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Old 02-12-2012, 01:51 PM   #61
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Do you know how "Romneycare" is working out financially for MA? It seems like if MA is able to do it as a pay-as-you-go system for those very reasonable premiums, they have a winner. Are the premiums collected today covering all costs so that MA residents won't be looking at some sort of debt mountain or higher taxes in the future? If so, it's a great system.

My Medicare Part B + Part D + supplement will cost more than $340/mo and we know that Medicare isn't making it financially. I wonder how MA is doing it? Maybe just more efficient than the feds?
Costs are a big issue. There was a big spike in expensive ER usage soon after the plan started as many people just didn't think of going to the doctor. That's tailed off now. MA realizes that if costs continue to go up there will be big funding trouble so they are moving away form a "fee for procedure" model of payment and limit the annual increase in premiums.

Another great thing is being able to compare monthly premiums between insurance providers when you go on the MA website to choose a plan

https://www.mahealthconnector.org/po...ite/connector/

All plans have to provide state mandated levels of care so when I look at the various Bronze level plans (2000/5000 with co-payments) there's no difference in coverage. The cheapest plan is $331 a month and the most expensive is $555. The more expensive plans are from the big companies like Blue Cross and presumably reflect higher administrative costs and that they include the most expensive hospitals like Mass General more often.
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Old 02-12-2012, 01:51 PM   #62
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Are you sure they would be jumping the queue? Does Sweden not have private health clinics outside the socialized medicine system like the UK has?
No, I'm not sure at all. That's why I was asking the question. Thanks for your inputs.
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Socialized medicine does not necessarily mean there are no private clinics and hospitals providing services for those that can afford it.
OK. Interesting. I admit that when mulling over the concept of going to some sort of socialized HI plan here in the USA, the thought that I'd be forced (if the plan worked that way) to use the system as it is while private pay "outsiders" could jump the queue (as you put it) rubs me the wrong way. But I see what you're saying Alan. In the UK system, I'd be on an even keel with "insiders" and would not have to compete for services with private pay "outsiders" for resources of the NHS. For the private side of the system, I could get what I could pay for in competition with the rest of the world. That makes sense.

How does the UK handle folks who need care (likely emergency) and who both don't qualify for NHS (say non-citizens there without documentation) and who can't pay within the private system.
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Old 02-12-2012, 02:02 PM   #63
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Socialized medicine does not necessarily mean there are no private clinics and hospitals providing services for those that can afford it.
Most foreign systems are a mix of public and privately funded hospitals and doctors. In the UK there are is a private system that you can pay for yourself (FYI premiums are far less than in the US) and the public system is funded from general taxation and healthcare is free to all at the point of service. This is at one end of the spectrum, with the US approach at the other. Most countries fall in between and mandate that people buy health insurance from highly regulated non-profit insurance companies and they have access to both public and privately funded hospitals.
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Old 02-12-2012, 02:09 PM   #64
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How does the UK handle folks who need care (likely emergency) and who both don't qualify for NHS (say non-citizens there without documentation) and who can't pay within the private system.
All emergency care is free in the UK, no matter what your status. I have US friends who had an issue with a pregnancy while visiting the UK and they went to the ER, had a load of scans and it was all no charge because it was deemed an emergency.

If you are not UK resident you are supposed to pay for non-emergency treatment. Also your citizenship or whether you are a tax payer has nothing to do with eligibility for NHS treatment, you just have to be a resident or in an emergency.
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Old 02-12-2012, 02:10 PM   #65
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The cheapest plan is $331 a month and the most expensive is $555. The more expensive plans are from the big companies like Blue Cross and presumably reflect higher administrative costs and that they include the most expensive hospitals like Mass General more often.
Hmmmm...... That's close to amazing. I'm currently getting ready for Medicare as I turn 65 in a few months. Right now it looks like my costs will be approximately:

Part B - 161
Part D - 36
Plan F supplement - 150

Total /mo - 347 The supplement and Part D are from BCBS.

It appears folks in MA can do better even before they reach Medicare age than I can with Medicare.

If Medicare is going broke, as some claim, perhaps all geezers can simply move to MA?

Edit: After looking over the link nun provided, I see that MA kicks your butt out of their plan when you reach Medicare age so guess we geezers won't all be moving there after all.
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Old 02-12-2012, 02:18 PM   #66
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Part B - 161
Part D - 36
Plan F supplement - 150

Total /mo - 347 The supplement and Part D are from BCBS.
I got there a couple of months ago. For comparison:

Part B - 100
Part D - 15
Plan F supplement - 44 (BCBS high deductible plan)
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Old 02-12-2012, 02:28 PM   #67
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I got there a couple of months ago. For comparison:

Part B - 100
Part D - 15
Plan F supplement - 44 (BCBS high deductible plan)
Isn't your Part B 115, not 100? Mine will be 161 because because my adj income is a few bux over the limit for 2010. I'm keeping that number on the front burner as I tax plan going forward.

My Part D was the best deal I could find covering the 4 drugs I take. I think I remember you mentioning your strategy and coverage based on not currently taking any drugs.

