Originally Posted By SuperDry <<< I will never forget we went from being affluent with 3 houses and some boats, to just hanging on to one house because I broke my leg and arm, had surgery and my mom got sick. This was in the space of 3 years due to loop holes. >>> You just don't seem to get it. That's what makes America great!
Originally Posted By fkurucz >>Out of college before I got my first full-time job, I called it the "God forbid plan." Meaning, "God forbid" I was hit by a bus, I had some insurance so the hospital bills wouldn't wipe me out. But the deductible was so high that anything short of that was basically my expense. It was the sort of thing that people without full-time jobs got as a stop-gap measure, just to prevent against catastrophic injury or illness. Now, it's becoming more and more the norm even for people who have full-time jobs that provide insurance (and by no means do all full-time jobs do so any more to begin with).<< Bingo! And that works OK for young singles who are basicually young and healthy and rarely have to see a doctor. Not so good when you have a family or when you are older.
Originally Posted By fkurucz >>You just don't seem to get it. That's what makes America great!<< That's right! Anything else is for commies!
Originally Posted By tashajilek You never know things might change in the future. They have talked some years about Canada privitizing medical. That wouldnt fly to well over here, there woyld be no point living here w/o medical.
Originally Posted By beamerdog The high deductibles are the way insurance companies are getting around mental health care parity. Think of having a deductible on your "regular" health care and then another one applied separately to your mental health care.
Originally Posted By Labuda "It means that Americans are not visiting the doctor as much as the used to because they cannot afford to pay for an office visit, which typically costs more than $100." Ok, seriously? $100 for someone with insurance to see a doctor?!?!?! I know my $15 copay is low, but most of the other folks I've heard being billed at the doctor are paying copays of about $30. Is it really so bad that people WITH INSURANCE are having to pay $100 just to see their GP/PCP?
Originally Posted By hopemax That's what these high deductible plans mean. The first $3000, or $5000 is yours BEFORE insurance starts paying out. So you pay the full price of the office exam, which runs $100+. There isn't a co-pay, like what you are used to.
Originally Posted By fkurucz >> Is it really so bad that people WITH INSURANCE are having to pay $100 just to see their GP/PCP?<< Yes, it is. The insurance is now basically only for covering "catastrophic" events like hospitalization. Plans with "copays" (like yours and mine) are now considered the "Cadillac" plans. The High deductible plans that are becoming more and more common (because they are cheaper) do NOT always offer copays. Employers are now pressuring their employees to take the high deductible plans with a Health Savings Account (that the employee funds) to pay for office visits. I was really shocked to learn how few of the soccer team families still had plans with copays. It seemed that the few with good insurance worked for the government.
Originally Posted By Labuda Wow. My deductible only comes in to play if I'm doing surgery, or a major piece of equipment like my CPAP.
Originally Posted By queenbee Yes, we have Anthem/Blue Cross in California. This year our deductable doubled to $3K/person or $6K/family. The cost of the plan also increased by 27%. That is getting to be the norm around here.
Originally Posted By Kar2oonMan >>Ok, seriously? $100 for someone with insurance to see a doctor?!?!?! I know my $15 copay is low, but most of the other folks I've heard being billed at the doctor are paying copays of about $30. Is it really so bad that people WITH INSURANCE are having to pay $100 just to see their GP/PCP?<< For a few years, we were paying for our own health insurance plan. For the EXACT same coverage I had at my former company, our co-pay went from $1 (one dollar) co-pay for an office visit to $50. The flat $10 prescription drugs skyrocketed. Our doctor would give us some "sample" packs to help defray the cost a little, but it was incredible.
Originally Posted By fkurucz >>That's what these high deductible plans mean. The first $3000, or $5000 is yours BEFORE insurance starts paying out. So you pay the full price of the office exam, which runs $100+. There isn't a co-pay, like what you are used to.<< Exactly. One of families on the soccer team are health care folks (Dad's an MD. Mom's a Nurse). They have told us that office visits are WAY down, almost 40%. And you know what? Even they have a high deductible plan (I guess he can do the family office "visits" at home). He's not mt PCP, but as I have mentioned before I can almost always see my Dr now the same say I call. 5 years ago waits could be as long as 2 weeks (usually just 3-4 days). Self rationed healthcare.
Originally Posted By fkurucz "Wow. My deductible only comes in to play if I'm doing surgery, or a major piece of equipment like my CPAP." Mine as well, a $500 deductible. And my employer is really twisting my arm to switch to the HD plan, which I am resisting. I expect that next year we won't have a choice.
Originally Posted By fkurucz >>For a few years, we were paying for our own health insurance plan. For the EXACT same coverage I had at my former company, our co-pay went from $1 (one dollar) co-pay for an office visit to $50. The flat $10 prescription drugs skyrocketed.<< The same would have happened had you stayed at your old job with the old plan. I saw this happen during my time at Hewlett Packard. Copays for office visits and prescriptions kept going up year after year, A prescription copay that used to be $15 slowly became a $60 copay. An office visit copy that was $5 became $25 ($40 for a specialist),
Originally Posted By Princessjenn5795 I have a very good insurance plan. My copay is $20 with a $500indv/$1500family deductible. My husbands company pays for 80% of our coverage and we still pay about $500/month for our family of 4 but it is worth it because we are insured right? My husband had to have a minor procedure done last year and we had to battle with the insurance company for nine months before they would pay the 80% they were supposed to pay (we had already satisfied the deductible). We ended up having to pay out of pocket so that the hospital did not send us to collections and then having the insurance company reimburse us. It is becoming more and more difficult for even those of us with "Cadillac" insurance plans to get our care covered...My heart really goes out to anyone, covered or not, that actually has to get medical care...it is getting harder and harder for them to do so.
Originally Posted By SuperDry <<< A prescription copay that used to be $15 slowly became a $60 copay. >>> Another thing that's happening with prescription drug coverage is that for certain drugs that are considered elective (but still nonetheless treat a bona fide medical condition like Claritin for allergies, prior to it going OTC), coverage is given for less-than continual dosage. For example, in addition to the high co-pay, the insurance may cover only 20 daily doses per month. If you really need to take a dose each day, you have to pay for the extra 10 per month at full price out of pocket.
Originally Posted By fkurucz >>Yes, we have Anthem/Blue Cross in California. This year our deductable doubled to $3K/person or $6K/family. The cost of the plan also increased by 27%. That is getting to be the norm around here.<< It won't be long until even the high deductible plans are unaffordable. Once we get there I'm guessing that over 3/4 of the populace will be paying for everything out of pocket. Hopefully the healthcare industry will change its costs structures, or Doctors will be as lonely as the good old Maytag repairman.
Originally Posted By fkurucz Hey Dave, If you're still out there, what do you think of the "greatest healthcare system in the world" now after hearing about our wonderful High deductible plans?
Originally Posted By Mr X No way no how does America possess the "greatest healthcare system", far far FAR from it (it seems to be France, if all the stats are to be believed). That's not to say that America doesn't have some of the best HEALTHCARE in the world, perhaps even THE best...but that doesn't mean jack if the vast majority of your citizens have no access to it (it's great if you're rich though...no question about where to go if you're a rich foreigner with an unusual illness).
Originally Posted By fkurucz No argument X. I wrote it in quotes because those who opposed any heathcare reform often insisted that we have the "greatest healthcare system in the world" and that any meddling to reform it would ruin it.
