health insurance (not political)

[crazyqx83_rivals88013]

Basically health insurance for people without an employer subsidy is juse a streamline to approved physicians to fleece you. They don't cover ****. Even the **** they say they cover... they don't cover.

I'm just not paying anymore. I'll pay my premium but I'm never paying another bill again. We make $70k a year, pay $650 a month in premiums and it isn't worth ****. If I was a leech on medicaid I'd be set.

And if anyone here is in the insurance industry email me at [email protected]. I'll give you my address so you can come over and I'll pinch you right in the nads.

 

[BlueKel_rivals210266]

Originally posted by crazyqx83:
I'll give you my address so you can come over and I'll pinch you right in the nads.

There are probably other websites for that kind of thing.

 

[FutureCityCats_rivals]

Agree 100%. FCC.

 

[crazyqx83_rivals88013]

Originally posted by BlueKel:

Originally posted by crazyqx83:
I'll give you my address so you can come over and I'll pinch you right in the nads.

There are probably other websites for that kind of thing.

Now they're infiltrating my posts...

 

[Chuckinden]

Originally posted by crazyqx83:
Basically health insurance for people without an employer subsidy is juse a streamline to approved physicians to fleece you. They don't cover ****. Even the **** they say they cover... they don't cover.

I'm just not paying anymore. I'll pay my premium but I'm never paying another bill again. We make $70k a year, pay $650 a month in premiums and it isn't worth ****. If I was a leech on medicaid I'd be set.

And if anyone here is in the insurance industry email me at [email protected]. I'll give you my address so you can come over and I'll pinch you right in the nads.

So it's the Agent's fault?

 

[crazyqx83_rivals88013]

Originally posted by Chuckinden:

Originally posted by crazyqx83:
Basically health insurance for people without an employer subsidy is juse a streamline to approved physicians to fleece you. They don't cover ****. Even the **** they say they cover... they don't cover.

I'm just not paying anymore. I'll pay my premium but I'm never paying another bill again. We make $70k a year, pay $650 a month in premiums and it isn't worth ****. If I was a leech on medicaid I'd be set.

And if anyone here is in the insurance industry email me at [email protected]. I'll give you my address so you can come over and I'll pinch you right in the nads.

So it's the Agent's fault?

Everyone in the industry contributes to the problem. It's like if you were hitler's secretary. Sure, you may not be putting anybody in an oven, but you are a willing participant by association.

FWIW, my wife called the insurance company (thhis was for a diagnostic mammogram) and they told her for 5 minutes it wasn't covered until she read the coverage agreement verbatim, which said it was (wwhich she confirmed back in december by calling ahead of time).

These companies are scum. They sell you something you are required by law to have and then will do everything in their power to not pay for the things they agree up front to pay for. They will try to bill you. They will play dumb. They will take every measure possible to line their pockets rather than upholding their contractual obligations upfront and ethically.

 

[krazykats]

Watch rainmaker some time. It's been going on for years and years people are just more susceptible to it now!

 

[BlueKel_rivals210266]

So much FALSE and paranoia in this thread. Goodness gracious.

 

[WayneDougan_rivals170043]

Not blaming any of you, but you guys are 100% describing an issue caused by bastardizing the term insurance, which is a hedge against risk.

If it weren't for regulations (and the fact that I have no idea how to operate an insurance company), I would start an insurance company that does the following:

Requires yearly physicalsRequires you maintain proper weightRequires you to not smokePays for no preventative care, child birth (complications would be covered by insurance), or anything else that isn't truly a bad surprise (aka, cancer, heart attacks, car accidents)
I'd also become speaker of the house and pass the following rules:


Doctors must post prices for services on their website enabling customers to shop around (a mammogram shouldn't cost much anyway)Prevent doctors from charging different prices depending on customer insurance plan
This would go a long way in solving all of insurance cost and poor service issues you guys are describing. It would also wipe out many people in the health insurance business, which would be a great thing.

 

[crazyqx83_rivals88013]

Originally posted by BlueKel:
So much FALSE and paranoia in this thread. Goodness gracious.

Whatever you say, Jake...

