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Author Topic: Health Insurance  (Read 746 times)

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hog.goblin

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Health Insurance
« on: December 27, 2017, 09:11:41 am »

I'm not interested in the politics of it, but the economics of it.  I know it's related, but let's discuss the economics/mechanics, with as little political view as possible, of rising insurance costs.

I'm about to pay my bill for Jan 2018.  It's $875.  That's an increase of 19.3% over last year.   It's up 75.5% since 2013.  I made a policy change in 2012 so that year isn't comparable, but the 5 years leading up to 2013 my insurance only increased 38.3%.

The big issue is that it's not sustainable.

Are the insurance companies really making more money (a little, but not significantly larger amounts)?
Is the cost of insuring the uninsured that expensive (likely so )?
Will dropping the individual mandate cause the otherwise uninsured to volunteer to drop out, thereby slowing down the increase in rates?
Can Congress pass laws to increase interstate competition?

Or should we focus on the longer term issues causing insurance to cost more:

1) Too many people go to the doctor's office for a cold (increase co-pays to stop this).
2) Insurance is too involved.  Doctor's have far too many people on staff that are in the business of billing, posting, and collecting insurance and payments.
3) Tort reform - every little bit helps, but I think this is a more modest issue.
4) Removing the individual mandate will allow for higher deductibles again.  I may move to a $5K or $10K deductible.  I never go to the doctor anyway unless it's a serious issue.

What are your ideas?
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ricepig

Re: Health Insurance
« Reply #1 on: December 27, 2017, 10:05:52 am »

The current situation isn't feasible, but I don't know how to fix it. My 91yr old Mom has been in the hospital and rehab facility for 5 weeks since kid Sept, her bill, should we have had to pay it would bankrupt a small nation. Medicare, Medi-Pak, and some other private insurance has it all covered, but it's ridiculous.

I've not been to the doctor outside of an annual checkup in 9 years. I will be due some of those pleasant scopes again next year, unless they say I'm good for some other test. As a SE, my insurance has always been high. I'm pooled with others in a group, but we continually go up. Whereas, Mom's didn't increase this year......
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Vantage 8 dude

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Re: Health Insurance
« Reply #2 on: December 27, 2017, 11:10:32 am »

I'm not interested in the politics of it, but the economics of it.  I know it's related, but let's discuss the economics/mechanics, with as little political view as possible, of rising insurance costs.

I'm about to pay my bill for Jan 2018.  It's $875.  That's an increase of 19.3% over last year.   It's up 75.5% since 2013.  I made a policy change in 2012 so that year isn't comparable, but the 5 years leading up to 2013 my insurance only increased 38.3%.

The big issue is that it's not sustainable.

Are the insurance companies really making more money (a little, but not significantly larger amounts)?
Is the cost of insuring the uninsured that expensive (likely so )?
Will dropping the individual mandate cause the otherwise uninsured to volunteer to drop out, thereby slowing down the increase in rates?
Can Congress pass laws to increase interstate competition?

Or should we focus on the longer term issues causing insurance to cost more:

1) Too many people go to the doctor's office for a cold (increase co-pays to stop this).
2) Insurance is too involved.  Doctor's have far too many people on staff that are in the business of billing, posting, and collecting insurance and payments.
3) Tort reform - every little bit helps, but I think this is a more modest issue.
4) Removing the individual mandate will allow for higher deductibles again.  I may move to a $5K or $10K deductible.  I never go to the doctor anyway unless it's a serious issue.

What are your ideas?
Just got my first bill for my insurance for 2018. While I suspect a LOT of folks got a big bump in their premiums, when I found out my went up ANOTHER 8% over last year I called the company. Was told that while my wife and I have been fortunate not to have needed our coverage to any great degree, obviously with the rate being determined in part on the coverage universe's use this past year we were going to get a kick up thanks to those folks.

