How has the ACA affected your current healthcare costs?

[Gin1984]

I don't know just relaying what has been shared with me. 

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.

Unfortunately politics has gotten so toxic its no longer OK to disagree because if you do you are miss informed stupid or whatever else decides to label you.  Because of the toxic politics we can't have a good discussion regarding the facts. And it doesn't matter which party a person subscribes too.

I am not sure about that.  Other countries do pay less than we do.  However, the US pays more partly because of additional tests (something I am honestly ok with) and the money that goes into research.  The drugs and treatments we have today would not exist if we spent like the other countries. 
Though I do agree with you on your second paragraph.

[BlueHouse]

So far,  I like it. I'm just about to change plans (it's open enrollment period) and this year I'm changing to a different plan   Not sure how this will all work out, but here's my plan.
2015 buy platinum plan. Get all tests and doctors visits that I've been putting off. If clean bill of health, switch to a low premium plan next year Andy void all doctors for one to two years. In third year, switch back to platinum plan. Repeat.
I've never had the freedom to switch plans before and I've always paid much more in than I ever got out of it (except once). I never want to be afraid to go to the doctor again. I love knowing that someone has to cover me regardless of what I may develop.

[Exflyboy]

I don't know just relaying what has been shared with me. 

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.

Unfortunately politics has gotten so toxic its no longer OK to disagree because if you do you are miss informed stupid or whatever else decides to label you.  Because of the toxic politics we can't have a good discussion regarding the facts. And it doesn't matter which party a person subscribes too.

I am not sure about that.  Other countries do pay less than we do.  However, the US pays more partly because of additional tests (something I am honestly ok with) and the money that goes into research.  The drugs and treatments we have today would not exist if we spent like the other countries. 
Though I do agree with you on your second paragraph.

Many countries spend HALF what we do on a per GDP basis... HALF!!!!!

[usmarine1975]

Many countries spend HALF what we do on a per GDP basis... HALF!!!!!

And I Repeat. The American System does NEED REFORM in a BIG WAY.  IT's TOO EXPENSIVE. 

The ACA in my opinion does not fix that, nor does it attempt too.  A One Payer system will not fix that just look at the VA system too expensive and behind on technology I am in Awe every time I visit the VA in my area to see all the money we are spending.

Other Countries spend less for various reasons.  And our cost are so high for many different reasons, equipement, the kind of care provided to all, research, lawsuits, etc....  Simply saying their cost per GDP is half does not mean we should switch how our system is set up.  We need to have a proper in depth cost analysis.  The tiny bit of research that I have done has shown that the area's above are some of the reasons.  One concern with other countries is they do not provide the same amount of care to their elderly as we do. 

Sadly as stated above we Can't have a good discussion among legislators or even American's for that matter because we have over politicized the whole thing.  Again I AGREE we need REFORM

[johnhenry]

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.

Is this for real??  You don't think at least part of the problem in America has been precisely BECAUSE OF how healthcare has been paid for?  Meaning by for-profit insurance companies who had been operating in a regulatory system that allows them to dictate costs to providers AND/OR delaying or denying claims (which are two BIG reason prices are so high), leaving customers with huge bills, even when  they HAVE insurance.  The outrageous costs basically FORCED folks to buy insurance who may normally self-insure (if prices were reasonable) because bankruptcy would be the only option if in the case of a medical incident.

[usmarine1975]

Part of the problem yes but not all of it.  One payer doesn't fix all of it.  Again look at the VA system and how expensive it is.

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.

Is this for real??  You don't think at least part of the problem in America has been precisely BECAUSE OF how healthcare has been paid for?  Meaning by for-profit insurance companies who had been operating in a regulatory system that allows them to dictate costs to providers AND/OR delaying or denying claims (which are two BIG reason prices are so high), leaving customers with huge bills, even when  they HAVE insurance.  The outrageous costs basically FORCED folks to buy insurance who may normally self-insure (if prices were reasonable) because bankruptcy would be the only option if in the case of a medical incident.

[Gin1984]

Part of the problem yes but not all of it.  One payer doesn't fix all of it.  Again look at the VA system and how expensive it is.

