Author Topic: What comes after the ACA?  (Read 747886 times)

DreamFIRE

  • Handlebar Stache
  • *****
  • Posts: 1230
Re: What comes after the ACA?
« Reply #4500 on: July 08, 2018, 08:30:38 AM »

DreamFIRE

  • Handlebar Stache
  • *****
  • Posts: 1230
Re: What comes after the ACA?
« Reply #4501 on: July 08, 2018, 08:34:05 AM »
Maybe I should rephrase from dead to dying and will die in the future.  I just don't see any positive rhetoric that is improving healthcare in this country.  Having  more people on the exchange does not equal improved healthcare

It's improved over 20 million people losing healthcare coverage.  We need to vote out everyone contributing to the sabotage of the ACA.
« Last Edit: July 08, 2018, 09:05:42 AM by DreamFIRE »

TrudgingAlong

  • Stubble
  • **
  • Posts: 170
Re: What comes after the ACA?
« Reply #4502 on: July 08, 2018, 10:34:51 AM »

Medicare for all?  Unfortunately, Medicare can still be expensive for decent coverage.  If you get plan A, B, D, and supplemental to cover everything else, someone posted earlier in this thread it was costing over $900/mo.  Medicare doesn't mean you get everything for free.

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036422/#msg2036422

This is a pretty fair concern. Putting everyone on it, though, means Medicare is not just old people, who suck up most of the healthcare in this country. We also currently have made it illegal to negotiate drug prices, which raises costs in a major way. Fix that, plus level costs between healthy and sick, and it think the basic rate would go down quite a bit.

Another thought: if everyone has Medicare, every doctor should take it. This fixing the access/changing provider problems.
« Last Edit: July 08, 2018, 10:36:59 AM by TrudgingAlong »

EnjoyIt

  • Handlebar Stache
  • *****
  • Posts: 1049
Re: What comes after the ACA?
« Reply #4503 on: July 08, 2018, 10:44:15 AM »
Maybe I should rephrase from dead to dying and will die in the future.  I just don't see any positive rhetoric that is improving healthcare in this country.  Having  more people on the exchange does not equal improved healthcare

It's improved over 20 million people losing healthcare coverage.  We need to vote out everyone contributing to the sabotage of the ACA.

Sure is...but just because 20 million people have health insurance does not mean that they have access to healthcare, have good healthcare, or affordable healthcare.  It also does not meant that the cost of healthcare for the US government or its citizens is decreasing which is the underlying problem and why certain groups of people have poor healthcare to begin with.

ACA is dying because it doesn't address the underlying problem and I do not see any Democrat or Republican trying to fix it.
« Last Edit: July 08, 2018, 11:02:58 AM by EnjoyIt »

Exflyboy

  • Walrus Stache
  • *******
  • Posts: 5480
  • Age: 56
  • Location: Corvallis, Oregon
  • Expat Brit living in the New World..:)
Re: What comes after the ACA?
« Reply #4504 on: July 08, 2018, 11:02:00 AM »
Of course nobody (who matters) really wants to reduce the cost of healthcare.. Healthcare is the 4th largest sector of the US stock market by market cap.

There is zero motivation to reduce cost because the dividends paid to billionares far outstrips whatever they spend (if indeed you pay anything if you're in Congress) on their own HC.

I just found some numbers.. the HC sector is $5.36T vs a total market of about $45.7T... This comes to 11.7%.

So even for a small $1M portfolio using an average return of around 10% pa it means your baby millionare is making $11,700 per year out of the HC industry.

What is the average networth of a member of Congress?... If its $10M, then good luck with getting anything to change and thats not including the backhanders the lobbyests give them.
« Last Edit: July 08, 2018, 11:11:23 AM by Exflyboy »

talltexan

  • Handlebar Stache
  • *****
  • Posts: 1824
Re: What comes after the ACA?
« Reply #4505 on: July 11, 2018, 07:01:58 AM »
I tend to be one of those optimists who believes--now that they've passed the TCJA to secure their own tax cut--the wealthiest members of Congress will revert back to trying to answer to the voters.

Threshkin

  • Pencil Stache
  • ****
  • Posts: 872
  • Location: Colorado
    • My Journal
Re: What comes after the ACA?
« Reply #4506 on: July 11, 2018, 10:37:09 AM »
I tend to be one of those optimists who believes--now that they've passed the TCJA to secure their own tax cut--the wealthiest members of Congress will revert back to trying to answer to the voters.

Go back?  It is hard to go back to a place they have never been to.

DavidAnnArbor

  • Handlebar Stache
  • *****
  • Posts: 1723
  • Age: 52
  • Location: Ann Arbor, Michigan
Re: What comes after the ACA?
« Reply #4507 on: July 11, 2018, 06:26:59 PM »
Approx. 85% of people on the ACA exchange get some kind of subsidy, so while some will drop out, many will choose to stay.

You can get health coverage outside of the exchange with these 6 month or 1 year insurance plans, but these insurance plans are woefully inadequate, and if you've saved up a stash of money, you're putting that at risk. https://www.bogleheads.org/forum/viewtopic.php?t=232507

swampwiz

  • Bristles
  • ***
  • Posts: 396
Re: What comes after the ACA?
« Reply #4508 on: July 11, 2018, 08:03:20 PM »
Another thought: if everyone has Medicare, every doctor should take it. This fixing the access/changing provider problems.

That's called monopsony pricing.