Yep, there are a number of reasons that insurance rates have skyrocketed. Some you've listed above; however, one you've overlooked is that hospitals have been flooded with folks who use the emergency room as a doctor's office. Instead of using the services as they were intended, truly serious medical situations, they figure they should go ahead and clog up the waiting rooms to see physicians for common colds, the sniffles, the flu, etc. And since hospitals are by law required to treat all these folks, whether or not they can actually reimburse the facility, the cost gets passed on to you know who......

BTW you're absolutely correct when it comes to the bloated staff at many doctor's offices. However, with all the federal mandated paperwork, gosh who would have guessed the government might create endless piles of paperwork and red tape,  the need for more and more administrative staff is also endless. Then again, perhaps that's where some of this alleged increase in the employment rate is going ;) :puke:
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HawgWild

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Re: Health Insurance
« Reply #3 on: December 27, 2017, 08:12:44 pm »

hog.goblin writes “Too many people go to the doctor's office for a cold”
V8 opines about “folks who use the emergency room as a doctor’s office”

Are both true?
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ricepig

Re: Health Insurance
« Reply #4 on: December 27, 2017, 08:34:37 pm »

hog.goblin writes “Too many people go to the doctor's office for a cold”
V8 opines about “folks who use the emergency room as a doctor’s office”

Are both true?

Well, as the sibling being responsible for the care of our parents, I live in the same town, I can tell you that my numerous trips taking my parents to the E.R. that it was usually full of people with the flu/colds.
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hog.goblin

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Re: Health Insurance
« Reply #5 on: December 27, 2017, 09:31:34 pm »

hog.goblin writes “Too many people go to the doctor's office for a cold”
V8 opines about “folks who use the emergency room as a doctor’s office”

Are both true?

I don't think they are mutually exclusive.  I have employees that go to the ER office at least twice a year and the doctor's office once a month.  They are relatively fit people working in an office environment.  It's never injuries.  It's a cold, the flu, a stomach bug.  All things I would fight off with some chicken soup or an ice pack.  It makes no sense to me.
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HawgWild

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Re: Health Insurance
« Reply #6 on: December 28, 2017, 08:13:55 am »

What about those walk in, “urgent” care facilities, Med-Express and such? Do they screen out the uninsured, those that are unable to pay?

I think that in order to manage health care costs you have to have all the recipients in the pool. People need to have access to primary, preventive health care services and use them. We need to incentivize people to have good health practices with regards to weight, exercise, blood pressure, smoking, etc.

Lots of robust discussion needed on this issue. “Nobody knew it was so complex.”

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ricepig

Re: Health Insurance
« Reply #7 on: December 28, 2017, 08:20:54 am »

What about those walk in, “urgent” care facilities, Med-Express and such? Do they screen out the uninsured, those that are unable to pay?

I think that in order to manage health care costs you have to have all the recipients in the pool. People need to have access to primary, preventive health care services and use them. We need to incentivize people to have good health practices with regards to weight, exercise, blood pressure, smoking, etc.

Lots of robust discussion needed on this issue. “Nobody knew it was so complex.”



Yes, they do, they send them to the ER, or do whenever I've been in one with a child of mine. Of course, our two competing hospitals run them, lol.
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tasteslikechicken

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Re: Health Insurance
« Reply #8 on: December 31, 2017, 08:56:35 pm »

I received a notice that mine would go up 19% this year with Blue Cross. I am a self employed farmer and just turned 41 last July. I have only been to the Dr. about 3-4 times in the last 20 years so I decided a high deductible plan with an HSA would be a good route to go. Spent an hour on hold with them during the open enrollment period to inquire about a new plan. Was stunned to learn the high deductible plan was even higher than my current plan. Needless to say I just kept my current plan and ditched the HSA idea for now.
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onebadrubi

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Re: Health Insurance
« Reply #9 on: January 01, 2018, 11:44:07 am »

I received a notice that mine would go up 19% this year with Blue Cross. I am a self employed farmer and just turned 41 last July. I have only been to the Dr. about 3-4 times in the last 20 years so I decided a high deductible plan with an HSA would be a good route to go. Spent an hour on hold with them during the open enrollment period to inquire about a new plan. Was stunned to learn the high deductible plan was even higher than my current plan. Needless to say I just kept my current plan and ditched the HSA idea for now.

