Good luck and let us know how it goes. It’s good to know it might be a possibility.
8 Likes
Thanks.
Actually, that’s consistent with my experience. Approximate thinking, in support of a preferred narrative.
5 Likes
Either I am not getting that benefit, or they are billing the insurance $500, telling me to pay $250 until I meet the deductible, wheres as I have been just paying $80 cash.
In a way, that is how my insurance is. I see it like car insurance. I get in a bad accident, I have insurance. I hit a pole on my own or the brakes need replaced, I need to do it.
The reasons for the cost of health care are varied, with no single reason. Personally I think the problem started with making it tied to the employer. So one’s care is going to vary greatly based on where you work. And if you are out of work for an extended period you are fucked.
The ACA was a decent idea, but not well written or executed. Hell most of the people voting on it didn’t read the whole thing. Some of it though was definitely a step in the right direction, such as per-existing conditions. Repealing it would be a mistake. Altering parts that need fixed in incremental steps is probably the best move, but no one in Washington knows WTF they are doing, so good luck with that.
1 Like
This is the thing
You want to make sure that people aren’t denied coverage for pre-existing conditions, so any health plan has to have standardised risk pools.
So in order to keep the risk pools viable, you need to mandate that people have insurance, so that you don’t end up with people waiting until they are sick to buy insurance (pushing rates up, death spiral etc…)
Then in order to make the mandate work, you need to have the exchanges and the subsidies to ensure that even the low waged can afford coverage.
That’s why the Republicans can’t tell us how their replacement for Obamacare is going to work. It’s literally impossible to have a private insurance based system that doesn’t work like this.
Of course, there are other ways to get universal coverage It’s just that they’re all things that the Republicans hate even more than Obama/Romney care.
Medicare / Medicaid expansion
Public option insurance.
Or best of all, single payer healthcare.
16 Likes
That would be for a typical Republican. Right-wing populists don’t limit themselves to income as a criteria for inclusion, so more precisely #nextpresident’s footnote would be:
“* who’s deserving”
7 Likes
I had major surgery about 5 years ago and spent a week in the hospital. The insurance statement said the “cost” of my procedures amounted to over $360,000 while the negotiated in-network rates meant they paid out ‘only’ $90,000 (I still paid thousands in out-of-pocket and co-insurance costs even though I have excellent employer-based insurance).
The problem with this is the billed costs are entirely fabricated and not based on anything other than fantasy coming from the hospital superbill - except if you don’t have insurance at all you’d be forced to pay the ‘walk up rate’.
15 Likes
Well, two things. First, that’s a negotiated price, not “patient list price” that you’d be charged as someone who walked in off the street. Second, there’s a huge “gotcha” there… did you see this line?
Note: Our fee includes the removal and pathology lab fees for an unlimited number of polyps. This is important as usually the colonoscopy fees does not include pathology costs which sometimes exceeds the cost of the procedure.
This is a HUGE factor… often out-of-network or uncovered providers provide services and you don’t find out about it until you get a bill, sometimes months later.
5 Likes
Also the mandate of regular checkups and lab work as no cost covered services across the board was an ACA breakthrough too.
5 Likes
Ugh… this sucks. It should be covered, obviously!
6 Likes
And I wouldn’t call that experience exactly…pleasant either.
3 Likes
Well, I tell you what, let’s see what he actually does instead of says he is going to do.
Because if this jackwagon can actually do any of the stuff he said today I’d be shocked. So, in the same way that I mock someone who believes that we’re going to build a wall and have Mexico pay for it, I’ll mock someone who thinks that he’s actually going to provide healthcare to all with low deductibles.
So before I go through any moral dilemma about supporting any of his policies, let’s see what he actually can do vs. what he says he can do.
11 Likes
I agree - I mean I get not covering expensive things on a whim but with a direct family history of this mutation and associated cancers and an Ashkenazi heritage I’m high risk. You’d think this would be a no brainer but since I’m a guy they are like literally “for now, be more vigilant with looking for lumps.” Gee, thanks.
7 Likes
We were hoping you could explain it to us. 
9 Likes
For sure I haven’t seen any plan from Trump or the GOP worth supporting yet. Or any plan at all, for that matter. (But hey, they’ve only been assuring us that they could give us a great healthcare reform package since shooting down the one the Clintons supported in the early 90s so maybe they just need more time.)
11 Likes
Rest assured it will be the best. 
11 Likes
All of those.
BRCA, and genetic testing in general, is a problem, because it is a predictive test, not diagnostic. Usually insurance companies don’t want to pay for predictive tests, because either you may not be their member any longer when you fall ill, and under the ACA they can’t dump you for having significant risk factors.
As for the lab charges… yes, we have a healthy profit factor based in part on the need to require discounts for insurance and Medicare negotiated rates. Many (most?) states (and all the large insurers) have laws that their rates are based on a factor calculated from the Medicare discount. And the Medicare rates are open for bids. Also, the reagents, equipment, and process are horrendously complicated and are derived from human sources, which can be problematic in the US.
Much of what our lab does here in the EU involves stem cell testing, which is going to work miracles eventually but is illegal in the US if there is federal money involved anywhere.
7 Likes
Dude! They totally just had an announcement about it. It’s already almost a done deal. He just needs to get his guy into HHS and then it’s done.
Like ISIS.
As soon as those Generals hear his plan: DONE. BIGLY GAME OVER.
7 Likes
How good is the Russian healthcare system, anyway?
7 Likes
Double plus bigly.
#room101
6 Likes
When I hear that Trump wants a plan that “covers everybody” I think “is he still campaigning?”
I also think “keep talking Donny, you’re making it that much harder for the GOP by promising things they won’t support, and you can’t enact.”
13 Likes
