sassyangel
Drama Llama
Posts: 7,456
Jun 26, 2014 23:58:32 GMT
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Post by sassyangel on Aug 5, 2019 14:20:59 GMT
The damn insurance companies and drug companies have to be regulated! I cant speak for pharmaceutical companies, but health insurance companies most certainly are heavily regulated at both state and federal level. I spend my days up to my elbows in both. The gap between coverages often falls where some states have far better protections for their residents than others. Personally, I feel healthcare being for profit overall is one aspect where it all falls down - and that’s not just insurance companies, that includes hospitals and providers too getting their profit cuts, not the amount of regulation they’re all subject to overall.
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sassyangel
Drama Llama
Posts: 7,456
Jun 26, 2014 23:58:32 GMT
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Post by sassyangel on Aug 5, 2019 14:24:28 GMT
You might not mind paying a little more in taxes if you know you're not going to have to pay tens of thousands in premiums plus a high deductible. This is what I aways think when these discussions come up. People say they don't want to pay higher taxes but they're apparently happy to get into massive debt or go bankrupt if they break their leg or suffer kidney failure or some such. I don't get it. P.S. The UK standard tax rate is 20%, 40% for higher earners. I’ve have the experience of having lived and worked within two countries - one with single payer and one without. I’ll tell you what, I’ve done the maths, and with what we pay in premiums and out of pocket, I came out ahead take home pay wise in the single payer system. Easily. Now granted that’s only for my personal middle class experience. My sister has a medically fragile child, and I thank God she doesn’t live here with him.
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Post by freecharlie on Aug 5, 2019 14:26:51 GMT
You might not mind paying a little more in taxes if you know you're not going to have to pay tens of thousands in premiums plus a high deductible. This is what I aways think when these discussions come up. People say they don't want to pay higher taxes but they're apparently happy to get into massive debt or go bankrupt if they break their leg or suffer kidney failure or some such. I don't get it. P.S. The UK standard tax rate is 20%, 40% for higher earners. some people's insurance is cheaper than what they will be taxed
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sassyangel
Drama Llama
Posts: 7,456
Jun 26, 2014 23:58:32 GMT
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Post by sassyangel on Aug 5, 2019 14:31:36 GMT
This is what I aways think when these discussions come up. People say they don't want to pay higher taxes but they're apparently happy to get into massive debt or go bankrupt if they break their leg or suffer kidney failure or some such. I don't get it. P.S. The UK standard tax rate is 20%, 40% for higher earners. some people's insurance is cheaper than what they will be taxed You mean their share of it? I know the insurance premiums for various plans and products for my company, and almost all of them (except the bare bones HDHP) are fairly substantial per month, especially family. Most are heavily employer subsidized though, so most people never see the full actual cost of them.
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Post by gar on Aug 5, 2019 15:05:55 GMT
This is what I aways think when these discussions come up. People say they don't want to pay higher taxes but they're apparently happy to get into massive debt or go bankrupt if they break their leg or suffer kidney failure or some such. I don't get it. P.S. The UK standard tax rate is 20%, 40% for higher earners. some people's insurance is cheaper than what they will be taxed But isn’t it the case many times that insurance doesn’t stump up, too many things aren’t covered or only partially or that after a claim the insurance goes through the roof?
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Post by Darcy Collins on Aug 5, 2019 15:11:22 GMT
Keep in mind that the real issue is underlying cost and that's the ugly underbelly that NO ONE wants to talk about. How do other countries do it - they spend less on health care per person - on average half as much. How do they do that? Their medical providers are paid half to a third of what they would make in the US. The US absorbs something like 90% of all pharmaceutical R&D - and pay through the nose for our prescription drugs. Who wants to bet on the success of the politician who says nurses should anticipate a 30% drop in income - techs will see a 50% drop, doctors will make 1/3 or less. Oh and don't worry that we're going to suddenly reduce total GDP spending by 10% Can you imagine the economic impact. Healthcare is 20% of our total GDP. The ramification to our economy would be HUGE - for reference the economic crisis only dropped GDP by about 4%
That's a political hand grenade that absolutely NO ONE is going to to deal with - so what will they do instead? Pretend that they can expand coverage to all at existing rates and it won't bankrupt the country. It's not possible. I've said for years, if you think that it's easy to implement another countries system in the US - go for it. Take the total federal spending on healthcare and cover everyone. We spend more TODAY on the federal level than every other country - just for Medicare, Medicaid and the VA. Take those dollars and now spend them on 100% of the population. No need to raise any taxes at all - the money is right there in the budget today. But you don't hear a single person suggesting that do you?