Why ditch the HSA?  You can put tax deductible cash there, invest it, and save it for a rainy day of medical expenses? 

My wife also saw a large increase going into 18 with a high deductible plan through BCBS.  Sad thing is though, they didn't send her any notice letters of the jump until the first bill.  We are actually working with them now for proof of the notice, our agent seems to think we might have a case with them because BCBS said we should have received "multiple" notices but they can seem to tell us when. 
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onebadrubi

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Re: Health Insurance
« Reply #10 on: January 01, 2018, 12:20:38 pm »

I'm not interested in the politics of it, but the economics of it.  I know it's related, but let's discuss the economics/mechanics, with as little political view as possible, of rising insurance costs.

I'm about to pay my bill for Jan 2018.  It's $875.  That's an increase of 19.3% over last year.   It's up 75.5% since 2013.  I made a policy change in 2012 so that year isn't comparable, but the 5 years leading up to 2013 my insurance only increased 38.3%.

The big issue is that it's not sustainable.

Are the insurance companies really making more money (a little, but not significantly larger amounts)?
Is the cost of insuring the uninsured that expensive (likely so )?
Will dropping the individual mandate cause the otherwise uninsured to volunteer to drop out, thereby slowing down the increase in rates?
Can Congress pass laws to increase interstate competition?

Or should we focus on the longer term issues causing insurance to cost more:

1) Too many people go to the doctor's office for a cold (increase co-pays to stop this).
2) Insurance is too involved.  Doctor's have far too many people on staff that are in the business of billing, posting, and collecting insurance and payments.
3) Tort reform - every little bit helps, but I think this is a more modest issue.
4) Removing the individual mandate will allow for higher deductibles again.  I may move to a $5K or $10K deductible.  I never go to the doctor anyway unless it's a serious issue.

What are your ideas?

My in laws are all medical, wife is as well.  There is range of ER docs, nurses, APN's, and so on.  I can offer what they say for the economics of it which are it is  strangling the profits and bogging down the office personnel. 

From the ones working in the ER; they are still seeing as many un insured people coming in.  You still see the people coming in looking for drugs, begging for testing, wanting certain procedures with no ability to pay nor following procedures of seeing a family doctor or even specialist.  The ER's are still just viewed as fix all centers that you don't have to pay for.

Labor and Delivery; Still seeing a large amount of uninsured people coming in to deliver a baby with no intentions of repaying the bill.  The view it as I am pregnant and they have to deliver and assist.  They view it as being able to delivery a healthy baby, carry it out, and never worry about the finances of it.

Doc N a Box/Urgent care;  You are seeing these pop up, but they are really making their money on the people who were insured even before the health care bill.  The people going in and the ones that need a simple flu test/tamiflu, stitches, etc, things that your local doc either is stacked full of and can't get too or maybe their operation is a M-F 8-5 and you need Tamiflu that has a 48 hour window of successfulness on a Saturday?  These are things that people before might have used an ER for, but the strain has for whatever reason not been lifted of the Er's. 


Back to the economics of this bill, I personally have always thought this bill was written to help insurance companies and that the fore front of every deal was to benefit insurance companies.  I think politicians saw the "everyone getting insurance" as a way to sell it and hide things.  They cluttered a huge bill up with many things to hide certain things, in my opinion.  Politicians forced customers to insurance companies, they made sure the largest of insurance companies could afford the paper work and need for added staff, drove the cost way up, the deductibles up, all netting in insurance company revenues up and expenditures down. 

