Interesting idea to beat crazy health care premiums

[photoguy]

We've not had any issues so far, though we live in an urban area. Our regular hospital, labs, doctors and urgent care are all on our Covered CA plan and the list of network doctors seems quite large. Only our eye doctor was not on our Covered CA plan, but finding another one was not a problem. There are 1.5M Covered California customers so are 51 Blue Shield and 94 Anthem complaints in the link above indicative of a huge problem? We do always confirm with the doctors / labs that they are in network and do not go solely by the provider lists, though sometimes in our experience they leave out providers that are actually in network, so it is more likely a problem with accuracy than planned deception.

If the insurance company provider lists have 9 - 13% error rates as mentioned in the article, that doesn't quite jibe with the man who said he was calling all over and no one would take Covered California. If the provider network lists are 87 - 91% accurate, then it would seem like if he made calls for appointments based on the lists, the majority of doctors he called would still be in network.

We also have not had any problems with doctors not taking ACA plans in california (or in other states we traveled through). We didn't have a regular set of doctors but have now settled in San Diego and just look them up in the provider list. One or two had long wait lists but it wasn't a problem to find another close-by physician.

 

[ESRwannabe]

I think expating for reasonable health insurance is an excellent idea. The cost of living in the US is not competitive. I would love it if people were more mobile and countries actually needed to compete for citizens. Politicians would be forced to actually care about the welfare of the citizens.

 

[ShokWaveRider]

I saw a Mythbuster report today on the news. The UK has the highest longevity rating and is rated as the Number one Healthcare system (Overall) in 11 surveyed developed countries, Canada was not in the Top 3 but was in the Longevity report. The US was 11/11 dead last. Maybe the UK is the way to beat the Costs?

 

[daylatedollarshort]

I can tell you how it works for Ohio Medicaid. You get a list of providers "who take Medicaid." Then you start calling them and find that only 3 in 100 are taking new Medicaid patients. Surprise! So, the supplied list is 100% accurate and 97% meaningless if you are on Medicaid and looking for a doctor.

This gets to the bigger point about "being covered" WRT health insurance. "Having coverage" is sometimes very different from being able to actually get quality care. Everyone on Medicaid is "covered," but you can be sure that many aren't able to get quality treatment in a timely manner.

Don't most insurers, as well as Medicare, have in network and out of network providers these days? I don't know why you are comparing Medicaid in Ohio and to a pricey monthly premium plan in the Bay Area. Stanford Hospital is on some Covered California plans. We buy our insurance through Covered California. Our plan choices are through traditional insurance companies like Kaiser and Blue Shield. For our zip we have 23 plans to choose from offered by 3 national and one regional insurance company.

 

[NYEXPAT]

I think expating for reasonable health insurance is an excellent idea. The cost of living in the US is not competitive. I would love it if people were more mobile and countries actually needed to compete for citizens. Politicians would be forced to actually care about the welfare of the citizens.

I agree with you, although at the time I left it did not occur to me. I retired 30 years ago and have not paid for HI since. I recently bought a policy for my two young boy's ( 2&12) and it cost's $100/mth for the both of them and has no deductible, $15 copay (Dr comes to our house within an hour and includes all medications) and is accepted everywhere. The same policy for myself (63 y/o) would run $260/mth for me.

 

[samclem]

I don't know why you are comparing Medicaid in Ohio and to a pricey monthly premium plan in the Bay Area.

Re-read my post. I am answering your question. You did not understand how a state-supplied list of providers who "take" a certain type insurance might not be of much relevance to a person who has that insurance and wants to find a doctor. I supplied an example.

 

[daylatedollarshort]

Re-read my post. I am answering your question. You did not understand how a state-supplied list of providers who "take" a certain type insurance might not be of much relevance to a person who has that insurance and wants to find a doctor. I supplied an example.

The issue in the article referred to in my post was not one of accepting new patients - it was not being able to find a doctor who accepted his plan. The complaint from the article was, "He explained how a typical phone call goes: "'Hey, I have Blue Shield. I need to see the doctor.' And every single doctor told me, 'Wait, is it real Blue Shield or Covered California? If it's Covered California, we don't take it.'"

 

[samclem]

I saw a Mythbuster report today on the news. The UK has the highest longevity rating and is rated as the Number one Healthcare system (Overall) in 11 surveyed developed countries, Canada was not in the Top 3 but was in the Longevity report. The US was 11/11 dead last. Maybe the UK is the way to beat the Costs?