 

[dgtatu01]

If everyone hadn't grown so accustomed to living paycheck to paycheck and payment to payment, then we might have better options, unfortunately if you haven't saved crap then you have no choice other than to go along with whatever product the people or corporations with money sell you to help you when you need money that is not in your paycheck. By not saving you become a slave to banks, landlords, credit cards, insurance companies, etc.

 

[crazyqx83_rivals88013]

Originally posted by dgtatu01:
If everyone hadn't grown so accustomed to living paycheck to paycheck and payment to payment, then we might have better options, unfortunately if you haven't saved crap then you have no choice other than to go along with whatever product the people or corporations with money sell you to help you when you need money that is not in your paycheck. By not saving you become a slave to banks, landlords, credit cards, insurance companies, etc.

What the hell are you talking about? How does saving money change the fact that the insurance companis are sheisters? I have quite a bit more saved than the bill we got, but it doesn't change the fact that the bastards were trying to charge us $500 for something we actually owed zero. Would you go to a restaurant with a coupon for a free meal, get slapped with a bill for $500 then happily pay it?

 

[CAT Scratch FVR]

First you said it was the physicians fleecing us, now it's the insurance companies.Your ignorance is dominating this thread.

 

[crazyqx83_rivals88013]

Originally posted by CAT Scratch FVR:
First you said it was the physicians fleecing us, now it's the insurance companies.Your ignorance is dominating this thread.

It's both, you imbecile. The doctors charge $40 for an aspirin because the consumers don't give a **** about the cost because it's not coming out of their pocket. The insurance companies swallow it because they can charge whatever they want because it's largely corporations paying for it and there's no competition due to outrageous regulation and mandates. It's complete friggin collusion that leaves the general consumer paying $10k in premiums every year for a product that doesn't cover anything.

the entire industry is over inflated and a huge bloat. I'm giddy about the time that's coming when the boomers die off and half of the employees in the industry are in the bread line because the demand has plummeted.

 

[CAT Scratch FVR]

Originally posted by crazyqx83:

Originally posted by CAT Scratch FVR:
First you said it was the physicians fleecing us, now it's the insurance companies.Your ignorance is dominating this thread.

It's both, you imbecile. The doctors charge $40 for an aspirin because the consumers don't give a **** about the cost because it's not coming out of their pocket. The insurance companies swallow it because they can charge whatever they want because it's largely corporations paying for it and there's no competition due to outrageous regulation and mandates.

Uh, false. Each doctor negotiates a fee with each carrier that they choose to do business. Within each carrier are multiple products that they must, typically, negotiate rates for each service separately. If they don't agree, they don't do business and those doctors are shut off from that business.Now, some people and/or their employers may band together to get a doctor back in a network. So, the carrier may go back and negotiate a better rate for that doctor.

The insurance carriers can't just charge anything. they are beholden to employers and individual customers who can take their purchasing power elsewhere. the employers rely on them to keep rates for services down, which affects their plan experience, which affects the premium the carriers charge them ultimately.

A large employer, typically, self insures, so it is in their best interest to have the carrier negotiating the best rates possible. They will hire consultants to assist them in monitoring the carriers performance. this benefits all the employers covered under that specific product. The downside is that smaller employers are grouped together and don't have the buying power, for better premiums, but they still hire consultants to monitor plan performance.Decisions are made to stay or shop the plan elsewhere or change plan design.

The individual market still has multiple roles in this eco system. They can shop plans, choose from multiple plan designs, choosing higher deductibles/co-pays and paying lower premiums. These are all choices as are being self-employed or working for a small employer that does not offer coverage or working for an employer who just offers what may be considered lousy coverage. They can also choose to live a healthy lifestyle, not smoke, etc, which would affect their lifestyle. As stated earlier, insurance's purpose was for catastrophic claims and it morphed into people running to the doctor when their kid had a cold. This was abetted by rich benefits where people were not forced to look at their healthcare spend.

Now more than ever consumers do care how it's coming out of their pocket, If you're not using the pricing tools available shame on you.Don't just use a facility because your doctor tells you. There may be a better deal elsewhere. That's on you, not the system.

 

[rmattox]

Bottom line is this: heath care is too expensive, insurance is too expensive. For physicians: liability and malpractice insurance are too expensive. A biggest "fleecers" are the attorneys that walk around like salivating dogs looking for a way to take a dr to court...usually only to settle. These attorneys have figured out most insurance companies are an easy target because they are willing to shell out a nice settlement rather than spend big $ on THEIR OWN ATTORNEYS fighting a suit.