I know someone else who is really being screwed by this bill.  Trying to start a new business, paying taxes on about 40,000-50,000 in profits/income, and health insurance is over $800/month. 
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tasteslikechicken

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Re: Health Insurance
« Reply #11 on: January 03, 2018, 09:55:47 pm »

Why ditch the HSA?  You can put tax deductible cash there, invest it, and save it for a rainy day of medical expenses? 
 

My wife also saw a large increase going into 18 with a high deductible plan through BCBS.  Sad thing is though, they didn't send her any notice letters of the jump until the first bill.  We are actually working with them now for proof of the notice, our agent seems to think we might have a case with them because BCBS said we should have received "multiple" notices but they can seem to tell us when.

I was under the impression that you could not open an HSA unless you were on a high deductible plan. I chose to keep the plan I had (which does not qualify as a high deductible plan) because it was cheaper so I will have to wait until the next enrollment period at least.
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NuttinItUp

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Re: Health Insurance
« Reply #12 on: January 03, 2018, 10:09:23 pm »

I was under the impression that you could not open an HSA unless you were on a high deductible plan.

Yes, you can only open an HSA if you are on a qualifying high-deductible health care plan.

https://www.healthcare.gov/glossary/high-deductible-health-plan/

Quote
High Deductible Health Plan (HDHP)

A plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (your deductible). A high deductible plan (HDHP) can be combined with a health savings account (HSA), allowing you to pay for certain medical expenses with money free from federal taxes.

The IRS defines a high deductible health plan as any plan with a deductible of at least $1,300 for an individual or $2,600 for a family. An HDHP’s total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can’t be more than $6,550 for an individual or $13,100 for a family. (This limit doesn’t apply to out-of-network services.)


I started looking into HSA options, but then found out my plan does not qualify as high-deductible, so that option was out for me.
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onebadrubi

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Re: Health Insurance
« Reply #13 on: January 04, 2018, 10:40:53 am »

I was under the impression that you could not open an HSA unless you were on a high deductible plan. I chose to keep the plan I had (which does not qualify as a high deductible plan) because it was cheaper so I will have to wait until the next enrollment period at least.

That is correct, but you said you had a high deductible plan and after being on hold for an hour stuck with your current plan, which is why I asked why you ditched it. 
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onebadrubi

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Re: Health Insurance
« Reply #14 on: January 04, 2018, 10:41:57 am »

Yes, you can only open an HSA if you are on a qualifying high-deductible health care plan.

https://www.healthcare.gov/glossary/high-deductible-health-plan/


I started looking into HSA options, but then found out my plan does not qualify as high-deductible, so that option was out for me.

I think more and more plans are starting to qualify as HDHP's with the deductibles going up.  Which part of the HDHP rules did you not qualify for? 
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NuttinItUp

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Re: Health Insurance
« Reply #15 on: January 04, 2018, 11:17:54 am »

I think more and more plans are starting to qualify as HDHP's with the deductibles going up.  Which part of the HDHP rules did you not qualify for? 
Deductible was not high enough, but that was at the beginning of 2017 when I checked. I might need to check again--like you said deductibles have been going up.
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majestic

Re: Health Insurance
« Reply #16 on: January 04, 2018, 11:23:44 am »

Just a little side rant about our generally f'd up system:

I broke my hand shortly before Thanksgiving. I have been generally pleased with my doctor, PT, etc. But I went to the BCBS site to review claim activity and was shocked at some of the amounts.

*The amount billed for surgery was almost $18k. The negotiated rate with the insurance company was just under $2k. My out of pocket was close to $700. How in the world can a $2k procedure be billed at $18k?

We hit our $4k deductible, so it looks like the remainder of the charges, anesthetist, x-rays, etc. will be billed at 20%. All in all, this incident is going to run me around $2500 AFTER insurance.

