insisted on charging $1,000. Ridiculous. I shopped around and finally came across a place that would do it for $300. Insurance is important and I’m willing to pay the crazy premiums - because without it, one significant sickness can wipe you out. Just a fact of life in the US.

[quote]you do have some things that are first dollar coverage because the ACA law requires preventive services to be covered with no member cost-sharing, even with plans such as yours that have a high deductible.

Yeah, I know that. But, it's work to get them to figure that out at both the doctor's office and the insurance billing departments. And, they'll do things that aren't covered during the exam that is covered, like order lab tests and then you get that bill a couple of months later. It's a mess.

[quote]Lastly, if you think you'd have to be dying to burn through $6,000, you are mistaken. That wouldn't touch a single night in a hospital. It's even close to that for a trip to the emergency room with some tests and imaging.

Yeah, I know that, too. What I meant was that I won't even consider going to the ER unless I'm in such bad shape that I think I'm dying because I know that one visit is going to cost me probably $7000 by the time I'm done. It's the absolute worst way to run any kind of health system because I'm going to be way sicker when I show up than if I felt like I could have gone before it became critical. But, after my $8000 out of pocket max is reached, they can fuck themselves.

R65 glad you shared that important fact. Cash patients are ripped off. Insurance companies negotiate discounted rates with all medical providers including pharmacies and hospitals. A true story:

I stopped shopping at Walgreens, which is morally bankrupt. Humana and Walgreens attempted to merge, which the Department of Justice possibly wouldn't approve. Walgreens HQ possibly attempted to move off-shore to avoid US regulations and taxation.

Years ago, an older man wearing paint-covered overalls was immediately in front of me at Walgreens and picked up possibly a dozen prescriptions. I mind my own business, but couldn't completely ignore this transaction. The tired man pulled out of his large work pocket a wad of $100 bills large enough to choke a horse! I glanced at the total on the register, which was more than $2200.

[quote]Cash patients are ripped off. Insurance companies negotiate discounted rates with all medical providers including pharmacies and hospitals.

Which would be entirely ended by a Medicare for All type system thereby locking in those lower rates across the board because there are no longer any cash patients and the risk pool is every single person in the country.

What hospitals and, to a lesser extent, doctors charge is a joke. Everyone should understand that Medicare and Insurance companies only pay a fraction of the bills that are submitted. For example, they will pay $50 on a doctor's visit which was billed as $250. (So 1/5th). If a hospital bill is $10,000/night, they will pay $2000/night.....and so forth. However, if the doctor ONLY billed $50, Medicare or the Insurance company would only reimburse him $10. If the hospital only billed $2000/night, the reimbursement would only be $400. So those enormous bills have no basis in "reality" - the entity (doctor or hospital) figures out how much they WANT to be reimbursed, and then multiply by 5, knowing that the payee will divide by 5. The problem comes when an uninsured patient arrives. Does the hospital or doctor make an instant adjustment? No, not in most cases, because it could be a set up by a government agency to check for Medicare or insurance fraud. So the poor schmuck without coverage really gets screwed. Sometimes hospitals will take payments over time, and eventually will write off a substantial part of the bill. It's this kind of game-playing that everyone would love to do away with, and a single payer system, or tightly regulated national insurance system would eliminate a bunch of that kind of crap.

R69, I respectfully point out a potentially erroneous part of your comment. Today, private hospitals will not take payments over time and write-off a substantial part of the bill, not in my state. There are also laws that prevent that, depending on a patient's status and coverage. In my area, there's only one hospital that's considered a public or charity hospital. In every hospital in my state, there's a sign in emergency rooms that remind patients of state law: nobody is entitled to treatment unless you can prove you can pay unless you are a woman giving birth or you are moribund, meaning you are suffering for an illness or injury about to kill you.

Wouldn't it be nice if some government, somewhere in the US would pass a law stating that all medical prices must be charged at the same rate to insurance companies and cash patients? People could pay on their own if it was only $50 to go to the doctor and $10 for their prescription but then the insurance companies don't get all of those nice profits anymore. Can't hurt the poor insurance companies. Thank god our government is there to protect the insurance companies at the people's expense.

[quote] The problem comes when an uninsured patient arrives. Does the hospital or doctor make an instant adjustment? No, not in most cases, because it could be a set up by a government agency to check for Medicare or insurance fraud. So the poor schmuck without coverage really gets screwed.

So the moral of the story is to get coverage, isn’t it?

Interesting point - most medical bills don’t affect your credit - and hospitals write off a huge amount of what they charge as uncollectible. So if you can’t afford, just don’t pay, Ive gone to the ER - when I’ve felt like it could be life or death - and been charged huge amounts that for some reason arent covered by my insurance. Just ignored bills. Credit rating 780.

What's messing it up is the people that do pay.

Just stop paying those outlandish fees. It's insane! Literally insane.

