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Family health coverage passes $20K this year

Helix said:
yeah, that really sucks. has she been able to try CBD?
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The CDB does not do a complete job. CDB also will counter many of the side effects of the drugs she does take. However, the time there was a screw up at the doctors office, and she ran out of the drug for 3 days, a full bottle of the 900 MG cdb oil did counter getting a seizure, although she felt like it came close a number of times. (A full bottle costs 100 bucks of the proper strength). When she has the med, going through about a bottle a month helps control the side effects, and seems to have a synergistic action. She basically gets the suspension in coconut oil (not vaping). It's very lucky it's now off the schedule. For her, the CDB is good for an adjunct to the meds, but hardly a replacement.

The good and reliable sources for CDB are still a bit on the expensive side.
 
RAMOSS said:
The CDB does not do a complete job. CDB also will counter many of the side effects of the drugs she does take. However, the time there was a screw up at the doctors office, and she ran out of the drug for 3 days, a full bottle of the 900 MG cdb oil did counter getting a seizure, although she felt like it came close a number of times. (A full bottle costs 100 bucks of the proper strength). When she has the med, going through about a bottle a month helps control the side effects, and seems to have a synergistic action. She basically gets the suspension in coconut oil (not vaping). It's very lucky it's now off the schedule. For her, the CDB is good for an adjunct to the meds, but hardly a replacement.

The good and reliable sources for CDB are still a bit on the expensive side.
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yeah, that kind of stinks. i hate being in a situation in which a family member is just a bit of bad luck away from needing a very expensive drug.
 
Helix said:
yeah, that kind of stinks. i hate being in a situation in which a family member is just a bit of bad luck away from needing a very expensive drug.
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Yes, indeed. Well, I have some very expensive drugs, but their copay options are much better. I pay 5 bucks a month for one that would normally cost 60K a year (25K in Canada). What is good for my situation is that if I get that med as the first med of the year, the copay card will cover my yearly deductible. I plan for it not covering things, but it's always nice to have it covered.

I do know people who don't have my insurance and resources that get it up the yin yang because of things. I'm fortunate. Many are not. The 'Junk policies' with high deductibles have proliferated over the last couple of years.
 
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RAMOSS said:
They might like the lower payments, however, just wait till one gets sick. A friend of mine just had emergency surgery because of a meletona near their eye, and they got hit with a 7000 bill all at once. That's what their deductible is.
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Well but there is the thing... would you rather pay 7000 a year.. for a plan with a 3000 dollar deductible. Or be able to put 7000 a year in an HSA.. or save it for other things.. and have no payments for a 6000k deductible? It makes more sense fiscally to save the money year after year.. especially when the stop loss is 6000 as well.
 
jaeger19 said:
Well but there is the thing... would you rather pay 7000 a year.. for a plan with a 3000 dollar deductible. Or be able to put 7000 a year in an HSA.. or save it for other things.. and have no payments for a 6000k deductible? It makes more sense fiscally to save the money year after year.. especially when the stop loss is 6000 as well.
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A lot of the people who have the 7000 deductable can't AFFORD to put 7000 into a HSA. There is this thing known as 'food, utilities and rent'.
 
RAMOSS said:
A lot of the people who have the 7000 deductable can't AFFORD to put 7000 into a HSA. There is this thing known as 'food, utilities and rent'.
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Wait.. that doesn't make a lot of sense when you think about it. You just said "well they would enjoy the lower payment". Well.. if they could not afford the payment to the insurance for the LOWER deductible... they aren't going to GET the insurance for the lower deductible anyway.

So they have a choice.. a lower deductible.. which COSTS them out of pocket. More than the cost of the deductible per year. OR they go to a higher deductible.. and save the money that it would have cost them.

The fact is.. the insurance companies make money when you pay for more coverage than you need... that's the way insurance works..
 
jaeger19 said:
Wait.. that doesn't make a lot of sense when you think about it. You just said "well they would enjoy the lower payment". Well.. if they could not afford the payment to the insurance for the LOWER deductible... they aren't going to GET the insurance for the lower deductible anyway.

So they have a choice.. a lower deductible.. which COSTS them out of pocket. More than the cost of the deductible per year. OR they go to a higher deductible.. and save the money that it would have cost them.

The fact is.. the insurance companies make money when you pay for more coverage than you need... that's the way insurance works..
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Yes, they would . However, a lower payment doesn't go into an HSA. it goes to provide food for the family, and clothing, and other things. A big bill comes out, and they are in trouble.

And, yes, the insurance company makes more money. That's why get rid of the insurance companies, and go single payer. Get rid of the profit motive of the middle man.
 
