Obamacare renewal

[Financial.Velociraptor]

So, I just waded through the marketplace website to get quotes for 2016 ACA.  My current plan is the best for my needs.  I could save a few bucks a month to go with a less reputable provider and have to change primary care doctors.  My cost is going up 22.8% from 198.06 to 243.22.  It still beats the crap out of what my old employer wanted for COBRA though.  I live in fear of Trump winning the presidency and killing ACA.

[Exflyboy]

I just live in fear of Trump period!

But then again, none of the Repubs are in favour of the ACA, Ben Carson a few months ago was talking on some show about how we can have great HC without the Government being involved... Yeah, because its worked so well up to now.. NOT!.. and we pay double the cost of most of Europe and their evil socialist regimes...

[FIRE me]

I live in fear of Trump winning the presidency and killing ACA.

Same here. I don't like any of them, and for that reason I never vote. I especially dislike Hillary. Which makes me feel odd because I hope she wins (I think hoping for a Sanders win would be way too much to ask for).

[Frankies Girl]

My current BCBS plan is disappearing, but we were likely changing it to a completely different company anyway. I still need to see how much the replacement plan they said they would switch me to would end up costing. I'm sure it's much higher.

[Miss Prim]

I am still on Cobra from my job and I was mad that it went up 15%!  I guess I will stick with it until they kick me off next October.  I could go on the ACA, but though the premiums would be a little less, the max. out of pocket is way more.  I won't have a choice after October though. 

                                                         Miss Prim

[Trudie]

My employer just went from a BCBS PPO plan (80/20) to a HDHP with an HSA.  They're making pretty decent HSA contributions on our behalf, but the OOP will be a shock to those who have catastrophic years.  It was not communicated well and employees are thoroughly confused and upset, but I'm just studying up on the plan bennies and provisions and trying to make the best of it.  In a decent health year I will be able to accumulate in my HSA.  The odds of falling on the good end of the financial spectrum are pretty high.

Because I administer payroll and benefits I've needed to study up on the plan, and because I will be dependent on Obamacare upon FIRE I have an interest.  Rather than wringing my hands over it, I figure that it's a good opportunity to figure out the system and become comfortable with it while I'm still working.  Then when I retire I'll be more confident in purchasing a similar policy.

I live in fear of the ACA being gutted as well, and it's probably the thing that keeps me awake at night.  Maybe early retirees should start their own lobby...

[bacchi]

There were individual healthcare plans before ACA. They were even less expensive than the current plans. As long as you had no chronic condition, or really any serious prior illnesses or injuries, you could get one. If not, some states had health care pools for, oh, $600/month for a 25 year old. Ahh, the good ol' days.

[Financial.Velociraptor]

There were individual healthcare plans before ACA. They were even less expensive than the current plans. As long as you had no chronic condition, or really any serious prior illnesses or injuries, you could get one. If not, some states had health care pools for, oh, $600/month for a 25 year old. Ahh, the good ol' days.

Back in the "good ol' days" I couldn't get a private health care plan (Tourette's Syndrome).  Best I could do in the state of Texas was a 'health indemnity plan' which is not quite the same thing as insurance.  Obamacare has improved my lot in life greatly.

[lthenderson]

My mother-in-law is in the process of becoming a U.S. Citizen and must stay in the country for the majority of five years before qualifying. She has insurance but in her home country (not recognized here) but due to her citizenship status, she wasn't eligible for insurance here until the ACA came along. We signed her up for $425/month back when it first started which I thought very reasonable for a 65 year old lady. Last year it increased to $560/month and next year it will be $680/month. It is now my second largest monthly expense after the mortgage payment. I think I will refer to it from now on as the LACA or Less Affordable Care Act. Fortunately I only have two more potential/likely increases to suffer through before she can qualify for Medicaid.

