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  1. #2841  
    Quote Originally Posted by rjwerth View Post
    It is so obvious that you have never had to insure yourself and thus have no idea as to what you are talking about. I was 28 and paying $350/month in rent. My 0 deductible health insurance was $250. At the time, I was only taking home $1000-$1500 a month.

    I have recently changed my insurance due to the rising costs, so while I no longer have a 0 deductible, I'm still paying around $300/month. Now, I don't know where you live, but if your rent is less than $300/month..more power to you.



    Could I pay for medical costs at the current system rates out of my pocket? No, probably not. But that's my point. There are too many people out there who do not pay for their heath insurance getting crazy good policies and using every inch of them and thus driving up the cost for EVERYONE. If everyone paid everything out of pocket, it would not cost $10,000 to have a baby because no one would pay it.
    You know, it must be nice to be able to fork over $300 per month. I mean, I have no problem doing it. Of course, my family plan covering four people (my oldest daughter is just 26 so still covered) is over $1500 a month. Admittedly it's excellent coverage. But let's just say we're talking about one single person with type 2 diabetes at age 50 who just lost his job and wants to get some health insurance. It will cost around $800 a month in Florida for a $2000 deductible policy, and of course it won't cover any diabetes related expenses for two years.

    Don't get me wrong, I'd love to get rid of insurance companies. But there is no way that people can pay out of pocket and have any kind of health care system survive.
  2. #2842  
    Quote Originally Posted by davidra View Post
    Doesn't make a difference to me. A lot of the dissatisfaction is coming from his base because of Afghanistan and DADT, Gitmo and other things. The thing about that population is they will end up voting for him regardless; they sure as hell won't vote for Palin. As I recall he is somewhat behind a generic republican but leads all republicans head to head by a pretty good majority. It would be different if there was a real republican challenger, but there isn't and I don't see one. The right hates Romney because of his relligion and he flipflops more than anyone, like on health care; Palin is a mental dwarf and even republicans don't think she can get elected. Huckabee? Right, sure. He'll get the evangelist vote. I don't see anyone close, actually. And even if he is a one term president (and I'll be glad to bet he won't be), he's already done more positive things that Bush did in 8 years....and a lot fewer negative things. I'm pleased as punch with his performance.
    That's odd....the polls I saw had him behind about 4 specific Republicans, and TIED with Palin! LOL. My point is that he won the last election with the help of the Independents. The hard core dems are of course going to vote for him and the hard core Republicans will vote for their candidate....it's the Independents that win the election and they have left this socialist Prez in droves. Obama is too far to the left and these Independents now see that. There is still plenty of time for Obama to get those Independents back, but I don't see obama suddenly changing from his socialist agenda....the majority of Americans do not want to become Europe and you can take that to the bank (ooops, maybe that statement isn't a good one these days, lol).

    As for health care....Americans are finally realizing they can't believe anything obama says about healthcare reform and how it will save everyone money. Obama lied to get his socialist agenda started, and Americans, though slow, are seeing through his whole "change" BS. I loved that woman in NC going after the senator and telling it like it is. I'm sure you will say that woman is a plant, or doesn't know what she is talking about....but if anyone knows how obamacare will affect the system, it would be a woman who has 2 children getting major treatment now. The amazing part was how she ran into people from UK and Canada who cannot get the treatment their children need in those countries....so where do they come? The good ole US of A!
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  3. #2843  
    Quote Originally Posted by davidra View Post
    You know, it must be nice to be able to fork over $300 per month. I mean, I have no problem doing it. Of course, my family plan covering four people (my oldest daughter is just 26 so still covered) is over $1500 a month. Admittedly it's excellent coverage. But let's just say we're talking about one single person with type 2 diabetes at age 50 who just lost his job and wants to get some health insurance. It will cost around $800 a month in Florida for a $2000 deductible policy, and of course it won't cover any diabetes related expenses for two years.