Exflyboy

  • Walrus Stache
  • *******
  • Posts: 5480
  • Age: 56
  • Location: Corvallis, Oregon
  • Expat Brit living in the New World..:)
Re: What comes after the ACA?
« Reply #4509 on: July 11, 2018, 10:28:20 PM »
Approx. 85% of people on the ACA exchange get some kind of subsidy, so while some will drop out, many will choose to stay.

You can get health coverage outside of the exchange with these 6 month or 1 year insurance plans, but these insurance plans are woefully inadequate, and if you've saved up a stash of money, you're putting that at risk. https://www.bogleheads.org/forum/viewtopic.php?t=232507

Well what is adequate is an interesting question. On ACA Bronze plans in my area they have virtually zero out of network coverage.

This so bad that that we refuse to take driving holidays in the USA anymore.. Much cheaper to buy travel insurance for Europe or pay out of pocket in Asia.

Threshkin

  • Pencil Stache
  • ****
  • Posts: 872
  • Location: Colorado
    • My Journal
Re: What comes after the ACA?
« Reply #4510 on: July 12, 2018, 02:18:46 PM »
Approx. 85% of people on the ACA exchange get some kind of subsidy, so while some will drop out, many will choose to stay.

You can get health coverage outside of the exchange with these 6 month or 1 year insurance plans, but these insurance plans are woefully inadequate, and if you've saved up a stash of money, you're putting that at risk. https://www.bogleheads.org/forum/viewtopic.php?t=232507

Well what is adequate is an interesting question. On ACA Bronze plans in my area they have virtually zero out of network coverage.

This so bad that that we refuse to take driving holidays in the USA anymore.. Much cheaper to buy travel insurance for Europe or pay out of pocket in Asia.

This is one of my biggest concerns about current US health insurance.  The plans (ACA or other) commonly provide little to no coverage outside of a very limited geographical area. 

When I put on my tinfoil hat I start to worry that this is an intentional plan to discourage migration or relocation within the US.  All kinds of scary ideas and motives come out of this line of thinking............  Then I take off my hat and feel just fine.

DreamFIRE

  • Handlebar Stache
  • *****
  • Posts: 1230
Re: What comes after the ACA?
« Reply #4511 on: July 12, 2018, 03:52:21 PM »
Approx. 85% of people on the ACA exchange get some kind of subsidy, so while some will drop out, many will choose to stay.

You can get health coverage outside of the exchange with these 6 month or 1 year insurance plans, but these insurance plans are woefully inadequate, and if you've saved up a stash of money, you're putting that at risk. https://www.bogleheads.org/forum/viewtopic.php?t=232507

Well what is adequate is an interesting question. On ACA Bronze plans in my area they have virtually zero out of network coverage.

This so bad that that we refuse to take driving holidays in the USA anymore.. Much cheaper to buy travel insurance for Europe or pay out of pocket in Asia.

This is one of my biggest concerns about current US health insurance.  The plans (ACA or other) commonly provide little to no coverage outside of a very limited geographical area. 

And even if the plan provides out of network coverage with an out of pocket max, that doesn't stop the provider from balance billing you, as was discussed several pages back.   Some states have partial protections, but even that won't necessarily help if you receive services from another state.

Bateaux

  • Handlebar Stache
  • *****
  • Posts: 1168
  • Location: Port Vincent
Re: What comes after the ACA?
« Reply #4512 on: July 12, 2018, 10:28:34 PM »
Approx. 85% of people on the ACA exchange get some kind of subsidy, so while some will drop out, many will choose to stay.

You can get health coverage outside of the exchange with these 6 month or 1 year insurance plans, but these insurance plans are woefully inadequate, and if you've saved up a stash of money, you're putting that at risk. https://www.bogleheads.org/forum/viewtopic.php?t=232507

Well what is adequate is an interesting question. On ACA Bronze plans in my area they have virtually zero out of network coverage.

This so bad that that we refuse to take driving holidays in the USA anymore.. Much cheaper to buy travel insurance for Europe or pay out of pocket in Asia.

This is a huge issue with the ACA.   We need a national plan not state plans.  I want to have the same coverage provided anywhere in the country.   

Exflyboy

  • Walrus Stache
  • *******
  • Posts: 5480
  • Age: 56
  • Location: Corvallis, Oregon
  • Expat Brit living in the New World..:)
Re: What comes after the ACA?
« Reply #4513 on: July 12, 2018, 11:38:48 PM »
Its not even a state plan.. if I travel basically 30 miles away from my front door I am out of network.

It was mentioned before that this problem is not just limited to plans on the ACA though.

Oregon does at least have some protection against balance billing.

The whole system is the US is F'd up its depressing!

Roadrunner53

  • Handlebar Stache
  • *****
  • Posts: 1319
Re: What comes after the ACA?
« Reply #4514 on: July 13, 2018, 05:48:59 AM »
My husband and I have been on (ACA) Anthem Blue Cross silver plan. Hub had major surgery 2016 and we did have to pay out of pocket but probably less than $5,000. He went to a hospital about an hour away from our home for the surgery. It all went really well and we were glad to have had ACA. He moved on to Medicare and supplement Plan F. He needed radiation last year and we did not receive one bill for that. That was very expensive too.

If  you are on a Bronze plan, have you considered moving up to a silver plan? If you keep your income under $63,000 (approx.) you will get a subsidy for family of 2. I am paying $495 just for me now and the subsidy is somthing like $769. Next month I move on to Medicare and Plan F too.