[tjalexander]

So, I just waded through the marketplace website to get quotes for 2016 ACA.  My current plan is the best for my needs.  I could save a few bucks a month to go with a less reputable provider and have to change primary care doctors.  My cost is going up 22.8% from 198.06 to 243.22.  It still beats the crap out of what my old employer wanted for COBRA though.  I live in fear of Trump winning the presidency and killing ACA.

Didn't Obama promise lower premiums? Oh well, you are full kool-aid on Obama and don't care. One could argue that killing ACA would result in lower premiums as the free loaders (i.e. those that receive subsidies) would be off your insurance pool.

[monarda]

There were individual healthcare plans before ACA. They were even less expensive than the current plans. As long as you had no chronic condition, or really any serious prior illnesses or injuries, you could get one. If not, some states had health care pools for, oh, $600/month for a 25 year old. Ahh, the good ol' days.

Back in the "good ol' days" I couldn't get a private health care plan (Tourette's Syndrome).  Best I could do in the state of Texas was a 'health indemnity plan' which is not quite the same thing as insurance.  Obamacare has improved my lot in life greatly.

Precisely.  Why do so many people who complain about ACA forget about this (or don't care about this)???? The system HAS to be one where anyone can have access. Longing for the good ol' days only considers that  YOU have lower rates. The old system was terribly broken. ACA is better, but I'm for single payer.

[Mntngoat]

tell me again why the government should be in the insurance business?    I mean they do well with SSA/ IRS/ VA 

ML

[jzb11]

There were individual healthcare plans before ACA. They were even less expensive than the current plans. As long as you had no chronic condition, or really any serious prior illnesses or injuries, you could get one. If not, some states had health care pools for, oh, $600/month for a 25 year old. Ahh, the good ol' days.

Back in the "good ol' days" I couldn't get a private health care plan (Tourette's Syndrome).  Best I could do in the state of Texas was a 'health indemnity plan' which is not quite the same thing as insurance.  Obamacare has improved my lot in life greatly.

Precisely.  Why do so many people who complain about ACA forget about this (or don't care about this)???? The system HAS to be one where anyone can have access. Longing for the good ol' days only considers that  YOU have lower rates. The old system was terribly broken. ACA is better, but I'm for single payer.

Because the ACA is has driven up healthcare costs exponentially, under the guise of lowering costs and being "health reform". I went from paying 100 to 400 a month due to the ACA though I am YOUNG and HEALTHY, and I despise the notion that I should bust my ass and work 80 hour weeks, travel and be isolated from people I love and care about, and sacrifice on a daily basis in order to pay for the health care of people who are not making similar sacrifices.

In sum I'm disgusted and offended by the notion that the money I sacrifice my life to earn belongs to those who are not making similar sacrifices.

[crazyworld]

tell me again why the government should be in the insurance business?    I mean they do well with SSA/ IRS/ VA 

ML

I thought the government is not providing insurance - they are just mandating that everyone buy coverage.
Now, this involves paying enough to provide a profit to the provider, so premiums will include that.  The healthcare companies are doing really well - so I am assuming the profit is on the high side.
How do you propose to keep old people fed/housed, war vets treated etc without SSA/VA?
When we started fighting wars, was funding for VA increased to account for the large influx of vets? 

[BTDretire]

So, I just waded through the marketplace website to get quotes for 2016 ACA.  My current plan is the best for my needs.  I could save a few bucks a month to go with a less reputable provider and have to change primary care doctors.  My cost is going up 22.8% from 198.06 to 243.22.  It still beats the crap out of what my old employer wanted for COBRA though.  I live in fear of Trump winning the presidency and killing ACA.

  Hi F.V.
 Is that $243.22 for just one person and is that the real cost or your cost? ie, how much is your cost plus the subsidy?
                    Thanks
What is the deductible?

[BTDretire]

Back in the "good ol' days" I couldn't get a private health care plan (Tourette's Syndrome).  Best I could do in the state of Texas was a 'health indemnity plan' which is not quite the same thing as insurance.  Obamacare has improved my lot in life greatly.