Maybe the problem with the medical system has to do with the legal system.

The biggest complaints I have about insurance are 1. Paying higher rates for my family and myself in order to pay for the services provided to those who don't or can't pay. 2. Paying higher rates when a company's claims increase (whether I've made a claim or not).

 

[UKGrad93]

ram1955 - I agree with you about lawyers & lawsuits driving up the cost of healthcare. But the second part of your post shows me that you lack an understanding of how insurance works.
Everyone that has the same insurance is in the pool. Its shared risk. Without shared risk, it just wouldn't make sense.

 

[BlueKel_rivals210266]

Originally posted by ram1955:
. 2. Paying higher rates when a company's claims increase (whether I've made a claim or not).

There lies the fallacy of the consumer argument. Insurance is not a zero sum game for the individual. Its real purpose is to protect you in the event of a catastrophe. Tell me, if you had a MAJOR health situation - brain surgery, heart surgery, cancer, etc. - who is going to pay for that? Your premiums over your lifetime will not come close to paying the total of all those bills. Is the insurance company just supposed to absorb those losses? How are they paid for?

Insurance is a collection of EVERYONE'S premiums, to pay out everyone's claims. Sure people pay more or less depending on certain characteristics - smoking, etc. Bottom line though is if you had a major event, you'd expect it to be paid for regardless of how much or little you paid in. It is the number/amount of ALL the claims that dictate the rates, not those of an individual.

 

[FtWorthCat]

Too many unnecessary middle men with their hands in the pie in our system. Why should all of these bimbo pharma sales reps be getting paid well over $100k per year for cozying up to doctors and selling people drugs that they supposedly need to stay healthy. Doesn't seem to me that what they provide warrants the salary they make.

 

[maverick1_rivals376538]

OP drop your insurance and send me your phone number/email. I'll hook you up with my buddy Tor Eckman. He's a natural healer. 20 bucks per visit.

 

[ktbug]

Originally posted by FtWorthCat:

Too many unnecessary middle men with their hands in the pie in our system. Why should all of these bimbo pharma sales reps be getting paid well over $100k per year for cozying up to doctors and selling people drugs that they supposedly need to stay healthy. Doesn't seem to me that what they provide warrants the salary they make.

And their boss makes even more, one of the many problems. Lawyers suck, but states that have limited settlements have not had their prices go down, some have gone up.

 

[rmattox]

I understand the shared risk part. All I know is my family's insurance went up more than $100 a month when healthcare act kicked in. I assumed it was because the pool was much larger.... Insuring everyone would automatically increase the risk the insurer assumed. I understand why the rates increased. For me, if insuring more people causes my rates to increase, I'm not for it.
This post was edited on 1/31 8:16 PM by ram1955

 

[rmattox]

I understand and agree that insurance companies cannot absorb costs. As for catastrophes...from where I stand, I see lots of people that would be taken care of in the event of a major health issue; people that don't pay a cent toward insurance or for their own health care. I simply don't want my premiums to subsidize their care.

I would not have a problem with the health care/insurance system if everyone paid an equal share of their resources...but that's not the case.

 

[TankedCat]

the real people that are making out in Obamacare are the health care administrators.

While Obamacare does have provisions built into to keep insurance companies in check, it does not have any provisions to keep health care costs under control - so now you have a system in place where

1. Insurance companies are profitable because they now have added millions of new people because insurance is mandatory
2. They get to set rates based on something like an 80/20 rule so while their earnings are somewhat static, they will never lose money (remember - insurance is mandatory)
3. Health care providers can go unchecked in pricing - whatever they charge, insurance has to pay it (thru the negotiated rate) and insurance has little incentive to negotiate costs because their profit ratios are fixed based on expenditures, not savings.
4. You can't totally blame doctors because in most cases they are paid by the hospital and have fixed rates mandated by the government for medicare and other costs.
5. The bottom line is its a bonanza for health care providers/administrators and a set income stream for insurance companies. There are *no* incentives in Obamacare to reduce costs for us - the citizens - outside of federal mandates tied to medicare.