Donny Boy is strangling ACA every way he can. What happened to Donny's campaign statement that he would make it "better and cheaper'? LIES!
« Last Edit: July 13, 2018, 09:48:49 AM by Roadrunner53 »

DreamFIRE

  • Handlebar Stache
  • *****
  • Posts: 1230
Re: What comes after the ACA?
« Reply #4515 on: July 13, 2018, 09:03:59 AM »
Donny Boy is strangling ACA every way he can. What happened to Donny's campaign statement that he would make it "better and cheaper'? LIES!

He was never believable.  The only detail he gave on that was about insurance being sold across state lines.  Rubio even mocked him in one of the debates about it.

EnjoyIt

  • Handlebar Stache
  • *****
  • Posts: 1049
Re: What comes after the ACA?
« Reply #4516 on: July 13, 2018, 04:55:04 PM »
My husband and I have been on (ACA) Anthem Blue Cross silver plan. Hub had major surgery 2016 and we did have to pay out of pocket but probably less than $5,000. He went to a hospital about an hour away from our home for the surgery. It all went really well and we were glad to have had ACA. He moved on to Medicare and supplement Plan F. He needed radiation last year and we did not receive one bill for that. That was very expensive too.

If  you are on a Bronze plan, have you considered moving up to a silver plan? If you keep your income under $63,000 (approx.) you will get a subsidy for family of 2. I am paying $495 just for me now and the subsidy is somthing like $769. Next month I move on to Medicare and Plan F too.

Donny Boy is strangling ACA every way he can. What happened to Donny's campaign statement that he would make it "better and cheaper'? LIES!

Without the mandate I suspect that in 2019 my options will be better and cheaper since I do not qualify for any subsidy and can now choose a plan that fits our needs better.  In addition over the last few years the ACA plans in my area have shitty surgeons in network.  I would not let them operate on any of my loved ones and would pay out of pocket for someone more competent if I had to. 

I'll let you know later this year if you remind me.

DavidAnnArbor

  • Handlebar Stache
  • *****
  • Posts: 1723
  • Age: 52
  • Location: Ann Arbor, Michigan
Re: What comes after the ACA?
« Reply #4517 on: July 13, 2018, 08:27:05 PM »
That's a shame about the surgeons.  Being in Ann Arbor I have access to the University of Michigan Hospital system, and I believe there that the surgeons have to be better than average to gain employment at such a prestigious medical school hospital.

EnjoyIt

  • Handlebar Stache
  • *****
  • Posts: 1049
Re: What comes after the ACA?
« Reply #4518 on: July 13, 2018, 11:01:01 PM »
That's a shame about the surgeons.  Being in Ann Arbor I have access to the University of Michigan Hospital system, and I believe there that the surgeons have to be better than average to gain employment at such a prestigious medical school hospital.

I am near a very prestigious medical center and work at one of their hospitals, but I am not an employee and therefor buy insurance on the open market.  I have access to some of the best surgeons in the US but not a single one of them is on any of the ACA open market plans I have available to me which was not the case prior to ACA implementation.  In all honesty, this year my wife has decent insurance for us.  But with the plan of semi retiring soon we will be back in the open market.  I for one am thrilled that the mandate is being eliminated for the health and potential need for my family and myself.  "Cheaper and better" is not a lie for us.

pecunia

  • Bristles
  • ***
  • Posts: 481
Re: What comes after the ACA?
« Reply #4519 on: July 15, 2018, 06:49:20 AM »
Enjoyit:
Quote
I for one am thrilled that the mandate is being eliminated for the health and potential need for my family and myself.  "Cheaper and better" is not a lie for us.

I don't understand how it can be cheaper when young healthy people are the ones being eliminated from the insurance pool.  These are the people you want.  They do not need / use the services and so bring the prices down.

There are about three similar discussions taking place on this forum.  If the comments I see represent those of the public at large, health is going to be an issue in the next election and may, in fact, affect election outcomes.  I've not seen positive comments made for our Republican representatives.  Of course, I've not seen positive comments made for the other guys too,......almost nothing there.

maizeman

  • Magnum Stache
  • ******
  • Posts: 2676
Re: What comes after the ACA?
« Reply #4520 on: July 15, 2018, 07:06:16 AM »
I don't understand how it can be cheaper when young healthy people are the ones being eliminated from the insurance pool.  These are the people you want.  They do not need / use the services and so bring the prices down.

Pecunia, you realize a lot of us on the forum ARE those young / healthy people, right?

Not ACA, but I've worked for my current employer for a bit more than four years. In that time I estimate that, between what I pay and what my employer pays my insurance company has received ~$25,000. In that same four years, my total consumption of medical services has been one minor visit to urgent care, which cost ~$150 (and my insurance paid nothing because obviously I hadn't met my deductible).

In the absence of the ACA, someone like me could probably get much much cheaper health insurance (with the same degree of coverage I now enjoy). Now I'm willing to pay a lot more than my fair share for the peace of mind of knowing I'll still be able to buy healthcare if I were to develop a chronic medical condition.

But please do remember the relatively young relatively healthy people who are subsidizing your healthcare are indeed people too. And the reason your premiums aren't as high as they otherwise would be is because ours aren't as low as they otherwise would be.

pecunia

  • Bristles
  • ***
  • Posts: 481
Re: What comes after the ACA?
« Reply #4521 on: July 15, 2018, 08:51:07 AM »
Quote
But please do remember the relatively young relatively healthy people who are subsidizing your healthcare are indeed people too.

Yes - Here's another fact.  Some of us older people do not get sick either and end up paying a great deal of money for nothing.  I believe I still can share your pain.  I've paid for it for many years and have received little.  They don't even give out a glossy calendar.  They just take the money.