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Post by Darcy Collins on Aug 5, 2019 15:15:57 GMT
some people's insurance is cheaper than what they will be taxed But isn’t it the case many times that insurance doesn’t stump up, too many things aren’t covered or only partially or that after a claim the insurance goes through the roof? That's not the way employer based insurance works - which is what more than 50% of Americans have. Your rates don't change at all based on any claim. Premiums go up as the overall cost of health care goes up. I've never had an issue with a claims being denied, and most people don't. Overall satisfactions rates for employer based insurance are high. ETA I went to look at satisfaction rates to give a quantitative number - latest survey I could find was a 71% satisfaction rate (https://healthpayerintelligence.com/news/71-of-workers-satisfied-with-employer-sponsored-health-plans) which compares pretty well with the latest survey of NHS of 57% (https://www.kingsfund.org.uk/publications/public-satisfaction-nhs-2017) for way of comparison. As I'm sure you can imagine the uproar of suggesting abandoning NHS for a totally different system - that's how many people in employer plans feel about them going away.
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Post by freecharlie on Aug 5, 2019 15:27:44 GMT
some people's insurance is cheaper than what they will be taxed You mean their share of it? I know the insurance premiums for various plans and products for my company, and almost all of them (except the bare bones HDHP) are fairly substantial per month, especially family. Most are heavily employer subsidized though, so most people never see the full actual cost of them. But isn’t it the case many times that insurance doesn’t stump up, too many things aren’t covered or only partially or that after a claim the insurance goes through the roof? I'm sure it depends on the employer and then plan. We pay approximately $300 per month for our family of 4. Each member has a $250 deductible up to a family maximum of $750. After that everything is covered 100%. In addition we have $30 co pays for office visits, $40 for specialist, and $150 for ER unless we are admitted and then it falls under the deductible. Also diabetes supplies are covered 100%. Medications are $60 per 90 day supply for brand names and less for the cheaper meds. Specialty medications are $100 per 90 day supply. Maximum out of pocket for the family is either $8000 or $15000 depending on the plan. I know we are fortunate to have the insurance and the healthcare we have.
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sassyangel
Drama Llama
Posts: 7,456
Jun 26, 2014 23:58:32 GMT
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Post by sassyangel on Aug 5, 2019 17:17:42 GMT
You mean their share of it? I know the insurance premiums for various plans and products for my company, and almost all of them (except the bare bones HDHP) are fairly substantial per month, especially family. Most are heavily employer subsidized though, so most people never see the full actual cost of them. But isn’t it the case many times that insurance doesn’t stump up, too many things aren’t covered or only partially or that after a claim the insurance goes through the roof? I'm sure it depends on the employer and then plan. We pay approximately $300 per month for our family of 4. Each member has a $250 deductible up to a family maximum of $750. After that everything is covered 100%. In addition we have $30 co pays for office visits, $40 for specialist, and $150 for ER unless we are admitted and then it falls under the deductible. Also diabetes supplies are covered 100%. Medications are $60 per 90 day supply for brand names and less for the cheaper meds. Specialty medications are $100 per 90 day supply. Maximum out of pocket for the family is either $8000 or $15000 depending on the plan. I know we are fortunate to have the insurance and the healthcare we have. You are. I can’t even tell you how rare a $250/$750 deductible is these days. While I can’t speak for other insurers, I can tell you, those kind of fully insured (self insureds are calculated differently) non-HDHP plans with low deductibles and copays and excellent coverage run $2200 to $2800 a month for families, depending on all benefits offered. It was eye opening to me when I started working there, just how expensive they were and how much direct responsibility, my employer shielded me from. I wondered how on earth people who had no employer coverage managed, and it didn’t shock me in the least so many went without.
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Post by revirdsuba99 on Aug 5, 2019 17:27:56 GMT
Wait, are you saying that no one else should have access to health care until you get yours? Thinking that is not what she is saying. I think it is leave those of us WITH ins now stay where we are and work on new ins, whatever it turns out to be before we go there! In other words, help those who need it now, we are covered.