We have to come up with a different solution to health care/insurance as a country. Something as simple as a broken hand would bankrupt a lot of people.
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HawgWild

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Re: Health Insurance
« Reply #17 on: January 04, 2018, 12:02:20 pm »

Just think, that would have been the billing amount for someone with no insurance. That's what's always chapped me. Someone that can't "afford" insurance pays 9Xs the rate of someone with insurance!? How can you not afford insurance?

A couple of years back I went in for an MRI. The hospital wanted $965 up front. I paid it. A few weeks later I got a letter from my insurance saying they'd paid the $365 for the MRI. I called the hospital to find out what had happened to the $600 over payment. They said they were going to refund it to me. (Took 2 months.) I asked them what they would have done if I had not paid the $965 up front (for a $365 procedure.) would they have given me the MRI. The associate said "I'll have to let you speak to my supervisor."
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NuttinItUp

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Re: Health Insurance
« Reply #18 on: January 04, 2018, 02:49:21 pm »

You guys have to remember that most people who cannot afford healthcare are on Medicaid for free.

Or, they just go to the ER and get fixed up and don't ever pay. (How are you going to collect money from someone with no money? They usually just write it off.)

Sometimes I think it might be cheaper to not have any official income. (Note: I did not say no income, just no income recognized by the gov't.)


Sorry to hear about your hand, majestic. That sucks big time.
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onebadrubi

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Re: Health Insurance
« Reply #19 on: January 04, 2018, 05:21:11 pm »

You guys have to remember that most people who cannot afford healthcare are on Medicaid for free.

Or, they just go to the ER and get fixed up and don't ever pay. (How are you going to collect money from someone with no money? They usually just write it off.)

Sometimes I think it might be cheaper to not have any official income. (Note: I did not say no income, just no income recognized by the gov't.)


Sorry to hear about your hand, majestic. That sucks big time.

You mean like the guys that come around every year wanting to mow my yard in new 70,000 pick ups that say I'll give you $10 off time if you pay in cash?  Yeaaahhh, I feel ya. 

And I disagree, the people who ultimately have no money, sure they are covered.  But the current system is killing the people who had a job, could afford to own a home, but at the end of the month barely could save enough for a good steak dinner.  Now, those people are paying so much in insurance, once case I know about is over 10% of their gross income is going to health insurance.  Someone making 65,000 should not have to pay over 10,000 in health insurance a year that has a $5,000 deductible.  These are the people who can't afford it. 
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onebadrubi

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Re: Health Insurance
« Reply #20 on: January 04, 2018, 05:28:53 pm »

Just a little side rant about our generally f'd up system:

I broke my hand shortly before Thanksgiving. I have been generally pleased with my doctor, PT, etc. But I went to the BCBS site to review claim activity and was shocked at some of the amounts.

*The amount billed for surgery was almost $18k. The negotiated rate with the insurance company was just under $2k. My out of pocket was close to $700. How in the world can a $2k procedure be billed at $18k?

We hit our $4k deductible, so it looks like the remainder of the charges, anesthetist, x-rays, etc. will be billed at 20%. All in all, this incident is going to run me around $2500 AFTER insurance.

We have to come up with a different solution to health care/insurance as a country. Something as simple as a broken hand would bankrupt a lot of people.

I mentioned this stuff when everyone was discussing the politics of Obamacare as it was getting shoved down out throats.  You can NOT trust any of the numbers used given for stats on this topic, they are so easy manipulated to fit an agenda or bias its unbelievable. 

That loss in you deal they can write off and say they are losing that money, which is not true in the least.  This negotiated rate with insurance company is all a freaking crock.  I had a major knee surgery a few years ago and learned about this then.  It was eye opening to see how much they would settle for cash, how much they wanted to bill, and how much the insurance company was willing to pay. 

