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my collision with Obamacare

jaeger19 said:
Office visits definitely. Not so much emergency department.. actually a decrease there but that's because now they can go to the office rather than the ED.. and we have done a lot to try and encourage folks to go the clinics rather than the ED for things not really emergency.

Of course the reimbursement is terrible.. (at least in 2 states we have business, ones not so bad.. better than medicare)... you know medicine.. work harder for less money...
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Im also a Paramedic, and my employers southern California divisions are also busier. So busy that additional units have been hired over the last few years. Certainly more than population growth in the region.
 
Fenton said:
Yes, the Health Insurance companies were SO untrustworthy and deceitful we needed the Government to come in and pull the largest Bait and switch scam in our Nation's history.

If a Private insurance company did what the Democrats did to Millions of Americans they would currently at the center of a major Federal Trade Commission investigation.

ObamaCare is a disaster. It targets the discretionary income of the Middle class and its smothering the economy.
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PSSST....

They are still doing it. No one ever asks how much of their premiums go for wages and benefits of the CEO's of the Insurance companies, nor the profits.
 
US Conservative said:
Im also a Paramedic, and my employers southern California divisions are also busier. So busy that additional units have been hired over the last few years. Certainly more than population growth in the region.
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Obamacare is creating millions of jobs for the middle-class. Did you remember to thank Obama?
 
socca said:
Latest Update:
+ today I received a letter from Aetna offering renewal for 2016 at $398.28 / month. Getting out my trusty calculator, that's a 25% rate increase. So, I get nailed with an 83% increase when I was forced to join Obamacare in July, and now I get hit with another 25% increase if I stay with Aetna for 2016. Where is the "affordable" in the Affordable Care Act? Sure, the low-income folks are tickled pink by the massive subsidies available, but the middle class is getting screwed.

+ When open enrollment starts in November, I will check if there are any other insurers offering a lower premium. I don't have much hope.

+ I enjoy excellent health and am thus a low risk for any health insurer, but Obamacare forbids insurers from asking the kinds of questions that would allow them to properly calculate the risk of offering me health insurance.

+ I have voted Democrat my entire life, but no Democrat is getting my vote as long as the U.S. health care system is so screwed up. It was bad before Obamacare, and now it's even worse.
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Sorry to hear that you got hit man. Really.

I suppose the cries for repealing ObamaCare don't seem all that far fetched or radical anymore.
 
Dittohead not! said:
It depends on what replaces it.
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Very true. One can only hope that such a replacement would be a more bi-partisan crafted and bi-partisan supported bill than ObamaCare, this first one.

We've seen how well it works when one party goes it alone, shuts out the other one, and shoves it up the nation's collective ass, sideways, without lube. It's not pretty, and leaves a great many with a starting negative disposition, rather than a positive one.

Hard to succeed when the electorate is mostly stacked against it like that from the git go.
 
Gaius46 said:
jaeger19 said:
Okay so then my basic premise is still valid though possibly not to the extent that I originally thought.
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No.. your basic premise is not correct. You are not responsible for things not reasonable and necessary.

However, if you go to the hospital say in Boise Idaho..

And the next week go the hospital in say LA. California.. you will find that the whats reasonable and necessary is different
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US Conservative said:
Im also a Paramedic, and my employers southern California divisions are also busier. So busy that additional units have been hired over the last few years. Certainly more than population growth in the region.
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Yep.. Well.. combine the population growth.. and that California probable expanded more people on Medicaid.. (where as some of the states I do business did not expand Medicaid).. its not surprising.

What irks me though is the BS. Okay.. so we hear all this talk about "preventative medicine" and getting people care before they cost more money. OK.. that makes sense. THEN they have people on the expansion of Medicaid.. and nickel and dime the cheap preventative stuff.

we had a lady that blew her knee OUT. Complete disruption of her ACL, almost complete tear of her MCL and a huge tear of her medial meniscus She was on the expansion of Medicaid. She spent two weeks in a brace basically unable to use it.. until she could get approval of surgery. THEN after surgery we wanted therapy right away. DENIED. Home program afterward only. so what do we see at follow up? She is unable to bear weight and is developing a contracture. We get approval for therapy... 3 visits.. that's it. Therapy gets her started and moving but wants more therapy... they fight for more and get another 3 visits. After that.. no more visits. So when we see her.. the gains she made in therapy were gone.. and she was worse.
So we end up manipulating her. We want therapy again. Nope.. denied. After she started tightening up yet again.. we got three visits again of therapy. Luckily the therapist was smart enough to recognize that there was no way therapy was going to work with the insurance nickel and diming it..so he recommended an expensive dynamic splint for her knee to pull her into extension as something better than nothing. Luckily.. that seemed to work to a degree so she ended up with a very slight contracture but functional.

of course the cost of the brace alone was more than 3 months of therapy would have been.. not to mention the manipulation, and the extra pain medication, and doctors visits.

