Seriously? (Health Ins. Rant)

Duke wrote: The ACA, however, **requires ME to have insurance that covers ME**, even if I don't want it at all, or want less than what they consider minimum. Other than being about insurance, they are not the same thing at all. But I suspect you knew that.

Meanwhile, the hospitals are legally obligated to treat you without knowing if you can pay or not. In some cases you cannot legally refuse treatment.

Swank Force One wrote:

Curmudgeon wrote: Picking on the insurance company again: my new oncologist prescribed a series of shots to bring my white cell count up; it dropped as a result of the chemo. I already described how they were 'closed for training' but I also found out later that they were balking at paying for this treatment. Waitadamnminnit: my doc prescribed the shots as necessary to ensure my survival. So why is the insurance company balking? It's not like it's some nebulous unproven BS, this shot series is a PROVEN treatment for this. The doc can't continue chemo if the white cell count is low. Is BCBS willing to let me die over this?

Federal government things. It sucks.

Explain, please? It astounds me that the federal gov't might be able to interfere with my insurer paying for a proven (meaning it should be FDA approved) treatment.

Curmudgeon wrote:

Swank Force One wrote:

Curmudgeon wrote: Picking on the insurance company again: my new oncologist prescribed a series of shots to bring my white cell count up; it dropped as a result of the chemo. I already described how they were 'closed for training' but I also found out later that they were balking at paying for this treatment. Waitadamnminnit: my doc prescribed the shots as necessary to ensure my survival. So why is the insurance company balking? It's not like it's some nebulous unproven BS, this shot series is a PROVEN treatment for this. The doc can't continue chemo if the white cell count is low. Is BCBS willing to let me die over this?

Federal government things. It sucks.

Explain, please? It astounds me that the federal gov't might be able to interfere with my insurer paying for a proven (meaning it should be FDA approved) treatment.

FDA approved doesn't mean "meets Medicare guidelines," unfortunately. And that's really the case here. Like i explained over on the other board a couple weeks ago, we follow Medicare guidelines for medical necessary.

It's not specifically BCBS that's balking at paying this (stupidly), it would be everyone.

madmallard wrote: ... but back to the original post... I too find it really annoying that health care is one industry where almost every position other than doctor or nurse faces such ridiculous customer service deficiencies... it seems like only cable companies do consistently worse...

The funny thing is, the hospitals and doctors bombard me with patient surveys. I answered the first two or three, I've finally started throwing them in the damn trash. So far everyone I have dealt with have all been very nice etc, even the oncologist who royally screwed up the first 5 months of my treatment has been nothing but nice to me. That doesn't excuse her incompetence, though. I'd rather have a brusque professional who knows WTF they are doing.

Duke wrote:

Flight Service wrote: In reply to Duke: Yes you have to be covered. That is accurate. But you have to have insurance to have a car on the road. I am confused to the difference.

When driving a car, I am required to have insurance that covers **MY LIABILITY TO OTHERS** in case I cause **them** damage or injury. I am not in any way required to have insurance that covers **my** car for damage at all. That is entirely optional and at my own discretion. The ACA, however, **requires ME to have insurance that covers ME**, even if I don't want it at all, or want less than what they consider minimum. Other than being about insurance, they are not the same thing at all. But I suspect you knew that.

Technically since you can't be refused medical care, you are being required to pay for insurance for you to cover the hospital.

SVreX wrote:

iadr wrote: FIX YOUR GOVERNMENT! YOU need it (to work properly)!

That's very Utopian, but also very naive. It presupposes that the government CAN be fixed, and that fixing it is in someone's best interest. It also suggests that one person or group can offer a formula to fix it. I've realized something in the last few years that has radically changed how I view government. Government doesn't want to be fixed. Chaos is a candidate's best friend, and BOTH Republicans and Democrats are pursuing the same thing. Chaos, anger, and righteous indignation drive voters to the polls. Peace and contentment do not. It has become the job of the politician to rile up the masses. The more angry and worked up you can get one group of constituents, the better it is at the polls. The only difference between Repubs and Dems is WHO they are good at pissing off. When they fight with each other, they are actually working together, because they both want chaos. So, go ahead. Get pissed at your government. They LIKE it that way, and intend to keep it that way.