It has helped some people, but at a great cost.

"By the end of 2016, roughly 10 million people will be enrolled in a marketplace plan, according to updated projections from the U.S. Department of Health and Human Services (HHS). That's up from the 9.1 million people who will have coverage in place by the end of 2015, officials said."

  10 million people out of a 330 million population, many of those had insurance before the ACA, but were kicked off.
 It could have been done without disrupting the whole market.
  Remember the plan was to help the estimated 30 to 40 million uninsured,
I doubt it has cobered 5 million that didn't have insurance before.
Start with the fact that if I took Obamacare, my subsidy would pay the premium on my excisting private insurance plan and still have $4,344 leftover!

"But, health plan premiums offered by HealthCare.gov and state marketplaces for 2016 are rising sharply in many regions of the country, reflecting actual costs under the Affordable Care Act."

> http://www.webmd.com/health-insurance/20151030/in-its-third-year-obamacare-faces-growing-pains?src=RSS_PUBLIC

I was listening to public radio and heard an Obamacare user that his $31,000 premium for a family of 5 was too expensive, he said he could pay it on his $142,000 income, but his family would do much better using that money for other things. At $142,000 income, he didn't qualify for any subsidy.

Because the ACA is has driven up healthcare costs exponentially, under the guise of lowering costs and being "health reform". I went from paying 100 to 400 a month due to the ACA though I am YOUNG and HEALTHY,

In sum I'm disgusted and offended by the notion that the money I sacrifice my life to earn belongs to those who are not making similar sacrifices.

Yep, I was paying $5,256 for 4 people in 2012 for what many thought was catastrophic insurance, $10,000 deductible.
 Today an Obamacare policy for 3 people is $17,112 with a $13,700 family deductible.
 I'm still keeping my partial free market plan at $8,448 with $10,000 deductible for 3 people.
 Note: $5,256 to $8,448 is a 60% increase for one less person in 3 years. Thanks Obamacare.
Yes, I could save $4,128 if I took the $12,792 yearly Obamacare subsidy on a $70,000 MAGI. I find it hard to believe the hardworking taxpayers want to give me $12,792 to
pay my health insurance policy.
 

[Eric]

There were individual healthcare plans before ACA. They were even less expensive than the current plans. As long as you had no chronic condition, or really any serious prior illnesses or injuries, you could get one. If not, some states had health care pools for, oh, $600/month for a 25 year old. Ahh, the good ol' days.

Back in the "good ol' days" I couldn't get a private health care plan (Tourette's Syndrome).  Best I could do in the state of Texas was a 'health indemnity plan' which is not quite the same thing as insurance.  Obamacare has improved my lot in life greatly.

Precisely.  Why do so many people who complain about ACA forget about this (or don't care about this)???? The system HAS to be one where anyone can have access. Longing for the good ol' days only considers that  YOU have lower rates. The old system was terribly broken. ACA is better, but I'm for single payer.

Because the ACA is has driven up healthcare costs exponentially, under the guise of lowering costs and being "health reform". I went from paying 100 to 400 a month due to the ACA though I am YOUNG and HEALTHY, and I despise the notion that I should bust my ass and work 80 hour weeks, travel and be isolated from people I love and care about, and sacrifice on a daily basis in order to pay for the health care of people who are not making similar sacrifices.

In sum I'm disgusted and offended by the notion that the money I sacrifice my life to earn belongs to those who are not making similar sacrifices.

Welcome to the world of insurance.  That's how it works.  The ones without claims always subsidize those that have them.  We should all be so lucky as to be the subsidizers instead of the subsidizees.

[bacchi]

There were individual healthcare plans before ACA. They were even less expensive than the current plans. As long as you had no chronic condition, or really any serious prior illnesses or injuries, you could get one. If not, some states had health care pools for, oh, $600/month for a 25 year old. Ahh, the good ol' days.

