Medical Costs

[Rocky Mountain Shock]

Sir, we are certainly not making the same point. En garde!


T


...:cool:

It appears he is making the same point. A criticism of our system before ACA is exactly what you described--people would sign up for coverage only when they're diagnosed with a condition. The ACA mandates coverage, so people have to sign up for coverage before they're diagnosed (ie when they are healthy). What you are claiming the ACA does is not what the ACA does.

[Kung Wu]

So you must not be aware of one of the largest abuses of BO-Care which is signing up for "insurance" the moment you are diagnosed with a condition. A semester of economics with an exit exam requiring mastery of the incentives section should be compulsory for all Americans and those aspiring to be one.

Actually, you cannot sign up for insurance as soon as you are diagnosed with a condition. You have to wait until the enrollment period, which I believe is October or November or something.

If you don't have insurance and you get in a car wreck in February, you are stuck with 100% of the tab until you sign up during the enrollment period. By then you have drained your savings account and wracked up some pretty nice credit card bills. So we are told preexisting conditions are covered, but that's only true if you can wait until the enrollment period to get your condition covered -- which means a massive percent of preexisting conditions are NOT covered for up to about 270 days.

[Kung Wu]

Yup, that's what's happening. But a lot of people out there think that their accident is covered automatically, and it just isn't. Serious illness with long term consequences is, but only after the enrollment period.

[Rocky Mountain Shock]

CB, please elaborate on your "abuse is rampant" claims. TIA.

[C0|dB|00ded]

https://www.forbes.com/sites/gracemarieturner/2016/06/11/aca-rules-allow-people-to-game-the-system-contributing-to-premium-spikes/

T


...:cool:

[C0|dB|00ded]

It appears he is making the same point. A criticism of our system before ACA is exactly what you described--people would sign up for coverage only when they're diagnosed with a condition. The ACA mandates coverage, so people have to sign up for coverage before they're diagnosed (ie when they are healthy). What you are claiming the ACA does is not what the ACA does.

No, no, no, no...

He's commenting on how the ACA cannot work without mandates. I'm not even considering the reality of mandated healthcare in America. I'm discounting the entire premise of BO's dream socialistic plan before it even has a chance to be gamed by your average citizen.


T


...:cool:

[jdshock]

No, no, no, no...

He's commenting on how the ACA cannot work without mandates. I'm not even considering the reality of mandated healthcare in America. I'm discounting the entire premise of BO's dream socialistic plan before it even has a chance to be gamed by your average citizen.


T


...:cool:

You're misunderstanding what I'm saying since you think we absolutely have to disagree on every point. I'm saying that coverage of pre-existing conditions appears to be economically unfeasible without a mandate. You generally agree with that statement, correct?

Now, I do think it is economically feasible with a mandate. You may disagree, but that's also not what we're talking about. My first post was literally me saying "look, I'm a liberal, but I'm just not sure I support broad pre-existing coverage without a mandate."

[C0|dB|00ded]

Wanna know how I would run healthcare? Here's a snippet:

Let's say you catch ball cancer. You need a ball lopped off ASAP (sorry bro but one will do).

You head on over to CB's network of ball surgeons listed across the country replete with reviews from previous patients. You pick the one you like based on price (there will be some incentive built in to choose the cheaper doc over the more expensive), availability, and location. Maybe you don't mind flying to Alaska to have your bad ball removed while your good one freezes. The surgeon in Anchorage charges $15k less than the one in Wichita and you like the idea of not dinging your healthcare savings account over a small procedure. Off you go to the great frozen tundra.

Dr. Galichia sees eye to eye with me on this plan. Patients should be able to shop for their doctors/surgeons. The cost for same surgeries can vary by hundreds of thousands of dollars across America. Very broken system.


T


...:cool:

[C0|dB|00ded]

You're misunderstanding what I'm saying since you think we absolutely have to disagree on every point. I'm saying that coverage of pre-existing conditions appears to be economically unfeasible without a mandate. You generally agree with that statement, correct?

