
Health Insurance That Doesn’t Cover the Bills Has Flooded the Market - JumpCrisscross
https://www.bloomberg.com/news/features/2019-09-17/under-trump-health-insurance-with-less-coverage-floods-market
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systematical
Recently had an x-ray and an MRI done on my leg. My out of pocket cost was at
least around $600. I'm not exactly sure what my health "insurance" covered.
You never know what your insurance will cover until the bill arrives. What are
my options? I don't have free choice. I have two plans offered by my employer.
Shit and Shitty. Worse, they found nothing wrong with my ligaments. The x-ray
was a waste. I was told to keep a "pain journal" of any specific movements and
positions that cause discomfort.

Tear it down. I rather have the peace of mind that I am just covered no matter
what, even if it means I pay a bit more in taxes. Let me focus on work and
life. Not healthcare.

I do understand the problems this creates for a healthcare system organized
around private insurance. I get this will have a negative impact on the
economy by putting those companies out of work, but I'm deeply unsatisfied
with this system. Even finding a doctor on my plan can be difficult.

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Ididntdothis
The US system really needs to be torn down and rebuilt from scratch. Stories
like this simply shouldn’t happen. There is almost no way as a patient to
ensure your coverage is sufficient besides having a lot of money in case. It’s
insane and hard to understand how anyone can defend this.

With the lack of information the patient has nobody should talk about free
markets. A functioning market requires that all participants have information
available for making a decision.

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wutbrodo
Honestly, a free market might even be better than what we have (though
something like single-payer would be ideal). As usual, we have the weird half-
assed worst of both works policy solution that comes from neither self-
consistent solution being palatable to the electorate.

~~~
Ididntdothis
In my view a free market can only work if participation is optional. When you
have a heart attack you can't really negotiate with the ambulance or the
hospital. There needs to be some kind of regulations to keep costs in check.
But I would advocate total price transparency so you can at least shop around
before non-emergency treatments. Also, insured and uninsured patients need to
be charged the same money.

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kthejoker2
> When you have a heart attack you can't really negotiate with the ambulance
> or the hospital

I mean, in some crazy alternate universe, this is _exactly what insurance is
for._ I pay you a fixed premium ahead of time in exchange for you paying out
the costs when it occurs.

Truly we're in the darkest timeline.

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tempsy
Even the bronze plan (which was always compliant) is terrible, though.

Depending on the state and plan, but it’s around $400/month and $7500
deductible for a single adult, so you’re paying more than $12k out of pocket
before you get anything, except some very basic preventative care.

Our health care system is a joke.

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ryanobjc
Not true. Even the bronze plans cover doctor visits with just copays, no
deductible to be met. Copays count towards deductibles.

Now when you need hospital services, surgery, emergency, yes the deductible is
formidable. After that they cover at some amount, 80% typically.

So the notion you have to pay $12k first is a blatant lie.

The bronze plans are akin to what low end employers used to/still offer. It’s
better than nothing, for example in the scenarios listed in the article, max
out of pocket would be their total liability, probably about $12k as you
noted.

None of this is good, but it’s better than plans literally designed to scam
people. That’s what the “short term healthcare” being proffered is. Scams.

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tempsy
I said “except some very basic preventative care.”

So you’re paying $12k/year for a 30m checkup and potentially still have to
shell out $30 for a copay. Not sure why that doesn’t illustrate my point
exactly.

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Johnny555
Aren't you paying for insurance against the exact same thing that happened to
the couple in the linked article?

You're paying for coverage against a $250K bill for an unexpected health
problem, not coverage for routine care.

I've paid for car and home insurance for over a decade, but have gotten no
paying from either, but that doesn't mean that I haven't gotten value out of
it. I'd still purchase that insurance even if it weren't required.

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tempsy
Well again, you’re illustrating how screwed up American healthcare is. The
reality is that most Americans need varying levels of routine care (vs
insurance against catastrophic events only), and a system where healthcare is
accessible via insurance instead of a system of universal healthcare doesn’t
make sense for something that you need to access routinely.

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Johnny555
No doubt, the American healthcare system is completely screwed up, I'm just
pointing out that catastrophic healthcare insurance is not worthless. Unless
you are completely destitute and have no assets that you can lose to pay off
catastrophic medical bills, it may very well be worth the high cost.

(assuming that it actually pays, unlike the insurance in the linked article)

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sambull
Guaranteed strategy for a progressive wave 2020 and a democratic president.
Expect massive executive action to address climate change and end corruption.
There's nothing more evident than the greed of the insurance companies, it
cuts bipartisan. Finally the hope of adults in the reigns again

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rayiner
I'm a proponent of universal healthcare, but pointing to "insurance industry
greed" is a dishonest narrative. Health insurers are having a banner year, and
that means their profit margins are approaching 6%. (By contrast, Facebook is
regularly over 40%.) For the year ending Q3 2018, health insurer profits
amounted to $25 billion, _industry wide_ , which is about the same as Google
alone makes in a year.

If running a business that makes 6% profit margins is "greedy" then the word
literally means nothing. The only reason health insurer profits are even part
of the discussion is because Democrats reflexively lean to anti-corporatism to
explain any societal problem. But it's like republicans blaming everything on
the decline of two-parent households. It's rah-rah narrative that has no basis
in reality.

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chillwaves
People are dying over healthcare, not over facebook.

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rayiner
Does the fact that people might die create an obligation to run your business
like a charity?

What even is your moral theory? That a company that makes 6% profits saving
lives is evil, but a company that makes 40% profits _and doesn 't save any
lives in the process_ is not evil? Apple makes laptops that, for the price of
a single one, could save someone in Africa from malaria. The opportunity cost
of every MacBook Pro is a death in Africa. If there is an affirmative
obligation to save lives, how evil is Apple?

This is an incoherent--but extremely common--ideology. It would be one thing
if these people followed their ideas to the logical conclusion. It's evil for
_anyone_ to make more than 6% profits because that money could be spent saving
lives. But it makes no sense to impose that moral obligation on a selected
group.

