Venting about ACA and requesting suggestions

[NW-Bound]

... By the way, even Obama calls the ACA "Obamacare"...

I remember Obama himself said he did not mind the term "Obamacare".

And he added "Of course I care". Very astute.

 

[Alan]

Just a 20K copay to see my doctor.

Prices have really increased since I left.

 

[NW-Bound]

I paid $640 for a Bronze ACA plan this year until I qualified for a subsidy in July. By the way, even Obama calls the ACA "Obamacare". After the initial doctor visit and mammogram in January, if was out of pocket for all doctor visits, labwork, xrays, and medicine. It stopped me from going to the doctor by mid year. One visit cost me $753 in doctors fees as my Primary sent me to see 2 "Specialists" during the visit. I am with Kaiser Permanente...

Prior to ACA, I had a PPO plan with Golden Rule, a subsidiary of United Healthcare. The deductible was $10K/year. I paid everything until $10K, then they paid everything. Due to a serious illness of my son, then myself, I hit that 3 years in a row. Still would not complain, as our hospital bills were more than $200K. For years, the insurance got "free money" from us, it looked like. Then, they lost more than that.

And people call health insurers names. I don't.

PS. By the way, an office visit cost me about $90. This year, another doctor charged only $80. That's cheap.

I went to see a laryngologist 3 years ago. He charged less than $150. This year, an ophthalmology charged me $120.

 

[ShokWaveRider]

Prices have really increased since I left.

Much better in the UK and Canada Ay? We are still thinking that as a last resort. Although I am on Medicare next year. If the UK stays in the EU, we will consider moving back to Cornwall or Devon... We noticed home prices are coming down. Maybe we really do want Brexit to go through , they may come down more if it does.

 

[VanWinkle]

This alone sounds like a prime reason to overwhelmingly support Medicare for all. At least for those over 50 - 55 perhaps. A Partial Medicare for some maybe?

Because it costs less when the government takes our money and then gives it back as services? They have little or no overhead? Have you recently seen the # of federal employees. And I am sure lobbyists wouldn't line someone's pockets to get preferential treatment for there services. Supply and demand can be messy, but not as unbridled as government(no matter who is in power).

The easy path is not always the best path.

VW

 

[jimbee]

Because it costs less when the government takes our money and then gives it back as services? They have little or no overhead? Have you recently seen the # of federal employees. And I am sure lobbyists wouldn't line someone's pockets to get preferential treatment for there services. Supply and demand can be messy, but not as unbridled as government(no matter who is in power).

The easy path is not always the best path.

VW

Medicare overhead is very low.

 

[ShokWaveRider]

Because it costs less when the government takes our money and then gives it back as services? They have little or no overhead? Have you recently seen the # of federal employees. And I am sure lobbyists wouldn't line someone's pockets to get preferential treatment for there services. Supply and demand can be messy, but not as unbridled as government(no matter who is in power).

The easy path is not always the best path.

VW

It could not be worse that what we have now, with or without the ACA. At least ALL would get an opportunity to get affordable care and the pool would be huge. The government could help regulate prices and NOT the insurance companies.

 

[Mr._Graybeard]

I paid $640 for a Bronze ACA plan this year until I qualified for a subsidy in July. By the way, even Obama calls the ACA "Obamacare". After the initial doctor visit and mammogram in January, if was out of pocket for all doctor visits, labwork, xrays, and medicine. It stopped me from going to the doctor by mid year. One visit cost me $753 in doctors fees as my Primary sent me to see 2 "Specialists" during the visit. I am with Kaiser Permanente. Medicine costs at their pharmacy weren't too bad, but all other services are expensive. I like them, however, because all services and doctors are in the same building--its like a mini hospital and the staff is polite and friendly. In my state the cliff for a single is $16-46K. Under 16K you must get a Medicaid plan. I had to do a 10K Roth conversion to get me in range for a subsidy this year. I get no earned income or SS or Pension. Now I hope I don't get socked by surprise large cap gains at the end of the year.
The ACA costs are ridiculous for a Bronze Plan. Now that I get a subsidy, I have elected to pay for a Gold plan for 2019. Just a $20 copay to see my doctor. 0 deductable. I want the peace of mind of having good coverage.

Some politicians like to describe this as having "skin in the game."

 

[VanWinkle]

Medicare overhead is very low.

Medicare payments are low, not sure about the overhead, but I would need proof before I would agree. The government never cooks the books!!