    Don't get me wrong, I'd love to get rid of insurance companies. But there is no way that people can pay out of pocket and have any kind of health care system survive.
    Doc....you could reduce your monthly health insurance premium by going to an HSA plan. Doesn't your group offer such a thing? I bet your could save $300 to $400 per month in premium.....now.....take that $300 and put it aside in an HSA savings account ($3600 for the year and a tax deduction, I'm sure your wife can explain that) and you've got plenty of funds to offset your family deductible. Since you are in the medical profession, you obviously make a lot of money each year so I'm sure you could handle even putting aside a little more (I believe the annual max for family coverage is $6,150 or so). You might even save more money than that on the premium....just depends on the situation. Seems like an HSA option would be ideal for you, why do you need co-pays for everything being a wealthy doctor?

    You know the new law says that dependents under the age of 26 must be allowed to stay on your plan, is your plan more generous? I think you said your daughter is 26, which would mean she wouldn't qualify under the new obamacare law (that doesn't mean a group plan can't raise the age).
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  4. #2844  
    Quote Originally Posted by clemgrad85 View Post
    Doc....you could reduce your monthly health insurance premium by going to an HSA plan. Doesn't your group offer such a thing? I bet your could save $300 to $400 per month in premium.....now.....take that $300 and put it aside in an HSA savings account ($3600 for the year and a tax deduction, I'm sure your wife can explain that) and you've got plenty of funds to offset your family deductible. Since you are in the medical profession, you obviously make a lot of money each year so I'm sure you could handle even putting aside a little more (I believe the annual max for family coverage is $6,150 or so). You might even save more money than that on the premium....just depends on the situation. Seems like an HSA option would be ideal for you, why do you need co-pays for everything being a wealthy doctor?

    You know the new law says that dependents under the age of 26 must be allowed to stay on your plan, is your plan more generous? I think you said your daughter is 26, which would mean she wouldn't qualify under the new obamacare law (that doesn't mean a group plan can't raise the age).
    As I told you, it's a generous plan. There is no deductible. There are no co-pays as long as care is provided at one of our institutions. My daughter is covered until she is no longer 26...i.e. until next May.

    In other words, everything is covered. You know, kind of like universal health care.
  5. #2845  
    Quote Originally Posted by davidra View Post
    As I told you, it's a generous plan. There is no deductible. There are no co-pays as long as care is provided at one of our institutions. My daughter is covered until she is no longer 26...i.e. until next May.

    In other words, everything is covered. You know, kind of like universal health care.
    Well no wonder your premium is $1500! No deductible? Who has such a plan these days? I guess just doctors, LOL. Most plans these days that I see are minimum of $1000 ded, but of course, you have co-pays ($25/$50) for doctor visits and an Rx card. What also is becoming popular are the non-HSA high deductible plans (say, $3000) that pay 100% after you meet the deductible but also provide physician co-pays as well as an Rx card. But anyway, no wonder your premium is so high....good grief....you are one special person. Plans like yours are part of the problem. Are you in a union?
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  6. Micael's Avatar
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       #2846  
    Quote Originally Posted by davidra View Post
    Not now...but it will be much better in 2014 when insurance companies will have to control their rates in order to stay in the exchange. And as for me, I've never fantasized that costs would be controlled by this weak bill. It needs much more rigor. Dems had to do what they had to do, but the bill needs much work.
    Is that what all this was about? All you had to do was remove the "in state only" barrier, and let the market self-regulate it's pricing through some serious competition. Wouldn't have cost us a dime.

    And the bill needs much work, is right. Let's work it back off of the books.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  7. #2847  
    Quote Originally Posted by Micael View Post
    Is that what all this was about? All you had to do was remove the "in state only" barrier, and let the market self-regulate it's pricing through some serious competition. Wouldn't have cost us a dime.

    And the bill needs much work, is right. Let's work it back off of the books.

    More work indeed. Like a public option and cost controls, both of which I'm sure you favor.
    Yeah, that's another conservative fantasy, like tort reform. For one thing, if you do that, you will have to set up a much larger centralized bureaucracy to deal with cross-state issues, and I'm SURE you want to increase the size of the federal government. Additionally, any improvement in costs might be around 5% or less savings....which probably wouldn't pay for the increased costs of management. This is a very reasoned discussion about the "across state lines" fantasy.

