"affordable" C.A.

Discussion in 'Politics, Religion, Social Issues' started by jkcerda, Nov 12, 2014.

  1. jkcerda macrumors 6502a

    jkcerda

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    #1
    "Affordable" to WHO?
    just got our HC plan meeting. comparing our plans to what is offered under the ACA.

    same co-pays
    current plan out of pocket max 3500 individual 7000 family.

    ACA plan out of pocket max 6350 individual 12700 family.

    current plan on the left, ACA plan on the right.
    [​IMG]
     
  2. bradl macrumors 68040

    bradl

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    #2
    I remember a time.. I think it was roughly 20 years ago, and right around this time of the year. I remember it because the entire incident pissed me off because an episode of Animaniacs I was recording was pre-empted by it..

    But there was an incident that happened down in your part of the state, in which a guy in a truck or his bike went joyriding down either I-110 or I-405 or some freeway in Los Angeles, got the cops and media to chase him.. when he stopped, he unfurled a long banner or sign that completely blasted HMOs for their prices/price gouging, and/or treatment...

    .. then promptly took out a sawed-off shotgun and blew his brains out.

    The media stood by their airing of this, despite being during the time of afternoon cartoons/kids shows being on and interrupting those shows to show it.

    My point: HMOs, being a one-stop shop for all of your medical needs, may not effectively get you the best deal. That, outside the fact that you have to go to them each and every time to get a referral for any other service, and the fact that that they are limited in location (at least Kaiser is; everything else outside their facilities is non-network), makes HMOs a real pain to use.

    If anything, I'd always prefer PPOs as I get to choose who I want to go to for my medical needs, not the facility.

    BL.
     
  3. VulchR macrumors 68020

    VulchR

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    #3
    National Health Service: Taxes sure enough, but not insurance. Forms about medical conditions of course, but not insurance. No credit cards or second mortgages. Managed health care prioritisation, yes admittedly – to each according to their need.

    The horror, the horror. :rolleyes:
     
  4. barkmonster macrumors 68020

    barkmonster

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    #4
    They really can't get over the idea of state subsidised healthcare in the states. They seem to think it's some kind of "commie" socialism. Breaking Bad would be a very short-lived show if it was based in Britain :)
     
  5. VulchR macrumors 68020

    VulchR

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    #5
    I from the US and even I do not understand now that I have experienced the UK National Health Service. I get a lot of 'you have to wait for an appointment in the UK' from my family in the US, and then I see the glacial pace at which healthcare proceeds everywhere. Sure, in the US you get an appointment. And then you wait, just like the UK.

    The US has government-provided armed forces, schools, universities, emergency services, etc. Heck, the US government even has veterinary surgeons. Yet the idea of making the Public Health Service an actual public health service is seen as some sort homage to the devil.
     
  6. jkcerda thread starter macrumors 6502a

    jkcerda

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    #6
    how well does social security =medicaid-medicare work under the GOVT?
     
  7. shinji macrumors 65816

    shinji

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  8. jkcerda thread starter macrumors 6502a

    jkcerda

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    #8
    ACA version is 12 per MONTH cheaper. What a joke
     
  9. shinji macrumors 65816

    shinji

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    #9
    Yeah, that's not fair for the much higher out of pocket costs in the new plan. MRI copay especially is a ripoff.
     
  10. SLC Flyfishing Suspended

    SLC Flyfishing

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    #10
    HMO's, and Kaiser in particular, are quite well loved by the people who use them. I met people in Portland who refused to move north of Longview, WA because that's where the Kaiser facilities end.
     
  11. Macky-Mac macrumors 68030

    Macky-Mac

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    #11
    I notice that's a "gold" plan, which is an upscale product, not the affordable "bronze" product.....if you go for an upscale product, then shouldn't you be expecting an upscale price?

    But congratulations.....it seems you make too much money for us taxpayers to provide you with a more affordable plan :p
     
  12. SLC Flyfishing Suspended

    SLC Flyfishing

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    #12
    There is a Nephrologist visiting at my current hospital that I was chatting with yesterday. I took my typical deferential stance on the subject of the health care systems in our respective nations. He was very adamant that the system in the USA was far superior; and that relative lack of access is the only flaw from where he stands.

    He cited the fact that all physicians are salaried, have a very fixed income potential etc makes them lazy. There's no incentive to go the extra mile for the patient. He said you generally won't see doctors in the UK being willing to take call in the middle of the night, or take calls from patients at home etc. They get paid the same whether they do the bare minimum or go above and beyond.

    So the care is readily available, but very suboptimal. He said the same thing I always say, that the capabilities of the American system are unparalleled anywhere else in the world, and that we should be working on ways to increase access while maintaining the state of the system. He doesn't think UHC is the way to do that.
     
  13. jkcerda thread starter macrumors 6502a

    jkcerda

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    #13
    Bronze product has the same out of pocket cost. You can afford the premiums but you get taken to the cleaners if you actually use it:mad:
     
  14. Macky-Mac, Nov 12, 2014
    Last edited: Nov 12, 2014

    Macky-Mac macrumors 68030

    Macky-Mac

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    #14
    you do realize that you would still be buying from an insurance company and that CoveredCA is just directing you to a policy?