An observation - Have you ever stopped at a gas station and seen those cans / jars with a picture of a sick person on it?  they are looking for a donation to give that person some medical treatment.  Usually, they have some sort of Cancer.  Have you also noticed that they are almost always kids?

Any of us can get sick at any time.

maizeman

  • Magnum Stache
  • ******
  • Posts: 2676
Re: What comes after the ACA?
« Reply #4522 on: July 15, 2018, 09:01:34 AM »
It seems you are pivoting your position substantially from what you wrote in your previous post (6:49 AM) without acknowledging the change.

Certainly we can all get sick at any time. That's why it makes sense to have insurance. But I don't appreciate people talking about my generation losing health insurance as mainly bad because we won't be around to subsidize older folks since, as a group, we tend to pay a lot more than we cost to take care of.

Roadrunner53

  • Handlebar Stache
  • *****
  • Posts: 1319
Re: What comes after the ACA?
« Reply #4523 on: July 15, 2018, 09:06:16 AM »
Yes, true, young people get sick too. Illness strikes when you least expect it to happen.

DreamFIRE

  • Handlebar Stache
  • *****
  • Posts: 1230
Re: What comes after the ACA?
« Reply #4524 on: July 15, 2018, 11:16:29 AM »
Enjoyit:
Quote
I for one am thrilled that the mandate is being eliminated for the health and potential need for my family and myself.  "Cheaper and better" is not a lie for us.

I don't understand how it can be cheaper when young healthy people are the ones being eliminated from the insurance pool.

I didn't see any of the responses clarify this point, but EnjoyIt wasn't talking about the ACA plans being cheaper and better by eliminating the mandate.  He was talking about other healthcare insurance plans that may be an option in 2019 as a result which he feels will better suit his needs and provide access to the surgeons he prefers.  But the ACA plans won't be any cheaper if everything else remains the same.

TrudgingAlong

  • Stubble
  • **
  • Posts: 170
Re: What comes after the ACA?
« Reply #4525 on: July 15, 2018, 11:26:29 AM »
It seems you are pivoting your position substantially from what you wrote in your previous post (6:49 AM) without acknowledging the change.

Certainly we can all get sick at any time. That's why it makes sense to have insurance. But I don't appreciate people talking about my generation losing health insurance as mainly bad because we won't be around to subsidize older folks since, as a group, we tend to pay a lot more than we cost to take care of.

You seem to think you wonít get old and cost other, younger people money. The point is to equalize the costs. Obviously we havenít got the method right, but moaning about paying for other people is not going to solve anything. Someday, youíll be thrilled to have others moderate your costs if you are unlucky enough to need it.

maizeman

  • Magnum Stache
  • ******
  • Posts: 2676
Re: What comes after the ACA?
« Reply #4526 on: July 15, 2018, 11:36:15 AM »
No I am perfectly aware that in the future my own insurance will be much more expensive as I get older. There are good reasons the ACA is set up so the young subsidize the old. But we should acknowledge that the young are also people, are also members of this forum, and we ARE paying more than we did pre ACA to make the whole system work.

pecunia

  • Bristles
  • ***
  • Posts: 481
Re: What comes after the ACA?
« Reply #4527 on: July 15, 2018, 11:50:55 AM »
maizeman:
Quote
But we should acknowledge that the young are also people, are also members of this forum, and we ARE paying more than we did pre ACA to make the whole system work.

Acknowledged - Everyone is paying more.  That is the core of the problem.

Trudging Along:
Quote
Someday, youíll be thrilled to have others moderate your costs if you are unlucky enough to need it.

I realize this was intended for Maizeman whom I acknowledge, but I'll jump in anyway.  It is almost obscene to be looking forward to the day when I can get medicare, but it's true.  I think of old drooling geezers in wheel chairs, glazed looks over their eyes and difficulties with basic movements.

This whole medical discussion has reminded me how cruel life can be to some and I guess eventually to us all.  Nature deals out a bad enough hand now.  Medical policies are the works of man and not nature.  The system by which medicine is doled out shouldn't be doing the equivalent of rubbing salt into the wounds.


Roadrunner53

  • Handlebar Stache
  • *****
  • Posts: 1319
Re: What comes after the ACA?
« Reply #4528 on: July 15, 2018, 12:16:17 PM »
maizeman:
Quote
But we should acknowledge that the young are also people, are also members of this forum, and we ARE paying more than we did pre ACA to make the whole system work.

Acknowledged - Everyone is paying more.  That is the core of the problem.

Trudging Along:
Quote
Someday, you’ll be thrilled to have others moderate your costs if you are unlucky enough to need it.

I realize this was intended for Maizeman whom I acknowledge, but I'll jump in anyway.  It is almost obscene to be looking forward to the day when I can get medicare, but it's true.  I think of old drooling geezers in wheel chairs, glazed looks over their eyes and difficulties with basic movements.

This whole medical discussion has reminded me how cruel life can be to some and I guess eventually to us all.  Nature deals out a bad enough hand now.  Medical policies are the works of man and not nature.  The system by which medicine is doled out shouldn't be doing the equivalent of rubbing salt into the wounds.



Wow you think all people on Medicare are drooling geezers in wheelchairs? I happen to be one of those geezers who goes on Medicare in 2 1/2 weeks and doing quite fine. Also, be prepared to open your pocketbook when you get on Medicare because only Part A (hospitalization) is free if you have worked 10 years. Part B is $134 (doctors/tests) a month, the prescription plan Part D we chose is $78 a month and we bought a supplement, Part F is $241.50 a month. For the two of us it is over $10,000 a year. For people who think Medicare For All is the answer, good luck with that. Add a few kids onto those numbers. Yes, there are cheaper options with Plan F and Plan D but in the end you will still have to pay more out of your pocket because the plans will not cover stuff with cheaper plans. It's like pay me now or pay me later. Doesn't matter they will find a way to suck you dry.