    Buying Health Insurance Across State Lines - a Reality Check
  8. Micael's Avatar
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       #2848  
    Quote Originally Posted by davidra View Post
    More work indeed. Like a public option and cost controls, both of which I'm sure you favor.
    Yeah, that's another conservative fantasy, like tort reform. For one thing, if you do that, you will have to set up a much larger centralized bureaucracy to deal with cross-state issues, and I'm SURE you want to increase the size of the federal government. Additionally, any improvement in costs might be around 5% or less savings....which probably wouldn't pay for the increased costs of management. This is a very reasoned discussion about the "across state lines" fantasy.

    Buying Health Insurance Across State Lines - a Reality Check
    You mean a lot of hot air opinion. Who wrote it? Donald Marchand. Nice guy. He say's "Currently, I am a teacher. I teach Social Studues at a small school in southern Maryland. But I think I've been a lot more in my life. Among my occupations, I've been a lifeguard, a pool operator, a pizza delivery driver, a dj, and an usher. I've sold shoes, music, video recorders, tv's, and stereos. Besides Social Studies, I've taught Language Arts, Reading, Music, and Math. And I teach private music lessons."

    Wow. Such an insurance authority. And he doesn't know how to consistently spell "Studies". But he seems like a nice guy. He's certainly sold a lot of stuff. I'll humor you both and respond to a couple of his points(?):

    BCBS has been split up for years. They aren't 'divisions' - they are totally separate and independant. BCBS is now just an association. Some of the BCBS's of today are not for profit, some are for profit. I used to work for BCBSFL. I personally know this to be a fact - and he's got his 'facts' wrong.

    Second, who the heck thought people would be able to purchase insurance based on other state's local rates? That's just silly. Ever look into auto insurance? People aren't idiots; they know better. That whole part of his discussion was a waste of text.

    As for Kaiser's "findings" of a difference of 5%, well maybe - but that's based on today's model. Remove the state line barriers and those companies that wish to compete competitively on other's turf will have to offer better rates and plans. At the very least, that 5% difference would evaporate and all rates would uniformly drop. Experts far more knowlegable that myself or Marchand have agreed on this.

    Your opinion blog was hardly a 'reasoned discussion', but full of fantasy - you got that part right.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  9. rjwerth's Avatar
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    #2849  
    Quote Originally Posted by davidra View Post
    You know, it must be nice to be able to fork over $300 per month.
    And how much do you think it is going to cost productive people to pay for a public option? I can guarantee it's going to be more than $300 in addition to paying for yourself.
    I mean, I have no problem doing it. Of course, my family plan covering four people (my oldest daughter is just 26 so still covered) is over $1500 a month. Admittedly it's excellent coverage.
    As I told you, it's a generous plan. There is no deductible. There are no co-pays as long as care is provided at one of our institutions. My daughter is covered until she is no longer 26...i.e. until next May.

    In other words, everything is covered. You know, kind of like universal health care.
    And you think the government program is going to be just as generous? Furthermore, let's look at your coverage for just a moment...I'm going to assume that you are on a plan that is provided directly from your hospital network and not an outside vendor (if I'm wrong..well the next part is mute). What you are telling us is that it costs them $1500 for a family of four to provide you with coverage equal to what you want the government to provide everyone. Yikes. Right here and now, they have the power to control their own costs and the best they can do for their own employees (who are doctors and should know how to take care of themselves) is $1500? That should really tell you something.

    But let's just say we're talking about one single person with type 2 diabetes at age 50 who just lost his job and wants to get some health insurance. It will cost around $800 a month in Florida for a $2000 deductible policy, and of course it won't cover any diabetes related expenses for two years.
    Don't forget, if he had health insurance, he is allowed cobra, which the government is assisting people with already. No, it doesn't last forever, but it is strange you didn't mention it.
  10. #2850  
    Quote Originally Posted by rjwerth View Post
    And how much do you think it is going to cost productive people to pay for a public option? I can guarantee it's going to be more than $300 in addition to paying for yourself.