This is Medicaid.. a government program.. so its amazing to me to see these fellows think that if we went to single payer government healthcare that its going to be just great.
 
jaeger19 said:
Very true.. its one of the faults of Obamacare.. What people need is catastrophic policies that reduce the possibility of owing tens or hundreds of thousands of dollars. What they should have done and should do..
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And yet conservatives complain endlessly about high deductible plans which are exactly what you describe.
 
jaeger19 said:
Yep.. Well.. combine the population growth.. and that California probable expanded more people on Medicaid.. (where as some of the states I do business did not expand Medicaid).. its not surprising.

What irks me though is the BS. Okay.. so we hear all this talk about "preventative medicine" and getting people care before they cost more money. OK.. that makes sense. THEN they have people on the expansion of Medicaid.. and nickel and dime the cheap preventative stuff.

we had a lady that blew her knee OUT. Complete disruption of her ACL, almost complete tear of her MCL and a huge tear of her medial meniscus She was on the expansion of Medicaid. She spent two weeks in a brace basically unable to use it.. until she could get approval of surgery. THEN after surgery we wanted therapy right away. DENIED. Home program afterward only. so what do we see at follow up? She is unable to bear weight and is developing a contracture. We get approval for therapy... 3 visits.. that's it. Therapy gets her started and moving but wants more therapy... they fight for more and get another 3 visits. After that.. no more visits. So when we see her.. the gains she made in therapy were gone.. and she was worse.
So we end up manipulating her. We want therapy again. Nope.. denied. After she started tightening up yet again.. we got three visits again of therapy. Luckily the therapist was smart enough to recognize that there was no way therapy was going to work with the insurance nickel and diming it..so he recommended an expensive dynamic splint for her knee to pull her into extension as something better than nothing. Luckily.. that seemed to work to a degree so she ended up with a very slight contracture but functional.

of course the cost of the brace alone was more than 3 months of therapy would have been.. not to mention the manipulation, and the extra pain medication, and doctors visits.

This is Medicaid.. a government program.. so its amazing to me to see these fellows think that if we went to single payer government healthcare that its going to be just great.
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Ive had similar episodes, its a shame the system puts providers in that situation. As for cost savings, Im not seeing how they are possible, and how the this can be sustainable. It seems to be violating some basic economic laws.
 
US Conservative said:
Ive had similar episodes, its a shame the system puts providers in that situation. As for cost savings, Im not seeing how they are possible, and how the this can be sustainable. It seems to be violating some basic economic laws.
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So true. But you and I both know that the problem has been and always will be that the people running and deciding how things are done don't really understand medicine.

Part of its really is providers faults. We all "just want to treat patients" and have stuck our heads in the sand when it comes to understanding insurance and reimbursement issues. Instead of confronting insurance companies and making a case.. we often just find a way to work around them rather than butt heads until it hurts.

Look at my post. ultimately the insurance company got away with it.. and they sure think they were smart. Even though at the end of the day.. they were dumb.
 
reinoe said:
And yet conservatives complain endlessly about high deductible plans which are exactly what you describe.
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Yeah.. you got that backwards. Liberals complain endlessly about high deductible plans and that's why Obamacare mandates lower deductibles etc... That's why so many people that were told "you can keep your insurance".. lost their insurance because the insurance didn't meet the deductible and or out of pocket mandates under obamacare.
 
eohrnberger said:
Very true. One can only hope that such a replacement would be a more bi-partisan crafted and bi-partisan supported bill than ObamaCare, this first one.

We've seen how well it works when one party goes it alone, shuts out the other one, and shoves it up the nation's collective ass, sideways, without lube. It's not pretty, and leaves a great many with a starting negative disposition, rather than a positive one.

Hard to succeed when the electorate is mostly stacked against it like that from the git go.
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At times I wonder whether a well crafted bi partisan bill is even possible any more.
Other times, I'm sure it isn't.
 
