Health Insurance No Longer Means Health Care

Discussion in 'Politics, Religion, Social Issues' started by Plutonius, Apr 4, 2018.

  1. Plutonius macrumors 604

    Plutonius

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    #1
    An interesting study was just released that shows between 1/3 and 1/2 of people between the ages of 45 and 59 are skipping necessary health care even though most of them have insurance.

    From the study
    • 49% didn’t go to the doctor last year when they were sick or injured
    • 45% skipped a recommended medical test or treatment
    • 43% didn’t go to a dentist when they needed treatment
    • 40% went without a routine physical or other preventive health care
    • 30% didn’t fill a prescription or took less than the prescribed dose of medicine
    The reason people gave was cost.

    I guess that I fall into this group since I no longer seek medical care because of cost (The exception would be the dentist) :).

    Do you find yourselves skipping medical care in some or all cases because of cost ?
     
  2. BorderingOn macrumors 6502

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    #2
    Don’t most health plans cover preventative care in full? More detail is needed on some of the others. I may not go for sickness or injury if they are not severe. Oftentimes there is nothing a doctor can do and you’re just wasting their time. But you have to know your body and make the call whether your symptoms warrant it. Or call a nurse at the doctor’s office for guidance. Meds? Depends on what they are. Why take pain pills if you feel okay? Much of that is way over prescribed.

    The thing in the article that stands out to me is transparency. Medicine in the US lacks it. I can see a lot of anxiety from that alone.
     
  3. Huntn macrumors P6

    Huntn

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    #3
    No, I don't. Now maybe I can afford it, in comparison, or maybe I regard it as a high priority than you do. I don't know. Keep in mind, that little expense now, can avoid a much bigger expense later and may save your life.

    This is not an example of that... A little over a year ago, my EKG showed a Right Bundle Branch Blockage, which in itself is not a concern, but just to be safe the doctor advised me to get some heart tests. I've always been proactive about potential significant medical issues, so I agreed. About $6k later, they told me no problems found. I paid about $700. The doctors made significant profits. I have confidence I have a good heart.

    In regards to health costs that effect the bulk of our citizens, this could be indicative of a problem with our system.
    Such as in many cases, medical expenses to expensive even with insurance to address. I am reminded of the slogan, one illness away from bankruptcy.
     
  4. Zenithal macrumors 604

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    #4
    The big problem is people have been conditioned into reactive healthcare, while other nations focus on proactive health. The majority of non-genetic disease can be avoided with proper measures, but it's easier to do something off the cuff and then respond to it down the line.
     
  5. Plutonius thread starter macrumors 604

    Plutonius

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    #5
    The problem with preventive care is if they find something, it's no longer free. They also often claim additional test are needed that are not covered under preventive care.

    I equate it to a free auto diagnosis that repair places use to generate paying business.

    I agree with you on the transparency issue.
     
  6. SusanK macrumors 68000

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    #6
    No. I don't skip necessary care due to cost.

    Health insurance never was health care. Car insurance is not car care.
     
  7. 0007776 Suspended

    0007776

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    #7
    I don’t want to get hit with a big bill with my deductible. I chose a plan that wouldn’t bankrupt me if I go to the ER, but that doesn’t mean it is affordable to use, so I’ll only use it as a last resort if I’m about to die.
     
  8. A.Goldberg macrumors 68020

    A.Goldberg

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    #8
    I’m fortunate enough to be able to afford healthcare and have an excellent healthcare, but I’ve seen a lot of people (especially low wage hourly employees or people hired via a 3rd party i.e. food service) fall into this predicament to barely afford their premiums, let alone their deductibles or copays.

    As someone mentioned, preventative care may be covered, but if you need a specialist or medications, then you run into major financial barriers (particuarly if your Rx coverage is wrapped into your deductible).

    When you have people who make $20/hr with $300 premiums and a $3000 deductible or more, it’s pretty easy to see how unaffordable things can be, especially if you have a chronic condition that requires attention.