Back in the "good ol' days" I couldn't get a private health care plan (Tourette's Syndrome).  Best I could do in the state of Texas was a 'health indemnity plan' which is not quite the same thing as insurance.  Obamacare has improved my lot in life greatly.

I was being sarcastic. The "good ol' days" were only good if you were lucky enough to not be/get sick. Get cancer? You're looking at rescission because you didn't tell them about your tonsils being removed when you were 15.

http://articles.latimes.com/2009/jun/17/business/fi-rescind17

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

[tjalexander]

Lol at all the surprise of people that rates are raising...

“In terms of risk-rated subsidies, if you had a law which said that healthy people are going to pay in—you made explicit that healthy people pay in and sick people get money, it would not have passed, okay. Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass.

[bacchi]

Lol at all the surprise of people that rates are raising...

“In terms of risk-rated subsidies, if you had a law which said that healthy people are going to pay in—you made explicit that healthy people pay in and sick people get money, it would not have passed, okay. Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass.

Nah, most people realized that rates would have to rise. That's how insurance pools (used to) work -- kick out the sick and keep the healthy. It was a perverse system.

[Financial.Velociraptor]

So, I just waded through the marketplace website to get quotes for 2016 ACA.  My current plan is the best for my needs.  I could save a few bucks a month to go with a less reputable provider and have to change primary care doctors.  My cost is going up 22.8% from 198.06 to 243.22.  It still beats the crap out of what my old employer wanted for COBRA though.  I live in fear of Trump winning the presidency and killing ACA.

  Hi F.V.
 Is that $243.22 for just one person and is that the real cost or your cost? ie, how much is your cost plus the subsidy?
                    Thanks
What is the deductible?

That's for a single person, no subsidy.  My deductible is 6,000.

[crazyworld]

The $31k premium someone mentioned upthread, I am almost certain that related to coverage in Alaska. It is an anamoly and claims are very high there. Even with the high premium, the insurance company is in losses and they are working on some kind of fix.
Not to say that costs are not a concern, but premiums went up 20% give or take for our company every year, before ACA so not really fair to blame the gubmint...

[Mntngoat]

i thought the average family would save $2500/ year  at least that was the lie to get the sheeple behind it.

[Mntngoat]

tell me again why the government should be in the insurance business?    I mean they do well with SSA/ IRS/ VA 

ML

How do you propose to keep old people fed/housed, war vets treated etc without SSA/VA?
When we started fighting wars, was funding for VA increased to account for the large influx of vets?

Privitize SSA...   Im betting 100% of the mebers here  could do a better job  of  managing the $ then the government currently does.

Its my opinion most things the government involves itself in they more they  will screw it up.

[tjalexander]

https://youtu.be/_o65vMUk5so

Health Care insurance is the only insurance that doesn't reward you for not filing a claim. Mandating catastrophic health care ins for the uncontrollable events would have been cheaper.

[BTDretire]

  Hi F.V.
 Is that $243.22 for just one person and is that the real cost or your cost? ie, how much is your cost plus the subsidy?
                    Thanks
What is the deductible?

That's for a single person, no subsidy.  My deductible is 6,000.

 Wow, I'm surprised, I ran the numbers when your my age 60, rather than 43 yrs old and it jumps 86%. I knew it went up, but...
 I also ran my family, but as single individuals, the total was $12,780 vs $17,112 as a family. This does cause the deductible and OOP to increase over $19,000.
 Not sure the cheaper price makes sense.

[Gin1984]

tell me again why the government should be in the insurance business?    I mean they do well with SSA/ IRS/ VA 

ML

How do you propose to keep old people fed/housed, war vets treated etc without SSA/VA?
When we started fighting wars, was funding for VA increased to account for the large influx of vets?

Privitize SSA...   Im betting 100% of the mebers here  could do a better job  of  managing the $ then the government currently does.

Its my opinion most things the government involves itself in they more they  will screw it up.

But we are not average.  75% of the population does not feel they themselves could do a better job.