Dittohead not! said:
At times I wonder whether a well crafted bi partisan bill is even possible any more.
Other times, I'm sure it isn't.
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Yeah, I know. It's troubling that such a thing appears to be so completely out of the reach and so completely beyond the ability of our so called 'statesmen' and 'leaders'.
 
Dittohead not! said:
At times I wonder whether a well crafted bi partisan bill is even possible any more.
Other times, I'm sure it isn't.
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that's because the hyperbole on both sides has reached a fever pitch. Just look at the responses on this board.

We swing from "nothings wrong".. to "the bodies keep piling up" and everyone is " a broken arm away from bankruptcy".

Its a sad but true fact that in a representative government.. our elected leaders are representative and reflective of the attitudes of the people they represent. In other words.. we get the government that we deserve.

People as individuals have to be able to set aside their partisan ship before we can expect it from Congress. (that's why I like to post on this website.. in a small way it moves us toward that)

But the task is monumental. this board has more informed people than probably the average person.. and yet.. we can't even agree that the cost of healthcare in America is influence by factors like obesity.. like that other countries pay for provider education etc.

We can't get people to recognize that preventative medicine is detecting the fellow that has diabetes and getting him care before he has kidney failure.
 
jaeger19 said:
we had a lady that blew her knee OUT. Complete disruption of her ACL, almost complete tear of her MCL and a huge tear of her medial meniscus She was on the expansion of Medicaid. She spent two weeks in a brace basically unable to use it.. until she could get approval of surgery. THEN after surgery we wanted therapy right away. DENIED. Home program afterward only. so what do we see at follow up? She is unable to bear weight and is developing a contracture. We get approval for therapy... 3 visits.. that's it. Therapy gets her started and moving but wants more therapy... they fight for more and get another 3 visits. After that.. no more visits. So when we see her.. the gains she made in therapy were gone.. and she was worse.
So we end up manipulating her. We want therapy again. Nope.. denied. After she started tightening up yet again.. we got three visits again of therapy. Luckily the therapist was smart enough to recognize that there was no way therapy was going to work with the insurance nickel and diming it..so he recommended an expensive dynamic splint for her knee to pull her into extension as something better than nothing. Luckily.. that seemed to work to a degree so she ended up with a very slight contracture but functional.

of course the cost of the brace alone was more than 3 months of therapy would have been.. not to mention the manipulation, and the extra pain medication, and doctors visits.

This is Medicaid.. a government program.. so its amazing to me to see these fellows think that if we went to single payer government healthcare that its going to be just great.
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And yet, you argued that the rich and the poor receive the same care. Now you're saying the opposite

jaeger19 said:
Actually the wealthy are really prevented from purchasing preferential treatment in the states to a large degree. In the hospital.. the person in room one is a multimillionaire and the person in the bed next to him is on Medicaid and as poor as a church mouse. and they get the same care.
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socca said:
A couple of days ago I finally received the long-dreaded policy cancellation letter from Blue Cross / Blue Shield of Florida. My previous monthly premium for my grandfathered policy was $174 / mo ($2,088 / yr). The cheapest Obamacare-compliant policy available from BCBSFL is $412 / mo ($4,944 / yr). :eek: Almost $3k more per year for health insurance if I stay with BCBSFL! To put it mildly, I am not pleased. :censored

So, is my grandfathered policy "junk"? Absolutely not. It has a much higher deductible (now illegal under Obamacare), but I was fine with that. It also excluded coverage for my pre-existing condition (a hernia). I decided that I was willing to risk having to pay for the hernia repair myself in exchange for a lower monthly premium (I've had the hernia for many years, the condition has never changed, and it causes me no pain or discomfort). This kind of mental calculation is forbidden under Obamacare.

Despite Obamacare's rhetoric of helping the middle class, I have a middle-class income as a self-employed manager, do not qualify for subsidies, and am getting slammed with higher premiums for the privilege of being force-fed a health insurance policy I do not want.

I did some searching online, and found a website that claims that the average premium for a 50 year old male (I'm 52) in my county is $325 / mo. I found another insurance company online who quoted a bronze policy around that number. I tried to register on healthcare.gov, but the website malfunctioned with an "unexpected error".

Entirely by coincidence, a couple of weeks ago I deregistered as a Democrat (I've long considered myself an Independent who votes with the Dems). Well, now I'm an Independent who is severely disgusted with both political parties.

I have a few months to arrange for new health insurance. I will post an update as the situation evolves. Thanks for letting me rant. :2wave:
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I feel your pain and am in a boat much like yours. BCBS also withdrew all its PPOs here in Texas. I didn't know it had done it in FL, too.