    I know someone who at work in food services, similar financial situation to above, and has asthma. She’s in her 40’s and single with no kids, and is otherwise healthy except for significant asthma. She can barely afford the insurance and sees her PCP for treatment. Her Rx benefits are wrapped into her healthcare deductible, and if you know anything about Asthma drugs, most of them are brand name and very expensive. For years she pretty much went untreated because she didn’t think she could afford it. She’s a nice lady and so I volunteered to work with her and her PCP to find cheaper medications that would work and to find a pharmacy that wouldn’t kill her on pricing. She can now barely afford her healthcare, but at least she’s being treated. The problem is if anything else comes up healthwise, it’s probably going to be a problem financially.
     
  9. Plutonius thread starter macrumors 604

    Plutonius

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    #9
    Agreed but insurance was always there so people could get health care. Now it looks like people can't afford health care (and are skipping it) even when they have insurance.

    Another question is what you consider necessary care ?
    --- Post Merged, Apr 4, 2018 ---
    That's actually how I'm treating it.
     
  10. blackfox macrumors 65816

    blackfox

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    #10
    Well, I don't mean to hijack the thread, but there is another part of this. My Elderly Father (who was otherwise in good health), had a stint rupture and needed to be hospitalized. Through a combination of Bureaucratic crap, privatization, and legal protections - he has been a bed for 6+ weeks and counting. He lost his kidney functions (forever). He has lost 50lbs (mostly muscle) and now hass a major problem, where it was easily minor prior. My parents have above-average insurance and private funds also. Quality of Health Care has severely tanked. I've had to take vacation time. The rest of my family have done similar sacrifices. Healthcare has just become so focused on some financial algorithm here in the US, it's insulting almost to the point of absurdity - and this is with people who can (and have) payed into the system.
     
  11. shinji macrumors 65816

    shinji

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    #11
    You'd think most people who skip necessary health care due to cost would be in favor of single payer, or at least the public option.
     
  12. bopajuice, Apr 4, 2018
    Last edited: Apr 4, 2018

    bopajuice Suspended

    bopajuice

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    #12
    Maybe if we Americans were not so fat, much of this would not be an issue.
    --- Post Merged, Apr 4, 2018 ---
    Single payer and the public option are not financial choices. It is a government taking care of their citizens choice. Too bad so many citizens are more concerned about their guns than they are about their own health.
     
  13. shinji macrumors 65816

    shinji

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    #13
    Sad but true.
     
  14. 0007776 Suspended

    0007776

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    #14
    I would hope most of us are.
     
  15. Plutonius thread starter macrumors 604

    Plutonius

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    #15
    On my current plan, the plan doesn't reimburse till I reach my deductible of $6250. It then has a copay on almost everything. I would have probably had to pay most of that $6k bill out of my pocket.

    If you knew that you were going to be billed $6k and probably end up paying it yourself, would that make any difference in your decision to get the test ?
     
  16. Huntn, Apr 5, 2018
    Last edited: Apr 5, 2018

    Huntn macrumors P6

    Huntn

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    #16
    Oh, you are on one of those excrutiinatingly high, high deductible plans. To answer your question if I could pay installments, yes, but not if they wanted it all at once. I’d look into negotiating an installment option. That’s the problem with those plans, it’s not like having insurance, other than moderated fees dictated by the insurance company to doctors in network, until you hit the deductible.

    The other question might be, if you had no insurance, would they be charging the patient as much? Not sure about that. I went to get a MRI preventative because my Mom had a tumor by her ear, and I was having vertigo and a difference in hearing between each ear, sometime indicative of this kind of tumor. The facility was out of network, my impression is they can be expensive, but it cost me $25. I got a really strange explanation, like we will submit to your insurance and take whatever they give us.

    Back to high deductible plans, if it causes you not to follow your doctors advice, is this kind of plan really serving you? I know the idea/advantage of such a plan is to cap your annual expenses, and by virtue of a lower monthly payment (for the insurance itself) and you regard yourself as healthy, you’ll save money.

    Here’s the rub, by not following the doctor’s advice and getting tests when he sees a possible issue, you are setting yourself up for missing something preventative or in early stages that if ignored, turns into something huge later. Ok, in the latter case your expenses are capped and you saved a ton of money, but for things like cancer, or a bad heart, I have to regard preventativevas the way to go, because, you may not survive the latter.