If the government really cared about the cost of our health care, they'd regulate the cost and mandate minimum deductibles that are more in line with family expenditures.

For many middle class Americans who have seen their incomes drop by an average of $3K per household in the last 10 years , Obamacare has added between 2500 and 4500 in out of pocket deductible costs to their family - something most of them didn't have with an HMO or PPO plan.

Its VERY political. Its the result of lobbyists writing an 11,000 page document and our government adopting it as our their own. And people clamored for it because at the time almost 1 in 2 people weren't making ends meet without government assistance. Quite frankly , many of them saw this as a free pass for health care.





This post was edited on 2/2 12:54 PM by TankedCat

 

[kghighroller]

Originally posted by TankedCat:
the real people that are making out in Obamacare are the health care administrators.

While Obamacare does have provisions built into to keep insurance companies in check, it does not have any provisions to keep health care costs under control - so now you have a system in place where

1. Insurance companies are profitable because they now have added millions of new people because insurance is mandatory
2. They get to set rates based on something like an 80/20 rule so while their earnings are someone static, they will never lose money
3. Health care providers can go unchecked in pricing - whatever they charge, insurance has to pay it (thru the negotiated rate) and insurance has little incentive to negotiate costs because their prices are fixed.
4. You can't totally blame doctors because in most cases they are paid by the hospital and have fixed rates mandated by the government for medicare and other costs.
5. The bottom line is its a bonanza for health care providers and a set income stream for insurance companies. There are *no* incentives in Obamacare to reduce costs for us - the citizens - outside of federal mandates tied to medicare.

If the government really cared about the cost of our health care, they'd regulate the cost and mandate minimum deductibles that are more in line with family expenditures.

For many middle class Americans who have seen their incomes drop by an average of $3K per household in the last 10 years , Obamacare has added between 2500 and 4500 in out of pocket deductible costs to their family - something most of them didn't have with an HMO or PPO plan.

Its VERY political. Its the result of lobbyists writing an 11,000 page document and our government adopting it as our their own.


This post was edited on 2/2 11:32 AM by TankedCat

If #3 is referring to hospitals and other providers you are incorrect. Big Pharma, on the other hand, can charge what they want and it is mandated by law that Medicare/Medicaid pay it.

 

[TankedCat]

Author Steve Brill who wrote Americas Bitter Pill


Steven Brill: If you go after costs, you're never going to get
anything passed because the lobbyists will just not allow it to be
passed.
Lesley Stahl: So let's go through what each entity won.

Steven Brill: The drug companies they were going to get $200-plus billion
worth of new customers able to pay for drugs. They were going to avoid
the calamity of the real reforms that they were worried about: price
controls generally.

Lesley Stahl: Canada.

Steven Brill: You and I being able to buy drugs from Canada. That would have cost them hundreds of billions.
The hospital lobby did agree to cuts in how much the federal government
compensates them for Medicare patients, but Brill says overall the trade
off in new paying patients would more than make up for that. And the
hospitals managed to keep other cost controls completely off the table,
allowing them to charge whatever they can get for hospital stays and
greatly mark up drug and test prices.

Like a PET scan for $5,453 - a 400 percent mark up.
Three CT scans for $9,685 - an 1,100 percent mark up.
The charge for a room was $10,746 for six days. That comes to $1,791 a day.

Steven Brill: You and I need to get into this business. It's a really good-- They call it nonprofit, but it's a good business.
The single largest charge was for one patient was his cancer drug, Rituxan: for one dose, the hospital billed him $13,702.
Steven Brill: The hospital paid $3,500 for that drug. OK?
Lesley Stahl: How many times - that's for--
Steven Brill: That's a 400 percent mark up.
Lesley Stahl: This is a nonprofit hospital. What does nonprofit mean?
Steven Brill: It means they don't pay taxes, that's the first thing it means.


This post was edited on 2/2 11:43 AM by TankedCat

 

[TruBluCatFan]

Can't blame lawyers on this one. Med Mal cases are most difficult cases to win. Most carriers who wrote med mal coverage fight tooth and nail against paying a settlement. There are no nuisance settlements in med mal cases.

