Anyone Else Worried About Health Premiums Going UP?

[dansamy]

What are these costs? These wholesale costs? I am Canadian, and my dd fell and hit her head in Disney 5 years ago, and our emergency room visit for 3 staples was $1700.00. This was for the hospital and the doctor. I just about fell off my chair! Thank goodness I had travel insurance. To compare, an ER visit here, with a similar injury would have cost a non-citizen around $400.00. How can health care be that more money in the US? I looked for figures on delivery, but the most recent I could find was from 2002-03. A non-complicated ******l birth could cost a non-citizen ( no free health care) $2700.00. Doctor and hospital. Even assuming that the price has gone up by 50% in 10 years, it would still only be $4000.00. How much would that birth cost me in the us? I bet more than that, even at "wholesale" costs. Why? Why is it so expensive?

That $1700 bill was not a wholesale cost. There's profit margin in that. When I am referring to the wholesale cost of providing a service, I'm referring to what it costs the hospital to provide the service: supplies, staff, etc. That's the cost that the hospital pays to provide the service. What they bill to an insurer, patient or even Medicaid is more than that. Medicaid pays about a third of the billed amount, which is about half of the hospital's actual expenses in providing the service. Now, many insurers are reducing their reimbursement to match Medicaid/Medicare. It's unsustainable for facilities to continue to provide care & only be reimbursed for half of what they spent to provide the services. One hospital in my area closed last fall. A large system in another state is laying off hundreds. Another system is cutting housekeeping services & asking the RNs to pick up additional housekeeping duties. I'm not snooty. I'll take out trash. Wipe down beds. But if I'm spending my time doing housekeeping, who's doing the nursing? Who's at the bedside with your post-op hip replacement grandmother? Or after your daughter just had her baby? I only have a certain amount of time in a day. Multiple research studies have shown that patient outcomes are better and safer if their nurse is not overloaded with too many patients or too many extraneous duties. If a nurse has an appropriate load, she can focus on high quality care & patients benefit from it.

 

[lauradis]

Thank you, someone finally gets it!!!

Your Welcome that was us 20 years ago. Made to much for government freebies, but not enough to be taxed to death.

Kid fell down stairs broke her arm I didn't run her to er I called the orth specialist

cost me 6 months of pt night job to fix it, if the kids got sick they went to free health clinic, where we paid 20 bucks, shots and well clinics where from health dept.

Thank god no one got serious ill in 6 years we didn't have insurance.

We really don't need normal go to the dr sick insurance what we need is more like before hmo and ppo, a major medical accidental and screening health ins.

 

[racefanof88]

That's a fourth of the price you said her employer was trying to charge, so sounds like a pretty good deal to me. Again I get that is expensive but it's cheaper than getting sick. And she doesn't have to buy anything, she's low enough income that no one's gonna charge for a penalty for not having insurance. So how is she worse off ?

Your response is almost cavalier-- "That's a fourth of the price you said her employer was trying to charge, so sounds like a pretty good deal to me"--- So, your saying she should just break the law? The IRS doesn't care how low her income is, they will look at her tax return; she is just a number to them, and take the fine out of her return. Her income tax return is money she counts on. You obviously have no idea how hard it is for a single mother. Her dead beat husband walked out and left her and the kids; she hasn't seen a dime from him in several years.

Her kids qualified for Medicaid BEFORE Obamacare and she just went without insurance.

Everyone isn't as blessed as those of us who get to go to Disney for vacation. She never even takes vacation, she takes the pay and works on.

 

[pryncess527]

Your response is almost cavalier-- "That's a fourth of the price you said her employer was trying to charge, so sounds like a pretty good deal to me"--- So, your saying she should just break the law? The IRS doesn't care how low her income is, they will look at her tax return; she is just a number to them, and take the fine out of her return. Her income tax return is money she counts on. You obviously have no idea how hard it is for a single mother. n.

No, I am saying she will not be assessed a penalty because the penalty only applies to people who can afford insurance and do not buy. Based on the circumstances you have described she will not face a penalty. she will not be breaking the law. I do understand how hard it is for a single mother. You don't understand to understand the ACA

 

[lauradis]

What I see happening is if the tax penalty is cheaper lots of people will choose this and their returns will be less and the government will keep the extra for different special projects.