The 44 Plan F high deductible is one of my choices. I'm thinking about it.

Thanks for those inputs!
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Old 02-12-2012, 02:40 PM   #68
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Isn't your Part B 115, not 100?
It was $115 for Dec, then dropped to $100 (actually $99.90) starting in Jan.
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Mine will be 161 because because my adj income is a few bux over the limit for 2010.
Some of us are better endowed than others.

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My Part D was the best deal I could find covering the 4 drugs I take. I think I remember you mentioning your strategy and coverage based on not taking any drugs now.
+1

The $15 Humana/Walmart plan was the cheapest I could find. It is a place holder allowing me to switch to another plan in the future when (not if) I end up on maintenance meds.

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The 44 Plan F high deductible is one of my choices. I'm thinking about it.
I carry relatively high deductibles on all our insurance, choosing to pocket the savings in premiums for taking the added risk. The $2,070 plan F deductible wouldn't break the bank if I had to pay it and I can always switch to another plan in the future if needed.
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Old 02-12-2012, 02:59 PM   #69
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It was $115 for Dec, then dropped to $100 (actually $99.90) starting in Jan.
I need to revisit my 161 number. Perhaps it's down a tad too!
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Some of us are better endowed than others.
Not to worry. My income is shrinking like the rest of me (except my gut!).


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I carry relatively high deductibles on all our insurance, choosing to pocket the savings in premiums for taking the added risk. The $2,070 plan F deductible wouldn't break the bank if I had to pay it and I can always switch to another plan in the future if needed.
I usually carry high deductibles on insurance too. In the case of Plan F, the zero deductible/co-pay level has the appeal of pretty much eliminating paperwork. But with premiums over a kilobuck higher per year, I'm still thinking through that one. I can handle a bunch of paperwork for over $1k/yr!
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Old 02-12-2012, 03:04 PM   #70
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Edit: After looking over the link nun provided, I see that MA kicks your butt out of their plan when you reach Medicare age so guess we geezers won't all be moving there after all.
Yep that's true, but living in MA removes a lot of the worry about spanning the gap between ER and when Medicare starts. If you want to have the option not to buy healthcare or want to have a plan that has a deductible greater than 2k or an annual out of packet max greater than $5k, then don't move to MA. If you are ok with those things, MA does guarantee you can get a plan irrespective of your pre-existing conditions.
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Old 02-12-2012, 03:20 PM   #71
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Yep that's true, but living in MA removes a lot of the worry about spanning the gap between ER and when Medicare starts. If you want to have the option not to buy healthcare or want to have a plan that has a deductible greater than 2k or an annual out of packet max greater than $5k, then don't move to MA. If you are ok with those things MA does guarantee you can get a plan irrespective of your pre-existing conditions.
nun, you guys gotta change that policy. If the plan is paying its own way with current premiums, why boot folks cuz they become Medicare eligible? MA could be the geezer capital of the world! Tens of millions of boomers moving in to utilize the superior-to-Medicare health care coverage. It would be the economic boom of the century! Instead of being labeled blue or red, MA would be labeled grey.
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Old 02-12-2012, 03:45 PM   #72
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Yep that's true, but living in MA removes a lot of the worry about spanning the gap between ER and when Medicare starts. If you want to have the option not to buy healthcare or want to have a plan that has a deductible greater than 2k or an annual out of packet max greater than $5k, then don't move to MA. If you are ok with those things, MA does guarantee you can get a plan irrespective of your pre-existing conditions.
This is a concern, though. Will Massachusetts become the refuge for the old, the sick, the otherwise uninsurable who couldn't get coverage in other states? And what would that do to costs there?
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Old 02-12-2012, 04:47 PM   #73
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I suspect that it is currently cheaper that Medicare because Medicare's pool of users is older.

Providing insurance for people under 65 is generally going to be a lot cheaper than providing insurance for people over 65.

Allowing people to stay on the MA policies would drive up premiums.

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nun, you guys gotta change that policy. If the plan is paying its own way with current premiums, why boot folks cuz they become Medicare eligible? MA could be the geezer capital of the world! Tens of millions of boomers moving in to utilize the superior-to-Medicare health care coverage. It would be the economic boom of the century! Instead of being labeled blue or red, MA would be labeled grey.
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Old 02-12-2012, 05:43 PM   #74
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nun, you guys gotta change that policy. If the plan is paying its own way with current premiums, why boot folks cuz they become Medicare eligible? MA could be the geezer capital of the world! Tens of millions of boomers moving in to utilize the superior-to-Medicare health care coverage. It would be the economic boom of the century! Instead of being labeled blue or red, MA would be labeled grey.
I think Federal Law has something to say about that right now, but if Medicare goes away or states can opt out there might be something in what you say. Certainly the MA plan would become a lot more expensive if it had to replace Medicare as well. The MA plan does face serious financial problems if costs continue to increase, as do all plans. But at least MA is facing up to the issues. Many will not agree with the approach, but as Romney says it's right for MA and the majority of the citizens of the Commonwealth are happy with the system.

http://www.mass.gov/bb/h1/fy11h1/exec_11/hbuddevhc.htm

FYI MA has already gone down the path of attracting people from out of state because of our laws....as we've had same sex marriage for a few years now there is quite a big industry around gay marriage.....so we might not be the grey state, but we could claim to be the gay state.
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Old 02-12-2012, 06:34 PM   #75
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My opinion:
1. To cover everybody with single payer, all our taxes should increase to pay for it.