Then the hospitals will be bankrupt but do you really think they would be closed? No. The government would have to bail it out. Good. We don't need new nukes. Pay for people to live. Jesus Christ 🙏

Obamacare was a lifeline to hospitals as much as people. Hospitals dealt with a lot more uninsured - and dealt with much bigger write offs - before Obamacare.

OP, you asked a question and didn’t like the answers. So you shifted the focus to Whataboutism. You tried to fence response you didn’t like.

You’re just here to push your political agenda, so it’s time for “Fuck off!”

Speaking of which, where’s the DL Fruitcake baker? It’s not Christmas without him.

White trash Rhode Island is in the top five states for health insurance.

I loved my employer paid health insurance prior to Obama getting involved in health insurance and fucking it all up. It was 100% paid for by my employer, with low deductibles, low cost drug copays. The Obama got involved, our rates skyrocketed for our small company. Eventually we were dropped, as a small company. My employer finally said fuck it, I'm not in business to insure people and deal with this. He gave us an "allowance" which he told us if final, it will not increase, he doesn't care how much it goes up each year. So it has now almost doubled, with a shitty policy with an outrageous deductable. No major decent hospitals accept it, so basically it'll be like going to a veterinarian if I need hospital care. Its awful. Massively expensive for something that's nearly useless.

R39, Medicare isn’t that great. It’s cheap, and most doctors near me accept it. But it’s got a deductible, and it’s an old fashioned 80-20 plan, where 20% of costs are due from you. So, I have additional Gap insurance that covers most of that 20%, but it has a premium, too. One of these days, I’ll accidentally see a doctor who doesn’t accept Medicare and I’ll forget to ask, and unexpectedly get hit with a huge bill.

So, I don’t “love” Medicare. I preferred my old employer plan, but I’m no longer working now. So, Medicare is far better than the alternative for me now, but I don’t love it.

There ought to be a law that doctors have to accept Medicare. You don't get to deny seeing people by race and if you do your license should be revoked.

Yes because my state has Medicaid expansion and unbeknownst to me me I qualified for it and pay nothing for excellent care. I intended to just get something under Healthcare .Gov but my income threw me out of those plans and I had no choice. I have Caresource now. I feel really lucky.

I have Kaiser and LOVE it. It's super convenient and I've broken in my doctor so couldn't be more happier. Not okay with the notion of universal health care.

No one "LOVES" their health insurance OP

The issue with MFA is that people fear that system will be worse than what they currently have now, not better.

I have found many people seem to confuse MediCARE with MediCAID and assume that we'll be getting some system that's designed for poor people on welfare.

Thus their sudden allegiance to Aetna or BlueCross.

I'm 38, live in CA, an independent contractor and have Oscar Health. I pay $495/ a month on the private exchange after a disastrous experience with Obama care. My salary fluctuates, so I would be getting booted out of Covered CA when I made more or less money and then stuck w/o insurance until the enrollment period rolled around (this is really what I hate most - enrollment periods). I couldn't handle it and now treat health insurance like a luxury item that I am willing to pay for and forgo other things to feel covered. I have ADHD. This covers meds, PrEp, my shrink, and have a great network. They have MD's on call so if you have a cold or something, you can get a prescription w/o having to go to the MD. The one thing I hated about Blue Cross were the call centers in the Philippines. The absolute worst. Oscar has an American call center, which I love. I did lose my beloved and smoking hot doctor from when I was a teenager due to Obama care. A lot of MDs went into "bespoke executive" medicine where they cater to the wealthy with a hefty annual membership fee b/c they weren't making any money.

Oops, wrong thread at R326. Although, I wish they'd lose their health insurance!

Okay, that was weird. This thread had the wrong title and my post from the prior thread was here, along with it's post number. I went back to the other thread to put the post there and it was already there, right at R326. WTF?

Something similar happened to me the other day R87-- must be yet another charming quirk of the platform.

R85 - does OSCAR have decent doctors? I’m afraid to go to them because Blue Cross is accepted by almost everyone where I am. But expensive. It’s also Kushners - though the Dem one.

I pay $1000 a month. Just over that for the platinum plan of MVP. Over $12,000 per year for just myself.

Same here R90. 51 and relatively healthy. But my claims totaled $21,000. So worth it statistically.

The increase in prices for insurance including private wasn’t due to Obamacare - it was the continuation of the trend that had been occurring of skyrocketing inflation of medical costs. Don’t like it - but having had 2 family members survive cancers that killed my father and 4 aunts and uncles in the 90s due to new treatments, there is some reason/benefit.

R89 - Yes they do. I have been with them for 2 years and was nervous to try something other than Blue Cross. I did a lot of research before going with them. I am paying privately and Oscar is the same price as BC if not more per month. You also want to check which hospitals they are aligned with in your area for worst case and they are with the best in my city.