DreamFIRE

  • Handlebar Stache
  • *****
  • Posts: 1230
Re: What comes after the ACA?
« Reply #4529 on: July 15, 2018, 12:27:49 PM »
Wow you think all people on Medicare are drooling geezers in wheelchairs? I happen to be one of those geezers who goes on Medicare in 2 1/2 weeks and doing quite fine. Also, be prepared to open your pocketbook when you get on Medicare because only Part A (hospitalization) is free if you have worked 10 years. Part B is $134 (doctors/tests) a month, the prescription plan Part D we chose is $78 a month and we bought a supplement, Part F is $241.50 a month. For the two of us it is over $10,000 a year. For people who think Medicare For All is the answer, good luck with that. Add a few kids onto those numbers. Yes, there are cheaper options with Plan F and Plan D but in the end you will still have to pay more out of your pocket because the plans will not cover stuff with cheaper plans. It's like pay me now or pay me later. Doesn't matter they will find a way to suck you dry.

So many people think Medicare is just something that is free, except it's actually very expensive.  I'm not looking forward to those days under the current system and paying $1000/mo (probably a lot more by then) to be fully protected.

EnjoyIt

  • Handlebar Stache
  • *****
  • Posts: 1049
Re: What comes after the ACA?
« Reply #4530 on: July 15, 2018, 03:29:02 PM »
Enjoyit:
Quote
I for one am thrilled that the mandate is being eliminated for the health and potential need for my family and myself.  "Cheaper and better" is not a lie for us.

I don't understand how it can be cheaper when young healthy people are the ones being eliminated from the insurance pool.

I didn't see any of the responses clarify this point, but EnjoyIt wasn't talking about the ACA plans being cheaper and better by eliminating the mandate.  He was talking about other healthcare insurance plans that may be an option in 2019 as a result which he feels will better suit his needs and provide access to the surgeons he prefers.  But the ACA plans won't be any cheaper if everything else remains the same.

Exactly.  I prefer to be off the ACA plan since I get $0 in subsidies and the specialists that are in network are not physicians I prefer to use.  For me and my family eliminating the mandate will allow me to have cheaper and better health insurance.

EnjoyIt

  • Handlebar Stache
  • *****
  • Posts: 1049
Re: What comes after the ACA?
« Reply #4531 on: July 15, 2018, 03:34:46 PM »
Enjoyit:
Quote
I for one am thrilled that the mandate is being eliminated for the health and potential need for my family and myself.  "Cheaper and better" is not a lie for us.

I don't understand how it can be cheaper when young healthy people are the ones being eliminated from the insurance pool.

I didn't see any of the responses clarify this point, but EnjoyIt wasn't talking about the ACA plans being cheaper and better by eliminating the mandate.  He was talking about other healthcare insurance plans that may be an option in 2019 as a result which he feels will better suit his needs and provide access to the surgeons he prefers.  But the ACA plans won't be any cheaper if everything else remains the same.

Exactly.  I prefer to be off the ACA plan since I get $0 in subsidies and the specialists that are in network are not physicians I prefer to use.  For me and my family eliminating the mandate will allow me to have cheaper and better health insurance.

Wow you think all people on Medicare are drooling geezers in wheelchairs? I happen to be one of those geezers who goes on Medicare in 2 1/2 weeks and doing quite fine. Also, be prepared to open your pocketbook when you get on Medicare because only Part A (hospitalization) is free if you have worked 10 years. Part B is $134 (doctors/tests) a month, the prescription plan Part D we chose is $78 a month and we bought a supplement, Part F is $241.50 a month. For the two of us it is over $10,000 a year. For people who think Medicare For All is the answer, good luck with that. Add a few kids onto those numbers. Yes, there are cheaper options with Plan F and Plan D but in the end you will still have to pay more out of your pocket because the plans will not cover stuff with cheaper plans. It's like pay me now or pay me later. Doesn't matter they will find a way to suck you dry.

So many people think Medicare is just something that is free, except it's actually very expensive.  I'm not looking forward to those days under the current system and paying $1000/mo (probably a lot more by then) to be fully protected.

This is the reason why each and every one of us should save just a bit extra to be able to pay for health care costs in old age or if we unfortunately need it sooner.  We can't all be healthy forever and medicine isn't cheap these days.

pecunia

  • Bristles
  • ***
  • Posts: 481
Re: What comes after the ACA?
« Reply #4532 on: July 15, 2018, 07:14:03 PM »
Roadrunner:
Quote
Wow you think all people on Medicare are drooling geezers in wheelchairs? I happen to be one of those geezers who goes on Medicare in 2 1/2 weeks and doing quite fine.

What would I do if I only had 2-1/2 weeks before becoming a drooling geezer?  Wow!  Thought provoking.

Quote
Also, be prepared to open your pocketbook when you get on Medicare because only Part A (hospitalization) is free if you have worked 10 years. Part B is $134 (doctors/tests) a month, the prescription plan Part D we chose is $78 a month and we bought a supplement, Part F is $241.50 a month. For the two of us it is over $10,000 a year.

OK ($134 + $78 + $241.5) *12 = $5442 / annum per person   That will fit into the budget.  Good info.

As for opening it up, it may still be a good idea.  For the reasons expressed by maizeman and others, the incremental cost of the younger individuals can be expected to be much less.  In fact, if the government used the power of bidding (the marketplace) as other governments do, the costs could drop.

