| Posted By |
Message |
| Pages: 1 2 [3] |
belladi
LIF Adult
Member since 9/06 1011 total posts
Name:
diana
|
Re: The Cost of Health Care
Great ARticle on Breakdown of Plan.. Who it affects
What Health Reform Means to you
|
Posted 7/21/09 3:50 PM  |
| |
|
Long Island Weddings
Long Island's Largest Bridal Resource |
mrsej
The cutest!
Member since 1/07 2495 total posts
Name:
Mommy
|
Re: The Cost of Health Care
Posted by belladi
Posted by mrsej
Posted by belladi
Posted by Ophelia
Posted by belladi
People steal cause they can.... There are soo many loopholes and NO ONE CHECKS....
1) that doesn't make it right. that is blaming the VICTIM, not the perp. wrong attitude to have.
2) that is EMPHATICALLY not true.
I meant it, that the states and fed govt know the system is broken with medicaid but THEY Chose not to do anything about it, so if people steal who can we really blame? Its wrong on both ends...
I agree - there are tons of loopholes and there is no comprehensive system to check on fraud. For example, a home health aid received payments for rendering care to 3 different patients at the exact same time - Medicaid paid without any problems - why isn't there a program that would red flag this issue? people who are banned from opening home health care businesses that participate in Medicaid just open them in other people's names and steal millions. In fact, this man just plead gulity to stealing millions from Medicaid and his wife just filed an application to open up a "home health aid school". That should not happen.
Medicaids system is not equiped to cross reference ss#, or employment, or anything... They have a old system.. Thats why they cant ever verify anything and they just pay out..... Its cheaper for them to look the other way...
Totally crazy - a disgrace.
|
| Posted 7/21/09 4:05 PM |
| |
|
Janice
Sweet Jessie Quinn
Member since 5/05 27567 total posts
Name:
Janice
|
Re: The Cost of Health Care
Posted by racheeeee
I can not understand what propaganda people are reading that leads them to believe that there is no competition, or no money spent on Research within socialised medicine....
People are still supporting the big pharmaceutical companies, who do pay for quite a lot of research, however the NHS pays for our prescriptions (we do make small co-payments.) Doctors work to targets regularly and their pay is based on hitting those targets. That sounds like competition to me...Doctors still make quite a bit of money...
And private health insurance here, well guess what, you still see NHS doctors...same doctors, just sometimes quicker appointments.
Its not perfect, but I would rather be in a situation like this, than a young person without health care in the US.
according to these boards you live in either Communist Russia or a 3rd world country.
|
| Posted 7/21/09 4:25 PM |
| |
|
Janice
Sweet Jessie Quinn
Member since 5/05 27567 total posts
Name:
Janice
|
Re: The Cost of Health Care
Posted by Babyaholic
Just because I wasn't really clear in my last post. I am not even talking about people stealing money or fraud. I am talking about families who come in and are in desperate need of help having to be turned away cause they make too much money. When did we start considering 2 grand a month too much money??? Meanwhile, other people, undocumented, come in and they have no problem being approved. Since they are off the books, can't verify income - approval.
completely agree. there is a huge number of families that fall between the gap.
I know one mom whose credit is ruined since her baby spent 5 days in NICU. Insured, working, but deductible for her was 3K, baby was 3K. 6K that they just could not swing.
I know another insured working mom who makes me thank God my kid has asthma and not type 1 diabetes. The amount out of pocket she pays makes my stomach turn.
|
| Posted 7/21/09 4:30 PM |
| |
|
HoneyBadger
YourWorstNightmare.
Member since 10/06 15979 total posts
Name:
BahBahBlackJeep
|
Re: The Cost of Health Care
Posted by Sassyz75
what I find laughable are the contracted prices the doctors get through insurance- honestly, if I could just pay THOSE prices without having to pay for the insurance, I'd be better off- and just carry a hospitalization plan. It's crazy that something the doctor charges a non-insurance person is $300 they get $50 for from insurance.
this makes NO sense to me- and I think if there really were no insurance companies and that if doctors just charged reasonable fees for everyone- and maybe even took money over time like my dentist does- we'd be in a better place.