[Eric]

All of you posting your inane complaints about the ACA, in a Post-FIRE section nonetheless, are insane.  The ACA is easily the biggest boon to early retirees since the Roth Conversion ladder.  Not only does it control your costs once you retire (assuming you can stay w/in 400% of the federal poverty level), it makes it so that you're still insurable if you happen to develop a chronic condition.

Compared to the previous system of unknowable costs and unregulated ability to have your policy cancelled when you needed it most, it's an amazing gift.  You should be thanking your lucky stars that it came to pass.  But alas, you can't see what an amazing thing this is for everyone aspiring to FIRE and instead continually regurgitate tired sound bytes because POLITICS.  This forum is used to be filled with critical thinkers.  Apparently that's changing for the worse.

[geekette]

BCBS NC, in their infinite wisdom, decided to pull all "Select" plans in our area in favor of smaller network plans, which our GP (of 20 years) isn't in.

That said, UHC is offering a plan which includes our GP.  I think our OOP costs will be about the same.  The caveat is that they don't have an out of state network like BCBS does.  Since I don't think I'll be going out of state for health care (other than emergency, which is covered), I think we're good.

Our premium (unsubsidized) for two mid-50's is going from $1150 to $1250/month.

Honestly, I'm happy we can get insurance at all.

[Exflyboy]

All of you posting your inane complaints about the ACA, in a Post-FIRE section nonetheless, are insane.  The ACA is easily the biggest boon to early retirees since the Roth Conversion ladder.  Not only does it control your costs once you retire (assuming you can stay w/in 400% of the federal poverty level), it makes it so that you're still insurable if you happen to develop a chronic condition.

Compared to the previous system of unknowable costs and unregulated ability to have your policy cancelled when you needed it most, it's an amazing gift.  You should be thanking your lucky stars that it came to pass.  But alas, you can't see what an amazing thing this is for everyone aspiring to FIRE and instead continually regurgitate tired sound bytes because POLITICS.  This forum is used to be filled with critical thinkers.  Apparently that's changing for the worse.

^^^^^^^ This!

[Bob W]

Ugh -- the sickness care industry --- we're screwed.   Run by special interests and lobbyists it relies on the theory that the tragedy of the commons is a great business model.

It is becoming a very ironic system where the working middle/upper income group  pays the bill but does not use the product due to super high deductibles,  while low income and no income folks will enjoy unfettered access and no bill. 

But hey ---  It is not a tax! 

The up side is that millionaire mustachians can structure their lives so that someone else pays their premiums.  That is central planning at its best!

Can't wait for the same program to kick in with auto insurance.   All the mustachians will be walking and riding bikes while low income folks wiz by in their free insurance cars by them. 

There are some simple solutions ---  The easiest would be to just hire the Germans or Japanese to run the whole damn convoluted, ineffective system. 

[BTDretire]

i thought the average family would save $2500/ year at least that was the lie to get the sheeple behind it.

 Yes, it was a lie. When he said that, I was paying $4,534 for a family of 4.
Now an Obamacare policy for my family of 3 is $17,112.

[BTDretire]

All of you posting your inane complaints about the ACA, in a Post-FIRE section nonetheless,
 
snip other good stuff.

 it's an amazing gift.  You should be thanking your lucky stars that it came to pass.  But alas, you can't see what an amazing thing this is for everyone aspiring to FIRE and instead continually regurgitate tired sound bytes because POLITICS.  This forum is used to be filled with critical thinkers.  Apparently that's changing for the worse.

  As has been pointed out to me (here) several times, you can't always just think about yourself! Remember, all this upheaval is for less than 3% of the population,so far. But the higher rates get pushed up, the more people will signup for Obamacare.
 The more people that signup, the more paid out in subsidies, to the point where they will start getting cut it back and the subsidy cutoff income will get lower.
 Anybody know how much the total subsidy paidout this year was?