RAMOSS said:
Yes, they would . However, a lower payment doesn't go into an HSA. it goes to provide food for the family, and clothing, and other things. A big bill comes out, and they are in trouble.

And, yes, the insurance company makes more money. That's why get rid of the insurance companies, and go single payer. Get rid of the profit motive of the middle man.
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Well..what is better.. a higher payment to an insurance company... year in and year out.. year after year.. that is well beyond 7000 dollars. And goes on year after year you don;t use the insurance.. (which most people don't)..

Or having more money.. year after year.. for food, clothing.. kids education.. etc... and then you have a "big bill".. of 7000.. that you make payments on for a year or two until you pay it off. At the end of the day.. you are better off not paying the insurance company. You will be better off.

And no.. you are not going to get rid of insurance companies with single payer. First.. in this country.. insurance companies administer medicare and Medicaid.. so they ain;t going nowhere when it comes to single payer. Second.. just about every other country that has single payer.. STILL has private insurance companies to pay for what the single payer doesn't pay for... for example in Canada.. your single payer doesn't pay for pharmaceuticals..nor outpatient therapies. So.. you still have an insurance company making money.

Its just a reality.
 
jaeger19 said:
Well..what is better.. a higher payment to an insurance company... year in and year out.. year after year.. that is well beyond 7000 dollars. And goes on year after year you don;t use the insurance.. (which most people don't)..

Or having more money.. year after year.. for food, clothing.. kids education.. etc... and then you have a "big bill".. of 7000.. that you make payments on for a year or two until you pay it off. At the end of the day.. you are better off not paying the insurance company. You will be better off.

And no.. you are not going to get rid of insurance companies with single payer. First.. in this country.. insurance companies administer medicare and Medicaid.. so they ain;t going nowhere when it comes to single payer. Second.. just about every other country that has single payer.. STILL has private insurance companies to pay for what the single payer doesn't pay for... for example in Canada.. your single payer doesn't pay for pharmaceuticals..nor outpatient therapies. So.. you still have an insurance company making money.

Its just a reality.
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Yes, and that should be gotten rid of.
 
RAMOSS said:
Yes, and that should be gotten rid of.
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Can't. Unless you want to go to a national health system like the Brits. Total socialization of healthcare. Which just ain;t going to happen in the US. Nor would you want it frankly. Unless you want Trump in charge of your healthcare.
 
Neomalthusian said:
Numerous countries have hybrid UHC systems that utilize private insurance.

I don't think we can trust liberals or Democrats to comprehend or come up with good policy until they first learn the difference between UHC and single payer.
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One word: Buttigieg
 
Slavister said:
One word: Buttigieg
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He's only concerned with demonizing insurance companies while not doing anything about the real problem, which is the price of medical care. No plan will work while hospitals are charging $12 for a Dixie cup.
 
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aociswundumho said:
He's only concerned with demonizing insurance companies while not doing anything about the real problem, which is the price of medical care. No plan will work while hospitals are charging $12 for a Dixie cup.
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Yeah. you don't understand that it doesn't matter if they charge 12 dollars for a dixie cup or 200.. Their charges are largely absolutely meaningless. Particularly since they get paid largely on a DRG basis.

Its just fact.

Its also fact that reimbursements to hospitals for procedures have been falling since the 1990s. Declining reimbursement or stagnant reimbursements are the norm.. not the exception.
 
jaeger19 said:
Yeah. you don't understand that it doesn't matter if they charge 12 dollars for a dixie cup or 200.. Their charges are largely absolutely meaningless. Particularly since they get paid largely on a DRG basis.

Its just fact.
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If the prices are "meaningless", then why do so many Americans have to file for bankruptcy every year due to medical bills?
 
aociswundumho said:
If the prices are "meaningless", then why do so many Americans have to file for bankruptcy every year due to medical bills?
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They don't. That's a complete and utter myth. Numerous studies on bankruptcy and medical bills find out that when people file bankruptcy for medical issues.. the ACTUAL medical bills are a very small percentage of their overall debt. Averages of something like 8-11% of total debt depending on study. The reason people file for medical bankruptcy is NOT the medical bills.. its because of the loss of income when they are ill.

In fact.. studies that compared Canada and the US.. (Canada with lower healthcare costs and UHC).. and bankruptcy.. studies that compared the two using controls to be comparing apples to apples... found that Canadians had medical bankruptcy at the same rate that the US citizens did.

What it shows is that its not the medical bills.. it the loss of income when you are sick. If you want information.. start here.

