Trumpcare?

[LivingAlmostLarge]

Pre-exisiting conditions will still be covered, but at a higher rate? Do we know how it'll all be evaluated?

Why do you think they decided not to tax employer provided healthcare? Wouldn't it make sense to do it?

[JoeP]

The problem with our system is that profit is at the center. And as long as there is money to be made, laws will be written to favor those who can make money from it. The "end users" have no voice, because we can't bend the ear of politicians the same way the lobbyists can.

[creditcardfree]

Thought I had a response, but...never mind.

[TexasHusker]

The problem with our system is that profit is at the center. And as long as there is money to be made, laws will be written to favor those who can make money from it. The "end users" have no voice, because we can't bend the ear of politicians the same way the lobbyists can.

The problem with our system is that the government is deeply embedded into half of it. On that half, they set the fees and the rules. The fees are so low that they don't even meet a provider's cost. That means the provider has to sock it to you and me to make a buck.

The other problem is that people don't view health insurance like homeowners insurance. My homeowners insurance has a $5000 deductible, and it still costs me $300 a month. What would it cost if I had a $30 copay for every problem that occurred at my house? Window breaks? $30, insurance pays $200. Garage door comes unhinged? $30, insurance pays $150. Front porch brickwork crumbles? $30, insurance pays $350.

The premium would quickly go to $10,000 so the insurer could cover all of the claims.

We look at health insurance differently. We look at it as a welfare plan. It is to keep us healthy and pay for all of our prescriptions and ills, and it is offensive to us if we have to pay for anything above $30. And so, the premiums are outrageous.

If we looked at it as medical insurance, things would be different. Like homeowners insurance, we would pay for all of the non-catastrophic stuff, and then if we have cancer or a heart attack - God forbid - then the insurance takes over.

Same as my house. If - God forbid, a tornado blows it away or my roof gets hailed out, I'm covered after my $5,000 deductible.

This really isn't all that complicated. We as Americans have just come to view health insurance as some sort of catch-all entitlement that should pay for any and everything medically related, and it shouldn't cost us more than one latte a day. That's why we are dealing with this massive political and economic football - the gubmit simply doesn't know what to do with this beast that we have created.

Screwed up.

[cooliemae]

I'm not sure why we are not looking at the drivers of actual medical care cost increases as opposed to our continued approached of looking at insurance cost.

While not a perfect example, I don't talk to Allstate about trying to reduce the price of my next car. If I want a better price on the car, then I talk to the dealer and shop around.

So having a medical procedure is not like buying a car in every sense, but I think that one the drivers in medical care cost is the lack of transparency. So let's get into law policies that require medical provides to list actual cost and then let the patient have a say in some things. A great example is when my MIL had surgery on her arm last year. It was an outpatient surgery (less than 24 hours in the hospital) yet she was not allowed to bring her own meds to take. The hospital gave her meds from their inventory and then didn't even run it through her prescription plan because the meds didn't come from a pharmacy they came from the hospital and they "don't make claims for prescription drugs." So I filed the claim only to have it denied because the meds were more than alloted for in the timeframe (i.e. she already had a script and there was no reason to pay for more), thus she had to pay almost $200 out of pocket for a days worth of meds that she had at home and cost her about $30 for a months supply!

Sorry, a little tangent there. I'm just saying that we need to focus on actual cost and processes when it comes to medical care and drive those down, then the insurance rates will go down. And if we don't and prices continue to rise, insurance plans will continue to do so as well, it inevitable.

[TexasHusker]

I'm not sure why we are not looking at the drivers of actual medical care cost increases as opposed to our continued approached of looking at insurance cost.

While not a perfect example, I don't talk to Allstate about trying to reduce the price of my next car. If I want a better price on the car, then I talk to the dealer and shop around.

So having a medical procedure is not like buying a car in every sense, but I think that one the drivers in medical care cost is the lack of transparency. So let's get into law policies that require medical provides to list actual cost and then let the patient have a say in some things. A great example is when my MIL had surgery on her arm last year. It was an outpatient surgery (less than 24 hours in the hospital) yet she was not allowed to bring her own meds to take. The hospital gave her meds from their inventory and then didn't even run it through her prescription plan because the meds didn't come from a pharmacy they came from the hospital and they "don't make claims for prescription drugs." So I filed the claim only to have it denied because the meds were more than alloted for in the timeframe (i.e. she already had a script and there was no reason to pay for more), thus she had to pay almost $200 out of pocket for a days worth of meds that she had at home and cost her about $30 for a months supply!