Quoted for depressingly real truth.

Datsun1500 wrote: I love the "My employer is screwing me" attitude. If You work for me, and your premiums are $300 a month, of which we can pay $200 to help you out, that's fair. If your premiums jump to $750 a month and I say we can only still pay the $200, then I am the bad guy? That's why the employee contribution has gone up, because the cost has gone up. Put it in car terms. As part of your salary I give you $300 a month as a car allowance and you buy a car for $400 a month for the first 3 years so I am covering 75%. On year 4 you buy a more expensive car for $600 and complain that I am only covering 50%..... seems fair.

My employer said, Insurance is going up and we will no longer subsidize any family member.

So by your explanation We pay $200 to help you out but insurance premiums are going up so now we are only paying $150.

This happens alot, my company was just honest/nice/ballsy enough to tell us the truth. This is the equivalent to coming out and saying. "We want to make 30% more profit so instead of paying you $15 an hour we will now pay everyone $10."

One of the provisions of the ACA is that companies must show how much they are paying to insurance companies. That being said most people don't read them or keep them to compare.

spitfirebill wrote:

Gearheadotaku wrote: All I know is that I could not afford insurance before, and now its even more expensive. However, I get to pay a penalty because I don't have money.

And you think they didnt know that was in there BEFORE they passed the bill?

I'll bet not many did.....wasn't there a rumor floating around of "You'll have to pass it to read it" or something like that?

Flight Service wrote: Technically since you can't be refused medical care, you are being required to pay for insurance for you to cover the hospital.

Exactly. I'm being forced to buy insurance - even insurance I don't want - to cover myself, directly and indirectly, on several different levels. Because it's not about making sure I'm covered. It's about redistribution of wealth.

In reply to Duke:

How is making sure you don't deadbeat a hospital redistribution of wealth?

SVreX wrote: I've realized something in the last few years that has radically changed how I view government. Government doesn't want to be fixed. Chaos is a candidate's best friend, and BOTH Republicans and Democrats are pursuing the same thing.

I independently developed a strikingly similar view over the same period of time…we probably had a common set of observations which led us to the same conclusion.

I think in terms of entropy “second law of thermodynamics” which characterizes the deterioration of systems from a state of order to a state of disorder and is analogues to your chosen term of chaos.

My favorite example of entropy comes from one of Brian Greene’s quantum physics books where he used the 70’s TV show “The Odd Couple” to demonstrate the principle. In the example, Felix Unger’s (the neat freak that represents order) and Oscar Madison’s (the slob that represents disorder) apartment gets robed. The police show up and interview both Felix and Oscar. Felix can immediately provide ample proof that someone has been in their apartment (my socks are always neatly folded and now they’re strewn all over the room) whereas Oscar is incapable of making a determination (sometimes my socks are draped over the lampshade, sometimes they’re wadded up on the floor).

What this thought experiment revels is that change, though not readily apparent, is fundamentally a mechanism to drive entropy / chaos and will reliably have a detrimental effect on organized systems but will have a random effect on disorganized systems (sometimes benefiting, sometimes harming, and ultimately balancing out to be fairly neutral).

I’m squarely in the Felix Unger (highly organized) camp where I diligently consider taxes, investing, career trends, etc. and carefully plan my life out accordingly. As a result, I cringe when I know change is coming because I recognize it for what it is…a thinly veiled redistribution scheme to take from the Felix’s of the world and give to the Oscar’s of the world.

Of course if you get subsidized for ACA, that's taxable income. Not many people know that.

In reply to SVreX, unfortunately you are correct. That's why I cringe every time the government takes control of anything. Nothing good comes from it, and you can be assured you are going to pay more for something. Usually that means they are taking money from you, giving the money to their friends, and telling you it's to help the poor or the children, most of which never get anything but a bureaucracy full of people that do nothing but collect a pay check as well and cause more problems.

