I'd suggest studying up a bit then. All of the things Obama's done better are heavily overshadowed by his atrocious civil rights record. His administration has surpassed even Bush's by making the claims that they are allowed to infinitely detain, perform a warantless search on, and even kill anyone (US citizens included) as long as the determination is made on the basis of secret evidence in secret hearings that you are suspected of being a "terrorist".
Dude, you live in California. You've got more options than you realize for health plans. (I guessed on your age and ZIP code). And most preventive care has no charge (per section 2713 of the ACA).Originally Posted by Yakoob
Hell, for 196/mo you can get a Kaiser plan that's not a million miles away from the one I had through work when I was in California, with office visits and urgent care at $40 a visit before the deductible. Shop around more.
Reading all of this shit I am extremely fucking glad I am not an american. Dude I work with was telling me he got a $1000 bill for going to the ER and waiting four hours before having someone google porcupine zoonoses (turns out there are no diseases you can get from getting porcupine blood on your face, long story). Sounds like some of this bill thing is a good idea (like not letting companies drop people for arbitrary reasons, and attempting to reduce the whole profiteering side of it), but it also sounds like it doesn't stop you guys having a ridiculous healthcare system. If I break my wrist, either here or in the UK, I go to the ER and get it looked at, get an appointment, and get it set. Bang. All paid in full already as part of my taxes (the german system is a little different in that the health companies are a kind of NGO, but functionally there is little to tell the two apart). No fucking around arguing bills, talking to my insurance company, trying to squeeze it down as much as poss, arguing whether it was work related or not, etc etc. Just me with my broken bones sorted out. Doesn't that sound at least a little appealing?
Sounds like an interesting story though, now I'm curious.
It definitely does. I'm curious how it would work, but my experience with our existing government-run healthcare system (DOD hospitals) suggests that it wouldn't be anywhere near as easy in this country. And that was with a government agency that is usually far more helpful than the civilian side is.Doesn't that sound at least a little appealing?
I too am glad I was not born in the US. I am continually amazed by some of what I hear from the health system. Such as:
* There are, on average the equivalent of twenty-eight 9/11s a year in the US in preventable deaths due to health care shortfall (US has worst record for preventable deaths of any developed nation).
* ~ 46% of all personal bankruptcy in the US is related to medical bills and >80% of those are people with insurance plans.
I am disturbed by the US health care system. People being dropped for pre-existing conditions, running out of cover and being expected to start paying, co-pay plans!? I couldn't live somewhere which enables an industry to trade health for wealth.
Last edited by faetal; 2nd Jul 2012 at 12:16.
I'm in favor of socialist healthcare. This Obama thing isn't socialist healthcare. It's even more capitalist than what we already had, and it's gonna leave unemployed and "unofficially handicapped" people like me, completely screwed. What the fuck are they going to do to the people who can't afford the $600, um, charge? Throw us in prison? Wouldn't surprise me at this point. I'm trying to make up my mind whether blowing my brains out or moving to Canada is a better option. [half-smile]
Correct me if I'm wrong, but if you're within 400% of the official poverty level don't you get subsidised anyway? Isn't that one of the big new ideas of this thing? That, and making it much more likely that your employer will offer insurance? I mean, it looks like you guys are edging towards the German system. Which works pretty well.
What's 'unofficially handicapped' mean out of interest? And yeah, it does leave the unemployed a little fucked, I guess. It would make sense to tie firmly to your income (German system), but I don't know how they deal with unemployed sick people. England, they get a free pass on everyone else's contributions, same as visitors and other none-contributors, which might piss me off if I was a dickhead.
Healthcare should be socialised because it is the one thing which everyone is guaranteed to need at some point. In the UK it works just fine (or at least did, before our current government rammed a dick up it with the new NHS bill) with tax funded health care, free at the point of service for all with the option to buy health insurance if you want luxury healthcare. Worth noting is that UK health insurance is relatively cheap as things like ambulances, emergency care, blood banks etc.. are provided by the NHS already. Putting a financial gradient on someone's medical treatment is just plain immoral and having a system in place which does so, is essentially the same as saying that profits outweigh people, given the inevitable results.
Last edited by faetal; 2nd Jul 2012 at 12:42. Reason: Wrote "...Uk healthcare is relatively cheap.." but meant "...UK health insurance is relatively cheap..."