[Miss Prim]

Well, I ended up switching from COBRA to the ACA because my premium is going to be much lower.  People who are complaining about the price must make quite a lot of money and can afford to pay their premiums.  My plan is BCBS select silver and I figured at the most my husband and I (he is on Medicare) would have $52,000 coming in between his small business, a rental, SS for him, a small pension from his previous job and still pulling out some from the stache.  My premium is $455 per month, COBRA was going to be $627.  They are pretty much comparable plans, except now my Dr.'s are not as limited and I can go to other hospitals that are actually closer to me.

It amazes me such selfishness I see from people replying to this post!  Sure, you're young and healthy now and want to pay low premiums, but then how about later when you have saved your ass off and now are sick, we'll just take everything you own!  Boy would we be hearing screaming from you then about how unfair it is, etc! Just because people don't have the kind of resources or brains to have big time paying jobs doesn't make them "freeloaders"!  If you get a catastrophic illness while you are young and can't work, can we call you a "freeloader" too!  It works both ways.

                                                                                        Miss Prim

[Exflyboy]

I keep waiting for wailing and gnashing of teeth to turn to a constructive conversation about the REAL issue.

I.e why does America pay twice as much for HC as pretty much any other developed nation.. and the care is no better.

Maybe when we start addressing the real issue we'll get real results.. In the meantime lets all keep screaming and point fingers towards Obama because clearly he's a Muslim and Donald Trump will fix ALL our problems.

Now where did I put that brain of mine?

[UnleashHell]

Now where did I put that brain of mine?

No idea but if its spare then I think Ben Carson needs it.

[bacchi]

i thought the average family would save $2500/ year at least that was the lie to get the sheeple behind it.

 Yes, it was a lie. When he said that, I was paying $4,534 for a family of 4.
Now an Obamacare policy for my family of 3 is $17,112.

Yes, he did, but I got news for you: Every politician lies.

Bush 1: "No new taxes"
Clinton: "I did not have sex with that woman"
Bush II: "WMDs! WMDs!"

It's done. If you want change, vote for someone who will change it. Otherwise, get over it and move on. As Exflyboy stated, we should be addressing the real issue: Why is American health care so f'ing expensive in the first place?

[Daisy]

As Exflyboy stated, we should be addressing the real issue: Why is American health care so f'ing expensive in the first place?

Highly paid insurance middle men/women not adding value to "health" care.
Extra employees at doctor's offices to handle said complicated insurance.
Unhealthy lifestyles (bad diet, poor exercise) leading to more diseases.
Reliance on (expensive) pharmaceuticals when there are more natural and holistic alternatives that people are "scared" of but the rest of the world embraces. Note some diseases require such pharmaceuticals but many chronic conditions are better handled differently.
Malpractice insurance for doctors due to being in a litigious society.

[regulator]

To put it bluntly, the ACA sucks.  The old system (rescission, ridiculous underwriting, kick you out when you get sick, etc.) sucked worse.  Its a mystery to me why we did not do what the rest of the first world does when changes were being made.  Now we have a system which actually does cover people, but it is even more absurdly expensive than it used to be.  Yay.

Screw it.  I will limbo as hard as I can to get subsidies until this system blows up and/or the subsidies get taken away.  Carpe Diem.

[Rezdent]

Someone up thread mentioned that the politics and money are connected - yeah, we've got to fix that.  I have no clue how we get them apart, other than vote.

I think all healthcare provider's fees should be fully disclosed and transparent.  If I call hospital A and hospital B,  both of them should be able to tell me what an x-ray  costs.  And this should be in the paperwork when I sign.  They make me sign to state I will pay the bill, and that paper should include the cost.  If for some reason that cost changes, they should be liable to inform me, allow me to make a decision, etc...

As consumers, we've got to take some responsibility.  When a salesman provider suggests a test or procedure we need to ask questions.  The most important one is:
How will this affect treatment?
I always ask that question, and I am shocked at the number of times I've found out that the treatment would not change.  If the test isn't going to change the outcome, why would I consent to a CT scan?