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.

Is this for real??  You don't think at least part of the problem in America has been precisely BECAUSE OF how healthcare has been paid for?  Meaning by for-profit insurance companies who had been operating in a regulatory system that allows them to dictate costs to providers AND/OR delaying or denying claims (which are two BIG reason prices are so high), leaving customers with huge bills, even when  they HAVE insurance.  The outrageous costs basically FORCED folks to buy insurance who may normally self-insure (if prices were reasonable) because bankruptcy would be the only option if in the case of a medical incident.

VA system also includes research not just medical care though.  And do you happen to have #s for the cost for the VA per person compared to the cost in single payer countries?  In addition, would not veterans have a higher incident rate of needing medical care, because their previous positions?

[johnhenry]

Part of the problem yes but not all of it.  One payer doesn't fix all of it.  Again look at the VA system and how expensive it is.

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.

Is this for real??  You don't think at least part of the problem in America has been precisely BECAUSE OF how healthcare has been paid for?  Meaning by for-profit insurance companies who had been operating in a regulatory system that allows them to dictate costs to providers AND/OR delaying or denying claims (which are two BIG reason prices are so high), leaving customers with huge bills, even when  they HAVE insurance.  The outrageous costs basically FORCED folks to buy insurance who may normally self-insure (if prices were reasonable) because bankruptcy would be the only option if in the case of a medical incident.

Scratching my head.  You do understand that the VA is not operating in a "single payer system", right.  It pays for healthcare products and services offered in the only marketplace we have, which has more than one payer.... obviously. 

[historienne]

usmarine, what data leads you to conclude that VA costs are high?  The articles collected here suggest the opposite, that (quoting from an abstract of one of the research articles) "VA costs do appear to have been significantly lower than fee-for-service charges that the federal government might have to pay if veterans were treated in private sector hospitals for the same diagnoses."
http://www.herc.research.va.gov/resources/faq_b06.asp

It's certainly true that the high cost of health care in the US is a complex issue, and some of it is related to both direct and indirect subsidies for research.  However, a significant portion is also related to the cost of administering health care in the US, which is much higher than it is in other countries, largely because of the greater complexity of our insurance/billing system.  A single-payer system would reduce those costs.  This article has a good summary of the issue: http://www.commonwealthfund.org/publications/in-the-literature/2014/sep/hospital-administrative-costs

[clifp]

Last year my grandfathered Kaiser plan went up 13% that is the biggest one year jump I've seen since getting the policy 12 years ago.  This year the increase was much more typical 3.5% to 390/month.  However there was some good news. I am able to switch to a silver plan (which is basically bronze in ACA terminology) for only $160. There is no coverage at all until I hit $5,000 deductible but than most everything is covered completely.  On the other hand I can get a lot of doctor visits at $120 a piece and lab test for the $230/month I'm saving.  In the past if I had switched and I got really sick I would have been stuck with the high deductible plan forever (and there were things like prescription drugs and transplants that it didn't cover at all). But now I can switch to silver or gold ACA  plan next year if I get sick.

I definitely feel like I am gaming the system, heads I win. Tails I get a do over.

[Gin1984]

Last year my grandfathered Kaiser plan went up 13% that is the biggest one year jump I've seen since getting the policy 12 years ago.  This year the increase was much more typical 3.5% to 390/month.  However there was some good news. I am able to switch to a silver plan (which is basically bronze in ACA terminology) for only $160. There is no coverage at all until I hit $5,000 deductible but than most everything is covered completely.  On the other hand I can get a lot of doctor visits at $120 a piece and lab test for the $230/month I'm saving.  In the past if I had switched and I got really sick I would have been stuck with the high deductible plan forever (and there were things like prescription drugs and transplants that it didn't cover at all). But now I can switch to silver or gold ACA  plan next year if I get sick.

I definitely feel like I am gaming the system, heads I win. Tails I get a do over.

That is odd, when I was COBRAing a kaiser plan in jumped over 15% both years and that was back in 09. 