Myth medical bankruptcy - Google Search
 
jaeger19 said:
They don't. That's a complete and utter myth. Numerous studies on bankruptcy and medical bills find out that when people file bankruptcy for medical issues.. the ACTUAL medical bills are a very small percentage of their overall debt. Averages of something like 8-11% of total debt depending on study. The reason people file for medical bankruptcy is NOT the medical bills.. its because of the loss of income when they are ill.

In fact.. studies that compared Canada and the US.. (Canada with lower healthcare costs and UHC).. and bankruptcy.. studies that compared the two using controls to be comparing apples to apples... found that Canadians had medical bankruptcy at the same rate that the US citizens did.

What it shows is that its not the medical bills.. it the loss of income when you are sick. If you want information.. start here.

Myth medical bankruptcy - Google Search
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Looks like you are correct regarding bankruptcies due to medical bills - they are much rarer than I thought they were.

So are you saying US hospital prices are reasonable compared to the rest of the world?
 
Helix said:
we can make it work. a bunch of people will act like it's the end of the world, but in a generation or two, it will be the status quo like Medicare for old people. the mistake that we make is attempting to convince the unconvincible. the best path to fixing our healthcare system is to vote out the naysayers and then start doing it.
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How unsurprising that a communist liked your post.
 
This is just Democrats doing for healthcare what they did for college tuition to make that more "affordable".
 
aociswundumho said:
Looks like you are correct regarding bankruptcies due to medical bills - they are much rarer than I thought they were.

So are you saying US hospital prices are reasonable compared to the rest of the world?
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Well.. there is really no way to "compare prices of US hospitals".. with each other much less other countries and that's because of the way hospitals get paid in the US.

For example. A hospital say charges 5000 for a coloscopy. and then charges say 10,000 for arthroscopic meniscal debridement.

Insurance A.. will only allow 2000 for the colonoscopy... but 8, 0000 for the arthroscopic meniscal debridement.
Insurance B will allow 5000 for the colonoscopy but the allowable on the meniscal debridement is only 5000.

So what IS the actual price? Hospitals basically have to charge as high as possible to capture the most reimbursement. If they only charge 2000 for the colonoscopy.. then they miss the out on 3000 that they would get from insurance B.. and if they charge only 5000 for the meniscal debridement.. then they miss out on the 3000 extra they would get from insurance A.

Looking at hospital charges are pretty much useless for comparison. Hospital A charges 500 for an MRI. Hospital B charges 3000 for the MRI. The reason could be cost shifting. Hospital A.. doesn't have say a pediatric wing, nor does it have a ventilators etc.. so.. its costs are less.. so it doesn't have to get 1700 for the MRI.

Meanwhile hospital B DOES have a pediatric wing that's available if needed and it has ventilators capability if needed.. and that has a cost. And since those things are necessary when you need them.. but not used much..then they have to shift that cost onto the MRI which does get used more.

SO.. that leads us to one of the reasons that US hospitals DO cost more than other countries.. and that's availability. We pay more.. to have more rural hospitals, more access, more availability than in other countries. One regional hospital that services a 150 mile radius... is much more efficient than 5 hospitals that service the 5 small communities in that region. BUT.. with those 5 hospitals.. there is no waiting for a bed in the ICU.. no waiting for a pediatric bed to open up. No waiting 2 months for a non emergent MRI.. and no traveling 90 miles to get to the hospital.
 
jaeger19 said:
Well.. there is really no way to "compare prices of US hospitals".. with each other much less other countries and that's because of the way hospitals get paid in the US.

For example. A hospital say charges 5000 for a coloscopy. and then charges say 10,000 for arthroscopic meniscal debridement.

Insurance A.. will only allow 2000 for the colonoscopy... but 8, 0000 for the arthroscopic meniscal debridement.
Insurance B will allow 5000 for the colonoscopy but the allowable on the meniscal debridement is only 5000.
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Different car insurance companies also pay different amounts for various repairs. Property insurance companies pay different amounts for rebuilding. Yet autobody shops and roofers will still provide you with a firm price.

Hospitals basically have to charge as high as possible to capture the most reimbursement.
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Every business on the planet charges as high as possible. The difference is US hospitals are screwing over sick and dying people.


SO.. that leads us to one of the reasons that US hospitals DO cost more than other countries.. and that's availability. We pay more.. to have more rural hospitals, more access, more availability than in other countries.
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We have an average amount of hospital beds:

chartoftheday_3696_the_countries_with_the_most_hospital_beds_n.jpg


One regional hospital that services a 150 mile radius... is much more efficient than 5 hospitals that service the 5 small communities in that region. BUT.. with those 5 hospitals.. there is no waiting for a bed in the ICU.. no waiting for a pediatric bed to open up. No waiting 2 months for a non emergent MRI.. and no traveling 90 miles to get to the hospital.
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Sorry, that doesn't justify the prices. Heart bypass surgery in the US costs between 100 and 200k. In Singapore it's 25k max. In Israel it's 30k. In Germany it's 50k max, which was the most expensive one I could find. None of these countries have waiting lines.