    The government is NOT in competition with the insurance companies. This is not a program to sell cheaper "government" insurance than the insurance industry offers you. You're still buying your insurance from the insurance companies at their prices........so you shouldn't expect much of a difference in price.

    it's true that if your income is low enough then you can get a tax credit if you buy through CoveredCA (but you're unlikely to get a credit if you decide to buy the fancy upscale policy you're looking at)
     
  15. samiwas macrumors 68000

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    #15
    So, let me make sure I understand this. We want to make sure that everything stays as amazing as it is, but everyone should be able to access it at an affordable cost without going bankrupt for life over a medical procedure.

    YAY! Literally 100% of the people in the world agree with you. Too bad it's almost entirely impossible.

    But what's better, for now?
    A: The best system money can buy that few can afford
    B: A slightly less perfect system that everyone has access to and cannot end up in a lifetime of crippling debt through?

    I know your answer is A, so not sure you need to bother.
     
  16. jkcerda thread starter macrumors 6502a

    jkcerda

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    #16
    The ACA policies are anything but "affordable". Bronze/platinum/gold it makes no difference. You still pay high out of pocket cost
     
  17. malman89 macrumors 68000

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    Michigan
    #17
    ACA plans sure are tricky to navigate. If you search by lowest to highest monthly premium, you could get royally screwed. You should search by level.

    Sometimes there's say a Silver plan a few bucks more than the Bronze, but ends up on the next page. The plan is say $15 more/month but has thousands less in the out of pocket maximum.

    ACA plans really require a lot of research and debating the trade-off of higher premiums for lower out of pocket costs based on how much you think you'll use your plan.

    As a healthy 25-26 year old male non-smoker with no allergies, prescriptions, or pre-existing conditions (I know, I'm lucky), a lot of the plans are really disappointing from a price per coverage standpoint.
     
  18. samiwas macrumors 68000

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    #18
    I can't access my thing right now because I have to sign up again. But when I looked last year, I could have gotten a platinum plan for under $600/month and with max out of pockets something like $3000/person $6000/family.

    That was about $7,000 less in premiums per year, so my max out of pocket including premiums for a year would have been less than my premiums alone are now. Unfortunately, the sign up period ended before I got around to dealing with it. I need to look into it again, because my current group plan is freaking ridiculous in its costs.

    Believe it or not, many ACA plans are much, MUCH cheaper than what some people have now.
     
  19. SLC Flyfishing Suspended

    SLC Flyfishing

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    #19
    I can tell you that this British doctor chose A.
     
  20. Sydde macrumors 68020

    Sydde

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    #20
    In the US, doctors do not "go the extra mile", they go the extra parsec. Which is not because of capitalistic incentives, it is all CYA. They are more afraid of being sued for not having ordered the right test, so they order all of them, just to be safe. And I seriously doubt that most American doctors offer more personalized service, most American doctors are just out to make big bucks and low golf scores.
     
  21. Macky-Mac, Nov 12, 2014
    Last edited: Nov 12, 2014

    Macky-Mac macrumors 68030

    Macky-Mac

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    #21
    Good lord man!!! With those supposed ACA policies you're paying market rate private industry prices!

    you socialists types simply want to destroy American private enterprise by having the government undercut the prices that GOD's own beloved insurance industry has determined is the best and fairest way to provide the profits that well heeled investors need!

    Don't you understand that paying too much for too little is what real freedom loving americans want!!!!!! :mad:

    well, given the number of guns and kids you have around your house, I can understand why you might deceive yourself into thinking you need all that fancy upscale insurance stuff......but I have to ask.......why do you expect another government handout in your pocket??? what kind of socialist are you???

    oh my! :rolleyes:
     
  22. SLC Flyfishing Suspended

    SLC Flyfishing

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    #22
    American doctors are incentivized to work harder. If my Cardiology attending (supervising physician) gets called in in the middle of the night to cath someone who's having a heart attack, that's one more procedure he gets reimbursed for. If he's salaried, he won't get paid any more or less to come in, so why do it at all?

    Same goes for my primary care doc, he's available for night calls much of the time because he gets paid to be available. If he didn't, I'm sure he'd elect to get his sleep, undisturbed; and I'd be left waiting till regular business hours to ask if I need to come in to be seen. If that's not "more personalized service" then I don't know what is.

    And the notion that doctors order everything under the sun to CYA is a myth. Every single doctor I've worked with, in 3 states now, has asked me why I want each and every test, procedure, study, or prescription I propose. Costs v's benefits are weighed, and I'm often told not to be so quick to order superfluous tests. Generally, the rule of thumb is to ask: "Is this test important to the problem at hand and are there less expensive alternatives if so?" and "will the results I get from this test change my management". If the answer is no to either question, the test isn't run.
     
  23. jkcerda thread starter macrumors 6502a

    jkcerda

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    #23
    A smart one :D
     
  24. Macky-Mac macrumors 68030

    Macky-Mac

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    #24
    you left out an important question......"will the insurance company pay for this?"
     
  25. SLC Flyfishing, Nov 12, 2014
    Last edited: Nov 12, 2014

    SLC Flyfishing Suspended

    SLC Flyfishing

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    #25
    Nope. Because if the insurance company won't, the patient will. Hence the necessity to scrutinize every decision. Plus, it's not as though the doctor gets paid more to order another lab, that's just not how it works.

    I'm being completely honest here. I'm sorry if that doesn't fit into your world-view.
     

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