Because the German government is running it, not the American one.
But here's the point everyone is missing - it's NOT socialist healthcare, it's forced emergency-only health insurance, with like a "bonus" free routine health checkup a year. And the definition of "emergency" usually means "after you spend 6000-10000 dollars." So if I have the sniffles, break my arm, or want to consult a doctor on a specific health issue - I am shit out of luck, and will have to foot 100% of the bill :/
THIS is why I am against ObamaCareInsurance. If I am forced to pay for healthcare, fine, but actually GIVE ME healthcare.
Your link PROVES my point dude. Look at it - 7000 deductible? 196 / month premium? Those are NOT low costs for a lot of people, especially on top of California's already pretty high cost of living. And it is true you get some free routine check ups a year, but that's it, routine check ups. If something happens and you actually NEED care, as I said above, you are shit out of luck until you already spend like 10,000 out of your own pocket (between premiums, wait-periods, copays and deductible).
Oh and the $35 / visit copay ? Guess what, if you buy into the government-sponsored Health Saving Account, it goes up to you pay 100%. And lets not forget it also legally requires a "higher-premium plan" on top of that. So the government programs actually encourage higher cost to to the consumer, BEFORE deductible is met. Look:
The pic doesn't contain the premium but IIRC the HSA was $130/mo, the non-HSA was $100.
Yes, the plan is BETTER in emergency cases when you speend > 10,000. But before you meet your deductible / out of pocket, it RAPES you with higher deductible, uncovered doctor visits, uncovered prescription drugs, etc.
As I said, that is my beef - it's EMERGENCY INSURANCE, not proper healthcare, and as such I should NOT be forced into it.
My yearly healthcare cost is probably like few 1000s tops, so I would never reach my deductible, and would get no benefit. Why would I want to pay an extra 100/month that goes straight to the insurance company profits? Yes, emergency cases I am not covered for, but if that's what the bill does, lets stop pretending it's universal healthcare. Because it's not.
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For the record, I am not 100% AGAINST the bill and I do genuinely like aspects such as extended age limit for parent insurance and not-discriminating on pre-exisitng conditions. These things make insurance more accessible.
But while it makes shitty insurance more accessible, it doesn't fix said insurance being shitty, which is the whole problem. If current private healthcare options actually covered healthcare without ridiculous premiums, restrictions or deductibles, we wouldn't even NEED the 2014 mandate.
I keep hearing how this law is supposed to help the "weak" and "poor" who cant afford health insurance, but those are the ones who actually get screwed over the most.
Last edited by Yakoob; 2nd Jul 2012 at 17:29.
Well, you clearly haven't gotten it, yet.
True. But fixing the system altogether was rejected - never had a chance.
Yeah, you're not supposed to be able to get into that trap, but there are always cracks when the baseline isn't "everyone". I know some "unofficially disabled" people, and it's just really hard in this country to get out of the trap of being unable to function yet unable to prove that you cannot function, because all of the aid that's intended for those who cannot function is walled off to prevent it from getting into the hands of those who simply won't function. Which probably doesn't work, or at least people are routinely busted for getting disability benefits while performing high-level athletics or whatnot.
Okay, Yakoob, here's the thing. You. Apparently. Do. Not. Understand. The reasons behind this at all. You are absolutely correct that it's EMERGENCY INSURANCE, and that's precisely why you're "forced" (er, encouraged, really) to have it.As I said, that is my beef - it's EMERGENCY INSURANCE, not proper healthcare, and as such I should NOT be forced into it.
Nobody really cares about the health care you can afford. Whether you pay for routine, reasonably affordable care a la carte by yourself, or pay someone else to pay it for you, in the larger scheme it doesn't matter, nobody really cares. Romneycare/Obamacare isn't about that stuff, generally speaking.
It is about EMERGENCY INSURANCE, and while that probably won't benefit you in any given year, there is a certain percentage of people who are essentially just like you who will desperately need it. And if you don't have that EMERGENCY INSURANCE and are not super rich and you do have an expensive health problem, you literally just cannot afford it, no matter what.