In what private entity can you walk in be billed $10,000, pay a monthly annuity amount that is suppose to cover things yet they can tell you to spend $5,000, the said person you are paying an annuity too can negotiate to pay $2100, or you can pay cash for the service $3500.  So then WTH is the $10,000?  It's a number used to make the situation worse when used for budgeting, political issues, research funding, etc.  All a big scam. 

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NuttinItUp

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Re: Health Insurance
« Reply #21 on: January 04, 2018, 05:45:59 pm »

And I disagree, the people who ultimately have no money, sure they are covered.  But the current system is killing the people who had a job, could afford to own a home, but at the end of the month barely could save enough for a good steak dinner.  Now, those people are paying so much in insurance, once case I know about is over 10% of their gross income is going to health insurance.  Someone making 65,000 should not have to pay over 10,000 in health insurance a year that has a $5,000 deductible.  These are the people who can't afford it. 

US healthcare costs are at around 17.9% of GDP, which is the highest of any developed country. The average American family spends about 10.1% of income on healthcare.

The problem is the higher taxes that would be required to fund a single-payer system. (Also, less money for healthcare providers, research, etc. which all have big lobbying budgets.)

Perhaps getting a little too political, though, so I won't push it any further than that in a non-politics forum.
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HoginMemphis

Re: Health Insurance
« Reply #22 on: January 05, 2018, 10:30:47 am »

Just think, that would have been the billing amount for someone with no insurance. That's what's always chapped me. Someone that can't "afford" insurance pays 9Xs the rate of someone with insurance!? How can you not afford insurance?

A couple of years back I went in for an MRI. The hospital wanted $965 up front. I paid it. A few weeks later I got a letter from my insurance saying they'd paid the $365 for the MRI. I called the hospital to find out what had happened to the $600 over payment. They said they were going to refund it to me. (Took 2 months.) I asked them what they would have done if I had not paid the $965 up front (for a $365 procedure.) would they have given me the MRI. The associate said "I'll have to let you speak to my supervisor."
Not accurate AT ALL. I do not have health insurance. I pay cash. I had to go to ER for first time in my life in October. I said I am cash pay and they told me they give cash payers a 74% discount. The hospital and physician bills cost me $580. I was there about 90 min. I just got a cash cost on a colonoscopy: $625 all in. Getting it next month.
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HoginMemphis

Re: Health Insurance
« Reply #23 on: January 05, 2018, 10:34:11 am »

If state and federal gov't would get out of education and healthcare industries, pricing would normalize and be affordable for all. No one wants to try to understand that or admit it is true/right. Most want to believe that the gov't is our friend and making things better for all, overall, in both higher education and healthcare when reality is what we are seeing now: simple hand surgery on out-patient basis for a small broken bone being billed at $18,000 and cost (room, board, fees and tuition) for 1 year at state university at in-state tuition is $20K plus. 30 years ago, one semester tuition at U of A was about $600. Then came gov't-backed student lending.
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NuttinItUp

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Re: Health Insurance
« Reply #24 on: January 05, 2018, 11:31:52 am »

Not accurate AT ALL. I do not have health insurance. I pay cash. I had to go to ER for first time in my life in October. I said I am cash pay and they told me they give cash payers a 74% discount. The hospital and physician bills cost me $580. I was there about 90 min. I just got a cash cost on a colonoscopy: $625 all in. Getting it next month.

Probably a lot less expensive to do it that way than have insurance, too.
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HawgWild

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Re: Health Insurance
« Reply #25 on: January 05, 2018, 03:53:21 pm »

Probably a lot less expensive to do it that way than have insurance, too.

Yep, works just fine until you have a catastrophic medical event.
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HoginMemphis

Re: Health Insurance
« Reply #26 on: January 06, 2018, 09:40:27 am »

Yep, works just fine until you have a catastrophic medical event.
You can't insure everything.