    And you think the government program is going to be just as generous? Furthermore, let's look at your coverage for just a moment...I'm going to assume that you are on a plan that is provided directly from your hospital network and not an outside vendor (if I'm wrong..well the next part is mute). What you are telling us is that it costs them $1500 for a family of four to provide you with coverage equal to what you want the government to provide everyone. Yikes. Right here and now, they have the power to control their own costs and the best they can do for their own employees (who are doctors and should know how to take care of themselves) is $1500? That should really tell you something.

    Don't forget, if he had health insurance, he is allowed cobra, which the government is assisting people with already. No, it doesn't last forever, but it is strange you didn't mention it.
    That's part of the issue....Humana takes a nice chunk of money for managing our health insurance. The fact is that providing insurance for me and my family, who are generally healthy, could be provided at much less than $1500 because I know enough to refuse tests and procedures that are ineffective, not because they won't be covered....they will...but because their use is bad medical care.

    Do I really think that everyone in the country could get the coverage that I have? Nope. But they could get something. And now, 30 to 45 million of them have nothing....other than going to an ER. And please stop with the health department and Medicaid arguments. These are people who aren't eligible. With appropriate control of unnecessary tests, using brand name drugs with no advantage over generics, being able to negotiate prices with drug companies for patented drugs, and approving only procedures that have been shown to be beneficial, we would easily have enough money to provide very good care. Since as many as a third of all expenditures are unnecessary, we're talking real money here. It can be done. Just requires some trust from those that really don't understand medical costs.
  11. #2851  
    Quote Originally Posted by Micael View Post
    You mean a lot of hot air opinion. Who wrote it? Donald Marchand. Nice guy. He say's "Currently, I am a teacher. I teach Social Studues at a small school in southern Maryland. But I think I've been a lot more in my life. Among my occupations, I've been a lifeguard, a pool operator, a pizza delivery driver, a dj, and an usher. I've sold shoes, music, video recorders, tv's, and stereos. Besides Social Studies, I've taught Language Arts, Reading, Music, and Math. And I teach private music lessons."

    Wow. Such an insurance authority. And he doesn't know how to consistently spell "Studies". But he seems like a nice guy. He's certainly sold a lot of stuff. I'll humor you both and respond to a couple of his points(?):

    BCBS has been split up for years. They aren't 'divisions' - they are totally separate and independant. BCBS is now just an association. Some of the BCBS's of today are not for profit, some are for profit. I used to work for BCBSFL. I personally know this to be a fact - and he's got his 'facts' wrong.

    Second, who the heck thought people would be able to purchase insurance based on other state's local rates? That's just silly. Ever look into auto insurance? People aren't idiots; they know better. That whole part of his discussion was a waste of text.

    As for Kaiser's "findings" of a difference of 5%, well maybe - but that's based on today's model. Remove the state line barriers and those companies that wish to compete competitively on other's turf will have to offer better rates and plans. At the very least, that 5% difference would evaporate and all rates would uniformly drop. Experts far more knowlegable that myself or Marchand have agreed on this.

    Your opinion blog was hardly a 'reasoned discussion', but full of fantasy - you got that part right.
    Please. You think his concepts are incorrect because of his background and not what he wrote? Your arguments don't address his point at all....there are multiple providers across state lines with different rates everywhere. You didn't address the immediate requirement of a new national office to manage this stuff.

    There are plenty of discussions about this. I'm sure you won't like any of them, because they all give good reasons why, just like tort reform, selling insurance across state lines is not an important way to control costs.

    Across State Lines Explained: Why Selling Health Insurance Across State Lines is Not the Answer | NewAmerica.net
  12. #2852  
    Quote Originally Posted by davidra View Post
    That's part of the issue....Humana takes a nice chunk of money for managing our health insurance. The fact is that providing insurance for me and my family, who are generally healthy, could be provided at much less than $1500 because I know enough to refuse tests and procedures that are ineffective, not because they won't be covered....they will...but because their use is bad medical care.