We older people are getting hit with higher premiums, since the ins. cos. aren't allowed to jack up the premiums of people who turn in high claims, or by gender. Only if yu use tobacco or are older.
 
socca said:
When open enrollment starts in November, I will check if there are any other insurers offering a lower premium. I don't have much hope.
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I just checked healthcare.gov, and my lack of hope was justified. Aetna is offering the lowest premium in my service area. So, to review the data:
+ my annual premium prior to Obamacare (2015, first half): $174/mo or $2,088/yr
+ my annual premium with Obamacare (2016): $398.28/mo or $4,779.36/yr

The Obamacrats pat me condescendingly on the head and claim, "Oh, you're getting a much better policy under Obamacare! This more than justifies your $2,691.36 increase in annual insurance premiums." Unfortunately, this is completely false. In some ways, my new policy is worse, and the ways in which it is better do not apply to my situation. For someone who has lived modestly and saved aggressively for many years, a $6k reduction in the annual out-of-pocket maximum is pocket change.

The Supreme Court got it right: Obamacare is a tax, but the burden of paying the healthcare costs of all of these chronically-ill poor people is not being distributed fairly (IMO). Obamacare managed to preserve the worst feature of market-driven health insurance (having to deal with an insurance company while you're sick) and the worst feature of socialized health insurance (having to deal with dim-witted gov't bureaucrats who do not suffer the consequences of the programs they devise and implement).

Thanks for letting me rant. :2wave:
 
socca said:
I just checked healthcare.gov, and my lack of hope was justified. Aetna is offering the lowest premium in my service area. So, to review the data:
+ my annual premium prior to Obamacare (2015, first half): $174/mo or $2,088/yr
+ my annual premium with Obamacare (2016): $398.28/mo or $4,779.36/yr

The Obamacrats pat me condescendingly on the head and claim, "Oh, you're getting a much better policy under Obamacare! This more than justifies your $2,691.36 increase in annual insurance premiums." Unfortunately, this is completely false. In some ways, my new policy is worse, and the ways in which it is better do not apply to my situation. For someone who has lived modestly and saved aggressively for many years, a $6k reduction in the annual out-of-pocket maximum is pocket change.

The Supreme Court got it right: Obamacare is a tax, but the burden of paying the healthcare costs of all of these chronically-ill poor people is not being distributed fairly (IMO). Obamacare managed to preserve the worst feature of market-driven health insurance (having to deal with an insurance company while you're sick) and the worst feature of socialized health insurance (having to deal with dim-witted gov't bureaucrats who do not suffer the consequences of the programs they devise and implement).

Thanks for letting me rant. :2wave:
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Funny, how what was promised by Obama, his administration, and the Democratic majority on congress flies in the face of the reality that the electorate is now stuck with, and paying through the nose for. Exactly how oh so many critics were claiming before it was even passed, all shouted down by the ObamaCare supporters.

Next up: Using ObamaCare's failures as a justification for government run single payer healthcare, so be prepared for the VA experience coming soon for you.
 
socca said:
I just checked healthcare.gov, and my lack of hope was justified. Aetna is offering the lowest premium in my service area. So, to review the data:
+ my annual premium prior to Obamacare (2015, first half): $174/mo or $2,088/yr
+ my annual premium with Obamacare (2016): $398.28/mo or $4,779.36/yr

The Obamacrats pat me condescendingly on the head and claim, "Oh, you're getting a much better policy under Obamacare! This more than justifies your $2,691.36 increase in annual insurance premiums." Unfortunately, this is completely false. In some ways, my new policy is worse, and the ways in which it is better do not apply to my situation. For someone who has lived modestly and saved aggressively for many years, a $6k reduction in the annual out-of-pocket maximum is pocket change.

The Supreme Court got it right: Obamacare is a tax, but the burden of paying the healthcare costs of all of these chronically-ill poor people is not being distributed fairly (IMO). Obamacare managed to preserve the worst feature of market-driven health insurance (having to deal with an insurance company while you're sick) and the worst feature of socialized health insurance (having to deal with dim-witted gov't bureaucrats who do not suffer the consequences of the programs they devise and implement).

