- Joined
- Nov 7, 2010
- Messages
- 7,676
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- Very Conservative
It's all a matter of interpretation...that's why we have judges...but even they are not devoid of bias, able to interpret the meaning objectively....because the writings are ambiguous as to intent. If that were not so, every decision would be unanimous.
It is not ambiguous. It is very clear and well defined. The ambiguity only comes in when people try to read in what they want it to mean.
And yes, my plan was a comprehensive one, as should be all such plans...I paid zero in deductibles. What good is low cost insurance if it doesn't cover what you end up needing? If the plan you have does not cover you, but you have the medical treatment anyway, say in a triage situation....others end up paying it for you. That needs to stop if we allow you to opt for a low cost plan which ends up being insufficient for your needs. Can't pay on the spot? Though.
Follow with me. Let's say I have a $1 million hospital stay for a car accident. Assuming my auto insurance doesn't have coverage (which it does) let's compare the costs of both plans for one year.
Full Coverage:
$20 copay
$150 copay emergency room
$3,000 deductible
10% copay after $3,000
I would pay $150 for the emergency room and then $2,850 for the hospital stay plus $99,700 for the stay unless it had an out of pocket maximum, then I'd pay that. My current OOP is $15,000. So, I'd pay $15,000 plus (at pre ACA rates) $330 over 12 months or $3,960 for my premiums. A grand total of $18,960.
Catastrophic Coverage:
$5,000 deductible
0 Copay after $5,000
Premiums $100 over 12 months or $1,200
Grand total $6,200
This is the con that insurance companies have been winning and won big with the ACA. We were all forced into bad insurance. We have been convinced that bad insurance is the only insurance and it must be provided by someone else. Well guess what, if I buy your insurance and you buy mine we both end up paying more...but it's free? Right?
Good insurance covers the big ticket items. Most catastrophic insurance had no copay after the deductible was met and was less than 1/3 of the premium for full. But people saw that $5,000 (or whatever) tag and thought they'd go bankrupt. So they paid more than $5,000 a year for more coverage. There is no way a full plan is ever cheaper than catastrophic. It just never happens. Not before the ACA.