Sorry, a little tangent there. I'm just saying that we need to focus on actual cost and processes when it comes to medical care and drive those down, then the insurance rates will go down. And if we don't and prices continue to rise, insurance plans will continue to do so as well, it inevitable.

Hard to focus on actual cost when your cooay is 30 bucks. When you have a $5000 deductible, you suddenly become a shrewd buyer of medical services.

Example: I needed a sleep study done. My doctor said "call the hospital (his employer). Their cash price? $2300. I due some shopping around and found a company that would come to my house and do it for $100. Sign me up.

So after the $100 sleep study, THAT company tried to sell me a CPAP machine for $995. I did some shopping around online and found the identical machine for $450 delivered overnight.

So I got my sleep apnea diagnosed and resolved for under $600. Going to conventional route, it would have been 5-6 times that amount.

I am fine if everyone else wants the $30 copay plan, but don't mandate that on me. Give me the cheap catastrophic plan and I'll take most matters into my own hands. I don't need Obama to tell me what kind of insurance I need, but thank you.

[cooliemae]

Hard to focus on actual cost when your cooay is 30 bucks. When you have a $5000 deductible, you suddenly become a shrewd buyer of medical services. Give me the cheap catastrophic plan and I'll take most matters into my own hands. I don't need Obama to tell me what kind of insurance I need, but thank you.

I get where you're coming from and I in some cases we are seeing more transparent pricing. My wife needed an MRI done and our insurance company actually called us to let us know there was a cheaper provider close to her doctor's office. That's more of what should be happening, right. Let's help the consumer.

Of course the catastrophic incident isn't going to let you shop around. You're going to get the ambulance that shows up, you're not going to price that out. You're most likely going to head to the hospital that their contracted with or the closest one, again you're not going to price that out. So the same argument against a $30 copay and not caring about the insurance cost could be applied to a $5,000 deductible (i.e. you pay the $5,000 and let the insurance handle the rest). In this regard the medical provider does not have an incentive to drive cost down because someone's going to pay for it.

So IMO we need to look at the cost of medical care first, for which more competition isn't always going to be the answer. Competition for non-emergency commodity services such as blood work, MRI's, sleep test, etc. are ripe for competition, but the emergency situations aren't. So there are legislative things that can be done to help drive cost down. In this regard we can even look to preventive care and lifestyles as a medical cost driver. Would it be cheaper for a company to incentivize fitness in their employees (ie gym access, on the clock workout times, etc.) than to pay higher premiums for a group health insurance policy? Generally better fitness and more preventative care should lower the cost paid out by everyone.

Back to cars. If i know that the premiums for car insurance on a brand new car are going to be too much for my budget I can decide to get a car whose premiums are going to be less. I'm not going to harp on the insurance company for charging too much or get them to negotiate the price on the new car.

Hope that makes sense...its late

[JoeP]

The end users have very little influence on the price charged. When you go to the doctor and tests are ordered, how many of us shop around for the best price for those tests? Nobody does; we just go where they tell us and trust that our insurance company, the doctor, the test lab, and our copay will sort it all out and we can move on.

There are many factors behind high cost: medical device certification, FDA approvals, patent application and enforcement, exclusivity, greed (prices are high because they can get away with it), marketing and advertising costs, lack of competition, little or no downward price pressure from consumers...to name a few.

[hamchan]

I can choose not to own a car. I can choose not to own a home. I can live comfortably without either of these things. I can't say the same about medical care.

Sometimes there ARE no options to shop around. Sometimes even if you did, it would still be too much. Just ONE of my husband's medications is over 3000 a month without insurance. There are no other cheaper meds he can try. You don't fool around with your medications after an organ transplant. You take what they tell you to take or you risk rejection.