 

[Vacation4us]

I paid $640 for a Bronze ACA plan this year until I qualified for a subsidy in July. By the way, even Obama calls the ACA "Obamacare". After the initial doctor visit and mammogram in January, if was out of pocket for all doctor visits, labwork, xrays, and medicine. It stopped me from going to the doctor by mid year. One visit cost me $753 in doctors fees as my Primary sent me to see 2 "Specialists" during the visit. I am with Kaiser Permanente. Medicine costs at their pharmacy weren't too bad, but all other services are expensive. I like them, however, because all services and doctors are in the same building--its like a mini hospital and the staff is polite and friendly. In my state the cliff for a single is $16-46K. Under 16K you must get a Medicaid plan. I had to do a 10K Roth conversion to get me in range for a subsidy this year. I get no earned income or SS or Pension. Now I hope I don't get socked by surprise large cap gains at the end of the year.
The ACA costs are ridiculous for a Bronze Plan. Now that I get a subsidy, I have elected to pay for a Gold plan for 2019. Just a $20 copay to see my doctor. 0 deductable. I want the peace of mind of having good coverage.

Just don't get sick! Your covered with KP and their preventative care is good even great for young healthy families BUT if you get sick don't plan on the best up to date care. KP is cheap care not the best care.

Did you know that KP physicians don't have to use KP. They have KP and they have the option to go outside the plan and have a 20% co pay. No other "member" or employee is offered this option. Want a second opinion? Ok you see another KP doctor who opens your chart and agrees with whatever the last guy said.

Want to go to an expert in the field ? Go right ahead and pay for it, it will be like not having any coverage at all.

 

[ivinsfan]

Much better in the UK and Canada Ay? We are still thinking that as a last resort. Although I am on Medicare next year. If the UK stays in the EU, we will consider moving back to Cornwall or Devon... We noticed home prices are coming down. Maybe we really do want Brexit to go through , they may come down more if it does.

Dang you managed to bring up Brexit in an ACA thread..You're a master at touching the 3rd rail ...

 

[ivinsfan]

Medicare overhead is very low.

Got any data to back this up?

 

[gerntz]

Could you posters use the proper term which is ACA instead of the constant references to Obamacare?

ACA isn't the proper term. It's an acronym. If you going to complain about others for being improper, start with yourself.

 

[ivinsfan]

ACA isn't the proper term. It's an acronym. If you going to complain about others for being improper, start with yourself.

Do you have suggestion for an all purpose correct phrase for this..I'll gladly listen to anyone that can give us a "proper" name. A name that everyone will use and that doesn't have political connotations. What do you call it when you talk and post about it, I use ACA so I put my money where my mouth is.


I'm far from proper, but I do try not to be rude when expressing my opinions...











.

 

[zinger1457]

Because it costs less when the government takes our money and then gives it back as services? They have little or no overhead? Have you recently seen the # of federal employees. And I am sure lobbyists wouldn't line someone's pockets to get preferential treatment for there services. Supply and demand can be messy, but not as unbridled as government(no matter who is in power).

The easy path is not always the best path.

VW

Almost all the other developed nations have found a way to do it with government involvement at about half the cost of what the US spends on healthcare. Universal healthcare doesn't require that government take over 100% of the healthcare system.

 

[Bir48die]

I very seldom post at this website but read it often because it's made up of people that are bright and well educated. Over the years I have learned a lot here.

This post is mostly venting and a little bit asking questions. I live in Oregon and just shopped for my health care for 2019. (61 year old male, single, healthy, no drug use of any kind, no alcohol or tobacco, healthy weight, 2 hours of exercise a day) Income: Pension + rental income + dividends = about 60,000 a year. The bronze plan is going to be about 880.00 a month, with about 7000 deductible. With the high deductible you can pretty much figure anytime you might require a doctors visit that the cost will be entirely out of pocket. The year before Obama care took place I had a policy with Moda with 5000 deductible and the monthly premiums were only 200.00.