Now, I do think it is economically feasible with a mandate. You may disagree, but that's also not what we're talking about. My first post was literally me saying "look, I'm a liberal, but I'm just not sure I support broad pre-existing coverage without a mandate."

Brother... you had me at hello.

No government-sponsored healthcare.

No mandates.

Nothing in between or outside the lines.

If you're sick and unemployed and for some reason can't qualify for welfare, there are mission-based healthcare options - Gracemed of Wichita would be an example.

A decent job offers a group plan that covers preexisting conditions as employers are incentivized to maintain the health of their employees.


Most importantly:

If you don't prepare for the possibility of your body to fail and said body fails... you will experience pain and/or a shortened lifespan. It's no different than driving without your seatbelt, being obese, consuming massive quantities of sugar, or abusing drugs. Your choice, your body (Libby ears should perk up on that one), but it will be... your consequences.


T


...:cool:

[Rocky Mountain Shock]

Brother... you had me at hello.

No government-sponsored healthcare.

No mandates.

Nothing in between or outside the lines.

If you're sick and unemployed and for some reason can't qualify for welfare, there are mission-based healthcare options - Gracemed of Wichita would be an example.

A decent job offers a group plan that covers preexisting conditions as employers are incentivized to maintain the health of their employees.


Most importantly:

If you don't prepare for the possibility of your body to fail and said body fails... you will experience pain and/or a shortened lifespan. It's no different than driving without your seatbelt, being obese, consuming massive quantities of sugar, or abusing drugs. Your choice, your body (Libby ears should perk up on that one), but it will be... your consequences.


T


...:cool:

OK, I'll bite.

Several years ago my son was born 12 weeks premature and spent 51 days in the NICU. He was born with chronic lung disease and some other complications. At the time, both my wife and I were self-employed and we had a Colorado health exchange (Obamacare) plan. All of the other (non-Obamacare) insurance options were WAY too expensive, and even the "affordable" Obamacare plan put a heavy strain on our finances. His birth, treatment, etc., cost almost $700,000. Insurance picked up most of that.

Without Obamacare, we could not have afforded insurance--plain and simple. And it's not like Gracemed--or our equivalent--has a NICU. I don't honestly know what we would have done without the ACA. We simply could not have afforded the care he needed. And without the ACA, I'm not sure any insurance carrier would accept him when he's old enough to be on his own insurance plan--he has a pre-existing condition after all. And it's not his fault.

Insurance companies are blood sucking vampires in a callous and compassionless system. I don't like government mandates anymore than you do. But I am in favor of a single-payer system that removes the profit motive from a system that should NEVER have had one to begin with. You cannot and should not balance people's lives against the interest of making money.

[ShockerPrez]

And a government single payor system wouldn't be callous and compassionless?

[MoValley John]

Aargh, get the HBO. I know the people in hyperbaric medicine at Nebraska Medicine. I showed them your post. Here was their response. While HBO cannot guarantee results and the radiation may have damaged your tissue too much, HBO can be life changing for head - neck cancer survivors. Judging success off of the success, or lack thereof of from chest radiation is not a good comparison. Radiation in the chest can be far worse and more difficult to treat. You are dealing with organs, ribs, the sternum and more. Head - neck wound involve the jaw bone and soft tissue.

Also, HBO either works or it doesn't. At Nebraska Medicine, it would be 40, not 30 treatments. And if there aren't results, there isn't another round of treatments. The only time more treatments are ordered is if improvement is being made but not to a yet acceptable level. Nobody is ordering treatments simply to order treatments. I can't say the same for Wichita, I don't know the practitioners there. I would be glad to pm you more information on HBO specific to head - neck wounds and succeeds rates, let me know if you are interested. The people I know that work with people like yourself are extremely passionate and care. They have enough work as it is that they absolutely don't needlessly add billing cycles to people with whom the treatments aren't helping, and they care too much for the people they do treat to ever just stick them in the tube to collect a check.