When lowest cost of the only policy I can get that is ACA compliant is $1050/month for 2 of us along with $6400 per person deductible, that is not smart to purchase unless you are in poor health and have a chronic condition. i can self insure anything else and for a lot less than $20K per year. Premiums add up to $12,600/year and before insurance pays a penny on one of us, another $6400 in deductible has to be paid out of our pocket. The $12,600 in premiums is a deductible expense on our federal tax return but the $6400 per person per year deductible is not.

Again, I can self insure for almost anything but open heart surgery or cancer.
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hog.goblin

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Re: Health Insurance
« Reply #27 on: January 06, 2018, 09:43:02 am »

You can't insure everything.

When lowest cost of the only policy I can get that is ACA compliant is $1050/month for 2 of us along with $6400 per person deductible, that is not smart to purchase unless you are in poor health and have a chronic condition. i can self insure anything else and for a lot less than $20K per year. Premiums add up to $12,600/year and before insurance pays a penny on one of us, another $6400 in deductible has to be paid out of our pocket. The $12,600 in premiums is a deductible expense on our federal tax return but the $6400 per person per year deductible is not.

Again, I can self insure for almost anything but open heart surgery or cancer.

We should see some new plans being offered now that the individual mandate is dead
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HoginMemphis

Re: Health Insurance
« Reply #28 on: January 06, 2018, 10:16:19 am »

We should see some new plans being offered now that the individual mandate is dead
I have heard that is coming and hope it is true. I don't mind having to "qualify" for a lower rate. Both of us are healthy with no chronic conditions other than me taking a statin for high cholesterol. But it is totally under control with low dose of daily statin.

I just do not want to be forced to buy a policy that covers maternity and pediatric health and dental when I am done with kids and do not have any living with me anymore.

Further, I do not mind a high deductible policy as long as it has a reasonable premium. In fact, that is what I want: a HSA eligible, high-deductible policy because we almost never visit the doctor. I'll take a $6400 per person annual deductible but not for $1050/month. We should not have to pay more than $2 or $3K a year max for such a policy.
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NuttinItUp

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Re: Health Insurance
« Reply #29 on: January 06, 2018, 10:28:19 am »

Yep, works just fine until you have a catastrophic medical event.

I like HoginMemphis' idea of a super-low premium plan that ONLY covers catastrophic stuff. Everything else is covered out-of-pocket. Would be cheaper overall for most people, I think.

Of course, then you get into the whole idea of people only getting it when they know they have a catastrophic event, but the fact that you can only sign up during the enrollment period should mitigate that somewhat, I would think.
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WaltKowalski

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Re: Health Insurance
« Reply #30 on: January 06, 2018, 11:16:58 am »

Yep, works just fine until you have a catastrophic medical event.

Thats why we should have universal catastrophic coverage. Anything over 10k 15k? We could go back cash for everything else. Take all money saved and invest in tax reforms that incentivize health. If you knew you could get a refundable credit for getting your labs, BMI, routine care would you invest more in your health? Why do we incentivize stupid darn but not the things that would make the US the worlds healthiest country?
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HoginMemphis

Re: Health Insurance
« Reply #31 on: January 06, 2018, 11:34:20 am »

Thats why we should have universal catastrophic coverage. Anything over 10k 15k? We could go back cash for everything else. Take all money saved and invest in tax reforms that incentivize health. If you knew you could get a refundable credit for getting your labs, BMI, routine care would you invest more in your health? Why do we incentivize stupid darn but not the things that would make the US the worlds healthiest country?
Why? Because politicians take advantage of stupid people in order to buy votes. And they like $ from healthcare industry lobbies. Follow the money. How do you think politicians who enter Congress with a net worth in six figures leave several terms later with net worth well into 7 figures on a salary of around $200K?
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WaltKowalski

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Re: Health Insurance
« Reply #32 on: January 06, 2018, 11:42:23 am »

Why? Because politicians take advantage of stupid people in order to buy votes. And they like $ from healthcare industry lobbies. Follow the money. How do you think politicians who enter Congress with a net worth in six figures leave several terms later with net worth well into 7 figures on a salary of around $200K?

