Vent about health insurance and how screwed up it is

[NetSkyBlue]

I wish that standard healthcare didn't have to cost so much that you NEED insurance to protect yourself. Insurance should be against catastrophic things - you're hit by a car and in critical condition, you get cancer, etc.

It really shouldn't need to cost hundreds of dollars to go to the clinic for a UTI or stitches or something, when you're in the presence of the doctor for maybe 10 minutes, max.

[bUU]

As I understand it, Insurance Companies have clerks whose job description and bonus system requires they find reasons to deny claims, including claims that were pre approved before service was delivered. I wonder how physicians and patients would feel about Obama Care, government managed Health Care which has limitations and different problems fo both patients and physicians than for profit insurance companies.

ACA actually adds minimum requirements for what is to be covered. It does not add limitations to what is covered.

[Nika]

Healthcare is like nothing else. Imagine going to restaurants and having no idea how much your meal is until after you ate it. It can be $30 or it can be $5,600, completely randomly. You are not given the bill until 3 months later. You won't be shown the menu.

Except going to a restaurant is optional, getting healthcare is not.

I was amazed when I had my first complicated heath situation with large influx of bills during my difficult pregnancy. I would get bills and than, weeks later, what the insurance would pay. And sometimes they would pay 100% of a $9K bill, or 20% of a 4k bill or 5%, or any random number in between. How is consumer supposed to know how much things really cost? That the hospital will take $400 on a 3,600 bill, for example, but I would be on the hook for the entire $3,600 if I had no insurance. It feels like they just pick those numbers out of their *sses.

[disneysteve]

I've often wondered if every driver is required to have auto/vehicle insurance, why medical insurance isn't compulsory. People don't carry insurance with a plan to crash, nor would they carry health insurance with a plan to be sick.

You can't compare the two because they are totally different. Auto insurance is to protect others. Health insurance is to protect you. You are not required to carry collision insurance to fix your own car. You are required to carry liability insurance in case you cause damage or injury to someone else.

Also, I've often pointed out that health insurance should be more like auto insurance in some ways. Auto insurance covers catastrophic stuff but not every day stuff. It doesn't cover an oil change, new tires, a blown transmission, a leaking radiator, or a faulty power window. It covers major body damage, theft, fire, etc.

People expect health insurance to cover every scrape, ache, and sniffle. If we could change the system to only cover significant health problems, we could save billions.

[JoeP]

I wish that standard healthcare didn't have to cost so much that you NEED insurance to protect yourself. Insurance should be against catastrophic things - you're hit by a car and in critical condition, you get cancer, etc.

It really shouldn't need to cost hundreds of dollars to go to the clinic for a UTI or stitches or something, when you're in the presence of the doctor for maybe 10 minutes, max.

Any time you add to the equation a third party that doesn't exhibit the same amount of scrutiny to purchases, that sector will see increased demand. That in turn triggers higher prices due to limited supply. When the consumer simply pays the premiums and the co-pay, the full impact of the cost isn't felt, so it feels like they're getting a deal.

I am not suggesting getting rid of insurance, or going to a cash-only system. How about a happy medium, voluntary option: high deductible insurance for those catastrophic incidents, and then a subscription based cash system?

[hamchan]

The problem comes when your everyday medical expenses would be running you hundreds a month without insurance coverage. When you are dealing with a lifelong chronic illness. This situation is expensive enough as it is. Our deductible isn't particularly low in the first place but we wind up meeting it every single year for at least one of us, if not both. At least one in two years we reach the out of pocket max as well. I can't even imagine how much that would cost us on a higher deductible catastrophic plan.

[NetSkyBlue]

The problem comes when your everyday medical expenses would be running you hundreds a month without insurance coverage. When you are dealing with a lifelong chronic illness. This situation is expensive enough as it is. Our deductible isn't particularly low in the first place but we wind up meeting it every single year for at least one of us, if not both. At least one in two years we reach the out of pocket max as well. I can't even imagine how much that would cost us on a higher deductible catastrophic plan.

In a world where such things weren't covered by insurance, consumers might be more savvy and shop around for healthcare, and thus create a competitively (and lower) priced market. Although when you accidentally chop off a finger and need immediate care, that kind of throws shopping around right out the window.

[Baby_nurse]

You can't compare the two because they are totally different. Auto insurance is to protect others. Health insurance is to protect you. You are not required to carry collision insurance to fix your own car. You are required to carry liability insurance in case you cause damage or injury to someone else.

Also, I've often pointed out that health insurance should be more like auto insurance in some ways. Auto insurance covers catastrophic stuff but not every day stuff. It doesn't cover an oil change, new tires, a blown transmission, a leaking radiator, or a faulty power window. It covers major body damage, theft, fire, etc.

