Never heard an E-1 through O-6 (didn’t talk to many O-7/10’s in my career) complain about their medical care, bills or access in over two decades. Must be the evil messaging of that socialism stuff we punish our brave servicemembers with.
Oh, never mind, half of the country would loose their mind over having to be vaccinated and do push ups to qualify.
Through the years we’ve off and on had decent insurance through the National Association of the Self Employed (NASE). That really started going away when the ACA became law. When we started in about 2000 our family premium was $600/month. Seemed like so much back then. But we could afford it. We planned our budget with that in mind. Now fast forward towards the 2020’s you could no longer buy into the “group” policy that we had. So, I had a fear of dropping it. Each year our premiums went up, then up and up some more. It got to the point where our family premium was $2400/month. Yeah. We don’t make that much in our small business. We had several really bad years financially – but we believe in being covered.
Then the other half got a “regular” W-2 job with benefits. The thing I was most excited about was health insurance. Employee portion was now a drop in the bucket. Ahh…some breathing room. So nice. Now we could also contribute some to retirement.
When I look at ACA plans now, the cheapest tier which gives us way less that what we’re accustomed to having is $30k+/year.;
It is so hard to discuss health care insurance because there are so many different groups of people who benefit from any change and so many different groups of people who are hurt by any change.
Rarely are both groups represented in any discussion.
One year after Massachusetts added many new mandates for coverage to all of the plans in the state (excluding big employer plans that were governed by ERISA), my premium went up 20%.
A public radio program had as a guest a state official who lauded the new coverages. I was one of the listeners who called in who was chosen to be on the air. I asked the official whether it was fair that I had to pay a 20% increase in my premium to fund those coverages which I would never need.
The guest tried every form of evasion he could think of, from denying there was any cost to me for these coverages to denying the amount of the increase, to it is only fair that these coverages were added since other conditions were covered.
The host moved on to the next caller.
The ACA effectively started the process over again based on the vision of an academic, and has repeated the process with one difference, there are some income based subsidies.
I’ve been on Medicare a long time. I actually read the mail I get from Medicare and my Medigap insurance provider. I have a Medigap plan because some of my doctors are out of state and Medicare Advantage plans have limited networks of only in state doctors. The amount Medicare limits provider payments to is insanely low compared to the amount they bill. So low that I really wonder how any of the providers make payroll.
The amounts they pay make little sense to me. For example, they pay $5.00 for an x-ray. That requires a capital investment which is relatively high, and a trained tech to take the x-ray. On the other hand, they paid $25 for a photo taken on a smartphone by a medical assistant.
My 2020 medical bills including a cardiac bypass exceeded half a million dollars. I paid about $3k. Medicare and my insurer paid less than $100k to the providers. It is quite evident the profits come from soaking the uninsured, private insurers and anyone else who is not the government.
I do not know who the good guys are or who the bad guys are. But I know and acknowledge that.
Isn’t this the entire premise of health insurance? All insurance? That a large group of people who don’t need it pay in to cover the expenses of fewer people who do, plus a healthy profit margin for the insurance company? I’m not arguing that it’s good or fair or optimally efficient, but it’s the underlying core of the business model. If you want people with kidney conditions to pay enough to cover your heart condition, you need to make sure everyone, including you, is paying enough to cover their kidney treaments. Plus a healthy profit margin for the insurance company, of course.
Sounds like you got a direct answer.
Legacy services and treatments such as x-rays have been “settled” by decades of negotiations. X-rays are also a staple of medical diagnostics. Those numbers start to take on their own momentum. Also, some things like x-rays haven’t changed much in a while. Newer, less used (or those determined to be ‘less critical’), or evolving services often have higher and more variable prices.
Also, some of them just don’t make sense.
Yes it is, but that does not necessarily mean that there should not be limits on coverages to keep the cost to the entire insured community within affordability limits.
An example of covered non-drug expenses in Massachusetts at that time was food for children suffering from Phenylketonuria (PKU) This coverage was controversial and was added as a result of a campaign by families of the affected.
Other coverages were not traditionally covered by insurance.
I am not taking a stand on any of the individual coverages. But the ACA coverage of pre-existing conditions an expensive example of the same logic. Many states chose to deal with such problems differently, with assigned risk pools which did not raise the premiums of all of the insured.
Similarly, the ACA required all policies to cover pregnancy and childbirth, even if it was an individual policy for a male.
The ACA made insurance more expensive for many who were previously insured, and often it was because it intended to spread the cost from people who were not willing or able to pay for their coverage to those who were already footing their own bills.
It also effectively outlawed Catastrophic Health Care insurance polices which keep many people from bankruptcy when disaster struck them, by forcing them to insure for medical bills they could pay for out of pocket.
Once again, our government decided to choose winners and losers. It does that a lot.
And the winners and losers need not be of different economic status.
I’m sure that you’re old enough to be aware that in the case of pregnancy, a male is involved. Why should they not share the cost?
Yes, in many cases it shifted the cost to being attributed to health care. I recall one time that I went to the ER for an allergic reaction. While there, a woman came in with an asthma attack. I heard enough from conversations to learn that she came in 3-4 times/month for help; she could not afford insurance, and could not pay the ER costs; so her ER bills were covered by the taxpayer. Payments for ER doctors, nurses, and support staff, not to mention taking up their time and a bed. But since she was not insured, taxpayer money would not pay for the inhaler that she could carry with her that would resolve her problems; $50/month instead of several thousand. The policy was that people were on their own until they were in serious condition; only then would there be help.
Insurance companies long ago figured out that prevention was more cost effective than treatment after the fact. Helping people to afford care actually saves money for all in the long run.
Unless of course you are one of those people who feels that poor people deserve to die if they get sick, rather than having the government help them out.
Again, this varied greatly by state. Those states that refused to participate with a policy put in place by a black president of the wrong party (even though the framework was designed by the “right” party) saw few if any advantages; those states that cared about their citizens often saw better results. Of course, it also depended on what policies the states had in place previously.
Odd. My ACA bills were far less than just one or two simple visits for illnesses; not even “catastrophic” care.
Yep. The winners are the responsible type, who make sure that they are prepared. The losers are the type who figured that they would pay nothing if they could get away with it; then depend on others (whom they didn’t want to support) if something went wrong.
Very true. There are those who honestly cannot afford to pay for the basics, and then there are those who can easily afford them but resent any attempt to be told to actually pay for them.
Most resistance by the states was to the Medicaid expansion, not the rules governing ACA which were set by that Black President’s advisors. Ezekiel Emmanuel had more impact on the program than any state.
Catastrophic health insurance gets the one-time hospital bill paid, but most people go into debt because of the cost of medications, lab/imaging tests, and doctor visits that are not covered by catastrophic health insurance.
There should be things that are free to everyone for the greater good. Health care should be a shared expense. The you-don’t-want-to-pay-unless-you-need-it model results in no insurance for anyone at all, because you’re effectively paying for your own expenses. Most people don’t think they need it until they need it - cancer strikes or something. It’s very selfish to just want those who are sick to die because they can’t take care of themselves. I find the survival of the fittest believers tend to think they are on the fittest end of the stick. We don’t stay on that side forever.
Because our family has insurance through an employer, these out-of-pocket costs count toward our deductible. And once that dollar amount is met, a lot more of it then becomes covered.
Without that, we would be like so many US families: in medical debt, without end or relief. Which is ridiculous.