Now, as you are very proudly and very blindly demonstrating, healthy folks don't like to pay for EMERGENCY INSURANCE, the sort of insurance that only covers what you cannot afford, and thus will not kick in normally. But every year, some "healthy" people become not healthy, and in a very expensive way, whether they believed that they get "NO BENEFIT" from "EMERGENCY INSURANCE" - as you so loudly and repeatedly expounded on - or not.
So, here's the deal. You don't get to opt out. That's not something Obamacare started, BTW. It's always been the law. You walk into an emergency room, they treat you, that's the law, penniless or whatever. And now we insist that, if you're able to pay for that privilege, you do. And I'm not in the slightest bit sorry or sympathetic. If we're not going to go full-on survival-of-the-fittest and let emergency rooms pitch sick people out if they fail a credit check, then yes, I expect you to pitch in, in case you get severely ill and can't afford treatment.
Oh, and yes, it's very expensive. That's what happens when something increases in cost 10% per year for decades on end. This law is supposed to do a little about that, too, but we'll see.
"Encouraged" is a naive way of putting it, even if "forced to have it" isn't accurate either. "Forced to pay for it" is a better way of putting it, because we will be, one way or the other. Or, rather, the poor will be, because the rich already have healthcare. So this fine, or "tax," if you like, is exclusively for the poor. You support a tax which is, by intention, solely for the poor?
Argh. Another discussion I should have avoided for my sanity's sake. Excuse for sanity, anyway.
Here's a crazy thought: don't get the HSA. You've already established that it's an option (that being the key word) that's essentially incompatible with your financial situation (and no wonder, since the HSA was established as part of Bush's shit-tastic health care 'reforms'). Get a regular health plan and write off the premiums in your taxes at the end of the year.
Whut? The with HSA deductible is exactly the same (you could even say its $750 less than non-HSA), the after deductible co-pay is 20% lower, the annual out of pocket maximum is ~$1600 less, the prescription drug deductible is integrated with the medical, and the after deductible co-pay is less. Where is your '>10,000' number even coming from?Yes, the plan is BETTER in emergency cases when you speend > 10,000. But before you meet your deductible / out of pocket, it RAPES you with higher deductible, uncovered doctor visits, uncovered prescription drugs, etc.
Thanking God every day that I live in Canada.
I visited P.E.I. once, with my family, when I was a child. It wasn't a bad place, if a bit chilly. No culture shock at all, either.
And I already said that in my post:
Everyone talks about ObamaCare and how it's universal socalist healthcare, so either they throw " OMG COMMUNISM" shitbricks or talk about how it will make US the healthutipia where the poor and the weak will not need to worry about their health bills. It does neither.Yes, emergency cases I am not covered for, but if that's what the bill does, lets stop pretending it's universal healthcare. Because it's not.
My point is that it illustrates the Government's intention: higher cost to individuals, particularily, as Sg3 points, the poor variety, and bigger profits for insurance companies. After all, ObamaCare is only the beginning, so it's not unwise to think of its long-term intention.
Accessibility is definitely one, and a good one I fully support. But so far it has done little to suggest it means to actually make it affordable.
Yes, but your premium is higher, and you dont get free health doctor visits until you meet your deductible, hence my point - it is worse for day-to-day healthcare, and only better in emergency situations.Whut? The with HSA deductible is exactly the same (you could even say its $750 less than non-HSA), the after deductible co-pay is 20% lower, the annual out of pocket maximum is ~$1600 less, the prescription drug deductible is integrated with the medical, and the after deductible co-pay is less. Where is your '>10,000' number even coming from?
and the 10k figure is roughly deductible + out of pocket, basically how much of your own cash you need to put in before you stop paying and your healthcare plan actually provides "universal free socialist healthcare" or whatever buzzwords people want to use.
It doesn't do any such thing. HSA was created in 2003 as part of the Medicare Prescription Drug, Improvement, and Modernization Act, which was acknowledged by just about everyone as total fucking bullshit that actively made the US health care system worse (HSAs and their predecessors, MSAs were all part of Republican health care reform initiatives), and has absolutely nothing to do with the ACA.