I also agree with tort reform and administrative costs- they are completely out of hand.
Insurance is big big business and they need to be reformed.
I agree completely. I think the place to start on health care reform is with the insurance companies and the pharmaceutical companies.
These two factions are NOT about making people well, they're about the bottom line, P&L statements, annual bonuses and making their board members happy.
If the gov't went after these companies, I'm sure we the people would see a huge difference.
|
| Posted 7/21/09 4:44 PM |
| |
|
Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
|
Re: The Cost of Health Care
Dh's insurance (big Fortune 1000 company) has a huge deductible as well. This can break people. I think the family deductible is $10K then they pay out at 70%.
I can see where there are a lot of insured folks who could use another option.
My insurance is golden compared to his and I'm still out of pocket $1500 in network and $4K out of network for a family before the plan pays at 100%.
|
| Posted 7/21/09 4:44 PM |
| |
|
SweetestOfPeas
J'taime Paris!
Member since 3/06 32345 total posts
Name:
|
Re: The Cost of Health Care
Posted by mrsej
I just posted this on the last topic thread about Obama - there is such waste in government run industries. Medicaid costs NY 43.4 billiion dollars. There are people stealing millions of dollars from Medicaid. Just recently, a man was arrested for stealing 47 million from Medicaid - one person! Last year 20 people were arrested for stealing 20 million from Medicaid. There are no checks and balances. People send in bills to Medicaid and Medicaid pays it out. There are Health care aids and Home health care companies that steal millions from Medicaid and there is noone to check - Department of Labor and Department of Health don't cross check each other. The only way any people are ever caught are b/c of people turning them in. IN the case of the 20 people being arrested, the only way they were caught was b/c the husband of one of the home health care aids was ****** b/c he caught his wife cheating and he knew of the scam. he called the dept of labor and health to report her and they did nothing. he called the AG's office - they did nothing. He actually walked to the AG's office, knocked on their door and demanded to speak to someone and then finally someone listened. no one cares b/c it is government money. Medicaid is a COMPLETE DISASTER. It makes my head hurt to think of what Obama's health plan might cost in the long run.
 
|
| Posted 7/21/09 5:09 PM |
| |
|
|
|
Re: The Cost of Health Care
Posted by Sassyz75
what I find laughable are the contracted prices the doctors get through insurance- honestly, if I could just pay THOSE prices without having to pay for the insurance, I'd be better off- and just carry a hospitalization plan. It's crazy that something the doctor charges a non-insurance person is $300 they get $50 for from insurance.
this makes NO sense to me- and I think if there really were no insurance companies and that if doctors just charged reasonable fees for everyone- and maybe even took money over time like my dentist does- we'd be in a better place.
I also agree with tort reform and administrative costs- they are completely out of hand.
Insurance is big big business and they need to be reformed.
Totally hit the nail on the head. Our two biggest health care issues are the doctors and the insurance companies.
If they are willing to take $85.00 from the ins plus my $30.00 co-pay for a test, why does the uninsured person have to shel out over $500.00. The ins company is billed at the same rate as those that privately pay, but PACR (pay at contracted rate) which is a fraction of the bill. Likewise, the ins. companies make foolish decisions that they feel are cost effective but usually are not. For example, my ins wil not pay at all for IVF, but I have unlimited coverage for medication, monitoring and inseminations. Guess what? They could have paid for 2 IVF cycles by now for what they have shelled out and I'd probably have a kid or two. So, why not just put a life time max on certain procedures (not random criteria) and let the patient decide their course of treatment? If that were the case, my decisions would be much more cost effective!
|
| Posted 7/21/09 5:30 PM |
| |
|
Janice
Sweet Jessie Quinn
Member since 5/05 27567 total posts
Name:
Janice
|
Re: The Cost of Health Care
Posted by Blu-ize
Dh's insurance (big Fortune 1000 company) has a huge deductible as well. This can break people. I think the family deductible is $10K then they pay out at 70%.