    Do I really think that everyone in the country could get the coverage that I have? Nope. But they could get something. And now, 30 to 45 million of them have nothing....other than going to an ER. And please stop with the health department and Medicaid arguments. These are people who aren't eligible. With appropriate control of unnecessary tests, using brand name drugs with no advantage over generics, being able to negotiate prices with drug companies for patented drugs, and approving only procedures that have been shown to be beneficial, we would easily have enough money to provide very good care. Since as many as a third of all expenditures are unnecessary, we're talking real money here. It can be done. Just requires some trust from those that really don't understand medical costs.
    You're darn right everyone in the country couldn't get the coverage that you have....that plan of yours is just plain ridiculous. As I said earlier, no one that I know has a plan like that....that type of plan is for the elite. Is that $1500 your portion of the premium or the total premium? We pay about $400 a month (our portion) for a $4000 HSA (just me and spouse). So, no copays or Rx card until you first hit your deductible. After that, copays until you hit an out-of-pocket max. Of course, because my premium is relatively low, I'm able to put money into the HSA savings account as well as put additional funds aside into my retirement account that would have been going to an insurance company. It certainly fits what I'm trying to protect.....the catastrophic illness or accident. To me, that is what everyone should be concerned with....protecting against the catastrophic. We need to get back to what insurance is supposed to be.....protecting against the major situations, not these daily doctor appts where you gotta have a $15 co-pay. Imagine if your home owners insurance had copays for water leaks, or rotting wood, or a new roof....that coverage would be even higher.

    And despite what you say doc, HSA plans (though not for everyone) allow you to negotiate with doctors and to actually look at your EOB statement and see what the heck they are charging you. It's crazy what they try and sneak by you....and most people don't even pay attention....they just bend over and complain about the insurance company. "thank you doctor may I have another".
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  13. #2853  
    Quote Originally Posted by clemgrad85 View Post
    You're darn right everyone in the country couldn't get the coverage that you have....that plan of yours is just plain ridiculous. As I said earlier, no one that I know has a plan like that....that type of plan is for the elite. Is that $1500 your portion of the premium or the total premium? We pay about $400 a month (our portion) for a $4000 HSA (just me and spouse). So, no copays or Rx card until you first hit your deductible. After that, copays until you hit an out-of-pocket max. Of course, because my premium is relatively low, I'm able to put money into the HSA savings account as well as put additional funds aside into my retirement account that would have been going to an insurance company. It certainly fits what I'm trying to protect.....the catastrophic illness or accident. To me, that is what everyone should be concerned with....protecting against the catastrophic. We need to get back to what insurance is supposed to be.....protecting against the major situations, not these daily doctor appts where you gotta have a $15 co-pay. Imagine if your home owners insurance had copays for water leaks, or rotting wood, or a new roof....that coverage would be even higher.

    And despite what you say doc, HSA plans (though not for everyone) allow you to negotiate with doctors and to actually look at your EOB statement and see what the heck they are charging you. It's crazy what they try and sneak by you....and most people don't even pay attention....they just bend over and complain about the insurance company. "thank you doctor may I have another".
    Yeah, the problem is easily seen in your characterization of "catastrophic illness" versus "daily doctor visits" as being the only kind of health care costs. That's fine, but you just don't see the very high percentage of people that don't fall into either category. Let me give you a few scenarios that happen every day millions of times.