The AMA and insurance companies campaign of misinformation on malpractice cases has been extremely effective.
Posted from Rivals Mobile

 

[_Chase_]

Originally posted by ram1955:
A biggest "fleecers" are the attorneys that walk around like salivating dogs looking for a way to take a dr to court...usually only to settle. These attorneys have figured out most insurance companies are an easy target because they are willing to shell out a nice settlement rather than spend big $ on THEIR OWN ATTORNEYS fighting a suit.

Maybe the problem with the medical system has to do with the legal system.

Your ignorance is astounding.

 

[Big_Blue79]

^ agree with the last 2 posters. The problem of medical cost has very little to do with medical malpractice suits.

 

[Kattopper]

Originally posted by TankedCat:
the real people that are making out in Obamacare are the health care administrators.

While Obamacare does have provisions built into to keep insurance companies in check, it does not have any provisions to keep health care costs under control - so now you have a system in place where

1. Insurance companies are profitable because they now have added millions of new people because insurance is mandatory
2. They get to set rates based on something like an 80/20 rule so while their earnings are somewhat static, they will never lose money (remember - insurance is mandatory)
3. Health care providers can go unchecked in pricing - whatever they charge, insurance has to pay it (thru the negotiated rate) and insurance has little incentive to negotiate costs because their profit ratios are fixed based on expenditures, not savings.
4. You can't totally blame doctors because in most cases they are paid by the hospital and have fixed rates mandated by the government for medicare and other costs.
5. The bottom line is its a bonanza for health care providers/administrators and a set income stream for insurance companies. There are *no* incentives in Obamacare to reduce costs for us - the citizens - outside of federal mandates tied to medicare.

If the government really cared about the cost of our health care, they'd regulate the cost and mandate minimum deductibles that are more in line with family expenditures.

For many middle class Americans who have seen their incomes drop by an average of $3K per household in the last 10 years , Obamacare has added between 2500 and 4500 in out of pocket deductible costs to their family - something most of them didn't have with an HMO or PPO plan.

Its VERY political. Its the result of lobbyists writing an 11,000 page document and our government adopting it as our their own. And people clamored for it because at the time almost 1 in 2 people weren't making ends meet without government assistance. Quite frankly , many of them saw this as a free pass for health care.





This post was edited on 2/2 12:54 PM by TankedCat

This is a good post. The rise in deductibles and premiums coupled with fact that you have to have it makes it rough on some folks. I don't qualify for subsidies but this cost me another 4-5 k out of pocket. I can't afford to use something that I am forced to buy. My family would actually be better off if me or my spouse quit our job to get to a income level where we get money to pay for healthcare. The current Obamacare system is not sustainable. Yo can't keep adding people to the system that do not pay for healthcare. The people that are signing up through the exchanges in this state are mostly going to Medicaid. They aren't paying anything in. How long will this last? It will last until the people paying the bills run out of money.

 

[TankedCat]

I don't think its sustainable either.

Yes, there are some isolated cases where person X was paying some crazy rate and now he has a more affordable rate, but those people are in the minority. On the whole, everyone is going to pay more for health coverage and the costs will continue to rise as long as coverage is mandated. You do not control costs if consumers do not have a choice. The government has created a form of inelastic demand on healthcare.

Obamacare, regardless of what the president and supporters say, is not designed to reduce costs. Its designed to create a system where everyone gets health care set to specific standards and putting in cost containment would have derailed the program. Insurance and Health care providers would not have got on board with it had they had a system that limited their growth potential or didn't guarantee a stream of income.

It will be interesting to see just how many democratic presidential nominees stay on board with Obamacare in the upcoming presidential election because I see a wholesale revolt on Obamacare in the next 2 years as people realizes with these deductibles they are choosing between health care and money out of their pocket.

Some people will say that's the only way to control costs, to force people to think about the cost of health care, but that won't happen - they'll just forego the littany of pneumonia , flu, blood pressure, etc - ailments that can be controlled or cured with regular doctor visits where they are now forced to absorb the entire cost and we'll see health care in Americans overall decline.

In my case, last year I held off going to the doctor because I wasn't going to hit my deductible. This year, two weeks into it, I had one preventive medical procedure that costs my entire deductible, so now I am going to wear the **** out of my insurance. For the remainder of 2015, everyone in my family is going to doctor as much as they can. If my kids sneeze, they are going to the doctor.