I can see where there are a lot of insured folks who could use another option.
My insurance is golden compared to his and I'm still out of pocket $1500 in network and $4K out of network for a family before the plan pays at 100%.
OMG. 10K is an insane number.
|
| Posted 7/21/09 5:42 PM |
| |
|
Beth
The Key to your new home....
Member since 2/06 24849 total posts
Name:
Beth
|
Re: The Cost of Health Care
Posted by Janice
Posted by Blu-ize
Dh's insurance (big Fortune 1000 company) has a huge deductible as well. This can break people. I think the family deductible is $10K then they pay out at 70%.
I can see where there are a lot of insured folks who could use another option.
My insurance is golden compared to his and I'm still out of pocket $1500 in network and $4K out of network for a family before the plan pays at 100%.
OMG. 10K is an insane number.
wow- I was complaining over a $300 dedductible.......
|
| Posted 7/21/09 5:44 PM |
| |
|
Ophelia
she's baaccckkkk ;)
Member since 5/06 23378 total posts
Name:
remember, when Gulliver traveled....
|
Re: The Cost of Health Care
Posted by BaseballWidow
Posted by Sassyz75
what I find laughable are the contracted prices the doctors get through insurance- honestly, if I could just pay THOSE prices without having to pay for the insurance, I'd be better off- and just carry a hospitalization plan. It's crazy that something the doctor charges a non-insurance person is $300 they get $50 for from insurance.
this makes NO sense to me- and I think if there really were no insurance companies and that if doctors just charged reasonable fees for everyone- and maybe even took money over time like my dentist does- we'd be in a better place.
I also agree with tort reform and administrative costs- they are completely out of hand.
Insurance is big big business and they need to be reformed.
Totally hit the nail on the head. Our two biggest health care issues are the doctors and the insurance companies.
If they are willing to take $85.00 from the ins plus my $30.00 co-pay for a test, why does the uninsured person have to shel out over $500.00. The ins company is billed at the same rate as those that privately pay, but PACR (pay at contracted rate) which is a fraction of the bill. Likewise, the ins. companies make foolish decisions that they feel are cost effective but usually are not. For example, my ins wil not pay at all for IVF, but I have unlimited coverage for medication, monitoring and inseminations. Guess what? They could have paid for 2 IVF cycles by now for what they have shelled out and I'd probably have a kid or two. So, why not just put a life time max on certain procedures (not random criteria) and let the patient decide their course of treatment? If that were the case, my decisions would be much more cost effective!
you are both absolutely right.
the problem with this is that the contracted rates being paid by in network or insured patients is NOT enough for the doctors to make a decent bottom line. they NEED the inflated prices of the private payer to bolster their overall profits.
doctors are NOT making what they used to. especially for the hours they work and the insurance premiums they pay (unless they are not in any network and have all private pay) hospital, nurses, everyone is suffering...including and especially patients and their care.
it's hard to say which side of this **** sandwich we take a bit out of first....it needs to be addressed simulaneously on multiple fronts, but I just don't think that is possible. 
|
| Posted 7/21/09 5:57 PM |
| |
|
|
|
Re: The Cost of Health Care
Posted by Ophelia
the problem with this is that the contracted rates being paid by in network or insured patients is NOT enough for the doctors to make a decent bottom line. they NEED the inflated prices of the private payer to bolster their overall profits.
What they need to do is have SET prices that everyone pays, the ins co or the private payer...if the ins co's were forced to pay more logical rates, the the OOP people would have more reasonable expenses and could have extended healthcare options. I can't see how the docs benefit from low rates from ins co's, and expect to make up the difference from private payers in the short term; eventually they will run out of money and forgo health care with even greater costs and consequenses in the end! Such a frustrating situation.