So where's all the money going in US hospitals?
 
aociswundumho said:
Different car insurance companies also pay different amounts for various repairs. Property insurance companies pay different amounts for rebuilding. Yet autobody shops and roofers will still provide you with a firm price.
?
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And I daresay that insurance probably does not make up 90% of their business. Plus a lot of insurance companies right a check to their clients and let them go where they will. Not so with healthcare.

Every business on the planet charges as high as possible. The difference is US hospitals are screwing over sick and dying people.
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Naw.. they aren't I showed you why are charges are this high. by the way.. do other businesses have a legal obligation to provide you services when they can't pay? Hmmm.. I think not.. but hospitals do. So.. comparing hospitals and healthcare to other businesses is quite tricky.

We have an average amount of hospital beds:
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Uh huh... which is more efficient. 1000 beds between 2 large regional hospitals.

1000 beds between between 100 smaller hospitals... that have almost all the equipment, etc.. of the regional hospitals?

think about it. think about the concentration of people in the US and where they are..

Sorry, that doesn't justify the prices. Heart bypass surgery in the US costs between 100 and 200k. In Singapore it's 25k max. In Israel it's 30k. In Germany it's 50k max, which was the most expensive one I could find.
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Well.. lets start with what I already said. You cannot compare heart surgery in the US versus Singapore.. Germany because of the way we get paid. Are you talking what is charged... or what is ACTUALLY PAID.

And there is the access issue. More specialists.. the more inefficient.. the more the cost.

But.. lets talk about the other differences in countries. So.. there is cost shifting. So in Germany.. and many other countries.. the doctors and other providers education is often a public.. no cost or low cost to the Doctor, nurse, x ray tech etc.. ... educational costs for staff etc.. is all born by the State public system.

Not so in the US.. so that educational cost has to be passed on to the consumer.. Which is seen in higher cost of healthcare. Its a shift in costs.

There are other costs as well that get shifted from healthcare to say their retirements system etc.

Then there is the cost of hospitals have for the uninsured. US hospitals have to provide care to people regardless of ability to pay. So.. the cost of care that YOU pay.. reflects making up for what other people don't pay.

Then there is flat out the difference in wages from one country to the next. The average salary in the US is 56,000 the average salary in the germany is around 43,000.
(in US dollars). I would suspect the difference in Singapore is greater. Providers in the US..generally just get paid more... and when you think of that.. it means that everyone else in the community.. also gets paid more. Healthcare is one of the leading source of jobs in the US. AND whats more.. a large portion of those healthcare systems are NON PROFIT. Which means that money is turned back into salaries for providers.. or more equipment or services.

There are other things that contribute to higher costs as well. The comorbidities between someone who needs CABG and germany and someone in the US.. who ALSO has diabetes.. is overweight.. and sedentary etc.
 
Neomalthusian said:
Democrats are admittedly the only ones talking about workable policy for health care. Unfortunately there are some making outlandish campaign promises and others talking about serious policy fixes. I prefer the latter.
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Huh ? It was their last " workable policy " ( the ACA ) that created this mess.

The ACA forced everyone into the same State based risk pool. Both healthy and sick and subsidised plans and unsubsidized plans
Those who qualify for subsidizes typically have higher healthcare cost than people who don't qualify, but since their get subsidies they're insulated from premium and deductable hikes

Now, every State pool is disproportionately weighted with subsidized plans, because premiums have risen to the point where millions of people have been priced out of the market.

The risk pools set the premium price for each State, and are one of the big reasons where seeing these stratospheric cost for health insurance.

What a disaster that law is, and people actually want the same party thats responsible for it to take total control of our healthcare system. Unreal !
 
jaeger19 said:
Well but there is the thing... would you rather pay 7000 a year.. for a plan with a 3000 dollar deductible. Or be able to put 7000 a year in an HSA.. or save it for other things.. and have no payments for a 6000k deductible? It makes more sense fiscally to save the money year after year.. especially when the stop loss is 6000 as well.
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That all depends. There are countless medical needs that are far more expensive than what you or I can sock away. A heart bipass can cost $50,000 to $100,000, which means most people can’t save enough to prefund their medical costs with HSAs. That’s why we need insurance.
 
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