Both parties do it, one seems to do it faster, but that's the only difference I see.

In reply to Curmudgeon:

i've been following your posts and i do -not- envy the fight you have on your hands, because i know it will be on 2 fronts; in the room and in the office. best wishes~

I think your particular problem pointed out is also reflective of the inadequate supply of health care workers. people who have no competition among the workforce aren't driven to do better in a meaningful way.

I work in an insurance services job on a non-medical side and I see how complicated certain processes can get. I get frustrated because there are many things that people are ignorant of and shouldnt be so irresponsible, and i see just as many things that nobody should ever be expected to know about but must to get their foot in the door.

Flight Service wrote: In reply to Duke: How is making sure you don't deadbeat a hospital redistribution of wealth?

I think he's pointing out that due to this, risky cases cannot be charged more, so the rest make up for it.

Someone earlier likened it to driving a car, but what the ACA did was basically make the rest of us who behave behind the wheel pay for some idiot that drives recklessly and has caused 5 accidents a year. But instead of refusing coverage to said insurance risk, its now illegal to refuse as well as illegal to charge them more.

The money always comes from somewhere, and that might be seen as a redistribution of wealth in some sort.

racerdave600 wrote: Of course if you get subsidized for ACA, that's taxable income. Not many people know that.

IN witnessing all the tax evasion....

Flight Service wrote: In reply to Duke: How is making sure you don't deadbeat a hospital redistribution of wealth?

Because I'm paying for health insurance (required by ACA) I may not want, and also paying additional insurance to make sure I get medical care I may not want.

In reply to yamaha:

Yes. More clearly put than I was able to get out.

Republicans Hurt By Slowing Costs in Health Care

‘Skyrocketing’ Premiums

Don't consume anyone's opinions without checking the facts first. Whether that's Fox news or MSNBC.

yamaha wrote:

spitfirebill wrote:

Gearheadotaku wrote: All I know is that I could not afford insurance before, and now its even more expensive. However, I get to pay a penalty because I don't have money.

And you think they didnt know that was in there BEFORE they passed the bill?

I'll bet not many did.....wasn't there a rumor floating around of "You'll have to pass it to read it" or something like that?

That's what I was mockingly referring to. But the people that wrote it and those on the inside it knew.

In reply to Xceler8x:

Ok, I'll just ignore what I see with my own eyes and believe what those "news" articles say is happening. They have numbers it must be true

Edit; I don't believe anything that is said or written about this. From any source. Factcheck.org has an agenda too, and facts are not it.

This is what I'm seeing. Every single person that I know, including my family as well as my extended family and coworkers that had health insurance previously have seen significant increases in cost along with worse coverage. All the people I know who didn't have any insurance prior, still have no insurance and that is a much larger number than those that have insurance. I personally don't know of anyone who has benefited in any way whatsoever from the ACA.

Xceler8x wrote: Republicans Hurt By Slowing Costs in Health Care ‘Skyrocketing’ Premiums Don't consume anyone's opinions without checking the facts first. Whether that's Fox news or MSNBC.

Both those articles were written last year, the first one about six weeks before the mid-term election. The results indicate the prediction was less than accurate. Most polls currently show an increasing rate of disapproval for the PPACA and the majority of those who don't like it were NEVER in a minority.

Perhaps those who disapprove of the law are those who are most directly and negatively effected by its' implementation. As the law expands more and more people are facing higher personal costs and receiving less. The law sucks on a level of magnitude that Richter can't measure.

As much as things needed changing, the PPACA wasn't/isn't the way to do it.

Swank Force One wrote:

Curmudgeon wrote:

Swank Force One wrote:

Curmudgeon wrote: Picking on the insurance company again: my new oncologist prescribed a series of shots to bring my white cell count up; it dropped as a result of the chemo. I already described how they were 'closed for training' but I also found out later that they were balking at paying for this treatment. Waitadamnminnit: my doc prescribed the shots as necessary to ensure my survival. So why is the insurance company balking? It's not like it's some nebulous unproven BS, this shot series is a PROVEN treatment for this. The doc can't continue chemo if the white cell count is low. Is BCBS willing to let me die over this?