    The highest deductible plan I had was $2500 individual, $3500 family and then everything was 90% or 95% paid with a cap of $5000 as I recall. That could be off a little.
    --- Post Merged, Apr 5, 2018 ---
    Another case of greed brought to us by the GOP. I make many pronouncements in this forum why the GOP is not the answer. At the end if WWII, the US had it all and since then, we have so blown it in the name of big business at the expense of average citizens. Here is more information:

    Did you know that before 1973 it was illegal in the US to profit off of health care. The Health Maintenance Organization Act of 1973 passed by Nixon changed everything.
    March 16, 2017 by IWB
    http://www.investmentwatchblog.com/...t-of-1973-passed-by-nixon-changed-everything/

    And do you know who’s to blame? Believe it or not, the downfall of the American health insurance system falls squarely on the shoulders of former President Richard M. Nixon.
    In 1973, Nixon did a personal favor for his friend and campaign financier, Edgar Kaiser, then president and chairman of Kaiser-Permanente. Nixon signed into law, the Health Maintenance Organization Act of 1973, in which medical insurance agencies, hospitals, clinics and even doctors, could begin functioning as for-profit business entities instead of the service organizations they were intended to be. And which insurance company got the first taste of federal subsidies to implement HMOA73
     
  17. s2mikey macrumors 68020

    s2mikey

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    #17
    I fully agree. I hate to say this but a lot of peoples health problems are directly caused by their terrible decisions aka poor eating habits, lack of exercise and poor stress management. Im not saying that people dont just get sick. Of course they do. But its more than fair to say that people need to get their collective !@#$ together and take control of their health.

    Id like to see some "incentivizing" of taking care of yourself. But in the USA - its all about being a "victim" and poeple refusing to take responsibility for their actions/choices.
     
  18. Huntn, Apr 5, 2018
    Last edited: Apr 5, 2018

    Huntn macrumors P6

    Huntn

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    #18
    Extensive free annual physicals should be mandatory in all plans. I discovered under Medicare w/Supplemental that my free annual preventative wellness check is not a physical. It’s a cursory exam, with a how are you feeling? thrown in. :rolleyes: Tests cost, but the types of tests for routine blood work, psa, ekg and such are reasonable, and it would be foolish imo to pass on these tests, or why get an annual physical at all?
    --- Post Merged, Apr 5, 2018 ---
    We were screwed when healthcare changed from a service industry to big profits. The only way I ever seeing that revert would be a huge majorities of liberals in Congress. What you get from conservatives is what we have, for profit, focus on max profits, not affordable healthcare. . Where we have arrived at with health care in the US is a crime imo, and it’s going to take a critical mass of citizens to demand change.
     
  19. Tomorrow macrumors 604

    Tomorrow

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    #19
    I've never believed that "health insurance" = "health care."
     
  20. Huntn macrumors P6

    Huntn

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    #20
    What do you believe? Not a critical question, just curious.
     
  21. Plutonius thread starter macrumors 604

    Plutonius

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    #21
    but you need one to get the other.
    --- Post Merged, Apr 5, 2018 ---
    I believe that insurance is indirectly responsible for the current high healthcare cost.
     
  22. NT1440 macrumors G4

    NT1440

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    #22
    So is the illusion of the ACA finally being seen? It is obviously better than the way it was before but I can’t consider it even a half step towards a humane system. If anything it locked us into another ten years of insurance companies running the show, because the public is temporarily subdued under the “we did something” mindset.
     
  23. SusanK macrumors 68000

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    #23
    Necessary care is care I consider necessary for me. I responded to your question. I don't set standards for others.

    This thread appeared at an interesting time. I was thinking of the multitudinous threads complaining about ACA until Trump was inaugurated. ACA is still in effect. The mandate stands for 2018 but the complaints disappeared.

    Not to worry. Trump promised the best health care at a very low cost. We know Trump never hustled Average Joe so it must be true.
     
  24. Huntn macrumors P6

    Huntn

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    #24
    Turning medical care into a big for profit business is the cause imo.
     
  25. VulchR macrumors 68020

    VulchR

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    #25
    Nope. I use the UK's NHS. :p

    That being said, the NHS does do triage, focusing on the most urgent cases first. Also, given that the NHS is a limited shared resource, I try not to bother them with minor things (so I'm not going to go rushing off to a physician just because I have a head cold). Thus, it would be fair to say I delay medical care for minor problems, seeking help only if they do not improve on their own.
    --- Post Merged, Apr 5, 2018 ---
    All very well and fine, until you suffer from a genetic disorder.
     

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