More emphasis on quality of life, and better handling of end life care.

Medicare should negotiate RX pricing.

Move the system away from fee-for-service.

[forummm]

As Exflyboy stated, we should be addressing the real issue: Why is American health care so f'ing expensive in the first place?

Highly paid insurance middle men/women not adding value to "health" care.
Extra employees at doctor's offices to handle said complicated insurance.
Unhealthy lifestyles (bad diet, poor exercise) leading to more diseases.
Reliance on (expensive) pharmaceuticals when there are more natural and holistic alternatives that people are "scared" of but the rest of the world embraces. Note some diseases require such pharmaceuticals but many chronic conditions are better handled differently.
Malpractice insurance for doctors due to being in a litigious society.

Paying too much for care, and "care". We pay far more for drugs than other rich countries. The same identical drugs. And there's a ton of profit at every level--insurers, hospitals, doctors (some more than others), devices, drugs, etc. It's ridiculous. And we also don't research what things are cost effective compared to which other things (is this new $500 pill actually better than the old $0.10 one?) and provide too much "care" to certain people (like $100k cancer treatments that make people worse off and don't prolong life) and too little to others (like prevention amongst the disadvantaged).

[UnleashHell]

its easy. change the system to treating people instead of generating billings. right now the focus is financial first.

[BTDretire]

Someone up thread mentioned that the politics and money are connected - yeah, we've got to fix that.  I have no clue how we get them apart, other than vote.

I think all healthcare provider's fees should be fully disclosed and transparent.  If I call hospital A and hospital B,  both of them should be able to tell me what an x-ray  costs.  And this should be in the paperwork when I sign.  They make me sign to state I will pay the bill, and that paper should include the cost.  If for some reason that cost changes, they should be liable to inform me, allow me to make a decision, etc...

As consumers, we've got to take some responsibility.  When a salesman provider suggests a test or procedure we need to ask questions.  The most important one is:
How will this affect treatment?
I always ask that question, and I am shocked at the number of times I've found out that the treatment would not change.  If the test isn't going to change the outcome, why would I consent to a CT scan?

More emphasis on quality of life, and better handling of end life care.

Medicare should negotiate RX pricing.

Move the system away from fee-for-service.

Agree with all the above.
 I think there is a scam going on with companies selling knee and back braces by TV comercial. It is always medicare or an insurance company that is paying the bill.
I can see 10's of thousands of these braces in a closet and then a yard sale.
  I received a phone recording asking if I had knee or back pain. It said I could possibly get a brace at no cost to me. Push 1 if you have a PPO, push 2 if you have an HMO, or some letter combination, etc. I pushed 1 just to tell the operator what I thought, it was clearly a boiler room with all the chatter in the background. I hope the insurance companies band together and mark these companies as not part of the reimbursment program.

[seattlecyclone]

To put it bluntly, the ACA sucks.  The old system (rescission, ridiculous underwriting, kick you out when you get sick, etc.) sucked worse.  Its a mystery to me why we did not do what the rest of the first world does when changes were being made.

It's not as though "the rest of the first world" agrees on how to pay for health care.

The English have the NHS, where most doctors work directly for the government, providing treatment to residents at no cost at the time of service.

In France, most doctors work in private practice, but the amount they can charge is regulated by the government. Patients pay a percentage of this fee for every service, with the remainder being reimbursed by a national insurance program funded by a dedicated income tax.

Switzerland is actually very similar to the US under the ACA: you buy insurance from one of several private companies, this insurance must cover a certain list of treatments set by the government, you're responsible for paying an annual deductible ranging from a few hundred to a few thousand dollars, and you have to pay for a percentage of costs after that.

These places all have pretty different approaches to paying for health care, yet they all achieve similar results for much less money than in the US.

[regulator]

These places all have pretty different approaches to paying for health care, yet they all achieve similar results for much less money than in the US.

I am not picky on how we get there, I just want to do so before I get priced out of the market forever.