And then you're ignoring that if you make between ~14,000 and ~43,000/year (133% and 400% of poverty level) as an individual (you're a self-employed web designer, so I kind of doubt you make more than 43,000/year. If you did, you wouldn't think 200 bucks a month for a no-deductible health plan was outrageously expensive), you qualify for a pretty big subsidy on any plan purchased through a Health Benefits Exchange (and no state has set those up yet, so neither you nor I can accurately say what the premiums and coverage will be on plans in the Exchange, beyond a maximum out of pocket of $5950), but you won't have to pay more than 9.5% of your annual income on premiums a year, and that's if you're at that $43,000 income level.
[edit]Actually, I'm not quite right on the subsidy thing. The scale slides on age and % of poverty level income, not just income. So if you're in your 20s, single, and making 400% of poverty level (and fuck you if you are), you don't get a subsidy. Subsidy calculator with tables and stuff.
Last edited by Fafhrd; 4th Jul 2012 at 01:11.
Yakoob -
Don't go uninsured. All it takes is one fall off your bike that requires an ambulance trip and ER admission and you're out $3k easily. And if you require surgery or get cancer or something you'll have a mountain of debt and collectors chasing you forever. It's an unbelievable risk you're taking.
You said the non-HSA plan has a monthly premium of $100, which is $1200 a year. Suppose you see your primary care physician for a routine annual checkup ($35 annual copay). And you're on some medication for which there is a generic ($15/month copay). And suppose something comes up in the year and you have to make a one-off visit, followed by a trip to see a specialist ($35 and $50 copays) and a one time prescription for something else ($35). That's a typical year for a healthy person, and if I total that up it comes to $1535. That's not terrible, in fact it's cheaper than I expected.
Now if something bad happens and you need emergency care or hospitalization, then you're responsible for $3500-7500. That's a bit steep, but you can probably opt for a higher monthly premium to lower the annual deductible and out of pocket maximum. But assuming you're a young healthy person, I wouldn't. Do not go for a HSA. HSAs are for people who have significant predictable health care costs every year, not for people who only require health care sporadically.
Heywood - how does Aussie healthcare work? I've heard it is some of the best in the world.
Fafhrd thanks for your input and links, I will check it out. As much as I enjoy sperging about healthcare, I wouldn't mind being proved absolutely wrong because, hey, this means I can actually get healthcare!
So to address your point - ok I concede my HSA hate is a bit misguided, then; I always heard about it in relation to ObamaCare and naturally assumed it was part of it but I was wrong. Funny how between all the resaerch on it (including reading the lengthy IRS website) I did it never occured to actually check the date
Hmm I need to resaerch it more. Basically I looked at variety of insurance companies (Kasier, Aetna, Blue Shield, Sigma etc.) and even met with like two insurance-specialists (or whatever their name is) that were NOT representatives of any particular companies and the plans they suggested were not much better than what I found. No one mentioned subsidies or "other options" tho.And then you're ignoring that if you make between ~14,000 and ~43,000/year as an individual ... you qualify for a pretty big subsidy on any plan purchased through a Health Benefits Exchange
[edit]Actually, I'm not quite right on the subsidy thing. The scale slides on age and % of poverty level income, not just income. So if you're in your 20s, single, and making 400% of poverty level (and fuck you if you are), you don't get a subsidy. Subsidy calculator with tables and stuff.
But see that's my point, if I do fall off my bike and need a trip to ER, from my understanding, I would STILL be paying the $3k myself since the decutible alone is like $6k, and most advanced procedures and hospital visits usually are not covered until it is fully met :/Don't go uninsured. All it takes is one fall off your bike that requires an ambulance trip and ER admission and you're out $3k easily. And if you require surgery or get cancer or something you'll have a mountain of debt and collectors chasing you forever. It's an unbelievable risk you're taking.
Diseases like cancer I am not so worried about, as that is exactly why I do annual physical, bloodwork etc. The one I did few months ago basically showed I am in amazing health on every indicator possible. I also don't take any medicine or supplements.
And you are acting as if I don't have any savings or a safety net. I do, exactly for these kind of emergencies; I'd rather put the 100 bucks a month into a savings account than give to a company that will STILL make me pay out of my own pocket for procedures. I've been doing it for a while now.