Shopping around is fine for people in a non emergent situation, who are relatively healthy and have enough savings to cover the deductible. But I don't think people realize how quickly that situation can change. And for many people it has never really been an option in the first place. Medical care is much different (and MUCH more expensive) from what it was like 60 or 70 years ago and the reality is we are never going back to those days and we need a better solution.

[cooliemae]

Oh I agree and is why I think we need to look at options to drive down cost of medical care and not solely focus on insurance.

Ya'll are absolutely right that medical care is different than other consumer items and I think that we need to treat it differently. So making a claim that ultimately more competition will bring down prices isn't completely true because the health care system is not and can never be a true free market. In a free market we have a choice, but a good portion of the medical services field does not provide that option.

Medications, especially before generics are available, are available only through a single source.

Emergency Care doesn't allow for patient choice.

Overall Care in Rural Areas where choice is limited or non-existent due to small numbers of people.

Insurance plans are dedicated to networks versus cost. For example, an MRI might be cheaper overall at Location A, but because it's out of network patient goes to the overall more expensive Location B because their out of pocket cost actually go up if they went to the out-of-network location.

So we need more regulatory intervention to try and push those cost down because of the nature of the services versus the consumer product industry that can actually function as a free market.

[Mjenn]

I thought Obamacare allowed for people to select a high deductible plan as long as it included some basic well-visits? Or maybe I am missing something. I don't have Obamacare, I had to file the paper every year saying I was covered out of country.

I don't believe the problem is the government meddling, I think the problem is that the government has only meddled half way.

I also think there are way too many people making a living off of health care to give individuals a fair choice -- you have doctors, hospitals, administrative personnel there, insurance people, sales, CEO's, share holders, pharma companies, etc. etc. etc. So while yes, having these things are required to provide health care, the money from your pocket is going towards a LOT of fluff. And as others pointed out, this isn't something you can opt out of, and when you need emergency care, you cannot really negotiate best price. And what does best price when it comes to health care even mean?

Insurance stopped being really about just insurance a long time ago. Yes, you can have that deductible on your home insurance and you don't charge everything, but as soon as you charge 1 thing, the insurance can drop you as a customer, spike up your rates, and treat you like an outcast for no other reason than that yo use the insurance for what you purchased it for.

I'm not in the US, my insurance for my pets, home, car, etc (and even health, but that covers income lost during sickness, all treatment is covered by the state) work like this -- they make a risk assessment. I get charged a monthly fee. I have an issue and contact the insurance company. They pay me out a what they say according to the agreement. I continue to pay the same monthly fee I paid as the payout was included in my risk assessment. For my health insurance they reassess my rates every 5-10 years and bump it up accordingly. For car we have had our windshield repaired a few times, and small repairs, but our rates remain stable. Our cat was insured as a very low risk housecat but ended up requiring custom made shots that were covered 80% by our insurance and our rates remained the same.

[TexasHusker]

I thought Obamacare allowed for people to select a high deductible plan as long as it included some basic well-visits? Or maybe I am missing something.

The dirty little secret is that ALL Obamacare plans are high deductible plans now. Only they are priced about triple what my previous high deductible plan was that was outlawed.

It is an incredibly poor product and very expensive simultaneously.

If you were going to HAVE to make a $1300 a month car payment, would you be happy with a Kia Sorrento, or the Range Rover Sport Autobiography which the money should have easily afforded?

When Obummercare, everyone is paying for Range Rovers, but getting a worn out Kia. AND IT'S THE LAW.

[TexasHusker]

So we need more regulatory intervention to try and push those cost down because of the nature of the services versus the consumer product industry that can actually function as a free market.

Price controls have never worked.

[LivingAlmostLarge]

that's because until you are sick and dying you don't think you need health insurance and it's everyone else's problem. That's why people who are small government really believe it until they get cancer or something else that is very expensive to treat and realize no one can self-insure. At least not in the US.

[TexasHusker]

that's because until you are sick and dying you don't think you need health insurance and it's everyone else's problem. That's why people who are small government really believe it until they get cancer or something else that is very expensive to treat and realize no one can self-insure. At least not in the US.

I don't mind self insuring up to 10K. I don't know why it should be unlawful to buy such a policy- it's not much different than my homeowners insurance and it is perfectly legal.

I feel like I can do a fairly decent job figuring out if I'm getting ripped off underneath that amount.