My mom passed away relatively recently, but Medicare allowed a heart operation to take place that would have killed her.  It gave her another 20 years of life.  I will say little bad regarding that particular government program.

Besides, if they weren't spending the money on Medicare, they'd just probably use it on another war.


Monkey Uncle

  • Handlebar Stache
  • *****
  • Posts: 1326
  • Location: West-by-god-Virginia
Re: What comes after the ACA?
« Reply #4533 on: July 16, 2018, 04:59:55 AM »
As for opening it up, it may still be a good idea.  For the reasons expressed by maizeman and others, the incremental cost of the younger individuals can be expected to be much less.  In fact, if the government used the power of bidding (the marketplace) as other governments do, the costs could drop.

And that right there is the solution to the US health care mess in a nutshell: everybody into the pool, then use that super-customer to cut out the third party paperwork and provider price-gouging.  Then the problem becomes how to restrain the use of that monopsony power so that all the providers don't just quit.  Every other civilized country in the world has done it, so we ought to be able to find a good example to follow.

toganet

  • Stubble
  • **
  • Posts: 204
  • Location: Buffalo, NY
Re: What comes after the ACA?
« Reply #4534 on: July 16, 2018, 08:23:33 AM »
I'll add that recent points about costs for young vs. old, use of benefits vs. what's paid in all highlight the problems with viewing health care need as something that should be insured against.

It seems to me that folks of all ages don't perceive value in their health spending the way they do, say, liability insurance or auto insurance.  That is, something you pay for that you hope you wan't ever need to use.  Sure, no one wants to get sick -- but health care also keeps you healthy, bear children, etc -- you should WANT to spend some money on it.  However, as we all know, the market is not efficient and demand is not elastic.

Once everyone's in the pool, it's almost like the pool disappears.

sol

  • Walrus Stache
  • *******
  • Posts: 7004
  • Age: 41
  • Location: Pacific Northwest
Re: What comes after the ACA?
« Reply #4535 on: July 16, 2018, 08:46:23 AM »
Once everyone's in the pool, it's almost like the pool disappears.

Unfortunately, we've built an entire profitable industry around maintaining and servicing those separate pools.  There are lots of very high paying jobs in the medical and insurance fields that rely on the very inefficiencies this thread is upset about, some of which would simply cease to exist under a universal coverage law.

We're so far down this road of exploiting deliberate inefficiencies that we will have to blow a huge hole in our national economy to revert back to a more rational healthcare system.  There will be a major recession.  Millions of people will go bankrupt, or default on their mortgages or car notes, or stop paying child support.  Those same people will lose what is currently the best and most heavily subsidized healthcare in the world, for themselves and their families.  They have a very strong incentive to spend approximately 90% of their collective net income on lobbying Congress to keep things shitty for as long as possible.

Roadrunner53

  • Handlebar Stache
  • *****
  • Posts: 1319
Re: What comes after the ACA?
« Reply #4536 on: July 16, 2018, 08:51:12 AM »
Insurance of all types is a necessary evil. Car insurance, hurricane insurance, flood insurance, health insurance. No one wants to have a car accident and total their vehicle. No one wants their house to be flooded or blown away in a hurricane. No one plans to get cancer, leukemia or the other millions of afflictions or diseases. BUT, in all cases most people are pretty happy if disaster strikes and insurance pays. What makes paying for healthcare any different? Seems most people that are griping about mandatory health insurance think because they are young they won't get sick. In most states it is mandatory to have car insurance and if you have a mortgage it is mandatory to have house insurance. Before ACA many people with pre existing conditions were either denied health insurance or they had to pay such high premiums they couldn't afford it. By having a massive pool of people it should have lowered the premiums for all. I am thankful to have had ACA but even with subsidy it seems way too high. I am paying almost $500 for one person. Subsidy is around $740+ a month. I don't know how anyone will afford health insurance once people are allowed to opt out.

I have no idea how healthcare costs can be reduced but something needs to be done before it is only something rich people can afford.

fuzzy math

  • Pencil Stache
  • ****
  • Posts: 566
  • Location: PNW ---> Midwest (for now)
Re: What comes after the ACA?
« Reply #4537 on: July 16, 2018, 09:36:22 AM »
Once everyone's in the pool, it's almost like the pool disappears.

Unfortunately, we've built an entire profitable industry around maintaining and servicing those separate pools.  There are lots of very high paying jobs in the medical and insurance fields that rely on the very inefficiencies this thread is upset about, some of which would simply cease to exist under a universal coverage law.

We're so far down this road of exploiting deliberate inefficiencies that we will have to blow a huge hole in our national economy to revert back to a more rational healthcare system.  There will be a major recession.  Millions of people will go bankrupt, or default on their mortgages or car notes, or stop paying child support.  Those same people will lose what is currently the best and most heavily subsidized healthcare in the world, for themselves and their families.  They have a very strong incentive to spend approximately 90% of their collective net income on lobbying Congress to keep things shitty for as long as possible.

Ultimate truth here!!

