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Where will healthcare go in the near future?


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9 hours ago, Daveh said:

It seems insane to push this so fast without numbers telling you what may happen. Like Driving with your  eyes closed.

It looks too much like what happened with the last big health care bill! Don't political people ever learn?

Good travelin !...............Kirk

Full-time 11+ years...... Now seasonal travelers.
Kirk & Pam's Great RV Adventure

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And the White House's numbers are worst. I was very surprised when I read that the people who don't want health Insurance

will not have to buy it! We will be back to the emergency rooms for care. Sad to see that. If you really want to provide health care

and not have people die because they don't have it, how can you let people not have it? The healthy people will not get it and only the

ill and elderly will, thanks to Medicare or Medicaid, how much do you think that will cost?

I have heard all of the "I don't want the government to tell me what to do" and I say that I don't hear people complaining that the government

makes us buy auto insurance? Do the same people who don't want to buy health insurance think that it is a good to not have to buy auto insurance?

The US and South Africa are the only industrial nations in the world without universal health care. The US health care system is number 11 or 12 best

in the world, look it up if you think that this is not true. Oh but we know better, free market is the way to go! LOL

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With the costs going up under ACA and less MDs available in networks, I personally know people dropping out of the ACA, especially if you travel.  It is hard to justify $400 a month after subsidy with $25,000 income you have a high deductible that does not pay for the services you use if fairly healthy if there is limited ER coverage should you need it. 

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6 hours ago, trostberg said:

With the costs going up under ACA and less MDs available in networks, I personally know people dropping out of the ACA, especially if you travel.  It is hard to justify $400 a month after subsidy with $25,000 income you have a high deductible that does not pay for the services you use if fairly healthy if there is limited ER coverage should you need it. 

Trostberg.  The numbers in your scenario, including subsidies, are addressed in this article. (I do think that fulltimers costs, with subsidies, are higher  than  cited in the article because we need plans that allow coverage out of state but as set  forth here the new proposal increases costs by 750% before we even get to deductibles. For a 64 year old with a $25,000.00 about $15,000.00 of that would need to go to premiums.        http://www.vox.com/policy-and-politics/2017/3/13/14914596/ahca-cbo-premiums-age       This proposed legislation will devastate those in the 55-64 year age group.  Dave H

 

Dave and Lana Hasper

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Just pointing out that the current system is not working well either.  There are maybe one or two states left that offer multistate plans.  I had one last year but no longer and the premiums doubled.  I also have just a flip phone and pay tracfpne $100 a year for minutes.A previous plan told me if I left the state for 2 months to work in Yellowstone I had to drop there insurance and had no other choices.

 

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1 hour ago, trostberg said:

Just pointing out that the current system is not working well either.  There are maybe one or two states left that offer multistate plans.  I had one last year but no longer and the premiums doubled.  I also have just a flip phone and pay tracfpne $100 a year for minutes.A previous plan told me if I left the state for 2 months to work in Yellowstone I had to drop there insurance and had no other choices.

"Multistate" plans may only work for a couple of states. That is, a WI multistate plan may only cover you in WI, IL, and MI -- not the entire US. You should be looking for a PPO plan with a nationwide provider network (like BCBS). 

If you bought your health plan through the ACA, then know that State residency requirements are NOT the same as ACA residency requirements.

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
www.rvSeniorMoments.com
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On 1/3/2017 at 0:44 PM, jmserafin said:

I did not know the history: "You may not be aware that the coupling of health insurance to employment began when post-WWII wage controls exempted health care premiums paid by employers"...

I believe that wage and price controls were started during WWII, not after. Also, Richard Nixon in an attempt to control inflation after the oil embargo of the early 70s, instituted wage an price controls which exempted employee health insurance premiums, which has exacerbated the problem of healthcare costs.