People expect health insurance to cover every scrape, ache, and sniffle. If we could change the system to only cover significant health problems, we could save billions.

I disagree, Steve. The point of it covering the little stuff is to prevent it turning in to the big stuff. Prevention is the way to save billions. Improved prenatal care reduces the likelihood of preterm deliveries and their associated costs. Immunizations prevent hundreds of thousands of kids from dying from preventable illnesses. Early detection of cancers leads to prolonged lives. Controlling cholesterol reduces the risk of heart attacks. Good control of blood sugars reduces the risk of vision loss, heart disease etc. When these things are not covered, we see a huge increase in cost in both dollars and human terms.

[Nika]

You can't compare the two because they are totally different. Auto insurance is to protect others. Health insurance is to protect you. You are not required to carry collision insurance to fix your own car. You are required to carry liability insurance in case you cause damage or injury to someone else.

Also, I've often pointed out that health insurance should be more like auto insurance in some ways. Auto insurance covers catastrophic stuff but not every day stuff. It doesn't cover an oil change, new tires, a blown transmission, a leaking radiator, or a faulty power window. It covers major body damage, theft, fire, etc.

People expect health insurance to cover every scrape, ache, and sniffle. If we could change the system to only cover significant health problems, we could save billions.

Unless we, as a society, are willing to leave poor people die on sidewalks, health insurance is protecting others from having to absorb financial consequences of your illness. If a fast food worker can't afford insurance on his salary, what are the chances he can afford to pay the hospital for his heart attack and recovery?

[hamchan]

In a world where such things weren't covered by insurance, consumers might be more savvy and shop around for healthcare, and thus create a competitively (and lower) priced market. Although when you accidentally chop off a finger and need immediate care, that kind of throws shopping around right out the window.

I don't see that as being even remotely doable in our situation. Especially since there is a major medical emergency at least every other year. The insurance we have right now is decent but it still barely keeps these costs manageable for us.

[disneysteve]

I disagree, Steve. The point of it covering the little stuff is to prevent it turning in to the big stuff. Prevention is the way to save billions. Improved prenatal care reduces the likelihood of preterm deliveries and their associated costs. Immunizations prevent hundreds of thousands of kids from dying from preventable illnesses. Early detection of cancers leads to prolonged lives. Controlling cholesterol reduces the risk of heart attacks. Good control of blood sugars reduces the risk of vision loss, heart disease etc. When these things are not covered, we see a huge increase in cost in both dollars and human terms.

Sorry if I wasn't clear. I totally agree with your entire post. That wasn't the kind of stuff I was talking about. I'm talking about people seeing the doctor for nonsense. When you make care too accessible, you encourage abuse of the system.

"I have a headache"
When did it start?
"About an hour ago"
Have you taken anything for it?
"No"

"I woke up during the night sick to my stomach and vomited a couple of times"
What did you eat or drink last night?
"We went to a party and I had 5 or 6 beers and a lot of hot wings"

"My back hurts"
Did you do anything to injure it?
"I moved some furniture with my brother yesterday"
Have you taken anything or used heat or ice?
"No. I haven't done anything for it"

"I have a terrible cold that I just can't get rid of."
When did it start.
"I woke up with it this morning.

There's no reason for insurance companies to have to pay for visits like this. The ER docs could tell you even better stories, and that's where costs really skyrocket. The law says the hospital has to evaluate and treat them, even if there is very clearly nothing wrong with the person and it is not at all an emergency.

Preventative care, however, is vitally important and absolutely should be covered.

[JoeP]

Steve, I suspect that many of the patients who come in with those symptoms you describe have very little skin in the game. Their co-pay is probably $30, so they feel like they're getting a deal being able to see a doctor for that price.

[disneysteve]

Steve, I suspect that many of the patients who come in with those symptoms you describe have very little skin in the game. Their co-pay is probably $30, so they feel like they're getting a deal being able to see a doctor for that price.

Exactly. They have low copays or no copays (Medicaid). It is actually cheaper for them to come see me and get a prescription than it is to go to the store and buy a bottle of generic cough syrup or a bottle of ibuprofen. But those visits aren't free. The insurance company is paying their share of the charges.

[elessar78]

My risk was very low, I had no other symptoms, and having a minor infection on a surgical wound is not unheard of. If the infection were severe or not responding to treatment then it would make sense to test for diabetes, but generally speaking I already pay too much in medical bills to be testing for every single minute possibility. I have already had to file bankruptcy once because of medical bills building up faster than I would ever be able to pah them.

There are a lot of skinny people with diabetes and healing wounds is a huge issue for people with diabetes.

[Baby_nurse]

My favorite question to ask when I worked ER (briefly!) was "what changed about your cold that required you taking an ambulance to the hospital at 2 a.m.?"

Never failed, these were the same people who complained the loudest about the wait.