FIRE@50

  • Bristles
  • ***
  • Posts: 311
  • Age: 40
  • Location: Maryland
Re: What comes after the ACA?
« Reply #4538 on: July 16, 2018, 09:43:23 AM »
Insurance of all types is a necessary evil. Car insurance, hurricane insurance, flood insurance, health insurance. No one wants to have a car accident and total their vehicle. No one wants their house to be flooded or blown away in a hurricane. No one plans to get cancer, leukemia or the other millions of afflictions or diseases. BUT, in all cases most people are pretty happy if disaster strikes and insurance pays. What makes paying for healthcare any different? Seems most people that are griping about mandatory health insurance think because they are young they won't get sick. In most states it is mandatory to have car insurance and if you have a mortgage it is mandatory to have house insurance. Before ACA many people with pre existing conditions were either denied health insurance or they had to pay such high premiums they couldn't afford it. By having a massive pool of people it should have lowered the premiums for all. I am thankful to have had ACA but even with subsidy it seems way too high. I am paying almost $500 for one person. Subsidy is around $740+ a month. I don't know how anyone will afford health insurance once people are allowed to opt out.

I have no idea how healthcare costs can be reduced but something needs to be done before it is only something rich people can afford.
Health insurance is not a necessary evil. The government should be simply providing free healthcare for all.

Roadrunner53

  • Handlebar Stache
  • *****
  • Posts: 1319
Re: What comes after the ACA?
« Reply #4539 on: July 16, 2018, 09:53:43 AM »
Insurance of all types is a necessary evil. Car insurance, hurricane insurance, flood insurance, health insurance. No one wants to have a car accident and total their vehicle. No one wants their house to be flooded or blown away in a hurricane. No one plans to get cancer, leukemia or the other millions of afflictions or diseases. BUT, in all cases most people are pretty happy if disaster strikes and insurance pays. What makes paying for healthcare any different? Seems most people that are griping about mandatory health insurance think because they are young they won't get sick. In most states it is mandatory to have car insurance and if you have a mortgage it is mandatory to have house insurance. Before ACA many people with pre existing conditions were either denied health insurance or they had to pay such high premiums they couldn't afford it. By having a massive pool of people it should have lowered the premiums for all. I am thankful to have had ACA but even with subsidy it seems way too high. I am paying almost $500 for one person. Subsidy is around $740+ a month. I don't know how anyone will afford health insurance once people are allowed to opt out.

I have no idea how healthcare costs can be reduced but something needs to be done before it is only something rich people can afford.
Health insurance is not a necessary evil. The government should be simply providing free healthcare for all.

First of all the Government is US! So there is no free. We pay taxes to make programs run. Health care is just another program we pay for one way or the other.

FIRE@50

  • Bristles
  • ***
  • Posts: 311
  • Age: 40
  • Location: Maryland
Re: What comes after the ACA?
« Reply #4540 on: July 16, 2018, 10:01:57 AM »
Insurance of all types is a necessary evil. Car insurance, hurricane insurance, flood insurance, health insurance. No one wants to have a car accident and total their vehicle. No one wants their house to be flooded or blown away in a hurricane. No one plans to get cancer, leukemia or the other millions of afflictions or diseases. BUT, in all cases most people are pretty happy if disaster strikes and insurance pays. What makes paying for healthcare any different? Seems most people that are griping about mandatory health insurance think because they are young they won't get sick. In most states it is mandatory to have car insurance and if you have a mortgage it is mandatory to have house insurance. Before ACA many people with pre existing conditions were either denied health insurance or they had to pay such high premiums they couldn't afford it. By having a massive pool of people it should have lowered the premiums for all. I am thankful to have had ACA but even with subsidy it seems way too high. I am paying almost $500 for one person. Subsidy is around $740+ a month. I don't know how anyone will afford health insurance once people are allowed to opt out.

I have no idea how healthcare costs can be reduced but something needs to be done before it is only something rich people can afford.
Health insurance is not a necessary evil. The government should be simply providing free healthcare for all.

First of all the Government is US! So there is no free. We pay taxes to make programs run. Health care is just another program we pay for one way or the other.
Really? Obviously, the government uses taxes to pay for stuff. My point is, the "one way or the other" should not involve an insurance company.

On the other hand, some people don't pay taxes, so for them it would be free.

Monkey Uncle

  • Handlebar Stache
  • *****
  • Posts: 1326
  • Location: West-by-god-Virginia
Re: What comes after the ACA?
« Reply #4541 on: July 16, 2018, 11:01:33 AM »
We're so far down this road of exploiting deliberate inefficiencies that we will have to blow a huge hole in our national economy to revert back to a more rational healthcare system.  There will be a major recession.  Millions of people will go bankrupt, or default on their mortgages or car notes, or stop paying child support. 

Well, that's the narrative that the health care industry will push.  In reality, it's just the broken window fallacy.  Once the nation as a whole is no longer paying through the nose to fix all the deliberately broken windows, we'll have a lot of extra money left over to stimulate the rest of the economy.

sol

  • Walrus Stache
  • *******
  • Posts: 7004
  • Age: 41
  • Location: Pacific Northwest
Re: What comes after the ACA?
« Reply #4542 on: July 16, 2018, 11:33:32 AM »
We're so far down this road of exploiting deliberate inefficiencies that we will have to blow a huge hole in our national economy to revert back to a more rational healthcare system.  There will be a major recession.  Millions of people will go bankrupt, or default on their mortgages or car notes, or stop paying child support. 

Well, that's the narrative that the health care industry will push.  In reality, it's just the broken window fallacy.  Once the nation as a whole is no longer paying through the nose to fix all the deliberately broken windows, we'll have a lot of extra money left over to stimulate the rest of the economy.

I agree that we'll be better off after the change, but there will still be some short term pain.  We have lots of healthcare freeloaders right now, people making crazy salaries to do jobs that probably should not exist, and are therefore effectively just parasites on the national economy.  Even parasites buy iPhones and pickup trucks, though

EnjoyIt

  • Handlebar Stache
  • *****
  • Posts: 1049
Re: What comes after the ACA?
« Reply #4543 on: July 16, 2018, 10:52:38 PM »
Once everyone's in the pool, it's almost like the pool disappears.