 

2005 Winnebago Voyage 38J

 

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I just have to say that the idea of making things cheaper by allowing purchases across state lines is mostly bs. It might save some money for a year or 2 but premiums will be adjusted. Insurance will equalize cost over time or you will have one area subsidizing the other.

 

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There are very few PPOs.  My plan is an BCBS plan but replaced by only EPO offerings.  I am very familiar with the Nov 2016 definitions that just came out for ACA that I am hoping will help.  Just heard an interview from my health policy professor I had decades ago and his take is that competition among insurers might help but no telling what costs the insurers would offer even in a competitive environment that would limit access.   My access is limited by the RV lifestyle.

 

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Unfortunately, healthcare system has a lot of issues nowadays, such as lack of the proper management of medical equipment and avoidable harm of patient. Last time along with my colleagues we found ultrasound transducers from Japan at https://bimedis.com/search/search-items/ultrasound-ultrasound-transducers for our clinic in Denver. I'm sure that it's necessary to order medical equipment only at reliable services to prevent the high risk that medical devices being used without evidence of adequate training or maintenance. Hope in future these problems will be solved.

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I don't see how medical insurance  costs can be lowered substatially untill medical costs are lowered.  I am sure most of us can quote many outrageous  bills associated with fairly routine care and my neighbors  story is the latest I have heard.  His adult son dropped a pipe on his foot.  He took his son to the ER.  They x-ray ed his foot and told him it was broken in 2 places.  They recommended he see a specialist.   The bill for an x-ray and ER visit $4,000.  The specialist he took his son to x-rayed his foot, manipulated the bones followed by another x-ray and cast for a total cost less than $300.  Any insurance company paying ER bills like this will have to charge high rates.  

Randy

2001 Volvo VNL 42 Cummins ISX Autoshift

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The ER bill was $4000, but the settlement with the insurance company will be a lot less.  The difference the hospital write off as a "loss".  They know how much insurance will pay, they negotiate it, but the higher 'list' charge gives them the write off.    I just got my EOB for my mammogram and bone density test done in December.  Total for the two procedures was $1080.  Medicare paid $222. 

The ER charges will always be higher than a regular physicians office because they need to be able to treat anything that walks in the door, from a broken foot, runny nose to gunshots, heart attacks/strokes, and everything in between.  

Barb & Dave O'Keeffe
2002 Alpine 36 MDDS (Figment II), 2018 Ford C-Max HYBRID
Blog: http://www.barbanddave.net
SPK# 90761 FMCA #F337834

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For me a few months ago, billed $2,652.00  for a Medicare approved $150.00. It took one person around 15 minutes to do all the paper work to have me ready for the test. One person to do the test while he was training another for the 1/2 to 3/4 hour the test took. The ultrasound machine is probably all digital now. I have no idea what the hospitable paid for the ultrasound machine.

Not sure how the doctor gets all the read out from my test. But he gets it right away and gives me the results of it within a hour after the test. OH! Medicare pays him $54.65 out of the $163.00 he bills to give me the results, price is including his nurse giving me a blood pressure test in both arms and asking me many questions and inputting them in a computer.  Then later when I get home I can go on line and  see the info from the visit.

In April I will be going through the same test again. And all billing will probable be the same.

Of total billed($561,879.16) over 5 years Medicare & my supplemental Insurance has paid the below percent of billed each year.

2012  19.76%

2013  23.10%

2014    4.17%

2015  10.22%

2016  8.82%

Full Time since Oct. 1999
99 Discovery 34Q DP | ISB
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Private insurance does not have the deep discounts that Medicare does.  ACA insurance companies are limiting networks to keep their costs down and refusing to payout of network even for emergency care.  Many ER bills end up being out of network and you will not know it even if you go to a hospital that is in your network.   And MDs are refusing to accept the low Medicare rates more and more.

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Well today the House canceled the repeal & replace bill of ACA.  This seems to mean there will be NO improvements in ACA (or any other health care bill) for the near future, maybe for 2-4 years. 