And I really don't want to hear about the "poor" doctors and their student loans....I know a few doctors and I can assure you those student loans paid for a lot of trips to Jamaica and a few wedding expenses!!
|
| Posted 7/21/09 6:36 PM |
| |
|
ChilisWife
God Bless America
Member since 5/05 3572 total posts
Name:
A.K.
|
Re: The Cost of Health Care
I firmly believe that if you think health care is expensive now, just wait until it is "free." You will still "pay" for nationalized health care, only you'll pay more. It's nice to think that the government is paying for it...but where do you think the government is getting the money from? Why don't we start addressing some other areas that can use some fixing and may help the situation...like limiting outrageous malpractice lawsuits/awards? No, the current health care system isn't perfect, far from it. But rushing a bill through Congress that nobody has even had time to read is irresponsible and a major atrocity.
|
| Posted 7/21/09 10:22 PM |
| |
|
Janice
Sweet Jessie Quinn
Member since 5/05 27567 total posts
Name:
Janice
|
Re: The Cost of Health Care
Posted by ChilisWife
I firmly believe that if you think health care is expensive now, just wait until it is "free." You will still "pay" for nationalized health care, only you'll pay more.
I can guarentee you I will not be paying more then I am now.
And, even if it was more expensive, maybe I would not be as scared to go for a dental cleaning or have a primary care physician run blood work or give me a booster shot.
Maybe I would not be tossing my kid into my car in the middle of the night, driving and crying like a lunatic because I can't afford the 900 ambulance bills.
|
| Posted 7/21/09 11:27 PM |
| |
|
yankinmanc
Happy Days!
Member since 8/05 18208 total posts
Name:
|
Re: The Cost of Health Care
Posted by Janice
Posted by ChilisWife
I firmly believe that if you think health care is expensive now, just wait until it is "free." You will still "pay" for nationalized health care, only you'll pay more.
I can guarentee you I will not be paying more then I am now.
And, even if it was more expensive, maybe I would not be as scared to go for a dental cleaning or have a primary care physician run blood work or give me a booster shot.
Maybe I would not be tossing my kid into my car in the middle of the night, driving and crying like a lunatic because I can't afford the 900 ambulance bills.
Janice, stupid question. Do you have to pay for every prescription for Josh?
|
| Posted 7/22/09 8:01 AM |
| |
|
luvsun27
Check out my cool glasses
Member since 5/05 8135 total posts
Name:
Kim
|
Re: The Cost of Health Care
I am a small business owner and I am far from rich! I pay $2,000/month for a family plan for 4 people...that is more than some peoples mortgage, oh yeah...I have a mortgage to pay also. I can't afford to pay more, so anything that will help me pay less, I'm willing to listen to. I do not think we have to rush into anything just to say it's done, I think more time should be had to outline who/what is going to be effected. Oh...and I don't make even close to the $350K that puts me in the upper bracket of more taxes
|
| Posted 7/22/09 9:22 AM |
| |
|
Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
|
Re: The Cost of Health Care
Posted by Janice
Posted by Blu-ize
Dh's insurance (big Fortune 1000 company) has a huge deductible as well. This can break people. I think the family deductible is $10K then they pay out at 70%.
I can see where there are a lot of insured folks who could use another option.
My insurance is golden compared to his and I'm still out of pocket $1500 in network and $4K out of network for a family before the plan pays at 100%.
OMG. 10K is an insane number.
Yep and that's why his friend who has 3 kids signed up for an HMO which was offered. Even with the HMO (and they can't go out of network if they begged) their OOP is still $3K before it's 100%.
Preventative is covered at 100% with the other (PPO) plan. If you have a cold or break your leg, that expense is out of pocket until you reach your $10K.
Nice right? This is a huge company with thousands of employees. That plan costs $1500 a month for the family plan.
There should be another choice for them too. They were encouraged to establish a FSA to offset the expense by paying with pre-tax dollars. That's fine but the out of pocket is still huge.
Message edited 7/22/2009 9:46:28 AM.
|
| Posted 7/22/09 9:41 AM |
| |
|
Janice
Sweet Jessie Quinn
Member since 5/05 27567 total posts
Name:
Janice
|
Re: The Cost of Health Care
Posted by racheeeee
Janice, stupid question. Do you have to pay for every prescription for Josh?
yes, I finally got it down to just under 200 a month.
its our copay.
|
| Posted 7/22/09 10:00 AM |
| |
|
yankinmanc
Happy Days!