[clifp]

That is odd, when I was COBRAing a kaiser plan in jumped over 15% both years and that was back in 09.

Kaiser region operate  independently. I am guessing you weren't in Hawaii. Also by far the most expensive Health Insurance I ever bought was COBRA.

[Gin1984]

That is odd, when I was COBRAing a kaiser plan in jumped over 15% both years and that was back in 09.

Kaiser region operate  independently. I am guessing you weren't in Hawaii. Also by far the most expensive Health Insurance I ever bought was COBRA.

Nah, Ca.  I just find it strange that in one area they'd need to increase inflow by 15% yet not anywhere close in other areas.  I wonder why that is.  And I had no choice at the time, I was not eligible for a private plan. 

[geekette]

Also by far the most expensive Health Insurance I ever bought was COBRA.

This probably isn't news to you, but COBRA rates are what your employer pays, plus a 2% admin fee.  Until a couple years ago when employers started including info on their portion of the insurance premium, I don't think many people had a clue how much insurance cost. 

We were on COBRA over 20 years ago, and IIRC, it went from under $300 to over $400 (for 2 adults) between '91 and '92.  Sounds cheap now, but I about cried when we got that letter.

[wberkgal]

So I retired Dec. 1 and enrolled in Covered California (ACA, Obamacare) today for my husband and me. Thought these figures might be useful. We're in our early 60s. I had worked for a giant company, self-insuring, where payroll deduction was $259.32/month for the 2 of us. According to the 2013 W-2, the company paid $10964.72 for health insurance. Not sure if that includes my payroll deduction or if it was just the company's part. COBRA, for  Kaiser HMO, is $1013.42/month for the 2 of us.

Covered California is $1598/month for the 2 of us for Kaiser HMO Silver plus. With the $1484/month credit we'll pay $114/month based on our taking $2250/month from our IRAs (not planning to take SS or having other earned income.)

Coverage looks slightly worse (higher deductibles) but the giant company coverage was reduced in the same way next year, so they look about the same in the end. If we had to take COBRA we would have, as my husband has minor health issues and I don't think we would have been able to get coverage any other way. Most likely I would not have been able to retire yet as COBRA coverage would have expired before he was eligible for Medicare.

[Gin1984]

So I retired Dec. 1 and enrolled in Covered California (ACA, Obamacare) today for my husband and me. Thought these figures might be useful. We're in our early 60s. I had worked for a giant company, self-insuring, where payroll deduction was $259.32/month for the 2 of us. According to the 2013 W-2, the company paid $10964.72 for health insurance. Not sure if that includes my payroll deduction or if it was just the company's part. COBRA, for  Kaiser HMO, is $1013.42/month for the 2 of us.

Covered California is $1598/month for the 2 of us for Kaiser HMO Silver plus. With the $1484/month credit we'll pay $114/month based on our taking $2250/month from our IRAs (not planning to take SS or having other earned income.)

Coverage looks slightly worse (higher deductibles) but the giant company coverage was reduced in the same way next year, so they look about the same in the end. If we had to take COBRA we would have, as my husband has minor health issues and I don't think we would have been able to get coverage any other way. Most likely I would not have been able to retire yet as COBRA coverage would have expired before he was eligible for Medicare.

California allows for COBRA to be extended to 3 years instead of 18 months, so if he is over 62, you should have been ok.

[wberkgal]

That's interesting, GIN, my separation paperwork specifically  mentions "up to 18 months following your termination of employment."  I know there are a lot of California-specific benefits rules so I shouldn't be surprised that they got this wrong, although usually they're correct. If I happen to have more contact with the HR dept, I'll let them know their paperwork is wrong for CA. Thanks.

[Gin1984]

That's interesting, GIN, my separation paperwork specifically  mentions "up to 18 months following your termination of employment."  I know there are a lot of California-specific benefits rules so I shouldn't be surprised that they got this wrong, although usually they're correct. If I happen to have more contact with the HR dept, I'll let them know their paperwork is wrong for CA. Thanks.

It is called CAL-COBRA.  I can PM you some info if you need.  My mom is on it now.