Lets get elected? We can split the profits.
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Ash

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Re: Health Insurance
« Reply #33 on: January 17, 2018, 03:47:22 pm »

I mentioned this stuff when everyone was discussing the politics of Obamacare as it was getting shoved down out throats.  You can NOT trust any of the numbers used given for stats on this topic, they are so easy manipulated to fit an agenda or bias its unbelievable. 

That loss in you deal they can write off and say they are losing that money, which is not true in the least.  This negotiated rate with insurance company is all a freaking crock.  I had a major knee surgery a few years ago and learned about this then.  It was eye opening to see how much they would settle for cash, how much they wanted to bill, and how much the insurance company was willing to pay. 

In what private entity can you walk in be billed $10,000, pay a monthly annuity amount that is suppose to cover things yet they can tell you to spend $5,000, the said person you are paying an annuity too can negotiate to pay $2100, or you can pay cash for the service $3500.  So then WTH is the $10,000?  It's a number used to make the situation worse when used for budgeting, political issues, research funding, etc.  All a big scam. 



YES

I spent years doing revenue accounting for a corporation.

The hospital will book the $18k as billed revenue and write off the difference between that and the negotiated rate. If they 'billed' you $18k and the insurance 'paid' $2k the hospital booked a $16k write off which saves them $5,600 in taxes.

It is all a crock of darn. We have been sold down the river by the medical establishment.
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HawgWild

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Re: Health Insurance
« Reply #34 on: January 17, 2018, 05:27:30 pm »

That explains it. I never understood why someone without insurance was being billed 4+X the rate my insurance was being charged.
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onebadrubi

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Re: Health Insurance
« Reply #35 on: January 17, 2018, 11:51:22 pm »

YES

I spent years doing revenue accounting for a corporation.

The hospital will book the $18k as billed revenue and write off the difference between that and the negotiated rate. If they 'billed' you $18k and the insurance 'paid' $2k the hospital booked a $16k write off which saves them $5,600 in taxes.

It is all a crock of darn. We have been sold down the river by the medical establishment.

It's funny your name is ARk surg hospital, this was the discussion I had with ASH after a surgery and paying cash and noticing this first hand.  I asked the lady and she explained, I said so you are scamming the public by tax evasion. 

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hog.goblin

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Re: Health Insurance
« Reply #36 on: January 18, 2018, 09:24:31 pm »

YES

I spent years doing revenue accounting for a corporation.

The hospital will book the $18k as billed revenue and write off the difference between that and the negotiated rate. If they 'billed' you $18k and the insurance 'paid' $2k the hospital booked a $16k write off which saves them $5,600 in taxes.

It is all a crock of darn. We have been sold down the river by the medical establishment.

Hold on there, that’s not exactly how math and taxes work.  If you bill $18K that’s revenue.  If you write-off $16K that’s certainly a deduction.  The hospital is left with $2K of taxable income.  Or they could bill $2K and have the same result.  There is no tax benefit.

Now, if they are getting some unrelated benefit for having write downs, not the tax deduction as that’s no benefit, but say grant money or foundation money for “showing mercy” through write-offs then you have a story.  But there isn’t as much of that going on as you think.
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onebadrubi

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Re: Health Insurance
« Reply #37 on: January 19, 2018, 05:46:49 am »

Hold on there, that’s not exactly how math and taxes work.  If you bill $18K that’s revenue.  If you write-off $16K that’s certainly a deduction.  The hospital is left with $2K of taxable income.  Or they could bill $2K and have the same result.  There is no tax benefit.

Now, if they are getting some unrelated benefit for having write downs, not the tax deduction as that’s no benefit, but say grant money or foundation money for “showing mercy” through write-offs then you have a story.  But there isn’t as much of that going on as you

 think.

They use the higher numbers to push for certain things, like higher budgeting, funding, etc. 

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