Unfortunately, we've built an entire profitable industry around maintaining and servicing those separate pools.  There are lots of very high paying jobs in the medical and insurance fields that rely on the very inefficiencies this thread is upset about, some of which would simply cease to exist under a universal coverage law.

We're so far down this road of exploiting deliberate inefficiencies that we will have to blow a huge hole in our national economy to revert back to a more rational healthcare system.  There will be a major recession.  Millions of people will go bankrupt, or default on their mortgages or car notes, or stop paying child support.  Those same people will lose what is currently the best and most heavily subsidized healthcare in the world, for themselves and their families.  They have a very strong incentive to spend approximately 90% of their collective net income on lobbying Congress to keep things shitty for as long as possible.

WOW!  In my not so humble opinion, I think this is the most accurate and rational thing you said on the subject of healthcare in this entire thread.  This is one of the big reasons why our healthcare industry is so fucked and why the ACA is failing.

DreamFIRE

  • Handlebar Stache
  • *****
  • Posts: 1230
Re: What comes after the ACA?
« Reply #4544 on: July 17, 2018, 05:35:18 AM »
I agree that we'll be better off after the change, but there will still be some short term pain.  We have lots of healthcare freeloaders right now, people making crazy salaries to do jobs that probably should not exist, and are therefore effectively just parasites on the national economy.

Having worked in the healthcare sector quite a bit in the past on the IT side, I wouldn't call the workers who get educated and take jobs, pay taxes, etc. to be parasites merely because they are working in the healthcare sector.  Parasites sounds like a description more appropriate for the able-bodied people who are living on government handouts who have never contributed to society and of course government workers.

EnjoyIt

  • Handlebar Stache
  • *****
  • Posts: 1049
Re: What comes after the ACA?
« Reply #4545 on: July 17, 2018, 07:45:50 AM »
I agree that we'll be better off after the change, but there will still be some short term pain.  We have lots of healthcare freeloaders right now, people making crazy salaries to do jobs that probably should not exist, and are therefore effectively just parasites on the national economy.

Having worked in the healthcare sector quite a bit in the past on the IT side, I wouldn't call the workers who get educated and take jobs, pay taxes, etc. to be parasites merely because they are working in the healthcare sector.  Parasites sounds like a description more appropriate for the able-bodied people who are living on government handouts who have never contributed to society and of course government workers.

I wonder if he is referring to all the waste and inefficiency in providing good and effective healthcare to people.  All that waste carries the  cost of wages and benefits that use up the global healthcare dollar.

DavidAnnArbor

  • Handlebar Stache
  • *****
  • Posts: 1723
  • Age: 52
  • Location: Ann Arbor, Michigan
Re: What comes after the ACA?
« Reply #4546 on: July 17, 2018, 11:45:58 AM »
Complain all you want about the ACA, but when we revert back to the way things were before,  if you are considered to have a preexisting condition you may no longer be able to even gain access to health insurance, or you might not be able to afford the extraordinary pricetag.  Pregnancy is considered a pre-existing condition - so good look with raising a family.

"Health Insurers Are Vacuuming Up Details About You ó And It Could Raise Your Rates "  - NPR
https://www.npr.org/sections/health-shots/2018/07/17/629441555/health-insurers-are-vacuuming-up-details-about-you-and-it-could-raise-your-rates


DavidAnnArbor

  • Handlebar Stache
  • *****
  • Posts: 1723
  • Age: 52
  • Location: Ann Arbor, Michigan
Re: What comes after the ACA?
« Reply #4547 on: July 17, 2018, 01:23:32 PM »
If you're self-employed and you make too much money to qualify for subsidies on the ACA, you should consider setting up a defined benefit plan.  It's more expensive and involves an attorney, and an actuary, but it could be a way shelter hundreds of thousands of dollars of income, and thereby qualify for subsidies under ACA by getting your AGI low enough

EnjoyIt

  • Handlebar Stache
  • *****
  • Posts: 1049
Re: What comes after the ACA?
« Reply #4548 on: July 17, 2018, 04:05:49 PM »
If you're self-employed and you make too much money to qualify for subsidies on the ACA, you should consider setting up a defined benefit plan.  It's more expensive and involves an attorney, and an actuary, but it could be a way shelter hundreds of thousands of dollars of income, and thereby qualify for subsidies under ACA by getting your AGI low enough

I have a DBP but there are limits that are based on age and income.  The plan is nowhere near enough to qualify us for subsidies nor am I interested in what the ACA has to offer us because as I stated before, non of the good specialists take any of the open market plans.

As for pre-existing conditions.  I highly doubt that part of the ACA will ever disappear.  It will be political suicide to push for it.

swampwiz

  • Bristles
  • ***
  • Posts: 396
Re: What comes after the ACA?
« Reply #4549 on: July 17, 2018, 04:45:49 PM »
Quote
But please do remember the relatively young relatively healthy people who are subsidizing your healthcare are indeed people too.

Yes - Here's another fact.  Some of us older people do not get sick either and end up paying a great deal of money for nothing.  I believe I still can share your pain.  I've paid for it for many years and have received little.  They don't even give out a glossy calendar.  They just take the money.

Well, it sounds like you are angry that you are not getting your money's worth.  Here's hoping you get that big cancer diagnosis so you can get your "bang for the buck"!

MOD NOTE: Forum rule #1.
« Last Edit: July 19, 2018, 05:34:40 PM by arebelspy »