[UnleashHell]

In England you also have private Doctors and insurance.

The doctors commit a certain amount of days to the nhs and the rest private. So you can go private or have insurance to go private as well as the basic underlying health service.

Years ago I screwed my knee up playing rugby. I had private insurance.
I went to my nhs doctor who referred me to a specialist. The specialist examined the knee and told me what needed (kneeded?) doing to resolve the issues.
At that point i could wait on the NHS waiting list and get the operation (18 month waiting list but no cost) or go private.

Private was covered by my private insurance. Took 2 weeks to the operation, done in a private hospital and by the same specialist who would have done it at the NHS hospital 2 miles away.


If you can afford the private coverage then things can be done quicker but it costs more. Otherwise I'd have got the same treatment but it would have take longer but covered under the NHS.


I see no reason why a similar system could work in the states. No system is perfect but this one here now is an expensive shambles.

[Exflyboy]

In England you also have private Doctors and insurance.

The doctors commit a certain amount of days to the nhs and the rest private. So you can go private or have insurance to go private as well as the basic underlying health service.

Years ago I screwed my knee up playing rugby. I had private insurance.
I went to my nhs doctor who referred me to a specialist. The specialist examined the knee and told me what needed (kneeded?) doing to resolve the issues.
At that point i could wait on the NHS waiting list and get the operation (18 month waiting list but no cost) or go private.

Private was covered by my private insurance. Took 2 weeks to the operation, done in a private hospital and by the same specialist who would have done it at the NHS hospital 2 miles away.


If you can afford the private coverage then things can be done quicker but it costs more. Otherwise I'd have got the same treatment but it would have take longer but covered under the NHS.


I see no reason why a similar system could work in the states. No system is perfect but this one here now is an expensive shambles.

Exactly, and remember before ACA if you had a pre-existing condition (Cancer has a habit of coming back) then you couldn't get insurance to cover that// So $100k please.. or just simply die!

[FrancisinPa]

I noticed the price of ACA plans rising significantly in my area too. I also see more HMO plans and less PPO plans. Also the total number of plans is much less, 17 this year and there were about 35 last year. The big issue for early retirees is how much are these ACA plans going to cost in 10 years plus (if it's still around). I know many Doctors in their early+mid 50's leaving the profession mostky from dealing with reimbursement issues with insurers. I see local insurance companies paying their executives multi millions while they deny every claim possible. I see it often where insurers deny coverage for a new drug until the patient fails treatment with one or two older (cheaper) meds. Sure that saves money for the insurance company but during the time needed to fair the older treatments do you think your disease might get worse? The system is severely broken.

How to deal with it? Why doesn't the government create a supply/demand situation with providers? Why not create 5 new medical schools in each state to increase the supply of Doctors? You'll surely find more providers willing to accept pre negotiated rates from insurers.

[bacchi]

I think there is a scam going on with companies selling knee and back braces by TV comercial. It is always medicare or an insurance company that is paying the bill.
I can see 10's of thousands of these braces in a closet and then a yard sale.
  I received a phone recording asking if I had knee or back pain. It said I could possibly get a brace at no cost to me. Push 1 if you have a PPO, push 2 if you have an HMO, or some letter combination, etc. I pushed 1 just to tell the operator what I thought, it was clearly a boiler room with all the chatter in the background. I hope the insurance companies band together and mark these companies as not part of the reimbursment program.

There's almost certainly a scam going on there. Scooters for the elderly were the same way, for years. Their ads just screamed scam and it took a decade before the feds closed down one of the main offenders, The Scooter Store.

https://en.wikipedia.org/wiki/Scooter_Store

[Arktinkerer]

...
Can't wait for the same program to kick in with auto insurance.   All the mustachians will be walking and riding bikes while low income folks wiz by in their free insurance cars by them. 

Even if we are walking/riding bikes we will still be forced to buy auto insurance!  Probably require us to buy comprehensive coverage as well!