Its the oldest shell game out there, stop think, read the government rules don't listen to the talking heads they hardly report real news any more.

I give Obama credit for trying something new, (I don't like what I see so far)

Reality is you will always have people that can't afford to go to doctors unless we have national insurance "free" to all. homeless to congress. Call me jaded if you like but people that have more green will get better care.

 

[averysmom]

That $1700 bill was not a wholesale cost. There's profit margin in that. When I am referring to the wholesale cost of providing a service, I'm referring to what it costs the hospital to provide the service: supplies, staff, etc. That's the cost that the hospital pays to provide the service. What they bill to an insurer, patient or even Medicaid is more than that. Medicaid pays about a third of the billed amount, which is about half of the hospital's actual expenses in providing the service. Now, many insurers are reducing their reimbursement to match Medicaid/Medicare. It's unsustainable for facilities to continue to provide care & only be reimbursed for half of what they spent to provide the services. One hospital in my area closed last fall. A large system in another state is laying off hundreds. Another system is cutting housekeeping services & asking the RNs to pick up additional housekeeping duties. I'm not snooty. I'll take out trash. Wipe down beds. But if I'm spending my time doing housekeeping, who's doing the nursing? Who's at the bedside with your post-op hip replacement grandmother? Or after your daughter just had her baby? I only have a certain amount of time in a day. Multiple research studies have shown that patient outcomes are better and safer if their nurse is not overloaded with too many patients or too many extraneous duties. If a nurse has an appropriate load, she can focus on high quality care & patients benefit from it.

No, I get that there is profit in the 1700.00... But if you are saying that the actual expenses for those 3 staples are 850, why is it that it is still twice as much as it would cost in Canada? And I am using prices that are non-citizen prices, so there is no subsidy or "free healthcare" Involved. These are the actual costs- and that includes the "profit". As an outsider looking in, I think the root of the problem is that the healthcare itself costs too much- it is unsustainable. Insurance is so expensive b/c the costs of healthcare are too expensive.

 

[racefanof88]

What are these costs? These wholesale costs? I am Canadian, and my dd fell and hit her head in Disney 5 years ago, and our emergency room visit for 3 staples was $1700.00. This was for the hospital and the doctor. I just about fell off my chair! Thank goodness I had travel insurance. To compare, an ER visit here, with a similar injury would have cost a non-citizen around $400.00. How can health care be that more money in the US? I looked for figures on delivery, but the most recent I could find was from 2002-03. A non-complicated ******l birth could cost a non-citizen ( no free health care) $2700.00. Doctor and hospital. Even assuming that the price has gone up by 50% in 10 years, it would still only be $4000.00. How much would that birth cost me in the us? I bet more than that, even at "wholesale" costs. Why? Why is it so expensive?

One thing that should have been addressed in the whole ACA is tort reform. The high cost of healthcare in the USA is somewhat driven by the irrational, unwarranted medical malpractice lawsuits. Now, don't get me wrong there are times that something that should never have happened, does happen. It is sad and often could have been avoided, but the lawsuits that some bring are so ridiculous it should be illegal. The cost of medical malpractice in the United States is ~$55.6 billion a year, which is 2.4 percent of annual health-care spending.

Not sure how malpractice lawsuits work in Canada, but I bet it isn't along the lines we see here!!! Every other commercial on TV is a lawyer hawking for someone to sue a pharmaceutical company, nursing home, durable medical equipment company...etc.

 

[racefanof88]

No, I am saying she will not be assessed a penalty because the penalty only applies to people who can afford insurance and do not buy. Based on the circumstances you have described she will not face a penalty. she will not be breaking the law. I do understand how hard it is for a single mother. You don't understand to understand the ACA

If you will show me where it says she won't face a fine I will concede that point.

 

[racefanof88]

Reality is you will always have people that can't afford to go to doctors unless we have national insurance "free" to all. homeless to congress. Call me jaded if you like but people that have more green will get better care.

There have always been, and always will be, those who have and those who do not!!!

Even in a country with socialized medicine, the rich get better care/treatment because they can afford it!! Does anyone really think Catherine, Duchess of Cambridge received the same care as Mary the maid?

 

[lauradis]

There have always been, and always will be, those who have and those who do not!!!