One of the reasons I'm angry is because I suspect that the main reason the cost is so high is to provide good quality health care for the large percentage of the population that practices self destructive behavior (alcoholics, drug addicts, people that totally ignore the advice of the health experts by overeating, not exercising, etc. people more likely to require health care and less likely to be employed). I think this falls under the category of " your right to swing your fist about wildly ends at the tip of my nose". Well, that fist has done more than just brush peoples noses; It has pummelled us to the ground and left us a bloody mess. I'm not suggesting that we eliminate all the programs to assist people in need. I'm suggesting the system needs changing and very strict policing. I also suspect that there has probably been an increase of middle class people dying as a result of Obama care because they are forced to have such a high deductible on their insurance that they don't go to the doctor when they should (minor chest pain, etc). Furthermore, while I know it's not reasonable to price heath insurance exactly like auto or life insurance, there should be a financial reward/penalty for good/bad practices. Hypothetical situation: A guy on the street standing there hitting himself in the head with a hammer. Government man walks up to me and says "see that guy hitting himself with the hammer? Well he's going to need medical care and he doesn't have any money, so you're going to pay for it". That's exactly how I feel it's going down.

Phew, that was a lot of complaining Now for the questions- Is 880.00 a month pretty typical for the Bronze plan? Anyone here have knowledge of any options or strategies I might have to reduce this high cost?
(Other than "short term" coverage. I'm too active for short term policies. The sports I practice would not be covered).

Thank you,
RDW

Amen brother! Oregon resident, a couple years older but exact same story. This year was brutal on total costs. I am hoping for a pain and surgery free year. If my wife wasn't covered by Tricare I'd still be working.

I am thankful for insurance but the ACA has allowed the system to overcharge older independent rate payers to subsidize others. Please don't suggest lowering AGI for subsidies as I cannot lower current income to those levels.

I think if the system has taken us to this point then there needs to be behavior or some sort of controls to push people into healthier lifestyles. We can get into all sorts of discussions on those who struggle financially or have limited time to fix healthy meals. However, a revamped BMI index type program with a wellness piece to it is critical.

Just think in the next ten years what's going to happen to the system. Thank goodness I'll be on Medicare by then.

 

[Sojourner]

Almost all the other developed nations have found a way to do it with government involvement at about half the cost of what the US spends on healthcare. Universal healthcare doesn't require that government take over 100% of the healthcare system.

+1000

 

[ivinsfan]

Almost all the other developed nations have found a way to do it with government involvement at about half the cost of what the US spends on healthcare. Universal healthcare doesn't require that government take over 100% of the healthcare system.

Half the cost per person, is there data to back this number up, the words all and about half make me wonder if it accurate. Is it comparable care? If we're going to advocate for government controlled healthcare these details are important.

 

[Synergy]

Thanks for everyone's input.

Lot's of food for thought.

 

[Sue J]

ACA isn't the proper term. It's an acronym.

How about "Marketplace Insurance".

 

[jimbee]

Got any data to back this up?

Administrative expenses are reported as $9.2 billion of $679 billion total Medicare expenses in 2016.


https://www.cms.gov/Research-Statis...eports/ReportsTrustFunds/Downloads/TR2017.pdf

 

[ivinsfan]

Administrative expenses are reported as $9.2 billion of $679 billion total Medicare expenses in 2016.


https://www.cms.gov/Research-Statis...eports/ReportsTrustFunds/Downloads/TR2017.pdf

That is a good number as a lot of ACA plans are required to spend 85% of premiums for actual health claims...

I wonder how much of this is due to the increasing number of people getting Medicare Advantage plans where the government issues a flat sum per person monthly to the insurance company and doesn't process any claims.

 

[ivinsfan]

How about "Marketplace Insurance".

another possible description that isn't political ..I'm actually waiting for a reply from the poster who told me I was "improper"...

 

[jkern]

I don't know about ACA, but my Medical Insurance Premiums (subsidized retiree plan) have increased 128% over the last three years (representing 50% of income).

Medicare for all sounds good, but just because Denmark (population 5M) can do it relatively successfully doesn't mean the USA can be just as successful. Have you been to the DMV lately, ugh.......

 

[GravitySucks]

Half the cost per person, is there data to back this number up, the words all and about half make me wonder if it accurate. Is it comparable care? If we're going to advocate for government controlled healthcare these details are important.

Drops to half when you get down to Belgium.

https://www.healthpopuli.com/wp-con...D-2017-health-spending-10-K-US-4-K-OECD-1.png

And when you look at certain markers on outcomes like death due to childbirth and lifespan US doesn't look very good.
We pay more for less. At least ACA tried to bring down total cost by making preventative visits free. The problem isn't all on the insurance side, there is a problem with the overall cost. If US costs got down to Canada levels the insurance could also get down to half. I 'd like to see what the US could do to drop prices as other countries have obviously done something different.