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Post by revirdsuba99 on Aug 5, 2019 17:34:30 GMT
Before we we start talking about giving out more free stuff maybe Cummings and his oversight committee should start looking into the waste, fraud and abuse that's already occurring in the federal government. No problem with that!
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Post by iamkristinl16 on Aug 5, 2019 17:39:26 GMT
Wait, are you saying that no one else should have access to health care until you get yours? Thinking that is not what she is saying. I think it is leave those of us WITH ins now stay where we are and work on new ins, whatever it turns out to be before we go there! In other words, help those who need it now, we are covered. I took it to mean that she has coverage but is struggling to get appointments and approvals, so don't add more people onto insurance because then she and her children who require a lot of medical care will have even less access to care than they do now. She wants to make sure her family is taken care of before extending benefits to others.
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Post by iamkristinl16 on Aug 5, 2019 17:43:04 GMT
But isn’t it the case many times that insurance doesn’t stump up, too many things aren’t covered or only partially or that after a claim the insurance goes through the roof? That's not the way employer based insurance works - which is what more than 50% of Americans have. Your rates don't change at all based on any claim. Premiums go up as the overall cost of health care goes up. I've never had an issue with a claims being denied, and most people don't. Overall satisfactions rates for employer based insurance are high. ETA I went to look at satisfaction rates to give a quantitative number - latest survey I could find was a 71% satisfaction rate (https://healthpayerintelligence.com/news/71-of-workers-satisfied-with-employer-sponsored-health-plans) which compares pretty well with the latest survey of NHS of 57% (https://www.kingsfund.org.uk/publications/public-satisfaction-nhs-2017) for way of comparison. As I'm sure you can imagine the uproar of suggesting abandoning NHS for a totally different system - that's how many people in employer plans feel about them going away. Your individual rates don't go up after a claim in the way that car insurance goes up after an accident. However, the insurance claims for your group can go up based on the type of claims that the group had the previous year. When we had our annual insurance sign up meeting last year, the reps said that the premiums for the agency were going up because two people had knee replacements the previous year. So, if you have an employee who has a lot of medical care (or their family members do), they are costing the employer money as well as the rest of the employees.
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Post by freecharlie on Aug 5, 2019 23:59:27 GMT
That's not the way employer based insurance works - which is what more than 50% of Americans have. Your rates don't change at all based on any claim. Premiums go up as the overall cost of health care goes up. I've never had an issue with a claims being denied, and most people don't. Overall satisfactions rates for employer based insurance are high. ETA I went to look at satisfaction rates to give a quantitative number - latest survey I could find was a 71% satisfaction rate (https://healthpayerintelligence.com/news/71-of-workers-satisfied-with-employer-sponsored-health-plans) which compares pretty well with the latest survey of NHS of 57% (https://www.kingsfund.org.uk/publications/public-satisfaction-nhs-2017) for way of comparison. As I'm sure you can imagine the uproar of suggesting abandoning NHS for a totally different system - that's how many people in employer plans feel about them going away. Your individual rates don't go up after a claim in the way that car insurance goes up after an accident. However, the insurance claims for your group can go up based on the type of claims that the group had the previous year. When we had our annual insurance sign up meeting last year, the reps said that the premiums for the agency were going up because two people had knee replacements the previous year. So, if you have an employee who has a lot of medical care (or their family members do), they are costing the employer money as well as the rest of the employees. Wow, I hope everybody didn't blame those two people. My district tells us if it is going up and how much more we used, but never points out procedures so we all know who cost the most.
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Post by iamkristinl16 on Aug 6, 2019 0:52:04 GMT
Your individual rates don't go up after a claim in the way that car insurance goes up after an accident. However, the insurance claims for your group can go up based on the type of claims that the group had the previous year. When we had our annual insurance sign up meeting last year, the reps said that the premiums for the agency were going up because two people had knee replacements the previous year. So, if you have an employee who has a lot of medical care (or their family members do), they are costing the employer money as well as the rest of the employees. Wow, I hope everybody didn't blame those two people. My district tells us if it is going up and how much more we used, but never points out procedures so we all know who cost the most. Yeah, I thought it was a little TMI as well.
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