We'll go back to the cost/value ratio in 2016 when my deductible resets.


This post was edited on 2/2 2:01 PM by TankedCat

 

[P.PattersonISwalkingthruthatdoor]

Q1: The excessive cost of US health care (in relation to outcomes when compared to the rest of the developed world) is likely due to which of the following?

(A) Pharmaceutical companies
(B) Hospital pricing opacities
(C) Provider compensation rates
(D) Patient/consumer behaviors
(E) Administrative costs
(F) Insurance companies
(G) All of the above

 

[maverick1_rivals376538]

Originally posted by jamo0001:
Q1: The excessive cost of US health care (in relation to outcomes when compared to the rest of the developed world) is likely due to which of the following?

(A) Pharmaceutical companies
(B) Hospital pricing opacities
(C) Provider compensation rates
(D) Patient/consumer behaviors
(E) Administrative costs
(F) Insurance companies
(G) All of the above

 

[wkycatfan_rivals376690]

Sometimes I wonder if we weren't better off when the doc rode out to your cabin on a horse carrying a medicine bag.

DWS.

 

[Boyd_Givens]

*
This post was edited on 2/3 12:35 PM by Boyd_Givens

 

[P.PattersonISwalkingthruthatdoor]

Originally posted by wkycatfan:
Sometimes I wonder if we weren't better off when the doc rode out to your cabin on a horse carrying a medicine bag.

DWS.

Your pocketbook was, but that's about it.

 

[rmattox]

Perhaps my views are misguided. Perhaps I'm wrong in thinking health insurance and medical costs are too high. Perhaps my disdain for contributing to the health care of others, particularly those who are in desperate situations by choice, is also misguided. Show me why my views are wrong.

When I speak of the legal system, I can only speak of my experiences with the system...both personal and with my business.

 

[Big Blue 1977]

I think people are suggesting that your anger is misplaced. You're focusing on a minute aspect of an infinitely bigger systemic problem. Ambulance-chasers and monster torts are a mere pittance compared to the completely rigged, large-scale game.

 

[warrior-cat]

Originally posted by TankedCat:
I don't think its sustainable either.

Yes, there are some isolated case where person X was paying some crazy rate and now he has a more affordable rate, but those people are in the minority. On the whole, everyone is going to pay more for health coverage and the costs will continue to rise as long as coverage is mandated. You do not control costs if consumers do not have a choice. The government has created a form of inelastic demand on healthcare.

Obamacare, regardless of what the president and supporters say, is not designed to reduce costs. Its designed to create a system where everyone gets health care set to specific standards and putting in cost containment would have derailed the program. Insurance and Health care providers would not have got on board with it had they had a system that limited their growth potential or didn't guarantee a stream of income.

It will be interesting to see just how many democratic presidential nominees stay on board with Obamacare in the upcoming presidential election because I see a wholesale revolt on Obamacare in the next 2 years as people realizes with these deductibles they are choosing between health care and money out of their pocket.

Some people will say that's the only way to control costs, to force people to think about the cost of health care, but that won't happen - they'll just forego the littany of pneumonia , flu, blood pressure, etc - ailments that can be controlled or cured with regular doctor visits where they are now forced to absorb the entire cost and we'll see health care in Americans overall decline.

In my case, last year I held off going to the doctor because I wasn't going to hit my deductible. This year, two weeks into it, I had one preventive medical procedure that costs my entire deductible, so now I am going to wear the **** out of my insurance. For the remainder of 2015, everyone in my family is going to doctor as much as they can. If my kids sneeze, they are going to the doctor.

We'll go back to the cost/value ratio in 2016 when my deductible resets.


This post was edited on 2/2 2:01 PM by TankedCat

At my wifes company the average rise in cost per worker was about $650.00 more per month. We had to drop it and just use TRI-CARE which we were using as a supplimental insurance.

 

[TankedCat]

we're going to keep hearing stories like this until people just get fed up and demand this program is repealed.

Its not a republican fox news conspiracy thing - this program doesn't care what political ideology you subscribe to, its going to cost you (and if you have company provided health care) your company thousands of dollars.

That's not hyperbole.