Thanks for letting me rant. :2wave:
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Greetings, Socca. :2wave:

When justified, ranting is good to get errors corrected. However, knowing that when government gets involved with "fixing" things, we can probably expect them to follow their usual procedures and make things worse! Since there were so many lies told to the public about Obamacare in the first place, can anyone expect anything different this time? Odds are against it, IMO! :thumbdown:
 
Summerwind said:
Come back when you can tell us your actual out of pocket cost. Til then you're ranting for nothing.
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Um, no. Higher premiums matter. They result in guaranteed less money per year for individuals and families whereas higher deductible plans only result in higher out of pocket costs if you actually go get health care.


If you make enough to not receive a subsidy, then you should have proper insurance and extra cost should be less than a drop in the bucket.
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One way to be disqualified from subsidies is if just one income earner is offered employer insurance, at which point the rest of the family is ineligible for subsidies. Further, in many places it is not a drop in the bucket. A family in Fairbanks, AK who earns 400% of the poverty level (say, $150,000 for a family of 5) can pay upwards of $40,000 a year just in premiums. Whereas if the family earned 399% of the federal poverty level they'd pay less than $15,000 a year. That is the idiocy of a benefit cliff. It discourages income growth for people around that level of income.

So find out what your subsidy is, then compare out of pocket, not premium cost.
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Evidently no one should be taking insurance shopping advice from you. Insurance companies love people like you.
 
socca said:
I just checked healthcare.gov, and my lack of hope was justified. Aetna is offering the lowest premium in my service area. So, to review the data:
+ my annual premium prior to Obamacare (2015, first half): $174/mo or $2,088/yr
+ my annual premium with Obamacare (2016): $398.28/mo or $4,779.36/yr

The Obamacrats pat me condescendingly on the head and claim, "Oh, you're getting a much better policy under Obamacare! This more than justifies your $2,691.36 increase in annual insurance premiums." Unfortunately, this is completely false. In some ways, my new policy is worse, and the ways in which it is better do not apply to my situation. For someone who has lived modestly and saved aggressively for many years, a $6k reduction in the annual out-of-pocket maximum is pocket change.

The Supreme Court got it right: Obamacare is a tax, but the burden of paying the healthcare costs of all of these chronically-ill poor people is not being distributed fairly (IMO). Obamacare managed to preserve the worst feature of market-driven health insurance (having to deal with an insurance company while you're sick) and the worst feature of socialized health insurance (having to deal with dim-witted gov't bureaucrats who do not suffer the consequences of the programs they devise and implement).

Thanks for letting me rant. :2wave:
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You were lied to. Remember what was promised with the ACA, how you would be saving money.

And while he was pushing that lie-Obama KNEW it wasn't possible, but he pushed the lie for his personal political benefit.

And look at what we got.
 
socca said:
I just checked healthcare.gov, and my lack of hope was justified. Aetna is offering the lowest premium in my service area. So, to review the data:
+ my annual premium prior to Obamacare (2015, first half): $174/mo or $2,088/yr
+ my annual premium with Obamacare (2016): $398.28/mo or $4,779.36/yr

The Obamacrats pat me condescendingly on the head and claim, "Oh, you're getting a much better policy under Obamacare! This more than justifies your $2,691.36 increase in annual insurance premiums." Unfortunately, this is completely false. In some ways, my new policy is worse, and the ways in which it is better do not apply to my situation. For someone who has lived modestly and saved aggressively for many years, a $6k reduction in the annual out-of-pocket maximum is pocket change.

The Supreme Court got it right: Obamacare is a tax, but the burden of paying the healthcare costs of all of these chronically-ill poor people is not being distributed fairly (IMO). Obamacare managed to preserve the worst feature of market-driven health insurance (having to deal with an insurance company while you're sick) and the worst feature of socialized health insurance (having to deal with dim-witted gov't bureaucrats who do not suffer the consequences of the programs they devise and implement).

Thanks for letting me rant. :2wave:
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I feel badly for you.

What I recall is a smiling president Obama campaigning on the pledge the "average America" would have his premiums reduced by $2,500 a year. Yet, I never read actual accounts of that happening to people, only the reverse like your case.

Obamacare is the worst possible combination, a force fed mandate to buy a for-profit service from a small band of designated suppliers, whose investors are becoming or are already the dreaded 1% the Democrats hate.

Where I come from we have a term for that, its called being ****ed.
 
Lutherf said:
If you're not eligible for a subsidy then there isn't a need to go through the exchange.
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And if America had just joined the rest of the Civilized World when it had the chance and done UHC, there'd be no need for any of this nonsense at all.
 
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