~~~
chillwaves
My "moral theory" is you can't claim market rates to a hostage.

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no_opinions
In European countries I visited, primarily Scandinavian ones, they take such
pride in their social system.

If some European countries is any example, publicly run healthcare can
incentivize innovation in private health insurances.

Apparently EU citizens (and visa holders?) get a healthcare card that's
portable across EU. Is this true?

Any Europeans healthcare users have opinions on the healthcare system there?
Any wisdom to impart?

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Ididntdothis
"Apparently EU citizens (and visa holders?) get a healthcare card that's
portable across EU. Is this true? "

I don't think so. The systems are very different. But if you get sick in
another country they won't rip you off like they doing in the US. My sister
from Germany was charged $1200 when her daughter had a fever in NYC. She
talked to a doctor for 5 minutes and got an antibiotic.

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downrightmike
Fevers shouldn't get antibiotics...

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effingwewt
Not exactly. Many infections can cause quite dangerous fevers, and infections
are treated with antibiotics.

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ada1981
How do folks feel about outfits like Liberty Health Share?

They are positioned as an alternative non-profit shared health cost
collective.

I have some friends who swear by it.

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elliekelly
I just DDG’d this because it sounds like a great idea but I wouldn’t sign
those “five core statements of belief, freedom, and ethics” even if it meant
I’d get free healthcare. One thing I know for certain: our health insurance
system needs _less_ religious involvement if we want to fix it, not more.

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ada1981
I don’t know if the religious affiliation impacts anything about the quality
of coverage, does it?

But I get not wanting to sign something you don’t endorse or believe in.

If this model is successful for religious folks, it seems an alternative could
be made for hackers or any other group.

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elliekelly
Well historically religious organizations have resisted providing adequate
coverage for women’s health. So yes, religious affiliation often does impact
the quality of coverage.

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ada1981
Fair enough. I’m curious to see — one of my friends is big into women’s health
and she recommended it.

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Animats
Well, that was the Republican plan. They were up front about it. Trump voters
can't complain.

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Simulacra
What I know is that before ACA, my health insurance was about $150 a month.
Now it’s $650 a month. I can’t afford to subsidize other people’s bad choices
and inability to pay. Health insurance should not be robbing Peter to pay
Paul, we should return to an open market place.

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knz
Is the ACA responsible for the rise? Personally, my health insurance rates
(for a family plan offered through my employer of ~1,000 people) were
increasing by 5-10% per year before the ACA and have been more stable since
(3-5% increases per year).

Its currently at a total of $22,000/year (between employer and employee
contributions) - that's equivalent to $35,000 dollars in my country of birth
(New Zealand), or 700% of what the _total_ tax on the median income is.
Somehow, kiwis get all of the functions of government for 14% of what health
_insurance_ costs in America. It's insane and reminds me every enrolment
season of how poor the ROI on healthcare dollars is in the US.