Even in a country with socialized medicine, the rich get better care/treatment because they can afford it!! Does anyone really think Catherine, Duchess of Cambridge received the same care as Mary the maid?

No that's my point, im not really sure this will provide healthcare for all. I'm sure that my coverage (that we have work hard to get) will go down way down. and My taxes and insurance cost is going to go way up over ACA.

 

[dansamy]

I'm seriously considering taking up travel nursing, which would allow me to minimize my taxable income. Then, my family could benefit from the subsidies that Judy keeps touting.

 

[manning]

One thing that should have been addressed in the whole ACA is tort reform. The high cost of healthcare in the USA is somewhat driven by the irrational, unwarranted medical malpractice lawsuits. Now, don't get me wrong there are times that something that should never have happened, does happen. It is sad and often could have been avoided, but the lawsuits that some bring are so ridiculous it should be illegal. The cost of medical malpractice in the United States is ~$55.6 billion a year, which is 2.4 percent of annual health-care spending.

Not sure how malpractice lawsuits work in Canada, but I bet it isn't along the lines we see here!!! Every other commercial on TV is a lawyer hawking for someone to sue a pharmaceutical company, nursing home, durable medical equipment company...etc.

Care to take a guess why tort reform was not addressed? Start with counting the number of lawyers in congress.

 

[crisi]

There have always been, and always will be, those who have and those who do not!!!

Even in a country with socialized medicine, the rich get better care/treatment because they can afford it!! Does anyone really think Catherine, Duchess of Cambridge received the same care as Mary the maid?

Yep, if we did UHC the most likely scenario would be offering supplemental insurance. Some doctors might see you faster if you had supplemental insurance - some might only work for people who had it. You might get a private room where a hospital might share rooms for people who didn't have it. Some procedures might be covered with supplemental insurance where they wouldn't be under UHC - you might get to use brand name instead of generic drugs.

But everyone - rich or poor, homeless of having seven of them, would be covered. You might not get to have your cancer treated at Mayo, but when you discover the lump in your breast, you wouldn't have to wait until it fell off to seek treatment. http://www.atlantamagazine.com/features/2012/02/01/dr-otis-brawley

(by the way, don't do an image search looking for more information about that one....just don't).

 

[Colleen27]

I hate to argue, but a deductible is NOT a max out of pocket, it is just want it says a deductible. The max out of pocket for the plan I was quoted was $12,700, so that would mean AFTER I met my $6000 deductible the most I would be out of pocket would be an additional $6700. That $6000 would have to be paid before the insurance paid the first dime!!

The estimator tool isn't quoting deductibles, though. It is only quoting max OOP costs - how a family reaches that cap (deductibles, copays, etc) will vary from plan to plan. And I know all about high deductibles. Since 2006, when my husband first started his business, we've paid over 50K for insurance that has never covered a single thing for us because we've never met our deductible, and probably another 15K in actual medical care.

 

[crisi]

The estimator tool isn't quoting deductibles, though. It is only quoting max OOP costs - how a family reaches that cap (deductibles, copays, etc) will vary from plan to plan. And I know all about high deductibles. Since 2006, when my husband first started his business, we've paid over 50K for insurance that has never covered a single thing for us because we've never met our deductible, and probably another 15K in actual medical care.

And, God Forbid, if you get really ill....

We thought my brother in law was going to max out his lifetime maximum when he was dying of cancer - fortunately , he passed away about $300,000 short. The maximum was $3M. And he was only ill for two years.

Which wouldn't have been horrible - he had few assets so he would have moved to Medicaid. But it would have been a hassle. If it happened to us, we'd have gone bankrupt.

 

[Vickmeys]

. . . McCain said yesterday, it's the law of the land, work with it & wait & see how it all works.

Then why is McCain EXEMPT from the law of the land? Does make me wonder, doesn't it you? If Obamacare is so fantastic, why is the President and Congress EXEMPT from this wonderful piece of legislation?

 

[crisi]

Then why is McCain EXEMPT from the law of the land? Does make me wonder, doesn't it you? If Obamacare is so fantastic, why is the President and Congress EXEMPT from this wonderful piece of legislation?

http://www.snopes.com/politics/medical/28thamendment.asp

 

[pat fan]

There have been waivers given to a LOT of certain/connected people to get them out of ACA/Obamacare.

 

[KathyTX]

Politics- don't post it.