Are people in the UK as fat as those in the US? Do they smoke at the same rate? Exercise? There are a lot of things that contribute to longevity that have nothing to do with medical care.

US overweight (incl obese): Men: 71% Women: 62%
UK overweight (incl obese): Men 67% Women: 57%
Obesity in Women: US: 34% UK: 25%

Smoking: The US consumes 40% more tobacco per capita than the UK


Regardless of health care, stuff every Brit with as many Big Macs and Marlboroughs as his American counterpart consumes, sit him on the sofa in front of TV, then let's see what happens to longevity figures in 30 years.

 

[EastWest Gal]

My current insurance is exactly the same through the ACA as it is off the ACA. I called the insurance company and discussed their plans. You can't tell from the contracts with the providers, the card, or anything else that I went through the ACA.

 

[samclem]

The issue in the article referred to in my post was not one of accepting new patients - it was not being able to find a doctor who accepted his plan. The complaint from the article was, "He explained how a typical phone call goes: "'Hey, I have Blue Shield. I need to see the doctor.' And every single doctor told me, 'Wait, is it real Blue Shield or Covered California? If it's Covered California, we don't take it.'"

Exactly. He has insurance of a particular type, he's trying to find a new doctor. He's a new patient. A new patient. They won't accept him with that insurance. Neither you or I know if every receptionist used the exact same wording, do you think they did? As far as this guy is concerned, "We don't take Covered California" is functionally identical to "we don't take new Covered California patients." I've explained to you how a government supplied list of providers is not necessarily relevant to the experiences of a patient trying to find a doc. I do not know if it applies to California, to Utah or to Pacoima.

 

[daylatedollarshort]

Exactly. He has insurance of a particular type, he's trying to find a new doctor. He's a new patient. A new patient. They won't accept him with that insurance. Neither you or I know if every receptionist used the exact same wording, do you think they did? As far as this guy is concerned, "We don't take Covered California" is functionally identical to "we don't take new Covered California patients." I've explained to you how a government supplied list of providers is not necessarily relevant to the experiences of a patient trying to find a doc. I do not know if it applies to California, to Utah or to Pacoima.

The whole article was on issues with the provider lists being inaccurate, not accepting new patients. It would be unlikely a receptionist would even use the wording we do not accept Covered California, since that is a market place to buy a plan, not a plan itself. The whole complaint in the article sounded kind of sketchy, like either the person didn't understand how his plan worked or he had a hidden agenda.

 

[Alan]

Are people in the UK as fat as those in the US? Do they smoke at the same rate? Exercise? There are a lot of things that contribute to longevity that have nothing to do with medical care.

US overweight (incl obese): Men: 71% Women: 62%
UK overweight (incl obese): Men 67% Women: 57%
Obesity in Women: US: 34% UK: 25%

Smoking: The US consumes 40% more tobacco per capita than the UK


Regardless of health care, stuff every Brit with as many Big Macs and Marlboroughs as his American counterpart consumes, sit him on the sofa in front of TV, then let's see what happens to longevity figures in 30 years.

Excellent point.

I expect it would be near impossible to measure accurately but I wonder how many steps taken or miles walked there are per person on average in the U.K. because without any extra effort our step count (and miles walked) has seen a major increase this last year since we returned. We wear step counters nearly all day, me with my iPhone, DW with her Fitbit and have done for over 2 years now. We are health conscious and exercise just as often in our gym here as we did in our gym in the USA, plus we would often walk out for breakfast or lunch in our place in Texas, however we not only walk about town from here a lot, we see loads of other folks walking everywhere as well.

However, the increasing rates of type II obesity, particularly in children, is often in the news here so the UK is far from immune in this respect.

 

[Fedup]

Excellent point.

I expect it would be near impossible to measure accurately but I wonder how many steps taken or miles walked there are per person on average in the U.K. because without any extra effort our step count (and miles walked) has seen a major increase this last year since we returned. We wear step counters nearly all day, me with my iPhone, DW with her Fitbit and have done for over 2 years now. We are health conscious and exercise just as often in our gym here as we did in our gym in the USA, plus we would often walk out for breakfast or lunch in our place in Texas, however we not only walk about town from here a lot, we see loads of other folks walking everywhere as well.

However, the increasing rates of type II obesity, particularly in children, is often in the news here so the UK is far from immune in this respect.