2. We have to change our attitude that health care is a right, not a commodity. like Canada.

3. To economize, more effort should be in Prevention with actual mandates and rules for people to follow. Can't abuse the system and expect no consequences.

4. It will be tough to decide which is standard care which is covered and which is not. OK no Viagra!

5. All new proceedures should pass thru a random study with standard treatments before it will be approved for use. There's a lot of loopholes here which lead to very expensive care.

6. Well, this will be controversial, but there should be a public option!
and let it compete with private insurance companies.

7. In the end there will be a main government single payer system for standard care and extra private insurance for those who want Cadillac care. Such exist in England, Sweden, Germany etc.

8. No matter what, there will always be complaints!!
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Old 02-12-2012, 07:38 PM   #76
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At least the last part of your dream will come true without you moving anywhere. Your grandkids will be paying for our national debt.
But they'll have health care! ...and THEIR grandkids will pay for it!
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Old 02-12-2012, 09:02 PM   #77
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I did my homework

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I tried to find more info about this but couldn't. The WIKI article Alan listed didn't mention Sweden. It raises interesting questions. Did this private pay American cause any Swedes to wait longer for their similar surgeries? Did the Swedes charge a "mark-up" over what the cost to their socialized system actually was? How does the average Swede on the street feel about Americans, or others, receiving services from their socialized system while they have long waiting times?

I can understand how "outsiders" fit into the health care systems of capitalistic, private-pay systems like ours. It's harder to imagine how one would fit into a socialized system as a private pay "outsider."

I'd appreciate comments from folks who know.

Ok folks, I did some research and here is more information:

A July 14, 2011 article from Yahoo News about how the world's first synthetically grown organ was sucessfully transplanted in Sweden.
http://voices.yahoo.com/synthetic-organ-transplants-possible-first-time-done-8767819.html

A July 13, 2011 article from the London, UK Telegraph about a team of doctors in Gothenberg, Sweden who will perform only the second womb transplant in the world on a UK businesswoman donating her womb to her daughter.
http://www.telegraph.co.uk/health/8571487/Worlds-first-womb-transplant-planned.html

An August 3, 2011 article from a newspaper in Vermont about a Burlington, VT woman who will get lifesaving surgery at Karolinska in Stockholm.
http://www.7dvt.com/2011fletcher-allen-has-candidate-groundbreaking-windpipe-transplant

A November 30, 2011 article from the website www.transplantcafe.com about a Maryland man going to Sweden for a lifesaving transplant.
http://transplantcafe.com/profiles/blogs/helphopelive-patient-spotlight-groundbreaking-use-of-stem-cells

Who paid for these procedures or how this affected Sweden's free for all medical care I could not tell you. There is plenty more, but it is time for me to have a beer and go to sleep. Happy reading!!
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Old 02-12-2012, 09:12 PM   #78
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America has big heath care cost issues. You spend 16% of GDP on it when most countries spend less than 10% and they cover a far larger %age of their populations and are healthier. Looking at it like that the US has one of the most expensive and least efficient health care services in the world. People in countries with good systems actually laugh at America's system, it seems so ridiculous to them. The US needs to wake up and look at systems that work abroad and give up the "shinning city" mentality on this one before it kills you.
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Old 02-12-2012, 09:37 PM   #79
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We have some good friends who traveled to Nantes, France for surgery. She had a condition called Pudenal Nerve Entrapment for which surgery was available in Houston but was not covered by their HI company at the time as it was still classed as experimental. (They live in Louisiana). After trips to Houston for tests to confirm the diagnosis they faced a $25k bill for surgery or they could could go to Nantes where they could have it done privately by the surgeon who pioneered this particular surgery. The total cost of the surgery and hospital stay was <$5k...
Wow! Such cheap hospital costs, compared to the cost of food in their restaurants. I wonder how the incomes of healthcare professionals in other countries compare to those of their US counterparts, and also hospital profits.

The above malady sounded scary, so I had to look it up. From Wikipedia, Pudendal nerve entrapment (PNE), also known as Alcock canal syndrome, is an uncommon source of chronic pain, in which the pudendal nerve (located in the pelvis) is entrapped or compressed... The typical symptoms of PNE or PN are seen, for example, in male competitive cyclists (it is often called "cyclist syndrome")...

I know there is something wrong about the shape of those bicycle seats. You will not see me sitting on one. Anyway, we were in Nantes once...
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Old 02-12-2012, 09:53 PM   #80
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I wonder how the incomes of healthcare professionals in other countries compare to those of their US counterparts, and also hospital profits.
Most hospitals in France are non-profit, like the insurance companies.
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