Basically, I am taking my healthcare in my own hands instead of letting an insurance company manage it for me at steep cost and unbeneficial policies. I do realize most of the people don't do that, however, and neither bother with checkups+preventive care, nor have much of emergency savings, hence when "shit goes down" the government needs to foot the bill. But I am not one of them, and it's just aggravating that those who are smart and plan ahead (notice I am NOT saying rich) are effectively penalized because of those who are not (notice I am NOT saying poor). Why can't we have options that cater to both? HSA is such a missed opportunity for a government-subsidized self-managed healthcare...
And yes I know I can never be 100% prepared and there is always a risk of a bigger thing coming in and swooping me I am unprepared for, but as I said, it is a "gamble" I am consciously willing to take given my *current* situation, health and savings etc. Of course, each year as I get older, I re-evaluate my options and there will definitely be an age, maybe 5, maybe 10 years from now, when my risk factor or income will naturally increase to a point where I will get full-on emergency insurance as a viable option.
-----------------
As an anecdote, I recently chipped my tooth, which set me back $250 and needs a $700 crown. I started looking at dental insurance and, I still need to check a few sources, but so far it looks like it confirms my reason for not having insurance:
* 6-month wait period
* only covers 50% of the procedure
* only covers the shittiest metal crown, not even with ceramic coating
* usually has upper limit of how much it will pay, like measly $500 in one case.
Taking all those into account, I would end up shelling out about the same on insurance + the 50% cost for the crappiest crown available, than if I paid in cash with no insurance for a higher-grade crown.
I understand that "business is business" and if I got the same quality at the same price as my own cash it means the insurance company would be making 0% profit and could not be afloat, hence they must be more pricy or lower quality.
But then we are talking of insurance as a commercial business in which case, I do NOT agree I should be forced into it.
Last edited by Yakoob; 5th Jul 2012 at 13:43.
Yeah, it kinda feels like a law has been created which requires us to choose between buying copious amounts of Hannah Montana albums or paying a hefty tax. I guess I should just be happy that Hot Topic doesn't have the sort of clout with the government that insurance companies do. ; )
Last edited by Sg3; 5th Jul 2012 at 15:06.
I don't think anyone who has actually seen universal socialist health care would call it such.
Anyway, as I said, it is possible, so far as I understand it, that healthy individual insurance buyers are getting the short end of the stick in this. But that's mainly because of where most of the insurance actually is (ie, employer based plans) v. the uninsured problem.
This NY Times article covers what seem to be most of the ideals for the bill that I've absorbed. There is a pact with the devil-ish quality about it the way the insurers' position is maintained, but while it might seem like the government is forcing you to pay for nothing the new inability to refuse cover, for starters, is a pretty big deal in the scheme of things. That is a massively un-economic hit for insurers in the long run.
It's not the the creation of a perfect solution. It's the only way to start to break the US insurance cost death spiral that would actually get through (The dems themselves would have voted against single payer).
He better not talk shit to Muz again or he'll need the insurance
Sorry, I missed seeing your question. Muzman or Shug (or the other Aussies here) would be better to ask about it since I've only been living here a little over 2 years. Anyway, Australia has a mixed public/private system. The public component is called Medicare and consists of public hospitals and a reimbursement system which covers all permanent residents. Most people seem to get their routine health care needs met by private medical practices, and Medicare generally covers the vast majority of the expense (with some limits and small out of pocket costs). Same for pharmaceuticals. The public hospitals are free for Medicare recipients, but there are also private hospitals. Australia has a number of private health insurers, and the government encourages people to get private insurance by offering rebates for premiums and a tax break. Something like 1/3 to 1/2 of Australians have some form of private health insurance and I believe the trend is increasing.
My personal experience with the system is very limited: just a couple of office visits, some tests, and two prescriptions. I have no complaints. My first impression is that the quality of service and competence of practitioners is similar to what I experienced in the US. And the prices charged for office visits, tests, and prescriptions are somewhat less. I do hear some complaints, e.g. long waiting periods for elective procedures, two tiers of service, and some people have to go overseas and spend a fortune to get treatment for rare diseases. But overall a lot less complaining than in the US. It could be a model for the US to follow if a "public option" were put back on the table.
This reminds me when I was in India and went to a dentist, to find out that a typical US $150 filling was literally like ten bucks there. I am kicking myself for not getting it taken care of while I was there (I only found out like a week before leaving). I know India is cheap and all, but it just boggles my mind at the 90% price difference. And that was without any insurance and being on a tourist visa.
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