My 4 months in UK/Europe probably saves my life. I did so much walking that I didn't know I possibly could. Plus I noticed people eat more vegs, or more veg choices there than USA. Plus I love the vegs there, they taste a lot better than even the ones I grow here. Plus I think overall people have smaller portion. Bottom line is so many factors.

 

[NW-Bound]

However, the increasing rates of type II obesity, particularly in children, is often in the news here so the UK is far from immune in this respect.

Does the US export a lot of corn syrup to the UK? I saw diabetes and obesity on the rise everywhere, and people getting their toes, feet, and even lower legs amputated all over the place, or should I say all over the media. Scary.

 

[Alan]

Does the US export a lot of corn syrup to the UK? I saw diabetes and obesity on the rise everywhere, and people getting their toes, feet, and even lower legs amputated all over the place, or should I say all over the media. Scary.

When we first moved to the USA we couldn't believe how sugar was added to everything including bread, beans, peanut butter, whatever. Everything tasted way too sweet for us. We'd actually never heard of HFCS in the U.K. This was 40 years ago, but a quick search shows the consumption of it is still low compared to the USA. ( a study in 2012 showed that it was <1lb per capita compared to the USA of 55lbs per capita)

Nations with high-fructose corn syrup consumption have more diabetes - UPI.com

Countries with per-capita consumption of less than 1 pound per year included: Australia, China, Denmark, France, India, Ireland, Italy, Sweden, the United Kingdom and Uruguay.

 

[NW-Bound]

55 lbs vs. 1 lb? I strongly believe the countries with low consumption of corn syrup get their sweet teeth satisfied with other types of sweeteners, such as sugar from cane or beet. Nobody can eat just 1 lb/year. They still eat less sugar than the Americans, but it cannot be that low.

 

[Alan]

55 lbs vs. 1 lb? I strongly believe the countries with low consumption of corn syrup get their sweet teeth satisfied with other types of sweeteners, such as sugar from cane or beet. Nobody can eat just 1 lb/year. They still eat less sugar than the Americans, but it cannot be that low.

The article is not about sugar it is in response to what you asked about consumption of corn syrup.

The UK climate is not suited for corn and the majority of sugar comes from beets.

 

[NW-Bound]

Yes. Now, I read about corn syrup being blamed for a lot, but have not looked into why it is worse than other types of sugar.

 

[MRG]

When we first moved to the USA we couldn't believe how sugar was added to everything including bread, beans, peanut butter, whatever. Everything tasted way too sweet for us. We'd actually never heard of HFCS in the U.K. This was 40 years ago, but a quick search shows the consumption of it is still low compared to the USA. ( a study in 2012 showed that it was <1lb per capita compared to the USA of 55lbs per capita)

Nations with high-fructose corn syrup consumption have more diabetes - UPI.com

Alan,
The sugar combats the evil ICE!

 

[Alan]

Alan,
The sugar combats the evil ICE!

Internal Combustion Engine?

 

[Fedup]

Yes. Now, I read about corn syrup being blamed for a lot, but have not looked into why it is worse than other types of sugar.

It's toxin because the way it's made. It makes fatty liver. But all carbs are bad because they turn into sugar in your body. Not just sugar. I check when I purchase any food to avoid high fructose corn sugar.

 

[MRG]

Internal Combustion Engine?

I was thinking of the stuff that is solid water below 0°. I was warned of it.

 

[NW-Bound]

For that, I prefer carb in the liquid form. The formula is C2H6O. It comes in different flavors, and has the attractive amber color to it, although clear liquid carb is also common.

 

[Alan]

I was thinking of the stuff that is solid water below 0°. I was warned of it.

Ah, I see now. I thought you were referring to all the extra sugar we consumed while in America, which for us was SE Texas so frozen water did not occur to me

 

[Accidental Retiree]

The whole article was on issues with the provider lists being inaccurate, not accepting new patients. It would be unlikely a receptionist would even use the wording we do not accept Covered California, since that is a market place to buy a plan, not a plan itself. The whole complaint in the article sounded kind of sketchy, like either the person didn't understand how his plan worked or he had a hidden agenda.

I had a dermatologist's receptionist look at my insurance card and tell me they did not take Covered CA.

This was after I'd found the dermatologist's name in the insurer's website and then calling and telling them what insurance I had when I called for the appointment.

At the time of the call, I didn't mention Covered CA. I assumed that I didn't need to since I'd found the doctor's name on the website.

They saw it on the card when I showed up.

The next year we just went with Kaiser. No more problems.