    Your moronic teenage son falls off his skateboard and hits his head. He is taken to the emergency room. He is evaluated with an MRI, which is normal, a skull film, which is normal, some routine blood work, and because he is drowsy it's determined that he needs to stay in observation overnight. Is that a catastrophe? Wanna guess what it would cost you out of pocket? Somewhere north of $5000....for one night's care. So you pony up out of your HSA account to cover the costs. While at the hospital you partake of some fine hospital food but after getting home you suddenly develop explosive diarrhea that won't stop. You continue to drink fluids but your temperature goes up and you have to go back to the ER yourself. While there you are given fluids, cultures of your stool are taken, you get multiple blood cultures and blood work done, and because your diarrhea hasn't stopped you have to be admitted right next to your son for at least 24 hours of observation. Pony up another $5K. Now....when are you going to negotiation prices for this treatment? From the commode? I guess you think things like this don't happen very often to people. Guess what? Every ER is full of people just like this, generating huge bills that they would not be able to pay without insurance. The vast majority of health care costs are generated not in catastrophic care or simple outpatient visits, but everything in between. And most people just cannot afford that care. That's why everything needs to be covered, however that can be accomplished...public, private, however. And this coverage must be combined with cost controls based on using only effective treatments and testing. That is the way to control costs, not tort reform, not insurance reform. Those are smokescreens.
  14. #2854  
    Quote Originally Posted by davidra View Post
    Yeah, the problem is easily seen in your characterization of "catastrophic illness" versus "daily doctor visits" as being the only kind of health care costs. That's fine, but you just don't see the very high percentage of people that don't fall into either category. Let me give you a few scenarios that happen every day millions of times.

    Your moronic teenage son falls off his skateboard and hits his head. He is taken to the emergency room. He is evaluated with an MRI, which is normal, a skull film, which is normal, some routine blood work, and because he is drowsy it's determined that he needs to stay in observation overnight. Is that a catastrophe? Wanna guess what it would cost you out of pocket? Somewhere north of $5000....for one night's care. So you pony up out of your HSA account to cover the costs. While at the hospital you partake of some fine hospital food but after getting home you suddenly develop explosive diarrhea that won't stop. You continue to drink fluids but your temperature goes up and you have to go back to the ER yourself. While there you are given fluids, cultures of your stool are taken, you get multiple blood cultures and blood work done, and because your diarrhea hasn't stopped you have to be admitted right next to your son for at least 24 hours of observation. Pony up another $5K. Now....when are you going to negotiation prices for this treatment? From the commode? I guess you think things like this don't happen very often to people. Guess what? Every ER is full of people just like this, generating huge bills that they would not be able to pay without insurance. The vast majority of health care costs are generated not in catastrophic care or simple outpatient visits, but everything in between. And most people just cannot afford that care. That's why everything needs to be covered, however that can be accomplished...public, private, however. And this coverage must be combined with cost controls based on using only effective treatments and testing. That is the way to control costs, not tort reform, not insurance reform. Those are smokescreens.
    Well good doc.....you apparently don't understand how an HSA plan works. Using your example of my "moronic teeanage son", once he hits the $4000 deductible, the remaining $1000 will be paid at 100%. Next, when I have to go back to the hospital after eating their "fine food" (I wonder if this is a ploy of theirs?) and I have that $5000 ER expense, guess how much I will pay? I'll help you doc, the answer is $0 because I hit the family deductible when my moronic teenage son hit the family deductible. Now, let's say later in the same year, I have back surgery and have to stay one night in the hospital (will try and avoid their food as much as possible this time) and they send me a bill for $17,485.52....can you guess how much of that I'll pay? Yes....you are catching on, $0! The anethesiologist sends me a bill for $1500....how much? $0. Oh, I went for pain medication after the surgery, how much of that will I pay? $0! Now, my wife twists her knee later in the same year and goes to a specialist and gets charged $300 for the visit and probably another $300 for crutches....how much will she pay? $0!

    So....all of that was paid for from meeting the family deductible of $4000....my total out of pocket expense for a son's head injury, my ER visit, my back surgery and one night in the hospital and my wife's knee issue. I'm not surprised you don't understand how the HSA plan works, most of the doctors I talk to don't understand it either, they just want their money. How about take some time to understand how it works before you discuss how bad it is?

    I will agree with you that not everyone should be on these plans....but....many people should be. I think a wealthy doctor such as yourself would be a prime candidate for it. You could actually save money....but....since you are a liberal, you aren't really interested in saving money as you'd rather complain and, of course, blame it all on George Bush.
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  15. Micael's Avatar
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       #2855  
    Aren't all teenage sons "moronic"? Shouldn't they have special deductible?
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.

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