Federal government things. It sucks.

Explain, please? It astounds me that the federal gov't might be able to interfere with my insurer paying for a proven (meaning it should be FDA approved) treatment.

FDA approved doesn't mean "meets Medicare guidelines," unfortunately. And that's really the case here. Like i explained over on the other board a couple weeks ago, we follow Medicare guidelines for medical necessary. It's not specifically BCBS that's balking at paying this (stupidly), it would be everyone.

along those lines … I had a nuclear stress test this past summer … one of the requirements prior to doing the test was a base line EKG ….

finally, this past month I got a bill from the VA for $15 .. I have a BCBS Medicare Supplement … supposedly pays for "everything" …

after much digging I "found out" that the $15 was for the baseline EKG (I'm not really believing this, as I can't believe that ANY ekg would cost only $15…but that's another story) …

it turns out that BCBS won't pay for it because Medicare says that it's not medically necessary … even though it's a required test prior to the "real" test

whatever .. I can afford $15 .. just think it's bullE36 M3 that it would be considered "not medically necessary" .. since it's required

Flight Service wrote:

Duke wrote:

Flight Service wrote: In reply to Duke: Yes you have to be covered. That is accurate. But you have to have insurance to have a car on the road. I am confused to the difference.

When driving a car, I am required to have insurance that covers **MY LIABILITY TO OTHERS** in case I cause **them** damage or injury. I am not in any way required to have insurance that covers **my** car for damage at all. That is entirely optional and at my own discretion. The ACA, however, **requires ME to have insurance that covers ME**, even if I don't want it at all, or want less than what they consider minimum. Other than being about insurance, they are not the same thing at all. But I suspect you knew that.

actually you do if you've borrowed money from a lending institution to purchase said car … and that's way and gone beyond the liability coverage

wbjones wrote:

Flight Service wrote:

Duke wrote:

Flight Service wrote: In reply to Duke: Yes you have to be covered. That is accurate. But you have to have insurance to have a car on the road. I am confused to the difference.

When driving a car, I am required to have insurance that covers **MY LIABILITY TO OTHERS** in case I cause **them** damage or injury. I am not in any way required to have insurance that covers **my** car for damage at all. That is entirely optional and at my own discretion. The ACA, however, **requires ME to have insurance that covers ME**, even if I don't want it at all, or want less than what they consider minimum. Other than being about insurance, they are not the same thing at all. But I suspect you knew that.

actually you do if you've borrowed money from a lending institution to purchase said car … and that's way and gone beyond the liability coverage

Comprehensive and collision insurance is required by the bank (not the government) to protect the bank's equity in the car. Which is even less relevant to the topic at hand than the previous car insurance example.

You buying insurance isn't redistribution of wealth. That is a stretch by any position.

The fact you keep using the term "redistribution of wealth" tells me enough.

Flight Service wrote: You buying insurance isn't redistribution of wealth. That is a stretch by any position. The fact you keep using the term "redistribution of wealth" tells me enough.

It's redistribution in that you pay a tax on your healthcare insurance so others get theirs for free, sort of. Nicer healthcare plans are now going to be considered income and you will be liable for it on your federal taxes.

Flight Service wrote: You buying insurance isn't redistribution of wealth. That is a stretch by any position. The fact you keep using the term "redistribution of wealth" tells me enough.

You are correct. Me buying insurance is NOT redistribution of wealth. I agree as far as that statement goes - but it does not go anywhere near far enough. And again, I suspect you already knew that, and just chose to include the parts that look nice.

Me being REQUIRED to buy insurance, or being penalized for a decision to NOT buy insurance, so that my premiums and/or penalty can subsidize those who are given insurance for free or radically reduced rates, is redistribution of wealth. And that is not a stretch. No matter how much lipstick you try to put on that pig, or how artfully you try to describe it, it's still a pig.

The fact that they call it the "Individual Shared Responsibility Payment" tells me enough.