Anyway, I'm not going to give my opinion of healthcare costs, they are out of control on so many levels and both the right and the left have some of the answers, but won't listen to each other. I'm just replying to let you know thatI sympathize with your plight, and if I can help you with some information, let me know.

[Kung Wu]

All of the other (non-Obamacare) insurance options were WAY too expensive, and even the "affordable" Obamacare plan put a heavy strain on our finances.

And without the ACA, I'm not sure any insurance carrier would accept him when he's old enough to be on his own insurance plan--he has a pre-existing condition after all. And it's not his fault.

Insurance companies are blood sucking vampires in a callous and compassionless system.

I'm curious about what non-Obamacare options you shopped? Also, was your Obamacare partially subsidized?

Prior to Obamacare: Regarding your son not being accepted, he would not have a preexisting condition wait period if he went to group coverage straight off your insurance, because he never had a lapse in coverage. And if he's on group coverage he could not have been denied. If you let him fall off your insurance and he didn't pick up insurance without a gap in coverage, THEN he could theoretically have preexisting conditions. It's was always that way. He could only be declared uninsurable if he sought an individual plan, but IMHO you should never do that. I suspect that's what you and your wife were shopping for and comparing to Obamacare?

Most of the above is still true in the Obamacare era, and most certainly will be true in the post-Obamacare era.

I disagree that health insurance companies are blood sucking vampires. They are a heavily regulated industry with capped profit margins. Even if they are blood sucking, they are only allowed to suck so much blood. That industry absolutely needs a profit incentive in order to work properly and provide a vast array of choices. What it needs is substantially LESS regulation to help keep costs down (e.g. not being allowed to compete across state borders making groups artificially smaller than they should be).

[C0|dB|00ded]

OK, I'll bite.

Several years ago my son was born 12 weeks premature and spent 51 days in the NICU. He was born with chronic lung disease and some other complications. At the time, both my wife and I were self-employed and we had a Colorado health exchange (Obamacare) plan. All of the other (non-Obamacare) insurance options were WAY too expensive, and even the "affordable" Obamacare plan put a heavy strain on our finances. His birth, treatment, etc., cost almost $700,000. Insurance picked up most of that.

Without Obamacare, we could not have afforded insurance--plain and simple. And it's not like Gracemed--or our equivalent--has a NICU. I don't honestly know what we would have done without the ACA. We simply could not have afforded the care he needed. And without the ACA, I'm not sure any insurance carrier would accept him when he's old enough to be on his own insurance plan--he has a pre-existing condition after all. And it's not his fault.

Insurance companies are blood sucking vampires in a callous and compassionless system. I don't like government mandates anymore than you do. But I am in favor of a single-payer system that removes the profit motive from a system that should NEVER have had one to begin with. You cannot and should not balance people's lives against the interest of making money.

ShockerPrez and Kung Wu saved me a lot of typing, but I will respond on a few points. First I'd like to say congratulations on your newborn and may he live a long and healthy life.

Part of the reason you couldn't find an "affordable" insurance solution is because BO's unilateral swipe at capitalism destroyed the marketplace. Prior to King Hussein's rule, I was able to obtain top level Blue Cross for 1/10th of what my Bummer premium skyrocketed to before I dumped it. Insurance was always affordable (with reasonable deductibles) IF you bought it ahead of any unscheduled health concerns or childbirths. If you obtained BummaCare AFTER you knew you were expecting... well... you know what I'm going to say about that. But good move on your part (if you did) as you gamed the system just like everybody else - don't buy "insurance" until your house is burning to the ground. Please don't take this as a personal attack as I'm only reiterating my previous argument with another example. If you bought insurance before the pregnancy then your actions would have gotten you an affordable plan prior to any socialistic meddling from the previous administration.

Insurance companies are just as "blood-sucking" as any other free market enterprise. Remember, these companies are filled and ran with people just like you and me. They exist because the marketplace demands them to, and they persist because they are competitive (when there is adequate competition).