This is not a good thing in my opinion.  The way the rate increases for ACA are going, many people are going to be priced out of the insurance.  Also availability seems to be decreasing.  

Note: I am not against ACA, and I certainly think the bill which was shot down was very seriously flawed.  Something needs to be done to lower cost and increase availability.   

 

Al & Sharon
2006 Winnebago Journey 36G 
2020 Chevy Colorado Toad
San Antonio, TX

http://downtheroadaroundthebend.blogspot.com/

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Al, i agree, what they need to do an probably will not do it is. fix what we got rather then let it die. Greed is the ruler of all evil. Someone that is a billionaire , an needs more money is beyond me. I'm 100% for ACA. i lost a good friend , happen just prior to it (ACA) getting in the works. possible it could of saved him. as he had no insurance . I am very glad it got thrown out yesterday. as that would of made things worst. Heathcare should not be a GOP/DEM debate. It should be a humane debate.
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21 hours ago, trostberg said:

  Many ER bills end up being out of network and you will not know it even if you go to a hospital that is in your network.   And MDs are refusing to accept the low Medicare rates more and more.

If you're not already aware of it ,Texas Insurance LAW guarantees that all fully-funded medical insurance plans must pay for ALLemergency medical claims at the in-network level regardless of network status. This means that your visit will be processed under your in-network benefits. 

This statement was taken from the website of one of the "standalone ER clinics" that doesn't accept a lot of insurance coverage and I've been told the same thing by several others.  Of course, if you don't really have an emergency you could get into a fight over the bill, but,  under the law, the bill is paid using the "prudent man standard", not the eventual diagnosis.  In other words, if a prudent person would have agreed that you needed emergency treatment then you should be covered, even if you do have to fight about it..

Here's a link to where this quote came from: http://caprocker.com/understanding-your-bill/  I haven't yet found a link to the law underlying this.

Sandie & Joel

2000 40' Beaver Patriot Thunder Princeton--425 HP/1550 ft-lbs CAT C-12
2014 Honda CR-V AWD EX-L with ReadyBrute tow bar/brake system
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44 minutes ago, docj said:

If you're not already aware of it ,Texas Insurance LAW guarantees that all fully-funded medical insurance plans must pay for ALLemergency medical claims at the in-network level regardless of network status. This means that your visit will be processed under your in-network benefits.

There's still your deductible though, right?

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
www.rvSeniorMoments.com
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I posted this article five years ago on my Facebook page, and I believe it is still relevant today, maybe even more so in light of the failure of the House of Representatives to repeal and replace Obamacare.

 

http://www.slate.com/articles/news_and_politics/politics/2015/03/america_s_hospitals_our_system_lets_big_hospitals_charge_exorbitant_prices.html

2005 Winnebago Voyage 38J

 

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3 hours ago, Zulu said:

There's still your deductible though, right?

If your policy has a deductible for emergency care then I presume it would have to be paid.  I think many (some?) policies exclude ER care from deductibles.

Sandie & Joel

2000 40' Beaver Patriot Thunder Princeton--425 HP/1550 ft-lbs CAT C-12
2014 Honda CR-V AWD EX-L with ReadyBrute tow bar/brake system
WiFiRanger Ambassador
Follow our adventures on Facebook at Weiss Travels

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31 minutes ago, docj said:

If your policy has a deductible for emergency care then I presume it would have to be paid.  I think many (some?) policies exclude ER care from deductibles.

I believe they're common. From what I've seen, they're around $400-500.

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
www.rvSeniorMoments.com
DISH TV for RVs

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3 hours ago, Zulu said:

I believe they're common. From what I've seen, they're around $400-500.

My deductible is the same for emergency room care as my major medical.  $6,650 per person.  After deductible, insurance pays 50% of charges.  No additional penalty for out of network.  I'm in Florida.

Mike and Retha Hopkins

2014 Fleetwood Discovery 40G

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