Member since 8/05 18208 total posts
Name:
|
Re: The Cost of Health Care
Posted by Janice
Posted by racheeeee
Janice, stupid question. Do you have to pay for every prescription for Josh?
yes, I finally got it down to just under 200 a month.
its our copay.
I see, on the NHS all prescriptions are free to under 16's.
|
| Posted 7/22/09 10:31 AM |
| |
|
Janice
Sweet Jessie Quinn
Member since 5/05 27567 total posts
Name:
Janice
|
Re: The Cost of Health Care
Posted by racheeeee
I see, on the NHS all prescriptions are free to under 16's.
uhhh, yeah. you posted this a month ago on parenting and I had to reread it about 5 times to really grasp that.
That would have prevented me from begging pulminologist for samples like a crack ***** looking for a fix.
|
| Posted 7/22/09 10:43 AM |
| |
|
Ophelia
she's baaccckkkk ;)
Member since 5/06 23378 total posts
Name:
remember, when Gulliver traveled....
|
Re: The Cost of Health Care
Posted by BaseballWidow
Posted by Ophelia
the problem with this is that the contracted rates being paid by in network or insured patients is NOT enough for the doctors to make a decent bottom line. they NEED the inflated prices of the private payer to bolster their overall profits.
What they need to do is have SET prices that everyone pays, the ins co or the private payer...if the ins co's were forced to pay more logical rates, the the OOP people would have more reasonable expenses and could have extended healthcare options. I can't see how the docs benefit from low rates from ins co's, and expect to make up the difference from private payers in the short term; eventually they will run out of money and forgo health care with even greater costs and consequenses in the end! Such a frustrating situation.
And I really don't want to hear about the "poor" doctors and their student loans....I know a few doctors and I can assure you those student loans paid for a lot of trips to Jamaica and a few wedding expenses!!
they make up the $$ from the ins contracts in QUANTITY of patients (in network patient, meet in network physician)
I know many physicians. some have $$. some do not. I don't begrudge ANYONE a trip or a vacation.
I work for the federal govt and I take some pretty swanky vacays myself
I am not speaking of student loans either. I am talking about med mal premiums. and some specialities pay far more than others.
I am not asking you to "feel badly" for doctors. it's just a stark reality. doctors are going out of business. doctors are opting to leave their practices b/c they can't provide for their families.
I am not trying to argue how it should change or what it should change. I don't feel my brain can truly wrap itself around this issue.
I DO know that we have have DOES NOT work. our politicians are too busy being political and making friends and being lobbied to make decisions FOR the people.
It is a terrible state of affairs we are in. We need to take a good look at the systems that DO work.
and Chiliwife, why do you think anyone believes their healtcare will suddenly be "free". I still anticipate having to pay a premium for the service, and I will pay it gladly.
|
| Posted 7/22/09 10:43 AM |
| |
|
cjik
Welcome 2010!
Member since 2/06 8879 total posts
Name:
|
Re: The Cost of Health Care
It has been interesting to read all the posts on here about this topic. It is one I feel strongly about, having gone without health insurance myself at one point. Thank God nothing happened, but at the time I was going to grad school, didn't have it through work, and I couldn't afford the cobra plan offered by a previous employer. I didn't qualify for any public programs either, though if a more affordable option was available, I would have taken it.
DH and I have really good insurance right now, which has saved our necks since we both have developed chronic illnesses which are $$$ to treat. Can't say either one of us saw it coming, one day we were both well, one day we were not. So I do feel for people in this siutation who have no insurance, or bad insurance that doesn't cover pricey healthcare. It would have been horrible to lose our house or try and determine who needed treatment more. But if he ever loses his job, not sure what we'll do since we both now have pre-existing conditions. Probably we would need to take Cobra covereage.
But thanks for the posts.
|
| Posted 7/22/09 2:56 PM |
| |
|
| Pages: 1 2 [3] |