The concept of insurance was designed to allow large amounts of people to pool their capital ensuring that no single member would endure life-disrupting events due to what the insurance policy covered. Insurance was NEVER designed to be a membership card obtainable at will entitling said member to free access for whatever was listed. It's a "small" monthly bet FOR the possibility of need at a later date. You cannot make a bet on a horse race after it has finished. If this was the case you'd only have gamblers betting on the winning horse. Guess what happens then? There's no losers to pay the winners... and voila', you have BumCare and it's impending doom.

Regarding government run, single-payer insurance...

Dr. Galichia tells a story about the time he was in Canada volunteering in the ER. They had all the current patients attended to and their critical needs were met. Galichia goes to the hospital administrator and asks why they aren't being discharged as the waiting room is full. The administrator responds, "We are over our patient quota for the day and cannot release our current patients because then we'll have to admit those waiting" .................................................. ...... that's all I'm going to say about that.


T


...:cool:

[C0|dB|00ded]

I'd also like to comment again on outreach health programs like GraceMed. I know somebody that works/volunteers for that organization and I've heard stories about insurance-less people walking in and paying a tiny (sub 100.00 copay) and eventually having tumors removed off their newborn's brain. Some of these needs-based health programs can provide pretty potent health services FYI.

I don't know how they finance these massive health expenditures and don't understand why the patient wouldn't qualify for Medicaid but it happens.

P.S. A lot of illegal aliens utilize these services...


T


...:cool:

[jdshock]

You cannot make a bet on a horse race after it has finished. If this was the case you'd only have gamblers betting on the winning horse. Guess what happens then? There's no losers to pay the winners... and voila', you have BumCare and it's impending doom.

Alright, I'll take one more crack at this:

There are "losers" to pay the winners when you have mandated coverage. That's why my stance is that--if you want to cover pre-existing conditions--you must also mandate everybody buy insurance. Which... "BumCare" did and then the current administration got rid of the mandate but left the pre-existing conditions coverage. Which is, without a doubt, economically the worst approach between mandated coverage with pre-existing condition protections vs. no mandate but also pre-existing condition protections. Now, to prevent incredible premium hikes because the current system actually does allow freeriders, the majority party is stuck between a rock and a hard place. They're in the perilous position of trying to walk back protections for pre-existing conditions (politically disastrous) and trying to prevent premium hikes (also politically disastrous).

[C0|dB|00ded]

Alright, I'll take one more crack at this:

There are "losers" to pay the winners when you have mandated coverage. That's why my stance is that--if you want to cover pre-existing conditions--you must also mandate everybody buy insurance. Which... "BumCare" did and then the current administration got rid of the mandate but left the pre-existing conditions coverage. Which is, without a doubt, economically the worst approach between mandated coverage with pre-existing condition protections vs. no mandate but also pre-existing condition protections. Now, to prevent incredible premium hikes because the current system actually does allow freeriders, the majority party is stuck between a rock and a hard place. They're in the perilous position of trying to walk back protections for pre-existing conditions (politically disastrous) and trying to prevent premium hikes (also politically disastrous).

Keep crackin' baby!

But I'm a tough nut...

The mandate was dropped because it's un-American.

The pre-existing condition rider was allowed to remain because: A: The Republicans didn't have the balls to do what they said they would do (what got them elected); and B: it assures the demise of BumCare, but in a less direct way (if we can control the White House long enough).

Mandates do not alleviate free riders as the penalty would never be equal to the cost of insurance. Many just paid the fine and saved thousands... while still being uninsured.

Premium hikes are no problem because they're easily blamable on our previous king.

Yes, allowing CommieCare to implode is painful and will hurt poor people while freeing the productive hardworking Americans. It's always difficult to break an opiod-like government welfare program addiction but it must happen to keep America, America... Still the most sought after land in the world where billions living in "luxurious" socialist countries would sell their children for just one chance of making it big in the Land 'o Plenty.


T


...:cool:

[Kung Wu]

Obama's fault.